Search

Antipsychotics are frequently used for inpatients with alcohol withdrawal syndromes (AWS). While there is evidence on the effects of these medications in other settings there is little data on the mortality rate associated with these drugs for the treatment of AWS) We utilized the national COSMOS Epic database to identify inpatients with AWS. We then assessed the mortality rate for adult patients with or without the use of anti-psychotics along with subsets of patients based on age, gender, race, and ethnicity. We identified 233,821 patients of whom 26% received antipsychotic agents. The mortality rate was 1.5%. Patients aged 60 or over and those who received typical antipsychotic agents had a higher mortality rate. The use of typical antipsychotic agents is associated with a higher mortality rate. The use of any antipsychotic agent in patients aged 60 or over is associated with an increased mortality rate. Further study of this effect is warranted. [ABSTRACT FROM AUTHOR]

Like everything for the past 2 centuries, agriculture has depended increasingly on fossil fuel energy. Pressures to shift to renewable energy and changes in the fossil fuel industry are set to massively alter the energy landscape over the next 30 years. Two near-certainties are increased overall prices and/or decreased stability of energy supplies. The impacts of these upheavals on specialty crop production and consumption are unknowable in detail but the grand lines of what will likely change can be foreseen. This foresight can guide the research, extension, and teaching needed to successfully navigate a future very unlike the recent past. Major variables that will influence outcomes include energy use in fertilizer manufacture, in farm operations, and in haulage to centers of consumption. Taking six increasingly popular fruit and vegetable crops and the top two horticultural production states as examples, here we use simple proxies for the energy requirements (in gigajoules per ton of produce) of fertilizer, farm operations, and truck transport from Florida or California to New York to compare the relative sizes of these requirements. Trucking from California is the largest energy requirement in all cases, and three times larger than from Florida. As these energy requirements themselves are all fairly fixed, but in future will likely rise in price and/or be subject to interruptions and shortages, this pilot study points to two commonsense inferences: First, that fruit and vegetable production and consumption are set to reposition to more local/regional and seasonal patterns due to increasing expenses associated with fuel, and second, that coastto-coast produce shipment by truck will become increasingly expensive and difficult. [ABSTRACT FROM AUTHOR]

Tricuspid valve annuloplasty (TA) during mitral valve repair (MVr) is associated with increased risk of permanent pacemaker (PPM) implantation, but the magnitude of risk and long-term clinical consequences have not been firmly established. This study assesses the incidence rates of PPM implantation after isolated MVr and following MVr with TA as well as the associated long-term clinical consequences of PPM implantation. State-mandated hospital discharge databases of New York and California were queried for patients undergoing MVr (isolated or with concomitant TA) between 2004 and 2019. Patients were stratified by whether or not they received a PPM within 90 days of index surgery. After weighting by propensity score, survival, heart failure hospitalizations (HFHs), endocarditis, stroke, and reoperation were compared between patients with or without PPM. A total of 32,736 patients underwent isolated MVr (n = 28,003) or MVr + TA (n = 4,733). Annual MVr + TA volumes increased throughout the study period (P < 0.001, trend), and PPM rates decreased (P < 0.001, trend). The incidence of PPM implantation <90 days after surgery was 7.7% for MVr and 14.0% for MVr + TA. In 90-day conditional landmark-weighted analyses, PPMs were associated with reduced long-term survival among MVr (HR: 1.96; 95% CI: 1.75-2.19; P < 0.001) and MVr + TA recipients (HR: 1.65; 95% CI: 1.28-2.14; P < 0.001). In both surgical groups, PPMs were also associated with an increased risk of HFH (HR: 1.56; 95% CI: 1.27-1.90; P < 0.001) and endocarditis (HR: 1.95; 95% CI: 1.52-2.51; P < 0.001), but not with stroke or reoperation. Compared to isolated MVr, adding TA to MVr was associated with a higher risk of 90-day PPM implantation. In both surgical groups, PPM implantation was associated with an increase in mortality, HFH, and endocarditis. [Display omitted] [ABSTRACT FROM AUTHOR]

The visibility of populations, policies, and the state matters greatly for questions of power, inequality, and democratic life. This article builds on existing scholarship by examining how visibility operates as a lever and effect of social control in a racially and economically stratified society. By doing so, the article identifies a paradox. Race- and class-empowered groups often pressure state actors to implement punitive policies or otherwise visibly contain and control disadvantaged populations. But they also tend to decry and disavow the necessary public costs of these disciplinary interventions. This creates a conundrum for authorities: how to satisfy popular demands for social control while concealing resource commitments. We use the term disciplinary tensions to describe the contradictory political desires that state actors must navigate to maintain legitimacy with privileged constituents. We examine two state projects that, in different ways, crystallize this dilemma: the expansion of low-income housing development in New York in the 1960s and 1970s and state prison construction in California in the 1980s and 1990s. In both episodes, officials responded to disciplinary tensions by turning to covert public finance options: specifically, revenue bonds, which seemingly detach policy from conventional tax-and-spend public finance. We argue that these cases shed light on the shifting nature of power as finance has come to pervade all aspects of government and covert governing tactics supplement and supplant society's more direct practices of social control. Revenue bonds, in particular, allow governing actors to appease and placate the populace by reconfiguring the state's disciplinary power so that social control appears to pay for itself. [ABSTRACT FROM AUTHOR]

Introduction New York (NY) implemented a statewide restriction on the retail sale of flavored vaping products to reduce availability of vaping products having youth-appealing flavors in 2020. We assessed the intended effects of the NY law on sales of flavored vaping products and explored whether policy implementation had unintended effects on consumer behavior by evaluating policy-associated changes in sales of combusted cigarettes, which could serve as more harmful substitute products for NY consumers of flavored vaping products. Aims and Methods We analyzed custom product-level weekly retail tobacco sales scanner data for NY and a comparison state (California [CA]) for convenience stores and other outlets from June 2018 through June 2021. We categorized flavor descriptors for vaping products as flavored or as tobacco or unflavored and categorized cigarettes as menthol or non-menthol. We used a difference-in-difference model to assess the effect of the sales restriction on unit sales of flavored and unflavored vaping products and menthol and non-menthol cigarettes in NY compared with CA. Results Following NY policy implementation, flavored and total vaping product sales decreased in NY relative to CA. Unflavored vaping product sales increased in NY, while menthol cigarette sales did not change significantly relative to CA sales. Conclusions The NY flavored vaping product policy was associated with fewer sales of flavored and total vaping products. The increase in sales of unflavored vaping products did not suggest complete substitution, and sales data suggest that consumers did not turn to cigarettes after flavored vaping products became unavailable. Implications This study provides evidence that NY's flavored vaping product policy is associated with reduced flavored vaping product access and sales. Our analyses of potential unintended consequences indicate that some consumers switched from flavored to unflavored vaping products, but that cigarette sales did not change concurrent with the policy which means that decreased availability of flavored vaping products did not result in vapers switching to cigarettes. NY's policy had its intended effect with limited unintended consequences. [ABSTRACT FROM AUTHOR]