Palatal Fistula Risk after Primary Palatoplasty

2018 ◽  
Vol 55 (6) ◽  
pp. 807-813 ◽  
Author(s):  
Kimberly M. Daniels ◽  
Emily Yang Yu ◽  
Rebecca G. Maine ◽  
Yin Heng ◽  
Li Yang ◽  
...  
Keyword(s):  
United States ◽  
San Francisco ◽  
Rural China ◽  
Surgical Care ◽  
The United States ◽  
University Hospital ◽  
Chinese Patients ◽  
Fistula Formation ◽  
Complication Rates ◽  
Palatal Fistula

Background: Humanitarian surgical organizations provide palatoplasties for patients without access to surgical care. Few organizations have evaluated the outcomes of these trips. This study evaluates the palatal fistula rate in patients from two cohorts in rural China and one in the United States. Methods: This study compared the odds of fistula formation among three cohorts whose palates were repaired between 2005 and 2009. One cohort included 97 Chinese patients operated on by teams from the United States and Canada under the auspices of Resurge International. They were compared to cohorts at Huaxi Stomatology Hospital and the University of California San Francisco (UCSF). Age, fistula presence, and Veau class were compared among cohorts using Chi-square tests. Logistic regression was used to analyze predictors of fistula formation. Results: The fistula risk was 35.4% in patients treated by humanitarian teams, 12.8% at Huaxi University Hospital and 2.5% at UCSF ( P < 0.001). Age and Veau class were associated with fistula formation (Age P = 0.0015; Veau P < 0.001). ReSurge and Huaxi patients had 20.2 and 5.6 times the odds of developing a fistula, respectively, compared to UCSF patients ( P < 0.01, both). A multivariable model controlling for surgical group, age, and gender showed an association between Veau class and the odds of fistula formation. Conclusions: Chinese children undergoing palatoplasty by international teams had higher odds of palatal fistula than children treated by Chinese surgeons in established institutions and children treated in the United States. More research is required to identify factors affecting complication rates in low-resource environments.

scholarly journals Trends in Bariatric Surgery Procedures among Patients with ESKD in the United States

2019 ◽  
Vol 14 (8) ◽  
pp. 1193-1199 ◽  
Author(s):  
Kyle H. Sheetz ◽  
Kenneth J. Woodside ◽  
Vahakn B. Shahinian ◽  
Justin B. Dimick ◽  
John R. Montgomery ◽  
...  
Keyword(s):  
United States ◽  
Bariatric Surgery ◽  
Sleeve Gastrectomy ◽  
Confidence Interval ◽  
Practice Patterns ◽  
Surgical Care ◽  
The United States ◽  
Complication Rates ◽  
Linear Regression Models ◽  
Number Of Patients

Background and objectivesDespite the potential for improving health status or increasing access to transplantation, national practice patterns for bariatric surgery in obese patients with ESKD are poorly understood. The purpose of this study was to describe current trends in surgical care for this population.Design, setting, participants, & measurementsUsing 100% Medicare data, we identified all beneficiaries undergoing bariatric surgery in the United States between 2006 and 2016. We evaluated longitudinal practice patterns using linear regression models. We also estimated risk-adjusted complications, readmissions, and length of stay using Poisson regression for patients with and without ESKD.ResultsThe number of patients with ESKD undergoing bariatric surgery increased ninefold between 2006 and 2016. The proportional use of sleeve gastrectomy increased from <1% in 2006 to 84% in 2016. For sleeve gastrectomy, complication rates were similar between patients with and without ESKD (3.4% versus 3.6%, respectively; difference, −0.3%; 95% confidence interval, −1.3% to 0.1%; P=0.57). However, patients with ESKD had more readmissions (8.6% versus 5.4%, respectively; difference, 3.2%; 95% confidence interval, 1.9% to 4.6%; P<0.001) and slightly longer hospitals stays (2.2 versus 1.9 days, respectively; difference, 0.3; 95% confidence interval, 0.1 to 0.4; P<0.001).ConclusionsThis study suggests that laparoscopic sleeve gastrectomy has replaced Roux-en-Y gastric bypass as the most common bariatric surgical procedure in patients with ESKD. The data also demonstrate a favorable complication profile in patients with sleeve gastrectomy.

The “Japanese Turn” in Fine Dining in the United States, 1980–2020

2020 ◽  
Vol 20 (2) ◽  
pp. 45-54
Author(s):  
Samuel H. Yamashita
Keyword(s):  
United States ◽  
New York ◽  
Los Angeles ◽  
San Francisco ◽  
San Francisco Bay Area ◽  
The United States ◽  
First Century ◽  
Further Training ◽  
Bay Area ◽  
Wide Acceptance

In the 1970s, Japanese cooks began to appear in the kitchens of nouvelle cuisine chefs in France for further training, with scores more arriving in the next decades. Paul Bocuse, Alain Chapel, Joël Robuchon, and other leading French chefs started visiting Japan to teach, cook, and sample Japanese cuisine, and ten of them eventually opened restaurants there. In the 1980s and 1990s, these chefs' frequent visits to Japan and the steady flow of Japanese stagiaires to French restaurants in Europe and the United States encouraged a series of changes that I am calling the “Japanese turn,” which found chefs at fine-dining establishments in Los Angeles, New York City, and later the San Francisco Bay Area using an ever-widening array of Japanese ingredients, employing Japanese culinary techniques, and adding Japanese dishes to their menus. By the second decade of the twenty-first century, the wide acceptance of not only Japanese ingredients and techniques but also concepts like umami (savory tastiness) and shun (seasonality) suggest that Japanese cuisine is now well known to many American chefs.

scholarly journals Anxiety- and Health-Related Quality of Life Among Patients With Breast Cancer: A Cross-Cultural Comparison of China and the United States

2018 ◽  
pp. 1-9
Author(s):  
Jin You ◽  
Qian Lu ◽  
Michael J. Zvolensky ◽  
Zhiqiang Meng ◽  
Kay Garcia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
United States ◽  
Trait Anxiety ◽  
State Anxiety ◽  
Cultural Context ◽  
The United States ◽  
Cross Cultural ◽  
Chinese Patients

Purpose Literature has documented the prevalence of anxiety and its adverse effect on quality of life among patients with breast cancer from Western countries, yet cross-cultural examinations with non-Western patients are rare. This cross-cultural study investigated differences in anxiety and its association with quality of life between US and Chinese patients with breast cancer. Methods Patients with breast cancer from the United States and China completed measures for anxiety (Spielberger State-Trait Anxiety Inventory) and quality of life (Functional Assessment of Cancer Therapy-Breast). Results After controlling for demographic and medical characteristics, Chinese patients reported higher levels of trait and state anxiety than US patients. Although there was an association between anxiety and quality of life in both groups of patients, the association between state anxiety and quality of life was stronger among Chinese patients than among US patients, with the association between trait anxiety and quality of life the same between the two cultural samples. Conclusion These findings suggest that anxiety and its association with quality of life among patients with breast cancer varies depending on cultural context, which reveals greater anxiety and poorer quality of life among Chinese patients compared with US patients. This suggests greater unmet psychosocial needs among Chinese patients and highlights the need to build comprehensive cancer care systems for a better quality of life in Chinese populations.

Labor Unions and Undocumented Immigrants: Local Perspectives on Transversal Solidarity During DACA and DAPA

2020 ◽  
pp. 089692052098012
Author(s):  
Els de Graauw ◽  
Shannon Gleeson
Keyword(s):  
United States ◽  
San Francisco ◽  
Labor Unions ◽  
Undocumented Immigrants ◽  
The United States ◽  
Immigrant Communities ◽  
Immigrant Rights ◽  
Deferred Action ◽  
Immigrant Organizations ◽  
Local Perspectives

National labor unions in the United States have formally supported undocumented immigrants since 2000. However, drawing on 69 interviews conducted between 2012 and 2016 with union and immigrant rights leaders, this article offers a locally grounded account of how union solidarity with undocumented immigrants has varied notably across the country. We explore how unions in San Francisco and Houston have engaged with Obama-era immigration initiatives that provided historic relief to some undocumented immigrants. We find that San Francisco’s progressive political context and dense infrastructure of immigrant organizations have enabled the city’s historically powerful unions to build deep institutional solidarity with immigrant communities during the Deferred Action for Childhood Arrivals (DACA [2012]) and Deferred Action for Parents of Americans (DAPA [2014]) programs. Meanwhile, Houston’s politically divided context and much sparser infrastructure of immigrant organizations made it necessary for the city’s historically weaker unions to build solidarity with immigrant communities through more disparate channels.

Access through Altruism: A Community-based Free Outpatient Surgery Program for the Working Poor in the United States

2017 ◽  
Vol 27 (6) ◽  
pp. 141-144
Author(s):  
HR Nolan ◽  
B Christie
Keyword(s):  
United States ◽  
Outpatient Surgery ◽  
Healthcare Access ◽  
Large Population ◽  
Surgical Care ◽  
The United States ◽  
Community Based ◽  
Uninsured Adults ◽  
One Year ◽  
Working Uninsured

Despite healthcare reform, a large population in the United States is without healthcare coverage. The Surgery for People in Need (SPIN) program offers free outpatient surgical procedures to working, uninsured adults. Taking nearly one year to construct, the program has been operational for three years and has performed 22 procedures. Free surgery programs can improve healthcare access by providing interventions to patients who otherwise have no outlet for surgical care.

scholarly journals A Comparison of Mental Health Outcomes in the United States and Italy at Different Levels of Cumulative COVID-19 Prevalence

2021 ◽  
Author(s):  
Anthony D Mancini ◽  
Gabriele Prati
Keyword(s):  
Mental Health ◽  
United States ◽  
New York ◽  
San Francisco ◽  
The United States ◽  
Ptsd Symptoms ◽  
General Distress ◽  
High Prevalence ◽  
Low Prevalence ◽  
Different Levels

How does the prevalence of COVID-19 impact people’s mental health? In a preregistered study (N = 857), we sought to answer this question by comparing demographically matched samples in four regions in the United States and Italy with different levels of cumulative COVID-19 prevalence. No main effect of prevalence emerged. Rather, prevalence region had opposite effects, depending on the country. New York City participants (high prevalence) reported more general distress, PTSD symptoms, and COVID-19 worry than San Francisco (low prevalence). Conversely, Campania participants (low prevalence) reported more general distress, PTSD symptoms, and COVID-19 worry than Lombardy (high prevalence). Consistent with these patterns, COVID-19 worry was more strongly linked with general distress and PTSD symptoms in New York than San Francisco, whereas COVID-19 worry was more strongly linked with PTSD in Campania than Lombardy. In exploratory analyses, media exposure predicted and mapped on to geographic variation in mental health outcomes.

scholarly journals Impact of the first COVID-19 shelter-in-place order in the United States on emergency department utilization, Marin County, California

2020 ◽  
Author(s):  
Brett R. Bayles ◽  
Michaela F George ◽  
Haylea Hannah ◽  
Patti Culross ◽  
Rochelle R. Ereman ◽  
...  
Keyword(s):  
United States ◽  
San Francisco ◽  
Large Scale ◽  
Temporal Dynamics ◽  
The United States ◽  
Emergency Department Utilization ◽  
Marin County ◽  
Before And After ◽  
Ed Visits ◽  
The Impact

Background: The first shelter-in-place (SIP) order in the United States was issued across six counties in the San Francisco Bay Area to reduce the impact of COVID-19 on critical care resources. We sought to assess the impact of this large-scale intervention on emergency departments (ED) in Marin County, California. Methods: We conducted a retrospective descriptive and trend analysis of all ED visits in Marin County, California from January 1, 2018 to May 4, 2020 to quantify the temporal dynamics of ED utilization before and after the March 17, 2020 SIP order. Results: The average number of ED visits per day decreased by 52.3% following the SIP order compared to corresponding time periods in 2018 and 2019. Both respiratory and non-respiratory visits declined, but this negative trend was most pronounced for non-respiratory admissions. Conclusions: The first SIP order to be issued in the United States in response to COVID-19 was associated with a significant reduction in ED utilization in Marin County.

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