29 results on '"Li, Guohua"'
Search Results
2. Medication use and driving patterns in older drivers: preliminary findings from the LongROAD study
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Hill, Linda L, Andrews, Howard, Li, Guohua, DiGuiseppi, Carolyn G, Betz, Marian E, Strogatz, David, Pepa, Patricia, Eby, David W, Merle, David, Kelley-Baker, Tara, Jones, Vanya, and Pitts, Samantha
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Health Services and Systems ,Health Sciences ,Clinical Research ,Aging ,Older adult ,Driving safety ,Older driver ,Medication ,Driving outcome ,Public Health and Health Services ,Epidemiology ,Public health - Abstract
BackgroundThe potential for impaired driving due to medication use can occur at any age, though older adults are more likely to take multiple prescribed medications and experience side effects that may affect driving ability. The purpose of this study was to characterize the relationship between medications and driving safety behaviors.MethodsData for this study came from the five-site Longitudinal Research on Aging Drivers (LongROAD) project. Participants were active drivers, age 65-79 years at enrollment, and patients at one of the 5 participating sites. Medication names and doses were obtained at baseline based on the "brown-bag review" method. Medications were coded using the American Hospital Formulary Service system. Driving data were collected by a GPS accelerometer installed in the study participants' main vehicles.ResultsMedication data were available for 2949 (98.6%) of the 2990 participants, and 2898 (96.9% of all participants) had both medication data and at least 30 recorded days of driving. The median number of medications taken per study participant was seven, with a range of 0-51. Total number of medications was significantly associated with a higher rapid deceleration rate. Certain medication classes were significantly associated with other driving outcomes, including central nervous system agents (more speeding events), hormones and gastrointestinal medications (more rapid decelerations), electrolytes (fewer rapid decelerations), and antihistamines (greater right to left turn ratio).ConclusionsOlder adult drivers are taking large quantities of prescription and non-prescription medications that may affect their driving safety. Certain medication classes are associated with potentially adverse driving patterns, such as speeding and rapid decelerations, while others are associated with potentially protective maneuvers, such as right hand turning. Further research is warranted to identify and mitigate potential adverse effects of such medications on driving safety in older adults.
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- 2020
3. Are Female Drivers Safer? An Application of the Decomposition Method
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Li, Guohua, Baker, Susan P., Langlois, Jean A., and Kelen, Gabor D.
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- 1998
4. Launching injury epidemiology
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Li, Guohua and DiMaggio, Charles J
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- 2014
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5. Emergency Department Visits for Heat Stroke in the United States, 2009 and 2010
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Wu, Xian, Brady, Joanne E, Rosenberg, Henry, and Li, Guohua
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- 2014
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6. Homicide Incidents Involving Children with Autism Spectrum Disorder as Victims Reported in the US News Media, 2000–2019.
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Guan, Joseph, Blanchard, Ashley, DiGuiseppi, Carolyn G., Chihuri, Stanford, and Li, Guohua
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HOMICIDE ,GUNSHOT wounds ,MASS media ,CHILDREN with disabilities ,BURDEN of care ,EPIDEMIOLOGY ,DROWNING ,DISEASE incidence ,RISK assessment ,AUTISM ,DESCRIPTIVE statistics ,VICTIMS ,WOUNDS & injuries ,ASPHYXIA ,PSYCHOLOGICAL stress ,DISEASE complications - Abstract
Recent research indicates that children with autism are at increased risk of maltreatment. We examined news media reports on homicide incidents involving children with autism as victims in the United States between 2000 and 2019. Of the 52 victims studied, 47 (90.4%) were male. Age of victims ranged from 2 to 20 years (mean = 10.4 ± 5.3 years). Parents and other caregivers accounted for 63.5% and 13.5% of the perpetrators, respectively. The leading injury mechanism was gunshot wounds (23.1%), followed by drowning (19.2%), and suffocation, strangulation, or asphyxiation (19.2%). The most commonly cited contributing factor (47.1%) was overwhelming stress from caring for the autistic child. These results underscore the importance of supporting services for caregivers of children with autism. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Characteristics of unintentional drowning deaths in children with autism spectrum disorder
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Guan, Joseph and Li, Guohua
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Children--Mortality ,Children with autism spectrum disorders ,Epidemiology ,population characteristics ,social sciences ,human activities ,health care economics and organizations ,Drowning victims - Abstract
Background: The reported prevalence of autism spectrum disorder (ASD) has increased markedly in the past two decades. Recent research indicates that children with ASD are at a substantially increased risk of injury mortality, particularly from unintentional drowning. The purpose of this study was to explore the circumstances of fatal unintentional drowning incidents involving children with ASD under 15 years of age. Findings: During January 2000 through May 2017, US newspapers reported a total of 23 fatal drowning incidents involving 18 boys and 5 girls with ASD. Age of victims ranged from 3 to 14 years (mean = 7.7 ± 2.9 years). These drowning incidents most commonly occurred in ponds (52.2%), followed by rivers (13.0%), and lakes (13.0%). For 11 incidents with location data available, the distance between victim residence and the water body where drowning occurred averaged 290.7 m (± 231.5 m). About three-quarters (73.3%) of the drowning incidents occurred in the afternoon hours from 12:00 to 18:59. Wandering was the most commonly reported activity that led to drowning, accounting for 73.9% of the incidents. Conclusions: Fatal drowning in children with ASD typically occur in water bodies near the victims’ homes in the afternoon hours precipitated by wandering. Multifaceted intervention programs are urgently needed to reduce the excess risk of drowning in children with ASD.
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- 2017
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8. National Safe Routes to School program and risk of school-age pedestrian and bicyclist injury
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DiMaggio, Charles J., Frangos, Spiros, and Li, Guohua
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Crash injuries ,Public health ,Bicycle commuting--Safety measures ,Epidemiology ,Pedestrians--Safety measures ,Traffic safety and children - Abstract
Purpose Safe Routes to School (SRTS) was a federally funded transportation program for facilitating physically active commuting to and from school in children through improvements of the built environment. There is evidence that SRTS programs increase walking and bicycling in school-age children, but their impact on pedestrian and bicyclist safety has not been adequately examined. We investigate the impact and effects of the SRTS program on school-age pedestrian and bicyclist injuries in a nationwide sample in the United States. Methods Data were crash records for school-age children (5–19 years) and adults (30–64 years), in 18 U.S. states for a 16-year period (1995–2010). Multilevel negative binomial models were used to examine the association between SRTS intervention and the risk of pedestrian and bicyclist injury in children aged 5–19 years. Results SRTS was associated with an approximately 23% reduction (incidence rate ratio = 0.77, 95% confidence interval = 0.65–0.92) in pedestrian/bicyclist injury risk and a 20% reduction in pedestrian/bicyclist fatality risk (incidence rate ratio = 0.80, 95% confidence interval = 0.68–0.94) in school-age children compared to adults aged 30–64 years. Conclusions Implementation of the SRTS program appears to have contributed to improving traffic safety for school-age children in the United States.
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- 2016
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9. Pediatric Anesthesia and Neurodevelopmental Impairments: A Bayesian Meta-analysis
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DiMaggio, Charles J., Sun, Lena S. Y., Ing, Caleb H., and Li, Guohua
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Neurotoxicology ,Anesthesiology ,Epidemiology ,FOS: Clinical medicine ,Neurosciences ,Anesthesia ,Pediatric anesthesia ,Pediatric anesthesia--Complications - Abstract
Experimental evidence of anesthesia-induced neurotoxicity has caused serious concern about the long-term effect of commonly used volatile anesthetic agents on young children. Several observational studies based on existing data have been conducted to address this concern with inconsistent results. We conducted a meta-analysis to synthesize the epidemiologic evidence on the association of anesthesia/surgery with neurodevelopmental outcomes in children. Using Bayesian meta-analytic approaches, we estimated the synthesized odds ratios (OR) and 95% credible interval (CrI) as well as the predictive distribution of a future study given the synthesized evidence. Data on 7 unadjusted and 6 adjusted measures of association were abstracted from 7 studies. The synthesized OR based on the 7 unadjusted measures for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.9 (95% CrI, 1.2-3.0). The most likely unadjusted OR from a future study was estimated to be 2.2 (95% CrI, 0.6-6.1). The synthesized OR based on the 6 adjusted measures for the association of anesthesia/surgery with an adverse behavioral or developmental outcome was 1.4 (95% CrI, 0.9-2.2). The most likely adjusted OR from a future study was estimated to be 1.5 (95% CrI, 0.5-4.0). We conclude that existent epidemiologic evidence suggests a modestly elevated risk of adverse behavioral or developmental outcomes in children who were exposed to anesthesia/surgery during early childhood. The evidence, however, is considerably uncertain.
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- 2016
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10. Emergency department visits for traumatic brain injury in a birth cohort of medicaid-insured children
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DiMaggio, Charles J. and Li, Guohua
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Children--Wounds and injuries ,Epidemiology ,Hospitals--Emergency services ,FOS: Clinical medicine ,Wounds and injuries ,Neurosciences ,Brain--Wounds and injuries ,Wounds and injuries--Epidemiology - Abstract
Objectives: To analyse emergency department-based data on paediatric traumatic brain injury (TBI). Methods: This study constructed a retrospective cohort of 493 890 children who were born in New York City between 1999–2007 and who were enrolled in the New York Medicaid programme at the time of their birth and followed these children from birth to the end of 2007. Results: There were 62 089 injury-related emergency department visits, of which 1290 had ICD-9 codes consistent with TBI. Children with TBI were more likely to be male (59.4% vs 51.4%) and Hispanic (43.9% vs 26.3%) than those in the underlying birth cohort and were more than twice as likely to be admitted to the hospital for inpatient care (RR = 2.4, 95% CI = 2.2, 2.6). The most commonly listed cause of injury was falls (58.3%). Spatially-smoothed risk estimates indicated that some areas of the city are associated with a greater risk of paediatric TBI than others. Conclusions: Emergency department data can be used to describe paediatric TBI in ways not easily available through more routinely collected administrative health data. This information can be used to target prevention and control efforts.
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- 2013
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11. Depression, antidepressants and driving safety.
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Hill, Linda, Lauzon, Vanessa, Winbrock, Elise, Li, Guohua, Chihuri, Stanford, and Lee, Kelly
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TRAFFIC accidents ,TRAFFIC safety ,MENTAL depression ,THERAPEUTICS ,ANTIDEPRESSANTS ,EPIDEMIOLOGY - Abstract
Background: The purpose of this study was to review to review the reported associations of depression and antidepressants with motor vehicle crashes. Purpose: A literature search for material published in the English language between January, 1995, and October, 2015, in bibliographic databases was combined with a search for other relevant material referenced in the retrieved articles. Methods: Retrieved articles were systematically reviewed for inclusion criteria: 19 epidemiological studies (17 case-control and 2 cohort studies) fulfilled the inclusion criteria by estimating the crash risk associated with depression and/or psychotropic medications in naturalistic settings. Results: The estimates of the odds ratio (OR) of crash involvement associated with depression ranged from 1.78 to 3.99. All classes of antidepressants were reported to have side effects with the potential to affect driving safety. The majority of studies of antidepressant effects on driving reported an elevated crash risk, and ORs ranged from 1.19 to 2.03 for all crashes, and 3.19 for fatal crashes. In meta-analysis, depression was associated with approximately 2-fold increased crash risk (summary OR = 1.90; 95% CI, 1.06 to 3.39), and antidepressants were associated with approximately 40% increased crash risk (summary OR = 1.40; 95%CI, 1.18 to 1.66). Conclusion: Based on the findings of the studies reviewed, depression, antidepressants or the combination of depression and antidepressants may pose a potential hazard to driving safety. More research is needed to understand the individual contributions of depression and the medications used to treat depression. [ABSTRACT FROM AUTHOR]
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- 2017
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12. Emergency department visits for traumatic brain injury in a birth cohort of medicaid-insured children.
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DiMaggio, Charles and Li, Guohua
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BRAIN injury treatment , *ACADEMIC medical centers , *CONFIDENCE intervals , *EPIDEMIOLOGY , *MEDICAID , *MEDICAL records , *PREVENTIVE health services , *RESEARCH funding , *WOUNDS & injuries , *SOCIOECONOMIC factors , *RELATIVE medical risk , *RETROSPECTIVE studies , *CHILDREN - Abstract
Objectives: To analyse emergency department-based data on paediatric traumatic brain injury (TBI). Methods: This study constructed a retrospective cohort of 493 890 children who were born in New York City between 1999-2007 and who were enrolled in the New York Medicaid programme at the time of their birth and followed these children from birth to the end of 2007. Results: There were 62 089 injury-related emergency department visits, of which 1290 had ICD-9 codes consistent with TBI. Children with TBI were more likely to be male (59.4% vs 51.4%) and Hispanic (43.9% vs 26.3%) than those in the underlying birth cohort and were more than twice as likely to be admitted to the hospital for inpatient care (RR = 2.4, 95% CI = 2.2, 2.6). The most commonly listed cause of injury was falls (58.3%). Spatially-smoothed risk estimates indicated that some areas of the city are associated with a greater risk of paediatric TBI than others. Conclusions: Emergency department data can be used to describe paediatric TBI in ways not easily available through more routinely collected administrative health data. This information can be used to target prevention and control efforts. [ABSTRACT FROM AUTHOR]
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- 2013
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13. The social norms of birth cohorts and adolescent marijuana use in the United States, 1976-2007.
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Keyes, Katherine M., Schulenberg, John E., O'Malley, Patrick M., Johnston, Lloyd D., Bachman, Jerald G., Li, Guohua, and Hasin, Deborah
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SUBSTANCE abuse & psychology ,SUBSTANCE abuse risk factors ,SOCIAL values ,AGE distribution ,ANALYSIS of variance ,CANNABIS (Genus) ,CONFIDENCE intervals ,EPIDEMIOLOGY ,HIGH school students ,LONGITUDINAL method ,RESEARCH funding ,STATISTICAL sampling ,DATA analysis ,SECONDARY analysis ,SOCIAL attitudes ,MAXIMUM likelihood statistics ,DATA analysis software ,ADOLESCENCE - Abstract
ABSTRACT Aims Studies of the relationship between social norms and marijuana use have generally focused on individual attitudes, leaving the influence of larger societal-level attitudes unknown. The present study investigated societal-level disapproval of marijuana use defined by birth cohort or by time-period. Design Combined analysis of nationally representative annual surveys of secondary school students in the United States conducted from 1976 to 2007 as part of the Monitoring the Future study. Setting In-school surveys completed by adolescents in the United States. Participants A total of 986 003 adolescents in grades 8, 10 and 12. Measurements Main predictors included the percentage of students who disapproved of marijuana in each birth cohort and time-period. Multi-level models with individuals clustered in time-periods of observation and birth cohorts were modeled, with past-year marijuana use as the outcome. Findings Results indicated a significant and strong effect of birth cohort disapproval of marijuana use in predicting individual risk of marijuana use, after controlling for individual-level disapproval, perceived norms towards marijuana and other characteristics. Compared to birth cohorts in which most (87-90.9%) adolescents disapproved of marijuana use, odds of marijuana use were 3.53 times higher in cohorts where fewer than half (42-46.9%) disapproved (99% confidence interval: 2.75, 4.53). Conclusions Individuals in birth cohorts that are more disapproving of marijuana use are less likely to use, independent of their personal attitudes towards marijuana use. Social norms and attitudes regarding marijuana use cluster in birth cohorts, and this clustering has a direct effect on marijuana use even after controlling for individual attitudes and perceptions of norms. [ABSTRACT FROM AUTHOR]
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- 2011
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14. Drug violations and aviation accidents: findings from the US mandatory drug testing programs.
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Li, Guohua, Baker, Susan P., Zhao, Qi, Brady, Joanne E., Lang, Barbara H., Rebok, George W., and DiMaggio, Charles
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ACCIDENTS , *AERONAUTICS , *CONFIDENCE intervals , *DRUG use testing , *EPIDEMIOLOGY , *RESEARCH funding , *SUBSTANCE abuse , *DATA analysis , *GOVERNMENT regulation , *DISEASE prevalence , *CASE-control method - Abstract
To assess the role of drug violations in aviation accidents. Case-control analysis. Commercial aviation in the United States. Aviation employees who were tested for drugs during 1995-2005 under the post-accident testing program (cases, n = 4977) or under the random testing program (controls, n = 1 129 922). Point prevalence of drug violations, odds ratio of accident involvement and attributable risk in the population. A drug violation was defined as a confirmed positive test for marijuana (≥50 ng/ml), cocaine (≥300 ng/ml), amphetamines (≥1000 ng/ml), opiates (≥2000 ng/ml) or phencyclidine (≥25 ng/ml). The prevalence of drug violations was 0.64% [95% confidence interval (CI): 0.62-0.65%] in random drug tests and 1.82% (95% CI: 1.47-2.24%) in post-accident tests. The odds of accident involvement for employees who tested positive for drugs was almost three times the odds for those who tested negative (odds ratio 2.90, 95% CI: 2.35-3.57), with an estimated attributable risk of 1.2%. Marijuana accounted for 67.3% of the illicit drugs detected. The proportion of illicit drugs represented by amphetamines increased progressively during the study period, from 3.4% in 1995 to 10.3% in 2005 ( P < 0.0001). Use of illicit drugs by aviation employees is associated with a significantly increased risk of accident involvement. Due to the very low prevalence, drug violations contribute to only a small fraction of aviation accidents. [ABSTRACT FROM AUTHOR]
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- 2011
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15. Trends and Pattern of Drug Abuse Deaths in Maryland Teenagers.
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Li, Ling, Zhang, Xiang, Levine, Berry, Li, Guohua, Zielke, H. Ronald, and Fowler, David R.
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DRUG abuse ,TEENAGERS ,NARCOTICS ,ECSTASY (Drug) ,TEENAGERS & death - Abstract
The Office of the Chief Medical Examiner of Maryland recorded a total of 149 drug abuse deaths of teenagers aged 13–19 years four (2.7%) by both narcotics and methylenedioxymethamphetamine, six (4.0%) by cocaine only, and 14 (9.4%) by volatile substances (e.g., butane, Freon, nitrous oxide, and propane). The annual death rate from drug abuse for teenagers increased from 1.4 deaths per 100,000 population in 1991 to 2.7 deaths per 100,000 population in 2006 (chi-square test for time trend, p < 0.01). The increase in teenager drug abuse deaths occurred in 1999 and since has remained at a higher rate. Further analysis revealed that the increase in drug abuse deaths was attributable to a large degree to narcotic drugs, particularly heroin ⁄ morphine and methadone, and was confined to teenagers residing in the suburban and rural areas. [ABSTRACT FROM AUTHOR]
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- 2011
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16. Validity of suspected alcohol and drug violations in aviation employees.
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Li, Guohua, Brady, Joanne E., DiMaggio, Charles, Baker, Susan P., and Rebok, George W.
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ALCOHOL , *DRUGS of abuse , *MARIJUANA , *COCAINE , *PHENCYCLIDINE , *EMPLOYEE drug testing , *CONFIDENCE intervals - Abstract
Aims In the United States, transportation employees who are suspected of using alcohol and drugs are subject to reasonable-cause testing. This study aims to assess the validity of suspected alcohol and drug violations in aviation employees. Methods Using reasonable-cause testing and random testing data from the Federal Aviation Administration for the years 1995-2005, we calculated the positive predictive value (PPV) and positive likelihood ratio (LR+) of suspected alcohol and drug violations. The true status of violations was based on testing results, with an alcohol violation being defined as a blood alcohol concentration of ≥0.04 mg/dl and a drug violation as a test positive for marijuana, cocaine, amphetamines, phencyclidine or opiates. Results During the 11-year study period, a total of 2284 alcohol tests and 2015 drug tests were performed under the reasonable-cause testing program. The PPV was 37.7% [95% confidence interval (CI), 35.7-39.7%] for suspected alcohol violations and 12.6% (95% CI, 11.2-14.1%) for suspected drug violations. Random testing revealed an overall prevalence of 0.09% for alcohol violations and 0.6% for drug violations. The LR+ was 653.6 (95% CI, 581.7-734.3) for suspected alcohol violations and 22.5 (95% CI, 19.6-25.7) for suspected drug violations. Conclusion The discriminative power of reasonable-cause testing suggests that, despite its limited positive predictive value, physical and behavioral observation represents an efficient screening method for detecting alcohol and drug violations. The limited positive predictive value of reasonable-cause testing in aviation employees is due in part to the very low prevalence of alcohol and drug violations. [ABSTRACT FROM AUTHOR]
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- 2010
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17. Driving-while-intoxicated history as a risk marker for general aviation pilots
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Li, Guohua, Baker, Susan P., Qiang, Yandong, Grabowski, Jurek G., and McCarthy, Melissa L.
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DRUNK driving , *AIR pilots , *AIRCRAFT accidents - Abstract
Abstract: The Federal Aviation Administration conducts background checking for driving-while-intoxicated (DWI) convictions on all pilots. This study examined the association between DWI history and crash risk in a cohort of 335,672 general aviation pilots. These pilots were followed up from 1994 to 2000 through the aviation crash surveillance system of the National Transportation Safety Board. At baseline, 3.4% of the pilots had a DWI history. DWI history was associated with a 43% increased risk of crash involvement (adjusted relative risk: 1.43; 95% confidence interval: 1.15–1.77). The population-attributable risk fraction for DWI history was estimated as 1.4%. In addition to DWI history, male gender, older age, and inexperience were associated with significantly increased risk of crash involvement. The results of this study support DWI history as a valid risk marker for general aviation pilots. The safety benefit of background checking for DWI history needs to be further evaluated. [Copyright &y& Elsevier]
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- 2005
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18. Research utility of the National Violent Death Reporting System: a scoping review.
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Nazarov, Oybek, Guan, Joseph, Chihuri, Stanford, and Li, Guohua
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VIOLENT deaths ,AMED (Information retrieval system) ,SUBSTANCE abuse ,VIOLENCE prevention ,TREND analysis ,FACTOR analysis - Abstract
Background: To better understand and prevent suicide and homicide, the National Center for Injury Prevention and Control of the US Centers for Disease Control and Prevention launched the National Violent Death Reporting System (NVDRS) in six states in 2002. As of 2018, the NVDRS has been expanded to include all 50 states, the District of Columbia and Puerto Rico. The purpose of this review was to assess the research utility of the NVDRS based on studies indexed in major bibliographical databases. Methods: We performed a scoping review of published studies that were based on data from the NVDRS, identified by searching six electronic databases: PubMed, EMBASE, Google Scholar, OVID, Scopus, and Web of Science. We examined the time trend of annual NVDRS-based research output, generated a word cloud using the keywords listed in the publications, and mapped the knowledge domains covered by NVDRS-based studies. Results: Our review included a total of 150 studies published between 2005 and 2018. There was a marked increase in the annual number of NVDRS-based publications, with 120 (80.0%) of the 150 studies published between 2011 and 2018. Overall, 104 (69.3%) studies focused on suicide and 39 (26.0%) on homicide. Of the included studies, 100 (66.7%) were descriptive epidemiology, 31 (20.7%) were risk factor analyses, 9 (6.0%) were evaluations, 7 (4.7%) were trend analyses, and 4 (2.7%) were data quality assessments. Knowledge domain mapping identified two major clusters of studies, one on suicide and the other on homicide. The cluster on suicide was commonly linked to "circumstance," "alcohol" and "substance abuse" and the cluster on homicide was commonly linked to "firearm," "injury," and "gang." The two clusters were interlinked to overlapping networks of keywords, such as "firearm" and "mental health problem." Conclusions: Research utility of the NVDRS has increased considerably in recent years. Studies based on data from the NVDRS are clustered in two knowledge domains – suicide and homicide. The vast potential of the NVDRS for violence research and prevention remains to be fully exploited. [ABSTRACT FROM AUTHOR]
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- 2019
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19. Risk markers for fatal and non-fatal prescription drug overdose: a meta-analysis
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Brady, Joanne E., Giglio, Rebecca E., Keyes, Katherine M., DiMaggio, Charles J., and Li, Guohua
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Health risk assessment ,Analgesics ,Drugs--Overdose ,Epidemiology ,Opioid abuse ,3. Good health - Abstract
Background: Drug overdose is a public health crisis in the United States, due in part to the unintended consequences of increases in prescribing of opioid analgesics. Many clinicians evaluate risk markers for opioid-related harms when prescribing opioids for chronic pain; however, more data on predictive risk markers are needed. Risk markers are attributes (modifiable and non-modifiable) that are associated with increased probability of an outcome. This review aims to identify risk markers associated with fatal and non-fatal prescription drug overdose by synthesizing findings in the existing peer-reviewed and grey literature. Eligible cohort, case-control, cross-sectional, and case-cohort studies were reviewed and data were extracted for qualitative and quantitative synthesis. Findings: Summary odds ratios (SOR) were estimated from 29 studies for six risk markers: sex, age, race, psychiatric disorders, substance use disorder (SUD), and urban/rural residence. Heterogeneity was assessed and effect estimates were stratified by study characteristics. Of the six risk markers identified, SUD had the strongest association with drug overdose death (SOR = 5.24, 95% confidence interval (CI) = 3.53 - 7.76), followed by psychiatric disorders (SOR = 3.94, 95% CI = 3.09 - 5.01), white race (SOR = 2.28, 95% CI = 1.93 - 2.70), the 35-44 year age group relative to the 25-34 year reference group (SOR = 1.52, 95% CI = 1.31 - 1.76), and male sex (SOR = 1.33, 95% CI = 1.17 - 1.51). Conclusions: This review highlights fatal and non-fatal prescription drug risk markers most frequently assessed in peer-reviewed and grey literature. There is a need to better understand modifiable risk markers and underlying reasons for drug misuse in order to inform interventions that may prevent future drug overdoses.
20. Work stress and alcohol consumption among adolescents: moderation by family and peer influences
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Liu, Xianfang C., Keyes, Katherine M., and Li, Guohua
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Public health ,Epidemiology ,4. Education ,education - Abstract
Excessive alcohol use in adolescence can be detrimental to health and academic performance. Few studies consider the moderating effects of parental and peer influence within the context of adolescent work outside of the school environment. This study aims to examine work stress among adolescents and the association with alcohol use and drunkenness, in the context of parental and peer influences. Grade 12 students who participated in Monitoring the Future surveys between 2005 and 2009 (n = 12,341) were included in this study. Independent variables included work stress (job satisfaction, perceived safety, and perceived safety of possessions), self-reported perceptions towards academics and influence from parents and peers. Frequency of alcohol use and drunkenness were measured for lifetime, last 30 days and 12 months. The moderating effects of academic aspiration, parental, and peer influence were assessed on the relationship between work stress and alcohol use. Any work stress was positively associated with alcohol use over the past 12 months (odds ratio = 1.12, 95% confidence interval (CI) 1.02-1.23). Stratified analysis found that peer influence significantly moderated the relationship between work stress and alcohol use over the lifetime and past 12 months. Among adolescents with work stress, odds ratios of alcohol use over the lifetime was 0.83 (95% CI 0.71-0.97) for those with low negative peer influence and 1.09 (95% CI 0.97-1.22) for those with high negative peer influence. Problematic drinking patterns were more apparent among high school students who experienced stress at work. Positive peer influence, however, may buffer the adverse effect of work stress on alcohol use.
21. Validity of oral fluid test for Delta-9-tetrahydrocannabinol in drivers using the 2013 National Roadside Survey Data
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Jin, Huiyan, Williams, Sharifa Z., Chihuri, Stanford T., Li, Guohua, and Chen, Qixuan
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Epidemiology ,organic chemicals ,mental disorders ,Tetrahydrocannabinol ,Drugged driving ,Drug testing ,3. Good health ,Marijuana - Abstract
Background Driving under the influence of marijuana is a serious traffic safety concern in the United States. Delta 9-tetrahydrocannabinol (THC) is the main active compound in marijuana. Although blood THC testing is a more accurate measure of THC-induced impairment, measuring THC in oral fluid is a less intrusive and less costly method of testing. Methods We examined whether the oral fluid THC test can be used as a valid alternative to the blood THC test using a sensitivity and specificity analysis and a logistic regression, and estimate the quantitative relationship between oral fluid THC concentration and blood THC concentration using a correlation analysis and a linear regression on the log-transformed THC concentrations. We used data from 4596 drivers who participated in the 2013 National Roadside Survey of Alcohol and Drug Use by Drivers and for whom THC testing results from both oral fluid and whole blood samples were available. Results Overall, 8.9% and 9.4% of the participants tested positive for THC in oral fluid and whole blood samples, respectively. Using blood test as the reference criterion, oral fluid test for THC positivity showed a sensitivity of 79.4% (95% CI: 75.2%, 83.1%) and a specificity of 98.3% (95% CI: 97.9%, 98.7%). The log-transformed oral fluid THC concentration accounted for about 29% of the variation in the log-transformed blood THC concentration. That is, there is still 71% of the variation in the log-transformed blood THC concentration unexplained by the log-transformed oral fluid THC concentration. Back-transforming to the original scale, we estimated that each 10% increase in the oral fluid THC concentration was associated with a 2.4% (95% CI: 2.1%, 2.8%) increase in the blood THC concentration. Conclusions The oral fluid test is a highly valid method for detecting the presence of THC in the blood but cannot be used to accurately measure the blood THC concentration.
22. Applying Farr’s Law to project the drug overdose mortality epidemic in the United States
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Darakjy, Salima, Brady, Joanne E., DiMaggio, Charles J., and Li, Guohua
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Epidemiology ,3. Good health - Abstract
Unintentional drug overdose has increased markedly in the past two decades and surpassed motor vehicle crashes as the leading cause of injury mortality in many states. The purpose of this study was to understand the trajectory of the drug overdose epidemic in the United States by applying Farr’s Law. Farr’s “law of epidemics” and the Bregman-Langmuir back calculation method were applied to United States drug overdose mortality data for the years 1980 through 2011 to project the annual death rates from drug overdose from 2012 through 2035. From 1980–2011, annual drug overdose mortality increased from 2.7 to 13.2 deaths per 100,000 population. The projected drug overdose mortality would peak in 2016–2017 at 16.1 deaths per 100,000 population and then decline progressively until reaching 1.9 deaths per 100,000 population in 2035. The projected data based on Farr’s Law suggests that drug overdose mortality in the United States will decline in the coming years and return to the 1980 baseline level approximately by the year 2034.
23. Prescription drug monitoring and drug overdose mortality
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Li, Guohua, Brady, Joanne E., Lang, Barbara, Giglio, James F., Wunsch, Hannah, and DiMaggio, Charles J.
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Public health ,Epidemiology ,3. Good health - Abstract
Background: Abuse of prescription drugs, particularly opioid analgesics, has become a major source of injury mortality and morbidity in the United States. To prevent the diversion and misuse of controlled substances, many states have implemented prescription drug monitoring programs (PDMPs). This study assessed the impact of state PDMPs on drug overdose mortality. Methods: We analyzed demographic and drug overdose mortality data for state-quarters with and without PDMPs in 50 states and the District of Columbia during 1999–2008, and estimated adjusted risk ratios (aRRs) and 95% confidence intervals (CIs) of drug overdose mortality associated with the implementation of state PDMPs through multivariable negative bionomial regression modeling. ResultsL During the study period, annual national death rates from drug overdose increased by 96%, from 5.7 deaths per 100,000 population in 1999 to 11.2 in 2008. The impact of PDMPs on drug overdose mortality varied greatly across states, ranging from a 35% decrease in Michigan (aRR = 0.65; 95% CI = 0.54–0.77) to a more than 3-fold increase in Nevada (aRR = 3.37; 95% CI = 2.48–4.59). Overall, implementation of PDMPs was associated with an 11% increase in drug overdose mortality (aRR = 1.11; 95% CI = 1.02–1.21). Conclusions: Implementation of PDMPs did not reduce drug overdose mortality in most states through 2008. Program enhancement that facilitates the access and use of prescription drug monitoring data systems by healthcare practitioners is needed.
24. Association of the Safe Routes to School program with school-age pedestrian and bicyclist injury risk in Texas
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DiMaggio, Charles J., Brady, Joanne E., and Li, Guohua
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Cycling accidents ,Public health ,Child pedestrians ,Epidemiology ,11. Sustainability ,Pedestrian accident investigation ,human activities ,3. Good health - Abstract
Background Safe Routes to School (SRTS) is a federally funded transportation program for facilitating physically active commuting to and from school in children through improvements of the built environment, such as sidewalks, bicycle lanes, and safe crossings. Although it is evident that SRTS programs increase walking and bicycling in school-age children, their impact on pedestrian and bicyclist injury has not been adequately examined. Methods We analyzed quarterly traffic crash data between January 2008 and June 2013 in Texas to assess the effect of the SRTS program implemented after 2009 on school-age pedestrian and bicyclist injuries. Results The annualized rates of pedestrian and bicyclist injuries between pre- and post-SRTS periods declined 42.5% (95% confidence interval (CI) 39.6% to 45.4%) in children aged 5 to 19 years and 33.0% (95% CI 30.5% to 35.5%) in adults aged 30 to 64 years. Negative binomial modeling revealed that SRTS intervention was associated with a 14% reduction in the school-age pedestrian and bicyclist injury incidence rate ratio (IRR 0.86, 95% CI 0.75 to 0.98). The effect of the SRTS intervention on pedestrian and bicyclist fatalities was similar though smaller in magnitude and was not statistically significant (adjusted IRR 0.90, 95% CI 0.67 to 1.21). Conclusions These results indicate that the implementation of the SRTS program in Texas may have contributed to declines in school-age pedestrian and bicyclist injuries.
25. Emergency Department Visits for Heat Stroke in the United States, 2009 and 2010
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Wu, Xian, Brady, Joanne E., Rosenberg, Henry, and Li, Guohua
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Public health ,Epidemiology ,3. Good health - Abstract
Background: The effect of extreme heat on health has become a growing public health concern due to climate change. We aimed to examine the epidemiological patterns of hospital-based emergency department (ED) visits for heat stroke in the United States. Findings: We analyzed data from the 2009 and 2010 Nationwide Emergency Department Sample, the largest ED data system sponsored by the Agency for Healthcare Research and Quality. ED visits for heat stroke were identified by screening the recorded diagnoses using the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code 992.0. Annual incidence rates of ED visits for heat stroke were computed according to demographic characteristics and geographic regions. In 2009 and 2010, there were an estimated 8,251 ED visits for heat stroke in the United States, yielding an annual incidence rate of 1.34 visits per 100,000 population (95% Confidence Interval [CI] = 1.23-1.45). Significantly higher incidence rates were found in males (1.99 per 100,000; 95% CI = 1.82-2.16), adults aged ≥ 80 years (4.45 per 100,000; 95% CI = 3.73-5.18), and residents living in the southern region (1.61 per 100,000; 95% CI = 1.43-1.79). The majority (63.1%) of ED visits for heat stroke occurred during the summer months of June, July and August. Over one-half (54.6%) of the ED visits for heat stroke required hospitalization and 3.5% of the patients died in the ED or hospital. Conclusions: Heat stroke results in approximately 4,100 ED visits each year in the United States, with the majority occurring in the summer months and requiring admission to the hospital. Men, the elderly, and people living in the south region are at heightened risk.
26. Effects of minimum legal drinking age on alcohol and marijuana use: evidence from toxicological testing data for fatally injured drivers aged 16 to 25 years
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Keyes, Katherine M., Brady, Joanne E., and Li, Guohua
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Epidemiology ,3. Good health - Abstract
Alcohol and marijuana are among the most commonly used drugs by adolescents and young adults. The question of whether these two drugs are substitutes or complements has important implications for public policy and prevention strategies, especially as laws regarding the use of marijuana are rapidly changing. Data were drawn from fatally injured drivers aged 16 to 25 who died within 1 h of the crash in nine states with high rates of toxicology testing based from 1999 to 2011 on the Fatality Analysis Reporting System (N = 7,191). Drug tests were performed using chromatography and radioimmunoassay techniques based on blood and/or urine specimens. Relative risk regression and Joinpoint permutation analysis were used. Overall, 50.5% of the drivers studied tested positive for alcohol or marijuana. Univariable relative risk modeling revealed that reaching the minimum legal drinking age was associated with a 14% increased risk of alcohol use (RR = 1.14, 95% CI: 1.02 to 1.28), a 24% decreased risk of marijuana use (RR = 0.76, 95% CI: 0.53 to 1.10), and a 22% increased risk of alcohol plus marijuana use (RR=1.22, 95% CI: 0.90 to 1.66). Joinpoint permutation analysis indicated that the prevalence of alcohol use by age is best described by two slopes, with a change at age 21. There was limited evidence for a change at age 21 for marijuana use. These results suggest that among adolescents and young adults, increases in alcohol availability after reaching the MLDA have marginal effect on marijuana use.
27. Effectiveness of bystander naloxone administration and overdose education programs: a meta-analysis
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Giglio, Rebecca E., Li, Guohua, and DiMaggio, Charles J.
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Public health ,Naloxone ,Drugs--Overdose ,Epidemiology ,Opioid abuse ,3. Good health - Abstract
The objective of this review was to assess the effectiveness of bystander naloxone administration and overdose education programs by synthesizing quantitative results reported in the research literature. Studies meeting predefined criteria were identified and reviewed, and their results were synthesized through meta-analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated for overdose recoveries for individuals who received naloxone dispensed by non-medical community members, and the standardized mean difference was calculated for test scores of non-medical volunteers who received training in overdose management versus the scores of untrained volunteers. Pooled data from four studies showed that naloxone administration by bystanders was associated with a significantly increased odds of recovery compared with no naloxone administration (OR = 8.58, 95% CI = 3.90 to 13.25). Data from five studies of overdose education indicated that average scores were significantly higher for trained participants than untrained participants for tests on naloxone administration, overdose recognition, and overdose response (standardized mean difference = 1.35, 95% CI = 0.92 to 1.77). Empirical evidence in the research literature suggests that bystander naloxone administration and overdose education programs are associated with increased odds of recovery and with improved knowledge of overdose recognition and management in non-clinical settings.
28. Prevalence of malignant hyperthermia diagnosis in hospital discharge records in California, Florida, New York, and Wisconsin.
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Lu, Zhen, Rosenberg, Henry, and Li, Guohua
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MALIGNANT hyperthermia , *NEUROMUSCULAR blocking agents , *DISEASE prevalence , *PUBLIC health , *DIAGNOSIS - Abstract
Study Objective: Malignant hyperthermia (MH) is a rare yet potentially fatal pharmacogenetic disorder triggered by exposure to inhalational anesthetics and the depolarizing neuromuscular blocking agent succinylcholine. Epidemiologic data on the geographic variation in MH prevalence is scant. The objective of this study is to examine the prevalence of recorded MH diagnosis in patients discharged from hospitals in four states in the United States.Design: Observational study.Setting: Healthcare Cost and Utilization Project (HCUP) State Inpatient Database (SID) for California (2011), Florida (2011), New York (2012) and Wisconsin (2012).Patients: A total of 164 hospital discharges that had a recorded diagnosis of MH using the International Classification of Disease, 9th Revision, Clinical Modification code 995.86.Methods: MH prevalence was assessed by patient demographic and clinical characteristics.Main Results: The prevalence of MH per 100,000 hospital discharges ranged from 1.23 (95% Confidence Interval [CI], 0.80-1.66) in New York to 1.91 (95% CI, 1.48-2.34) in California, and the prevalence of MH per 100,000 surgical discharges ranged from 1.47 (95% CI, 0.93-2.02) in New York to 2.86 (95% CI, 2.00-3.71) in Florida. The prevalence of MH in male patients was more than twice the prevalence in female patients. Of the 164 patients with MH diagnosis, 11% were dead on discharge.Conclusions: There exists a modest variation in the prevalence of recorded MH diagnosis in hospital discharges in California, Florida, New York and Wisconsin. Epidemiologic patterns of MH diagnosis in hospital discharges appear to be similar across the four states. Further research is needed to better understand the geographic variation and contributing factors of MH in different populations. [ABSTRACT FROM AUTHOR]- Published
- 2017
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29. Prevalence, risk factors and multi-group latent class analysis of lifetime anxiety disorders comorbid depressive symptoms.
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Chen, Hongguang, Wang, Xiao, Huang, Yueqin, Li, Guohua, Liu, Zhaorui, Li, Yanxiang, and Geng, Hongchun
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LATENT class analysis (Statistics) , *ANXIETY disorders , *COMORBIDITY , *MENTAL depression , *SURVEYS - Abstract
Background: Previous studies about comorbidity have primarily focused on disorders based on diagnostic criteria instead of symptoms. This study aimed to describe the prevalence and risk factors of anxiety comorbid depression based on a population-based sample in Chifeng City Inner Mongolia and explored the gender differences of depressive subtypes in anxiety patients.Methods: This study was a cross-sectional study conducted among 6376 community residents. Logistics analysis and multiple-group latent class analysis was used in exploring the risk factors and subtypes of anxiety comorbid depressive symptoms.Results: A total of 4528 respondents were interviewed in this study. The lifetime prevalence estimates for anxiety in the total sample was 5.70%. Among residents who had ever had anxiety, most of them reported having depressive symptoms while 15.79% of them met the criteria of MDD. Logistics analysis showed childhood adversities were associated with anxiety comorbid depressive symptoms. The results of multiple-group latent class analysis showed that the latent class probabilities were different between males and females.Conclusion: The prevalence rates of comorbidity were similar to the reports of previous regional surveys in China with statistically significant differences of comorbidity occurring between males and females. Precision prevention should therefore be targeted towards different kinds of populations. [ABSTRACT FROM AUTHOR]- Published
- 2019
- Full Text
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