Effect of a new cancer diagnosis on labor force participation (LFP): Has there been a change over time?

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e18004-e18004
Author(s):  
Amy J. Davidoff ◽  
Linda F. Cantley ◽  
Deron H. Galusha
Keyword(s):  
Lung Disease ◽  
Cancer Diagnosis ◽  
Health Conditions ◽  
Prior History ◽  
Wave Condition ◽  
Net Worth ◽  
Working Adults ◽  
History Of ◽  
Over Time ◽  
Heart Condition

e18004 Background: Health shocks, such as a new cancer diagnosis, have been shown to reduce LFP in working adults. Over the past decade, there have economic swings, retirement age has increased, while newer cancer treatments may be less toxic or disabling. We update prior estimates of LFP responses, and assess whether patterns changed over time. Methods: Adults from the 1998-2014 waves of the Health and Retirement Study (HRS) who were aged 51+ yrs and working in 1998 or at HRS cohort entry in 2004 or 2010, were followed until their LFP decreased. Decreased LFP was defined as a switch from fulltime work, or a 10 hour or 25% decrease in hours worked. We created time varying indicators for health conditions (cancer, heart condition, lung disease, stroke) newly reported or worsened since the prior wave, condition history, demographics, net worth, and insurance coverage. We estimated discrete Cox proportional hazard survival models for the full sample, and with person-wave observations stratified pre/post 2008. Results: Among 13,918 working adults, mean age was 56 years, 45% women; health history included 5.3% cancer, 9.5% heart condition, 4.1% lung disease, 1.5% stroke; new health conditions included 2.9% cancer, 4.7% heart, 2.3% lung, and 1.3% stroke. Newly reported or worsened cancer, heart and lung disease were associated with similar risk of LFP decrease (see table). Prior history of lung disease, diabetes, arthritis and psychiatric disorders were associated with LFP decreases, but cancer was not. There was no difference in the effect of a new condition on LFP pre/post 2008. Conclusions: Many working adults reported preexisting health conditions. New diagnoses or worsening of cancer and other serious health conditions were associated with LFP reductions, although a longer term history of cancer was not associated with LFP changes. [Table: see text]

scholarly journals Seroresponse to SARS-CoV-2 vaccines among maintenance dialysis patients over six months

2021 ◽  
Author(s):  
Caroline M Hsu ◽  
Daniel E Weiner ◽  
Harold J Manley ◽  
Gideon N Aweh ◽  
Vladimir Ladik ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Prior History ◽  
Time To Event ◽  
Dialysis Patients ◽  
History Of ◽  
Maximum Titer ◽  
Lower Titer ◽  
Maintenance Dialysis ◽  
Over Time

Background and Objectives: While most maintenance dialysis patients exhibit initial seroresponse to vaccination, concerns remain regarding the durability of this antibody response. This study evaluated immunity over time. Design, setting, participants, and measurements: This retrospective cohort study included maintenance dialysis patients from a midsize national dialysis provider who received a complete SARS-CoV-2 vaccine series and had at least one antibody titer checked after full vaccination. Immunoglobulin G spike antibodies (SAb-IgG) titers were assessed monthly with routine labs beginning after full vaccination and followed over time; the semiquantitative SAb-IgG titer reported a range between 0 and ≥20 U/L. Descriptive analyses compared trends over time by prior history of COVID-19 and type of vaccine received. Time-to-event analyses were conducted for the outcome of loss of seroresponse (SAb-IgG < 1 U/L or development of COVID-19). Cox proportional hazards regression was used to adjust for additional clinical characteristics of interest. Results: Among 1898 maintenance dialysis patients, 1567 (84%) had no prior history of COVID-19. Patients without a history of COVID-19 had declining titers over time. Among 441 BNT162b2/Pfizer recipients, median [IQR] SAb-IgG titer declined from 20 [5.99-20] U/L in month 1 to 1.30 [0.15-3.59] U/L by month 6. Among 779 mRNA-1273/Moderna recipients, median [IQR] SAb-IgG titer declined from 20 [20-20] in month 1 to 6.20 [1.74-20] by month 6. The 347 Ad26.COV2.S/Janssen recipients had a lower titer response than mRNA vaccine recipients over all time periods. In time-to-event analyses, Ad26.COV2.S/Janssen and mRNA-1273/Moderna recipients had the shortest and longest time to loss of seroresponse, respectively. The maximum titer reached in the first two months after full vaccination was predictive of the durability of the SAb-IgG seroresponse; patients with SAb-IgG titer 1-19.99 U/L were more likely to have loss of seroresponse compared to patients with SAb-IgG titer ≥20 U/L (HR 23.9 [95% CI: 16.1-35.5]). Conclusions: Vaccine-induced seroresponse wanes over time among maintenance dialysis patients across vaccine types. Early titers after full vaccination predict the durability of seroresponse.

A survival comparison between women with uterine serous and/or clear cell carcinoma with and without a history of breast cancer

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 5580-5580
Author(s):  
A. Mendivil ◽  
T. J. Vogel ◽  
V. L. Bae-Jump ◽  
P. A. Gehrig
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Cancer Diagnosis ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Uterine Cancer ◽  
Breast Cancer Diagnosis ◽  
Prior History ◽  
Type Ii ◽  
History Of

5580 Background: The association between breast and uterine is well known. However, the effect that a prior breast cancer diagnosis may have on women with a new endometrial cancer diagnosis is less well described. The goal of our study was to determine the effect that a prior history of breast cancer would have on the outcome for women with type II uterine cancer. Methods: After obtaining IRB exemption, a retrospective chart review was performed. All women treated for uterine carcinoma between 1994 and 2007 were identified and we identified women with either uterine serous (UPSC) or clear cell carcinoma (UCCC) as the study group. The patients were then divided between those with and those without a prior breast cancer diagnosis. Patient demographics, cancer histologies, and stage of disease data were collected. Fisher's exact test and unpaired t test were used as appropriate. Progression-free (PFS) and overall survival (OS) were calculated using the Kaplan Meier method. Results: Approximately 1,083 patients were treated for uterine carcinoma during the study period of which 74 had pre-existing breast carcinoma (6.9%). One hundred and fifty women had USC and/or UCCC (13.8%) of whom 23 also had pre-existing breast carcinoma (13.3%). The women with breast cancer where older at the time of their uterine cancer diagnosis (77 y.o.) compared to those without breast cancer (68 y.o.) (p = 0.0089); were more likely to develop USC/UCCC (OR 2.56; 95% CI 1.47–4.44); and were more likely to be white compared to black (OR 4.6; 95% CI 1.74–11.99). At five years, there was no significant difference in PFS or OS between those women with and without a prior history of breast cancer. Conclusions: Women with a history of breast cancer have more the twice the likelihood of developing USC and/or UCCC. While having two primary malignancies can be devastating, our study indicated that women who developed a type II uterine cancer and also had a history of a prior breast cancer had the same outcomes as those women without a prior cancer diagnosis. This finding may help to allay patients’ fears about developing another malignancy and its impact on their prognosis. No significant financial relationships to disclose.

Current health status and history of traumatic brain injury among Ohio adults

2019 ◽  
Vol 26 (2) ◽  
pp. 129-137 ◽  
Author(s):  
Kara Manchester ◽  
John D. Corrigan ◽  
Bhavna Singichetti ◽  
Lihong Huang ◽  
Jennifer Bogner ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Poor Health ◽  
Health Conditions ◽  
Prior History ◽  
Public Health Burden ◽  
Lifetime History ◽  
Adverse Health ◽  
History Of ◽  
The Relationship

IntroductionLifetime history of traumatic brain injury (TBI) with loss of consciousness (LOC) is prevalent in 21% of adult, non-institutionalised residents of Ohio. Prior history has been associated with lower incomes, inability to work and disability. The current study sought to evaluate the relationship between lifetime history and adverse health conditions.MethodsData came from the 2014 Ohio Behavioral Risk Factors Surveillance System, which included a state-specific module eliciting lifetime history of TBI.ResultsNon-institutionalised adults living in Ohio who have had at least one TBI with LOC were more likely to report fair or poor health, more days of poor health, more days when poor health limited activities, being diagnosed with a chronic condition and having less than 7 hours of sleep per night. The relationship with increasing number of TBIs was monotonic, with the likelihood of adverse health increasing as the number increased. A similar relationship was observed for increasing severity of the worst lifetime TBI. Experiencing a first TBI before age 15 was associated with poorer health but was not statistically different than incurring a first after age 15.ConclusionsAdults who have experienced TBI with LOC in their lifetime are two to three times more likely to experience adverse health conditions when compared with same age-matched, sex-matched and race-matched adults without such history. These findings support re-examining the public health burden of TBI in light of lifetime exposure and not just the consequences of an index injury.

scholarly journals Prior History of Venous Thromboembolism Is a Significant Risk Factor for Recurrence of Thrombosis after Cancer Diagnosis

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 32-33
Author(s):  
Sargam Kapoor ◽  
Aman Opneja ◽  
Jahnavi Gollamudi ◽  
Lalitha V. Nayak
Keyword(s):  
Cancer Diagnosis ◽  
Factor V Leiden ◽  
Personal History ◽  
Prior History ◽  
Cancer Type ◽  
Patients With Cancer ◽  
History Of ◽  
Diagnosis Of Cancer ◽  
Recurrent Vte ◽  
The Impact

Introduction: The risk of venous thromboembolism (VTE) is increased in patients with cancer and contributes to significant morbidity, treatment delays and mortality. The Khorana score is the most well-validated VTE risk prediction tool that guides use of prophylactic anticoagulation in patients with cancer. The Khorana score includes cancer type, body mass index (BMI), hemoglobin, platelet count and leukocyte count but not a prior history of VTE which may increase the risk of recurrent VTE. Scant published data have suggested that a personal history of VTE increases the risk of VTE recurrence by 2 to 7-fold after cancer diagnosis. In this study, we examine the impact of history of VTE on VTE recurrence in a large cohort of patients with cancer. Methods: We performed a retrospective cohort study of patients diagnosed with cancer using aggregated de-identified data from electronic medical record of &gt;300 major hospitals in US (IBM Watson Explorys). Patients with a personal history of VTE (deep vein thrombosis and/ or pulmonary embolism) more than one year prior to the diagnosis of cancer were included. Within this cohort, patients who developed recurrent VTE within 180 days of diagnosis of cancer were identified. The primary end-point was the incidence of cancer associated VTE (CVTE) in patients with prior history of VTE as compared to patients without history of VTE. Baseline characteristics including age, race, gender, BMI, prothrombotic mutations (Factor V Leiden, prothrombin gene 20210A mutation), antineoplastic agent use, cancer type and laboratory values (as included in Khorana risk score) were compared in all patients. Results: A total of 4,159,400 patients with a diagnosis of cancer were included. Of these, 138,820 patients (3.3%) had a history of VTE &gt;1 year prior to being diagnosed with cancer. The incidence of CVTE at 180 days was 10-fold higher in those with prior history of VTE compared to those without (36.9% vs 3.66%; OR 15.4, 95% CI 15.22-15.6, P value &lt;0.0001). While the inherent risk of CVTE varied based on cancer type (highest risk of 10.5% in pancreatic cancer), the risk of recurrent VTE in patients with prior VTE history is magnified to a similar degree across all cancer types as shown in Figure 1. Baseline characteristics including age, race, gender and cancer type distribution were similar in all groups, as shown in Table 1. Factor V Leiden mutation or activated protein C resistance (FVL/APC) was more prevalent in patients with prior history of VTE and subsequent CVTE (3%) as compared to all patients with CVTE regardless of history (1%), as shown in Table 1. A higher BMI was noted in patients with prior history of VTE (49% and 71% respectively in patients with and without CVTE) as compared to 41% in all patients with CVTE. Greater use of antineoplastic agents (41%) was noted in the group of patients with prior history of VTE and subsequent CVTE as compared to patients with prior VTE but no CVTE (36%). Conclusion: Our study highlights that a prior personal history of VTE &gt;1 year before cancer diagnosis significantly increases the risk of cancer associated VTE independently, regardless of other established risk factors for VTE suggesting that this group of patients, especially those undergoing anti-cancer treatment may benefit from prophylactic anticoagulation. Increased incidence of FVL/ APC in patients with prior history of VTE and recurrent CVTE may reflect increased testing for prothrombotic mutations in this cohort. Our ongoing efforts include examining the effect of addition of history of VTE to the Khorana score. Finally, large prospective observational studies would be key to assess the impact of history of VTE on cancer thrombosis. Disclosures No relevant conflicts of interest to declare.

Masters of Illusion: Bank and Regulatory Accounting for Losses in Distressed Banks

2020 ◽  
pp. 1-31
Author(s):  
Edward J. Kane
Keyword(s):  
Federal Reserve ◽  
Central Banking ◽  
Net Worth ◽  
Know How ◽  
Regulatory Frameworks ◽  
History Of ◽  
Over Time

This essay is part of a larger work on the history of Federal Reserve policymaking entitled Banking on Bull. The study seeks to explain why the instruments of central banking inevitably break down over time. A big part of the explanation is that policymakers want accounting measures of bank net worth to be flexible enough to allow bankers and regulators to slow the release of adverse information about distressed banks, particularly very large ones. Modern regulatory frameworks focus on maintaining what can be described as the adequacy of accounting capital. But this framework is bull, because in tough times, bank accountants know how to make losses disappear.

scholarly journals A case of secondary tension pneumothorax in COVID-19 pneumonia in a patient with no prior history of lung disease

2020 ◽  
Vol 8 ◽  
pp. 2050313X2096750
Author(s):  
Kwesi Amoah ◽  
Kulothungan Gunasekaran ◽  
Mandeep Singh Rahi ◽  
Michael G Buscher
Keyword(s):  
Lung Disease ◽  
Tension Pneumothorax ◽  
Kidney Injury ◽  
Sudden Onset ◽  
Prior History ◽  
Unusual Complication ◽  
Mediastinal Shift ◽  
Life Threatening ◽  
History Of ◽  
Chest X Ray

Complications that arise in patients with severe COVID-19 pneumonia are acute respiratory distress syndrome, often leading to mechanical ventilation, shock requiring vasopressors, acute kidney injury, stroke, thromboembolic phenomena, and myocardial injury. To date, there are four cases of tension pneumothorax in patients with COVID-19, published in literature. We present a 33-year-old man with no prior history of lung disease who was admitted to our hospital on account of hypoxic respiratory failure secondary to COVID-19 pneumonia. During his hospitalization, he developed sudden onset of chest pain which worsened with coughing. A chest X-ray showed a right-sided pneumothorax with left-sided mediastinal shift. He required placement of chest tubes with eventual resolution of the pneumothorax several days later. This case highlights the need for clinical recognition, consideration of differential diagnoses, prompt evaluation, appropriate imaging, and management of this severe life-threatening unusual complication of COVID-19 pneumonia.

The connection of observed hostile family conflict to adolescents' developing autonomy and relatedness with parents

1996 ◽  
Vol 8 (2) ◽  
pp. 425-442 ◽  
Author(s):  
Joseph P. Allen ◽  
Stuart T. Hauser ◽  
Thomas G. O'Connor ◽  
Kathy L. Bell ◽  
Charlene Eickholt
Keyword(s):  
Observational Data ◽  
Marital Conflict ◽  
Family Conflict ◽  
Parenting Behaviors ◽  
Family Interaction ◽  
Prior History ◽  
History Of ◽  
Adolescent Parent ◽  
Parent Conflict ◽  
Over Time

AbstractThis study examined the link between hostile conflict in families with adolescents and adolescents' efforts to establish autonomy and relatedness in interactions with parents in both normal and psychiatrically impaired groups. Longitudinal, observational data were obtained by coding family interaction tasks involving 53 adolescents and their two parents at age 14 and age 16 years. Measures were obtained for hostile adolescent-parent conflict, hostile marital conflict, and indices of adolescents' success or difficultly in establishing autonomy and relatedness in interactions with parents. Relative increases in adolescent-parent hostile conflict from age 14 to 16 years were predicted by adolescents' behaviors actively undermining autonomy in disagreements with parents at age 14 years. Hostile marital conflict observed by the adolescent at age 14 years predicted adolescent withdrawal from the hostile parent over time, a prediction that was not mediated by observed parenting behaviors. Difficulties in establishing autonomy and relatedness were linked to prior history of psychiatric difficulty. A developmental view of conflict as both reflecting and predicting difficulties in adolescents' establishing autonomy and relatedness in interactions with parents is proposed.

Heparin use and venous thromboembolism (VTE) among cancer patients receiving chemotherapy with a prior history of VTE

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 6616-6616
Author(s):  
G. Cherkowski ◽  
J. Dietrich ◽  
F. Chen ◽  
J. Fryzek ◽  
K. Bridges
Keyword(s):  
Venous Thromboembolism ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Prior History ◽  
Low Molecular Weight ◽  
Chemotherapy Treatment ◽  
Effective Treatment Option ◽  
History Of ◽  
Diagnosis Of Cancer ◽  
After Cancer

6616 Background: Heparin is an effective treatment option for the prevention of venous thromboembolism (VTE) in cancer patients on chemotherapy. To date, information on the use of both low molecular weight heparin (LMWH) and non-LMWH in cancer patients receiving chemotherapy that have had a prior VTE is lacking. We evaluated heparin treatment patterns as well as the incidence of VTE in a cohort of cancer patients receiving chemotherapy, who have had a VTE prior to their cancer diagnosis. Methods: We conducted a retrospective cohort study using a large claims database representing the U.S. commercially-insured population. The cohort included all patients 18–64 years old from 2000 to 2007 who were diagnosed with cancer, were on chemotherapy, and who had a VTE occurring up to 12 months before cancer (n=331). We defined a diagnosis of cancer as two ICD-9 claims 30 days apart or more. A combination of ICD-9, HCPCS, and CPT codes were used to capture chemotherapy treatment after cancer. A VTE was identified by a single ICD-9 claim of 415.1, 451.2, 451.81, 451.9, 453.1, 453.2, 453.8, or 453.9. VTE claims occurring within 6 months of the index claim were considered part of the same VTE event. A patient was considered to have a VTE after cancer if they had a VTE claim that occurred both after the cancer diagnosis and at least 6 months beyond the most recent pre-cancer index VTE date. Results: Fifty-one percent of cancer patients with a history of VTE were prescribed an anticoagulant (n = 171). Fewer patients took LMWH compared to non-LMWH (6.7% versus 27.8%) while a portion took both (17.2%). A VTE after cancer was experienced by 49.1% of those on any kind of anticoagulant, 45.4% of those taking LMWH, 43.5% of those taking non-LMWH, and 59.6% of those who had taken both types. Fewer VTEs were reported among those taking no anticoagulants (29.4%). Conclusions: Approximately half of all cancer patients receiving chemotherapy were receiving heparin, with a smaller proportion using only LMWH. Even with prophylaxis, VTE recurs in half of cancer patients with a VTE history who receive chemotherapy. Recurrent VTE is a serious risk despite heparin or LMWH prophylaxis. [Table: see text]

The Path of Standard Albanian Language Formation

2018 ◽  
Vol 5 (2) ◽  
pp. 106-115
Author(s):  
Sindorela Doli Kryeziu
Keyword(s):  
Single Unit ◽  
Cultural Factors ◽  
Language History ◽  
Whole Process ◽  
History Of ◽  
Social And Cultural Factors ◽  
Cultural Body ◽  
Over Time ◽  
Language Literature

Abstract In our paper we will talk about the whole process of standardization of the Albanian language, where it has gone through a long historical route, for almost a century.When talking about standard Albanian language history and according to Albanian language literature, it is often thought that the Albanian language was standardized in the Albanian Language Orthography Congress, held in Tirana in 1972, or after the publication of the Orthographic Rules (which was a project at that time) of 1967 and the decisions of the Linguistic Conference, a conference of great importance that took place in Pristina, in 1968. All of these have influenced chronologically during a very difficult historical journey, until the standardization of the Albanian language.Considering a slightly wider and more complex view than what is often presented in Albanian language literature, we will try to describe the path (history) of the standard Albanian formation under the influence of many historical, political, social and cultural factors that are known in the history of the Albanian people. These factors have contributed to the formation of a common state, which would have, over time, a common standard language.It is fair to think that "all activity in the development of writing and the Albanian language, in the field of standardization and linguistic planning, should be seen as a single unit of Albanian culture, of course with frequent manifestations of specific polycentric organization, either because of divisions within the cultural body itself, or because of the external imposition"(Rexhep Ismajli," In Language and for Language ", Dukagjini, Peja, 1998, pp. 15-18.)

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