29 results on '"King, Robert"'
Search Results
2. How important is the transitional yield (t-yield)? An analysis of reforms to organic crop insurance.
- Author
-
Delbridge, Timothy A. and King, Robert P.
- Subjects
- *
CROP insurance , *ORGANIC farmers - Abstract
Purpose The USDA's Risk Management Agency (RMA) made several changes to the crop insurance products available to organic growers for the 2014 crop year. Most notably, a 5 percent premium surcharge was removed and organic-specific transitional yields (t-yields) were issued for the first time. The purpose of this paper is to use farm-level organic crop yield data to analyze the impact of these reforms on producer insurance outcomes and compare the insurance options for new organic growers.Design/methodology/approach This study uses a unique panel data set of organic corn and soybean yields to analyze the impact of organic crop insurance reforms. Actual Production History values and premium rates are calculated for each farm and crop yield sequence. Producer loss ratios and subsidized premium wedges are compared for yield, revenue and area-risk products before and after the instituted reforms.Findings Results indicate that RMA succeeded in improving the actuarial soundness of the organic insurance program, though further refinement of organic t-yields may be necessary to accurately reflect the yield potential of organic producers and avoid reductions in program participation.Originality/value This paper provides insight into the effectiveness of reforms intended to improve the actuarial soundness of organic crop insurance and demonstrates the effect that the reforms are likely to have on new and existing organic farms. Because this analysis uses data collected independently of RMA and includes farms that may or may not have purchased crop insurance, it avoids the self-selection problems that might affect analyses using crop insurance program data. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
3. Are Case Volume and Facility Complexity Level Associated With Postoperative Complications After Hip Fracture Surgery in the Veterans Affairs Healthcare System?
- Author
-
Wong, Jimmy K., Kim, T. Edward, Mudumbai, Seshadri C., Howard, Steven K., Mariano, Edward R., King, Robert, Memtsoudis, Stavros G., Giori, Nicholas J., and Oka, Roberta K.
- Subjects
HIP surgery ,SURGICAL complications ,SURGICAL site infections ,VENOUS thrombosis ,OBSTRUCTIVE lung diseases ,CLINICAL medicine ,COMPARATIVE studies ,DATABASES ,DIAGNOSIS related groups ,FRACTURE fixation ,BONE fractures ,HIP joint injuries ,HOSPITALS ,VETERANS ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,RISK assessment ,TIME ,VETERANS' hospitals ,EVALUATION research ,KEY performance indicators (Management) ,TREATMENT effectiveness ,RETROSPECTIVE studies - Abstract
Background: Hospital-related factors associated with mortality and morbidity after hip fracture surgery are not completely understood. The Veterans Health Administration (VHA) is the largest single-payer, networked healthcare system in the country serving a relatively homogenous patient population with facilities that vary in size and resource availability. These characteristics provide some degree of financial and patient-level controls to explore the association, if any, between surgical volume and facility resource availability and hospital performance regarding postoperative complications after hip fracture surgery.Questions/purposes: (1) Do VHA facilities with the highest complexity level designation (Level 1a) have a disproportionate number of better-than-expected performance outliers for major postoperative complications compared with lower-complexity level facilities? (2) Do VHA facilities with higher hip fracture surgical volume have a disproportionate number of better-than-expected performance outliers for major postoperative complications compared with lower-volume facilities?Methods: We explored the Veterans Affairs Surgical Quality Improvement Project (VASQIP) database from October 2001 to September 2012 for records of hip fracture surgery performed. Data reliability of the VASQIP database has been previously validated. We excluded nine of the 98 VHA facilities for contributing fewer than 30 records. The remaining 89 VHA facilities provided 23,029 records. The VHA designates a complexity level to each facility based on multiple criteria. We labeled facilities with a complexity Level 1a (38 facilities)-the highest achievable VHA designated complexity level-as high complexity; we labeled all other complexity level designations as low complexity (51 facilities). Facility volume was divided into tertiles: high (> 277 hip fracture procedures during the sampling frame), medium (204 to 277 procedures), and low (< 204 procedures). The patient population treated by low-complexity facilities was older, had a higher prevalence of severe chronic obstructive pulmonary disease (26% versus 22%, p < 0.001), and had a higher percentage of patients having surgery within 2 days of hospital admission (83% versus 76%, p < 0.001). High-complexity facilities treated more patients with recent congestive heart failure exacerbation (4% versus 3%, p < 0.001). We defined major postoperative complications as having at least one of the following: death within 30 days of surgery, cardiac arrest requiring cardiopulmonary resuscitation, new q-wave myocardial infarction, deep vein thrombosis and/or pulmonary embolism, ventilator dependence for at least 48 hours after surgery, reintubation for respiratory or cardiac failure, acute renal failure requiring renal replacement therapy, progressive renal insufficiency with a rise in serum creatinine of at least 2 mg/dL from preoperative value, pneumonia, or surgical site infection. We used the observed-to-expected ratio (O/E ratio)-a risk-adjusted metric to classify facility performance-for major postoperative complications to assess the performance of VHA facilities. Outlier facilities with 95% confidence intervals (95% CI) for O/E ratio completely less than 1.0 were labeled "exceed expectation;" those that were completely greater than 1.0 were labeled "below expectation." We compared differences in the distribution of outlier facilities between high and low-complexity facilities, and between high-, medium-, and low-volume facilities using Fisher's exact test.Results: We observed no association between facility complexity level and the distribution of outlier facilities (high-complexity: 5% exceeded expectation, 5% below expectation; low-complexity: 8% exceeded expectation, 2% below expectation; p = 0.742). Compared with high-complexity facilities, the adjusted odds ratio for major postoperative complications for low-complexity facilities was 0.85 (95% CI, 0.67-1.09; p = 0.108).We observed no association between facility volume and the distribution of outlier facilities: 3% exceeded expectation and 3% below expectation for high-volume; 10% exceeded expectation and 3% below expectation for medium-volume; and 7% exceeded expectation and 3% below expectation for low-volume; p = 0.890). The adjusted odds ratios for major postoperative complications were 0.87 (95% CI, 0.73-1.05) for low- versus high-volume facilities and 0.89 (95% CI, 0.79-1.02] for medium- versus high-volume facilities (p = 0.155).Conclusions: These results do not support restricting facilities from treating hip fracture patients based on historical surgical volume or facility resource availability. Identification of consistent performance outliers may help health care organizations with multiple facilities determine allocation of services and identify characteristics and processes that determine outlier status in the interest of continued quality improvement.Level Of Evidence: Level III, therapeutic study. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
- View/download PDF
4. Refining and implementing the Food Assortment Scoring Tool (FAST) in food pantries.
- Author
-
Caspi, Caitlin E, Grannon, Katherine Y, Wang, Qi, Nanney, Marilyn S, and King, Robert P
- Subjects
PANTRIES ,MOBILE food services ,FOOD quality ,NUTRITIONAL requirements ,FOOD ,COMPARATIVE studies ,FOOD relief ,FOOD supply ,RESEARCH methodology ,MEDICAL cooperation ,RESEARCH ,RESEARCH funding ,EVALUATION research ,NUTRITIONAL value - Abstract
Objective: Hunger relief agencies have a limited capacity to monitor the nutritional quality of their food. Validated measures of food environments, such as the Healthy Eating Index-2010 (HEI-2010), are challenging to use due to their time intensity and requirement for precise nutrient information. A previous study used out-of-sample predictions to demonstrate that an alternative measure correlated well with the HEI-2010. The present study revised the Food Assortment Scoring Tool (FAST) to facilitate implementation and tested the tool's performance in a real-world food pantry setting.Design: We developed a FAST measure with thirteen scored categories and thirty-one sub-categories. FAST scores were generated by sorting and weighing foods in categories, multiplying each category's weight share by a healthfulness parameter and summing the categories (range 0-100). FAST was implemented by recording all food products moved over five days. Researchers collected FAST and HEI-2010 scores for food availability and foods selected by clients, to calculate correlations.Setting: Five food pantries in greater Minneapolis/St. Paul, Minnesota, USA.Subjects: Food carts of sixty food pantry clients.Results: The thirteen-category FAST correlated well with the HEI-2010 in prediction models (r = 0·68). FAST scores averaged 61·5 for food products moved, 63·8 for availability and 62·5 for client carts. As implemented in the real world, FAST demonstrated good correlation with the HEI-2010 (r = 0·66).Conclusions: The FAST is a flexible, valid tool to monitor the nutritional quality of food in pantries. Future studies are needed to test its use in monitoring improvements in food pantry nutritional quality over time. [ABSTRACT FROM AUTHOR]- Published
- 2018
- Full Text
- View/download PDF
5. Safety net hospitals concerned with method CMS will use to allocate $30B in grants to providers.
- Author
-
King, Robert
- Subjects
HOSPITALS ,GRANTS (Money) - Abstract
America's Essential Hospitals is concerned about the method CMS is using to disperse $30B in grant funding to providers, but more help is on the way. [ABSTRACT FROM AUTHOR]
- Published
- 2020
6. AHIP calls for CMS to delay mandatory new Medicare Advantage requirements due to COVID-19.
- Author
-
King, Robert
- Subjects
COVID-19 ,MEDICARE ,HEALTH insurance ,INSURANCE companies ,TECHNICAL specifications - Abstract
AHIP wants CMS to give insurers a reprieve from any new requirements in 2021 for Medicare Advantage to help them deal with the impact of COVID-19. [ABSTRACT FROM AUTHOR]
- Published
- 2020
7. Insurers demand CMS increase MA payments to account for influx of ESRD beneficiaries.
- Author
-
King, Robert
- Subjects
INSURANCE companies ,MEDICARE ,MEDICAID ,PAYMENT ,KIDNEY diseases - Abstract
Insurers are worried the Centers for Medicare & Medicaid Services' payments to Medicare Advantage plans next year won't be enough to cover an expected increase in new patients with kidney disease. [ABSTRACT FROM AUTHOR]
- Published
- 2020
8. SXSW, AHIP and ACHE announce conference cancellations due to COVID-19 concerns.
- Author
-
King, Robert
- Subjects
COVID-19 ,INFORMATION resources management ,CONFERENCES & conventions - Abstract
More healthcare conferences are deciding to shut down because of the increasing spread of the coronavirus. [ABSTRACT FROM AUTHOR]
- Published
- 2020
9. Oncologists press Congress to set 72-hour limit for payers to fill cancer drug prescriptions.
- Author
-
King, Robert
- Subjects
DRUG prescribing ,ONCOLOGISTS ,PRESSURE groups ,CANCER ,PHARMACY benefit management - Abstract
An oncologist advocacy group wants Congress to set a 72-hour deadline for pharmacies to fill cancer drugs for patients, the latest on a growing list of calls for prior authorization reform. [ABSTRACT FROM AUTHOR]
- Published
- 2020
10. Trump administration extends comment period on insurer transparency rule.
- Author
-
King, Robert
- Subjects
INSURANCE companies ,HEALTH insurance exchanges ,HEALTH insurance - Abstract
The Trump administration has given insurers more time to comment on a proposed rule to require individual and group plans to give consumers out-of-pocket cost information. [ABSTRACT FROM AUTHOR]
- Published
- 2019
11. No price concessions in CMS' final drug-price rule.
- Author
-
King, Robert
- Subjects
- *
DRUG laws , *MEDICAL care costs , *MEDICARE ,DRUGS & economics - Abstract
The article mentions U.S. President Donald Trump administration's release of a final rule on increasing drug cost transparency on Medicare Part D, but without the proposed passing of price concessions negotiated by the pharmacy to patients as of May 20, 2019.
- Published
- 2019
12. MACPAC wants to change how DSH payments are calculated.
- Author
-
King, Robert
- Subjects
- *
GOVERNMENT aid laws , *MEDICAID , *PRACTICAL politics , *HEALTH policy , *HEALTH insurance reimbursement ,HOSPITALS & economics - Abstract
The article reports on the recommendation of the Medicaid and CHIP Payment Advisory Commission (MACPAC) that the U.S. Congress change the definition of a Medicaid shortfall following hospitals' challenge of the calculation in court. Topics discussed include MACPAC's proposal for the exclusion of the costs and payments for Medicaid patients and the impact of terms in the shortfall on the amount of disproportionate-share hospital (DSH) payments.
- Published
- 2019
13. Congress and the Trump administration are attacking high drug prices on a number of fronts.
- Author
-
King, Robert
- Subjects
- *
EXECUTIVES , *DRUG laws , *GENERIC drugs , *MEDICARE , *DRUG approval ,DRUGS & economics - Abstract
The article focuses on the measures undertaken by U.S. President Donald Trump's administration and the Congress to address the issue on high drug prices in 2019. Topics discussed include a proposed bill called the Creates Act that would support the development of generic version of a drug; a proposal from the U.S. Department of Health and Human Services to remove the safe-harbor protection for drug rebates; and formulary management tools for Medicare Advantage plans.
- Published
- 2019
14. Outdated regulations cost inpatient psychiatric facilities $1.7 billion: report.
- Author
-
King, Robert
- Subjects
- *
HEALTH services administration , *ORGANIZATIONAL change , *PSYCHIATRIC hospitals , *REPORT writing , *SURVEYS , *REGULATORY approval , *GOVERNMENT regulation , *PATIENT dumping -- Law & legislation , *MEDICAL laws , *ECONOMICS - Abstract
The article reports that inpatient psychiatric facilities spend $1.7 billion yearly due to outdated regulations and inconsistencies among surveyors in the United States as of March 2019. The average annual cost of ligature-risk point regulatory compliance is $880 million. Mark Covall, chief executive officer of the National Association for Behavioral Healthcare (NABH), comments on the changing regulations implemented by the state. Discussion on B-tags is also presented.
- Published
- 2019
15. Medicaid work rules cause concern for tribal leaders.
- Author
-
King, Robert
- Subjects
- *
MEDICAID law , *ELIGIBILITY (Social aspects) , *EMPLOYMENT , *NATIVE Americans , *STATE governments , *LAW - Abstract
The article discusses the actions taken by Indian tribe leaders in relation to work requirements for tribal members provided with Medicaid benefits under the rule of the U.S. Centers for Medicare and Medicaid Services.
- Published
- 2019
16. Indian Health Service swept up in efforts to boost transparency, oppose Medicare for All.
- Author
-
King, Robert
- Subjects
- *
FEDERAL government , *MEDICAL policy laws , *ALASKA Natives , *HEALTH services accessibility , *HEALTH status indicators , *PROPRIETARY hospitals , *MEDICAL care , *MEDICAL quality control , *MEDICARE , *PRACTICAL politics , *PUBLIC health administration , *MEDICAL care of indigenous peoples - Abstract
The article focuses on the quality issues and allegations of sexual assault facing the Indian Health Service (IHS) of the United States as of March 2019. Topics discussed include the investigation of pediatrician Stanley Patrick Weber, actions taken by the Congress to ensure quality in IHS facilities, IHS statement concerning their efforts to improve healthcare service delivery, and a legislation advanced by the Senate Indian Affairs Committee.
- Published
- 2019
17. HHS, Medicaid get deep cuts in White House budget proposal.
- Author
-
King, Robert
- Subjects
- *
MEDICAID , *ECONOMIC impact , *HEALTH policy , *BUDGET , *COST control , *HEALTH care reform , *INSURANCE ,PATIENT Protection & Affordable Care Act - Abstract
The article reports on the impacts of the fiscal 2020 budget proposal of the administration of United States President Donald Trump on the U.S. Department of Health and Human Services (HHS) and Medicaid. Topics discussed include imposition of copayments for non-emergency use of emergency departments, Medicaid's disproportionate-share hospital adjustment payments, and reductions in the Affordable Care Act spending for Medicaid expansion.
- Published
- 2019
18. Name and shame: HHS using disclosure, transparency to try to force change.
- Author
-
King, Robert
- Subjects
- *
MANAGEMENT of medical records , *DRUG delivery systems , *HEALTH care reform , *MEDICAL informatics , *GOVERNMENT regulation , *ACCESS to information , *ELECTRONIC health records , *LAW - Abstract
The article reports on U.S. Department of Health and Human Services' use of disclosure and transparency to try to force change. Topics discussed include proposed rules issued by the Centers for Medicare & Medicaid Services and the Office of the National Coordinator for Health Information Technology to spur interoperability and counter information-blocking and a provision to post a list online of healthcare clinicians and hospitals that block the transfer of patient information.
- Published
- 2019
19. Medicaid enrollees last in line when docs accepting new patients.
- Author
-
King, Robert
- Subjects
- *
ECONOMIC impact , *LEGISLATION , *USER charges , *HEALTH insurance reimbursement laws , *HEALTH insurance statistics , *HEALTH insurance , *MEDICAID , *MEDICARE ,PATIENT Protection & Affordable Care Act -- Economic aspects - Abstract
The article reports on a study which claims that physicians are accepting new Medicaid patients at a far lower rate compared with patients on Medicare or private insurance. The study was based on an assessment of 2015 data from the National Ambulatory Medical Care Survey. The survey broke down the acceptance rate by type of provider. The Affordable Care Act's Medicaid expansion did not have a significant impact on Medicare acceptance rates overall.
- Published
- 2019
20. MACPAC wants Congress to slow down DSH cuts.
- Author
-
King, Robert
- Subjects
- *
GOVERNMENT aid laws , *MEDICAID , *HEALTH policy ,HOSPITALS & economics - Abstract
The article reports that the Medicaid and CHIP Payment and Access Commission (MACPAC) wants U.S. Congress to slow down reductions in payments to disproportionate-share hospitals (DSH). MACPAC suggested cutting funding by 2 billion U.S. dollars in October 2019. Easing the DSH cuts gives time for hospitals and states to mitigate the impact of the funding decrease. MACPAC suggested the U.S. Department of Health & Human Services to form a methodology to spread out the cuts.
- Published
- 2019
21. Trump, Democrats reach spending deal to end shutdown.
- Author
-
Luthi, Susannah and King, Robert
- Subjects
- *
PRACTICAL politics , *GOVERNMENT agencies , *CONFLICT (Psychology) , *FEDERAL government , *HEALTH care industry - Abstract
The article reports on a temporary truce reached by U.S. President Donald Trump and congressional Democrats on January 25, 2019 over the partial government shutdown. Both parties agreed to a continuing budget resolution to finance department operations through February 15, 2019. The deal did not include financing for a border wall. A funding lapse for the U.S. Food and Drug Administration stopped food safety inspections.
- Published
- 2019
22. With the US Innovation Act stalled, will courts rein in NPEs?
- Author
-
King, Robert A.
- Subjects
NONPRACTICING entities (Patent law) ,PATENT infringement ,ALICE Corp. Pty. Ltd. v. CLS Bank International ,ACTIONS & defenses (Law) - Abstract
The author comments on how U.S. courts address problem related to patent trolls (non-practising entities (NPEs)) Topics discussed include a study by PricewaterhouseCoopers which found NPEs accounting 67 percent of U.S. patent infringement lawsuits, five executive actions issued by U.S. President Barack Obama, directing the U.S. Patent and Trademark Office (USPTO) to increase patent system's transparency, and the decision held in the U.S. Supreme Court case Alice Corp Pty Ltd v. CLS Bank Intl.
- Published
- 2014
23. The Challenge of Examining Social Determinants of Health in People Living With Tourette Syndrome.
- Author
-
Dy-Hollins ME, Carr SJ, Essa A, Osiecki L, Lackland DT, Voeks JH, Mejia NI, Sharma N, Budman CL, Cath DC, Grados MA, King RA, Lyon GJ, Rouleau GA, Sandor P, Singer HS, Chibnik LB, Mathews CA, and Scharf JM
- Subjects
- Adolescent, Adult, Child, Child, Preschool, Female, Humans, Male, Young Adult, Educational Status, Ethnicity, Parents, United States, White, Racial Groups, Social Determinants of Health, Tourette Syndrome
- Abstract
Background: To examine the association between race, ethnicity, and parental educational attainment on tic-related outcomes among Tourette Syndrome (TS) participants in the Tourette Association of America International Consortium for Genetics (TAAICG) database., Methods: 723 participants in the TAAICG dataset aged ≤21 years were included. The relationships between tic-related outcomes and race and ethnicity were examined using linear and logistic regressions. Parametric and nonparametric tests were performed to examine the association between parental educational attainment and tic-related outcomes., Results: Race and ethnicity were collapsed as non-Hispanic white (N=566, 88.0%) versus Other (N=77, 12.0%). Tic symptom onset was earlier by 1.1 years (P < 0.0001) and TS diagnosis age was earlier by 0.9 years (P = 0.0045) in the Other group (versus non-Hispanic white). Sex and parental education as covariates did not contribute to the differences observed in TS diagnosis age. There were no significant group differences observed across the tic-related outcomes in parental education variable., Conclusions: Our study was limited by the low number of nonwhite or Hispanic individuals in the cohort. Racial and ethnic minoritized groups experienced an earlier age of TS diagnosis than non-Hispanic white individuals. Tic severity did not differ between the two groups, and parental educational attainment did not affect tic-related outcomes. There remain significant disparities and gaps in knowledge regarding TS and associated comorbid conditions. Our study suggests the need for more proactive steps to engage individuals with tic disorders from all racial and ethnic minoritized groups to participate in research studies., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: M.E.D.-H. has received research support from the Tourette Association of America and NIH K12NS098482. S.J.C., A.E., L.O., D.T.L., J.H.V., L.B.C., C.L.B., M.A.G., R.A.K., G.J.L., G.A.R., and P.S. report no disclosures relevant to the manuscript. N.I.M. receives funding for projects she leads: Massachusetts General Brigham receives funding from the following non-profit entities: Biogen Foundation, Massachusetts Life Sciences Center, and Muscular Dystrophy Association. N.S. has received research support from NIH grants NIH P01NS087997 and R21NS118541. Dr. Sharma has received honoraria from John Wiley Publishing for serving as editor-in-chief for Brain and Behavior. D.C.C. has no financial disclosures. She has been an unpaid member of the steering committee of the European Society for the Study of Tourette Syndrome (ESSTS) and is a member of the Dutch TS advisory board. H.S.S. receives royalties from the 3(rd) edition of book, Movement Disorders in Childhood, Elsevier. C.A.M. has received research support from NIH grants R01NS105746 and R01NS102371. She is an unpaid member of the International OCD Foundation Scientific and Clinical Advisory Board and the Family Foundation for OCD Research Advisory Board. J.M.S. has received research support from NIH grants R01NS105746 and R01NS102371. Dr. Scharf is also an unpaid member of the Tourette Association of America Scientific Advisory Board., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
- Published
- 2024
- Full Text
- View/download PDF
24. Age and Medicare Insurance are Barriers to Telemedicine Access-A Quality Improvement Project.
- Author
-
Madabhushi V, McLouth CJ, King R, Bhakta A, Beck S, and Patel JA
- Subjects
- Aged, Humans, United States, Quality Improvement, Appalachian Region, Kentucky, Medicare, Telemedicine
- Abstract
Background: Telehealth use has had widespread expansion and adoption over the past two years. This study aims to evaluate access to telehealth essentials (TE) using a novel metric., Methods: This single institute study surveyed outpatient surgical patients to determine their access to TE. Generalized linear mixed models were used to determine the relationship of demographic and county-level variables on access to four TE., Results: 138 patients were surveyed. Sixty-six (47.8%) were from Appalachian Kentucky. In the survey cohort, 122 (88.4%) had smart phones, 109 (80.7%) had devices with video messaging capabilities, 106 (80.9%) had cellular reception, and 112 (82.4%) had access to WiFi. Increasing age and Medicare insurance were the most consistent predictors of lack of access to TE., Conclusion: Rural Appalachian Kentucky has access to TE. Telehealth has the potential to decrease the healthcare inequity in rural populations, but incompletely address this inequity for the aging population.
- Published
- 2023
- Full Text
- View/download PDF
25. Measuring the effect of the COVID-19 pandemic on solid organ transplantation.
- Author
-
Suarez-Pierre A, Choudhury R, Carroll AM, King RW, Iguidbashian J, Cotton J, Colborn KL, Kennealey PT, Cleveland JC, Pomfret E, and Fullerton DA
- Subjects
- Adult, Cohort Studies, Humans, Pandemics, United States epidemiology, Waiting Lists, COVID-19 epidemiology, Organ Transplantation
- Abstract
Background: The COVID-19 pandemic has uniquely affected the United States. We hypothesize that transplantation would be uniquely affected., Methods: In this population-based cohort study, adult transplantation data were examined as time series data. Autoregressive-integrated-moving-average models of transplantation rates were developed using data from 1990 to 2019 to forecast the 2020 expected rates in a theoretical scenario if the pandemic did not occur to generate observed-to-expected (O/E) ratios., Results: 32,594 transplants were expected in 2020, and only 30,566 occurred (O/E 0.94, CI 0.88-0.99). 58,152 waitlist registrations were expected and 50,241 occurred (O/E 0.86, CI 0.80-0.94). O/E ratios of transplants were kidney 0.92 (0.86-0.98), liver 0.96 (0.89-1.04), heart 1.05 (0.91-1.23), and lung 0.92 (0.82-1.04). O/E ratios of registrations were kidney 0.84 (0.77-0.93), liver 0.95 (0.86-1.06), heart 0.99 (0.85-1.18), and lung 0.80 (0.70-0.94)., Conclusions: The COVID-19 pandemic was associated with a significant deficit in transplantation. The impact was strongest in kidney transplantation and waitlist registration., (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2022
- Full Text
- View/download PDF
26. Survival following lung transplantation: A population-based nested case-control study.
- Author
-
Iguidbashian J, Cotton J, King RW, Carroll AM, Gergen AK, Meguid RA, Fullerton DA, and Suarez-Pierre A
- Subjects
- Adult, Case-Control Studies, Female, Humans, Survival Rate, Transplant Recipients, United States epidemiology, Lung Transplantation, Tissue and Organ Procurement
- Abstract
Background: Lung transplantation is the mainstay of treatment for patients with end-stage respiratory failure. This study sought to evaluate survival following transplantation compared to the general population and quantify standardized mortality ratios (SMRs) using a nested case-control study design., Methods: Control subjects were nonhospitalized inhabitants of the United States identified through the National Longitudinal Mortality Study. Case subjects were adults who underwent lung transplantation between 1990 and 2007 and identified through the Organ Procurement and Transplantation Network. Propensity-matching (5:1, nearest neighbor, caliper = 0.1) was utilized to identify suitable control subjects based on age, sex, race, and location of residency. The primary study endpoint was 10-year survival., Results: About 14,977 lung transplant recipients were matched to 74,885 nonhospitalized US residents. The 10-year survival rate of lung transplant recipients was 28% (95% confidence interval [CI] = 27%-29%). The population expected mortality rate was 19 deaths/100 person-years while the observed ratio was 104 deaths/100 person-years (SMR = 5.39, 95% CI = 5.35-5.43). The largest discrepancies between observed and expected mortality rates were in females (SMR = 5.97), Hispanic (SMR = 10.70), and single lung recipients (SMR = 5.92). SMRs declined over time (1990-1995 = 5.79, 1996-2000 = 5.64, and 2001-2007 = 5.10). Standardized mortality peaks in the first year after transplant and decreases steadily over time., Conclusions: Lung transplant recipients experience a fivefold higher SMR compared to the nonhospitalized population. Long-term mortality rates have experienced consistent decline over time., (© 2022 Wiley Periodicals LLC.)
- Published
- 2022
- Full Text
- View/download PDF
27. Association Between Cardiorespiratory Fitness and Health Care Costs: The Veterans Exercise Testing Study.
- Author
-
Myers J, Doom R, King R, Fonda H, Chan K, Kokkinos P, and Rehkopf DH
- Subjects
- Aged, Female, Humans, Male, Middle Aged, Risk Factors, United States, Cardiorespiratory Fitness physiology, Cardiovascular Diseases economics, Cardiovascular Diseases therapy, Exercise Therapy economics, Health Care Costs statistics & numerical data, Physical Fitness physiology, Veterans statistics & numerical data
- Abstract
Objective: To determine the association between cardiorespiratory fitness (CRF) and annual health care costs in Veterans., Patients and Methods: The sample included 9942 subjects (mean age, 59±11 years) undergoing a maximal exercise test for clinical reasons between January 2005 and December 2012. Cardiorespiratory fitness, expressed as a percentage of age-predicted peak metabolic equivalents (METs) achieved, was categorized in quartiles. Total and annualized health care costs, derived from the Veterans Administration Allocated Resource Center, were compared using multiple regression, controlling for demographic and clinical characteristics., Results: A gradient for reduced health care costs was observed as CRF increased, with subjects in the least-fit quartile having approximately $14,662 (P<.001) higher overall costs per patient per year compared with those in the fittest quartile, after controlling for potential confounding variables. Each 1-MET higher increment in fitness was associated with a $1592 annual reduction in health care costs (5.6% lower cost per MET), and each higher quartile of fitness was associated with a $4163 annual cost reduction per patient. The effect of CRF was more pronounced among subjects without cardiovascular disease (CVD), suggesting that the results were not driven by the possibility that less-fit individuals had greater CVD. Cost savings attributable to higher fitness were greatest in overweight and obese subjects, with lower savings observed among those individuals with a body mass index less than 25 kg/m
2 . In a model including historical, clinical, and exercise test responses, heart failure was the strongest predictor of health care costs, followed by CRF (P<.01)., Conclusion: Low CRF is associated with higher health care costs. Efforts to improve CRF may not only improve health but also result in lower health care costs., (Published by Elsevier Inc.)- Published
- 2018
- Full Text
- View/download PDF
28. Social disinhibition is a heritable subphenotype of tics in Tourette syndrome.
- Author
-
Hirschtritt ME, Darrow SM, Illmann C, Osiecki L, Grados M, Sandor P, Dion Y, King RA, Pauls DL, Budman CL, Cath DC, Greenberg E, Lyon GJ, Yu D, McGrath LM, McMahon WM, Lee PC, Delucchi KL, Scharf JM, and Mathews CA
- Subjects
- Adolescent, Adult, Age of Onset, Attention Deficit Disorder with Hyperactivity epidemiology, Canada epidemiology, Comorbidity, Factor Analysis, Statistical, Female, Humans, Male, Netherlands epidemiology, Obsessive-Compulsive Disorder epidemiology, Phenotype, Tics diagnosis, Tics epidemiology, Tourette Syndrome diagnosis, Tourette Syndrome epidemiology, United Kingdom epidemiology, United States epidemiology, Young Adult, Inhibition, Psychological, Social Behavior, Tics genetics, Tourette Syndrome genetics
- Abstract
Objective: To identify heritable symptom-based subtypes of Tourette syndrome (TS)., Methods: Forty-nine motor and phonic tics were examined in 3,494 individuals (1,191 TS probands and 2,303 first-degree relatives). Item-level exploratory factor and latent class analyses (LCA) were used to identify tic-based subtypes. Heritabilities of the subtypes were estimated, and associations with clinical characteristics were examined., Results: A 6-factor exploratory factor analysis model provided the best fit, which paralleled the somatotopic representation of the basal ganglia, distinguished simple from complex tics, and separated out socially disinhibited and compulsive tics. The 5-class LCA model best distinguished among the following groups: unaffected, simple tics, intermediate tics without social disinhibition, intermediate with social disinhibition, and high rates of all tic types. Across models, a phenotype characterized by high rates of social disinhibition emerged. This phenotype was associated with increased odds of comorbid psychiatric disorders, in particular, obsessive-compulsive disorder and attention-deficit/hyperactivity disorder, earlier age at TS onset, and increased tic severity. The heritability estimate for this phenotype based on the LCA was 0.53 (SE 0.08, p 1.7 × 10(-18))., Conclusions: Expanding on previous modeling approaches, a series of TS-related phenotypes, including one characterized by high rates of social disinhibition, were identified. These phenotypes were highly heritable and may reflect underlying biological networks more accurately than traditional diagnoses, thus potentially aiding future genetic, imaging, and treatment studies., (© 2016 American Academy of Neurology.)
- Published
- 2016
- Full Text
- View/download PDF
29. GDNF gene is associated with tourette syndrome in a family study.
- Author
-
Huertas-Fernández I, Gómez-Garre P, Madruga-Garrido M, Bernal-Bernal I, Bonilla-Toribio M, Martín-Rodríguez JF, Cáceres-Redondo MT, Vargas-González L, Carrillo F, Pascual A, Tischfield JA, King RA, Heiman GA, and Mir P
- Subjects
- Adolescent, Adult, Child, Cohort Studies, Female, Humans, Male, Middle Aged, Pedigree, Polymorphism, Genetic, United States, Young Adult, Genetic Association Studies, Glial Cell Line-Derived Neurotrophic Factor genetics, Synaptic Transmission genetics, Tourette Syndrome genetics
- Abstract
Background: Tourette syndrome is a disorder characterized by persistent motor and vocal tics, and frequently accompanied by the comorbidities attention deficit hyperactivity disorder and obsessive-compulsive disorder. Impaired synaptic neurotransmission has been implicated in its pathogenesis. Our aim was to investigate the association of 28 candidate genes, including genes related to synaptic neurotransmission and neurotrophic factors, with Tourette syndrome., Methods: We genotyped 506 polymorphisms in a discovery cohort from the United States composed of 112 families and 47 unrelated singletons with Tourette syndrome (201 cases and 253 controls). Genes containing significant polymorphisms were imputed to fine-map the signal(s) to potential causal variants. Allelic analyses in Tourette syndrome cases were performed to check the role in attention deficit hyperactivity disorder and obsessive-compulsive disorder comorbidities. Target polymorphisms were further studied in a replication cohort from southern Spain composed of 37 families and three unrelated singletons (44 cases and 73 controls)., Results: The polymorphism rs3096140 in glial cell line-derived neurotrophic factor gene (GDNF) was significant in the discovery cohort after correction (P = 1.5 × 10(-4) ). No linkage disequilibrium was found between rs3096140 and other functional variants in the gene. We selected rs3096140 as target polymorphism, and the association was confirmed in the replication cohort (P = 0.01). No association with any comorbidity was found., Conclusions: As a conclusion, a common genetic variant in GDNF is associated with Tourette syndrome. A defect in the production of GDNF could compromise the survival of parvalbumin interneurons, thus altering the excitatory/inhibitory balance in the corticostriatal circuitry. Validation of this variant in other family cohorts is necessary., Competing Interests: Relevant conflicts of interest/financial disclosures: Nothing to report. Full financial disclosures and author roles may be found in the online version of this article., (© 2015 International Parkinson and Movement Disorder Society.)
- Published
- 2015
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.