Health Policy Commons^™

Timing Of Hospital Admission At First Childbirth: A Prospective Cohort Study, Kristen H. Kjerulff, Laura B. Attanasio, Jennifer Vanderlaan, Kristin K. Sznajder

Health Promotion and Policy Faculty Publication Series

Background and aims

It is difficult for women in labor to determine when best to present for hospital admission, particularly at first childbirth. While it is often recommended that women labor at home until their contractions have become regular and ≤ 5-minutes apart, little research has investigated the utility of this recommendation. This study investigated the relationship between timing of hospital admission, in terms of whether women’s labor contractions had become regular and ≤ 5-minutes apart before admission, and labor progress.

Methods

This was a cohort study of 1,656 primiparous women aged 18–35 years with singleton pregnancies who began labor …

Vibrio Cholerae In Rural And Urban Bangladesh, Findings From Hospital-Based Surveillance, 2000–2021, Rina Das, Sabiha Nasrin, Parag Palit, Rukaeya Amin Sobi, Al-Afroza Sultana, Soroar Hossain Khan, Md. Ahshanul Haque, Sharika Nuzhat, Tahmeed Ahmed, A. S. G. Faruque, Mohammod Jobayer Chisti

Biostatistics and Epidemiology Faculty Publications Series

With more than 100,000 cases estimated each year, Bangladesh is one of the countries with the highest number of people at risk for cholera. Moreover, Bangladesh is formulating a countrywide cholera-control plan to satisfy the GTFCC (The Global Task Force on Cholera Control) Roadmap's goals. With a particular focus on cholera trends, variance in baseline and clinical characteristics of cholera cases, and trends in antibiotic susceptibility among clinical isolates of Vibrio cholerae, we used data from facility-based surveillance systems from icddr,b’s Dhaka, and Matlab Hospitals from years 2000 to 2021. Female patients comprised 3,553 (43%) in urban and 1,099 (51.6%) …

Dietary Fat Quality And Serum Androgen Concentrations In Middle-Aged Men, Miika M. Wynne-Ellis, Jaakko J. Mursu, Tomi-Pekka Tuomainen, Elizabeth Bertone-Johnson, Jukka T. Salonen, Jyrki K. Virtanen

Health Promotion and Policy Faculty Publication Series

Average testosterone concentrations in men have declined over the last few decades. The reasons for this are not fully known, but changes in dietary fat quality have been suggested to have a role. This study aimed to investigate the associations of different dietary fatty acids with serum androgen concentrations.

A Cross-Ancestry Genome-Wide Meta-Analysis, Fine-Mapping, And Gene Prioritization Approach To Characterize The Genetic Architecture Of Adiponectin, Casssandra N. Spracklen, Et. Al.

Biostatistics and Epidemiology Faculty Publications Series

No abstract provided.

Childhood And Adulthood Passive And Active Smoking, And The Abo Group As Risk Factors For Pancreatic Cancer In Women, Anne-Laure Vedie, Nasser Laouali, Amandine Gelot, Gianluca Severi, Marie-Christine Boutron-Ruault, Vinciane Rebours

Biostatistics and Epidemiology Faculty Publications Series

Objectives

Active smoking and the A blood group are associated with pancreatic adenocarcinoma (PC) risk. However, potential interactions between those risk factors and the role of passive smoking have been little investigated. We aimed to explore specific and joint associations of passive and active smoking, and effect modification by the ABO blood group in French women.

Methods

The study included 96,594 women from the E3N prospective cohort, mean age: 49 years (SD 6.7). Information on active and passive smoking was reported at inclusion and throughout follow-up. Cases were classified according to the International Classification of Diseases 10. Associations with passive …

Comparison Of Combination Methods To Create Calibrated Ensemble Forecasts For Seasonal Influenza In The U.S., Nutcha Wattanachit, Evan L. Ray, Thomas C. Mcandrew, Nicholas G. Reich

Biostatistics and Epidemiology Faculty Publications Series

The characteristics of influenza seasons vary substantially from year to year, posing challenges for public health preparation and response. Influenza forecasting is used to inform seasonal outbreak response, which can in turn potentially reduce the impact of an epidemic. The United States Centers for Disease Control and Prevention, in collaboration with external researchers, has run an annual prospective influenza forecasting exercise, known as the FluSight challenge. Uniting theoretical results from the forecasting literature with domain-specific forecasts from influenza outbreaks, we applied parametric forecast combination methods that simultaneously optimize model weights and calibrate the ensemble via a beta transformation and made …

The Massachusetts Public Health Data Warehouse And The Opioid Epidemic: A Qualitative Study Of Perceived Strengths And Limitations For Advancing Research, Elizabeth A. Evans, Elizabeth Delorme, Karl D. Cyr, Kimberly H. Geissler

Health Promotion and Policy Faculty Publication Series

Due to the opioid overdose epidemic, Massachusetts created a Public Health Data Warehouse, encompassing individually-linked administrative data on most of the population as provided by more than 20 systems. As others seek to assemble and mine big data on opioid use, there is a need to consider its research utility. To identify perceived strengths and limitations of administrative big data, we collected qualitative data in 2019 from 39 stakeholders with knowledge of the Massachusetts Public Health Data Warehouse. Perceived strengths included the ability to: (1) detect new and clinically significant relationships; (2) observe treatments and services across institutional boundaries, broadening …

Transitions In Health Insurance During The Perinatal Period Among Patients With Continuous Insurance Coverage, Chanup Jeung, Laura B. Attansio, Kimberly H. Geissler

Health Promotion and Policy Faculty Publication Series

Importance Although health insurance continuity is important during the perinatal period to improve birth outcomes and reduce maternal morbidity and mortality, insurance disruptions are common. However, little is known about insurance transitions among insurance types for individuals who remained insured during the perinatal period.

Objective To examine insurance transitions for birthing individuals with continuous insurance, including those with Medicaid and Medicaid managed care coverage, before, during, and after pregnancy.

Design, Setting, and Participants This cohort study used January 1, 2014 to December 31, 2018 data from the Massachusetts All-Payer Claims Database. The sample included deliveries from January 1, 2015, to …

Dental Fluoride Varnish Application During Medical Visits Among Children Who Are Privately Insured, Kimberley H. Geissler Phd, Andrew W. Dick Phd, Sarah L. Goff Phd, Christopher Whaley Phd, Ashley M. Kranz Phd

Health Promotion and Policy Faculty Publication Series

Fluoride varnish is effective at reducing tooth decay, which affects nearly a quarter of US children ages 2 to 5 years and more than half of children ages 6 to 8 years.^1,2 To increase young children’s receipt of preventive oral health services, the US Preventive Services Task Force recommends medical providers apply fluoride varnish to young children’s teeth during well-child visits through 5 years of age.² Offering fluoride varnish in medical settings may increase young children’s receipt of this service because 89% of children younger than 6 years of age had a preventive medical visit in …

Per- And Polyfluoroalkyl Substances And Kidney Function: Follow-Up Results From The Diabetes Prevention Program Trial, Pi-I D. Lin, Andres Cardenas, Russ Hauser, Diane R. Gold, Ken P. Kleinman, Marie-France Hivert, Antonia M. Calafat, Thomas F. Webster, Edward S. Horton, Emily Oken

Biostatistics and Epidemiology Faculty Publications Series

Per- and polyfluoroalkyl substances (PFAS) are ubiquitously detected in populations worldwide and may hinder kidney function. The objective of the study was to determine longitudinal associations of plasma PFAS concentrations with estimated glomerular filtration rate (eGFR) and evaluate whether a lifestyle intervention modify the associations. We studied 875 participants initially randomized to the lifestyle or placebo arms in the Diabetes Prevention Program (DPP, 1996–2002) trial and Outcomes Study (DPPOS, 2002–2014). We ran generalized linear mixed models accounting a priori covariates to evaluate the associations between baseline PFAS concentrations and repeated measures of eGFR, separately, for six PFAS (PFOS, PFOA, PFHxS, …

The Zoltar Forecast Archive, A Tool To Standardize And Store Interdisciplinary Prediction Research, Nicholas G. Reich, Matthew Cornell, Evan L. Ray, Katie House, Khoa Le

Biostatistics and Epidemiology Faculty Publications Series

Forecasting has emerged as an important component of informed, data-driven decision-making in a wide array of felds. We introduce a new data model for probabilistic predictions that encompasses a wide range of forecasting settings. This framework clearly defnes the constituent parts of a probabilistic forecast and proposes one approach for representing these data elements. The data model is implemented in Zoltar, a new software application that stores forecasts using the data model and provides standardized API access to the data. In one real-time case study, an instance of the Zoltar web application was used to store, provide access to, and …

Effect Of A Patient-Centered Hypertension Delivery Strategy On All-Cause Mortality: Secondary Analysis Of Search, A Community-Randomized Trial In Rural Kenya And Uganda, Matthew D. Hickey, James Ayieko, Asiphas Owaraganise, Nicholas Sim, Laura B. Balzer, Jane Kabami, Mucunguzi Atukunda, Frederick J. Opel, Erick Wafula, Et. Al.

Biostatistics and Epidemiology Faculty Publications Series

Background

Hypertension treatment reduces morbidity and mortality yet has not been broadly implemented in many low-resource settings, including sub-Saharan Africa (SSA). We hypothesized that a patient-centered integrated chronic disease model that included hypertension treatment and leveraged the HIV care system would reduce mortality among adults with uncontrolled hypertension in rural Kenya and Uganda.

Methods and findings

This is a secondary analysis of the SEARCH trial (NCT:01864603), in which 32 communities underwent baseline population-based multidisease testing, including hypertension screening, and were randomized to standard country-guided treatment or to a patient-centered integrated chronic care model including treatment for hypertension, diabetes, and HIV. …

Civilian-Military Malaria Outbreak Response In Thailand: An Example Of Multi-Stakeholder Engagement For Malaria Elimination, Michelle E. Roh, Kanyat Lausatianragit, Nithinart Chaitaveep, Krisada Jongsakul, Prayuth Sudathip, Chatree Raseebut, Sutchana Tabprasit, Prasert Nonkaew, Michele Spring, Montri Arsanok, Parat Boonyarangka, Sabaithip Sriwichai, Piayporn Sai-Ngam, Chaiyaporn Chaisatit, Peerapol Pokpong, Preecha Prempree, Sara Rossi, Mita Feldman, Mariusz Wojnarski, Adam Bennett, Roly Gosling, Danai Jearakul, Wanchai Lausatianragit, Philip L. Smith, Nicholas J. Martin, Andrew A. Lover, Mark M. Fukuda

Biostatistics and Epidemiology Faculty Publications Series

Background

In April 2017, the Thai Ministry of Public Health (MoPH) was alerted to a potential malaria outbreak among civilians and military personnel in Sisaket Province, a highly forested area bordering Cambodia. The objective of this study was to present findings from the joint civilian-military outbreak response.

Methods

A mixed-methods approach was used to assess risk factors among cases reported during the 2017 Sisaket malaria outbreak. Routine malaria surveillance data from January 2013 to March 2018 obtained from public and military medical reporting systems and key informant interviews (KIIs) (n = 72) were used to develop hypotheses about potential factors …

Family Support And Readiness To Consider Smoking Cessation Among Chinese And Vietnamese American Male Smokers, Joan A. Daniel, Jin E. Kim-Mozeleski, Krishna C. Poudel, Angela Sun, Nancy J. Burke, Janice Y. Tsoh

Health Promotion and Policy Faculty Publication Series

Introduction. Smoking prevalence is disproportionately high among Asian American immigrant men with limited English proficiency. Understanding the role of family support may provide insights into culturally acceptable strategies to promote smoking cessation. Aims. This study examined how family support was associated with readiness to consider smoking cessation among Chinese and Vietnamese American male daily smokers. Methods. We analyzed baseline data (N = 340) from a cluster randomized trial of a family-based healthy lifestyle intervention. We assessed the frequency of receiving family support in various forms (encouraging use of cessation resources, praising efforts, checking in, and reminding of familial role). Multiple …

Prevalence Of Glucose-6-Phosphate Dehydrogenase Deficiency (G6pdd) Carestart Qualitative Rapid Diagnostic Test Performance, And Genetic Variants In Two Malaria-Endemic Areas In Sudan, Musab M. Ali Albsheer, Andrew A. Lover, Sara B. Eltom, Leena Omereltinai, Nouh Mohamed, Mohamed S. Muneer, Abdelrahim O. Mohamad, Muzamil Mahdi Abdel Hamid

Biostatistics and Epidemiology Faculty Publications Series

Glucose-6-phosphate dehydrogenase deficiency (G6PDd) is the most common enzymopathy globally, and deficient individuals may experience severe hemolysis following treatment with 8-aminoquinolines. With increasing evidence of Plasmodium vivax infections throughout sub-Saharan Africa, there is a pressing need for population-level data at on the prevalence of G6PDd. Such evidence-based data will guide the expansion of primaquine and potentially tafenoquine for radical cure of P. vivax infections. This study aimed to quantify G6PDd prevalence in two geographically distinct areas in Sudan, and evaluating the performance of a qualitative CareStart rapid diagnostic test as a point-of-care test. Blood samples were analyzed from 491 …

In Utero Exposure To Persistent Organic Pollutants And Childhood Lipid Levels, Maegan E. Boutot, Brian W. Whitcomb, Nadia Abdelouahab, Andrea A. Baccarelli, Amélie Boivin, Artuela Caku, Virginie Gillet, Guillaume Martinez, Jean-Charles Pasquier, Jiping Zhu, Larissa Takser, Lindsay St-Cyr, Alexander Suvorov

Biostatistics and Epidemiology Faculty Publications Series

Animal studies have shown that developmental exposures to polybrominated diphenyl ethers (PBDE) permanently affect blood/liver balance of lipids. No human study has evaluated associations between in utero exposures to persistent organic pollutants (POPs) and later life lipid metabolism. In this pilot, maternal plasma levels of PBDEs (BDE-47, BDE-99, BDE-100, and BDE-153) and polychlorinated biphenyls (PCB-138, PCB-153, and PCB-180) were determined at delivery in participants of GESTation and Environment (GESTE) cohort. Total cholesterol (TCh), triglycerides (TG), low- and high-density lipoproteins (LDL-C and HDL-C), total lipids (TL), and PBDEs were determined in serum of 147 children at ages 6–7. General linear regression …

Evaluating Epidemic Forecasts In An Interval Format, Johannes Bracher, Evan L. Ray, Tilmann Gneiting, Nicholas G. Reich

Biostatistics and Epidemiology Faculty Publications Series

For practical reasons, many forecasts of case, hospitalization, and death counts in the context of the current Coronavirus Disease 2019 (COVID-19) pandemic are issued in the form of central predictive intervals at various levels. This is also the case for the forecasts collected in the COVID-19 Forecast Hub (https://covid19forecasthub.org/). Forecast evaluation metrics like the logarithmic score, which has been applied in several infectious disease forecasting challenges, are then not available as they require full predictive distributions. This article provides an overview of how established methods for the evaluation of quantile and interval forecasts can be applied to epidemic forecasts in …

Branched-Chain Amino Acids And Risk Of Breast Cancer, Oana A. Zeleznik, Raji Balasubramanian, Yumeng Ren, Deirdre K. Tobias, Bernard A. Rosner, Cheng Peng, Alaina M. Bever, Lisa Frueh, Sarah Jeanfavre, Julian Avila-Pacheco, Clary B. Clish, Samia Mora, Frank B. Hu, A. Heather Eliassen

Biostatistics and Epidemiology Faculty Publications Series

Background

Circulating branched-chain amino acid (BCAA) levels reflect metabolic health and dietary intake. However, associations with breast cancer are unclear. Methods

We evaluated circulating BCAA levels and breast cancer risk within the Nurses’ Health Study (NHS) and NHSII (1997 cases and 1997 controls). A total of 592 NHS women donated 2 blood samples 10 years apart. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) of breast cancer risk in multivariable logistic regression models. We conducted an external validation in 1765 cases in the Women’s Health Study (WHS). All statistical tests were 2-sided. Results

Among NHSII participants (predominantly premenopausal …

Pubertal Development And Risk Of Premenstrual Disorders In Young Adulthood, Donghao Lu, Jurate Alenaviciute, Ragnar Bjarnason, Unnur A. Valdimarsdóttir, Elizabeth R. Bertone-Johnson

Health Promotion and Policy Faculty Publication Series

STUDY QUESTION

Is pubertal timing associated with risk of premenstrual disorders (PMDs) in young adulthood? SUMMARY ANSWER

Late pubertal development is associated with decreased premenstrual symptom burden and risk of PMDs in young adulthood. WHAT IS KNOWN ALREADY

PMDs, including premenstrual syndrome and premenstrual dysphoric disorder, may begin during the teenage years. Few risk factors in early life have been identified for PMD development. STUDY DESIGN, SIZE, DURATION

A prospective cohort study of 6495 female participants during 1996–2013. PARTICIPANTS/MATERIALS, SETTING, METHODS

We included participants from the Growing Up Today Study (GUTS). Pubertal development was indicated by the timing of menarche, …

Coxphlb: An R Package For Analyzing Length Biased Data Under Cox Model, Chi Hyun Lee, Heng Zhou, Jing Ning, Diane D. Liu, Yu Shen

Biostatistics and Epidemiology Faculty Publications Series

Data subject to length-biased sampling are frequently encountered in various applications including prevalent cohort studies and are considered as a special case of left-truncated data under the stationarity assumption. Many semiparametric regression methods have been proposed for lengthbiased data to model the association between covariates and the survival outcome of interest. In this paper, we present a brief review of the statistical methodologies established for the analysis of length-biased data under the Cox model, which is the most commonly adopted semiparametric model, and introduce an R package CoxPhLb that implements these methods. Specifically, the package includes features such as fitting …

Shifting To Virtual Cbpr Protocols In The Time Of Corona Virus/Covid-19, Elizabeth Salerno Valdez, Aline Gubrium

Health Promotion and Policy Faculty Publication Series

COVID-19 has upended community based participatory research (CBPR) projects across the United States and globally. COVID-19 disproportionately impacts historically disenfranchised communities and communities of color, the very communities that CBPR is meant to engage, elevate, and support. In-person activities that help develop rapport and research protocols, build capacity, conduct collaborative data collection and analysis, disseminate findings to the community, and engage in sustainability planning are an impossible practice during the COVID-19 pandemic. The purpose of this article is to describe the challenges and facilitators of shifting to a virtual/online CBPR protocol with a Massachusetts community disproportionately affected by COVID19, as …

The Incubation Period Of Coronavirus Disease 2019 (Covid-19) From Publicly Reported Confirmed Cases: Estimation And Application, Stephen A. Lauer, Kyra H. Grantz, Qifang Bi, Forest K. Jones, Qulu Zheng, Hannah R. Meredith, Andrew S. Azman, Nicholas G. Reich, Justin Lessler

Biostatistics and Epidemiology Faculty Publications Series

Background:

A novel human coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was identified in China in December 2019. There is limited support for many of its key epidemiologic features, including the incubation period for clinical disease (coronavirus disease 2019 [COVID-19]), which has important implications for surveillance and control activities.

Objective:

To estimate the length of the incubation period of COVID-19 and describe its public health implications.

Design:

Pooled analysis of confirmed COVID-19 cases reported between 4 January 2020 and 24 February 2020.

Setting:

News reports and press releases from 50 provinces, regions, and countries outside Wuhan, Hubei province, China. …

Development Of The Gambling Disorder Identification Test: Results From An International Delphi And Consensus Process, Olof Molander, Rachel Volberg, Viktor Månsson, Kristina Sundqvist, Peter Wennberg, Anne H. Berman

Biostatistics and Epidemiology Faculty Publications Series

Objectives

Diverse instruments are used to measure problem gambling and Gambling Disorder intervention outcomes. The 2004 Banff consensus agreement proposed necessary features for reporting gambling treatment efficacy. To address the challenge of including these features in a single instrument, a process was initiated to develop the Gambling Disorder Identification Test (GDIT), as an instrument analogous to the Alcohol Use Disorders Identification Test and the Drug Use Disorders Identification Test.

Methods

Gambling experts from 10 countries participated in an international two‐round Delphi (n = 61; n = 30), rating 30 items proposed for inclusion in the GDIT. Gambling researchers and …

Improved Viral Suppression With Streamlined Care In The Search Study, Matthew D. Hickey, James Ayieko, Dalsone Kwarisiima, Fredrick J. Opel, Asiphas Owaraganise, Laura B. Balzer, Gabriel Chamie, Vivek Jain, James Peng, Carol Camlin, Edwin D. Charlebois, Craig R. Cohen, Elizabeth A. Bukusi, Moses R. Kamya, Maya L. Petersen, Diane V. Havlir

Biostatistics and Epidemiology Faculty Publications Series

Background:

HIV differentiated service delivery (DSD) models are scaling up in resource-limited settings for stable patients; less is known about DSD outcomes for patients with viremia. We evaluated the effect on viral suppression (VS) of a streamlined care DSD model implemented in the SEARCH randomized universal test and treat trial in rural Uganda and Kenya (NCT:01864603).

Methods:

We included HIV-infected adults at baseline (2013) who were country guideline antiretroviral therapy (ART) eligible (prior ART experience or CD4 ≤ 350) with ≥1 HIV clinic visit between 2013 and 2017 in SEARCH communities randomized to intervention (N = 16) or control (N …

State Or Market? How To Effectively Decrease Alcohol-Related Crash Fatalities And Injuries, Jose I. Nazif-Muñoz, Brice Batomen, Youssef Oulhote, Arijit Nandi

Biostatistics and Epidemiology Faculty Publications Series

Background It is estimated that more than 270 000 people die yearly in alcohol-related crashes globally. To tackle this burden, government interventions, such as laws which restrict blood alcohol concentration (BAC) levels and increase penalties for drunk drivers, have been implemented. The introduction of private-sector measures, such as ridesharing, is regarded as alternatives to reduce drunk driving and related sequelae. However, it is unclear whether state and private efforts complement each other to reduce this public health challenge.

Methods We conducted interrupted time-series analyses using weekly alcohol-related traffic fatalities and injuries per 1 000 000 population in three urban conglomerates …

Flavonoid Intake And Plasma Sex Steroid Hormones, Prolactin, And Sex Hormone-Binding Globulin In Premenopausal Women, You Wu, Susan E. Hankinson, Stephanie A. Smith-Warner, Molin Wang, A. Heather Eliassen

Biostatistics and Epidemiology Faculty Publications Series

Background: Flavonoids potentially exert anti-cancer effects, as suggested by their chemical structures and supported by animal studies. In observational studies, however, the association between flavonoids and breast cancer, and potential underlying mechanisms, remain unclear. Objective: To examine the relationship between flavonoid intake and sex hormone levels using timed blood samples in follicular and luteal phases in the Nurses’ Health Study II among premenopausal women. Methods: Plasma concentrations of estrogens, androgens, progesterone, dehydroepiandrosterone (DHEA), DHEA sulfate (DHEAS), prolactin, and sex hormone-binding globulin (SHBG) were measured in samples collected between 1996 and 1999. Average flavonoid were calculated from semiquantitative food frequency questionnaires …

Incidence Of Pediatric Cannabis Exposure Among Children And Teenagers Aged 0 To 19 Years Before And After Medical Marijuana Legalization In Massachusetts, Jennifer M. Whitehill, Calla Harrington, Cheryl J. Lang, Michael Chary, Waqaas A. Bhutta, Michael D. Burns

Health Promotion and Policy Faculty Publication Series

Importance Pediatric health care contacts due to cannabis exposure increased in Colorado and Washington State after cannabis (marijuana) policies became more liberal, but evidence from other US states is limited.

Objective To document the incidence of pediatric cannabis exposure cases reported to the Regional Center for Poison Control and Prevention (RPC) before and after medical marijuana legalization (MML) in Massachusetts.

Design, Setting, and Participants Cross-sectional comparison of pediatric cannabis exposure cases 4 years before and after MML in Massachusetts. The exposure cases included those of 218 children and teenagers aged between 0 and 19 years, as reported to the RPC …

Pregnancies, Abortions, And Pregnancy Intentions: A Protocol For Modeling And Reporting Global, Regional And Country Estimates, Jonathan Marc Bearak, Anna Popinchalk, Gilda Sedgh, Bela Ganatra, Ann-Beth Moller, Özge Tunçalp, Leontine Alkema

Biostatistics and Epidemiology Faculty Publications Series

Background

Estimates of pregnancies, abortions and pregnancy intentions can help assess how effectively women and couples are able to fulfil their childbearing aspirations. Abortion incidence estimates are also a necessary foundation for research on the safety of abortions performed and the consequences of unsafe abortion. Furthermore, periodic estimates of these indicators are needed to help inform policy and programmes.

Methods

We will develop a Bayesian hierarchical times series model which estimates levels and trends in pregnancy rates, abortion rates, and percentages of pregnancies and births unintended for each five-year period between 1990 and 2019. The model will be informed by …

Identifying Metabolomic Profiles Of Insulinemic Dietary Patterns, Fred K. Tabung, Raji Balasubramanian, Liming Liang, Steven K. Clinton, Elizabeth M. Cespedes Feliciano, Joann E. Manson, Linda Van Horn, Jean Wactawski-Wende, Clary B. Clish, Edward L. Giowanucci, Kathryn M. Rexrode

Biostatistics and Epidemiology Faculty Publications Series

The food-based empirical dietary index for hyperinsulinemia (EDIH) score assesses the insulinemic potential of diet. This cross-sectional study evaluated associations between EDIH scores from food frequency questionnaires with c-peptide concentrations and with 448 metabolites, from fasting plasma samples, in multivariable linear regression analyses. Metabolites were measured with liquid chromatography tandem mass spectroscopy. Using a robust two-stage study design, discovery of metabolite associations was conducted among 1109 Women’s Health Initiative (WHI) Hormone Therapy (HT) trial participants and results replicated in an independent dataset of 810 WHI Observational Study (OS) participants. In both discovery and replication datasets, statistical significance was based on …

Food Insecurity At A Four-Year College Campus, Danielle Corrado

School of Public Policy Capstones

This paper, through an adaption of the United States Department of Agriculture Adult Food Security survey tool, aims to identify food insecurity rates at the University of Massachusetts Amherst, the demographic characteristics associated with food insecurity, potential financial factors that contribute and predict food insecurity rates, and the relationship between food insecurity and academic performance. Lastly, this paper examines on and off campus resources available to students and students perception of food insecurity before college as compared to actual food security status in college.