State Of New York Research Articles

Introduction: Love Is Solidarity in Action

Introduction:Love Is Solidarity in Action Rashida L. Harrison (bio), Mary Frances Phillips (bio), and Nicole M. Jackson (bio) On November 24, 2021, we watched as a white southern judge reported the verdicts determined by a marjority white jury; they convicted two white men of murdering Ahmaud Arbery, a Black man, while a third, received guilty verdicts for his actions as an accomplice. Arbery, a twenty-five-year-old Black man, was out jogging in a white neighborhood when he was violently pursued by a retired police officer and his son. They claimed Arbery was responsible for several thefts in the predominantly white neighborhood. Many of us were holding our breaths and exhaling a little more with each guilty count. The week prior, however, we experienced a collective anger as a seventeen-year-old white teenager was acquitted for several counts of homicide, even as he purportedly left his home with a loaded assault rifle and drove roughly thirty minutes away to "help protect private property and serve as a medic" at a Black Lives Matter demonstration. Protestors of all backgrounds were out in support of an unarmed Black man, Jacob Blake, who was shot by a white police officer seven times in Kenosha, Wisconsin. Even as the two men killed were white, they supported Black lives, and their lives were rendered inconsequential. The white teenager who was acquitted was rewarded for his loyalty to white supremacy as sanctioned by the state. As has been required in countless instances surrounding the extralegal lynching of Black bodies, the survival of Black people over those two weeks has been preserved because love imbues us with hope and the energy to continue the fight for justice. We began our coediting journey thinking about freedom and justice. As our conversations evolved, we often came back to the question of what motivates and sustains Black communities. We came back to love and care as core to our foundation. [End Page 12] In our early discussions, we realized the necessity for ongoing attention to a canon of Black love, particularly within Black feminist traditions. We had several discussions among ourselves about the meaning of love, the historical approach to uncovering Black love, and the barriers to teasing out moments of love in a past too often shaped by violence. We realized that Black love is not always an explicit theme in the writings of Black scholars, but it can function as the prevailing framework in which we research. This realization offered a myriad of possibilities, most importantly, the notion that a conceptualization of love is intertwined with a pursuit of justice. It is from here that we began to reinvision both the intentional and unintentional acts of justice that amount to a particular expression of Black love. We turn to two less obvious examples of public acts of love and the gendered nature of enacting love and care for people of color. Even as they occur in the U.S., they illustrate transnational solidarities. The example of activist and immigrant from the Democratic Republic of Congo Therese Patricia Okoumou opened conversations about how we "do love." Okoumou climbed the Statue of Liberty on July 4, 2018, in protest of the federal government's policy separating immigrant children from their parents at the U.S. border. After being found guilty by the state of New York, she defined her political action as centered in empathy and care for dispossessed people. Okoumou's protest to climb the Statue of Liberty highlighted that instead of welcoming them "what we showed them is cages. So, if I go in a cage with them, I am on the right side of history." Her activism is firmly rooted in empathy, offering the potential for radical solidarity based on love. During the summer of 2018, another event held the attention of Black and brown communities during an Atlanta Braves baseball game. Players, Curacaoan, Ozzie Albies and Venezuelan-born Ronald Acuna Jr. shared an intimate embrace in the dugout. There were varied responses to this public display, which ultimately denied these men the space to show affection, demonstrating the depths of toxic masculinity and the feminization of emotion. But, as one person commented on...

Life cycle assessment of behind-the-meter Bitcoin mining at US power plant.

PurposeDue to its highly energy-intensive process, Bitcoin has attracted the global attention of climate research and media. At the time of this submission, behind-the-meter Bitcoin mining has gained significant traction; however, not a single environmental impact assessment has been conducted on this type of operation. This study seeks to fill the gap, applying the established Life Cycle Assessment methodology to estimate the environmental footprint of a single case study.MethodsA life cycle assessment methodology of a natural gas power plant mining Bitcoin behind-the-meter in the state of New York following the ISO 14040 guidelines was applied. The functional unit (FU) is defined as the attributed generation capacity of 14 MW over the course of a regular full-calendar year in the attributional model. The FU is scaled to 22 MW and 104 MW in the predictive models to represent planned expansion. The TRACI 2.1 method was applied to characterize the environmental impact. The environmental impact categories considered in this study included global warming, acidification, smog formation, and particulate emissions.Results and discussionLocated in New York State, Greenidge LLC, a natural gas power plant produces an estimated 88,440 metric tons of CO2-eq per year to mine Bitcoin behind-the-meter. Annual emissions would total 656,983 metric tons of CO2-eq if the plant devotes 100% of its generation to Bitcoin mining. The primary driver of greenhouse gas emissions is the generation of electricity itself, accounting for ~ 79% of the total emissions. At full capacity, annual emissions are comparable to the annual emissions of 140,000 passenger vehicles or the emissions resulting from the burning of 600 million lb of coal. Further, additional planned cases could produce an estimated 1.9 million tons tCO2-eq per annum.ConclusionsBehind-the-meter Bitcoin mining makes the power plant a significant contributor to global warming at a time when New York State is attempting to radically reduce its greenhouse gas emissions by 85% by 2050 and to have 100% carbon-free electricity by 2040. The environmental impact of this business model is not limited to individual sites but is spread out over upstream impacts as well. In combination, we see that behind-the-meter Bitcoin mining not only goes against local climate initiatives but also poses a significant danger to national initiatives due to feasible scalability, caused by an availability of existing infrastructure and favorable financials.Supplementary informationThe online version contains supplementary material available at 10.1007/s11367-022-02025-0.

Maltreatment Related Hospitalizations Among Children Ages 17 Years and Younger: New York State, 2011-2013.

Child maltreatment is an important societal and public health problem. However, there are limited data on the epidemiology of maltreatment related hospitalizations. The objective of this study was to describe maltreatment related hospitalizations among children ages 17 and younger in New York State (NYS). Using 2011-2013 statewide planning and research cooperative system (SPARCS) inpatient hospital discharge data, maltreatment related hospitalizations among children ages 17years and younger were identified using international classification of diseases, ninth revision, clinical modification codes for diagnoses and external cause of injury. Distributions of demographic and inpatient care characteristics were compared between hospitalizations for maltreatment and those for other causes, and between different types of maltreatment, using chi-square tests (for categorical variables) and t-tests (for continuous variables). During 2011-2013, a total of 853 maltreatment related hospitalizations among 836 children ages 17years and younger were documented in NYS SPARCS. Infants (children < 1) had the highest rates of hospitalization. Overall, physical abuse was the most prevalent maltreatment type reported. This is the first study in NYS to describe the epidemiology of child maltreatment hospitalizations; it establishes a statewide baseline for this public health and societal issue.

Mary T Bassett: more justice, more equity, better health for all

Having spent, in her words, “a lifetime working at the intersection of health and social justice”, it seems like a natural choice for Mary Travis Bassett, former director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University (Cambridge, MA, USA), to become the new Health Commissioner for the state of New York (USA) from December 2021, an appointment now confirmed by the New York State Senate. In our interview, Bassett was emphatic that one of the most important goals in her new appointment will be to address the health inequities in New York driven by structural racism and economic disparities.

Mortality of workers employed in refractory ceramic fiber manufacturing: An update.

This study evaluates the possible association between refractory ceramic fiber (RCF) exposure and all causes of death. Current and former employees (n = 1,119) hired from 1952 to 1999 at manufacturing facilities in New York (NY) state and Indiana were included. Work histories and quarterly plant-wide sampling from 1987 to 2015 provided cumulative fiber exposure (CFE) estimates. The full cohort was evaluated as well as individuals with lower and higher exposure, <45 and ≥45 fiber-months/cc. The Life-Table-Analysis-System was used for all standardized mortality rates (SMRs). Person-years at risk were accumulated from start of employment until 12/31/2019 or date of death. There was no significant association with all causes, all cancers, or lung cancer in any group. In the higher exposed, there was a significant elevation in both malignancies of the "urinary organs" (SMR = 3.59, 95% confidence interval [CI] 1.44, 7.40) and "bladder or other urinary site" (SMR = 4.04, 95% CI 1.10, 10.36), which persisted in comparison to regional mortality rates from NY state and Niagara County. However, six of the nine workers with urinary cancers were known smokers. In the lower exposed, there was a significant elevation in malignancies of the lymphatic and hematopoietic system (SMR = 2.54, 95% CI 1.27, 4.55) and leukemia (SMR = 4.21, 95% CI 1.69, 8.67). There was one pathologically unconfirmed mesothelioma death. A second employee currently living with a pathologically confirmed mesothelioma was identified, but the SMR was non-significant when both were included in the analyses. The association of these two mesothelioma cases with RCF exposure alone is unclear because of potential past exposure to asbestos.

Tracking the New York State Faculty Shortage: Report on the Schools and Faculty Survey 2013 and 2017

Background: This secondary analysis of existing data compared the results of the 2013 New York State (NYS) Nursing Schools and Faculty Report Survey to the results of a replication study completed in 2017. The NYS Council of Deans representing baccalaureate and higher degree programs in NYS and the Council of Associate Degree Nursing were surveyed in academic years 2012-2013 and 2016-2017 (referenced as 2013 and 2017, respectively). Objective: The purpose of this study was to provide detailed and aggregate baseline data about NYS nursing schools' capacity in relation to the number, characteristics, distribution, vacancy rates, and retirement plans of faculty and to contextualize these findings in current national trends. While the issue of nursing faculty shortage is not new in NYS, two studies were conducted in academic years 2012-2013 and 2016-2017, respectively, that examined the rate of nursing faculty vacancies and factors contributing to the nursing faculty shortage. In addition, the secondary analysis revealed trends that have implications for the current and future state of New York States' ability to prepare an adequate nursing workforce. Methodology: Data analysis included 22 questions that appeared on both surveys. The survey response rate was 71.4% in 2013 and 43% in 2017. SPSS was used for data analysis. Descriptive statistics summarize the data and identify patterns and trends between the two data collection points. Results: Faculty gender composition remained unchanged from 2013 to 2017, with 92% women and 8% men. Race and ethnicity of faculty also remained stable in 2013 and 2017, with 78% and 79% of faculty reported as White, respectively. There was little change in the percentage of minority faculty. Most faculty were between the ages of 50 and 59 years (35% in 2013 and 31% in 2017). The master's degree was the highest level of degree for most nursing faculty at 64% in 2013 and 63% in 2017. The top strategy used by nursing schools to fill vacancies was to hire more adjunct faculty, while the most cited strategy to recruit full-time faculty was to increase salaries. The most cited reason for the separation of faculty in 2013 was that faculty accepted a position elsewhere (31%), and in 2017 the most cited reason was retirement (49%). Limitations: The limitations of this analysis include: (a) decrease in survey response rates between the two survey periods, since response rates are a potential source of bias, and (b) the wording of questions was not identical in some cases, which could have led to different responses based on how the question was worded. Conclusions and Recommendations: Complex factors contribute to the NYS faculty shortage and include an aging faculty, increasing retirements, lack of diversity, and low compensation. These results mirror the results of national surveys on the faculty shortage, indicating that NYS needs to take action now to address the nursing pipeline issue.

Covid Conversations 5: Robert Wilson

World-renowned for having made a totally new kind of theatre, director-designer Robert Wilson first astonished international audiences in Paris in 1971 with Le Regard du sourd (Deafman Glance) and then with his twenty-four-hour Ouverture at the first edition of the Festival d’Automne in 1972. He also refers in this Conversation to Einstein on the Beach, premiered at the Avignon Festival in 1976, as another example among more of France offering him a home before he eventually founded the Watermill Center in 1992 on Long Island in the State of New York. Watermill, a laboratory for multidisciplinary creativity, opened its doors to the public in 2006 and is a focal point of the Conversation as a whole. Wilson’s immediately pre-Covid-pandemic production of The Messiah by Mozart was premiered at the Mozartwoche Salzburg in February 2020 and performed subsequently in Paris during a brief Covid ‘lull’ in September of that year. Discussion of this pivotal work leads to reflections on the opera productions that he had staged not so long before it, emphasizing the elements fundamental to his compositions – light, time, space, architecture, and silence. The Conversation, followed by audience questions addressed to Wilson, took place live online and on Facebook on 4 December 2020 as a prelude to the Festival Internacional Santiago a Mil in Chile, which opened on 3 January 2021. This was the Festival’s twenty-eighth year, but in a significantly restricted form due to Covid-19. A sequel to the Santiago interchange, also online but this time located in Paris, occurred on 17 September 2021. It resumes dialogue mainly on the Watermill Center’s broader cultural and social goals in the present and for the future, noting as well Wilson’s then current activities in Paris: a heavy schedule of four productions from the beginning of September to the end of December 2021, and a sound installation planned for 2022.Maria Shevtsova gratefully thanks the Fundación Teatro a Mil and its General Director Carmen Romero for their initiative in inviting Robert Wilson with her to converse publicly as part of the Festival a Mil, and for permission to edit the transcript for publication in New Theatre Quarterly. Thanks are due to interpreters Margit Schmohl and Jorge Ramirez, and to Maria Luisa Vergara for organizing the audience participation included below, as well as to Alfonso Arenas, former Coordinator of the Education and Communities Area at the Theatre Foundation a Mil. Warmest gratitude is extended to Robert Wilson for his generosity in all sorts of ways, and not least for finding the time to continue the Conversation in Paris. Thanks for their kind support to Nuria Moreno, Production at Teatro Real Madrid, Christof Belka, Executive Director of RW Work Ltd, Clifford Allen, Director of Archives of the Watermill Center, and Leesa Kelly and Noah Khoshbin, curators of the 2021 outdoor exhibition Minneapolis Protest Murals at the Crossroads Summer Festival held at the Watermill Center. The exhibition presented 190 public artworks from the 900 boards of the Minneapolis Protest Murals which were created organically in Minneapolis following the murder of George Floyd on 25 May 2020. Special thanks for their gift of images are given to photographers Lucie Jansch, Javier del Real, Kristian Kruuser and Kaupo Kikkas, Lovik Delger Ostenrik, and Martyna Szczesna. Kunsang Kelden and Maria Shevtsova transcribed this Conversation in two parts. Shevtsova, Editor of New Theatre Quarterly and author of Robert Wilson (Routledge, 2007; updated edition, 2019) edited and annotated the combined transcript for publication.

Association of Emergency Department Payer Mix with ED Receipt of Telehealth Services: An Observational Analysis.

IntroductionTelehealth is commonly used to connect emergency department (ED) patients with specialists or resources required for their care. Its infrastructure requires substantial upfront and ongoing investment from an ED or hospital and may be more difficult to implement in lower-resourced settings. Our aim was to examine for an association between ED payer mix and receipt of telehealth services.MethodsUsing data from the National Emergency Department Inventory (NEDI)-USA 2016 survey, we categorized EDs based on receipt of telehealth services (yes/no). The NEDI-USA data for EDs in New York state was linked with data from state ED datasets (SEDD) and state inpatient data (SID) to determine EDs’ payer mix (percent self-pay or Medicaid). Other ED characteristics of interest were rural location, academic status, and annual ED visit volume. We compared EDs with and without telehealth receipt, and used a logistic regression model to examine the relationship between ED payer mix and telehealth receipt after accounting for other ED characteristics.ResultsOf the 162 New York EDs in the SEDD-SID dataset, 160 (99%) were linked to the NEDI-USA dataset and 133 of those responded (83%) to the survey. Telehealth receipt was reported by 48 EDs (36%, 95% confidence interval [CI], 28–44%). Emergency departments with and without telehealth receipt were similar (all P >0.40) with respect to rurality (6% vs 9%, respectively), academic status (13% vs 8%), and annual volume (median 36,728 vs 43,000). By contrast, median percent of Medicaid or self-pay patients was lower in telehealth EDs (36%) vs non-telehealth EDs (45%, P = 0.02). In adjusted analysis, increasing proportion of Medicaid and self-pay patients was associated with decreased odds of telehealth receipt (odds ratio 0.87 per 5% increase; 95% CI, 0.77–0.99). Rural location, academic status, and ED volume were not significantly associated with odds of ED telehealth receipt in the adjusted model.ConclusionAmong EDs in the state of New York, increasing proportion of self-pay and Medicaid patients was associated with decreased odds of ED telehealth receipt, even after accounting for rural location, academic status, and ED volume. The findings support the need for additional infrastructural investment in EDs serving a greater proportion of disadvantaged patients to ensure equitable access.

Regional trends of minimally invasive radical hysterectomy for cervical cancer and exploration of perioperative outcomes

IntroductionRadical hysterectomy (RH) with bilateral pelvic lymph node dissection is the standard treatment for early stage cervical cancer which can be performed either by an abdominal or a minimally invasive (MIS) approach. In 2018, Ramirez et al. presented their randomized-controlled trial data which demonstrated that patients who were treated with minimally invasive surgical (MIS) radical hysterectomy (RH) had higher rates of locoregional disease recurrence and lower rates of overall survival when compared to patients treated with an abdominal approach. The objective of this study is to examine the trends in management of patients diagnosed with cervical cancer in New York State (NYS) and to analyze their perioperative outcomes. MethodsUsing the Statewide Planning and Research Cooperative System (SPARCS) Database, patients undergoing RH for early stage cervical cancer in NYS between the years of 2007–2015 were identified and categorized based on surgical approach. Demographic information was collected and multivariable regression was conducted to assess the impact of hysterectomy approach on perioperative outcomes. ResultsIn NYS, 5575 patients were treated with RH for early stage cervical cancer with 3257 (58.4%) treated by abdominal RH and 2318 (41.6%) treated with MIS RH. Between the years of 2007 and 2015, patients diagnosed with cervical cancer treated with MIS RH increased from 25.7% to 48.3% respectively. Surgeons performing MIS RH were more likely to be younger (average age 47.1 vs 49.2, p < 0.001) and have less time elapsed from their fellowship graduation (20.37 vs 22.64 years, p < 0.001). Patients who saw high volume doctors (OR 1.95, CI 1.65–2.31) and were seen in high volume facilities (OR 1.40, CI 1.18–1.65) were more likely to undergo MIS RH compared to abdominal RH. Patients who underwent MIS RH were more likely to be discharged home as opposed to acute rehab or nursing facility, when compared to patients treated with abdominal RH (98.5 vs 94.2% p < 0.001). When analyzing perioperativce outcomes, patient undergoing MIS RH had a 85% decrease in length of hospital stay compared to abdominal RH, a 40% reduction in 30-day readmission rates, and a 10% reduction in hospital costs respectively. DiscussionIn our study period, between the years of 2007 and 2015, the number of cervical cancer cases treated with MIS RH increased from 25.7% to 48.3%. MIS techniques led to a reduction in length of hospital stay, patient readmission rates, and hospital costs. Based on recent data from Ramirez et al., preliminary data demonstrated decrease in MIS RH for treatment of cervical cancer after presentation of the LACC trial and our data confirmed these reported trends in NYS. With this change in surgical practice, there will be associated changes in perioperative outcomes. Moreover, for patients diagnosed with cervical cancer with microscopic disease or previous treatment with an excisions procedure, MIS approach should be considered for improvement in perioperative outcomes as long as oncologic outcomes are not compromised.

Coping with COVID-19 at the community level: Testing the predictors and outcomes of communal coping.

The COVID‐19 pandemic is a socially shared health issue that has had profound impacts on all aspects of community life and requires collaborative coping responses. Drawn from the extended theoretical model of communal coping, we examined (a) factors that promote community members' communal coping and (b) the influence of communal coping on perceived stress and positive adaptation in the context of COVID‐19. An empirical test based on the survey of participants (N = 257) living in the state of New York showed that strong community identity, but not the length of residency in the same community and integrated connectedness to communication resources of the community, was positively associated with communal coping orientation. Having a higher communal coping orientation was not related to perceived stress, but it was positively related to engagement in COVID‐19 preventive behaviors. The implications of these findings for understanding communal coping at the community level and future directions are discussed.

Effects of the COVID-19 shutdown on spatial and temporal patterns of air pollution in New York City

Using spatially- and temporally-resolved data from the New York City Community Air Survey (NYCCAS) and the New York State (NYS) Department of Environmental Conservation (DEC) network, we characterized changes in fine particulate matter (PM2.5) and nitrogen dioxide (NO2) following the COVID-19 shutdown in NYC (3/20/20 – 6/7/20). Difference-in-difference analysis of PM2.5 and NO2 measured at 93 sites were used to estimate the change in citywide pollution attributable to the shutdown. We also quantified how these pollutant changes varied among different demographic groups using difference-in-difference analyses stratified by neighborhood poverty levels and rates of PM2.5-attributable health outcomes. Spatial patterns of PM2.5 and NO2 were interpolated across NYC by fitting land-use regression models to measurements at the 93 sites. Weather conditions and emission source trends were analyzed to determine the potential effects of meteorology and specific emission sources on the observed pollution changes. We estimate that citywide average PM2.5 and NO2 decreased by approximately 25% and 29%, respectively, due to the shutdown. Weather readings show little evidence that meteorology biased our results in the direction of our findings. Data on major sources of PM2.5 and NO2 pollution suggests that decreased vehicle traffic and commercial cooking contributed to declines in air pollution during this period. Pollution reductions occurred disproportionately in the city's central business district (CBD), with smaller changes in other areas of the city, such as those with the highest burden of air pollution-related health impacts. These findings emphasize the need to target pollution sources in communities that suffer the greatest from pollution exposure in the design of equitable environmental health policy.

Is New York State good at managing hollow viscus injury?

There are an estimated 100,000 cases of abdominal injury (ABI) in the USA, annually resulting in over $12 billion in direct medical cost and $18 billion in lost productivity. This study assesses the timeliness, safety, and efficacy of the surgical management of abdominal injuries (ABIs), hollow viscus injuries (HVIs), and colonic injuries (CIs) for patients residing in New York State (NYS). Using data from NYS's Statewide Planning and Research Cooperative System (SPARCS), we identified all trauma patients with ABI admitted between 2006 and 2015. We subdivided ABI into HVI and CI using diagnosis and procedure codes and examined processes of care and outcomes adjusting for patient characteristics, injury severity score, structural, and process indicators. We identified 31,043 hospitalized patients with ABI, 71% were incurred from blunt forces. Most patients with ABI (72%) were treated at a Level I/II trauma center (TC) and 7% patients were transferred to Level I/II TC. Failure to be treated at Level I/II TC was associated with 16% increased hazard of death. HVI was diagnosed in 23% of ABI patients (n = 7294); 18% experienced delayed hollow viscus repair (dHVR); dHVR was associated with a 76% increased hazard of death. CI was diagnosed in 9% of ABI patients (n = 2921) and 18% experienced dHVR. Seventy-five percent of CI were repaired primarily (n = 1354). Less than 37% of stomas were reversed by 4years of index trauma. Most abdominal trauma in NYS was caused by motor vehicle accidents, falls, and assault. dHVR and not being treated at Level I/II TC were associated with worse outcomes. More research is needed to reduce under-triage and delays in the operative treatment of blunt abdominal trauma.

Physical Educators Teachers Perceptions when Teaching English Language Learners (ELL)

The purpose of this study was to explore how physical educators from the state of New York accommodate English Language Learners (ELL) in their Physical Education (PE) classes. Furthermore, to find out how many teachers have a background in foreign languages and the strategies they use to teach these students. A content-validated open-ended questionnaire was used to collect the data. A total of 53 PE teachers completed the questionnaire. Results from this study indicated that the majority (73%) do not know a second language other than English. They also expressed the need for teacher preparation programs to provide more information on effective strategies on how to teach ELL students. Data analysis uncovered two recurrent themes: (a) lack of knowledge on a second language, and (b) the lack of knowledge of effective teaching strategies. Professional development opportunities and clear guidelines on how to teach ELL students need to be provided to PE teachers.

An Open Source Representation for the NYS Electric Grid to Support Power Grid and Market Transition Studies

Under the increasing need to decarbonize energy systems, there is coupled acceleration in connection of distributed and intermittent renewable resources in power grids. To support this transition, researchers and other stakeholders are embarking on detailed studies and analyses of the evolution of this complex system, which require a validated representation of the essential characteristics of the power grid that is accurate for a specific region of interest. For example, the Climate Leadership and Community Protection Act (CLCPA) in New York State (NYS) sets ambitious targets for the transformation of the energy system, opening many interesting research and analysis questions. To provide a platform for these analyses, this paper presents an overview of the current NYS power grid and develops an open-source<xref ref-type="fn" rid="fn1">¹</xref><fn id="fn1"><label>¹</label> https://github.com/AndersonEnergyLab-Cornell/NYgrid </fn> baseline model using publicly available data. The proposed model is validated with real data for power flow and Locational Marginal Prices (LMPs), demonstrating the feasibility, functionality, and consistency of the model. The model is easily adjustable and customizable for various analyses of future configurations and scenarios that require spatiotemporal information about the NYS power grid with access to all the available historical data and serves as a practical system for general methods and algorithms testing.

Administracyjnoprawne aspekty stwierdzenia zgonu

The subject of the article is a detailed analysis of the administrative and legal aspects of ascertainment causes of death. The first part of the article describes the Polish law regarding ascertainment death. Then, the author defines problems of interpretation and application of the law, as well as the author presents legislation project of new funeral law. The third subsection of the article relates to comparative law – selected aspects of the death investigation system, in particular the position of a coroner in England, Wales, the state of New York.

La figura de Robert F. Kennedy en el marco sociopolítico estadounidense. Bobby Kennedy for President

By the end of the 1950s, the Kennedys were one of the most influential families on the American political scene. The Democratic Party, in an expansive electoral phase in the 1960s, became a promoter of legislative reform in favor of minorities, which would broaden its electoral base. At the same time, said reform caused a major split between the Democrat factions more conservative. The programmatic rearrangement of the Democrats occurred in parallel to the personal evolution of Robert F. Kennedy. The joyful and gesticulating character of the chief justice of the Supreme Court, during the Kennedy-Johnson administration (1961-1965), gave way to a sad and reflective senator from the state of New York, during the first three years of the Johnson administration (1965-1968). Dawn Porter’s documentary (2018) is a magnificent example of quality historical divulgation, in a commemorative time frame, in which certain aspects of the American political landscape are rigorously exposed.

E-cigarette Use Among Middle and High School Students in New York City Before and After Passage of Tobacco 21

IntroductionDespite declines in cigarette smoking in the US, electronic cigarette (e-cigarette) use has increased among middle and high school students. In 2014, New York City (NYC) implemented Tobacco 21 (T21) to prohibit sales to anyone under age 21. Our study goal was to measure the effectiveness of T21 on e-cigarette use.MethodsWe used the New York State (NYS) Youth Tobacco Survey—a biennial, school-based, self-administered survey. We explored middle (N = 5249) and high (N = 7296) school NYC students’ (male and female) current (past 30 days’) e-cigarette use from 2014 (pre-T21) to 2018 (post-T21). Results were compared with students in the rest of NYS (ROS). Bivariate and multivariable logistic regression analyses assessed correlates of e-cigarette use, beliefs about harmfulness, addictiveness, and susceptibility.ResultsNYC high school students’ current e-cigarette use increased from 2014 to 2018 (8.1% vs 23.5%, P < .001). Middle school students’ use increased between 2014 (4.8%) and 2016 (9.0%) yet reversed by 2018 (5.7%) (2014 vs 2018, P = .576). ROS middle school (2.2% vs 7.4%, P < .001) and high school (12.0% vs 29.3%, (P < .001) use increased from 2014 to 2018. Willingness to try e-cigarettes among those who had never tried an e-cigarette was twice as high (AOR = 2.19, 95% CI = 1.15-3.17) among NYC high school students in 2018 compared with 2014.ConclusionsE-cigarette use increased among NYC high school students despite T21. T21 may have reduced use among middle school students over time. Programs that denormalize e-cigarettes and policies that further restrict access are needed to decrease youth e-cigarette use.

The Implementation of a State-wide Rapid Initiation of Antiretroviral Therapy as a Best Practice in Primary Care Practices Using an Academic Detailing Approach: Lessons Learned from NewYork State, United States

Background:New York State Department of Health AIDS Institute policy recommends that primary care clinicians should initiate same-day-antiretroviral treatment (ART) of a new HIV diagnosis or at the next clinical visit as the standard of care. However, non-HIV-specialized primary care clinicians might not be sufficiently trained to initiate a specialized ART with a newly HIV diagnosed patient. We assessed clinicians’ knowledge and attitudes toward the rapid initiation of ART and provided academic sessions as a training method to guide clinicians through the implementation of a new standard of care.Methods:A Research Electronic Data Capture (REDCap), Health Insurance Portability and Accountability Act (HIPAA)-compliant, online survey was sent to primary care clinicians to assess their knowledge and attitudes towards Rapid Initiation of ART (RIA). We provided personalized academic detailing sessions, addressing questions and concerns gathered from both the initial survey and the individual pre-assessment questionnaire completed prior to the sessions.Results:The survey was initially distributed in February 2019, followed by 4 weekly reminders. Approximately 585 providers completed the survey. Subsequently, 552 health care providers from 25 out of 62 counties in NY State were detailed between March 2019 and March 2021. Lessons learned from the sessions included the identification of pragmatic strategies that could be used in the design of effective detailing sessions, followed by enhanced clinical knowledge, which improved patient care.Conclusion and Global Health Implications:Inconsistencies in the current testing practices result in missed HIV diagnoses and an increased risk of HIV transmission. Academic detailing-training techniques can be used to respond to clinician-identified key issues/attitudes that may result in a new intervention, suggesting a promising approach in addressing the implementation barriers of of rapid-treatment initiation as the standard of care. The academic detailing approach can be easily adapted and can be beneficial in global public health, HIV/ AIDS control, and other conditions that require a medical practice change.

Incidence of Head and Neck Cancers before and after 9/11 in New York City and New York State

Introduction: The incidence of cancers in New York State (NYS) before and after 9/11 including lung, colorectal, and renal cancers has been previously described. To date, the incidence of head and neck cancers (HNCs) before and after 9/11 has not been described. Methods: Cancers involving the oral cavity and oropharynx; the nose, nasal cavity, nasopharynx, and middle ear; larynx; and thyroid were identified using the New York State Cancer Registry (NYSCR). Age-adjusted incidence and rates per 100,000 residents from 1987 to 2015 were analyzed using joinpoint regression. Trends in incidence using annual percent changes are presented. Results: The overall rate of HNC increased slightly by 0.7% (p < 0.001) from 1987 to 2003 in NYS. From 2003 to 2008, the rate increased by 5.73% (p < 0.001), and from 2008 to 2015, the rate increased by 1.68% (p < 0.001). The rate of thyroid cancer increased by 6.79% (p < 0.001) from 1987 to 2003, by 9.99% (p < 0.001) from 2003 to 2009, and by 2.41% (p = 0.001) from 2009 to 2015. The rate of thyroid cancer was higher in women at all time points. In a subset analysis of HNCs excluding thyroid cancer, the rate decreased by 2.02% (p < 0.001) from 1991 to 2001, followed by a nonsignificant increase of 0.1% (p = 0.515) from 2001 to 2015. The rate of oropharyngeal (OP) cancer significantly increased from 1999 to 2015 (2.65%; p < 0.001). The rate of oral cavity cancer significantly decreased from 1987 to 2003 (1.97%; p < 0.001), with no significant change after 2003. The rate of laryngeal cancer decreased significantly by 2.43% (p < 0.001) from 1987 to 2015, as did the rate of nasal cavity/nasopharyngeal cancer (0.33%; p = 0.03). Conclusions: In NYS, OP cancer and thyroid cancer rates increased significantly during the study period. The rate of thyroid cancer was higher in women. The rate of combined HNC increased significantly after 9/11 compared to before 9/11; however, in a subset analysis of all HNC patients excluding thyroid cancer, the rate decreased significantly prior to 9/11 and then nonsignificantly increased afterward. This suggests that the increase in thyroid cancer accounts for the increase in combined HNC in NYS. The impact of 9/11 on rates of HNC requires further research.

Low Hospice Utilization in New York State: Comparisons Using National Data

ContextHospice utilization in New York State (NYS) is low compared to the rest of the U.S. ObjectivesThe first part of a mixed-methods study elicited information from New York State stakeholders and identified 54 hospice-related barriers in nine categories, some specific to NYS. This second part used national data to examine the differences between NYS and the rest of the country by evaluating the variables associated with low NYS hospice utilization. MethodsTen Medicare or publicly available datasets provided data from the year prior to death for all traditional Medicare-insured patients dying in 2018. Multivariate analyses identified variables independently associated with differences in hospice enrollment or length of stay between NYS and the rest of the country. ResultsThe NYS population was relatively older, included more women and minorities, had higher socioeconomic status (SES), and saw more physicians during the last two years of life. NYS had more physicians, more skilled nursing facility (SNF) beds, and fewer for-profit hospitals, SNFs, home care agencies, and hospice agencies. In multivariate analyses, lower NYS hospice utilization was associated with higher SES; more physicians seen during the last two years of life; more SNF beds and fewer for-profit SNF facilities; and fewer hospice agencies. ConclusionNYS's low hospice utilization is independently associated with diverse factors, including those related to the health care system. Combined with information from stakeholders, these findings may help target, and inform initiatives to improve hospice utilization.