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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 ...


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 ...


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 ...


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 ...


Advancing Population Health: New Models And The Role Of Research. An Overview Of The 22nd Annual Health Care Systems Research Network Conference, Robert T. Greenlee, Lois E. Lamerato, Sarah M. Greene 2016 Marshfield Clinic Research Foundation

Advancing Population Health: New Models And The Role Of Research. An Overview Of The 22nd Annual Health Care Systems Research Network Conference, Robert T. Greenlee, Lois E. Lamerato, Sarah M. Greene

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN; formerly HMO Research Network) held its annual conference in Atlanta, Georgia, in April 2016. A consortium of research organizations affiliated with 20 large health care delivery systems, the HCSRN met for the 22nd consecutive year to report on scientific achievements, develop and share skills and best practices, and promote new research collaborations. The 2016 conference, with a theme of “Advancing Population Health: New Models and the Role of Research,” was co-hosted on behalf of HCSRN by Marshfield Clinic Research Foundation and Henry Ford Health System’s Public Health Sciences Department. The 350 ...


Using Machine Learning And Natural Language Processing Algorithms To Automate The Evaluation Of Clinical Decision Support In Electronic Medical Record Systems, Donald A. Szlosek, Jonathan M. Ferretti 2016 University of Southern Maine

Using Machine Learning And Natural Language Processing Algorithms To Automate The Evaluation Of Clinical Decision Support In Electronic Medical Record Systems, Donald A. Szlosek, Jonathan M. Ferretti

eGEMs (Generating Evidence & Methods to improve patient outcomes)

Introduction: As the number of clinical decision support systems incorporated into electronic medical records increases, so does the need to evaluate their effectiveness. The use of medical record review and similar manual methods for evaluating decision rules is laborious and inefficient. Here we use machine learning and natural language processing (NLP) algorithms to accurately evaluate a clinical decision support rule through an electronic medical record system and compare it against manual evaluation.

Methods: Modeled after the electronic medical record system EPIC at Maine Medical Center, we developed a dummy dataset containing physician notes in free text for 3621 artificial patients ...


Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar 2016 University of Massachusetts Medical School

Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar

Tiffany A. Moore Simas

OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were ...


Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar 2016 University of Massachusetts Medical School

Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar

Jeroan J. Allison

OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were ...


Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar 2016 University of Massachusetts Medical School

Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar

Nancy Byatt

OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were ...


Multiple Chronic Conditions And Psychosocial Limitations In A Contemporary Cohort Of Patients Hospitalized With An Acute Coronary Syndrome, Mayra Tisminetsky, Jerry H. Gurwitz, David D. McManus, Jane S. Saczynski, Molly E. Waring, Nathaniel Erskine, Milena D. Anatchkova, David C. Parish, Darleen M. Lessard, Catarina I. Kiefe, Robert J. Goldberg 2016 University of Massachusetts Medical School

Multiple Chronic Conditions And Psychosocial Limitations In A Contemporary Cohort Of Patients Hospitalized With An Acute Coronary Syndrome, Mayra Tisminetsky, Jerry H. Gurwitz, David D. Mcmanus, Jane S. Saczynski, Molly E. Waring, Nathaniel Erskine, Milena D. Anatchkova, David C. Parish, Darleen M. Lessard, Catarina I. Kiefe, Robert J. Goldberg

Molly E. Waring

Background: As adults live longer, multiple chronic conditions have become more prevalent over the past several decades. We describe the prevalence of, and patient characteristics associated with, cardiac and non-cardiac-related multimorbidities in patients discharged from the hospital after an acute coronary syndrome (ACS).

Methods: We studied 2,174 patients discharged from the hospital after an ACS at 6 medical centers in Massachusetts and Georgia between April, 2011 and May, 2013. Hospital medical records yielded clinical information including presence of 8 cardiac-related and 8 non-cardiac-related morbidities on admission. We assessed multiple psychosocial characteristics during the index hospitalization using standardized in-person instruments ...


Accumulation Of Metabolic Cardiovascular Risk Factors In Black And White Young Adults Over 20 Years, Nina P. Paynter, Catarina I. Kiefe, Cora E. Lewis, Catherine M. Loria, David C. Goff, Donald Lloyd-Jones 2016 Harvard Medical School

Accumulation Of Metabolic Cardiovascular Risk Factors In Black And White Young Adults Over 20 Years, Nina P. Paynter, Catarina I. Kiefe, Cora E. Lewis, Catherine M. Loria, David C. Goff, Donald Lloyd-Jones

Catarina I. Kiefe

BACKGROUND: Cross-sectional clustering of metabolic risk factors for cardiovascular disease in middle-aged adults is well described, but less is known regarding the order in which risk factors develop through young adulthood and their relation to subclinical atherosclerosis.

METHOD AND RESULTS: A total of 3178 black and white women and men in the Coronary Artery Risk Development in Young Adults study were assessed to identify the order in which cardiovascular disease risk factors including diabetes, hypertension, dyslipidemia (low high-density lipoprotein cholesterol or high triglyceride levels), hypercholesterolemia (high total or low-density lipoprotein cholesterol), and obesity develop. Observed patterns of risk factor development ...


Age And Sex Differences In Long-Term Outcomes Following Implantable Cardioverter-Defibrillator Placement In Contemporary Clinical Practice: Findings From The Cardiovascular Research Network, Frederick A. Masoudi, Jerry H. Gurwitz, Robert J. Goldberg 2016 University of Colorado

Age And Sex Differences In Long-Term Outcomes Following Implantable Cardioverter-Defibrillator Placement In Contemporary Clinical Practice: Findings From The Cardiovascular Research Network, Frederick A. Masoudi, Jerry H. Gurwitz, Robert J. Goldberg

Robert J. Goldberg

BACKGROUND: Patient sex and age may influence rates of death after receiving an implantable cardioverter-defibrillator for primary prevention. Differences in outcomes other than mortality and whether these differences vary by heart failure symptoms, etiology, and left ventricular ejection fraction are not well characterized.

METHODS AND RESULTS: We studied 2954 patients with left ventricular ejection fraction < /=0.35 undergoing first-time implantable cardioverter-defibrillator for primary prevention within the Cardiovascular Research Network; 769 patients (26%) were women, and 2827 (62%) were aged > 65 years. In a median follow-up of 2.4 years, outcome rates per 1000 patient-years were 109 for death, 438 for hospitalization, and 111 for heart failure hospitalizations. Procedure-related complications occurred in 8.36%. In multivariable models, women had significantly lower risks of death (hazard ...


Culturally Adaptive Storytelling Method To Improve Hypertension Control In Vietnam - "We Talk About Our Hypertension": Study Protocol For A Feasibility Cluster-Randomized Controlled Trial, Jeroan J. Allison, Hoa L. Nguyen, Duc A. Ha, German A. Pihan, Ha N. Ly, Hanh T. Tran, Ngoc T. Phan, Nguyen C. Vu, Minjin Kim, Robert J. Goldberg 2016 University of Massachusetts Medical School

Culturally Adaptive Storytelling Method To Improve Hypertension Control In Vietnam - "We Talk About Our Hypertension": Study Protocol For A Feasibility Cluster-Randomized Controlled Trial, Jeroan J. Allison, Hoa L. Nguyen, Duc A. Ha, German A. Pihan, Ha N. Ly, Hanh T. Tran, Ngoc T. Phan, Nguyen C. Vu, Minjin Kim, Robert J. Goldberg

Jeroan J. Allison

BACKGROUND: Vietnam is experiencing an epidemiologic transition with an increased prevalence of non-communicable diseases. At present, the major risk factors for cardiovascular disease (CVD) are either on the rise or at alarming levels in Vietnam; inasmuch, the burden of CVD will continue to increase in this country unless effective prevention and control measures are put in place. A national survey in 2008 found that the prevalence of hypertension (HTN) was approximately 25 % among Vietnamese adults and it increased with advancing age. Therefore, novel, large-scale, and sustainable interventions for public health education to promote engagement in the process of detecting and ...


Can Physician Champions Improve Kangaroo Care? Trends Over 5 Years In Rural Western India, Apurv Soni, Amee Amin, Dipen V. Patel, Nisha Fahey, Ajay G. Phatak, Jeroan Allison, Somashekhar M. Nimbalkar 2016 University of Massachusetts Medical School

Can Physician Champions Improve Kangaroo Care? Trends Over 5 Years In Rural Western India, Apurv Soni, Amee Amin, Dipen V. Patel, Nisha Fahey, Ajay G. Phatak, Jeroan Allison, Somashekhar M. Nimbalkar

Jeroan J. Allison

Introduction: In 2013, approximately 2.8 million children worldwide died within the neonatal period. India is at the epicenter of this tragedy, accounting for one-third of all neonatal mortalities. Prematurity and/or with low birth weight are the leading cause of neonatal mortality and India has the highest number of neonates born preterm and weighing less than 2,500 grams worldwide. It is estimated that Kangaroo Care can avert up to 48% of all neonatal deaths among premature babies by 2025. However, the promise of Kangaroo Care as a low-cost, safe, and efficacious intervention to reduce neonatal mortality in India ...


The Rivas Cohort Study: Design And Baseline Characteristics Of A Nicaraguan Cohort, Madeline Fiore, Amos Lichtman, Keriann Nobil, Louis Fiore 2016 University of Massachusetts Medical School

The Rivas Cohort Study: Design And Baseline Characteristics Of A Nicaraguan Cohort, Madeline Fiore, Amos Lichtman, Keriann Nobil, Louis Fiore

Open Access Articles

BACKGROUND: A lack of advanced healthcare information systems and validated scientific cohorts in Nicaragua makes it difficult to estimate disease prevalences and other public health statistics. Although there is concern of an "epidemic" of chronic kidney disease (CKD) in this country, statistics regarding its magnitude are derived from only a small number of non-representative studies. Budgetary constraints and the logistical problems of maintaining a study cohort make longitudinal studies difficult. The Rivas Cohort was created to measure disease burden of CKD and other public health priorities in the Department of Rivas, Nicaragua. Using primarily volunteer research students and technologic innovation ...


Predictors Of Post-Injury Mortality In Elderly Patients With Trauma: A Master's Thesis, Charles M. Psoinos 2016 University of Massachusetts Medical School

Predictors Of Post-Injury Mortality In Elderly Patients With Trauma: A Master's Thesis, Charles M. Psoinos

GSBS Dissertations and Theses

Background: Traumatic injury remains a major cause of mortality in the US. Older Americans experience lower rates of injury and higher rates of death at lower injury severity than their younger counterparts. The objectives of this study were to explore pre-injury factors and injury patterns that are associated with post-discharge mortality among injured elderly surviving index hospitalization.

Methods: We queried a 5% random sample of Medicare beneficiaries (n=2,002,420) for any hospitalization with a primary ICD-9 diagnosis code for injury. Patients admitted without urgent/emergent admission were excluded, as well as patients presenting from inpatient hospitalization or rehabilitation ...


Implementation And Reporting Of Causal Mediation Analysis In 2015: A Systematic Review In Epidemiological Studies, Shao-Hsien Liu, Christine M. Ulbricht, Stavroula A. Chrysanthopoulou, Kate L. Lapane 2016 University of Massachusetts Medical School

Implementation And Reporting Of Causal Mediation Analysis In 2015: A Systematic Review In Epidemiological Studies, Shao-Hsien Liu, Christine M. Ulbricht, Stavroula A. Chrysanthopoulou, Kate L. Lapane

Open Access Articles

BACKGROUND: Causal mediation analysis is often used to understand the impact of variables along the causal pathway of an occurrence relation. How well studies apply and report the elements of causal mediation analysis remains unknown.

METHODS: We systematically reviewed epidemiological studies published in 2015 that employed causal mediation analysis to estimate direct and indirect effects of observed associations between an exposure on an outcome. We identified potential epidemiological studies through conducting a citation search within Web of Science and a keyword search within PubMed. Two reviewers independently screened studies for eligibility. For eligible studies, one reviewer performed data extraction, and ...


Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar 2016 University of Massachusetts Medical School

Association Of Common Mental Disorder Symptoms With Health And Healthcare Factors Among Women In Rural Western India: Results Of A Cross-Sectional Survey, Apurv Soni, Nisha Fahey, Nancy Byatt, Anusha Prabhakaran, Tiffany A. Moore Simas, Jagdish Vankar, Ajay Phatak, Eileen O'Keefe, Jeroan J. Allison, Somashekhar Nimbalkar

UMass Center for Clinical and Translational Science Supported Publications

OBJECTIVES: Information about common mental disorders (CMD) is needed to guide policy and clinical interventions in low-income and middle-income countries. This study's purpose was to characterise the association of CMD symptoms with 3 inter-related health and healthcare factors among women from rural western India based on a representative, cross-sectional survey.

SETTING: Surveys were conducted in the waiting area of various outpatient clinics at a tertiary care hospital and in 16 rural villages in the Anand district of Gujarat, India.

PARTICIPANTS: 700 Gujarati-speaking women between the ages of 18-45 years who resided in the Anand district of Gujarat, India, were ...


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