York Community Research Articles

Does OER Research-Based Learning Improve Performance: A Case Study from Students Enrolled in a Community College at City University of New York (CUNY)

This study investigates the effectiveness of Open Education Resources (OER) and research-based learning. A quantitative analysis was conducted on students enrolled in Macroeconomic courses at a City University of New York (CUNY) community college in Spring 2018 and Spring 2019. Prior studies have shown the positive effects of conducting research in natural sciences. Yet, there is a lot to be inquired about regarding the impact of research-based learning on social sciences and the use of OER materials as a cheaper and more equitable alternative to commercial textbooks. Additionally, this study evaluates the academic effectiveness of research-based learning through assessment scores through a new indicator, the growth mindset profile. Findings should be used to assess critically research-based learning applications incorporated with OER materials and open pedagogy, as well as to consider the duration, wide application throughout the program rather than isolated courses, and design of course assignments and research projects to engage students actively and effectively.

Peer education as a strategy to promote vaccine acceptance: A randomized controlled trial within New York community healthcare practices

BackgroundEffective strategies are needed to improve vaccine acceptance. This study sought to determine if a peer-led vaccine education intervention embedded within community medical practices increases parental acceptance of pediatric pneumococcal conjugate vaccination. MethodsFrom March 2022-July 2023, we conducted a randomized trial at three pediatric health practices in predominantly Hasidic Jewish neighborhoods in New York, where vaccine deferral is common. Parents of children up to 18 months due/overdue for routine pneumococcal vaccination were randomized (1:1) to receive routine care alone or routine care plus a peer educational intervention. Peer educators trained in motivational interviewing and vaccine science provided counseling at enrollment and follow-up telephone engagement in the intervention arm at day 30 and 60. Primary outcome was child’s pneumococcal immunization status by allocation arm expressed as at least one dose received between enrollment and 90 days post-enrollment. Results144 parent–child dyads were eligible for outcome analysis. Participants in the group receiving routine care along with peer-led vaccine counseling were significantly more likely to have their child receive at least 1 vaccine dose between enrollment and 90 days compared to the group who received routine care alone (28.4 % vs 12.9 %, risk ratio [RR] 2.21, confidence interval [CI] 1.09–4.49, p = 0.022). The effect of peer education was greatest in dyads with children less than 1 year old at enrollment (34 % vs 12.7 %, RR 2.67, CI (1.22–5.86), p = 0.009). ConclusionsPeer vaccine education can increase vaccine acceptance compared to routine care alone and may be particularly valuable in decreasing vaccination delays for younger infants. (Funded by EGL Charitable Foundation, ClinicalTrials.gov NCT05875779).

Better out than in: a case series of retained rectal foreign bodies in a New York Community Hospital

Better out than in: a case series of retained rectal foreign bodies in a New York Community Hospital

The Power of Partnership: NYCEAL Collaborations With Health Agencies and Mobile Vaccination Vans.

New York City experienced a high COVID-19 burden and striking disparities among racial and ethnic minoritized groups. The New York Community Engagement Alliance Against COVID-19 Disparities (NYCEAL) collaborated with health agencies and clinical providers to increase and facilitate COVID-19 vaccinations across New York City. NYCEAL partners and their network of hundreds of community health workers delivered vaccine education, fostered community trust, and supported vaccine uptake among low-income, limited‒English-proficient, and racial and ethnic minoritized communities. With funding from the National Institutes of Health (NIH), the objective of NYCEAL was to reduce COVID-19 disparities by increasing vaccine uptake and promoting trust in science. (Am J Public Health. 2024;114(S1):S92-S95. https://doi.org/10.2105/AJPH.2023.307455).

Crohn's Disease Mortality and Ambient Air Pollution in New York City.

The worldwide increase in Crohn's disease (CD) has accelerated alongside rising urbanization and accompanying decline in air quality. Air pollution affects epithelial cell function, modulates immune responses, and changes the gut microbiome composition. In epidemiologic studies, ambient air pollution has a demonstrated relationship with incident CD and hospitalizations. However, no data exist on the association of CD-related death and air pollution. We conducted an ecologic study comparing the number of CD-related deaths of individuals residing in given zip codes, with the level of air pollution from nitric oxide, nitrogen dioxide, sulfur dioxide (SO2), and fine particulate matter. Air pollution was measured by the New York Community Air Survey. We conducted Pearson correlations and a Poisson regression with robust standard errors. Each pollution component was modeled separately. There was a higher risk of CD-related death in zip codes with higher levels of SO2 (incidence rate ratio [IRR], 1.16; 95% confidence interval [CI], 1.06-1.27). Zip codes with higher percentage of Black or Latinx residents were associated with lower CD-related death rates in the SO2 model (IRR, 0.58; 95% CI, 0.35-0.98; and IRR, 0.13; 95% CI, 0.05-0.30, respectively). There was no significant association of either population density or area-based income with the CD-related death rate. In New York City from 1993 to 2010, CD-related death rates were higher among individuals from neighborhoods with higher levels of SO2 but were not associated with levels of nitric oxide, nitrogen dioxide, and fine particulate matter. These findings raise an important and timely public health issue regarding exposure of CD patients to environmental SO2, warranting further exploration.

Advancing community-academic partnerships to achieve breast health equity: Applying the community-based participatory model to build capacity for sustained impact.

This formative study leveraged a community-academic partnership to identify barriers to care that are potential sources of breast cancer disparities in Black women. Through this partnership and using a community-based participatory research approach, the objective was to develop a community task force to inform future interventions aimed at addressing breast cancer disparities and increasing health equity. The authors assessed gaps in care related to breast cancer in Buffalo, New York, by collecting and analyzing qualitative data from focus groups and interviews with breast cancer survivors and breast navigation groups assessing barriers and facilitators across the cancer care continuum. Then, community-based participatory research approaches were used to build a task force to develop an action plan addressing gaps in care. The authors conducted a thematic analysis of qualitative findings to understand barriers and facilitators to cancer care. Three main domains of themes emerged, including medical mistrust, fear, and stigma; the importance of patient navigation as a form of social support; and the importance of faith and faith-based community. Finally, the findings were presented to a newly formed community task force to validate the data collected and set future priorities to address breast cancer disparities and increase breast health equity in the region. The authors observed that health equity is a critically important issue in cancer care and that developing culturally tailored interventions has the potential to improve care delivery and reduce breast cancer disparities. Learning from and working with community members helps set the future agenda related to health equity. Our overall goal was to assess gaps in breast cancer care in Buffalo, New York, and to use community-based participatory approaches to build a task force to work toward breast health equity. Recent and historical data indicate that the Western New York community is facing a continued wide gap in breast cancer mortality trends between Black and White patients. We collected qualitative data to understand potential sources of inequity related to breast cancer and presented findings to a community task force to set future priorities for addressing breast cancer disparities and increasing breast health equity in our region.

MP30-05 CONCORDANCE OF TESTIS HISTOLOGY AMONG MEN UNDERGOING BILATERAL TESTICULAR SPERM EXTRACTION PROCEDURES

You have accessJournal of UrologyCME1 Apr 2023MP30-05 CONCORDANCE OF TESTIS HISTOLOGY AMONG MEN UNDERGOING BILATERAL TESTICULAR SPERM EXTRACTION PROCEDURES Jessica Marinaro, Jonathan Gal, and James Kashanian Jessica MarinaroJessica Marinaro More articles by this author , Jonathan GalJonathan Gal More articles by this author , and James KashanianJames Kashanian More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: For men undergoing a microdissection testicular sperm extraction (mTESE) procedure, if sperm are not found in one testis, a bilateral procedure is typically performed; however, this invasive dissection may have adverse effects. While testicular histology may predict sperm retrieval rates (SRRs), little is known about the concordance of histology between testes. Since this may inform the utility of performing a bilateral versus unilateral dissection, our objective was to assess the rate of histological concordance between left and right testis biopsies and as well as the overall sperm retrieval rate (SRR) for these patients. METHODS: We retrospectively reviewed electronic medical records using CPT codes 55899 and 54505 for 1 surgeon from 6/2016 to 8/2022. Men were included if they underwent a testicular sperm extraction (TESE) or mTESE procedure. Biopsies were evaluated by 4 pathologists at our institution. Histology was classified as Sertoli-cell only (SCO), maturation arrest (MA; early or late), active spermatogenesis (AS), or tubular atrophy (TA). Each pattern was reported as a percentage contributing to a total of 100%. A successful sperm retrieval was defined as the presence of sperm after processing by an andrology lab. RESULTS: Of 128 men who underwent a TESE or mTESE, 38 (29.7%) had a bilateral procedure. Mean demographics for these 38 men included an age at surgery of 39.4 ± 7.0 years, baseline testosterone 400.1 ± 198.0 ng/dL, baseline FSH 18.7 ± 14.9 mIU/mL, right testis volume 10.1 ± 6.4 mL, and left testis volume 10.2 ± 6.4 mL. Thirty-one men (31/38, 81.6%) had biopsies sent for histology from both testes. Of these, 9 (29.0%) had the same histology in the same proportions bilaterally, 14 (45.2%) had the same predominant histology but in variable proportions, and 8 (25.8%) had discordant predominant histology. Ten of 31 men (32.3%) had sperm retrieved; of these, 6 (60%) had no evidence of spermatogenesis on either histology specimen. CONCLUSIONS: While it is known that there is often heterogeneity within the testis, this study confirms that there is also significant heterogeneity between each testis for >25% of men. Though histology may help to predict SRRs, this study emphasizes that histology alone is not reliable in determining which men will have sperm present after processing by an andrology lab. Ultimately, while histology may provide patients and providers with useful information on testicular architecture, it should not be the only factor in clinical decision making, such as who should undergo a bilateral procedure or repeat procedure. Source of Funding: Authors JM and JG are supported in part by the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e392 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Marinaro More articles by this author Jonathan Gal More articles by this author James Kashanian More articles by this author Expand All Advertisement PDF downloadLoading ...

MP30-08 EVALUATING THE CHANGES IN SEMEN PARAMETERS OVER TIME FOR MEN WITH AZOOSPERMIA FACTOR C (AZFc) MICRODELETIONS

You have accessJournal of UrologyCME1 Apr 2023MP30-08 EVALUATING THE CHANGES IN SEMEN PARAMETERS OVER TIME FOR MEN WITH AZOOSPERMIA FACTOR C (AZFc) MICRODELETIONS Jessica Marinaro, Jonathan Gal, Anna Mielnik, and Peter Schlegel Jessica MarinaroJessica Marinaro More articles by this author , Jonathan GalJonathan Gal More articles by this author , Anna MielnikAnna Mielnik More articles by this author , and Peter SchlegelPeter Schlegel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Men with complete azoospermia factor C (AZFc) microdeletions may have variable degrees of spermatogenic failure. While some are persistently azoospermic, most intermittently or consistently have sperm in the ejaculate. It has been proposed that these men may experience a temporal decline in semen quality with age. The objective of this study was to assess changes in semen parameters over time among men with complete AZFc deletions. METHODS: We retrospectively reviewed 163 men with complete AZFc deletions who were tested at our center from 4/1996 to 7/2022. Of these, 41 had ≥2 semen analyses performed (SA). ANOVA tests were used to compare mean demographic values between azoospermic, intermittently azoospermic, and non-azoospermic men. Wilcoxon matched-pairs signed rank tests were used to compare initial and final semen analyses. RESULTS: In total, 179 SAs were reviewed. The mean number of SAs per patient was 4.4 ± 2.2. The mean time between each SA was 189.6 ± 420.0 days, and the mean time between the first and last SA was 638.9 ± 850.9 days. Of 41 men, 13 (32%) were azoospermic, 9 (22%) intermittently azoospermic, and 19 (46%) were non-azoospermic. Of the non-azoospermic men, most (n=14, 73.7%) had severe oligospermia (<1 million/mL).Of 9 men with intermittent azoospermia, most had an increase in sperm concentration (n=8, 89%), total sperm count (TSC) (n=8, 89%), and total motile sperm count (TMSC) (n=6, 67%) between the first and last SA. Similarly, most non-azoospermic men also had an increase in sperm concentration (n=12, 63%), TSC (n=11, 58%), and TMSC (n=11, 58%). In comparing semen parameters, men with intermittent azoospermia had an increase in sperm concentration (p=0.0078) and TSC (p=0.0078) between the first and last SA, but no change in TMSC. There was no difference in concentration, TSC, or TMSC over time for non-azoospermic men.While non-azoospermic men were older (mean: 37.0 +/- 5.6 years; p=0.004) versus intermittently azoospermic (mean: 33.4 +/- 3.3 years) or azoospermic men (mean: 30.3 +/- 5.6 years), there were no differences in baseline testosterone (p=0.24), baseline FSH (p=0.31), or testis size (p=0.17 right, p=0.50 left). CONCLUSIONS: In this study, there was no significant decline in sperm concentration, TSC, or TMSC over time for men with complete AZFc deletions; rather, sperm number tended to increase over time. These data suggest that men with AZFc deletions are not at substantive risk of decline in sperm production and do not need to take aggressive early measures for fertility preservation. Source of Funding: Authors JM and JG are supported in part by the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e393 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jessica Marinaro More articles by this author Jonathan Gal More articles by this author Anna Mielnik More articles by this author Peter Schlegel More articles by this author Expand All Advertisement PDF downloadLoading ...

MP38-17 PROSTATE CANCER GRADE MIGRATION AND FACILITY-LEVEL TREATMENT TRENDS FOR LOW GRADE DISEASE

You have accessJournal of UrologyCME1 Apr 2023MP38-17 PROSTATE CANCER GRADE MIGRATION AND FACILITY-LEVEL TREATMENT TRENDS FOR LOW GRADE DISEASE Leonardo Borregales, Michael Tzeng, Ashwin Ramaswamy, Xiangmei Gu, Meenakshi Davuluri, Himanshu Nagar, and Jim Hu Leonardo BorregalesLeonardo Borregales More articles by this author , Michael TzengMichael Tzeng More articles by this author , Ashwin RamaswamyAshwin Ramaswamy More articles by this author , Xiangmei GuXiangmei Gu More articles by this author , Meenakshi DavuluriMeenakshi Davuluri More articles by this author , Himanshu NagarHimanshu Nagar More articles by this author , and Jim HuJim Hu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003276.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Overtreatment of low-grade prostate cancer (PCa) reflect poor quality of care and prompted changes to guidelines over the past decade. Active surveillance (AS) is the preferred choice for low-grade PCa, due to excellent oncological safety and ability to mitigate the consequences of definitive treatment. Nonetheless, uptake of AS in the US continues to lag behind other healthcare systems, such as Sweden, where implementation for GG (Gleason grade group) 1 disease reached 74% by 2014.The lack of AS adoption has been attributed to significant heterogeneity in facility-level practice patterns in the US. Contemporary trends in GG1 PCa management can inform policymakers and guide future initiatives. We sought to characterize trends in the incidence of GG1 disease at biopsy and prostatectomy pathology and assess treatment variability by facility type. METHODS: Men with newly diagnosed PCa between 2010-2019 were identified in the National Cancer Database. Analysis of trends in GG distribution included 1,024,607 men in the biopsy cohort and 511,199 men in the RP cohort. Analysis of treatment trends (AS vs. RP, radiation therapy [RT], focal therapy [FT], or androgen deprivation therapy [ADT]) of localized GG1 PCa according to facility type included 249,585 men. Patients with unknown stage/grade, treatment, or facility type were excluded. Facility was defined as academic (academic/research program) vs. non-academic (community cancer program, comprehensive community cancer program, or integrated network cancer program). AS was defined per the NCDB variable “RX_SUMM_TREATMENT_STATUS” code 2(AS). Joinpoint Regression Program 4.9.0.1 was used for joinpoint analysis. RESULTS: From 2010-2019, GG1 PCa incidence significantly declined from 45% to 25% at biopsy and from 33% to 10% at RP pathology. Among academic sites, use of AS increased from 12% to 62% (AAPC=21%, 95% CI [19,22]), RP decreased from 61% to 25% (AAPC=-9.3%, 95%CI [-10, -8.5]), and RT from 25% to 12% (AAPC=-7.9%, 95%CI [-8.8, -7.0]). Similar trends were seen in nonacademic sites, AS increased from 5% to 49% (AAPC=28%, 95% CI [24,32]), RP decreased from 54% to 28% (AAPC=-6.9%, 95% CI [-8.7, -5.2]), and RT from 38% to 22% (AAPC=-5.9%, 95% CI [-6.6, -5.3]), p<0.001 for all trends. ADT and FT were scarcely utilized, with less than 1% of men receiving such therapies by 2019 at any level. CONCLUSIONS: Declines in the diagnosis and treatment of GG1 disease demonstrate a positive shift in PCa epidemiology and proper stewardship of PCa screening. Nonetheless, heterogeneity in AS utilization remains and reflects opportunities for improvement. Source of Funding: This work was supported by the National Institute of Health (R01 CA241758, R01 CA259173-01A1 to J.C.H); and Patient-Centered Outcomes Research Institute (CER-2019C1-15682, CER-2019C2- 17372 to J.C.H). J.C.H. and L.D.B, receive salary support from the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust, J.C.H, receives salary support from Prostate Cancer Challenge Award. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e531 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Leonardo Borregales More articles by this author Michael Tzeng More articles by this author Ashwin Ramaswamy More articles by this author Xiangmei Gu More articles by this author Meenakshi Davuluri More articles by this author Himanshu Nagar More articles by this author Jim Hu More articles by this author Expand All Advertisement PDF downloadLoading ...

MP17-18 PROSTATE CANCER GENETIC ALTERATIONS IN HISPANIC MEN

You have accessJournal of UrologyCME1 Apr 2023MP17-18 PROSTATE CANCER GENETIC ALTERATIONS IN HISPANIC MEN Camilo Arenas-Gallo, Stephen Rhodes, Jorge A. Garcia, Lina Posada, Ilon Weinstein, Megan Prunty, Patrick Lewicki, Aaron Brant, Spyridon P. Basourakos, Christopher E. Barbieri, Fredrick R. Schumacher, and Jonathan E. Shoag Camilo Arenas-GalloCamilo Arenas-Gallo More articles by this author , Stephen RhodesStephen Rhodes More articles by this author , Jorge A. GarciaJorge A. Garcia More articles by this author , Lina PosadaLina Posada More articles by this author , Ilon WeinsteinIlon Weinstein More articles by this author , Megan PruntyMegan Prunty More articles by this author , Patrick LewickiPatrick Lewicki More articles by this author , Aaron BrantAaron Brant More articles by this author , Spyridon P. BasourakosSpyridon P. Basourakos More articles by this author , Christopher E. BarbieriChristopher E. Barbieri More articles by this author , Fredrick R. SchumacherFredrick R. Schumacher More articles by this author , and Jonathan E. ShoagJonathan E. Shoag More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003237.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Prostate cancer is the most common cancer among Hispanic men and a leading cause of cancer death in Hispanic countries. Differences in DNA alterations in prostate cancer among White, Black, and Asian men have been widely described. This is the first description of the DNA alterations frequency in primary and metastatic prostate cancer of Hispanic men. METHODS: We utilized the targeted next-generation sequencing tumor genomic profiles from men with prostate cancer who underwent clinical sequencing tests at academic medical centers (GENIE 11th), for a total of 4,169 patients. We used data from all institutions with the Ethnicity category available for Spanish/Hispanic, non-Hispanic White, and non-Hispanic Black men. Numbers of men by ethnicity and racial categories were analyzed via Fisher’s exact test. RESULTS: Our final cohort comprised 2,140 primary and 1,251 metastatic adenocarcinomas. Among primary cancer, TMPRSS2 alterations were less common in White men as compared with Hispanic men (32.80% vs 45.16%; p=0.017) and Black men (23.81% vs 45.16%; p=0.0009). FOXA1 alterations were present more common in Black men than Hispanic men (20.77% vs 9.20%; p=0.024). For metastatic disease, TP53 alterations were less common in White men as compared with Hispanic (44.01% vs 60.38%; p=0.023) or Black (29.36% vs 60.38%; p=<0.001) men. FOXA1 alterations occurred more frequently in White men than Hispanic men (18.85% vs 6.00%; p=0.022). No significant differences were noted in the prevalence of actionable alterations between races. As patient and tumor characteristics are unknown in this dataset, differences in these characteristics according to race were not considered in the analyses. CONCLUSIONS: There appear to be clear differences in the frequency of DNA alterations in primary and metastatic prostate cancer among Hispanic, white, and black men. Notably, we found no significant differences in the prevalence of actionable genetic alterations between the groups, suggesting that a significant number of Hispanic men could benefit from the development of targeted therapies. Source of Funding: J.E.S is supported by the Frederick J. and Theresa Dow Fund of the New York Community Trust, the Vinney Scholars Award, and a Damon Runyon Cancer Research Foundation Physician-Scientist Training Award. F.R.S. is supported by NCI CA2333216, CA043703, CA241956, and CA254566 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e219 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Camilo Arenas-Gallo More articles by this author Stephen Rhodes More articles by this author Jorge A. Garcia More articles by this author Lina Posada More articles by this author Ilon Weinstein More articles by this author Megan Prunty More articles by this author Patrick Lewicki More articles by this author Aaron Brant More articles by this author Spyridon P. Basourakos More articles by this author Christopher E. Barbieri More articles by this author Fredrick R. Schumacher More articles by this author Jonathan E. Shoag More articles by this author Expand All Advertisement PDF downloadLoading ...

MP77-13 OUTPATIENT VERSUS INPATIENT ROBOTIC ASSISTED RADICAL PROSTATECTOMY: COMPLICATIONS, TIME DRIVEN ACTIVITIES BASED COSTING AND PATIENT SATISFACTION

You have accessJournal of UrologyCME1 Apr 2023MP77-13 OUTPATIENT VERSUS INPATIENT ROBOTIC ASSISTED RADICAL PROSTATECTOMY: COMPLICATIONS, TIME DRIVEN ACTIVITIES BASED COSTING AND PATIENT SATISFACTION Emily Cheng, Aaron Laviana, Spyridon Basourakos, Sofia Gereta, Alec Zhu, Leonardo Borregales, Xiangmei Gu, Miko Yu, Chunmei Mckernan, Siwen Xie, Christopher Barbieri, Douglas Scherr, and Jim Hu Emily ChengEmily Cheng More articles by this author , Aaron LavianaAaron Laviana More articles by this author , Spyridon BasourakosSpyridon Basourakos More articles by this author , Sofia GeretaSofia Gereta More articles by this author , Alec ZhuAlec Zhu More articles by this author , Leonardo BorregalesLeonardo Borregales More articles by this author , Xiangmei GuXiangmei Gu More articles by this author , Miko YuMiko Yu More articles by this author , Chunmei MckernanChunmei Mckernan More articles by this author , Siwen XieSiwen Xie More articles by this author , Christopher BarbieriChristopher Barbieri More articles by this author , Douglas ScherrDouglas Scherr More articles by this author , and Jim HuJim Hu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003351.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Radical prostatectomy lengths of stay decreased with ketorolac analgesia and adoption of robotic assisted radical prostatectomy (RARP). During the COVID-19 pandemic, the transition to outpatient RARP freed up critically needed hospital beds. The healthcare cost reduction afforded by the shift to outpatient RARP and its effect on patient satisfaction has yet to be explored. We compared healthcare costs, patient satisfaction and complications for outpatient vs. inpatient RARP. METHODS: We identified and compared a series of consecutive RARP performed as outpatient vs. inpatient and determined the capacity cost rate for every resource, including personnel, equipment, and space. After the lifting of hospital restrictions, men were given the option of inpatient vs. outpatient RARP. We also administered a validated Patient Satisfaction Outcome Questionnaire (PSOQ) post-operatively and compared median scores in perceived outcomes and satisfaction. A time-driven activity-based costing (TDABC) analysis was applied to compare the total costs of care for RARP performed. Finally, we captured complications within 30 days of surgery using the Clavien-Dindo classification. We used multivariable regression to adjust for age, race, BMI, and ASA classification to assess the impact of outpatient vs. inpatient RARP on complications. RESULTS: There were no significant differences in patient characteristics for outpatient (n=145) vs. inpatient (n=80) RARP. When given the choice, 86.6% of men elected for outpatient vs. inpatient RARP. Outpatient RARP netted a $1387 (13.5%) cost reduction compared to inpatient RARP. There were no significant differences in outpatient vs. inpatient median satisfaction survey scores or complications within 30 days (11.0% vs. 11.3%, p=0.961). CONCLUSIONS: Outpatient RARP can be safely performed, with similar outcomes and compared to inpatient RARP. Outpatient RARP has significantly lower costs compared to inpatient RARP while maintaining similar patient satisfaction outcomes. Source of Funding: Jim C. Hu receives research support from the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust. Jim C. Hu also receives salary support from NIH R01 CA241758, R01 CA259173, R01 CA273031, PCORI CER-2019C1-15682 and CER-2019C2-17372 and a Prostate Cancer Foundation Challenge Award. The remaining authors report no further disclosures related to this work © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1107 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emily Cheng More articles by this author Aaron Laviana More articles by this author Spyridon Basourakos More articles by this author Sofia Gereta More articles by this author Alec Zhu More articles by this author Leonardo Borregales More articles by this author Xiangmei Gu More articles by this author Miko Yu More articles by this author Chunmei Mckernan More articles by this author Siwen Xie More articles by this author Christopher Barbieri More articles by this author Douglas Scherr More articles by this author Jim Hu More articles by this author Expand All Advertisement PDF downloadLoading ...

MP30-07 EVALUATION OF MTESE OUTCOMES IN PATIENTS WITH PARTIAL AZFb Y CHROMOSOME MICRODELETIONS

You have accessJournal of UrologyCME1 Apr 2023MP30-07 EVALUATION OF MTESE OUTCOMES IN PATIENTS WITH PARTIAL AZFb Y CHROMOSOME MICRODELETIONS Jonathan Gal, Jessica Marinaro, Anna Mielnik, and Peter Schlegel Jonathan GalJonathan Gal More articles by this author , Jessica MarinaroJessica Marinaro More articles by this author , Anna MielnikAnna Mielnik More articles by this author , and Peter SchlegelPeter Schlegel More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003258.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Y chromosome microdeletions (YCMD) are a common cause of non-obstructive azoospermia. While men with deletions in the azoospermia factor C (AZFc) region have a high likelihood of having sperm in the ejaculate, or sperm retrievable with effective microdissection testicular sperm extraction (mTESE) procedure, those with complete deletions in the AZFa or AZFb regions have a poor prognosis for identification of sperm. Men with AZFa deletions typically do not have any germ cells, and no men, to-date, with complete AZFb deletions have had usable sperm identified. Partial deletions of AZFb appear to portend a different prognosis for fertility potential. Our objective was to evaluate semen parameters, sperm retrieval rates and fertility outcomes in men with partial deletions of the AZFb region. METHODS: We retrospectively reviewed 468 men with YCMDs who underwent testing at our institution from 4/1996 to 8/2022. Of these, we identified 20 men with partial AZFb deletions, defined as a deletion of some but not all tested segments from sY1227 to sY1291. Of these, 8 had documented semen analysis and underwent mTESE by a single, high-volume surgeon (PS). Sperm retrieval rate (SRR) was defined as the presence of mature sperm identified after processing by a trained andrologist. RESULTS: Of the 8 men with a partial AZFb deletion, 7 (87.5%) had a sY117-sY1291 deletion, and one (12.5%) had an sY1227-sY1192 deletion. All 8 men (100%) were azoospermic. Mean testosterone levels were 450.5 ± 350.5 (ng/dL), Mean FSH 6.5±2.8 (mIU/mL). After mTESE, 1 of 7 men (14%) with an sY117-sY1291 deletion was found to have sperm, and the 1 man with a sY1227-sY1192 deletion was found to have round spermatids on histology. Overall, the SRR was 12%. All pathology specimens (n=8, 100%) demonstrated maturation arrest. CONCLUSIONS: In this large series, we demonstrate that while patients with partial AZFb deletions are azoospermic, it is possible to find sperm at least for some men with mTESE. Distinguishing partial from complete AZFb deletions may have prognostic value. Further work is needed to determine which men with partial AZFb deletions are more likely to have a successful mTESE procedure. Source of Funding: Author JG is supported in part by the Frederick J. and Theresa Dow Wallace Fund of the New York Community Trust © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e393 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan Gal More articles by this author Jessica Marinaro More articles by this author Anna Mielnik More articles by this author Peter Schlegel More articles by this author Expand All Advertisement PDF downloadLoading ...

What one community foundation learned over 40 years of operating funder collaboratives

ABSTRACT The recent surge in funder collaboratives has allowed foundations to increase their impact as they tackle large-scale, complicated local issues. This article addresses the practice of philanthropic collaboration at one community foundation, shares a decision tree to help donors decide when a collaborative is and is not appropriate, and provides six lessons on what makes for an effective funder collaborative. Two leaders from The New York Community Trust the community foundation serving New York City, LongIsland, and Westchester provide a case study drawn from 34 funder collaboratives over the past 40 years to help others successfully embark on these joint ventures.

Should Teachers Carry Guns? An Emergency Room Survey of Parents of Two New York Communities.

The purpose of this study was to compare parents' perceptions of threats and solutions to school gun violence in two different communities. Parents of school-aged children visiting emergency rooms of two large trauma centers in Upstate New York (UNY) and New York City (NYC), between October 2019 and December 2020, were surveyed (UNY: n=202, NYC: n=100). Responses were compared by site, firearm experience, and concern for school safety. Respondents from the two sites differed by sociodemographic characteristics. Of the 302 respondents, 64% feared a school shooting incident, but UNY respondents were less likely to report concern (46.5% vs 99%, p<0.001). UNY respondents were more likely to feel safe for their children (75.3% vs 7%, p<0.001) and to report feeling safer if guns were available to teachers (22.3% vs 6%, p <0.001). Both sites' respondents agreed on the need for armed police presence (76.7% vs 74%, p=0.11). Of the 193 parents concerned about a school shooting, 11.9% indicated feeling safer if guns were available to teachers versus 25.7% of those who were not (p=0.002). Agreement on solutions for making schools safer differed by the site. NYC respondents were unanimously supportive, but UNY support ranged from 52% for metal detectors to 84.5% for controlled entry points. Although perceptions of child safety and experience with guns varied by location, most parents agreed on potential solutions, that it should be the security officers, not teachers, who should be carrying firearms and that armed police should be present in schools to provide safety.

Performance management: Learning community, capacity building, and innovation incubator

ABSTRACT In 2009, the Central New York Community Foundation (CNYCF) noticed a need in the community for greater sophistication in the area of data collection and management, with the goal of demonstrating and increasing impact. Federal funding frequently requires proven impact, but across New York State, few organizations can document this at a level that is competitive. To meet this challenge, CNYCF set out to build capacity in our community across a wide variety of nonprofit organizations. In this paper, we chronicle the ten year journey that included the evolution of a performance management learning community and the eventual launch of a community-wide and free data system to foster increased community data capacity.

How social policies shape the health and well-being of sexual- and gender-minority youth: Pathways of influence, social side effects and implications for life course trajectories

Recent research has documented the harmful health consequences of structural-level stigma that targets sexual and gender minority (SGM) individuals. In the case of sexual and gender minority youth (SGMY), life trajectories are shaped not only by targeted, SGM-focused policies, but also by social policies more broadly which may have unique impacts on SGMY given their social position. However, little work has explored the pathways that connect both targeted and universal social policies and the health and well-being of SGMY. In this study, we conducted 68 qualitative interviews with SGMY in New York City (n = 30) and community stakeholders across the US (n = 38) and used the constant comparative method to identify the pathways through which social policies affect SGMY health and well-being. We propose three pathways that are shaped by specific inter-related social policies in ways that contribute to health inequities among SGMY: 1) access to social inclusion in educational settings; 2) housing-related regulations and subsequent (in)stability; and 3) access to material resources through labor market participation. We also highlight ways that SGMY, and organizations that support them, engage in agency and resistance to promote inclusion and wellbeing. Drawing on ecosocial theory, we demonstrate how policies work across multiple domains and levels to influence cycles of vulnerability and risk for SGMY. We close by discussing the implications of our findings for future research and policy.

Exploring system resiliency within the North York Toronto Health Partners North York Community Access to Resources Enabling Support Program – A pragmatic case study

The International Journal of Integrated Care (IJIC) is an online, open-access, peer-reviewed scientific journal that publishes original articles in the field of integrated care on a continuous basis.IJIC has an Impact Factor of 2.913 (2021 JCR, received in June 2022)The IJIC 20th Anniversary Issue was published in 2021.

Equality, inclusion, and the opt-out movement: Who chooses to opt out?

There is ongoing debate in the United States about just how diverse, inclusive, and equitable the opt-out movement—and grassroots education activism more broadly—has been over the past decade. Today, a prevailing stereotype holds that the opt-out movement predominantly mobilizes white, middle-class, and suburban parents and is therefore a force for educational privilege, not equity. However, this stereotype has never been rigorously tested and it is still an open question as to how opt-out movement participants differ from non-participants, especially along the lines of race and class. Leveraging a comprehensive quantitative dataset of New York school district opt-out rates and community characteristics as well as original case study data collected from four purposefully sampled New York school districts, this study uncovers evidence challenging the dominant narrative of opt-out participation. It finds that the opt-out movement has been active across a diversity of district contexts and, with only small qualifications, has simultaneously mobilized a diverse cross section of parents within districts. However, the most active and longest-tenured opt-out parents do appear to be whiter and wealthier than the movement as a whole. This paper concludes by discussing the implications of these findings for our understanding of the U.S. opt-out movement as well as the potential of grassroots educational activism to be a force for equity and inclusion in U.S. education politics more generally.

Investigating The Causes and Effects Of Gender Based Violence on Women in New York Community in Sierra Leone. Case Study: Bo City

Investigating The Causes and Effects Of Gender Based Violence on Women in New York Community in Sierra Leone. Case Study: Bo City

Acceptability of supervised injection facilities among persons who inject drugs in upstate New York

BackgroundSupervised injection facilities (SIFs) provide spaces where persons who inject drugs (PWID) can inject under medical supervision and access harm reduction services. Though SIFs are not currently sanctioned in most of the US, such facilities are being considered for approval in several Upstate New York communities. No data exist from PWID in Upstate New York, and little from outside major US urban centers, on willingness to use SIFs and associated factors.MethodsThis analysis included 285 PWID (mean age = 38.7; 57.7% male; 72.3% non-Hispanic white) recruited for a study on hepatitis C prevalence among PWID in Upstate New York, where participants were recruited from syringe exchange programs (n = 80) and able to refer other PWID from their injection networks (n = 223). Participants completed an electronic questionnaire that included a brief description of SIFs and assessed willingness to use SIFs. We compared sociodemographic characteristics, drug use/harm reduction history, healthcare experience, and stigma between participants who were willing vs. unwilling to use such programs.ResultsOverall, 67.4% were willing to use SIFs, 18.3% unwilling, and 14.4% unsure. Among those reporting being willing or unwilling, we found higher willingness among those who were currently homeless (91.8% vs. 74.6%; p = 0.004), who had interacted with police in the past 12 months (85.7% vs. 74.5%; p = 0.04), and who were refused service within a healthcare setting (100% vs. 77.1%; p = 0.03).ConclusionOur results support SIF acceptability in several Upstate New York PWID communities, particularly among those reporting feelings of marginalization. A large proportion reported being unsure about usage of SIFs, suggesting room for educating PWID on the potential benefits of this service. Our results support SIF acceptability in Upstate New York and may inform programming for underserved PWID, should SIFs become available.