scholarly journals Super-Spreader Businesses and Risk of COVID-19 Transmission

2020 ◽  
Author(s):  
Ashley O’Donoghue ◽  
Tenzin Dechen ◽  
Whitney Pavlova ◽  
Michael Boals ◽  
Garba Moussa ◽  
...  
Keyword(s):  
New York ◽  
Rhode Island ◽  
Potential Risk ◽  
Negative Binomial ◽  
Risk Index ◽  
Positive Association ◽  
Negative Binomial Regression ◽  
The United States ◽  
Transmission Risk ◽  
Cumulative Number

AbstractPurposeThe United States has the highest number of confirmed COVID-19 cases in the world to date, with over 94,000 COVID-19-related deaths1. The true risk of a COVID-19 resurgence as states prepare to reopen businesses is unknown. This paper aims to classify businesses by their risk of transmission and provide a method to measure traffic and risk at businesses as states reopen in order to quantify the relationship between the density of potential super-spreader businesses and COVID-19 cases.MethodsWe constructed a COVID-19 Business Transmission Risk Index based upon the frequency and duration of visits and square footage of businesses pre-pandemic in 2019 in 8 states (Massachusetts, Rhode Island, Connecticut, New Hampshire, Vermont, Maine, New York, and California). We used this index to classify businesses as potential super-spreaders. Then, we analyzed the association between the density of super-spreader businesses in a county and the rate of COVID-19 cases. We performed significance testing using a negative binomial regression. The main outcome of interest is the cumulative number of COVID-19 cases each week.ResultsWe developed an index to monitor traffic and quantify potential risk at businesses and found a positive association between the density of potential super-spreader businesses and COVID-19 cases. A 1 percentage point increase in the density of super-spreader businesses is associated with 5% higher COVID-19 cases, all else equal.ConclusionHigher densities of potential super-spreader businesses are associated with higher rates of COVID-19 cases. This may have important implications for how states reopen potential super-spreader businesses. Our main contribution is an index that provides a way for policymakers to monitor traffic and potential risk at businesses as states reopen.

scholarly journals Injury-related falls from bicycles, skateboards, roller skates, and non-motorized scooters in the United States: 2005 - 2014

2017 ◽  
Vol 4 (1) ◽  
pp. 16
Author(s):  
William Milczarski ◽  
Peter Tuckel ◽  
Richard Maisel
Keyword(s):  
Public Health ◽  
New York ◽  
Negative Binomial ◽  
Local Level ◽  
Specific Treatment ◽  
Negative Binomial Regression ◽  
The United States ◽  
Treatment Modalities ◽  
Public Health Officials ◽  
National Databases

Purpose: To provide an updated and comparative analysis of injury-related falls from bicycles, skateboards, roller skates and non-motorized scooters.Methods: The study uses two national databases – the Nationwide Emergency Department Sample and the Nationwide Inpatient Sample  – and subnational databases for New York, California, and Maryland.  Univariate and multivariate analyses (negative binomial regression) are performed to identify effects of age, gender, racial-ethnic background, and region on the incidence of injury-related falls from each of the four devices.Results: The rate of injuries due to falls from bicycles far surpasses the rates due to falls from the other devices.  When a measure of “exposure” is taken into consideration, however, the rate of injuries from skateboards outstrips the rates from bicycles or roller skates.  The profile of patients who are injured from falls from each of the four devices is distinctive.  Asian-Americans are greatly underrepresented among those who suffer a fall-related injury from any of the four devices.  The incidence of injuries attributable to falls varies considerably by geographic region.Conclusions: Public health officials need to be mindful that while certain activities such as scootering might be gaining in popularity, the number of injuries sustained from bicycles still dwarfs the number attributable to falls from skateboards, roller skates, and scooters combined.  Thus special attention needs to be paid to both prevent falls from bicycles and specific treatment modalities.  It is important for public health officials to gather injury data at the local level to allocate prevention and treatment resources more efficiently.

Temporal trends in opioid prescribing patterns among oncologists in the Medicare population.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12022-12022
Author(s):  
Vikram Jairam ◽  
Daniel X. Yang ◽  
Saamir Pasha ◽  
Pamela R. Soulos ◽  
Cary Philip Gross ◽  
...  
Keyword(s):  
New York ◽  
Negative Binomial ◽  
Temporal Trends ◽  
Negative Binomial Regression ◽  
The United States ◽  
Prescribing Patterns ◽  
Part D ◽  
Opioid Prescribing ◽  
Provider Characteristics ◽  
Final Study

12022 Background: In the wake of the United States (U.S.) opioid epidemic, there have been significant governmental and societal efforts to curb opioid prescribing. However, it is unknown whether these efforts have affected prescribing among oncologists, whose patient population often requires narcotics for symptom management. We investigated temporal patterns in opioid prescribing for Medicare patients among oncologists. Methods: We queried the Centers for Medicare and Medicaid Services Part D prescriber dataset to identify independently practicing physicians between January 1, 2013 and December 31, 2017. We used population-averaged multivariable negative binomial regression to estimate the association between time and per-provider opioid prescribing rate, defined as number of opioid claims (original prescriptions and refills) per 100 patients, among oncologists and non-oncologists on both a national and statewide level. All models were adjusted for provider characteristics and annual total patient count per provider. Results: The final study sample included 20,513 oncologists and 711,636 non-oncologists. From 2013 to 2017, the national opioid prescribing rate declined by 19.3% (68.8 to 55.5 opioid prescriptions per 100 patients; P< 0.001) among oncologists and 20.4% (50.7 to 40.3 prescriptions per 100 patients; P< 0.001) among non-oncologists. During this timeframe, 40 U.S. states experienced a significant ( P< 0.05) decrease in opioid prescribing among oncologists, most notably in Vermont (-43.2%), Idaho (-34.5%), and Maine (-32.8%). In comparison, all 50 states exhibited a significant decline ( P< 0.05) in opioid prescribing among non-oncologists. In 5 states, opioid prescribing decreased more among oncologists than non-oncologists, including Oklahoma (-24.6% vs. -7.1%), Idaho (-34.5% vs. -17.8%), Utah (-31.7% vs. -18.7%), Texas (-19.9% vs. -14.7%), and New York (-24.0% vs. -19.7%) (all P< 0.05). Conclusions: Between 2013 and 2017, the opioid prescribing rate decreased by approximately 20% nationwide among both oncologists and non-oncologists. These findings raise concerns about whether opioid prescribing legislation and guidelines intended for the non-cancer population are being applied inappropriately to patients with cancer and survivors.

scholarly journals Analysis of Pneumonia Occurrence in Relation to Climate Change in Tanga, Tanzania

2021 ◽  
Vol 18 (9) ◽  
pp. 4731
Author(s):  
Samweli Faraja Miyayo ◽  
Patrick Opiyo Owili ◽  
Miriam Adoyo Muga ◽  
Tang-Huang Lin
Keyword(s):  
Climate Change ◽  
Negative Binomial ◽  
Health Management ◽  
Severe Pneumonia ◽  
Positive Association ◽  
Negative Binomial Regression ◽  
Health Management Information System ◽  
Cold Temperatures ◽  
Climate Indicators ◽  
And Control

In 2018, 70% of global fatalities due to pneumonia occurred in about fifteen countries, with Tanzania being among the top eight countries contributing to these deaths. Environmental and individual factors contributing to these deaths may be multifaceted, but they have not yet been explored in Tanzania. Therefore, in this study, we explore the association between climate change and the occurrence of pneumonia in the Tanga Region, Tanzania. A time series study design was employed using meteorological and health data of the Tanga Region collected from January 2016 to December 2018 from the Tanzania Meteorological Authority and Health Management Information System, respectively. The generalized negative binomial regression technique was used to explore the associations between climate indicators (i.e., precipitation, humidity, and temperature) and the occurrence of pneumonia. There were trend differences in climate indicators and the occurrence of pneumonia between the Tanga and Handeni districts. We found a positive association between humidity and increased rates of non-severe pneumonia (incidence rate ratio (IRR) = 1.01; 95% CI: 1.01–1.02; p ≤ 0.05) and severe pneumonia (IRR = 1.02; 95% CI: 1.01–1.03; p ≤ 0.05). There was also a significant association between cold temperatures and the rate of severe pneumonia in Tanga (IRR = 1.21; 95% CI: 1.11–1.33; p ≤ 0.001). Other factors that were associated with pneumonia included age and district of residence. We found a positive relationship between humidity, temperature, and incidence of pneumonia in the Tanga Region. Policies focusing on prevention and control, as well as promotion strategies relating to climate change-related health effects should be developed and implemented.

Bike Count Forecast Model with Multimodal Network Connectivity Measures

2021 ◽  
pp. 036119812110218
Author(s):  
Bingqing Liu ◽  
Divya Bade ◽  
Joseph Y. J. Chow
Keyword(s):  
New York ◽  
Negative Binomial ◽  
Network Connectivity ◽  
Negative Binomial Regression ◽  
Forecast Model ◽  
Negative Binomial Regression Model ◽  
Significance Level ◽  
Commute Time ◽  
Improve Model ◽  
Subway Stations

With the rise of cycling as a mode choice for commuting and short-distance delivery, as well as policy objectives encouraging this trend, bike count models are increasingly critical to transportation planning and investment. Studies have found that network connectivity plays a role in such models, but there remains a lack of measure for the connectivity of a link in a multimodal trip context. This study proposes a connectivity measure that captures the importance of a link in connecting the origins of cyclists and nearby subway stations, and incorporates it in a negative binomial regression model to forecast bike counts at links. Representative bike trips are generated with regard to bike-friendliness using the New York City transit trip planner and used to determine the deviation from the shortest path via the designated link. The measure is shown to improve model fitness with a significance level within 10%. Insights are also drawn for income levels, bike lanes, subway station availability, and average commute time of travelers.

scholarly journals Trends in Opioid Prescribing Among Hemodialysis Patients, 2007–2014

2018 ◽  
Vol 49 (1) ◽  
pp. 20-31 ◽  
Author(s):  
Matthew Daubresse ◽  
G. Caleb Alexander ◽  
Deidra C. Crews ◽  
Dorry L. Segev ◽  
Mara A. McAdams-DeMarco
Keyword(s):  
Low Income ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
The United States ◽  
Incidence Rates ◽  
Opioid Prescription ◽  
Opioid Prescribing ◽  
Hispanic Patients ◽  
Estimate Annual Incidence ◽  
National Trends

Background: Hemodialysis (HD) patients frequently experience pain. Previous studies of HD patients suggest increased opioid prescribing through 2010. It remains unclear if this trend continued after 2010 or declined with national trends. Methods: Longitudinal cohort study of 484,745 HD patients in the United States Renal Data System/Medicare data. We used Poisson/negative binomial regression to estimate annual incidence rates of opioid prescribing between 2007 and 2014. We compared prescribing rates with the general US population using IQVIA’s National Prescription Audit data. Outcomes included the following: percent of HD patients receiving an opioid prescription, rate of opioid prescriptions, quantity, days supply, morphine milligram equivalents (MME) dispensed per 100 person-days, and prescriptions per person. Results: In 2007, 62.4% of HD patients received an opioid prescription. This increased to 63.2% in 2010 then declined to 53.7% by 2014. Opioid quantity peaked in 2011 at 73.5 pills per 100 person-days and declined to 62.6 pills per 100 person-days in 2014. MME peaked between 2010 and 2012 then declined through 2014. In 2014, MME rates were 1.8-fold higher among non-Hispanic patients and 1.6-fold higher among low-income patients. HD patients received 3.2-fold more opioid prescriptions per person compared to the general US population and were primarily prescribed oxycodone and hydrocodone. Between 2012 and 2014, HD patients experienced greater declines in opioid prescriptions per person (18.2%) compared to the general US population (7.1%). Conclusion: Opioid prescribing among HD patients declined between 2012 and 2014. However, HD patients continue receiving substantially more opioids than the general US population.

scholarly journals The association between self-harm and area-level characteristics in Northern Ireland: an ecological study

2019 ◽  
Vol 29 (5) ◽  
pp. 948-953 ◽  
Author(s):  
Eve Griffin ◽  
Brendan Bonner ◽  
Christina B Dillon ◽  
Denise O’Hagan ◽  
Paul Corcoran
Keyword(s):  
Northern Ireland ◽  
Population Density ◽  
Suicidal Behaviour ◽  
Urban Areas ◽  
Negative Binomial ◽  
Positive Association ◽  
Negative Binomial Regression ◽  
Binomial Regression ◽  
Self Harm ◽  
Deprived Areas

Abstract Background Factors contributing to suicidal behaviour are complex and multi-faceted. This study took an ecological approach to examine the association between area-level factors and rates of self-harm in Northern Ireland. Methods Data on self-harm presentations to emergency departments (EDs) were obtained from the Northern Ireland Self-harm Registry. The study included residents of Northern Ireland aged 16–64 years. Deprivation was measured using the Northern Ireland Multiple Deprivation Measure 2017. Population density and social fragmentation were calculated using measures from the 2011 census. Associations between area-level factors and self-harm rates were explored using negative binomial regression. Results Between 2013 and 2015, 14 477 individuals aged 16–64 years presented to EDs in Northern Ireland following self-harm. The rate of self-harm was 472 per 100 000 and was higher for male residents (478 vs. 467). Self-harm rates were highest in urban areas—680 per 100 000 in Belfast City and 751 per 100 000 in Derry City. Rates of self-harm in Northern Ireland were more than four times higher in the most deprived areas. A positive association with rates of self-harm held for the deprivation domains of employment, crime, education, health and income. There was a moderate association with population density. Some gender differences emerged, with associations with male rates of self-harm more pronounced. Conclusion These findings indicate that self-harm rates are highest for those residing in highly deprived areas, where unemployment, crime and low level of education are challenges. Community interventions tailored to meet the needs of specific areas may be effective in reducing suicidal behaviour.

The Emergence of Spatial Clustering in Medical Vaccine Exemptions Following California Senate Bill 277, 2015–2018

2020 ◽  
Vol 110 (7) ◽  
pp. 1084-1091 ◽  
Author(s):  
Ashley Gromis ◽  
Ka-Yuet Liu
Keyword(s):  
Disease Transmission ◽  
Negative Binomial ◽  
Spatial Clustering ◽  
Local Level ◽  
Spatial Association ◽  
Positive Association ◽  
Negative Binomial Regression ◽  
Scan Statistics ◽  
Senate Bill ◽  
Before And After

Objectives. To understand how the elimination of nonmedical vaccine exemptions through California Senate Bill 277 (SB277) may have resulted in increased spatial clustering of medical exemptions. Methods. We used spatial scan statistics and negative binomial regression models to examine spatial clustering in medical vaccine exemptions in California kindergartens from 2015 to 2018. Results. Spatial clustering of medical exemptions across schools emerged following SB277. Clusters were located in similar geographic areas to previous clusters of nonmedical vaccine exemptions, suggesting a spatial association between high nonmedical exemption prevalence and increasing rates of medical exemptions. Regression results confirmed this positive association at the local level. The sociodemographic characteristics of the neighborhoods in which schools were located explained some, but not all, of the positive spatial associations between exemptions before and after SB277. Conclusions. Elimination of nonmedical vaccine exemptions via SB277 may have prompted some parents to instead seek medical exemptions to required school vaccines. The spatial association of these 2 types of exemptions has implications for maintaining pockets of low vaccine compliance and increased disease transmission.

scholarly journals Unmet Social Needs and No-Show Visits in Primary Care in a US Northeastern Urban Health System, 2018–2019

2020 ◽  
Vol 110 (S2) ◽  
pp. S242-S250 ◽  
Author(s):  
Kevin P. Fiori ◽  
Caroline G. Heller ◽  
Colin D. Rehm ◽  
Amanda Parsons ◽  
Anna Flattau ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Health System ◽  
Urban Health ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Social Needs ◽  
Positive Trend ◽  
Missed Appointments ◽  
Primary Care Practices

Objectives. To characterize the association between social needs prevalence and no-show proportion and variation in these associations among specific social needs. Methods. In this study, we used results from a 10-item social needs screener conducted across 19 primary care practices in a large urban health system in Bronx County, New York, between April 2018 and July 2019. We estimated the association between unmet needs and 2-year history of missed appointments from 41 637 patients by using negative binomial regression models. Results. The overall no-show appointment proportion was 26.6%. Adjusted models suggest that patients with 1 or more social needs had a significantly higher no-show proportion (31.5%) than those without any social needs (26.3%), representing an 19.8% increase (P < .001). We observed a positive trend (P < .001) between the number of reported social needs and the no-show proportion—26.3% for those with no needs, 30.0% for 1 need, 32.1% for 2 needs, and 33.8% for 3 or more needs. The strongest association was for those with health care transportation need as compared with those without (36.0% vs 26.9%). Conclusions. We found unmet social needs to have a significant association with missed primary care appointments with potential implications on cost, quality, and access for health systems.

scholarly journals Density of outdoor advertising of consumable products in NYC by neighborhood poverty level

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tamar Adjoian ◽  
Rachel Dannefer ◽  
Shannon M. Farley
Keyword(s):  
New York ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Poverty Level ◽  
Outdoor Advertising ◽  
Neighborhood Poverty ◽  
Sugary Drinks ◽  
Total Product ◽  
Product Image ◽  
June July

Abstract Background To determine if outdoor advertising density for non-alcoholic drinks, food, tobacco products, and alcohol, is associated with neighborhood poverty or other Census-level characteristics in New York City (NYC). Methods From June – July of 2015, photographs were taken of all street-level, stationary outdoor advertising (posters, stickers, decals, etc.) for consumable products in a sample of 953 NYC retail-dense street segments. Density of product images was analyzed by neighborhood poverty level and other characteristics using multivariate negative-binomial regression. Results A total of 16,305 discrete advertisements displaying 50,673 product images were photographed. Total product image prevalence relative to retail density was not significantly higher in high- vs. low-poverty neighborhoods, as hypothesized (OR: 1.31; 95% CI: 0.98, 1.77). However, total product image prevalence was higher in neighborhoods with a higher percentage of Black residents (OR: 1.08; 95% CI: 1.04, 1.12), and for sugary drinks in areas with a higher percentage of adults with <HS diploma (OR: 1.32; 95% CI: 1.11, 1.58). Conclusions Product images were abundant throughout NYC’s retail-dense areas, with marginally greater prevalence by some Census-level demographics, irrespective of the content displayed.

scholarly journals An empirical analysis of the financial benefits of health information exchange in emergency departments

2015 ◽  
Vol 22 (6) ◽  
pp. 1169-1172 ◽  
Author(s):  
Niam Yaraghi
Keyword(s):  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Laboratory Tests ◽  
Negative Binomial ◽  
Health Information Exchange ◽  
Negative Binomial Regression ◽  
Control Group ◽  
History Of ◽  
The Impact

Abstract Objective To examine the impact of health information exchange (HIE) on reducing laboratory tests and radiology examinations performed in an emergency department (ED). Materials and Methods The study was conducted in an ED setting in Western New York over a period of 2 months. The care of the patients in the treatment group included an HIE query for every encounter, while the care of other patients in the control group did not include such queries. A group of medical liaisons were hired to query the medical history of patients from an HIE and provide it to the ED clinicians. Negative binomial regression was used to analyze the effects of HIE queries on the number of performed laboratory tests and radiology examinations. The log files of the HIE system since 1 year before the ED admission were used to analyze the differences in outcome measures between the 2 groups of patients. Results Ceteris paribus, HIE usage is associated with, respectively, 52% and 36% reduction in the expected total number of laboratory tests and radiology examinations ordered per patient at the ED. Conclusions The results indicate that access to additional clinical data through the HIE will significantly reduce the number of laboratory tests and radiology examinations performed in the ED settings and thus support the ongoing HIE efforts.

Sign in / Sign up

Export Citation Format

Share Document