Biostatistics Commons^™

Rural-Based Health Promotion Model For Pregnant Women In Banyumas District, Elviera Gamelia, Dian Anandari, Dyah Umiyarni Purnamasari

Kesmas

Penelitian sebelumnya menunjukkan bahwa pengetahuan pelayanan prenatal di wilayah pedesaan masih rendah yang berdampak pada perilaku buruk sehingga mengembangkan model promosi kesehatan dibutuhkan untuk meningkatkan pengetahuan prenatal, sikap dan perilaku. Penelitian ini bertujuan untuk mengembangkan model promosi kesehatan pelayanan prenatal di wilayah pedesaan berdasarkan penilaian kebutuhan. Penelitian dilakukan pada Juni 2015 dengan pendekatan kualitatif melibatkan 16 ibu hamil pertama di trimester ketiga dengan kehamilan berisiko sebagai informan kunci dan 16 anggota keluarga yang tinggal bersama ibu hamil dan mengetahui kehidupan sehari-harinya, 27 bidan dan 3 tokoh agama sebagai informan tambahan. Teknik pengumpulan data adalah wawancara mendalam dan observasi untuk ibu …

Well Water Consumed And Urolithiasis In Gedangsari Subdistrict, Yogyakarta, Sulistyawati Sulistyawati, Fardhiasih Dwi Astuti, Ruri Trisasri, Asep Rustiawan

Kesmas

Tanah di wilayah Kecamatan Gedangsari mengandung batuan kapur. Masyarakat di daerah ini banyak yang mengkonsumsi air minum dari sumur gali yang mengandung kadar kalsium tinggi, dan banyak yang menderita urolithiasis. Penelitian ini bertujuan untuk mendapatkan gambaran distribusi kalsium atau Ca(OH)2 pada air sumur dan menjelaskan hubungannya dengan kejadian urolithiasis. Penelitian dilakukan di Kecamatan Gedangsari, Kabupaten Gunungkidul selama Juli sampai November 2013. Penelitian dilakukan secara potong lintang dengan konfirmasi uji titrasi di laboratorium. Sejumlah 94 sampel sumur dipilih secara acak dari populasi 3.849 sumur. Kriteria pemilihan sampel adalah sumur gali yang telah digunakan untuk minum oleh penduduk berusia lebih dari 30 …

Identification Of Pathogenic Leptospira In Rat And Shrew Populations Using Rpob Gene And Its Spatial Distribution In Boyolali District, Dyah Widiastuti, Zumrotus Sholichah, Agustiningsih Agustiningsih, Nastiti Wijayanti

Kesmas

Leptospirosis merupakan masalah kesehatan di Indonesia. Hingga April 2014, dilaporkan kasus leptospirosis yang ditularkan oleh tikus di Kabupaten Boyolali dengan angka kematian 83,3%. Genus Leptospira terdiri dari ratusan serovar dan tipe genetik yang hidup di pelbagai jenis habitat. Pengelompokan spesies Leptospira berdasarkan gen rpoB dapat digunakan karena tingkat polimorfisme gen tersebut tinggi. Penelitian ini bertujuan untuk mengidentifikasi serovar bakteri Leptospira pada populasi tikus di Kabupaten Boyolali menggunakan analisis hubungan kekerabatan didasarkan pada polimorfisme gen rpoB dan menggambarkan distribusi spasial tikus positif Leptospira di Kabupaten Boyolali. Penelitian potong lintang dilaksanakan pada bulan April 2014 di Desa Sindon Kecamatan Ngemplak dan Desa …

Measles Immunization And Vitamin A For Prevention Of Pneumonia In Indonesia, Ratno Widoyo

Kesmas

Pneumonia merupakan penyebab kematian tertinggi pada anak di Indonesia setelah diare. Pengendalian pneumonia dapat dilakukan dengan peningkatan cakupan imunisasi campak, pertusis, Streptococcus pneumoniae (Spn), dan Haemophilus influenzae b (Hib). Vaksin Spn dan Hib belum masuk ke dalam kategori imunisasi wajib di Indonesia. Vaksin campak lebih memiliki pengaruh langsung terhadap pneumonia dibandingkan dengan vaksin pertusis. Pemberian imunisasi yang disertai pemberian vitamin A akan meningkatkan titer antibodi pada anak. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian imunisasi campak dan vitamin A terhadap kejadian pneumonia. Metode penelitian adalah potong lintang dengan menggunakan 13.062 data anak yang terdapat pada data Survei Demografi dan Kesehatan …

Role Of Hearth Program With Undernutrition Incidence Among Toddlers In Tangerang City, Gizella Gizella, Dany Hilmanto, Dedi Rachmadi

Kesmas

Kelompok yang rentan terhadap gizi kurang adalah balita. World Health Organization (WHO) menyatakan kematian anak bawah lima tahun (balita) akibat gizi kurang sebesar 54% pada tahun 2002. Di Indonesia, prevalensinya mengalami peningkatan dari 17,9% pada tahun 2010 menjadi 19,6% pada tahun 2013. Di Kota Tangerang, terdapat 1,43% balita yang mengalami gizi buruk pada tahun 2013. Penelitian ini bertujuan untuk membuktikan secara valid hubungan antara Program Pos Gizi yang meliputi perilaku pemberian makan, perilaku kebersihan balita, perilaku mencari pelayanan kesehatan dan perilaku pengasuhan balita dengan kejadian gizi kurang pada balita. Penelitian ini merupakan penelitian kuantitatif, potong lintang, menggunakan data primer serta …

Good Corporate Governance Implementation And Performance Of Civil Servant, Muhammad Hasan, Dumilah Ayuningtyas, Misnaniarti Misnaniarti

Kesmas

Dalam rangka mencapai visi dan misi, setiap rumah sakit harus menjalankan tata kelola perusahaan yang baik (Good Corporate Governance/GCG). Penerapan GCG sendiri bertujuan untuk meningkatkan kinerja pegawai secara optimal, yang akhirnya akan meningkatkan kinerja organisasi. Penelitian ini bertujuan untuk menganalisis hubungan penerapan prinsip-prinsip GCG terhadap kinerja pegawai negeri sipil (PNS) Rumah Sakit Umum Lapangan Natuna Kabupaten Kepulauan Anambas. Jenis penelitian ini adalah deskriptif analitik dengan desain potong lintang pada 56 PNS. Pengumpulan data dilakukan pada tahun 2012 dengan kuesioner terstruktur. Digunakan analisis dengan uji kai kuadrat dan regresi logistik, dan untuk penyederhanaan model dilakukan eliminasi terhadap faktor perancu dengan menggunakan …

Environmental, Behavioral Factors And Filariasis Incidence In Bintan District, Riau Islands Province, Zainul Ikhwan, Lucky Herawati, Suharti Suharti

Kesmas

Tingkat mikrofilaria filariasis di Kabupaten Bintan masih tinggi, khususnya di Kecamatan Teluk Bintan, Teluk Sebong, dan Sri Kuala Lobam. Penelitian ini bertujuan untuk mengetahui hubungan faktor risiko lingkungan (faktor fisik, biologi, kimia, sosial budaya, ekonomi) dan faktor perilaku dengan kejadian filariasis. Jenis penelitian observasional analitik yang dilakukan pada Mei – September 2015 dengan desain kasus kontrol, yang terdiri dari jumlah kasus 33 orang penderita filariasis dan kontrol 65 orang bukan penderita filariasis dengan teknik cluster sampling. Populasi penelitian adalah masyarakat di Kabupaten Bintan. Data yang diperoleh dianalisis menggunakan uji kai kuadrat dan regresi logistik. Hasil menunjukkan adanya hubungan pengetahuan (nilai …

Distance-Based Analysis Of Variance For Brain Connectivity, Russell T. Shinohara, Haochang Shou, Marco Carone, Robert Schultz, Birkan Tunc, Drew Parker, Ragini Verma

UPenn Biostatistics Working Papers

The field of neuroimaging dedicated to mapping connections in the brain is increasingly being recognized as key for understanding neurodevelopment and pathology. Networks of these connections are quantitatively represented using complex structures including matrices, functions, and graphs, which require specialized statistical techniques for estimation and inference about developmental and disorder-related changes. Unfortunately, classical statistical testing procedures are not well suited to high-dimensional testing problems. In the context of global or regional tests for differences in neuroimaging data, traditional analysis of variance (ANOVA) is not directly applicable without first summarizing the data into univariate or low-dimensional features, a process that may …

Diffuse Optical Measurements Of Head And Neck Tumor Hemodynamics For Early Prediction Of Chemoradiation Therapy Outcomes, Lixin Dong, Mahesh Kudrimoti, Daniel Irwin, Li Chen, Sameera Kumar, Yu Shang, Chong Huang, Ellis L. Johnson, Scott D. Stevens, Brent J. Shelton, Guoqiang Yu

Biomedical Engineering Faculty Publications

This study used a hybrid near-infrared diffuse optical instrument to monitor tumor hemodynamic responses to chemoradiation therapy for early prediction of treatment outcomes in patients with head and neck cancer. Forty-seven patients were measured once per week to evaluate the hemodynamic status of clinically involved cervical lymph nodes as surrogates for the primary tumor response. Patients were classified into two groups: complete response (CR) (n = 29) and incomplete response (IR) (n = 18). Tumor hemodynamic responses were found to be associated with clinical outcomes (CR/IR), wherein the associations differed depending on human papillomavirus (HPV-16) status. In HPV-16 …

The Use Of Permutation Tests For The Analysis Of Parallel And Stepped-Wedge Cluster Randomized Trials, Rui Wang, Victor Degruttola

Harvard University Biostatistics Working Paper Series

We investigate the use of permutation tests for the analysis of parallel and stepped-wedge cluster randomized trials. Permutation tests for parallel designs with exponential family endpoints have been extensively studied. The optimal permutation tests developed for exponential family alternatives require information on intraclass correlation, a quantity not yet defined for time-to-event endpoints. Therefore, it is unclear how efficient permutation tests can be constructed for cluster-randomized trials with such endpoints. We consider a class of test statistics formed by a weighted average of pair-specific treatment effect estimates and offer practical guidance on the choice of weights to improve efficiency. We apply …

Improving Precision By Adjusting For Baseline Variables In Randomized Trials With Binary Outcomes, Without Regression Model Assumptions, Jon Arni Steingrimsson, Daniel F. Hanley, Michael Rosenblum

Johns Hopkins University, Dept. of Biostatistics Working Papers

In randomized clinical trials with baseline variables that are prognostic for the primary outcome, there is potential to improve precision and reduce sample size by appropriately adjusting for these variables. A major challenge is that there are multiple statistical methods to adjust for baseline variables, but little guidance on which is best to use in a given context. The choice of method can have important consequences. For example, one commonly used method leads to uninterpretable estimates if there is any treatment effect heterogeneity, which would jeopardize the validity of trial conclusions. We give practical guidance on how to avoid this …

Left And Right Ventricular Dyssynchrony And Strains From Cardiovascular Magnetic Resonance Feature Tracking Do Not Predict Deterioration Of Ventricular Function In Patients With Repaired Tetralogy Of Fallot, Linyuan Jing, Gregory J. Wehner, Jonathan D. Suever, Richard Charnigo, Sudad Alhadad, Evan Stearns, Dimitri Mojsejenko, Christopher M. Haggerty, Kelsey Hickey, Anne Marie Valente, Tal Geva, Andrew J. Powell, Brandon K. Fornwalt

Saha Cardiovascular Research Center Faculty Publications

Background: Patients with repaired tetralogy of Fallot (rTOF) suffer from progressive ventricular dysfunction decades after their surgical repair. We hypothesized that measures of ventricular strain and dyssynchrony would predict deterioration of ventricular function in patients with rTOF.

Methods: A database search identified all patients at a single institution with rTOF who underwent cardiovascular magnetic resonance (CMR) at least twice, > 6 months apart, without intervening surgical or catheter procedures. Seven primary predictors were derived from the first CMR using a custom feature tracking algorithm: left (LV), right (RV) and inter-ventricular dyssynchrony, LV and RV peak global circumferential strains, and LV and …

Mediation Analysis For A Survival Outcome With Time-Varying Exposures, Mediators, And Confounders, Sheng-Hsuan Lin, Jessica G. Young, Roger Logan, Tyler J. Vanderweele

Harvard University Biostatistics Working Paper Series

We propose an approach to conduct mediation analysis for survival data with time-varying exposures, mediators, and confounders. We identify certain interventional direct and indirect effects through a survival mediational g-formula and describe the required assumptions. We also provide a feasible parametric approach along with an algorithm and software to estimate these effects. We apply this method to analyze the Framingham Heart Study data to investigate the causal mechanism of smoking on mortality through coronary artery disease. The risk ratio of smoking 30 cigarettes per day for ten years compared with no smoking on mortality is 2.34 (95 % CI = …

The Impact Of Patient Navigation On The Delivery Of Diagnostic Breast Cancer Care In The National Patient Navigation Research Program: A Prospective Meta-Analysis., Tracy A Battaglia, Julie S Darnell, Naomi Ko, Fred Snyder, Electra D Paskett, Kristen J Wells, Elizabeth M Whitley, Jennifer J Griggs, Anand Karnad, Heather Young, Victoria Warren-Mears, Melissa A Simon, Elizabeth Calhoun

Epidemiology Faculty Publications

Patient navigation is emerging as a standard in breast cancer care delivery, yet multi-site data on the impact of navigation at reducing delays along the continuum of care are lacking. The purpose of this study was to determine the effect of navigation on reaching diagnostic resolution at specific time points after an abnormal breast cancer screening test among a national sample. A prospective meta-analysis estimated the adjusted odds of achieving timely diagnostic resolution at 60, 180, and 365 days. Exploratory analyses were conducted on the pooled sample to identify which groups had the most benefit from navigation. Clinics from six …

Diabetes Is Associated With Cerebrovascular But Not Alzheimer's Disease Neuropathology, Erin L. Abner, Peter T. Nelson, Richard J. Kryscio, Frederick A. Schmitt, David W. Fardo, Randall L. Woltjer, Nigel J. Cairns, Lei Yu, Hiroko H. Dodge, Chengjie Xiong, Kamal Masaki, Suzanne L. Tyas, David A. Bennett, Julie A. Schneider, Zoe Arvanitakis

Sanders-Brown Center on Aging Faculty Publications

INTRODUCTION: The relationship of diabetes to specific neuropathologic causes of dementia is incompletely understood.

METHODS: We used logistic regression to evaluate the association between diabetes and infarcts, Braak neurofibrillary tangle stage, and neuritic plaque score in 2365 autopsied persons. In a subset of >1300 persons with available cognitive data, we examined the association between diabetes and cognition using Poisson regression.

RESULTS: Diabetes increased odds of brain infarcts (odds ratio [OR] = 1.57, P < .0001), specifically lacunes (OR = 1.71, P < .0001), but not Alzheimer's disease neuropathology. Diabetes plus infarcts was associated with lower cognitive scores at end of life than infarcts or diabetes alone, and diabetes plus high level of Alzheimer's neuropathologic changes was associated with lower mini-mental state examination scores than the pathology alone.

DISCUSSION: This study supports the conclusions that diabetes increases the risk of cerebrovascular but not Alzheimer's disease pathology, and at least some of diabetes' relationship to …

Learning From Data: Plant Breeding Applications Of Machine Learning, Alencar Xavier

Open Access Dissertations

Increasingly, new sources of data are being incorporated into plant breeding pipelines. Enormous amounts of data from field phenomics and genotyping technologies places data mining and analysis into a completely different level that is challenging from practical and theoretical standpoints. Intelligent decision-making relies on our capability of extracting from data useful information that may help us to achieve our goals more efficiently. Many plant breeders, agronomists and geneticists perform analyses without knowing relevant underlying assumptions, strengths or pitfalls of the employed methods. The study endeavors to assess statistical learning properties and plant breeding applications of supervised and unsupervised machine learning …

Multilevel Models For Longitudinal Data, Aastha Khatiwada

Electronic Theses and Dissertations

Longitudinal data arise when individuals are measured several times during an ob- servation period and thus the data for each individual are not independent. There are several ways of analyzing longitudinal data when different treatments are com- pared. Multilevel models are used to analyze data that are clustered in some way. In this work, multilevel models are used to analyze longitudinal data from a case study. Results from other more commonly used methods are compared to multilevel models. Also, comparison in output between two software, SAS and R, is done. Finally a method consisting of fitting individual models for each …

Propensity Score Based Methods For Estimating The Treatment Effects Based On Observational Studies., Younathan Abdia

Electronic Theses and Dissertations

This dissertation consists of two interconnected research projects. The first project was a study of propensity scores based statistical methods for estimating the average treatment effect (ATE) and the average treatment effect among treated (ATT) when there are two treatment groups. The ATE is defined as the mean of the individual causal effects in the whole population, while ATT is defined as the treatment effect for the treated population. Propensity score based statistical methods, such as matching, regression, stratification, inverse probability weighting (IPW), and doubly robust (DR) methods were used to estimate the ATE and ATT. Simulation studies and case …

Apoe Ε4 Allele Modifies The Association Of Lead Exposure With Age-Related Cognitive Decline In Older Individuals, Diddier Prada, Elena Colicino, Melinda C. Power, Marc G Weisskopf, Jia Zhong, Lifang Hou, Avron Spiro, Pantel Vokonas, Plus 4 Others...

Epidemiology Faculty Publications

BACKGROUND: Continuing chronic and sporadic high-level of lead exposure in some regions in the U.S. has directed public attention to the effects of lead on human health. Long-term lead exposure has been associated with faster cognitive decline in older individuals; however, genetic susceptibility to lead-related cognitive decline during aging has been poorly studied.

METHODS: We determined the interaction of APOE-epsilon variants and environmental lead exposure in relation to age-related cognitive decline. We measured tibia bone lead by K-shell-x-ray fluorescence, APOE-epsilon variants by multiplex PCR and global cognitive z-scores in 489 men from the VA-Normative Aging Study. To determine global cognitive …

Retention Of Mothers And Infants In The Prevention Of Mother-To-Child Transmission Of Hiv Programme Is Associated With Individual And Facility-Level Factors In Rwanda., Godfrey B Woelk, Dieudonne Ndatimana, Sally Behan, Martha Mukaminega, Epiphanie Nyirabahizi, Heather J. Hoffman, Placidie Mugwaneza, Muhayimpundu Ribakare, Anouk Amzel, B Ryan Phelps

Epidemiology Faculty Publications

OBJECTIVES: Investigate levels of retention at specified time periods along the prevention of mother-to-child transmission (PMTCT) cascade among mother-infant pairs as well as individual- and facility-level factors associated with retention.

METHODS: A retrospective cohort of HIV-positive pregnant women and their infants attending five health centres from November 2010 to February 2012 in the Option B programme in Rwanda was established. Data were collected from several health registers and patient follow-up files. Additionally, informant interviews were conducted to ascertain health facility characteristics. Generalized estimating equation methods and modelling were utilized to estimate the number of mothers attending each antenatal care visit …