Individual and county level predictors of asthma related emergency department visits among children on Medicaid: A multilevel approach

Objective: Disparities in asthma outcomes are well documented in the United States. Interventions to promote equity in asthma outcomes could target factors at the individual and community levels. The objective of this analysis was to understand the effect of individual (race, gender, age, and preventive inhaler use) and county-level factors (demographic, socioeconomic, health care, air-quality) on asthma emergency department (ED) visits among Medicaid-enrolled children. This was a retrospective cohort study of Medicaid-enrolled children with asthma in 29 states in 2009. Multilevel regression models of asthma ED visits were constructed utilizing individual-level variables (race, gender, age, and preventive inhaler use) from the Medicaid enrollment file and county-level variables reflecting population and health system characteristics from the Area Resource File (ARF). County-level measures of air quality were obtained from Environmental Protection Agency (EPA) data. Results: The primary modifiable risk factor at the individual level was found to be the ratio of long-term controller medications to total asthma medications. County-level factors accounted for roughly 6% of the variance in the asthma ED visit risk. Increasing county-level racial segregation (OR=1.04, 95% CI=1.01-1.08) was associated with increasing risk of asthma ED visits. Greater supply of pulmonary physicians at the county level (OR=0.81, 95% CI=0.68-0.97) was associated with a reduction in risk of asthma ED visits. Conclusions: At the patient care level, proper use of controller medications is the factor most amenable to intervention. There is also a societal imperative to address negative social determinants, such as residential segregation.     

The King laryngeal tube: a mimic of esophageal intubation in the emergency department

The King Airway is a temporary airway device used primarily in the pre-hospital setting and typically exchanged for an endotracheal tube upon arrival to the emergency department. Since this usually occurs before imaging, many radiologists are unfamiliar with the King Airway. This lack of familiarity can have important consequences for the patient and treating team. The purpose of this article is to raise awareness of the King Airway among radiologists, emphasize appropriate positioning, and review the imaging complications of incorrect positioning.     

Fate of abstracts presented at the annual meetings of the American association of clinical anatomists

A recent study examined the rate of full‐length research paper publication following abstract presentation at the British association of clinical anatomists (BACA) annual meetings. The accepted standard for research dissemination is peer‐reviewed publication following presentation at a national or international meeting. The study objectives were quantitative assessment of the abstracts presented at the American Association of Clinical Anatomists' (AACA) annual meetings with regards to the rate of subsequent full‐length publication and comparison to BACA publication rates. All abstracts presented at the AACA annual meetings between 2003 and 2010 were analysed. MEDLINE was searched to identify peer‐reviewed publications arising from each presented abstract. In total, 1,120 abstracts were presented with 22.9% (n = 257) subsequently published as full‐length research papers. The mean number of abstracts presented each year was 140.0 ± 35.9. The median time to publication was 16 months. Chi‐squared analysis showed the publication rate of abstracts presented at AACA (22.9%) was not statistically significantly different to BACA (20.4%) (P = 0.09). A total of 11.3% (n = 29) of the articles were published as full‐length research articles before presentation as an abstract at an AACA meeting compared to 5.4% of abstracts presented at a BACA meeting. These rates are lower but comparable to those of surgical specialty meetings. Further work should try to identify any concerning reasons for the reduced rate of abstract publication in anatomical research. Clin. Anat. 30:140–144, 2017. © 2017 Wiley Periodicals, Inc.     

Continuing Medical Education Activity in Echocardiography

Article Title: Transesophageal Echocardiographic Assessment of Pulmonary Veins and Left Atrium in Patients Undergoing Atrial Fibrillation Ablation (Echocardiography 2011;28:774)