State Residents Research Articles

A Bayesian Structural Time Series Analysis of the Effect of Basic Income on Crime: Evidence From the Alaska Permanent Fund

AbstractThis paper examines the impact of Alaska’s Permanent Fund Dividend on crime. The Dividend has been payable annually to state residents since 1982 and is the world’s longest-running example of a basic income. Initially universal, from 1989 onwards eligibility was withdrawn from an increasing proportion of those in prison. A Bayesian structural time series estimator is used to simulate Alaskan crime rates in the counterfactual no-Dividend case. A comparison with actual rates provides an estimate of the Dividend’s impact. This does not provide strong evidence of an effect. However, incorporating information on Dividend amounts suggests the size of payments is important, with larger amounts reducing crime. There is no evidence that this effect is reinforced by the 1989 change to eligibility. The results demonstrate the potential for a basic income to encourage positive outcomes and lend support to payment being universal rather than conditional.

Predictors of State-Level Stay-at-Home Orders in the United States and Their Association With Mobility of Residents.

To evaluate predictors of stay-at-home order adoption among US states, as well as associations between order enactment and residents' mobility. We assess associations between state characteristics and adoption timing. We also assess associations between enactment and aggregate state-level measures of residents' mobility (Google COVID-19 Community Mobility Reports). The United States. Adoption population: 50 US states and District of Columbia. Mobility population: state residents using devices with GPS tracking accessible by Google. State characteristics: COVID-19 diagnoses per capita, 2016 Trump vote share, Republican governor, Medicaid expansion status, hospital beds per capita, public health funding per capita, state and local tax revenue per capita, median household income, population, percent residents 65 years or older, and percent urban residents. Mobility exposure: indicator of order enactment by March 29, 2020 (date of mobility data collection). Order adoption timing: days since adoption of first order. Mobility: changes in mobility to 6 locations from February 6 to March 29, 2020. In bivariate models, order adoption was associated with COVID-19 diagnoses (hazard ratio [HR] = 1.01; 95% confidence interval [CI], 1.00 to 1.01), Republican governor (HR = 0.24; 95% CI, 0.13 to 0.44), Medicaid expansion (HR = 2.50; 95% CI, 1.40 to 4.48), and hospital capacity (HR = 0.43; 95% CI, 0.26 to 0.70), consistent with findings in the multivariate models. Order enactment was positively associated with time at home (beta (B) = 1.31; 95% CI, 0.35 to 2.28) and negatively associated with time at retail and recreation (B = -7.17; 95% CI, -10.89 to -3.46) and grocery and pharmacy (B = -8.28; 95% CI, -11.97 to -4.59) locations. Trump vote share was associated with increased mobility for 4 of 6 mobility measures. While politics influenced order adoption, public health considerations were equally influential. While orders were associated with decreased mobility, political ideology was associated with increased mobility under social distancing policies.

The complexity of TB/HIV coinfection: an analysis of the social and health services context in the state of São Paulo, Brazil.

Brazil is in the 19th position of priority countries for the control of TB/HIV coinfection, so we aimed to analyze the social and health services contexts that are associated with TB/HIV coinfection in São Paulo state. Ecological study conducted in 645 cities of the state. The study population consisted of 10,389 new cases of TB/HIV coinfection in state residents between 2010 and 2015. The variables and indicators used in the study were collected from secondary sources. To identify the factors associated with the occurrence of TB/HIV coinfection cases, generalized additive models for location, scale and shape were used. The best distribution model was defined from the lowest Akaike information criterion value. There was an association between the occurrence of coinfection and the diagnosis of TB after death and greater treatment default. There was also an association with greater coverage of nurses and Family Health Strategy, which comprises Primary Care settings focused on families. Regarding the social context, the Gini Coefficient of inequality was identified as a determinant of coinfection. The study presents the complexity of TB/HIV coinfection, proposing critical points in the health services and social context. Despite the high coverage of nurses and Family Health Strategy in some cities, this did not affect the reduction of the incidence of coinfection. These findings may be attributed to a fragmented care and focused on acute conditions. Furthermore, this model of care holds few prospects for care integration or prioritization of prevention and health promotion actions.

Assessing Recognition of the Vector of Lyme Disease Using Resin-Embedded Specimens in a Lyme Endemic Area.

Lyme disease (LD) is the most common vector-borne disease in the United States. To assess whether a tick bite puts someone at risk for LD, adequate tick identification skills are needed. We surveyed residents of a high LD-incidence state, Wisconsin, on their ability to distinguish ticks from insects and to identify the specimens that could transmit the LD causative agent. Surveys were conducted using resin blocks with four insects and four tick specimens embedded. About half of the participants (64 of 130) recognized all of the ticks, and 60% of those individuals chose only ticks and no insects. Younger participants (18- to 44-yr old) were more likely to identify ticks correctly compared with those 45 yr and older. Participants who agreed strongly with the statement 'I know a lot about ticks` were also likelier to correctly identify ticks. When asked to identify which specimens could transmit LD, less than 25% of participants chose both the Ixodes scapularis Say adult female and nymph and about half of those (15% of participants) picked only those two and no other specimens. Although the relatively small convenience sample was biased toward younger participants who consider themselves 'outdoorsy', results showed that further assessments of tick recognition skills are needed to understand what determines whether people can recognize medically important ticks and to evaluate the potential benefits of enhanced education. In addition to the value of the resin blocks as research tools, the blocks may be useful as training tools to improve tick check efficacy.

Assessment of Birth Defects and Cancer Risk in Children Conceived via In Vitro Fertilization in the US

Children with birth defects have a greater risk of developing cancer, but this association has not yet been evaluated in children conceived with in vitro fertilization (IVF). To assess whether the association between birth defects and cancer is greater in children conceived via IVF compared with children conceived naturally. This cohort study of live births, birth defects, and cancer from Massachusetts, New York, North Carolina, and Texas included 1 000 639 children born to fertile women and 52 776 children conceived via IVF (using autologous oocytes and fresh embryos) during 2004-2016 in Massachusetts and North Carolina, 2004-2015 in New York, and 2004-2013 in Texas. Children were followed up for an average of 5.7 years (6 008 985 total person-years of exposure). Data analysis was conducted from April 1 to August 31, 2020. Conception by IVF for state residents who gave birth to liveborn singletons during the study period. Birth defect diagnoses recorded by statewide registries. Cancer diagnosis as recorded by state cancer registries. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs for birth defect-cancer associations separately in fertile and IVF groups. A total of 1 000 639 children (51.3% boys; 69.7% White; and 38.3% born between 2009-2012) were in the fertile group and 52 776 were in the IVF group (51.3% boys; 81.3% White; and 39.6% born between 2009-2012). Compared with children without birth defects, cancer risks were higher among children with a major birth defect in the fertile group (hazard ratio [HR], 3.15; 95% CI, 2.40-4.14) and IVF group (HR, 6.90; 95% CI, 3.73-12.74). The HR of cancer among children with a major nonchromosomal defect was 2.07 (95% CI, 1.47-2.91) among children in the fertile group and 4.04 (95% CI, 1.86-8.77) among children in the IVF group. The HR of cancer among children with a chromosomal defect was 15.45 (95% CI, 10.00-23.86) in the fertile group and 38.91 (95% CI, 15.56-97.33) in the IVF group. This study found that among children with birth defects, those conceived via IVF were at greater risk of developing cancer compared with children conceived naturally.

Climate Change Adaptive Capacity as Modified by Identity, Experience and Health Status in the Eastern Caribbean

As health systems evolve in the face of climate change impacts, residents of the Eastern Caribbean small island states remain especially vulnerable to compromised health status. This study explored adaptive capacity as well as pro-health attitudes and behaviors among residents, age 15 to 75 years, in St. Kitts & Nevis between 2015 and 2019. Bivariate and multivariate logistic regressions were used to assess the likelihoods of capacity building across community members. Of 392 survey participants, at least 35% reported impacts of storms, droughts, high heat or vector borne diseases in their community. The most commonly reported adaptive behaviors were spending less time outdoors (52%), employing additional water storage (54%), taking cooler baths (57%), reducing clothing layers (59%), relying on natural ventilation (60%), and using air conditioning (AC) or fan (80%). Persons 30 years and older were more likely to initiate health-protective home repairs (OR: 2.37; 95%CI: 1.53, 3.69), eliminate mosquito breeding sites (OR: 2.63; 95%CI: 1.73, 4.02), install pest barriers (OR: 2.08; 95%CI: 1.38, 3.16), or wear less clothing (OR: 2.01; 95%CI: 1.31, 3.11) than younger residents. LGBTQ persons were more likely to initiate health-protective home repairs (OR: 2.17; 95%CI: 1.20, 3.85), eliminate mosquito breeding sites (OR: 2.70; 95%CI: 1.52, 5.00), reduce clothing layers (OR: 2.33; 95%CI: 1.22, 4.55), or use sunscreen (OR: 2.17; 95%: 1.06, 4.17) than non-LGBTQ individuals. Health professionals were more likely to initiate health-centric home repairs (OR: 7.58; 95%CI: 4.24, 14.02), eliminate mosquito breeding sites (OR: 6.45; 95%CI: 3.56, 12.22), physically intervene to help someone threatened by extreme weather (OR: 4.08; 95%CI: 2.31, 7.21), or install pest barriers (OR: 8.51; 95%CI: 4.26, 18.99) relative to non-health professionals. Results reflect the critical importance of demographics - sex, sexuality, age, and profession - as a modifier of risk perception and management.

COVID-19 and public health risk communication in Manipur: a phone-based cross-sectional study

Background: In the fight against COVID-19, communication remains as one of its most important strategic tools. To facilitate healthy behaviour among the general public, Central and State governments has been carrying out various awareness generating activities. This study plans to assess the adequacy of these activities by investigating people’s response by assessing their knowledge, attitudes and actions.Methods: This cross sectional study was conducted among 1493 adults (≥ 18years) residents of Manipur state selected through Random Number Dialling of mobile numbers using a pre-tested interview schedule. Descriptive statistics were generated and multiple logistic regression analysis was performed to test for association. A p-value of <0.05 was taken as significant. Approval was obtained from the institutional ethics committee.Results: The average age of the participants was 34.3 years with females constituting 51%. Majority were aware of the common symptoms i.e. Fever (94.5%), Cough (87.1%), Difficulty in breathing (74.9%) of COVID-19. Preventive measures of hand-hygiene, wearing masks and social distancing were known to 90.3%, 94.8% and 75.6% respectively. Almost 60% agree that the lockdown imposed has worsened their daily living, and more than four-fifth of the participants were stressed and worried. Increase in level of education and per capita income per month was significantly associated with the higher knowledge regarding COVID-19 (p<0.05). There was gap in knowledge and practice and wrong practices were seen.Conclusions: A change in the health communication messages with emphasis on the need for correct practices through appropriate channels and community engagement is urgently required at this hour.

Comparing public perceptions of sea level rise with scientific projections across five states of the U.S. Gulf Coast region

Sea level rise (SLR) in the twenty-first century poses fundamental risks to coastal residents. The US Gulf of Mexico Coast (Gulf Coast) is among the regions experiencing the most rapid relative SLR. Beyond its increasing exposure to SLR and related coastal flooding, the Gulf Coast is home to a large population and displays high social vulnerability. How the coastal population in this vulnerable region perceives the impending risks posed by SLR warrants further examination. Do coastal residents’ perceptions of SLR conform to the scientific projections? We adopt an integrative approach based on a 2019 survey merged with contextual data including percentage of population living within the Special Flood Hazard Area (SFHA) and social vulnerability at the county level, both of which are extracted from the Centers for Disease Control and Prevention. We find that public risk perceptions of sea level change are influenced by political predisposition, with Republicans being less likely than Democrats to expect SLR in the future. Moreover, SLR remains a temporally distant issue among coastal residents. We then directly compare public expectations and scientific estimations of SLR in five states of the US Gulf Coast region and find that coastal residents in states that have experienced faster SLR in the past are more optimistic about future SLR by underestimating its magnitude compared to those experiencing slower SLR. Moreover, we find that people likely conflate the severity with likelihood of SLR risk. The contextual force represented by percentage of population living within the SFHA designated by the Federal Emergency Management Agency (FEMA) can significantly influence individuals’ estimations of future SLR, with higher percentages leading to higher estimates. We suspect that the SFHA has become a powerful risk communication tool that influences coastal residents’ judgments about future risk.

Health and economic impact of nitrate pollution in drinking water: a Wisconsin case study.

Nitrate contamination of drinking water, common in agricultural areas, increases the risk of certain cancers and impacts fetal development during pregnancy. Building on previously published methodology, this study evaluates nitrate-attributable disease cases and adverse birth outcomes as well as their economic costs for Wisconsin, USA. Nitrate is the most common contaminant in groundwater in Wisconsin. Two-thirds of the state's residents use groundwater as the primary source of drinking water. Here, we analyze nitrate exposure from drinking water in Wisconsin based on nitrate test results for community water systems for the period of 2010-2017 and a novel methodology for estimating nitrate exposure for the 28% of state's residents who use private wells. We estimate that annually, 111-298 combined cases of colorectal, ovarian, thyroid, bladder, and kidney cancer in Wisconsin may be due to nitrate contamination of drinking water. Each year, up to 137-149 cases of very low birth weight, 72-79 cases of very preterm birth, and two cases of neural tube defects could be due to nitrate exposure from drinking water. The direct medical cost estimates for all nitrate-attributable adverse health outcomes range between $23 and $80 million annually. Simulating targeted reductions in the counties with the highest current drinking water nitrate concentrations resulted in similar reductions in adverse health outcomes as statewide reduction efforts, up to nitrate reductions of 20%. Time trend analysis suggests that groundwater nitrate concentrations are overall increasing. Thus, nitrate contamination of water supplies in Wisconsin is a public health problem that needs to be addressed.

A Survey of Health-Seeking Behaviour of Residents in Two Local Government Areas in Ibadan, Oyo State, Nigeria during COVID-19 Pandemic

Introduction: COVID-19 has affected all spheres of human endeavour in a developing country like Nigeria. In a bid to stop the spread of this virus, different preventive measures were put in place by all the levels of government. Therefore, studying the health-seeking behaviour of residents in the face of the deadly COVID-19 virus becomes paramount in this study. 
 Aim: This cross-sectional survey sought to investigate various health seeking behaviours exhibited by residents of Oyo state, Nigeria during the COVID-19 Pandemic.
 Methods: In this cross-sectional study, the multi-stage sampling techniques were finally used to select 327 respondents, aged 22-51 years with (Mean = 31.11, SD = 7.22) from two local government areas in Ibadan, Oyo state, Nigeria.
 Results: The result found that majority of the respondents’ experienced one form of signs and symptoms during COVID-19 pandemic. Also, many of the respondents experienced headache as major signs and symptoms during the COVID-19 Pandemic. Furthermore, fear of being diagnosed with COVID-19 was the major barrier to health seeking behaviour during COVID-19 pandemic while taking of local herbs was used by majority of respondents’ during COVID-19 pandemic.
 Conclusion and Recommendation: The COVID-19 pandemic affected residents’ healthcare-seeking behaviour Ibadan, Oyo state Nigeria. It was recommended that professional sociologists and health experts should develop health promotion and intervention programme tailored toward improving heath seeking behaviour of residents during and after COVID-19 pandemic.

Case-Linked Jurisdiction and Busybody States

Beginning with Justice Ginsburg’s 2011 opinion in the Goodyear case – and echoed in Justice Thomas’s 2014 opinion in Walden v. Fiore and Justice Alito’s 2017 opinion in Bristol-Myers Squibb v. Superior Court – the Supreme Court has suggested that the distinctiveness of specific personal jurisdiction (in contrast to general jurisdiction) resides in its being “case-linked.” However, to date, the Justices have not spelled out what it takes for a defendant’s contacts with a forum to be case-linked, although they now have an opportunity to do so in a pair of personal injury cases brought against Ford Motor Company. This essay aims to provide the missing account of case-linkage, explaining along the way how it applies to the Court’s pending cases. Our method is constructive and interpretive: we take as our starting point the Court’s precedents and its reasoning about two pillars of personal jurisdiction: state sovereignty and defendant’s due process rights. After Part I’s introduction, Part II re-examines the Court’s personal jurisdiction decisions from International Shoe to the present with the goal of understanding the concept of case-linkage as it has played out in the cases. Part III describes the Ford litigations presently before the Court, explaining why they invite consideration of an aspect of specific jurisdiction that the Court has yet to address adequately. We put forward our theory of case-linked jurisdiction in Part IV. Case-linkage, we argue, can only be understood within a framework that isolates the key concepts that matter for due process. Two are crucial: (1) a concept of the scope of the defendant’s submission to state authority, and (2) a concept of the scope of the forum state’s legitimate interests. We explain the latter in terms of the principle that a state’s courts ought not meddle in affairs beyond the state’s legitimate reach (labeled “the Anti-Busybody Principle”). By explaining case-linkage both in terms of the scope of a defendant’s submission to state power and of a state’s legitimate interests, we offer a way to bring together the process and sovereignty concerns that underlie the law of personal jurisdiction. With our own affirmative account in place, Part V shows why the “causation” approach to case-linkage advocated Ford and by some lower courts are indefensible, even if the more expansive “relatedness” tests of other courts are also not up to the task at hand. We also show that the intuitively right answer to the Ford cases—that a state court has jurisdiction to hear tort claims brought by state residents injured in-state by the defendant’s product (when the defendant has extensively sold the product-line in that state)—not only meshes with all relevant Supreme Court precedents, but also points to the best path forward for understanding, defining, and demarcating case-linked jurisdiction.

Is there referral bias in outcomes of septal myectomy for hypertrophic cardiomyopathy?

PurposeTo determine the potential impact of referral bias on short- and long-term outcomes following septal myectomy for hypertrophic cardiomyopathy. MethodsWe reviewed 2303 adult patients who underwent transaortic septal myectomy for obstructive hypertrophic cardiomyopathy from January 1993 to April 2016. Patients were divided into 3 groups according to their permanent address: local (state) residents (n = 324), regional (surrounding 5 states) patients (n = 515), and national (outside 5 states) patients (n = 1464). ResultsPatient groups were similar for age, sex, preoperative New York Heart Association class, and left ventricular ejection fraction. Local patients had increased prevalence of diabetes mellitus (13%, 11%, 8%; P = .006), coronary artery disease (25%, 21%, 19%; P = .031), severe chronic lung disease (2.3%, 1.9%, 0.4%; P < .001), and atrial fibrillation (24%, 18%, 19%; P = .045) when compared with regional and national patients. Echocardiographic features did not differ between the 3 groups, including prevalence of moderate or greater mitral regurgitation (59%, 61%, 56%; P = .161). Local and regional patients were more likely to undergo concomitant procedures than national patients (P < .001). Mitral valve surgery was performed in 9.6% of the patients, more commonly in local and regional patients (12%, 12%, 8%; P = .018). There were 11 operative deaths (0.5%), and early mortality was similar among the groups. Geographic origin did not impact overall late survival. ConclusionsCompared with distant referrals, local patients who undergo septal myectomy at our institution have more comorbid conditions, and require more concomitant surgical procedures. Despite these differences, referral patterns did not impact early or late outcomes following transaortic septal myectomy.

Neurodegenerative hospital admissions and long-term exposure to ambient fine particle air pollution

PurposeLong-term exposure to ambient fine particle (PM2.5) concentrations has been associated with an increased rate or risk of neurodegenerative conditions, but individual PM sources have not been previously examined in relation to neurodegenerative diseases. MethodsUsing the Statewide Planning and Research Cooperative System database, we studied 63,287 hospital admissions with a primary diagnosis of either Alzheimer's disease, dementia, or Parkinson's disease for New York State residents living within 15 miles from six PM2.5 monitoring sites. In addition to PM2.5 concentrations, we studied seven specific PM2.5 sources: secondary sulfate, secondary nitrate, biomass burning, diesel, spark-ignition emissions, pyrolyzed organic rich, and road dust. We estimated the rate of neurodegenerative hospital admissions associated with increased concentration of PM2.5 and individual PM2.5 sources average concentrations in the previous 0–29, 0–179, and 0–364 days. ResultsIncreases in ambient PM2.5 concentrations were not consistently associated with increased hospital admissions rates. Increased source-specific PM2.5 concentrations were associated with both increased (e.g., secondary sulfates and diesel emissions) and decreased rates (e.g., secondary nitrate and spark-ignition vehicular emissions) of neurodegenerative admissions. ConclusionsWe did not observe clear associations between overall ambient PM2.5 concentrations or source-apportioned ambient PM2.5 contributions and rates of neurologic disease hospitalizations.

WHEN DO SHELTER-IN-PLACE ORDERS FIGHT COVID-19 BEST? POLICY HETEROGENEITY ACROSS STATES AND ADOPTION TIME.

This study explores the impact of Shelter‐in‐Place Orders (SIPOs) on health, with attention to heterogeneity in their impacts. First, using daily state‐level social distancing data, we document that adoption of a SIPO was associated with a 9%–10% increase in the rate at which state residents remained in their homes full‐time. Using daily state‐level coronavirus case data, we find that approximately 3 weeks following the adoption of a SIPO, cumulative COVID‐19 cases fell by approximately 53.5%. However, this average effect masks important heterogeneity across states‐early adopters and high population density states appear to reap larger benefits from their SIPOs. (JEL H75, I12, I18)

Exploration of the Complex Relationships Among Multilevel Predictors of PrEP Use Among Men Who Have Sex with Men in the United States.

To explore the relationships among individual-, social-, and contextual- (state-level characteristics, including LBGTQ + and racial inequality) level factors and PrEP use. A cross-sectional survey was conducted in 2015-2016 among a geographically diverse group of men who have sex with men (MSM). Survey data was linked to publicly available state-level data based on participant zip code. Multivariable multilevel logistic regression was used to explore the association between multilevel variables and PrEP use. Of 4165 HIV-negative MSM, 13.4% were taking PrEP. In the regression analysis, several demographic and behavioral factors were associated with higher odds of PrEP use. Importantly, after adjusting for individual- and social-level factors, residents of states with high LGBTQ + equality had significantly higher odds of taking PrEP (OR 1.57; 95% CI 1.119, 2.023) compared to low equality states. LGBTQ + inequality between states may hinder PrEP use. States may need to take proactive measures to reduce LGBTQ + inequality as this may negatively impact the ability to reach the federal administration's stated goal to end the HIV epidemic in the US.

Willingness of community based health insurance uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, a cross-sectional study

BackgroundGlobally, Millions of people cannot use health services because of the fear of payment for the service at the time of service delivery. From the agenda of transformation and the current situation of urbanization as well as to ensure universal health coverage implementing this program to the urban resident is mandatory. The aim of this study is to assess the willingness of community-based health insurance (CBHI) uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, 2018.MethodsA community-based cross-sectional study was conducted. From the total of eighteen towns; six towns which account for 33% of the total were selected randomly for the study. One population proportion formula was employed to get a total of 845 households. A pre-tested, semi-structured interviewer-administered questionnaire was used to collect the required data. Double-Bounded Dichotomous Choice Variant of the contingent valuation method was used to assess the maximum willingness to pay for the scheme, and a multiple logistic regression model was used to determine the effect of various factors on the willingness to join and willingness to pay for the households.ResultAbout 839 (99.3%) of the respondents participated. The mean ages of the respondents were 40.44(SD ± 11.12) years. 621 (74.1%) ever heard about CBHI with 473 (56.3%) knowing the benefits package. Out of 839, 724 (86.3%) were willing to uptake CBHI of which 704 (83.9%) were willing to pay if CBHI established in their town.ConclusionIf CBHI established about 86.3% of the households would enroll in the scheme. Having education, with a family size between 3 & 6, having difficulty in paying for health care and less than 20mins it took to reach the nearest health facility were the independent predictors of the willingness of CBHI uptake. The Oromia and Towns Health Bureau should consider the availability of health facilities near to the community and establishing CBHI in the urban towns.

High-Risk Opioid Prescribing Trends: Prescription Drug Monitoring Program Data From 2010 to 2018.

Deaths due to opioids have continued to increase in South Carolina, with 816 opioid-involved overdose deaths reported in 2018, a 9% increase from the prior year. The objective of the current study is to examine longitudinal trends (quarter [Q] 1 2010 through Q4 2018) of opioid prescribing volume and high-risk opioid prescribing behaviors in South Carolina using comprehensive dispensing data available in the South Carolina Prescription Drug Monitoring Program (SC PDMP). Retrospective analyses of SC PDMP data were performed using general linear models to assess quarterly time trends and change in rate of each outcome Q1 2010 through Q4 2018. Opioid analgesic prescription fills from SC state residents between Q1 2010 and Q4 2018. High-risk prescribing behaviors included (1) opioid prescribing rate; (2) percentage of patients receiving opioids dispensed 90 or more average morphine milligram equivalents daily; (3) percentage of opioid prescribed days with overlapping opioid and benzodiazepine prescriptions; (4) rate per 100 000 residents of multiple provider episodes; and (5) percentage of patients prescribed extended release opioids who were opioid naive. A total of 33 027 461 opioid prescriptions were filled by SC state residents within the time period of Q1 2010 through Q4 2018. A 41% decrease in the quarterly prescribing rate of opioids occurred from Q1 2010 to Q4 2018. The decrease in overall opioid prescribing was mirrored by significant decreases in all 4 high-risk prescribing behaviors. PDMPs may represent the most complete data regarding the dispensing of opioid prescriptions and as such be valuable tools to inform and monitor the supply of licit opioids. Our results indicate that public health policy, legislative action, and multiple clinical interventions aimed at reducing high rates of opioid prescribing across the health care ecosystem appear to be succeeding in the state of South Carolina.

Infection Fatality Ratios for COVID-19 Among Noninstitutionalized Persons 12 and Older: Results of a Random-Sample Prevalence Study

Infection Fatality Ratios for COVID-19 Among Noninstitutionalized Persons 12 and Older: Results of a Random-Sample Prevalence Study

Mortality trends for all causes of cancer in Mato Grosso State, Brazil

Abstract Background Cancer is the second leading cause of death in Brazil, being the most common breast, lung, colorectal, cervix and pancreas among women and lung, prostate, colorectal, stomach and esophagus among men. The mortality trends for all causes of cancer in Brazil have been increased, with variations between sexes and regions. The objective was to analyze standardized mortality trend rates for all causes of cancer in Mato Grosso State, Brazil, from 2000 to 2015. Methods This is a descriptive, ecological, time-series study using data from the Mortality Information System, made available by the Department of Health of the Mato Grosso State. Deaths from cancer of all ages were selected, whose basic cause was identified by the letter “C” from the 10th revision of International Classification of Diseases. The direct method of standardization was performed with the 1960 world population and expected deaths were estimated. To estimate the trend, the annual percentage variation (APV) was calculated using the ratio regression coefficient/2000 mortality rate, for the state and its five macroregions. Results From 2000 to 2015, 28.525 deaths from cancer occurred in the state residents. There was an increasing trend in the mortality rates for all causes of cancer, with APV of 0.81% (p = 0.001). Considering the macroregions, the south (APV = 1.12%; p = 0.01), north (APV = 1.51%; p = 0.01) and east (APV = 1.82%; p = 0.01) had an increasing trend and the west (APV = 0.51%; p = 0.44) and the center-north (APV = 0.46%; p = 0.12) had a stable trend. Conclusions Mato Grosso follows the Brazilian cancer mortality increased trend. Variation in mortality rates found among different macroregions of the state and no decreased rates reveal regional disparities and the importance of cancer control and prevention in the state. Key messages Mortality rate for all causes of cancer increased in Mato Grosso State, Brazil, from 2000 to 2015. Variation in mortality trends by macroregions of the Mato Grosso State reveals regional disparities and the importance of cancer control and prevention in the state.

PREGNANCY LOSS RATES AFTER SINGLE, EUPLOID FROZEN-THAWED EMBRYO TRANSFER IN THE COVID-19 ERA

Data on the impact of COVID-19 on early pregnancy is extremely limited, and patients and practitioners remain cautious about initiating pregnancy in areas of high SARS-CoV-2 transmission.1-4 In April 2020, during the peak of the pandemic, the prevalence of COVID-19 among New York State residents was estimated to be 22.7%, consisting largely of asymptomatic infection.5 If SARS-CoV-2 is pathogenic to early pregnancy, an increase in loss might be expected given this high transmission. The objective of this study is to determine if an increase in early pregnancy loss occurred in patients undergoing single euploid frozen embryo transfer (FET) during the height of the COVID-19 pandemic.