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Using Public Health Pbrn Research To Inform Policy & Practice, Public Health Practice-Based Research Networks

Health Management and Policy Reports

The Public Health Practice-Based Research Networks Program is a national program of the Robert Wood Johnson Foundation that supports research networks dedicated to producing new scientific knowledge on how best to organize, finance, and deliver public health strategies in realworld practice settings. This body of scientific inquiry, known as Public Health Services and Systems Research (PHSSR), is a rapidly developing area of scholarship within the larger fields of public health research and health services research. A public health practice-based research network (PBRN) brings multiple public health organizations into collaboration with an academic research center for the purposes of designing and …

Heterogeneity And Data Analysis, Peter J. Taylor

Working Papers on Science in a Changing World

This working paper is a discussion paper for a September 2011 meeting of the research group of Prof. Di Cook on data visualization and exploratory data analysis at Iowa State University. A taxonomy of eleven kinds of heterogeneity is presented, followed by a set of vignettes that illustrate some of the meanings and sketch some implications, then a series of images that illustrate the heterogeneities. Several of the vignettes speak to a broad contention about heterogeneity and control: In relation to modern understandings of heredity and development over the life course, research and application of resulting knowledge are untroubled by …

A Regularization Corrected Score Method For Nonlinear Regression Models With Covariate Error, David M. Zucker, Malka Gorfine, Yi Li, Donna Spiegelman

Harvard University Biostatistics Working Paper Series

No abstract provided.

Estimation Of Risk Ratios In Cohort Studies With Common Outcomes: A Simple And Efficient Two-Stage Approach, Eric J. Tchetgen

Harvard University Biostatistics Working Paper Series

No abstract provided.

Stimulant Reduction Intervention Using Dosed Exercise (Stride) - Ctn 0037: Study Protocol For A Randomized Controlled Trial, Madhukar H. Trivedi, Tracy L. Greer, Bruce D. Grannemann, Timothy S. Church, Eugene Somoza, Steven N. Blair, Jose Szapocznik, Mark Stoutenberg, Chad Rethorst, Diane Warden, Kolette M. Ring, Robrina Walker, David W. Morris, Andrzej S. Kosinski, Tiffany Kyle, Bess H. Marcus, Becca Crowell, Neal Oden, Edward Nunes

Faculty Publications

Background: There is a need for novel approaches to the treatment of stimulant abuse and dependence. Clinical data examining the use of exercise as a treatment for the abuse of nicotine, alcohol, and other substances suggest that exercise may be a beneficial treatment for stimulant abuse, with direct effects on decreased use and craving. In addition, exercise has the potential to improve other health domains that may be adversely affected by stimulant use or its treatment, such as sleep disturbance, cognitive function, mood, weight gain, quality of life, and anhedonia, since it has been shown to improve many of these …

Supplier-Induced Demand For Psychiatric Admissions In Northern New England, Bradley V. Watts, Brian Shiner, Gunnar Klauss, William B. Weeks

Dartmouth Scholarship

The development of hospital service areas (HSAs) using small area analysis has been useful in examining variation in medical and surgical care; however, the techniques of small area analysis are underdeveloped in understanding psychiatric admission rates. We sought to develop these techniques in order to understand the relationship between psychiatric bed supply and admission rates in Northern New England. Our primary hypotheses were that there would be substantial variation in psychiatric admission across geographic settings and that bed availability would be positively correlated with admission rates, reflecting a supplier-induced demand phenomenon. Our secondary hypothesis was that the construction of psychiatric …

On The Nondifferential Misclassification Of A Binary Confounder, Elizabeth L. Ogburn, Tyler J. Vanderweele

COBRA Preprint Series

Abstract Consider a study with binary exposure, outcome, and confounder, where the confounder is nondifferentially misclassified. Epidemiologists have long accepted the unproven but oft-cited result that, if the confounder is binary, odds ratios, risk ratios, and risk differences which control for the mismeasured confounder will lie between the crude and the true measures. In this paper the authors provide an analytic proof of the result in the absence of a qualitative interaction between treatment and confounder, and demonstrate via counterexample that the result need not hold when there is a qualitative interaction between treatment and confounder. They also present an …

Hiv And Concurrent Sexual Partnerships: Modelling The Role Of Coital Dilution, Larry Sawers, Alan G. Isaac, Eileen Stillwaggon

Economics Faculty Publications

Background: The concurrency hypothesis asserts that high prevalence of overlapping sexual partnerships explains extraordinarily high HIV levels in sub-Saharan Africa. Earlier simulation models show that the network effect of concurrency can increase HIV incidence, but those models do not account for the coital dilution effect (nonprimary partnerships have lower coital frequency than primary partnerships).

Methods: We modify the model of Eaton et al (AIDS and Behavior, September 2010) to incorporate coital dilution by assigning lower coital frequencies to non-primary partnerships. We parameterize coital dilution based on the empirical work of Morris et al (PLoS ONE, December …

Equating Accelerometer Estimates Of Moderate-To-Vigorous Physical Activity: In Search Of The Rosetta Stone, Daniel B. Bornstein, Michael W. Beets, Wonwoo Byun, Gregory J. Welk, Matteo Bottai, Marsha Dowda, Russell R. Pate

Faculty Publications

Purpose - No universally accepted ActiGraph accelerometer cutpoints for quantifying moderate-to-vigorous physical activity (MVPA) exist. Estimates of MVPA from one set of cutpoints cannot be directly compared to MVPA estimates using different cutpoints, even when the same outcome units are reported (MVPA min•d^-1). The purpose of this study was to illustrate the utility of an equating system that translates reported MVPA estimates from one set of cutpoints into another, to better inform public health policy.

Design - Secondary data analysis.

Methods - ActiGraph data from a large preschool project (N=419, 3-6yr-olds, CHAMPS) was used to conduct the analyses. …

Setting Research Priorities To Reduce Global Mortality From Childhood Pneumonia By 2015, Igor Rudan, Shams El Arifeen, Zulfiqar Ahmed Bhutta, Robert E. Black, Abdullah Brooks, Kit Yee Chan, Mickey Chopra, Trevor Duke, David Marsh, Antonio Pio, Eric A. F. Simoes, Giorgio Tamburlini, Evropi Theodoratou, Martin W. Weber, Cynthia G. Whitney, Harry Campbell, Shamim A. Qazi

Department of Paediatrics and Child Health

No abstract provided.

A Quantitative Method For Reproducible Ionization Chamber Alignment To A Water Surface For External Beam Radiation Therapy Depth Dose Measurements, James Ververs

Theses and Dissertations

Ionization chambers (ICs) are the most commonly used detectors for radiation therapy dose measurements. Typical IC measurements use cylindrical ICs in a water phantom and therefore require initial IC alignment to the water surface. This alignment has long been ignored and only recently has a qualitative governing recommendation been made. This thesis describes a reproducible methodology for quantitative ionization chamber water surface alignment. Depth-ionization measurements are taken with twenty-eight IC designs under varying conditions including, but not limited to, changes in scan direction, speed, and resolution, radiation beam type, field size, energy, and electron contamination. Measurements are acquired using standard …

Modification By Frailty Status Of Ambient Air Pollution Effects On Lung Function In Older Adults In The Cardiovascular Health Study, Sandrah P. Eckel, Thomas A. Louis, Paulo H.M. Chaves, Linda P. Fried, Helene G. Margolis

Johns Hopkins University, Dept. of Biostatistics Working Papers

Older adult susceptibility to air pollution health effects is well-recognized. Advanced age may act as a partial surrogate for conditions associated with aging. The authors investigated whether gerontologic frailty (a clinical health status metric) modified the effects of ambient ozone or particulate matter (PM10) air pollution on lung function in 3382 older adults using 7 years of followup data from the Cardiovascular Health Study (CHS) and the CHS Environmental Factors Ancillary Study. Monthly average pollution and annual frailty assessments were related to up to 3 repeated measurements of lung function using novel cumulative summaries of pollution and frailty histories that …

Analyse Des Activités De Manutention De Journaliers D'Une Grande Municipalité Québécoise : Un Outil Pour Composer Avec Le Caractère Changeant De La Manutention, Denys Denis, Marie St-Vincent, Monique Lortie, Maud Gonella, Marie-Hélène Dion

Rapports de recherche scientifique

Un trait caractéristique de la grande majorité des activités de manutention est d'être changeant, les tâches de manutention simples (i.e. circonscrites dans l'espace, les lieux et le temps) ayant, dans bien des cas, été automatisées dans les entreprises. Les tâches de manutention que l'on confie aux travailleurs sont plus complexes et demandent de manipuler des charges variées, dans des contextes de travail diversifiés et changeants qui demandent des ajustements constants. Cet aspect « mouvant » est parfois difficile à saisir pour un intervenant qui n'est pas spécialiste de la manutention. C'est le cas d'une grande majorité d'intervenants en santé et …

Validity Of Estimating Minute-By-Minute Energy Expenditure Of Continuous Walking Bouts By Accelerometry, Erin E. Kuffel, Scott E. Crouter, Jere D. Haas, Edward A. Frongillo Jr., David R. Bassett Jr

Faculty Publications

Background: Objective measurement of physical activity remains an important challenge. For wearable monitors such as accelerometer-based physical activity monitors, more accurate methods are needed to convert activity counts into energy expenditure (EE).

Purpose: The purpose of this study was to examine the accuracy of the refined Crouter 2-Regression Model (C2RM) for estimating EE during the transition from rest to walking and walking to rest. A secondary purpose was to determine the extent of overestimation in minute-by-minute EE between the refined C2RM and the 2006 C2RM.

Methods: Thirty volunteers (age, 28 ± 7.7 yrs) performed 15 minutes of seated rest, 8 …

Détermination Du Béryllium Dans L’Air En Milieu De Travail : Mise Au Point D’Une Méthode D’Analyse En Fluorescence, Marie-Claude Giguère, Pierre Larivière, Chantal Dion, Huu Van Tra

Rapports de recherche scientifique

Le béryllium (Be) est rencontré lors de multiples usages industriels grâce à ses propriétés uniques, toutefois il représente un risque pour la santé des travailleurs qui y sont exposés. La bérylliose chronique (BC), une maladie professionnelle reliée à l'exposition au Be, serait la progression d'une phase de sensibilisation consistant en une réponse immunitaire spécifique suite à une exposition au Be. La voie d'absorption principale du Be est l'inhalation de particules, toutefois la pénétration cutanée ne serait pas négligeable dans le processus de sensibilisation.

Depuis les années 90, la CSST a dû indemniser de nombreux travailleurs amenant une préoccupation grandissante face …

Validating The Pridit Method For Determining Hospital Quality With Outcomes Data., Robert D. Lieberthal, Phd, Dominique Comer, Pharmd, Katherine O’Connell, Bs

College of Population Health Lectures, Presentations, Workshops

Presented for The 46th Actuarial Research Conference, University of Connecticut, Storrs, CT.

15 PowerPoint slides

The Use Of Chloramines To Eradicate Quagga Mussel Larvae, Trea Lacroix, Kumud Acharya

Undergraduate Research Opportunities Program (UROP)

Quagga Mussels, Dressenia bugensis, are a growing problem in the western United States, particularly in their ability to infest underwater infrastructures and clog water intake pipes and screens of power and treatment plants. Chlorine has been found to be the most effective chemical to get rid of veligers (planktonic larval form of quagga mussels) in the pipes. However, chlorine leaves a residue called trihalomethane, which is a carcinogen at higher concentrations. The purpose of this project is to test the effectiveness of an alternate chemical, chloramines (chlorine and ammonia), which leaves behind little to no residual trihalomethane. Upon experimentation with …

The Holistic Complementary Structure Of Western Bio-Medicine And Traditional Healing And Achieving Complete Health, Candace Gail Oubre

USF Tampa Graduate Theses and Dissertations

Achieving complete health requires a deep understanding of complementary cultural competency sensitivity between physician and patient. This may include but is not limited to access to preventative health care resources, access to health educational resources and access to cultural healing resources, for example, shamans, Ayurvedic physicians, and herbal healers. Advocates of cultural competency emphasize great importance on knowledge of the patients' cultural background; however, the transcendence of this knowledge can be explained further through complementary cultural competency sensitivity. This is when the cultures of the physician and patient complement each other in terms of understanding what is in the patients' …

An Empirical Investigation Of Supply Chain Excellence In Healthcare, Brian Keith Smith

Graduate Theses and Dissertations

This research is motivated by opportunities to improve the cost and quality of healthcare delivery through improved supply chain processes. This research assesses the quality of the healthcare supply chain and identifies factors that are driving supply chain excellence among organizations in the healthcare industry. The first objective of this research is to assess the state of quality measurement in the healthcare supply chain. The achievement of this first objective is presented in Chapter 3 of this dissertation in the form of a manuscript accepted for publication in The Quality Management Journal. The second research objective is to develop …

Access To Essential Medicines: In Pakistan Identifying Policy Research And Concerns, Shehla Zaidi, Noureen Nishtar

Community Health Sciences

The fundamental importance of ensuring access to medicines, particularly for the poor, is reflected in MDG 8 however remains poor in many low and middle income countries (LMICs). Country specific evidence on access to medicines is weak in LMICs and research has rarely been from an integrated health systems perspective. This study used an evidence based approach to identify key priority concerns and emerging research questions related to access to medicines in Pakistan. WHO’s Access to Medicine Framework was used as the conceptual basis for data collection on rational usage, affordability, financing and health systems. Methods involved a systematic desk …

Appropriate Medication Prescribing In Elderly Patients: How Knowledgeable Are Primary Care Physicians? A Survey Study In Parma, Italy., Vittorio Maio, Pharmd, Ms, Mph, Eric Jutkowitz, Ba, Karina Herrera Ba, Ms, Safiya Abouzaid Pharmd, Giavanna Negri, Pharmd, Stefano Del Canale, Md, Phd

College of Population Health Faculty Papers

What is known and Objective:  Increasing attention is being paid to inappropriate medication prescribing for the elderly. A growing body of studies have detected a prevalence of inappropriate prescribing ranging from 12% to 40% worldwide, including Regione Emilia-Romagna, Italy. To improve quality of prescribing, a multi-phase pilot project in the Local Health Unit (LHU) of Parma, Regione Emilia-Romagna, was established. This phase aimed to assess primary care physicians' knowledge of appropriate prescribing in elderly patients. Methods:  In total, 155 primary care physicians (51% of the total), convened by the LHU of Parma for an educational session, were asked to complete …

Gene By Bmi Interactions Influencing C-Reactive Protein Levels In European-Americans, Sarah Tudor

Dissertations and Theses (Open Access)

C-Reactive Protein (CRP) is a biomarker indicating tissue damage, inflammation, and infection. High-sensitivity CRP (hsCRP) is an emerging biomarker often used to estimate an individual’s risk for future coronary heart disease (CHD). hsCRP levels falling below 1.00 mg/l indicate a low risk for developing CHD, levels ranging between 1.00 mg/l and 3.00 mg/l indicate an elevated risk, and levels exceeding 3.00 mg/l indicate high risk. Multiple Genome-Wide Association Studies (GWAS) have identified a number of genetic polymorphisms which influence CRP levels. SNPs implicated in such studies have been found in or near genes of interest including: CRP, APOE, APOC, IL-6, …

Pathways To Sexual Risk Taking Among Female Adolescent Detainees, Vera Lopez, Albert M. Kopak, Alyssa G. Robillard, Mary Rogers Gillmore, Rhonda Conerly Holliday, Ronald L. Braithwaite

Faculty Publications

Sexual risk taking among female delinquents represents a significant public health problem. Research is needed to understand the pathways leading to sexual risk taking among this population. This study sought to address this issue by identifying and testing two pathways from child maltreatment to non-condom use among 329 White and 484 African American female adolescent detainees: a relational pathway and a substance use coping pathway. The relational pathway indicated that child maltreatment would be related to non-condom use via depressive self-concept and condom use self-efficacy. The substance use coping pathway suggested that depressive self-concept and alcohol-based expectancies for sexual enhancement …

Association Study Of Candidate Gene Polymorphisms And Obesity In A Young Mexican-American Population From South Texas, Jorge Duran-Gonzalez, Ixiu Ortiz, Enrique Gonzales, Nicole Ruiz, Manti Ortiz, Arthur Gonzalez, Edna K. Sanchez, Eugenia Curet, Susan P. Fisher-Hoch, Anne R. Rentfro, Saraswathy Nair

Health & Biomedical Sciences Faculty Publications

Background and Aims

Obesity is increasingly a health problem and a risk factor for diabetes in young Mexican-American populations. Genetic association studies in older, mostly non-Hispanic populations have reported that polymorphisms in the candidate genes HSD11B1, CRP, ADIPOQ, PPARG, ANKK1, ABCC8 and SERPINF1 are associated with obesity or diabetes. We analyzed the polymorphisms rs846910, rs1205, rs1501299, rs1801282, rs1800497, rs757110 and rs1136287in these candidate genes, for association with obesity and metabolic traits in a young Mexican-American population from south Texas.

Methods

Genotyping of the seven common SNPs were performed by allelic discrimination assays in 448 unrelated Mexican Americans (median age = …

How Many Steps/Day Are Enough? For Children And Adolescents, Catrine Tudor-Locke, Cora L. Craig, Michael W. Beets, Sarahjane Belton, Greet M. Cardon, Scott Duncan, Yoshiro Hatano, David R. Lubans, Timothy S. Olds, Anders Raustorp, David A. Rowe, John C. Spence, Shigeho Tanaka, Steven N. Blair

Faculty Publications

Worldwide, public health physical activity guidelines include special emphasis on populations of children (typically 6-11 years) and adolescents (typically 12-19 years). Existing guidelines are commonly expressed in terms of frequency, time, and intensity of behaviour. However, the simple step output from both accelerometers and pedometers is gaining increased credibility in research and practice as a reasonable approximation of daily ambulatory physical activity volume. Therefore, the purpose of this article is to review existing child and adolescent objectively monitored step-defined physical activity literature to provide researchers, practitioners, and lay people who use accelerometers and pedometers with evidence-based translations of these public …

How Many Steps/Day Are Enough? For Adults, Catrine Tudor-Locke, Cora L. Craig, Wendy J. Brown, Stacy A. Clemes, Katrien Decocker, Billie Giles-Corti, Yoshiro Hatano, Shigeru Inoue, Sandra M. Matsudo, Nanette Mutrie, Jean-Michel Oppert, David A. Rowe, Michael D. Schmidt, Grant M. Schofield, John C. Spence, Pedro J. Teixeira, Mark A. Tully, Steven N. Blair

Faculty Publications

Physical activity guidelines from around the world are typically expressed in terms of frequency, duration, and intensity parameters. Objective monitoring using pedometers and accelerometers offers a new opportunity to measure and communicate physical activity in terms of steps/day. Various step-based versions and translations of physical activity guidelines are emerging, reflecting public interest in such guidance. However, there appears to be a wide discrepancy in the exact values that are being communicated. It makes sense that step-based recommendations should be harmonious with existing evidence-based public health guidelines that recognized that "some physical activity is better than none" while maintaining a focus …

Comparing Cognitive Functioning And Adverse Metabolic Effects Of Consumers Taking Type 1 Or Type 2 Antipsychotic Medications With Un-Medicated Consumers, Muhammad Puri

Master of Public Health Program Student Publications

Obesity and metabolic side effects such as diabetes mellitus are major concerns in public health. Mentally ill people are a high risk subgroup for obesity and metabolic syndrome because of behavior, non treatment, and medication side effects. In this research, I conducted a retrospective chart review to compare the weight and body mass index of consumers who were prescribed antipsychotic Type 1 or Type 2 medications. The sample was drawn from consumers attending the Consumer Advocacy Model (CAM) program which is an outpatient substance abuse and mental health treatment program in the Wright State University Boonshoft School of Medicine Department …

Got Worms?: Planning And Evaluation Of A Culturally Appropriate Health Education Pilot Program For The Control Of Soil-Transmitted Helminth Infections In Rwandan Village Children, Pier Hart

Master of Public Health Capstone Presentations

Infections with parasitic intestinal worms known as soil-transmitted helminthes (STH) are endemic in most poor countries in Africa, Asia and Latin America. In Rwanda, the prevalence of helminth infections among school-age children was found to be nearly 70%. Chronic STH infections are associated with malnutrition and anemia, which cause physical and cognitive developmental problems. These morbidities negatively affect educational attainment and vocational productivity and thereby perpetuate the cycle of poverty in affected communities. Control of STH requires both regular deworming treatments and changes in health behaviors relevant to transmission, including personal hygiene and sanitation practices. In Rwanda, a nationwide program …

Assessing Nutrition Knowledge, Skill And Attitudes In Adolescent Girls, Tatyana Jean

Master of Public Health Capstone Presentations

There is still much to be understood about the nutrition habits of adolescents who are just beginning to break away from familial habits and developing individual identities. The African American community in particular, is known to experience disproportionate amounts of overweight and obesity resulting in chronic diseases such as diabetes and hypertension. This study used quantitative and qualitative measures to assess the nutrition skills, knowledge, and attitudesof African American girls aged 14-17. After data analysis, it was found that African American adolescent girls had high body image and self esteem but poor nutrition skill and knowledge. Body image and weight …

Variable Importance Analysis With The Multipim R Package, Stephan J. Ritter, Nicholas P. Jewell, Alan E. Hubbard

U.C. Berkeley Division of Biostatistics Working Paper Series

We describe the R package multiPIM, including statistical background, functionality and user options. The package is for variable importance analysis, and is meant primarily for analyzing data from exploratory epidemiological studies, though it could certainly be applied in other areas as well. The approach taken to variable importance comes from the causal inference field, and is different from approaches taken in other R packages. By default, multiPIM uses a double robust targeted maximum likelihood estimator (TMLE) of a parameter akin to the attributable risk. Several regression methods/machine learning algorithms are available for estimating the nuisance parameters of the models, including …