Medicine and Health Sciences Commons^™

A National Estimate Of The Cost Of Illness In Parkinson's Disease Using Retrospective Data Analysis, Katherine Anderson

Theses and Dissertations (ETD)

The purpose of this study was to estimate the cost of illness of Parkinson’s disease in the United States. Direct medical expenditures, with the exception of nursing home costs, were estimated using data from the 1999-2003 Medical Expenditures Panel Survey Household Component (MEPS-HC). Nursing home costs were estimated using the Medical Expenditures Panel Survey Nursing Home Component (MEPS-NHC). Indirect costs for lost productivity due to missed work or bed-days (morbidity) were estimated using the MEPS-HC and the Bureau of Labor Statistics (BLS). Indirect costs for lost productivity due to death (mortality) were estimated using the National Vital Statistics System.

Direct …

What Is The Cost To Employers Of Direct Medical Care For Chronic Obstructive Pulmonary Disease?, Tursynbek Nurmagambetov, Adam Atherly, Seymour Williams, Fernando Holguin, David M. Mannino, Stephen C. Redd

David M. Mannino

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the United States. In 2000, an estimated 10.5 million people had COPD, of which more than 7.2 million were from the under-age 65 employed population. The prevalence of COPD in the workforce population was substantial with 46.5% of current employment among adults having the disease. However, the cost burden in the employed population is unknown. We examined COPD prevalence and costs in a large employment-based population. Using claims data from 1999 to 2003, we estimated the cost associated with COPD-related hospitalizations, emergency department visits, outpatient services, …

Assessing The Effectiveness Of Antiretroviral Adherence Interventions: Using Marginal Structural Models To Replicate The Findings Of Randomized Controlled Trials., Maya L. Petersen, Yue Wang, Mark J. Van Der Laan, David R. Bangsberg

Maya Petersen

Randomized controlled trials of interventions to improve adherence to antiretroviral medications are not always feasible. Marginal Structural Models (MSM) are a statistical methodology that aims to replicate the findings of randomized controlled trials using observational data. Under the assumption of no unmeasured confounders, three MSM estimators are available to estimate the causal effect of an intervention. Two of these estimators, G-computation and Inverse Probability of Treatment Weighted, can be implemented using standard software. G-computation relies on fitting a multivariable regression of adherence on the intervention and confounders. Thus, it is related to the standard multivariable regression approach to estimating causal …

Stress, Coping, Social Support, And Prostate Cancer Risk Among Older African American And Caucasian Men, Ann L. Coker, Maureen Sanderson, Gary L. Ellison, Mary Kay Fadden

CRVAW Faculty Journal Articles

Objectives: While psychosocial stress and high effort coping have been associated with reduced immune function, no epidemiologic study has addressed psychological stress and risk of prostate cancer. The purpose of this analysis was to investigate the association between stress, coping, social support, and risk of prostate cancer among older men (age 65–79 years). Design: Population-based case-control study in South Carolina.

Participants: Cases were 400 incident, histologically confirmed prostate cancer cases identified through the South Carolina Central Cancer Registry between 1999 and 2001 (70.6% response rate). Controls were 385 men identified through the 1999 Health Care Financing Administration Medicare beneficiary file …

Changing The Burden Of Copd Mortality, David M. Mannino, Victor A. Kiri

David M. Mannino

COPD is a major cause of mortality and morbidity worldwide with an estimated 2.75 million deaths in 2000 (fourth leading cause of death). In addition to the considerable morbidity and mortality associated with COPD, this disease incurs significant healthcare and societal costs. Current COPD guidelines acknowledge that the following can improve COPD mortality: smoking cessation; long-term oxygen therapy; and lung volume reduction surgery in small subsets of COPD patients. To date, no randomized controlled trials have demonstrated an effect of pharmacological treatment on mortality, although several observational studies suggest that both long-acting bronchodilators and inhaled corticosteroids may provide a survival …

Central Nervous System Involvement In Dengue Viral Infection, Romasa Channa, Mohammad Wasay

Department of Medicine

Neurological manifestations of dengue infection are rare. This review includes data regarding the epidemiology of the disease, neurological manifestations,pathogenesis, diagnosis and prognosis. It is based on 9 original articles and 10 case reports, adding up to 200 cases of dengue fever with neurological manifestations. Relevant cases have been reported from Asia, the Pacific rim, the Americas, the Mediterranean region, and Africa. A wide range of neurological manifestations has been reported. Altered consciousness and seizure are among the more common manifestations. The exact pathogenesis of this disease has not yet been established. However, recent studies hypothesize that the virus is neurotropic. …

Botulinum Toxin Type A In The Prophylactic Treatment Of Chronic Tension-Type Headache: A Multicentre, Double-Blind, Randomized, Placebo-Controlled, Parallel-Group Study, Stephen D. Silberstein, H. Göbel, R. Jensen, A. H. Elkind, R. Degryse, J. M.C.M. Walcott, C. Turkel

Department of Neurology Faculty Papers

We studied the safety and efficacy of 0 U, 50 U, 100 U, 150 U (five sites), 86 Usub and 100 Usub (three sites) botulinum toxin type A (BoNTA; BOTOX); Allergan, Inc., Irvine, CA, USA) for the prophylaxis of chronic tension-type headache (CTTH). Three hundred patients (62.3% female; mean age 42.6 years) enrolled. For the primary endpoint, the mean change from baseline in the number of TTH-free days per month, there was no statistically significant difference between placebo and four BoNTA groups, but a significant difference favouring placebo vs. BoNTA 150 was observed (4.5 vs. 2.8 tension headache-free days/month; P …

Hospitalization For Patients With Sarcoidosis: 1979-2000, M. G. Foreman, David M. Mannino, L. Kamugisha, G. E. Westney

David M. Mannino

BACKGROUND AND AIM:

Sarcoidosis is a multi-system granulomatous disease of unknown etiology with significant racial and gender differences in disease severity, incidence, and prevalence. Primarily treated in outpatients, limited information is available on hospital outcomes in patients with sarcoidosis. The National Hospital Discharge Survey (NHDS) was analyzed over a 22-year period to determine trends in hospitalization and the impact of concurrent comorbidities.

METHODS:

Secondary analysis was done of the NHDS, a national survey of inpatient medical care for short stays in nonfederal facilities.

RESULTS:

There were a total of 750 million hospitalizations over this 22-year period, with 593,455 (0.08%) hospitalizations …

Energy Balance And Breast Cancer Risk: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Jain Meera, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

While there is evidence that breast cancer risk is positively associated with body mass index (in postmenopausal women) and energy intake and inversely associated with physical activity, few studies have examined breast cancer risk in association with energy balance, the balance between energy intake and expenditure. Therefore, in the cohort study reported here, we studied the independent and combined associations of vigorous physical activity, energy consumption, and body mass index (BMI), with breast cancer risk. The investigation was conducted in 49,613 Canadian women who were participants in the National Breast Screening Study (NBSS) and who completed self- administered lifestyle and …

Estimation Of Direct Causal Effects., Maya L. Petersen, Sandra E. Sinisi, Mark J. Van Der Laan

Maya Petersen

Many common problems in epidemiologic and clinical research involve estimating the effect of an exposure on an outcome while blocking the exposure's effect on an intermediate variable. Effects of this kind are termed direct effects. Estimation of direct effects arises frequently in research aimed at understanding mechanistic pathways by which an exposure acts to cause or prevent disease, as well as in many other settings. Although multivariable regression is commonly used to estimate direct effects, this approach requires assumptions beyond those required for the estimation of total causal effects. In addition, when the exposure and intermediate interact to cause disease, …

Seasonal Variation In Food Intake, Physical Activity, And Body Weight In A Predominantly Overweight Population, Yunsheng Ma, Barbara C. Olendzki, W. Li, Andrea R. Hafner, David E. Chiriboga, James R. Hébert, Mary Jane Campbell, M. Sarnie, Ira S. Ockene

Faculty Publications

OBJECTIVE:

To describe seasonal variation in food intake, physical activity, and body weight in a predominantly overweight population.

DESIGN:

A longitudinal observational study.

SETTING:

Most of the study participants were recruited from a health maintenance organization (HMO) in central Massachusetts, USA. Additional individuals of Hispanic descent were recruited from outside of the HMO population to increase the ethnic diversity of this sample.

SUBJECTS:

Data from 593 participants, aged 20-70, were used for this investigation. Each participant was followed quarterly (five sampling points: baseline and four consecutive quarters) for 1-year period. Body weight measurements and three 24-h dietary and physical activity …

Carotenoid, Vitamin A, Vitamin C, And Vitamin E Intake And Risk Of Ovarian Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

It is thought that oxidative stress resulting to repeated ovulation may increase the risk of ovarian cancer by inducing DNA damage (1). Consumption of antioxidants may, therefore, decrease ovarian cancer risk by counteracting oxidative stress and the resultant DNA damage (2, 3). Currently, the epidemiologic evidence regarding associations between antioxidants and risk of ovarian cancer is mixed (4-12). Of the two prospective studies, Kushi et al. (4) and Fairfield et al. (7) both reported no association between β-carotene and ovarian cancer risk. In addition, Fairfield et al. …

Observation And Model Error Effects On Parameter Estimates In Susceptible-Infected-Recovered Epidemiological Models, Tom L. Burr, Gerardo Chowell

Public Health Faculty Publications

Recently, confidence intervals (CIs) associated with parameter estimates in the susceptibleinfected-recovered epidemiological model have been developed. When model assumptions are met and the observation error is relatively small, these CIs are relatively short. This work describes the behavior of CIs for parameters as observation and/or equation or model error becomes larger, and includes a comparison of two estimation procedures. One procedure demonstrates significant bias as observation error increases; the other procedure demonstrates significant bias as model error increases.

Serological And Virological Investigations Of Bovine Viral Diarrhoea Virus (Bvdv) Infection In Dairy Cattle Herds In Aydın Province, Mehmet Tolga Tan, M. Taner Karaoğlu, Nural Erol, Yakup Yildirim

Turkish Journal of Veterinary & Animal Sciences

A total of 288 dairy cattle from 4 different closed barns were sampled in order to investigate the presence of bovine viral diarrhoea virus (BVDV) infection. Based on the data gathered from neutralisation peroxidase-linked antibody (NPLA) tests, which were conducted to detect BVDV antibodies, all of the barns monitored previously had the infection; the rates of seropositive animals were between 44% and 100%. Overall, the results obtained from Aydın province showed that 248 of the 288 dairy cows (86%) monitored were seropositive. BVDV antigen ELISA kits (Bio-X Diagnostics- Belgium) were used to detect BVDV antigen (NS3 protein) in blood samples. …

Diseases Of White Sea Bream (Diplodus Sargus L.) Reared In Experimental And Commercial Conditions In Greece, Eleni Golomazou, Fotini Athanassopoulou, Styliani Vagianou, Olga Sabatakou, Hlias Tsantilas, Georgios Rigos, Lambros Kokkokiris

Turkish Journal of Veterinary & Animal Sciences

A bacteriological and parasitological study of the white sea bream, Diplodus sargus L., was conducted as this species is a potential candidate for aquaculture in Mediterranean countries. The study comprised fish reared in commercial cages (2 farms) located in different geographical localities, as well as fish reared experimentally in cages located in a natural enclosed lagoon. Fish were examined in the fresh state by means of smears from all internal and external organs and by histology. Microbiology was also performed at all sites. Mortality was low (12%) at farm 1 (Argolida), while at farm 2 (Korinth) and the lagoon it …

Access To Death Certificates: What Should Research Ethics Committees Require For Approval?, Tore Nilstun, Colleen Cartwright, Rurik Lofmark, L Deliens, Susanne Fischer, Guido Miccinesi, Michael Norup, Agnes Van Der Heide

Professor Colleen M Cartwright

Purpose: To present and discuss the reactions of research ethics committees (RECs) in a number of countries when asked for approval of a study requiring access to death certificates to identify the physicians signing the certificates and to send them a four-page questionnaire about medical decisions made at the patient's end-of-life that could possibly have hastened death. Methods: A simple questionnaire were sent to the responsible national investigator in an international study (Australia, Belgium, Denmark, Italy, the Netherlands, Sweden, Switzerland) asking about the interactions between the national research group and the national/regional REC(s). Results: Different laws or guidelines were used …

The Prevalence And Characteristics Of Intimate Partner Violence In A Community Study Of Chinese American Women., Madelyn Hicks

Madelyn Hsiao-Rei Hicks

No abstract provided.