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Abstract: Background: Shopping cart-related injuries are an important cause of childhood injury in the United States (US). To date, few studies have investigated the epidemiology and incidence of these injuries. Methods: The National Electronic Injury Surveillance System was utilized to identify shopping cart-related injuries from 2002 to 2006. Injury rates were calculated using the 2006 US population estimates for gender (male and female), age group (<5 years, 5–9 years, and 10–14 years), and race (White, Black, and other). Results: The overall injury rate was 37.8 per 100000 person years (PY). Injury rates did not differ significantly by gender or race. However, injury rates decreased markedly with increasing age and were highest among children <5 years of age (97.8 per 100000PY), followed by children 5–9 years (13.9 per 100000PY), and children 10–14 years (2.9 per 100000PY). Conclusions: Shopping carts continue to be an important cause of injuries among children. Directing safety awareness toward those families with children <5 years, mandatory safety standards, and modification of shopping cart design may decrease injury rates. [Copyright &y& Elsevier]

Explains strategies for adopting best value practices in developing business logistics in the United States. Definition of the best value approach in the Air Force FAR Supplement; Research findings indicating the most effective best value approaches.

Presents views on logistics in the U.S. Air Force. Comparison of the cost of proposal with the cost of conducting an operation; Requirements for the statement of work; Means of controlling the most efficient organization by functional commanders.

Introduction: The prevalence of obesity is on the rise in the Unites States, and obesity has been associated with increased complications and costs in a variety of complex surgeries. However, the contribution of obesity to the overall costs of radical cystectomy has not been studied in detail using contemporary data. Our objective is to assess the variation in healthcare costs due to obesity on the index hospitalization for radical cystectomy in the United States between 2003 and 2015.Materials and Methods: This was a retrospective cohort study, using the Premier Healthcare Database, of 1,242 patients who underwent radical cystectomy and were either overweight (25  ≤  body mass index [BMI] < 30), obese (30  ≤  BMI < 40), or morbidly obese (BMI ≥ 40). The primary outcome costs of the index hospitalization for each BMI category. Multivariable median regression was used to identify drivers of increased costs.Results: The cost of the index hospitalization for cystectomy was $24,596 (95% confidence interval [CI], $22,599-$26,592) for overweight patients. The costs for obese and morbidly obese patients were $2,158 (95% CI, -$80 to $4,395, P = 0.059) and $5,308 (95% CI, $2,652-$7,964, P < 0.001) higher compared to overweight patients, respectively. After adjustment for operative time or length of stay in the multivariable models, there were no longer any differences in cost. Operative time was prolonged as BMI increased (median operative time for overweight, obese, and morbidly obese: 346, 391, and 420 minutes, respectively P = 0.0001). Median length of stay was 1 day shorter for overweight vs. morbidly obese patients (P = 0.0030), with each additional day costing $1,738 (95% CI, $1,654 to $1,821, P < 0.0001) on multivariable analysis.Conclusions: The cost of radical cystectomy is greater for obese and morbidly obese patients compared to overweight patients. The increased financial cost is driven by increased operative times and longer length of stay. [ABSTRACT FROM AUTHOR]

Background: Penile cancer remains a rare disease in the United States, and its understanding may be limited by the uncommon nature of the malignancy. We sought to describe recent penile cancer treatment patterns using the National Cancer Data Base.Methods: A retrospective review of data obtained from the National Cancer Data Base from 1998 to 2012 was performed. We obtained demographic information and therapeutic approaches within the following2 clinical scenarios: performance of partial penectomy for early stage disease (clinical Ta-T2) and the use of chemotherapy for metastatic disease. Multivariate logistic analysis was performed.Results: A total of 2,677 patients presented with early stage penile carcinoma. The proportion receiving partial penectomy increased from 74% in 1998 to 2000 to 80% in 2010 to 2012 (P<0.001). Partial penectomy was more common in the elderly (age>80, odd ratios [OR] = 1.53, 95% CI: 1.05-2.23), young (age<50, OR = 1.46, 95% CI: 1.02-2.07), and in African Americans (OR = 1.45, 95% CI: 1.00-2.12). Increasing tumor size was significantly associated with decreased likelihood of receiving partial penectomy. Of those presenting with metastatic disease (n = 819), use of chemotherapy increased over the time period from 39% receiving chemotherapy in 1998 to 2000 to 49% in 2010 to 2012 (P<0.03). Patients least likely to receive chemotherapy were older and with higher Comorbidity score (both P<0.05), African American (OR = 0.46, 95% CI: 0.30-0.73), and living≥50 miles from the nearest treatment hospital (OR = 0.37, 95% CI: 0.25-0.55).Conclusions: Penile-sparing surgery for early stage disease and the use of chemotherapy for metastatic disease are becoming more commonly utilized over the past several years. Further work is needed to define clinical and nonclinical factors associated with the treatment. [ABSTRACT FROM AUTHOR]