Medicine and Health Sciences Commons^™

Sleep Well To Stay Safe: Ready For Primetime?, Mihai C. Teodorescu, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

Commentary on Kling et al. Sleep problems and workplace injuries in Canada. Sleep 2010;33:611-618.

Prospective Associations Of Insomnia Markers And Symptoms With Depression, Mariana Szklo-Coxe, Terry Young, Paul E. Peppard, Laurel A. Finn, Ruth M. Benca

Community & Environmental Health Faculty Publications

Whether insomnia, a known correlate of depression, predicts depression longitudinally warrants elucidation. The authors examined 555 Wisconsin Sleep Cohort Study participants aged 33-71 years without baseline depression or antidepressant use who completed baseline and follow-up overnight polysomnography and had complete questionnaire-based data on insomnia and depression for 1998-2006. Using Poisson regression, they estimated relative risks for depression (Zung scale score >= 50) at 4-year (average) follow-up according to baseline insomnia symptoms and polysomnographic markers. Twenty-six participants (4.7%) developed depression by follow-up. Having 3-4 insomnia symptoms versus none predicted depression risk (age-, sex-, and comorbidity-adjusted relative risk (RR) = 3.2, 95% …

Robustness Of The Healthcare Utilization Results From The Rotavirus Efficacy And Safety Trial (Rest) Evaluating The Human-Bovine (Wc3) Reassortant Pentavalent Rotavirus Vaccine (Rv5), Robbin Itzler, Gary Koch, David O. Matson, Leif Gothefors, Pierre Van Damme, Mark J. Dinubile, Penny M. Heaton

Community & Environmental Health Faculty Publications

Background: The Rotavirus Efficacy and Safety Trial was a placebo-controlled Phase III study that evaluated the safety and efficacy of a three-dose pentavalent rotavirus vaccine (RV5) including its effect on healthcare utilization for rotavirus gastroenteritis (RVGE). The per-protocol (PP) analyses, which counted events occurring 14 days after dose 3 among infants without protocol violations, have already been published. This paper evaluates the consistency of the healthcare utilization results based on the modified intention to treat (MITT) analyses with the PP analyses. The MITT analyses include all infants receiving at least one dose of vaccine or placebo and follow-up begins after …

Socioeconomic Disparity In Healthcare-Seeking Behavior Among Chinese Women With Genitourinary Symptoms, Qi Zhang, Diane Lauderdale, Shanshan Mou, William I. Parish, Edward O. Laumann, John Schneider

Community & Environmental Health Faculty Publications

Background: Sexually transmitted infections (STIs) are of growing concern in China. Understanding the relationship between socioeconomic status (SES) and healthcare-seeking (HCS) behavior will help design effective policies to contain the epidemic of STIs across SES.

Methods: We used the Chinese Health and Family Life Survey, a nationally representative survey of 3813 adults from 48 Chinese cities and counties during 1999-2000. We studied the 730 women with at least one genito-urinary (GU) symptom. HCS was measured by whether respondents visited a hospital or an unrecognized clinic, self-treatment, or doing nothing. Formal treatment was defined as visiting a hospital. SES was measured …

Culture And The Social Context Of Health Inequalities, Carol Leler Mansyur, Benjamin C. Amick Iii, Luisa Franzini, Robert E. Roberts

Community & Environmental Health Faculty Publications

There is a great deal of recent interest and debate concerning the linkages between inequality and health cross-nationally. The U.S. National Institutes of Health recommended in 2001 that any new research on health disparities should include social and cultural systems as units of analysis. Nevertheless, many public health interventions and policies continue to decontextualize risk factors from the social environment. Exposures to social and health inequalities probably vary as a consequence of different cultural contexts. To identify the processes that cause social and health inequalities, it is important to understand culture's influence. Navarro's research on political institutions and inequality illustrates …

The Cultural Production Of Health Inequalities: A Cross-Sectional, Multilevel Examination Of 52 Countries, Carol L. Mansyur, Benjamin C. Amick Iii, Ronald B. Harrist, Luisa Franzini, Robert E. Roberts

Community & Environmental Health Faculty Publications

In a 2001 report, the U.S. National Institutes of Health called for more integration of the social sciences into health-related research, including research guided by theories and methods that take social and cultural systems into consideration. Based on a theoretical framework that integrates Hofstede's cultural dimensions with sociological theory, the authors used multilevel modeling to explore the association of culture with structural inequality and health disparities. Their results support the idea that cultural dimensions and social structure, along with economic development, may account for much of the cross-national variation in the distribution of health inequalities. Sensitivity tests also suggest that …

The Increasing Number Of Clinical Items Addressed During The Time Of Adult Primary Care Visits, Elmer D. Abbo, Qi Zhang, Martin Zelder, Elbert S. Huang

Community & Environmental Health Faculty Publications

BACKGROUND: Primary care physicians report that there is insufficient time to meet patients' needs during clinical visits, but visit time has increased over the past decade.

OBJECTIVE: To determine whether the number of clinical items addressed during the primary care visit has increased, and if so, whether this has been associated with changes in visit length and the pace of clinical work.

DESIGN: Analysis of non-hospital-based adult primary care visits from 1997 to 2005, as reported in the National Ambulatory Medical Care Survey.

PARTICIPANTS: A total of 46,431 adult primary care visits.

MEASUREMENTS: We assessed changes over time for …

Childhood Obesity In Minority Populations In The United States, Qi Zhang, Youfa Wang

Community & Environmental Health Faculty Publications

Obesity became a public health crisis in the United States, which affects both adults and children.^1,2,24,25 Approximately 31% of U.S. children and adolescents aged 2-19 years were overweight or obese, and almost 17% were obese in 1999-2004.^3-5,24 Studies suggest that increased consumption of more energy-dense, nutrient-poor foods with high levels of sugar and saturated fats, combined with reduced physical activity, have contributed to the rising obesity epidemic among children.^6,21,28 Childhood obesity increased the risk of many diet-related chronic diseases, including type 2 diabetes, cardiovascular disease, hypertension, stroke, and certain forms of cancers.⁷ It is important to …

Do Hospitalists Or Physicians With Greater Inpatient Hiv Experience Improve Hiv Care In The Era Of Highly Active Antiretroviral Therapy? Results From A Multicenter Trial Of Academic Hospitalists, John A. Schneider, Qi Zhang, Andrew Auerbach, David Gonzales, Peter Kaboli, Jeffrey Schnipper, Tosha B. Wetterneck, David L. Pitrak, David O. Meltzer

Community & Environmental Health Faculty Publications

Background. Little is known about the effect of provider type and experience on outcomes, resource use, and processes of care of hospitalized patients with human immunodeficiency virus (HIV) infection. Hospitalists are caring for this population with increasing frequency.

Methods. Data from a natural experiment in which patients were assigned to physicians on the basis of call cycle was used to study the effects of provider type—that is, hospitalist versus non hospitalist—and HIV-specific inpatient experience on resource use, outcomes, and selected measures of processes of care at 6 academic institutions. Administrative data, inpatient interviews, 30-day follow-up interviews, and the National Death …

Longitudinal Association Of Sleep-Disordered Breathing And Nondipping Of Nocturnal Blood Pressure In The Wisconsin Sleep Cohort Study, Khin Mae Hla, Terry Young, Laurel Finn, Paul E. Peppard, Mariana Szklo-Coxe, Maryan Stubbs

Community & Environmental Health Faculty Publications

Study objectives: The association of sleep-disordered breathing (SDB) and blunting of normal nocturnal lowering of blood pressure (BP) (nondipping) has only been examined cross-sectionally. The purpose of this study is to investigate whether SDB is prospectively associated with nondipping.

Methods: The longitudinal association between SDB and incident nondipping was examined in a subsample of 328 adults enrolled in the Wisconsin Sleep Cohort Study who completed 2 or more 24-hour ambulatory BP studies over an average of 7.2 years of follow-up. SDB identified by baseline in-laboratory polysomnography was defined by apnea-hypopnea index (AHI) categories. Systolic and diastolic nondipping was defined by …

On A Multinational Assessment Of Rotavirus Disease In Europe, David O. Matson

Community & Environmental Health Faculty Publications

Rotaviruses were discovered in the 1960s in animals and in the 1970s in humans; the latter discovery was made by an intrepid group who performed duodenal biopsies on children with acute gastroenteritis (AGE) [1]. By the late 1970s, data already clearly indicated that rotavirus was the cause of the annual winter peak of AGE affecting young children, as well as a frequent cause of severe gastroenteritis in various animal species (e.g., [2–5]). Use of the retrospectroscope clarified or left as tantalizing the suggestion that rotaviruses were the cause of the annual “winter vomiting syndrome” first described in children in 1910 …

Using Concentration Index To Study Changes In Socio-Economic Inequality Of Overweight Among Us Adolescents Between 1971 And 2002, Qi Zhang, Youfa Wang

Community & Environmental Health Faculty Publications

Background: The prevalence of overweight among adolescents continues to increase in the United States. This study examines the changes in socio-economic status (SES) inequality of overweight among US adolescents in the past three decades.

Methods: Concentration Index (CI) was utilized to measure changes in the SES inequality in prevalence of overweight among US adolescents. Data collected from 15286 adolescents in four waves of the National Health and Nutrition Examination Surveys (NHANES) between 1971 and 2002 and Hispanic Health and Nutrition Examination Survey (HHANES) (1982-84) were used.

Results: Changes in the SES inequality of overweight among US adolescents and considerable gender …

Depression: Relationships To Sleep Paralysis And Other Sleep Disturbances In A Community Sample, Mariana Szklo-Coxe, Terry Young, Laurel Finn, Emmanuel Mignot

Community & Environmental Health Faculty Publications

Sleep disturbances are important correlates of depression, with epidemiologic research heretofore focused on insomnia and sleepiness. This epidemiologic study’s aim was to investigate, in a community sample, depression’s relationships to other sleep disturbances: sleep paralysis (SP), hypnagogic/hypnopompic hallucinations (HH), cataplexy – considered rapid eye movement-related disturbances – and automatic behavior (AB). Although typical of narcolepsy, these disturbances are prevalent, albeit under-studied, in the population. Cross-sectional analyses (1998–2002), based on Wisconsin Sleep Cohort Study population-based data from 866 participants (mean age 54, 53% male), examined: depression (Zung Self-Rating Depression Scale), trait anxiety (Spielberger State-Trait Anxiety Inventory, STAI-T ≥ 75th percentile), and …

The Cost-Effectiveness Of Improving Diabetes Care In U.S. Federally Qualified Community Health Centers, Elbert S. Huang, Qi Zhang, Sydney E. S. Brown, Melinda L. Drum, David O. Meltzer, Marshall H. Chin

Community & Environmental Health Faculty Publications

Objective. To estimate the incremental cost-effectiveness of improving diabetes care with the Health Disparities Collaborative (HDC), a national collaborative quality improvement (QI) program conducted in community health centers (HCs).

Data Sources/Study Settings. Data regarding the impact of the Diabetes HDC program came from a serial cross-sectional follow-up study (1998, 2000, 2002) of the program in 17 Midwestern HCs. Data inputs for the simulation model of diabetes came from the latest clinical trials and epidemiological studies.

Study Design. We conducted a societal cost-effectiveness analysis, incorporating data from QI program evaluation into a Monte Carlo simulation model of diabetes.

Data Collections/Extraction …

Changes In Immunological And Hematological Parameters Of Female Residents Exposed To Volatile Organic Compounds In The City Of Kaohsiung, Taiwan, Hueiwang Anna Jeng, I-Long Lee, Yang-Yen Gau, Ching-Tzu Yang, Chitsan Lin, Yu-Jue Hong

Community & Environmental Health Faculty Publications

The objective of this study was to assess the effects, if any, of volatile organic compounds (VOCs) in the ambient air of Kaohsiuug, Taiwan, on certain hematological and immunological parameters of 153 female study participants. The major source of VOCs was vehicle emissions. The participants were selected from three areas, each area at a different distance from a freeway. Results indicated that total concentrations of VOCs and a subgroup of 25 VOCs (VOC₂₅.) ranged from 250 to 335 ppb and 89 to 113 ppb, respectively. The distribution of VOC concentrations did not correlate with distance from the freeway. …

Are Residents' Extended Shifts Associated With Adverse Events, Mariana Szklo-Coxe

Community & Environmental Health Faculty Publications

First paragraph:

Heated debates and controversies surrounding the regulation of medical residents’ work hours have raged for over twenty years. In the wake of Libby Zion’s untimely death in 1984 and resulting recommendations by the Bell Commission, New York State enacted legislation (Code 405.4) governing residents’ working conditions and supervision [1]. Since then, there has been growing interest in regulating residents’ work hours, culminating recently (2003–2004) in national guidelines and legislation on duty-hour restrictions both in the United States and Europe [2,3].

How Physicians Feel About Assisting Female Victims Of Intimate-Partner Violence, Ramani N. Garimella, Stacey B. Plichta, Clare Houseman, Laurel Garzon

Community & Environmental Health Faculty Publications

Purpose. To assess the feelings of physicians about assisting female victims of intimate-partner violence (IPV), and to examine factors related to positive and negative feelings about assisting victims of IPV.

Method. In 1998, a total site sample of 150 physicians practicing in a large general hospital in the area of Virginia Beach, Virginia, was surveyed by questionnaire via the mail. Four specialties were represented: emergency medicine, family practice, obstetrics-gynecology, and psychiatry. The questionnaire asked about medical training and training in assisting victims of IPV The physicians' feelings about working with victims of IPV were measured on a nine-item, five-point …

Identification Of Violence In The Home - Pediatric And Parental Reports, Bonnie D. Kerker, Sarah Mccue Horwitz, John M. Leventhal, Stacey Plichta, Phillip J. Leaf

Community & Environmental Health Faculty Publications

Objectives: To compare the rates of domestic violence reported by mothers with those identified by physicians, to compare the rates of harsh discipline practices reported by mothers with the rates of abuse identified by physicians, and to examine the relationship between reported domestic violence and harsh discipline practices.

Design: Interviews with parents and pediatricians to compare pediatric detection of domestic violence and child abuse with parental reports of domestic violence and harsh discipline practices.

Setting: Community-based pediatric practices in the 13-town greater New Haven, Conn, area.

Participants: Of the 23 practices invited, 19 agreed to participate. Of the 2006 parents …