scholarly journals EPIDEMIOLOGY OF PEDIATRIC CARTILAGE RESTORATION PROCEDURES IN THE UNITED STATES: INSURANCE AND GEOGRAPHY PLAY A ROLE

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0024
Author(s):  
Tyler B. Hall ◽  
Max J. Hyman ◽  
Neeraj M. Patel
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
Statistical Significance ◽  
Private Insurance ◽  
Univariate Analysis ◽  
The United States ◽  
National Database ◽  
The West ◽  
Cartilage Restoration ◽  
Common Diagnosis

Background: A number of surgical options are available for sizeable articular cartilage lesions of the knee. These include osteochondral autograft (OAU) or allograft (OAL) transfer, or autologous chondrocyte implantation (ACI). In the pediatric population, there is little data on the patients undergoing these procedures or evidence to support one technique over another, which may lead to variation in preferred practice. Hypothesis/Purpose: The purpose of this study is to analyze the epidemiology of children and adolescents undergoing OAU, OAL, and ACI in the United States, with attention to variation along the lines of demographic and geographic factors. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing OAU, OAL, and ACI between 2012 and 2018. Demographic information was collected for each subject. United States Census guidelines were used to categorize hospitals geographically into regions. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 809 subjects with a mean age of 15.4±2.4 years were included in the analysis. Of these, 393 (48.6%) underwent OAL, 339 (41.9%) underwent OAU, and 77 (9.5%) underwent ACI. The most common diagnosis at the time of surgery was osteochondritis dissecans in 360 patients (44.5%) followed by an associated cruciate ligament injury in 126 (15.6%) and patellar instability in 98 (12.1%). After adjusting for confounders in a multivariate model, ACI was more 3.4 times more likely to be performed in patients with private insurance than those that were publicly insured (95% CI 1.5-7.5, p=0.002). Furthermore, a patient in this Northeast was 29.3 times more likely to undergo ACI than in the West (95% CI 4.0-217.4, p=0.001). OAU was performed most frequently in the West and Midwest (52.4% and 51.8% of the time, respectively; p<0.001). Univariate analysis also revealed differences along the lines of race, but these findings did not maintain statistical significance in multivariate analysis. Conclusion: In the United States, there is substantial variation in the procedures performed for cartilage restoration in children and adolescents. Though ACI is the least commonly selected operation overall, it is significantly more likely to be performed on patients with private insurance and those in the Northeast. OAU is the most commonly performed procedure in the West and Midwest.

Mafias on the Move

2011 ◽  
Author(s):  
Federico Varese
Keyword(s):  
United States ◽  
New York ◽  
Organized Crime ◽  
The United States ◽  
The West ◽  
Market Expansion ◽  
The North ◽  
Economic Transformations ◽  
At Will

Organized crime is spreading like a global virus as mobs take advantage of open borders to establish local franchises at will. That at least is the fear, inspired by stories of Russian mobsters in New York, Chinese triads in London, and Italian mafias throughout the West. As this book explains, the truth is more complicated. The author has spent years researching mafia groups in Italy, Russia, the United States, and China, and argues that mafiosi often find themselves abroad against their will, rather than through a strategic plan to colonize new territories. Once there, they do not always succeed in establishing themselves. The book spells out the conditions that lead to their long-term success, namely sudden market expansion that is neither exploited by local rivals nor blocked by authorities. Ultimately the inability of the state to govern economic transformations gives mafias their opportunity. In a series of matched comparisons, the book charts the attempts of the Calabrese 'Ndrangheta to move to the north of Italy, and shows how the Sicilian mafia expanded to early twentieth-century New York, but failed around the same time to find a niche in Argentina. The book explains why the Russian mafia failed to penetrate Rome but succeeded in Hungary. A pioneering chapter on China examines the challenges that triads from Taiwan and Hong Kong find in branching out to the mainland. This book is both a compelling read and a sober assessment of the risks posed by globalization and immigration for the spread of mafias.

The Rise and Fall of Great Powers

2017 ◽  
Author(s):  
Geir Lundestad
Keyword(s):  
United States ◽  
International Relations ◽  
Nuclear Weapons ◽  
The United States ◽  
Great Powers ◽  
Foreseeable Future ◽  
The West ◽  
Economic Modernization

There are no laws in history. Realists, liberals, and others are both right and wrong. Although no one can be certain that military incidents may not happen, for the foreseeable future China and the United States are unlikely to favor major war. They have cooperated well for almost four decades now. China is likely to continue to focus on its economic modernization. It has far to go to measure up to the West. The American-Chinese economies are still complementary. A conflict with the United States or even with China’s neighbors would have damaging repercussions for China’s economic goals. The United States is so strong that it would make little sense for China to take it on militarily. There are also other deterrents against war, from nuclear weapons to emerging norms about international relations. It is anybody’s guess what will happen after the next few decades. History indicates anything is possible.

The Proximity of Other Skins

2019 ◽  
Author(s):  
Celine Parreñas Shimizu
Keyword(s):  
United States ◽  
South Korea ◽  
The United States ◽  
The Philippines ◽  
The Other ◽  
The West ◽  
Pain And Suffering ◽  
The Spectator ◽  
Existing Frames ◽  
The Voice

Transnational films representing intimacy and inequality disrupt and disgust Western spectators. When wounded bodies within poverty entangle with healthy wealthy bodies in sex, romance and care, fear and hatred combine with desire and fetishism. Works from the Philippines, South Korea, and independents from the United States and France may not be made for the West and may not make use of Hollywood traditions. Rather, they demand recognition for the knowledge they produce beyond our existing frames. They challenge us to go beyond passive consumption, or introspection of ourselves as spectators, for they represent new ways of world-making we cannot unsee, unhear, or unfeel. The spectator is redirected to go beyond the rapture of consuming the other to the rupture that arises from witnessing pain and suffering. Self-displacement is what proximity to intimate inequality in cinema ultimately compels and demands so as to establish an ethical way of relating to others. In undoing the spectator, the voice of the transnational filmmaker emerges. Not only do we need to listen to filmmakers from outside Hollywood who unflinchingly engage the inexpressibility of difference, we need to make room for critics and theorists who prioritize the subjectivities of others. When the demographics of filmmakers and film scholars are not as diverse as its spectators, films narrow our worldviews. To recognize our culpability in the denigration of others unleashes the power of cinema. The unbearability of stories we don’t want to watch and don’t want to feel must be borne.

scholarly journals Semantic adaptation of the Global Psychotrauma Screen for children and adolescents in the United States

2021 ◽  
Vol 12 (1) ◽  
pp. 1911080
Author(s):  
Emma Grace ◽  
Shanelle Sotilleo ◽  
Rosalind Rogers ◽  
Renee Doe ◽  
Miranda Olff
Keyword(s):  
United States ◽  
Children And Adolescents ◽  
The United States ◽  
Semantic Adaptation

scholarly journals Environmental justice, settler colonialism, and more-than-humans in the occupied West Bank: An introduction

2021 ◽  
Vol 4 (1) ◽  
pp. 3-27
Author(s):  
Irus Braverman
Keyword(s):  
United States ◽  
Environmental Justice ◽  
West Bank ◽  
Settler Colonialism ◽  
The United States ◽  
Special Issue ◽  
The West ◽  
The Core ◽  
Waste Concrete

Our special issue provides a first-of-its kind attempt to examine environmental injustices in the occupied West Bank through interdisciplinary perspectives, pointing to the broader settler colonial and neoliberal contexts within which they occur and to their more-than-human implications. Specifically, we seek to understand what environmental justice—a movement originating from, and rooted in, the United States—means in the context of Palestine/Israel. Moving beyond the settler-native dialectic, we draw attention to the more-than-human flows that occur in the region—which include water, air, waste, cement, trees, donkeys, watermelons, and insects—to consider the dynamic, and often gradational, meanings of frontier, enclosure, and Indigeneity in the West Bank, challenging the all-too-binary assumptions at the core of settler colonialism. Against the backdrop of the settler colonial project of territorial dispossession and elimination, we illuminate the infrastructural connections and disruptions among lives and matter in the West Bank, interpreting these through the lens of environmental justice. We finally ask what forms of ecological decolonization might emerge from this landscape of accumulating waste, concrete, and ruin. Such alternative visions that move beyond the single axis of settler-native enable the emergence of more nuanced, and even hopeful, ecological imaginaries that focus on sumud, dignity, and recognition.

scholarly journals Emergency Department Visits From 2014 to 2018 for Head Injuries in Youth Non-Tackle Football Compared With Other Sports

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097540
Author(s):  
Jessica M. Zendler ◽  
Ron Jadischke ◽  
Jared Frantz ◽  
Steve Hall ◽  
Grant C. Goulet
Keyword(s):  
United States ◽  
Emergency Department ◽  
Head Injury ◽  
Head Injuries ◽  
The United States ◽  
Emergency Department Visits ◽  
Head Region ◽  
Cerebral Contusion ◽  
Common Diagnosis ◽  
Tackle Football

Background: Non-tackle football (ie, flag, touch, 7v7) is purported to be a lower-risk alternative to tackle football, particularly in terms of head injuries. However, data on head injuries in non-tackle football are sparse, particularly among youth participants. Purpose: To describe the epidemiology of  emergency department visits for head injuries due to non-tackle football among youth players in the United States and compare the data with basketball, soccer, and tackle football. Study Design: Descriptive epidemiology study. Methods: Injury data from 2014 to 2018 were obtained from the National Electronic Injury Surveillance System database. Injury reports coded for patients aged 6 to 18 years and associated with basketball, football, or soccer were extracted. Data were filtered to include only injuries to the head region, specifically, the head, ear, eyeball, mouth, or face. Football injuries were manually assigned to “non-tackle” or “tackle” based on the injury narratives. Sports & Fitness Industry Association data were used to estimate annual sport participation and calculate annual injury rates per 100,000 participant-years. Results: A total of 26,770 incident reports from 2014 to 2018 were analyzed. For head region injuries in non-tackle football, the head was the most commonly injured body part, followed by the face; the most common diagnosis was a laceration, followed by concussion and internal injury (defined as an unspecified head injury or internal head injury [eg, subdural hematoma or cerebral contusion]). The most common contacting object was another player. The projected national rate of head region injuries was lowest for non-tackle football across the 4 sports. In particular, the projected rate of injuries to the head for non-tackle football (78.0 per 100,000 participant-years) was less than one-fourth the rates for basketball (323.5 per 100,000 participant-years) and soccer (318.2 per 100,000 participant-years) and less than one-tenth the rate for tackle football (1478.6 per 100,000 participant-years). Conclusion: Among youth in the United States aged 6 to 18 years who were treated in the emergency department for injuries related to playing non-tackle football, the most common diagnosis for injuries to the head region was a laceration, followed by a concussion. Head region injuries associated with non-tackle football occurred at a notably lower rate than basketball, soccer, or tackle football.

scholarly journals THE EPIDEMIOLOGY OF PEDIATRIC MENISCAL ALLOGRAFT TRANSPLANTATION IN THE UNITED STATES

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0004
Author(s):  
Haley E. Smith ◽  
Madeline M. Lyons ◽  
Neeraj M. Patel
Keyword(s):  
United States ◽  
Pediatric Population ◽  
The United States ◽  
National Database ◽  
Control Group ◽  
Meniscal Allograft Transplantation ◽  
Children's Hospitals ◽  
Allograft Transplantation ◽  
Meniscal Allograft ◽  
Children’S Hospitals

Background: Meniscal allograft transplantation (MAT) is an option to slow the progression of degenerative disease in the setting of substantial meniscal deficiency. This may be especially important in children and adolescents, but there is little literature on MAT in this population. Hypothesis/Purpose: The purpose of this study was to evaluate the epidemiology of MAT in the pediatric population, with specific attention to regional and demographic trends. Methods: The Pediatric Health Information System, a national database consisting of 49 children’s hospitals, was queried for all patients undergoing MAT between 2011 and 2018. Demographic information was collected for each subject as well as data regarding previous and subsequent surgeries. The database was also queried for all meniscus surgeries (including repairs and meniscectomies) performed during the study period. Demographic and geographic data from this control group were compared to that of children undergoing MAT. Univariate analysis was followed by purposeful entry multivariate regression to adjust for confounding factors. Results: A total of 27,168 meniscus surgeries were performed in 47 hospitals, with MAT performed 67 times in 17 hospitals. Twelve patients (18%) underwent a subsequent procedure after transplantation. In multivariate analysis, each year of increasing age resulted in 1.1 times higher odds of having undergone MAT rather than repair or meniscectomy (95% CI 1.03-1.1, p=0.002). Patients that underwent transplantation had 2.0 times higher odds of being female (95% CI 1.2-3.3, p=0.01) and 2.0 times higher odds of being commercially insured (95% CI 1.1-3.6, p=0.02). MAT was performed most frequently in the Northeast (4.9/1000 meniscus surgeries) and least often in the South (1.1/1000 meniscus surgeries, p<0.001). Furthermore, transplantation was more likely to be performed in larger cities. The median pediatric population of cities in which MAT was performed was 983,268 (range 157,253-3,138,870) compared to 662,290 (range 4,420-4,311,500) in cities where it was not (p=0.04). Conclusion: In the United States, patients that underwent MAT were older, more likely to be female, and have commercial insurance than those undergoing meniscus repair or meniscectomy. MAT was only done in 17/47 children’s hospitals that perform meniscus surgery and was most frequently performed in the Northeast and in larger cities. These trends highlight the need for further research, especially regarding differences along the lines of sex and insurance status.

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