Hurricane Sandy hit the eastern coast of the United States in October 2012, causing billions of dollars in damage and acute physical and mental health problems. The long-term mental health consequences of the storm and their predictors have not been studied. New York City and Long Island residents completed questionnaires regarding their initial Hurricane Sandy exposure and mental health symptoms at baseline and 1 year later (N = 130). There were statistically significant decreases in anxiety scores (mean difference = −0.33, p < 0.01) and post-traumatic stress disorder (PTSD) scores (mean difference = −1.98, p = 0.001) between baseline and follow-up. Experiencing a combination of personal and property damage was positively associated with long-term PTSD symptoms (OR_adj 1.2, 95% CI [1.1–1.4]) but not with anxiety or depression. Having anxiety, depression, or PTSD at baseline was a significant predictor of persistent anxiety (OR_adj 2.8 95% CI [1.1–6.8], depression (OR_adj 7.4 95% CI [2.3–24.1) and PTSD (OR_adj 4.1 95% CI [1.1–14.6]) at follow-up. Exposure to Hurricane Sandy has an impact on PTSD symptoms that persists over time. Given the likelihood of more frequent and intense hurricanes due to climate change, future hurricane recovery efforts must consider the long-term effects of hurricane exposure on mental health, especially on PTSD, when providing appropriate assistance and treatment.

Background: The coronavirus disease 2019 (COVID‐19) pandemic has highlighted the importance of using information and communication technology (ICT) to address daily and healthcare needs. The barriers for older adults in the United States to learn a new technology to go online during the pandemic remain to be studied. Methods: Using data from the 2019–2020 National Health and Aging Trends Study (NHATS), a nationally representative survey of older Medicare beneficiaries aged 65 years and older in the United States, we used multivariable logistic regression models to identify sociodemographic and clinical factors associated with learning a new technology to go online during the COVID‐19 pandemic. Results: Our sample represented 23,547,688 older adults nationally, of which the majority (60.2%) increased ICT use during the COVID‐19 pandemic. However, most older adults (71.8%) did not report learning a new technology to go online. Those who did not learn a new technology to go online had less of an increase in ICT use than those who learned either with help or by themselves (50.7% vs. 78.4% or 89.2% respectively, p < 0.01). The odds of learning a new technology decreased with increasing age (aOR [95%CI] = 0.96 [0.94–0.98]), being male (aOR [95%CI] = 0.56 [0.45–0.72]), having lower than high school educational attainment (aOR [95%CI] = 0.38 [0.29–0.50]), decreasing income levels (aORs ranged from 0.28 to 0.54), and self‐reported fair or poor general health (aOR [95%CI] = 0.65 [0.47–0.90]). Conclusion: The identified sociodemographic and clinical factors could inform targeted intervention strategies to improve ICT use among older adults during the evolving COVID‐19 pandemic and in the future.

Introduction: Statistical methods to assess the impact of an intervention are increasingly used in clinical research settings. However, a comprehensive review of the methods geared toward practitioners is not yet available. Methods and Materials: We provide a comprehensive review of three methods to assess the impact of an intervention: difference-in-differences (DID), segmented regression of interrupted time series (ITS), and interventional autoregressive integrated moving average (ARIMA). We also compare the methods, and provide illustration of their use through three important healthcare-related applications. Results: In the first example, the DID estimate of the difference in health insurance coverage rates between expanded states and unexpanded states in the post-Medicaid expansion period compared to the pre-expansion period was 5.93 (95% CI, 3.99 to 7.89) percentage points. In the second example, a comparative segmented regression of ITS analysis showed that the mean imaging order appropriateness score in the emergency department at a tertiary care hospital exceeded that of the inpatient setting with a level change difference of 0.63 (95% CI, 0.53 to 0.73) and a trend change difference of 0.02 (95% CI, 0.01 to 0.03) after the introduction of a clinical decision support tool. In the third example, the results from an interventional ARIMA analysis show that numbers of creatinine clearance tests decreased significantly within months of the start of eGFR reporting, with a magnitude of drop equal to − 0.93 (95% CI, − 1.22 to − 0.64) tests per 100,000 adults and a rate of drop equal to 0.97 (95% CI, 0.95 to 0.99) tests per 100,000 per adults per month. Discussion: When choosing the appropriate method to model the intervention effect, it is necessary to consider the structure of the data, the study design, availability of an appropriate comparison group, sample size requirements, whether other interventions occur during the study window, and patterns in the data.

Hurricane Sandy continues to affect the mental health of New York residents. This study examined associations between Posttraumatic Growth (PTG) and mental health difficulties (MHD) including symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD). Participants (N = 1,356) recruited from the New York metropolitan area completed questionnaires regarding their PTG, demographics, MHD, and hurricane experiences. A weighted least squares regression assessed the association between MHD and PTG. A post hoc analysis determined whether anxiety or depression moderated the effect of PTSD on PTG. All MHD were crudely associated with greater PTG. After adjustment, an increased PTSD score was significantly associated with a 0.20 unit increase in PTG (t = 6.05, p < .001); this did not hold for depression or anxiety symptoms. Higher PTG was associated with being non-White (B = 5.90, t = 6.49, p < .001), Hispanic (B = 3.38, t = 2.89, p = .004), a smoker (B = 3.18, t = 3.28, p = .001), and greater Hurricane Sandy exposure (t = 7.11, p < .001). The positive association between PTSD symptoms and PTG was weaker among participants with probable depression. Results suggest that participants with higher PTSD symptoms were more likely to grow from the impact of the storm, indicating resilience. Highly exposed participants were more likely to experience PTG. A decrease in PTG was found among those with both PTSD and depression symptoms. The development and implementation of interventions fostering PTG could be beneficial in clinical disaster response work. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Besides specific, incidental radiation exposure, which has been associated with increased thyroid cancer risk, the effects of exposure to background radiation from uranium, a naturally occurring, radioactive, and ubiquitous element, on the thyroid gland has not been widely studied. We therefore investigated the association between uranium exposure and thyroid health in the US. Using the National Health and Nutrition Examination Survey (NHANES), we assessed the association between urinary uranium levels and thyroid-related antibodies, including thyroglobulin antibodies (TgAb) and anti-thyroid peroxidase (anti-TPO), in the general population. Secondly, we performed an ecological study of age-adjusted thyroid cancer incidence rates per state and sources of uranium exposure. We included 3125 eligible participants from the NHANES and found a significant association between increased TgAb and increased urinary uranium levels when analyzed as quartiles (p = 0.0105), while no association was found with anti-TPO. In addition, although no significant correlation was found in the ecological study, certain states had high age-adjusted thyroid cancer incidence rates and a high number of uranium activity locations and high uranium concentrations in water. The present study suggests that uranium exposure may affect thyroid health, which warrants increased sampling of soil and water in high-risk states.