High‐risk Opioid Analgesic Dispensing to Adolescents 12‐18 Years Old in South Carolina: 2010‐2017

2021 ◽  
Author(s):  
William T. Basco ◽  
Jenna L. McCauley ◽  
Jingwen Zhang ◽  
Justin E. Marsden ◽  
Kit N. Simpson ◽  
...  
Keyword(s):  
South Carolina ◽  
High Risk ◽  
Opioid Analgesic

The Adam Walsh Act

Sexual Abuse ◽  
2016 ◽  
Vol 28 (8) ◽  
pp. 722-740 ◽  
Author(s):  
Kristen M. Zgoba ◽  
Michael Miner ◽  
Jill Levenson ◽  
Raymond Knight ◽  
Elizabeth Letourneau ◽  
...  
Keyword(s):  
Risk Assessment ◽  
South Carolina ◽  
High Risk ◽  
Sex Offenders ◽  
Sex Offender ◽  
Assessment Instruments ◽  
Recidivism Rate ◽  
State Classification ◽  
Adam Walsh Act ◽  
Tier 3

This study was designed to compare the Adam Walsh Act (AWA) classification tiers with actuarial risk assessment instruments and existing state classification schemes in their respective abilities to identify sex offenders at high risk to re-offend. Data from 1,789 adult sex offenders released from prison in four states were collected (Minnesota, New Jersey, Florida, and South Carolina). On average, the sexual recidivism rate was approximately 5% at 5 years and 10% at 10 years. AWA Tier 2 offenders had higher Static-99R scores and higher recidivism rates than Tier 3 offenders, and in Florida, these inverse correlations were statistically significant. Actuarial measures and existing state tier systems, in contrast, did a better job of identifying high-risk offenders and recidivists. As well, we examined the distribution of risk assessment scores within and across tier categories, finding that a majority of sex offenders fall into AWA Tier 3, but more than half score low or moderately low on the Static-99R. The results indicate that the AWA sex offender classification scheme is a poor indicator of relative risk and is likely to result in a system that is less effective in protecting the public than those currently implemented in the states studied.

scholarly journals Trends in Dispensed Opioid Analgesic Prescriptions to Children in South Carolina: 2010–2017

PEDIATRICS ◽  
2021 ◽  
pp. e20200649
Author(s):  
William T. Basco ◽  
Jenna L. McCauley ◽  
Jingwen Zhang ◽  
Patrick D. Mauldin ◽  
Kit N. Simpson ◽  
...  
Keyword(s):  
South Carolina ◽  
Opioid Analgesic

The effect of state policies on rates of high-risk prescribing of an initial opioid analgesic

2021 ◽  
pp. 109232
Author(s):  
Bradley D. Stein ◽  
Flora Sheng ◽  
Erin A. Taylor ◽  
Andrew W. Dick ◽  
Mark Sorbero ◽  
...  
Keyword(s):  
High Risk ◽  
Opioid Analgesic ◽  
State Policies

scholarly journals Opioid analgesic use after ambulatory surgery: a descriptive prospective cohort study of factors associated with quantities prescribed and consumed

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e047928
Author(s):  
Christopher W Shanahan ◽  
Olivia Reding ◽  
Inga Holmdahl ◽  
Julia Keosaian ◽  
Ziming Xuan ◽  
...  
Keyword(s):  
Chronic Pain ◽  
High Risk ◽  
Drug Use ◽  
Opioid Analgesic ◽  
Safety Net ◽  
Opioid Consumption ◽  
Secondary Outcome ◽  
Prescribing Practices ◽  
Opioid Prescription ◽  
Opioid Prescribing

ObjectivesTo prospectively characterise: (1) postoperative opioid analgesic prescribing practices; (2) experience of patients undergoing elective ambulatory surgeries and (3) impact of patient risk for medication misuse on postoperative pain management.DesignLongitudinal survey of patients 7 days before and 7–14 days after surgery.SettingAcademic urban safety-net hospital.Participants181 participants recruited, 18 surgeons, follow-up data from 149 participants (82% retention); 54% women; mean age: 49 years.InterventionsNone.Primary and secondary outcome measuresTotal morphine equivalent dose (MED) prescribed and consumed, percentage of unused opioids.ResultsSurgeons postoperatively prescribed a mean of 242 total MED per patient, equivalent to 32 oxycodone (5 mg) pills. Participants used a mean of 116 MEDs (48%), equivalent to 18 oxycodone (5 mg) pills (~145 mg of oxycodone remaining per patient). A 10-year increase in patient age was associated with 12 (95% CI (−2.05 to –0.35)) total MED fewer prescribed opioids. Each one-point increase in the preoperative Graded Chronic Pain Scale was associated with an 18 (6.84 to 29.60) total MED increase in opioid consumption, and 5% (−0.09% to –0.005%) fewer unused opioids. Prior opioid prescription was associated with a 55 (5.38 to –104.82) total MED increase in opioid consumption, and 19% (−0.35% to –0.02%) fewer unused opioids. High-risk drug use was associated with 9% (−0.19% to 0.002%) fewer unused opioids. Pain severity in previous 3 months, high-risk alcohol, use and prior opioid prescription were not associated with postoperative prescribing practices.ConclusionsParticipants with a preoperative history of chronic pain, prior opioid prescription, and high-risk drug use were more likely to consume higher amounts of opioid medications postoperatively. Additionally, surgeons did not incorporate key patient-level factors (eg, substance use, preoperative pain) into opioid prescribing practices. Opportunities to improve postoperative opioid prescribing include system changes among surgical specialties, and patient education and monitoring.

Environmental Factors and High Risk of Esophageal Cancer Among Men in Coastal South Carolina

1988 ◽  
Vol 80 (20) ◽  
pp. 1620-1625 ◽  
Author(s):  
L. M. Brown ◽  
W. J. Blot ◽  
S. H. Schuman ◽  
V. M. Smith ◽  
A. G. Ershow ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
South Carolina ◽  
High Risk ◽  
Environmental Factors

Decreasing early mortality (30-day) in APL patients with use of streamlined treatment guidelines and support from core group of experts.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7091-7091
Author(s):  
Anand P. Jillella ◽  
Farrukh Tauseef Awan ◽  
Jeremy Mark Pantin ◽  
Ravindra B. Kolhe ◽  
Vamsi Kota
Keyword(s):  
South Carolina ◽  
High Risk ◽  
Large Scale ◽  
Causes Of Death ◽  
Treatment Guidelines ◽  
Treatment Algorithm ◽  
Treatment Protocol ◽  
Early Mortality ◽  
Low Risk ◽  
Catchment Population

7091 Background: Recent evidence from population based studies in Brazil and US SEER data show that the early mortality (EM) in APL is around 30%. This is in contrast to observation in clinical trials where it is 5%. The common causes of death are hemorrhagic complications (HC), infection, differentiation syndrome (DS) and multi-organ failure. HC are unique to this condition due to DIC and HC are seen in upto 60% of patients. Hence, decreasing early deaths is a high priority at all leukemia treatment centers. We report our updated results showing that use of set of streamlined treatment guidelines along with support from experts decreases early deaths. Methods: At Georgia Regents University, between 7/2005 and 6/2009, 19 patients were diagnosed with APL. 7 patients (5 high-risk and 2 low-risk) died during induction resulting in an unusually high mortality rate of 37%. All patients who survived induction are still in remission at present. The high early death rate prompted us to develop a simple, 2 page treatment algorithm that focuses on quick diagnosis, prompt initiation of therapy, and proactive and aggressive management of all the major causes of death during induction. We also made our treatment protocol available to smaller treatment centers and helped the treating oncologists manage the patient during the first few days after diagnosis. Results: From 11/2010 to 12/2012, we treated 5 patients at GRU and helped manage 9 patients at 5 practices. Age range was 30-60 years. 4 patients were high-risk, 7 intermediate and three low-risk. There were no deaths during induction. Only 1 patient (8%) had HC and 4 had DS. Conclusions: While we recognize that this is a small cohort, our own experience and a similar approach pioneered by investigators in Brazil clearly shows this to be an effective model to decrease early deaths in APL. We believe our experience warrants large scale implementation of our protocol in an attempt to decrease early mortality in APL. We were awarded a 1.68 million grant by the Leukemia Lymphoma Society to implement this protocol in the states of Georgia and South Carolina with a catchment population of 15 million over a 3 year period.

scholarly journals A Spatiotemporal Analysis of Socio-Environmental Patterns in Severe Maternal Morbidity: A Retrospective Birth Cohort

2021 ◽  
Author(s):  
Stella Harden ◽  
Jennifer D Runkle ◽  
Margaret Mae Sugg
Keyword(s):  
Risk Factors ◽  
South Carolina ◽  
High Risk ◽  
Maternal Morbidity ◽  
Spatial Clustering ◽  
Spatiotemporal Analysis ◽  
Severe Maternal Morbidity ◽  
Spatial Scan Statistic ◽  
Black Patients ◽  
The Impact

Objectives. Severe Maternal Morbidity (SMM) is a group of pregnancy complications in which a woman nearly dies. Despite its increasing prevalence, there is little research that evaluates geographic patterns of SMM and the underlying social determinants that influence excess risk. This study examines the spatial clustering of SMM across South Carolina, US, and its associations with place-based social and environmental factors. Methods. Hospitalized deliveries from 1999 to 2017 were analyzed using Kulldorff's spatial scan statistic to locate areas with abnormally high rates of SMM. Patients inside and outside risk clusters were compared using Generalized Estimating Equations (GEE) to determine underlying risk factors. Results. Final models revealed that the odds of living in a high-risk cluster were 84% higher among Black patients (OR=1.84, p<.001), 30% higher among Hispanic and Latina patients (OR=1.3, p<.05), and 1.51 times more likely among women living in highly segregated and poorer minority communities (OR=1.51 p<.001). Odds for residing in a high-risk cluster were 23% higher for those who gave birth during a period with temperatures above 30.65C/87.3F (OR=1.23, p<.001). Conclusions. This study is the first to characterize the geographic clustering of SMM risk in the US. Our geospatial approach contributes a novel understanding to factors which influence SMM beyond patient-level characteristics and identifies the impact of systemic racism on maternal morbidity. Findings address an important literature gap surrounding place-based risk factors by explaining the contextual social and built environment variables that drive SMM risk.

An Ultrastructural Comparison of Hepatocytes from ADH+ and ADH−Peromyscus Maniculatus

1996 ◽  
Vol 54 ◽  
pp. 30-31
Author(s):  
J. T. Ellzey ◽  
D. Borunda ◽  
B. P. Stewart
Keyword(s):  
South Carolina ◽  
Adult Male ◽  
Uranyl Acetate ◽  
Model System ◽  
Deer Mice ◽  
En Bloc ◽  
Genetic Stock ◽  
Hepes Buffer ◽  
Transmission Electron ◽  
Color Scanner

Genetically alcohol deficient deer mice (ADHN/ADHN) (obtained from the Peromyscus Genetic Stock Center, Univ. of South Carolina) lack hepatic cytosolic alcohol dehydrogenase. In order to determine if these deer mice would provide a model system for an ultrastructural study of the effects of ethanol on hepatocyte organelles, 75 micrographs of ADH+ adult male deer mice (n=5) were compared with 75 micrographs of ADH− adult male deer mice (n=5). A morphometric analysis of mitochondrial and peroxisomal parameters was undertaken.The livers were perfused with 0.1M HEPES buffer followed by 0.25% glutaraldehyde and 2% sucrose in 0.1M HEPES buffer (4C), removed, weighed and fixed by immersion in 2.5% glutaraldehyde in 0.1M HEPES buffer, pH 7.4, followed by a 3,3’ diaminobenzidine (DAB) incubation, postfixation with 2% OsO4, en bloc staining with 1% uranyl acetate in 0.025M maleate-NaOH buffer, dehydrated, embedded in Poly/Bed 812-BDMA epon resin, sectioned and poststained with uranyl acetate and lead citrate. Photographs were taken on a Zeiss EM-10 transmission electron microscope, scanned with a Howtek personal color scanner, analyzed with OPTIMAS 4.02 software on a Gateway2000 4DX2-66V personal computer and stored in Excel 4.0.

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