Burden and trajectory of multimorbidity in rheumatoid arthritis: a matched cohort study from 2006 to 2015

2020 ◽  
pp. annrheumdis-2020-218282 ◽  
Author(s):  
Bryant R England ◽  
Punyasha Roul ◽  
Yangyuna Yang ◽  
Harlan Sayles ◽  
Fang Yu ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Chronic Conditions ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Sensitivity Analyses ◽  
Cross Sectional ◽  
Diagnostic Codes ◽  
Binomial Regression

ObjectivesTo compare the onset and trajectory of multimorbidity between individuals with and without rheumatoid arthritis (RA).MethodsA matched, retrospective cohort study was completed in a large, US commercial insurance database (MarketScan) from 2006 to 2015. Using validated algorithms, patients with RA (overall and incident) were age-matched and sex-matched to patients without RA. Diagnostic codes for 44 preidentified chronic conditions were selected to determine the presence (≥2 conditions) and burden (count) of multimorbidity. Cross-sectional comparisons were completed using the overall RA cohort and conditional logistic and negative binomial regression models. Trajectories of multimorbidity were assessed within the incident RA subcohort using generalised estimating equations.ResultsThe overall cohort (n=277 782) and incident subcohort (n=61 124) were female predominant (76.5%, 74.1%) with a mean age of 55.6 years and 54.5 years, respectively. The cross-sectional prevalence (OR 2.29, 95% CI 2.25 to 2.34) and burden (ratio of conditions 1.68, 95% CI 1.66 to 1.70) of multimorbidity were significantly higher in RA than non-RA in the overall cohort. Within the incident RA cohort, patients with RA had more chronic conditions than non-RA (β 1.13, 95% CI 1.10 to 1.17), and the rate of accruing chronic conditions was significantly higher in RA compared with non-RA (RA × follow-up year, β 0.21, 95% CI 0.20 to 0.21, p<0.001). Results were similar when including the pre-RA period and in several sensitivity analyses.ConclusionsMultimorbidity is highly prevalent in RA and progresses more rapidly in patients with RA than in patients without RA during and immediately following RA onset. Therefore, multimorbidity should be aggressively identified and targeted early in the RA disease course.

The positive association between employment and self-reported mental health in the USA: a robust application of marginalized zero-inflated negative binomial regression (MZINB)

2020 ◽  
Vol 42 (2) ◽  
pp. 340-352
Author(s):  
Chinaeke Eric ◽  
Gwynn Melanie ◽  
Hong Yuan ◽  
Zhang Jiajia ◽  
Olatosi Bankole
Keyword(s):  
Mental Health ◽  
Chronic Conditions ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Chronically Ill ◽  
Interactive Effects ◽  
Behavioral Risk ◽  
Cross Sectional ◽  
Binomial Regression ◽  
The Impact

Abstract Background Few studies have assessed the impact of employment on mental health among chronically ill patients. This study investigated the association between employment and self-reported mental unhealthy days among US adults. Methods For this cross-sectional cohort study, we pooled 2011–2017 Behavioral Risk Factor Surveillance System (BRFSS) survey data. We examined the association between employment and mental health in nine self-reported chronic conditions using marginalized zero-inflated negative binomial regression (MZINB). All analyses were conducted using SAS statistical software 9.4. Results Respondents (weighted n = 245 319 917) were mostly white (77.16%), aged 18–64 (78.31%) and employed (57.08%). Approximately 10% of respondents reported one chronic condition. Expected relative risk of mental unhealthy days was highest for employed respondents living with arthritis (RR = 1.70, 95% CI = [1.66, 1.74]), COPD (RR = 1.45, 95% CI = [1.41, 1.49]) and stroke (RR = 1.31, 95% CI = [1.25, 1.36]) compared to unemployed respondents. Employed males had 25% lower risk of self-reported mental unhealthy days compared to females. Conclusions Results show the interactive effects of employment on self-reported mental health. Employment may significantly impact on self-reported mental health among patients suffering from chronic conditions than those without chronic conditions.

scholarly journals Rheumatoid Arthritis-associated Polymorphisms at 6q23 Are Associated with Radiological Damage in Autoantibody-positive RA

2012 ◽  
Vol 39 (9) ◽  
pp. 1781-1785 ◽  
Author(s):  
JAMES R. MAXWELL ◽  
IOANNA MARINOU ◽  
KAR-PING KUET ◽  
GISELA OROZCO ◽  
DAVID J. MOORE ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Nucleotide Polymorphisms ◽  
Cross Sectional ◽  
Genotype Combination ◽  
Risk Alleles ◽  
Binomial Regression ◽  
Radiological Damage ◽  
Autoantibody Status

Objective.Recent studies have identified 6q23 as an important susceptibility locus for rheumatoid arthritis (RA), with risk alleles at 3 single-nucleotide polymorphisms combining to give an effect size greater than that of these markers individually. We investigated whether these polymorphisms are also associated with disease severity measured by radiological damage.Methods.We studied 927 patients from a cross-sectional RA cohort. Median Larsen scores (LS) read from radiographs taken at study entry were compared by genotype at rs6920220, rs13207033, and rs5029937 according to a dominant model using negative binomial regression with stratification for autoantibody status.Results.Median LS was associated with genotype at rs6920220 [LS 31 GG vs 36 GA/AA (p = 0.02) in cyclic citrullinated peptide+ (CCP) RA] and rs13020220 [LS 37 GG vs 29 GA/AA (p = 0.02) in CCP+ RA] only in autoantibody-positive RA, with no association at rs5029937. Association was stronger for these markers in combination [LS 28 vs 42 for lowest vs highest risk genotype combination in rheumatoid factor positivity (p = 0.007), LS 28 vs 37 for anti-CCP+ (p = 0.01)].Conclusion.Established RA risk markers at 6q23 are associated also with radiographic severity in autoantibody-positive RA; as for susceptibility, the association for these markers in combination is stronger than that for markers alone.

Abstract 16807: Burden and Timing of Hospitalizations in Heart Failure: A Community Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Alanna M Chamberlain ◽  
Yariv Gerber ◽  
Shannon M Dunlay ◽  
Sheila M Manemann ◽  
Susan A Weston ◽  
...  
Keyword(s):  
Heart Failure ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Community Study ◽  
Olmsted County ◽  
Comorbid Conditions ◽  
Binomial Regression ◽  
Time Periods ◽  
Patients Experience

Background: Heart failure (HF) patients are experiencing an epidemic of hospitalizations. Nevertheless, data on the frequency and distribution of hospitalizations over the course of the disease are lacking. Methods: We determined the rates of hospitalizations during periods of follow-up in Olmsted County, MN residents with incident HF from 2000-2010. HF was identified using ICD-9 code 428 and validated by the Framingham criteria. All hospitalizations were obtained for the 2 years following incident HF and each was categorized as due to HF, other cardiovascular (ICD-9 codes 390-427, 429-459), or non-cardiovascular causes. Follow-up was divided into discrete time periods (epochs): 0-30, 31-182, 183-365, and 366-730 days. Negative binomial regression examined associations between epochs of follow-up time and hospitalizations. Results: Among 1702 incident HF patients (mean age 76, 44% male), 1143 (67%) were hospitalized at index. Over the 2 year follow-up, 3008 hospitalizations were observed among 1136 patients, and 351 patients were hospitalized within 30 days of incident HF (median time from HF to hospitalization: 11 days). The majority of hospitalizations were due to non-cardiovascular causes (63% vs. 14% HF, 23% other cardiovascular); however, a larger proportion of HF and other cardiovascular hospitalizations were observed within the first 30 days (52% non-cardiovascular, 18% HF, 30% other cardiovascular) compared to the other time periods. The rate of hospitalization was highest within the first 30 days and was similar across sex, presentation of incident HF (inpatient, outpatient), and type of HF (preserved (≥50%), reduced (<50%) ejection fraction) (Table). Conclusions: HF patients experience high rates of hospitalizations, particularly within the first 30 days, and the majority of hospitalizations are for non-cardiovascular causes. Continued efforts to manage comorbid conditions and reduce hospitalizations in HF patients are needed.

scholarly journals Association of Pre- Peri- and Postnatal Factors with Developmental Defects of Enamel in Schoolchildren

2018 ◽  
Vol 42 (2) ◽  
pp. 125-134 ◽  
Author(s):  
Fabiana Vargas-Ferreira ◽  
Marco Aurelio Peres ◽  
Samuel Carvalho Dumith ◽  
William Murray Thomson ◽  
Flávio Fernando Demarco
Keyword(s):  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Cross Sectional Study ◽  
Older Children ◽  
Cross Sectional ◽  
Developmental Defects ◽  
Enamel Defects ◽  
Regression Modelling ◽  
Binomial Regression ◽  
Developmental Defects Of Enamel

Objective: This study estimated the prevalence, extent, buccal distribution and associated factors involving enamel defects in Brazilian schoolchildren. Study design: A cross-sectional study using a multistage cluster random sample of 1,206 8–12-year-old Brazilian schoolchildren was carried out in Pelotas, Brazil. The prevalence of enamel defects in the permanent dentition was determined using the modified Developmental Defects of Enamel index (DDE). Sociodemographic and health data were collected from their mothers using a semi-structured questionnaire. Data were analyzed using Poisson regression modelling for DDE prevalence and negative binomial regression modelling for the extent of DDE. Results: The prevalence of any enamel defects was 64.0% (95% Confidence Interval: 61.4, 67.0); the main types were diffuse opacities (35.0%), demarcated opacities (29.5%) and hypoplasia (3.7%). In general, older children had a lower prevalence and extent of enamel defects than their counterparts (p&lt;0.001). There were no other significant associations. Conclusion: Enamel defects are common, especially among younger children, but the role of pre-, peri- and postnatal exposures remains unclear.

scholarly journals Network analysis of firearm movement among US states

2020 ◽  
Author(s):  
Sae Takada ◽  
Kristen Choi ◽  
Shaw Natsui ◽  
Altaf Saadi ◽  
Liza Buchbinder ◽  
...  
Keyword(s):  
Time Series ◽  
Network Analysis ◽  
Negative Binomial ◽  
State Level ◽  
Negative Binomial Regression ◽  
Similar Model ◽  
Cross Sectional ◽  
Us States ◽  
Binomial Regression ◽  
The Relationship

Abstract Background: The movement of firearm across state lines may decrease the effectiveness of state-level firearm laws. Yet how state-level firearm policies affect cross-state movement have not yet been widely explored. This study aims to characterize the interstate movement of firearms and its relationship with state-level firearm policies. Methods: Cross-sectional time series network analysis of interstate firearm movement using Bureau of Alcohol, Tobacco, Firearms, and Explosives firearm trace data (2010 -2017). We constructed the network of firearm movement between 50 states. We used zero-inflated negative binomial regression to estimate the relationship between the number of a state’s firearm laws and number of states for which it was the source of 100 or more firearms, adjusting for state characteristics. We used a similar model to examine the relationship between firearm laws and the number of states for which a given state was the destination of 100 or more firearms.Results: Over the 8-year period, states had an average of 26 (SD 25.2) firearm laws. On average, a state was the source of 100 or more crime-related firearms for 2.2 (SD 2.7) states and was the destination of 100 or more crime-related firearms for 2.2 (SD 3.4) states. Greater number of firearm laws was associated with states being the source of 100 or more firearms to fewer states (IRR0.67 per SD, p<0.001), higher odds of not being a source to any states (aOR1.56 per SD, p<0.001), and states being the destination of 100 or more firearms from more states (IRR1.83 per SD, p<0.001).Conclusions: Restrictive firearm policies are associated with less movement of firearms to other states, but with more movement of firearms from outside states. The effectiveness of state-level firearm-restricting laws is complicated by a network of interstate firearm movement.

scholarly journals Impact of long-term exposure to PM2.5 and temperature on coronavirus disease mortality: observed trends in France

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Anastase Tchicaya ◽  
Nathalie Lorentz ◽  
Hichem Omrani ◽  
Gaetan de Lanchy ◽  
Kristell Leduc
Keyword(s):  
Air Pollution ◽  
Mortality Rate ◽  
Negative Binomial ◽  
National Level ◽  
Negative Binomial Regression ◽  
Cross Sectional Study ◽  
Annual Average ◽  
Cross Sectional ◽  
Binomial Regression

Abstract Background The outbreak of coronavirus disease (COVID-19) began in Wuhan, China in December 2019 and was declared a global pandemic on 11 March 2020. This study aimed to assess the effects of temperature and long-term exposure to air pollution on the COVID-19 mortality rate at the sub-national level in France. Methods This cross-sectional study considered different periods of the COVID-19 pandemic from May to December 2020. It included 96 departments (or NUTS 3) in mainland France. Data on long-term exposure to particulate matter (PM2.5), annual mean temperature, health services, health risk, and socio-spatial factors were used as covariates in negative binomial regression analysis to assess their influence on the COVID-19 mortality rate. All data were obtained from open-access sources. Results The cumulative COVID-19 mortality rate by department increased during the study period in metropolitan France—from 19.8/100,000 inhabitants (standard deviation (SD): 20.1) on 1 May 2020, to 65.4/100,000 inhabitants (SD: 39.4) on 31 December 2020. The rate was the highest in the departments where the annual average of long-term exposure to PM2.5 was high. The negative binomial regression models showed that a 1 μg/m3 increase in the annual average PM2.5 concentration was associated with a statistically significant increase in the COVID-19 mortality rate, corresponding to 24.4%, 25.8%, 26.4%, 26.7%, 27.1%, 25.8%, and 15.1% in May, June, July, August, September, October, and November, respectively. This association was no longer significant on 1 and 31 December 2020. The association between temperature and the COVID-19 mortality rate was only significant on 1 November, 1 December, and 31 December 2020. An increase of 1 °C in the average temperature was associated with a decrease in the COVID-19-mortality rate, corresponding to 9.7%, 13.3%, and 14.5% on 1 November, 1 December, and 31 December 2020, respectively. Conclusion This study found significant associations between the COVID-19 mortality rate and long-term exposure to air pollution and temperature. However, these associations tended to decrease with the persistence of the pandemic and massive spread of the disease across the entire country.

scholarly journals Network analysis of firearm movement among US states

2020 ◽  
Author(s):  
Sae Takada ◽  
Kristen Choi ◽  
Shaw Natsui ◽  
Altaf Saadi ◽  
Liza Buchbinder ◽  
...  
Keyword(s):  
Time Series ◽  
Network Analysis ◽  
Negative Binomial ◽  
State Level ◽  
Negative Binomial Regression ◽  
Similar Model ◽  
Cross Sectional ◽  
Us States ◽  
Binomial Regression ◽  
The Relationship

Abstract Background: The movement of firearm across state lines may decrease the effectiveness of state-level firearm laws. Yet how state-level firearm policies affect cross-state movement have not yet been widely explored. This study aims to characterize the interstate movement of firearms and its relationship with state-level firearm policies. Methods : Cross-sectional time series network analysis of interstate firearm movement using Bureau of Alcohol, Tobacco, Firearms, and Explosives firearm trace data (2010 -2017). We constructed the network of firearm movement between 50 states. We used zero-inflated negative binomial regression to estimate the relationship between the number of a state’s firearm laws and number of states for which it was the source of 100 or more firearms, adjusting for state characteristics. We used a similar model to examine the relationship between firearm laws and the number of states for which a given state was the destination of 100 or more firearms. Results : Over the 8-year period, states had an average of 26 (SD 25.2) firearm laws. On average, a state was the source of 100 or more crime-related firearms for 2.2 (SD 2.7) states and was the destination of 100 or more crime-related firearms for 2.2 (SD 3.4) states. Greater number of firearm laws was associated with states being the source of 100 or more firearms to fewer states (IRR0.67 per SD, p<0.001), higher odds of not being a source to any states (aOR1.56 per SD, p<0.001), and states being the destination of 100 or more firearms from more states (IRR1.83 per SD, p<0.001). Conclusions: Restrictive firearm policies are associated with less movement of firearms to other states, but with more movement of firearms from outside states. The effectiveness of state-level firearm-restricting laws is complicated by a network of interstate firearm movement.

Gang organization and violence in youth correctional facilities

2016 ◽  
Vol 2 (2) ◽  
pp. 81-94 ◽  
Author(s):  
Daniel Walter Scott ◽  
Cheryl Lee Maxson
Keyword(s):  
Negative Binomial ◽  
Violent Behavior ◽  
Negative Binomial Regression ◽  
Correctional Facilities ◽  
Cross Sectional ◽  
Content Type ◽  
Institutional Violence ◽  
Binomial Regression ◽  
Gang Organization ◽  
The Relationship

Purpose – The purpose of this paper is to examine characteristics of gang organization in youth correctional facilities as reported by youth and staff as well as to analyze the relationship between institutional violence and level of gang organization. Design/methodology/approach – The data were collected through interviews with staff and youth in correctional facilities. Gang organization level averages are compared across youth and official perspectives, and the variability of responses among youth is also examined. Negative binomial regression models are conducted to determine the association between perceived level of gang organization and officially recorded violent behavior, both prior to and subsequent to the interview. Findings – Perceptions of institutional gang organization vary notably depending on who is reporting. In contrast with prior studies of street gangs, controlling for youth demographics and offense characteristics, the authors find no significant relationship between gang organization and violence. Research limitations/implications – The sample size is small and the data are cross-sectional. Future studies will need to be conducted in order to confirm these findings, as they contradict prior studies. The analysis of street gang organization may need to be approached differently by scholars. Originality/value – Research has not been conducted on the organizational structure of gangs in youth correctional facilities or its relationship to institutional violence.

scholarly journals Homicide and impunity: an ecological analysis at state level in Brazil

2009 ◽  
Vol 43 (5) ◽  
pp. 733-742 ◽  
Author(s):  
Paulo Nadanovsky ◽  
Roger Keller Celeste ◽  
Margo Wilson ◽  
Martin Daly
Keyword(s):  
Negative Binomial ◽  
State Level ◽  
Negative Binomial Regression ◽  
Study Data ◽  
Development Economic ◽  
Cross Sectional ◽  
Homicide Rates ◽  
Young Males ◽  
Binomial Regression ◽  
Homicide Victim

OBJECTIVE: To assess a new impunity index and variables that have been found to predict variation in homicide rates in other geographical levels as predictive of state-level homicide rates in Brazil. METHODS: This was a cross-sectional ecological study. Data from the mortality information system relating to the 27 Brazilian states for the years 1996 to 2005 were analyzed. The outcome variables were taken to be homicide victim rates in 2005, for the entire population and for men aged 20-29 years. Measurements of economic and social development, economic inequality, demographic structure and life expectancy were analyzed as predictors. An "impunity index", calculated as the total number of homicides between 1996 and 2005 divided by the number of individuals in prison in 2007, was constructed. The data were analyzed by means of simple linear regression and negative binomial regression. RESULTS: In 2005, state-level crude total homicide rates ranged from 11 to 51 per 100,000; for young men, they ranged from 39 to 241. The impunity index ranged from 0.4 to 3.5 and was the most important predictor of this variability. From negative binomial regression, it was estimated that the homicide victim rate among young males increased by 50% for every increase of one point in this ratio. CONCLUSIONS: Classic predictive factors were not associated with homicides in this analysis of state-level variation in Brazil. However, the impunity index indicated that the greater the impunity, the higher the homicide rate.

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