scholarly journals Distance to Kidney Transplant Center and Access to Early Steps in the Kidney Transplantation Process in the Southeastern United States

2020 ◽  
Vol 15 (4) ◽  
pp. 539-549 ◽  
Author(s):  
Laura J. McPherson ◽  
Vaughn Barry ◽  
Jane Yackley ◽  
Jennifer C. Gander ◽  
Stephen O. Pastan ◽  
...  
Keyword(s):  
United States ◽  
South Carolina ◽  
Kidney Transplantation ◽  
Confidence Interval ◽  
Southeastern United States ◽  
Odds Ratios ◽  
Medical Evaluation ◽  
Transplant Center ◽  
Dialysis Facility ◽  
Adjusted Logistic Regression

Background and objectivesAccess to kidney transplantation requires a referral to a transplant center for medical evaluation. Prior research suggests that the distance that a person must travel to reach a center might be a barrier to referral. We examined whether a shorter distance from patients’ residence to a transplant center increased the likelihood of referral and initiating the transplant evaluation once referred.Design, setting, participants, & measurementsAdults who began treatment for ESKD at any Georgia, North Carolina, or South Carolina dialysis facility from 1/1/2012 to 12/31/2015 were identified from the US Renal Data System. Referral (within 1 year of dialysis initiation) and evaluation initiation (within 6 months of referral) data were collected from all nine transplant centers located in that region. Distance was categorized as <15, 15–30, 31–60, 61–90, and >90 miles from the center of a patient’s residential zip code to the nearest center. We used multilevel, multivariable-adjusted logistic regression to quantify the association between distance with referral and evaluation initiation.ResultsAmong 27,250 adult patients on incident dialysis, 9582 (35%) were referred. Among those referred, 58% initiated evaluation. Although patients who lived farther from a center were less likely to be referred, distance was not statistically significantly related to transplant referral: adjusted odds ratios of 1.08 (95% confidence interval, 0.96 to 1.22), 1.07 (95% confidence interval, 0.95 to 1.22), 0.96 (95% confidence interval, 0.84 to 1.10), and 0.87 (95% confidence interval, 0.74 to 1.03) for 15–30, 31–60, 61–90, and >90 miles, respectively, compared with <15 miles (P trend =0.05). There was no statistically significant association of distance and evaluation initiation among referred patients: adjusted odds ratios of 1.14 (95% confidence interval, 0.97 to 1.33), 1.12 (95% confidence interval, 0.94 to 1.35), 1.04 (95% confidence interval, 0.87 to 1.25), and 0.89 (95% confidence interval, 0.72 to 1.11) for 15–30, 31–60, 61–90, and >90 miles, respectively, compared with <15 miles (P trend =0.70).ConclusionsDistance from residence to transplant center among patients undergoing long-term dialysis in the southeastern United States was not associated with increased likelihood of referral and initiating transplant center evaluation.

Dialysis Facility Profit Status and Early Steps in Kidney Transplantation in the Southeastern United States

2021 ◽  
pp. CJN.17691120
Author(s):  
Laura J. McPherson ◽  
Elizabeth R. Walker ◽  
Yi-Ting Hana Lee ◽  
Jennifer C. Gander ◽  
Zhensheng Wang ◽  
...  
Keyword(s):  
United States ◽  
Cohort Study ◽  
Kidney Transplantation ◽  
Confidence Interval ◽  
Kidney Failure ◽  
The United States ◽  
For Profit ◽  
Transplant Center ◽  
Dialysis Facility ◽  
Profit Status

Background and objectivesDialysis facilities in the United States play a key role in access to kidney transplantation. Previous studies reported that patients treated at for-profit facilities are less likely to be waitlisted and receive a transplant, but their effect on early steps in the transplant process is unknown. The study’s objective was to determine the association between dialysis facility profit status and critical steps in the transplantation process in Georgia, North Carolina, and South Carolina.Design, setting, participants, & measurementsIn this retrospective cohort study, we linked referral and evaluation data from all nine transplant centers in the Southeast with United States Renal Data System surveillance data. The cohort study included 33,651 patients with kidney failure initiating dialysis from January 1, 2012 to August 31, 2016. Patients were censored for event (date of referral, evaluation, or waitlisting), death, or end of study (August 31, 2017 for referral and March 1, 2018 for evaluation and waitlisting). The primary exposure was dialysis facility profit status: for profit versus nonprofit. The primary outcome was referral for evaluation at a transplant center after dialysis initiation. Secondary outcomes were start of evaluation at a transplant center after referral and waitlisting.ResultsOf the 33,651 patients with incident kidney failure, most received dialysis treatment at a for-profit facility (85%). For-profit (versus nonprofit) facilities had a lower cumulative incidence difference for referral within 1 year of dialysis (−4.5%; 95% confidence interval, −6.0% to −3.2%). In adjusted analyses, for-profit versus nonprofit facilities had lower referral (hazard ratio, 0.84; 95% confidence interval, 0.80 to 0.88). Start of evaluation within 6 months of referral (−1.0%; 95% confidence interval, −3.1% to 1.3%) and waitlisting within 6 months of evaluation (1.0%; 95% confidence interval, −1.2 to 3.3) did not meaningfully differ between groups.ConclusionsFindings suggest lower access to referral among patients dialyzing in for-profit facilities in the Southeast United States, but no difference in starting the evaluation and waitlisting by facility profit status.

Dialysis facility referral and start of evaluation for kidney transplantation among patients treated with dialysis in the Southeastern United States

2020 ◽  
Vol 20 (8) ◽  
pp. 2113-2125 ◽  
Author(s):  
Rachel E. Patzer ◽  
Laura McPherson ◽  
Zhensheng Wang ◽  
Laura C. Plantinga ◽  
Sudeshna Paul ◽  
...  
Keyword(s):  
United States ◽  
Kidney Transplantation ◽  
Southeastern United States ◽  
Dialysis Facility

Shell Mounds in the Southeast: Middens, Monuments, Temple Mounds, Rings, or Works?

2010 ◽  
Vol 75 (3) ◽  
pp. 551-570 ◽  
Author(s):  
William H. Marquardt
Keyword(s):  
United States ◽  
South Carolina ◽  
Climate Changes ◽  
Southeastern United States ◽  
Short Term ◽  
Mound Construction ◽  
Architectural Features ◽  
Shell Mounds ◽  
Shell Rings ◽  
Oriented Approach

Focusing on the southeastern United States, I provide some alternative perspectives on shell mounds previously interpreted as architectural features, temple mounds, and feasting sites. The same pattern of deposition often inferred to indicate mound construction—darker-colored, highly organic strata alternating with lighter-colored, shell-rich strata—can be accounted for by domestic midden accumulation and disposal of refuse away from living areas. Observed abundances of particular shell species can result from local or regional ecological conditions. Site complexes interpreted as architectural may have evolved largely in response to short-term climate changes. Shell rings on the Georgia and South Carolina coasts probably functioned to conserve and store unconfined water. To understand ancient shell mounds, we need a sediment-oriented approach to the study of mound deposits and more attention to the environmental contexts in which shell mounds accumulated.

scholarly journals Fungicide Rotation Programs for Managing Phytophthora Fruit Rot of Watermelon in Southeastern United States

2017 ◽  
Vol 18 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Chandrasekar (Shaker) S. Kousik ◽  
Pingsheng Ji ◽  
Daniel S. Egel ◽  
Lina M. Quesada-Ocampo
Keyword(s):  
United States ◽  
South Carolina ◽  
Phytophthora Capsici ◽  
Southeastern United States ◽  
Heavy Rain ◽  
Integrated Approach ◽  
The United States ◽  
Fruit Rot ◽  
Management Options ◽  
Before And After

About 50% of the watermelons in the United States are produced in the southeastern states, where optimal conditions for development of Phytophthora fruit rot prevail. Phytophthora fruit rot significantly limits watermelon production by causing serious yield losses before and after fruit harvest. Efficacy of fungicide rotation programs and Melcast-scheduled sprays for managing Phytophthora fruit rot was determined by conducting experiments in Phytophthora capsici-infested fields at three locations in southeastern United States (North Carolina, South Carolina, and Georgia). The mini seedless cultivar Wonder and seeded cultivar Mickey Lee (pollenizer) were used. Five weekly applications of fungicides were made at all locations. Significant fruit rot (53 to 91%, mean 68%) was observed in the nontreated control plots in all three years (2013 to 2015) and across locations. All fungicide rotation programs significantly reduced Phytophthora fruit rot compared with nontreated controls. Overall, the rotation of Zampro alternated with Orondis was highly effective across three locations and two years. Rotations of Actigard followed by Ranman+Ridomil Gold, Presidio, V-10208, and Orondis, or rotation of Revus alternated with Presidio were similarly effective. Use of Melcast, a melon disease-forecasting tool, may occasionally enable savings of one spray application without significantly impacting control. Although many fungicides are available for use in rotations, under very heavy rain and pathogen pressure, the fungicides alone may not offer adequate protection; therefore, an integrated approach should be used with other management options including well-drained fields.

Injury Rates in Intramural Sports

2014 ◽  
Vol 38 (2) ◽  
pp. 98-103 ◽  
Author(s):  
Michael McElveen ◽  
Tony North ◽  
Alicia Rossow ◽  
Maggie Cattell
Keyword(s):  
United States ◽  
Confidence Interval ◽  
Southeastern United States ◽  
Injury Rate ◽  
Private College ◽  
Action Plans ◽  
Injury Rates ◽  
Intramural Sports ◽  
Major Injury ◽  
Ultimate Frisbee

The purpose of this investigation was to determine the rate of injury in eight intramural league sports at a small (< 3,000 students) private college in the southeastern United States. The number and types of injuries were tracked during the 2011–2012 and 2012–2013 academic years for eight intramural league sports: flag football, softball, floor hockey, volleyball, 3v3 basketball, ultimate frisbee, soccer, and 5v5 basketball. For the two academic years combined, the injury rate was 5.56 (95% confidence interval, or CI, = [4.67, 6.61]) per 100 participants; the major injury rate was 0.37 (95% CI = [0.19, 0.73]) per 100 participants. By assessing the rate of injury for intramural sports, intramural staff can strategically implement action plans to minimize risk and be better prepared to respond to injuries when they occur.

Recent Research Concerning the Freezing Point Value of Milk Produced in the Southeastern United States

1963 ◽  
Vol 46 (4) ◽  
pp. 732-736
Author(s):  
R W Henningson
Keyword(s):  
United States ◽  
South Carolina ◽  
Freezing Point ◽  
Southeastern United States ◽  
Fat Content ◽  
Extensive Survey ◽  
Milk Solids

Abstract In 1953 Dahlberg, et al. published the first information indicating that the freezing point value of milk produced in the Southeastern United States might be higher than commonly accepted values. An extensive survey of retail milk marketed in South Carolina during 1957 produced an unweighted average freezing point value of –0.529°C, and disclosed that the unweighted average milk solids-not-fat content of retail milk marketed in South Carolina was 8.88%. Other surveys revealed such freezing point values as –0.537, –0.540, –-0.533, –0.528, and –0.532°C. Custer and Cardwell found freezing point depressions averaging 0.025—0.030°C less for reconstituted non-fat milks of southern origin than for similar milks of northern origin. The lactose and chloride contents of these milks were lower than those of the northern milks. Problems created by high freezing point values which are intensified by the effects of vacuum pasteurization, common in the Southeastern United States, on freezing point values will be discussed.

scholarly journals Seasonal Hydrological Forecasts for Watersheds over the Southeastern United States for the Boreal Summer and Fall Seasons

2013 ◽  
Vol 17 (25) ◽  
pp. 1-22 ◽  
Author(s):  
Satish Bastola ◽  
Vasubandhu Misra ◽  
Haiqin Li
Keyword(s):  
United States ◽  
South Carolina ◽  
Climate Model ◽  
Southeastern United States ◽  
Boreal Summer ◽  
Hydrological Models ◽  
State University ◽  
Streamflow Prediction ◽  
Seasonal Climate ◽  
Hydrological Prediction

Abstract The authors evaluate the skill of a suite of seasonal hydrological prediction experiments over 28 watersheds throughout the southeastern United States (SEUS), including Florida, Georgia, Alabama, South Carolina, and North Carolina. The seasonal climate retrospective forecasts [the Florida Climate Institute–Florida State University Seasonal Hindcasts at 50-km resolution (FISH50)] is initialized in June and integrated through November of each year from 1982 through 2001. Each seasonal climate forecast has six ensemble members. An earlier study showed that FISH50 represents state-of-the-art seasonal climate prediction skill for the summer and fall seasons, especially in the subtropical and higher latitudes. The retrospective prediction of streamflow is based on multiple calibrated rainfall–runoff models. The hydrological models are forced with rainfall from FISH50, (quantile based) bias-corrected FISH50 rainfall (FISH50_BC), and resampled historical rainfall observations based on matching observed analogs of forecasted quartile seasonal rainfall anomalies (FISH50_Resamp). The results show that direct use of output from the climate model (FISH50) results in huge biases in predicted streamflow, which is significantly reduced with bias correction (FISH50_BC) or by FISH50_Resamp. On a discouraging note, the authors find that the deterministic skill of retrospective streamflow prediction as measured by the normalized root-mean-square error is poor compared to the climatological forecast irrespective of how FISH50 (e.g., FISH50_BC, FISH50_Resamp) is used to force the hydrological models. However, our analysis of probabilistic skill from the same suite of retrospective prediction experiments reveals that, over the majority of the 28 watersheds in the SEUS, significantly higher probabilistic skill than climatological forecast of streamflow can be harvested for the wet/dry seasonal anomalies (i.e., extreme quartiles) using FISH50_Resamp as the forcing. The authors contend that, given the nature of the relatively low climate predictability over the SEUS, high deterministic hydrological prediction skills will be elusive. Therefore, probabilistic hydrological prediction for the SEUS watersheds is very appealing, especially with the current capability of generating a comparatively huge ensemble of seasonal hydrological predictions for each watershed and for each season, which offers a robust estimate of associated forecast uncertainty.

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