scholarly journals The Impact of Syringe Services Program Policy on Risk Behaviors Among Persons Who Inject Drugs in 3 US Cities, 2005-2015

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 138S-148S
Author(s):  
Tanner Nassau ◽  
Alia Al-Tayyib ◽  
William T. Robinson ◽  
Jennifer Shinefield ◽  
Kathleen A. Brady
Keyword(s):  
New Orleans ◽  
Risk Behaviors ◽  
Syringe Sharing ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Persons Who Inject Drugs ◽  
National Hiv Behavioral Surveillance ◽  
Program Policy ◽  
The Impact ◽  
Us Cities

Objectives The impact of a syringe services program (SSP) policy on risk behaviors and its durability are not as well studied as the impact of the SSPs themselves. We examined whether trends in syringe sharing among persons who inject drugs (PWID) were associated with changes to syringe access policies in 3 US cities: Denver, New Orleans, and Philadelphia. Methods PWID were surveyed through National HIV Behavioral Surveillance System surveys in each city in 2005, 2009, 2012, and 2015. We assessed changes in syringe sharing from 2005 to 2015 by city. We used multivariable stepwise logistic regression analysis to measure the associations among syringe sharing and injection works sharing, time, and SSP access. Results From 2005 to 2015, syringe sharing decreased significantly from 49.1% to 33.1% in Denver ( P < .001), increased significantly from 32.0% to 50.5% in New Orleans ( P < .001), and remained unchanged in Philadelphia (30.4% to 31.5%; P = .87). Compared with persons who obtained syringes from any nonsterile source, the adjusted odds of syringe sharing among PWID were significantly lower in each city if syringes were obtained from sterile sources only: Denver adjusted odds ratio (aOR) = 0.23 (95% confidence interval [CI], 0.18-0.30; New Orleans aOR = 0.26 (95% CI, 0.19-0.35), and Philadelphia aOR = 0.43 (95% CI, 0.33-0.57). Conclusions The lowest proportion of PWID reporting syringe sharing was in Philadelphia, which has a long-standing legal SSP. Implementation of a legal SSP in Denver in 2012 corresponded to a decrease in sharing, whereas the lack of a legal SSP in New Orleans corresponded to an increase in sharing. Universal long-term access to legal SSPs could further the progress made in HIV prevention among PWID.

Risk Factors for Delirium in Trauma Patients: The Impact of Ethanol Use and Lack of Insurance

2011 ◽  
Vol 77 (5) ◽  
pp. 621-626 ◽  
Author(s):  
Bernardino C. Branco ◽  
Kenji Inaba ◽  
Marko Bukur ◽  
Peep Talving ◽  
Matthew Oliver ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Chronic Ethanol ◽  
Ethanol Ingestion ◽  
Stepwise Logistic Regression ◽  
Trauma Patients ◽  
Stepwise Logistic Regression Analysis ◽  
Independent Risk Factors ◽  
The Impact

The purpose of this study was to examine independent risk factors, and in particular the impact of alcohol on the development of delirium, in a cohort of trauma patients screened for ethanol ingestion on admission to hospital. The National Trauma Databank (v. 7.0) was used to identify all patients 18 years or older screened for ethanol on admission. Patients who developed delirium were compared with those who did not. Stepwise logistic regression analysis was used to identify independent risk factors for the development of delirium. A total of 504,839 patients with admission ethanol levels were identified. Of those, 2,909 (0.6%) developed delirium. Patients developing delirium were significantly older, more frequently male, and more likely to sustain thermal injuries and falls. Patients developing delirium had more comorbidities including chronic ethanol use (19.1% vs 4.5%, P < 0.001) and cardiovascular disease (21.5% vs 12.2%, P < 0.001). On admission, patients developing delirium were more likely to be intoxicated with ethanol (55.4% vs 26.5%, P < 0.001) and were more likely to be uninsured (17.8% vs 0.9%, P < 0.001). A stepwise logistic regression model identified lack of insurance, positive ethanol on admission, chronic ethanol use, Intensive Care Unit admission, age ≥ 55 years, burns, Medicare insurance, falls, and history of cardiovascular disease as independent risk factors for the development of delirium. The incidence of delirium in this trauma patient cohort was 0.6 per cent. The above risk factors were independently associated with the development of delirium. This data may be helpful in designing interventions to prevent delirium.

scholarly journals Investigating the impact of structural factors upon that/zero complementizer alternation patterns in verbs of cognition: a diachronic corpus-based multifactorial analysis

2018 ◽  
pp. 83-112
Author(s):  
Christopher Shank ◽  
Koen Plevoets
Keyword(s):  
Predictive Power ◽  
Structural Features ◽  
Stepwise Logistic Regression ◽  
Large Set ◽  
Structural Factors ◽  
Quantitative Methodology ◽  
Stepwise Logistic Regression Analysis ◽  
Conditioning Factors ◽  
The Impact ◽  
Over Time

This corpus-based study examines the diachronic development of the that/zero alternation with nine verbs of cognition, viz. think, believe, feel, guess, imagine, know, realize, suppose and understand by means of a stepwise logistic regression analysis. The data comprised a total of (n=5,812) think, (n=3,056) believe, (n=1,273) feel, (n=1,885) guess, (n=2,225) imagine, (n=1,805) know, (n=1,244) realize, (n=2,836) suppose and (n=3,395) understand tokens from both spoken and written corpora from 1580–2012. Taking our cue from previous research suggesting that there has been a diachronic increase in the use of the zero complementizer form from Late Middle / Early Modern to Present-day English, we use a large set of parallel spoken and written diachronic data and a rigorous quantitative methodology to test this claim with the nine aforementioned verbs. In addition, we also investigate the impact of eleven structural features, which have been claimed to act as predictors for the use or presence of the zero complementizer form for ‘panchronic’ (i.e. effects are aggregated over all time periods) and diachronic effects. The objectives of this study are to examine the following: (i) whether there is indeed a diachronic trend towards more zero use; (ii) whether the conditioning factors proposed in the literature indeed predict the zero form; (iii) to what extent these factors interact; and (iv) whether the predictive power of the conditioning factors becomes stronger or weaker over time. The analysis shows that, contrary to the aforementioned belief that the zero form has been on the increase, there is in fact a steady decrease in zero use, but the extent of this decrease is not the same for all verbs. In addition, the analysis of interactions with verb type indicates differences between verbs in terms of the predictive power of the conditioning factors. Additional significant interactions emerged, notably with verb, mode (i.e. spoken or written data) and period. The interactions with period show that certain factors that are good predictors of the zero form overall lose predictive power over time.

scholarly journals Intraoperative magnesium infusion during carotid endarterectomy: a double-blind placebo-controlled trial

2009 ◽  
Vol 110 (5) ◽  
pp. 961-967 ◽  
Author(s):  
William J. Mack ◽  
Christopher P. Kellner ◽  
Daniel H. Sahlein ◽  
Andrew F. Ducruet ◽  
Grace H. Kim ◽  
...  
Keyword(s):  
Carotid Endarterectomy ◽  
Low Dose ◽  
Controlled Trial ◽  
Control Group ◽  
Stepwise Logistic Regression ◽  
High Dose ◽  
Stepwise Logistic Regression Analysis ◽  
Intravenous Magnesium ◽  
The Impact ◽  
Magnesium Therapy

Object Recent data from both experimental and clinical studies have supported the use of intravenous magnesium as a potential therapy in the setting of cerebral ischemia. This study assessed whether intraoperative magnesium therapy improves neuropsychometric testing (NPT) following carotid endarterectomy (CEA). Methods One hundred eight patients undergoing CEA were randomly assigned to receive placebo infusion or 1 of 3 magnesium-dosing protocols. Neuropsychometric testing was performed 1 day after surgery and compared with baseline performance. Assessment was also performed on a set of 35 patients concurrently undergoing lumbar laminectomy to serve as a control group for NPT. A forward stepwise logistic regression analysis was performed to evaluate the impact of magnesium therapy on NPT. A subgroup analysis was then performed, analyzing the impact of each intraoperative dose on NPT. Results Patients treated with intravenous magnesium infusion demonstrated less postoperative neurocognitive impairment than those treated with placebo (OR 0.27, 95% CI 0.10–0.74, p = 0.01). When stratified according to dosing bolus and intraoperative magnesium level, those who were treated with low-dose magnesium had less cognitive decline than those treated with placebo (OR 0.09, 95% CI 0.02–0.50, p < 0.01). Those in the high-dose magnesium group demonstrated no difference from the placebo-treated group. Conclusions Low-dose intraoperative magnesium therapy protects against neurocognitive decline following CEA.

scholarly journals Potential predictors of adoption of the Tobacco Heating System by U.S. adult smokers: An actual use study

F1000Research ◽  
2021 ◽  
Vol 8 ◽  
pp. 214
Author(s):  
Steve Roulet ◽  
Christelle Chrea ◽  
Claudia Kanitscheider ◽  
Gerd Kallischnigg ◽  
Pierpaolo Magnani ◽  
...  
Keyword(s):  
Population Level ◽  
Heating System ◽  
Tobacco Consumption ◽  
Tobacco Product ◽  
Ease Of Use ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Actual Use ◽  
Post Marketing ◽  
The Impact

Background: This was a pre-market, observational, actual use study with the Tobacco Heating System (THS), a candidate modified risk tobacco product. The main goal of the study was to describe THS adoption within current adult daily smokers by replicating the usage of THS in real-world conditions with participants being able to consume cigarettes, THS, and any other nicotine-containing products (e.g., e-cigarettes, cigars, etc.) ad libitum. Methods: This study assessed self-reported stick-by-stick consumption of THS compared with the use of commercial cigarettes over six weeks. The aim of the analysis was to identify potential predictors for adoption of THS using stepwise logistic regression analysis. Results: By the end of the observational period (in Week 6), 14.6% of participants (n=965) had adopted THS meaning that THS formed 70% or more of their total tobacco consumption. The main predictors of adoption were the liking of the smell, taste, aftertaste, and ease of use of THS. The proportion of adoption was higher in participants aged 44 years and older and in Hispanic or Latino adult smokers. Additionally, adoption of THS was more likely in participants who had never attempted to quit smoking and in participants who smoked up to 10 cigarettes per day. Finally, the adoption of THS was higher in participants who consumed both regular and menthol THS compared with those who consumed only one THS variant. Conclusions: The findings suggest that the introduction of THS in the U.S. has the potential to result in adoption by current adult smokers who would otherwise continue to smoke cigarettes, and that the adoption of THS is unlikely to result in an increase of tobacco consumption. Post-marketing studies will provide further insights on THS adoption and THS use patterns to allow assessment of the impact of the THS at the individual and the overall population level.

The Use of Total Contact Orthoses in Patients with Foot Problems in Foot Clinic, Siriraj Hospital

2020 ◽  
Vol 103 (12) ◽  
pp. 1292-1299
Keyword(s):  
Odds Ratio ◽  
Univariate Analysis ◽  
Stepwise Logistic Regression ◽  
Posterior Tibial Tendon ◽  
Posterior Tibial Tendon Dysfunction ◽  
Stepwise Logistic Regression Analysis ◽  
Cross Sectional ◽  
Siriraj Hospital ◽  
Foot Problems ◽  
Foot Clinic

Objective: To study the use rate, outcome, and concomitant factors of the use of the total contact orthoses (TCO) in the Foot Clinic, Siriraj Hospital Materials and Methods: The present study was a cross-sectional descriptive study collecting data from patient medical records and questionnaires. Patients who had foot problems without impairment of foot sensation and received the TCO from the Foot Clinic between July 2015 and April 2016 were interviewed before and after using the latest TCO for one month. Results: One hundred seven participants were recruited. Most were female (84.1%) with a median age of 59.3 years. The majority had chronic plantar fasciitis (26.2%), posterior tibial tendon dysfunction (PTTD) (25.2%), hallux valgus (21.5%), or metatarsalgia (21.5%). The TCO user was defined as a participant who had to use the TCO for more than three days per week and for more or equal to 50% of daily walking and standing duration. The use rate was 67.3%. The TCO provides standing and walking stability (p=0.008). For patients with metatarsalgia, using the TCO could significantly reduce pain (p=0.002). Using univariate analysis, many factors were found to be associated with the use of the TCO including having level of convenience of putting on or taking off shoes with TCO at 9 or more (odds ratio 2.66, 95% CI 1.16 to 6.12), having difficulty to find proper shoes that fit with the TCO (odds ratio 0.36, 95% CI 0.15 to 0.89), receiving more than one pair of TCO (odds ratio 4.09, 95% CI 1.51 to 11.05), and having level of comfort satisfaction during the TCO use at 9 or more (odds ratio 3.61, 95% CI 1.55 to 8.40). The latter two factors were found to be associated with the use of the TCO from stepwise logistic regression analysis (adjusted odds ratio 3.39, 95% CI 1.18 to 9.71 and 3.02, 95% CI 1.07 to 8.47, respectively). Conclusion: The use of the TCO in the Foot Clinic, Siriraj Hospital was 67.3%. Using the TCO could promote walking stability. Factors affecting the use of the TCO included receiving more than the first pair of TCO and having comfort satisfaction level of 9 or more. Keywords: Use, Total contact orthoses, Total contact insole, Foot problems

Patterns of care in Italian psychiatric services and psychosocial outcome of schizophrenic patients. A three-year prospective study

1989 ◽  
Vol 4 (1) ◽  
pp. 23-31 ◽  
Author(s):  
D. Kemali ◽  
M. Maj ◽  
B. Carpiniello ◽  
R.D. Giurazza ◽  
M. Impagnatiello ◽  
...  
Keyword(s):  
Psychosocial Adjustment ◽  
Ad Hoc ◽  
Social Withdrawal ◽  
Skills Training ◽  
Favourable Outcome ◽  
Stepwise Logistic Regression ◽  
Psychosocial Outcome ◽  
Stepwise Logistic Regression Analysis ◽  
Schizophrenic Patients ◽  
The Difference

Summary141 patients with an ICD-9 diagnosis of schizophrenic psychosis were followed up prospectively for 3 years in 7 Italian centres, representative of the different degrees of application of the psychiatric reform law (Law 180) passed in 1978. It was agreed that each centre would treat the patients according to its routine, and that all contacts with the patients and each intervention performed would be carefully recorded in an ad hoc schedule. The baseline evaluation of psychosocial adjustment was performed by the Disability Assessment Schedule (DAS), and this assessment was then repeated every 6 months during the follow-up period. At the end of this period, the rating on the DAS section 5 was taken as a global measure of patients’ psychosocial outcome. On a stepwise logistic regression analysis, 2 variables were found to be significantly predictive of psychosocial outcome, that is the use of social and/or vocational skills training (associated with a favourable outcome) and the number of days/year of full hospitalization (associated with a poor outcome). Trieste and Arezzo were the only centres in which a significant improvement of the score on some DAS subscales (namely, “occupational role, interest” and “social withdrawal”) was detected. In the whole patient sample, the difference between the final and the baseline score on these subscales correlated significantly with the number/year of outpatient contacts and of home visits. These findings confirm the favourable impact of the community-oriented care provided in some Italian centres on the Psychosocial outcome of schizophrenic patients.

scholarly journals A rapid screening model for early predicting novel coronavirus pneumonia in Zhejiang Province of China: a multicenter study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yi-Ning Dai ◽  
Wei Zheng ◽  
Qing-Qing Wu ◽  
Tian-Chen Hui ◽  
Nan-Nan Sun ◽  
...  
Keyword(s):  
Operating Characteristic ◽  
Clinical Manifestations ◽  
Cost Effective ◽  
Rapid Screening ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Screening Model ◽  
Epidemiological Features ◽  
Geographical Regions ◽  
Novel Coronavirus

AbstractNovel coronavirus pneumonia (NCP) has been widely spread in China and several other countries. Early finding of this pneumonia from huge numbers of suspects gives clinicians a big challenge. The aim of the study was to develop a rapid screening model for early predicting NCP in a Zhejiang population, as well as its utility in other areas. A total of 880 participants who were initially suspected of NCP from January 17 to February 19 were included. Potential predictors were selected via stepwise logistic regression analysis. The model was established based on epidemiological features, clinical manifestations, white blood cell count, and pulmonary imaging changes, with the area under receiver operating characteristic (AUROC) curve of 0.920. At a cut-off value of 1.0, the model could determine NCP with a sensitivity of 85% and a specificity of 82.3%. We further developed a simplified model by combining the geographical regions and rounding the coefficients, with the AUROC of 0.909, as well as a model without epidemiological factors with the AUROC of 0.859. The study demonstrated that the screening model was a helpful and cost-effective tool for early predicting NCP and had great clinical significance given the high activity of NCP.

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