scholarly journals Methamphetamine‐Associated Heart Failure Hospitalizations Across the United States: Geographic and Social Disparities

2021 ◽  
Author(s):  
Stephen D. Dickson ◽  
Isac C. Thomas ◽  
Harpreet S. Bhatia ◽  
Marin Nishimura ◽  
Ehtisham Mahmud ◽  
...  
Keyword(s):  
United States ◽  
Heart Failure ◽  
West Coast ◽  
Clinical Characteristics ◽  
Systems Of Care ◽  
The United States ◽  
The West ◽  
Cross Sectional ◽  
Discharge Data ◽  
Methamphetamine Abuse

Background Although methamphetamine abuse is associated with the development of heart failure (HF), nationwide data on methamphetamine‐associated HF (MethHF) hospitalizations are limited. This study evaluates nationwide HF hospitalizations associated with substance abuse to better understand MethHF prevalence trends and the clinical characteristics of those patients. Methods and Results This cross‐sectional period‐prevalence study used hospital discharge data from the National Inpatient Sample to identify adult primary HF hospitalizations with a secondary diagnosis of abuse of methamphetamines, cocaine, or alcohol in the United States from 2002 to 2014. All 2014 MethHF admissions were separated by regional census division to evaluate geographical distribution. Demographics, payer information, and clinical characteristics of MethHF hospitalizations were compared with all other HF hospitalizations. Total nationwide MethHF hospitalizations increased from 547 in 2002 to 6625 in 2014 with a predominance on the West Coast. Methamphetamine abuse was slightly more common among primary HF hospitalizations compared with all‐cause hospitalizations (7.4 versus 6.4 per 1000; Cohen h= 0.012; P< 0.001). Among HF hospitalizations, patients with MethHF were younger (mean age, 48.9 versus 72.4 years; Cohen d= 1.93; P< 0.001), more likely to be on Medicaid (59.4% versus 8.8%; Cohen h= 1.16; P< 0.001) or uninsured (12.0% versus 2.6%; Cohen h= 0.36; P< 0.001), and more likely to present to urban hospitals (43.8% versus 28.3%; Cohen h= 0.32 ; P< 0.001) than patients with non‐methamphetamine associated HF. Patients with MethHF had higher rates of psychiatric comorbidities and were more likely to leave the hospital against medical advice. Conclusions MethHF hospitalizations have significantly increased in the United States, particularly on the West Coast. Coordinated public health policies and systems of care are needed to address this rising epidemic.

scholarly journals A Climatology of 500-hPa Closed Lows in the Northeastern Pacific Ocean, 1948–2011

2014 ◽  
Vol 53 (6) ◽  
pp. 1578-1592 ◽  
Author(s):  
Nina S. Oakley ◽  
Kelly T. Redmond
Keyword(s):  
United States ◽  
Pacific Ocean ◽  
Interannual Variability ◽  
West Coast ◽  
The United States ◽  
Western United States ◽  
The West ◽  
Reanalysis Dataset ◽  
The Pacific ◽  
Northeastern Pacific

AbstractThe northeastern Pacific Ocean is a preferential location for the formation of closed low pressure systems. These slow-moving, quasi-barotropic systems influence vertical stability and sustain a moist environment, giving them the potential to produce or affect sustained precipitation episodes along the west coast of the United States. They can remain motionless or change direction and speed more than once and thus often pose difficult forecast challenges. This study creates an objective climatological description of 500-hPa closed lows to assess their impacts on precipitation in the western United States and to explore interannual variability and preferred tracks. Geopotential height at 500 hPa from the NCEP–NCAR global reanalysis dataset was used at 6-h and 2.5° × 2.5° resolution for the period 1948–2011. Closed lows displayed seasonality and preferential durations. Time series for seasonal and annual event counts were found to exhibit strong interannual variability. Composites of the tracks of landfalling closed lows revealed preferential tracks as the features move inland over the western United States. Correlations of seasonal event totals for closed lows with ENSO indices, the Pacific decadal oscillation (PDO), and the Pacific–North American (PNA) pattern suggested an above-average number of events during the warm phase of ENSO and positive PDO and PNA phases. Precipitation at 30 U.S. Cooperative Observer stations was attributed to closed-low events, suggesting 20%–60% of annual precipitation along the West Coast may be associated with closed lows.

Last Years

2018 ◽  
pp. 376-386
Author(s):  
Robert E. Lerner
Keyword(s):  
United States ◽  
West Coast ◽  
The United States ◽  
Virgin Islands ◽  
Ruptured Aneurysm ◽  
Nuclear War ◽  
The West ◽  
Richard Nixon ◽  
The 1950S

This chapter details Ernst Kantorowicz's final years. Kantorowicz died of a ruptured aneurysm in September 1963. Before this, he worked on a succession of recondite articles, attended the annual meetings of the Medieval Academy and the Byzantine Institute at “Oakbarton Dumps,” vacationed on the West Coast and the Virgin Islands, and carried on earnestly with his dining and imbibing. His politics also became more leftward from the postwar years until the time of his death. For a decade and a half he was deeply worried about the possibility of nuclear war, and he held the United States responsible. During the 1950s, he was bitterly hostile to Dwight Eisenhower and Richard Nixon. On the day after Kennedy's inauguration, Kantorowicz wrote the he “couldn't be worse than Eisenhower, ” although he did change his mind.

From the Gulf to the Courts

2017 ◽  
Author(s):  
Stephanie Hinnershitz
Keyword(s):  
United States ◽  
Civil Rights ◽  
Gulf Of Mexico ◽  
Great Lakes ◽  
Vietnam War ◽  
West Coast ◽  
The United States ◽  
District Court ◽  
The West ◽  
Family Connections

The wreckage of the Vietnam War and new American polices geared toward resettling refugees brought thousands of Vietnamese to the United States. Although many Vietnamese settled on the West Coast and in the Great Lakes region, thousands more came to the Gulf of Mexico through sponsors or established family connections seeking work in the shrimping or oil industries of Alabama, Louisiana, Mississippi, and Texas. But, as the Vietnamese soon discovered, they were not welcomed by the largely white population who feared competition and distrusted racial outsiders. The Vietnamese fought back in the Houston District Court, filing a civil rights suit against the Klan with the assistance of the Southern Poverty Law Center.

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