Public Health Commons^™

Determinants Of Obesity: Racial Differences, Nikkia L. Goforth

Theses and Dissertations

BACKGROUND: Obesity is a major public health problem. Studies have shown that there are racial and ethnic differences in the prevalence of obesity. However, there is limited research that examines the effects of sedentary and poor lifestyle behaviors and obesity among different racial and ethnic groups. Furthermore, most studies focus on the problem of obesity among children. This study was conducted to examine racial differences in determinants of obesity in adults in the United States. METHODS: Data from the 2005 Behavioral Risk Factor Surveillance System was used for this analysis. Demographics, lifestyle behaviors, and existence of chronic diseases were assessed. …

Individual Differences In Well-Being In Older Breast Cancer Survivors, Elizabeth A. Perkins, Brent J. Small, Lodovico Balducci, Martine Extermann, Claire Robb, William E. Haley

Epidemiology: Faculty Publications (2002-2018)

Older women who survive breast cancer may differ significantly in their long-term well-being. Using a risk and protective factors model, we studied predictors of well-being in 127 women age 70 and above with a history of at least one year's survival of breast cancer. Mean post-cancer survivorship was 5.1 years. Using life satisfaction, depression and general health perceptions as outcome variables, we assessed whether demographic variables, cancer-related variables, health status and psychosocial resources predicted variability in well-being using correlational and hierarchical regression analyses. Higher age predicted increased depression but was not associated with life satisfaction or general health perceptions. Cancer-related …

Analgesic Use In U.S. Emergency Departments For Patients Reporting Moderate To Severe Pain: Diagnosis And Select Patient Characteristics Influencing Narcotic Analgesic Prescribing Practices, Hassan Zakaria

Theses and Dissertations

Objective: This study aims to examine the relationship between emergency department patient encounter characteristics and narcotic analgesic prescribing practices in order to determine what patient characteristics, if any, influence the decision to prescribe narcotics.Methods: Cross sectional data on patients presenting to U.S. emergency departments from the 2003 and 2004 National Hospital Ambulatory Medical Care Survey were analyzed. Patients reporting moderate to severe pain were included in the sample and analysis. Chi square tests of significance were used to assess the association between individual demographic and encounter characteristics to narcotic prescription or administration. Separate multiple logistic regressions were then performed on …

Impact Of Combat Stress On Mental Health Outcomes: Brfss Survey Data 2006, Emily Pedneau

Theses and Dissertations

Objectives: This study sought to determine the relationship between combat experience and mental health outcomes. The study sought to determine whether age was a significant factor in poor mental health outcomes. Methods: Multiple logistic regression (n = 195,048) and multiple linear regression (n = 264,154) were performed on the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. Veteran status and a host of demographic and health status questions were analyzed in relation to diagnosis of anxiety or depressive disorder (multiple logistic regression) and to number of days poor mental health (multiple linear regression). Results: Diagnosis of anxiety or depression was …

Trend Analysis Of Automobile Collision Amongst 15-19 Year Olds In Virginia, 2000-2004, Imo F. Ndem

Theses and Dissertations

Purpose. This research study on automobile collision in Virginia amongst fifteen to nineteen (15-19) year olds looked into the trend analysis over a five (5) year period of 2000 to 2004. Trend analysis is usually done for aggregates of all injuries—either intentional or unintentional injuries, or both. The primary objective of this research study was to examine the trend in hospitalization rates and mortality rates for males and females independently. It further looked into the trend, if any, in hospitalization rates, mortality rates, and case-fatality rates, for both males and females combined. The different Tables illustrate the extent and the …

Examination Of Birth Outcomes With Mode Of Delivery For Breech Presentation, Kelly Marie Arey

Theses and Dissertations

Introduction: Approximately 3% to 4% of all pregnancies at term will have a fetus with a breech presentation. Studies have shown that the US has almost completely abandoned vaginal delivery for breech presentation through the influence of the "Term Breech Trial" (TBT) which concluded that a policy of planned caesarian section would reduce perinatal mortality, late neonatal mortality, and serious neonatal morbidity by approximately two-thirds for term fetuses. However, the recommendations are still being challenged by others.Objectives: The purpose of the study was to describe who in Virginia is having a vaginal delivery for a breech presentation and to determine …

Has Richmond, Virginia Become Safer In The Past Five Years (2002-2006)?: An Analysis Of Ambulance Data Regarding Penetrating Trauma Incidents, Ashleigh K. Mccabe

Theses and Dissertations

Introduction: The World Health Assembly declared violence as a worldwide public health problem. Homicides have been identified as a leading cause of death in the United States across all age groups. The national homicide rate for 2004 and 2005 are 5.5 and 5.6 per 100,000 population, respectively. The reported rates for Virginia are 5.2 (2004) and 5.6 (2005) per 100,000 population, showing a 16.9% increase. Richmond has been ranked as high as the sixth most dangerous among similar cities in the United States. This study examines penetrating trauma injuries identified through 9-1-1 calls as an indicator of the incidence of …

Breast And Cervical Cancer Screening In Virginia: The Impact Of Insurance Coverage And The Every Woman's Life Screening Program, Kamila Somayaji

Theses and Dissertations

Background: Screening for breast and cervical cancers is important because early detection increases cancer survival. Since 1991, the U.S. government has helped finance a national early detection program for breast and cervical cancer among uninsured low-income women, known in Virginia (VA) as Every Woman's Life (EWL).Objectives: This study aims to determine whether there are differences in the prevalence of breast and cervical cancer screening based on insurance coverage, assess the prevalence of screening by health district, and evaluate the ability of EWL to effectively reach its target population.Methods: Cross-sectional data from the 2005 Behavioral Risk Factor Surveillance System survey were …

The Association Between Adult Self-Reported Asthma & Potential Exposures To Asthma Triggers In Virginia Workplaces: An Ecological Study, Jeanette R. Bowman

Theses and Dissertations

Introduction: Work-related asthma (WRA) is thought to be the most common occupational lung disease in the U.S., but there is no standard case definition of WRA. Most states, including Virginia, do not require WRA diagnoses to be reported to health departments. At present, there is too little epidemiological data on WRA in Virginia to direct public health planning efforts. Objectives: The first objective of this study was to estimate potential exposure to workplace asthma triggers in each of Virginia's 35 health districts. The second objective was to examine associations at the health district level between workplace asthma triggers, other asthma …

Disparities In The Use Of Emergency Contraceptives, Rebecca Dallman

Theses and Dissertations

Purpose: Unintended pregnancies are often a burden to pregnant women and to the health care system. The rates of unintended pregnancies have decreased since the wide use of contraceptives has increased; however, young women, women with low income, and racial/ethnic minorities are more likely to use contraceptives inconsistently, which increases the risk of an unintended pregnancy. This risk could be reduced with the proper use of emergency contraceptives (ECs).Methods and Analysis: A cross-sectional study was conducted using the data from the female respondents of the 2002 Cycle 6 NSFG. Logistic regression was used to determine rates of use of ECs …

Outcomes Of Status Epilepticus In The Elderly, Alan R. Towne

Theses and Dissertations

Background: Status epilepticus (SE) is a serious medical condition associated with significant morbidity and mortality. Few studies have addressed this condition in the elderly. The present study examines predictors of SE mortality in this growing population.Methods: SE patients visiting the Virginia Commonwealth University Medical Center from July 1, 1989, to June 30,2006 were included in the study. Data on demographic characteristics, SE type, etiology, time to treatment and mortality were collected. Logistic regression analysis was conducted to examine the determinants of mortality due to SE. Data was stratified by age to examine the characteristics of SE among the elderly population.Results: …

Faktor-Faktor Yang Mempengaruhi Kematian Pasien Penyakit Jantung Koroner Di Pusat Jantung Nasional Harapan Kita Tahun 2004, Fatmah A. Gobel, Renti Mahkota

Kesmas

Menurut estimasi WHO, sekitar 50% dari 12 juta penduduk dunia meninggal akibat penyakit jantung dan pembuluh darah. Faktor prognosis pasien PJK dapat diubah dan dikendalikan, dan memungkinkan untuk mencegah kematian akibat PJK. Penelitian ini bertujuan mengetahui faktor prognosis yang berhubungan dengan terjadinya kematian pasien PJK di PJN Harapan Kita Tahun 2004, menggunakan data sekunder (data rekam medik pasien). Variabel-variabel yang diteliti meliputi variabel independen (jaminan pembayaran, asal daerah/kawasan, penyakit penyerta hipertensi, diabetes melitus, dislipidemia dan riwayat PJK sebelumnya) dan variabel kovariat (umur, jenis kelamin, pendidikan dan pekerjaan). Desain epidemiologi yang digunakan adalah analitik kasus kontrol dengan jumlah kasus 130, kontrol …

A Likelihood Based Method For Real Time Estimation Of The Serial Interval And Reproductive Number Of An Epidemic, Laura Forsberg White, Marcello Pagano

Harvard University Biostatistics Working Paper Series

No abstract provided.

Stability Analysis For An Seir Age-Structured Epidemic Model Under Vaccination, M. El-Doma

Applications and Applied Mathematics: An International Journal (AAM)

An SEIR age-structured epidemic model is investigated when susceptible and immune individuals are vaccinated indiscriminately and the force of infection of proportionate mixing type. We determine the steady states and obtain an explicitly computable threshold condition, and then study the stability of the steady states.

Global Stability Results And Well Posedness Of An Si Age-Structured Epidemic Model With Vertical Transmission, M. El-Doma

Applications and Applied Mathematics: An International Journal (AAM)

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

A Multilevel Analysis Of Socioeconomic Status And Prostate Cancer Risk, Maureen Sanderson, Ann L. Coker, Adriana Perez, Xianglin L. Du, Gerson Peltz, Mary K. Fadden

Health & Biomedical Sciences Faculty Publications

PURPOSE

We investigated whether prostate cancer was associated with socioeconomic status (SES) at the individual level, area level, or a combination of both levels.

METHODS

This population-based case–control study of prostate cancer in men aged 65 to 79 years was conducted between 2000 and 2002 in South Carolina. Complete interviews were available for 407 incident prostate cancer cases and 393 controls (with respective response rates of 61% and 64%). We used educational level to measure individual-level SES and a composite variable capturing income and education from 2000 Census data to measure area-level SES.

RESULTS

After adjustment for race, age, geographic …

Spatio-Temporal Analysis Of Areal Data And Discovery Of Neighborhood Relationships In Conditionally Autoregressive Models, Subharup Guha, Louise Ryan

Harvard University Biostatistics Working Paper Series

No abstract provided.

Semiparametric Regression Of Multi-Dimensional Genetic Pathway Data: Least Squares Kernel Machines And Linear Mixed Models, Dawei Liu, Xihong Lin, Debashis Ghosh

Harvard University Biostatistics Working Paper Series

No abstract provided.

Faktor-Faktor Prognosis Kematian Tetanus Neonatorum Di Rs Kabupaten Indramayu Dan Kabupaten Cirebon, Lili Tantijati, Krisnawati Bantas

Kesmas

Angka Kematian Bayi (AKB) di Indonesia masih tetap tinggi. Berdasarkan Biro Pusat Statistik (BPS) pada tahun 1995 adalah 55/1.000 kelahiran hidup. Salah satu penyebab utama dari kematian bayi adalah penyakit tetanus neonatorum. Tujuan dari penelitian ini adalah untuk menentukan hubungan antara usia saat ditemukan adanya indikasi penyakit neonatarum pada bayi dengan timbulnya kematian yang disebabkan oleh tetanus neonatorum pada bayi-bayi tersebut di Kabupaten Indramayu pada tahun 1996-2001. Penelitian ini menggunakan disain studi epidemiologi kasus-kontrol dengan perbandingan kasus dan kontrol 1:1. Jumlah sampel, 160 penderita tetanus neonatorum. Populasi studi adalah penderita tetanus neonatorum yang dirawat di RSD kabupaten Cirebon dan kabupaten …

Prevalensi Dan Determinan Hipertensi Di Pulau Jawa, Tahun 2004, Zamhir Setiawan

Kesmas

Hipertensi merupakan faktor risiko utama kardiovaskuler yang merupakan penyebab utama kematian di seluruh dunia. Peningkatan umur harapan hidup dan perubahan gaya hidup meningkatkan faktor risiko hipertensi di berbagai negara. Tujuan penelitian ini (1) Mengetahui prevalensi hipertensi dan penyebarannya di Pulau Jawa tahun 2004. (2) Mengetahui faktor-faktor sosiodemografi yang berhubungan dengan kejadian hipertensi. (3) Mengetahui kontribusi dan dampak potensial masing masing faktor tersebut. Penelitian dengan rancangan studi Ekologi Multilevel ini menggabungkan variabel tingkat pengukuran individu dengan tingkat pengukuran ekologi dalam analisis bersama, dengan unit analisis individu. Analisis kontekstual dilakukan melalui kerangka konsep hipertensi, menggunakan metode analisis regresi logistik ganda, dengan status …

Pengembangan Sistem Informasi Program Kusta Berbasis Geografis Di Kabupaten Cirebon Tahun 2005, Haeria Haeria

Kesmas

Kusta yang disebabkan oleh infeksi Mycobacterium leprae merupakan penyakit menular dengan masalah yang sangat kompleks. Tiga tahun terakhir, Kabupaten Cirebon yang melaporkan 1.207 penderita kusta (Prevalence 1,69/10.000 penduduk), belum mencapai tahap eliminasi sehinga penularan masuh berlansung. Tujuan penelitian mengembangan sistem informasi kusta berbasis geografis yang dapat dijadikan solusi percepatan eliminasi kusta di Kabupaten Cirebon. Metoda yang digunakan adalah System Development Life Cycle, yaitu planning, analysis, design, implementation, maintenance dan evaluation system. Hal tersebut dilakukan dengan memadukan konsep Data Base Management System dan data spasial. Hasil analisis sistem dapat mengidentifikasi masalah manajemen penanggulangan kusta serta alternatif solusi pada level …

Statistical Analysis Of Air Pollution Panel Studies: An Illustration, Holly Janes, Lianne Sheppard, Kristen Shepherd

UW Biostatistics Working Paper Series

The panel study design is commonly used to evaluate the short-term health effects of air pollution. Standard statistical methods for analyzing longitudinal data are available, but the literature reveals that the techniques are not well understood by practitioners. We illustrate these methods using data from the 1999 to 2002 Seattle panel study. Marginal, conditional, and transitional approaches for modeling longitudinal data are reviewed and contrasted with respect to their parameter interpretation and methods for accounting for correlation and dealing with missing data. We also discuss and illustrate techniques for controlling for time-dependent and time-independent confounding, and for exploring and summarizing …

Biologic Interaction And Their Identification, Tyler J. Vanderweele, James Robins

COBRA Preprint Series

The definitions of a biologic interaction and causal interdependence are reconsidered in light of a sufficient-component cause framework. Various conditions and statistical tests are derived for the presence of biologic interactions. The conditions derived are sufficient but not necessary for the presence of a biologic interaction. Through a series of examples it is made evident that in the context of monotonic effects, but not in general, the conditions which are derived are closely related but not identical to effect modification on the risk difference scale.

A Theory Of Sufficient Cause Interactions, Tyler J. Vanderweele, James M. Robins

COBRA Preprint Series

Sufficient-component causes are discussed within the potential outcome framework so as to formalize notions of sufficient causes, synergism and sufficient cause interactions. Doing so allows for the derivation of counterfactual conditions and statistical tests for detecting the presence of sufficient cause interactions. Under the assumption of monotonic effects, more powerful statistical tests for sufficient cause interactions can be derived. The statistical tests derived for sufficient cause interactions are compared with and contrasted to interaction terms in standard statistical models.

Exploiting Gene-Environment Independence For Analysis Of Case-Control Studies: An Empirical Bayes Approach To Trade Off Between Bias And Efficiency , Bhramar Mukherjee

The University of Michigan Department of Biostatistics Working Paper Series

Standard prospective logistic regression analysis of case-control data often leads to very imprecise estimates of gene-environment interactions due to small numbers of cases or controls in cells of crossing genotype and exposure. In contrast, modern ``retrospective'' methods, including the celebrated ``case-only'' approach, can estimate the interaction parameters much more precisely, but they can be seriously biased when the underlying assumption of gene-environment independence is violated. In this article, we propose a novel approach to analyze case-control data that can relax the gene-environment independence assumption using an empirical Bayes (EB) framework. In the special case, involving a binary gene and a …

Girls' Perception Of Physical Environmental Factors And Transportation: Reliability And Association With Physical Activity And Active Transport To School, Kelly R. Evenson, Amanda Birnbaum, Ariane L. Bedimo-Rung, James Sallis, Carolyn C. Voorhees, Kimberly Ring, John P. Elder

Department of Public Health Scholarship and Creative Works

Background

Preliminary evidence suggests that the physical environment and transportation are associated with youth physical activity levels. Only a few studies have examined the association of physical environmental factors on walking and bicycling to school. Therefore, the purpose of this study was (1) to examine the test-retest reliability of a survey designed for youth to assess perceptions of physical environmental factors (e.g. safety, aesthetics, facilities near the home) and transportation, and (2) to describe the associations of these perceptions with both physical activity and active transport to school.

Methods

Test and retest surveys, administered a median of 12 days later, …

Spatial Cluster Detection For Censored Outcome Data, Andrea J. Cook, Diane Gold, Yi Li

Harvard University Biostatistics Working Paper Series

No abstract provided.

Extending Marginal Structural Models Through Local, Penalized, And Additive Learning, Daniel Rubin, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

Marginal structural models (MSMs) allow one to form causal inferences from data, by specifying a relationship between a treatment and the marginal distribution of a corresponding counterfactual outcome. Following their introduction in Robins (1997), MSMs have typically been fit after assuming a semiparametric model, and then estimating a finite dimensional parameter. van der Laan and Dudoit (2003) proposed to instead view MSM fitting not as a task of semiparametric parameter estimation, but of nonparametric function approximation. They introduced a class of causal effect estimators based on mapping loss functions suitable for the unavailable counterfactual data to those suitable for the …

Structural Inference In Transition Measurement Error Models For Longitudinal Data, Wenqin Pan, Xihong Lin, Donglin Zeng

Harvard University Biostatistics Working Paper Series

No abstract provided.

Estimation In Semiparametric Transition Measurement Error Models For Longitudinal Data, Wenqin Pan, Donglin Zeng, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.