Revista De Historia Economica最新文献

Objectives: We evaluated the time course of the American Spinal Cord Injury Association (ASIA) impairment scale (AIS) for up to three months in participants within 72 h after traumatic spinal cord injury (TSCI) with complete paralysis. We aimed to determine the most useful sacral-sparing examination (deep anal pressure [DAP], voluntary anal contraction [VAC], S4-5 light touch [LT], or pin prick [PP] sensation) in determining AIS grades.

Design: Retrospective cohort study.

Setting: Spinal Injuries Center, Fukuoka, Japan.

Participants: Among 668 TSCI participants registered in the Japan Single Center study for Spinal Cord Injury Database (JSSCI-DB) between January 2012 and May 2020, we extracted the data of 80 patients with AIS grade A within 72 h after injury and neurological level of injury (NLI) at T12 or higher.

Interventions: None.

Outcome measures: The sacral-sparing examination at the time of the change to incomplete paralysis was compared to the AIS determination using a standard algorithm and with each assessment including the VAC, DAP, S4-5LT, and S4-5PP examinations at the time of AIS functional change. Agreement among assessments was evaluated using weighted kappa coefficients. The relationship was evaluated using Spearman's rank correlation coefficients.

Results: Fifteen participants (18.8%) improved to incomplete paralysis (AIS B to D) within three months after injury. The single assessment among the sacral-sparing examinations with the highest agreement and strongest correlation with AIS determination was the S4-5LT examination (k = 0.89, P < 0.01, r = 0.84, P < 0.01).

Conclusions: The S4-5LT examination is key in determining complete or incomplete paralysis due to its high discriminatory power.

Background: Colorectal cancer (CRC) is a prevalent cause of cancer-related deaths in Michigan, but not all Michigan adults had appropriate CRC screening. Objective: To assess the relationship between rurality and age on CRC screenings to inform how pharmacists could focus their efforts to educate, facilitate, or offer CRC health screenings. Methods: This was a retrospective, cross-sectional study using 2018 Michigan Behavioral Risk Factor Surveillance System (MiBRFSS) survey data. Michigan participants aged ≥ 50 years were included. Outcomes included the utilization of stool-based tests, sigmoidoscopies, colonoscopies, and the most recent CRC screening. Demographic variables included age, sex, income, race/ethnicity, relationship status, education level, employment status, income, rurality, and health insurance. Representative sampling weights were used to adjust for the complex survey design. Descriptive statistics, chi-square, and multivariable logistic regression analyses were conducted. IBM SPSS version 28.0.1.0 was used and an a priori p-value of <0.05 was deemed significant. Results: A weighted total of 3,762,540 participants were included, of which 21.3% (n = 781,907) reported living in a rural area and approximately 70% (n = 2,616,646) were between the ages of 50-69 years old. Most participants reported being White, non-Hispanic (n = 3,104,117, 84.5%), having health insurance (n = 3,619,801, 96.4%), and having a colonoscopy (74.6%, n= 2,620,581). There was no difference based on rurality. Compared to those aged 50-59 years, adults 60-69 years (AOR = 1.97, 95% CI: 1.58,2.45), 70-79 years (AOR = 3.29, 95% CI: 2.40,4.51), and ≥ 80 years (AOR = 2.23, 95% CI: 1.54,3.24) had higher odds of receiving a colonoscopy. Lack of insurance was associated with lower odds of receiving a colonoscopy (AOR = 0.38, 95% CI: 0.23, 0.56). Conclusion: Most participants reported having a CRC screening but efforts to increase CRC screening in Michigan adults aged 50-59 are warranted.