Sexual orientation and substance use trajectories in emerging adulthood

Aims The current study examined developmental changes in substance use behaviors (SUBS) based upon sexual orientation. The analyses also attempted to address a number of methodological limitations in the extant longitudinal literature (i.e. distinct operationalizations of sexual orientation, timing of sexual orientation assessment with respect to reports of SUBs, non‐linear growth). Participants Data were drawn from a longitudinal study of incoming first‐time college students at a large public university (n = 3720). Design After a paper‐and‐pencil assessment just prior to matriculation, participants completed a web‐based survey every fall and spring for 4 years (sub‐sample n = 2854). Findings Latent growth models revealed that sexual minorities demonstrated significant heterogeneity with regard to substance use trajectories. Initial levels and trajectories of the frequency of substance use for sexual minority individuals were distinct, generally, from their exclusively heterosexual peers. Methodologically, the timing of the assessment of sexual orientation influenced the results, and modeling non‐linear components indicated that sexual minorities are at risk for exponential increases in their frequency of certain SUBs over time (i.e. drunkenness; cannabis use). Conclusions Sexual minority and majority individuals exhibited differences in SUBs during emerging adulthood, especially when using self‐identification to define sexual orientation. Individuals who endorsed a sexual minority self‐identification at the onset of emerging adulthood, as opposed to 4 years later, evidenced exponential increases in rates of drunkenness and cannabis use. These results support that the timing of assessment is important and that some trajectories of sexual minority SUBs are non‐linear during this developmental period.     

Short- and long-term costs of laparoscopic colectomy are significantly less than open colectomy

Background  

The financial impact of laparoscopic colectomy remains poorly defined. We report the short-term costs of laparoscopic colectomy (LC) as compared with open colectomy (OC) in a high-volume tertiary care hospital, and are the first to incorporate the costs of late, colectomy-related complications in an analysis of long-term costs.     

Who Is Lost to Followup?: A Study of Patients with Distal Radius Fractures

Distal radius fractures are the most common upper extremity fracture, representing one-sixth of all fractures treated in emergency departments nationwide. Beyond the initial reduction and immobilization of these fractures, providing proper followup to ensure maintenance of the reduction and identify complications is necessary for optimal recovery of forearm and wrist functions. We sought to identify the clinical and demographic factors that characterize patients with distal radius fractures who do not return for followup and to assess the underlying causes for their poor followup rates. Compared with patients who were compliant with followup, those lost to followup had lower Physical and Mental Health scores on the SF-36 forms, more often were treated nonoperatively, and more likely had not surpassed secondary education. However, we found no difference between these two groups based on age, gender, mechanism of injury, marital status, or hand dominance. Early identification of patients who potentially are noncompliant can result in additional measures being taken to ensure the patient’s return to the treating hospital and physicians. This in turn will prevent complications attributable to lack of followup and allow more accurate assessment of results, thereby improving patient outcomes.