Medicine and Health Sciences Commons^™

Appropriateness Of Psychopharmaco-Logical Medication, Kate Lapane, Jacob Hunnicutt, Jennifer Tjia

Jennifer Tjia

No abstract provided.

Leukoaraiosis Predicts Poor 90-Day Outcome After Acute Large Cerebral Artery Occlusion, Nils Henninger, Eugene Lin, Stephen Baker, Ajay Wakhloo, Deepak Takhtani, Majaz Moonis

Nils Henninger

BACKGROUND: To date limited information regarding outcome-modifying factors in patients with acute intracranial large artery occlusion (ILAO) in the anterior circulation is available. Leukoaraiosis (LA) is a common finding among patients with ischemic stroke and has been associated with poor post-stroke outcomes but its association with ILAO remains poorly characterized. This study sought to clarify the contribution of baseline LA and other common risk factors to 90-day outcome (modified Rankin Scale, mRS) after stroke due to acute anterior circulation ILAO. METHODS: We retrospectively analyzed 1,153 consecutive patients with imaging-confirmed ischemic stroke during a 4-year period (2007-2010) at a single academic …

Recent Trends In Type-Specific Hpv Infection Rates In The United States, Elizabeth L. Dickson, R I. Vogel, X Luo, L S. Downs

Elizabeth L. Dickson, MD

Thirty Day Hospital Re-Admissions In Patients With Non St-Segment Elevation Acute Myocardial Infarction, Mayra Tisminetzky, David Mcmanus, Nathaniel Erskine, Jane Saczynski, Jorge Yarzebski, Edgard Granillo, Joel Gore, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: Limited data exist about relatively recent trends in the magnitude and characteristics of patients who are rehospitalized shortly after admission for a non ST-segment elevation acute myocardial infarction (NSTEMI). This observational study describes decade-long trends (1999-2009) in the magnitude and characteristics of patients readmitted to the hospital within 30 days of hospitalization for an incident (initial) episode of NSTEMI.

METHODS: We reviewed the medical records of 2,249 residents of the Worcester (MA) metropolitan area who were hospitalized for an initial NSTEMI in 6 biennial periods between 1999 and 2009 at 3 central MA medical centers.

RESULTS: The average age …

Medical Advice And Diabetes Self-Management Reported By Mexican-American, Black- And White-Non-Hispanic Adults Across The United States, Joan A. Vaccaro, Daniel J. Feaster, Sandra L. Lobar, Marianna K. Baum, Marcia Magnus, Fatma G. Huffman

Joan A. Vaccaro

Background

Diabetes has reached epidemic proportions in the United States, particularly among minorities, and if improperly managed can lead to medical complications and death. Healthcare providers play vital roles in communicating standards of care, which include guidance on diabetes self-management. The background of the client may play a role in the patient-provider communication process. The aim of this study was to determine the association between medical advice and diabetes self care management behaviors for a nationally representative sample of adults with diabetes. Moreover, we sought to establish whether or not race/ethnicity was a modifier for reported medical advice received and …

The National Health Security Preparedness Index: Harnessing Evidence & Experience To Drive Improvement, Glen P. Mays

Glen Mays

This presentation profiles the National Health Security Preparedness Index as a mechanism for measuring preparedness and resiliency levels across the U.S. Forthcoming enhancements in measurement and analytic methodologies will allow the Index to play heightened roles in informing policies and practices that protect the U.S. population from a broad range of hazards.

Hospital-Based Surveillance Of Invasive Pneumococcal Disease And Pneumonia In South Bangalore, India., R Nisarga, R Premalatha, Shivananda, Kl Ravikumar, U Shivappa, A Gopi, Sb Chikkadasarahalli, R Batuwanthudawe, Paul E. Kilgore, Sa Kim, I Balter, S Jouve, J Ye, M Moscariello

Paul E. Kilgore

OBJECTIVE: To estimate the incidence of invasive pneumococcal disease and pneumonia, distribution of pneumococcal serotypes, and antibiotic susceptibility in children aged 28 days to <60 months. DESIGN: Hospital-based surveillance. SETTING: South Bangalore, India. PARTICIPANTS: 9950 children aged 28 days to <60 months with clinical suspicion of invasive pneumococcal disease or pneumonia. RESULTS: The estimated at-risk population included 224,966 children <5 years of age. Forty cases of invasive pneumococcal disease were identified. Estimated invasive pneumococcal disease incidence was 17.8/100,000 with incidence being highest among children aged 6 months to <12 months (49.9/100,000). Clinical pneumonia syndrome was the most frequent diagnosis (12.5/100,000). Pneumococcal serotypes included: 6A (n=6, 16.7%); 14 (n=5, 13.9%); 5 (n=4, 11.1%); 6B (n=4, 11.1%); 1, 18C, and 19A (n=3 each, 8.3%); 9V (n=2, 5.6%); and 3, 4, 10C, 18A, 18F, and 19F (n=1 each, 2.8%). Serotypes 6A, 14, 6B, 1, 18C, 19A, 9V, 4, 10C, and 18A showed antibiotic resistance. Clinical pneumonia incidence was 2109/100,000, with incidence being highest among children aged 28 days to <6 months (5033/100,000). Chest radiograph-confirmed pneumonia incidence was 1114/100,000, with incidence being highest among children aged 28 days to <6 months (2413/100,000). CONCLUSIONS: Invasive pneumococcal disease and pneumonia were found to be common causes of morbidity in young children living in South Bangalore, India.

Challenges And Best Practices In Real-Time Prediction Of Infectious Disease: A Case Study Of Dengue In Thailand, Nicholas Reich, Stephen Lauer, Krzysztof Sakrejda, Sopon Iamsirithaworn, Soawapak Hinjoy, Paphanij Suangtho, Suthanun Suthachana, Hannah Clapham, Henrik Salje, Derek Cummings, Justin Lessler

Nicholas G Reich

Epidemics of communicable diseases place a huge burden on public health infrastructures across the world. Producing accurate and actionable forecasts of infectious disease incidence at short and long time scales will improve public health response to outbreaks. However, scientists and public health officials face many obstacles in trying to create accurate and actionable real-time forecasts of infectious disease incidence. Dengue is a mosquito-borne virus that annually infects over 400 million people worldwide. We developed a real-time forecasting model for dengue hemorrhagic fever in the 77 provinces of Thailand. We created an operational and computational infrastructure that generated multi-step predictions of …

Timely Health Service Utilization: A Longitudinal Cohort Study Of Older Foster Youth., Angelique G. Day

Angelique G Day

Purpose: To evaluate the impact of a policy change for older foster care youth from a fee-for-service (FFS) Medicaid program to health maintenance organization (HMO) providers on the timeliness of well-child visits (health care physicals). Methods: A three year observational study using linked administrative data collected by the Michigan Departments of Human Services and Community Health of 2,016 youth who were in foster care on or after their 14th birthdays during 2009-2012 was used to examine the odds of receiving a timely well-child visit within the recommended 30 day time frame (logistic regression) as well as days to the first …

Estimating Controlled Direct Effects Of Restrictive Feeding Practices In The `Early Dieting In Girls' Study, Yeying Zhu, Debashis Ghosh, Donna L. Coffman, Jennifer S. Williams

Debashis Ghosh

In this article, we examine the causal effect of parental restrictive feeding practices on children’s weight status. An important mediator we are interested in is children’s self-regulation status. Traditional mediation analysis (Baron and Kenny, 1986) applies a structural equation modelling (SEM) approach and decomposes the intent-to-treat (ITT) effect into direct and indirect effects. More recent approaches interpret the mediation effects based on the potential outcomes framework. In practice, there often exist confounders that jointly influence the mediator and the outcome. Inverse probability weighting based on propensity scores are used to adjust for confounding and reduce the dimensionality of confounders simultaneously. …

Case Studies In Evaluating Time Series Prediction Models Using The Relative Mean Absolute Error, Nicholas G. Reich, Justin Lessler, Krzysztof Sakrejda, Stephen A. Lauer, Sopon Iamsirithaworn, Derek A T Cummings

Nicholas G Reich

Statistical prediction models inform decision-making processes in many real-world settings. Prior to using predictions in practice, one must rigorously test and validate candidate models to ensure that the proposed predictions have sufficient accuracy to be used in practice. In this paper, we present a framework for evaluating time series predictions that emphasizes computational simplicity and an intuitive interpretation using the relative mean absolute error metric. For a single time series, this metric enables comparisons of candidate model predictions against naive reference models, a method that can provide useful and standardized performance benchmarks. Additionally, in applications with multiple time series, this …

Creating Healthy Community In The Postindustrial City, Brian A. Hoey

Brian A. Hoey, Ph.D.

Epidemiology Of Latency And Relapse In Plasmodium Vivax Malaria, Andrew A. Lover

Andrew Lover

Considerations For Comprehensive Analyses Of Sporozoite-Based Controlled Human Malaria Infection Studies, Andrew A. Lover

Andrew Lover

Short Report: Study Variability In Recent Human Challenge Experiments With Plasmodium Falciparum Sporozoites (Pfspz Challenge), Andrew A. Lover

Andrew Lover