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Cerdá M, Hamilton AD, Hyder A, Rutherford C, Bobashev G, Epstein JM, Hatna E, Krawczyk N, El-Bassel N, Feaster DJ, Keyes KM. Simulating the Simultaneous Impact of Medication for Opioid Use Disorder and Naloxone on Opioid Overdose Death in Eight New York Counties. Epidemiology 2024; 35:418-429. [PMID: 38372618 DOI: 10.1097/ede.0000000000001703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND The United States is in the midst of an opioid overdose epidemic; 28.3 per 100,000 people died of opioid overdose in 2020. Simulation models can help understand and address this complex, dynamic, and nonlinear social phenomenon. Using the HEALing Communities Study, aimed at reducing opioid overdoses, and an agent-based model, Simulation of Community-Level Overdose Prevention Strategy, we simulated increases in buprenorphine initiation and retention and naloxone distribution aimed at reducing overdose deaths by 40% in New York Counties. METHODS Our simulations covered 2020-2022. The eight counties contrasted urban or rural and high and low baseline rates of opioid use disorder treatment. The model calibrated agent characteristics for opioid use and use disorder, treatments and treatment access, and fatal and nonfatal overdose. Modeled interventions included increased buprenorphine initiation and retention, and naloxone distribution. We predicted a decrease in the rate of fatal opioid overdose 1 year after intervention, given various modeled intervention scenarios. RESULTS Counties required unique combinations of modeled interventions to achieve a 40% reduction in overdose deaths. Assuming a 200% increase in naloxone from current levels, high baseline treatment counties achieved a 40% reduction in overdose deaths with a simultaneous 150% increase in buprenorphine initiation. In comparison, low baseline treatment counties required 250-300% increases in buprenorphine initiation coupled with 200-1000% increases in naloxone, depending on the county. CONCLUSIONS Results demonstrate the need for tailored county-level interventions to increase service utilization and reduce overdose deaths, as the modeled impact of interventions depended on the county's experience with past and current interventions.
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Affiliation(s)
- Magdalena Cerdá
- From the Department of Population Health, New York University School of Medicine, New York, NY
| | - Ava D Hamilton
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Ayaz Hyder
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Georgiy Bobashev
- Center for Data Science, RTI International, Research Triangle Park, NC
| | - Joshua M Epstein
- Department of Epidemiology, New York University School of Global Public Health, New York, NY
| | - Erez Hatna
- Department of Epidemiology, New York University School of Global Public Health, New York, NY
| | - Noa Krawczyk
- From the Department of Population Health, New York University School of Medicine, New York, NY
| | | | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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Juster RP, Rutherford C, Keyes K, Hatzenbuehler ML. Associations Between Structural Stigma and Allostatic Load Among Sexual Minorities: Results From a Population-Based Study. Psychosom Med 2024; 86:157-168. [PMID: 38345315 DOI: 10.1097/psy.0000000000001289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
OBJECTIVE Structural forms of stigma and discrimination are associated with adverse health outcomes across numerous stigmatized groups, including lesbian, gay, and bisexual (LGB) individuals. However, the biological consequences of structural stigma among LGB populations are understudied. To begin to address this gap, we assessed associations between indicators of structural stigma (i.e., state-level policies) targeting LGB individuals and allostatic load (AL) indices representing physiological dysregulations. METHODS Pooled data from the continuous 2001-2014 National Health and Nutritional Examination Survey were analyzed (LGB: n = 864; heterosexual: n = 20,310). Ten state-level LGB-related policies (e.g., employment nondiscrimination protections, same-sex marriage) were used to operationalize structural stigma. A sex-specific AL index representing 11 immune, metabolic, and cardiovascular biomarkers was estimated. Multilevel models were used to examine associations between structural stigma and AL, net of nine individual-level characteristics (e.g., education, race/ethnicity, age, and health behaviors). RESULTS Sexual minority men living in states with low levels of structural stigma experienced significantly lower AL ( β = -0.45, p = .02) compared with sexual minority men living in states with high structural stigma (i.e., fewer protective policies). There was no significant association between structural stigma and AL among sexual minority women. CONCLUSIONS By demonstrating direct associations between structural stigma and indices of physiological dysregulation, our findings provide a mechanistic understanding of how the social environment can "get under the skin and skull" for sexual minority men in the United States. Future research should explore whether these mechanisms generalize to other marginalized groups exposed to structural stigma.
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Affiliation(s)
- Robert-Paul Juster
- From the Department of Psychiatry and Addiction (Juster), University of Montreal; Research Center of the Montreal Mental Health University Institute (Juster), Montreal, Quebec, Canada; Department of Epidemiology, Mailman School of Public Health, Columbia University (Rutherford, Keyes), New York, New York; and Department of Psychology, Harvard University (Hatzenbuehler), Cambridge, Massachusetts
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Keyes KM, Kandula S, Martinez-Ales G, Gimbrone C, Joseph V, Monnat S, Rutherford C, Olfson M, Gould M, Shaman J. Geographic Variation, Economic Activity, and Labor Market Characteristics in Trajectories of Suicide in the United States, 2008-2020. Am J Epidemiol 2024; 193:256-266. [PMID: 37846128 DOI: 10.1093/aje/kwad205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/05/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
Suicide rates in the United States have increased over the past 15 years, with substantial geographic variation in these increases; yet there have been few attempts to cluster counties by the magnitude of suicide rate changes according to intercept and slope or to identify the economic precursors of increases. We used vital statistics data and growth mixture models to identify clusters of counties by their magnitude of suicide growth from 2008 to 2020 and examined associations with county economic and labor indices. Our models identified 5 clusters, each differentiated by intercept and slope magnitude, with the highest-rate cluster (4% of counties) being observed mainly in sparsely populated areas in the West and Alaska, starting the time series at 25.4 suicides per 100,000 population, and exhibiting the steepest increase in slope (0.69/100,000/year). There was no cluster for which the suicide rate was stable or declining. Counties in the highest-rate cluster were more likely to have agricultural and service economies and less likely to have urban professional economies. Given the increased burden of suicide, with no clusters of counties improving over time, additional policy and prevention efforts are needed, particularly targeted at rural areas in the West.
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Palamar JJ, Fitzgerald ND, Carr TH, Rutherford C, Keyes KM, Cottler LB. National and regional trends in seizures of shrooms (psilocybin) in the United States, 2017-2022. Drug Alcohol Depend 2024:111086. [PMID: 38326175 DOI: 10.1016/j.drugalcdep.2024.111086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 11/17/2023] [Accepted: 12/23/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Psilocybin, the principle psychoactive component in "shrooms", is regaining acceptance in therapeutic settings, leading to media coverage of medical benefits associated with use. Possession is also becoming increasingly decriminalized throughout the United States. There is a lack of data on prevalence of shroom use, but trends in law enforcement seizure data can provide one indicator of shroom availability in US communities. We determined whether seizures of shrooms have shifted between 2017 and 2022. METHODS This study examined national and regional trends in counts and total weight of shroom seizures reported to High Intensity Drug Trafficking Areas in the US between 2017 and 2022 (N=4526). RESULTS There were 402 seizures in 2017 compared to 1396 in 2022 with the plurality occurring in the Midwest (36.0%), followed by the West (33.5%). Between 2017 Quarter 1 (Q1) and 2022 Quarter 4 (Q4), the number of seizures increased by 368.9% (AQPC=7.0; 95 CI: 5.9-8.1) and there were significant increases in all four regions. In terms of weight, 226.0kg was seized in 2017 vs. 844.0kg in 2022, and the greatest total weight in seizures was in the West (1864.2kg, 42.6%), followed by the South (1831.9kg, 41.8%). Between 2017 Q1 and 2022 Q4, the total weight seized in the US increased by 2749.7% (AQPC=6.2, 95% CI: 0.3-12.4) and there were significant increases in all four regions. CONCLUSIONS Seizures of shrooms have increased, suggesting that availability may be escalating; thus, increases in prevention efforts and harm reduction education are warranted.
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Affiliation(s)
- Joseph J Palamar
- NYU Grossman School of Medicine, Department of Population Health, New York, NY, USA.
| | - Nicole D Fitzgerald
- University of Florida, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, United States; NDEWS, University of Florida, USA
| | - Thomas H Carr
- Office of National Drug Control Policy, Washington-Baltimore High Intensity Drug Trafficking Areas Program; College of Public Affairs, Center for Drug Policy and Prevention, University of Baltimore, USA
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Linda B Cottler
- University of Florida, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, United States; NDEWS, University of Florida, USA
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Agrawal A, Romics L, Thekkinkattil D, Soliman M, Kaushik M, Barmpounakis P, Mortimer C, Courtney CA, Goyal A, Garreffa E, Carmichael A, Lane RA, Rutherford C, Kim B, Achuthan R, Pitsinis V, Goh S, Ray B, Grover K, Vidya R, Murphy J. 'PartBreCon' study. A UK multicentre retrospective cohort study to assess outcomes following PARTial BREast reCONstruction with chest wall perforator flaps. Breast 2023; 71:82-88. [PMID: 37544090 PMCID: PMC10430575 DOI: 10.1016/j.breast.2023.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 06/27/2023] [Accepted: 07/11/2023] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Partial breast reconstruction with a pedicled chest wall perforator flap (CWPF) enables breast conservation in a higher tumour: breast volume ratio scenario. Since there is limited evidence, this retrospective cohort study aimed to ascertain immediate (30-days) and medium-term (follow-up duration) surgical outcomes. METHODS STROBE-compliant protocol ascertained CWPF outcomes between March 2011-March 2021. UK centres known to perform CWPF were invited to participate if they performed at least 10 cases. Data were retrospectively collected, including patient demographics, tumour and treatment characteristics, and surgical and oncological outcomes. Statistical analysis (R™) included multivariable logistic regression and sensitivity analysis. RESULTS Across 15 centres, 507 patients with median age (54 years, IQR; 48-62), body mass index (25.4 kg/m2, IQR; 22.5-29), tumour size (26 mm, IQR; 18-35), and specimen weight (62 g, IQR; 40-92) had following flap types: LiCAP (54.1%, n = 273), MiCAP/AiCAP (19.6%, n = 99), LiCAP + LTAP (19.8%, n = 100) and TDAP (2.2%, n = 11). 30-days complication rates were in 12%: haematoma (4.3%, n = 22), wound infection (4.3%, n = 22), delayed wound healing (2.8%, n = 14) and flap loss (0.6%, n = 3; 1 full) leading to readmissions (2.6%, n = 13) and re-operations (2.6%, n = 13). Positive margins (n = 88, 17.7%) led to 15.9% (n = 79) re-excisions, including 7.5% (n = 37) at the planned 2nd of 2-stage surgery and 1.8% (n = 9) mastectomy. At median 23 months (IQR; 11-39) follow-up, there were 1.2% (n = 6) symmetrisations; recurrences: local (1%), regional/nodal (0.6%) and distant (3.2%). CONCLUSIONS This large multicentre cohort study demonstrates acceptable complication and margin re-excision rates. CWPF extends the range of breast conservation techniques. Further studies are required for long-term oncological outcomes.
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Affiliation(s)
- A Agrawal
- Cambridge University Hospitals, Cambridge, UK.
| | - L Romics
- New Victoria Hospital, Glasgow, UK.
| | | | - M Soliman
- Cambridge University Hospitals, Cambridge, UK; Mansoura University, Egypt.
| | - M Kaushik
- University Hospitals of Leicester NHS Trust, Leicester, UK.
| | - P Barmpounakis
- Department of Statistics, Athens University of Economics and Business, Athens, Greece.
| | | | | | - A Goyal
- Royal Derby Hospital, Derby, UK.
| | | | - A Carmichael
- University Hospital of Derby and Burton, Belvedere Road, Burton on Trent, UK.
| | - R A Lane
- Cambridge University Hospitals, Cambridge, UK.
| | | | - B Kim
- St. James's University Hospital, Leeds, UK.
| | - R Achuthan
- St. James's University Hospital, Leeds, UK.
| | | | - S Goh
- Peterborough Hospital, Peterborough, UK.
| | - B Ray
- Harrogate NHS Trust, Harrogate, UK.
| | | | - R Vidya
- Royal Wolverhampton NHS Trust, Wolverhampton, UK.
| | - J Murphy
- Manchester University Hospital, Manchester, UK.
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Hickie C, Rice L, McNally S, Rutherford C. Breast implant rupture mimicking BIA-ALCL. Ir Med J 2023; 116:841. [PMID: 37791844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
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Ananth CV, Rutherford C, Rosenfeld EB, Brandt JS, Graham H, Kostis WJ, Keyes KM. Epidemiologic trends and risk factors associated with the decline in mortality from coronary heart disease in the United States, 1990-2019. Am Heart J 2023; 263:46-55. [PMID: 37178994 DOI: 10.1016/j.ahj.2023.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 05/06/2023] [Accepted: 05/08/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND Despite the decline in the rate of coronary heart disease (CHD) mortality, it is unknown how the 3 strong and modifiable risk factors - alcohol, smoking, and obesity -have impacted these trends. We examine changes in CHD mortality rates in the United States and estimate the preventable fraction of CHD deaths by eliminating CHD risk factors. METHODS We performed a sequential time-series analysis to examine mortality trends among females and males aged 25 to 84 years in the United States, 1990-2019, with CHD recorded as the underlying cause of death. We also examined mortality rates from chronic ischemic heart disease (IHD), acute myocardial infarction (AMI), and atherosclerotic heart disease (AHD). All underlying causes of CHD deaths were classified based on the International Classification of Disease 9th and 10th revisions. We estimated the preventable fraction of CHD deaths attributable to alcohol, smoking, and high body-mass index (BMI) through the Global Burden of Disease. RESULTS Among females (3,452,043 CHD deaths; mean [standard deviation, SD] age 49.3 [15.7] years), the age-standardized CHD mortality rate declined from 210.5 in 1990 to 66.8 per 100,000 in 2019 (annual change -4.04%, 95% CI -4.05, -4.03; incidence rate ratio [IRR] 0.32, 95% CI, 0.41, 0.43). Among males (5,572,629 CHD deaths; mean [SD] age 47.9 [15.1] years), the age-standardized CHD mortality rate declined from 442.4 to 156.7 per 100,000 (annual change -3.74%, 95% CI, -3.75, -3.74; IRR 0.36, 95% CI, 0.35, 0.37). A slowing of the decline in CHD mortality rates among younger cohorts was evident. Correction for unmeasured confounders through a quantitative bias analysis slightly attenuated the decline. Half of all CHD deaths could have been prevented with the elimination of smoking, alcohol, and obesity, including 1,726,022 female and 2,897,767 male CHD deaths between 1990 and 2019. CONCLUSIONS The decline in CHD mortality is slowing among younger cohorts. The complex dynamics of risk factors appear to shape mortality rates, underscoring the importance of targeted strategies to reduce modifiable risk factors that contribute to CHD mortality.
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Affiliation(s)
- Cande V Ananth
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Cardiovascular Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, NJ.
| | - Caroline Rutherford
- Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY
| | - Emily B Rosenfeld
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Justin S Brandt
- Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Hillary Graham
- Division of Epidemiology and Biostatistics, Department of Obstetrics, Gynecology, and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Clinical Epidemiology Division, Faculty of Medicine at Solna, Karolinska Institute, Stockholm, Sweden
| | - William J Kostis
- Cardiovascular Institute of New Jersey, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ; Department of Medicine, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Katherine M Keyes
- Department of Epidemiology, Joseph L. Mailman School of Public Health, Columbia University, New York, NY
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Palamar JJ, Rutherford C, Le A, Keyes KM. Seasonal Variation of Use of Common Psychedelics and Party Drugs Among Nightclub/Festival Attendees in New York City. J Psychoactive Drugs 2023:1-8. [PMID: 37605471 PMCID: PMC10879452 DOI: 10.1080/02791072.2023.2240322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 06/29/2023] [Indexed: 08/23/2023]
Abstract
Few epidemiological studies have focused on seasonal variation in the use of common psychedelics and party drugs among nightclub and festival attendees, typically those who attend electronic dance music (EDM) events. We sought to determine whether the use of different drug types varies seasonally within this population. Across 15 seasons from summer 2017 through fall 2022, we surveyed 3,935 adults entering randomly selected nightclubs and festivals in New York City regarding their past-month use of cocaine, MDMA (3,4-methylenedioxymethamphetamine, commonly known as ecstasy), lysergic acid diethylamide (LSD), psilocybin (shrooms), and ketamine. Multivariable models were used to compare adjusted odds ratios for drug use within each season with the grand mean of combined seasons. Summer was associated with higher odds for use of LSD (aOR 2.72; 95% CI, 1.88-3.93) and psilocybin (aOR 1.65; CI, 1.12-2.43), independent of increases in psilocybin use over time (p < .001). A significant increase in use of ketamine (p = .014) and significant decreases in use of cocaine (p = .002) and ecstasy (p = .002) were found across time, but multivariable models did not detect seasonal variations. Summer is a risk factor for use of common psychedelics among people who attend EDM events. Therefore, the summer months may be the best time to disseminate information about harm reduction for psychedelic drug users.
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Affiliation(s)
- Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY
| | - Caroline Rutherford
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY
| | - Austin Le
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, New York, NY
- New York University College of Dentistry, New York, NY
| | - Katherine M. Keyes
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY
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Abstract
This cross-sectional study evaluates trends in the number and weight of illicit ketamine seizures in the US from 2017 to 2022.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York
| | | | - Thomas H. Carr
- Office of National Drug Control Policy, Washington-Baltimore High Intensity Drug Trafficking Areas Program, Baltimore, Maryland
- College of Public Affairs, Center for Drug Policy and Prevention, University of Baltimore, Baltimore, Maryland
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Linda B. Cottler
- Department of Epidemiology, College of Public Health and Health Professions, College of Medicine National Drug Early Warning System, University of Florida, Gainesville
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Kandula S, Martinez-Alés G, Rutherford C, Gimbrone C, Olfson M, Gould MS, Keyes KM, Shaman J. County-level estimates of suicide mortality in the USA: a modelling study. Lancet Public Health 2023; 8:e184-e193. [PMID: 36702142 PMCID: PMC9990589 DOI: 10.1016/s2468-2667(22)00290-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/11/2022] [Accepted: 10/31/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Suicide is one of the leading causes of death in the USA and population risk prediction models can inform decisions on the type, location, and timing of public health interventions. We aimed to develop a prediction model to estimate county-level suicide risk in the USA using population characteristics. METHODS We obtained data on all deaths by suicide reported to the National Vital Statistics System between Jan 1, 2005, and Dec 31, 2019, and age, sex, race, and county of residence of the decedents were extracted to calculate baseline risk. We also obtained county-level annual measures of socioeconomic predictors of suicide risk (unemployment, weekly wage, poverty prevalence, median household income, and population density) and state-level prevalence of major depressive disorder and firearm ownership from US public sources. We applied conditional autoregressive models, which account for spatiotemporal autocorrelation in response and predictors, to estimate county-level suicide risk. FINDINGS Estimates derived from conditional autoregressive models were more accurate than from models not adjusted for spatiotemporal autocorrelation. Inclusion of suicide risk and protective covariates further reduced errors. Suicide risk was estimated to increase with each SD increase in firearm ownership (2·8% [95% credible interval (CrI) 1·8 to 3·9]), prevalence of major depressive episode (1·0% [0·4 to 1·5]), and unemployment rate (2·8% [1·9 to 3·8]). Conversely, risk was estimated to decrease by 4·3% (-5·1 to -3·2) for each SD increase in median household income and by 4·3% (-5·8 to -2·5) for each SD increase in population density. An increase in the heterogeneity in county-specific suicide risk was also observed during the study period. INTERPRETATION Area-level characteristics and the conditional autoregressive models can estimate population-level suicide risk. Availability of near real-time situational data are necessary for the translation of these models into a surveillance setting. Monitoring changes in population-level risk of suicide could help public health agencies select and deploy targeted interventions quickly. FUNDING US National Institute of Mental Health.
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Affiliation(s)
- Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA.
| | - Gonzalo Martinez-Alés
- Department of Epidemiology, Columbia University, New York, NY, USA; CAUSALab, Harvard T H Chan School of Public Health, Boston, MA, USA; Mental Health Network Biomedical Research Center, Madrid, Spain; Mental Health Research Group, Hospital La Paz Institute for Health Research, Madrid, Spain
| | | | | | - Mark Olfson
- Department of Epidemiology, Columbia University, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA
| | - Madelyn S Gould
- Department of Epidemiology, Columbia University, New York, NY, USA; Department of Psychiatry, Columbia University, New York, NY, USA
| | | | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
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Palamar JJ, Le A, Rutherford C, Keyes KM. Exploring Potential Bellwethers for Drug-Related Mortality in the General Population: A Case for Sentinel Surveillance of Trends in Drug Use among Nightclub/Festival Attendees. Subst Use Misuse 2022; 58:188-197. [PMID: 36469638 PMCID: PMC9877192 DOI: 10.1080/10826084.2022.2151315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Background: Drug-related deaths in the US continue to increase. Sentinel surveillance of high-risk populations can provide early warning for shifts in trends. Nightclub/festival attendees have high levels of drug use, so we explored whether use among this population can serve as a potential bellwether or indicator for use-related mortality in the general population.Methods: Trends in past-year cocaine and methamphetamine use were estimated from nightclub/festival attendees in New York City (NYC) and among NY residents, and trends were estimated for related death rates in NYC (2014/15-2019/20). Using national data from England and Wales (2010-2019), trends in past-year cocaine and ecstasy use (among the full population and among nightclub attendees) and related deaths were also estimated.Results: In NY/NYC, cocaine use remained stable in the general population, but use among nightclub/festival attendees and cocaine-related deaths doubled. Methamphetamine use among nightclub/festival attendees and death rates also more than doubled while use among the general population remained stable. In UK countries, increases in cocaine and ecstasy use were larger for infrequent/frequent nightclub attendees than in the general population, with 3.6- and 8-fold increases in related deaths, respectively. In UK countries, the association between nightclub attendance and death rates increased in a dose-response-like manner with larger associations detected when death rates were lagged by one year.Conclusions: Patterns of use among nightclub/festival attendees, more so than patterns in the general population, were similar to patterns of drug-related deaths. Use among this subpopulation could possibly serve as a bellwether for use-related outcomes. Continued surveillance is recommended.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Austin Le
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- New York University College of Dentistry, New York, NY, USA
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Platt JM, Pamplin JR, Gimbrone C, Rutherford C, Kandula S, Olfson M, Gould MS, Martínez-Alés G, Shaman J, Keyes K. Racial Disparities in Spatial and Temporal Youth Suicide Clusters. J Am Acad Child Adolesc Psychiatry 2022; 61:1131-1140.e5. [PMID: 35031449 PMCID: PMC9271532 DOI: 10.1016/j.jaac.2021.12.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Deaths by suicide correlate both spatially and temporally, leading to suicide clusters. This study aimed to estimate racial patterns in suicide clusters since 2000. METHOD Data from the US National Vital Statistics System included all International Classification of Diseases, Tenth Revision (ICD-10)-coded suicide cases from 2000-2019 among American Indian/Alaska Native (AI/AN), Asian/Pacific Islander (A/PI), Black, or White youth and young adults, aged 5-34 years. We estimated age, period, and cohort (APC) trends and identified spatiotemporal clusters using the SaTScan space-time statistic, which identified lower- and higher-than-expected suicide rates (cold and hot clusters) in a prespecified area (150 km) and time interval (15 months). We also calculated the average proportion of deaths by suicide contained in clusters, to quantify the relative importance of spatiotemporal patterning as a driver of overall suicide rates. RESULTS From 2010-2019, suicide rates increased from between 37% among AI/AN (95% CI = 1.22, 1.55) to 81% among A/PI (95% CI = 1.65, 2.01) groups. Suicide clusters accounted for 0.8%-10.3% of all suicide deaths, across racial groups. Since 2000, the likelihood of detecting cluster increased over time, with considerable differences in the number of clusters in each racial group (4 among AI/AN to 72 among White youth). Among Black youth and young adults, 27 total clusters were identified. Hot clusters were concentrated in southeastern and mid-Atlantic counties. CONCLUSION Suicide rates and clusters in youth and young adults have increased in the past 2 decades, requiring attention from policy makers, clinicians, and caretakers. Racially distinct patterns highlight opportunities to tailor individual- and population-level prevention efforts to prevent suicide deaths in emerging high-risk groups.
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Affiliation(s)
| | - John R Pamplin
- Center for Urban Science and Progress, New York University, New York; Grossman School of Medicine, New York University, New York
| | | | | | | | - Mark Olfson
- Mailman School of Public Health, Columbia University, New York; Columbia University Irving Medical Center and New York State Psychiatric Institute, New York
| | - Madelyn S Gould
- Mailman School of Public Health, Columbia University, New York; Columbia University Irving Medical Center and New York State Psychiatric Institute, New York
| | | | - Jeffrey Shaman
- Mailman School of Public Health, Columbia University, New York
| | - Katherine Keyes
- Mailman School of Public Health, Columbia University, New York
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13
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Hardwick E, Rutherford C, Johnson L, Oezdogan Y. 773 Standardising Autologous Breast Reconstruction Referrals – a Quality Improvement Project. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Aim
Autologous breast reconstruction should be discussed with all suitable patients undergoing mastectomy, reinforced by the most recent Oncoplastic guidelines. This generates a large volume of referrals to the Plastics team, which are variable in content, and may neglect pertinent information. The aim of this project was to prospectively audit the quality of plastics referrals prior to the introduction of a standardised proforma with the aim of streamlining the patient pathway.
Method
A prospective audit of 19 consecutive referrals for autologous breast reconstruction was performed in December 2021 in a single centre. Referrals were assessed for the following essential data: immediate or delayed surgery, BMI, smoking status, neoadjuvant chemotherapy, and planned adjuvant treatment, specifically chemoradiotherapy.
Results
Immediate or delayed reconstruction status was reported in 18 (94.7%) of referrals made. Neoadjuvant chemotherapy was mentioned in 13 (68.4%) referrals. Plans for likely adjuvant treatment, including radiotherapy was mentioned in 15 (78.9%) referrals. Co-morbidities were reported in 6 (31.6%) referrals. Only 2 (10.5%) referrals reported on BMI and 4 (21.1%) on smoking status.
Conclusion
There is significant variability in the detail and quality of referrals for autologous breast reconstruction. Consequently, a standardised proforma was introduced to the unit which was presented at the Trust Audit Day. The proforma information was felt to be crucial in assessing the patient's appropriateness for surgery and its timing. This referral was introduced as an online tick-box form sent to a shared Plastics email. This has since been widely adopted allowing for efficient time-saving referrals with relevant information included.
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Affiliation(s)
- E Hardwick
- Barts and The London School of Medicine and Dentistry , London , United Kingdom
| | - C Rutherford
- St Bartholomew's Hospital, Barts NHS Trust , London , United Kingdom
| | - L Johnson
- St Bartholomew's Hospital, Barts NHS Trust , London , United Kingdom
| | - Y Oezdogan
- Royal London Hospital, Barts NHS Trust , London , United Kingdom
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14
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Keyes KM, Rutherford C, Smith GS. Alcohol-Induced Death in the USA from 1999 to 2020: a Comparison of Age–Period–Cohort Methods. CURR EPIDEMIOL REP 2022. [DOI: 10.1007/s40471-022-00300-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Martínez-Alés G, Gimbrone C, Rutherford C, Keyes K, López-Cuadrado T. Role of Foreign-Born Status on Suicide Mortality in Spain Between 2000 and 2019: An Age-Period-Cohort Analysis. Int J Public Health 2022; 67:1604538. [PMID: 35664647 PMCID: PMC9156625 DOI: 10.3389/ijph.2022.1604538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Accepted: 04/28/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: To examine recent age-period-cohort effects on suicide among foreign-born individuals, a particularly vulnerable sociodemographic group in Spain. Methods: Using 2000-2019 mortality data from Spain's National Institute of Statistics, we estimated age-period-cohort effects on suicide mortality, stratified by foreign-born status (native- vs. foreign-born) and, among the foreign-born, by Spanish citizenship status, a proxy for greater socioeconomic stability. Results: Annual suicide mortality rates were lower among foreign- than native-born individuals. There was heterogeneity in age-period-cohort effects between study groups. After 2010, suicide mortality increased markedly among the foreign-born-especially for female cohorts born around 1950, and slightly among native-born women-especially among female cohorts born after the 1960s. Among native-born men, suicide increased linearly with age and remained stable over time. Increases in suicide among the foreign-born were driven by increases among individuals without Spanish citizenship-especially among cohorts born after 1975. Conclusion: After 2010, suicide in Spain increased markedly among foreign-born individuals and slightly among native-born women, suggesting an association between the downstream effects of the 2008 economic recession and increases in suicide mortality among socioeconomically vulnerable populations.
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Affiliation(s)
- Gonzalo Martínez-Alés
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigacion Hospital Universitario La Paz (IdiPAZ), Madrid, Spain
| | - Catherine Gimbrone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Katherine Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Teresa López-Cuadrado
- National Centre of Epidemiology, Carlos III Health Institute (ISCIII), Madrid, Spain
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16
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Palamar JJ, Ciccarone D, Rutherford C, Keyes KM, Carr TH, Cottler LB. Trends in seizures of powders and pills containing illicit fentanyl in the United States, 2018 through 2021. Drug Alcohol Depend 2022; 234:109398. [PMID: 35370014 PMCID: PMC9027012 DOI: 10.1016/j.drugalcdep.2022.109398] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/03/2022] [Accepted: 03/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prevalence of fentanyl-laced counterfeit prescription pills has been increasing in the US, possibly placing a wider population at risk for unintentional exposure. We aimed to determine whether there have been shifts in the number of fentanyl seizures and in the form of fentanyl seized in the US. METHODS We examined quarterly national seizure data from High Intensity Drug Trafficking Areas to determine the number of drug seizures in the US containing fentanyl from January 2018 through December 2021. Generalized additive models were used to estimate trends in the number and weight of pill and powder seizures containing fentanyl. RESULTS There was an increase both in the number of fentanyl-containing powder seizures (from 424 in 2018 Quarter 1 [Q1] to 1539 in 2021 Quarter 4 [Q4], β = 0.94, p < 0.001) and in the number of pill seizures (from 68 to 635, β = 0.96, p < 0.01). The proportion of pills to total seizures more than doubled from 13.8% in 2018 Q1 to 29.2% in 2021 Q4 (β = 0.92, p < 0.001). Weight of powder fentanyl seizures increased from 298.2 kg in 2018 Q1 to 2416.0 kg in 2021 Q4 (β = 1.12, p = 0.01); the number of pills seized increased from 42,202 in 2018 Q1 to 2,089,186 in 2021 Q4 (β = 0.90, p < 0.001). CONCLUSIONS Seizures of drugs containing fentanyl have been increasing in the US. Given that over a quarter of fentanyl seizures are now in pill form, people who obtain counterfeit pills such as those disguised as oxycodone or alprazolam are at risk for unintentional exposure to fentanyl.
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Affiliation(s)
- Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, New York, NY, USA,Correspondence to: New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, Room 1752, New York, NY 10016, USA. (J.J. Palamar)
| | - Daniel Ciccarone
- University of California, San Francisco, Department of Family and Community Medicine, San Francisco, CA, USA
| | - Caroline Rutherford
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - Katherine M. Keyes
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY, USA
| | - Thomas H. Carr
- College of Public Affairs, Center for Drug Policy and Prevention, University of Baltimore, United States,Office of National Drug Control Policy, Washington, Baltimore High Intensity Drug Trafficking Areas Program, United States, Center for Drug Policy and Prevention, University of Baltimore, United States
| | - Linda B. Cottler
- NDEWS, University of Florida, United States,University of Florida, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, United States
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17
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Traore Y, Epstein J, Spitz E, March L, Maillefert JF, Rutherford C, Ricatte C, Alleyrat C, Cross M, King LK, Callahan LF, Fautrel B, Buttel T, Hawker G, Hunter DJ, Guillemin F. Development and validation of the Flare-OA questionnaire for measuring flare in knee and hip osteoarthritis. Osteoarthritis Cartilage 2022; 30:689-696. [PMID: 35066175 DOI: 10.1016/j.joca.2021.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 11/15/2021] [Accepted: 12/11/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Ability to assess flares in osteoarthritis (OA) of the knee and hip (KHOA) is important in clinical care and research. Using mixed methods, we developed a self-reported instrument measuring flare and assessed its psychometric properties. METHODS We constructed questionnaire items from semi-structured interviews and a focus group (patients, clinicians) by using a dual-language (English-French) approach. A Delphi consensus method was used to select the most relevant items. Patients with OA from Australia, France and the United States completed the preliminary Flare-OA, HOOS, KOOS and Mini-OAKHQOL questionnaires online. We used a factor analysis and content approach to reduce items and determine structural validity. We tested the resulting questionnaire (score 0-100) for internal consistency, convergent and known-groups validity. RESULTS Initially, 180 statements were generated and reduced to 33 items in five domains (response 0 = not at all, to 10 = absolutely) by Delphi consensus (50 patients, 116 professionals) and an expert meeting. After 398 patients (mean [SD] age 64 [8.5] years, 70.4% female, 86.7% knee OA) completed the questionnaire, it was reduced to 19 items by factor analysis and a content approach (RMSEA = 0.06; CFI = 0.96; TLI = 0.94). The Cronbach's alpha was >0.9 for the five domains and the whole questionnaire. Correlation coefficients between Flare-OA and other instrument scores were as predicted, supporting construct validity. The difference in Flare-OA score between patients with and without flare (31.8) largely exceeded 2 SEM (10.2). CONCLUSION Flare-OA is a valid and reliable patient-reported instrument for assessing the occurrence and severity of flare in patients with KHOA in clinical research.
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Affiliation(s)
- Y Traore
- Inserm, CHRUNancy, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - J Epstein
- Inserm, CHRUNancy, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France; Université de Lorraine, APEMAC - MICS, Nancy, France.
| | - E Spitz
- Université de Lorraine, APEMAC - EPSAM, Metz, France
| | - L March
- University of Sydney, Institute of Bone and Joint Research, Kolling Institute, And Royal North Shore Hospital, Rheumatology Department, Australia
| | - J-F Maillefert
- University Hospital, Department of Rheumatology, Dijon, France
| | - C Rutherford
- University of Sydney, Faculty of Science, School of Psychology, Sydney, Australia; University of Sydney, Faculty of Medicine and Health, Sydney Nursing School, Sydney, Australia
| | - C Ricatte
- Université de Lorraine, APEMAC - EPSAM, Metz, France
| | - C Alleyrat
- Inserm, CHRUNancy, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France
| | - M Cross
- University of Sydney, Institute of Bone and Joint Research, Kolling Institute, And Royal North Shore Hospital, Rheumatology Department, Australia
| | - L K King
- University of Toronto, Department of Medicine, Canada
| | - L F Callahan
- University of North Carolina, Thurston Arthritis Research Center, Chapel Hill, USA
| | - B Fautrel
- Sorbonne Université - Assistance Publique Hôpitaux de Paris, Rheumatology Dept, Pitié-Salpêtrière Hospital, Paris, France; Institut Pierre Louis d'Epidémiologie et Santé Publique, Inserm UMR-S 1136, Paris, France
| | - T Buttel
- University of Sydney, Institute of Bone and Joint Research, Kolling Institute, And Royal North Shore Hospital, Rheumatology Department, Australia; Inner West Psychology, Sydney, Australia
| | - G Hawker
- University of Toronto, Department of Medicine, Canada
| | - D J Hunter
- University of Sydney, Institute of Bone and Joint Research, Kolling Institute, And Royal North Shore Hospital, Rheumatology Department, Australia
| | - F Guillemin
- Inserm, CHRUNancy, Université de Lorraine, CIC 1433 Clinical Epidemiology, Nancy, France; Université de Lorraine, APEMAC - MICS, Nancy, France
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18
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Palamar JJ, Rutherford C, Cleland CM, Keyes KM. Concerts, bars, parties, and raves: Differential risk for drug use among high school seniors according to venue attendance. Subst Abuse 2022; 43:785-791. [PMID: 35113010 PMCID: PMC8924769 DOI: 10.1080/08897077.2021.2010253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: Nightlife attendance is an established risk factor for drug use, but studies have not focused on adolescent general population samples or compared risk according to type(s) of venues attended. We examined whether attendance of various types of venues was associated with drug use. Methods: Data were examined from an annual nationally representative survey of high school seniors in the US (2014-2019, N = 11,565). We determined whether past-year attendance of parties, concerts, bars or nightclubs, and raves or dance music events was associated with past-year drug use using mixed-effects logistic regression. Mall and movie attendance were examined as negative controls. Results: Compared to those who reported not attending specific venues, attending parties was associated with higher odds of using alcohol in particular (aOR = 5.03, 95% CI: 3.92-6.44). Attending concerts was associated with higher odds for use of alcohol, cannabis, ecstasy, and nonmedical use of prescription stimulants and opioids. All drugs examined were concentrated among those who attend bars, nightclubs, raves, and dance parties. Rave or dance party attendance was associated with higher odds for use of ecstasy (aOR = 3.71, 95% CI: 2.50-5.50) and methamphetamine (aOR = 4.92, 95% CI: 2.43-9.96) in particular, and bar or nightclub attendance was associated with higher odds of use of cocaine (aOR = 6.49, 95% CI: 4.37-9.63), ecstasy (aOR = 6.49, 95% CI: 4.54-9.27), and methamphetamine (aOR = 5.49, 95% CI: 2.57-11.72) in particular. Attending movies was associated with lower odds for use of cocaine and nonmedical prescription stimulant use. Conclusion: We determined differential risk of drug use depending on types of venues attended by adolescents.
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Affiliation(s)
- Joseph J. Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA,Center for Drug Use and HIV/HCV Research, New York University School of Global Public Health, New York, NY, USA
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Charles M. Cleland
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA,Center for Drug Use and HIV/HCV Research, New York University School of Global Public Health, New York, NY, USA
| | - Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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19
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Gimbrone C, Rutherford C, Kandula S, Martínez-Alés G, Shaman J, Olfson M, Gould MS, Pei S, Galanti M, Keyes KM. Associations between COVID-19 mobility restrictions and economic, mental health, and suicide-related concerns in the US using cellular phone GPS and Google search volume data. PLoS One 2021; 16:e0260931. [PMID: 34936666 PMCID: PMC8694413 DOI: 10.1371/journal.pone.0260931] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 11/19/2021] [Indexed: 12/23/2022] Open
Abstract
During the COVID-19 pandemic, US populations have experienced elevated rates of financial and psychological distress that could lead to increases in suicide rates. Rapid ongoing mental health monitoring is critical for early intervention, especially in regions most affected by the pandemic, yet traditional surveillance data are available only after long lags. Novel information on real-time population isolation and concerns stemming from the pandemic's social and economic impacts, via cellular mobility tracking and online search data, are potentially important interim surveillance resources. Using these measures, we employed transfer function model time-series analyses to estimate associations between daily mobility indicators (proportion of cellular devices completely at home and time spent at home) and Google Health Trends search volumes for terms pertaining to economic stress, mental health, and suicide during 2020 and 2021 both nationally and in New York City. During the first pandemic wave in early-spring 2020, over 50% of devices remained completely at home and searches for economic stressors exceeded 60,000 per 10 million. We found large concurrent associations across analyses between declining mobility and increasing searches for economic stressor terms (national proportion of devices at home: cross-correlation coefficient (CC) = 0.6 (p-value <0.001)). Nationally, we also found strong associations between declining mobility and increasing mental health and suicide-related searches (time at home: mood/anxiety CC = 0.53 (<0.001), social stressor CC = 0.51 (<0.001), suicide seeking CC = 0.37 (0.006)). Our findings suggest that pandemic-related isolation coincided with acute economic distress and may be a risk factor for poor mental health and suicidal behavior. These emergent relationships warrant ongoing attention and causal assessment given the potential for long-term psychological impact and suicide death. As US populations continue to face stress, Google search data can be used to identify possible warning signs from real-time changes in distributions of population thought patterns.
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Affiliation(s)
- Catherine Gimbrone
- Department of Epidemiology, Columbia University, New York, NY, United States of America
| | - Caroline Rutherford
- Department of Epidemiology, Columbia University, New York, NY, United States of America
| | - Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY, United States of America
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University, New York, NY, United States of America
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY, United States of America
| | - Mark Olfson
- Department of Epidemiology, Columbia University, New York, NY, United States of America
- Department of Psychiatry, Columbia University, New York, NY, United States of America
| | - Madelyn S. Gould
- Department of Epidemiology, Columbia University, New York, NY, United States of America
- Department of Psychiatry, Columbia University, New York, NY, United States of America
| | - Sen Pei
- Department of Environmental Health Sciences, Columbia University, New York, NY, United States of America
| | - Marta Galanti
- Department of Environmental Health Sciences, Columbia University, New York, NY, United States of America
| | - Katherine M. Keyes
- Department of Epidemiology, Columbia University, New York, NY, United States of America
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20
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Martínez-Alés G, Gimbrone C, Rutherford C, Kandula S, Olfson M, Gould MS, Shaman J, Keyes KM. Role of Firearm Ownership on 2001-2016 Trends in U.S. Firearm Suicide Rates. Am J Prev Med 2021; 61:795-803. [PMID: 34420829 PMCID: PMC8608719 DOI: 10.1016/j.amepre.2021.05.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 05/17/2021] [Accepted: 05/20/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION In the U.S., state-level household firearm ownership is strongly associated with firearm suicide mortality rates. Whether the recent increases in firearm suicide are explained by state-level household firearm ownership rates and trends remains unknown. METHODS Mortality data from the U.S. National Vital Statistics System and an estimate of state-level household firearm ownership rate were used to conduct hierarchical age-period-cohort (random-effects) modeling of firearm suicide mortality between 2001 and 2016. Models were adjusted for individual-level race and sex and for state-level poverty rate, unemployment rate, median household income in U.S. dollars, population density, and elevation. RESULTS Between 2001 and 2016, the crude national firearm suicide mortality rate increased from 6.8 to 8.0 per 100,000, and household firearm ownership rate remained relatively stable, at around 40%. Both variables were markedly heterogeneous and correlated at the state level. Age-period-cohort models revealed period effects (affecting people across ages) and cohort effects (affecting specific birth cohorts) underlying the recent increases in firearm suicide. Individuals born after 2000 had higher firearm suicide rates than most cohorts born before. A 2001-2006 decreasing period effect was followed, after 2009, by an increasing period effect that peaked in 2015. State-level household firearm ownership rates and trends did not explain cohort effects and only minimally explained period effects. CONCLUSIONS State-level firearm ownership rates largely explain the state-level differences in firearm suicide but only marginally explain recent increases in firearm suicide. Although firearms in the home increase firearm suicide risk, the recent national rise in firearm suicide might be the result of broader, more distal causes of suicide risk.
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Affiliation(s)
- Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, New York; Department of Psychiatry, La Paz University Hospital, Madrid, Spain.
| | - Catherine Gimbrone
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, New York
| | - Caroline Rutherford
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, New York
| | - Sasikiran Kandula
- Department of Environmental Health Sciences (EHS), Columbia University Mailman School of Public Health, Columbia University, New York, New York
| | - Mark Olfson
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, New York; Department of Psychiatry, Columbia University, New York, New York
| | - Madelyn S Gould
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, New York; Department of Psychiatry, Columbia University, New York, New York
| | - Jeffrey Shaman
- Department of Environmental Health Sciences (EHS), Columbia University Mailman School of Public Health, Columbia University, New York, New York
| | - Katherine M Keyes
- Department of Epidemiology, Columbia University Mailman School of Public Health, Columbia University, New York, New York
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21
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Platt JM, Jager J, Patrick ME, Kloska D, Schulenberg J, Rutherford C, Keyes KM. Forecasting future prevalence and gender differences in binge drinking among young adults through 2040. Alcohol Clin Exp Res 2021; 45:2069-2079. [PMID: 34741556 DOI: 10.1111/acer.14690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/21/2021] [Accepted: 07/29/2021] [Indexed: 01/24/2023]
Abstract
BACKGROUND Binge drinking among adolescents and young adults has changed over time, but patterns differ by age and gender. Identifying high-risk groups to target future efforts at reducing drinking in this population remains a public health priority. Forecasting methods can provide a better understanding of variation and determinants of future binge drinking prevalence. METHODS We implemented regression-based forecasting models to estimate the prevalence and gender differences in binge drinking among cohort groups of U.S. young adults, ages 18, 23-24, and 29-30 through 2040. Forecasting models were adjusted for covariates accounting for changes in demographic, Big-5 social roles (e.g., residential independence), and drinking norms and related substance use, to understand the drivers of forecasted binge drinking estimates. RESULTS From the last observed cohort group (years varied by age) through 2040, unadjusted binge drinking prevalence was forecasted to decrease from 26% (95% CI: 20, 33%) (2011-15) to 11% (95% CI: 4, 27%) at age 18, decrease from 38% (95% CI: 30, 45%) (2006-2010) to 34% (95% CI: 18, 55%) at ages 23/24, and increase from 32% (95% CI: 25, 40%) (2001-2005) to 35% (95% CI: 16, 59%) at ages 29/30. Gender-stratified forecasts show a continuation in the narrowing of binge drinking prevalence between young men and women, though the magnitude of narrowing differs by age. Estimated trends were partially explained by changing norms regarding drinking and other substance use, though these indirect effects explained less of the total trend as age increased. CONCLUSIONS Understanding how covariates influence binge drinking trends can guide public health policies to leverage the most important determinants of future binge drinking to reduce the harm caused by binge drinking from adolescence to adulthood.
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22
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Abstract
Objectives. To determine whether there have been shifts in nonmedical ketamine use, poisonings ("exposures"), and seizures. Methods. We used generalized additive models to detect trends in past-year use (2006-2019), exposures (1991-2019), and seizures (2000-2019) involving ketamine in the United States. Results. There was a quarterly increase in self-reported past-year nonmedical ketamine use in 2006 to 2014 (Β = 0.21; P = .030) and an increase in 2015 to 2019 (Β = 0.29; P = .036), reaching a peak of 0.9% in late 2019. The rate of exposures increased from 1991 through 2019 (Β = 0.87; P = .006), and there was an increase to 1.1 exposures per 1 000 000 population in 2014, with rates remaining stable through 2019. The rate of ketamine seizures increased from 2000 through 2019 (Β = 2.27; P < .001), with seizures reaching a peak in 2019 at 3.2 per 1000 seizures. Conclusions. Indicators suggest that ketamine use and availability has increased, including before increased medical indications, but nonmedical use is still currently uncommon despite increased acceptance and media coverage. (Am J Public Health. 2021;111(11):2046-2049. https://doi.org/10.2105/AJPH.2021.306486).
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Affiliation(s)
- Joseph J Palamar
- Joseph J. Palamar is with the Department of Population Health, New York University Grossman School of Medicine, New York, NY. Caroline Rutherford and Katherine M. Keyes are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Caroline Rutherford
- Joseph J. Palamar is with the Department of Population Health, New York University Grossman School of Medicine, New York, NY. Caroline Rutherford and Katherine M. Keyes are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
| | - Katherine M Keyes
- Joseph J. Palamar is with the Department of Population Health, New York University Grossman School of Medicine, New York, NY. Caroline Rutherford and Katherine M. Keyes are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY
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23
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Langford E, Rutherford C, Sawyer S, Molinari M, Bagwell M, Van Horn L. Conducting the Nutrition Focused Physical Exam (NFPE) on Diverse Populations: Are Practice Guidelines Needed for RDNs? J Acad Nutr Diet 2021. [DOI: 10.1016/j.jand.2021.06.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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24
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Keyes KM, Platt J, Rutherford C, Patrick ME, Kloska DD, Schulenberg J, Jager J. Cohort effects on gender differences in alcohol use in the United States: How much is explained by changing attitudes towards women and gendered roles? SSM Popul Health 2021; 15:100919. [PMID: 34541283 PMCID: PMC8435695 DOI: 10.1016/j.ssmph.2021.100919] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 09/06/2021] [Accepted: 09/07/2021] [Indexed: 01/26/2023] Open
Abstract
Gender differences in binge drinking have converged in recent cohorts, due in part to faster decreases in consumption among boys in adolescence, and faster increases in consumption among women in young to middle adulthood. Changes in education and occupation explain a portion, but not all, of these differences; the present study examines how attitudes about gender, religion and family additionally explain cohort effects in binge drinking by sex. Data were drawn from the Monitoring the Future panel studies, including >54,000 participants who were high school seniors from 1976 through 2006, followed to age 29/30 from 1988 through 2016. The main effect relationship between cohort and binge drinking was assessed, and 28 items on gender, religion and family were evaluated to determine if mediation criteria were met; mediation models assessed direct and indirect effects. Results indicated that gender, religion and family attitudes and beliefs among US adults across the 20 th and 21 st centuries have shifted dramatically but not monotonically. US adolescents and adults have largely become less religious; some attitudes on women and family have become less conservative and some more. Among men, views on marriage showed the largest mediation effects; agreeing with the statement 'one partner is too restrictive' mediated 3.35% of the cohort effect (95% C.I. 2.42, 4.31) and 'couples should live together before they are married' mediated 1.6% of the cohort effect (95% C.I. -2.37, -0.8). Among women, declines in religious service attendance mediated 2.0% of cohort effects in binge drinking (95% C.I. -3.03, -1.09), as well as similar family attitudes as men. In conclusion, changes in social roles, as well as some gender, and religious views, partially mediate cohort effects on binge drinking for men and women. The dynamic changes in how adolescents and adults view family and gender are important components of alcohol epidemiology.
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Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jonathan Platt
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Megan E. Patrick
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Deborah D. Kloska
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - John Schulenberg
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, AZ, USA
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25
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Martínez-Alés G, Pamplin JR, Rutherford C, Gimbrone C, Kandula S, Olfson M, Gould MS, Shaman J, Keyes KM. Age, period, and cohort effects on suicide death in the United States from 1999 to 2018: moderation by sex, race, and firearm involvement. Mol Psychiatry 2021; 26:3374-3382. [PMID: 33828236 PMCID: PMC8670065 DOI: 10.1038/s41380-021-01078-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/09/2021] [Accepted: 03/24/2021] [Indexed: 12/31/2022]
Abstract
The role of sex, race, and suicide method on recent increases in suicide mortality in the United States remains unclear. Estimating the age, period, and cohort effects underlying suicide mortality trends can provide important insights for the causal hypothesis generating process. We generated updated age-period-cohort effect estimates of recent suicide mortality rates in the US, examining the putative roles of sex, race, and method for suicide, using data from all death certificates in the US between 1999 and 2018. After designating deaths as attributable to suicide according to ICD-10 underlying cause of death codes X60-X84, Y87.0, and U03, we (i) used hexagonal grids to describe rates of suicide by age, period, and cohort visually and (ii) modeled sex-, race-, and suicide method-specific age, period, and cohort effects. We found that, while suicide mortality increased in the US between 1999 and 2018 across age, sex, race, and suicide method, there was substantial heterogeneity in age and cohort effects by method, sex, and race, with a first peak of suicide risk in youth, a second peak in older ages-specific to male firearm suicide, and increased rates among younger cohorts of non-White individuals. Our findings should prompt discussion regarding age-specific clinical firearm safety interventions, drivers of minoritized populations' adverse early-life experiences, and racial differences in access to and quality of mental healthcare.
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Affiliation(s)
| | - John R Pamplin
- Center for Urban Science and Progress, New York University, New York, NY, USA
| | | | | | - Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Madelyn S Gould
- Department of Epidemiology, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
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26
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Guillemin F, Barcenilla-Wong A, Vitaloni M, Adarmouch L, Durüoz T, Epstein J, Sebbani M, Traore Y, Rutherford C, Cross M, Fautrel B, Buttel T, Hawker G, March L, Hunter D, Spitz E. Validité de contenu d’un questionnaire en plusieurs langues pour la mesure de l’arthrose du genou et de la hanche : développement du Flare-OA. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2021.04.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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27
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Guillemin F, Barcenilla-Wong A, Vitaloni M, Adarmouch L, Duruöz MT, Epstein J, Sebbani M, Traore Y, Rutherford C, Cross M, Fautrel B, Buttel T, Hawker GA, March L, Hunter D, Spitz E. POS0269-HPR CONTENT VALIDITY OF A MULTIPLE LANGUAGES QUESTIONNAIRE FOR MEASURING FLARE IN KNEE AND HIP OA: DEVELOPMENT OF THE FLARE-OA. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Flare in osteoarthritis (OA) of the knee and hip (KHOA) is an important outcome for patients’ daily life and clinical research. A definition of a flare was set, and a core set of domains was recently endorsed by OMERACT/OARSI. No patient reported outcome (PRO) yet focusses on flare in OA specifically.Objectives:To develop a self-reporting instrument measuring flare in 5 languages, using qualitative methods and international Delphi consensus.Methods:We generated items using a dual-language (English and French) approach involving patients with OA from Australia, France and the United States and health care professionals (HCP) from international societies (OARSI, SFR, OMERACT). Item generation relied on semi-structured individual interviews conducted with OA patients and HCP and one focus group with patients. Content analysis allowed for identifying verbatim statements that were meaningful for patients and HCP. A Delphi consensus method was used to select the most relevant items, according to core domains set (OMERACT). A cross-cultural approach using current guidelines (1) was applied to produce Spanish (in Spain), Turkish and classical Arabic (in Morocco) versions using independent translation and expert committee to preserve its content validity.Results:From semi-structured interviews with 29 patients and 16 HCPs and one focus group with 10 patients, 180 statements in French (106) and English (77) were generated. Based on similarity or redundancy, 50 items with equivalent meaning in both languages were retained by an expert committee. After two Delphi rounds involving 50 patients and 116 HCPs from 17 countries on four continents, it was reduced to 33 items (response 0=not at all, to 10=absolutely) in five domains (pain, swelling, stiffness, consequences of symptoms and psychological aspects). This questionnaire was cross-culturally adapted into Spanish, Turkish and classical Arabic. The Spanish version uncovered one inappropriate item in the original questionnaire that was amended accordingly in all 5 languages.Conclusion:Flare is more than just an exacerbation of pain. The Flare-OA questionnaire includes all OMERACT recommended core domains. High content validity was seen in 2 original and 3 cross-culturally adapted languages. The Flare-OA should be considered as fit for purpose and evaluation of responsiveness in clinical studies in 5 languages.Disclosure of Interests:None declared
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28
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Traore Y, Epstein J, Spitz E, March L, Maillefert JF, Rutherford C, Ricatte C, Alleyrat C, Cross M, King L, Callahan L, Fautrel B, Buttel T, Hawker GA, Hunter D, Guillemin F. POS0270-HPR FLARE-OA QUESTIONNAIRE TO MEASURE FLARES IN OSTEOARTHRITIS OF THE KNEE AND HIP: ASSESSMENT OF ITS PSYCHOMETRIC PROPERTIES. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Hip and knee OA is characterised by disease flares – understanding the determinants and consequences of OA flares has been hampered by lack of a standardized flare measure beyond the pain aspect. The patients point of view on the different aspect of their flares is essential.Objectives:The objective was to assess the psychometric properties of a new questionnaire for measuring the multidimensional aspect of flares in OA.Methods:Using a bilingual version of the questionnaire (33 items, response on a numeric scale, from 0 to 10), a multicentre survey (Australia, France and United States) was conducted on line with patients diagnosed with OA of the hip and/or the knee. Based on an international OMERACT/OARSI endorsed definition of the five core domains (pain, swelling, stiffness, consequences of symptoms and psychological aspects) composing a flare in OA [1], a confirmatory factorial analysis linked to the content analysis has been used to reduce the number of items and to determine the validity of the structure. The Flare-OA questionnaire (score from 0 to 100) has been tested in French and English for its internal consistency, its convergent validity with HOOS/KOOS and Mini-OAKHQOL questionnaires, and its discriminant validity.Results:Out of 398 patients (mean age 64 years old) who completed the questionnaire, 70.4% were female and 86.7% had knee OA. The confirmatory factorial analysis retained a model with 19 items (RMSEA =0.06; SRMR =0.04; CFI =0.96 and TLI = 0.94). The Cronbach Alpha was > 0.9 for the 5 domains and for the whole questionnaire. The correlations between the Flare-OA and the other instruments were in line with that hypothesis flare is related but different from other concepts usually measured. The discriminant validity was evidenced by a significant score difference (31.8; p<0,0001) between patients with and without flare, i.e. over twice the standard measurement error.Conclusion:The optimized Flare-OA questionnaire (19 items) is a reliable and valid instrument freely available from the authors for measuring the frequency and severity of flare in knee and hip OA in clinical research.References:[1]King LK, Epstein J, Cross M, et al. Establishing the Domains of Knee and Hip Osteoarthritis (OA) Flare: A Report from the OMERACT 2020 Inaugural Virtual Consensus Vote from the Flares in OA Working Group. (Submitted)Disclosure of Interests:None declared
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29
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Mal-Sarkar T, Keyes K, Koen N, Barnett W, Myer L, Rutherford C, Zar HJ, Stein DJ, Lund C. The relationship between childhood trauma, socioeconomic status, and maternal depression among pregnant women in a South African birth cohort study. SSM Popul Health 2021; 14:100770. [PMID: 33855159 PMCID: PMC8025055 DOI: 10.1016/j.ssmph.2021.100770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 01/21/2023] Open
Abstract
Background Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression. Methods We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study: Mbekweni (N = 510) and TC Newman (N = 413). Data were collected from pregnant women between 28 and 32 weeks’ gestation. Results Associations between trauma and depressive symptoms differed by site (χ2=2163.6, df = 1419, p < 0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p < 0.01) and 0.47 in TC Newman (p < 0.01). Trauma was differentially associated with SES (Mbekweni: −0.10, p = 0.07; TC Newman: −0.05, p = 0.37) and SES with depression (Mbekweni: −0.18, p < 0.01; TC Newman: −0.02, p = 0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. −0.002-0.039) in Mbekweni and 0.001 (95% C.I. −0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni. Conclusion Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes. Childhood trauma and low socioeconomic status (SES) independently predict antenatal depression among a cohort of expecting women. The relationship between childhood trauma, SES, and antenatal depression differed by clinical site. These differential relationships may have been due to neighborhood effects on social determinants of mental health.
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Affiliation(s)
- Tatini Mal-Sarkar
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United States
| | - Katherine Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United States
| | - Nastassja Koen
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, 7925, South Africa.,South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South Africa
| | - Whitney Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.,South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, 7700, South Africa
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168thStreet, New York, NY, 10032, United States
| | - Heather J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa.,South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Klipfontein Road, Rondebosch, Cape Town, 7700, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Neuroscience Institute, Groote Schuur Hospital, Anzio Road, Observatory, Cape Town, 7925, South Africa.,South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, South Africa
| | - Crick Lund
- Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, 46 Sawkins Road, Rondebosch, Cape Town, 7700, South Africa.,King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, 18 de Crespigny Park, London, SE5 8AF, United Kingdom
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30
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Keyes KM, Kandula S, Olfson M, Gould MS, Martínez-Alés G, Rutherford C, Shaman J. Suicide and the agent-host-environment triad: leveraging surveillance sources to inform prevention. Psychol Med 2021; 51:529-537. [PMID: 33663629 PMCID: PMC8020492 DOI: 10.1017/s003329172000536x] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/14/2020] [Accepted: 01/06/2021] [Indexed: 12/11/2022]
Abstract
Suicide in the US has increased in the last decade, across virtually every age and demographic group. Parallel increases have occurred in non-fatal self-harm as well. Research on suicide across the world has consistently demonstrated that suicide shares many properties with a communicable disease, including person-to-person transmission and point-source outbreaks. This essay illustrates the communicable nature of suicide through analogy to basic infectious disease principles, including evidence for transmission and vulnerability through the agent-host-environment triad. We describe how mathematical modeling, a suite of epidemiological methods, which the COVID-19 pandemic has brought into renewed focus, can and should be applied to suicide in order to understand the dynamics of transmission and to forecast emerging risk areas. We describe how new and innovative sources of data, including social media and search engine data, can be used to augment traditional suicide surveillance, as well as the opportunities and challenges for modeling suicide as a communicable disease process in an effort to guide clinical and public health suicide prevention efforts.
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Affiliation(s)
| | - Sasikiran Kandula
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Mark Olfson
- Department of Epidemiology, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Madelyn S. Gould
- Department of Epidemiology, Columbia University, New York, NY, USA
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Gonzalo Martínez-Alés
- Department of Epidemiology, Columbia University, New York, NY, USA
- Universidad Autónoma de Madrid School of Medicine, Madrid, Spain
| | | | - Jeffrey Shaman
- Department of Environmental Health Sciences, Columbia University, New York, NY, USA
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31
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Traore Y, Epstein J, Spitz E, March L, Maillefert JF, Rutherford C, Ricatte C, Alleyrat C, Cross M, King L, Callahan L, Fautrel B, Buttel T, Hawker G, Hunter D, Guillemin F. Développement et validation du questionnaire Flare-OA pour la mesure d’une poussée d’arthrose du genou et de la hanche. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2020.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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32
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Palamar JJ, Salomone A, Rutherford C, Keyes KM. Extensive Underreported Exposure to Ketamine Among Electronic Dance Music Party Attendees. J Gen Intern Med 2021; 36:235-237. [PMID: 31997140 PMCID: PMC7858731 DOI: 10.1007/s11606-020-05672-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 12/12/2019] [Accepted: 01/13/2020] [Indexed: 10/25/2022]
Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
| | - Alberto Salomone
- Dipartimento di Chimica, Università di Torino, Torino, Italy.,Centro Regionale Antidoping e di Tossicologia, Orbassano, TO, Italy
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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33
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Keyes KM, Jager J, Platt J, Rutherford C, Patrick ME, Kloska DD, Schulenberg J. When does attrition lead to biased estimates of alcohol consumption? Bias analysis for loss to follow-up in 30 longitudinal cohorts. Int J Methods Psychiatr Res 2020; 29:1-9. [PMID: 32656917 PMCID: PMC7723204 DOI: 10.1002/mpr.1842] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES Survey nonresponse has increased across decades, making the amount of attrition a focus in generating inferences from longitudinal data. Use of inverse probability weights [IPWs] and other statistical approaches are common, but residual bias remains a threat. Quantitative bias analysis for nonrandom attrition as an adjunct to IPW may yield more robust inference. METHODS Data were drawn from the Monitoring the Future panel studies [twelfth grade, base-year: 1976-2005; age 29/30 follow-up: 1987-2017, N = 73,298]. We then applied IPW imputation in increasing percentages, assuming varying risk differences [RDs] among nonresponders. Measurements included past-two-week binge drinking at base-year and every follow-up. Demographic and other correlates of binge drinking contributed to IPW estimation. RESULTS Attrition increased: 31.14%, base-year 1976; 61.33%, base-year 2005. The magnitude of bias depended not on attrition rate but on prevalence of binge drinking and RD among nonrespondents. The probable range of binge drinking among nonresponders was 12-45%. In every scenario, base-year and follow-up binge drinking were associated. The likely range of true RDs was 0.14 [95% CI: 0.11-0.17] to 0.28 [95% CI: 0.25-0.31]. CONCLUSIONS When attrition is present, the amount of attrition alone is insufficient to understand contribution to effect estimates. We recommend including bias analysis in longitudinal analyses.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Justin Jager
- School of Social and Family Dynamics, Arizona State University, Tempe, Arizona, USA
| | - Jonathan Platt
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Megan E Patrick
- Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, Minnesota, USA.,Institute of Child Development, University of Minnesota, Minneapolis, Minnesota, USA
| | - Deborah D Kloska
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - John Schulenberg
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA.,Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
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34
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Wiltink L, White K, King M, Rutherford C. PO-1079: Systematic review of colorectal/anal cancer guidelines: managing long-term symptoms and functioning. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01096-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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35
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Lechner A, Kottner J, Coleman S, Muir D, Beeckman D, Chaboyer W, Cuddigan J, Moore Z, Rutherford C, Schmitt J, Nixon J, Balzer K. Outcomes for Pressure Ulcer Trials (OUTPUTs) project: review and classification of outcomes reported in pressure ulcer prevention research. Br J Dermatol 2020; 184:617-626. [DOI: 10.1111/bjd.19304] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 12/13/2022]
Affiliation(s)
- A. Lechner
- Charité – Universitätsmedizin Berlin Department of Dermatology and Allergy Clinical Research Center for Hair and Skin Science Berlin Germany
| | - J. Kottner
- Charité – Universitätsmedizin Berlin Department of Dermatology and Allergy Clinical Research Center for Hair and Skin Science Berlin Germany
- University Centre for Nursing and Midwifery Ghent University Ghent Belgium
| | - S. Coleman
- Institute of Clinical Trials Research Clinical Trials Research Unit University of Leeds Leeds UK
| | - D. Muir
- Institute of Clinical Trials Research Clinical Trials Research Unit University of Leeds Leeds UK
| | - D. Beeckman
- University Centre for Nursing and Midwifery Ghent University Ghent Belgium
- School of Health Sciences, Nursing and Midwifery University of Surrey Guildford UK
- School of Nursing and Midwifery Royal College of Surgeons in Ireland Faculty of Medicine and Health Sciences Dublin Ireland
- School of Health Sciences Örebro University Örebro Sweden
| | - W. Chaboyer
- School of Nursing and Midwifery Menzies Health Institute Queensland Griffith University and Gold Coast Hospital and Health Service Southport QLD Australia
| | - J. Cuddigan
- University of Nebraska Medical Center College of Nursing Omaha NE USA
| | - Z. Moore
- Royal College of Surgeons in Ireland Dublin Ireland
- Monash University Melbourne VIC Australia
- Faculty of Medicine and Health Sciences Ghent University Ghent Belgium
- Lida Institute Shanghai China
- Cardiff University Cardiff UK
| | - C. Rutherford
- Faculty of Science Quality of Life Office School of Psychology University of Sydney Sydney NSW Australia
- Faculty of Medicine and Health Susan Wakil School of Nursing and Midwifery Cancer Nursing Research Unit (CNRU) University of Sydney Sydney NSW Australia
| | - J. Schmitt
- Centre for Evidence‐based Healthcare Medical Faculty Carl Gustav Carus Technical University Dresden Dresden Germany
| | - J. Nixon
- Institute of Clinical Trials Research Clinical Trials Research Unit University of Leeds Leeds UK
| | - K. Balzer
- Institute of Clinical Trials Research Clinical Trials Research Unit University of Leeds Leeds UK
- Institute for Social Medicine and Epidemiology Nursing Research Unit University of Lübeck Lübeck Germany
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Bradley C, McKeown C, Rutherford C, Downey D, Addy C, Caskey S. P149 A review of the clinical trajectory of adults with cystic fibrosis prescribed nebulised Aztreonam Lysine (Cayston™). J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30484-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wiltink LM, White K, King MT, Rutherford C. Systematic review of clinical practice guidelines for colorectal and anal cancer: the extent of recommendations for managing long-term symptoms and functional impairments. Support Care Cancer 2020; 28:2523-2532. [PMID: 32025805 PMCID: PMC7181546 DOI: 10.1007/s00520-020-05301-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/09/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Due to increasing numbers of colorectal and anal cancer survivors, more individuals are living with long-term symptoms after treatment. A systematic review was undertaken to assess the extent to which practice guidelines for colorectal and anal cancer provide recommendations for managing long-term symptoms and functioning impairments. METHODS Four electronic databases and websites of 30 international cancer societies were searched for clinical practice guidelines, consensus statements, or best practice recommendations for colorectal or anal cancer. Quality of included guidelines was evaluated with the Appraisal of Guidelines for Research & Evaluation II tool. Results were narratively summarized. RESULTS We included 51 guidelines or consensus statements. Recommendations for managing long-term symptoms or functioning impairments were reported in 13 guidelines (25.4%). All 13 recommend a healthy lifestyle, diet, body weight, and physical activity. The ASCO Colorectal Cancer Survivorship Care Guideline is the most comprehensive, including interventions targeting sexual and bowel function to pain and cognitive issues, and also highlights limited evidence for informing management strategies. Other guidelines recommend treating incontinence, chronic diarrhea, and distress, and stress the need for greater awareness for sexual dysfunction, survivorship clinics, and referrals to specific supportive care interventions. CONCLUSIONS Few clinical practice guidelines include recommendations for managing long-term symptoms and functioning impairments. It is unclear if this is due to limited evidence or absence of management strategies and interventions. Clear recommendations for managing long-term symptoms and functioning to help health professionals in supporting colorectal and anal cancer survivors are needed.
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Affiliation(s)
- Lisette M Wiltink
- School of Psychology, Quality of Life Office, Faculty of Science, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse C39Z, Sydney, NSW, 2006, Australia.
- Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit (CNRU), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
- Department of Radiation Oncology, Leiden University Medical Center, Leiden, Netherlands.
| | - K White
- Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit (CNRU), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - M T King
- School of Psychology, Quality of Life Office, Faculty of Science, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse C39Z, Sydney, NSW, 2006, Australia
| | - C Rutherford
- School of Psychology, Quality of Life Office, Faculty of Science, The University of Sydney, Level 6 North, Chris O'Brien Lifehouse C39Z, Sydney, NSW, 2006, Australia
- Susan Wakil School of Nursing and Midwifery, Cancer Nursing Research Unit (CNRU), Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Bradley C, Rutherford C, McParland C, Addy C, Downey D, McKeown C, Caskey S. WS03.3 A review of ursodeoxycholic acid prescribing in an adult cystic fibrosis population. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30179-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Rutherford C, Bradley C, McKeown C, Caskey S, Downey D, Addy C. P197 The effect of ivacaftor on clinical trajectory of adults with cystic fibrosis carrying a R117H mutation. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Affiliation(s)
- Joseph J Palamar
- Department of Population Health, New York University School of Medicine, New York, NY, 10016, USA.
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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Hatzenbuehler ML, Rutherford C, McKetta S, Prins SJ, Keyes KM. Structural stigma and all-cause mortality among sexual minorities: Differences by sexual behavior? Soc Sci Med 2020; 244:112463. [PMID: 31439269 PMCID: PMC6926145 DOI: 10.1016/j.socscimed.2019.112463] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 07/25/2019] [Accepted: 07/30/2019] [Indexed: 12/18/2022]
Abstract
Using updated data from the General Social Survey/National Death Index (GSS/NDI) study, we examined whether the relationship between structural stigma-measured by aggregating 4 items assessing prejudice towards homosexuality to the community level-and all-cause mortality is present among gay men/lesbian women. Our hypothesis is based on emerging evidence that indicators of structural stigma specific to homosexuality, such as those used in the GSS/NDI, uniquely predict health outcomes among this group. Because the GSS/NDI lacked an identity-based measure of sexual orientation, we tested our hypothesis by employing a strategy that has a relatively high degree of sensitivity and specificity for ascertaining individuals most likely to identify as gay or lesbian: restricting analyses to individuals who reported same-sex sexual partners in the past year. We compared this approach against an alternative strategy, which has weaker specificity for identifying gay men/lesbian women: restricting analyses to individuals who reported any lifetime same-sex sexual behaviors. After controlling for 6 individual-level factors and fixed effects of survey year, structural stigma was associated with mortality among individuals who reported past-year same-sex sexual partners (HR = 1.95, 95% CI: 1.14, 3.31). Further, there was a dose-response relationship with mortality in this group, such that those residing in communities in the highest quartile of structural stigma had the greatest mortality risk, controlling for these same factors (HR = 2.12, 95% CI: 1.03, 4.38). In sensitivity analyses, the effect size for structural stigma ranged from 1.54 to 2.30, indicating a consistent, but small-to-moderate, effect. In contrast, no association between structural stigma and mortality was observed among respondents who reported lifetime same-sex sexual partners, nor among those reporting only opposite-sex sexual partners. This analysis therefore delimits potential boundary conditions of the association between structural stigma related to same-sex sexuality and all-cause mortality, highlighting the conditions under which this association is (and is not) observed.
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Affiliation(s)
- Mark L Hatzenbuehler
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, 722 West 168th, Street, New York, NY 10032, USA.
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th, Street, New York, NY 10032, USA.
| | - Sarah McKetta
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th, Street, New York, NY 10032, USA.
| | - Seth J Prins
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th, Street, New York, NY 10032, USA.
| | - Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, 722 West 168th, Street, New York, NY 10032, USA.
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Keyes KM, Calvo E, Ornstein KA, Rutherford C, Fox MP, Staudinger UM, Fried LP. Alcohol Consumption in Later Life and Mortality in the United States: Results from 9 Waves of the Health and Retirement Study. Alcohol Clin Exp Res 2019; 43:1734-1746. [PMID: 31276233 DOI: 10.1111/acer.14125] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 06/04/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Alcohol consumption in later life has increased in the past decade, and the relationship between alcohol consumption and mortality is controversial. Recent studies suggest little, if any, health benefit to alcohol. Yet most rely on single-time point consumption assessments and minimal confounder adjustments. METHODS We report on 16 years of follow-up from the Health and Retirement Study (HRS) cohorts born 1931 to 1941 (N = 7,904, baseline mean age = 61, SD = 3.18). Respondents were queried about drinking frequency/quantity. Mortality was established via exit interviews and confirmed with the national death index. Time-varying confounders included but were not limited to household assets, smoking, body mass index, health/functioning, depression, chronic disease; time-invariant confounders included baseline age, education, sex, and race. RESULTS After adjustment, current abstainers had the highest risk of subsequent mortality, consistent with sick quitters, and moderate (men: HR = 0.74, 95% CI: 0.60 to 0.91; women: HR = 0.82, 95% CI: 0.63 to 1.07) drinking was associated with a lower mortality rate compared with occasional drinking, though smokers and men evidenced less of an inverse association. Quantitative bias analyses indicated that omitted confounders would need to be associated with ~4-fold increases in mortality rates for men and ~9-fold increases for women to change the results. CONCLUSIONS There are consistent associations between moderate/occasional drinking and lower mortality, though residual confounding remains a threat to validity. Continued efforts to conduct large-scale observational studies of alcohol consumption and mortality are needed to characterize the changing patterns of consumption in older age.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University, New York, New York.,Robert N. Butler Columbia Aging Center, Columbia University, New York, New York.,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Esteban Calvo
- Department of Epidemiology, Columbia University, New York, New York.,Robert N. Butler Columbia Aging Center, Columbia University, New York, New York.,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, New York, New York
| | | | - Matthew P Fox
- Departments of Epidemiology and Global Health, Boston University, Boston, Massachusetts
| | - Ursula M Staudinger
- Robert N. Butler Columbia Aging Center, Columbia University, New York, New York.,Department of Sociomedical Sciences, Columbia University, New York, New York
| | - Linda P Fried
- Department of Epidemiology, Columbia University, New York, New York.,Robert N. Butler Columbia Aging Center, Columbia University, New York, New York
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43
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Keyes KM, Jager J, Mal-Sarkar T, Patrick ME, Rutherford C, Hasin D. Is There a Recent Epidemic of Women's Drinking? A Critical Review of National Studies. Alcohol Clin Exp Res 2019; 43:1344-1359. [PMID: 31074877 DOI: 10.1111/acer.14082] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/02/2019] [Indexed: 12/17/2022]
Abstract
Alcohol consumption is increasing in the United States, as is alcohol-attributable mortality. Historically, men have had higher rates of alcohol consumption than women, though evidence for birth cohort effects on gender differences in alcohol consumption and alcohol-related harm suggests that gender differences may be diminishing. We review studies using U.S. national data that examined time trends in alcohol consumption and alcohol-related harm since 2008. Utilizing a historical-developmental perspective, here we synthesize and integrate the literature on birth cohort effects from varying developmental periods (i.e., adolescence, young adulthood, middle adulthood, and late adulthood), with a focus on gender differences in alcohol consumption. Findings suggest that recent trends in gender differences in alcohol outcomes are heterogeneous by developmental stage. Among adolescents and young adults, both males and females are rapidly decreasing alcohol consumption, binge and high-intensity drinking, and alcohol-related outcomes, with gender rates converging because males are decreasing consumption faster than females. This pattern does not hold among adults, however. In middle adulthood, consumption, binge drinking, and alcohol-related harms are increasing, driven largely by increases among women in their 30s and 40s. The trend of increases in consumption that are faster for women than for men appears to continue into older adult years (60 and older) across several studies. We conclude by addressing remaining gaps in the literature and offering directions for future research.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Columbia University, New York, New York.,Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Tempe, Arizona
| | | | - Megan E Patrick
- Institute for Translational Research in Children's Mental Health, University of Minnesota, Minneapolis, Minnesota
| | | | - Deborah Hasin
- Department of Epidemiology, Columbia University, New York, New York
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Keyes KM, Rutherford C, Miech R. Historical trends in the grade of onset and sequence of cigarette, alcohol, and marijuana use among adolescents from 1976-2016: Implications for "Gateway" patterns in adolescence. Drug Alcohol Depend 2019; 194:51-58. [PMID: 30399500 PMCID: PMC6390293 DOI: 10.1016/j.drugalcdep.2018.09.015] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/15/2018] [Accepted: 09/21/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION In the past decade, marijuana use prevalence among adolescents has remained relatively steady while cigarette and alcohol prevalence has declined. We examined historical trends in: average grade of onset of marijuana, alcohol, and cigarette use by 12th grade; proportion who try alcohol/cigarettes before first marijuana use, among those who use by 12th grade; and conditional probability of marijuana use by 12th grade after trying alcohol/cigarettes. METHODS Data were drawn from 40 yearly, cross-sectional surveys of 12th grade US adolescents. A subset of students (N = 246,050) were asked when they first used each substance. We reconstructed cohorts of substance use from grade-of-onset to determine sequence of drug use, as well as probability of marijuana use in the same or later grade. RESULTS Average grade of first alcohol and cigarette use by 12th grade increased across time; e.g., first cigarette increased from grade 7.9 in 1986 to 9.0 by 2016 (β=0.04, SE = 0.001, p < 0.01). The proportion of 12th grade adolescents who smoke cigarettes before marijuana fell below 50% in 2006. Each one-year increase was associated with 1.11 times increased odds of first cigarette in a grade after first marijuana (95% C.I. 1.11-1.12). Among those who initiate alcohol/cigarettes prior to marijuana by 12th grade, the probability of subsequent marijuana use is increasing. CONCLUSION Marijuana is increasingly the first substance in the sequence of adolescent drug use. Reducing adolescent smoking has been a remarkable achievement of the past 20 years; those who continue to smoke are at higher risk for progression to marijuana use.
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Affiliation(s)
- Katherine M. Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA,Center for Research on Society and Health, Universidad Mayor, Santiago, Chile
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Richard Miech
- Institute for Social Research, University of Michigan, Ann Arbor, MI
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Keyes KM, Rutherford C, Popham F, Martins SS, Gray L. How Healthy Are Survey Respondents Compared with the General Population?: Using Survey-linked Death Records to Compare Mortality Outcomes. Epidemiology 2018; 29:299-307. [PMID: 29389712 PMCID: PMC5794231 DOI: 10.1097/ede.0000000000000775] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 10/19/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND National surveys are used to capture US health trends and set clinical guidelines, yet the sampling frame often includes those in noninstitutional households, potentially missing those most vulnerable for poor health. Declining response rates in national surveys also represent a challenge, and existing inputs to survey weights have limitations. We compared mortality rates between those who respond to surveys and the general population over time. METHODS Survey respondents from 20 waves of the National Health Interview Survey from 1990 to 2009 who have been linked to death records through 31 December 2011 were included. For each cohort in the survey, we estimated their mortality rates along with that cohort's mortality rate in the census population using vital statistics records, and differences were examined using Poisson models. RESULTS In all years, survey respondents had lower mortality rates compared with the general population when data were both weighted and unweighted. Among men, survey respondents in the weighted sample had 0.86 (95% confidence interval = 0.853, 0.868) times the mortality rate of the general population (among women, RR = 0.887; 95% confidence interval, 0.879, 0.895). Differences in mortality are evident along all points of the life course. Differences have remained relatively stable over time. CONCLUSION Survey respondents have lower death rates than the general US population, suggesting that they are a systematically healthier source population. Incorporating nonhousehold samples and revised weighting strategies to account for sample frame exclusion and nonresponse may allow for more rigorous estimation of the US population's health.
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Affiliation(s)
- Katherine M. Keyes
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Psychiatry, Columbia University Medical Center, New York, NY; and MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Caroline Rutherford
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Psychiatry, Columbia University Medical Center, New York, NY; and MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Frank Popham
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Psychiatry, Columbia University Medical Center, New York, NY; and MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Silvia S. Martins
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Psychiatry, Columbia University Medical Center, New York, NY; and MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
| | - Linsay Gray
- From the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY; Department of Psychiatry, Columbia University Medical Center, New York, NY; and MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, United Kingdom
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Keyes KM, Gary DS, Beardslee J, Prins SJ, O’Malley PM, Rutherford C, Schulenberg J. Joint Effects of Age, Period, and Cohort on Conduct Problems Among American Adolescents From 1991 Through 2015. Am J Epidemiol 2018; 187:548-557. [PMID: 28679165 DOI: 10.1093/aje/kwx268] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 06/23/2017] [Indexed: 12/17/2022] Open
Abstract
Although arrest rates among juveniles have substantially decreased since the 1990s, US national trends in conduct problems are unknown. Population variation in conduct problems would imply changes in the social environment, which would include emergent or receding risk factors. In the present study, we separated age, period, and cohort effects on conduct problems using nationally representative surveys of 375,879 US students conducted annually (1991-2015). The summed score of 7 items measuring the frequency of conduct problems was the outcome. Conduct problems have decreased during the past 25 years among boys; the total amount of the decrease was approximately 0.4 standard deviations (P < 0.01), and by item prevalence, the total amount of the decrease was 8%-11%. Declines are best explained by period effects beginning approximately in 2008, and a declining cohort effect beginning among those born after 1992, which suggests not only declines in population levels, but more rapid declines among younger cohorts of boys. Trends were also consistent with age-period-cohort effects on evenings spent out, which suggest a possible mechanism. Conduct problems among girls were lower than boys and did not demonstrate trends across time. These changes may reflect the changing nature of adolescence toward less unsupervised interaction.
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Affiliation(s)
- Katherine M Keyes
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Dahsan S Gary
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Jordan Beardslee
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Seth J Prins
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, New York
| | - Patrick M O’Malley
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
| | - Caroline Rutherford
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - John Schulenberg
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan
- Department of Psychology and Center for Growth and Human Development, University of Michigan, Ann Arbor, Michigan
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Winters ZE, Afzal M, Rutherford C, Holzner B, Rumpold G, da Costa Vieira RA, Hartup S, Flitcroft K, Bjelic-Radisic V, Oberguggenberger A, Panouilleres M, Mani M, Catanuto G, Douek M, Kokan J, Sinai P, King MT, Spillane A, Snook K, Boyle F, French J, Elder E, Chalmers B, Kabir M, Campbell I, Wong A, Flay H, Scarlet J, Weis J, Giesler J, Bliem B, Nagele E, del Angelo N, Andrade V, Assump¸ão Garcia D, Bonnetain F, Kjelsberg M, William-Jones S, Fleet A, Hathaway S, Elliott J, Galea M, Dodge J, Chaudhy A, Williams R, Cook L, Sethi S, Turton P, Henson A, Gibb J, Bonomi R, Funnell S, Noren C, Ooi J, Cocks S, Dawson L, Patel H, Bailey L, Chatterjee S, Goulden K, Kirk S, Osborne W, Harter L, Sharif MA, Corcoran S, Smith J, Prasad R, Doran A, Power A, Devereux L, Cannon J, Latham S, Arora P, Ridgway S, Coulding M, Roberts R, Absar M, Hodgkiss T, Connolly K, Johnson J, Doyle K, Lunt N, Cooper M, Fuchs I, Peall L, Taylor L, Nicholson A. International validation of the European Organisation for Research and Treatment of Cancer QLQ-BRECON23 quality-of-life questionnaire for women undergoing breast reconstruction. Br J Surg 2017; 105:209-222. [PMID: 29116657 DOI: 10.1002/bjs.10656] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/02/2017] [Accepted: 06/23/2017] [Indexed: 11/12/2022]
Abstract
Abstract
Background
The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction.
Methods
The EORTC module development guidelines were followed. Patients were recruited from 28 centres in seven countries. A prospective cohort completed the QLQ-BRECON15 before mastectomy and the QLQ-BRECON24 at 4–8 months after reconstruction. The cross-sectional cohort completed the QLQ-BRECON24 at 1–5 years after reconstruction, and repeated this 2–8 weeks later (test–retest reliability). All participants completed debriefing questionnaires.
Results
A total of 438 patients were recruited, 234 in the prospective cohort and 204 in the cross-sectional cohort. A total of 414 reconstructions were immediate, with a comparable number of implants (176) and donor-site flaps (166). Control groups comprised patients who underwent two-stage implant procedures (72, 75 per cent) or delayed reconstruction (24, 25 per cent). Psychometric scale validity was supported by moderate to high item-own scale and item-total correlations (over 0·5). Questionnaire validity was confirmed by good scale-to-sample targeting, and computable scale scores exceeding 50 per cent, except nipple cosmesis (over 40 per cent). In known-group comparisons, QLQ-BRECON24 scales and items differentiated between patient groups defined by clinical criteria, such as type and timing of reconstruction, postmastectomy radiotherapy and surgical complications, with moderate effect sizes. Prospectively, sexuality and surgical side-effects scales showed significant responsiveness over time (P < 0·001). Scale reliability was supported by high Cronbach's α coefficients (over 0·7) and test–retest (intraclass correlation more than 0·8). One item (finding a well fitting bra) was excluded based on high floor/ceiling effects, poor test–retest and weak correlations in factor analysis (below 0·3), thus generating the QLQ-BRECON23 questionnaire.
Conclusion
The QLQ-BRECON23 is an internationally validated tool to be used alongside the EORTC QLQ-C30 (cancer) and QLQ-BR23 (breast cancer) questionnaires for evaluating quality of life and satisfaction after breast reconstruction.
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Affiliation(s)
- Z E Winters
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
- Surgical and Interventional Trials Unit, Division of Surgical Sciences, University College London, London, UK
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - M Afzal
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
| | - C Rutherford
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
| | - B Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - G Rumpold
- Department of Medical Psychology, Evaluation Software Development, Rum, Austria
| | | | - S Hartup
- St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - K Flitcroft
- Breast and Surgical Oncology, Poche Centre, University of Sydney, New South Wales, Australia
| | - V Bjelic-Radisic
- Department of Breast Surgery and Gynaecology, Medical University Graz, Graz, Austria
| | - A Oberguggenberger
- Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University of Innsbruck, Innsbruck, Austria
| | - M Panouilleres
- Department of Plastic Surgery, Besançon University Hospital, Besançon, France
| | - M Mani
- Department of Surgical Sciences, Plastic and Reconstructive Surgery, Uppsala University, Uppsala, Sweden
| | - G Catanuto
- Multidisciplinary Breast Care, Cannizzaro Hospital, Catania, Italy
| | - M Douek
- Department of Surgical Oncology, Guy's Hospital, London, London, UK
| | - J Kokan
- Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK
| | - P Sinai
- Breast Cancer Surgery Patient-Reported and Clinical Outcomes Research Group, University of Bristol, School of Clinical Sciences, Southmead Hospital, Bristol, UK
| | - M T King
- Quality of Life Office, School of Psychology, Faculty of Science, University of Sydney, New South Wales, Australia
- Sydney Medical School, Faculty of Medicine, University of Sydney, New South Wales, Australia
| | - A Spillane
- Poche Centre, Sydney, New South Wales, Australia
| | - K Snook
- Poche Centre, Sydney, New South Wales, Australia
| | - F Boyle
- Poche Centre, Sydney, New South Wales, Australia
| | - J French
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - E Elder
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - B Chalmers
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | - M Kabir
- The Crown Princess Mary Westmead Breast Cancer Centre and Specialist Services, Sydney, New South Wales, Australia
| | | | - A Wong
- Waikato Hospital, Hamilton, New Zealand
| | - H Flay
- Waikato Hospital, Hamilton, New Zealand
| | - J Scarlet
- Waikato Hospital, Hamilton, New Zealand
| | - J Weis
- University of Freiburg, Freiberg, Germany
| | - J Giesler
- University of Freiburg, Freiberg, Germany
| | - B Bliem
- Medical University Graz, Graz, Austria
| | - E Nagele
- Medical University Graz, Graz, Austria
| | | | - V Andrade
- Barretos Cancer Hospital, Sao Paolo, Brazil
| | | | - F Bonnetain
- Besançon University Hospital, Besançon, France
| | | | - S William-Jones
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - A Fleet
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - S Hathaway
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - J Elliott
- Clinical Research Network, West Midlands, Queen-s Hospital, Burton upon Trent, UK
| | - M Galea
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | - J Dodge
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | - A Chaudhy
- Cancer Research Unit, Great Western Hospital, Swindon, UK
| | | | - L Cook
- Guy's Hospital, London, UK
| | | | - P Turton
- Leeds Teaching Hospital, Leeds, UK
| | - A Henson
- Leeds Teaching Hospital, Leeds, UK
| | - J Gibb
- Leeds Teaching Hospital, Leeds, UK
| | - R Bonomi
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - S Funnell
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - C Noren
- Worthing Hospital, Western Sussex Hospitals, Worthing, UK
| | - J Ooi
- Royal Bolton Hospital, Bolton, UK
| | - S Cocks
- Royal Bolton Hospital, Bolton, UK
| | - L Dawson
- Royal Bolton Hospital, Bolton, UK
| | - H Patel
- Royal Bolton Hospital, Bolton, UK
| | - L Bailey
- Royal Bolton Hospital, Bolton, UK
| | | | | | - S Kirk
- Salford Royal Hospital, UK
| | | | | | | | | | - J Smith
- Stepping Hill Hospital, Stockport, UK
| | - R Prasad
- Royal AlbertEdward Infirmary, Wigan, UK
| | - A Doran
- Royal AlbertEdward Infirmary, Wigan, UK
| | - A Power
- Royal AlbertEdward Infirmary, Wigan, UK
| | | | - J Cannon
- Royal AlbertEdward Infirmary, Wigan, UK
| | - S Latham
- Royal AlbertEdward Infirmary, Wigan, UK
| | - P Arora
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - S Ridgway
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - M Coulding
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - R Roberts
- Tameside General Hospital, Ashton-under-Lyne, UK
| | - M Absar
- North ManchesterGeneral Hospital, Manchester, UK
| | - T Hodgkiss
- North ManchesterGeneral Hospital, Manchester, UK
| | - K Connolly
- North ManchesterGeneral Hospital, Manchester, UK
| | - J Johnson
- North ManchesterGeneral Hospital, Manchester, UK
| | - K Doyle
- North ManchesterGeneral Hospital, Manchester, UK
| | - N Lunt
- Cancer Resource Centre, Macclesfield Hospital, Macclesfield, UK
| | - M Cooper
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - I Fuchs
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - L Peall
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - L Taylor
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
| | - A Nicholson
- Bristol Breast Care Centre, Southmead Hospital, Bristol, UK
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Rutherford C, Speirs C, Williams JJL, Ewart MA, Mancini SJ, Hawley SA, Delles C, Viollet B, Costa-Pereira AP, Baillie GS, Salt IP, Palmer TM. Phosphorylation of Janus kinase 1 (JAK1) by AMP-activated protein kinase (AMPK) links energy sensing to anti-inflammatory signaling. Sci Signal 2016; 9:ra109. [DOI: 10.1126/scisignal.aaf8566] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Gray L, Rutherford C, Martins SS, Popham F, Keyes KM. Using linkage and pseudo-cohorts for comparing US survey and general population mortality 1990-2011. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw166.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Davidson C, Rutherford C, Allan J, Simpson G, Gray J. A comparison of oesophageal self-expanding metal stents and their complications. Int J Surg 2016. [DOI: 10.1016/j.ijsu.2016.08.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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