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"Horowitz, Ruth"
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Breakout at the bug lab
When a giant cockroach named Max escapes from their mother's bug laboratory, Leo and his brother receive help from a mysterious stranger who advises them to think like a bug in order to recapture the runaway roach.
Book
In the Public Interest
How do we know when physicians practice medicine safely? Can we trust doctors to discipline their own? What is a proper role of experts in a democracy?In the Public Interestraises these provocative questions, using medical licensing and discipline to advocate for a needed overhaul of how we decide public good in a society dominated by private interest groups. Throughout the twentieth century, American physicians built a powerful profession, but their drive toward professional autonomy has made outside observers increasingly concerned about physicians' ability to separate their own interests from those of the general public.Ruth Horowitz traces the history of medical licensure and the mechanisms that democratic societies have developed to certify doctors to deliver critical services. Combining her skills as a public member of medical licensing boards and as an ethnographer, Horowitz illuminates the workings of the crucial public institutions charged with maintaining public safety. She demonstrates the complex agendas different actors bring to board deliberations, the variations in the board authority across the country, the unevenly distributed institutional resources available to board members, and the difficulties non-physician members face as they struggle to balance interests of the parties involved.In the Public Interestsuggests new procedures, resource allocation, and educational initiatives to increase physician oversight. Horowitz makes the case for regulations modeled after deliberative democracy that promise to open debates to the general public and allow public members to take a more active part in the decision-making process that affects vital community interests.
eBook
SAT-646 Double Jeopardy: Worse Outcomes and Higher Costs in DKA Patients with CKD
Abstract
Disclosure: S. Iftikhar: None. T. Jain: None. K. Zulqadar: None. A. Farid: None. N. Jaafar: None. R. Horowitz: None.
Double Jeopardy: Worse Outcomes and Higher Costs in DKA Patients with CKDIntroduction: Diabetic Ketoacidosis (DKA) is a serious but preventable complication that is associatedwith significant morbidity and mortality. Management depends on aggressive fluidresuscitation, insulin therapy, and electrolyte monitoring. However, available protocols areprimarily geared towards patients with normal kidney function. In this study, we aim toassess the effect of Chronic Kidney Disease (CKD)/End-Stage Renal Disease (ESRD) on theclinical outcomes and healthcare utilization in patients with DKA. Methods: We queried the 2021 National Inpatient Sample (NIS) for adult DKA hospitalizations andcompared patients based on the presence of CKD/ESRD, defined as CKD stages IV/V orESRD. The primary outcome was inpatient mortality and secondary outcomes includedcardiac arrest, intubation rates, length of stay (LOS), and total hospital charges. Univariateand multivariate logistic and linear regressions were used for statistical analyses . Weadjusted for age, gender, race, and primary insurance payer. Results: Nationwide, there were 354,195 DKA admissions in 2021, of which, 23,390 (6.60%) hadconcomitant CKD/ESRD. Patients with CKD/ESRD were older, more likely to be females orblack, and displayed an elevated Elixhauser comorbidity index. This index categorizespatient comorbidities using International Classification of Diseases (ICD) codes to predictin-hospital mortality and 30-day readmission risk. Patients with CKD/ESRD had higherrates of inpatient mortality, 9.90% vs. 8.80% with an adjusted odds ratio (aOR) of 1.53 (CI1.37–1.71, p < 0.001). They also demonstrated higher rates of cardiac arrest, 5.52% vs.2.49%, aOR 1.92 (CI 1.67–2.21, p < 0.001) and intubation, 13.53% vs. 7.79%, aOR 1.59 (CI1.44–1.75, p < 0.001). Additionally, patients with CKD/ESRD had longer LOS 9.58 vs. 5.63days with an adjusted mean difference (AMD) of 3.36 days (CI 2.98–3.74, p < 0.001) andhigher total hospital charges $139,931.20 vs. $77,302.25, AMD $55,149.80 (CI $47,055.90–$63,243.70, p < 0.001). Conclusion: While prospective trials are needed to determine the optimal management of patients withCKD/ESRD and DKA, our study suggests that patients with CKD/ESRD are at a higher risk ofworse clinical outcomes and higher healthcare utilization. Future research should explorepotential contributors to these disparities, such as higher rates of hypoglycemia, infection,or other metabolic derangements in ESRD patients, to identify modifiable factors that mayimprove outcomes. This study underscores the need for early identification and morepersonalized care to improve outcomes.
Presentation: Saturday, July 12, 2025
Journal Article
Organic Public Sociology in the Pragmatist Perspective: A Multifaceted Approach
This article argues that American pragmatism provides a model for organic public sociology, defined by Michael Burawoy as the sociologist's direct involvement with a group in a collaborative effort to bring about change, which permits and encourages a combined professional research and activist project. I use my project involving medical licensing and disciplinary boards to illustrate how those projects can be successfully combined. I served as a public member, conducted research, and was an advocate for change.
Journal Article