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Health-Exposure Modelling And The Ecological Fallacy, Jon Wakefield, Gavin Shaddick

UW Biostatistics Working Paper Series

Recently there has been increased interest in modelling the association between aggregate disease counts and environmental exposures measured, for example via air pollution monitors, at point locations. This paper has two aims: first we develop a model for such data in order to avoid ecological bias; second we illustrate that modelling the exposure surface and estimating exposures may lead to bias in estimation of health effects. Design issues are also briefly considered, in particular the loss of information in moving from individual to ecological data, and the at-risk populations to consider in relation to the pollution monitor locations. The approach …

Genotype-By-Sex Interaction In The Regulation Of High-Density Lipoprotein: Theframingham Heart Study, M.J. Mosher, L. J. Martin, L. A. Cupples, Q. Yang, T. D. Dyer, J. T. Williams, K. E. North

Anthropology Faculty and Staff Publications

Low levels of high-density lipoprotein (HDL) are widely documented as a risk factor for cardiovascular disease (CVD). Furthermore, there is marked sexual dimorphism in both HDL levels and the prevalence of CVD. However, the extent to which genetic factors contribute to such dimorphism has been largely unexplored. We examined the evidence for genotypeby- sex effects on HDL in a longitudinal sample of 1,562 participants from 330 families in the Framingham Heart Study at three times points corresponding approximately to 1971-1974, 1980-1983, and 1988-1991. Using a variance component method, we conducted a genome scan of HDL at each time point in …

What Is Comprehensive Sexuality Education Really All About? Perceptions Of Students Enrolled In An Undergraduate Human Sexuality Course, Eva Goldfarb

Department of Public Health Scholarship and Creative Works

The purpose of this study was to use qualitative evaluation techniques to explore the perceptions of students enrolled in undergraduate human sexuality classes regarding their expectations for the course as well as outcomes. One hundred forty-eight students were surveyed at the beginning and again at the end of the semester-long course. While pregnancy and STI prevention were considered important components of their courses, other outcomes associated with positive, healthy sexuality were given greater emphasis. Results suggest that while primary and secondary level sexuality education have been increasingly focused on abstinence-only education with a focus on pregnancy and STI reduction, this …

Factors Related To Delayed Time For Hiv Care Among Youth Living With Hiv: A Cross-Sectional Analysis Of Social Support Networks And Access To Care, Patricia L. Jones

Loma Linda University Electronic Theses, Dissertations & Projects

Purpose: This research explored the pattern of influence social support networks had on delayed time between diagnosis and first doctor’s visit after diagnosis of HIV in youth. Results showed that factors related to receiving a referral were prosocial peer behaviors and excessive fibbing in the past 6 months. The study identified sources of social support and described the relationship between the source of support and time of first doctor’s visit after HIV diagnosis. Both descriptive and multivariate analyses were performed on all youth (N=347) and specifically on those seeking care. Methodology: Historical data were extracted from the baseline dataset of …

High Potency And Other Alcoholic Beverage Consumption Among Adolescents, Edessa C. Jobli, Heather S. Dore, Chudley Werch, Michele Johnson Moore

Public Health Faculty Research and Scholarship

This study examined the prevalence of high potency (liquor, malt liquor, fortified wine) and other alcoholic beverage consumption (beer, wine/wine coolers) among adolescents, the impact of gender and ethnicity, and the risk and protective factors that predicted consumption. A confidential survey revealed that, among eighth grade students, wine/wine coolers were the most popular alcoholic beverages, with the highest levels of lifetime use, and the greatest current frequency and quantity of use, followed closely by beer and liquor. Minor gender differences were found, as well as notable ethnic differences, in consumption. Intentions and attitudes were important predictors of use across beverages. …

Are Specific Language Impairment And Dyslexia Distinct Disorders?, Hugh W. Catts, Suzanne M. Adlof, Tiffany Hogan, Susan Ellis Weismer

Faculty Publications

Purpose - The purpose of this study was to determine whether specific language impairment (SLI) and dyslexia are distinct developmental disorders.

Method - Study 1 investigated the overlap between SLI identified in kindergarten and dyslexia identified in 2nd, 4th, or 8th grades in a representative sample of 527 children. Study 2 examined phonological processing in a subsample of participants, including 21 children with dyslexia only, and 43 children with SLI only, 18 children with SLI and dyslexia, and 165 children with typical language/reading development. Measures of phonological awareness and nonword repetition were considered.

Results - Study 1 showed limited but …

Remote Physiological Monitoring: Clinical, Financial, And Behavioral Outcomes In A Heart Failure Population, Laurel R. Hudson Msn, Rn, G. Brent Hamar Dds, Mph, Patty Orr Rn, Edd, Jeffrey H. Johnson Bs, Amy Neftzger Ma, Richard S. Chung Md, Myra L. Williams Mph, William M. Gandy Edd, Albert Crawford Phd, Mba, Msis, Janice L. Clarke Rn, Bba, Neil I. Goldfarb

College of Population Health Faculty Papers

This article reports on the outcomes associated with remote physiological monitoring (RPM) conducted as part of a heart failure disease management program. Claims data, medical records, data transmission records, and survey results for 91 individuals ages 50–92 (mean 74 years) successfully completing a heart failure RPM program were analyzed for time periods before, during, and after the monitoring intervention. The program was associated with significant reductions in per member per month costs and emergency room and hospital utilization. More detailed analyses were performed for specific gender and age subgroups. Participant surveys indicated high levels of satisfaction, and improvements in self-perceived …

Differential Impairment As An Indicator Of Sex Bias In Dsm-Iv Criteria For Four Personality Disorders, Christina D. Boggs, Leslie C. Morey, Andrew E. Skodol, M. Tracie Shea, Charles A. Sanislow, Carlos M. Grilo, Thomas H. Mcglashan, Mary C. Zanarini, John G. Gunderson

Charles A. Sanislow, Ph.D.

The aim of the present study was to investigate the possibility of sex bias in the diagnostic criteria for borderline, schizotypal, avoidant, and obsessive-compulsive personality disorders. A clinical sample of 668 individuals was evaluated for personality disorder criteria using a semistructured interview, and areas of functional impairment were assessed with both self-report and semistructured interview. The authors used a regression model of bias to identify bias as differences in slopes or intercepts between men and women in the relationship between each diagnostic criterion and level of impairment. The results suggest that most of the diagnostic criteria examined do not seem …

Effects Of Screening And Brief Intervention Training On Resident And Faculty Alcohol Intervention Behaviours: A Pre- Post-Intervention Assessment, J. Paul Seale, Sylvia Shellenberger, John M. Boltri, Ike S. Okosun, Barbara Barton

Public Health Faculty Publications

Background: Many hazardous and harmful drinkers do not receive clinician advice to reduce their drinking. Previous studies suggest under-detection and clinician reluctance to intervene despite awareness of problem drinking (PD). The Healthy Habits Project previously reported chart review data documenting increased screening and intervention with hazardous and harmful drinkers after training clinicians and implementing routine screening. This report describes the impact of the Healthy Habits training program on clinicians' rates of identification of PD, level of certainty in identifying PD and the proportion of patients given advice to reduce alcohol use, based on self-report data using clinician exit questionnaires.

Methods: …

“A Black Spot”: Florida’S Crusade Against Venereal Disease, Prostitution, And Female Sexuality During World War Ii

Florida Public Health Review

No abstract provided.

Population Intervention Models In Causal Inference, Alan E. Hubbard, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Marginal structural models (MSM) provide a powerful tool for estimating the causal effect of a] treatment variable or risk variable on the distribution of a disease in a population. These models, as originally introduced by Robins (e.g., Robins (2000a), Robins (2000b), van der Laan and Robins (2002)), model the marginal distributions of treatment-specific counterfactual outcomes, possibly conditional on a subset of the baseline covariates, and its dependence on treatment. Marginal structural models are particularly useful in the context of longitudinal data structures, in which each subject's treatment and covariate history are measured over time, and an outcome is recorded at …

Gauss-Seidel Estimation Of Generalized Linear Mixed Models With Application To Poisson Modeling Of Spatially Varying Disease Rates, Subharup Guha, Louise Ryan

Harvard University Biostatistics Working Paper Series

Generalized linear mixed models (GLMMs) provide an elegant framework for the analysis of correlated data. Due to the non-closed form of the likelihood, GLMMs are often fit by computational procedures like penalized quasi-likelihood (PQL). Special cases of these models are generalized linear models (GLMs), which are often fit using algorithms like iterative weighted least squares (IWLS). High computational costs and memory space constraints often make it difficult to apply these iterative procedures to data sets with very large number of cases.

This paper proposes a computationally efficient strategy based on the Gauss-Seidel algorithm that iteratively fits sub-models of the GLMM …

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. N‐nitroso compounds are known carcinogens, which are found in cigarette smoke and can induce gliomas in rats. On this basis, it has been hypothesized that cigarette smoking may be associated with an increased risk of glioma. We investigated the association between cigarette smoking and glioma risk in the National Breast Screening Study, which included 89,835 Canadian women aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths …

Cigarette Smoking And Risk Of Glioma: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. N‐nitroso compounds are known carcinogens, which are found in cigarette smoke and can induce gliomas in rats. On this basis, it has been hypothesized that cigarette smoking may be associated with an increased risk of glioma. We investigated the association between cigarette smoking and glioma risk in the National Breast Screening Study, which included 89,835 Canadian women aged 40–59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths …

Evaluation Of African-American And White Racial Classification In A Surveillance, Epidemiology, And End Results Cancer Registry, Diva A. Patel, Alicia Knowles, Ann G. Schwartz, Kendra Schwartz

FMPHS Faculty Publications

Objectives: This study evaluated the validity of registry-reported race for individuals who participated in research studies conducted since 1980 through the Metropolitan Detroit Cancer Surveillance System (MDCSS), a Surveillance, Epidemiology, and End Results (SEER) Program registry.

Methods: 5329 individuals who self-identified as African American or White and were classified in the MDCSS registry as African American or White were included. Self-identified and registry-reported race were compared, and associations between demographics and racial misclassification were examined.

Results: Most self-identified African Americans and Whites were correctly classified (sensitivity= 98.5%, specificity=99.7%). Males were two times more likely to be misclassified than females [odds …

Estimation And Projection Of Indicence And Prevalence Based On Doubly Truncated Data With Application To Pharmacoepidemiological Databases, Henrik Stovring, Mei-Cheng Wang

Johns Hopkins University, Dept. of Biostatistics Working Papers

Incidences of disease are of primary interest in any epidemiological analysis of disease spread in general populations. Ordinary estimates obtained from follow-up of an initially non-diseased cohort are costly, and so such estimates are not routinely available. In contrast, routine registers exist for many diseases with data on all detected cases within a given calendar time period, but lacking information on non-diseased. In the present work we show how this type of data supplemented with data on the past birth process can be analyzed to yield age specific incidence estimates as well as lifetime prevalence. A non-parametric model is studied …

Is The Number Of Sick Persons In A Cohort Constant Over Time?, Paula Diehr, Ann Derleth, Anne Newman, Liming Cai

UW Biostatistics Working Paper Series

Objectives: To estimate the number of persons in a cohort who are sick, over time.

Methods: We calculated the number of sick persons in the Cardiovascular Health Study (CHS), a cohort study of older adults followed up to 14 years, using eight definitions of “healthy” and “sick”. We projected the number in each health state over time for a birth cohort.

Results: The number of sick persons in CHS was approximately constant for 14 years, for all definitions of “sick”. The estimated number of sick persons in the birth cohort was approximately constant from ages 55-75, after which it decreased. …

Abortion: The Reality For Women Of Praia Grande, Anna Tawse

Independent Study Project (ISP) Collection

Under Brazilian law, abortions are prohibited in all cases except for pregnancies resulting from rape or sexual violence and pregnancies which present possible death or harm to the mother. Upon a closer look, however, it is obvious that regardless of the illegality, Brazilian women are getting abortions. In light of this, I conducted a research project to uncover more about the reality that Brazilian women, specifically located in Praia Grande (a small community on Ilha de Mare off the coast of Salvador), face given the simultaneous existence of the two situations listed above (which I refer to as the “abortion …

Recruitment And Retention Of Emergency Medical Technicians: A Qualitative Study, P. Daniel Patterson, Janice C. Probst, Katherine H. Leith, Sara J. Corwin, M. Paige Powell

Faculty Publications

Emergency medical technicians (EMTs) are critical to out-of-hospital care, but maintaining staff can be difficult. The study objective was to identify factors that contribute to recruitment and retention of EMTs and paramedics. Information was drawn from three focus groups of EMT-Basic, EMT-Intermediate, and EMT-Paramedic personnel recruited from participants at an annual conference. Thoughts and feelings of EMTs and paramedics were investigated using eight questions designed to explore entry into emergency medical services, what it is like to be an EMT or paramedic, and the EMT educational process. Data were analyzed at the group level for common themes using NVivo. For …

A Preliminary Test Of A Student-Centered Intervention On Increasing Physical Activity In Underserved Adolescents, Dawn K. Wilson, Alexandra E. Evans, Joel Williams, Gary Mixon, John R. Sirard, Russell R. Pate

Faculty Publications

Background - Previous studies have shown that choice and self-initiated behavior changes are important for increasing intrinsic motivation and physical activity (PA), however, little of this research has focused on underserved adolescents.

Purpose - This study examined the effects of a 4-week student-centered intervention on increasing PA in underserved adolescents.

Methods - Twenty-eight students in the intervention school were matched (on race, percentage on free or reduced-price lunch program, gender, and age) with 20 students from another school who served as the comparison group (30 girls, 18 boys; ages 10-12 years; 83% African American; 83% on free or reduced-price lunch). …

People Living With, Not Dying From Disease: Patient Empowerment Through Anti-Retroviral Therapy And Possibilities For Social Change, Xin Wei Ngiam

Independent Study Project (ISP) Collection

In South Africa today, it is estimated that there are 6.5 million people living with HIV/AIDS, at least half a million of whom require urgent treatment. On the continent of Africa as a whole the numbers are even more startling. Unfortunately, although the South African government has now committed itself to rolling out anti-retroviral therapy through the public healthcare system, progress has been slower than expected. Yet in numerous sites around South Africa, rollout centres have been established successfully, even in the most rural parts of the country. These programmes rely on existing community initiatives, community health workers and volunteers, …

The Relationship Between Leisure-Time Physical Activity And The Metabolic Syndrome: An Examination Of Nhanes Iii, 1988-1994, Katrina D. Dubose, Cheryl L. Addy, Barbara E. Ainsworth, Gregory A. Hand, J. Larry Durstine

Faculty Publications

No abstract provided.

The Silence Around Them: Aids Ngos, Scaling Up And Aids Fatigue In University Students, Carolyn Holmes

Independent Study Project (ISP) Collection

HIV/AIDS is undoubtedly one of the most talked about aspects of the political scene in South Africa. This epidemic is expected to ravage the South African population, wholly changing the country’s demographic landscape. The most infected and affected generation is also the first generation to come of age in the democracy for which their parents fought. In this study, the author examines the attitudes and opinions of students within the aforementioned generation; current students at the Howard College Campus of the University of KwaZulu Natal in Durban. Largely, the students were found to be apathetic and overexposed to NGO’s campaigns …

The Collaborative Longitudinal Personality Disorders Study (Clps): Overview And Implications, Andrew E. Skodol, John G. Gunderson, M. Tracie Shea, Thomas H. Mcglashan, Leslie C. Morey, Charles A. Sanislow, Donna S. Bender, Carlos M. Grilo, Mary C. Zanarini, Shirley Yen, Maria E. Pagano, Robert L. Stout

Charles A. Sanislow, Ph.D.

The Collaborative Longitudinal Personality Disorders Study (CLPS; Gunderson et al., 2000) was developed to fill gaps in our understanding of the nature, course, and impact of personality disorders (PDs). Here, we review published findings to date, discuss their implications for current conceptualizations of PDs, and raise questions that warrant future consideration. We have found that PDs are more stable than major depressive disorder, but that meaningful improvements are possible and not uncommon. We have confirmed also that PDs constitute a significant public health problem, with respect to associated functional impairment, extensive treatment utilization, negative prognostic impact on major depressive disorder, …

A Population-Based Longitudinal Healthcare Database In The Emilia-Romagna Region, Italy: A Resource For Planning And Research, Daniel Z. Louis, Elaine J. Yuen, Vittorio Maio, Carol Rabinowitz, Mary Robeson, Kenneth D. Smith, Joseph S. Gonnella

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Assessing Chronic Disease Rates Through Automated Pharmacy Data, Vittorio Maio, Elaine J. Yuen, Masahito Jimbo, Carol Rabinowitz, Daniel Z. Louis

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Jchp To Conduct Ehealth Summer Institute, Kevin J. Lyons, Kathy Swenson-Miller, Diane Cornman-Levy

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Development Of An Instrument To Measure Lifelong Learning Among Physicians, Mohammadreza Hojat, Thomas J. Nasca, James B. Erdmann, Anthony J. Frisby, J. Jon Veloski, Joseph S. Gonnella

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

Jefferson's Patient Encounter Log System (Pels), Daniel Z. Louis, Susan L. Rattner, Richard Cowan, Michael Mei, Carol Rabinowitz

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.

A Comparison Of Matched African American And White Jefferson Graduates, John J. Gartland

Population Health Matters (Formerly Health Policy Newsletter)

No abstract available.