Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-2 (of 2 Records) |
Query Trace: Varley F[original query] |
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Prevalence of and risk factors associated with nonfatal overdose among veterans who have experienced homelessness
Riggs KR , Hoge AE , DeRussy AJ , Montgomery AE , Holmes SK , Austin EL , Pollio DE , Kim YI , Varley AL , Gelberg L , Gabrielian SE , Blosnich JR , Merlin J , Gundlapalli AV , Jones AL , Gordon AJ , Kertesz SG . JAMA Netw Open 2020 3 (3) e201190 Importance: Individuals with a history of homelessness are at increased risk for drug or alcohol overdose, although the proportion who have had recent nonfatal overdose is unknown. Understanding risk factors associated with nonfatal overdose could guide efforts to prevent fatal overdose. Objectives: To determine the prevalence of recent overdose and the individual contributions of drugs and alcohol to overdose and to identify characteristics associated with overdose among veterans who have experienced homelessness. Design, Setting, and Participants: This survey study was conducted from November 15, 2017, to October 1, 2018, via mailed surveys with telephone follow-up for nonrespondents. Eligible participants were selected from the records of 26 US Department of Veterans Affairs medical centers and included veterans who had received primary care at 1 of these Veterans Affairs medical centers and had a history of experiencing homelessness according to administrative data. Preliminary analyses were conducted in October 2018, and final analyses were conducted in January 2020. Main Outcomes and Measures: Self-report of overdose (such that emergent medical care was obtained) in the previous 3 years and substances used during the most recent overdose. All percentages are weighted according to propensity to respond to the survey, modeled from clinical characteristics obtained in electronic health records. Results: A total of 5766 veterans completed the survey (completion rate, 40.2%), and data on overdose were available for 5694 veterans. After adjusting for the propensity to respond to the survey, the mean (SD) age was 56.4 (18.3) years; 5100 veterans (91.6%) were men, 2225 veterans (38.1%) were black, and 2345 veterans (40.7%) were white. A total of 379 veterans (7.4%) reported any overdose during the past 3 years; 228 veterans (4.6%) reported overdose involving drugs, including 83 veterans (1.7%) who reported overdose involving opioids. Overdose involving alcohol was reported by 192 veterans (3.7%). In multivariable analyses, white race (odds ratio, 2.44 [95% CI, 2.00-2.98]), self-reporting a drug problem (odds ratio, 1.66 [95% CI, 1.39-1.98]) or alcohol problem (odds ratio, 2.54 [95% CI, 2.16-2.99]), and having witnessed someone else overdose (odds ratio, 2.34 [95% CI, 1.98-2.76]) were associated with increased risk of overdose. Conclusions and Relevance: These findings suggest that nonfatal overdose is relatively common among veterans who have experienced homelessness. While overdose involving alcohol was more common than any specific drug, 1.7% of veterans reported overdose involving opioids. Improving access to addiction treatment for veterans who are experiencing homelessness or who are recently housed, especially for those who have experienced or witnessed overdose, could help to protect this population. |
Regional bumps: case studies from the 1958 bump symposium
Whyatt J , Varley F . Trans Soc Min Metall Explor Inc 2010 326 101-105 A variety of dynamic failure cases with regional impact were described at a bump symposium held in 1958. These types of events, while rare, are of particular interest because their ability to impact a large area has disaster potential. These cases can be grouped into two broad classes of events by mechanism. These are (1) a slip along steeply dipping faults and (2) the fracturing of strong strata above or below the coal seam. Both failure modes produce dynamic or "shock" loads on the perimeter (roof, rib and floor) of mine openings. Special consideration should be given to these failure modes in the planning of deep coal mines, since their occurrence is not within the professional experience of many contemporary workers. In addition, their potential is not evaluated by many of the analysis tools commonly used to evaluate hazards in coal mine plans. |
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