Medicine and Health Sciences Commons^™

Faktor Risiko Tuberculosis Paru Di Kabupaten Rejang Lebong, Demsa Simbolon

Kesmas

Di Kabupaten Rejang Lebong, sejak tahun 1995 telah dilaksanakan kegiatan pemberantasan TB Paru dengan strategi DOTS, tetapi penderita baru tetap di temukan dan memperlihatkan trend yang meningkat dari tahun ke tahun. Penelitian ini bertujuan untuk mengetahui faktor risiko yang berhubungan dengan kejadian TB paru BTA (+) di Kabupaten Rejang Lebong. Desain penelitian yang digunakan adalah disain kasus kontrol. Kelompok kasus adalah penderita TB Paru BTA (+) berumur >15 tahun yang berobat pada Oktober 2005 sampai Mei 2006. Kontrol adalah tetangga kasus yang tidak mempunyai tanda-tanda gejala klinis TB paru dengan golongan umur >15 tahun. Jumlah sampel sebanyak 50 kasus dan …

Ketahanan Hidup Setahun Pasien Stroke Di Rs Cipto Mangunkusumo Jakarta, Sri Mulyani

Kesmas

Di Indonesia, penyebab utama kematian di rumah sakit adalah stroke. Penelitian ini bertujuan untuk mengetahui ketahanan hidup 1 tahun pasien stroke yang dirawat di RS Cipto Mangunkusumo Jakarta tahun 2003 dan faktor yang mempengaruhinya. Rancangan penelitian ini adalah kohort retrospektif. Sampelnya adalah total populasi, yaitu 275 pasien yang didiagnosa mengalami serangan stroke pertama dan dirawat di RS Cipto Mangunkusumo Jakarta, yang masuk tanggal 1 Januari sampai 31 Desember 2003. Hasil penelitian menunjukkan bahwa probabilitas ketahanan hidup pasien stroke berbeda beda, tergantung pada tipe stroke, ruang rawat, dan penyakit jantung. Masing-masing probabilitas ketahanan hidup setahun pasien stroke adalah sebagai berikut: 63,7% …

Outcomes Of Care By Hospitalists, General Internists, And Family Physicians, Peter K. Lindenauer, Michael B. Rothberg, Penelope Susan Pekow, Christopher Kenwood, Evan M. Benjamin, Andrew D. Auerbach

Penelope Susan Pekow

Background: The hospitalist model is rapidly altering the landscape for inpatient care in the United States, yet evidence about the clinical and economic outcomes of care by hospitalists is derived from a small number of single-hospital studies examining the practices of a few physicians.

Methods: We conducted a retrospective cohort study of 76,926 patients 18 years of age or older who were hospitalized between September 2002 and June 2005 for pneumonia, heart failure, chest pain, ischemic stroke, urinary tract infection, acute exacerbation of chronic obstructive pulmonary disease, or acute myocardial infarction at 45 hospitals throughout the United States. We used …

Outcomes Of Care By Hospitalists, General Internists, And Family Physicians, Peter K. Lindenauer, Michael B. Rothberg, Penelope Susan Pekow, Christopher Kenwood, Evan M. Benjamin, Andrew D. Auerbach

Peter Lindenauer MD

Background: The hospitalist model is rapidly altering the landscape for inpatient care in the United States, yet evidence about the clinical and economic outcomes of care by hospitalists is derived from a small number of single-hospital studies examining the practices of a few physicians.

Methods: We conducted a retrospective cohort study of 76,926 patients 18 years of age or older who were hospitalized between September 2002 and June 2005 for pneumonia, heart failure, chest pain, ischemic stroke, urinary tract infection, acute exacerbation of chronic obstructive pulmonary disease, or acute myocardial infarction at 45 hospitals throughout the United States. We used …

Intake Of Coffee And Tea And Risk Of Ovarian Cancer: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

There is some evidence from case-control studies that coffee consumption might be positively associated with ovarian cancer risk, whereas the epidemiologic evidence regarding tea consumption and ovarian cancer is inconsistent. To date, there have been few prospective studies of these associations. Therefore, we examined ovarian cancer risk in association with both coffee and tea intake in a prospective cohort study of 49,613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food frequency questionnaire between 1980 and 1985. Linkages to national mortality and cancer databases yielded data on deaths and cancer incidence, with follow-up ending …

Correction: Using Participatory Design To Develop (Public) Health Decision Support Systems Through Gis, S. Michelle Driedger, Anita Kothari, Jason Morrison, Michael Sawada, Eric J. Crighton, Ian D. Graham

Anita Kothari

Background: Organizations that collect substantial data for decision-making purposes are often characterized as being 'data rich' but 'information poor'. Maps and mapping tools can be very useful for research transfer in converting locally collected data into information. Challenges involved in incorporating GIS applications into the decision-making process within the non-profit (public) health sector include a lack of financial resources for software acquisition and training for nonspecialists to use such tools. This on-going project has two primary phases. This paper critically reflects on Phase 1: the participatory design (PD) process of developing a collaborative web-based GIS tool.

Methods: A case study …

Dislipidemia Dan Obesitas Sentral Pada Lanjut Usia Di Kota Padang, Sudijanto Kamso

Kesmas

Data-data di rumah sakit maupun di masyarakat menunjukkan penyakit kardiovaskuler yang terdiri dari penyakit jantung koroner, penyakit jantung hipertensi dan stroke adalah penyebab utama kematian pada kelompok lanjut usia. Penelitian-penelitian menunjukkan bahwa faktor yang dapat menyebabkan timbulnya penyakit kardiovaskuler tersebut adalah gangguan kadar lemak dalam darah (dislipidemia) dan obesitas sentral. Berbagai penelitian dibidang penyakit kardiovaskular telah dilakukan, tetapi data mengenai dislipidemia dan obesitas sentral pada lansia Indonesia masih dirasakan kurang. Tujuan utama penelitian ini adalah untuk mengetahui prevalensi dislipidemia dan obesitas sentral, serta faktor-faktor yang berhubungan dengan obesitas sentral pada lansia di Padang, daerah dengan prevalensi penyakit kardiovaskular yang tinggi. …

Glycaemic Index, Glycaemic Load And Ovarian Cancer Risk: A Prospective Cohort, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Background

There is some evidence that plasma insulin levels might influence ovarian cancer risk. Glyacemic index (GI) and glycaemic load (GL) are measures that allow the carbohydrate content of individual foods to be classified according to their postprandial glycaemic effects and hence their effects on circulating insulin levels. Therefore, we examined ovarian cancer risk in association with GI and GL, and intake of dietary carbohydrate and sugar. Methods

The study was conducted in a prospective cohort of 49 613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food-frequency questionnaire (FFQ) between 1980 and 1985. …

Glycaemic Index, Glycaemic Load And Ovarian Cancer Risk: A Prospective Cohort Study, Stephanie A. Navarro Silvera, Meera Jain, Geoffrey R. Howe, Anthony B. Miller, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Background

There is some evidence that plasma insulin levels might influence ovarian cancer risk. The glycaemic index (GI) and glycaemic load (GL) are measures that allow the carbohydrate content of individual foods to be classified according to their postprandial glycaemic effects and hence their effects on circulating insulin levels. Therefore, we examined ovarian cancer risk in association with GI and GL, and intake of dietary carbohydrate and sugar.

Methods

The study was conducted in a prospective cohort of 49 613 Canadian women enrolled in the National Breast Screening Study (NBSS) who completed a self-administered food-frequency questionnaire (FFQ) between 1980 and …

The Epidemiology And Economics Of Chronic Obstructive Pulmonary Disease, David M. Mannino, S. Braman

David M. Mannino

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease responsible for a large human and economic burden around the world. Cigarette smoking is the main risk factor for COPD in the developed world, although other important risk factors include occupational exposures, air pollution, airway hyperresponsiveness, asthma, and genetic predisposition. In most of the world, COPD prevalence and mortality continue to rise in response to increases in smoking, particularly by women and adolescents. COPD is also an important cause of disability, and is linked to comorbid diseases, such as depression and cardiovascular disease, which adds to the large economic …

Benign Proliferative Epithelial Disorders Of The Breast: A Review Of The Epidemiologic Evidence, Stephanie A. Navarro Silvera, Thomas E. Rohan

Department of Public Health Scholarship and Creative Works

Nearly one in four breast cancers is diagnosed before the age of 50, and many early-stage premalignant lesions are present but not yet diagnosed. Therefore, we review evidence to support the strategy that breast cancer prevention efforts must begin early in life. This study follows the literature review methods and format. Exposures during childhood and adolescence affect a woman’s long-term risk of breast cancer, but have received far less research attention than exposures that occur later in life. Breast tissue undergoes rapid cellular proliferation between menarche and first full-term pregnancy, and risk accumulates rapidly until the terminal differentiation that accompanies …

Kehamilan Dan Kejadian Malaria Di Puskesmas Way Muli, Lampung Selatan, Ismen Ismen

Kesmas

Kelompok yang paling rentan terhadap malaria adalah wanita hamil dengan berbagai akibat terhadap ibu dan janin yang dikandungnya. Di Indonesia, penelit- ian tentang hubungan kehamilan dengan kejadian malaria masih sangat jarang dilakukan. Tujuan penelitian ini adalah mengetahui hubungan antara kehamilan dengan kejadian malaria. Penelitian ini menggunakan desain studi kasus control dengan sumber data proner di populasi di wilayah kerja Puskesmas Way Muli Kecamatan Rajabasa, Kabupaten Lampung Selatan, Provinsi Lampung. Populasi studi adalah wanita usia 15 – 49 tahun yang datang pada saat penelit- ian pada periode November sampai dengan Desember 2006. Pengumpulan data dengan cara wawancara dan pengambilan sediaan darah. …

Correcting Instrumental Variables Estimators For Systematic Measurement Error, Stijn Vansteelandt, Manoochehr Babanezhad, Els Goetghebeur

Harvard University Biostatistics Working Paper Series

No abstract provided.

Modelling The Impact And Cost-Effectiveness Of The Hiv Intervention Programme Amongst Commercial Sex Workers In Ahmedabad, Gujarat, India, Isaac Chun-Hai Fung, Lorna Guinness, Peter Vickerman, Charlotte Watts, Gangadhar Vannela, Jagdish Vadhvana, Anna M. Foss, Laxman Malodia, Meena Gandhi, Gaurang Jani

Isaac Chun-Hai Fung

Background: Ahmedabad is an industrial city in Gujarat, India. In 2003, the HIV prevalence among commercial sex workers (CSWs) in Ahmedabad reached 13.0%. In response, the Jyoti Sangh HIV prevention programme for CSWs was initiated, which involves outreach, peer education, condom distribution, and free STD clinics. Two surveys were performed among CSWs in 1999 and 2003. This study estimates the cost-effectiveness of the Jyoti Sangh HIV prevention programme.
Methods: A dynamic mathematical model was used with survey and intervention-specific data from Ahmedabad to estimate the HIV impact of the Jyoti Sangh project for the 51 months between the two CSW …

Estimating The Prevalence Of Disease Using Relatives Of Case And Control Probands, Kristin N. Javaras, Nan M. Laird, James I. Hudson, Brian D. Ripley

COBRA Preprint Series

We introduce a method for estimating the prevalence of disease using data from a case-control family study performed to investigate the aggregation of disease in families. The families are sampled via case and control probands, and the resulting data consist of information on disease status and covariates for the probands and their relatives. We introduce estimators for overall prevalence and for covariate stratum-specific prevalence (e.g., sex-specific prevalence) that yield approximately unbiased estimates of their population counterparts. We also introduce corresponding confidence intervals that have good coverage properties even for small prevalences. The estimators and intervals address the over-representation of diseased …

Empirical Efficiency Maximization, Daniel B. Rubin, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

It has long been recognized that covariate adjustment can increase precision, even when it is not strictly necessary. The phenomenon is particularly emphasized in clinical trials, whether using continuous, categorical, or censored time-to-event outcomes. Adjustment is often straightforward when a discrete covariate partitions the sample into a handful of strata, but becomes more involved when modern studies collect copious amounts of baseline information on each subject.

The dilemma helped motivate locally efficient estimation for coarsened data structures, as surveyed in the books of van der Laan and Robins (2003) and Tsiatis (2006). Here one fits a relatively small working model …

A Relationship Between Us Healthcare Worker Smallpox Vaccination Rates In 2003 And Presidential Election Results In 2004, F. Matthew Mihelic, David G. Schultz Jr., Melinda R. Mihelic

Faculty Publications

A statistical relationship exists between state per capita smallpox vaccination rates of healthcare workers in 2003 and state presidential election results in 2004. The potential implications of political influence on national biosecurity decision making are discussed.

Global Stability Results Of An Sis Age-Structured Epidemic Model With Vertical Transmission, M. El-Doma

Applications and Applied Mathematics: An International Journal (AAM)

An SIS age-structured epidemic model for a vertically as well as horizontally transmitted disease is investigated when the fertility, mortality and cure rates depend on age and the force of infection of proportionate mixing assumption type. We determine the steady states and prove the global stability for the endemic equilibriums.

Factors Associated With Aids Risk Behaviors Of African Born Adolescents In Southern California, Dixon Anjejo

Loma Linda University Electronic Theses, Dissertations & Projects

The study was aimed at determining if cultural beliefs are salient factors contributing to the spread of HIV/AIDS among African born adolescents aged 15 to 19 years living in southern California. We used a cross-sectional design and collected data in two phases. The first phase was qualitative and data were collected from 25 participants in focus groups. The second phase utilized a questionnaire which was developed from the results of the focus group, using the theory of planned behavior. One hundred and thirty-five black African born teenagers between the ages of 15-19 years living in southern California completed the questionnaire. …

Frekuensi Keteraturan Senam Dan Penurunan Tekanan Darah Anggota Klub Jantung Sehat Pondalisa, Jakarta Tahun 2000 - 2005, Retno Asti Werdhani

Kesmas

Prevalensi hipertensi di Indonesia meningkat bersamaan dengan meningkatnya usia. Untuk itu, upaya pencegahan hipertensi dan komplikasinya perlu dilakukan sejak dini jauh sebelum usia lanjut. Olahraga khususnya jenis aerobik diketahui dapat mengendalikan tekanan darah. Penelitian ini bertujuan mengetahui hubungan frekuensi dan keteraturan senam terhadap penurunan tekanan darah pada peserta program latihan. Desain studi yang digunakan adalah kohort retrospektif dengan metoda analisis Cox Regression. Penelitian dilakukan terhadap sumber data sekunder 132 anggota KJS Pondalisa yang merupakan salah satu sarana olahraga masyarakat, selama periode satu tahun keanggotaan. Hasil penelitian memperlihatkan bahwa tidak ada anggota yang melakukan senam 3xper minggu sesuai program dengan keteraturan …

Is Mri-Based Volume A Mediator Of The Association Of Cumulative Lead Dose With Cognitive Function?, Brian S. Caffo, Sining Chen, Walter Stewart, Karen Bolla, David Yousem, Christos Davatzikos, Brian S. Schwartz

Johns Hopkins University, Dept. of Biostatistics Working Papers

This work considers the pathway through which past occupational lead exposure impacts cognitive function using cross-sectional data. It is motivated by studies linking cumulative lead dose with brain volumes, volumes with cognitive function, and lead dose with cognitive function. It is hypothesized that the brain regions associated with lead mediate a portion of the association between lead dose and cognitive function. The data were derived from an ongoing study of 513 former organolead manufacturing workers. Using MRIs, a novel analysis was performed to investigate Mediation. Volumes associated with cognitive function and lead dose were derived using registered images and used …

Risk Factors Of Gastrointestinal Nematode Parasite Infections In Small Ruminants Kept In Smallholder Mixed Farms In Kenya., Agricola Odoi, J M. Gathuma, C K. Gachuiri, A Omore

Faculty Publications and Other Works -- Biomedical and Diagnostic Sciences

BACKGROUND: Helminth infections in small ruminants are serious problems in the developing world, particularly where nutrition and sanitation are poor. This study investigated the burden and risk factors of gastrointestinal nematode parasite infections in sheep and goats kept in smallholder mixed farms in the Kenyan Central Highlands. Three hundred and seven small ruminants were sampled from 66 smallholder mixed farms in agro-ecological zones 1 (humid) and 3 (semi-humid) in the Kenyan Central highlands. The farms were visited once a month for eight months during which a health and production survey questionnaire was administered. Fecal samples were collected at each visit …

Risk Factors Of Gastrointestinal Nematode Parasite Infections In Small Ruminants Kept In Smallholder Mixed Farms In Kenya., Agricola Odoi, J M. Gathuma, C K. Gachuiri, A Omore

Agricola Odoi

BACKGROUND: Helminth infections in small ruminants are serious problems in the developing world, particularly where nutrition and sanitation are poor. This study investigated the burden and risk factors of gastrointestinal nematode parasite infections in sheep and goats kept in smallholder mixed farms in the Kenyan Central Highlands. Three hundred and seven small ruminants were sampled from 66 smallholder mixed farms in agro-ecological zones 1 (humid) and 3 (semi-humid) in the Kenyan Central highlands. The farms were visited once a month for eight months during which a health and production survey questionnaire was administered. Fecal samples were collected at each visit …

Physician Colorectal Cancer Screening Recommendations: An Explanation Based On Informed Decision-Making, Yelena N. Tarasenko, Sarah B. Wackerbarth, Jennifer M. Joyce, Steven A. Haist

Yelena N. Tarasenko

Objective: The purpose of this research was to examine the content of physicians’ colorectal cancer screening recommendations. More specifically, using the framework of informed decision making synthesized by Braddock and colleagues, we conducted a qualitative study of the content of recommendations to describe how physicians are currently presenting this information to patients.

Methods: We conducted semi-structured interviews with 65 primary care physicians. We analyzed responses to a question designed to elicit how the physicians typically communicate their recommendation.

Results: Almost all of the physicians (98.5%) addressed the “nature of decision” element. A majority of physicians discussed “uncertainties …

A Case Study Of Pediatric Diarrhea At Murchison District Hospital In Port Shepstone, Kwazulu-Natal, South Africa, T. Smith

Independent Study Project (ISP) Collection

This study investigates pediatric diarrhea in children under 5 years old at Murchison District Hospital in Port Shepstone, South Africa. Hospital Child Pip data was used to determine the number of admissions to the hospital for pediatric diarrhea and its mortality rate. Characteristics of deceased patients including age, malnutrition, and HIV status, were then synthesized with information on patients’ access to clean water and improved sanitation obtained through 20 interviews of mothers of patients as well as caregivers’ infant feeding practices and hygiene practices, such as handwashing with soap. Treatment and prevention of diarrhea was also explored. Murchison’s management of …

Down-Regulation Of Natural Killer Cell Activation In Response To Influenza Virus In Older Adults, Yu Jing

Theses and Dissertations in Biomedical Sciences

Immune senescence contributes to influenza-associated high mortality and morbidity and reduced vaccine efficacy in elderly people. Type I T cell (Thl)-mediated immunity plays a significant role in Immune responses to influenza infection and vaccination. Natural killer (NK) cells secrete significant amount of IFN-7 , a hallmark Thl cytokine, in response to influenza infection. How aging influences human NK cell IFN-7 production in response to influenza virus has not been well documented. In this study we employed human peripheral blood mononuclear cells (PBMC) and performed intracellular cytokine staining and flow cytometry primarily to investigate how aging influences NK cell activation with …

Trends In Particulate Matter And Mortality: An Approach To The Assessment Of Unmeasured Confounding, Holly Janes, Francesca Dominici, Scott Zeger

Johns Hopkins University, Dept. of Biostatistics Working Papers

We propose a method for diagnosing confounding bias under a model which links a spatially and temporally varying exposure and health outcome. We decompose the association into orthogonal components, corresponding to distinct spatial and temporal scales of variation. If the model fully controls for confounding, the exposure effect estimates should be equal at the different temporal and spatial scales. We show that the overall exposure effect estimate is a weighted average of the scale-specific exposure effect estimates.

We use this approach to estimate the association between monthly averages of fine particles (PM2.5) over the preceding 12 months and monthly mortality …

Adrb2 Arg16gly Polymorphism, Lung Function, And Mortality: Results From The Atherosclerosis Risk In Community Study, Jill M. Ferdinands, David M. Mannino, Marta L. Gwinn, Molly S. Bray

David M. Mannino

Background

Growing evidence suggests that the Arg16Arg genotype of the beta-2 adrenergic receptor gene may be associated with adverse effects of beta-agonist therapy. We sought to examine the association of beta-agonist use and the Arg16Gly polymorphism with lung function and mortality among participants in the Atherosclerosis Risk in Communities study.

Methodology and Principal Findings

We genotyped study participants and analyzed the association of the Arg16Gly polymorphism and beta-agonist use with lung function at baseline and clinical examination three years later and with all-cause mortality during 10 years of follow-up. Lung function was characterized by percent-predicted forced expiratory volume in 1 …

A Cohort Study Of Reproductive And Hormonal Factors And Renal Cell Cancer Risk In Women, Gc Kabat, Stephanie A. Navarro Silvera, Ab Miller, Te Rohan

Department of Public Health Scholarship and Creative Works

We examined the association of reproductive and hormonal factors with renal cell cancer risk in a cohort study of 89 835 Canadian women. Compared with nulliparous women, parous women were at increased risk (hazard ratio (HR) 1.78, 95% confidence interval (CI) 1.02–3.09), and there was a significant gradient of risk with increasing levels of parity: relative to nulliparous women, women who had X5 pregnancies lasting 4 months or more had a 2.4-fold risk (HR 1⁄4 2.41, 95% CI 1⁄4 1.27–4.59, P for trend 0.01). Ever use of oral contraceptives was associated with a modest reduction in risk. No associations were …

Power Boosting In Genome-Wide Studies Via Methods For Multivariate Outcomes, Mary J. Emond

UW Biostatistics Working Paper Series

Whole-genome studies are becoming a mainstay of biomedical research. Examples include expression array experiments, comparative genomic hybridization analyses and large case-control studies for detecting polymorphism/disease associations. The tactic of applying a regression model to every locus to obtain test statistics is useful in such studies. However, this approach ignores potential correlation structure in the data that could be used to gain power, particularly when a Bonferroni correction is applied to adjust for multiple testing. In this article, we propose using regression techniques for misspecified multivariate outcomes to increase statistical power over independence-based modeling at each locus. Even when the outcome …