Epidemiology Commons^™

A Reappraisal Of Stroke Mortality Trends In Brazil (1979 To 2009), Paulo A. Lotufo

Paulo A Lotufo

Background: Brazil has the highest cerebrovascular death rate in the Western Hemisphere. We investigated temporal trends according to gender and stroke subtypes. Methods: We analysed mortality rates between 1979 and 2009 for different stroke subtypes. Data were stratified by sex and age (35–74 y). The annual percent change (APC) and significant changes in the trends were identified with joinpoint Poisson regression. The average annual percent change (AAPC) for 2005-09 was presented because that period had the best quality of information. Results: After excluding deaths due to stroke sequels, for men, the APCs (95% confidence intervals) were: 1979-84: 0.7 (-0.8 to …

On The Nondifferential Misclassification Of A Binary Confounder, Elizabeth L. Ogburn, Tyler J. Vanderweele

COBRA Preprint Series

Abstract Consider a study with binary exposure, outcome, and confounder, where the confounder is nondifferentially misclassified. Epidemiologists have long accepted the unproven but oft-cited result that, if the confounder is binary, odds ratios, risk ratios, and risk differences which control for the mismeasured confounder will lie between the crude and the true measures. In this paper the authors provide an analytic proof of the result in the absence of a qualitative interaction between treatment and confounder, and demonstrate via counterexample that the result need not hold when there is a qualitative interaction between treatment and confounder. They also present an …

Micronutrient Intake And Premenstrual Syndrome, Patricia O. Chocano-Bedoya

Open Access Dissertations

Premenstrual syndrome (PMS) is characterized by the presence of physical and psychological symptoms restricted to the late luteal phase of the menstrual cycle and associated with substantial impairment in life activities. In the U.S. about 8 to 15% of women of reproductive age suffer from PMS. Many micronutrients are potentially involved in the development of this disorder due to their role in the synthesis of neurotransmitters and hormones or in their regulation, but few previous studies have evaluated the effects of micronutrients on PMS. The first study examined the association between B vitamin intakes, and PMS development among women participating …

Hiv And Concurrent Sexual Partnerships: Modelling The Role Of Coital Dilution, Larry Sawers, Alan G. Isaac, Eileen Stillwaggon

Economics Faculty Publications

Background: The concurrency hypothesis asserts that high prevalence of overlapping sexual partnerships explains extraordinarily high HIV levels in sub-Saharan Africa. Earlier simulation models show that the network effect of concurrency can increase HIV incidence, but those models do not account for the coital dilution effect (nonprimary partnerships have lower coital frequency than primary partnerships).

Methods: We modify the model of Eaton et al (AIDS and Behavior, September 2010) to incorporate coital dilution by assigning lower coital frequencies to non-primary partnerships. We parameterize coital dilution based on the empirical work of Morris et al (PLoS ONE, December …

Modification By Frailty Status Of Ambient Air Pollution Effects On Lung Function In Older Adults In The Cardiovascular Health Study, Sandrah P. Eckel, Thomas A. Louis, Paulo H.M. Chaves, Linda P. Fried, Helene G. Margolis

Johns Hopkins University, Dept. of Biostatistics Working Papers

Older adult susceptibility to air pollution health effects is well-recognized. Advanced age may act as a partial surrogate for conditions associated with aging. The authors investigated whether gerontologic frailty (a clinical health status metric) modified the effects of ambient ozone or particulate matter (PM10) air pollution on lung function in 3382 older adults using 7 years of followup data from the Cardiovascular Health Study (CHS) and the CHS Environmental Factors Ancillary Study. Monthly average pollution and annual frailty assessments were related to up to 3 repeated measurements of lung function using novel cumulative summaries of pollution and frailty histories that …

The Community Action Framework In Practice: An Illustration Based On The Ready By 21 Coalition Of Austin/Travis County, Raphael Travis Jr., Tamara Leech

Department of Public Health Scholarship and Creative Works

The field of positive youth development has expanded focus from articulating and measuring desired manifestations of positive well-being to assembling the environmental conditions known to promote these desired outcomes. Evidence of the effectiveness of community-level efforts promoting positive youth development is still emerging, in particular theory-driven examples of community-driven youth development. This study examined the Community Action Framework, one theory-based community youth development model, through the experiences of the Ready by 21 Austin/Travis County coalition (RB21). The coalition connects youth-serving organizations and also regional coalitions, while promoting the positive development of area youth. Participant observation, interviewing, and archival strategies were …

Assessment Of Organic And Inorganic Phosphorus In Soils Derived From Cretaceous Sediments And Basement Complex Soils Of Guinea Savannah Of Kogi State, North Central Nigeria, Sunday I. Amhakhian, H H. Isitekhale, Charles I. Oyewole

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

A pot experiment was carried out using 20 surface soils (0-15cm depth) in 2008 to assess soil organic phosphorus and some fraction of inorganic phosphorus in other to know their availability in the soils of the studied area and also work have not been done in this areas in respect to organic and in-organic phosphorus. The experiment was conducted using 20 soils 10 from each geological formation (Cretaceous sediments and Basement complex soils), respectively. The mean organic phosphorus of 63.51 mgkg 1 soil was obtained for Cretaceous sediment soils and 158.54 mgkg 1 soil for the basement complex soils respectively. …

Development Of Functional Indices Of Facility Occurrence Towards The Distribution Of Social Services In Lagos Island Nigeria., Augustus O. Atubi

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Proper coordination of transport and public facilities provision is vital to any balanced regional development strategy. The central aim of this study, therefore, is to find out what the relationship is between access to the transport network and the provision of functional indices of facility occurrence towards the distribution of social services in Lagos Island, Nigeria. In particular it seeks to find out areas that have below or above average level of facility occurrences relative to the level of accessibility. However, a pair wise correlation matrix of the eleven (11) variables employed in the index construction was carried out. The …

Neighborhood Disparities In Stroke And Myocardial Infarction Mortality: A Gis And Spatial Scan Statistics Approach, Agricola Odoi

Agricola Odoi

Background: Stroke and myocardial infarction (MI) are serious public health burdens in the US. These burdens vary by geographic location with the highest mortality risks reported in the southeastern US. While these disparities have been investigated at state and county levels, little is known regarding disparities in risk at lower levels of geography, such as neighborhoods. Therefore, the objective of this study was to investigate spatial patterns of stroke and MI mortality risks in the East Tennessee Appalachian Region so as to identify neighborhoods with the highest risks. Methods: Stroke and MI mortality data for the period 1999-2007, obtained free …

The Role Of Social Support In Multiple Morbidity Self-Management Among Rural Residents, Shoshana Bardach, Yelena N. Tarasenko, Nancy E. Schoenberg

Yelena N. Tarasenko

Social support generally is considered a valuable asset that may compensate for health service deficiencies among rural populations. Employing a mixed methods approach, we explored how vulnerable rural residents described social support in the context of self-management for multiple chronic conditions. Participants generally felt support was available, though emotional/ informational support was perceived as less available than other types of support. Participants did not rely heavily on informal support to help them manage their multiple morbidities, preferring to call on their doctor and their own resources. We discuss implications of these findings for meeting this vulnerable population’s self-management needs.

Race-Ethnicity As An Effect Modifier Of The Association Between Hbalc And Mortality In U.S. Adults Without Diagnosed Diabetes, Katharina G. Kehl, Hannes M. Findeisen, David W. Fardo, Dennis Bruemmer, David M. Mannino, Wayne T. Sanderson

David M. Mannino

Objective

HbAlc is increasingly appreciated as a risk factor for all-cause and cardiovascular disease (CVD) mortality in the non-diabetic population. In this study, we investigated the association between HbAlc and mortality with a particular focus on the impact of race–ethnicity.

Design

Cohort study.

Methods

We analyzed the association between HbAlc and all-cause and CVD mortality in 12 698 non-diabetic adults 20 years or older from the Third National Health and Nutrition Examination Survey using separate models for people of different race–ethnicity.

Results

In our stratified analyses, higher non-diabetic HbAlc levels were associated with all-cause and CVD mortality in non-Hispanic whites …

Gene By Bmi Interactions Influencing C-Reactive Protein Levels In European-Americans, Sarah Tudor

Dissertations & Theses (Open Access)

C-Reactive Protein (CRP) is a biomarker indicating tissue damage, inflammation, and infection. High-sensitivity CRP (hsCRP) is an emerging biomarker often used to estimate an individual’s risk for future coronary heart disease (CHD). hsCRP levels falling below 1.00 mg/l indicate a low risk for developing CHD, levels ranging between 1.00 mg/l and 3.00 mg/l indicate an elevated risk, and levels exceeding 3.00 mg/l indicate high risk. Multiple Genome-Wide Association Studies (GWAS) have identified a number of genetic polymorphisms which influence CRP levels. SNPs implicated in such studies have been found in or near genes of interest including: CRP, APOE, APOC, IL-6, …

A Comparison Of Spatio-Temporal Prediction Methods Of Cancer Incidence In The U.S, Michelle Hamlyn

UNLV Theses, Dissertations, Professional Papers, and Capstones

Cancer is the cause of one out of four deaths in the United States, and in 2009, researchers expected over 1.5 million new patients to be diagnosed with some form of cancer. People diagnosed with cancer, whether a common or rare type, need to undergo treatments, the amount and kind of which will depend on the severity of the cancer. So how do healthcare providers know how much funding is needed for treatment? What would better enable a pharmaceutical company to determine how much to allocate for research and development of drugs, the amount of each drug to manufacture, or …

Heterogeneity, Control, Social Infrastructure, And Possibilities Of Participation: Their Interplay In Modern Understandings Of Heredity And In Interpretation Of Science, Peter J. Taylor

Working Papers on Science in a Changing World

This working paper is a prospectus for research, writing, and engagement. It consists of vignettes, sketches of lines of inquiry, and proposals for engagement, all of which concern modern understandings of heredity and development over the life course as well as the social interpretation of science. The various items address a range of areas of science and of its interpretation: heritability studies, the social uses of genetic information, gene-by-environment interaction, personalized medicine, IQ paradoxes, racial group membership, biobanks, and life events and difficulties research. Fresh perspectives in these areas are opened up by examining the ways that research and application …

Identifying Unique Neighborhood Characteristics To Guide Health Planning For Stroke And Heart Attack: Fuzzy Cluster And Discriminant Analyses Approaches, Ashley Pedigo, William Seaver, Agricola Odoi

Agricola Odoi

Background: Socioeconomic, demographic, and geographic factors are known determinants of stroke and myocardial infarction (MI) risk. Clustering of these factors in neighborhoods needs to be taken into consideration during planning, prioritization and implementation of health programs intended to reduce disparities. Given the complex and multidimensional nature of these factors, multivariate methods are needed to identify neighborhood clusters of these determinants so as to better understand the unique neighborhood profiles. This information is critical for evidence-based health planning and service provision. Therefore, this study used a robust multivariate approach to classify neighborhoods and identify their socio-demographic characteristics so as to provide …

Urban Climate And Challenges Of Tropical Cities, B E. Omogbai

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

This study examines the nature of urban climate, features and the challenges on the developing tropical cities in the 21st century. It argues that the use of principles of urban climate would help in providing comfortable living conditions and problem immune working environments for the inhabitants of tropical cities. The findings reveal that owing to poor environmental planning, inadequate geotechnical landscape surveys prior to the development of urban infrastructures, and non-adherence to the principles of urban climate, challenges of landscape degradation, excessive flooding of the built infrastructures, heat-island effects, and collapse of buildings have emerged. Suggested measures to avert these …

Variable Importance Analysis With The Multipim R Package, Stephan J. Ritter, Nicholas P. Jewell, Alan E. Hubbard

U.C. Berkeley Division of Biostatistics Working Paper Series

We describe the R package multiPIM, including statistical background, functionality and user options. The package is for variable importance analysis, and is meant primarily for analyzing data from exploratory epidemiological studies, though it could certainly be applied in other areas as well. The approach taken to variable importance comes from the causal inference field, and is different from approaches taken in other R packages. By default, multiPIM uses a double robust targeted maximum likelihood estimator (TMLE) of a parameter akin to the attributable risk. Several regression methods/machine learning algorithms are available for estimating the nuisance parameters of the models, including …

Reduced Bayesian Hierarchical Models: Estimating Health Effects Of Simultaneous Exposure To Multiple Pollutants, Jennifer F. Bobb, Francesca Dominici, Roger D. Peng

Johns Hopkins University, Dept. of Biostatistics Working Papers

Quantifying the health effects associated with simultaneous exposure to many air pollutants is now a research priority of the US EPA. Bayesian hierarchical models (BHM) have been extensively used in multisite time series studies of air pollution and health to estimate health effects of a single pollutant adjusted for potential confounding of other pollutants and other time-varying factors. However, when the scientific goal is to estimate the impacts of many pollutants jointly, a straightforward application of BHM is challenged by the need to specify a random-effect distribution on a high-dimensional vector of nuisance parameters, which often do not have an …

Characterization Of The Serologic Responses To Plasmodium Vivax Dbpii Variants Among Inhabitants Of Pursat Province, Cambodia, Samantha Jones Barnes

USF Tampa Graduate Theses and Dissertations

The Plasmodium vivax Duffy Binding Protein (DBP) is the ligand in the major pathway for P. vivax invasion of human reticulocytes, making it an appealing vaccine candidate. Region II of DBP (DBP-RII) is the minimal portion of the ligand that mediates recognition of the Duffy Antigen Receptor for Chemokines (DARC receptor) on the reticulocyte surface and constitutes the primary vaccine target. Analysis of natural variation in the coding sequences of DBP-RII revealed signature evidence for selective pressure driving variation in the residues of the putative receptor-binding site. We hypothesize that anti-DBP immunity in P. vivax infections is strain-specific and hindered …

Principal Component Analysis Of Dietary And Lifestyle Patterns In Relation To Risk Of Subtypes Of Esophageal And Gastric Cancer, Stephanie A. Navarro Silvera, Susan T. Mayne, Harvey A. Risch, Marilie D. Gammon, Thomas Vaughan, Wong-Ho Chow, Joel A. Dubin, Robert Dubrow, Janet Schoenberg, Janet L. Stanford, A. Brian West, Heidrun Rotterdam, William J. Blot

Department of Public Health Scholarship and Creative Works

Purpose

To carry out pattern analyses of dietary and lifestyle factors in relation to risk of esophageal and gastric cancers.

Methods

We evaluated risk factors for esophageal adenocarcinoma (EA), esophageal squamous cell carcinoma (ESCC), gastric cardia adenocarcinoma (GCA), and other gastric cancers (OGA) using data from a population-based case-control study conducted in Connecticut, New Jersey, and western Washington state. Dietary/lifestyle patterns were created using principal component analysis (PCA). The impact of the resultant scores on cancer risk was estimated through logistic regression.

Results

PCA identified six patterns: meat/nitrite, fruit/vegetable, smoking/alcohol, legume/meat alternate, GERD/BMI, and fish/vitamin C. Risk of each …

Detecting Changes In Landuse/Cover Of Umuahia, South-Eastern Nigeria Using Remote Sensing And Gis Techniques, Fanan Ujoh, Olarewaju Oluseyi Ifatimehin, Adams Ndalai Baba

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

Since 1991 when it became the capital city of Abia State, Umuahia has undergone tremendous transformation in its land use and land cover due to rapid urbanization. The main materials employed for this study are a land use map (1991) and Landsat ETM+satellite image (2007) of the study area. These, combined with field survey/checks, were brought into a GIS environment using ILWIS 3.2 Academic image classification software to map the land use/land cover and to estimate the rate of urban expansion and loss of rural land at the peri-urban fringes of Umuahia between 1991 and 2007. The study revealed significant …

Farmwork-Related Injury Among Farmers 50 Years Of Age And Older In Kentucky And South Carolina: A Cohort Study, 2002-2005, Jennifer L. Marcum, Steven R. Browning, Deborah B. Reed, Richard Charnigo

Epidemiology and Environmental Health Faculty Publications

Farmers in the U.S. are becoming more diverse; the average age of the farmer is increasing, as is the number of women and minority farm operators. There is limited research on injury risk factors in these special populations of farmers. It is especially important to study the risk factors for injury in these growing and at-risk groups. A longitudinal survey was conducted of farmers (n = 1,394) age 50 and older who resided in Kentucky and South Carolina. The questionnaire was administered by telephone and mail surveys four times between 2002 and 2005 to the fixed cohort of farmers, obtained …

Faktor Risiko Kanker Serviks Di Rumah Sakit Umum Pemerintah Dr. Wahidin Sudirohusodo Makassar, Sulawesi Selatan, Sri Syatriani

Kesmas

Kanker serviks adalah tumor ganas terbanyak pada perempuan di seluruh dunia termasuk Indonesia. Jumlah penderita kanker serviks di Rumah Sakit Umum Pemerintah Dr. Wahidin Sudirohusodo pada tahun 2007 sebanyak 231 kasus, menurun menjadi 220 kasus tahun 2008 dan menurun sebanyak 167 kasus pada tahun 2009. Tujuan penelitian ini adalah untuk melihat besar risiko kejadian kanker serviks terhadap penggunaan pembalut, penggunaan sabun, status ekonomi, dan pasangan pria yang tidak disirkumsisi. Jenis penelitian adalah penelitian observasional analitik dengan desain kasus kontrol. Sampel adalah pasien yang berkunjung ke bagian ginekologi yang diambil secara accidental sampling sebanyak 213 orang. Pengumpulan data dilakukan dengan wawancara …

Studi Kematian Ibu Dan Kematian Bayi Di Provinsi Sumatera Barat: Faktor Determinan Dan Masalahnya, Ulvi Mariati, Z Agus, D Sulin, Masrul Masrul, Z Amri, F Arasy, Muslim Muslim, H Hanum, Mohanis Mohanis, F Arma

Kesmas

Salah satu tujuan yang hendak dicapai oleh World Health Organization pada tahun 2000 adalah health for all by year 2000. Beberapa indikator digunakan untuk mengukur pencapaian tersebut, diantaranya angka kematian bayi (AKB) dan angka kematian ibu (AKI). Dinas Kesehatan Sumatera Barat telah berhasil menurunkan AKB dan AKI selama 5 tahun terakhir, akan tetapi angka-angka tersebut tidak menggambarkan angka yang sebenarnya karena hanya diperoleh berdasarkan prediksi perhitungan statistik kependudukan. Angka tersebut juga tidak dapat memperlihatkan disparitas antarwilayah dan kelompok sosial ekonomi di Sumatera Barat. Penelitian ini dilakukan untuk mendapatkan AKB dan AKI yang tepat serta mengetahui faktor determinan dan permasalahannya di …

Perbandingan Rapid Diagnostic Test Dan Pemeriksaan Mikroskopik Pada Diagnosis Malaria, Lombok Siahaan

Kesmas

Penelitian ini dilakukan untuk membandingkan penggunaan Rapid diagnostic test dengan pemeriksaan mikroskopik (apusan darah) dalam menegakkan diagnosis malaria. Penelitian uji diagnostik ini dilakukan di Kabupaten Nias Selatan dan Kotamadya Sabang, Sumatera Utara. Apusan darah diwarnai dengan larutan Giemsa 10% dan dibaca oleh pemeriksa yang sudah terlatih. Rapid diagnostic test dilakukan dengan menggunakan parascreen. Uji diagnostik rapid diagnostic test secara umum diperoleh hasil yaitu sensitivitas 63,8%; spesifisitas 100%; Positive Predictive Value (PPV) 100%; dan negative predictive value (NPV) 93,5%. Kepadatan parasit pada rapid diagnostic test (+) dan mikroskopik (+) adalah 1.483 ± 583 parasit/μl. Sementara, kepadatan parasit pada pemeriksaan rapid diagnostic …

Perflurorochemical (Pfc) Exposure In Children: Associations With Impaired Response Inhibition, Brooks B. Gump, Qian Wu, Amy K. Dumas, Kurunthachalam Kannan

Brooks B. Gump

Background: Perfluorinated chemicals (PFCs) have been used widely in consumer products since the 1950s and are currently found at detectable levels in the blood of humans and animals across the globe. In stark contrast to this widespread exposure to PFCs, there is relatively little research on potential adverse health effects of exposure to these chemicals.Objectives: We performed this cross-sectional study to determine if specific blood PFC levels are associated with impaired response inhibition in children. Methods: Blood levels of 11 PFCs were measured in children (N = 83) and 6 PFCs: perfluorooctane sulfonate (PFOS), perfluorohexane sulfate (PFHxS), perfluorooctanoic acid (PFOA), …

Perflurorochemical (Pfc) Exposure In Children: Associations With Impaired Response Inhibition, Brooks B. Gump, Qian Wu, Amy K. Dumas, Kurunthachalam Kannan

Falk College Research Center

Background: Perfluorinated chemicals (PFCs) have been used widely in consumer products since the 1950s and are currently found at detectable levels in the blood of humans and animals across the globe. In stark contrast to this widespread exposure to PFCs, there is relatively little research on potential adverse health effects of exposure to these chemicals.Objectives: We performed this cross-sectional study to determine if specific blood PFC levels are associated with impaired response inhibition in children. Methods: Blood levels of 11 PFCs were measured in children (N = 83) and 6 PFCs: perfluorooctane sulfonate (PFOS), perfluorohexane sulfate (PFHxS), perfluorooctanoic acid (PFOA), …

State-Level Influences On Buprenorphine Utilization: Variations In Opioid Addiction Treatment, Lisa M. Lines Mph, Robin E. Clark Phd

Lisa M. Lines

Research Objective: Buprenorphine is a medication used to treat opioid addiction. Physicians are required to have special Drug Enforcement Agency certification to prescribe buprenorphine. Although it is more accessible and potentially safer than methadone, the leading opioid addiction treatment modality, there appear to be state-to-state variations in rates of buprenorphine adoption and use. The purpose of this study was to identify state-level influences on the volume of buprenorphine prescribed, using a limited set of supply and demand measures. Study Design: We developed a database using data on buprenorphine prescribing and factors hypothesized to influence variations in prescribing obtained from the …

Gender Participation In The Management Of Tricycle Transport For Youth Empowerment And Sustainable Development In Kano State, Nigeria, Nuratu Muhammed

Confluence Journal Environmental Studies (CJES), Kogi State University, Nigeria

The research examined gender participation in the management of tricycle for youth empowerment and sustainable development in Kano state, Nigeria. Stratified random sampling technique was used to select samples of drivers(150), passengers (150) and owners/managers the female tricycle owners fell under this category and they numbered(65).All together a total of 365 samples were selected for the study. Data obtained from the primary data was analyzed using simple statistical techniques and chi square test to ascertain whether there was any significant differences in some of the variables tested. The results of the analysis revealed that the main difference was found in …

U.S. Cultural Involvement And Its Association With Co-Occurring Substance Abuse And Sexual Risk Behaviors Among Youth In The Dominican Republic, Elián P. Cabrera-Nguyen, Juan B. Peña

Elián P. Cabrera-Nguyen

We examined the relationship of US cultural involvement with substance abuse and sexual risk behavior profiles from our nationally representative sample of public high school students in the Dominican Republic. Using a novel methodological approach to control for selection bias, we examined explanations for the so-called Latino or Hispanic immigrant paradox. A latent class regression analysis with manifest and latent covariates found that US cultural involvement indicators were independent and robust predictors of increased risk of co-ocurring substance abuse and sexual risk behaviors. Implications for prevention efforts targeting risk behaviors among Latino/a adolescents in the US and abroad are considered.