Survival Analysis of Time to Opioid Use and the Role of PTSD-Linked Stress Sensitivity for Predicting Onset Risk for Juvenile Offenders Following Adjudication

2021 ◽  
pp. 003288552110693
Author(s):  
Thomas W. Wojciechowski
Keyword(s):  
Survival Analysis ◽  
Juvenile Offenders ◽  
Stress Sensitivity ◽  
Hazard Models ◽  
Time Varying ◽  
Opioid Use ◽  
Time Varying Covariates ◽  
Moderating Role

This study sought to understand how PTSD predicts opioid use onset rates and how subsequent exposures to violence also influence this risk following adjudication. Survival analysis was used to examine the moderating role that baseline PTSD status plays for predicting rates of opioid use onset risk following adjudication. Hazard models used to examine the role of time-varying covariates for predicting opioid onset risk following adjudication. PTSD was found to predict significantly greater odds of opioid use initiation. Hazard of introducing opioid use was greater during observation periods in which participants witnessed violence. This effect was greater for PTSD sufferers.

scholarly journals Time-Varying Associations Between Conduct Problems and Alcohol Use in Adolescent Girls: The Moderating Role of Race*

2010 ◽  
Vol 71 (4) ◽  
pp. 544-553 ◽  
Author(s):  
Rolf Loeber ◽  
Stephanie D. Stepp ◽  
Tammy Chung ◽  
Alison E. Hipwell ◽  
Helene R. White
Keyword(s):  
Alcohol Use ◽  
Conduct Problems ◽  
Adolescent Girls ◽  
Time Varying ◽  
Moderating Role

scholarly journals Pain Persistence Is Associated With Increased Odds of MCI in Late Midlife and Early Older Adulthood

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 115-115
Author(s):  
Tyler Bell ◽  
Jeremy Elman ◽  
Carol Franz ◽  
William Kremen
Keyword(s):  
Pain Intensity ◽  
Persistent Pain ◽  
Time Varying ◽  
Opioid Use ◽  
Older Adulthood ◽  
Clinical Pain ◽  
Time Invariant ◽  
The Impact ◽  
Time Varying Covariates ◽  
Late Midlife

Abstract Twenty percent of older adults will experience persistent pain, the sensation of bodily harm lasting three or more months. Persistent pain doubles the risk of dementia, but we know less about the impact on earlier stages, such as mild cognitive impairment (MCI). As a step for clarification, this study leveraged data from the Vietnam Era Twin Study of Aging (VETSA) to understand how pain persistence relates to MCI in late midlife to early older adulthood. Participants (n=1,465, 100% male) were recruited across three waves at average ages 56, 62, and 68. At each wave, participants completed the SF-36 and were asked to rate their pain intensity from none (1) to very severe (6). Clinical pain was coded as pain intensity rated more than mild (>3/6). As a time-varying predictor, pain persistence was then calculated as a running frequency of the total waves reporting clinical pain. MCI diagnosis was based on Jak-Bondi criteria. Age, depressive symptoms, comorbidities, and opioid use were included as time-varying covariates. Age and education were included as time-invariant covariates. General estimating equations showed that pain persistence over two waves, reported in 35% of the sample, increased MCI odds by 57% (OR=1.57, 95%CI: 1.28 to 1.94). Pain persistence over three waves, reported in 17% of the sample, increased MCI odds by 98% (OR=1.98, 95%CI: 1.44 to 2.70). The findings emphasize the role of pain in earlier stages of dementia and the potential importance of pain management in offsetting cognitive decline.

Role of cytoreductive nephrectomy (CN) in metastatic renal cell carcinoma (mRCC).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 4582-4582
Author(s):  
Pooja Ghatalia ◽  
Elizabeth A. Handorf ◽  
Mengying Deng ◽  
Matthew R. Zibelman ◽  
Philip Abbosh ◽  
...  
Keyword(s):  
Propensity Score ◽  
Systemic Therapy ◽  
Proportional Hazards ◽  
Statistical Significance ◽  
Patient Characteristics ◽  
Cox Proportional Hazards ◽  
Time Varying ◽  
Health Database ◽  
Time Varying Covariates

4582 Background: The role of CN in mRCC was challenged by the results of the CARMENA trial in the targeted therapy (TT) era. We sought to evaluate the role of both upfront and deferred CN in pts receiving modern IO-based and TT regimens. Methods: Pts with synchronous mRCC who received systemic therapy (tx) for mRCC after 2011 were included from the de-identified nationwide Flatiron Health database. We evaluated 3 groups: systemic tx alone, systemic-> CN, and CN-> systemic tx. Overall survival (OS) was calculated from the time of initiation of first therapy – systemic or CN. Patient characteristics were compared using chi-squared tests or t-test. Weighted Kaplan-Meier curves, log-rank tests, and Cox proportional hazards regressions with time-varying covariates were used to assess the effect of tx on survival. Adjustment was conducted via inverse probability of treatment weighing based on the generalized propensity score, estimated via Bayesian Additive Regression Trees. Covariates in the model were age, gender, race, insurance at mRCC diagnosis, and IMDC risk group. Results: Of 1719 pts with mRCC, 972 (56.5%) received systemic tx alone, 605 (35.1%) received CN-> systemic tx, and 142 (8.2%) received systemic->CN. 310 pts received IO or IO/IO, 123 pts received IO+TT and 1152 pts received only TT. The median follow-up was 37.1 months. In adjusted analyses using propensity score weighting and time-varying covariates, CN-> systemic was significantly associated with improved OS compared with systemic tx alone (Table). When stratifying groups by type of systemic treatment (IO and TT), there was improvement of OS in the CN groups compared to systemic tx alone, although we lacked power to reach statistical significance. Among CN-treated patients, the order of systemic tx relative to CN did not change OS (hazard ratio [HR] = 1.00, 95% CI 0.76-1.32, p=0.96). Conclusions: Using a national, EHR-based cohort, which includes a large number of IO treated pts, our findings support an oncologic role for CN in select mRCC pts. The timing of CN, for pts who were able to receive both systemic therapy and CN, may not affect overall outcome. The associated improvement in survival of CN is seen in pts receiving IO and TKI based systemic tx.[Table: see text]

scholarly journals Longitudinal diet quality is not associated with depressive symptoms in a cohort of middle-aged Australian women

2016 ◽  
Vol 115 (5) ◽  
pp. 842-850 ◽  
Author(s):  
Jun S. Lai ◽  
Christopher Oldmeadow ◽  
Alexis J. Hure ◽  
Mark McEvoy ◽  
Julie Byles ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Diet Quality ◽  
Mixed Models ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Sensitivity Analyses ◽  
Time Varying ◽  
Time Varying Covariates ◽  
Residual Confounding

AbstractThere is increasing evidence for the role of nutrition in the prevention of depression. This study aims to describe changes in diet quality over 12 years among participants in the Australian Longitudinal Study on Women’s Health in relation to changes in depressive symptoms. Women born between 1946 and 1951 were followed-up for 12 years (2001–2013). Dietary intake was assessed using the Dietary Questionnaire for Epidemiological Studies (version 2) in 2001, 2007 and every 2–3 years after that until 2013. Diet quality was summarised using the Australian Recommended Food Score (ARFS). Depressive symptoms were measured using the ten-item Centre for Epidemiologic Depression Scale at every 2–3-year intervals during 2001–2013. Linear mixed models were used to examine trends in diet quality and its sub-components. The same model including time-varying covariates was used to examine associations between diet quality and depressive symptoms adjusting for confounders. Sensitivity analyses were carried out using the Mediterranean dietary pattern (MDP) index to assess diet quality. Minimal changes in overall diet quality and its sub-components over 12 years were observed. There was a significant association between baseline diet quality and depression (β=−0·24, P=0·001), but this was lost when time-varying covariates were added (β=−0·04, P=0·10). Sensitivity analyses showed similar performance for both ARFS and MDP in predicting depressive symptoms. In conclusion, initial associations seen when using baseline measures of diet quality and depressive symptoms disappear when using methods that handle time-varying covariates, suggesting that previous studies indicating a relationship between diet and depression may have been affected by residual confounding.

scholarly journals Survival Analysis with Error-Prone Time-Varying Covariates: A Risk Set Calibration Approach

Biometrics ◽  
2010 ◽  
Vol 67 (1) ◽  
pp. 50-58 ◽  
Author(s):  
Xiaomei Liao ◽  
David M. Zucker ◽  
Yi Li ◽  
Donna Spiegelman
Keyword(s):  
Survival Analysis ◽  
Time Varying ◽  
Time Varying Covariates ◽  
Calibration Approach

Nutrition, infant feeding and post-partum amenorrhoea in rural Bangladesh

1988 ◽  
Vol 20 (4) ◽  
pp. 461-469 ◽  
Author(s):  
Kathleen Ford ◽  
Sandra Huffman
Keyword(s):  
Infant Feeding ◽  
Maternal Nutrition ◽  
Pregnancy Termination ◽  
Post Partum ◽  
Hazard Models ◽  
Time Varying ◽  
Season Of Birth ◽  
Maternal Weight ◽  
Rural Bangladesh ◽  
Time Varying Covariates

SummaryThe duration of amenorrhoea among a group of chronically malnourished women in a rural area of Bangladesh is examined by application of multivariate hazard models with time-varying covariates, including the influence of maternal nutrition, seasonality and patterns of infant feeding. Both maternal weight at pregnancy termination and the pattern of infant feeding affected the length of post-partum amenorrhoea. Analyses focused on season of birth showed the importance of differences by education in infant feeding.

Testing the Strain Theory of Suicide – The Moderating Role of Social Support

Crisis ◽  
2020 ◽  
Vol 41 (2) ◽  
pp. 82-88 ◽  
Author(s):  
Bob Lew ◽  
Ksenia Chistopolskaya ◽  
Yanzheng Liu ◽  
Mansor Abu Talib ◽  
Olga Mitina ◽  
...  
Keyword(s):  
Social Support ◽  
Suicidal Behavior ◽  
Online Survey ◽  
Perceived Social Support ◽  
Strain Theory ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Psychological Strains ◽  
Moderating Role

Abstract. Background: According to the strain theory of suicide, strains, resulting from conflicting and competing pressures in an individual's life, are hypothesized to precede suicide. But social support is an important factor that can mitigate strains and lessen their input in suicidal behavior. Aims: This study was designed to assess the moderating role of social support in the relation between strain and suicidality. Methods: A sample of 1,051 employees were recruited in Beijing, the capital of China, through an online survey. Moderation analysis was performed using SPSS PROCESS Macro. Social support was measured with the Multidimensional Scale of Perceived Social Support, and strains were assessed with the Psychological Strains Scale. Results: Psychological strains are a good predictor of suicidality, and social support, a basic need for each human being, moderates and decreases the effects of psychological strains on suicidality. Limitations: The cross-sectional survey limited the extent to which conclusions about causal relationships can be drawn. Furthermore, the results may not be generalized to the whole of China because of its diversity. Conclusion: Social support has a tendency to mitigate the effects of psychological strains on suicidality.

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