Search

Earlier detection of cancer enables intervention when it is more likely to be treatable and curable, resulting in improved patient outcomes, such as the reduction of morbidity and mortality. Analysis of the National Cancer Institute's Surveillance, Epidemiology, and End Results data revealed that cancers diagnosed after distant metastasis represent ~18% of all diagnoses and close to half of all deaths.1 Reducing the proportion of cancers diagnosed at late stages is therefore important. [ABSTRACT FROM AUTHOR]

Background and aims: Buprenorphine is an effective medication for opioid use disorder that reduces mortality; however, many patients are not retained in buprenorphine treatment, and an optimal length of treatment after which patients can safely discontinue treatment has not been identified. This study measured the association between buprenorphine treatment duration and all‐cause mortality among patients who discontinued treatment. Secondary objectives were to measure the association between treatment duration and drug overdose and opioid‐related overdoses. Design: Multi‐site cohort study. Setting: Eight US health systems. Participants: Patients who initiated and discontinued buprenorphine treatment between 1 January 2012 and 31 December 2018 (n = 6550). Outcomes occurring after patients discontinued buprenorphine treatment were compared between patients who initiated and discontinued treatment after 8–30, 31–90, 91–180, 181–365 and > 365 days. Measurements Covariate data were obtained from electronic health records (EHRs). Mortality outcomes were derived from EHRs and state vital statistics. Non‐fatal opioid and drug overdoses were obtained from diagnostic codes. Four sites provided cause‐of‐death data to identify fatal drug and opioid‐related overdoses. Adjusted frailty regression was conducted on a propensity‐weighted cohort to assess associations between duration of the final treatment episode and outcomes. Findings The mortality rate after buprenorphine treatment was 1.82 per 100 person‐years (n = 191 deaths). In regression analyses with > 365 days as the reference group, treatment duration was not associated with all‐cause mortality and drug overdose (P > 0.05 for both). However, compared with > 365 days of treatment, 91–180 days of treatment was associated with increased opioid overdose risk (hazard ratio = 2.94, 95% confidence interval = 1.11–7.79). Conclusions: Among patients who discontinue buprenorphine treatment, there appears to be no treatment duration period associated with a reduced risk for all‐cause mortality. Patients who discontinue buprenorphine treatment after 91–180 days appear to be at heightened risk for opioid overdose compared with patients who discontinue after > 365 days of treatment. [ABSTRACT FROM AUTHOR]

The article discusses how examining the fabrication of decorative arts can gives access to their materiality and an insight into the lived experiences of artisans, an opportunity to step into the shoes of individuals whose daily actions and experiences are rarely recorded for posterity.

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.socscimed.2010.01.003 Byline: Christina A. Clarke (a), Tim Miller (d), Ellen T. Chang (a), Daixin Yin (b), Myles Cockburn (c), Scarlett L. Gomez (a) Abstract: Life expectancy, or the estimated average age of death, is among the most basic measures of a population's health. However, monitoring differences in life expectancy among sociodemographically defined populations has been challenging, at least in the United States (US), because death certification does not include collection of markers of socioeconomic status (SES). In order to understand how SES and race/ethnicity independently and jointly affected overall health in a contemporary US population, we assigned a small-area-based measure of SES to all 689,036 deaths occurring in California during a three-year period (1999-2001) overlapping the most recent US census. Residence at death was geocoded to the smallest census area available (block group) and assigned to a quintile of a multifactorial SES index. We constructed life tables using mortality rates calculated by age, sex, race/ethnicity and neighborhood SES quintile, and produced corresponding life expectancy estimates. We found a 19.6 ([+ or -]0.6) year gap in life expectancy between the sociodemographic groups with the longest life expectancy (highest SES quintile of Asian females; 84.9 years) and the shortest (lowest SES quintile of African-American males; 65.3 years). A positive SES gradient in life expectancy was observed among whites and African-Americans but not Hispanics or Asians. Age-specific mortality disparities varied among groups. Race/ethnicity and neighborhood SES had substantial and independent influences on life expectancy, underscoring the importance of monitoring health outcomes simultaneously by these factors. African-American males living in the poorest 20% of California neighborhoods had life expectancy comparable to that reported for males living in developing countries. Neighborhood SES represents a readily-available metric for ongoing surveillance of health disparities in the US. Author Affiliation: (a) Northern California Cancer Center, Surveillance Research, 2201 Walnut Ave, Fremont, CA 94538, United States (b) California Cancer Registry, Sacramento, CA, United States (c) University of Southern California, Los Angeles, CA, United States (d) United Nations Economic Commission for Latin America and the Caribbean, Santiago, Chile Article Note: (footnote) [star] The ideas and opinions expressed herein are those of the authors, and endorsement by the state of California, the National Cancer Institute, or the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred.