scholarly journals Trends in factors indicating increased risk for STI among key subpopulations in the United States, 2002–2015

2019 ◽  
Vol 96 (2) ◽  
pp. 121-123 ◽  
Author(s):  
Jami S Leichliter ◽  
Patricia J Dittus ◽  
Casey E Copen ◽  
Sevgi O Aral
Keyword(s):  
Risk Factors ◽  
National Survey ◽  
Temporal Trends ◽  
Male Partner ◽  
The United States ◽  
High Risk Factors ◽  
Increased Risk ◽  
The Usa ◽  
Sex With Men ◽  
Over Time

ObjectivesWithin the context of rising rates of reportable STIs in the USA, we used national survey data to examine temporal trends in high-risk factors that indicate need for STI/HIV preventive services among key subpopulations with disproportionate STI rates.MethodsWe used data from the 2002 (n=12 571), 2006–2010 (n=22 682) and 2011–2015 (n=20 621) National Survey of Family Growth (NSFG). NSFG is a national probability survey of 15–44 year olds living in US households. We examined STI risk factors among sexually active men who have sex with men (MSM) and Hispanic, non-Hispanic black, 15–19 year old, 20–24 year old, and 25–29 year old women who have sex with men (WSM) and men who have sex with women (MSW). Risk behaviours included: received money or drugs for sex, gave money or drugs for sex, partner who injected drugs, partner who has HIV, non-monogamous partner (WSM, MSW only) and male partner who had sex with other men (WSM only). Endorsement of any of these behaviours was recoded into a composite variable focusing on factors indicating increased STI risk (yes/no). We used chi-squares and logistic regression (calculating predicted marginals to estimate adjusted prevalence ratios (aPRs)) to examine STI risk factors over time among the key subpopulations.ResultsFrom 2002 to 2011–2015, reported STI risk factors did not change or declined over time among key subpopulations in the USA. In adjusted analyses comparing 2002 to 2011–2015, we identified significant declines among WSM: Hispanics (aPR=0.84 (0.68–1.04), non-Hispanic blacks (aPR=0.69 (0.58–0.82), adolescents (aPR=0.71 (0.55–0.91) and 25–29 year olds (aPR=0.76 (0.58–0.98); among MSW: Hispanics (aPR=0.53 (0.40–0.70), non-Hispanic blacks (aPR=0.74 (0.59–0.94) and adolescents (aPR=0.63 (0.49–0.82); and among MSM (aPR=0.53 (0.34–0.84).ConclusionsWhile reported STIs have increased, STI risk factors among key subpopulations were stable or declined. Condom use related to these risk factors, sexual mixing patterns and STI testing should be examined.

scholarly journals Transactional Sex between Men and Its Implications on HIV and Sexually Transmitted Infections in Nigeria

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Eniola A. Bamgboye ◽  
Titilope Badru ◽  
Afolabi Bamgboye
Keyword(s):  
Risk Factors ◽  
Sexually Transmitted Infections ◽  
Sexual Behaviors ◽  
Male Partner ◽  
Hiv Prevalence ◽  
Transactional Sex ◽  
Sexually Transmitted ◽  
Factors Associated ◽  
Increased Risk ◽  
Sex With Men

Introduction. Men who have transactional sex with men (MTSM) are known to be at higher risk for HIV and sexually transmitted infections (STIs). This study explored the risk factors associated with STI symptoms and HIV prevalence among men who have transactional sex with men in Nigeria. Methods. In 2014, a cross-sectional study, using respondent driven sampling technique, was carried out to recruit 3,172 MSM across eight states in Nigeria. Relevant information on sociodemographic characteristics, sexual behaviors, and self-reported symptoms of STI was obtained. Bivariate and multivariate analysis was performed to identify risk factors for STI symptoms and HIV. Results. 38.2% of the MSM were involved in transactional sex. Prevalence of self-reported STI symptoms was higher among MTSM than other MSM, while HIV prevalence was higher among other MSM than MTSM. Identified factors associated with STI symptoms and HIV among MSTM were being single, alcohol consumption, oral sex, and history of rape by a male partner. Conclusion. Sexually transmitted infections are a significant challenge to men who have transactional sex with men. Adolescents and single men are more at risk of these infections. Youth empowerment needs to be invested on to avoid increased risk among these groups of people.

565 Suicidality After Burn Injuries: A Systematic Review

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S123-S124
Author(s):  
Sheera F Lerman ◽  
C Scott Hultman ◽  
Carrie A Cox ◽  
Julie Caffrey
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
The United States ◽  
Burn Injuries ◽  
Psychiatric Comorbidities ◽  
Completed Suicide ◽  
Increased Risk ◽  
Burn Survivors ◽  
The Impact ◽  
Over Time

Abstract Introduction Burn injuries are associated with substantial pain and disability and may lead to significant long term psychological distress including suicidality. Suicide is among the leading causes of death in the United States and burn survivors may be at increased risk due to the nature of their injury and psychiatric comorbidities. The purpose of this review is to assess the evidence as to the prevalence of suicidal ideations and behaviors (attempts and completed suicides) in burn survivors as well as assessment of risk and protective factors for these behaviors. Methods MEDLINE, CINAHL, EMBASE and PsycINFO databases were searched using search terms regarding suicide, suicidality and burn. Studies evaluating self-immolation were excluded unless they also measured suicidality after the injury. Fourteen observational and population-based studies which measured any type of suicidality (ideation, attempts or completed suicide) post-burn injuries underwent critical appraisal. Results Few studies directly measure suicidality after burn injuries, and even fewer measure changes in suicidality over time. Overall, burn survivors demonstrate elevated suicidal ideations with rates as high as 32%. Pain at discharge, perceived level of disfigurement and premorbid psychiatric comorbidities are among the significant risk factors for suicidal ideations. There is mixed evidence as to rates of completed suicide post-burn injury, though rates appear to be relatively low. Conclusions Results of this systematic review shed light on the scarcity of data on rates of suicidality among burn survivors. This is surprising given the multiple risk factors burn survivors possess including chronic pain, sleep disturbances, history of substance abuse, post-traumatic stress disorder, social isolation and depression which are linked to suicidality in the general population. In addition, individuals with self-inflicted burns may be at even higher risk given that previous suicide attempts are of the strongest predictor of future suicidality. More research is needed to better understand the impact of these risk factors in burn survivors and inform their care. Applicability of Research to Practice There is high importance in screening burn survivors for suicidal ideations at discharge from the hospital and following them over time in order to understand the magnitude of this phenomena and offer targeted interventions to vulnerable individuals.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

scholarly journals Maternal mortality in six low and lower-middle income countries from 2010 to 2018: risk factors and trends

2020 ◽  
Vol 17 (S3) ◽  
Author(s):  
Melissa Bauserman ◽  
Vanessa R. Thorsten ◽  
Tracy L. Nolen ◽  
Jackie Patterson ◽  
Adrien Lokangaka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Maternal Mortality ◽  
Maternal Deaths ◽  
Middle Income ◽  
Maternal Risk ◽  
Live Births ◽  
Middle Income Countries ◽  
Risk Of Death ◽  
Increased Risk ◽  
Over Time

Abstract Background Maternal mortality is a public health problem that disproportionately affects low and lower-middle income countries (LMICs). Appropriate data sources are lacking to effectively track maternal mortality and monitor changes in this health indicator over time. Methods We analyzed data from women enrolled in the NICHD Global Network for Women’s and Children’s Health Research Maternal Newborn Health Registry (MNHR) from 2010 through 2018. Women delivering within research sites in the Democratic Republic of Congo, Guatemala, India (Nagpur and Belagavi), Kenya, Pakistan, and Zambia are included. We evaluated maternal and delivery characteristics using log-binomial models and multivariable models to obtain relative risk estimates for mortality. We used running averages to track maternal mortality ratio (MMR, maternal deaths per 100,000 live births) over time. Results We evaluated 571,321 pregnancies and 842 maternal deaths. We observed an MMR of 157 / 100,000 live births (95% CI 147, 167) across all sites, with a range of MMRs from 97 (76, 118) in the Guatemala site to 327 (293, 361) in the Pakistan site. When adjusted for maternal risk factors, risks of maternal mortality were higher with maternal age > 35 (RR 1.43 (1.06, 1.92)), no maternal education (RR 3.40 (2.08, 5.55)), lower education (RR 2.46 (1.54, 3.94)), nulliparity (RR 1.24 (1.01, 1.52)) and parity > 2 (RR 1.48 (1.15, 1.89)). Increased risk of maternal mortality was also associated with occurrence of obstructed labor (RR 1.58 (1.14, 2.19)), severe antepartum hemorrhage (RR 2.59 (1.83, 3.66)) and hypertensive disorders (RR 6.87 (5.05, 9.34)). Before and after adjusting for other characteristics, physician attendance at delivery, delivery in hospital and Caesarean delivery were associated with increased risk. We observed variable changes over time in the MMR within sites. Conclusions The MNHR is a useful tool for tracking MMRs in these LMICs. We identified maternal and delivery characteristics associated with increased risk of death, some might be confounded by indication. Despite declines in MMR in some sites, all sites had an MMR higher than the Sustainable Development Goals target of below 70 per 100,000 live births by 2030. Trial registration The MNHR is registered at NCT01073475.

scholarly journals Temporal trends in outcome and patient characteristics in dilated cardiomyopathy, data from the Swedish Heart Failure Registry 2003–2015

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Helen Sjöland ◽  
Jonas Silverdal ◽  
Entela Bollano ◽  
Aldina Pivodic ◽  
Ulf Dahlström ◽  
...  
Keyword(s):  
Heart Failure ◽  
Dilated Cardiomyopathy ◽  
Temporal Trends ◽  
Physical Symptoms ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Continuous Change ◽  
Ventricular Ejection Fraction ◽  
Increased Risk ◽  
Over Time

Abstract Background Temporal trends in clinical composition and outcome in dilated cardiomyopathy (DCM) are largely unknown, despite considerable advances in heart failure management. We set out to study clinical characteristics and prognosis over time in DCM in Sweden during 2003–2015. Methods DCM patients (n = 7873) from the Swedish Heart Failure Registry were divided into three calendar periods of inclusion, 2003–2007 (Period 1, n = 2029), 2008–2011 (Period 2, n = 3363), 2012–2015 (Period 3, n = 2481). The primary outcome was the composite of all-cause death, transplantation and hospitalization during 1 year after inclusion into the registry. Results Over the three calendar periods patients were older (p = 0.022), the proportion of females increased (mean 22.5%, 26.4%, 27.6%, p = 0.0001), left ventricular ejection fraction was higher (p = 0.0014), and symptoms by New York Heart Association less severe (p < 0.0001). Device (implantable cardioverter defibrillator and/or cardiac resynchronization) therapy increased by 30% over time (mean 11.6%, 12.3%, 15.1%, p < 0.0001). The event rates for mortality, and hospitalization were consistently decreasing over calendar periods (p < 0.0001 for all), whereas transplantation rate was stable. More advanced physical symptoms correlated with an increased risk of a composite outcome over time (p = 0.0043). Conclusions From 2003 until 2015, we observed declining mortality and hospitalizations in DCM, paralleled by a continuous change in both demographic profile and therapy in the DCM population in Sweden, towards a less affected phenotype.

Diverging trends in US male-female condom use by STI risk factors: a nationally representative study

2020 ◽  
pp. sextrans-2020-054642
Author(s):  
Casey E Copen ◽  
Patricia J Dittus ◽  
Jami S Leichliter ◽  
Sagar Kumar ◽  
Sevgi O Aral
Keyword(s):  
Risk Factors ◽  
Condom Use ◽  
Illicit Drugs ◽  
Female Condom ◽  
Cross Sectional ◽  
The Past ◽  
Representative Study ◽  
The Usa ◽  
Over Time ◽  
Sex Partner

ObjectiveCondom use behaviours are proximal to recent STI increases in the USA, yet it remains unclear whether the use of condoms has changed over time among unmarried, non-cohabiting young men who have sex with women (MSW) and how this variability is influenced by STI risk factors.MethodsTo examine condom use over time among MSW aged 15–29, we used three cross-sectional surveys from the 2002, 2006–2010 and 2011–2017 National Survey of Family Growth. We estimated weighted percentages, adjusted prevalence ratios (APRs) and 95% confidence intervals (CI) to assess changes in condom use, stratified by whether MSW reported any STI risk factors in the past 12 months (ie, perceived partner non-monogamy, male-to-male sex, sex in exchange for money or drugs, sex partner who injects illicit drugs, or an HIV-positive sex partner).ResultsWe observed a divergence in trends in condom use at last sex between men aged 15 –29 with STI risk factors in the past 12 months and those without such history. We saw significant declines in condom use from 2002 to 2011–2017 among men with STI risk factors (APR=0.80, 95% CI 0.68 to 0.95), specifically among those aged 15–19 (APR=0.73, 95% CI 0.57 to 0.94) or non-Hispanic white (APR=0.71, 95% CI 0.54 to 0.93). In contrast, trends in condom use among men with no STI factors remained stable or increased. Across all time periods, the most prevalent STI risk factor reported was perception of a non-monogamous female partner (23.0%–26.9%). Post-hoc analyses examined whether condom use trends changed once this variable was removed from analyses, but no different patterns were observed.ConclusionsWhile STIs have been increasing, men aged 15–29 with STI risk factors reported a decline in condom use. Rising STI rates may be sensitive to behavioural shifts in condom use among young MSW with STI risk factors.

Canada’s changing innovation landscape

2021 ◽  
Author(s):  
Md. Razib Alam ◽  
Bonwoo Koo ◽  
Brian Paul Cozzarin
Keyword(s):  
The United States ◽  
Destination Country ◽  
Firm Level ◽  
Individual Level ◽  
Patent Classification ◽  
The Usa ◽  
The Government ◽  
The Individual ◽  
The University ◽  
Over Time

Abstract Our objective is to study Canada’s patenting activity over time in aggregate terms by destination country, by assignee and destination country, and by diversification by country of destination. We collect bibliographic patent data from the Canadian Intellectual Property Office and the United States Patent and Trademark Office. We identify 19,957 matched Canada–US patents, 34,032 Canada-only patents, and 43,656 US-only patents from 1980 to 2014. Telecommunications dominates in terms of International Patent Classification technologies for US-only and Canada–US patents. At the firm level, the greatest number of matched Canada–US patents were granted in the field of telecommunications, at the university level in pharmaceuticals, at the government level in control and instrumentation technology, and at the individual level in civil engineering. We use entropy to quantify technological diversification and find that diversification indices decline over time for Canada and the USA; however, all US indices decline at a faster rate.

scholarly journals Longest reported case of symptomatic COVID-19 reporting positive for over 230 days in an immunocompromised patient in the United States

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110400
Author(s):  
Bilal Chaudhry ◽  
Lidiya Didenko ◽  
Maaria Chaudhry ◽  
Andrew Malek ◽  
Kirill Alekseyev
Keyword(s):  
Risk Factors ◽  
Polymerase Chain Reaction ◽  
Immunocompromised Patient ◽  
The United States ◽  
Immunocompromised Patients ◽  
Chain Reaction ◽  
Viral Shedding ◽  
Time Period ◽  
Increased Risk ◽  
Polymerase Chain

Coronavirus 2019 (COVID-19) pneumonia was first noted in Wuhan, China. Since the start of the pandemic, there have been millions of cases diagnosed. The average time from onset of symptoms to testing negative SARS-CoV-2 via reverse transcription polymerase chain reaction is roughly 25 days. In patients who continually test positive for COVID-19, it is essential to determine precisely which risk factors contribute to the increase in viral shedding duration. We present a case about a 62-year-old man who has persistently tested positive for COVID-19 for more than 230 days. We followed his treatment course, in which he had been hospitalized multiple times since the onset of symptoms back in April 2020. We have determined that patients with immunosuppression, especially those taking corticosteroids, are at increased risk of prolonged viral shedding. It is essential to continually monitor these immunocompromised patients as they required a greater time period in order to have an appropriate immune response in which antibodies are created.

scholarly journals Spatial and temporal trends in social vulnerability and COVID-19 incidence and death rates in the United States

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248702
Author(s):  
Brian Neelon ◽  
Fedelis Mutiso ◽  
Noel T. Mueller ◽  
John L. Pearce ◽  
Sara E. Benjamin-Neelon
Keyword(s):  
Social Vulnerability ◽  
Primary Care Physicians ◽  
Negative Binomial ◽  
Temporal Trends ◽  
The United States ◽  
Social Vulnerability Index ◽  
Crossover Effect ◽  
Death Rates ◽  
The Impact ◽  
Over Time

Background Socially vulnerable communities may be at higher risk for COVID-19 outbreaks in the US. However, no prior studies examined temporal trends and differential effects of social vulnerability on COVID-19 incidence and death rates. Therefore, we examined temporal trends among counties with high and low social vulnerability to quantify disparities in trends over time. Methods We conducted a longitudinal analysis examining COVID-19 incidence and death rates from March 15 to December 31, 2020, for each US county using data from USAFacts. We classified counties using the Social Vulnerability Index (SVI), a percentile-based measure from the Centers for Disease Control and Prevention, with higher values indicating more vulnerability. Using a Bayesian hierarchical negative binomial model, we estimated daily risk ratios (RRs) comparing counties in the first (lower) and fourth (upper) SVI quartiles, adjusting for rurality, percentage in poor or fair health, percentage female, percentage of smokers, county average daily fine particulate matter (PM2.5), percentage of primary care physicians per 100,000 residents, daily temperature and precipitation, and proportion tested for COVID-19. Results At the outset of the pandemic, the most vulnerable counties had, on average, fewer cases per 100,000 than least vulnerable SVI quartile. However, on March 28, we observed a crossover effect in which the most vulnerable counties experienced higher COVID-19 incidence rates compared to the least vulnerable counties (RR = 1.05, 95% PI: 0.98, 1.12). Vulnerable counties had higher death rates starting on May 21 (RR = 1.08, 95% PI: 1.00,1.16). However, by October, this trend reversed and the most vulnerable counties had lower death rates compared to least vulnerable counties. Conclusions The impact of COVID-19 is not static but can migrate from less vulnerable counties to more vulnerable counties and back again over time.

scholarly journals 1342. TOSCANA: The Observational Seroepidemiologic Study of COVID-19 at the United States Naval Academy

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S758-S759
Author(s):  
Eugene Millar ◽  
Eric Laing ◽  
Adam Saperstein ◽  
Jitu Modi ◽  
Christopher Heaney ◽  
...  
Keyword(s):  
United States ◽  
Risk Factors ◽  
Blood Sample ◽  
Saliva Sample ◽  
The United States ◽  
Pathogen Transmission ◽  
Naval Academy ◽  
United States Naval Academy ◽  
Increased Risk ◽  
Seroepidemiologic Study

Abstract Background University students, including those at military service academies, are at increased risk of acute respiratory infection (ARI), including SAR-CoV-2, due to crowded living conditions, frequent social interaction and other factors that facilitate pathogen transmission. Unlike many universities, the United States Naval Academy (USNA) continued in-person instruction in Fall 2020 in the midst of the COVID-19 pandemic. The Observational Seroepidemiologic Study of COVID-19 at the United States Naval Academy (TOSCANA,) a longitudinal cohort characterizes the burden and risk factors of SARS-CoV-2 in USNA midshipmen. Methods Midshipmen were enrolled August- October 2020. Participants were queried about their ARI risk factors, COVID-19 history, and recent receipt of medical care for any ARI at enrollment, in December 2020 and again in May 2021. Subjects were also asked to provide blood and saliva samples to assess their SARS-CoV-2 serostatus at the same three timepoints. A saliva sample was collected by a subset of subjects in February 2021. Presence of anti-SARS-CoV-2 serum IgG in dried blood spots and saliva was measured by multiplex magnetic microparticle-based immunoassays. Results 181 midshipmen consented to the study and completed the baseline survey (Table 1). 17 (17.5%) of the 97 subjects who submitted baseline blood sample were SARS-CoV-2 seropositive. Only 4 (24%) positive individuals reported having been tested for or diagnosed with COVID-19 prior to arrival at USNA. 121 participants completed the midyear survey, of whom 61 (50%) submitted a blood sample. 16 (26%) of the midyear specimens were SARS-CoV-2 positive. Of these, 3 were new infections. 73 subjects completed the May survey, and 63 (100%) of the submitted blood samples were positive. 83 subjects provided baseline saliva samples, and ~55 submitted saliva at each successive time point. 1 (5%) was positive at enrollment, 9 (17%) were positive at midyear and 47 (96%) were positive in May. Table 1. Key characteristics of TOSCANA participants Conclusion SAR-CoV-2 prevalence in a sample of USNA midshipmen was &lt; 20% at enrollment. A small proportion of subjects seroconverted between the September and December visits. SARS-CoV-2 positivity rose in May, following a COVID-19 outbreak in February and COVID-19 vaccination efforts in March at USNA. Disclosures Jitu Modi, MD, GSK (Speaker’s Bureau)

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