Public Health Commons^™

A Hybrid Model For Reducing Ecological Bias, Ruth Salway, Jon Wakefield

UW Biostatistics Working Paper Series

A major drawback of epidemiological ecological studies, in which the association between area-level summaries of risk and exposure are used to make inference about individual risk, is the difficulty in characterising within-area variability in exposure and confounder variables. To avoid ecological bias, samples of individual exposure/confounder data within each area are required. Unfortunately these may be difficult or expensive to obtain, particularly if large samples are required. In this paper we propose a new approach suitable for use with small samples. We combine a Bayesian non-parametric Dirichlet process prior with an estimating functions approach, and show that this model gives …

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 …

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 …

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. …

News From Cart, Patricia J. Fanning, Amos Nwosu

Bridgewater Review

No abstract provided.

Thought Suppression Change In Cancer Patients And Survivors After Writing, Erin O'Carroll Bantum

Loma Linda University Electronic Theses, Dissertations & Projects

Breast cancer is a debilitating and many times fatal disease that will affect approximately 215,990 women in the United States alone this year. Treatment for breast cancer can involve many physically and psychologically straining features. The illness perception theory states that individuals form illness representations to make sense of health threats and illness. These representations contain a number of individual, specific attributes about the illness identity, and cause, time-line, consequences of, and cure/control of the illness. Many women who have experienced breast cancer have also been found to be keeping their thoughts inside. Thought suppression has been linked to many …

Ukimwi : Hiv/Aids In Kenya, Virginia Wangui Gathua

Graduate Research Papers

This manuscript points out the deficiencies school counseling programs in Kenya for children/adolescents affected/infected by HIV/AIDS. In addition, the paper is intended to inform, guide, and encourage policy makers, program developers, and school counselors as they develop school counseling interventions for the disease. The focus of the paper is limited to children/adolescents because they bear the greatest burden of HIV/ AIDS infections. The paper also provides evidence for planning and implementation of culturally and developmentally relevant, school-based counseling interventions. The paper explores the impact of HIV/AIDS on Kenyan children/adolescents infected/affected by HIV/AIDS and points out the factors that hinder prevention …

Higher Burden Of Hemorrhagic Stroke Among Women An Autopsy-Based Study In São Paulo, Brazil, Paulo A. Lotufo

Paulo A Lotufo

The aim of this study was to verify the gender difference in sudden cardiovascular death, mainly comparing brain infarction and hemorrhagic stroke. We analyzed 970 autopsy cases from a total of 3,802 nonviolent deaths (448 considered as sudden deaths, 296 undetermined, and 226 non-sudden deaths) including patients aged 30–69 years. All cardiovascular diseases were responsible for 69% of sudden deaths, and all types of stroke for only 14%. The proportions of sudden death for all cardiovascular diseases, coronary heart disease and ischemic stroke deaths were similar for both sexes. However, sudden deaths due to all types of stroke (women 20.0%; …

Stroke In Brazil: A Neglected Disease, Paulo A. Lotufo

Paulo A Lotufo

The turning point in the transition from infectious diseases to non-transmittable diseases in Brazil occurred in the 1960s, taking the country as a whole. However, considering the main cities, such as São Paulo and Rio de Janeiro, cerebrovascular disease mortality rates have surpassed the “old cardiovascular diseases” like rheumatic heart disease and syphilitic aortic disease since the end of World War II. Until the end of the 1980s, the burden of stroke mortality observed in the main Brazilian cities was higher than in the United States, Canada and western European countries, and similar to what is observed in Eastern Europe …

Trends Of Stroke Subtypes Mortality In Sao Paulo, Brazil (1996-2003), Paulo A. Lotufo, Isabela M. Bensenor

Paulo A Lotufo

The decline of stroke mortality rates has been described in Brazil; however, there is no data about stroke subtypes. We described the changes of stroke mortality rates in the city of Sao Paulo (1996-2003) emphasizing intracerebral hemorrhage and cerebral infarction. We categorized mortality data by gender and 10-year age-strata from 30 to 79 years-old. For men, an annual reduction of all types of stroke (-3.9%), and of stroke subtypes as intracerebral hemorrhage (-3.0%) and cerebral infarction was observ e d (-2.7%) as well as, a decline of ill-defined stroke (-7.4%). For women, a decline was observed for all types of …

Why Brazil Does Not Have An Epidemic Of Chronic Diseases: Some Answers From Cardiovascular Diseases, Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

The "Common Soil" Theory: Coronary Disease, Diabetes And Inflammation., Paulo A. Lotufo

Paulo A Lotufo

No abstract provided.

Progress Testing: Evaluation Of Four Years Of Application In The School Of Medicine, University Of São Paulo, Paulo A. Lotufo

Paulo A Lotufo

Progress testing is a longitudinal tool for evaluating knowledge gains during the medical school years. Objectives: (1) To implement progress testing as a form of routine evaluation; (2) to verify whether cognitive gain is a continuous variable or not; and (3) to evaluate whether there is loss of knowledge relating to basic sciences in the final years of medical school. Methods: A progress test was applied twice a year to all students from 2001 to 2004. The mean percentage score was calculated for each school year, employing ANOVA with post hoc Bonferroni test evaluation for each test. Results:Progress testing was …

Community-Based Participatory Research: Defining Community Stakeholders, Laurene M. Tumiel-Berhalter, Robert Watkins, Carlos J. Crespo

Community Health Faculty Publications and Presentations

Community-based participatory research requires the participation of community stakeholders to inform the process. The West Side Community Asthma Project, a community-based participatory research program to study the effects of the environment on asthma conducted in Buffalo, N. Y, identified a stakeholders group of community leaders and activists. Creative strategies have been implemented to reach out to other community residents to invite them to participate in the participatory process.

Programming For Hiv Prevention In South African Schools: A Report On Program Implementation, Priscilla Reddy, Shegs James, Ann P. Mccauley

HIV and AIDS

An evaluation study conducted in KwaZulu Natal, South Africa, provides important insights into whether learners who participated in a fact-based, interactive course had more knowledge about HIV risks, prevention, and care practices; more positive attitudes toward prevention practices and people living with HIV and AIDS; and a higher prevalence of reported safe behaviors than comparable learners who did not participate in the course. Results show that the Life Skills Grade 9 Curriculum had a positive impact of students’ knowledge of HIV/AIDS, attitudes about abstinence, and intention to use condoms. There was, however, no evidence of increased adoption of such protective …

Understanding The Hiv/Sti Risks And Prevention Needs Of Men Who Have Sex With Men In Nairobi, Kenya, Washington Onyango-Ouma, Harriet Birungi, Scott Geibel

HIV and AIDS

Despite increasing awareness of the role men who have sex with men (MSM) can play in the dynamics of HIV transmission in Africa, research on MSM in Kenya has been limited. In response to this gap, researchers from the Institute of African Studies at the University of Nairobi and the Horizons and FRONTIERS programs of the Population Council undertook a study of MSM in Nairobi. The overall goals of the study were to understand the extent to which MSM are at risk of HIV and other STIs, identify the factors associated with risk behaviors, and identify MSM sexual health needs …

Reducing The Transmission Of Hiv And Sexually Transmitted Infections In A Mining Community: Findings From The Carletonville Mothusimpilo Intervention Project: 1998 To 2001, Lewis Ndhlovu, Catherine Searle, Johannes Van Dam, Yodwa Mzaidume, Bareng Rasego, Solly Moema

HIV and AIDS

The Horizons program, in collaboration with the Center for Scientific and Industrial Research, the South African Institute for Medical Research, and the London School of Economics, conducted an intervention study in the mining town of Carletonville, South Africa to examine the social determinants of the HIV epidemic, and to assess the impact of a targeted program of HIV and STI prevention and service delivery. The project did not reduce STI prevalence or HIV prevalence, as changing sexual behavior is far more complex than educating individuals about HIV. The report recommends interventions to support behavioral change education, STI treatment, the role …

Literature Review: Policies And Conditions Surrounding The Integration Of 'Traditional' Medical Systems And 'Western' Biomedicine, Treena Orchard

Dr. Treena Orchard

No abstract provided.

Understanding The Social And Cultural Context Of Female Sex Workers In Karnataka, India: Implications For Prevention Of Hiv Infection, J. Blanchard, J. O'Neil, B. Ramesh, P. Bhattacharjee, Treena Orchard, S. Moses

Dr. Treena Orchard

No abstract provided.

Conservation And Development Interventions At The Wildlife-Livestock Interface, Steven A. Osofsky, Sarah Cleaveland, William B. Karesh, Michael D. Kock, Philip J. Nyhus, Lisa Starr, Angela Yang

Philip J. Nyhus

No abstract provided.

One In Three, David J. Malebranche

David J Malebranche

No abstract provided.

Community-Acquired Methicillin-Resistant Staphylococcus Aureus: Time To Address The Problem, David J. Malebranche

David J Malebranche

No abstract provided.

Adverse Health Outcomes Among Black Americans: Living With Hiv - Nature Or Nurture?, David J. Malebranche

David J Malebranche

No abstract provided.

Focusing "Down Low": Bisexual Black Men, Hiv Risk And Heterosexual Transmission, Gregorio Millett, David Malebranche, Byron Mason, Pilgrim Spikes

David J Malebranche

Introduction: Black men who have sex with men (MSM) and women but who do not identify as gay or disclose their bisexual activities to main female partners, also known as men “on the down-low,” have been cited as the main reason for the increase in HIV infections in black women. Methods: Three online databases (PsychInfo, MEDLINE and AIDSLINE) were searched for scientific articles related to men on the down-low. A total of 24 articles and two conference abstracts were selected for review. Results: Data from existing studies of MSM reveal low agreement between professed sexual identity and corresponding sexual behavior …

A Wintertime Study Of Pahs In Fine And Coarse Aerosols In Sa˜O Paulo City, Brazil, Paulo A. Lotufo

Paulo A Lotufo

The Polycyclic aromatic hydrocarbons PAHs (naphthalene, acenaphthylene, acenaphthene, phenanthrene, fluoranthene, pyrene, benzo(a)anthracene, chrysene, benzo(b)fluoranthene, benzo(k)fluoranthene, benzo(a)pyrene, indeno(1,2,3-cd)pyrene and benzo(ghi)perylene) concentrations in fine (PM2.5) and coarse (PM2.5–10) atmospheric particulate matter were measured at Sa˜o Paulo city, Brazil. The dominant PAHcompounds were indeno(1,2,3-cd)pyrene, benzo(ghi)perylene and benzo(b)fluoranthene for both the fractions. The calculated ratios of some specific PAHs were in close agreement with those attributed to direct emissions of car exhaust. The factor analysis for PM2.5 produced four factors: Factor 1 was attributed to diesel emissions, Factor 2 was attributed to stationary combustion source, Factor 3 was attributed to vehicular emissions and Factor …

Clinical And Radiographic Correlates Clinical And Radiographic Correlates: A Molecular Epidemiology Study, Elvin H. Geng

Elvin H Geng

No abstract provided.