Academic literature on the topic 'Rhode island, directories'

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Physician Assisted Suicide (PAS) is illegal in Rhode Island. The Lila Manfield Sapinsley Compassionate Care Act would make PAS legal if passed into law and it was reintroduced (H-5572) in 2021 in the General Assembly of Rhode Island. This letter by SCSS Board of Directors member Dr. Peter Colosi of Salve Regina College in Rhode Island was written in response to that and was published in The Newport Daily News in Newport, Rhode Island, on March 18, 2021, and is reprinted in the Review with permission.

Were banks in the Jacksonian era merely bastions of privilege or were they vehicles of upward mobility for those without capital? The authors attempt to answer these questions by analyzing changes in the wealthholdings of directors of banks in Providence, Rhode Island, during the period 1830 to 1845. They find that bank charters granted in the 1830s did tend to benefit men with relatively little property and that they provided a rising group of entrepreneurs with the financial wherewithal to challenge the established elite.

Background:Young children’s physical activity (PA) is influenced by their child care environment. This study assessed PA practices in centers from Massachusetts (MA) and Rhode Island (RI), compared them to best practice recommendations, and assessed differences between states and center profit status. We also assessed weather-related practices.Methods:Sixty percent of MA and 54% of RI directors returned a survey, for a total of 254. Recommendations were 1) daily outdoor play, 2) providing outdoor play area, 3) limiting fixed play structures, 4) variety of portable play equipment, and 5) providing indoor play area. We fit multivariable linear regression models to examine adjusted associations between state, profit status, PA, and weather-related practices.Results:MA did not differ from RI in meeting PA recommendations (β = 0.03; 0.15, 0.21; P = .72), but MA centers scored higher on weather-related practices (β = 0.47; 0.16, 0.79; P = .004). For-profit centers had lower PA scores compared with nonprofits (β = −0.20; 95% CI: −0.38, −0.02; P = .03), but they did not differ for weather (β = 0.12; −0.19, 0.44; P = .44).Conclusions:More MA centers allowed children outside in light rain or snow. For-profit centers had more equipment—both fixed and portable. Results from this study may help inform interventions to increase PA in children.

Introduction: Secondary polycythemia is a disorder of increased hemoglobin or hematocrit most often resulting from states of systemic hypoxia such as chronic obstructive pulmonary disease (COPD). Many patients with secondary polycythemia are treated with phlebotomy to reduce hematocrit levels based on recommendations for polycythemia vera (PV)-a myeloproliferative neoplasm characterized by increased red blood cell mass and a greater risk for thromboembolic events-despite the lack of evidence demonstrating whether or not secondary polycythemia patients share this increased risk. While the pro-thrombotic state in PV has been associated with JAK2 allele burden, leukocytosis, and hypercoagulability, similar changes have not been reflected in secondary polycythemia. Because there is limited data on the efficacy or necessity of phlebotomy in patients with secondary polycythemia, our study aims to determine if phlebotomy affects the prevalence of arterial and venous thrombotic events in this patient population Methods: We retrospectively identified patients seen at Rhode Island Hospital/The Miriam Hospital from 1/1/2000 to 1/1/2019 with COPD and a diagnosis of secondary polycythemia via ICD9 coding. Polycythemia was defined as a hemoglobin level greater than 16.0 g/dL in women or 16.5 g/dL in men on at least 2 separate occasions. Data was collected on JAK2 allele status, phlebotomy treatment, co-morbidities, hematologic values, and thrombotic events. Arterial thrombotic events included myocardial infarction (MI), cerebrovascular accident (CVA), and transient ischemic attack (TIA). Venous thrombotic events included deep vein thrombosis (DVT) and pulmonary embolism (PE). Analysis of data was done by chi-square and Mann-Whitney U testing. Results: We identified 151 COPD patients who had a median age of 58 years and hemoglobin of 17 g/dL at time of secondary polycythemia diagnosis. Of these patients, all 58 (38.4%) that underwent testing were negative for the JAK2 V617F allele. Within the study population, 35 (23.2%) of patients were treated with phlebotomy and 116 (76.8%) were not. There was no difference in the median time of follow up for those who did and did not receive phlebotomy (5.6 vs 4.3 years, p=0.46). Phlebotomized patients had a higher hemoglobin (17.1 g/dL vs 16.9 g/dL, p=0.02) and hematocrit (52.2% vs 50%, p=0.007) compared to non-phlebotomized patients. Patients who underwent phlebotomy were more likely to be older (p=0.1) and have obstructive sleep apnea (p=0.06) (Table 1). Thrombotic events were recorded in 22.4% (26/116) of non-phlebotomized patients and 31.4% (11/35) of phlebotomized patients, with no statistically significant difference between the two groups (p=0.28) (Figure 1). Of the 42 patients who had COPD further confirmed by pulmonary function testing (PFT) with a documented post-bronchodilator FEV1/FVC < 0.7, there was also no significant difference in prevalence of total thrombotic events between patients who were and were not treated by phlebotomy. In this group of patients, there were thrombotic events in 18.8% (6/32) of phlebotomized patients and 10% (1/10) of non-phlebotomized patients (p=0.66). There was no statistically significant difference in prevalence of thrombotic events in phlebotomized patients who did and did not achieve phlebotomy goals. Patients who achieved a goal of hematocrit < 52% had a 25% (4/16) prevalence of thromboses compared to 36.8% (7/19) in those who did not (p=0.45). Conclusions: We found no difference between prevalence of arterial, venous, or total thromboses in COPD patients with secondary polycythemia who were phlebotomized compared to those who were not. Similarly, there was no statistically significant reduction in prevalence of thrombotic events in patients who met the phlebotomy hematocrit goal of 52%. Thus, while secondary polycythemia patients often undergo phlebotomy to reduce hematocrit levels, our results provide no clear evidence that phlebotomy is necessary for or effective at reducing thrombotic risk in secondary polycythemia patients. Disclosures Olszewski: Spectrum Pharmaceuticals: Research Funding; Adaptive Biotechnologies: Research Funding; Genentech: Research Funding; TG Therapeutics: Research Funding. Reagan:Pfizer: Research Funding; Incyte: Membership on an entity's Board of Directors or advisory committees.