Differences in disease prevalence among homeless and non-homeless veterans at an urban VA hospital

2021 ◽  
pp. 174239532110239
Author(s):  
Candace Tannis ◽  
Sritha Rajupet
Keyword(s):  
Risk Factors ◽  
Respiratory Illness ◽  
Disease Prevalence ◽  
Housing Quality ◽  
Chi Square ◽  
Homeless Veterans ◽  
The Us ◽  
Race Ethnicity ◽  
Social Environmental ◽  
Employment Characteristics

Objectives Approximately 10% of homeless adults in the US are veterans and that number is increasing. Veterans who experience homelessness tend to do so for longer periods compared to non-veterans; and homelessness is associated with more chronic disease complications. We compared the prevalence of five chronic, ambulatory-care sensitive conditions in homeless and domiciled individuals who received primary care at an urban VA hospital. Methods Data were obtained from the Veteran’s Hospital Administration clinical data warehouse. Differences in disease prevalence were compared between the two groups using chi-square analyses and then adjusted for age, gender, race/ethnicity, BMI, and other risk factors where appropriate, using logistic regression. All analyses were conducted using SAS version 9.4. Results Homeless individuals were 46% more likely to have asthma (OR 1.46, 95% CI 1.16–1.84) and 40% more likely to have COPD (OR 1.40, 95% CI 1.14–1.73) after adjustment for age, gender, race/ethnicity, BMI, and tobacco use status. After adjustment for covariates, there was no difference between homeless and domiciled veterans in the prevalence of diabetes, hypertension, or congestive heart failure. Discussion Future quality improvement projects should identify social-environmental risk factors like employment characteristics, and housing quality that can impact chronic respiratory illness prevalence and associated complications.

scholarly journals MON-585 Racial/Ethnic Contribution and Metabolic Factors of NAFLD/NASH in the US Population: Data from NNANES III

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Theodore C Friedman ◽  
Magda Shaheen ◽  
Dulcie Kermah ◽  
Deyu Pan ◽  
Katrina Schrode ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Liver Enzyme ◽  
Significant Risk ◽  
Significant Risk Factor ◽  
Healthy Eating Index ◽  
C Peptide ◽  
The Us ◽  
Race Ethnicity ◽  
Racial Ethnic

Abstract Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver condition. It is manifested by hepatic steatosis (HS) that can progress to non-alcoholic steatohepatitis (NASH), and even liver failure. Interestingly, it is marked by racial/ethnic disparities, with a high prevalence in Hispanics. We aimed to identify the risk factors for these chronic conditions in the US. To this end, we analyzed data from NHANES III (1988-1994) using multiple or multinomial logistic regression considering the design and sample weight. HS was identified by ultrasound. NAFLD was defined as HS in the absence of viral hepatitis or excessive use of alcohol or hepatotoxic drugs. The NAFLD population was further divided into those with NASH (defined by the HAIR score), or with simple NAFLD. The prevalence of HS was 19.8%, 16.6%, and 27.9%; of NAFLD was 17.8%, 14.7%, and 25.5%; and of NASH was 3.2%, 2.5%, and 5.1% in non-Hispanic Whites, non-Hispanic Blacks and Hispanics, respectively. Race/ethnicity was a significant predictor of HS, NAFLD and NASH, with Hispanics having the highest odds for all conditions, and non-Hispanic Blacks having the lowest odds relative to Whites (p<0.05). Other significant risk factors for all three conditions were older age, higher BMI, abnormal levels of C-peptide, and elevated serum glucose and triglycerides (p<0.05). HOMA insulin resistance was associated with HS and NAFLD (p<0.05). While smoking status was not associated with HS (p>0.05), current smokers had lower odds of NAFLD & NASH than non-smokers (p<0.05). Elevation of the liver enzyme aspartate aminotransferase was a significant risk factor of HS, while elevation of the liver enzyme alanine transaminase was a significant risk factor of NAFLD. Elevation in the levels of both liver enzymes was predictive of NASH (p<0.05). Although we included physical activity relative to national recommendation variable and the Healthy Eating Index (a measure of diet quality) in our analyses, neither of these factors was a predictor of any of the liver conditions (p>0.05). Our results showed an independent association between race/ethnicity and HS, NAFLD, and NASH, whereby Hispanics had the highest odds for every condition relative to non-Hispanic Whites. Providers should consider the race/ethnicity of their patients when evaluating the risk for NAFLD and NASH, and also be aware of the other risk factors, such as BMI and levels of C-peptide, glucose, and triglycerides.

scholarly journals The Social-environmental Risk Factor for Conjunctivitis

2021 ◽  
Vol 9 (T4) ◽  
pp. 319-323
Author(s):  
Lilis Suryani ◽  
Yunani Setyandriana ◽  
Nur Shani Meida
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Environmental Risk ◽  
Private Hospital ◽  
Total Sample ◽  
Bivariate Analysis ◽  
Chi Square ◽  
The Social ◽  
Social Environmental ◽  
Eye Clinic

BACKGROUND: Conjunctivitis is one of the most common eye disorders in the worldwide. The incidence of conjunctivitis in Indonesia reached 73% of the population. Conjunctivitis cases in Yogyakarta City have increased from year to year. AIM: This study purposed to identify the social-environmental risk factors that influence the incidence of conjunctivitis in Yogyakarta. METHODS: Design study was an observational analytic method with a case–control research design. The population study was all the patients visited at the Eye Clinic of PKU Muhammadiyah Gamping Hospital and private hospital Yogyakarta in 2019. The total sample is 204 respondents who were divided into case and control. One hundred and four respondents were in a case while 100 were controlled. The case was a conjunctivitis patient treated at the Eye Clinic of PKU Muhammadiyah Gamping Hospital and private hospital Yogyakarta in 2019, while the control was a non-conjunctivitis patient who went to the same two hospitals as the case respondent. Data were collected by direct interviews using a structured questionnaire covering the respondents’ demographics and social-environmental conditions. Then, the data were analyzed using SPSS 15.0 univariate and bivariate using Chi-square. RESULTS: The results of the bivariate analysis showed that age, the distance between the house and the river, the distance between the place and the temporary garbage dump, contacted from a close friend, the windows of the house were always opened every day as risk factors affecting the incidence of conjunctivitis. CONCLUSION: The study’s decision is the social-environmental as a risk factor for conjunctivitis in Yogyakarta.

Criminal Justice Issues Among Homeless Veterans

2018 ◽  
pp. 109-138
Author(s):  
Jessica Blue-Howells ◽  
Christine Timko ◽  
Sean Clark ◽  
Andrea K. Finlay
Keyword(s):  
Risk Factors ◽  
Criminal Justice ◽  
Department Of Veterans Affairs ◽  
Treatment Needs ◽  
Chronic Homelessness ◽  
Criminal Justice Involvement ◽  
Homeless Veterans ◽  
Wide Range ◽  
Prevalence Estimates ◽  
The Us

While there is not research that demonstrates that homelessness causes incarceration or that incarceration causes homelessness, there has long been an understanding that the two influence and create risk for one another. This chapter examines the prevalence of and risk factors for criminal justice involvement among homeless Veterans and the prevalence of and risk factors for homelessness among criminal justice–involved Veterans. The lack of shared definitions of homelessness and criminal justice involvement results in a wide range of prevalence estimates, few risk factors have been identified, and the cyclical nature and mechanisms explaining the link between homelessness and criminal justice involvement among Veterans is largely unknown. The US Department of Veterans Affairs currently has two programs designed to address treatment needs, including homelessness, among criminal justice–involved Veterans. As these programs expand and evolve, research is needed to fill our extensive knowledge gaps and develop programs and interventions to attenuate Veterans’ risks for chronic homelessness and criminal justice involvement.

Risk factors for gastric cancers in the United States: Variation by anatomic site and race/ethnicity.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 189-189
Author(s):  
Haejin In ◽  
Patricia Friedmann ◽  
Srawani Sarkar ◽  
Bruce Rapkin ◽  
Philip E. Castle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Family History ◽  
Ethnic Groups ◽  
Foreign Born ◽  
Anatomic Location ◽  
The Us ◽  
History Of ◽  
Male Sex ◽  
Race Ethnicity

189 Background: Gastric cancer (GC) is a high mortality cancer in the US. Differences in risk factors by anatomic location and race/ethnicity have been suggested but remain understudied in the US population. Methods: The Multiethnic Cohort (MEC) is a prospective cohort study that collected data on 5 racial/ethnic groups [Whites (W), Blacks (B), Latino (L), Japanese-American (JA), and Hawaiian (HA)] from Hawaii and Los Angeles in 1993-1996. Participants completed a detailed baseline survey and were followed for development of incident cancer. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) to identify GC risk factors by anatomic location (cardia, non-cardia) and by race/ethnicity. Results: Data from 192,626 participants was available. The cohort was 25% W, 17% B, 23% L, 28% JA, and 7% HA. During a median follow up of 20.3 years, 1,109 non-cardia and 201 cardia incident GCs were diagnosed. Older age (per year, non-cardia HR 1.08, 95% CI 1.07-1.92; cardia HR 1.06, 95% CI 1.05-1.09), male sex (non-cardia HR 1.6, 95% CI 1.4-1.8; cardia HR 3.0, 95% CI 2.1-4.4), and current (non-cardia HR 1.7, 95% CI 1.5-2.2, cardia HR 3.4, 95% CI 2.2-5.3) or former (non-cardia HR 1.3, 95% CI 1.1-1.5; cardia HR 2.0, 95% CI 1.3-2.9) smoking were associated with both cancer types. Notably, race/ethnicity (ref W: B HR 3.0, 95% CI 2.2-4.0; L HR 2.5, 95% CI 1.8-3.3; JA HR 3.9, 95% CI 3.0-5.1; HA HR 3.9, 95% CI 2.8-5.5), foreign-born (ref: self & parents US born: HR 1.3 95% CI 1.1-1.7), and family history of GC (OR 1.9, 95% CI 1.5-2.3) were associated with non-cardia GC. BMI ≥30 (HR 1.6, 95% CI 1.1-2.3), having ≥1 drink/week (HR 1.6, 95% CI 1.1-2.3), and being JA (ref W: HR 1.9, 95% CI 1.2-2.9) were associated with cardia GC. Risk factors other than age differed by race/ethnicity for non-cardia GC. Male sex was a risk factor for B, L and JA only. Having less than a high school education was a risk factor for B and JA only, smoking a risk factor for L and JA only, and having diabetes a risk factor for B only. Being in the highest sodium intake quartile was a risk factor among W and HA. A family history of GC was a risk factor for W, L, and JA. Having foreign-born parents was a risk factor for W and being foreign-born was a risk factor for JA. Conclusions: GC risk factors differ between subtypes and, for non-cardia, between race/ethnic groups. These differences provide an insight into the etiology of GC and the disproportionate incidence rates in high-risk groups, potentially aiding in the design of targeted intervention strategies.

Venous Thromboembolism and High Grade Gliomas

1993 ◽  
Vol 70 (03) ◽  
pp. 393-396 ◽  
Author(s):  
Mandeep S Dhami ◽  
Robert D Bona ◽  
John A Calogero ◽  
Richard M Hellman
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Medical Center ◽  
Significant Risk ◽  
Bleeding Complications ◽  
Fisher Exact Test ◽  
High Grade ◽  
Chi Square ◽  
Exact Test ◽  
High Grade Gliomas

SummaryA retrospective study was done to determine the incidence of and the risk factors predisposing to clinical venous thromboembolism (VTE) in patients treated for high grade gliomas. Medical records of 68 consecutive patients diagnosed and treated at Saint Francis Hospital and Medical Center from January 1986 to June 1991 were reviewed. The follow up was to time of death or at least 6 months (up to December 1991). All clinically suspected episodes of VTE were confirmed by objective tests. Sixteen episodes of VTE were detected in 13 patients for an overall episode rate of 23.5%. Administration of chemotherapy (p = 0.027, two tailed Fisher exact test) and presence of paresis (p = 0.031, two tailed Fisher exact test) were statistically significant risk factors for the development of VTE. Thrombotic events were more likely to occur in the paretic limb and this difference was statistically significant (p = 0.00049, chi square test, with Yates correction). No major bleeding complications were seen in the nine episodes treated with long term anticoagulation.We conclude that venous thromboembolic complications are frequently encountered in patients being treated for high grade gliomas and the presence of paresis and the administration of chemotherapy increases the risk of such complications.

Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

2019 ◽  
Vol 15 ◽  
Author(s):  
Bekalu Getachew Gebreegziabher ◽  
Tesema Etefa Birhanu ◽  
Diriba Dereje Olana ◽  
Behailu Terefe Tesfaye
Keyword(s):  
Risk Factors ◽  
Stroke Unit ◽  
Medical Center ◽  
Data Entry ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

Trends in the incidence and mortality of oral cancer in Nevada (Preprint)

2020 ◽  
Author(s):  
Kevin Foote ◽  
Karl Kingsley
Keyword(s):  
Public Health ◽  
Oral Cancer ◽  
Cancer Incidence ◽  
Cancer Control ◽  
Cancer Registries ◽  
Public Health Research ◽  
Chi Square ◽  
Incidence And Mortality ◽  
The Us ◽  
Chi Square Analysis

BACKGROUND Reviews of national and state-specific cancer registries have revealed differences in rates of oral cancer incidence and mortality that have implications for public health research and policy. Many significant associations between head and neck (oral) cancers and major risk factors, such as cigarette usage, may be influenced by public health policy such as smoking restrictions and bans – including the Nevada Clean Indoor Act of 2006 (and subsequent modification in 2011). OBJECTIVE Although evaluation of general and regional advances in public policy have been previously evaluated, no recent studies have focused specifically on the changes to the epidemiology of oral cancer incidence and mortality in Nevada. METHODS Cancer incidence and mortality rate data were obtained from the National Cancer Institute (NCI) Division of Cancer Control and Population Sciences (DCCPS) Surveillance, Epidemiology and End Results (SEER) program. Most recently available rate changes in cancer incidence and mortality for Nevada included the years 2012 – 2016 and are age-adjusted to the year 2000 standard US population. Comparisons of any differences between Nevada and the overall US population were evaluated using Chi square analysis. RESULTS This analysis revealed that the overall rates of incidence and mortality from oral cancer in Nevada differs from that observed in the overall US population. For example, although the incidence of oral cancer among Caucasians is increasing in Nevada and the US overall, it is increasing at nearly twice that rate in Nevada, P=0.0002. In addition, although oral cancer incidence among Minorities in the US is declining, it is increasing in Nevada , P=0.0001. Analysis of reported mortality causes revealed that mortality from oral cancer increased in the US overall but declined in Nevada during the same period (2012-2016). More specifically, mortality among both Males and Females in the US is increasing, but is declining in Nevada, P=0.0027. CONCLUSIONS Analysis of the epidemiologic data from Nevada compared with the overall US revealed significant differences in rates of oral cancer incidence and mortality. More specifically, oral cancer incidence increased in Nevada between 2012-2016 among all groups analyzed (Males, Females, White, Minority), while decreases were observed nationally among Females and Minorities. Although mortality in Nevada decreased over this same time period (in contrast to the national trends), the lag time between diagnosis (incidence) and mortality suggests that these trends will change in the near future. CLINICALTRIAL Not applicable

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