Mendelian Randomization Analysis Reveals No Causal Relationship Between Nonalcoholic Fatty Liver Disease and Severe COVID-19

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退伍军人生存质量研究

目的 研究退伍军人生存质量及其影响因素。方法 应用SF-36生存质量量表，对186名退伍军人的生存质量进行评分，然后根据年龄、居住地、文化程度、有无伤残、伤残等级、伤残性质、伤残时间、是否患慢性病等，将他们分成不同的组别，对各组生存质量的评分进行比较，并对生存质量总分及SF-36生存质量的8个健康维度之间的相关性进行分析。结果 伤残返伍军人生存质量与年龄、居住地、文化程度、有无伤残、伤残等级、伤残时间、是否患有慢性病有关；老年组和中青年组、乡村组和城镇组、文盲组和非文盲组、无伤残组和有伤残组、轻中度伤残组和重度伤残组、长伤残时间组和短伤残时间组、无慢性病组和有慢性病组的生存质量比较，前者均明显好于后者。结论退伍军人生存质量明显受年龄、文化程度、居住地、伤残情况等因素的影响，其中是否伤残、伤残等级及时间、居住地社会环境是最主要的影响因素。     

南通市离休干部医疗服务流向分析

目的:分析离休干部医疗服务利用与费用在不同类别医疗机构间的流向分布.方法:统计分析南通市2000年至2002年离休干部医疗保险数据.结果:(1) 门诊流向小医院增多,住院流向大医院增多;(2)离休干部选择社会医疗机构就医偏好高、门诊次均费用与医疗机构等级不相符等现象,可能与供需双方的道德损害行为有关;(3)住院费用增长快,占总医疗费比重大,应加强保障与管理.     

Female veterans of the OEF/OIF conflict: Concordance of PTSD symptoms and substance misuse

This study examined the post-deployment rates of comorbid PTSD and substance abuse in a cohort of female veterans who served in Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF). Female OEF/OIF veterans and reservists (N = 36) completed a battery of assessments as part of a larger study. Of the 36 participants, 11 (31%) screened positive for posttraumatic stress disorder (PTSD), 17 (47%) screened positive for high-risk drinking and 2 (6%) screened positive for drug abuse. Higher scores on measures of alcohol and drug use predicted positive PTSD status (p ≤ 0.01) and alcohol misuse was significant in explaining unique variance of PTSD status (p ≤ 0.05). Our findings suggest a trend toward increased problematic drinking among female OEF/OIF veterans and reservists and a relationship between substance misuse and PTSD. Future research should investigate needs for gender-specific PTSD and substance-abuse treatment needs.     

Sleep,suicide behaviors,and the protective role of sleep medicine

Objective/BackgroundSleep disturbance is associated with suicidal thoughts and behaviors. The relationship of specific sleep disorders to suicide attempts is less well established. Whether treating sleep disorders reduces suicide attempts remains controversial.MethodsSuicide attempts, treatment utilization, and psychiatric diagnoses were extracted from electronic medical records and a suicide attempt database from the U.S. Department of Veterans Affairs. The sample (N = 60,102) consisted of patients with any record of suicide attempt in FY13-14 and a 1:1 case-control of patients with no record of attempt, who were propensity score-matched based on age, gender, and prior year mental health treatment utilization. Associations among sleep disorders and suicide attempt were examined via logistic regression. Covariates included depression, anxiety, posttraumatic stress disorder (PTSD), bipolar, schizophrenia, substance use disorder (SUD), medical comorbidity, and obesity.ResultsInsomnia (OR = 5.62; 95% CI, 5.39–5.86), nightmares (odds ratio, OR = 2.49; 95% confidence interval, CI, 2.23–2.77), and sleep-related breathing disorders (OR = 1.37; 95% CI, 1.27–1.48) were positively associated with suicide attempt after accounting for age, gender, treatment utilization, and comorbid sleep disorders. Furthermore, when controlling for depression, anxiety, PTSD, bipolar, schizophrenia, substance use disorder (SUD), medical comorbidity, and obesity, insomnia (OR = 1.51, 95% CI, 1.43–1.59) remained positively associated with suicide attempt nightmares (OR = 0.96; 95% CI, 0.85–1.09) nor sleep-related breathing disorders (OR = 0.87, 95% CI = 0.79–0.94). Additionally, sleep medicine visits 180 days prior to index date were associated with decreased likelihood of suicide attempt for individuals with sleep disorders (OR = 0.86; 95% CI, 0.79–0.94).ConclusionInsomnia is associated with suicide attempt among veterans. Sleep medicine visits were associated with a reduced risk of suicide attempt in sleep disordered patients. The assessment and treatment of sleep disorders should be considered in context of strategies to augment suicide prevention efforts.