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Causal Inference In Hybrid Intervention Trials Involving Treatment Choice, Qi Long, Rod Little, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.

A Comparison Of Methods For Estimating The Causal Effect Of A Treatment In Randomized Clinical Trials Subject To Noncompliance, Rod Little, Qi Long, Xihong Lin

Harvard University Biostatistics Working Paper Series

No abstract provided.

Faktor-Faktor Yang Berhubungan Dengan Pemberian Asi Satu Jam Pertama Setelah Melahirkan, Setiyowati Rahardjo

Kesmas

Di Indonesia, Angka Kematian Bayi (AKB) masih yang tertinggi di negara-negara ASEAN. Penyebab utama kematian anak balita tersebut adalah penyakit infeksi saluran nafas dan diare yang dapat dicegah antara lain dengan pemberian ASI secara benar dan tepat. Pada periode 2002-2003, sekitar 95,9% balita sudah mendapat ASI, tetapi hanya 38,7 % balita mendapat ASI pertama satu jam setelah lahir. Tujuan penelitian ini adalah untuk mengetahui berbagai faktor yang berhubungan dengan pemberian ASI dalam satu jam pertama setelah melahirkan. Penelitian ini menggunakan sumber data sekunder SDKI 2002-2003 dengan desain cross sectional. Sampel berjumlah 6.018 terdiri dari ibu yang memiliki anak berusia 0 …

Epidemiologi Diskriptif Penyakit Avian Flu Di Lima Provinsi Di Indonesia, 2005-2006, Ajeng Tias Endarti, Ratna Djuwita

Kesmas

Jumlah kasus flu burung pada manusia meningkat sangat pesat. Studi ini bertujuan untuk mengetahui gambaran epidemiologi penyakit flu burung (Avian Influenza/AI) pada kejadian luar biasa di 5 provinsi Indonesia in 2005-2006. Studi ini mengunakan sumber data sekunder data surveilens, sub direktorat Surveilens, Depkes RI, pada periode Juli 2005-2006. Dari 28 kasus konfirmasi ditemukan banyak pada pria (57.1%). Sekitar 89.3% kasus memperlihatkan gejala demam tinggi (>38°C), batuk dan masalah pernapasan dan sekitar 80% diantaranya meninggal dunia. Gejala tersebut mengindikasikan kerusakan jaringan paru-paru pada tubuh penderita. Berdasarkan laporan hasil pemeriksaan laboratorium, terlihat bahwa 60.7% penderita mengalami penurunan kadar leukosit (leucopenia) dan …

Kelangsungan Hidup Bayi Di Perkotaan Dan Pedesaan Indonesia, Demsa Simbolon

Kesmas

Kelangsungan hidup bayi di Indonesia yang masih rendah terlihat pada angka kematian bayi (AKB) yang menempati posisi tertinggi di Asean, kondisi intermediate rock dan sangat bervariasi. Penelitian yang menggunakan sumber data sekunder SDKI 2002-2003 ini bertujuan mengetahui gambaran kelangsungan hidup bayi di wilayah perkotaan dan pedesaan di Indonesia serta berbagai faktor yang berpengaruh. Besar sampel yang digunakan adalah 11.588 terdiri dari 4.769 bayi di perko- taan dan 6.819 bayi di pedesaan. Metoda analisis yang digunakan meliputi metode life table dan regresi cox. Hasil penelitian memperlihatkan probabilitas kelangsungan hidup bayi di perkotaan (98,59%) lebih tinggi daripada bayi di pedesaan (97,54%) dan …

Infestasi Kecacingan Pada Anak Sd Di Kecamatan Sei Bingai Langkat, Sumut, 2005, Limin Ginting

Kesmas

Indonesia masih menghadapi masalah kesehatan yang berhubungan dengan kondisi lingkungan yang jelek, seperti infestasi cacing usus yang ditularkan melalui tanah (Soil Transmitted Helminths). Infestasi cacing pada anak akan mengganggu pertumbuhan, menurunkan kemampuan fisik, produktifitas belajar dan intelektualitas. Hasil Pemeriksaan yang dilakukan di beberapa SD di Kecamatan Stabat dan Kecamatan Hinai menemukan prevalensi kecacingan berada pada kisaran 30-60%. Penelitian ini bertujuan untuk menilai prevalensi infestasi kecacingan pada anak SD di Kecamatan Sei Bingai, Kabupaten Langkat serta mengetahui faktor-faktor yang mempengaruhinya. Penelitian dengan disain studi kasus kontrol ini dilakukan di 4 SD Kecamatan Sei Bingai, Kabupaten Langkat, Propinsi Sumatera Utara. Populasi adalah …

Hubungan Akreditasi Dengan Mutu Lulusan, Febrina Dumaria

Kesmas

Era globalisasi menimbulkan persaingan yang menuntut ketersediaan SDM yang bermutu dan profesional. Salah satu penentu mutu pelayanan kesehatan adalah ketersediaan tenaga kesehatan yang cukup dan profesional, yang tidak bisa terlepas dari sistem pendidikan tenaga kesehatan. Penelitian ini bertujuan untuk mengetahui hubungan antara nilai akreditasi sub-sub komponen Borang Akreditasi 2000 dengan Mutu Lulusan institusi Diknakes. Sumber data adalah data sekunder hasil akreditasi sampai Maret 2005 dan Laporan Sistim Informasi Pendidikan Tenaga Kesehatan dari Bidang Diknakes Khusus dan Akreditasi Pusat Pendidikan Tenaga Kesehatan Departemen Kesehatan. Desain penelitian ini adalah potong lintang dan analisis data dengan regresi logistik berganda dan analisis faktor. Proporsi …

Effects Of Food Marketing To Kids: I'M Lovin' It?, Eileen Salinsky

National Health Policy Forum

This issue brief reviews key findings and recommendations from the Institute of Medicine study on food marketing and its effects on childhood obesity. The brief describes the childhood obesity epidemic, discusses key trends associated with rising childhood obesity rates, and considers the relative role of marketing practices on diet and obesity within the broader context of complex contributory factors. The brief also summarizes the current legal framework for regulating marketing directed at children; discusses voluntary, self-regulatory mechanisms; and highlights proposals to re-orient marketing practices to combat childhood obesity.

Aboriginal And Torres Strait Islander Suicide In Context, Ernest Hunter, Helen Milroy

Aboriginal Policy Research Consortium International (APRCi)

Aboriginal and Torres Strait Islander suicide has been an issue of national public health and mental health concern for only one decade, having increased dramatically from levels that were very low in the late 1980s to levels of young adult male suicide that are now substantially higher than for the non-indigenous population. In this review the authors socially and historically contextualize these changes, identifying the causal frameworks adopted in developing interventions, and present an explanation in narrative and pictorial form that draws on critical family-centered trauma.

Long-Term Trends In Indigenous Deaths From Chronic Diseases In The Northern Territory: A Foot On The Brake, A Foot On The Accelerator, David P. Thomas, John R. Condon, Ian P. Anderson, Shu Q. Li, Stephen Halpin, Joan Cunningham, Steven L. Guthridge

Aboriginal Policy Research Consortium International (APRCi)

Objective: To examine trends in Northern Territory Indigenous mortality from chronic diseases other than cancer. Design: A comparison of trends in rates of mortality from six chronic diseases (ischaemic heart disease [IHD], chronic obstructive pulmonary disease [COPD], cerebrovascular disease [CVD], diabetes mellitus [DM], renal failure [RF] and rheumatic heart disease [RHD]) in the NT Indigenous population with those of the total Australian population.

Participants: NT Indigenous and total Australian populations, 1977–2001. Main outcome measures: Estimated average annual change in chronic disease mortality rates and in mortality rate ratios. Results: DeathratesfromIHDandDMamongNTIndigenouspeoplesincreased between 1977 and 2001, but this increase slowed after 1990. …

A Closer Look At The Medicare Part D Low–Income Benchmark Premium: How Low Can It Go?, Mary Ellen Stahlman

National Health Policy Forum

This issue brief explains how the Medicare Part D low–income benchmark premium is calculated, what factors influence the level of the low-income benchmark premium in any given year, and the implications of the benchmark amount for Medicare drug plans and beneficiaries as it changes from year to year. The paper provides a simplified, two-year example of how the low-income benchmark premium is calculated in order to illustrate the key factors that influence it.

Characteristics Of Marijuana Users Compared To Multiple Drug Users, Swateja Nimkar

Masters Theses & Specialist Projects

This study examines drug use behavior in a self-described sample of users. Comparisons are made between subjects whose only illicit drug use is marijuana and those who use both marijuana and other drugs. Data are from the DRUGNET study (1996, 1998, 1999), a multi-panel study conducted over the internet from 1996 - 1998. This sample was predominately white, male, young, and college educated. The majority of respondents were employed with incomes in the $50,000 - $60,000 (USD) range. A subset of respondents to the DRUGNET survey was selected for this analysis. Respondents had to be at least 18 years of …

Body Image And Weight Related Behaviors: The Role Of Gender, Ethnicity, And Immigration, Tina Hoover

Masters Theses & Specialist Projects

Obesity rates have aggressively climbed in both children and adults, and notably for particular ethnic and lower socioeconomic status groups. National data from 1999-2002 have shown that approximately one-half of African-American women were obese, as compared to one-third of Caucasian women. It has been substantiated that a significant portion of overweight or obese children will become obese adults, with a number of factors identified that may influence obesity in children including gender, ethnicity, and environment. This study analyzed secondary data from The Youth Behavioral Risk Factor Survey administered to students at BGHS to identify variations in body image for particular …

Factors Affecting Condom Use Among College Students, Amar Kanekar

Masters Theses & Specialist Projects

The absence of consistent and correct usage of condoms increases the risk of STI's and HIV/AIDS. However, most studies done to date across the nation indicate a low usage of condoms among college students. In fall of 2004, the National College Health Assessment was administered to a random sample of students at a state comprehensive university in south central Kentucky. Findings revealed that among the sexually active students, approximately half never used condoms during vaginal intercourse. Further among students engaging in anal sex, an alarmingly high proportion --95%- reported never using condom during this act. These findings along with differences …

Workshop Participants' Use Of The Care: Communities Against Rape In-School Curriculum, Alyson Lois Mcintyre

All-Inclusive List of Electronic Theses and Dissertations

CARe: Communities Against Rape initiative is a well-developed curriculum that focuses on rape and sexual assault prevention among youth in Indiana. The In-School Component is housed at Indiana State University, while the remainder of the project is located at Purdue University and community sections throughout the state oflndiana. The CARe project is funded by the Indiana State Department of Health, Center for Disease Control (CDC), Rape Prevention Education Grant. Assessing the use of the CARe In-School curriculum through a survey of past workshop participants will give an insightful view of the curriculum effectiveness. The results are specifically focused on three …

Applying Lean Manufacturing Techniques To Improve The Performance Of An Emergency Department, Ramesh Pondhe

All-Inclusive List of Electronic Theses and Dissertations

The research was an attempt to apply lean manufacturing (LM) techniques, to the healthcare setting specifically to Emergency Department (ED) of a local hospital and to improve its performance. An ED is meant to attend/provide immediate care to a patient who needs medical care immediately and also balancing the care to patients with lesser acuity who arrive at the ED for treatment. The data was collected from the ED by direct observation. The data was statistically analyzed to find out the bottlenecks in the process during the course of a patient's treatment to further provide solutions and improve the performance …

Agricultural Pesticide Use And Risk Of T(14;18)-Defined Subtypes Of Non-Hodgkin Lymphoma, Brian C.-H. Chiu, Bhavana J. Dave, Aaron Blair, Susan M. Gapstur, Shelia Hoar Zahm, Dennis D. Weisenburger

United States Public Health Resources

Pesticides have been specifically associated with the t(14;18)(q32;q21) chromosomal translocation. To investigate whether the association between pesticides and risk of non-Hodgkin lymphoma (NHL) differs for molecular subtypes of NHL defined by t(14; 18) status, we obtained 175 tumor blocks from case subjects in a population-based case-control study conducted in Nebraska between 1983 and 1986. The t(14;18) was determined by interphase fluorescence in situ hybridization in 172 of 175 tumor blocks. We compared exposures to insecticides, herbicides, fungicides, and fumigants in 65 t(14;18)-positive and 107 t(14;18)-negative case subjects with those among 1432 control subjects. Multivariate polytomous logistic regression was used to …

College Students And Gambling: Gauging The Effects Of Gender On Impulse Control, Sensation Seeking, And Mental Health As Predictors Of Involvement, Terry D. Burger

All-Inclusive List of Electronic Theses and Dissertations

The main purpose of the current study was to enhance the global understanding of adolescent Internet gambling involvement by examining rates of participation and the influence of impulse control, sensation seeking, and mental health problems as predictors of involvement. In addition to a demographic survey to gather information including year in school, age, gender, mode of gambling participation (online vs. traditional venues), age gambling participation began (for both non-Internet and Internet modes), disposable income, and hours spent online each week, the current research study questionnaire was comprised of a three standardized instruments: {a) the South Oaks Gambling Screen (SOGS); (b) …

Determinants Of Long-Term Care Service Utilization By Mexican-American Family Caregivers, Angelica P. Herrera

Loma Linda University Electronic Theses, Dissertations & Projects

Objectives: Participation in long-term care services may prevent the deterioration of family caregivers' mental and physical health, yet research suggests that Latino caregivers may forego using long-term care services in the absence of other barriers to long-term care use (e.g., lack of insurance).

Methods: An adapted version of the Andersen Model of Health Care Service Utilization served as a framework for examining familism, acculturation, gender roles, religiosity, and knowledge and perceptions about long-term care, as potential determinants of long-term care service use, alongside other factors known for their association with long-term care use (e.g. functional status of care recipient, caregiver …

Insights From The 2006 Disease Management Colloquium, David B. Nash, Robert A. Greene, Ronald R. Loeppke, Nancy Mccall, Tracey Moorhead

College of Population Health Faculty Papers

This roundtable discussion emanates from the presentations given and issues raised at the 2006 Disease Management Colloquium, which was held May 10–12, 2006 in Philadelphia, Pennsylvania.

Examining The Structural Covariates Of Methamphetamine Use: A Social Disorganization Perspective, Justin Smith

Masters Theses

There have been many anecdotal accounts describing the characteristics of individuals involved in methamphetamine use, trafficking and production. However, prior to the current study there was yet to be a macro-level analysis of methamphetamine use. The extant macro-level literature on drug use has suggested that areas with high levels of social disorganization experience high rates of drug use. It was expected that school-districts with low SES and high rates of ethnic heterogeneity, residential instability and family disruption will experience high rates of methamphetamine use. In addition, it was expected that rural school districts would show higher rates than urban and …

The Clinical Research Forum And Association Of American Physicians Disagree With Criticism Of The Nih Roadmap, William Crowley Jr, John Courtney, Larry Jameson, Herbert Pardes, Jay Moskowitz, Eugene Orringer, Arthur Rubenstein, Alastair Wood, Richard Rettig, Dennis Ausiello, David Brenner, Francis Collins, Jack Elias, Warner Greene, Ralph Horowitz, Larry Jameson, Elliott Kieff, Craig Thompson, Judith Swain

Faculty Publications

No abstract provided.

An Experimental Study Of The Effectiveness Of Three Safety Training Delivery Methods And The Knowledge Gained During A Workplace Violence Safety Program, Shoji Nakayama

All-Inclusive List of Electronic Theses and Dissertations

Due to the numerous advantages of electronic media, many companies have begun to incorporate online courses as a means of delivering corporate training, including corporate safety training. Consequently, researchers are beginning to investigate the effectiveness of online training over traditional face-to-face training methods. Many studies have indicated that results of training programs conducted over the Internet are equivalent to those results obtained from traditional face-to-face training. At the same time, other literature indicates that face-to-face training is better than Internet training due to the level of interaction between students and instructor. Some investigations on this subject have been conducted within …

Mechanisms Of Sickle Cell Anemia, Gary M. Onady, Lawrence Prochaska, John F. Donnelly, John Paietta, Dean Parmelee, Barbara Schuster

Family Medicine Faculty Publications

Team-based learning (TBL) is a well-defined instructional strategy that allows a single instructor to teach by conducting multiple small groups simultaneously in the same classroom. Learners actively participate in and out of class as they move through three phases: independent study assignments, readiness assurance testing, and group activities that force them to put knowledge into practice. Students prepare in advance by reading an assigned article. Class time is shifted away from learning facts and toward application and integration of information. The instructor retains control of content and acts as both facilitator and content expert. This TBL program is designed to …

Obesity, Physical Activity, And Mortality In A Prospective Chinese Elderly Cohort, Mary Schooling, Tai Hing Lam, Zhi Bin Li, Sai Yin Ho, Wai Man Chan, Kin Sang Ho, May Ked Tham, Benjamin J. Cowling, Gabriel M. Leung

Publications and Research

Background
In older people, it is unclear whether obesity relates to mortality, which calls into question its etiologic role in disease and its public health relevance. This apparent lack of relationship in older people could be an artifactual result of their diverse health states.

Methods
We used Cox regression analysis to determine whether the effect of body mass index (BMI) (calculated as weight in kilograms divided by the square of height in meters) or physical activity on mortality varied with health status in a prospective cohort study of Chinese people 65 years or older enrolled from 1998 to 2000 at …

Relative Risk Regression In Medical Research: Models, Contrasts, Estimators, And Algorithms, Thomas Lumley, Richard Kronmal, Shuangge Ma

UW Biostatistics Working Paper Series

The relative risk or prevalence ratio is a natural and familiar summary of association between a binary outcome and an exposure or intervention. For rare events, the relative risk can be approximately estimated by logistic regression. For common events estimation is more difficult. We review proposed estimation algorithms for relative risk regression. Some of these give inconsistent estimates or invalid standard errors. We show that the methods that give correct inference can be viewed as arising from a family of quasilikelihood estimating functions for the same generalized linear model, differing in their efficiency and in their robustness to outlying values …

Premium Assistance In Medicaid And Schip: Ace In The Hole Or House Of Cards?, Cynthia Shirk, Jennifer Ryan

National Health Policy Forum

This issue brief explores the use of premium assistance in publicly financed health insurance coverage programs. In the context of Medicaid and the State Children’s Health Insurance Program (SCHIP), premium assistance entails using federal and state funds to subsidize the premiums for the purchase of private insurance coverage for eligible individuals. This paper considers the evolution of premium assistance and some of the statutory and administrative limitations, as well as private market factors, that have prevented widespread enrollment in Medicaid or SCHIP premium assistance programs. Finally, this issue brief offers some ideas for potential legislative and/or programmatic changes that could …

Investigating Mediation When Counterfactuals Are Not Metaphysical: Does Sunlight Uvb Exposure Mediate The Effect Of Eyeglasses On Cataracts?, Brian Egleston, Daniel O. Scharfstein, Beatriz Munoz, Sheila West

Johns Hopkins University, Dept. of Biostatistics Working Papers

We investigate the degree to which a reduction in ocular sunlight ultra-violet B (UVB) exposure mediates a relationship between wearing eyeglasses and a decreased risk of cataracts. An estimand is proposed in which causal effects are estimated locally within strata based on potential UVB exposure without glasses and the degree to which glasses use reduces UVB exposure. We take advantage of the structure of the data in which the counterfactual UVB exposures if the participants in the study who wore glasses had not worn glasses are considered observable.

Don't Bring Me Your Tired, Your Poor: The Crowded State Of America's Emergency Departments, Jessamyn Taylor

National Health Policy Forum

If the time comes, people expect that the emergency department (ED) will have the resources necessary to treat them in a timely, high-quality manner. Increasingly, however, EDs may not be able to meet that expectation. Hospitals in urban areas with large populations, high population growth, and higher-than-average numbers of uninsured are particularly crowded: ambulances are often diverted to other hospitals and patients are frequently forced to “board” in the hallways (while they wait to be transferred to another facility or part of the hospital). This issue brief places EDs in the context of the U.S. health care system and its …

Aboriginal Health Workers And Diabetes Care In Remote Community Health Centres: A Mixed Method Analysis, Damin Si, Ross S. Bailie, Samantha J. Togni, Peter H N D'Abbs, Gary W. Robinson

Aboriginal Policy Research Consortium International (APRCi)

Objective: To assess the effect of employing Aboriginal health workers (AHWs) on delivery of diabetes care in remote community health centres, and to identify barriers related to AHWs’ involvement in diabetes and other chronic illness care.

Design, setting and participants: Three-year follow-up study of 137 Aboriginal people with type 2 diabetes in seven remote community health centres in the Northern Territory.

Main outcome measures: Delivery of guideline-scheduled diabetes services; intermediate outcomes (glycated haemoglobin [HbA1c] and blood pressure levels); number and sex of AHWs at health centres over time; barriers to AHWs’ involvement in chronic illness care.

Results: There was a …