scholarly journals Negative Impact of Amphetamine-Type Stimulant Use on Opioid Agonist Treatment Retention in Ontario, Canada

2021 ◽  
Vol 12 ◽  
Author(s):  
Kristen A. Morin ◽  
Frank Vojtesek ◽  
Shreedhar Acharya ◽  
David C. Marsh
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Drug Screening ◽  
Urban Areas ◽  
Logistic Regression Model ◽  
Opioid Agonist ◽  
Stimulant Use ◽  
Urine Drug ◽  
The Impact ◽  
Urine Drug Screening

Objective: The objective of this study was to evaluate epidemiological trends of co-use patterns of amphetamine-type stimulants and opioids and the impact of co-use patterns on Opioid Agonist Treatment (OAT) retention in Ontario, Canada. The secondary objective was to assess geographical variation in amphetamine-type stimulant use in Northern Rural, Northern Urban, Southern Rural and Southern Urban Areas of Ontario.Methods: A retrospective cohort study on 32,674 adults receiving OAT from ~70 clinics was conducted between January 1, 2014, and December 31, 2020, in Ontario, Canada. Patients were divided into four groups base on the proportion of positive urine drug screening results for amphetamine-type stimulants during treatment: group 1 (0–25%), group 2 (25–50%), group 3 (50–75%), and groups 4 (75–100%). A Fractional logistic regression model was used to evaluate differences over time in amphetamine-type stimulant use with urine drug screening results. A Cox Proportional Hazard Ratio model was used to calculate the impact of amphetamine-type stimulant use on retention in OAT and adjusted for sociodemographic characteristics, drug use and clinical factors. Lastly, a logistic regression model was used on a subgroup of patients to assess the impact of geography on amphetamine-type stimulant use in Northern Rural, Northern Urban, Southern Rural and Southern Urban Areas of Ontario.Results: There were significant differences in amphetamine-type stimulant positive urine drug screening results year-over-year from 2015 to 2020. Significant differences were observed between amphetamine-type stimulant groups with regards to sociodemographic, clinical and drug use factors. Compared to those with no amphetamine-type stimulant use, the number of days retained in OAT treatment for amphetamine-type stimulant users was reduced (hazard ratio 1.19; 95% confidence interval = 1.07–1.17; p < 0.001). Lastly, an adjusted logistic regression model showed a significant increase in the likelihood of amphetamine-type stimulant use in Northern Rural regions compared to Southern Urban areas.Conclusion: There was a significant increase in amphetamine-type stimulant use among individuals in OAT from 2014 to 2020, associated with decreased OAT retention. Research is required to determine if tailored strategies specific to individuals in OAT who use amphetamine-type stimulants can improve OAT outcomes.

scholarly journals Measuring Treatment Attrition at Various Stages of Engagement in Opioid Agonist Treatment in Ontario Canada Using a Cascade of Care Framework

2022 ◽  
Author(s):  
Farah Tahsin ◽  
Kristen A. Morin ◽  
Frank Vojtesek ◽  
David C. Marsh
Keyword(s):  
Drug Screening ◽  
Urban Areas ◽  
Primary Objective ◽  
Opioid Agonist ◽  
Opioid Agonist Treatment ◽  
Rural And Urban Areas ◽  
Urine Drug ◽  
Cascade Of Care ◽  
The Impact ◽  
Urine Drug Screening

Abstract Background The cascade of care framework is an effective way to measure attrition at various stages of engagement in Opioid Agonist Treatment (OAT). The primary objective of the study was to describe the cascade of care for individuals who have accessed OAT from a network of specialized addiction clinics in Ontario, Canada. The secondary objectives were to evaluate correlates associated with retention in OAT at various stages and the impact of patients' location of the residence on retention in OAT. Design: A multi-clinic retrospective cohort study was conducted using electronic medical record (EMR) data from the largest network of OAT clinics in Canada (70 clinics) from 2014-2020. Study participants included all individuals who received OAT from the network of clinics during the study period. Measurements: In this study, four stages of the cascade of care framework were operationalized to identify treatment engagement patterns, including patients retained within 90 days, 90 to 365 days, one to two years, and more than two years. Correlates associated with OAT retention for 90 days, 90 to 365 days, one to two years, and more than two years were also evaluated and compared across rural and urban areas in northern and southern Ontario. Results A total of 32,487 individuals were included in the study. Compared to individuals who were retained in OAT for 90 days, individuals who were retained for 90 to 365 days, one to two years, or more than two years were more likely to have a higher number of treatment attempts, a higher number of average monthly urine drug screening and a lower proportion of positive urine drug screening results for other drug use. Conclusion Distinct sociodemographic and clinical factors are likely to influence treatment retention at various stages of engagement along the OAT continuum. Research is required to determine if tailored strategies specific to people at different stages of engagement have the potential to improve outcomes of OAT.

scholarly journals The Application of a Logistic Regression Model for Predicting Preferences of Transport System Users

2018 ◽  
Vol 64 (4) ◽  
pp. 145-159
Author(s):  
A. Brzeziński ◽  
K. Brzeziński ◽  
T. Dybicz ◽  
Ł. Szymański
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Transport System ◽  
Urban Areas ◽  
Logistic Regression Model ◽  
Probabilistic Approach ◽  
The Impact ◽  
Selection Of ◽  
Made In

AbstractWithin the INMOP 3 research project, an attempt was made to solve a number of problems associated with the methodology of modelling travel in urban areas and the application of intermodal models. One of these is the ability to describe the behaviour of transport system users, when it comes to making decisions regarding the selection of means of transport and searching for relationships between travel describing factors and the decisions made in regard of means of transport choice.The paper describes a probabilistic approach to the determination of modal split, and the application of a logistic regression model to determine the impact of variables describing individual and mass transport travels on the probability of selecting specific means of transport. Travels in local model of Warsaw city divided into 9 motivation groups were tested, for which ultimately 8 models were developed, out of which 7 were deemed very well fitted (obtained pseudo R2 was well above 0.2).

scholarly journals Work absence and multimorbidity in Portugal: results from the 1st National Health Examination Survey

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
J Matos ◽  
C Matias Dias ◽  
A Félix
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Chronic Diseases ◽  
National Health ◽  
Logistic Regression Model ◽  
Health Examination ◽  
Work Absence ◽  
Health Examination Survey ◽  
Absence From Work ◽  
The Impact

Abstract Background Studies on the impact of patients with multimorbidity in the absence of work indicate that the number and type of chronic diseases may increase absenteeism and that the risk of absence from work is higher in people with two or more chronic diseases. This study analyzed the association between multimorbidity and greater frequency and duration of work absence in the portuguese population between the ages of 25 and 65 during 2015. Methods This is an epidemiological, observational, cross-sectional study with an analytical component that has its source of information from the 1st National Health Examination Survey. The study analyzed univariate, bivariate and multivariate variables under study. A multivariate logistic regression model was constructed. Results The prevalence of absenteeism was 55,1%. Education showed an association with absence of work (p = 0,0157), as well as professional activity (p = 0,0086). It wasn't possible to verify association between the presence of chronic diseases (p = 0,9358) or the presence of multimorbidity (p = 0,4309) with absence of work. The prevalence of multimorbidity was 31,8%. There was association between age (p < 0,0001), education (p < 0,001) and yield (p = 0,0009) and multimorbidity. There is no increase in the number of days of absence from work due to the increase in the number of chronic diseases. In the optimized logistic regression model the only variables that demonstrated association with the variable labor absence were age (p = 0,0391) and education (0,0089). Conclusions The scientific evidence generated will contribute to the current discussion on the need for the health and social security system to develop policies to patients with multimorbidity. Key messages The prevalence of absenteeism and multimorbidity in Portugal was respectively 55,1% and 31,8%. In the optimized model age and education demonstrated association with the variable labor absence.

Entrepreneurship Program at Secondary School

2019 ◽  
pp. 202-217
Author(s):  
Maria Jose Madeira ◽  
Andreia Rocha
Keyword(s):  
Logistic Regression ◽  
Secondary School ◽  
Regression Model ◽  
Extracurricular Activities ◽  
Secondary School Students ◽  
Logistic Regression Model ◽  
Secondary Level ◽  
Entrepreneurial Intentions ◽  
School Students ◽  
The Impact

The aim of this study is the analysis of the effect that the entrepreneurship activities have in the development of an entrepreneurial profile of the students of a secondary level and their future entrepreneurial intentions. To empirically test the formulated hypothesis, a questionnaire was developed. By the application of methods of factorial analysis and a logistic regression model, it was concluded that variables like the incentive given by school agents, the participation of students in extracurricular activities and the desire to continue studying, influenced the entrepreneurial intentions of the students. Concerning the entrepreneurial profile, it was concluded that the students who have higher capacity of creation and concretization of entrepreneurial projects and a winning will, have a higher propensity to create their own business. This research analysed the impact of entrepreneurship activities on the development of the secondary school students' entrepreneurial profile, and understand whether these same activities influence their future intentions.

scholarly journals Variation Among Hospitals in the Continuity of Care for Older Hospitalized Patients: a Cross-sectional Cohort Study

2021 ◽  
Author(s):  
James S. Goodwin ◽  
Shuang Li ◽  
Jie Zhou ◽  
Yong-Fang Kuo ◽  
Ann Nattinger
Keyword(s):  
Logistic Regression ◽  
Length Of Stay ◽  
Regression Model ◽  
Continuity Of Care ◽  
Logistic Regression Model ◽  
Large Degree ◽  
Patient Characteristics ◽  
Hospitalized Patients ◽  
Cross Sectional ◽  
The Impact

Abstract Background: Little is known about how continuity of care for hospitalized patients varies among hospitals. We describe the number of different general internal medicine physicians seeing hospitalized patients during a medical admission and how that varies by hospital. Methods: We conducted a retrospective study of a national 20% sample of Medicare inpatients from 01/01/16 to 12/31/18. In patients with routine medical admissions (length of stay of 3-6 days, no Intensive Care Unit stay, and seen by only one generalist per day), we assessed odds of receiving all generalist care from one generalist. We calculated rates for each hospital, adjusting for patient and hospital characteristics in a multi-level logistic regression model. Results: Among routine medical admissions with 3- to 6-day stays, only 43.1% received all their generalist care from the same physician. In those with a 3-day stay, 50.1% had one generalist providing care vs. 30.8% in those with a 6-day stay. In a two-level (admission and hospital) logistic regression model controlling for patient characteristics and length of stay, the odds of seeing just one generalist did not vary greatly by patient characteristics such as age, race/ethnicity, comorbidity or reason for admission. There were large variations in continuity of care among different hospitals and geographic areas. In the highest decile of hospitals, the adjusted mean percentage of patients receiving all generalist care from one physician was >84.1%, vs. <24.1% in the lowest decile. This large degree of variation persisted when hospitals were stratified by size, ownership, location or teaching status. Conclusions: Continuity of care provided by generalist physicians to medical inpatients varies widely among hospitals. The impact of this variation on quality of care is unknown.

scholarly journals The Impact of International Remittances on Poverty Alleviation in Bangladesh

2019 ◽  
Vol 4 (1) ◽  
pp. 67-86 ◽  
Author(s):  
Bezon Kumar
Keyword(s):  
Logistic Regression ◽  
Regression Model ◽  
Poverty Alleviation ◽  
Logistic Regression Model ◽  
Binary Logistic Regression ◽  
Primary Data ◽  
Binary Logistic Regression Model ◽  
Household Poverty ◽  
International Remittances ◽  
The Impact

This article mainly explores to what extent international remittances alleviate household poverty in Bangladesh. This study uses primary data collected from 216 households and employs multi-methods. Firstly, I measure the level of household poverty through Foster-Greer-Thorbecke index. The article secondly focuses on the impact of remittances on household poverty using a binary logistic regression model. I found that the level of poverty among remittance recipient households is notably lower than households that are not receiving remittances. Similarly, the probability of a household being poor is alleviated by 28.07 per cent if the household receives remittance. It can be suggested that nursing international remittances can be useful for poverty alleviation in Bangladesh. 

scholarly journals Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infection in Hematologic Patients: Experience at the Hospital Attending More Patients in Spain

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 30-31
Author(s):  
Alba Cabirta ◽  
Macarena Izuzquiza ◽  
Isabel Ruiz-Camps ◽  
David Valcarcel ◽  
Eva Catala ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Severe Acute Respiratory Syndrome ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Hematologic Malignancies ◽  
Active Therapy ◽  
Multivariable Logistic Regression Model ◽  
Hematopoietic Stem ◽  
Multivariable Logistic Regression ◽  
The Impact

INTRODUCTION: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic raises many questions about the management of patients with significant comorbidities. Hematologic patients are usually fragile due to an important immunosuppression, so the impact of coronavirus disease (COVID-19) is yet to be determined. MATERIALS AND METHODS: We conducted a single-center retrospective observational study of patients with hematologic malignancies diagnosed with SARS-CoV-2 at Vall d´Hebron University Hospital (HUVH) between March 1st and May 31st 2020 to analyze their clinical characteristics and evolution. Patient's demographic data, underlying pathology, signs and symptoms of COVID-19, treatment received and clinical course were collected. A statistical analysis was performed to identify the possible variables associated with COVID-19 mortality. For this purpose, we used univariate and multivariable logistic regression models. RESULTS: We identified 70 patients with PCR confirmed SARS-CoV-2 infection and hematologic malignancy. The median age was 75 years (range 22-91), and 44% were female. The majority (74%) had evidence of active malignancy and 53% were receiving active therapy. Lymphoid pathology (73%) predominated over myeloid. The median number of previous lines of treatment was 0 (range 0-6), 23% had received at least 2 lines, whereas 10% underwent hematopoietic stem cell transplantation (HSCT) (5 patients allo-HSCT, 2 auto-HSCT). Half of the patients had more than one pre-existing comorbidity (17% obstructive pulmonary disease). At diagnosis the most common symptoms were fever (76%), cough (60%) and dyspnea (31%). We observed that 58% of patients presented a chest X-ray compatible with COVID-19. Regarding laboratory parameters, stood out lymphopenia (65% of patients presented &lt;1200 lymphocytes/mm3) and elevation of inflammation parameters, such as D-dimer (median 365 ng/mL, range 50-5860), ferritin (median 1063 ng/mL, range 73-14191), IL-6 (median 59,6 pg/mL, range 3-4079) and PCR (median 11,2 mg/dL, range 0,3-79,9). Empirical therapy for COVID-19 included antibiotics (78%), anti-virals (50%, 3% remdesivir), and hydroxychloroquine (88%). Only 24% received tocilizumab, 50% heparin (33% prophylactic dose), 12% G-CSF, 9% norepinephrine, 4% corticosteroids and 1% ß-IFN. Most of patients (73%) required oxygen therapy: 36% high-flow, 29% low flow and 8% endotracheal intubation. There were 6 patients who did not receive any treatment. COVID-19 was acquired via nosocomial infection in 23% of patients, 91% of them requiring hospitalization, 14% in the Intensive Care Unit (ICU). The median days of hospitalization since diagnosis was 17 (range 3-55). The case fatality rate (CFR) from COVID-19 was higher in hematologic patients than the one observed in non-hematologic patients at the HUVH (figure 1), being of 41% at 11 days from diagnosis. CFR was higher in patients older than 75 years old (61%), while the mortality among patients receiving active therapy was 42%. The main cause of death was acute respiratory failure (93%). In the univariate logistic regression model, age &gt;75 years (OR 1.07; p=0.008), active malignancy (OR 5; p=0,02), &gt;1 comorbidity (OR 5.3; p=0,049) and high levels of IL-6 (OR 8.2; p= 0.005) were statistically significant. In the multivariable logistic regression model, age ≥75 years (OR 4.4; p=0.01) and IL-6 levels at baseline &gt; 59.6 pg/mL (OR 7.2; p=0.01) were associated with a higher mortality (table 1). The presence of an active malignancy was not a significant variable in the multivariable logistic regression model. CONCLUSIONS: Patients with hematologic malignancies and COVID-19 presented similar symptoms, signs and radiological characteristics to those described in the general population at diagnosis. In our cohort, advanced age and high IL-6 values were associated with higher mortality. Furthermore, it was observed that active hematologic disease is a factor of poor prognosis of COVID-19. Disclosures Salamero: Daichii Sankyo:Honoraria;Celgene:Consultancy, Honoraria;Novartis:Consultancy, Honoraria;Jazz Pharmaceuticals:Consultancy, Honoraria;Pfizer:Consultancy.Abrisqueta:Janssen:Consultancy, Honoraria, Speakers Bureau;AbbVie:Consultancy, Honoraria, Speakers Bureau;Roche:Consultancy, Honoraria, Speakers Bureau;Celgene:Consultancy, Honoraria.Bosch:Hoffmann-La Roche:Research Funding.

scholarly journals Impact of Urine Drug Screening on No Shows and Dropouts among Chronic Pain Patients: A Propensity-Matched Cohort Study

2016 ◽  
Vol 19 (2;2) ◽  
pp. 89-100
Author(s):  
Parthasarathy Krishnamurthy
Keyword(s):  
Chronic Pain ◽  
Cohort Study ◽  
Propensity Score ◽  
Drug Screening ◽  
Proportional Hazards ◽  
Pain Clinic ◽  
Urine Drug ◽  
The Impact ◽  
Pain Patients ◽  
Urine Drug Screening

Background: The last 2 decades have seen a substantial increase in both the prescription of opioids for managing chronic pain, and an increase in opioid-related deaths in the US. Urine drug screening (UDS) is the de facto monitoring tool aimed at detecting and deterring opioid misuse. Objective: We study whether administering UDS on pain patients influences post-screening behavior of no-shows and dropouts. Study Design: Observational cohort study of electronic medical records. Setting: Single urban academic pain-clinic. Methods: A retrospective cohort comparison of patients receiving UDS versus those not receiving UDS was conducted on the entire sample as well as in the propensity score-matched samples in which matching was based on age, gender, pain-score, procedure-scheduled, systolic and diastolic blood pressure (BP), pulse, temperature, physician ID, year of visit, psychology referral, and opioid prescription in the first visit. In addition, we conducted within-subjects logistic-regression to study no-shows and non-proportional hazards survival modeling to study dropout. Results: Analyses of 4,448 clinic visits by 723 pain patients indicated that UDS exposure in the first visit is associated with increased risk of no-show in the second visit (OR = 2.73, P < .0001); no-show rate was 10.24% for those without UDS compared to 23.75% for those with a UDS. Among those tested, the no-show rate was higher for those testing positive for illicit substances (34.57%) than for those testing negative (21.74%). These findings were replicated in 8 different propensity-score matched subsamples aimed at addressing potential nonrandom selection, as well as in within-subject analysis accounting for individual-level no-show propensity. Non-proportional hazards survival analysis shows that risk of dropout increased by 100.3% with every additional UDS (HR 95% CI: 1.54 to 2.61). Limitations: Retrospective design, non-randomized sample, single-setting. Conclusions: The results indicate that UDS is associated with increased no-shows and dropout from clinic subject to limitations of observational studies such as selection bias and confound by unobserved variables. These results serve as a call for additional prospective randomized studies to understand the impact of UDS, and where the patients might go when they dropout from the clinic. Key words: Chronic pain, opioid monitoring, UDS, urine-drug screening, no-show, dropout, adherence, propensity-score matching

How do situational variables, related to shooting, in elite Gaelic football impact shot success?

2021 ◽  
pp. 174795412110554
Author(s):  
Kevin McGuigan ◽  
Kieran Collins ◽  
Kevin McDaid
Keyword(s):  
High Pressure ◽  
Logistic Regression ◽  
Regression Model ◽  
Logistic Regression Model ◽  
Average Distance ◽  
Initial Model ◽  
Type Method ◽  
Situational Variables ◽  
Shot Type ◽  
The Impact

Analysis of 3926 shots from the 2019 Senior inter-county football championship aims to establish the impact of distance, angle, shot type, method and pressure on shot success. Findings demonstrate that shots from free kicks contribute 20.5% of the total attempts in Gaelic football, with a success rate of 75%, in contrast to 50% success of shots from open play. Moreover, the range from which free kick success is >57.6% accuracy extends to 40 m, while from open play this is passed at a range of 28 m. There were almost twice as many right foot shots (64.4%) compared with the left foot (32.4%), with right foot attempts marginally more accurate. Shots under low pressure were most successful, while those under medium pressure were less successful than those under high pressure, albeit taken from an average distance of 7.5 m closer to the target. A logistic regression model to explore the impact of all variables on shot outcome demonstrates the significance of shot distance, angle and pressure on the kicker, as well as whether shots are taken with the hand or foot. This research provides an important step in understanding the scale of the impact of a range of variables on shot success in Gaelic football while simultaneously providing an initial model to predict the shot outcome based on these variables.

Sign in / Sign up

Export Citation Format

Share Document