Characterization of a Cohort of Persons Who Use Methamphetamines in London, Ontario, and In-hospital Substance Use
Harry H. KimMichael SilvermanKelly K. AndersonRohit J. LodhiSisira SarmaChandlee C. DickeyCheryl Forchuk
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ABSTRACT Our objective was to describe the sociodemographic characteristics of a cohort of people who use methamphetamine with a history of hospitalizations in London, Ontario, including their substance use patterns, health and social service use patterns, and self-perceived quality of life. Participants were recruited from community and hospital settings in Southwest Ontario, and survey data were collected between October 2020 and May 2021. A total of 109 individuals were recruited in the study, of whom 32.1% reported a hospitalization directly related to methamphetamine use and 55.0% reported using substances during a hospitalization. The survey participants had high rates of health and social service use, as well as emergency department visits. Scores for quality of life and community integration were lower for the study participants compared with general population scores. We found that in-hospital substance use was higher than reported previously, highlighting the need to address this issue to support people who use methamphetamine in the hospital setting. Notre objectif était de décrire les caractéristiques sociodémographiques d’une cohorte de personnes consommant de la méthamphétamine et ayant des antécédents d’hospitalisation à London, en Ontario, incluant leurs habitudes de consommation de substances, leurs habitudes d’utilisation des services sociaux et de santé et leur perception de leur qualité de vie. Les participants ont été recrutés dans les milieux communautaires et hospitaliers du sud-ouest de l’Ontario, et les données de l’enquête ont été recueillies entre octobre 2020 et mai 2021. Au total, 109 personnes ont été recrutées dans l'étude. 32,1% ont déclaré une hospitalisation directement liée à la consommation de méthamphétamine, et 55,0% ont déclaré avoir consommé des substances pendant une hospitalisation. Les participants à l’enquête présentaient des taux élevés d’utilisation des services sociaux et de santé, ainsi que de visites aux urgences. Les scores de qualité de vie et d’intégration dans la communauté étaient inférieurs pour les participants à l'étude par rapport aux scores de la population générale. Nous avons constaté que la consommation de substances à l’hôpital était plus élevée que ce qui avait été rapporté précédemment, ce qui souligne la nécessité d’aborder cette question pour soutenir les personnes qui consomment de la méthamphétamine en milieu hospitalier.Cite
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<p>(A-B) Overall survival curve of three prognostic groups in the training cohort (Cohort Mono N=149) and the validation cohort (Cohort Multi, N=205, 5 patients in the Cohort Multi without enough clinicopathological data were excluded). (A) Training cohort. (B) Validation cohort.</p>
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Abstract This chapter discusses issues, implications, diagnosis, and treatment of substance use disorders in HIV-positive individuals. The learner will be able to describe the bidirectional interactions between HIV and unhealthy substance use, recognize unhealthy substance use in people with HIV, and provide an initial outline of possible approaches to the treatment of substance use disorders among people with HIV.
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Characterization of disease progression course is important for prevention and treatment of the disease. However, for the disease with slow progression such as Alzheimer disease (AD), the development of a progression course is not easy because of the difficulty to follow up for a long time. A solution to overcome this limitation is to use multiple single cohorts of successive stages of the disease, for example preclinical AD cohort and MCI cohort for AD. We present a method to integrate the two single cohorts to model a disease progression course over time. We suggested the four steps 1) estimating the model according to follow up time for each cohort (figure 1) 2) generating the predicted outcome and its 95% confidence interval for each subject 3) checking the overlapped region of the predicted values between the two successive cohorts and searching the time to start to overlap between the two cohorts postulating the cohort of the late stage (cohort 2) comes after the cohort of the early stage (cohort 1) at this time (figure 2) 4) finally estimating the linear mixed model of one whole course of the disease using cohort 1 and cohort 2 (figure 3). We examined the validity of our approach using the simulated data. The data of 100 subjects for each cohort was generated as the following setting assuming cohort 2 starts to overlap to cohort 1 at t=4. For cohort 1, ln(Y)=b10+b11*t+ε (t=0∼5), where b10∼N(1.0, 0.12), b11=0.025; ε∼N(0, σ112), σ11=0.1, 0.2. For cohort 2, ln(Y)=b20+b21*t+ε (t=0∼5), where b20∼N(2.2, 0.22), b21=0.03; ε∼N(0, σ212), σ12=0.2, 0.3. For each data of all combinations according to the random variability of intercept and residual in cohort 1 and cohort 2, the time to start to overlap between the two cohorts was estimated to very close to true value of t=4 (range 4.00∼4.03). The disease progression model over t=0∼10 was estimated to ln(Y)=0.920+0.028*t.
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Abstract The aim of this study was to compare the prevalence of the different types of eardrum pathology in a cohort of adults not previously treated by grommet insertion with corresponding findings obtained in a cohort previously treated with grommet insertion. A cohort born in 1955 were invited to a screening examination including otomicroscopy. In the untreated cohort, retraction of Shrapnell's membrane was found in four per cent of the ears compared to 20 per cent in the cohort treated with grommets. Tensa pathology, including atrophy and myringosclerosis, was found in six per cent of the ears in the untreated cohort and in 17 per cent in the treated cohort. Normal eardrums were found in 91 per cent of the ears. Despite the increased awareness of secretory otitis, as well as the increased rate of surgical treatment, the prevalence of eardrum pathology seems to be increasing. The reasons for this are discussed.
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In autumn 1977 91% of the women who had graduated from United Kingdom medical schools in 1949-51 (early cohort) and 1965 (late cohort) were practising medicine. Over the first 12 years after qualification the late cohort was marginally more active in medicine and had more members in career and training posts than the early cohort. On the survey date 1 October 1977 (26-28 years after qualification) the participation index of the early cohort was 0.73 and of the late cohort (12 years) 0.65. Both cohorts show the bimodal career pattern characteristic of British women's occupational experience.
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