Differences Among Incidence Rates of Invasive Listeriosis in the U.S. FoodNet Population by Age, Sex, Race/Ethnicity, and Pregnancy Status, 2008–2016

Palliative care improves quality-of-life and extends survival, however, is underutilized among gynecological cancer patients in the United States (U.S.). Our objective was to evaluate associations between healthcare access (HCA) measures and palliative care utilization among U.S. gynecological cancer patients overall and by race/ethnicity. We used 2004–2016 data from the U.S. National Cancer Database and included patients with metastatic (stage III–IV at-diagnosis) ovarian, cervical, and uterine cancer (n = 176,899). Palliative care was defined as non-curative treatment and could include surgery, radiation, chemotherapy, and pain management, or any combination. HCA measures included insurance type, area-level socioeconomic measures, distance-to-care, and cancer treatment facility type. We evaluated associations of HCA measures with palliative care use overall and by race/ethnicity using multivariable logistic regression. Our population was mostly non-Hispanic White (72%), had ovarian cancer (72%), and 24% survived <6 months. Five percent of metastatic gynecological cancer patients utilized palliative care. Compared to those with private insurance, uninsured patients with ovarian (aOR: 1.80,95% CI: 1.53–2.12), and cervical (aOR: 1.45,95% CI: 1.26–1.67) cancer were more likely to use palliative care. Patients with ovarian (aOR: 0.58,95% CI: 0.48–0.70) or cervical cancer (aOR: 0.74,95% CI: 0.60–0.88) who reside >45 miles from their provider were less likely to utilize palliative care than those within <2 miles. Ovarian cancer patients treated at academic/research programs were less likely to utilize palliative care compared to those treated at community cancer programs (aOR: 0.70, 95%CI: 0.58–0.84). Associations between HCA measures and palliative care utilization were largely consistent across U.S. racial-ethnic groups. Insurance type, cancer treatment facility type, and distance-to-care may influence palliative care use among metastatic gynecological cancer patients in the U.S.

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Comparison of Past Year Substance Use Estimates by Age, Sex, and Race/Ethnicity Between Two Representative Samples of the U.S. Adult Population

Population Research and Policy Review ◽

10.1007/s11113-021-09645-8 ◽

2021 ◽

Author(s):

Timothy J. Grigsby ◽

Krista Howard ◽

Jeffrey T. Howard

Keyword(s):

Substance Use ◽

Adult Population ◽

Race Ethnicity ◽

Representative Samples ◽

The U.S

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An economic and disease transmission model of human papillomavirus and oropharyngeal cancer in Texas

Scientific Reports ◽

10.1038/s41598-021-81375-5 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Chengxue Zhong ◽

Li Xu ◽

Ho-Lan Peng ◽

Samantha Tam ◽

Li Xu ◽

...

Keyword(s):

Public Health ◽

Human Papillomavirus ◽

Oropharyngeal Cancer ◽

Hpv Vaccine ◽

Health Benefits ◽

Incidence Rates ◽

Vaccine Uptake ◽

Males And Females ◽

Quality Adjusted Life ◽

The U.S

AbstractIn 2017, 46,157 and 3,127 new oropharyngeal cancer (OPC) cases were reported in the U.S. and Texas, respectively. About 70% of OPC were attributed to human papillomavirus (HPV). However, only 51% of U.S. and 43.5% of Texas adolescents have completed the HPV vaccine series. Therefore, modeling the demographic dynamics and transmission of HPV and OPC progression is needed for accurate estimation of the economic and epidemiological impacts of HPV vaccine in a geographic area. An age-structured population dynamic model was developed for the U.S. state of Texas. With Texas-specific model parameters calibrated, this model described the dynamics of HPV-associated OPC in Texas. Parameters for the Year 2010 were used as the initial values, and the prediction for Year 2012 was compared with the real age-specific incidence rates in 23 age groups for model validation. The validated model was applied to predict 100-year age-adjusted incidence rates. The public health benefits of HPV vaccine uptake were evaluated by computer simulation. Compared with current vaccination program, increasing vaccine uptake rates by 50% would decrease the cumulative cases by 4403, within 100 years. The incremental cost-effectiveness ratio of this strategy was $94,518 per quality-adjusted life year (QALY) gained. Increasing the vaccine uptake rate by 50% can: (i) reduce the incidence rates of OPC among both males and females; (ii) improve the quality-adjusted life years for both males and females; (iii) be cost-effective and has the potential to provide tremendous public health benefits in Texas.

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Seasonal Trends for Environmental Illness Incidence in the U.S. Army

Military Medicine ◽

10.1093/milmed/usab072 ◽

2021 ◽

Author(s):

David W DeGroot ◽

Catherine A Rappole ◽

Paige McHenry ◽

Robyn M Englert

Keyword(s):

Risk Mitigation ◽

Cold Season ◽

Incidence Rates ◽

Cold Weather ◽

Medical Surveillance ◽

Piecewise Regression ◽

Exertional Heat Illness ◽

Policies And Procedures ◽

Icd Codes ◽

The U.S

ABSTRACT Introduction The incidence of and risk factors for exertional heat illness (EHI) and cold weather injury (CWI) in the U.S. Army have been well documented. The “heat season”, when the risk of EHI is highest and application of risk mitigation procedures is mandatory, has been arbitrarily defined as May 1 through September 30, while the “cold season” is understood to occur from October 1 to April 30 each year. The proportions of EHI and CWI that occur outside of the traditional heat and cold seasons are unknown. Additionally, it is unknown if either of the seasonal definitions are appropriate. The primary purpose of this study was to determine the proportion of EHI and of CWI that occur within the commonly accepted seasonal definitions. We also report the location-specific variability, seasonal definitions, and the demographic characteristics of the populations. Methods The U.S. Army installations with the highest frequency of EHI and of CWI from 2008 to 2013 were identified and used for analysis. In total there were 15 installations included in the study, with five installations used for analysis in both the EHI and CWI projects. In- and out-patient EHI and CWI data (ICD-9-CM codes 992.0 to 992.9 and ICD codes 991.0 to 991.9, respectively) were obtained from the Defense Medical Surveillance System. Installation-specific denominator data were obtained from the Defense Manpower Data Center, and incidence rates were calculated by week, for each installation. Segmental (piecewise) regression analysis was used to determine the start and end of the heat and cold seasons. Results Our analysis indicates that the heat season starts around April 22 and ends around September 9. The cold season starts on October 3 and ends on March 24. The majority (n = 6,445, 82.3%) of EHIs were diagnosed during the “heat season” of May 1 to September 30, while 10.3% occurred before the heat season started (January1 to April 30) and 7.3% occurred after the heat season ended (October 1 to December 31). Similar to EHI, 90.5% of all CWIs occurred within the traditionally defined cold season, while 5.7% occurred before and 3.8% occurred after the cold season. The locations with the greatest EHI frequency were Ft Bragg (n = 2,129), Ft Benning (n = 1,560), and Ft Jackson (n = 1,538). The bases with the largest proportion of CWI in this sample were Ft Bragg (17.8%), Ft Wainwright (17.2%), and Ft Jackson (12.7%). There were considerable inter-installation differences for the start and end dates of the respective seasons. Conclusions The present study indicates that the traditional heat season definition should be revised to begin ∼3 weeks earlier than the current date of May 1; our data indicate that the current cold season definition is appropriate. Inter-installation variability in the start of the cold season was much larger than that for the heat season. Exertional heat illnesses are a year-round problem, with ∼17% of all cases occurring during non-summer months, when environmental heat strain and vigilance are lower. This suggests that EHI mitigation policies and procedures require greater year-round emphasis, particularly at certain locations.

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Incidence of VTE Among Patients with a Cancer Diagnosis in Oklahoma County

Blood ◽

10.1182/blood-2019-130604 ◽

2019 ◽

Vol 134 (Supplement_1) ◽

pp. 3463-3463

Author(s):

Micah Denay McCumber ◽

Aaron Mark Wendelboe ◽

Janis Campbell ◽

Kai Ding ◽

Michele G Beckman ◽

...

Keyword(s):

Native Americans ◽

Cancer Diagnosis ◽

Incidence Rates ◽

Cancer Type ◽

Surveillance Period ◽

Increased Risk ◽

History Of ◽

Race Ethnicity ◽

History Of Cancer ◽

Active Cancer

Background: Patients with cancer are at elevated risk for venous thromboembolism (VTE). Active cancer contributes a 4-7 fold increased risk for VTE; however, the incidence of VTE stratified by subpopulations of patients diagnosed with cancer, especially race/ethnicity, is uncertain. Objective: Describe the incidence of VTE among adult patients (age ≥ 18 years) with a cancer diagnosis in Oklahoma County, OK according to age, gender, race, and cancer type. Methods: In collaboration with the Centers for Disease Control and Prevention, we established a population-based surveillance system for VTE in Oklahoma County, OK between April 1, 2012-March 31, 2014 to estimate the incidences of first-time and recurrent VTE events. The Commissioner of Health made VTE a reportable condition and delegated surveillance-related responsibilities to the University of Oklahoma, College of Public Health. Active surveillance involved reviewing imaging studies (e.g., chest computed tomography and compression ultrasounds of the extremities) from all inpatient and outpatient facilities in the county and collecting demographic, treatment and risk factor data on all VTE case-patients. Patients were linked to the Oklahoma Central Cancer Registry. Any patient with a cancer diagnosis since 1997, excluding basal or squamous cell carcinoma, were included in the population-at-risk. Active cancer was defined as metastatic or a diagnosis ≤6 months before their VTE diagnosis. Poisson regression was used to estimate incidence rates (IRs) and 95% confidence intervals (CIs), which are reported per 1,000 person years (PY). Estimates with <10 events were suppressed. Results: Among all patients aged ≥18 years with a cancer diagnosis since 1997, 1.5% (n = 881) had a VTE event during the 2-year surveillance period. The overall annual age-adjusted incidence of VTE among those with cancer was 6.8 per 1,000 PY (95% CI: 5.81, 7.95). The demographic-specific incidence rates are summarized in Table 1. The VTE incidence did not significantly differ by sex. When stratified by age, annual VTE incidence was similar among those aged 18-39 years (6.1/1,000 PY, 95% CI: 4.35, 8.61), 40-59 years (6.2/1,000 PY, 95% CI: 5.4, 7.14), and 60-79 years (7.2/1,000 PY, 95% CI: 6.55, 7.90), however, the incidence was significantly higher (p<0.05) in those aged 80+ years (10.1/1,000 PY, 95% CI: 8.77, 11.61). When patients with a cancer diagnosis were stratified by race/ethnicity, non-Hispanic blacks had the highest VTE incidence (11.7/1,000 PY, 95% CI: 10.00, 13.59), followed by Hispanics (8.0/1,000 PY, 95% CI: 5.66, 11.44), non-Hispanic whites (6.9/1,000 PY, 95% CI: 6.41, 7.48), other non-Hispanic/unknown (5.8/1,000 PY, 95% CI: 3.45, 9.85), and non-Hispanic Native Americans (2.6/1,000 PY, 95% CI: 1.39, 4.79). VTE incidence was highest among those with active cancer or a history of cancer within the past three years, after which it appeared to decrease. When stratified by primary cancer type, VTE incidence was highest among those with brain cancer (16.6/1,000 PY, 95% CI: 11.06, 25.04) and lowest among those with prostate cancer (5.2/1,000 PY, 95% CI: 4.20, 6.44). As shown in Table 2, when stratified by cancer type, the incidence of VTE was higher (non-overlapping CIs) among those with active cancer compared to those with a history of cancer >6 months for several tumor types. Discussion: The incidence of VTE among those with cancer differs by race/ethnicity, with non-Hispanic blacks bearing the highest burden of disease. The risk of VTE persists and is particularly elevated up to three years after a cancer diagnosis. Disclosures Raskob: Eli Lilly: Consultancy; Pfizer: Consultancy, Honoraria; Portola: Consultancy; Novartis: Consultancy; BMS: Consultancy, Honoraria; Janssen R&D, LLC: Consultancy, Honoraria; Tetherex: Consultancy; Daiichi Sankyo: Consultancy, Honoraria; Anthos: Consultancy; Bayer Healthcare: Consultancy, Honoraria; Boehringer Ingelheim: Consultancy.

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Unraveling Demand for Dairy-Alternative Beverages in the United States: The Case of Soymilk

Agricultural and Resource Economics Review ◽

10.1017/s106828050000695x ◽

2014 ◽

Vol 43 (1) ◽

pp. 140-157 ◽

Cited By ~ 8

Author(s):

Senarath Dharmasena ◽

Oral Capps

Keyword(s):

United States ◽

Employment Status ◽

The United States ◽

Education Level ◽

Household Level ◽

Income Elasticities ◽

Price And Income Elasticities ◽

Race Ethnicity ◽

Targeted Marketing ◽

The U.S

Soymilk is one of the fastest growing categories in the U.S dairy alternative functional beverage market. Using household-level purchase data from Nielsen's 2008 Homescan panel and the Tobit econometric procedure, we estimate conditional and unconditional own-price, cross-price, and income elasticities for soymilk, white milk, and flavored milk. Income, age, employment status, education level, race, ethnicity, region, and presence of children in a household are significant drivers of demand for soymilk. White milk and flavored milk are competitors for soymilk, and soymilk is a competitor for white milk. Strategies for pricing and targeted marketing of soymilk are also discussed.

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Abstract 3039: Temporal Trends in the Prevalence of Dermatoses in Patients with Stroke and Transient Ischemic Attack in the United States

Stroke ◽

10.1161/str.43.suppl_1.a3039 ◽

2012 ◽

Vol 43 (suppl_1) ◽

Author(s):

Erine A Kupetsky ◽

Mitch Maltenfort ◽

Scott Waldman ◽

Fred Rincon

Keyword(s):

Temporal Trends ◽

Progressive Systemic Sclerosis ◽

The United States ◽

Primary Diagnosis ◽

Incidence Rates ◽

Secondary Diagnosis ◽

Cross Sectional ◽

Total Prevalence ◽

Skin Conditions ◽

The U.S

Background. We sought to determine the prevalence of skin conditions traditionally associated with acute ischemic stroke (AIS) and transient ischemic attacks (TIA) in the U.S. Methods. This is a cross-sectional study of data derived from the National Inpatient Sample from 1988-2008. We searched for admissions of patients <18 years, with a primary diagnosis of AIS, TIA, and the following secondary diagnoses (dermatoses): Psoriasis, Behcet’s Disease (BD), Dermatomyositis (DM), Systemic Lupus Eythematosis (SLE), Pseudoxanthoma Elasticum (PXE), Progressive Systemic Sclerosis or Scleroderma (SCD), and Bullous Pemphigoid (BP). Definitions were based on ICD9CM codes, and adjusted incidence rates for the U.S census and prevalence proportions were then calculated. Results. Over the 20-year period, we identified 9,085,147 admissions that corresponded to a primary diagnosis of AIS and TIA of which 53,060 had a secondary diagnosis of dermatoses, for a total prevalence of 0.6%. The adjusted rate of AIS/TIA increased from 71/100,000 in 1988 to 200/100,000 in 2008. Among the secondary diagnosis, the most prevalent condition after AIS/TIA admissions was SLE (54%), psoriasis (34%), SCD (9%), BP (2%), DM (1%), PXE (0.5%), and BD (0.14%). The prevalence of these dermatoses increased from 0.2% in 1988 to 0.8% in 2008 ( Figure 1 ). Conclusion. Despite an overall increase in the prevalence of dermatoses, these skin conditions remain a rare occurrence in AIS/TIA. The over-representation of traditional risk factors for AIS/TIA in patients with these dermatoses, may explain the observed epidemiological phenomenon.

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Incidence of insomnia and obstructive sleep apnea in active duty United States military service members

SLEEP ◽

10.1093/sleep/zsab024 ◽

2021 ◽

Author(s):

Brian A Moore ◽

Lynn M Tison ◽

Javier G Palacios ◽

Alan L Peterson ◽

Vincent Mysliwiec

Keyword(s):

United States ◽

Obstructive Sleep Apnea ◽

Military Service ◽

Active Duty ◽

Incidence Rates ◽

Service Members ◽

United States Military ◽

Obstructive Sleep ◽

Military Service Members ◽

The U.S

Abstract Study Objectives Epidemiologic studies of obstructive sleep apnea (OSA) and insomnia in the U.S. military are limited. The primary aim of this study was to report and compare OSA and insomnia diagnoses in active duty the United States military service members. Method Data and service branch densities used to derive the expected rates of diagnoses on insomnia and OSA were drawn from the Defense Medical Epidemiology Database. Single sample chi-square goodness of fit tests and independent samples t-tests were conducted to address the aims of the study. Results Between 2005 and 2019, incidence rates of OSA and insomnia increased from 11 to 333 and 6 to 272 (per 10,000), respectively. Service members in the Air Force, Navy, and Marines were diagnosed with insomnia and OSA below expected rates, while those in the Army had higher than expected rates (p < .001). Female service members were underdiagnosed in both disorders (p < .001). Comparison of diagnoses following the transition from ICD 9 to 10 codes revealed significant differences in the amounts of OSA diagnoses only (p < .05). Conclusion Since 2005, incidence rates of OSA and insomnia have markedly increased across all branches of the U.S. military. Despite similar requirements for overall physical and mental health and resilience, service members in the Army had higher rates of insomnia and OSA. This unexpected finding may relate to inherent differences in the branches of the military or the role of the Army in combat operations. Future studies utilizing military-specific data and directed interventions are required to reverse this negative trend.

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