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Full-Text Articles in Medicine and Health Sciences

Community-Level Characteristics Associated With Variations In Rates Of Homelessness Among Families And Single Adults, Jamison D. Fargo, Ellen A. Munley, Thomas H. Byrne, Ann Elizabeth Montgomery, Dennis P. Culhane Nov 2013

Community-Level Characteristics Associated With Variations In Rates Of Homelessness Among Families And Single Adults, Jamison D. Fargo, Ellen A. Munley, Thomas H. Byrne, Ann Elizabeth Montgomery, Dennis P. Culhane

Dennis P. Culhane

Objectives. We modeled rates of family and single-adult homelessness in the United States in metropolitan and nonmetropolitan regions and as a function of community-level demographic, behavioral, health, economic, and safety net characteristics.
Methods. We entered community-level characteristics and US Department of Housing and Urban Development point-in-time counts for a single night in January 2009 into separate mixed-effects statistical analyses that modeled homelessness rates for 4 subpopulations: families and single adults inmetropolitan and nonmetropolitan regions.
Results. Community-level factors accounted for 25% to 50% of the variance in homelessness rates across models. In metropolitan regions, alcohol consumption, social support, and several economic …


Active Presecription Drug Safety Surveillance: Exploring Omop 2011-2012 Experiments, Susan Gruber, James M. Robins Oct 2013

Active Presecription Drug Safety Surveillance: Exploring Omop 2011-2012 Experiments, Susan Gruber, James M. Robins

Susan Gruber

The Observational Medical Outcomes Partnership (OMOP), a consortium of pharmaceutical, FDA, and academic researchers focuses on developing and evaluating electronic records-based methods for enhancing post-market drug safety surveillance. The OMOP 2011-2012 experiment consists of applying variants of seven analysis methods to five different EMR or claims databases to estimate the increase (decrease) in risk associated with drug-outcome pairs whose causal association has been previously established, and serves as a gold standard for comparison. Variants of each method can produce very different effect estimates, sometimes at odds with the gold standard. We explore the reasons behind this heterogeneity, and in doing …


Designing The Search Trial: Ph250b In Practice, Laura Balzer Sep 2013

Designing The Search Trial: Ph250b In Practice, Laura Balzer

Laura B. Balzer

No abstract provided.


Rates Of Insurance For Injured Patients Before And After Health Care Reform In Massachusetts: Another Case Of Double Jeopardy?, Heena P. Santry, Courtney E. Collins, Jason T. Wiseman, Julie M. Flahive, Charles M. Psoinos, Zeling Chau, Shimul A. Shah, Catarina I. Kiefe Jul 2013

Rates Of Insurance For Injured Patients Before And After Health Care Reform In Massachusetts: Another Case Of Double Jeopardy?, Heena P. Santry, Courtney E. Collins, Jason T. Wiseman, Julie M. Flahive, Charles M. Psoinos, Zeling Chau, Shimul A. Shah, Catarina I. Kiefe

Catarina I. Kiefe

Background: As a result of healthcare reform (HCR), insurance rates among Massachusetts (MA) residents increased from 86.6% (2006) to 94.4% (2010) and conferred a 7.6% higher probability of being insured compared to neighboring states. The effect of an individual mandate on insurance rates among trauma patients is unknown.

Methods: This was retrospective analysis of adult (18-64yrs) trauma patients from MA and surrounding states (NH, RI, CT, NY, VT) treated at our level 1 trauma center in central MA before (2004-2005) and after (2009-2010) MA-HCR. We estimated changes in insurance rates across time-periods and state-residence.

Results: Before MA-HCR, 76.7% (1647/2,148) of …


Correlates Of Hiv Acquisition In A Cohort Of Black Men Who Have Sex With Men In The United States: Hiv Prevention Trials Network (Hptn) 061, Sheldon D. Fields Jul 2013

Correlates Of Hiv Acquisition In A Cohort Of Black Men Who Have Sex With Men In The United States: Hiv Prevention Trials Network (Hptn) 061, Sheldon D. Fields

Sheldon D. Fields

No abstract provided.


Editorial: Thematic Issue: Infection Control: A Paradigm Shift, Vineet Gupta, Mohamed H. Yassin May 2013

Editorial: Thematic Issue: Infection Control: A Paradigm Shift, Vineet Gupta, Mohamed H. Yassin

Vineet Gupta, MD, FACP

No abstract provided.


Why Are There Delays In Seeking Treatment For Childhood Diarrhoea In India?, Nisha Malhotra May 2013

Why Are There Delays In Seeking Treatment For Childhood Diarrhoea In India?, Nisha Malhotra

Nisha Malhotra

Abstract Aim To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment.

Methods Data from Indian Demographic and Health survey 2005–06 (NFHS-III) was used. Mothers were asked if their children (<5-years) had suffered from diarrhoea during the two weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness, and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the “delay” in seeking advice/treatment.

Results Out of a sample of 41,287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percent of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08 – 2.54), richest (OR 1.76; 95% CI, 1.24 – 2.48) wealth index, mother's lack of knowledge of oral …


Estimating Effects On Rare Outcomes: Knowledge Is Power, Laura B. Balzer, Mark J. Van Der Laan May 2013

Estimating Effects On Rare Outcomes: Knowledge Is Power, Laura B. Balzer, Mark J. Van Der Laan

Laura B. Balzer

Many of the secondary outcomes in observational studies and randomized trials are rare. Methods for estimating causal effects and associations with rare outcomes, however, are limited, and this represents a missed opportunity for investigation. In this article, we construct a new targeted minimum loss-based estimator (TMLE) for the effect of an exposure or treatment on a rare outcome. We focus on the causal risk difference and statistical models incorporating bounds on the conditional risk of the outcome, given the exposure and covariates. By construction, the proposed estimator constrains the predicted outcomes to respect this model knowledge. Theoretically, this bounding provides …


Special Report: Immigration Experience And Health, Shamara M. Baidoobonso, Roxanne Longman Marcellin, Julius Ehiemua, Rob Haile, Leah Meidinger, Harina Mokanan Feb 2013

Special Report: Immigration Experience And Health, Shamara M. Baidoobonso, Roxanne Longman Marcellin, Julius Ehiemua, Rob Haile, Leah Meidinger, Harina Mokanan

Shamara M Baidoobonso, PhD

No abstract provided.


A Case-Control Study Of Physical Activity Patterns And Risk Of Non-Fatal Myocardial Infarction, Jian Gong, Hannia Campos, Mark Fiecas, Stephen Mcgarvey, Robert Goldberg, Caroline Richardson, Ana Baylin Dec 2012

A Case-Control Study Of Physical Activity Patterns And Risk Of Non-Fatal Myocardial Infarction, Jian Gong, Hannia Campos, Mark Fiecas, Stephen Mcgarvey, Robert Goldberg, Caroline Richardson, Ana Baylin

Mark Fiecas

Background The interactive effects of different types of physical activity on cardiovascular disease (CVD) risk have not been fully considered in previous studies. We aimed to identify physical activity patterns that take into account combinations of physical activities and examine the association between derived physical activity patterns and risk of acute myocardial infarction (AMI). Methods We examined the relationship between physical activity patterns, identified by principal component analysis (PCA), and AMI risk in a case-control study of myocardial infarction in Costa Rica (N=4172), 1994-2004. The component scores derived from PCA and total METS were used in natural cubic spline models …


Progression From New Methicillin-Resistant Staphylococcus Aureus Colonisation To Infection: An Observational Study In A Hospital Cohort, Michelle Nd Balm, Andrew A. Lover, Sharon Salmon, Paul A. Tambyah, Dale A. Fisher Dec 2012

Progression From New Methicillin-Resistant Staphylococcus Aureus Colonisation To Infection: An Observational Study In A Hospital Cohort, Michelle Nd Balm, Andrew A. Lover, Sharon Salmon, Paul A. Tambyah, Dale A. Fisher

Andrew Lover

Background
Patients newly colonised with methicillin-resistant Staphylococcus aureus (MRSA) are at higher risk of clinical MRSA infection. At present, there are limited data on the duration or magnitude of this risk in a hospital population with a known time of MRSA acquisition.
Methods
A retrospective cohort study of 909 adult patients known to have newly identified MRSA colonisation during admission to National University Hospital, Singapore between 1 July 2007 and 30 June 2011 was undertaken. Patients were excluded if they had history of previous MRSA colonisation or infection, or if they had been a hospital inpatient in the preceding 12 …


Quantifying Effect Of Geographic Location On Epidemiology Of Plasmodium Vivax Malaria, Andrew A. Lover, Richard J. Coker Dec 2012

Quantifying Effect Of Geographic Location On Epidemiology Of Plasmodium Vivax Malaria, Andrew A. Lover, Richard J. Coker

Andrew Lover

Recent autochthonous transmission of Plasmodium vivax malaria in previously malaria-free temperate regions has generated renewed interest in the epidemiology of this disease. Accurate estimates of the incubation period and time to relapse are required for effective malaria surveillance; however, this information is currently lacking. By using historical data from experimental human infections with diverse P. vivax strains, survival analysis models were used to obtain quantitative estimates of the incubation period and time to first relapse for P. vivax malaria in broad geographic regions. Results show that Eurasian strains from temperate regions have longer incubation periods, and Western Hemisphere strains from …