Nationwide trends in diagnosed sedative, hypnotic or anxiolytic use disorders in adolescents and young adults enrolled in Medicaid: 2001-2019.

Background And Aim: Sedative, hypnotic or anxiolytic use disorders (SHA-UD) are defined by significant impairment or distress caused by recurrent sedative, hypnotic or anxiolytic use. This study aimed to measure trends in the prevalence of SHA-UD diagnoses in adolescent and young adult US Medicaid enrollees from 2001 to 2019.

Design: Annual, cross-sectional study, 2001-2019.

Completeness and quality of comprehensive managed care data compared with fee-for-service data in national Medicaid claims from 2001 to 2019.

Objective: To evaluate the completeness and quality of Medicaid comprehensive managed care (CMC) data in national MAX/TAF research files.

Study Setting And Design: This observational study compared CMC with fee-for-service (FFS) enrollee data in 2001-2019 Medicaid MAX/TAF inpatient, outpatient, and pharmacy files. Completeness was assessed as the proportion of enrollees with any claim and mean claims per enrollee with any claim.

Food Environments Within and Outside of Schools Play a Critical Role in Curtailing the Rise in Obesity among School-Aged Children over Time.

Background: Sound evidence for effective community-based strategies is needed to curtail upward trends in childhood obesity in the United States (US).

Objectives: The aim of the study was to assess the association between school and community food environments and the prevalence of obesity over time.

Methods: Data were collected from K-12 schools in 4 low-income New Jersey cities in the US.

The relationship between changes in neighborhood physical environment and changes in physical activity among children: a prospective cohort study.

Background: Physical activity (PA) is associated with positive health outcomes over the entire life course. Many community-based interventions that promote PA focus on implementing incremental changes to existing facilities and infrastructure. The objective of this study was to determine if such upgrades were associated with increases in children's PA.

Differential Associations Between Changes in Food Environment and Changes in BMI Among Adults Living in Urban, Low-Income Communities.

Background: Food environments can contribute to excess weight gain among adults, but the evidence is mixed.

Objectives: This longitudinal study investigated the associations between changes in the food environment and changes in BMI in adults and whether changes in the food environment differentially impact various subgroups.

Methods: At 2 time points, BMI was calculated using self-reported height and weight data from 517 adults (mean age, 41 years) living in 4 New Jersey cities.

The Impact of Payment Reforms on the Safety Net: Examining Effects of the New Jersey Delivery System Reform Incentive Payment Program on Quality of Care Among Medicaid Beneficiaries.

The Medicaid Delivery System Reform Incentive Payment (DSRIP) program has been among the most widely adopted value-based payment strategies to drive improved population health management among safety net populations. Using comprehensive claims data from New Jersey and difference-in-differences modeling, the authors examine the impact of DSRIP pay-for-performance disease management programs on outcomes related to targeted chronic conditions. The authors find DSRIP reduced asthma hospitalizations and emergency department visits, pneumonia readmissions, and improved alcohol and drug treatment.

Active commuting to school: A longitudinal analysis examining persistence of behavior over time in four New Jersey cities.

Evidence suggests that healthy behaviors initiated during childhood may continue over time. The objective of this study was to determine whether active commuting to/from school (ACS) at baseline predicted continued ACS at follow-up two to five years later. Two cohorts of households with 3-15 year-olds in four low-income New Jersey cities were randomly sampled and followed for two to five year periods between 2009 and 2017.

Evidence That Changes in Community Food Environments Lead to Changes in Children's Weight: Results from a Longitudinal Prospective Cohort Study.

Background: Strategies to improve the community food environment have been recommended for addressing childhood obesity, but evidence substantiating their effectiveness is limited.

Objective: Our aim was to examine the impact of changes in availability of key features of the community food environment, such as supermarkets, small grocery stores, convenience stores, upgraded convenience stores, pharmacies, and limited service restaurants, on changes in children's body mass index z scores (zBMIs).

Design: We conducted a longitudinal cohort study.

Healthier school food and physical activity environments are associated with lower student body mass index.

School food and physical activity (PA) environments can influence children's dietary and physical activity behaviors. However, evidence on whether school environment is associated with students' weight status is less definitive. In this study, we examined the association between students' body mass index (BMI) and measures of school food and PA environments.

Associations between the radiographic appearance of vascular channels in proximal sesamoid bones, their microstructural characteristics and past racing performance in Thoroughbreds.

Background: Abnormalities in vascular channel appearance within the proximal sesamoid bone (PSB) are the most common findings in Thoroughbred yearling presale radiographs and are often evaluated on radiographs of adult racehorses. Despite this, their pathogenesis and clinical significance are poorly understood, and associations with racing performance are inconsistent.

Objectives: To determine microstructural characteristics of the PSBs associated with the radiographic appearance of vascular channels using microcomputed tomography (µCT) and to determine associations with past racing performance in mature horses.

Accuracy of Parent-Measured and Parent-Estimated Heights and Weights in Determining Child Weight Status.

This cohort study assesses whether parent measurements of children’s height and weight are more accurate than their respective estimates for determining weight status and how both compare with professionally measured data.

Medicaid DSRIP in New Jersey: Trade-offs between Broad Hospital Participation and Safety Net Viability.

The Delivery System Reform Incentive Payment (DSRIP) program, an increasingly utilized payment strategy to foster population health management by hospitals and outpatient providers, may sometimes generate financial and operational hardships for safety net hospitals (SNHs). The authors utilized a hospital survey and stakeholder interviews to examine impacts of the New Jersey DSRIP program, particularly focusing on its participatory structure that extended eligibility to all hospitals, and specific effects on SNHs. They found that the New Jersey DSRIP fulfilled its primary objective of conditioning receipt of Medicaid supplementary payments on quality and reporting of care by hospitals.

Impact of the 2010 US Healthy, Hunger-Free Kids Act on School Breakfast and Lunch Participation Rates Between 2008 and 2015.

Objectives: To evaluate National School Lunch Program (NSLP) and School Breakfast Program (SBP) participation over a 7-year period before and after the implementation of the 2010 Healthy, Hunger-Free Kids Act (HHFKA), which required healthier school lunch options beginning in school year (SY) 2012-2013 and healthier school breakfast options beginning in SY2013-2014.

Methods: Data were gathered from low-income, high-minority public schools in 4 New Jersey cities. We conducted longitudinal analyses of annual average daily participation (ADP) in school meals among enrolled students overall and among those eligible for free or reduced-price meals.

Prehospital transportation to therapeutic hypothermia centers and survival from out-of-hospital cardiac arrest.

Background: Clinical trials supporting the use of therapeutic hypothermia (TH) in the treatment of out-of-hospital cardiac arrest (OHCA) are based on small patient samples and do not reflect the wide variation in patient selection, cooling methods, and other elements of post-arrest care that are used in everyday practice. This study provides a real world evaluation of the effectiveness of post-arrest care in TH centers during a time of growing TH dissemination in the state of New Jersey (NJ).

Methods: Using a linked database of prehospital, hospital, and mortality records for NJ in 2009-2010, we compared rates of neurologically intact survival at discharge and at 30 days for OHCA patients transported to TH centers (N = 2363) versus other hospitals (N = 2479).

Patterns of emergency department use for dental and oral health care: implications for dental and medical care coordination.

Objectives: To describe emergency department (ED) utilization for oral conditions (OCs) focusing on total volume, costs, repeat utilization, small area predictors, and implications for dental and medical care coordination.

Methods: Administrative and demographic data for New Jersey were used to identify users of the ED for OCs and a group of "high users," defined as individuals with four or more ED visits for OCs during 2008-2010. Cost-to-charge ratios were used to estimate costs, and linear regression models applied to zip codes were used to determine strongest predictors of small area variation in ED use for OCs.

Associations between food environment around schools and professionally measured weight status for middle and high school students.

Background: Obesity rates among school-age children remain high. Access to energy-dense foods at home, in schools, in stores, and restaurants around homes and schools is of concern. Research on the relationship between food environment around schools and students' weight status is inconclusive.

A closer examination of the relationship between children's weight status and the food and physical activity environment.

Objectives: Conflicting findings on associations between food and physical activity (PA) environments and children's weight status demand attention in order to inform effective interventions. We assess relationships between the food and PA environments in inner-city neighborhoods and children's weight status and address sources of conflicting results of prior research.

Methods: Weight status of children ages 3-18 was assessed using parent-measured heights and weights.

Early impact of the Affordable Care Act on health insurance coverage of young adults.

Research Objective: To evaluate one of the first implemented provisions of the Patient Protection and Affordable Care Act (ACA), which permits young adults up to age 26 to enroll as dependents on a parent's private health plan. Nearly one-in-three young adults lacked coverage before the ACA. STUDY DESIGN, METHODS, AND DATA: Data from the Current Population Survey 2005-2011 are used to estimate linear probability models within a difference-in-differences framework to estimate how the ACA affected coverage of eligible young adults compared to slightly older adults.

Failed endoscopic sinus surgery: spectrum of CT findings in the frontal recess.

Since its introduction over 2 decades ago, functional endoscopic sinus surgery (FESS) has revolutionized the surgical management of chronic sinusitis. Performed over 200,000 times annually in the United States to treat medically refractory sinusitis, FESS has success rates as high as 98%. When surgical failure occurs, it is typically due to postoperative scarring or unaddressed outflow tract obstruction in the region of the frontal recess.

Imaging of skull base cerebrospinal fluid leaks in adults.

Cerebrospinal fluid (CSF) leak occurs when there is an osseous and dural defect at the skull base, with direct communication of the subarachnoid space to the extracranial space, usually a paranasal sinus. Recognition of the leak site and source and appropriate treatment are necessary to avoid rhinorrhea or otorrhea, low-pressure headaches, and meningitis, known complications of CSF leak. The imaging evaluation has evolved over the past several decades.

Gastric reflux is uncommon in acute post-tympanostomy otorrhea.

Objective: Acute post-tympanostomy otorrhea (APTO) is a common complication of tympanostomy tube placement. APTO has been related primarily to viral upper respiratory infections and external ear contamination. Elevated levels of gastric enzymes have been found in a large proportion of chronic middle ear effusions, implicating gastric reflux (GR) in its pathogenesis.

Treatment and outcome of human bites in the head and neck.

Objective: Our goal was to review head and neck human bite injuries for demographic, treatment, and outcome data to identify factors influencing infection. Study design Retrospective chart review of all human bite injuries (adult and pediatric) over 10 years.

Setting: Tertiary referral medical center.