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Use of Antihyperglycemic Medications in U.S. Adults: An Analysis of the National Health and Nutrition Examination Survey

OBJECTIVE

1) To examine trends in the use of diabetes medications and 2) to determine whether physicians individualize diabetes treatment as recommended by the American Diabetes Association (ADA).

RESEARCH DESIGN AND METHODS

We conducted a retrospective, cross-sectional analysis of 2003–2016 National Health and Nutrition Examination Survey (NHANES) data. We included people ≥18 years who had ever been told they had diabetes, had an HbA1C >6.4%, or had a fasting plasma glucose >125 mg/dL. Pregnant women, and those aged <20 years receiving only insulin were excluded. We assessed trends in use of ADA’s seven preferred classes from 2003–2004 to 2015–2016. We also examined use by hypoglycemia risk (sulfonylureas, insulin, and meglitinides), weight effect (sulfonylureas, thiazolidinediones [TZDs], insulin, and meglitinides), cardiovascular benefit (canagliflozin, empagliflozin, and liraglutide), and cost (brand-name medications and insulin analogs).

RESULTS

The final sample included 6,323 patients. The proportion taking any medication increased from 58% in 2003–2004 to 67% in 2015–2016 (P < 0.001). Use of metformin and insulin analogs increased, while use of sulfonylureas, TZDs, and human insulin decreased. Following the 2012 ADA recommendation, the choice of drug did not vary significantly by older age, weight, or presence of cardiovascular disease. Patients with low HbA1C, or HbA1C <6%, and age ≥65 years were less likely to receive hypoglycemia-inducing medications, while older patients with comorbidities were more likely. Insurance, but not income, was associated with the use of higher-cost medications.

CONCLUSIONS

Following ADA recommendations, the use of metformin increased, but physicians generally did not individualize treatment according to patients’ characteristics. Substantial opportunities exist to improve pharmacologic management of diabetes.




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The Association of Energy and Macronutrient Intake at Dinner Versus Breakfast With Disease-Specific and All-Cause Mortality Among People With Diabetes: The U.S. National Health and Nutrition Examination Survey, 2003-2014

OBJECTIVE

This study aims to evaluate the association of energy and macronutrient intake at dinner versus breakfast with disease-specific and all-cause mortality in people with diabetes.

RESEARCH DESIGN AND METHODS

A total of 4,699 people with diabetes who enrolled in the National Health and Nutrition Examination Survey from 2003 to 2014 were recruited for this study. Energy and macronutrient intake was measured by a 24-h dietary recall. The differences () in energy and macronutrient intake between dinner and breakfast ( = dinner – breakfast) were categorized into quintiles. Death information was obtained from the National Death Index until 2015. Cox proportional hazards regression models were developed to evaluate the survival relationship between and diabetes, cardiovascular disease (CVD), and all-cause mortality.

RESULTS

Among the 4,699 participants, 913 deaths, including 269 deaths due to diabetes and 314 deaths due to CVD, were documented. After adjustment for potential confounders, compared with participants in the lowest quintile of in terms of total energy and protein, participants in the highest quintile were more likely to die due to diabetes (hazard ratio [HR]energy 1.92, 99% CI 1.08–3.42; HRprotein 1.92, 99% CI 1.06–3.49) and CVD (HRenergy 1.69, 99% CI 1.02–2.80; HRprotein 1.96, 99% CI 1.14–3.39). The highest quintile of total fat was related to CVD mortality (HR 1.67, 99% CI 1.01–2.76). Isocalorically replacing 5% of total energy at dinner with breakfast was associated with 4% and 5% lower risk of diabetes (HR 0.96, 95% CI 0.94–0.98) and CVD (HR 0.95, 95% CI 0.93–0.97) mortality, respectively.

CONCLUSIONS

Higher intake of energy, total fat, and protein from dinner than breakfast was associated with greater diabetes, CVD, and all-cause mortality in people with diabetes.




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Help with a Quick Survey

Hi, this is Dan Ariely, I am trying to understand how people think about the coronavirus. From time to time, I will add surveys here. If you have five minutes, please answer the survey below as truthfully as you can. We don’t...




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[ Polls & Surveys ] Open Question : Poll: Is it okay if I make love to my gin and tonic instead ?

It's lockdown after all. 




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[ Polls & Surveys ] Open Question : Did you ever take your cat on the tube/subway and listen to music with him?




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[ Polls & Surveys ] Open Question : What is your opinion on neofolk?




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[ Polls & Surveys ] Open Question : How do you like your toilet paper?




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Recent Asylum Seeker and Refugee Arrivals to Germany Are Getting into Labor Force More Quickly, Survey Finds

WASHINGTON — Asylum seekers and refugees who arrived in Germany in the leadup to and during the 2015-16 European migration crisis have integrated into the labor market at a slightly faster rate than previous refugee cohorts, a Migration Policy Institute (MPI) report finds.




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Sharing Services Offers Cost Savings and Better Service, Claims N.Y. Survey

New York superintendents who shared services reported more cost savings and improved service quality than improved student achievement, according to a new research brief.




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A survey of the orange-bellied parrot Neophema chrysogaster in Tasmania, Victoria & South Australia : a report prepared for World Wildlife Fund (Australia) / P. B. Brown & R. I. Wilson.




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Critical survey of graphic novels : heroes & superheroes / editors, Bart H. Beaty, Stephen Weiner.

Graphic novels -- History and criticism.




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Differential diagnosis of syphilitic and non-syphilitic affections of the skin, including tropical diseases : a survey for medical practioners and students / by George Pernet.

London : Adlard, 1904.




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Diseases and remedies : a concise survey of the most modern methods of medicine / written expressly for the drug trade by physicians and pharmacists.

London : Chemist and Druggist, 1898.




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Young men and drugs : a nationwide survey / by John A. O'Donnell, Harwin L. Voss, Richard R. Clayton, Gerald T. Slatin, Robin G. W. Room.

Rockville, Maryland : National Institute on Drug Abuse, 1976.




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Professional and paraprofessional drug abuse counselors : three reports / Leonard A. LoSciuto, Leona S. Aiken, Mary Ann Ausetts ; [compiled, written, and prepared for publication by the Institute for Survey Research, Temple University].

Rockville, Maryland : National Institute on Drug Abuse, 1979.




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Survey of drug information needs and problems associated with communications directed to practicing physicians : part III : remedial ad survey / [Arthur Ruskin, M.D.]

Springfield, Virginia : National Technical Information Service, 1974.




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A survey of alcohol and drug abuse programs in the railroad industry / [Lyman C. Hitchcock, Mark S. Sanders ; Naval Weapons Support Center].

Washington, D.C. : Department of Transportation, Federal Railroad Administration, 1976.




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Representation Learning for Dynamic Graphs: A Survey

Graphs arise naturally in many real-world applications including social networks, recommender systems, ontologies, biology, and computational finance. Traditionally, machine learning models for graphs have been mostly designed for static graphs. However, many applications involve evolving graphs. This introduces important challenges for learning and inference since nodes, attributes, and edges change over time. In this survey, we review the recent advances in representation learning for dynamic graphs, including dynamic knowledge graphs. We describe existing models from an encoder-decoder perspective, categorize these encoders and decoders based on the techniques they employ, and analyze the approaches in each category. We also review several prominent applications and widely used datasets and highlight directions for future research.




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A design-sensitive approach to fitting regression models with complex survey data

Phillip S. Kott.

Source: Statistics Surveys, Volume 12, 1--17.

Abstract:
Fitting complex survey data to regression equations is explored under a design-sensitive model-based framework. A robust version of the standard model assumes that the expected value of the difference between the dependent variable and its model-based prediction is zero no matter what the values of the explanatory variables. The extended model assumes only that the difference is uncorrelated with the covariates. Little is assumed about the error structure of this difference under either model other than independence across primary sampling units. The standard model often fails in practice, but the extended model very rarely does. Under this framework some of the methods developed in the conventional design-based, pseudo-maximum-likelihood framework, such as fitting weighted estimating equations and sandwich mean-squared-error estimation, are retained but their interpretations change. Few of the ideas here are new to the refereed literature. The goal instead is to collect those ideas and put them into a unified conceptual framework.




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A survey of bootstrap methods in finite population sampling

Zeinab Mashreghi, David Haziza, Christian Léger.

Source: Statistics Surveys, Volume 10, 1--52.

Abstract:
We review bootstrap methods in the context of survey data where the effect of the sampling design on the variability of estimators has to be taken into account. We present the methods in a unified way by classifying them in three classes: pseudo-population, direct, and survey weights methods. We cover variance estimation and the construction of confidence intervals for stratified simple random sampling as well as some unequal probability sampling designs. We also address the problem of variance estimation in presence of imputation to compensate for item non-response.




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Errata: A survey of Bayesian predictive methods for model assessment, selection and comparison

Aki Vehtari, Janne Ojanen.

Source: Statistics Surveys, Volume 8, , 1--1.

Abstract:
Errata for “A survey of Bayesian predictive methods for model assessment, selection and comparison” by A. Vehtari and J. Ojanen, Statistics Surveys , 6 (2012), 142–228. doi:10.1214/12-SS102.




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A survey of Bayesian predictive methods for model assessment, selection and comparison

Aki Vehtari, Janne Ojanen

Source: Statist. Surv., Volume 6, 142--228.

Abstract:
To date, several methods exist in the statistical literature for model assessment, which purport themselves specifically as Bayesian predictive methods. The decision theoretic assumptions on which these methods are based are not always clearly stated in the original articles, however. The aim of this survey is to provide a unified review of Bayesian predictive model assessment and selection methods, and of methods closely related to them. We review the various assumptions that are made in this context and discuss the connections between different approaches, with an emphasis on how each method approximates the expected utility of using a Bayesian model for the purpose of predicting future data.




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A survey of cross-validation procedures for model selection

Sylvain Arlot, Alain Celisse

Source: Statist. Surv., Volume 4, 40--79.

Abstract:
Used to estimate the risk of an estimator or to perform model selection, cross-validation is a widespread strategy because of its simplicity and its (apparent) universality. Many results exist on model selection performances of cross-validation procedures. This survey intends to relate these results to the most recent advances of model selection theory, with a particular emphasis on distinguishing empirical statements from rigorous theoretical results. As a conclusion, guidelines are provided for choosing the best cross-validation procedure according to the particular features of the problem in hand.




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Instruments for health surveys in children and adolescents

9783319988573 (electronic bk.)




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DICTIONARY OF CONSTRUCTION, SURVEYING, AND CIVIL ENGINEERING

9780192568632 (electronic bk.)




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Nearly one-third of Americans believe a coronavirus vaccine exists and is being withheld, survey finds

The Democracy Fund + UCLA Nationscape Project found some misinformation about the coronavirus is more widespread that you might think.





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Larry Brown’s Contributions to Parametric Inference, Decision Theory and Foundations: A Survey

James O. Berger, Anirban DasGupta.

Source: Statistical Science, Volume 34, Number 4, 621--634.

Abstract:
This article gives a panoramic survey of the general area of parametric statistical inference, decision theory and foundations of statistics for the period 1965–2010 through the lens of Larry Brown’s contributions to varied aspects of this massive area. The article goes over sufficiency, shrinkage estimation, admissibility, minimaxity, complete class theorems, estimated confidence, conditional confidence procedures, Edgeworth and higher order asymptotic expansions, variational Bayes, Stein’s SURE, differential inequalities, geometrization of convergence rates, asymptotic equivalence, aspects of empirical process theory, inference after model selection, unified frequentist and Bayesian testing, and Wald’s sequential theory. A reasonably comprehensive bibliography is provided.




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Lasso Meets Horseshoe: A Survey

Anindya Bhadra, Jyotishka Datta, Nicholas G. Polson, Brandon Willard.

Source: Statistical Science, Volume 34, Number 3, 405--427.

Abstract:
The goal of this paper is to contrast and survey the major advances in two of the most commonly used high-dimensional techniques, namely, the Lasso and horseshoe regularization. Lasso is a gold standard for predictor selection while horseshoe is a state-of-the-art Bayesian estimator for sparse signals. Lasso is fast and scalable and uses convex optimization whilst the horseshoe is nonconvex. Our novel perspective focuses on three aspects: (i) theoretical optimality in high-dimensional inference for the Gaussian sparse model and beyond, (ii) efficiency and scalability of computation and (iii) methodological development and performance.




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Aerial Surveys Reveal Possible Fort of Scottish Patriot William Wallace

The freedom fighter may have once used the structure to conspire against English forces




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Empire State Mfg Survey

The New York Fed conducts this monthly survey of manufacturers in New York State. Participants from across the state represent a variety of industries. On the first of each month, the same pool of roughly 200 manufacturing executives (usually the CEO or the president) is sent a questionnaire to report the change in an assortment of indicators from the previous month. Respondents also give their views about the likely direction of these same indicators six months ahead.




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A Simple Method To Detect Point Mutations in Aspergillus fumigatus cyp51A Gene Using a Surveyor Nuclease Assay [Analytical Procedures]

One of the main mechanisms of azole resistance of Aspergillus fumigatus is thought to be a reduction in the drug’s affinity for the target molecule, Cyp51A, due to its amino acid mutation(s). It is known that the azole resistance pattern is closely related to the mutation site(s) of the molecule. In this study, we tried to develop a simple and rapid detection method for cyp51A mutations using the endonuclease Surveyor nuclease. The Surveyor nuclease assay was verified using several azole-resistant strains of A. fumigatus that possess point mutations in Cyp51A. For validation of the Surveyor nuclease assay, blind tests were conducted using 48 strains of A. fumigatus (17 azole-resistant and 31 azole-susceptible strains). The Surveyor nuclease assay could rapidly detect cyp51A mutations with one primer set. Also, all the tested strains harboring different cyp51A single point mutations could be clearly distinguished from the wild type. The Surveyor nuclease assay is a simple method that can detect cyp51A mutations rapidly.




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Climate-related financial risks: a survey on current initiatives

This report summarises the main results of a stocktake conducted by the Basel Committee of its members' initiatives on climate-related financial risks.




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Take the Penn State Community Survey beginning Feb. 3

On Feb. 3, all students, faculty and staff members at every Penn State campus location will receive an email to take the Penn State Community Survey to share their attitudes and experiences of community, diversity and inclusion at Penn State. Every 100 survey takers will have a chance to win an Amazon or Starbucks gift card.




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National Survey Tracks Impact of Coronavirus on Schools: 10 Key Findings

The EdWeek Research Center is conducting twice-monthly surveys of teachers and district leaders across the country to help the K-12 system navigate these unprecedented times.




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Survey Tracker: Monitoring How K-12 Educators Are Responding to Coronavirus

Track how educators and district leaders are responding to challenges related to COVID-19 through recurring surveys from The EdWeek Research Center.




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K-12 Tech Leaders Prioritize Cybersecurity, But Many Underestimate Risks, Survey Says

Less than 20 percent of respondents to a new CoSN survey marked any items on a list of cybersecurity threats as "high-risk" from their perspective.




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Cyberbullying Is on the Rise Among Teenagers, National Survey Finds

A growing number of students—especially girls—are experiencing bullying online, according to the latest federal data on bullying and crime in schools.




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Most Teachers Don't Want to Extend the Next School Year, Survey Shows

How should schools address learning loss from coronavirus-related closures? A new survey from the Collaborative for Student Success asked teachers, administrators, and policymakers.




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Survey: Teachers Are Conflicted About the Role of Suspensions

Most teachers say that school discipline is inconsistent or inadequate, a new study from the Fordham Institute finds.




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Cardiac Screening Prior to Stimulant Treatment of ADHD: A Survey of US-Based Pediatricians

Over the past decade, drug oversight committees and professional organizations have debated the evidence regarding cardiac screening to identify undiagnosed disorders associated with sudden cardiac death in youth with attention-deficit/hyperactivity disorder before beginning treatment with stimulants.

How practicing pediatricians have responded to this controversy is not known. We present results from a national sample of pediatricians regarding current attitudes, barriers, and practices for cardiac screening in youth with attention-deficit/hyperactivity disorder before prescribing stimulants. (Read the full article)




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Carpooling and Booster Seats: A National Survey of Parents

Booster seat use improves seat belt fit and reduces risk of injury for children <57 in tall. Booster seat use decreases between ages 4 and 8 years. Children observed riding with other children frequently do not use booster seats.

In this national survey of parents, we found that a majority of parents of 4- to 8-year-old children carpool, and when they carpool booster seat use is inconsistent. Social norms and self-efficacy appear to influence booster seat use when carpooling. (Read the full article)




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Health Risks of Oregon Eighth-Grade Participants in the "Choking Game": Results From a Population-Based Survey

Estimates of youth participation in strangulation activity, commonly referred to as the "choking game," range from 5% to 11%. Previous studies have documented correlations between youth choking game participation and health risks such as substance use and mental health issues.

Among Oregon eighth-graders surveyed, >6% had ever participated in the choking game. Participation was linked to poor nutrition and gambling among females, exposure to violence among males, and sexual activity and substance use among both genders. (Read the full article)




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Pediatric Residents' Perspectives on Reducing Work Hours and Lengthening Residency: A National Survey

In 2011, the Accreditation Council on Graduate Medical Education increased restrictions on resident duty-hours. Further changes have been considered, including greater work-hour restrictions and lengthening residency. Residents’ views about these policies are unclear.

This is the first systematic, national inquiry into resident opinions on reduced work-hours and longer residency. More pediatric residents support than oppose reduced hours, and a minority would add a year to residency to achieve them. (Read the full article)




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Racial Disparity Trends in Children's Dental Visits: US National Health Interview Survey, 1964-2010

Various studies have documented marked racial/ethnic disparities in children’s receipt of dental services at single time points or brief periods.

This study reveals significant improvements in children’s receipt of dental care overall, as well as a dramatic narrowing of African American/white disparities in children’s receipt of dental services over the last 40 years in the United States. (Read the full article)




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Pediatric Residency Training Director Tobacco Survey II

A 2001 survey of pediatric residency training directors indicated that few programs prepared residents to intervene on tobacco. A decade later, it is not known whether programs are doing more to prepare residents to intervene effectively with patients and parents.

Despite the need for pediatricians to play a leadership role in tobacco prevention and control, most pediatric residency training programs focus more on health effects of tobacco use and smoke exposure than on how to intervene with patients and parents. (Read the full article)




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Variations in Children's Dental Service Use Based on Four National Health Surveys

Oral health researchers and policy makers primarily use 4 national surveys to examine use of dental services among US children. Estimates from the surveys may vary, posing a challenge to population-based monitoring.

The authors of this study compared estimates of dental service use and delayed dental care obtained from 4 commonly used health surveys to appraise their utility for guiding pediatric oral health research and policy. (Read the full article)




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Informed Choice for Newborn Blood Spot Screening in the United Kingdom: A Survey of Parental Perceptions

Newborn screening is often seen as a fait accompli, even in programs that ostensibly proceed on the basis of informed choice and parental consent.

The study reports details of parental understanding, perceived ability to make an informed choice, and the availability of choice together with variables predictive of parental assessments of having made an informed choice. (Read the full article)




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Pediatricians' Use of Health Information Technology: A National Survey

Information is limited on adoption of fully functional electronic health records (EHRs) in office-based pediatric practices, such as rates of adoption, barriers to adoption, and features that pediatricians choose.

A nationwide survey of members of the AAP in 2009 found that pediatric adoption of fully functional EHRs lags general adoption. Barriers include financial and productivity concerns, but pediatricians are also concerned about finding systems that meet their specific needs. (Read the full article)




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Disparities in Unmet Need for Care Coordination: The National Survey of Children's Health

Care coordination has been proposed as a key mechanism for increasing quality and reducing costs of care. Little is known about the degree to which disparities exist in care coordination or whether having high-quality primary care attenuates disparities.

A considerable proportion of parents reported unmet care coordination needs for their children, especially parents of children with special health care needs. Black and Latino children also may have more unmet needs because they received family-centered care less often. (Read the full article)




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The Utility of Follow-up Skeletal Surveys in Child Abuse

Follow-up skeletal surveys are conducted commonly in children with suspected physical abuse, despite limited evidence. Different guidelines recommend follow-up skeletal surveys in children with abnormal initial skeletal surveys or in cases with high risk.

Across several centers, follow-up skeletal surveys revealed new information in >20% of cases and frequently affected the perceived likelihood of abuse, even in cases where the initial level of concern for abuse was moderate. (Read the full article)