Introduction-Vertebral compression fractures (VCFs) are the most common type of osteoporotic fracture. Administrative claims data might be useful to identify VCFs, but this approach to case finding has received limited evaluation.

Introduction Predominantly uncontrolled studies suggest that there may be a greater risk of subsequent vertebral compression fractures (VCFs) associated with vertebroplasty and kyphoplasty. To further understand the risk of VCFs, we conducted a population-based retrospective cohort study using data from a large regional health insurer. Materials and Methods Administrative claims procedure codes were used to identify a treatment group of patients receiving either a vertebroplasty or kyphoplasty (treatment group) and a comparison group of patients with a primary diagnosis of VCF who did not receive treatment during the same time period. The main outcomes of interest, validated by two independent medical record reviewers and adjudicated by a physician panel, were any new VCFs within: 1) 90-days; 2) 360-days; and 3) at adjacent vertebral levels. Multivariable logistic regression examined the association of vertebroplasty/kyphoplasty with new VCFs. Results Among 48 treatment (51% vertebroplasty, 49% kyphoplasty) and 164 comparison patients, treated patients had a significantly greater risk of secondary VCFs than comparison patients for fractures within 90 days of the procedure or comparison group time point (adjusted odds ratio (OR) = 6.3; 95% confidence interval (CI) 1.7 – 23.0) and within 360 days (adjusted OR = 3.1; 95% CI:1.1 – 8.4). Vertebroplasty and kyphoplasty were associated with a significantly greater rate of adjacent-level fractures as well. Conclusions Patients who had undergone vertebroplasty and kyphoplasty had a greater risk of new VCFs compared to patients with prior VCFs who did not undergo either procedure.

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Findings from a prospective study of project-induced migration in China's Three Gorges Dam project are reported. The study tests the hypotheses that anticipation of involuntary migration is stressful and that the harmful effects are partially mediated and moderated by the resources migrants possess. Using data collected from a sample of designated migrants (n = 975) who will be forced to relocate because they live in an area which will be flooded once the Three Gorges project is completed, and non-migrants (n = 555) in the same region, our analysis indicates that anticipation of involuntary migration is a robust predictor of mental distress. Anticipation of forced migration elevates depression (CES-D) not only directly, but also indirectly by weakening the social and the psychological resources (i.e., social support and mastery) which safeguard the mental well-being of migrants. However, our results show much less support for the hypothesis that resources moderate harmful effects of forced migration. KeywordsChina; Three Gorges; Development; Involuntary migration; Stress Main textMoving has often been seen as a stressful life event because it disturbs the equilibrium between the mover and the environment and compels the mover to readjust (Ben-Sira, 1997;Bhugra, 2004;Lev-Wiesel, 1998). While this view has been proven useful to explain the prevalence ofCorresponding Author E-Mail: shwang@uab.edu. 2 Although sample size may have played a role in these tests, we believe the effect of the variable is robust using even the most rigid definition of robustness.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers

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