scholarly journals Offender trajectories, health and hospital admissions: relationships and risk factors in the longitudinal Cambridge Study in Delinquent Development

2020 ◽  
Vol 113 (3) ◽  
pp. 110-118 ◽  
Author(s):  
Guy CM Skinner ◽  
David P Farrington ◽  
Jonathan P Shepherd
Keyword(s):  
Inner City ◽  
Health Risks ◽  
Hospital Admissions ◽  
Late Onset ◽  
Antisocial Behaviour ◽  
Adult Health ◽  
Odds Ratios ◽  
Life Course Persistent ◽  
The Stability ◽  
Significant Health

Objectives Research suggests that antisocial lifestyles constitute significant health risks. However, there are marked individual differences in the stability of antisocial behaviour. These different offending pathways may bear differential risks for adult health. Design Injury and illness data were collected prospectively in the longitudinal Cambridge Study in Delinquent Development. Setting Working-class inner-city area of South London. Participants Participants included the 411 men from the Cambridge Study in Delinquent Development, with interview data collected at ages 18, 32 and 48 years for each individual. Main outcome measures Organic illness, hospitalisation and injuries. Results By age 48, adjusted odds ratios showed that the incidence of organic illness was higher among Life-Course-Persistent, Late-Onset offenders and offenders in general. Based on adjusted odds ratios at age 32, the incidence of hospitalisations was higher for Late-Onset offenders. Adjusted odds ratios at age 48 also showed that the incidence of hospitalisations was higher for all three offender types and offenders in general. Our results also provide evidence that offenders were more likely to suffer injuries than non-offenders. Conclusions The findings of this study imply that preventing individuals from offending is likely to have substantial benefits for health.

Abstract 3789: Nessun Dorma : Have the Risks of Rosiglitazone been Exaggerated?

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
George A Diamond ◽  
Sanjay Kaul
Keyword(s):  
Confidence Intervals ◽  
Effect Size ◽  
Fixed Effects ◽  
Meta Analysis ◽  
Cardiovascular Death ◽  
Sensitivity Analyses ◽  
Odds Ratios ◽  
True Effect Size ◽  
Index Study ◽  
The Stability

Background A highly publicized meta-analysis of 42 clinical trials comprising 27,844 diabetics ignited a firestorm of controversy by charging that treatment with rosiglitazone was associated with a “…worrisome…” 43% greater risk of myocardial infarction ( p =0.03) and a 64% greater risk of cardiovascular death ( p =0.06). Objective The investigators excluded 4 trials from the infarction analysis and 19 trials from the mortality analysis in which no events were observed. We sought to determine if these exclusions biased the results. Methods We compared the index study to a Bayesian meta-analysis of the entire 42 trials (using odds ratio as the measure of effect size) and to fixed-effects and random-effects analyses with and without a continuity correction that adjusts for values of zero. Results The odds ratios and confidence intervals for the analyses are summarized in the Table . Odds ratios for infarction ranged from 1.43 to 1.22 and for death from 1.64 to 1.13. Corrected models resulted in substantially smaller odds ratios and narrower confidence intervals than did uncorrected models. Although corrected risks remain elevated, none are statistically significant (*p<0.05). Conclusions Given the fragility of the effect sizes and confidence intervals, the charge that roziglitazone increases the risk of adverse events is not supported by these additional analyses. The exaggerated values observed in the index study are likely the result of excluding the zero-event trials from analysis. Continuity adjustments mitigate this error and provide more consistent and reliable assessments of true effect size. Transparent sensitivity analyses should therefore be performed over a realistic range of the operative assumptions to verify the stability of such assessments especially when outcome events are rare. Given the relatively wide confidence intervals, additional data will be required to adjudicate these inconclusive results.

scholarly journals Fatal opioid overdoses during and shortly after hospital admissions in England: A case-crossover study

PLoS Medicine ◽  
2021 ◽  
Vol 18 (10) ◽  
pp. e1003759
Author(s):  
Dan Lewer ◽  
Brian Eastwood ◽  
Martin White ◽  
Thomas D. Brothers ◽  
Martin McCusker ◽  
...  
Keyword(s):  
Drug Use ◽  
Hospital Admission ◽  
Crossover Study ◽  
Hospital Admissions ◽  
Conditional Logistic Regression ◽  
Early Discharge ◽  
Odds Ratios ◽  
Drug Poisoning ◽  
Case Crossover ◽  
Increased Risk

Background Hospital patients who use illicit opioids such as heroin may use drugs during an admission or leave the hospital in order to use drugs. There have been reports of patients found dead from drug poisoning on the hospital premises or shortly after leaving the hospital. This study examines whether hospital admission and discharge are associated with increased risk of opioid-related death. Methods and findings We conducted a case-crossover study of opioid-related deaths in England. Our study included 13,609 deaths between January 1, 2010 and December 31, 2019 among individuals aged 18 to 64. For each death, we sampled 5 control days from the period 730 to 28 days before death. We used data from the national Hospital Episode Statistics database to determine the time proximity of deaths and control days to hospital admissions. We estimated the association between hospital admission and opioid-related death using conditional logistic regression, with a reference category of time neither admitted to the hospital nor within 14 days of discharge. A total of 236/13,609 deaths (1.7%) occurred following drug use while admitted to the hospital. The risk during hospital admissions was similar or lower than periods neither admitted to the hospital nor recently discharged, with odds ratios 1.03 (95% CI 0.87 to 1.21; p = 0.75) for the first 14 days of an admission and 0.41 (95% CI 0.30 to 0.56; p < 0.001) for days 15 onwards. 1,088/13,609 deaths (8.0%) occurred in the 14 days after discharge. The risk of opioid-related death increased in this period, with odds ratios of 4.39 (95% CI 3.75 to 5.14; p < 0.001) on days 1 to 2 after discharge and 2.09 (95% CI 1.92 to 2.28; p < 0.001) on days 3 to 14. 11,629/13,609 deaths (85.5%) did not occur close to a hospital admission, and the remaining 656/13,609 deaths (4.8%) occurred in hospital following admission due to drug poisoning. Risk was greater for patients discharged from psychiatric admissions, those who left the hospital against medical advice, and those leaving the hospital after admissions of 7 days or more. The main limitation of the method is that it does not control for time-varying health or drug use within individuals; therefore, hospital admissions coinciding with high-risk periods may in part explain the results. Conclusions Discharge from the hospital is associated with an acute increase in the risk of opioid-related death, and 1 in 14 opioid-related deaths in England happens in the 2 weeks after the hospital discharge. This supports interventions that prevent early discharge and improve linkage with community drug treatment and harm reduction services.

scholarly journals Underage Rural Drinking: Survey Data and Implications for Educators

2019 ◽  
Vol 31 (3) ◽  
Author(s):  
Jon Lasser ◽  
Eric Schmidt ◽  
James Diep ◽  
Amy Huebel
Keyword(s):  
Health Care ◽  
Alcohol Use ◽  
Survey Data ◽  
Health Care Providers ◽  
Health Risks ◽  
Underage Drinking ◽  
Care Providers ◽  
Prevention Strategies ◽  
Texas County ◽  
Significant Health

This article reports data collected in a rural Texas county that explores the beliefs and perceptions of youth about alcohol use. Results from the study suggest high rates of underage drinking and present significant health risks. The data also shed some light on how yuth perceive parents, responsibilities, access, and prevention strategies with regard to alcohol usage. Implications for rural educators and health care providers are discussed in light of the findings, with an emphasis on both prevention and intervention.

scholarly journals Hospital admissions for hyperglycemic emergencies in young adults at an inner-city hospital

2019 ◽  
Vol 157 ◽  
pp. 107869 ◽  
Author(s):  
Rachel A Wolf ◽  
J. Sonya Haw ◽  
Sudeshna Paul ◽  
Melissa Spezia Faulkner ◽  
EunSeok Cha ◽  
...  
Keyword(s):  
Young Adults ◽  
Inner City ◽  
Hospital Admissions ◽  
City Hospital

Human and animal disease outbreaks in India due to mycotoxins other than aflatoxins

2009 ◽  
Vol 2 (1) ◽  
pp. 23-30 ◽  
Author(s):  
C. Raghavender ◽  
B. Reddy
Keyword(s):  
Health Risks ◽  
Rural Areas ◽  
South India ◽  
Animal Health ◽  
Disease Outbreaks ◽  
Western India ◽  
Animal Disease ◽  
The People ◽  
Contaminated Food ◽  
Significant Health

Mycotoxins are gaining increasing importance due to their deleterious effects on human and animal health. Chronic health risks are particularly prevalent in India where the diets of the people are highly prone to mycotoxins due to poor harvesting practices, improper storage and transport coupled with high temperature and moisture. This paper reviews disease outbreaks of mycotoxicoses other than aflatoxins in India due to ingestion of mycotoxincontaminated food. Ergotism is one of the earliest known outbreaks of mycotoxins reported in rural areas of western India associated with pearl millet grain. Trichothecenes have been involved in an acute human mycotoxicosis known as alimentary toxic aleukia in India during 1987 and were attributed to the consumption of mouldy wheat. Deoxynivalenol was implicated in an outbreak of emetic syndrome in Kashmir State. An outbreak of acute foodborne disease caused by fumonisin was reported in south India during 1995 affecting 1,424 people due to contaminated sorghum and maize. Rhizopus toxicosis was reported from Maharashtra State and caused the death of three people. These outbreaks continue to be a significant health problem of people in India, because their poor purchasing power compels them to consume contaminated food.

The Stability of Veins Under Torsion

2012 ◽  
Author(s):  
Justin R. Garcia ◽  
Hai-Chao Han
Keyword(s):  
Diabetes Mellitus ◽  
Health Risks ◽  
Mechanical Stability ◽  
Thrombus Formation ◽  
Body Movement ◽  
Critical Value ◽  
The Body ◽  
Clinical Interest ◽  
The Stability

Twisted veins are observed throughout the body and are often associated with health risks such as hypertension and diabetes mellitus [1]. Recently, it has been shown that veins will buckle and become tortuous when lumen pressure exceeds a critical value [2]. However, veins also undergo twist deformations in vivo due to body movement, vein grafting, and microanastomosis procedures which may lead to reduced patency, kinking, and thrombus formation [3, 4]. In spite of this, little data is available regarding the stability of veins when subject to twist deformations. Therefore, it is of clinical interest to investigate the mechanical stability of veins under torsion.

scholarly journals Generalised anxiety disorder and hospital admissions: findings from a large, population cohort study

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e018539 ◽  
Author(s):  
Olivia Remes ◽  
Nicholas Wainwright ◽  
Paul Surtees ◽  
Louise Lafortune ◽  
Kay-Tee Khaw ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Service Use ◽  
Hospital Admissions ◽  
Late Onset ◽  
Large Population ◽  
Population Based ◽  
Generalised Anxiety Disorder ◽  
Increased Risk ◽  
Using Data ◽  
Administrative Health Databases

ObjectiveGeneralised anxiety disorder (GAD) is the most common anxiety disorder in the general population and has been associated with high economic and human burden. However, it has been neglected in the health services literature. The objective of this study is to assess whether GAD leads to hospital admissions using data from the European Prospective Investigation of Cancer-Norfolk. Other aims include determining whether early-onset or late-onset forms of the disorder, episode chronicity and frequency, and comorbidity with major depressive disorder (MDD) contribute to hospital admissions.DesignLarge, population study.SettingUK population-based cohort.Participants30 445 British participants were recruited through general practice registers in England. Of these, 20 919 completed a structured psychosocial questionnaire used to identify presence of GAD. Anxiety was assessed in 1996–2000, and health service use was captured between 1999/2000 and 2009 through record linkage with large, administrative health databases. 17 939 participants had complete data on covariates.Main outcome measurePast-year GAD defined according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition.ResultsIn this study, there were 2.2% (393/17 939) of respondents with GAD. Anxiety was not independently associated with hospital admissions (incidence rate ratio (IRR)=1.04, 95% CI 0.90 to 1.20) over 9 years. However, those whose anxiety was comorbid with depression showed a statistically significantly increased risk for hospital admissions (IRR=1.23, 95% CI 1.02 to 1.49).ConclusionPeople with GAD and MDD comorbidity were at an increased risk for hospital admissions. Clinicians should consider that meeting criteria for a pure or individual disorder at one point in time, such as past-year GAD, does not necessarily predict deleterious health outcomes; rather different forms of the disorder, such as comorbid cases, might be of greater importance.

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