Epidemiology Commons^™

Introducing The Black, African And Caribbean Canadian Health (Blacch) Study, Shamara M. Baidoobonso, Harina Mokanan, Mercy Nleya-Ncube, Greta Bauer

Shamara M Baidoobonso, PhD

Background and Objectives: African, Caribbean and other Black (ACB) persons account for an increasing proportion of new HIV cases in Canada, and are 12.6 times more likely to acquire HIV than the rest of Canada’s population. Few studies have fully acknowledged the ethnic, religious and socioeconomic diversity in ACB communities. Also, studies have rarely considered the social determinants of health and broader context in which ACB persons live and access health services, and how these may potentially impact HIV vulnerability. This lack of information negatively impacts HIV prevention and care efforts. The Black, African and Caribbean Canadian Health (BLACCH) Study …

Highlighting The Social Determinants Of Health As They Pertain To Africans In London, Ontario, Shamara M. Baidoobonso

Shamara M Baidoobonso, PhD

No abstract provided.

What Are The Factors That Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, P. Tai, R. Malthaner, L. Stitt, G. Rodrigues, R. Dar, B. Yaremko, J. Younus, M. Sanatani, M. Vincent, B. Dingle, D. Fortin, R. Inculet

Edward Yu

OBJECTIVES: The present study investigated factors affecting outcome at relapse after previous surgery and adjuvant chemoradiation (crt) in high-risk esophageal cancer patients. PATIENTS AND METHODS: From 1989 to 1999, we followed high-risk resected esophageal cancer patients who had completed postoperative crt therapy. Patients who relapsed with a disease-free interval of less than 3 months were treated with palliative crt when appropriate. Patients with a disease-free interval of 3 months or more were treated with best supportive care. Post-recurrence survival was estimated using the Kaplan-Meier technique, and statistical comparisons were made using log-rank chi-square tests and Cox regression. RESULTS: Of the …

Update On The Management Of Chronic Obstructive Pulmonary Disease, Andrea K. Maas, David M. Mannino

David M. Mannino

Chronic obstructive pulmonary disease is a highly prevalent, underdiagnosed, and undertreated chronic lung disease. Early and appropriate treatment may help modify the course of the disease with respect to exacerbation timing and frequency, quality of life, and mortality. Steady progress continues to be made in understanding the disease pathogenesis and treatment modalities, and there is some evidence that outcomes are improving.

The Pathways To Mental Health Care Of First-Episode Psychosis Patients: A Systematic Review., Kelly K. Anderson, Rebecca Fuhrer, Ashok K. Malla

Epidemiology and Biostatistics Publications

BACKGROUND: Although there is agreement on the association between delay in treatment of psychosis and outcome, less is known regarding the pathways to care of patients suffering from a first psychotic episode. Pathways are complex, involve a diverse range of contacts, and are likely to influence delay in treatment. We conducted a systematic review on the nature and determinants of the pathway to care of patients experiencing a first psychotic episode.

METHOD: We searched four databases (Medline, HealthStar, EMBASE, PsycINFO) to identify articles published between 1985 and 2009. We manually searched reference lists and relevant journals and used forward citation …

The Health Of Latinos In Massachusetts: A Snapshot, Dharma Cortés, Rodolfo R. Vega

Gastón Institute Publications

People’s health outcomes are shaped in part by non-biological factors. Most immediately, limited access to health care services can have a deleterious impact on individuals’ health outcomes (Andrulis, 1998). In turn, access to healthcare services is influenced by socioeconomic factors such as whether a person has health insurance or the financial means to pay for their health care. Familiarity with the health care system is another important factor that may influence an individual’s access to healthcare services (Morgan et al., 2008). Language also plays an important role in health outcomes. For instance, individuals with limited English proficiency may find it …

Smoking During Pregnancy And Risk Of Abnormal Glucose Tolerance: A Prospective Hohort Study, Lisa Chasan-Taber, Amy E. Haskins, Elizabeth R. Bertone-Johnson, Penelope Pekow, Elena Carbone, Renée T. Fortner

Lisa Chasan-Taber

Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 …

Smoking During Pregnancy And Risk Of Abnormal Glucose Tolerance: A Prospective Hohort Study, Amy E. Haskins, Elizabeth R. Bertone-Johnson, Penelope Pekow, Elena Carbone, Renée T. Fortner, Lisa Chasan-Taber

Elizabeth R. Bertone-Johnson

Background Disturbances in glucose metabolism during pregnancy are associated with negative sequalae for both mother and infant. The association between smoking and abnormal glucose tolerance (AGT) remains controversial. Therefore, the aim of this study was to examine the relationship between smoking prior to and during pregnancy and risk of AGT. Methods We utilized data from a prospective cohort of 1,006 Hispanic (predominantly Puerto Rican) prenatal care patients in Western Massachusetts. Women reported pre- and early pregnancy smoking at recruitment (mean = 15 weeks) and mid pregnancy smoking at a second interview (mean = 28 weeks). AGT was defined as > 135 …

Exposure To Indoor Biomass Fuel Pollutants And Asthma Prevalence In Southeastern Kentucky: Results From The Burden Of Lung Disease (Bold) Study, Anna C. Barry, David M. Mannino, Claudia Hopenhayn, Heather Bush

David M. Mannino

BACKGROUND:

Asthma is a chronic inflammatory respiratory disease, characterized by episodic and reversible airflow obstruction and airway hyperresponsiveness and is influenced by both genetic and environmental factors.

METHODS:

The Burden of Obstructive Lung Disease (BOLD) survey was used to determine the prevalence of self-reported asthma in a target population of 325,000 adults aged > or =40 in Southeastern Kentucky. Postbronchodilator spirometry was used to classify subjects based on lung function. Risk factors for asthma in this population, in particular indoor usage of biomass fuels, were evaluated.

RESULTS:

The overall study population was comprised of 508 individuals, with 15.5% reporting current asthma …

The Efficacy Of Spirometry As A Screening Tool In Detection Of Air Flow Obstruction, Nabeel Manzar, A. Suleman Haque, Bushra Manzar, Muhammad Irfan

Section of Pulmonary & Critical Care

Background/Objectives: In developing countries, spirometry has not been considered a part of routine medical check-up. The purpose of the study was to establish the usefulness of spirometry as a primary screening tool in detecting air flow obstruction (AFO) during routine medical check-up (RMC). Methods: This was a hospital based, retrospective, non-randomized case series study of 3696 participants, who presented to hospital for routine medical check-up. All subjects were assisted at the Pulmonary Medicine Department, from January 2003 till December 2008 who, having met other inclusion criteria, underwent spirometry. Data were analyzed using proportion, group means, standard deviations and …

Concurrent Sexual Partnerships Do Not Explain The Hiv Epidemics In Africa: A Systematic Review Of The Evidence, Larry Sawers, Eileen Stillwaggon

Economics Faculty Publications

The notion that concurrent sexual partnerships are especially common in sub-Saharan Africa and explain the region’s high HIV prevalence is accepted by many as conventional wisdom. In this paper, we evaluate the quantitative and qualitative evidence offered by the principal proponents of the concurrency hypothesis and analyze the mathematical model they use to establish the plausibility of the hypothesis.

We find that research seeking to establish a statistical correlation between concurrency and HIV prevalence either finds no correlation or has important limitations. Furthermore, in order to simulate rapid spread of HIV, mathematical models require unrealistic assumptions about frequency of sexual …

Sexual Health, Risk Behaviors, And Substance Use In Heterosexual-Identified Women With Female Sex Partners: 2002 Us National Survey Of Family Growth., Greta Bauer, Jennifer Jairam, Shamara Baidoobonso

Shamara M Baidoobonso, PhD

BACKGROUND: Despite knowledge that some people engage in same-sex sexuality without espousing a sexual minority identity, this has rarely been studied in women. METHODS: Heterosexual women aged 20 to 44 who indicated one or more female sex partners in the past year were compared to those with less recent female sex partners, and to bisexual, homosexual, and exclusively heterosexual women using 2002 US National Survey of Family Growth data. RESULTS: Compared to exclusively heterosexual women, heterosexual women with a past-year female sex partner were significantly more likely to smoke tobacco (46% vs. 19%), binge drink (34% vs. 11%), use marijuana …

Perfil Dos Acidentes De Trabalho No Brasil, 2004-2007 / Analysis Of Labor Accidents In Brazil, 2004 - 2007, Everton Fernando Alves

Everton Fernando Alves

Neste estudo sintetizam-se achados epidemiológicos de morbi- mortalidade decorrentes de acidentes de trabalho napopulação brasileira. O objetivo do estudo é descrever o perfil dos acidentes de trabalho no Brasil entre 2004 e 2007. Trata-se de um estudo descritivoexploratório utilizando como fonte de dados a estatística anual de acidentes do trabalho da Previdên- cia Social. Foram notificados 465.700 mil acidentesem 2004 e 653.090 em 2007, mostrando uma tendência ascendente nos acidentes com trabalhado- res formais no Brasil. Evidenciou-se que o estado de residência com maior acidentabilidade foi Santa Catarina com uma média de 577,3 acidentes para cada 100.000 trabalhadores. O aumento …

Kie Untuk Peningkatan Pengetahuan, Sikap, Dan Praktik Pencegahan Dan Penanggulangan Penyakit Flu Burung Di Kabupaten Gowa, Sulawesi Selatan, Ridwan M. Said, M. Ridwan Thaha, M. Syafar

Kesmas

Avian influenza adalah suatu kejadian luar biasa yang disebabkan oleh virus influenza subtipe H5N1, ditularkan oleh ternak liar atau domestik dan kemungkinan menyerang manusia. Tujuan penelitian ini untuk mengungkapkan peningkatan pengetahuan masyarakat , perubahan sikap dan partisipasi masyarakat dalam pencegahan dan penanganan influenza di Kabupaten Bontonompo, Gowa. Desain riset adalah desain kuantitatif kuasi eksperimen. Penelitian ini dilakukan pada 120 peternak unggas sebagai sampel yang dipilih dengan metode purposive sampling dan menggunakan metoda analisis uji statistic T-Test. Penelitian membuktikan bahwa sebelum intervensi model pendidikan komunikasi informasi dilakukan, pengetahuan, sikap dan praktik pencegahan dan pengendalian avian influenza terbatas. Setelah intervensi informasi, pendidikan …

Surrogate Screening Models For The Low Physical Activity Criterion Of Frailty, Sandrah P. Eckel, Karen Bandeen-Roche, Paulo H.M. Chaves, Linda P. Fried, Thomas A. Louis

Johns Hopkins University, Dept. of Biostatistics Working Papers

Background and Aims. Low physical activity, one of five criteria in a validated clinical phenotype of frailty, is assessed by a standardized questionnaire on up to 20 leisure time activities. Because of the time demanded to collect the interview data, it has been challenging to translate to studies other than the Cardiovascular Health Study (CHS), for which it was developed. Considering subsets of activities, we identified and evaluated streamlined surrogate assessment methods and compared them to one implemented in the Women’s Health and Aging Study (WHAS).

Methods. Using data on men and women ages 65 and older from the CHS, …

Using Multiple Sources Of Data To Assess The Prevalence Of Diabetes At The Subcounty Level, Duval County, Florida, 2007, William C. Livingood, Luminita Razaila, Elena Reuter, Rebecca Filipowicz, Ryan C. Butterfield, Katryne Lukens-Bull, Linda Edwards, Carlos Palacio, David L. Wood

David L. Wood

Distribution Of Health Care Expenditures For Hiv-Infected Patients, Ray Y. Chen, Neil A. Accortt, Andrew O. Westfall, Michael J. Mugavero, James L. Raper, Gretchen A. Cloud, Beth K. Stone, Jerome Carter, Stephanie Call, Maria Pisu, Jeroan J. Allison, Michael S. Saag

Jeroan J. Allison

BACKGROUND: Health care expenditures for persons infected with human immunodeficiency virus (HIV) in the United State determined on the basis of actual health care use have not been reported in the era of highly active antiretroviral therapy.

METHODS: Patients receiving primary care at the University of Alabama at Birmingham HIV clinic were included in the study. All encounters (except emergency room visits) that occurred within the University of Alabama at Birmingham Hospital System from 1 March 2000 to 1 March 2001 were analyzed. Medication expenditures were determined on the basis of 2001 average wholesale price. Hospitalization expenditures were determined on …

Trends In Aids-Defining And Non-Aids-Defining Malignancies Among Hiv-Infected Patients: 1989-2002, Roger Bedimo, Ray Y. Chen, Neil A. Accortt, James L. Raper, Carol Linn, Jeroan J. Allison, John Dubay, Michael S. Saag, Craig J. Hoesley

Jeroan J. Allison

In a comparison of rates of acquired immunodeficiency syndrome (AIDS)-defining malignancies (ADMs) for 1989-1996 versus 1997-2002, we found a decrease in ADMs (rate ratio, 0.31; P<.0001) and a significant increase in non-AIDS-defining malignancies (non-ADMs; rate ratio, 10.87; P<.0002). The mean CD4 cell count was lower among patients with ADMs than among those with non-ADMs. A longer duration of survival during highly active antiretroviral therapy might explain the increasing incidence of non-ADMs.

Adherence To The American College Of Surgeons (Acs) Recommendation On Double Gloving, Hand Free Zone And Blunt Suture Needle Use Among Surgeon Ranks, Akbar Nassiry

Theses and Dissertations

Background: The American College of Surgeons guidelines suggest the use of intact gloves, double gloving, hands-free zone technique to pass sharp instruments, and blunt tip suture needles to protect patients, as well as the surgical team. This study estimates the extent to which these guidelines are followed in a large academic health system. Methods: Over a two-month period in the spring of 2010, 320 general surgical attendings, subspecialty surgical attendings, and surgical resident physicians practicing at a large academic health system, were approached during or after surgical conferences to participate in a cross-sectional study. Nearly 1/3rd completed an anonymous and …

Growth, Immune And Viral Responses In Hiv Infected African Children Receiving Highly Active Antiretroviral Therapy: A Prospective Cohort Study., Philippa M. Musoke, Peter Mudiope, Linda N. Barlow-Mosha, Patrick Ajuna, Danstan Bagenda, Michael M. Mubiru, Thorkild Tylleskar, Mary G. Fowler

Journal Articles: Epidemiology

BACKGROUND: Scale up of paediatric antiretroviral therapy in resource limited settings continues despite limited access to routine laboratory monitoring. We documented the weight and height responses in HIV infected Ugandan children on highly active antiretroviral therapy and determined clinical factors associated with successful treatment outcomes.

METHODS: A prospective cohort of HIV infected children were initiated on HAART and followed for 48 weeks. Body mass index for age z scores(BAZ), weight and height-for-age z scores (WAZ & HAZ) were calculated: CD4 cell % and HIV-1 RNA were measured at baseline and every 12 weeks. Treatment outcomes were classified according to; both …