ABSTRACT
The rising prevalence of autism spectrum disorder (ASD) has led to increased efforts to support individuals with ASD across numerous aspects of life, including driving. While obtaining a driver's license substantially impacts quality of life and independence, it also creates distinct challenges for those with ASD. Challenges surrounding social communication, executive functioning, and sensory sensitivities are particularly evident when considering interactions between drivers with ASD and law enforcement personnel. Connecticut's Blue Envelope Program aims to improve interactions between drivers with and ASD law enforcement by providing instructions for officers and drivers to follow during routine traffic stops on a physical, blue colored, envelope. The instructional guidelines aim to assist officers in understanding and appropriately responding to common ASD-related behaviors which may be otherwise misinterpreted and includes accommodations officers could consider during a stop. Additionally, the envelope outlines clear steps for drivers with ASD to follow through the stop as to support predictability and expectations. The widespread acceptance, efficacy and popularity of the Blue Envelope program underscores the importance of increasing awareness and understanding of ASD among law enforcement and the need for more supports to aid in these increasing interactions. Discussion is offered on a broader implementation of this program to support individuals with ASD and officers, while improving the outcomes of interactions.
ABSTRACT
BACKGROUND: Previous research has shown that underweight patients may be at a greater risk of experiencing postsurgical complications. The purpose of this study was to investigate the association between body mass index (BMI) and postoperative complications following single-level anterior lumbar fusion (ALF). METHODS: All single-level elective ALF procedures performed between 2010 and 2020 were identified in the PearlDiver Mariner Database. Patients were separated into 6 groups based on the World Health Organization BMI classifications. Differences in postsurgical complications (ie, deep vein thrombosis, pulmonary embolism, surgical site infection, hardware malfunction, wound dehiscence, and blood transfusion) among BMI categories were assessed using a χ2 contingency test. RESULTS: Results indicated that underweight patients (BMI <20) were at a significantly greater risk of developing deep vein thromboses, experiencing hardware malfunction, and requiring blood transfusion compared with any other BMI classification (P < 0.001). Results also demonstrated that underweight individuals had similar risks of developing surgical site infection and wound dehiscence compared with patients classified as having obesity class III. CONCLUSION: Underweight patients may be at a greater risk than currently believed of experiencing postoperative complications following single-level ALF procedures. CLINICAL RELEVANCE: Patients with a BMI of 20 or less should be carefully evaluated prior to surgical intervention to ensure they are optimized for surgery.
