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1.
J Neurotrauma ; 39(1-2): 86-92, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-33626946

RESUMO

This case-control study using baseline data from the population cohort Adolescent Brain Cognitive Development (ABCD) Study® compared lifetime history of concussion between children with and without attention-deficit/hyperactivity disorder (ADHD). We hypothesized that children with ADHD would have a greater lifetime history of concussion than children without ADHD. Children were recruited from schools across the United States, sampled to provide strong generalizability to the US population. The current sample included 10,585 children (age: mean = 9.9; standard deviation = 0.6; range 9-10 years; 48.9% girls; 64.6% White), including 1085 with ADHD and 9500 without ADHD. The prevalence of prior concussion among children with ADHD was 7.2% (95% CI: 6.6-7.8%) compared with 3.2% (3.1-3.3%) among children without ADHD, meaning current ADHD status was associated with twice the odds of experiencing a prior concussion [χ2 = 44.54; p < 0.001; odds ratio = 2.34 (1.81-3.03)]. No significant differences were observed in proportion of boys and girls with ADHD who had a prior concussion history. The number of current ADHD symptoms were not meaningfully associated with prior concussion history. Lower socioeconomic status was associated with lower rates of reported concussion, but not differentially in association with ADHD. ADHD is associated with twice the lifetime prevalence of prior concussion before age 11 among children from the general U.S. population. Boys and girls with ADHD did not differ in proportions with prior concussion and concussion history was not related to the number of ADHD symptoms reported by parents.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Concussão Encefálica , Adolescente , Atletas/psicologia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Concussão Encefálica/psicologia , Estudos de Casos e Controles , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Estados Unidos/epidemiologia
2.
PLoS One ; 17(8): e0272297, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35930583

RESUMO

The diagnosis of type 1 diabetes mellitus (DM) in humans is associated with high altitude, few sunshine hours, cold climate, and winter. The goals of this study were to investigate seasonal and geographic patterns of DM diagnosis in United States of America (USA) dogs with juvenile and mature onset DM. Data were collected by means of an online survey widely distributed in the USA through breed clubs, academic veterinary institutions, private veterinary referral practices, social media outlets, and the American Kennel Club. Juvenile DM (JDM) and mature onset DM were defined as DM with an age of onset <365 days and DM with an age of onset ≥365 days, respectively. Meteorological seasons were defined as: winter from December through February, spring from March through May, summer from June through August, and fall from September through November. Four geographic regions were also defined as the West, North, South, and Central regions of the USA. Nonoverlapping 95% confidence intervals (CI) for season, geographic region, and breed specific proportions of dogs with JDM were considered statistically significantly different. The study included 933 dogs with mature onset DM and 27 dogs with JDM. Dogs were diagnosed with DM significantly more in the winter and northern USA compared to all other seasons and all other geographic regions, respectively. The prevalence of JDM among dogs with DM was 2.8%. The proportion of dogs with JDM among pure breeds was not significantly different than the proportion of JDM in mixed breed dogs. It is concluded that winter and cold climate could be shared environmental factors influencing DM expression in dogs and humans. Additionally, pure breed dogs do not appear to be at increased risk for JDM compared to mixed breed dogs, indicating that factors other than genetics could influence spontaneous JDM development in dogs.


Assuntos
Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Animais , Cruzamento , Cães , Geografia , Humanos , Estações do Ano , Estados Unidos/epidemiologia
3.
PLoS One ; 17(8): e0272740, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35930603

RESUMO

Uninsured or underinsured individuals with cancer are likely to experience financial hardship, including forgoing healthcare or non-healthcare needs such as food, housing, or utilities. This study evaluates the association between health insurance coverage and financial hardship among cancer survivors during the COVID-19 pandemic. This cross-sectional analysis used Patient Advocate Foundation (PAF) survey data from May to July 2020. Cancer survivors who previously received case management or financial aid from PAF self-reported challenges paying for healthcare and non-healthcare needs during the COVID-19 pandemic. Associations between insurance coverage and payment challenges were estimated using Poisson regression with robust standard errors, which allowed for estimation of adjusted relative risks (aRR). Of 1,437 respondents, 74% had annual household incomes <$48,000. Most respondents were enrolled in Medicare (48%), 22% in employer-sponsored insurance, 13% in Medicaid, 6% in an Affordable Care Act (ACA) plan, and 3% were uninsured. Approximately 31% of respondents reported trouble paying for healthcare during the COVID-19 pandemic. Respondents who were uninsured (aRR 2.58, 95% confidence interval [CI] 1.83-3.64), enrolled in an ACA plan (aRR 1.86, 95% CI 1.28-2.72), employer-sponsored insurance (aRR 1.70, 95% CI 1.23-2.34), or Medicare (aRR 1.49, 95% CI 1.09-2.03) had higher risk of trouble paying for healthcare compared to Medicaid enrollees. Challenges paying for non-healthcare needs were reported by 57% of respondents, with 40% reporting trouble paying for food, 31% housing, 28% transportation, and 20% internet. In adjusted models, Medicare and employer-sponsored insurance enrollees were less likely to have difficulties paying for non-healthcare needs compared to Medicaid beneficiaries. Despite 97% of our cancer survivor sample being insured, 31% and 57% reported trouble paying for healthcare and non-healthcare needs during the COVID-19 pandemic, respectively. Greater attention to both medical and non-medical financial burden is needed given the economic pressures of the COVID-19 pandemic.


Assuntos
COVID-19 , Sobreviventes de Câncer , Neoplasias , Idoso , COVID-19/epidemiologia , Estudos Transversais , Estresse Financeiro/epidemiologia , Humanos , Cobertura do Seguro , Seguro Saúde , Pessoas sem Cobertura de Seguro de Saúde , Medicare , Neoplasias/epidemiologia , Pandemias , Patient Protection and Affordable Care Act , Estados Unidos/epidemiologia
4.
PLoS One ; 17(8): e0272809, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35930611

RESUMO

In the United States (U.S.), a hepatitis E virus (HEV) seroprevalence between 6 and 21% has been described, with a decreasing trend. We aimed to investigate HEV infection in the U.S. population from 2009 to 2016, and examine the differences in seroprevalence using different assays. We used data from the National Health and Nutrition Examination Survey (NHANES-CDC) to estimate HEV seroprevalence and analyze demographic variables related to the infection. Additionally, we compared 4 serological tests used. The estimated HEV seroprevalence between 2009-2016 was 6.1% (95% CI: 5.6%-7.0%) for IgG and 1.02% (0.8%-1.2%) for IgM. Higher HEV IgG prevalences were found in older people, females, non-Hispanic Asians and those born outside of the U.S. The in-house immunoassay and the Wantai HEV-IgG ELISA presented the highest sensitivity values in the tested population. The highest specificity values corresponded to the DSI-EIA-ANTI-HEV-IgG assay. The kappa statistical values showed concordances no greater than 0.64 between the assays. HEV prevalence in our study was similar to previously reported, and a decline in the prevalence was observed through the NHANES assessments (from 1988 to 2016). The sensitivity and specificity of the assays varied widely, making comparisons difficult and highlighting the need to develop a gold standard assay.


Assuntos
Vírus da Hepatite E , Hepatite E , Idoso , Feminino , Anticorpos Anti-Hepatite , Humanos , Imunoglobulina G , Imunoglobulina M , Inquéritos Nutricionais , Fatores de Risco , Estudos Soroepidemiológicos , Estados Unidos/epidemiologia
6.
Spat Spatiotemporal Epidemiol ; 42: 100522, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35934328

RESUMO

Preventive measures, health behaviors, environmental exposures, and sociodemographic characteristics affect individual-level cancer risks. It is unclear how they influence neighborhood-level cancer risks. We developed a large-scale neighborhood health dataset for 72,337 census tracts in the United States by combining data from three publicly available sources. We used Bayesian additive regression trees to identify the most important predictors of tract-level cancer prevalence among adults (age ≥18 years), and examined their impact on cancer prevalence using partial dependence plots. The five most important census tract-level correlates of cancer prevalence were the proportion of population who were aged 65 years and older, had routine checkup and were non-Hispanic White, the proportion of houses built before 1960, and the proportion of population living below the poverty line. The identified predictors of neighborhood-level cancer prevalence may inform public health practitioners and policymakers to prioritize the improvement of environmental and neighborhood factors in reducing the cancer burden.


Assuntos
Setor Censitário , Neoplasias , Adulto , Teorema de Bayes , Humanos , Aprendizado de Máquina , Neoplasias/epidemiologia , Prevalência , Características de Residência , Fatores Socioeconômicos , Estados Unidos/epidemiologia
7.
Sleep ; 45(4)2022 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-35934503

RESUMO

STUDY OBJECTIVES: This study aims to examine associations between acculturative stress-defined as the psychological impact, or stress reaction, of adapting to a new cultural context-and self-reported sleep outcomes among Chinese and Korean immigrants in the United States. METHODS: In this cross-sectional study, acculturative stress was assessed using a 9-item scale, and sleep disturbance was measured using the 8-item scale. Sleep duration was self-reported. Poisson and linear regression analyses were conducted to examine the associations between acculturative stress, sleep disturbance, and sleep duration. RESULTS: Our sample consists of 400 participants (females: 52%, Chinese: 50%, Koreans: 50%, the mean of age = 58.4). 81.8% of them were classified as having no sleep disturbance, whereas 18.2% were classified as having sleep disturbance. Poisson models revealed that greater acculturative stress was associated with a higher prevalence of sleep disturbance (Prevalence Ratio (PR): 1.18, 95% confidence interval (CI): 1.06% to 1.31%). In linear models, a one-unit increase in acculturative stress was associated with 0.08 hr less sleep (p < .05). Interaction tests indicated effect modification for sleep disturbance by sex and ethnic identity: only women had a significant association between acculturative stress and sleep disturbance (PR: 1.30; 95% CI: 1.13 to 1.49), while the association was significant for individuals identifying as "very Asian" (PR: 1.21; 95% CI: 1.08 to 1.35), but not for those identifying as "mostly Asian" or "bicultural/western". CONCLUSIONS: If findings are replicated, we suggest developing intervention programs for Asian immigrants to minimize acculturative stress and bolster protective factors that decrease the risk for poor sleep outcomes.Information on Clinical Trial: Name: Screening To Prevent ColoRectal Cancer (STOP CRC) among At-Risk Asian American Primary Care Patients NCT Number: NCT03481296 URL: https://clinicaltrials.gov/ct2/show/NCT03481296?term=Sunmin+Lee&draw=2&rank=1.


Assuntos
Emigrantes e Imigrantes , Transtornos do Sono-Vigília , Aculturação , Americanos Asiáticos/psicologia , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Autorrelato , Transtornos do Sono-Vigília/epidemiologia , Estresse Psicológico/epidemiologia , Estados Unidos/epidemiologia
8.
JAMA ; 328(5): 460-471, 2022 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-35916842

RESUMO

Importance: Malaria is caused by protozoa parasites of the genus Plasmodium and is diagnosed in approximately 2000 people in the US each year who have returned from visiting regions with endemic malaria. The mortality rate from malaria is approximately 0.3% in the US and 0.26% worldwide. Observations: In the US, most malaria is diagnosed in people who traveled to an endemic region. More than 80% of people diagnosed with malaria in the US acquired the infection in Africa. Of the approximately 2000 people diagnosed with malaria in the US in 2017, an estimated 82.4% were adults and about 78.6% were Black or African American. Among US residents diagnosed with malaria, 71.7% had not taken malaria chemoprophylaxis during travel. In 2017 in the US, P falciparum was the species diagnosed in approximately 79% of patients, whereas P vivax was diagnosed in an estimated 11.2% of patients. In 2017 in the US, severe malaria, defined as vital organ involvement including shock, pulmonary edema, significant bleeding, seizures, impaired consciousness, and laboratory abnormalities such as kidney impairment, acidosis, anemia, or high parasitemia, occurred in approximately 14% of patients, and an estimated 0.3% of those receiving a diagnosis of malaria in the US died. P falciparum has developed resistance to chloroquine in most regions of the world, including Africa. First-line therapy for P falciparum malaria in the US is combination therapy that includes artemisinin. If P falciparum was acquired in a known chloroquine-sensitive region such as Haiti, chloroquine remains an alternative option. When artemisinin-based combination therapies are not available, atovaquone-proguanil or quinine plus clindamycin is used for chloroquine-resistant malaria. P vivax, P ovale, P malariae, and P knowlesi are typically chloroquine sensitive, and treatment with either artemisinin-based combination therapy or chloroquine for regions with chloroquine-susceptible infections for uncomplicated malaria is recommended. For severe malaria, intravenous artesunate is first-line therapy. Treatment of mild malaria due to a chloroquine-resistant parasite consists of a combination therapy that includes artemisinin or chloroquine for chloroquine-sensitive malaria. P vivax and P ovale require additional therapy with an 8-aminoquinoline to eradicate the liver stage. Several options exist for chemoprophylaxis and selection should be based on patient characteristics and preferences. Conclusions and Relevance: Approximately 2000 cases of malaria are diagnosed each year in the US, most commonly in travelers returning from visiting endemic areas. Prevention and treatment of malaria depend on the species and the drug sensitivity of parasites from the region of acquisition. Intravenous artesunate is first-line therapy for severe malaria.


Assuntos
Antimaláricos , Resistência a Medicamentos , Malária , Doença Relacionada a Viagens , Adulto , Antimaláricos/efeitos adversos , Antimaláricos/uso terapêutico , Artemisininas/efeitos adversos , Artemisininas/uso terapêutico , Artesunato/efeitos adversos , Artesunato/uso terapêutico , Cloroquina/efeitos adversos , Cloroquina/uso terapêutico , Humanos , Malária/diagnóstico , Malária/tratamento farmacológico , Malária/epidemiologia , Malária/prevenção & controle , Malária Falciparum/diagnóstico , Malária Falciparum/tratamento farmacológico , Malária Falciparum/epidemiologia , Malária Falciparum/prevenção & controle , Viagem/estatística & dados numéricos , Estados Unidos/epidemiologia
9.
MMWR Morb Mortal Wkly Rep ; 71(31): 993-999, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35925799

RESUMO

Post-COVID-19 (post-COVID) symptoms and conditions* are new, recurring, or ongoing health problems that occur 4 or more weeks after infection with SARS-CoV-2 (the virus that causes COVID-19). Previous studies have characterized and estimated the incidence of post-COVID conditions among adults (1,2), but data among children and adolescents are limited (3-8). Using a large medical claims database, CDC assessed nine potential post-COVID signs and symptoms (symptoms) and 15 potential post-COVID conditions among 781,419 U.S. children and adolescents aged 0-17 years with laboratory-confirmed COVID-19 (patients with COVID-19) compared with 2,344,257 U.S. children and adolescents without recognized COVID-19 (patients without COVID-19) during March 1, 2020-January 31, 2022. The analysis identified several symptoms and conditions with elevated adjusted hazard ratios among patients with COVID-19 (compared with those without). The highest hazard ratios were recorded for acute pulmonary embolism (adjusted hazard ratio [aHR] = 2.01), myocarditis and cardiomyopathy (1.99), venous thromboembolic event (1.87), acute and unspecified renal failure (1.32), and type 1 diabetes (1.23), all of which were rare or uncommon in this study population. Conversely, symptoms and conditions that were most common in this study population had lower aHRs (near or below 1.0). Patients with COVID-19 were less likely than were patients without to experience respiratory signs and symptoms, symptoms of mental conditions, muscle disorders, neurological conditions, anxiety and fear-related disorders, mood disorders, and sleeping disorders. COVID-19 prevention strategies, including vaccination for all eligible children and adolescents, are critical to prevent SARS-CoV-2 infection and subsequent illness, including post-COVID symptoms and conditions (9).


Assuntos
COVID-19 , Doenças do Sistema Nervoso , Adolescente , Adulto , COVID-19/epidemiologia , Criança , Humanos , Incidência , Laboratórios , SARS-CoV-2 , Estados Unidos/epidemiologia
10.
MMWR Morb Mortal Wkly Rep ; 71(31): 988-992, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35925807

RESUMO

The NVX-CoV2373 (Novavax) COVID-19 vaccine is a recombinant spike (rS) protein nanoparticle vaccine with Matrix-M adjuvant to protect against infection with SARS-CoV-2, the virus that causes COVID-19. On July 13, 2022, the Food and Drug Administration (FDA) issued Emergency Use Authorization (EUA) for the Novavax vaccine for primary COVID-19 immunization of unvaccinated adults aged ≥18 years, administered as 2 doses (5 µg rS and 50 µg Matrix-M adjuvant in each dose) 3 weeks apart (1). On July 19, 2022, the Advisory Committee on Immunization Practices (ACIP) issued an interim recommendation for use of the Novavax vaccine in persons aged ≥18 years for the prevention of COVID-19.* In the per-protocol† efficacy analysis, vaccine efficacy (VE) against reverse transcription-polymerase chain reaction (RT-PCR)-confirmed symptomatic COVID-19 was 89.6% (95% CI = 82.4%-93.8%). The Alpha variant (B.1.1.7) of SARS-CoV-2 was the predominant circulating variant during the period of case accrual for VE assessments. Cases of myocarditis or pericarditis were reported in temporal association with vaccination, suggesting a possible causal relationship. The ACIP recommendation for the use of the Novavax COVID-19 vaccine is interim and will be updated as additional information becomes available. The adjuvanted, protein subunit-based Novavax COVID-19 vaccine provides an additional option for unvaccinated adults, increasing flexibility for the public and for vaccine providers. Vaccination is important for protection against COVID-19.


Assuntos
COVID-19 , Vacinas , Adolescente , Adulto , Comitês Consultivos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Humanos , Imunização , SARS-CoV-2 , Estados Unidos/epidemiologia , Vacinação
11.
Am J Gastroenterol ; 117(8): 1324-1328, 2022 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-35926495

RESUMO

INTRODUCTION: Acetaminophen (APAP) toxicity is the main cause of acute liver failure in the United States. A prior series (1992-1995) identified 71 hospitalized adults with APAP toxicity through the International Statistical Classification of Disease and Related Health Problems, 9th revision (ICD-9) code at Parkland Hospital, Dallas, TX. METHODS: We used a laboratory database search of serum APAP levels from 2011 to 2015 to identify patients with APAP toxicity in the same hospital. RESULTS: We identified 140 patients hospitalized for APAP toxicity from 27,143 APAP levels obtained; 35 required Intensive Care Unit (ICU) admission, and there were no deaths. APAP toxicity/100,000 admissions was similar between eras. DISCUSSION: APAP toxicity continues unabated after 20 years but with improved overall outcomes.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas , Overdose de Drogas , Falência Hepática Aguda , Acetaminofen , Adulto , Doença Hepática Induzida por Substâncias e Drogas/epidemiologia , Doença Hepática Induzida por Substâncias e Drogas/etiologia , Bases de Dados Factuais , Overdose de Drogas/epidemiologia , Hospitais de Condado , Humanos , Falência Hepática Aguda/induzido quimicamente , Falência Hepática Aguda/epidemiologia , Estados Unidos/epidemiologia
13.
Sci Rep ; 12(1): 13398, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927271

RESUMO

The widespread COVID-19 pandemic fundamentally changed many people's ways of life. With the necessity of social distancing and lock downs across the United States, evidence shows more people engage in outdoor activities. With the utilization of location-based service (LBS) data, we seek to explore how visitation patterns to national parks changed among communities of color during the COVID-19 pandemic. Our results show that visitation rates to national parks located closer than 347 km to individuals have increased amidst the pandemic, but the converse was demonstrated amongst parks located further than 347 km from individuals. More importantly, COVID-19 has adversely impacted visitation figures amongst non-white and Native American communities, with visitation volumes declining if these communities are situated further from national parks. Our results show disproportionately low-representations amongst national park visitors from these communities of color. African American communities display a particularly concerning trend whereby their visitation to national parks is substantially lower amongst communities closer to national parks.


Assuntos
COVID-19 , Telefone Celular , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Humanos , Pandemias , Parques Recreativos , Estados Unidos/epidemiologia
14.
Int J Equity Health ; 21(1): 105, 2022 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-35927667

RESUMO

Recent literature has suggested a link between poor air quality and worse COVID-19 outcomes. In the United States, this link is particularly noteworthy because of residential sorting along ethnic lines within the US population; minorities are disproportionately exposed to health hazards, including air pollution. The impacts of the COVID-19 pandemic have also been disproportionately concentrated amongst minorities. We explore the association between air quality and COVID-19 outcomes, using county level data for the United States from the first wave of the pandemic in 2020, and test whether exposure to more polluted air can account for some of the observed disparities in COVID-19 outcomes among minorities.


Assuntos
Poluição do Ar , COVID-19 , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , COVID-19/epidemiologia , Etnicidade , Humanos , Grupos Minoritários , Pandemias , Estados Unidos/epidemiologia
15.
Environ Health Perspect ; 130(8): 87003, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35921071

RESUMO

BACKGROUND: Studies of thunderstorm asthma to understand risk factors using high-resolution climate data and asthma outcomes on a large scale are scarce. Moreover, thunderstorm asthma is not well studied in the United States. OBJECTIVES: We examined whether climate parameters involved in thunderstorms are associated with emergency department (ED) visits for acute asthma attacks in the United States. METHODS: We analyzed 63,789 asthma-related, daily ED visits for all age groups, and thunderstorm-associated climate data in Louisiana during 2010 through 2012. We performed time-series analyses using quasi-Poisson regression models with natural cubic splines of date, parish, holiday, day of week, season, daily maximum concentrations of ozone (O3) and fine particulate matter [PM ≤2.5µm in aerodynamic diameter (PM2.5)], and daily mean pressure, precipitation, and temperature. Because of a significant interaction effect between temperature and lightning days on asthma-related visits, we performed stratified analyses by days with/without lightning or thunderstorm (defined by any lightning and precipitation). RESULTS: On thunderstorm days, higher asthma-related ED visits were associated with higher daily mean precipitation [relative risk (RR)=1.145 per 1 g/m2/s (95% CI: 1.009, 1.300)] and lower daily mean temperature [RR=1.011 per 1°C change (1.000-1.021)] without carry-over effect to the next non-thunderstorm day. These higher risks were found mainly among children and adults <65 years of age. We observed similar results on lightning days. However, we did not find similar associations for non-thunderstorm or non-lightning days. Daily maximum O3 and PM2.5 levels were not significantly associated with asthma ED visits on thunderstorm days. DISCUSSION: Higher precipitation and lower temperature on thunderstorm days appear to contribute to asthma attacks among people with asthma, suggesting they should consider taking precautions during thunderstorms. EDs should consider preparing for a potential increase of asthma-related visits and ensuring sufficient stock of emergency medication and supplies for forecasted severe thunderstorm days. https://doi.org/10.1289/EHP10440.


Assuntos
Poluentes Atmosféricos , Asma , Adulto , Poluentes Atmosféricos/análise , Asma/induzido quimicamente , Criança , Serviço Hospitalar de Emergência , Humanos , Material Particulado/análise , Temperatura , Estados Unidos/epidemiologia
16.
J Med Internet Res ; 24(8): e38776, 2022 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-35943771

RESUMO

BACKGROUND: The COVID-19 pandemic caused a critical public health crisis worldwide, and policymakers are using lockdowns to control the virus. However, there has been a noticeable increase in aggressive social behaviors that threaten social stability. Lockdown measures might negatively affect mental health and lead to an increase in aggressive emotions. Discovering the relationship between lockdown and increased aggression is crucial for formulating appropriate policies that address these adverse societal effects. We applied natural language processing (NLP) technology to internet data, so as to investigate the social and emotional impacts of lockdowns. OBJECTIVE: This research aimed to understand the relationship between lockdown and increased aggression using NLP technology to analyze the following 3 kinds of aggressive emotions: anger, offensive language, and hate speech, in spatiotemporal ranges of tweets in the United States. METHODS: We conducted a longitudinal internet study of 11,455 Twitter users by analyzing aggressive emotions in 1,281,362 tweets they posted from 2019 to 2020. We selected 3 common aggressive emotions (anger, offensive language, and hate speech) on the internet as the subject of analysis. To detect the emotions in the tweets, we trained a Bidirectional Encoder Representations from Transformers (BERT) model to analyze the percentage of aggressive tweets in every state and every week. Then, we used the difference-in-differences estimation to measure the impact of lockdown status on increasing aggressive tweets. Since most other independent factors that might affect the results, such as seasonal and regional factors, have been ruled out by time and state fixed effects, a significant result in this difference-in-differences analysis can not only indicate a concrete positive correlation but also point to a causal relationship. RESULTS: In the first 6 months of lockdown in 2020, aggression levels in all users increased compared to the same period in 2019. Notably, users under lockdown demonstrated greater levels of aggression than those not under lockdown. Our difference-in-differences estimation discovered a statistically significant positive correlation between lockdown and increased aggression (anger: P=.002, offensive language: P<.001, hate speech: P=.005). It can be inferred from such results that there exist causal relations. CONCLUSIONS: Understanding the relationship between lockdown and aggression can help policymakers address the personal and societal impacts of lockdown. Applying NLP technology and using big data on social media can provide crucial and timely information for this effort.


Assuntos
COVID-19 , Mídias Sociais , Agressão , COVID-19/prevenção & controle , Controle de Doenças Transmissíveis , Mineração de Dados/métodos , Humanos , Pandemias , Estados Unidos/epidemiologia
17.
Ann Fam Med ; 20(20 Suppl 1)2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35947449

RESUMO

Introduction: The prevalence of Intimate Partner Violence (IPV) continues to increase in the USA. IPV is a major risk factor for suicide and inflicts a substantial economic burden on the United States in terms of health care costs and reduced productivity. The increased racial disparity has been explained in terms of higher prevalence of traditional risk factors of suicide in the white population. Aim: To determine if race/ethnicity is an independent predictor of suicide risk among women with background of intimate partner violence. Method: We queried the National Inpatient Database NIS 2005-2015 using the ICD-9 diagnosis codes to extract data on IPV associated in the study period. We conducted a trend analysis to determine trends of IPV from 2005-2015. A multivariate regression was done to determine the predictors of suicides in the study cohort. Patients with background IPV who attempted suicide was compared with a propensity score generated control group controlling for age, gender, alcohol addiction, schizophrenia, obesity, insurance and median income. The primary outcome was racial disparity among the two groups. Results: There were a total of 18,769 IPV associated hospitalization in the NIS from 2005-2015. The prevalence of self-inflicted injury or suicide in the study population was 2.6%. This is higher than the average prevalence in the general population attesting to the increased prevalence of suicide among people with background IPV. The prevalence of IPV increased between 2000-2015, however, this remained stable at 20%: 80% among men and women with background IPV. Whites experienced suicides more than any other race/ethnicity, even after controlling for age, gender, alcohol addiction, schizophrenia, obesity, insurance and median income (OR=3.87; 95% CI 2.68-5.56, p < 0.05). Conclusion: The prevalence of IPV has continue to increase in the USA. The higher prevalence of suicides among whites with background IPV is independent of traditional risk factors.


Assuntos
Alcoolismo , Violência por Parceiro Íntimo , Feminino , Humanos , Masculino , Obesidade , Prevalência , Fatores de Risco , Estados Unidos/epidemiologia , Violência
18.
Ann Fam Med ; 20(20 Suppl 1)2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35947517

RESUMO

Context: There were 50,000 U.S. opioid overdose deaths in 2019. Millions suffer from opioid addiction. Identifying protective factors for low community opioid mortality may have important implications for addressing the opioid epidemic. This study was funded through the Virginia (VA) Department of Medical Assistance Services (DMAS) through a SUPPORT Act Grant. Objective: To identify "Bright Spot" communities in Virginia with protective factors associated with reduced opioid mortality and morbidity. Study Design: Ecologic study. Dataset: Virginia All Payer Claims Database (APCD), Virginia Department of Health (VDH) statewide medical examiner registry, and American Community Survey (ACS). Time Period: 2016-2019; 2019 data cited here. Population Studied: APCD includes VA residents with medical claims through commercial, Medicaid, and Medicare coverage. VDH data includes fatal drug overdoses. ACS surveys all VA residents. Outcome Measures: Primary outcome: fatal opioid overdoses. Secondary outcomes: emergency room visits for overdoses and opioid-related diagnoses, outpatient diagnoses for opioid-related disorder, prescription rate for opioids, and prescription rate for buprenorphine. Results: Opioid mortality was associated with higher rates of community poverty (r=.38, p<.0001) and disability (r=.52, r<.0001). Opioid mortality was associated with inequality, with higher Gini index associated with higher opioid mortality (r=.23, p<.0001). A higher percentage of black residents was associated with increased fatal opioid overdoses (r=.37, p<.0001) and ED visits for overdoses (r=.30, p<.0001). A higher percentage of white residents correlated with increased outpatient visits for opioid use disorder (r=.24, p<.0001) and higher rates of buprenorphine (r=.34, p<.0001) and opioid prescriptions (r=.31, p <.0001). Conclusions: These findings suggest significant racial disparities in opioid outcomes. Communities with a higher percentage of black residents are more likely to have higher opioid mortality and a lower rate of outpatient treatment. This association may be affected by the time period used in the analysis (2015-2019), as nationally there has been an increasing rate of synthetic opioid deaths in Black communities. These measures have been incorporated into a multivariate analysis to identify Bright Spot communities, which will be discussed during the presentation.


Assuntos
Buprenorfina , Overdose de Drogas , Overdose de Opiáceos , Transtornos Relacionados ao Uso de Opioides , Idoso , Analgésicos Opioides/uso terapêutico , Buprenorfina/uso terapêutico , Atenção à Saúde , Overdose de Drogas/epidemiologia , Humanos , Medicare , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Estados Unidos/epidemiologia , Recursos Humanos
19.
Natl Vital Stat Rep ; 71(1): 1-64, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35947823

RESUMO

Objectives-This report presents complete period life tables for the United States by Hispanic origin, race, and sex, based on age-specific death rates in 2020.


Assuntos
Hispânico ou Latino , Expectativa de Vida , Distribuição por Idade , Humanos , Lactente , Tábuas de Vida , Mortalidade , Distribuição por Sexo , Estados Unidos/epidemiologia
20.
Natl Vital Stat Rep ; 71(4): 1-20, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35947824

RESUMO

Objectives-This report presents 2020 fetal mortality data by maternal race and Hispanic origin, age, tobacco use during pregnancy, and state of residence, as well as by plurality, sex, gestational age, birthweight, and selected causes of death. Trends in fetal mortality are also examined.


Assuntos
Mortalidade Fetal , Hispânico ou Latino , Peso ao Nascer , Feminino , Idade Gestacional , Humanos , Gravidez , Gravidez Múltipla , Estados Unidos/epidemiologia
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