Medicine and Health Sciences Commons^™

Estimation Of Uninsurance Rate: Comparison Of Four Estimation Methods, Jackie Zhang, Renee Hotchkiss, Thomas Wan

Thomas T.H. Wan

Objective: Although high percentage of the uninsured is an important public policy issue, the discrepancies in both state and national estimates of the numbers of uninsured are reported. This study compares four advanced estimation methods for uninsurance, by using Florida Health Insurance Survey data as an example. Design: The four predictive models include decision tree, neural network, general logistic regression, and two-stage logistic regression. Risk factors to uninsurance are identified. Population: The study sample comes from the Florida Health Insurance Study data collected for the Florida Agency of Health Care Administration in 1999, representing the first large-scale study designed exclusively …

Environmental Equity Is Child's Play: Mapping Public Provision Of Recreation Opportunities In Urban Neighbourhoods, Jason Gilliland, Martin Holmes, Jennifer Irwin, Patricia Tucker

Trish Tucker

This paper examines the spatial distribution of recreational opportunities for children and youth in a mid-sized Canadian city (London, Ontario), in relation to the socioeconomic status of neighbourhoods and estimated local need for publicly provided recreation spaces. Public recreation facilities (N = 537) throughout the city were identified, mapped and analysed in a geographic information system. To explore potential socio-environmental inequities, neighbourhoods (N = 22) were characterized by socioeconomic and environmental variables, an index of neighbourhood social distress, a neighbourhood play space needs index, and measures of the prevalence and density of recreational opportunities. The results of the spatial analysis …

Feasibility Of A Campus-Based "Buddy System" To Promote Physical Activity: Canadian Students' Perspectives, Patricia Tucker, Jennifer Irwin

Trish Tucker

Objective: To explore the characteristics of a university-wide buddy system that students would be receptive to using. Methods: This study targeted a heterogeneous sample of undergraduate university students age 18 to 25 y. An experienced moderator, using a semi-structured interview guide, conducted 13 focus groups (n = 65). Focus group discussions were audio recorded and transcribed verbatim. Inductive content analysis was conducted independently by two researchers. Measures were incorporated throughout to ensure data trustworthiness. Results: The value of this campus-based physical activity intervention was emphasized by the vast majority of participants. Five main themes exemplified students' preferences: sign-up methods; matching …

Surveillance Of The Colorectal Cancer Disparities Among Demographic Subgroups: A Spatial Analysis, Chiehwen Hsu, Francisco Soto Mas

Francisco Soto Mas

Objective: The literature suggests that colorectal cancer mortality in Texas is distributed inhomogeneously among specific demographic subgroups and in certain geographic regions over an extended period. To understand the extent of the demographic and geographic disparities, the present study examined colorectal cancer mortality in 15 demographic groups in Texas counties between 1990 and 2001. Methods: The Spatial Scan Statistic was used to assess the standardized mortality ratio, duration and age-adjusted rates of excess mortality, and their respective p-values for testing the null hypothesis of homogeneity of geographic and temporal distribution. Results: The study confirmed the excess mortality in some Texas …

Depressed Contractile Responses To Neurokinin A In Idiopathic But Not Neurogenic Overactive Human Detrusor Muscle, Donna Sellers, Christopher Chapple, Douglas Hay, Russell Chess-Williams

Russ Chess-Williams

Objective: The role of tachykinins such as neurokinin A in regulating bladder function is unclear, but NK2 receptors seem to mediate contraction in the human bladder and it has been suggested that these peptides may have a role in the pathophysiology of bladder dysfunction. The present study investigates neurokinin receptor-mediated contractility of detrusor muscle in the idiopathic overactive and neurogenic overactive bladder and investigates the neurokinin receptor subtypes involved.

Methods: Human bladder was obtained from patients undergoing cystectomy (normal) or clam cystoplasty (idiopathic overactive) and from patients with spinal injuries (neurogenic overactive). Strips of isolated detrusor muscle were mounted in …

2007 Tschochner Superiority Of Infectivity-Based Over Particle-Based Methods For Quantitation Of Drug Resistant Hiv-1 As Inocula For Cell Cultures.Pdf, M Tschochner

Monika Tschochner

No abstract provided.

The Plant Structure Ontology, A Unified Vocabulary Of Anatomy And Morphology Of A Flowering Plant, Katica Ilic, Elizabeth A. Kellogg, Pankaj Jaiswal, Felipe Zapata, Peter F. Stevens, Leszek P. Vincent, Shulamit Avraham, Leonore Reiser, Anuradha Pujar, Martin M. Sachs, Noah T. Whitman, Susan R. Mccouch, Mary L. Schaeffer, Doreen H. Ware, Lincoln D. Stein, Seung Y. Rhee

Peter Stevens

Modeling The Incubation Period Of Anthrax, Ron Brookmeyer, Elizabeth Johnson, Sarah Barry

Ron Brookmeyer

Models of the incubation period of anthrax are important to public health planners because they can be used to predict the delay before outbreaks are detected, the size of an outbreak and the duration of time that persons should remain on antibiotics to prevent disease. The difficulty is that there is little direct data about the incubation period in humans. The objective of this paper is to develop and apply models for the incubation period of anthrax. Mechanistic models that account for the biology of spore clearance and germination are developed based on a competing risks formulation. The models predict …

An Overview Of The Near-Death Experience Phenomenon, David San Filippo Ph.D.

David San Filippo Ph.D.

Near-death experiences appear to be universal phenomena that have been reported for centuries. A near-death encounter is defined as an event in which the individual could very easily die or be killed, or may have already been considered clinically dead, but nonetheless survives, and continue his or her physical life. Reports of near-death experiences date back to the Ice Age. There are cave paintings, in France and Spain that depict possible after life scenes that are similar to reported scenes related to near-death experiences. Plato's Republic presents the story of a near-death experience of a Greek soldier named Er. In …

Wavelet-Based Functional Mixed Models To Characterize Population Heterogeneity In Accelerometer Profiles: A Case Study. , Jeffrey S. Morris, Cassandra Arroyo, Brent A. Coull, Louise M. Ryan, Steven L. Gortmaker

Jeffrey S. Morris

We present a case study illustrating the challenges of analyzing accelerometer data taken from a sample of children participating in an intervention study designed to increase physical activity. An accelerometer is a small device worn on the hip that records the minute-by-minute activity levels of the child throughout the day for each day it is worn. The resulting data are irregular functions characterized by many peaks representing short bursts of intense activity. We model these data using the wavelet-based functional mixed model. This approach incorporates multiple fixed effects and random effect functions of arbitrary form, the estimates of which are …

Alternative Probeset Definitions For Combining Microarray Data Across Studies Using Different Versions Of Affymetrix Oligonucleotide Arrays, Jeffrey S. Morris, Chunlei Wu, Kevin R. Coombes, Keith A. Baggerly, Jing Wang, Li Zhang

Jeffrey S. Morris

Many published microarray studies have small to moderate sample sizes, and thus have low statistical power to detect significant relationships between gene expression levels and outcomes of interest. By pooling data across multiple studies, however, we can gain power, enabling us to detect new relationships. This type of pooling is complicated by the fact that gene expression measurements from different microarray platforms are not directly comparable. In this chapter, we discuss two methods for combining information across different versions of Affymetrix oligonucleotide arrays. Each involves a new approach for combining probes on the array into probesets. The first approach involves …

Cross-Cultural Reliability Of The Health Control & Competence Index And The Health Perception Index, Dr. Vincent L. Salyers

Dr. Vincent L Salyers

It is well documented that men of Latino origin are subject to health disparities with an increased morbidity and mortality from preventable diseases. Despite their proclivity for health problems, these men also have the lowest participation in health promotion services. This may be due to health disparity factors, health access factors, cultural factors, gender role factors, and constraints to receiving culturally competent health care. Addressing such factors as health knowledge, health perceptions, access to care, and culturally/linguistically competent care is essential to increasing participation in health care, health promotion and screening activities by men of Latino origin. This mixed-measures exploratory …

Managing Complications Of Radiation Therapy In Head And Neck Cancer Patients: Part Ii. Management Of Radiation-Induced Caries, W. L. Chai, W.C. Ngeow, R. Ramli, R. A. Rahman

Wei Cheong Ngeow

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral complications after radiation therapy. The management of xerostomia has been reviewed in Part I of this series. In this article, the management of dental caries, a sequalae of xerostomia following radiation therapy is reviewed. …

Managing Complications Of Radiation Therapy In Head And Neck Cancer Patients: Part I. Management Of Xerostomia, W.C. Ngeow, W. L. Chai, R. A. Rahman, R. Ramli

Wei Cheong Ngeow

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they receive radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral adverse effects after radiation therapy. Part I of this series reviews the management of xerostomia. The management of the effect of xerostomia to the dentition/oral cavity is discussed in Part II. © 2006 Elsevier. …

Managing Complications Of Radiation Therapy In Head And Neck Cancer Patients: Part V. Management Of Mucositis, W.C. Ngeow, W. L. Chai, R. A. Rahman, R. Ramli

Wei Cheong Ngeow

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral adverse effects after radiation therapy. The second last part of this series reviews and discusses the management of complication that commonly occur to the oral mucosa, i.e. mucositis. © 2006 Elsevier. All rights reserved.

Managing Complications Of Radiation Therapy In Head And Neck Cancer Patients: Part Vi. Management Of Opportunistic Infections, W.C. Ngeow, W. L. Chai, R. Ramli, R. A. Rahman

Wei Cheong Ngeow

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral adverse effects after radiation therapy. The last part of this series reviews the opportunistic infections that can occur to the perioral structure. Their management is briefly discussed. © 2006 Elsevier. All rights reserved.

Managing Complications Of Radiation Therapy In Head And Neck Cancer Patients: Part Iv. Management Of Osteoradionecrosis, R. Ramli, W.C. Ngeow, R. A. Rahman, W. L. Chai

Wei Cheong Ngeow

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Pretreatment dental assessment should be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally and, as a result, they succumb to complicated oral adverse effects after radiation therapy. Osteoradionecrosis (ORN) is a severe debilitating condition that impairs healing due to reduction in vascularity and osteocyte population in the affected bone. This article reviews methods of treatment used to treat ORN such …

Transient Loss Of Power Of Accommodation In 1 Eye Following Inferior Alveolar Nerve Block: Report Of 2 Cases, W.C. Ngeow, C. K. Shim, W. L. Chai

Wei Cheong Ngeow

Unintended intravascular injection from inferior alveolar nerve blocks can result in frustrating distant complications affecting such structures as the middle ear and eyes. Possible complications affecting the eyes include blurring of vision, diplopia, mydriasis, palpebral ptosis and amaurosis ( temporary or permanent). In this article, we present a complication that has been reported only rarely. Two patients developed transient loss of power of accommodation of the eye resulting in blurred vision after routine inferior alveolar nerve blocks on the ipsilateral side. Clear vision returned within 10 - 15 minutes after completion of the blocks. The possible explanation for this phenomenon …

Managing Complications Of Radiation Therapy In Head And Neck Cancer Patients: Part Iii. Provision Of Dentures, R. A. Rahman, W.C. Ngeow, W. L. Chai, R. Ramli

Wei Cheong Ngeow

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Pretreatment dental assessment should be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally and, as a result, they succumb to complicated oral adverse effects after radiation therapy. The management of radiation-induced caries, a sequelae of xerostomia has been reviewed in Part II of this series. In this article, the management of difficulty with dentures, another sequelae of xerostomia following radiation …

Identifying Important Explanatory Variables For Time-Varying Outcomes., Oliver Bembom, Maya L. Petersen, Mark J. Van Der Laan

Maya Petersen

This chapter describes a systematic and targeted approach for estimating the impact of each of a large number of baseline covariates on an outcome that is measured repeatedly over time. These variable importance estimates can be adjusted for a user-specified set of confounders and lend themselves in a straightforward way to obtaining confidence intervals and p-values. Hence, they can in particular be used to identify a subset of baseline covariates that are the most important explanatory variables for the time-varying outcome of interest. We illustrate the methodology in a data analysis aimed at finding mutations of the human immunodeficiency virus …

Risks And Protective Factors Associated With Symptoms Of Depression In Low-Income African American And Caucasian Women During Pregnancy, Darlene Elizabeth Jesse

D. Elizabeth Jesse

No abstract provided.

Child Laundering: How The Intercountry Adoption System Legitimizes And Incentivizes The Practices Of Buying, Trafficking, Kidnapping, And Stealing Children, David M. Smolin

David M. Smolin

This article documents and analyzes a substantial incidence of "child laundering" within the intercountry adoption system. Child laundering occurs when children are taken illegally from birth families through child buying or kidnapping, and then "laundered" through the adoption system as "orphans" and then "adoptees." The article then proposes reforms to the intercountry adoption system that could substantially reduce the incidence of child laundering.

Identifying Important Explanatory Variables For Time-Varying Outcomes., Oliver Bembom, Maya L. Petersen, Mark J. Van Der Laan

Oliver Bembom

This chapter describes a systematic and targeted approach for estimating the impact of each of a large number of baseline covariates on an outcome that is measured repeatedly over time. These variable importance estimates can be adjusted for a user-specified set of confounders and lend themselves in a straightforward way to obtaining confidence intervals and p-values. Hence, they can in particular be used to identify a subset of baseline covariates that are the most important explanatory variables for the time-varying outcome of interest. We illustrate the methodology in a data analysis aimed at finding mutations of the human immunodeficiency virus …

What Is The Cost To Employers Of Direct Medical Care For Chronic Obstructive Pulmonary Disease?, Tursynbek Nurmagambetov, Adam Atherly, Seymour Williams, Fernando Holguin, David M. Mannino, Stephen C. Redd

David M. Mannino

Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the United States. In 2000, an estimated 10.5 million people had COPD, of which more than 7.2 million were from the under-age 65 employed population. The prevalence of COPD in the workforce population was substantial with 46.5% of current employment among adults having the disease. However, the cost burden in the employed population is unknown. We examined COPD prevalence and costs in a large employment-based population. Using claims data from 1999 to 2003, we estimated the cost associated with COPD-related hospitalizations, emergency department visits, outpatient services, …

Howe V. Mgh And Hudson V. Texas Children's Hospital: Two Approaches To Resolving Family-Physician Disputes In End-Of-Life Care, Michael Moreland

Michael P. Moreland

No abstract provided.

The Role Of Bnp Testing In Heart Failure, Jenny Doust, Richard Lehman, Paul Glasziou

Jenny Doust

Brain natriuretic peptide (BNP) levels are simple and objective measures of cardiac function. These measurements can be used to diagnose heart failure, including diastolic dysfunction, and using them has been shown to save money in the emergency department setting. The high negative predictive value of BNP tests is particularly helpful for ruling out heart failure. Treatment with angiotensin-converting enzyme inhibitors, angiotensin-II receptor blockers, spironolactone, and diuretics reduces BNP levels, suggesting that BNP testing may have a role in monitoring patients with heart failure. However, patients with treated chronic stable heart failure may have levels in the normal range (i.e., BNP …

Using Electronic Patient Records In Mental Healthcare To Capture Housing And Homelessness Information Of Psychiatric Consumers, Richard Booth

Richard G Booth

No abstract provided.

Obligations In Offering To Disclose Genetic Research Results, Conrad Fernandez, Charles Weijer

Charles Weijer

No abstract provided.

Organochlorine Levels In Seawater And Sediment From The Florida Gulf Coast, If Present, Are Low. , Richard B. Philp

Richard B. Philp

Seawater and sediment from the Florida panhandle coast were assayed for a panel of 28 organochlorine insecticides and PCBs. No samples exeeded the detection limits of the analytical technique, which were well below levels reported for other ocean locales. Organochlorine levels in this area of the Gulf must be very low. This does not preclude their biomagnificatioon up the food web.

Organochlorine Levels In Seawater And Sediment From The Florida Gulf Coast, If Present, Are Low., Richard B. Philp

Richard B. Philp

Abstract Seawater and bottom sediment from two areas of the Gulf of Mexico near-shore waters along the Florida panhandle, one near Panacea (South of Tallahassee) and the other, St. Joseph Bay, about 100 km to the west, were analyzed for organochlorines (OCs). The first area is contiguous with the open water of Apalachee Bay and receives significant fresh water inflow. The second is a long, narrow bay with a north-facing mouth adjacent to the mainland and little fresh water inflow. Samples were analyzed for a panel of 28 OCs including several insecticides and metabolites as well as hexaxhlorobenzene and total …