scholarly journals Alcohol- and Drug-Associated Injury Outcomes Among Older Adults Involved in Car Crashes

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 127-127
Author(s):  
Oluwaseun Adeyemi
Keyword(s):  
Older Adults ◽  
Drug Use ◽  
Census Data ◽  
Predictor Variable ◽  
The Body ◽  
Ordinal Scale ◽  
Outcome Variable ◽  
Revised Trauma Score ◽  
Car Crashes ◽  
Trauma Score

Abstract Understanding how recent alcohol or drug use among older adults involved in car crashes can inform emergency care team on the morbidity and mortality risks. This study aimed to assess the odds of worsened health outcomes among older adults with evidence of alcohol or drug ingestion. This cross-sectional analysis used crash census data from the National EMS Information System. The outcome variable was the health outcome after EMS care, measured on a four-point ordinal scale: lower acuity, emergent, critical, and dead. The predictor variable was alcohol/drug use (present/not present). Age, race, gender, part of the body injured, and the revised trauma score of the patients were used as confounders. Odds ratio were calculated using proportional ordinal logistic regression. A total of 42,992 individuals, aged 65 years and older, were involved in car crash events, which required EMS activation. About 22.9% needed emergent care, 4.4% were classified as critical, and 0.4% died without resuscitation efforts. At the time of crash, 3.8% of the older population had evidence of alcohol or drug use. After adjusting for age, gender, race, injury location and revised trauma score of the crash patients, alcohol/drugs were associated with 54% increased odds of worse clinical outcome (AOR:1.54; 95% CI: 1.32-1.80). The adjusted odds remained elevated in urban (AOR: 1.69; 95% CI: 1.42-2.02) and suburban (AOR: 2.21; 95% CI: 1.12-4.35) and not significantly elevated in rural areas. Study findings can inform EMS service and emergency room care as well as policies that strengthen the urban and suburban EMS.

Prediction to Successful Treatment Outcome by Client Characteristics and Retention in Treatment in Adolescent Drug Treatment Programs: A Large-Scale Cross Validation Study

1986 ◽  
Vol 16 (2) ◽  
pp. 149-165 ◽  
Author(s):  
Alfred S. Friedman ◽  
Nita W. Glickman ◽  
Margaret R. Morrissey
Keyword(s):  
Drug Use ◽  
Large Scale ◽  
Treatment Time ◽  
Predictor Variable ◽  
Treatment Programs ◽  
Outcome Variable ◽  
Client Characteristics ◽  
Successful Treatment Outcome ◽  
Time In Treatment ◽  
Retention In Treatment

NIDA–CODAP file data on adolescent clients admitted to thirty selected outpatient programs were available for calendar years 1979 ( N = 2509) and 1980 ( N = 3094). Two outcome criterion variables were utilized: 1) CODAP's “Reasons for Discharge” classification, and 2) a formula for “Reduction of Drug Use.” School grade, controlled for age, was the only client predictor variable found to account for more than 1 percent of the variance in the “Reasons for Discharge” outcome variable. Marijuana as the primary drug of abuse was the only client variable to account for more than 1 percent (4.4 percent) of the variance in the Reduction in Drug Use. The primary marijuana users showed less reduction in amount of drug use, and were less often considered to have completed the course of treatment. Time in treatment accounted for 1.6 percent in 1979 and 1.3 percent in 1980 of the variance in the “Reduction in Drug Use” criterion.

Social Support Moderates the Negative Association Between Reduced Driving and Life Satisfaction in Older Adults

2019 ◽  
Vol 39 (11) ◽  
pp. 1258-1262
Author(s):  
Vanya C. Jones ◽  
Renee M. Johnson ◽  
Carey Borkoski ◽  
George W. Rebok ◽  
Andrea C. Gielen ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Life Satisfaction ◽  
Longitudinal Research ◽  
Predictor Variable ◽  
Negative Association ◽  
Outcome Variable ◽  
Measurement Information ◽  
Linear Regression Models ◽  
Patient Reported

When older adults reduce their driving, there can be subsequent decreases in life satisfaction. In this cross-sectional study, we used baseline data from the multi-site Longitudinal Research on Aging Drivers (LongROAD) study to examine whether social support moderates the negative association between reduced driving and life satisfaction. The outcome variable was life satisfaction, and the main predictor variable was past-year reduced driving (yes/no). Emotional, instrumental, and informational social support were measured using PROMIS v2.0 (Patient-Reported Outcomes Measurement Information System) items. We used generalized linear regression models to examine how social support moderated the association between reduced driving and life satisfaction. Statistical adjustment for social support attenuated the negative effect of reduced driving on life satisfaction by ~10% for all three types of social support.

scholarly journals An analysis of predictors of morbidity after stab wounds of the pancreas in 78 consecutive injuries

2014 ◽  
Vol 96 (6) ◽  
pp. 427-433 ◽  
Author(s):  
JEJ Krige ◽  
UK Kotze ◽  
R Sayed ◽  
PH Navsaria ◽  
AJ Nicol
Keyword(s):  
Blood Transfusion ◽  
Damage Control ◽  
Cohort Analysis ◽  
Pancreatic Injury ◽  
Uncinate Process ◽  
The Body ◽  
Stab Wounds ◽  
Revised Trauma Score ◽  
Trauma Score ◽  
Grade Iii

Introduction Penetrating injuries of the pancreas may result in serious complications. This study assessed the factors influencing morbidity after stab wounds of the pancreas. Methods A retrospective univariate cohort analysis was carried out of 78 patients (74 men) with a median age of 26 years (range: 16–62 years) with stab wounds of the pancreas between 1982 and 2011. Results The median revised trauma score (RTS) was 7.8 (range: 2.0–7.8). Injuries involved the body (n=36), tail (n=24), head/uncinate process (n=16) and neck (n=2) of the pancreas. All 78 patients underwent a laparotomy. Sixty-five patients had AAST (American Association for the Surgery of Trauma) grade I or II pancreatic injuries and thirteen had grade III, IV or V injuries. Eight patients (10.3%) had an initial damage control operation. Sixty-nine patients (84.6%) had drainage of the pancreas only, six had a distal pancreatectomy and one had a pancreaticoduodenectomy. Most pancreas related complications occurred in patients with AAST grade III injuries; eight patients (10.2%) developed a pancreatic fistula. Four patients (5.1%) died. Grade of pancreatic injury (AAST grade I–II vs grade III–V injuries, p<0.001), RTS (odds ratio [OR]: 5.01, 95% confidence interval [CI]: 1.46–17.19, p<0.007), presence of shock on admission (OR: 3.31, 95% CI: 1.16–9.42, p=0.022), need for a blood transfusion (OR: 6.46, 95% CI: 2.40–17.40, p<0.001) and repeat laparotomy (p<0.001) had a significant influence on the development of general complications. Conclusions Although mortality was low after a pancreatic stab wound, morbidity was high. Increasing AAST grade of injury, high RTS, shock on admission to hospital, need for blood transfusion and repeat laparotomy were significant factors related to morbidity.

scholarly journals Life Course Predictors of Allostatic Load Among LGBTQ Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 735-735
Author(s):  
Charles Hoy-Ellis ◽  
Hyun Kim ◽  
Karen Fredriksen Goldsen
Keyword(s):  
Older Adults ◽  
Life Course ◽  
Interpersonal Violence ◽  
Allostatic Load ◽  
Identity Management ◽  
The Body ◽  
Linear Regression Models ◽  
Psychophysiological Stress ◽  
Increased Risk ◽  
Wear And Tear

Abstract LGBTQ older adults are at significantly increased risk for poor mental and physical health, likely consequential to lifelong bias. Allostatic load (AL), the net effect of “wear and tear” on the body resulting from repeated, chronic over-activation of the psychophysiological stress response system. Utilizing the Health Equity Promotion Model, the aim of this study was to test potential life course predictors of AL, including interpersonal violence, legal marriage, and identity management in a sample of LGBTQ adults 50 to 97 years of age (n=317). Results from a series of hierarchical linear regression models showed that adult physical abuse and late identity disclosure for those who had been in an opposite-sex marriage predicted higher AL in this sample of LGBTQ older adults, indicating need for increased research on bias over the life course as contributory to AL and biopsychosocial dysfunction among LGBTQ older adults.

Total Cerebral Small Vessel Disease Score and Anthropometric Indices: A Population-Based Study in Older Adults of Amerindian Ancestry

2021 ◽  
pp. 1-4
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera
Keyword(s):  
Older Adults ◽  
Small Vessel Disease ◽  
Brain Magnetic Resonance Imaging ◽  
Population Based ◽  
Cerebral Small Vessel Disease ◽  
The Body ◽  
Small Vessel ◽  
Population Based Study ◽  
Vessel Disease ◽  
Ordinal Logistic Regression Model

A total of 590 older adults of Amerindian ancestry living in rural Ecuador received anthropometric measurements and a brain magnetic resonance imaging to estimate the total cerebral small vessel disease (cSVD) score. A fully adjusted ordinal logistic regression model, with categories of the total cSVD score as the dependent variable, disclosed significant associations between the waist circumference, the waist-to-hip, and the waist-to-height ratios – but not the body mass index (BMI) – and the cSVD burden. Indices of abdominal obesity may better correlate with severity of cSVD than the BMI in Amerindians. Phenotypic characteristics of this population may account for these results.

Toward a conceptual model for successful transgender aging

2021 ◽  
pp. 147332502199466
Author(s):  
Steffany Sloan ◽  
Jacquelyn J Benson
Keyword(s):  
Older Adults ◽  
Successful Aging ◽  
Work Practice ◽  
Later Life ◽  
Theoretical Models ◽  
Social Work Practice ◽  
The Body ◽  
Aging Research ◽  
Research Findings ◽  
Resilience Factors

Transgender older adults have been subject to life-long stigma and marginalization, resulting in significant social and health consequences. Despite these challenges, this population commonly reports thriving in later life. In order to attend to nuanced experiences of older transgender adults, theoretical models of successful aging must reflect complexities presented by gender minority status. In order to address theoretical gaps, a systematic qualitative meta-synthesis was conducted to summarize findings across the body of qualitative transgender aging research. Findings indicated that transgender older adults conceptualize successful aging through the process of embracing gender identity. Themes were identified to conceptualize successful transgender aging such as gender expression, shedding internalized stigma, and championing a resilience mindset. Implications for social work practice are provided, suggesting a more comprehensive understanding of both challenges and resilience factors amongst the aging transgender population.

scholarly journals Predictors for Confidence in Self-Management of Falls and the Role of Fear of Falls

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 301-301
Author(s):  
Qiwei Li ◽  
Becky Knight
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Predictor Variable ◽  
Path Model ◽  
Self Management ◽  
Hierarchical Regression ◽  
Mediating Role ◽  
Self Protection ◽  
Fear Of Falls

Abstract Falls have been a crucial threat for older adults to stay independent. Once they have fallen, older adults are more likely to receive injuries and become people with disabilities. Conventionally, the measurement of fall efficacy focused on the capacity of performing certain activities such as walking or bathing without a fall. However, given the fact that one out of five older adults fall every year, self-efficacy in self-protection when falls do happen calls for a better understanding of confidence in self-management of a fall. Among predictors for fall prevention outcomes, “fear of falls” has received attention. However, “fear of falls” was largely missing in studies exploring self-management of falls in scenarios where falls do happen. This study explores the predictors for CSMoF including “fear of falls”. A series of simultaneous and hierarchical regression analyses with related interaction analyses and a path model were applied to determine the contribution of each predictor variable and the mediating role of “fear of falls”. The findings of the study reported that demographic characteristics, chronic conditions, and perceptions of falls were associated with CSMoF. The path analysis confirmed the mediating role of “fear of falls” as the indirect effects were occupying substantial percentages in the total identified effects. “Fear of falls” should continue to be a core of fall prevention programs and is particularly important for programs that aim to teach older adults what to do when they fall, whom to call for help, and how to avoid injuries upon falling.

scholarly journals Detecting Instruction Effects—Deciding Between Covariance Analytical and Change-Score Approach

2021 ◽  
Author(s):  
Carmen Köhler ◽  
Johannes Hartig ◽  
Alexander Naumann
Keyword(s):  
Latent Variable ◽  
Outcome Measurement ◽  
Predictor Variable ◽  
Change Score ◽  
Regression Coefficients ◽  
Outcome Variable ◽  
Analysis Model ◽  
Hypothetical Data ◽  
Instructional Research ◽  
Time Point

AbstractThe article focuses on estimating effects in nonrandomized studies with two outcome measurement occasions and one predictor variable. Given such a design, the analysis approach can be to include the measurement at the previous time point as a predictor in the regression model (ANCOVA), or to predict the change-score of the outcome variable (CHANGE). Researchers demonstrated that both approaches can result in different conclusions regarding the reported effect. Current recommendations on when to apply which approach are, in part, contradictory. In addition, they lack direct reference to the educational and instructional research contexts, since they do not consider latent variable models in which variables are measured without measurement error. This contribution assists researchers in making decisions regarding their analysis model. Using an underlying hypothetical data-generating model, we identify for which kind of data-generating scenario (i.e., under which assumptions) the defined true effect equals the estimated regression coefficients of the ANCOVA and the CHANGE approach. We give empirical examples from instructional research and discuss which approach is more appropriate, respectively.

scholarly journals The prevalence of obesity in older adults in Iran: a systematic review and meta-analysis

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Aliakbar Vaisi-Raygani ◽  
Masoud Mohammadi ◽  
Rostam Jalali ◽  
Akram Ghobadi ◽  
Nader Salari
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Older Adult ◽  
Meta Analysis ◽  
The Body ◽  
Obesity Prevalence ◽  
Analysis Software ◽  
Obesity And Overweight ◽  
Age Dependent ◽  
Prevalence Of Obesity

Abstract Background one of the most important age-dependent physiologic alterations in the body composition of older adult people is obesity and overweight, increasing the risk of cardiovascular disease and mortality rate. Objective The aim of the present study is to determine the prevalence of obesity in older adults in Iran. Methods The present study was conducted via meta-analysis and systematic review method, from March 2000 to October 2018. Subject-related literature was obtained via searches in ScienceDirect, Medline (PubMed), SID, Magiran, Scopus, and Google Scholar databases. Heterogeneity of studies was assessed using the I2 index, and data were analyzed by Comprehensive-Meta analysis software. Results In the assessment of 18 studies and 29,943 persons aged over 50 years, the prevalence of obesity in older adults of Iran was 21.4% (95%CI: 26.6–16.9%) based on the meta-analysis. The highest obesity prevalence was obtained in older adults of Babol (Amir Shahr) which was 44.2% (95%CI: 41.1–47.2%) in 2007, while the minimum obesity prevalence was found in older adults of Razavi Khorasan which was 11.3% (95%CI, 10–12.8%) in 2007. Further, as the sample size and the study year increased, the obesity prevalence diminished in older Iranian adults (p < 0.05). Conclusion This study suggests that the prevalence of obesity in the older adults of Iran is high. Accordingly, healthcare planners and politicians should consider effective and practical policies to reduce obesity in older adults.

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