A National Survey of Hand Surgeons: Understanding the Rural Landscape

Hand ◽  
2021 ◽  
pp. 155894472110588
Author(s):  
Joseph Meyerson ◽  
Andrew Liechty ◽  
Tyler Shields ◽  
David Netscher
Keyword(s):  
Employment Status ◽  
Community Hospital ◽  
Hand Surgery ◽  
Rural Landscape ◽  
Metropolitan Region ◽  
The Us ◽  
Case Type ◽  
American Society ◽  
Multispecialty Group ◽  
Shed Light

Background: Twenty percent of the US population is described as being rural and may have limited access to hand surgeons, especially on an emergency basis. Little is known about case type, call hours, employment status, and other relevant details of rural hand surgery. Methods: We surveyed members of the American Society of Surgery for the Hand to begin to describe the problem. Results: There were 471 responses from 2256 members surveyed with 387 completing 100% of questions asked. Ninety (19%) identified themselves as primarily located in a rural population and 381 (81%) in a metropolitan region. In our study, rural hand surgeons were more likely to be employed by a community hospital, followed by independent private practice, multispecialty group, academics, and then locum tenens. Rural surgeons’ practices were 80% solely hand surgery, while metropolitan surgeons’ practices were 89% ( P < .01). Metropolitan surgeons felt that of the transfers from rural facilities, 46% did not need emergency hand care and that 60% of the time, there was not actually a need for specialty hand surgery care. Conclusions: Our survey begins to shed light on the details of rural hand surgery practice. We found that rural surgeons are more likely to be employed in community hospitals and take more call. When available, hand surgery specialists could prevent unnecessary transfer of patients to metropolitan areas. More work needs to be done to describe the differences between rural and metropolitan hand surgery practices as well as create rural hand surgeons.

Study of Structural Change in Paddy Agriculture under Reorganization of Direct Payment Policy

Impact ◽  
2020 ◽  
Vol 2020 (6) ◽  
pp. 55-57
Author(s):  
Kunio Nishikawa
Keyword(s):  
Structural Change ◽  
Rice Production ◽  
Direct Payment ◽  
Japan Society ◽  
Payment Policy ◽  
The Us ◽  
Shed Light

Rice has long been an integral part of Japan's culture and economy, as well as an important commodity in Japan-US relations, but farmers in Japan are concerned that trouble is afoot due to competition from countries such as the US, where rice production is more competitive, as well as reorganization of direct payment policy. The question is, how can rice production in Japan remain competitive amidst such competition? One researcher is seeking to shed light on the situation and explore how paddy agriculture in Japan can potentially flourish. Dr Kunio Nishikawa is based at Ibaraki University, Japan, whose Japan Society for the Promotion of Science (JSPS)-funded work is exploring the discrepancy in crop output in the US versus Japan, and seeking to find new ways to boost Japan's agriculture.

Progressive Catholicism in the United States

2018 ◽  
Author(s):  
Matthew A. Shadle
Keyword(s):  
Common Good ◽  
The United States ◽  
Economic Life ◽  
Ethical Framework ◽  
Social Teaching ◽  
American Catholicism ◽  
The Common Good ◽  
The Us ◽  
The Common ◽  
American Society

American Catholicism has long adapted to US liberal institutions. Progressive Catholicism has taken the liberal values of democratic participation and human rights and made them central to its interpretation of Catholic social teaching. This chapter explores in detail the thought of David Hollenbach, S.J., a leading representative of progressive Catholicism. Hollenbach has proposed an ethical framework for an economy aimed at the common good, ensuring that the basic needs of all are met and that all are able to participate in economic life. The chapter also looks at the US Catholic bishops’ 1986 pastoral letter Economic Justice for All, which emphasizes similar themes while also promoting collaboration between the different sectors of American society for the sake of the common good.

Re-municipalization of local public services: incidence, causes and prospects

2021 ◽  
pp. 002085232110064
Author(s):  
Daniel Albalate ◽  
Germà Bel ◽  
Raymond Gradus ◽  
Eoin Reeves
Keyword(s):  
Public Management ◽  
Public Services ◽  
Turn Of The Century ◽  
The Public ◽  
Local Public Services ◽  
High Profile ◽  
Global Trend ◽  
The Us ◽  
House Production ◽  
Shed Light

Since the turn of the century, a global trend of re-municipalization has emerged, with cities reversing earlier privatizations and returning infrastructure and public service delivery to the public sector. The reversal of privatization measures is not an entirely new phenomenon. In the US, for example, returning public services to in-house production has been a long-standing feature of ‘pragmatic public management’. However, many cases of re-municipalization that have occurred since the early 2000s represent a distinctive shift from earlier privatization policies. High-profile cases in cities including Paris and Hamburg have thrust re-municipalization into the limelight as they have followed public campaigns motivated by dissatisfaction with the results of privatization and a desire to restore public control of vital services, such as water and energy. Just as the reform of public services towards privatization spawned a vast body of scholarship, the current re-municipalization phenomenon is increasingly attracting the attention of scholars from a number of disciplinary perspectives. The articles contained in this symposium contribute to this emerging literature. They address some of the burning issues relating to re-municipalization, but they also point to issues yet to be resolved and shed light on a research agenda that is still taking shape.

Assessment of the Implementation of AUC Dosing and Monitoring Practices With Vancomycin at Hospitals Across the United States

2021 ◽  
pp. 089719002110123
Author(s):  
Nicole Bradley ◽  
Yuman Lee ◽  
Muaz Sadeia
Keyword(s):  
The United States ◽  
Descriptive Statistics ◽  
Therapeutic Drug ◽  
User Friendliness ◽  
Electronic Survey ◽  
The Us ◽  
Institutional Adoption ◽  
American Society ◽  
Trough Levels ◽  
Do So

Introduction: The latest vancomycin therapeutic drug monitoring guidelines for serious MRSA infections have made a pivotal change in dosing, switching from targeting trough levels to AUC dosing. Because of these new recommendations, antimicrobial stewardship programs across the country are tasked with implementing AUC based dosing. Objectives: To assess plans for institutional adoption of vancomycin AUC dosing programs and perceptions of currently used programs in hospitals across the US. Methods: An electronic survey was distributed to members of the American College of Clinical Pharmacy IDprn Listserv and American Society of Health-System Pharmacists between May and June 2020 to assess current institutional vancomycin dosing. Institutional program use and multiple software user parameters were analyzed using descriptive statistics. Results: Two hundred two pharmacists responded to the survey with the majority practicing in institutions with 251-500 beds. Most respondents have yet to implement AUC dosing (142/202, 70.3%) with many of them planning to do so in the next year (81/142, 57.0%). Of those that already implemented AUC dosing programs, purchased Bayesian software (23/60, 38.3%) and homemade software (21/60, 35.0%) were the 2 methods most frequently utilized. Purchased Bayesian software users were more likely to recommend their software to other institutions and ranked user friendliness higher compared to non-purchased software. Conclusion: Most respondents have not made the switch to vancomycin AUC dosing, but there is a growing interest with many institutions looking to adopt a program within the next year.

The effect of Medicare Part D on prescription drug composition and demand

2015 ◽  
Vol 42 (2) ◽  
pp. 170-185 ◽  
Author(s):  
David Zimmer
Keyword(s):  
Prescription Drug ◽  
Medicare Part D ◽  
Medicare Part ◽  
Part D ◽  
Content Type ◽  
The Us ◽  
Upper Respiratory ◽  
Nationally Representative ◽  
The Impact ◽  
Shed Light

Purpose – The US Medicare Modernization Act of 2003 introduced optional prescription drug coverage, beginning in 2006, widely known as Medicare Part D. This paper uses up-to-date nationally representative survey data to investigate the impact of Part D not only on drug spending and consumption, but also on the composition of drug consumption. The paper aims to discuss these issues. Design/methodology/approach – Specifically, the paper investigates whether Part D impacted the number of therapeutic classes for which drugs were prescribed, and also whether Part D lead to increased usage of drugs for specific medical conditions that typically receive drug-intensive therapies. Findings – In addition to confirming findings from previous studies, this paper shows that Part D increased the number of therapeutic classes to which seniors receive drugs by approximately four classes. Part D also lead to increased usage of drugs used to treat upper respiratory disease, hypertension, and diabetes. Originality/value – While mostly concurring with previous studies on the spending impacts of Part D, this paper is the first to shed light on other impacts of Part D, specifically with respect to its impact on therapeutic classes for which drugs are prescribed.

scholarly journals Substance Use and Cumulative Exposure to American Society: Findings From Both Sides of the US–Mexico Border Region

2016 ◽  
Vol 106 (1) ◽  
pp. 119-127 ◽  
Author(s):  
Guilherme Borges ◽  
Cheryl J. Cherpitel ◽  
Ricardo Orozco ◽  
Sarah E. Zemore ◽  
Lynn Wallisch ◽  
...  
Keyword(s):  
Substance Use ◽  
Border Region ◽  
Cumulative Exposure ◽  
The Us ◽  
Mexico Border ◽  
American Society ◽  
Us Mexico Border

I

1986 ◽  
Vol 80 (4) ◽  
pp. 896-901 ◽  
Author(s):  
Manfred Lachs
Keyword(s):  
International Law ◽  
The United States ◽  
Second World War ◽  
World War ◽  
International Court Of Justice ◽  
International Court ◽  
History Of ◽  
American Society ◽  
Second World ◽  
Shed Light

To write of Philip Jessup means to survey the history of the teaching of international law in the United States throughout the last half century; to cover all important events concerning the birth of international organizations on the morrow of the Second World War; to visit the halls of the General Assembly and the Security Council; to attend meetings of the American Society of International Law and the Institute of International Law, where he so frequently took the floor to shed light on their debates; to attend sittings of the International Court of Justice in the years 1960-1969. I could hardly undertake this task; there are others much more qualified to do so. What I wish to do is to recall him as a great jurist I knew and a delightful human being; in short, a judge and a great friend whom I learned to admire.

scholarly journals The integrative force of political institutions? Direct democracy and voter turnout across ethnic and nativity groups

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Anita Manatschal
Keyword(s):  
Voter Turnout ◽  
Political Institutions ◽  
Direct Democracy ◽  
First Generation ◽  
The Us ◽  
Alternative Measures ◽  
Hispanic Voters ◽  
Democratic Elections ◽  
Positive Effect ◽  
Shed Light

AbstractMuch has been written on the positive effect of direct democracy (initiatives, referendums) on voter turnout. However, we have limited knowledge about potential differential effects on voters belonging to various ethnic groups. The paper argues that depending on a group’s responsiveness to the political context, direct democracy can (dis-)integrate voters (from) into the electorate. Empirical analysis of Current Population Survey (CPS) voting supplement survey data, together with data on the absolute use of direct democracy across US states, corroborates this theoretical expectation, however lending more support for the disintegrating assumption. Frequent direct democratic elections further widen the negative voting gap between first-generation Asian voters and voters living in the US for three generations or longer, whereas they tend to diminish this voting gap for first-generation Hispanic voters. The disintegrative pattern for first-generation Asian voters remains even significant when excluding California from the state sample, yet not the integrative tendency for first-generation Hispanics. Additional analyses using alternative measures of direct democracy and voting, and applying statistical adjustments to address causality concerns, confirm the robustness of these findings, which shed light on the so-far underexplored (dis-)integrative potential of political institutions.

COVID-19 as an Extreme Event in the New York Metropolitan Region

2021 ◽  
Author(s):  
Peter J. Marcotullio ◽  
William D. Solecki
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Extreme Event ◽  
Metropolitan Region ◽  
Special Issue ◽  
The Us ◽  
The World ◽  
Deadly Disease

During early 2020, the world encountered an extreme event in the form of a new and deadly disease, COVID-19. Over the next two years, the pandemic brought sickness and death to countries and their cities around the globe. One of the first and initially the hardest hit location was New York City, USA. This article is an introduction to the Special Issue in this journal that highlights the impacts from and responses to COVID-19 as an extreme event in the New York City metropolitan region. We overview the aspects of COVID-19 that make it an important global extreme event, provide brief background to the conditions in the world, and the US before describing the 10 articles in the issue that focus on conditions, events and dynamics in New York City during the initial phases of the pandemic.

scholarly journals Reimbursement of Apps for Mental Health: Findings From Interviews

10.2196/14724 ◽  
2019 ◽  
Vol 6 (8) ◽  
pp. e14724 ◽  
Author(s):  
Adam C Powell ◽  
Matthias B Bowman ◽  
Henry T Harbin
Keyword(s):  
Mental Health ◽  
Care Delivery ◽  
Coding System ◽  
Reimbursement Mechanisms ◽  
Common Procedure ◽  
The Us ◽  
Varied Range ◽  
Potential Channels ◽  
Physician Work ◽  
Shed Light

Background Although apps and other digital and mobile health tools are helping improve the mental health of Americans, they are currently being reimbursed through a varied range of means, and most are not being reimbursed by payers at all. Objective The aim of this study was to shed light on the state of app reimbursement. We documented ways in which apps can be reimbursed and surveyed stakeholders to understand current reimbursement practices. Methods Individuals from over a dozen stakeholder organizations in the domains of digital behavioral and mental health, care delivery, and managed care were interviewed. A review of Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCSPCS) codes was conducted to determine potential means for reimbursement. Results Interviews and the review of codes revealed that potential channels for app reimbursement include direct payments by employers, providers, patients, and insurers. Insurers are additionally paying for apps using channels originally designed for devices, drugs, and laboratory tests, as well as via value-based payments and CPT and HCSPCS codes. In many cases, it is only possible to meet the requirements of a CPT or HCSPCS code if an app is used in conjunction with human time and services. Conclusions Currently, many apps face significant barriers to reimbursement. CPT codes are not a viable means of providing compensation for the use of all apps, particularly those involving little physician work. In some cases, apps have sought clearance from the US Food and Drug Administration for prescription use as digital therapeutics, a reimbursement mechanism with as yet unproven sustainability. There is a need for simpler, more robust reimbursement mechanisms to cover stand-alone app-based treatments.

Sign in / Sign up

Export Citation Format

Share Document