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Minimum Description Length And Empirical Bayes Methods Of Identifying Snps Associated With Disease, Ye Yang, David R. Bickel

COBRA Preprint Series

The goal of determining which of hundreds of thousands of SNPs are associated with disease poses one of the most challenging multiple testing problems. Using the empirical Bayes approach, the local false discovery rate (LFDR) estimated using popular semiparametric models has enjoyed success in simultaneous inference. However, the estimated LFDR can be biased because the semiparametric approach tends to overestimate the proportion of the non-associated single nucleotide polymorphisms (SNPs). One of the negative consequences is that, like conventional p-values, such LFDR estimates cannot quantify the amount of information in the data that favors the null hypothesis of no disease-association.

We …

Exposition Au Béryllium Des Travailleurs De La Transformation D'Aluminium Et Du Magnésium : Évaluation Des Paramètres De Surveillance Environnementale, Chantal Dion, Stéphanie Viau, André Dufresne, Yves Cloutier, Guy Perrault

Rapports de recherche scientifique

En 1999, on a constaté un nombre important de réclamations pour des maladies professionnelles reliées à l’exposition au béryllium (Be). Le réseau de la santé mène depuis des interventions dans des établissements de secteurs d’activités ciblés afin de mieux caractériser cette exposition dans ces milieux et d’estimer le nombre de travailleurs potentiellement à risque. C’est dans ce contexte que les auteurs ont exploré la possibilité de suggérer un paramètre de l’exposition au Be, mieux relié à la sensibilisation à ce métal que la mesure présentement utilisée. Les opérations dans les secteurs prioritaires devraient permettre d’y cerner les niveaux d’exposition, de …

The Handling Of Missing Data In Molecular Epidemiologic Studies, Manisha Desai, Jessica Kubo, Denise Esserman, Mary Beth Terry

COBRA Preprint Series

Background: Molecular epidemiologic studies face a missing data problem as biospecimen data are often collected on only a proportion of subjects eligible for study.

Methods: We investigated all molecular epidemiologic studies published in CEBP in 2009 to characterize the prevalence of missing data and to elucidate how the issue was addressed. We considered multiple imputation (MI), a missing data technique that is readily available and easy to implement, as a possible solution.

Results: While the majority of studies had missing data, only 16% compared subjects with and without missing data. Furthermore, 95% of the studies with missing data performed a …

The Use Of Multiple Imputation In Molecular Epidemiologic Studies Assessing Interaction Effects, Manisha Desai, Denise Esserman, Marilie Gammon, Mary Beth Terry

COBRA Preprint Series

Background: In molecular epidemiologic studies biospecimen data are collected on only a proportion of subjects eligible for study. This leads to a missing data problem. Missing data methods, however, are not typically incorporated into analyses. Instead, complete-case (CC) analyses are performed, which result in biased and inefficient estimates.

Methods: Through simulations, we characterized the bias that results from CC methods when interaction effects are estimated, as this is a major aim of many molecular epidemiologic studies. We also investigated whether standard multiple imputation (MI) could improve estimation over CC methods when the data are not missing at random (NMAR) and …

Translating The Diabetes Prevention Program For Northern Plains Indian Youth Through Community-Based Participatory Research Methods, Blakely D. Brown, Kari J. Harris, Jeri Lyn Harris, Martin Parker, Christiana Lea Ricci, Curtis W. Noonan

Public and Community Health Sciences Faculty Publications

Purpose—The purpose of this study was to use a community-based participatory research (CBPR) approach to translate the original Diabetes Prevention Program (DPP) to be age and culturally specific for American Indian (AI) youth.

Methods—Tribally enrolled members on 2 Montana Indian reservations conducted focus groups and interviews to discuss community members’ perspectives of factors that encouraged or were barriers to healthy diet and exercise behaviors in AI youth. In total, 31 community members, aged 10 to 68 years old, participated in 4 focus groups and 14 individual interviews. Participants were self-identified as elder, cultural expert, tribal health worker, educator, …

Motivational Interviewing For Smoking Cessation In College Students: A Group Randomized Controlled Trial, Kari J. Harris, Delwyn Catley, Glenn E. Good, Nikole J. Cronk, Solomon W. Harrar, Karen B. Williams

Public and Community Health Sciences Faculty Publications

Objective—To examine the efficacy of four individually-delivered Motivational Interviewing counseling sessions for smoking cessation versus a matched intensity comparison condition.

Method—From 2006–2009, students attending college in the Midwest smoking at least 1 of 30 days were recruited regardless of their interest in quitting. 30 fraternities and sororities were randomized, resulting in 452 participants.

Results—No significant differences were found for 30-day cessation between treatment and comparison at end of treatment (31.4% vs 28%, OR=1.20, 95% CI .72,1.99) or at follow-up (20.4% vs 24.6%, OR=.78, 95% CI .50,1.22). Predictors of cessation at follow-up, regardless of condition, included more sessions …

A Qualitative Study Of Coping In Mothers Of Children With An Autism Spectrum Disorder, Heather Miller Kuhaneck, Tajhma Burroughs, Jamie Wright, Theresa Lemanczyk, Amy Rowntree Darragh

Occupational Therapy Faculty Publications

A significant body of research exists that explores the stressors of raising a child with an autism spectrum disorder (ASD). There are fewer studies, however, that examine specific effective coping strategies of mothers of children with an ASD. This qualitative study explored mothers’ perceptions of effective coping strategies for their parenting stressors. In-depth interviews were conducted with 11 mothers to inquire about their personal coping methods. Interviews were coded and emergent themes identified which included coping strategies such as “me time,” “planning,” “knowledge is power,” “sharing the load,” “lifting the restraints of labels,” and “recognizing the joys.” The information from …

Brachytherapy Seed And Applicator Localization Via Iterative Forward Projection Matching Algorithm Using Digital X-Ray Projections, Damodar Pokhrel

Theses and Dissertations

Interstitial and intracavitary brachytherapy plays an essential role in management of several malignancies. However, the achievable accuracy of brachytherapy treatment for prostate and cervical cancer is limited due to the lack of intraoperative planning and adaptive replanning. A major problem in implementing TRUS-based intraoperative planning is an inability of TRUS to accurately localize individual seed poses (positions and orientations) relative to the prostate volume during or after the implantation. For the locally advanced cervical cancer patient, manual drawing of the source positions on orthogonal films can not localize the full 3D intracavitary brachytherapy (ICB) applicator geometry. A new iterative forward …

A Maximum Pseudo-Likelihood Approach For Estimating Species Trees Under The Coalescent Model, Liang Liu, Lili Yu, Scott V. Edwards

Biostatistics: Faculty Publications

Background

Several phylogenetic approaches have been developed to estimate species trees from collections of gene trees. However, maximum likelihood approaches for estimating species trees under the coalescent model are limited. Although the likelihood of a species tree under the multispecies coalescent model has already been derived by Rannala and Yang, it can be shown that the maximum likelihood estimate (MLE) of the species tree (topology, branch lengths, and population sizes) from gene trees under this formula does not exist. In this paper, we develop a pseudo-likelihood function of the species tree to obtain maximum pseudo-likelihood estimates (MPE) of species trees, …

Prevention, Intervention And Evaluation Of Maternal Child Health Programs And Practices, Diane J. Abatemarco, Phd, Msw

College of Population Health Lectures, Presentations, Workshops

PowerPoint presentation given by Diane Abatemarco, PhD, MSW.

A Case Study Of Appendicitis At Antanimalandy Lutheran Hospital, Jennifer Gemmell

Independent Study Project (ISP) Collection

From the introduction:

The island of Madagascar houses a total of 19,159,000 people who spend only $34 per person per year on health care (“Madagascar,” 2008). The government claims to have “committed itself to the principle that good health is a right of each Malagasy citizen, and has made significant studies in the area of health care,” according to the country study for the Library of Congress. However, with political corruption, political crisis after political crisis, and lack of international support, the government does not dispense the funds necessary to support this commitment (Metz, 1994). For example, in 1976 the …

Access To Mental Health Services And Family Impact Of Rural Children With Mental Health Problems, Jennifer D. Lenardson Mhs, Erika C. Ziller Phd, David Lambert Phd, Melanie M. Race Ms, Anush Yousefian Hansen Ms, Ma

Mental Health / Substance Use Disorders

Mental health problems have considerable impact on children and their families and some of these impacts are higher in rural than urban areas. Rural children are slightly but significantly more likely to have a mental health problem than urban children, are more likely to have a behavioral difficulty, and are more likely to be usually or always affected by their condition. Compared to urban children, rural children are more likely to go without access to all parent-reported needed mental health services and their families spend more time coordinating their care. This working paper and policy brief provide information on prevalence …

Put Your Money Where Your Butt Is: A Commitment Contract For Smoking Cessation, Xavier Giné, Dean Karlan, Jonathan Zinman

Dartmouth Scholarship

We designed and tested a voluntary commitment product to help smokers quit smoking. The product (CARES) offered smokers a savings account in which they deposit funds for six months, after which they take a urine test for nicotine and cotinine. If they pass, their money is returned; otherwise, their money is forfeited to charity. Of smokers offered CARES, 11 percent took up, and smokers randomly offered CARES were 3 percentage points more likely to pass the 6-month test than the control group. More importantly, this effect persisted in surprise tests at 12 months, indicating that CARES produced lasting smoking cessation. …

Crouching Tiger Hidden Goiter Belt: A Critique Of Health Care And Universal Salt Iodization In The Tsum Valley, Julian Goetz, Vanessa Soetanto

Independent Study Project (ISP) Collection

The Tsum Valley, opened to visitors in 2008, has only recently begun the process of modernization. The health of the population is still not stable with regards to nutrition, and the health care system is still inadequate due to geographic conditions of remoteness and difficulty of access. The health condition is further exacerbated by political interactions affecting iodine consumption. This paper presents original information collected via interviewing processes throughout the valley and in Kathmandu over the course of a four-week period. The results include the inadequacy of health care facilities in treating endemic health issues and of the failure of …

Simulation-Based Team Training At The Sharp End: A Qualitative Study Of Simulation-Based Team Training Design, Implementation, And Evaluation In Healthcare, Sallie J. Weaver, Eduardo Salas, Rebecca Lyons, Elizabeth H. Lazzara, Michael A. Rosen, Deborah Diazgranados, Julia G. Grim, Jeffrey S. Augenstein, David J. Birnbach, Heidi King

Publications

This article provides a qualitative review of the published literature dealing with the design, implementation, and evaluation of simulation-based team training (SBTT) in healthcare with the purpose of providing synthesis of the present state of the science to guide practice and future research. A systematic literature review was conducted and produced 27 articles meeting the inclusion criteria. These articles were coded using a low-inference content analysis coding scheme designed to extract important information about the training program. Results are summarized in 10 themes describing important considerations for what occurs before, during, and after a training event. Both across disciplines and …

Tools For Evaluating Team Performance In Simulation-Based Training, Michael A. Rosen, Sallie J. Weaver, Elizabeth H. Lazzara, Eduardo Salas, Teresa Wu, Salvatore Silvestri, Nicola Schiebel, Sandra Almeida, Heidi B. King

Publications

Teamwork training constitutes one of the core approaches for moving healthcare systems toward increased levels of quality and safety, and simulation provides a powerful method of delivering this training, especially for face-paced and dynamic specialty areas such as Emergency Medicine. Team performance measurement and evaluation plays an integral role in ensuring that simulation-based training for teams (SBTT) is systematic and effective. However, this component of SBTT systems is overlooked frequently. This article addresses this gap by providing a review and practical introduction to the process of developing and implementing evaluation systems in SBTT. First, an overview of team performance evaluation …

Landmark Prediction Of Survival, Layla Parast, Tianxi Cai

Harvard University Biostatistics Working Paper Series

No abstract provided.

Injury In Nevada, Michelle Chino, Jonathon Lavalley, Darlene R. Haff, Deborah A. Harris, Andrea R. Rivers

School of Public Health Faculty Research

Injury is a major threat to health and safety. In a typical day in the US, 400 people will die as the result of an injury, 7,500 will be hospitalized due to an injury, and more than 150,000 will suffer an injury severe enough to restrict activities and seek medical attention. Many of these deaths, hospitalizations, and disabling events will be the result of motor vehicle crashes. Others will result from vio­lence, falls, drowning, and poisoning – all of which are considered injuries.

The costs of injury are high. In the United States, the cost of injuries is estimated to …

Manutention : Comparaison Des Façons De Faire Entre Les Experts Et Les Novices, André Plamondon, Denys Denis, Sophie Bellefeuille, Alain Delisle, Maud Gonella, Erik Salazar, Denis Gagnon, Christian Larivière, Marie St-Vincent, Iuliana Nastasia

Rapports de recherche scientifique

Il a déjà été démontré que des manutentionnaires d’expérience, reconnus par leurs collègues comme étant des experts, ont développé des façons de faire différentes de celles des novices qui pourraient être à la fois sécuritaires et plus efficientes. Les auteurs croient que ces façons de faire pourraient inspirer l’élaboration de programmes de formation mieux adaptés au travail. Pour les fins de cette étude des experts en manutention et des travailleurs novices ont été invités à reproduire en laboratoire leurs façons de faire dans des conditions de travail variées. Cela a permis aux chercheurs de recueillir des données biomécaniques et de …

Rural America: A Look Beyond The Images, John A. Gale Ms

Access / Insurance

The issues faced by patients and providers in rural health care differ greatly from those of urban counterparts. They also differ across rural communities. Understanding these differences, and the differences among rural populations across America, is critical to providing health services to rural Americans, who are often impeded by economic factors, cultural and social differences, educational shortcomings and isolation in their efforts to lead normal, healthy lives. The challenges provide opportunities for Catholic health care to make a difference in the lives and health of some of the nation's most vulnerable citizens.

Particle Size On Respiratory Protection Provided By Two Types Of N95 Respirators On Agricultural Settings, Jacob Cho Kyungmin, M. Susan Jones, Gordon Jones, Roy Mckay, Sergey A. Grinshpun, Alok Swivedi, Rakesh Shukla, Umesh Singh, Tiina Reponen

Nursing Faculty Publications

The objective of this study was to compare size-selective workplace protection factors (WPFs) of an N95 elastomeric respirator (ER) and an N95 filtering facepiece respirator (FFR) in agricultural environments. Twenty-five healthy farm workers ranging in age from 20 to 30 years voluntarily participated in the study. Altogether eight farms were included representing three different types: two horse farms, three pig barns, and three grain handling sites. Subjects wore the ER and FFR while performing their daily activities, such as spreading hay, feeding livestock, and shoveling. Aerosol concentrations in an optical particle size range of 0.7–10 µm were determined simultaneously inside …

Envisioning Nevada’S Future: Goals & Strategies For Advancing Our Quality Of Life, Nevada Vision Stakeholder Group, Moody’S Analytics

Brookings Mountain West Publications

Nevada’s severe downturn has brought to light many of the long-term challenges facing the state. Not only is its economy subject to painful swings, but Nevada’s primary drivers— consumer services (primarily gaming, hospitality and housing) and resource extraction—will provide less support than they have in past business cycles. Less economic vitality will make it harder to offer Nevadans the quality of life they expect.

The importance of the economy to quality of life is equally clear—quality of life is a hollow promise without a healthy and supportive economy. Similarly, a proper fiscal structure—both in terms of spending and revenues—is critical …

Neighborhood Effects On Health: Concentrated Advantage And Disadvantage, Brian K. Finch, D. Phuong Do, Melonie Heron, Chloe E. Bird, Teresa Seeman, Nicole Lurie

Faculty Publications

We investigate an alternative conceptualization of neighborhood context and its association with health. Using an index that measures a continuum of concentrated advantage and disadvantage, we examine whether the relationship between neighborhood conditions and health varies by socio-economic status. Using NHANES III data geo-coded to census tracts, we find that while largely uneducated neighborhoods are universally deleterious, individuals with more education benefit from living in highly educated neighborhoods to a greater degree than individuals with lower levels of education.

Neural Plasticity And Treatment-Induced Recovery Of Sentence Processing In Agrammatism, Cynthia K. Thompson, Dirk B. Den Ouden, Borna Bonakdarpour, Kyla Garibaldi, Todd B. Parrish

Faculty Publications

This study examined patterns of neural activation associated with treatment-induced improvement of complex sentence production (and comprehension) in six individuals with stroke-induced agrammatic aphasia, taking into account possible alterations in blood flow often associated with stroke, including delayed time-to-peak of the hemodynamic response function (HRF) and hypoperfused tissue. Aphasic participants performed an auditory verification fMRI task, processing object cleft, subject cleft, and simple active sentences, prior to and following a course of Treatment of Underlying Forms (TUR; Thompson et al., 2003), a linguistically based approach for treating aphasic sentence deficits, which targeted objective relative clause constructions. The patients also were …

Muscular And Performance Fitness And The Incidence Of Type 2 Diabetes: Prospective Study Of Japanese Men, Susumu S. Sawada, I-Min Lee, Hisashi Naito, Koji Tsukamoto, Takashi Muto, Steven N. Blair

Faculty Publications

Background: Limited data are available on the relationship between muscular and performance fitness (MPF) and the incidence of type 2 diabetes.

Methods: A cohort of 3792 Japanese men completed a medical examination that included MPF and cardiorespiratory fitness tests. MPF index composite score was calculated using Z-scores from vertical jump, sit-ups, side step, and functional reach tests.

Results: The mean follow-up period was 187 months (15.6 years). There were 240 patients who developed type 2 diabetes during follow-up. Relative risks and 95% confidence intervals (CI) for incidence of diabetes across baseline quartiles of MPF index composite score were obtained using …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Prevalence, Knowledge And Care Patterns For Gastro-Oesophageal Reflux Disease In United States Minority Populations., Elaine Yuen, Martha Romney, Richard W. Toner, Nicole M. Cobb, Philip O. Katz, Maya Spodik, Neil I. Goldfarb

College of Population Health Faculty Papers

BACKGROUND: While there is evidence of ethnic variation in the prevalence of gastro-oesophageal reflux disease (GERD) symptoms, few population-based studies examine GERD symptom prevalence amongst the growing Hispanic minority in the US as well as Asians in the West. AIM: To examine the prevalence, awareness and care patterns for GERD across different ethnic groups.

METHODS: A population-based, cross-sectional survey was fielded in English, Chinese and Spanish that assessed self-reported GERD prevalence, awareness and care patterns in four ethnic groups (Caucasian, African American, Asian, Hispanic).

RESULTS: A total of 1172 subjects were included for analysis: 34.6% experienced GERD symptoms at least …

One And Only Campaign Nevada Evaluation Of Educational Materials For Injection Safety Executive Summary, Nevada Institute For Children’S Research And Policy, School Of Community Health Science, University Of Nevada, Las Vegas, Amanda Haboush, Tara Phebus, Kari Wolkwitz, Denise Tanata Ashby, Enrique Lopez, Christopher M. Aquino, Sheila Clark

Nevada Institute for Children's Research and Policy Reports

The goal of the evaluation was to measure the effectiveness of the Campaign’s educational materials in raising awareness among the general public and enhancing the knowledge of healthcare personnel. Through this measurement the evaluation results would then also provide recommendations for improvements to the materials. To achieve these goals the evaluation team at NICRP created a strategic dissemination plan designed to support a formal evaluation of messages within the materials, message delivery and general knowledge and understanding of safe injection practices by both providers and the general public. Methods utilized to conduct this evaluation included:

• Surveys of both patients and …

Governmental Public Health: An Overview Of State And Local Public Health Agencies, Eileen Salinsky

National Health Policy Forum

The Patient Protection and Affordable Care Act significantly expands federal support for community prevention and public health. This paper describes the governmental public health infrastructure at both the state and local level in terms of organizational structure, activities, financing, workforce, partnerships, and performance improvement efforts.

Chronic Pain And Pain Management Among Older Veterans, Juyoung Park

Florida Public Health Review

The aim of the study was to examine chronic pain in older veterans (65+) and the pain treatment that they received at the Veteran Medical Center. Using a cross-sectional research design, a survey was administered to 107 older veteran participants with self-reported chronic pain recruited from outpatient centers of the Veterans Administration Medical Center: Pain Management Center, Geriatric Clinic, Arthritis Treatment Center, Mental Health Clinic, and Primary Care Clinic. Severity of pain, functional status, depression, spirituality, social support, and social network were assessed, and demographic data were collected. A majority of the participants (92.5%, n = 99) reported having had …