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Als Surveillance In Massachusetts: A One-Of-A-Kind Registry For Tracking An Elusive Disease, Vannalyn Abille, Alicia Fraser, Robert Knorr 2017 Massachusetts Department of Public Health

Als Surveillance In Massachusetts: A One-Of-A-Kind Registry For Tracking An Elusive Disease, Vannalyn Abille, Alicia Fraser, Robert Knorr

Community Engagement and Research Symposia

Background: Amyotrophic Lateral Sclerosis (ALS) is a progressive and fatal neuromuscular disease with an etiology not yet fully understood. The Massachusetts Argeo Paul Cellucci ALS Registry is a unique population-based surveillance system used to monitor the occurrence of ALS throughout the state and to explore possible environmental causes of the disease.

Methods: The Registry gathers annual reports of ALS cases from physicians, hospitals, and clinics in accordance with state regulations. Medical records are obtained and abstracted for each case, and eligible cases are reviewed by a consulting neurologist to confirm diagnosis. Necessary clinical and demographic information are recorded in a ...


Longitudinal Changes In Neurodevelopmental Outcomes Between 18 And 36 Months In Children With Prenatal Triptan Exposure: Findings From The Norwegian Mother And Child Cohort Study, Mollie E. Wood, Jean A. Frazier, Hedvig M.E. Nordeng, Kate L. Lapane 2017 University of Massachusetts Medical School

Longitudinal Changes In Neurodevelopmental Outcomes Between 18 And 36 Months In Children With Prenatal Triptan Exposure: Findings From The Norwegian Mother And Child Cohort Study, Mollie E. Wood, Jean A. Frazier, Hedvig M.E. Nordeng, Kate L. Lapane

Jean A. Frazier

OBJECTIVE: This study sought to determine whether changes in neurodevelopmental outcomes between 18 and 36 months of age were associated with prenatal exposure to triptan medications, a class of 5-HT receptor agonists used in the treatment of migraine. METHOD: Using data from the Norwegian Mother and Child Cohort Study, a prospective birth cohort that includes nearly 40% of all pregnancies in Norway from 1999 to 2008, we identified 50 469 mother-child dyads who met inclusion criteria and were present for at least one follow-up assessment at 18 or 36 months postpartum. Neurodevelopment was assessed using the Child Behaviour Checklist, the ...


Breast Cancer Care In California And Ontario: Primary Care Protections Greatest Among The Most Socioeconomically Vulnerable Women Living In The Most Underserved Places, Kevin M. Gorey, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty 2017 University of Windsor

Breast Cancer Care In California And Ontario: Primary Care Protections Greatest Among The Most Socioeconomically Vulnerable Women Living In The Most Underserved Places, Kevin M. Gorey, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty

Social Work Publications

Background: Better health care among Canada’s socioeconomically vulnerable versus America’s has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. Methods: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists. The optimal care criterion was being diagnosed early with node negative disease and received breast conserving surgery followed by adjuvant radiation ...


Demographic Differences And Annual Trends In Childhood And Adolescent Cancer Incidence And Mortality In Michigan During The Period 1999-2012, Gergana Kodjebacheva, Jeremy Blankenship, Lenwood Hayman, Shan Parker 2017 University of Michigan - Flint

Demographic Differences And Annual Trends In Childhood And Adolescent Cancer Incidence And Mortality In Michigan During The Period 1999-2012, Gergana Kodjebacheva, Jeremy Blankenship, Lenwood Hayman, Shan Parker

Journal of Health Disparities Research and Practice

Background. Michigan has declining economic conditions and factories that release pollutants. During the period 1999-2012, only 10 out of 50 states had an overall cancer incidence rate that was higher than that in Michigan. It is not known how children’s cancer rates in Michigan vary by age, gender, race/ethnicity, and year as well as how these rates compare to those in the U.S.

Method: The Center for Disease Control and Prevention WONDER database obtained cancer incidence and mortality data from cancer registries and death certificates. We compared age-adjusted incidence and mortality cancer rates by gender, race/ethnicity ...


Unique Breast Cancer Features Within The Vietnamese Population, Polly Niravath, Melissa Bondy, Susan G. Hilsenbeck 2017 Baylor College of Medicine

Unique Breast Cancer Features Within The Vietnamese Population, Polly Niravath, Melissa Bondy, Susan G. Hilsenbeck

Journal of Health Disparities Research and Practice

BACKGROUND: Breast cancer is known to be a heterogeneous disease across women, and even within individual tumors. However, relatively little is known about heterogeneity across cultures. There has been some evidence to suggest that Asian women are more likely to have HER2+ breast cancer than their Caucasian counterparts.

PURPOSE: The aim of this study was to further investigate the unique pattern of breast cancer incidence and subtype in the Vietnamese population.

METHODS: We retrospectively collected data on all Vietnamese women diagnosed with invasive breast cancer at the Lester & Sue Smith Breast Center in Houston, Texas over a four year period ...


Gender Differences In Hiv Care Among Criminal Justice-Involved Persons: Baseline Data From The Care+ Corrections Study., Curt Beckwith, Breana Uhrig Castonguay, Claudia Trezza, Lauri Bazerman, Rudy Patrick, Alice Cates, Halli Olsen, Ann Kurth, Tao Liu, James Peterson, Irene Kuo 2017 George Washington University

Gender Differences In Hiv Care Among Criminal Justice-Involved Persons: Baseline Data From The Care+ Corrections Study., Curt Beckwith, Breana Uhrig Castonguay, Claudia Trezza, Lauri Bazerman, Rudy Patrick, Alice Cates, Halli Olsen, Ann Kurth, Tao Liu, James Peterson, Irene Kuo

Epidemiology and Biostatistics Faculty Publications

BACKGROUND: HIV-infected individuals recently released from incarceration have suboptimal linkage and engagement in community HIV care. We conducted a study to evaluate an information and communication technology intervention to increase linkage to community care among HIV-infected persons recently involved in the criminal justice (CJ) system. Baseline characteristics including risk behaviors and HIV care indicators are reported and stratified by gender.

METHODS: We recruited HIV-infected individuals in the District of Columbia jail and persons with a recent history of incarceration through community and street outreach. Participants completed a baseline computer-assisted personal interview regarding HIV care and antiretroviral treatment (ART) adherence, substance ...


Organ Donation: Gauging Perception, Interest, And Clarifying Misconceptions, Tridu Huynh 2017 University of Vermont - College of Medicine

Organ Donation: Gauging Perception, Interest, And Clarifying Misconceptions, Tridu Huynh

Family Medicine Block Clerkship, Student Projects

Around 120,000 people currently need a lifesaving organ transplant in the United States. On average, 22 people die each day while waiting for a life-saving organ transplant. In 2011, over $34 billion dollars were spent on dialysis patients with end-stage renal disease. Only 52% of the national population is registered for organ donation. In Vermont, that number is 44%. This project aimed to clarify some common misconceptions regarding organ donation in the form of a brochure. Participants' subsequent interest and concerns regarding registering as an organ donor were also gauged. A total of 50 people filled out the form ...


Stroke Outreach In The Lao Community, Noor A. Dythavon 2016 University of San Francisco

Stroke Outreach In The Lao Community, Noor A. Dythavon

Master's Projects

CNL Abstract

A community health needs assessment for the service area prompted concern regarding access to quality healthcare for non-English speaking Southeast Asians (SEA) in the area. Goals of an initial investigation and subsequent implementation of sustainable stroke health fairs for non-English speaking communities were evaluated to assess primary healthcare concerns that the SEA community face and to suggest long-term solutions to these issues. Initial investigation required researching population-specific minority health statistics to quantify the prevalence of chronic diseases and conditions which were prioritized in terms of needs versus disparities. Research came from evidence base practice guidelines and personal concern ...


Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean 2016 University of San Francisco

Vitamin D, Calcium And Blood Pressure In The U.S., Sarah Bean

Master's Projects

Vitamin D and calcium have received increased attention for their potential roles in improving cardiovascular health. The active form of vitamin D, 1,25-hydroxyvitamin D (25[OH]D), may influence blood pressure by increasing gastrointestinal calcium absorption. The objectives of this study were to first examine the association between blood pressure and blood serum 25(OH)D levels, and then explore the interaction between 25(OH)D, calcium intake, and blood pressure. Cross-sectional analysis featured 24,844 U.S. adults aged 20-80 years from three cycles of the National Health and Examination Survey (NHANES 2001-2006). Linear regression models were used ...


Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg 2016 University of Massachusetts Medical School

Decade-Long Trends In The Timeliness Of Receipt Of A Primary Percutaneous Coronary Intervention, Han-Yang Chen, Joel M. Gore, Kate L. Lapane, Jorge L. Yarzebski, Sharina D. Person, Catarina I. Kiefe, Robert J. Goldberg

Jorge L. Yarzebski

OBJECTIVES: The purpose of this study was to examine decade-long trends (2001-2011) in, and factors associated with, door-to-balloon time within 90 minutes of hospital presentation among patients hospitalized with ST-segment elevation myocardial infarction (STEMI) who received a primary percutaneous coronary intervention (PCI). METHODS: Residents of central Massachusetts hospitalized with STEMI who received a primary PCI at two major PCI-capable medical centers in central Massachusetts on a biennial basis between 2001 and 2011 comprised the study population (n=629). Multivariable regression analyses were used to examine factors associated with failing to receive a primary PCI within 90 minutes after emergency department ...


A Delphi Process To Address Medication Appropriateness For Older Persons With Multiple Chronic Conditions, Terri R. Fried, Kristina Niehoff, Jennifer Tjia, Nancy Redeker, Mary K. Goldstein 2016 Yale University

A Delphi Process To Address Medication Appropriateness For Older Persons With Multiple Chronic Conditions, Terri R. Fried, Kristina Niehoff, Jennifer Tjia, Nancy Redeker, Mary K. Goldstein

Jennifer Tjia

BACKGROUND: Frameworks exist to evaluate the appropriateness of medication regimens for older patients with multiple medical conditions (MCCs). Less is known about how to translate the concepts of the frameworks into specific strategies to identify and remediate inappropriate regimens.

METHODS: Modified Delphi method involving iterative rounds of input from panel members. Panelists (n = 9) represented the disciplines of nursing, medicine and pharmacy. Included among the physicians were two geriatricians, one general internist, one family practitioner, one cardiologist and two nephrologists. They participated in 3 rounds of web-based anonymous surveys.

RESULTS: The panel reached consensus on a set of markers to ...


Development Of A Database Model To Support Inpatient Physicians’ Patient Handoff Needs, Benjamin Barsotti 2016 Oregon Health & Science University

Development Of A Database Model To Support Inpatient Physicians’ Patient Handoff Needs, Benjamin Barsotti

Scholar Archive

Medicine is faced with the unintended safety consequences of increased physician-to-physician handoffs of patients. Patient care had traditionally been provided by one physician who would follow a patient throughout his or her admission, but recent changes including restrictive resident duty hours and development of hospitalists have increased the frequency of transitioning patient care from physician to physician or team to team.

These transitions of care have been identified as a high-risk situation for increasing medical errors. This is compounded by the complexity of patients including polypharmacy, increasing acuity, changing code status, and multiple consultants. Studies have found that high-quality handoffs ...


Association Between Pregnancy Intention And Maternal Characteristics, Outcomes, And Cost Of Care: A Pilot Study, Kristy M. Kelel, Kiley B. Vander Wyst, Danielle M. Greer, Danish Siddiqui 2016 Department of Obstetrics and Gynecology, Aurora Sinai Medical Center

Association Between Pregnancy Intention And Maternal Characteristics, Outcomes, And Cost Of Care: A Pilot Study, Kristy M. Kelel, Kiley B. Vander Wyst, Danielle M. Greer, Danish Siddiqui

Journal of Patient-Centered Research and Reviews

Background: An estimated 51% of pregnancies in the United States are unintended. In Wisconsin, unplanned pregnancies account for 40% of all pregnancies and cost $148 million in public funds. Unintended pregnancy, which creates increased hardship for mothers and threatened well-being of infants, has been recognized as an important health, social and economic problem.

Purpose: To determine the pregnancy intentions of postpartum women and the maternal characteristics, outcomes and costs of care associated with unintended pregnancies at a large urban hospital in Milwaukee, Wisconsin.

Methods: Postpartum women were surveyed prior to discharge. The 20-item survey included whether or not the woman ...


Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi 2016 Aurora Nursing Administration

Determining The Incidence And Factors Of Cardiotoxicity In Breast Cancer Patients Treated With Anthracycline And/Or Trastuzumab-Containing Regimen At Aurora Health Care, Stephanie Ghojallu, Matthew Rappelt, Han-Yang Chen, Ruth Perez, Lydia Garlie, Geoffrey Riddell, Yingying Gu, Jun Zhang, Rubina Qamar, Bijoy K. Khandheria, Arshad Jahangir, Yang Shi

Journal of Patient-Centered Research and Reviews

Background: Anthracycline and trastuzumab are common breast cancer treatments. While improving survival, they elevate risk of congestive heart failure. The incidence of cardiotoxicity (CTx) with these therapies varies in the literature from 10% to 59%, higher than those reported in clinical trials (4%–10%) that excluded patients with preexisting cardiovascular comorbidities. Studies have failed to establish consensus on the risk factors for CTx associated with these therapies.

Purpose: We aim to determine the incidence and risk factors of CTx in breast cancer patients treated with anthracycline and/or trastuzumab at Aurora Health Care.

Methods: A retrospective review of patients with ...


Comparative Effectiveness Research Using Observational Data: Active Comparators To Emulate Target Trials With Inactive Comparators, Anders Huitfeldt, Miguel A. Hernan, Mette Kalager, James M. Robins 2016 Harvard T.H. Chan School of Public Health

Comparative Effectiveness Research Using Observational Data: Active Comparators To Emulate Target Trials With Inactive Comparators, Anders Huitfeldt, Miguel A. Hernan, Mette Kalager, James M. Robins

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: Because a comparison of non-initiators and initiators of treatment may be hopelessly confounded, guidelines for the conduct of observational research often recommend using an “active” comparator group consisting of people who initiate a treatment other than the medication of interest. In this paper, we discuss the conditions under which this approach is valid if the goal is to emulate a trial with an inactive comparator.

Identification of Effects: We provide conditions under which a target trial in a subpopulation can be validly emulated from observational data, using an active comparator that is known or believed to be inactive for ...


Nortex Fall 2016 Newsletter, North Texas Primary Care Practice-Based Research Network 2016 University of North Texas Health Science Center

Nortex Fall 2016 Newsletter, North Texas Primary Care Practice-Based Research Network

North Texas Primary Care Practice-Based Research Network (NorTex) Newsletter

No abstract provided.


Atrial Fibrillation Without Comorbidities: Prevalence, Incidence And Prognosis (From The Framingham Heart Study), Eun-Jeong Kim, Xiaoyan Yin, Joao D. Fontes, Jared W. Magnani, Steven A. Lubitz, David D. McManus, Sudha Seshadri, Ramachandran S. Vasan, Patrick T. Ellinor, Martin G. Larson, Emelia J. Benjamin, Michael Rienstra 2016 Massachusetts General Hospital

Atrial Fibrillation Without Comorbidities: Prevalence, Incidence And Prognosis (From The Framingham Heart Study), Eun-Jeong Kim, Xiaoyan Yin, Joao D. Fontes, Jared W. Magnani, Steven A. Lubitz, David D. Mcmanus, Sudha Seshadri, Ramachandran S. Vasan, Patrick T. Ellinor, Martin G. Larson, Emelia J. Benjamin, Michael Rienstra

David D. McManus

BACKGROUND: The epidemiology of atrial fibrillation (AF) without comorbidities, known as 'lone AF', is uncertain. Although it has been considered a benign condition, we hypothesized that it confers a worse prognosis compared with a matched sample without AF.

METHODS: We described the proportion of AF without comorbidities (clinical, subclinical cardiovascular disease and triggers) among the entire AF sample in Framingham Heart Study (FHS). We compared AF without comorbidities with typical AF, and age-, sex- and cohort-matched individuals without AF, using Cox proportional hazards analysis in relation to combined cardiovascular events (stroke, heart failure, myocardial infarction), and mortality.

RESULTS: Of 10 ...


Multimodal Learning And Intelligent Prediction Of Symptom Development In Individual Parkinson's Patients, Andrzej W. Przybyszewski, Mark Kon, Stanislaw Szlufik, Artur Szymanski, Piotr Habela, Dariusz M. Koziorowski 2016 University of Massachusetts Medical School

Multimodal Learning And Intelligent Prediction Of Symptom Development In Individual Parkinson's Patients, Andrzej W. Przybyszewski, Mark Kon, Stanislaw Szlufik, Artur Szymanski, Piotr Habela, Dariusz M. Koziorowski

Open Access Articles

We still do not know how the brain and its computations are affected by nerve cell deaths and their compensatory learning processes, as these develop in neurodegenerative diseases (ND). Compensatory learning processes are ND symptoms usually observed at a point when the disease has already affected large parts of the brain. We can register symptoms of ND such as motor and/or mental disorders (dementias) and even provide symptomatic relief, though the structural effects of these are in most cases not yet understood. It is very important to obtain early diagnosis, which can provide several years in which we can ...


Longitudinal Changes In Neurodevelopmental Outcomes Between 18 And 36 Months In Children With Prenatal Triptan Exposure: Findings From The Norwegian Mother And Child Cohort Study, Mollie E. Wood, Jean A. Frazier, Hedvig M.E. Nordeng, Kate L. Lapane 2016 University of Massachusetts Medical School

Longitudinal Changes In Neurodevelopmental Outcomes Between 18 And 36 Months In Children With Prenatal Triptan Exposure: Findings From The Norwegian Mother And Child Cohort Study, Mollie E. Wood, Jean A. Frazier, Hedvig M.E. Nordeng, Kate L. Lapane

Open Access Articles

OBJECTIVE: This study sought to determine whether changes in neurodevelopmental outcomes between 18 and 36 months of age were associated with prenatal exposure to triptan medications, a class of 5-HT receptor agonists used in the treatment of migraine.

METHOD: Using data from the Norwegian Mother and Child Cohort Study, a prospective birth cohort that includes nearly 40% of all pregnancies in Norway from 1999 to 2008, we identified 50 469 mother-child dyads who met inclusion criteria and were present for at least one follow-up assessment at 18 or 36 months postpartum. Neurodevelopment was assessed using the Child Behaviour Checklist, the ...


Sample Size Formulas For Estimating Intraclass Correlation Coefficients In Reliability Studies With Binary Outcomes, Mengxiao Xu 2016 The University of Western Ontario

Sample Size Formulas For Estimating Intraclass Correlation Coefficients In Reliability Studies With Binary Outcomes, Mengxiao Xu

Electronic Thesis and Dissertation Repository

Introduction: Measurement errors can seriously affect quality of clinical practice and medical research. It is therefore important to assess such errors by conduct- ing studies to estimate a coefficients reliability and assessing its precision. The intraclass correlation coefficient (ICC), defined on a model that an observation is a sum of information and random error, has been widely used to quantify reliability for continuous measurements. Sample formulas have been derived for explicitly incorporation of a prespecified probability of achieving the prespecified precision, i.e., the width or lower limit of a confidence interval for ICC. Although the concept of ICC is ...


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