4 results on '"Hannah Wild"'
Search Results
2. Disparities in detection of suspected child abuse
- Author
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Modupeola Diyaolu, Chaonan Ye, Zhuoyi Huang, Ryan Han, Hannah Wild, Lakshika Tennakoon, David A. Spain, and Stephanie D. Chao
- Subjects
Pediatrics, Perinatology and Child Health ,Surgery ,General Medicine - Abstract
Child abuse is a significant cause of injury and death among children, but accurate identification is often challenging. This study aims to assess whether racial disparities exist in the identification of child abuse.The 2010-2014 and 2016-2017 National Trauma Data Bank was queried for trauma patients ages 1-17. Using ICD-9CM and ICD-10CM codes, children with injuries consistent with child abuse were identified and analyzed by race.Between 2010-2014 and 2016-2017, 798,353 patients were included in NTDB. Suspected child abuse victims (SCA) accounted for 7903 (1%) patients. Of these, 51% were White, 33% Black, 1% Asian, 0.3% Native Hawaiian/Other Pacific Islander, 2% American Indian, and 12% other race. Black patients were disproportionately overrepresented, composing 12% of the US population, but 33% of SCA patients (p 0.001). Although White SCA patients were more severely injured (ISS 16-24: 20% vs 16%, p 0.01) and had higher in-hospital mortality (9% vs. 6%, p = 0.01), Black SCA patients were hospitalized longer (7.2 ± 31.4 vs. 6.2 ± 9.9 days, p 0.01) despite controlling for ISS (1-15: 4. 5.7 ± 35.7 vs. 4.2 ± 6.2 days, p 0.01). In multivariate regression, Black children continued to have longer lengths of stay despite controlling for ISS and insurance type.Utilizing a nationally representative dataset, Black children were disproportionately identified as potential victims of abuse. They were also subjected to longer hospitalizations, despite milder injuries. Further studies are needed to better understand the etiology of the observed trends and whether they reflect potential underlying unconscious or conscious biases of mandated reporters.Treatment study.III.
- Published
- 2023
- Full Text
- View/download PDF
3. Strengthening global health security by improving disease surveillance in remote rural areas of low-income and middle-income countries
- Author
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Katherine E L Worsley-Tonks, Jeff B Bender, Sharon L Deem, Adam W Ferguson, Eric M Fèvre, Dino J Martins, Dishon M Muloi, Suzan Murray, Mathew Mutinda, Darcy Ogada, George P Omondi, Shailendra Prasad, Hannah Wild, Dawn M Zimmerman, and James M Hassell
- Subjects
COVID-19 ,Humans ,General Medicine ,Global Health ,Developing Countries ,Pandemics ,Poverty - Abstract
The COVID-19 pandemic has underscored the need to strengthen national surveillance systems to protect a globally connected world. In low-income and middle-income countries, zoonotic disease surveillance has advanced considerably in the past two decades. However, surveillance efforts often prioritise urban and adjacent rural communities. Communities in remote rural areas have had far less support despite having routine exposure to zoonotic diseases due to frequent contact with domestic and wild animals, and restricted access to health care. Limited disease surveillance in remote rural areas is a crucial gap in global health security. Although this point has been made in the past, practical solutions on how to implement surveillance efficiently in these resource-limited and logistically challenging settings have yet to be discussed. We highlight why investing in disease surveillance in remote rural areas of low-income and middle-income countries will benefit the global community and review current approaches. Using semi-arid regions in Kenya as a case study, we provide a practical approach by which surveillance in remote rural areas can be strengthened and integrated into existing systems. This Viewpoint represents a transition from simply highlighting the need for a more holistic approach to disease surveillance to a solid plan for how this outcome might be achieved.
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- 2022
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4. Surgery for adrenocortical carcinoma: When and how?
- Author
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Electron Kebebew, Hannah Wild, Andrea Gillis, Tiffany J. Sinclair, and Wilson M. Alobuia
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Time Factors ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Malignancy ,Asymptomatic ,Metastasis ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Positron Emission Tomography Computed Tomography ,Adrenocortical Carcinoma ,medicine ,Humans ,Adrenocortical carcinoma ,Neoplasm Metastasis ,Stage (cooking) ,Pelvis ,Neoplasm Staging ,medicine.diagnostic_test ,business.industry ,Liver Neoplasms ,Adrenalectomy ,Prognosis ,medicine.disease ,Magnetic Resonance Imaging ,Adrenal Cortex Neoplasms ,Surgery ,030104 developmental biology ,medicine.anatomical_structure ,Positron emission tomography ,Abdomen ,medicine.symptom ,Tomography, X-Ray Computed ,business - Abstract
Adrenocortical carcinoma (ACC) is a rare malignancy that is frequently asymptomatic at presentation, yet has a high rate of metastatic disease at the time of diagnosis. Prognosis is overall poor, particularly with cortisol-producing tumors. While the treatment of ACC is guided by stage of disease, complete surgical resection is the most important step in the management of patients with primary, recurrent, or metastatic ACC. Triphasic chest, abdomen, and pelvis computer tomography (CT) scans and 18F flourodeoxyglucose positron emission tomography CT scanning are essential for accurate staging; moreover, MRI may be helpful to identify liver metastasis and evaluate the involvement of adjacent organs for operative planning. Surgical resection with negative margins is the single most important prognostic factor for survival in patients with ACC. To achieve the highest rate of R0 resection, open adrenalectomy is the gold standard surgical approach for confirmed or highly suspected ACC. It is extremely important that the tumor capsule is not ruptured, regardless of the surgical approach used. The best post-operative outcomes (complications and oncologic) are achieved by high-volume surgeons practicing at high-volume centers.
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- 2020
- Full Text
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