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Article ; Online: The Surgeon and the Mother.

Carmichael, Heather

2021 Volume 384, Issue 4, Page(s) 302–303

MeSH term(s)	Female ; Hernias, Diaphragmatic, Congenital ; Humans ; Infant, Newborn ; Male ; Mother-Child Relations/psychology ; Surgeons/psychology
Language	English
Publishing date	2021-01-23
Publishing country	United States
Document type	Journal Article ; Personal Narrative
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMp2029239
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Article ; Online: Response Regarding: "Bedside Anatomy": A Tool to Contextualize Learning and Introduce Surgical Careers.

Carmichael, Heather

The Journal of surgical research

2020 Volume 253, Page(s) 306

MeSH term(s)	Education, Medical, Undergraduate ; Learning
Language	English
Publishing date	2020-05-06
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2020.04.002
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Article ; Online: AUTHOR REPLY.

Antoine, Samuel G / Carmichael, Heather / Lloyd, Granville L

Urology

2022 Volume 163, Page(s) 49

Language	English
Publishing date	2022-05-28
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2021.05.095
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Article: Evolution of Transanal Total Mesorectal Excision.

Carmichael, Heather / Sylla, Patricia

Clinics in colon and rectal surgery

2020 Volume 33, Issue 3, Page(s) 113–127

Abstract: Minimally invasive techniques continue to transform the field of colorectal surgery. Because traditional surgical approaches for rectal cancer are associated with significant mortality and morbidity, developing less invasive approaches to this disease is ...

Abstract	Minimally invasive techniques continue to transform the field of colorectal surgery. Because traditional surgical approaches for rectal cancer are associated with significant mortality and morbidity, developing less invasive approaches to this disease is paramount. Natural orifice transluminal endoscopic surgery (NOTES), commonly known as "no incision surgery," represents the ultimate minimally invasive approach to disease. Although transgastric and transvaginal approaches for NOTES surgery were the initially explored, a transrectal approach for colorectal disease is intuitive given that it makes use of the resected organ for transluminal access. Furthermore, the transanal approach allows for improved, precise visualization of the presacral mesorectal plane compared with an abdominal viewpoint, particularly in the narrow, male pelvis. Finally, experience with existing transanal platforms that have been used for decades for local excision of rectal disease made the development of a transanal approach to total mesorectal excision (TME) feasible. Here, we will review the evolution of minimally invasive and transanal surgical techniques that allowed for the development of transanal TME and its introduction into clinical practice.
Language	English
Publishing date	2020-04-28
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2048635-2
ISSN	1531-0043
ISSN	1531-0043
DOI	10.1055/s-0039-3402773
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Article ; Online: Geographic distribution of colonoscopy providers in the United States: An analysis of medicare claims data.

Carmichael, Heather / Samuels, Jason M / Velopulos, Catherine G / Jones, Edward L

Surgical endoscopy

2022 Volume 36, Issue 10, Page(s) 7673–7678

Abstract: Introduction: Screening colonoscopy is one of the few procedures that can prevent cancer. While the majority of colonoscopies in the USA are performed by gastroenterologists, general surgeons play a key role in at-risk, rural populations. The aim of ... ...

Abstract	Introduction: Screening colonoscopy is one of the few procedures that can prevent cancer. While the majority of colonoscopies in the USA are performed by gastroenterologists, general surgeons play a key role in at-risk, rural populations. The aim of this study was to examine geographic practice patterns in colonoscopy using a nationwide Medicare claims database. Methods and procedures: The 2017 Medicare Provider Utilization and Payment database was used to identify physicians performing colonoscopy. Providers were classified as gastroenterologists, surgeons, ambulatory surgical centers (ASCs), or other. Rural-Urban Commuting Area classification at the zip code level was used to determine whether the practice location for an individual provider was in a rural area/small town (< 10,000 people), micropolitan area (10-50,000 people), or metropolitan area (> 50,000 people). Results: Claims data from 3,861,187 colonoscopy procedures on Medicare patients were included. The majority of procedures were performed by gastroenterologists (57.2%) and ASCs (32.1%). Surgeons performed 6.8% of cases overall. When examined at a zip code level, surgeons performed 51.6% of procedures in small towns/rural areas and 21.7% of procedures in micropolitan areas. Individual surgeons performed fewer annual procedures as compared to gastroenterologists (median 51 vs. 187, p < 0.001). Conclusions: Surgeons perform the majority of colonoscopies in rural zip codes on Medicare patients. High-quality, surgical training in endoscopy is essential to ensure access to colonoscopy for patients outside of major metropolitan areas.
MeSH term(s)	Aged ; Colonoscopy ; Endoscopy, Gastrointestinal ; Humans ; Medicare ; Rural Population ; Surgeons ; United States
Language	English
Publishing date	2022-06-21
Publishing country	Germany
Document type	Journal Article
ZDB-ID	639039-0
ISSN	1432-2218 ; 0930-2794
ISSN (online)	1432-2218
ISSN	0930-2794
DOI	10.1007/s00464-022-09083-3
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Article ; Online: When more is less: Urban disparities in access to surgical care by transportation means.

Carmichael, Heather / Tran, Billy / Velopulos, Catherine G

American journal of surgery

2021 Volume 223, Issue 1, Page(s) 112–119

Abstract: Background: Structural factors limiting access to surgical care require elucidation. We hypothesize transportation time to hospitals with surgical capacity disproportionately burdens minority populations.: Methods: We identified hospitals with ... ...

Abstract	Background: Structural factors limiting access to surgical care require elucidation. We hypothesize transportation time to hospitals with surgical capacity disproportionately burdens minority populations. Methods: We identified hospitals with surgical capacity within a 20-mile radius of our city center. Using geocoding, we estimated travel times from each census tract to the nearest facility by car or public bus. Results: For 143 tracts within the county, drive time was 13 ± 4 min and bus time was 33 ± 15 min. Only 41.2% of the population had a facility within 30 min by bus; access was further diminished for those with minority race/ethnicity and/or no insurance. Bus time was associated with percent minority population in a census tract: for each 10% increase in minority population there was a 4.3-min increase in bus time (p < 0.001) when controlling for socioeconomic status and other characteristics. Conclusions: Geographic information systems analysis has potential to identify communities with disproportionate burden to access surgical services.
MeSH term(s)	Adult ; Census Tract ; Health Services Accessibility/economics ; Health Services Accessibility/statistics & numerical data ; Healthcare Disparities/statistics & numerical data ; Hospitals, Urban/statistics & numerical data ; Humans ; Social Determinants of Health/economics ; Social Determinants of Health/statistics & numerical data ; Socioeconomic Factors ; Time Factors ; Transportation/economics ; Transportation/methods ; Transportation/statistics & numerical data
Language	English
Publishing date	2021-08-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2021.07.052
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Article ; Online: The Impact of Race, Ethnicity and Insurance Status on Surgery Rates for Benign Prostatic Hyperplasia.

Antoine, Samuel G / Carmichael, Heather / Lloyd, Granville L

Urology

2021 Volume 163, Page(s) 44–49

Abstract: Objective: To determine whether patient race/ethnicity are associated with differences in likelihood of undergoing surgical treatment for LUTS/BPH.: Methods: Queried hospital network database between 1/2011 and 10/2018. Men over age 40 on medical ... ...

Abstract	Objective: To determine whether patient race/ethnicity are associated with differences in likelihood of undergoing surgical treatment for LUTS/BPH. Methods: Queried hospital network database between 1/2011 and 10/2018. Men over age 40 on medical therapy for LUTS (selective alpha blockade and/or 5-alpha-reductase inhibitor), with 2+ provider visits, and without bladder/prostate malignancy were included. Ethnicity/race determined by self-identification. Insurance status classified as public (Medicare/Medicaid/Tricare), private, self-pay, or other. Multivariable backwards step-wise logistic regression was performed to compare odds of undergoing a surgical procedure by race/ethnicity, controlling for patient age, insurance status, comorbidities, and type of medical therapy. Results: 30,466 patients included, with White (n=24,443, 80.2%), Hispanic (n=2,715, 8.9%), Black (n=1,245, 4.1%), and other race/ethnicity (2,073, 6.8%) identified within the study population. After adjusting for age, insurance status, major comorbidities, and type of medical therapy, Black patients were less likely to undergo surgery than White patients (OR 0.57, 95% CI 0.37 - 0.88, P = .011), as were patients of other race/ethnicity (OR 0.67, 95% CI 0.49 - 0.92, P = .013). Conclusions: Adjusting for age, insurance status, major comorbidities and type of LUTS medication, men categorized as Black were significantly less likely to undergo surgical treatment for LUTS/BPH than White patients. It is unknown whether this difference results from differences in counseling, access, or other bias in therapy. Efforts to understand and respond to this disparity are necessary. Limitations include lack of IPSS data, additional comorbidity data, limited geographic area, and retrospective nature.
MeSH term(s)	Adult ; Aged ; Ethnicity ; Humans ; Insurance Coverage ; Male ; Medicare ; Prostatic Hyperplasia/epidemiology ; Prostatic Hyperplasia/surgery ; Retrospective Studies ; United States
Language	English
Publishing date	2021-07-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	192062-5
ISSN	1527-9995 ; 0090-4295
ISSN (online)	1527-9995
ISSN	0090-4295
DOI	10.1016/j.urology.2021.05.092
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Article ; Online: Circumstances of Suicide Among Lesbian, Gay, Bisexual and Transgender Individuals.

Patten, Monica / Carmichael, Heather / Moore, Alison / Velopulos, Catherine

The Journal of surgical research

2021 Volume 270, Page(s) 522–529

Abstract: Introduction: Suicide rates for sexual minorities are higher than the heterosexual population. The purpose of this study is to explore circumstances surrounding suicide completion to inform future intervention strategies for suicide among lesbian, gay, ... ...

Abstract	Introduction: Suicide rates for sexual minorities are higher than the heterosexual population. The purpose of this study is to explore circumstances surrounding suicide completion to inform future intervention strategies for suicide among lesbian, gay, bisexual and transgender (LGBT) individuals. Materials and methods: We completed a retrospective analysis of data from the National Violent Death Reporting System (NVDRS) from 2013-2017. Victims identified as transgender were considered separately. We stratified analysis by identified sex of the victim for the LGB population. Results: Of the 16,831 victims whose sexual orientation or transgender status was known: 3886 (23.1%) were identified as female, 12,945 (76.9%) were identified as male. 479 (2.8%) were identified as LGBT; of these, 53 (11%) were transgender. LGBT victims were younger than non-LGBT victims. Male LGB victims were more likely to have a history of prior suicide attempts, past or current mental illness diagnosis, and were less likely to use firearms than male heterosexual victims. Female LGB victims were more likely to have problems in an intimate partner relationship than heterosexual women, while LGB men were more likely to have problems in family or other relationships. Transgender victims were again more likely to have mental health problems and a history of prior attempts, but less likely to have intimate partner problems and more likely to have a history of child abuse. Conclusions: These results highlight the importance of promoting suicide interventions that recognize the complex intersection between stated gender, sex, and sexuality and the different cultural impacts these identities can have.
MeSH term(s)	Female ; Gender Identity ; Humans ; Male ; Retrospective Studies ; Sexual Behavior ; Sexual and Gender Minorities ; Transgender Persons
Language	English
Publishing date	2021-11-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2021.08.029
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Article ; Online: Medical Response and Factors Leading to Violent Death in the United States Incarcerated Population.

Moore, Allison / Carmichael, Heather / Velopulos, Catherine

The Journal of surgical research

2021 Volume 269, Page(s) 234–240

Abstract: Background: This study aims to characterize trauma-associated deaths in the United States prison system. We hypothesize that incarcerated victims are less likely to receive appropriate medical care compared to the non-incarcerated.: Methods: We ... ...

Abstract	Background: This study aims to characterize trauma-associated deaths in the United States prison system. We hypothesize that incarcerated victims are less likely to receive appropriate medical care compared to the non-incarcerated. Methods: We utilized 2015-2017 National Violent Death Reporting System data. Victims were classified by whether they were seen by emergency medical services, in the emergency room, or hospitalized prior to death, with the latter considered higher levels of care. Propensity score matching was used to compare highest level of care received by incarcerated versus non-incarcerated victims with similar age, sex, race/ethnicity, weapon type, and state where the incident occurred. Results: Of 101,054 victims, 1229 (1.2%) were incarcerated at the time of fatal injury; 64.4% died by suicide. For suicide, the proportion of minority victims was higher in the incarcerated compared to the non-incarcerated population, but the opposite was true of homicide. Firearms were more commonly used in the non-incarcerated population. After Propensity score matching, we found that incarcerated victims received higher levels of medical care following suicide (P < 0.001) while there was no difference for homicide (P = 0.28). However, when only victims injured in public settings were included, we found that incarcerated homicide victims were less likely to receive hospital-based medical care. Conclusions: Contrary to our hypothesis, overall, incarcerated victims received similar levels of medical care as compared to non-incarcerated victims following lethal injury. However, this fails to account for the highly supervised setting of prisons. Our findings reinforce that violence prevention methods should be tailored to specific populations.
MeSH term(s)	Cause of Death ; Homicide ; Humans ; Population Surveillance ; Prisoners ; United States/epidemiology ; Violence
Language	English
Publishing date	2021-10-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2021.07.002
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Article ; Online: Immigrating to Unsafe Spaces: Unique Patterns of Homicide in Immigrant Victims Compared to Native-Born Citizens.

Abolarin, Joshua / Myers, Quintin W O / Carmichael, Heather / Moore, Allison / Velopulos, Catherine G

The Journal of surgical research

2023 Volume 288, Page(s) 321–328

Abstract: Introduction: Contrary to popular belief, immigrant enclaves produce less crime than other areas of the United States, yet that does not mean immigrants avoid violent crime altogether. The purpose of this project is to better characterize the victims of ...

Abstract	Introduction: Contrary to popular belief, immigrant enclaves produce less crime than other areas of the United States, yet that does not mean immigrants avoid violent crime altogether. The purpose of this project is to better characterize the victims of homicide in this population. Specifically, we sought to compare differences in victim demographics, injury patterns, and circumstances of violent death between the immigrant population and native-born victims of homicide. Methods: We queried the National Violent Death Reporting System (NVDRS) from the years 2003-2019 for deaths in victims who were born outside of the United States. We extracted demographic information including age, race or ethnicity, means of homicide, and circumstances surrounding the event to compare immigrant to nonimmigrant deaths. Results: Immigrant victims were less likely to be killed by a firearm and to have substance use or alcohol implicated. Immigrant victims were twice as likely to be killed during multiple homicide events that involved suicide of the perpetrator (2.1% to 1%, P ≤ 0.001) and to be killed by a stranger (12.9% to 6.2%, P ≤ 0.001). Immigrant victims were also more likely to be killed during the perpetration of another crime (19.1% to 15%, P ≤ 0.001), and more likely to be killed in a commercial setting such as a grocery store or retail outlet (7.6% to 2.4%, P ≤ 0.001). Conclusions: Injury prevention measures for the immigrant population require different techniques, focusing on distinct features of victimization centered on random acts in contrast to native-born citizens who tend to be victims of people they know.
MeSH term(s)	Humans ; United States/epidemiology ; Homicide ; Cause of Death ; Population Surveillance ; Emigrants and Immigrants ; Indigenous Peoples
Language	English
Publishing date	2023-04-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2023.01.005
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