scholarly journals Concussion Among Children in the United States General Population: Incidence and Risk Factors

2021 ◽  
Vol 12 ◽  
Author(s):  
Nathan E. Cook ◽  
Grant L. Iverson
Keyword(s):  
United States ◽  
Risk Factors ◽  
General Population ◽  
The United States ◽  
Health History ◽  
The Us ◽  
History Of ◽  
Concussion History ◽  
Current Sample

The objective of this study was to examine the incidence of concussion and risk factors for sustaining concussion among children from the United States general population. This prospective cohort study used data from the Adolescent Brain Cognitive Development (ABCD) Study®. Children were recruited from schools across the US, sampled to reflect the sociodemographic variation of the US population. The current sample includes 11,013 children aged 9 to 10 years old (47.6% girls; 65.5% White) who were prospectively followed for an average of 1 year (mean = 367.9 days, SD = 40.8, range 249–601). The primary outcome was caregiver-reported concussion during a 1 year follow-up period. Logistic regression was used to determine which potential clinical, health history, and behavioral characteristics (assessed at baseline) were prospectively associated with concussion. In the 1 year follow-up period between ages 10 and 11, 1 in 100 children (n = 123, 1.1%) sustained a concussion. In univariate models, three baseline predictors (ADHD, prior concussion, and accident proneness) were significantly associated with sustaining a concussion. In a multivariate model, controlling for all other predictors, only prior concussion remained significantly associated with the occurrence of a concussion during the observation period (Odds Ratio = 5.49, 95% CI: 3.40–8.87). The most robust and only independent prospective predictor of sustaining a concussion was history of a prior concussion. History of concussion is associated with 5.5 times greater odds of sustaining concussion between ages 10 and 11 among children from the general US population.

scholarly journals An Evaluation of PROMIS Health Domains in Sarcoma Patients Compared to the United States Population

Sarcoma ◽  
2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Benjamin Wilke ◽  
Anna Cooper ◽  
Mark Scarborough ◽  
C. Parker Gibbs ◽  
Andre Spiguel
Keyword(s):  
United States ◽  
General Population ◽  
Physical Function ◽  
The United States ◽  
Successful Outcome ◽  
Measurement Information ◽  
Patient Reported ◽  
The Us ◽  
Health Domains

Background. The Patient Reported Outcomes Measurement Information System (PROMIS) is a patient-directed system that allows comparisons across medical conditions. With this tool, comparisons can now be made between rare conditions, such as sarcomas, and more common ailments, of the United States general population. This allows comparisons between rare conditions, such as sarcomas, to more common ailments, or even the United States (US) general population. Objectives. Our purpose was to use PROMIS to compare outcomes in patients that had undergone resection of a nonmetastatic sarcoma to the US population. Methods. One hundred thirty-eight patients were included in the analysis. These patients were divided into early (<2 years) and late follow-up (>2 years). Results. We evaluated results from seven health domains and found significantly lower scores in the physical function and depression domains. These differences were present in both the early and late cohorts when compared to the US population. Conclusion. While physical function was found to be worse in the sarcoma cohorts, we observed significantly improved levels of depression in these patients when compared to the US population. This finding was maintained over time and is an important reminder that a patient’s goals and desires change following a cancer diagnosis and must be taken into consideration when planning treatment and determining a successful outcome.

The Septuagenarians’ Sankofa Dialogue

2018 ◽  
Vol 5 (1) ◽  
Author(s):  
Kalamu Ya Salaam ◽  
Jerry W. Ward Jr.
Keyword(s):  
United States ◽  
Turning Point ◽  
The United States ◽  
Donald Trump ◽  
President Obama ◽  
Pivotal Moments ◽  
The Us ◽  
History Of ◽  
First Time

Salaam: We might call this the Sankofa Dialogue because we are looking back in order to orient ourselves as we move forward. Approximately eight years ago, in 2008, there was a great brouhaha and hope because of the upcoming election for the US presidency. For the first time in the history of the United States, a Black man—and it’s befitting that he was truly an African American—was running for office. We don’t generally have such pivotal moments in history, either as individuals or as a people.Ward: But I would suggest that in the closing months of the second term of President Obama, we had a devastatingly pivotal moment. As we scrutinize the behavior of Donald Trump, we ought also to be concerned about what is driving people who, under other circumstances, might have hesitated to elect a clown. Those voters were so full of disgust, disappointment, and dismay that they saw Trump as the Great White Hope. Many of the voters wanted a president who might restore the bogus privileges of “white superiority.”Salaam: I concur, but I would broaden the dialog a bit. I think this historic moment, this turning point, comes at a critical moment in what defines what it means to be American. I don’t think there’s a post-Obama era as such. I think Obama was just part of this era where we are grappling with what it means to be an American now that it no longer means what it has meant from the beginning of the United States up until Obama. We’re still struggling with that. What we see right now is a repetition of what happened at the closing of, and in the immediate follow-up to, the Civil War in terms of the identity questions that were being raised.

The American War in Afghanistan

2021 ◽  
Author(s):  
Carter Malkasian
Keyword(s):  
United States ◽  
Decision Making ◽  
The United States ◽  
State Building ◽  
The State ◽  
The Us ◽  
History Of ◽  
Narrative Format

The American War in Afghanistan is a full history of the war in Afghanistan between 2001 and 2020. It covers political, cultural, strategic, and tactical aspects of the war and details the actions and decision-making of the United States, Afghan government, and Taliban. The work follows a narrative format to go through the 2001 US invasion, the state-building of 2002–2005, the Taliban offensive of 2006, the US surge of 2009–2011, the subsequent drawdown, and the peace talks of 2019–2020. The focus is on the overarching questions of the war: Why did the United States fail? What opportunities existed to reach a better outcome? Why did the United States not withdraw from the war?

scholarly journals Prevalence and Clinical Correlates of Coronary Artery Disease among New Dialysis Patients in the United States: A Cross-Sectional Study

2001 ◽  
Vol 12 (7) ◽  
pp. 1516-1523 ◽  
Author(s):  
AUSTIN G. STACK ◽  
WENDY E. BLOEMBERGEN
Keyword(s):  
United States ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
The United States ◽  
Comorbid Conditions ◽  
Clinical Correlates ◽  
History Of ◽  
Artery Disease

Abstract. Despite the high prevalence of coronary artery disease (CAD) among patients with end-stage renal disease (ESRD), few studies have identified clinical correlates using national data. The purpose of this study was to determine the prevalence and clinical associations of CAD in a national random sample of new ESRD in the United States in 1996/1997 (n = 4025). Data on demographic characteristics and comorbidities were obtained from the Dialysis Morbidity and Mortality Study, Wave 2. The principal outcome was CAD, defined as the presence of a previous history of CAD, myocardial infarction, or angina, coronary artery bypass surgery, coronary angioplasty, or abnormal coronary angiographic findings. Multivariate logistic regression analysis was used to assess the relationship of conventional factors and proposed uremic factors to the presence of CAD. CAD was present in 38% of patients. Of the total cohort, 17% had a history of myocardial infarction and 23% had angina. Several conventional risk factors, including advancing age, male gender, diabetes mellitus, and smoking, were significantly associated with CAD. Of the proposed uremic factors, lower serum albumin levels but higher residual renal function and higher hematocrit values were significantly associated with the presence of CAD. Vascular comorbid conditions, structural cardiac abnormalities, white race, and geographic location were also strongly correlated with the presence of CAD. This national study suggests that several conventional CAD risk factors may also be risk factors for CAD among the ESRD population. This study identifies nonconventional factors such as serum albumin levels, vascular comorbid conditions, and structural cardiac abnormalities as important disease correlates. Future logitudinal studies are required to explore the relative importance of the relationships observed here.

scholarly journals Conflict in the Middle East: The US and the Turkish-Kurdish Conflict

2018 ◽  
Vol 25 ◽  
pp. 11-21
Author(s):  
Matthew Dotzler
Keyword(s):  
United States ◽  
Foreign Policy ◽  
National Security ◽  
Boiling Point ◽  
The United States ◽  
Us Foreign Policy ◽  
Northern Iraq ◽  
The Us ◽  
History Of ◽  
Kurdish Conflict

The conflict between Turkey and the Kurds is once again reaching a boiling point. Following the defeat of ISIL in northern Iraq and Syria, Turkey is now concerned that the returning Kurdish militias pose a threat to its national security. The United States, as an ally to both parties, finds itself in a unique position to push for diplomatic solutions and to mediate the conflict before it grows out of control once again. This paper will examine the history of the Turkish-Kurdish conflict, the actors involved, and how US foreign policy can be used to try and deter yet another war in the region.

Abstract WMP60: Temporal Trends in Incidence, Prevalence and Epidemiological Characteristics of Cerebral Venous Thrombosis in the United States

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Fadar Otite ◽  
Smit Patel ◽  
Richa Sharma ◽  
Pushti Khandwala ◽  
Devashish Desai ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Cerebral Venous Thrombosis ◽  
The United States ◽  
P Value ◽  
Joinpoint Regression ◽  
The Us ◽  
Epidemiological Characteristics ◽  
Over Time ◽  
Age And Sex

Background: The primary aim of this study is to describe current trends in racial-, age- and sex-specific incidence, clinical characteristics and burden of cerebral venous thrombosis (CVT) in the United States (US). Methods: Validated International Classification of Disease codes were used to identify all adult new cases of CVT (n=5,567) in the State Inpatients Database of New York and Florida (2006-2016) and all cases of CVT in the entire US from the National Inpatient Sample 2005-2016 (weighted n=57,315). Incident CVT counts were combined with annual US Census data to compute age and sex-specific incidence of CVT. Joinpoint regression was used to evaluate trends in incidence over time. Results: From 2005-2016, 0.47%-0.80% of all strokes in the US were CVTs but this proportion increased by 70.4% over time. Of all CVTs over this period, 66.7% were in females but this proportion declined over time (p<0.001). Pregnancy/puerperium (27.4%) and cancer (11.8%) were the most common risk factors in women, while cancer (19.5%) and central nervous trauma (11.3) were the most common in men. Whereas the prevalence of pregnancy/puerperium declined significantly over time in women, that of cancer, inflammatory conditions and trauma increased over time in both sexes. Annual age and sex-standardized incidence of CVT in cases/million population ranged from 13.9-20.2, but incidence varied significantly by sex (women: 20.3-26.9; men 6.8-16.8) and by age/sex (women 18-44yo: 24.0-32.6%; men: 18-44yo: 5.3-12.8). Age and sex-standardized incidence also differed by race (Blacks:18.6-27.2; whites: 14.3-18.5; Asians: 5.1-13.8). On joinpoint regression, incidence increased across 2006-2016 but most of this increase was driven by increase in all age groups of men (combined annualized percentage change (APC) 9.2%, p-value <0.001), women 45-64 yo (APC 7.8%, p-value <0.001) and women ≥65 yo (APC 7.4%, p-value <0.001). Incidence in women 18-44 yo remained unchanged over time . Conclusion: The epidemiological characteristics of CVT patients in the US is changing. Incidence increased significantly over the last decade. Further studies are needed to determine whether this increase represents a true increase from changing risk factors or artefactual increase from improved detection.

Introduction

2018 ◽  
Author(s):  
Emily Abrams Ansari
Keyword(s):  
United States ◽  
Cold War ◽  
The United States ◽  
American Identity ◽  
American Composers ◽  
The Us ◽  
Challenges And Opportunities ◽  
History Of ◽  
The Cold War ◽  
Changing Attitudes

The introduction provides an overview of the history of musical Americanism, from the 1920s to the 1970s, in tandem with an assessment of changing attitudes toward American identity in the United States. It introduces scholarly debates surrounding the Cold War politicization of serialism and tonality and describes the various opportunities for work with government exploited by American composers during the 1950s and 1960s. These opportunities included serving as advisers to the State Department, the US Information Agency, and organizations funded by the CIA, as well as touring overseas as government-funded cultural ambassadors. These contexts establish the basis for the book’s argument that the Cold War presented both challenges and opportunities for Americanist composers that would ultimately result in a rebranding of their style.

scholarly journals Incidence of and Risk Factors for Glenohumeral Osteoarthritis After Anterior Shoulder Instability: A US Population–Based Study With Average 15-Year Follow-up

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096251
Author(s):  
Bradley M. Kruckeberg ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
Aaron J. Krych ◽  
Diane L. Dahm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Shoulder Instability ◽  
The United States ◽  
Anterior Shoulder Instability ◽  
Geographic Population ◽  
Increased Risk ◽  
Modifiable Factors ◽  
History Of ◽  
Former Smokers

Background: The rate of osteoarthritis (OA) in patients with a history of previous anterior shoulder instability (ASI) varies within the literature, with the majority of studies investigating rates after surgical stabilization. ASI appears to lead to increased rates of OA, although risk factors for developing OA in cohorts treated nonoperatively and operatively are not well-defined. Purpose: To determine the incidence of clinically symptomatic OA and identify potential risk factors for the development of OA in patients younger than 40 years with a known history of ASI. Study Design: Case-control study; Level of evidence, 3. Methods: An established, geographically based database was used to identify patients in the United States who were younger than 40 years and were diagnosed with ASI between 1994 and 2014. Patient information, including demographic, imaging, and surgical details, was collected. Comparative analysis was performed between groups with and without OA at final follow-up as well as between patients who underwent surgical and nonsurgical management. Results: The study population consisted of 154 patients with a mean follow-up of 15.2 years (range, 5.1-29.8 years). The mean age at initial instability event was 20.9 years (95% CI, 19.9-22.0 years). Overall, 22.7% of patients developed clinically symptomatic glenohumeral OA. Multivariate analysis revealed that current or former smokers (odds ratio [OR], 4.3; 95% CI, 1.1-16.5; P = .030), hyperlaxity (OR, 10.1; 95% CI, 1.4-72.4; P = .020), laborer occupation (OR, 6.1; 95% CI, 1.02-36.1; P = .043), body mass index (BMI) (OR, 1.2; 95% CI, 1.03-1.3; P = .012), and age at initial instability (OR, 1.1; 95% CI, 1.02-1.2; P = .013) as potential independent risk factors when accounting for other demographic and clinical variables. Conclusion: In a US geographic population of patients younger than 40 years with ASI, approximately one-fourth of patients developed symptomatic OA at a mean follow-up of 15 years from their first instability event. When accounting for differences in patient demographic and clinical data, we noted a potentially increased risk for the development of OA in patients who are current or former smokers, have hyperlaxity, are laborers, have higher BMI, and have increased age at initial instability event. Smoking status, occupation, and BMI are modifiable factors that could potentially decrease risk for the development of symptomatic OA in these patients.

THE INTELLECTUAL MIGRATION AND THE “OTHER WEIMAR”

2015 ◽  
Vol 14 (2) ◽  
pp. 597-606
Author(s):  
NOAH B. STROTE
Keyword(s):  
United States ◽  
Twentieth Century ◽  
Intellectual History ◽  
The United States ◽  
The Other ◽  
Left Wing ◽  
Weimar Germany ◽  
Jewish Heritage ◽  
The Us ◽  
History Of

These two books bring fresh eyes and much-needed energy to the study of the intellectual migration from Weimar Germany to the United States. Research on the scholars, writers, and artists forced to flee Europe because of their Jewish heritage or left-wing politics was once a cottage industry, but interest in this topic has waned in recent years. During the height of fascination with the émigrés, bookstores brimmed with panoramic works such as H. Stuart Hughes's The Sea Change: The Migration of Social Thought, 1930–1965 (1975), Lewis Coser's Refugee Scholars in America: Their Impact and Their Experiences (1984), and Martin Jay's Permanent Exiles: Essays on the Intellectual Migration from Germany to America (1985). Now, while historians still write monographs about émigré intellectuals, their focus is often narrowed to biographies of individual thinkers. Refreshingly, with Emily Levine's and Udi Greenberg's new publications we are asked to step back and recapture a broader view of their legacy. The displacement of a significant part of Germany's renowned intelligentsia to the US in the mid-twentieth century remains one of the major events in the intellectual history of both countries.

Incidence of and Risk Factors for Nosocomial Bloodstream Infections in Adults in the United States, 2003

2009 ◽  
Vol 30 (11) ◽  
pp. 1036-1044 ◽  
Author(s):  
Omar M. AL-Rawajfah ◽  
Frank Stetzer ◽  
Jeanne Beauchamp Hewitt
Keyword(s):  
United States ◽  
Risk Factors ◽  
Case Fatality Rate ◽  
Nationwide Inpatient Sample ◽  
Hospital Admissions ◽  
Case Fatality ◽  
The United States ◽  
Fatality Rate ◽  
The Us ◽  
National Estimates

Background.Although many studies have examined nosocomial bloodstream infection (BSI), US national estimates of incidence and case-fatality rates have seldom been reported.Objective.The purposes of this study were to generate US national estimates of the incidence and severity of nosocomial BSI and to identify risk factors for nosocomial BSI among adults hospitalized in the United States on the basis of a national probability sample.Methods.This cross-sectional study used the US Nationwide Inpatient Sample for the year 2003 to estimate the incidence and case-fatality rate associated with nosocomial BSI in the total US population. Cases of nosocomial BSI were defined by using 1 or more International Classification of Diseases, 9th Revision, Clinical Modification codes in the secondary field(s) that corresponded to BSIs that occurred at least 48 hours after admission. The comparison group consisted of all patients without BSI codes in their NIS records. Weighted data were used to generate US national estimates of nosocomial BSIs. Logistic regression was used to identify independent risk factors for nosocomial BSI.Results.The US national estimated incidence of nosocomial BSI was 21.6 cases per 1,000 admissions, while the estimated case-fatality rate was 20.6%. Seven of the 10 leading causes of hospital admissions associated with nosocomial BSI were infection related. We estimate that 541,081 patients would have acquired a nosocomial BSI in 2003, and of these, 111,427 would have died. The final multivariate model consisted of the following risk factors: central venous catheter use (odds ratio [OR], 4.76), other infections (OR, 4.61), receipt of mechanical ventilation (OR, 4.97), trauma (OR, 1.98), hemodialysis (OR, 4.83), and malnutrition (OR, 2.50). The total maximum rescaled R2 was 0.22.Conclusions.The Nationwide Inpatient Sample was useful for estimating national incidence and case-fatality rates, as well as examining independent predictors of nosocomial BSI.

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