scholarly journals Potential predictors of adoption of the Tobacco Heating System by U.S. adult smokers: An actual use study

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 214 ◽  
Author(s):  
Steve Roulet ◽  
Christelle Chrea ◽  
Claudia Kanitscheider ◽  
Gerd Kallischnigg ◽  
Pierpaolo Magnani ◽  
...  
Keyword(s):  
Real World ◽  
Population Level ◽  
Heating System ◽  
Tobacco Consumption ◽  
The United States ◽  
Tobacco Product ◽  
Ease Of Use ◽  
Stepwise Logistic Regression ◽  
Actual Use ◽  
The Impact

Background:This was a pre-market actual use study with the Tobacco Heating System (THS), a candidate modified risk tobacco product, conducted with adult smokers in eight cities in the United States. The main goal of the study was to describe THS adoption in a real-world setting. The aim of this analysis was to identify potential predictors for adoption of THS using stepwise logistic regression method.Methods:This actual use study was an observational study assessing self-reported stick-by-stick consumption of the THS product compared with the use of commercial cigarettes over six weeks. The study aimed at replicating the usage of THS in real-world conditions with participants being able to consume cigarettes, THS, and any other nicotine-containing products (e.g., e-cigarettes, cigars, etc.)ad libitum.Results:14.6% of participants adopted THS, which comprised 70% or more of their total tobacco consumption by the end of the observational period (in Week 6). The main predictors of adoption were the liking of the smell, taste, aftertaste, and ease of use of THS. The proportion of adoption was higher in participants aged 44 years and older and in Hispanic or Latino adult smokers. Additionally, adoption of THS was more likely in participants who had never attempted to quit smoking and in participants who smoked up to 10 cigarettes per day. Finally, the adoption of THS was higher in participants who consumed both regular and menthol THS compared with those who consumed only one THS variant.Conclusions:The main predictors of THS adoption were positive sensory assessment and the ease of use. Socio-demographic characteristics and smoking habits appeared much less important. Post-marketing studies will provide further insights on the impact of the THS at the individual and the overall population level.

scholarly journals Potential predictors of adoption of the Tobacco Heating System by U.S. adult smokers: An actual use study

F1000Research ◽  
2021 ◽  
Vol 8 ◽  
pp. 214
Author(s):  
Steve Roulet ◽  
Christelle Chrea ◽  
Claudia Kanitscheider ◽  
Gerd Kallischnigg ◽  
Pierpaolo Magnani ◽  
...  
Keyword(s):  
Population Level ◽  
Heating System ◽  
Tobacco Consumption ◽  
Tobacco Product ◽  
Ease Of Use ◽  
Stepwise Logistic Regression ◽  
Stepwise Logistic Regression Analysis ◽  
Actual Use ◽  
Post Marketing ◽  
The Impact

Background: This was a pre-market, observational, actual use study with the Tobacco Heating System (THS), a candidate modified risk tobacco product. The main goal of the study was to describe THS adoption within current adult daily smokers by replicating the usage of THS in real-world conditions with participants being able to consume cigarettes, THS, and any other nicotine-containing products (e.g., e-cigarettes, cigars, etc.) ad libitum. Methods: This study assessed self-reported stick-by-stick consumption of THS compared with the use of commercial cigarettes over six weeks. The aim of the analysis was to identify potential predictors for adoption of THS using stepwise logistic regression analysis. Results: By the end of the observational period (in Week 6), 14.6% of participants (n=965) had adopted THS meaning that THS formed 70% or more of their total tobacco consumption. The main predictors of adoption were the liking of the smell, taste, aftertaste, and ease of use of THS. The proportion of adoption was higher in participants aged 44 years and older and in Hispanic or Latino adult smokers. Additionally, adoption of THS was more likely in participants who had never attempted to quit smoking and in participants who smoked up to 10 cigarettes per day. Finally, the adoption of THS was higher in participants who consumed both regular and menthol THS compared with those who consumed only one THS variant. Conclusions: The findings suggest that the introduction of THS in the U.S. has the potential to result in adoption by current adult smokers who would otherwise continue to smoke cigarettes, and that the adoption of THS is unlikely to result in an increase of tobacco consumption. Post-marketing studies will provide further insights on THS adoption and THS use patterns to allow assessment of the impact of the THS at the individual and the overall population level.

Determining the Long-Term Effectiveness of a Group-Based Physical Activity Program

2018 ◽  
Vol 20 (3) ◽  
pp. 401-408
Author(s):  
Anamica Batra ◽  
Richard C. Palmer ◽  
Elena Bastida ◽  
H. Virginia McCoy ◽  
Hafiz M. R. Khan
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Healthy Aging ◽  
Population Level ◽  
The United States ◽  
South Florida ◽  
Community Based ◽  
Evidence Based Programs ◽  
The Impact

Objective. In 2015, only half (48%) of older adults in the United States (≥60 years) reported engaging in any kind of physical activity. Few studies examine the impact of evidence-based programs when adopted in community-based settings. The purpose of this study is to assess the effectiveness of EnhanceFitness (EF) upto 12-months. Method. EF was offered to older adults in South Florida. A total of 222 EF classes were offered between October 2008 and December 2014. Program consisted of a 1-hour session held three times a week. Even though participation was required for 4 months, 1,295 participants continued the program for at least 1 year. Results. All participants showed significant improvement in outcome measures. A mean change of 1.5, 1.7, and 1.9 was seen in number of chair stands at 4, 8, and 12 months (p < .001), respectively. The number of arm curls performed improved from 16.8 at baseline to 18.8, 18.8, and 19.2 at 4-, 8-, and 12-months, respectively. Participants improved their up-and-go time by decreasing from 9.1 (baseline) to 8.7 (4 months) to 8.6 (12 months; p = .001). Discussion. Randomized controlled trials are commonly used to determine the efficacy of an intervention. These interventions when disseminated at the population level have the potential to benefit large masses. EF is currently offered at more than 700 locations. This tremendous success of EF brings attention to an important question of continuous monitoring of these programs to ensure program consistency and intended outcomes. The model used by the Healthy Aging Regional Collaborative could be replicated by other communities.

The range of bicycle helmet performance at real world impact locations

2021 ◽  
pp. 175433712110577
Author(s):  
Ann R Harlos ◽  
Steven Rowson
Keyword(s):  
Real World ◽  
Test Line ◽  
Linear Acceleration ◽  
The United States ◽  
Consumer Product Safety Commission ◽  
Bicycle Helmets ◽  
Impact Location ◽  
Increased Risk ◽  
Post Hoc ◽  
The Impact

In the United States, all bicycle helmets must comply with the standard created by the Consumer Product Safety Commission (CPSC). In this standard, bike helmets are only required to by tested above an established test line. Unregulated helmet performance below the test line could pose an increased risk of head injury to riders. This study quantified the impact locations of damaged bike helmets from real-world accidents and tested the most commonly impacted locations under CPSC bike helmet testing protocol. Ninety-five real-world impact locations were quantified. The most common impact locations were side-middle (31.6%), rear boss-rim (13.7%), front boss-rim (9.5%), front boss-middle (9.5%), and rear boss-middle (9.5%). The side-middle, rear boss-rim, and front boss (front boss-middle and front boss-rim regions combined) were used for testing. Two of the most commonly impacted regions were below the test line (front boss-rim and rear boss-rim). Twelve purchased helmet models were tested under CPSC protocol at each location for a total of 36 impacts. An ANOVA test showed that impact location had a strong influence on the variance of peak linear acceleration (PLA) ( p = 0.002). A Tukey HSD post hoc test determined that PLA at the side-middle (214.9 ± 20.8 g) and front boss (228.0 ± 39.6 g) locations were significantly higher than the PLA at the rear boss-rim (191.5 ± 24.2 g) location. The highest recorded PLA (318.8 g) was at the front boss-rim region. This was the only test that exceeded the 300 g threshold. This study presented a method for quantifying real-world impact locations of damaged bike helmets. Higher variance in helmet performance was found at the regions on or below the test line than at the region above the test line.

scholarly journals OR30-01 Real-World Minimed™ 670G System Use and Glycemic Outcomes of Pediatric and Adult Individuals Living with Type 1 Diabetes (T1D) in the United States

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Robert Alan Vigersky ◽  
Michael Stone ◽  
Pratik Agrawal ◽  
Alex Zhong ◽  
Kevin Velado ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Real World ◽  
Adult Population ◽  
Age Groups ◽  
The United States ◽  
System Use ◽  
System Data ◽  
The Mean ◽  
The Impact ◽  
The U.S

Abstract Introduction: The MiniMed™ 670G system was FDA-approved in 2016 for adults and adolescents ≥14yrs, and in 2018 for children ages 7-13yrs with T1D. Since then, use of the system has grown to over 180,000 people in the U.S. The glycemic control benefits of real-world MiniMed™ 670G system Auto Mode use in the U.S. were assessed. Methods: System data (aggregated five-minute instances of sensor glucose [SG]) uploaded from March 2017 to July 2019 by individuals (N=118,737) with T1D and ≥7yrs of age who enabled Auto Mode were analyzed to determine the mean % of overall time spent &lt;54mg/dL/&lt;70mg/dL (TBR); between 70-180mg/dL (TIR); and &gt;180mg/dL/&gt;250mg/dL (TAR). The impact of Auto Mode was further assessed in a sub-group of individuals (N=51,254) with, at least, 7 days of SG data for both Auto Mode turned ON and turned OFF. The % of TIR, TBR and TAR, and the associated glucose management indicator (GMI) were evaluated for the overall OFF (2,524,570 days) and ON (6,308,806 days) periods, and across different age groups. Results: System data TIR was 71.3%; TBR was 0.4% and 1.9%, respectively; and TAR was 26.8% and 6.2%, respectively. User-wise data of Auto Mode OFF versus ON showed a mean of 70.3% of the time spent in Auto Mode, that TIR increased from 60.9% to 69.9%; and that both TBR and TAR decreased. For those 7-13yrs (N=1,417), TIR increased from 48.7% to 61.5%; TBR increased from 0.5% to 0.6% and from 2.0% to 2.2%, respectively; and TAR decreased from 49.3% to 36.3% and from 20.5% to 13.0%, respectively. For those 14-21yrs (N=4,194), TIR increased from 51.0% to 61.5%; TBR decreased from 0.7% to 0.6% and from 2.3% to 2.0%, respectively; and TAR decreased from 46.7% to 36.5% and from 18.5% to 12.5%, respectively. For those ≥22yrs (N=45,643), TIR increased from 62.2% to 70.9%; TBR decreased from 0.7% to 0.5% and from 2.6% to 1.9%, respectively; and TAR decreased from 35.2% to 27.3% and from 9.9% to 6.3%, respectively. The mean GMI decreased by 0.23% (overall), 0.48% (7-13yrs), 0.35% (14-21yrs), and 0.22% (≥22yrs), respectively, with Auto Mode ON versus OFF. Discussion: In over 6 million days of real-world MiniMed™ 670G system Auto Mode use in the U.S., TIR of a large pediatric and adult population with T1D improved by 9% compared to when Auto Mode was OFF, which was comparable to or exceeded the TIR observed in the smaller pivotal trials. These results further support outcomes of the pivotal trials and increased glycemic control with system use.

scholarly journals The Great Recession and Mental Health in the United States

2019 ◽  
Vol 7 (5) ◽  
pp. 900-913 ◽  
Author(s):  
Miriam K. Forbes ◽  
Robert F. Krueger
Keyword(s):  
Mental Health ◽  
United States ◽  
Great Recession ◽  
Population Level ◽  
Safety Net ◽  
The United States ◽  
Panic Attacks ◽  
The Great Recession ◽  
Additional Support ◽  
The Impact

The full scope of the impact of the Great Recession on individuals’ mental health has not been quantified to date. In this study we aimed to determine whether financial, job-related, and housing impacts experienced by individuals during the recession predicted changes in the occurrence of symptoms of depression, generalized anxiety, panic attacks, and problematic alcohol use or other substance use. Longitudinal survey data ( n = 2,530 to n = 3,293) from the national Midlife in the United States study that were collected before (2003–2004) and after (2012–2013) the Great Recession were analyzed. The population-level trend was toward improvements in mental health over time. However, for individuals, each recession impact experienced was associated with long-lasting and transdiagnostic declines in mental health. These relationships were stronger for some sociodemographic groups, which suggests the need for additional support for people who suffer marked losses during recessions and for those without a strong safety net.

Real-world treatment and outcomes of frontline chemotherapy in patients with metastatic pancreatic cancer.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16249-e16249
Author(s):  
Salwan Al Mutar ◽  
Muhammad Shaalan Beg ◽  
Eric Hansen ◽  
Andrew J. Belli ◽  
Maegan Vaz ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Clinical Trial ◽  
Real World ◽  
Univariate Analysis ◽  
The United States ◽  
Metastatic Pancreatic Cancer ◽  
Future Research ◽  
Real World Data ◽  
The Real ◽  
The Impact

e16249 Background: The difference between the FOLFIRINOX and gemcitabine/nab-paclitaxel (GnP) regimens’ clinical trial designs limit the ability to generate cross-study comparisons. Therefore, there is a significant need to understand the impact of various demographic and clinical characteristics on the effectiveness of these systemic therapies in the real-world treatment setting. This study seeks to compare the real-world outcomes of patients with metastatic pancreatic cancer treated with frontline FOLFIRINOX or GnP. Methods: Patients with primary metastatic pancreatic cancer who received first-line (1L) FOLFIRINOX or GnP were identified in the COTA real-world database. The COTA database is a de-identified database of real-world data (RWD) derived from the electronic health records of healthcare providers in the United States. Real-world overall response rate (rwORR) was calculated as the proportion of patients achieving complete response (CR) or partial response (PR). Overall survival (OS) was calculated using the Kaplan-Meier method and multivariate analyses utilized Cox proportional hazards. Results: The overall qualified cohort (n=236) was stratified by 1L FOLFIRINOX (n=109) or GnP (n=127). Select patient characteristics are shown in table. Patients treated with 1L FOLFIRINOX showed greater rwORR as compared to those treated with GnP (68.8% vs. 55.9%, p=0.04). Additionally, patients treated with 1L FOLFIRINOX had longer median OS (14.4 vs 11.4 mos, respectively). In univariate analysis, patients treated with GnP had a greater chance of mortality (HR: 1.3, 95% CI: 1.0, 1.8, p=0.05). This relationship strengthened in multivariate analysis (GnP treated HR: 1.6, 95% CI: 1.1, 2.1, p=0.01). Conclusions: Due to lack of enrollment of representative patients in clinical trials and in the absence of a comparative clinical trial, real-world experience with chemotherapy regimens provide critical insights on the outcome of treatments. In our cohort, patients treated with frontline GnP had a significantly greater chance of mortality as compared to patients treated with frontline FOLFIRINOX. The FOLFIRINOX cohort also showed greater rwORR. Future research will continue to expand on treatment patterns in subsequent lines of therapy, as well as emerging therapy types, in order to better understand the optimal treatment sequence in metastatic pancreatic cancer.[Table: see text]

scholarly journals Risk of Negative Health Outcomes and High Costs for People With Diabetes and Unmet Psychological Needs in the United States

2022 ◽  
Author(s):  
Aryana Sepassi ◽  
Mark Bounthavong ◽  
Renu F. Singh ◽  
Mark Heyman ◽  
Kristin Beizai ◽  
...  
Keyword(s):  
Health Care ◽  
Resource Utilization ◽  
Health Care Expenditure ◽  
Population Level ◽  
The United States ◽  
Psychological Needs ◽  
Medical Expenditure ◽  
Psychological Need ◽  
Total Health Care Expenditure ◽  
The Impact

Measuring the population-level relationship between compromised mental health and diabetes care remains an important goal for clinicians and health care decision-makers. We evaluated the impact of self-reported unmet psychological need on health care resource utilization and total health care expenditure in people with type 2 diabetes. Patients who reported unmet psychological needs were more likely than those who did not to incur a higher annual medical expenditure, have greater resource utilization, and have a higher risk of all-cause mortality.

scholarly journals Impact of the WHO FCTC over the first decade: a global evidence review prepared for the Impact Assessment Expert Group

2018 ◽  
Vol 28 (Suppl 2) ◽  
pp. s119-s128 ◽  
Author(s):  
Janet Chung-Hall ◽  
Lorraine Craig ◽  
Shannon Gravely ◽  
Natalie Sansone ◽  
Geoffrey T Fong
Keyword(s):  
Tobacco Control ◽  
Information Exchange ◽  
Data Extraction ◽  
Smoking Initiation ◽  
Tobacco Consumption ◽  
Tobacco Product ◽  
Health Warnings ◽  
Hand Search ◽  
Tobacco Epidemic ◽  
The Impact

ObjectiveTo present findings of a narrative review on the implementation and effectiveness of 17 Articles of the WHO Framework Convention on Tobacco Control (FCTC) during the Treaty’s first decade.Data sourcesPublished reports on global FCTC implementation; searches of four databases through June 2016; hand-search of publications/online resources; tobacco control experts.Study selectionWHO Convention Secretariat global progress reports (2010, 2012, 2014); 2015 WHO report on the global tobacco epidemic; studies of social, behavioural, health, economic and/or environmental impacts of FCTC policies.Data extractionProgress in the implementation of 17 FCTC Articles was categorised (higher/intermediate/lower) by consensus. 128 studies were independently selected by multiple authors in consultation with experts.Data synthesisImplementation was highest for smoke-free laws, health warnings and education campaigns, youth access laws, and reporting/information exchange, and lowest for measures to counter industry interference, regulate tobacco product contents, promote alternative livelihoods and protect health/environment. Price/tax increases, comprehensive smoking and marketing bans, health warnings, and cessation treatment are associated with decreased tobacco consumption/health risks and increased quitting. Mass media campaigns and youth access laws prevent smoking initiation, decrease prevalence and promote cessation. There were few studies on the effectiveness of policies in several domains, including measures to prevent industry interference and regulate tobacco product contents.ConclusionsThe FCTC has increased the implementation of measures across several policy domains, and these implementations have resulted in measurable impacts on tobacco consumption, prevalence and other outcomes. However, FCTC implementation must be accelerated, and Parties need to meet all their Treaty obligations and consider measures that exceed minimum requirements.

scholarly journals Optimizing the impact of low-efficacy influenza vaccines

2018 ◽  
Vol 115 (20) ◽  
pp. 5151-5156 ◽  
Author(s):  
Pratha Sah ◽  
Jan Medlock ◽  
Meagan C. Fitzpatrick ◽  
Burton H. Singer ◽  
Alison P. Galvani
Keyword(s):  
Age Groups ◽  
Population Level ◽  
The Elderly ◽  
The United States ◽  
Vaccine Uptake ◽  
Influenza Vaccines ◽  
Health Practitioner ◽  
Specific Distribution ◽  
Life Years ◽  
The Impact

The efficacy of influenza vaccines varies from one year to the next, with efficacy during the 2017–2018 season anticipated to be lower than usual. However, the impact of low-efficacy vaccines at the population level and their optimal age-specific distribution have yet to be ascertained. Applying an optimization algorithm to a mathematical model of influenza transmission and vaccination in the United States, we determined the optimal age-specific uptake of low-efficacy vaccine that would minimize incidence, hospitalization, mortality, and disability-adjusted life-years (DALYs), respectively. We found that even relatively low-efficacy influenza vaccines can be highly impactful, particularly when vaccine uptake is optimally distributed across age groups. As vaccine efficacy declines, the optimal distribution of vaccine uptake shifts toward the elderly to minimize mortality and DALYs. Health practitioner encouragement and concerted recruitment efforts are required to achieve optimal coverage among target age groups, thereby minimizing influenza morbidity and mortality for the population overall.

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