Epidemiology Commons^™

Potret Kebijakan Pengendalian Demam Berdarah Dengue Di Kabupaten Indramayu, Henri Peranginangin, Hasim Hasim, Bambang Pramudya, Sri Budiarti

Kesmas

Penyakit demam berdarah dengue (DBD) masih menjadi masalah di Kabupaten Indramayu. Penelitian ini bertujuan mengidentifikasi elemen-elemen prioritas kebijakan pengendalian penyakit DBD di Kabupaten Indramayu menurut pakar berdasarkan metode Analytical Hierarchy Process (AHP). Hasil penelitian menunjukkan “strategi utama” pengendalian penyakit DBD di Kabupaten Indramayu adalah peningkatan kesehatan lingkungan permukiman; “aktor utama pengendalian” ialah Pemerintah Kabupaten Indramayu; “faktor utama pengendalian” adalah lingkungan; “tujuan utama pengendalian” ialah Kabupaten Indramayu bebas penyakit DBD; dan “kriteria utama pengendalian” adalah jumlah dan mutu sumber daya manusia. Agar implementasi strategi pengendalian itu efektif maka Pemerintah Kabupaten Indramayu perlu meningkatkan kerja sama lintas program dan sektoral; dukungan teknologi, …

Kesehatan Jiwa Yang Terabaikan Dari Target Milenium, Sri Idaiani

Kesmas

Millenium Development Goals (MDG) yang dicanangkan pada tahun 2000 sangat didominasi oleh penyakit menular serta kesehatan ibu dan anak, tetapi mengabaikan berbagai masalah penyakit tidak menular. Tidak sedikitpun terlintas dalam benak para pemimpin dunia itu target dan indikator yang menyentuh atau berhubungan dengan masalah kesehatan jiwa. Tulisan ini bertujuan membahas posisi kesehatan jiwa di seluruh dunia yang cenderung semakin memprihatinkan, tetapi justru terabaikan dari target MDG. Pencapaian target milenium tampaknya tidak memperhitungkan beban penyakit akibat berbagai masalah kejiwaan. Padahal, jika dibiarkan, pada masa mendatang masalah kesehatan jiwa akan menjadi besar seperti yang tengah dihadapi oleh berbagai negara maju. Berdasarkan prediksi …

The Association Between Lead Exposure And Respiratory Health In Children, Colleen Coleman

Theses and Dissertations

Purpose: The substantial impact of indoor air quality and environmental hazards in the home on one’s health has long been recognized in the field of public health. This cross-sectional study investigates the risk between home based hazards, specifically lead, and respiratory health in children. The objective of this study is to examine the extent to which children testing positive for blood lead exposure are at an increased risk for having poor respiratory health. Methods: A nationally representative sample of 977 children ages 1- 6 years was obtained from the 2005-2006 National Health and Nutrition Examination Survey (NHANES). Information from the …

Examining The Association Of Fruit And Vegetable Intake And Breast And Prostate Cancer Screening, Mark Yu

Theses and Dissertations

Breast and prostate cancer incidence and mortality have been steadily decreasing. Reasons for these reductions may be related to increased rates of cancer screening and other factors such as improvements in diet, including consumption of fruits and vegetables. We wanted to determine if individuals who get screened for breast and prostate cancer are more or less likely to consume adequate servings of fruit and vegetables. A cross-sectional study using the BRFSS survey was conducted. Individuals included in this study (n=26,222), were asked about their breast or prostate cancer screening history. They were also asked about their servings per day of …

Community Voice: Taking It To The People, Guidelines For Conducting A Process Evaluation, Tiffany Mcghee

Theses and Dissertations

Background The Community Voice program is designed for African-Americans and explores key factors that can contribute to African-American infant mortality. This program was implemented in Henrico County based on Virginia Health Statistics that the White infant mortality rate average during the years of 2001-2005 was 5.3 deaths per 1,000 live births and in the same time period the infant mortality rate for African-Americans was 13.7 deaths per 1,000 live births. At the time of implementation of the program, no plans to evaluate the program had been made. Objective This evaluation was designed to develop guidelines regarding the evaluation process of …

The 2009 H1n1 Influenza A “Swine Flu” Virus Presentation In Virginia 2009, Tammie Smith

Theses and Dissertations

Objective: 2009 H1N1 influenza was first detected in the Northern Hemisphere in April 2009. National data have suggested that the novel influenza virus disproportionately causes severe illness in children and young adults, a somewhat different presentation from traditional seasonal flu which normally strikes hardest in the very young and older adults. This may or may not be the case in Virginia, which, if it is different, may suggest a need to alter flu prevention messages and vaccine policy as the outbreak continues through the fall 2009-10 influenza season. This report examined the early presentation of the new influenza virus in …

Association Between Preconception Multivitamin Use And The Risk Of Preeclampsia/High Blood Pressure In Pregnant Women, Krisandra Allen

Theses and Dissertations

Gestational Hypertension and Preeclampsia are significant causes of morbidity and mortality among pregnant women and neonates. This study examined the relationship between multivitamin use and incidence of reported high blood pressure or preeclampsia using data from the 2007 Oregon State Pregnancy Risk Assessment Monitoring System (PRAMS). Overall there were n=1894 women included in the study. Women were asked two to four months after delivery to report their multivitamin or prenatal vitamin usage in the month prior to conception and were categorized as daily users, or less than daily users. The unadjusted prevalence of high blood pressure or preeclampsia was 13.4% …

Developing A Comprehensive Youth Obesity Initiative For The State Of Virginia, Jennifer Thompson

Theses and Dissertations

The 2009 Virginia General Assembly Session unanimously voted to change the legislation governing the Virginia Tobacco Settlement Foundation to create the Virginia Foundation for Healthy Youth (VFHY) and incorporate childhood overweight and obesity prevention and reduction in its mission. In order to successfully meet the requirements of this legislation, VFHY needed assistance developing a strategic plan for the obesity initiative and a knowledge base to draw from. A comprehensive assessment of the status of Virginia’s childhood obesity problem was conducted, including the prevalence of the illness, the barriers existing to and the benefits to obesity prevention programs, the need for …

Use Of Oral Chemotherapeutic Medications In Non-Traditional Ambulatory Settings, Sameer Arora

Theses and Dissertations

Background: Cancer is the second leading cause of death in economically developed countries. The use and availability of oral treatment for cancer has increased dramatically in the past 10 years. Few studies have described the use of oral chemotherapy in non-traditional ambulatory settings by health care professionals across different specialties. Objective: The purpose of this study is to describe the usage of oral chemotherapeutic medications in ambulatory settings. Methods: Cross sectional study of 2007 NAMCS Survey analysis involving 21,761 subjects aged 18 years and above with cancer who participated in the 2007 National Ambulatory Medical Survey (NAMCS). Main Outcome Measure: …

Association Between Obesity And Depression And Anxiety Disorders: Results From The 2008 National Health Interview Survey, Monica Gaidhane

Theses and Dissertations

Introduction: Obesity is one of the most important medical problems in the U.S. and is considered to be an epidemic with over 30% of the population being obese. Obesity is associated with increased risk of hypertension, diabetes, cardiovascular diseases, certain cancers and a shorter life expectancy. Recent studies have shown that higher BMI levels are also significantly associated with several lifetime mental disorders such as major depressive disorder, anxiety disorders as well as panic attacks and panic disorders. Purpose: The purpose of this study was to quantify the extent to which higher BMI increased the likelihood of Depression, Anxiety Disorder …

Intimate Partner Violence And Pregnancy: Data From The Chicago Women's Health Risk Study, Anne Zehner

Theses and Dissertations

Background: Intimate partner violence (IPV) during pregnancy increases the risks of adverse outcomes for both mothers and their unborn children, including maternal and fetal death. However, more research is needed to determine if IPV increases in frequency or severity during pregnancy and to determine what the risk factors are for IPV during pregnancy. Objectives: To use data from the Chicago Women’s Health Risk Study to determine (1) if abuse is more prevalent during the pregnancy period, 2) if abuse during the pregnancy period increases in frequency or severity, 3) if pregnant women who are abused are at increased risk for …

Client Perceptions And Working Alliance: Predictors Of Outcome?, Theresa Do

Theses and Dissertations

BACKGROUND In recent years, there has been a push to measure and monitor the quality of health care and the delivery of effective services. Substance use disorders are debilitating and in order to better understand this facet of substance abuse, it is important for organizations and providers to assess the quality of services, client satisfaction, and the relationships that exist between clients and treatment providers. PURPOSE The purpose of the study was to (1) assess the extent of the relationship between measures of client perceptions of satisfaction and treatment outcomes and (2) to assess the relationship between measures of therapeutic …

Survival Analysis With Error-Prone Time-Varying Covariates: A Risk Set Calibration Approach, Xiaomei Liao, David M. Zucker, Yi Li, Donna Spiegelman

Harvard University Biostatistics Working Paper Series

No abstract provided.

Gangguan Akibat Kekurangan Iodium Di Indonesia: Tinjauan Epidemiologis Dan Kebijakan Kesehatan, Laurentius Aswin Pramono

Kesmas

Gangguan Akibat Kekurangan Iodium (GAKI) merupakan penyebab retardasi mental terbesar di seluruh dunia yang dapat dicegah. Dewasa ini, GAKI masih merupakan masalah kesehatan masyarakat yang penting di Indonesia karena belum mampu mencapai kondisi eliminasi seperti yang diharapkan. Hasil survei tahun 2003 dan Riskesdas 2007 menunjukkan bahwa pencapaian program penanggulangan GAKI di Indonesia masih jauh dari target Universal Salt Iodization dan Indonesia Sehat 2010. Artikel ini bertujuan mengevaluasi berbagai eviden epidemiologi yang berhubungan dengan kebijakan GAKI di Indonesia. Pada masa mendatang, berbagai komitmen lintas sektoral sangat diperlukan bagi pencapaian kondisi eliminasi GAKI. Perhatian klinisi dan ahli epidemiologi terhadap permasalahan GAKI di …

Causal Inference In Epidemiological Studies With Strong Confounding, Kelly L. Moore, Romain S. Neugebauer, Mark J. Van Der Laan, Ira B. Tager

U.C. Berkeley Division of Biostatistics Working Paper Series

One of the identifiabilty assumptions of causal effects defined by marginal structural model (MSM) parameters is the experimental treatment assignment (ETA) assumption. Practical violations of this assumption frequently occur in data analysis, when certain exposures are rarely observed within some strata of the population. The inverse probability of treatment weighted (IPTW) estimator is particularly sensitive to violations of this assumption, however, we demonstrate that this is a problem for all estimators of causal effects. This is due to the fact that the ETA assumption is about information (or lack thereof) in the data. A new class of causal models, causal …

What Factors Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, Patricia Tai, Richard Malthaner, Larry Stitt, George Rodrigues, Rashid Dar, Brian Yaremko, Jawaid Younus, Michael Sanatani, Mark Vincent, Brian Dingle, Dalilah Fortin, Richard Inculet

Oncology Presentations

Management of patients who have disease relapse after completion of surgery and adjuvant chemo-radiation (CRT) is controversial.

Some oncologists would advocate intensive therapeutic intervention due to promising experience on treatment for recurrence disease while others would recommend palliative support due to the concerns for poor patient outcome post disease recurrence.

In Addition, it is not clear if patient outcome is improved post adjuvant CRT when patients at risk have resection margin involvement and if time interval to recurrence can affect patient survival post relapse.

The present study was conducted to determine what factors will affect patient outcome at relapse after …

Causal Inference For Nested Case-Control Studies Using Targeted Maximum Likelihood Estimation, Sherri Rose, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

A nested case-control study is conducted within a well-defined cohort arising out of a population of interest. This design is often used in epidemiology to reduce the costs associated with collecting data on the full cohort; however, the case control sample within the cohort is a biased sample. Methods for analyzing case-control studies have largely focused on logistic regression models that provide conditional and not marginal causal estimates of the odds ratio. We previously developed a Case-Control Weighted Targeted Maximum Likelihood Estimation (TMLE) procedure for case-control study designs, which relies on the prevalence probability q0. We propose the use of …

Estimating Effects By Combining Instrumental Variables With Case-Control Designs: The Role Of Principal Stratification, Russell T. Shinohara, Constantine E. Frangakis, Elizabeth Platz, Konstantinos Tsilidis

Johns Hopkins University, Dept. of Biostatistics Working Papers

The instrumental variable framework is commonly used in the estimation of causal effects from cohort samples. In the case of more efficient designs such as the case-control study, however, the combination of the instrumental variable and complex sampling designs requires new methodological consideration. As the prevalence of Mendelian randomization studies is increasing and the cost of genotyping and expression data can be high, the analysis of data gathered from more cost-effective sampling designs is of prime interest. We show that the standard instrumental variable analysis is not applicable to the case-control design and can lead to erroneous estimation and inference. …

Impact Of Ambient Air Pollution On Survival Of Renal Transplant Recipients, Rhonda Kristine Hwang

Loma Linda University Electronic Theses, Dissertations & Projects

There is increasing evidence that ambient air pollution is associated with coronary heart disease morbidity and mortality. This research has focused on the general public and less so on possible sensitive subgroups even though these may have even greater susceptibility to adverse effects of ambient air pollution. With highly prevalent traditional as well as nontraditional risk factors, renal transplant recipients may potentially be a sensitive subgroup. The purpose of this study was to evaluate the possible effect of between long-term exposure to air pollution on the risk of CHD mortality among renal transplant recipients. This cohort study includes 32,239 adult, …

Pengaruh Kemiskinan Keluarga Pada Kejadian Pneumonia Balita Di Indonesia, Rizanda Machmud

Kesmas

Pneumonia merupakan penyakit infeksi saluran pernapasan akut yang menjadi kausa utama kematian balita. Di Indonesia, pada akhir tahun 2000, angka kematian balita akibat pneumonia diperkirakan 4,9/1000 balita. Faktor sosio-ekonomi berkontribusi besar terhadap penyakit saluran pernapasan. Tujuan penelitian ini adalah mengetahui faktor sosio-ekonomi yang paling berpengaruh terhadap pneumonia pada balita. Penelitian dengan dengan disain krosseksional ini menggunakan sumber data sekunder Benefit Evaluation Study (BES) II oleh Pusat Penelitian Kesehatan Universitas Indonesia bekerja sama dengan Proyek Intensifikasi Pemberantasan Penyakit Menular, Departemen Kesehatan. Sampel diambil berdasarkan multilevel statistical frameworkdari 7.170 ba-lita pada 10.900 rumah tangga di 27 kabupaten di tujuh provinsi. Metode analisis …

Makanan Etnik Minahasa Dan Kejadian Penyakit Jantung Koroner, Grace Debbie Kandou

Kesmas

Penyakit jantung koroner yang menjadi kausa utama kematian di seluruh dunia merupakan masalah kesehatan masyarakat yang penting di seluruh dunia, termasuk Indonesia dan Sulawesi Utara. Kebiasaan makan yang dipengaruhi oleh faktor budaya, adat istiadat, agama dan kepercayaan berperan penting dalam proses kejadian penyakit. Penelitian ini bertujuan mengetahui pengaruh kebiasaan makan etnik Minahasa terhadap kejadian penyakit jantung koroner. Penelitian di RSU Prof. Dr. R.D. Kandou ini menggunakan disain studi kasus kontrol dengan ukuran sampel 128 kasus dan 128 kontrol. Data frekuensi makan dikumpulkan dengan Food Frequency Quationnaire (FFQ). Makanan etnik Minahasa ditentukan berdasarkan 41 jenis makanan yang dikompositkan. Asam lemak jenuh …

The Effects Of Physical Activity And Nutrient Intake On The Risk Of Hip Fracture : Results From The Adventist Health Study-2, Wen-Ling Liao

Loma Linda University Electronic Theses, Dissertations & Projects

This is a two year of follow up study of Adventist Health Study-2 (AHS-2). We assessed the association between physical activity, nutrient intake and risk of hip fracture among peri- and post menopausal Caucasian women using unconditional logistic regression models. All subjects completed a lifestyle questionnaire which including information of physical activity and frequency and portion size of food intake at enrollment into the study (2002-2007). The “Bi-Annual Hospitalization History” questionnaire which included a question about hip fractures due to minor trauma/falls was sent to subjects approximately two years after enrollment, with a response rat of 82.84%. In this cohort, …

Complexity, Cofactors, And The Failure Of Aids Policy In Africa, Eileen Stillwaggon

Economics Faculty Publications

Global AIDS policy still treats HIV as an exceptional case, abstracting from the context in which infection occurs. Policy is based on a simplistic theory of HIV causation, and evaluated using outdated tools of health economics. Recent calls for a health systems strategy – preventing and treating HIV within a programme of comprehensive health care – have not yet influenced the silo approach of AIDS policy.

Evidence continues to accumulate, showing that multiple factors, such as malnutrition, malaria and helminthes, increase the risk of sexual and vertical transmission of HIV. Moreover, complementary interventions that reduce viral load, improve immune response, …

Situasi Malaria Di Kabupaten Lebak, Fauzul Hayat, Nia Kurniatillah

Kesmas

Pada periode 2002-2006, di Kabupaten Lebak, API tergolong Middle Case Incidence (MCI), dengan nilai rata-rata (2.87%) dan berada pada kisaran 2.04-4.51%. Dari 35 wilayah kerja puskesmas terdapat enam wilayah endemis yang meliputi puskesmas Malimping, Binuangeun, Bayah, Cihara, Panggarangan dan Cilograng. Ada wilayah kerja puskesmas yang dilaporkan dengan klasifikasi MCI. Penderita positif malaria cenderung meningkat secara fluktuatif dengan puncak yang tidak jelas, kasus positif malaria tertingi ditemukan pada bulan Februari, Maret, Mei, Juli dan Desember. Tingkat infeksi malaria yang tinggi pada kelompok populasi ditentukan berdasarkan proporsi sediaan darah positif malaria dari sediaan darah yang diperiksa dengan angka SPR 006 rata-rata 12.64%, …

A Spatio-Temporal Approach For Estimating Chronic Effects Of Air Pollution, Sonja Greven, Francesca Dominici, Scott L. Zeger

Johns Hopkins University, Dept. of Biostatistics Working Papers

Estimating the health risks associated with air pollution exposure is of great importance in public health. In air pollution epidemiology, two study designs have been used mainly. Time series studies estimate acute risk associated with short-term exposure. They compare day-to-day variation of pollution concentrations and mortality rates, and have been criticized for potential confounding by time-varying covariates. Cohort studies estimate chronic effects associated with long-term exposure. They compare long-term average pollution concentrations and time-to-death across cities, and have been criticized for potential confounding by individual risk factors or city-level characteristics.

We propose a new study design and a statistical model, …

Spatial Cluster Detection For Repeatedly Measured Outcomes While Accounting For Residential History, Andrea J. Cook, Diane Gold, Yi Li

Harvard University Biostatistics Working Paper Series

No abstract provided.

Spatial Cluster Detection For Weighted Outcomes Using Cumulative Geographic Residuals, Andrea J. Cook, Yi Li, David Arterburn, Ram C. Tiwari

Harvard University Biostatistics Working Paper Series

No abstract provided.

A Machine-Learning Algorithm For Estimating And Ranking The Impact Of Environmental Risk Factors In Exploratory Epidemiological Studies, Jessica G. Young, Alan E. Hubbard, B Eskenazi, Nicholas P. Jewell

U.C. Berkeley Division of Biostatistics Working Paper Series

No abstract provided.

Modeling And Analysis Of The Spread Of Japanese Encephalitis With Environmental Effects, Ram Naresh, Surabhi Pandey

Applications and Applied Mathematics: An International Journal (AAM)

A nonlinear mathematical model for the spread of Japanese Encephalitis, caused by infected mosquito feeding on susceptible human population incorporating demographic and environmental factors is proposed and analyzed. In the modeling process, it is assumed that the growth rates of reservoir animal population and vector mosquito population are enhanced due to environmental discharges caused by human population related factors. The model is analyzed by stability theory of differential equations and computer simulation. Both the disease-free and the endemic equilibria are found and their stability is investigated. It is found that whenever the disease-free equilibrium is locally asymptotically stable, the endemic …

Tuberculosis In San Bernardino County, 1993-2004 : Lifestyle And Environmental Factors, Anuj Bhatia

Loma Linda University Electronic Theses, Dissertations & Projects

An observational retrospective study was conducted for tuberculosis (TB) cases between San Bernardino County (SBC), Riverside County, and the state of California from 1996 to 2004. A univariate comparison between San Bernardino County and California indicated a higher proportion of U.S. born cases in SBC. Additionally, it was found that San Bernardino had a higher proportion of non-injection drug using TB cases, compared with California in 1996. Further comparisons were made along country of birth between TB cases in San Bernardino County from 1993 to 2004. Notable differences were observed for injection drug use, non injection drug use, alcohol abuse, …