scholarly journals High-intensity cannabis use and hospitalization: a prospective cohort study of street-involved youth in Vancouver, Canada

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Hudson Reddon ◽  
M.-J. Milloy ◽  
Evan Wood ◽  
Ekaterina Nosova ◽  
Thomas Kerr ◽  
...  
Keyword(s):  
Prospective Cohort ◽  
Estimating Equation ◽  
Cannabis Use ◽  
Vulnerable Groups ◽  
Care Utilization ◽  
Generalized Estimating Equation ◽  
At Risk Youth ◽  
Future Studies ◽  
Youth Study ◽  
The Relationship

Abstract Background There is concern that cannabis use negatively affects vulnerable groups such as youth; however, the relationship between cannabis use and health care utilization has not been well characterized in this population. We longitudinally evaluated the association between daily cannabis use and hospitalization among a prospective cohort of street-involved youth. Methods Data were collected from the At-Risk Youth Study (ARYS) in Vancouver, Canada, from September 2005 to May 2015. Participants were interviewed semi-annually and multivariable generalized estimating equation (GEE) logistic regression was used to examine the relationship between daily cannabis use and hospitalization. Results A total of 1216 participants (31.2% female) were included in this analysis, and 373 (30.7%) individuals reported hospitalization at some point during the study period. In a multivariable GEE analysis, daily cannabis use was not significantly associated with hospitalization (Adjusted Odds Ratio [AOR] = 1.17, 95% Confidence interval [CI] = 0.84, 1.65). We did observe a significant interaction between daily cannabis use and sex (AOR = 0.51, 95% CI = 0.34, 0.77), whereby cannabis use was associated with a decreased odds of hospitalization among males (AOR = 0.60, 95% CI = 0.47, 0.78), yet was not significantly associated with hospitalization among females (AOR = 1.19, 95% CI = 0.84, 1.67). Conclusions The finding that daily cannabis use was not associated with hospitalization among street-involved youth is encouraging given the high rates of cannabis use in this population and the expansion of cannabis legalization and regulation. Future studies, however, are warranted to monitor possible changes in the consequences of cannabis use as cannabis legalization and regulation increase internationally.

scholarly journals Increased burden of suicidality among young street-involved sex workers who use drugs in Vancouver, Canada

2018 ◽  
Vol 41 (2) ◽  
pp. e152-e157
Author(s):  
Brittany Barker ◽  
Scott E Hadland ◽  
Huiru Dong ◽  
Kate Shannon ◽  
Thomas Kerr ◽  
...  
Keyword(s):  
Sex Work ◽  
Sex Workers ◽  
Multivariable Analysis ◽  
Well Being ◽  
Estimating Equation ◽  
Elevated Risk ◽  
Generalized Estimating Equation ◽  
At Risk Youth ◽  
Youth Study ◽  
Health And Well Being

AbstractBackgroundThe risks of suicidality among street-involved youth who use drugs and engage in sex work are not well described. This study sought to evaluate if street-involved youth who engage in sex work were at an elevated risk for attempting suicide.MethodsData were derived from the At-Risk Youth Study, a prospective cohort of street-involved youth who use drugs in Vancouver, Canada. Multivariable generalized estimating equation analyses were employed to examine whether youth who engaged in sex work were at elevated risk of attempting suicide, controlling for possible confounders.ResultsBetween September 2005 and May 2015, 1210 youth were recruited into the cohort, of whom, 173 (14.3%) reported recently attempting suicide at some point during the study period. In multivariable analysis, youth who engaged in sex work were significantly more likely to report a recent suicide attempt (adjusted odds ratio = 1.93; 95% confidence interval: 1.28–2.91).ConclusionsStreet-involved youth who engage in sex work were observed to be at a significantly higher risk for suicidality. Systematic discrimination and unaddressed trauma may contribute to the observed increased burden of suicidality among this population. Interventions that support the mental health and well-being of street-involved youth who engage in sex work are urgently needed.

The relationship between remission and health-related quality of life in a cohort of SLE patients

Rheumatology ◽  
2018 ◽  
Vol 58 (4) ◽  
pp. 628-635 ◽  
Author(s):  
Michel W P Tsang-A-Sjoe ◽  
Irene E M Bultink ◽  
Maaike Heslinga ◽  
Lilian H van Tuyl ◽  
Ronald F van Vollenhoven ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Global Assessment ◽  
Short Form ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Relationship

Abstract Objective To investigate the relationship between remission and health-related quality of life (HRQoL) in patients with SLE in a longitudinal observational cohort. Methods HRQoL was measured at cohort visits using the physical and mental component score (PCS and MCS, respectively) of the Short Form 36 questionnaire. Definitions of Remission in SLE remission categories (no remission/remission on therapy/remission off therapy) were applied. Determinants of PCS and MCS were identified with simple linear regression analyses. Association between remission and HRQoL was assessed using generalized estimating equation models. Results Data from 154 patients with 2 years of follow-up were analysed. At baseline 60/154 (39.0%) patients were in either form of remission. Patients in remission had higher Short Form 36 scores in all subdomains compared with patients not in remission. PCS was positively associated with remission and employment, and negatively associated with SLICC damage index, ESR, medication, patient global assessment and BMI. MCS was positively associated with Caucasian ethnicity and negatively associated with patient global assessment. In generalized estimating equation analysis, a gradual and significant increase of PCS was observed from patients not in remission (mean PCS 36.0) to remission on therapy (41.8) to remission off therapy (44.8). No significant difference in MCS was found between remission states. Conclusion we show a strong and persistent association between remission and PCS, but not MCS. These results support the relevance (construct validity) of the Definition of Remission in SLE remission definitions and the further development of a treat-to-target approach in SLE.

scholarly journals Food insufficiency is associated with depression among street-involved youth in a Canadian setting

2018 ◽  
Vol 22 (1) ◽  
pp. 115-121 ◽  
Author(s):  
Julia Goldman-Hasbun ◽  
Ekaterina Nosova ◽  
Kora DeBeck ◽  
Lucia Dahlby ◽  
Thomas Kerr
Keyword(s):  
Illicit Drugs ◽  
Epidemiological Studies ◽  
At Risk Youth ◽  
Food Insufficiency ◽  
Symptoms Of Depression ◽  
Health Related ◽  
Youth Study ◽  
The Relationship ◽  
Dose Dependent ◽  
Related Harm

AbstractObjectiveFood insufficiency, defined by the experience of hunger, is known to be prevalent and a source of health-related harm among-street involved youth, but little is known about its relationship with depression in this population. Therefore, we sought to assess the association between food insufficiency and symptoms of depression among a cohort of street-involved youth.DesignMultivariable logistic regression was used to assess the relationship between food insufficiency, defined as being hungry but not having enough money to buy food, and depression as measured by the Center for Epidemiological Studies Depression (CES-D) scale.SettingData from April 2006 to November 2013 were derived from the At-Risk Youth Study (ARYS), a prospective cohort of street-involved youth who use illicit drugs in Vancouver, Canada.SubjectsThere were 1066 street-involved youth enrolled in the study, including 340 (31·9 %) females.ResultsOf 1066 youth enrolled in the study, 724 (67·9 %) reported some food insufficiency and 565 (53·0 %) met criteria for depression. Compared with youth who did not report food insufficiency, those who reported often experiencing food insufficiency had a higher likelihood of reporting depression (adjusted OR=2·52; 95 % CI 1·74, 3·67), as did those who reported sometimes experiencing food insufficiency (adjusted OR=1·99; 95 % CI 1·47, 2·70).ConclusionsFood insufficiency was prevalent and associated in a dose-dependent trend with symptoms of depression among street-involved youth in our setting. Findings highlight the need to address the nutritional and mental health needs of youth and identify pathways by which food insufficiency may contribute to depression among vulnerable populations.

scholarly journals Interactions between cannabis and schizophrenia in humans and rodents

2017 ◽  
Vol 28 (7) ◽  
Author(s):  
Ahmed A. Moustafa ◽  
Mohamed Salama ◽  
Roseanne Peak ◽  
Richard Tindle ◽  
Amir Salem ◽  
...  
Keyword(s):  
Neural Mechanism ◽  
Cannabis Use ◽  
Human Studies ◽  
Clinical Implications ◽  
Future Studies ◽  
The Relationship

AbstractIn this review, we provide an overview of the relationship between cannabis use and the development of schizophrenia, using both animal and human studies. We further discuss the potential neural mechanism that may mediate the relationship between cannabis use and schizophrenia symptoms. We finally provide clinical implications and future studies that can further elucidate the relationship between cannabis and schizophrenia.

scholarly journals Who Has an Unsuccessful Observation Care Stay?

Healthcare ◽  
2018 ◽  
Vol 6 (4) ◽  
pp. 138 ◽  
Author(s):  
Gelareh Gabayan ◽  
Brian Doyle ◽  
Li-Jung Liang ◽  
Kwame Donkor ◽  
David Huang ◽  
...  
Keyword(s):  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Inpatient Service ◽  
Intestinal Infections ◽  
Sample Data ◽  
Medicare Patients ◽  
Prolonged Observation ◽  
Nationally Representative ◽  
The Relationship ◽  
Successful Observation

Background: With the recent increase use of observation care, it is important to understand the characteristics of patients that utilize this care and either have a prolonged observation care stay or require admission. Methods: We a conducted a retrospective cohort study utilizing 5% sample data from Medicare patients age ≥65 years that was nationally representative in the year 2013. We performed a generalized estimating equation (GEE) logistic regression analysis to evaluate the relationship between an unsuccessful observation stay (defined as either requiring an inpatient admission from observation or having a prolonged observation stay) compared to having successful observation care. Observation cut offs of “successful” vs. “unsuccessful” were based on the CMS 2 midnight rule. Results: Of 154,756 observation stays in 2013, 19 percent (n = 29,604) were admitted to the inpatient service and 34,275 (22.2%) had a prolonged observation stay. The two diagnoses most likely to have an unsuccessful observation stay were intestinal infections (OR 1.56, 95% CI 1.32–1.83) and pneumonia (OR 1.26, 95% CI 1.13–1.41). Conclusion: We found patients placed in observation care with intestinal infections and pneumonia to have the highest odds of either being admitted from observation or having a prolonged observation stay.

scholarly journals Effort Expenditure and Cannabis Use: Testing the Amotivational Hypothesis

2021 ◽  
Author(s):  
Samuel Acuff ◽  
Nicholas Simon ◽  
James Murphy
Keyword(s):  
College Students ◽  
Decision Making ◽  
Estimating Equation ◽  
Reward Processing ◽  
Cannabis Use ◽  
Generalized Estimating Equation ◽  
High Reward ◽  
The Us ◽  
Goal Directed Behavior ◽  
High Effort

Cannabis is the most commonly used illicit drug in the US and appears to have an indirect effect on dopamine (DA) output in the mesolimbic projection, a circuit implicated in reward processing and effort expenditure. Thus, some have suggested that cannabis use might be associated with aberrant effort-based decision making. The most popular theory positing changes in motivation due to cannabis use is the amotivation syndrome hypothesis, which suggests that chronic cannabis use results in impaired executive functioning, arousal, and affective reactivity leading to reduced capacity for goal-directed behavior other than drug seeking. However, only one study has examined this among cannabis users, and the results suggested no difference between cannabis and non-cannabis users. Further, other studies suggest greater effort expenditure among the substance using groups compared to controls. The current study extends these findings by examining the relation between cannabis use and effort-related decision making in a sample of college students. Cannabis using (n = 25) and non-cannabis using (n = 22) students completed the Effort Expenditure for Rewards Task (EEfRT), in which participants choose between a ‘hard’ task that requires pressing a button 100 times with the nondominant little finger for a large sum of money (high effort/high reward) or an ‘easy’ task that requires pressing a button 30 times with the dominant index finger for a smaller sum of money (low effort/low reward). Results were then compared between the cannabis and non-cannabis using groups. On average, participants selected the hard trials 46% of the time (SD = 19%). Participants successfully completed the hard trials 74% of the time (SD 29%), while they completed the easy trials 97% of the time (SD = 6%). No participant selected only hard or easy trials during the duration of the task. Cannabis users (M=41.40, SD=3.55) completed significantly fewer trials compared to nonusers (M=43.64, SD=3.74). Further, Nonusers (M=26.82, SD=10.01) selected easy trials significantly more often compared to cannabis users (M=21.40, SD=8.34), and nonusers (M=99%, SD=2%) also successfully completed easy trials more often compared to cannabis users (M=95%, SD=7%). However, cannabis users and nonusers did not differ in the number of hard trials selected (Cannabis users M=16.82, SD=5.67; Nonusers M=16.82, SD=7.68) or the percentage of successfully completed hard trials out of the total number of hard trials (Cannabis users M=72%, SD=27%; Nonusers M=76%, SD =32%). Both the reward magnitude and probability of reward receipt predicted greater likelihood of selecting a hard trial. In generalized estimating equation models, past month cannabis days and cannabis use disorder symptoms predicted the likelihood of selecting a hard trial, such that greater levels of both cannabis use days and symptoms were associated with an increased likelihood after controlling for reward value, probability, and expected value. The results suggest that college students who use cannabis are more likely to expend effort, even after controlling for the magnitude of the reward and the probability of reward receipt, suggesting the possibility for aberrant reward processing, albeit in the opposite direction of the amotivational syndrome hypothesis.

scholarly journals Emergency department increased use of observation care for elderly medicare patients

2018 ◽  
Vol 7 (3) ◽  
pp. 9 ◽  
Author(s):  
Gelareh Z. Gabayan ◽  
Li-Jung Liang ◽  
Brian Doyle ◽  
David Yu-Chuang Huang ◽  
Catherine A. Sarkisian
Keyword(s):  
Emergency Department ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
Inpatient Service ◽  
Medicare Beneficiaries ◽  
The Past ◽  
Medicare Patients ◽  
Nationally Representative ◽  
Using Data ◽  
The Relationship

Background: Over the past decade, a growing number of older Medicare beneficiaries visit the emergency department (ED) and have been placed in observation care. We investigated and compared the prevalence and factors associated with patients age ≥ 65 years with Medicare insurance who are placed in the hospital, observation care, or discharged following an ED visit.Methods: We conducted a retrospective cohort study using data from a nationally representative 5% sample of Medicare patients age ≥ 65 years during the year 2013. We performed multiple generalized estimating equation (GEE) logistic regression analyses to assess the relationship between placement in a hospital vs. discharge, observation care vs. discharge, and observation care vs. admission.Results: Of 537,455 Medicare beneficiaries age ≥ 65 years who visited an ED in 2013, 48.0% (N = 258,083) were discharged, 10.5% (N = 56,184) placed in observation care, and 41.5% (N = 223,188) were admitted to the inpatient service following the ED visit. The top 2 diagnoses associated with placement in the hospital vs. discharge were ischemic heart disease and renal disease. Patients with symptomatic diagnoses such as chest pain and dizziness were more likely to be placed in observation care following an ED visit as compared to admission to the hospital.Conclusions: Compared to prior studies, we found a greater number of older Medicare ED patients placed in observation care and a lower number admitted to the hospital. Most common diagnoses of placement in observation care were symptom-based as compared to being admitted to the hospital which were disease-based.

scholarly journals The Relationship between Democracy embracement and COVID-19 reported casualties worldwide

2021 ◽  
Author(s):  
Muhammad R. Hussein ◽  
Thamer AlSulaiman ◽  
Mohamed Habib ◽  
Engy A. Awad ◽  
Islam Morsi ◽  
...  
Keyword(s):  
Free Speech ◽  
International Aid ◽  
Estimating Equation ◽  
Generalized Estimating Equation ◽  
The World ◽  
Vaccine Distribution ◽  
The Relationship ◽  
Additional Explanation ◽  
Longitudinal Dataset ◽  
Country Specific

AbstractBackgroundThe COVID-19 toll of cases and deaths followed an uneven pattern across the world. The literature has partly explained the observed discrepancy between the different countries by country-specific and systemic patterns worldwide. In this study, we propose an additional explanation that the magnitude of COVID-19 toll reported to the WHO could be influenced by the level of free speech and Democracy in the reporting countries.MethodsWe constructed a longitudinal dataset including the daily COVID-19 count of cases and deaths worldwide and each country’s respective score on the Freedom in the World index. We applied two Generalized Estimating Equation models to investigate if a country’s reported toll count of COVID-19 cases and deaths is related to that country’s freedom level. We controlled for factors identified in the current literature to affect the pandemic’s spread.ResultsA country’s score on the Freedom In the World Index was associated with its reported COVID-19 cases count (57028.43, 95% CI 985.3619 - 113071.5, P= 0.0461) and deaths count (3473.273, 95% CI1217.12-5729.42, P=.002). Also, despite having almost equal shares of the world’s population, countries at the bottom category of the Freedom index reported 21% and 11% of the COVID-19 toll cases and death counts reported by countries of highest scores on the index, respectively.ConclusionsThe known magnitude of the COVID-19 pandemic’s morbidity and mortality appears to be as transparent as the reporting countries uphold free speech and Democracy. This pattern could potentially misguide international aid and global vaccine distribution plans.

scholarly journals Relationship Between Severity of Comorbidities and Self-Perceptions of Aging

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1053-1053
Author(s):  
DaJung Chang
Keyword(s):  
Estimating Equation ◽  
Health Condition ◽  
Generalized Estimating Equation ◽  
Physical Limitation ◽  
Self Perceptions ◽  
Risk Of Mortality ◽  
Perceptions Of Aging ◽  
The Times ◽  
The Relationship ◽  
Retirement Study

Abstract An older adult with negative self-perceptions of aging (SPA) can lead to lower self-rated health and a higher risk of mortality. To stay a positive SPA, keep a healthier status is very important. However, evidence also proved that health conditions, like a physical limitation, could predict the level of SPA. Older adults usually have a higher prevalence rate of chronic diseases than the younger population, which can adversely impact them. The purpose of this study is to determine the relationship between the severity of comorbidities and the change of SPA during a time. I examined data in 7,034 people from the 2012 wave Health and Retirement Study (HRS) and followed the respondents who have answer the SPA scale in the leave-behind questionnaire in 2016. The generalized estimating equation was used to analyze the relationship between the severity of comorbidities and SPA in different waves. To measure the severity of comorbidities, a reduced index of the comorbidities severity scale (CmSS) was created to collect the health condition from HRS. Results statistical model shows that an individual with more severity of comorbidities may have a more negative SPA. However, the relationship does not follow through with the times. These findings enhance the previous study that there are relationships between severity of comorbidities and SPA. The benefit of this study is to use a different measurement to identify the severity of comorbidities and extend to more in-depth research.

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