scholarly journals Racial and ethnic disparities in opioid use for adolescents at US emergency departments

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Michael T. Phan ◽  
Daniel M. Tomaszewski ◽  
Cody Arbuckle ◽  
Sun Yang ◽  
Candice Donaldson ◽  
...  
Keyword(s):  
Black Women ◽  
Ethnic Disparities ◽  
Cross Sectional Study ◽  
Opioid Use ◽  
Cross Sectional ◽  
Opioid Agonists ◽  
Ed Visits ◽  
Race Ethnicity ◽  
Using Data ◽  
The Impact

Abstract Background Racial/ethnic disparities in the use of opioids to treat pain disorders have been previously reported in the emergency department (ED). Further research is needed to better evaluate the impact race/ethnicity may have on the use of opioids in adolescents for the management of pain disorders in the ED. Methods This was a cross-sectional study using data from the National Hospital Ambulatory Medical Care Survey from 2006 to 2016. Multivariate models were used to evaluate the role of race/ethnicity in the receipt of opioid agonists while in the ED. All ED visits with patients aged 11–21 years old were analyzed. Races/ethnicities were stratified as non-Hispanic Whites, non-Hispanic Blacks, and Hispanics. In addition to race, statistical analysis included the following covariates: pain score, pain diagnosis, age, region, sex, and payment method. Results There was a weighted total of 189,256,419 ED visits. Those visits involved 109,826,315 (58%) non-Hispanic Whites, 46,314,977 (24%) non-Hispanic Blacks, and 33,115,127 (18%) Hispanics, with 21.6% (95% CI, 21.1%-22.1), 15.2% (95% CI, 14.6–15.9%), and 17.4% (95% CI, 16.5–18.2%) of those visits reporting use of opioids, respectively. Regardless of age, sex, and region, non-Hispanic Whites received opioids at a higher rate than non-Hispanic Blacks and Hispanics. Based on diagnosis, non-Hispanic Whites received opioids at a higher rate in multiple pain diagnoses. Additionally, non-Hispanic Blacks and Hispanics were less likely to receive an opioid when reporting moderate pain (aOR = 0.738, 95% CI 0.601–0.906, aOR = 0.739, 95% CI 0.578–0.945, respectively) and severe pain (aOR = 0.580, 95% CI 0.500–0.672, aOR = 0.807, 95% CI 0.685–0.951, respectively) compared to non-Hispanic Whites. Conclusions Differences in the receipt of opioid agonists in EDs among the races/ethnicities exist, with more non-Hispanic Whites receiving opioids than their minority counterparts. Non-Hispanic Black women may be an especially marginalized population. Further investigation into sex-based and regional differences are needed.

scholarly journals Relationship between housing insecurity, diabetes processes of care, and self-care behaviors

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Elise Mosley-Johnson ◽  
Rebekah J. Walker ◽  
Madhuli Thakkar ◽  
Jennifer A. Campbell ◽  
Laura Hawks ◽  
...  
Keyword(s):  
Employment Status ◽  
Self Care ◽  
Logistic Models ◽  
Cross Sectional Study ◽  
Behavioral Risk ◽  
Cross Sectional ◽  
Processes Of Care ◽  
Flu Vaccine ◽  
Race Ethnicity ◽  
The Impact

Abstract Background The aim of this analysis was to examine the influence of housing insecurity on diabetes processes of care and self-care behaviors and determine if that relationship varied by employment status or race/ethnicity. Methods Using nationally representative data from the Behavioral Risk Factor Surveillance System (2014-2015), 16,091 individuals were analyzed for the cross-sectional study. Housing insecurity was defined as how often respondents reported being worried or stressed about having enough money to pay rent/mortgage. Following unadjusted logistic models testing interactions between housing insecurity and either employment or race/ethnicity on diabetes processes of care and self-care behaviors, stratified models were adjusted for demographics, socioeconomic status, health insurance status, and comorbidity count. Results 38.1% of adults with diabetes reported housing insecurity. Those reporting housing insecurity who were employed were less likely to have a physicians visit (0.58, 95%CI 0.37,0.92), A1c check (0.45, 95%CI 0.26,0.78), and eye exam (0.61, 95%CI 0.44,0.83), while unemployed individuals were less likely to have a flu vaccine (0.84, 95%CI 0.70,0.99). Housing insecure White adults were less likely to receive an eye exam (0.67, 95%CI 0.54,0.83), flu vaccine (0.84, 95%CI 0.71,0.99) or engage in physical activity (0.82, 95%CI 0.69,0.96), while housing insecure Non-Hispanic Black adults were less likely to have a physicians visit (0.56, 95%CI 0.32,0.99). Conclusions Housing insecurity had an influence on diabetes processes of care and self-care behaviors, and this relationship varied by employment status and race/ethnicity. Diabetes interventions should incorporate discussion surrounding housing insecurity and consider differences in the impact by demographic factors on diabetes care.

Differential Effect of Recurrent Concussions on Symptom Clusters in Sport Concussion Assessment Tool

2019 ◽  
Vol 28 (7) ◽  
pp. 735-739
Author(s):  
Jian Chen ◽  
Bruce Oddson ◽  
Heather C. Gilbert
Keyword(s):  
Assessment Tool ◽  
Cross Sectional Study ◽  
Physical Symptoms ◽  
Symptom Clusters ◽  
Cross Sectional ◽  
Sport Concussion ◽  
Comprehensive Survey ◽  
Using Data ◽  
Composite Scores ◽  
The Impact

Context: Symptom checklist in Sport Concussion Assessment Tool has been widely used in preseason assessment and in concussion diagnosis, but the impact of prior concussions on the graded symptoms after a new concussion has not been evaluated. Objective: This study was undertaken to examine reported symptoms associated with recurrent concussions using data of a comprehensive survey among athletes. Design: Retrospective survey and cross-sectional study. Setting: College athletes. Participants: Student athletes who sustained one or more concussions. Main Outcome Measures: Concussion history and graded symptoms of the most recent concussion at time of the survey were surveyed. The impact of prior concussions was examined over symptoms and aggregated symptoms. Results: Multiple concussions were associated with greater reporting of individual symptoms related to emotion and physical symptoms of sensitivity to light and noise: more emotional (z = 2.3, P = .02); sadness (z = 2.4, P = .02); nervousness (z = 2.4, P = .02); irritability (z = 3.6, P = .01); sensitivity to light (z = 2.6, P = .01); and sensitivity to noise (z = 2.4, P = .04). The composite scores of emotional symptom and sensitivity symptom clusters were significantly higher: t = 2.68 (P < .01) and t = 3.35 (P < .01), respectively. Conclusions: The significant rises in emotional and sensitivity symptoms may be an important additive effect of concussive injury. Closer attention should be given to these symptom clusters when evaluating concussion injury and recovery.

scholarly journals Hospitalized Patients Accessing Information on Prescribed Medications from the Bedside Terminal: A Cross-Sectional Study

2020 ◽  
Vol 17 (13) ◽  
pp. 4850
Author(s):  
Jungwon Cho ◽  
Seungyeon Kim ◽  
Sangyoon Shin ◽  
Hyejin Yoo ◽  
Gi Hyue Park ◽  
...  
Keyword(s):  
Associated Factors ◽  
Cross Sectional Study ◽  
Hospitalized Patients ◽  
Health Care Information ◽  
Sectional Study ◽  
Cross Sectional ◽  
Expert Review ◽  
Medication Information ◽  
Using Data ◽  
The Impact

Studies have documented the impact of various types of health care information technology (HIT) on patient outcomes. However, literature on the HIT products is largely for outpatients and little is known about those for hospitalized patients. In 2014, a Korean hospital developed an inpatient portal known as the Smart Bedside Station (SBS). A retrospective cross-sectional study was conducted to evaluate the associated factors for accessing the medication view menu (Today’s Medication) on the SBS using data from October 2018 through September 2019. A root cause analysis with expert review was conducted to identify additional barriers for accessing the medication view menu. Approximately 92.58% of the study population accessed the SBS at least once during their hospital stay. However, 99.20% of accessed patients used the SBS for entertainment purposes (e.g., television) and 40.16% viewed the medication information. Younger age, higher education, and certain jobs were significant associated factors for accessing the medication information. In conclusion, this study revealed strong associations between accessing the medication view menu on the SBS and a number of associated factors. Based on the results, further research is warranted to suggest new items to access the medication view menu by hospitalized patients.

scholarly journals Respiratory syncytial and influenza virus detecting rapid tests in children younger than 5 years of age in Armenia

2019 ◽  
Vol 13 (05.1) ◽  
pp. 075S-080S ◽  
Author(s):  
Hrachuhi Ghazaryan ◽  
Ara Babloyan ◽  
Ashot Sarkissian ◽  
Karapet Davtyan ◽  
Christoph Berger
Keyword(s):  
Respiratory Infections ◽  
Medical Center ◽  
Respiratory Viruses ◽  
Polymerase Chain Reaction Method ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Rapid Tests ◽  
Using Data ◽  
Antigen Tests ◽  
The Impact

Introduction: Acute respiratory infections (ARIs) are major causes of morbidity in early childhood. They are mainly caused by viruses, including influenza (INF) and respiratory syncytial viruses (RSV). We aimed to investigate the role of RSV and INF in children hospitalized for ARIs and to show the impact of RSV/INF rapid testing on management of patients. Methodology: Cross-sectional study using data of inpatient care of children younger than five years hospitalized in Arabkir Medical Center due to ARI from November 1, 2013 to April 1, 2014. Nasopharyngeal swabs were tested for RSV and INF types A and B by direct antigen detection tests. Results: A total of 915 patients, 583 (63.7%) boys and 332 (36.3%) girls were included in the study with the mean age of 18.8 ± 16.3 months. Among them, 390 (42.6%) were tested positive, 3 (0.3%) subjects tested positive both for RSV and INF: 269 (29.4%) for RSV and 124 (13.6%) for INF (A – 121, B – 3). Out of 915 children, 209 (23%) were pretreated with antibiotics, most often with oral amoxicillin/clavulanic acid (n = 54, 25.8%), sulfamethoxazole/trimethoprim (n = 46, 22%), and amoxicillin (n = 38, 18.2%), followed by intramuscular ceftriaxone (n = 37, 17.7%). Conclusions: The usage of antigen tests for detection of respiratory viruses allowed to document high rates of RSV and INF in children admitted to the hospital. In settings where polymerase chain reaction method is not readily available, implementation of rapid tests for detection of respiratory viruses is important in the management of pediatric patients including cohorting and more targeted use of antibiotics.

Differences in Consumption of NASEM Priority Nutrients and Food Groups by Race/Ethnicity Among Women Living in WIC-Participating Households

2020 ◽  
Vol 34 (7) ◽  
pp. 791-795
Author(s):  
Meghan C. Zimmer ◽  
Veronica Rubio ◽  
Kristina W. Kintziger ◽  
Cristina Barroso
Keyword(s):  
Black Women ◽  
Dietary Intake ◽  
White Women ◽  
Food Group ◽  
Cross Sectional Study ◽  
Food Groups ◽  
Cross Sectional ◽  
Race Ethnicity ◽  
Nutrition Messages ◽  
Hispanic White

Purpose: To examine racial/ethnic differences in dietary intake of women in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Design: Cross-sectional study. Setting: Data from the US National Health and Nutrition Examination Survey. Participants: Women 19 to 50 years of age living in WIC-participating households. Measures: Nutrient/food group intake from one 24-hour dietary recall. Analysis: Multivariable linear regression was used to evaluate the relationship between race/ethnicity and nutrient/food group intake. Results: Compared to non-Hispanic white women, Hispanic women had lower dietary energy density (1.7 ± 0.1 vs 2.2 ± 0.1 kcal/g, P < .001), and better nutrient intake, including more folate (429 ± 20 vs 364 ± 29 µg, P = .024), fiber (20.1 ± 0.9 vs 13.6 ± 0.9 g, P ≤ .001), and potassium (2575 ± 78 vs 2251 ± 66 mg, P = .012). This may be related to greater consumption of total vegetables (1.67 ± 0.16 vs 1.17 ± 0.17 cup equivalents [c-eq], P = .029), including more red and orange vegetables (0.64 ± 0.11 vs 0.32 vs 0.09 c-eq, P = .013) and more legumes (0.17 ± 0.04 vs 0.07 ± 0.02 c-eq, P = .006). Both Hispanic and non-Hispanic black women consumed more sodium (Hispanic: P = .015; non-Hispanic black: P = .008), but less added sugars (Hispanic: P ≤ .001; non-Hispanic black: P = .015), than non-Hispanic white women. Conclusion: These findings highlight differences in dietary intake by race/ethnicity and can inform nutrition messages of WIC nutrition educators and dietitians.

scholarly journals Racial and Ethnic Disparities in Maternal and Infant Outcomes Among Opioid-Exposed Mother–Infant Dyads in Massachusetts (2017–2019)

2020 ◽  
Vol 110 (12) ◽  
pp. 1828-1836
Author(s):  
Mary Peeler ◽  
Munish Gupta ◽  
Patrice Melvin ◽  
Allison S. Bryant ◽  
Hafsatou Diop ◽  
...  
Keyword(s):  
Black Women ◽  
White Women ◽  
Hispanic Women ◽  
Ethnic Disparities ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Infant Outcomes ◽  
Race Ethnicity ◽  
Hispanic White ◽  
Maternal Race

Objectives. To examine the extent to which differences in medication for opioid use disorder (MOUD) in pregnancy and infant neonatal opioid withdrawal syndrome (NOWS) outcomes are associated with maternal race/ethnicity. Methods. We performed a secondary analysis of a statewide quality improvement database of opioid-exposed deliveries from January 2017 to April 2019 from 24 hospitals in Massachusetts. We used multivariable mixed-effects logistic regression to model the association between maternal race/ethnicity (non-Hispanic White, non-Hispanic Black, or Hispanic) and prenatal receipt of MOUD, NOWS severity, early intervention referral, and biological parental custody at discharge. Results. Among 1710 deliveries to women with opioid use disorder, 89.3% (n = 1527) were non-Hispanic White. In adjusted models, non-Hispanic Black women (AOR = 0.34; 95% confidence interval [CI] = 0.18, 0.66) and Hispanic women (AOR = 0.43; 95% CI = 0.27, 0.68) were less likely to receive MOUD during pregnancy compared with non-Hispanic White women. We found no statistically significant associations between maternal race/ethnicity and infant outcomes. Conclusions. We identified significant racial/ethnic differences in MOUD prenatal receipt that persisted in adjusted models. Research should focus on the perspectives and treatment experiences of non-Hispanic Black and Hispanic women to ensure equitable care for all mother–infant dyads.

scholarly journals Clinical Trial Data Sharing: A Cross-Sectional Study of Outcomes Associated with Two NIH Models

2021 ◽  
Author(s):  
Anisa Rowhani-Farid ◽  
Alexander C. Egilman ◽  
Audrey D. Zhang ◽  
Cary P. Gross ◽  
Harlan M. Krumholz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Data Sharing ◽  
Clinical Trial Data ◽  
Cross Sectional Study ◽  
Trial Data ◽  
Cross Sectional ◽  
Shared Data ◽  
Using Data ◽  
Meta Analyses ◽  
The Impact

AbstractBackgroundThe impact and value of clinical trial data sharing, including the number and quality of publications that result from shared data – “shared data publications” – may differ depending on the data sharing model used.MethodsWe characterized the outcomes associated with two data sharing models previously used by Institutes of the U.S. National Institutes of Health (NIH): NHLBI’s centralized model, which uses a repository to manage data sharing requests, and NCI’s decentralized model, which entrusted research groups to independently manage data sharing requests. We identified trials completed in 2010 that met NIH data sharing criteria and matched studies sponsored by each Institute based on cost or size, determining whether trial data were shared and the frequency of shared data publications.ResultsWe identified 14 NHLBI-funded trials and 48 NCI-funded trials that met NIH data sharing criteria. We matched 14 NCI-funded trials to the 14 NHLBI-funded trials; among these, 4 NHLBI-sponsored trials (29%) and 2 NCI-sponsored trials (14%) shared data. From the 2 NCI-sponsored trials sharing data, we identified 2 shared data publications, one per trial, both of which were meta-analyses. From the 4 NHLBI-sponsored trials sharing data, we identified 7 shared data publications, all using data from 1 trial, 5 of which were pooled analyses and 2 reported secondary outcomes.ConclusionWhen characterizing the outcomes associated with two NIH data sharing models, both the NHLBI and the NCI models resulted in only 21% of trials sharing data and few shared data publications. There are opportunities to optimize clinical trial data sharing efforts both to enhance clinical trial data sharing and increase the number of shared data publications.

scholarly journals Racial/ethnic disparities in antibiotic use and healthcare utilization, United States, 2016/2018: a cross-sectional study

2021 ◽  
Author(s):  
Scott W. Olesen ◽  
Sanjat Kanjilal ◽  
Stephen M. Kissler ◽  
Daphne S. Sun ◽  
Yonatan H. Grad
Keyword(s):  
Healthcare Utilization ◽  
Underserved Populations ◽  
Ethnic Disparities ◽  
Antibiotic Use ◽  
Cross Sectional Study ◽  
Antibiotic Prescribing ◽  
Cross Sectional ◽  
Antibiotic Overuse ◽  
Race Ethnicity ◽  
Racial Ethnic

ABSTRACTAntibiotic prescribing rates vary by patient race/ethnicity, with whites more likely to receive antibiotics and broader-spectrum antibiotics. However, the drivers of this disparity, and to what extent it represents antibiotic overuse or underprescribing of appropriate antibiotic treatment, remains unclear. Here, we investigate how antibiotic prescribing appropriateness varies by race/ethnicity and to what extent disparities in antibiotic use can be explained by differing rates of healthcare utilization. In data from two nationally representative healthcare utilization surveys, we found that racial/ethnic disparities in numbers of healthcare visits, not prescribers’ behavior, better explained disparities in antibiotic prescribing rates. We also found that the proportion of antibiotic prescriptions that were appropriate, potentially appropriate, or inappropriate did not vary significantly by race/ethnicity. These results suggest that whites’ higher antibiotic use is due primarily to increased healthcare utilization and that whites’ higher antibiotic use represents a mix of greater appropriate and inappropriate use. Thus, antibiotic stewardship goals should be informed by research into differing rates of antibiotic-treatable disease and healthcare seeking and access across different populations, to ensure that efforts to reduce inappropriate antibiotic overuse do not also reduce appropriate use in underserved populations.

scholarly journals Prevalence and predictors of obesity-related cancers among racial/ethnic groups with metabolic syndrome

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249188
Author(s):  
Shanada Monestime ◽  
Bettina Beech ◽  
Dulcie Kermah ◽  
Keith Norris
Keyword(s):  
Metabolic Syndrome ◽  
Smoking Status ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Income Insurance ◽  
Unit Increase ◽  
Chi Square Test ◽  
Race Ethnicity ◽  
Using Data

Background Obesity-related cancer (ORC) is associated with higher amounts of body fat, which could increase the risk of developing cardiovascular disease (CVD). A significant factor associated with CVD is metabolic syndrome (MetS), and MetS prevalence differs by race/ethnicity. The purpose of this study was to compare the prevalence and predictors of ORCs by race/ethnicity among adults (>18) with MetS. Methods This was a retrospective, cross-sectional study using data from the 1999–2014 National Health and Nutrition Examination Survey (NHANES). A chi-square test was performed to determine differences in ORC prevalence between non-Hispanic White (NHW), non-Hispanic Black (NHB), and Hispanic participants with MetS. A multivariate logistic regression was used to evaluate predictors (race, sex, income, insurance, education, marital status, and smoking status) of ORC among adults with MetS. Results Of the 1,554 adults, the prevalence of ORC was 30.6% among NHWs, 51.3% in NHBs, and 54.1% in Hispanics (p = <0.001). Females were 6.27 times more likely to have an ORC compared to males (95% CI = 4.95–14.11). Compared to NHWs, NHBs were 2.1 times more likely to have an ORC (95% CI = 1.40–3.38); and Hispanics were 2.5 times more likely (95% CI = 1.39–4.77). For every 1-year unit increase in age, the odds of ORC increased by 3% (95% CI = 1.00–1.05). Conclusions Among NHANES participants with MetS, the prevalence of ORCs was significantly higher in NHBs and Hispanics, females, and older adults with MetS. Future studies, by race/ethnicity, are warranted on mortality risk of persons with MetS and ORC.

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