Hannah Wallace

The Inc. 5000 company went from humble beginnings to mall food courts everywhere by following three particular rules.

Amid false narratives of urban collapse, the homegrown nonprofit Literary Arts is investing in Portland’s renaissance, one book at a time.

Objective To evaluate the patterns of abnormal estimated glomerular filtration rate (eGFR) and urine albumin–creatinine ratio (UACR) follow-up testing for the detection of chronic kidney disease (CKD) in Australian general practices. Design Retrospective, population-based observational study. Setting and participants 2 717 966 adults who visited a MedicineInsight participating general practice between 1 January 2012 and 31 December 2020, had ≥1 serum creatinine measurement (with or without a UACR measurement) and did not have CKD at baseline. Main outcome measure ‘Guideline-concordant follow-up’ was defined as having a record of a repeat eGFR or UACR testing (assessed separately) within 6 months following the abnormal (eGFR<60 mL/min/1.73 m2; UACR≥2.5 mg/mmol in males, ≥3.5 mg/mmol in females) incident result. Multivariable logistic regression was used to identify patient factors associated with receiving appropriate follow-up testing. Results A total of 220 841 and 114 889 patients with an abnormal incident eGFR and UACR result, respectively, were identified. Nearly half (45.0%) of the patients with an abnormal eGFR result and over two-thirds (69.7%) of the patients with an abnormal UACR result did not have a follow-up test within 6 months. Patient factors associated with a higher likelihood of follow-up eGFR testing included indicators of poorer baseline health and greater CKD risk, such as comorbid diabetes (adjusted OR 1.36, 95% CI 1.32 to 1.40) or more severe incident eGFR (adjusted ORs for eGFR categories 30–44, 15–29 and <15 mL/min/1.73 m², respectively, vs eGFR 45–59 mL/min/1.73 m²: 1.51 (1.47 to 1.55), 1.85 (1.76 to 1.95) and 1.62 (1.47 to 1.78)). Higher incident UACR level was associated with greater follow-up UACR testing (adjusted OR for severely increased albuminuria vs moderately increased albuminuria (OR 1.42, 95% CI 1.37 to 1.48). Conclusions In this large, population-based study, we observed substantial gaps in the follow-up of abnormal eGFR and UACR for the detection of CKD in primary care settings. Effective strategies to optimise follow-up testing for CKD detection are needed. All data relevant to the study are included in the article or uploaded as supplementary information.

White oaks once dominated the vineyard-blanketed Willamette Valley. Maggie Harrison shows they don’t have to be sacrificed to grapes.

While most of the state's coastal eateries import seafood from as far as India, one has gone all-in on the boats docked right outside.

Amid the cyclospora outbreak that has sickened more than 27,000 people in 47 states, causing more than 800 hospitalizations and two untimely

Amid the cyclospora outbreak that has sickened more than 27,000 people in 47 states, causing more than 800 hospitalizations and two untimely

Amid the cyclospora outbreak that has sickened more than 27,000 people in 47 states, causing more than 800 hospitalizations and two untimely deaths, many people are blaming the federal government for letting its guard down on the monitoring of food-born illnesses.

Amid the cyclospora outbreak that has sickened more than 27,000 people in 47 states, causing more than 800 hospitalizations and two untimely deaths, many people are blaming the federal government for letting its guard down on the monitoring of food-born illnesses.