Biostatistics Commons^™

Determinan Stres Pada Pegawai Kementerian Kesehatan Republik Indonesia, Besral Besral, Winne Widiantini

Kesmas

Kejadian stres pada pelbagai kelompok di Indonesia cukup tinggi dan belum banyak diketahui determinannya. Penelitian ini bertujuan untuk mengetahui determinan stres pada pegawai Kementerian Kesehatan Republik Indonesia (Kemenkes RI). Penelitian potong lintang ini dilakukan pada tahun 2013 terhadap 230 pegawai sekretariat jenderal yang dipilih secara acak. Analisis statistik menggunakan regresi logistik ganda. Responden dikatakan stres jika memiliki skor 28 atau lebih dengan menggunakan 17 pertanyaan terkait personal stress inventory. Hasil penelitian menunjukkan prevalensi stres sebesar 79% dan determinan stres adalah obesitas, usia, jabatan, suku, pendidikan, dan aktivitas fisik. Risiko stres lebih tinggi pada pegawai yang obesitas (ORadj = 1,9), pegawai …

Bioindikator Cemaran Timbal Pada Rambut Masyarakat Sekitar Kilang Minyak, Sukar Sukar, Suharjo Suharjo

Kesmas

Timbal atau Plumbum (Pb) bersifat toksik, karsinogenik, bioakumulator dan biomagnifikasi. Bioakumulasi Timbal dari media lingkungan dapat terjadi pada kuku, hati, dan rambut. Tujuan penelitian untuk mengetahui faktor risiko kejadian bioindikator timbal rambut masyarakat di kawasan industri minyak. Penelitian dilakukan pada tahun 2012 di Kota Dumai, Provinsi Riau. Rancangan penelitian khusus pencemaran lingkungan 2012 adalah type- 1 health study, yang disarankan US Agency for Toxic Substances and Drugs Registry (ATSDR). Analisis statistik bivariat dengan uji kai kuadrat. Populasi penelitian adalah penduduk Kota Dumai yang tinggal di desa Jayamukti, Tanjung Palas, Mekarsari, dan Bukit Timah. Sejumlah 110 ibu rumah tangga diambil dengan …

Efektivitas Air Perasan Kulit Jeruk Manis Sebagai Larvasida Nyamuk Aedes Aegypti, Dita Nurhaifah, Tri Wahyuni Sukesi

Kesmas

Demam berdarah dengue ditularkan nyamuk Aedes aegypti yang dapat dicegah dengan temefos. Penggunaan yang berkelanjutan berdampak pada resistensi nyamuk dan kerusakan lingkungan. Untuk itu perlu larvasida alami dengan menggunakan air perasan kulit jeruk manis. Tujuan penelitian untuk membuktikan efektivitas air perasan kulit jeruk manis dalam membunuh larva uji dilihat dari nilai LC50 dan LT50 serta perbedaan efektivitasnya dengan temefos. Sampel 25 larva Aedes aegypti setiap gelas media dengan kriteria inklusi instar III yang aktif dan kriteria eksklusi larva instar I, II dan yang telah menjadi pupa/mati. Larva uji diamati selama 24 jam dengan tiga kali pengulangan. Desain penelitian adalah eksperimental …

Protein Sectors: Statistical Coupling Analysis Versus Conservation, Tiberiu Teşileanu, Lucy J. Colwell, Stanislas Leibler

Publications and Research

Statistical coupling analysis (SCA) is a method for analyzing multiple sequence alignments that was used to identify groups of coevolving residues termed “sectors”. The method applies spectral analysis to a matrix obtained by combining correlation information with sequence conservation. It has been asserted that the protein sectors identified by SCA are functionally significant, with different sectors controlling different biochemical properties of the protein. Here we reconsider the available experimental data and note that it involves almost exclusively proteins with a single sector. We show that in this case sequence conservation is the dominating factor in SCA, and can alone be …

Risk Of Gastrointestinal Bleeding Associated With Oral Anticoagulants: Population Based Retrospective Cohort Study, Hsien-Yen Chang, Meijia Zhou, Wenze Tang, G. Caleb Alexander, Sonal Singh

Epidemiology Faculty Publications

Objectives To determine the real world safety of dabigatran or rivaroxaban compared with warfarin in terms of gastrointestinal bleeding.

Design Retrospective cohort study.

Setting Large administrative database of commercially insured people in United States from 1 October 2010 through 31 March 2012.

Participants Enrollees with a prescription of warfarin, dabigatran, or rivaroxaban between 1 October 2010 and 31 March 2012, who were aged 18 years or older, had continuous enrollment and no oral anticoagulant use during the six months before the entry date, with known age and sex, and with no gastrointestinal bleeding for at least six months before the …

Optimal Dynamic Treatments In Resource-Limited Settings, Alexander R. Luedtke, Mark J. Van Der Laan

U.C. Berkeley Division of Biostatistics Working Paper Series

A dynamic treatment rule (DTR) is a treatment rule which assigns treatments to individuals based on (a subset of) their measured covariates. An optimal DTR is the DTR which maximizes the population mean outcome. Previous works in this area have assumed that treatment is an unlimited resource so that the entire population can be treated if this strategy maximizes the population mean outcome. We consider optimal DTRs in settings where the treatment resource is limited so that there is a maximum proportion of the population which can be treated. We give a general closed-form expression for an optimal stochastic DTR …

Applying Multiple Imputation For External Calibration To Propensty Score Analysis, Yenny Webb-Vargas, Kara E. Rudolph, D. Lenis, Peter Murakami, Elizabeth A. Stuart

Johns Hopkins University, Dept. of Biostatistics Working Papers

Although covariate measurement error is likely the norm rather than the exception, methods for handling covariate measurement error in propensity score methods have not been widely investigated. We consider a multiple imputation-based approach that uses an external calibration sample with information on the true and mismeasured covariates, Multiple Imputation for External Calibration (MI-EC), to correct for the measurement error, and investigate its performance using simulation studies. As expected, using the covariate measured with error leads to bias in the treatment effect estimate. In contrast, the MI-EC method can eliminate almost all the bias. We confirm that the outcome must be …

Adaptive, Group Sequential Designs That Balance The Benefits And Risks Of Wider Inclusion Criteria, Michael Rosenblum, Brandon S. Luber, Richard E. Thompson, Daniel F. Hanley

Johns Hopkins University, Dept. of Biostatistics Working Papers

We propose a new class of adaptive randomized trial designs aimed at gaining the advantages of wider generalizability and faster recruitment, while mitigating the risks of including a population for which there is greater a priori uncertainty. Our designs use adaptive enrichment, i.e., they have preplanned decision rules for modifying enrollment criteria based on data accrued at interim analyses. For example, enrollment can be restricted if the participants from predefined subpopulations are not benefiting from the new treatment. To the best of our knowledge, our designs are the first adaptive enrichment designs to have all of the following features: the …

Inferential Methods To Assess The Difference In The Area Under The Curve From Nested Binary Regression Models, Glenn Heller, Venkatraman E. Seshan, Chaya S. Moskowitz, Mithat Gonen

Memorial Sloan-Kettering Cancer Center, Dept. of Epidemiology & Biostatistics Working Paper Series

The area under the curve (AUC) is the most common statistical approach to evaluate the discriminatory power of a set of factors in a binary regression model. A nested model framework is used to ascertain whether the AUC increases when new factors enter the model. Two statistical tests are proposed for the difference in the AUC parameters from these nested models. The asymptotic null distributions for the two test statistics are derived from the scenarios: (A) the difference in the AUC parameters is zero and the new factors are not associated with the binary outcome, (B) the difference in the …

Association Between Respiratory Syncytial Virus Activity And Pneumococcal Disease In Infants: A Time Series Analysis Of Us Hospitalization Data., Daniel M. Weinberger, Keith P. Klugman, Claudia A. Steiner, Lone Simonsen, Cécile Viboud

Epidemiology Faculty Publications

BACKGROUND:

The importance of bacterial infections following respiratory syncytial virus (RSV) remains unclear. We evaluated whether variations in RSV epidemic timing and magnitude are associated with variations in pneumococcal disease epidemics and whether changes in pneumococcal disease following the introduction of seven-valent pneumococcal conjugate vaccine (PCV7) were associated with changes in the rate of hospitalizations coded as RSV.

METHODS AND FINDINGS:

We used data from the State Inpatient Databases (Agency for Healthcare Research and Quality), including >700,000 RSV hospitalizations and >16,000 pneumococcal pneumonia hospitalizations in 36 states (1992/1993-2008/2009). Harmonic regression was used to estimate the timing of the average seasonal …

Variable Selection With False Discovery Control, Kevin He, Yanming Li, Ji Zhu, Hongliang Liu, Jeffrey E. Lee, Christopher I. Amos, Terry Hyslop, Jiashun Jin, Qinyi Wei, Yi Li

The University of Michigan Department of Biostatistics Working Paper Series

Technological advances that allow routine identification of high-dimensional risk factors have led to high demand for statistical techniques that enable full utilization of these rich sources of information for genome-wide association studies (GWAS). Variable selection for censored outcome data as well as control of false discoveries (i.e. inclusion of irrelevant variables) in the presence of high-dimensional predictors present serious challenges. In the context of survival analysis with high-dimensional covariates, this paper develops a computationally feasible method for building general risk prediction models, while controlling false discoveries. We have proposed a high-dimensional variable selection method by incorporating stability selection to control …

Tests For Gene-Environment Interactions And Joint Effects With Exposure Misclassification, Philip S. Boonstra, Bhramar Mukherjee, Stephen B. Gruber, Jaeil Ahn, Stephanie L. Schmit, Nilanjan Chatterjee

The University of Michigan Department of Biostatistics Working Paper Series

The number of methods for genome-wide testing of gene-environment interactions (GEI) continues to increase with the hope of discovering new genetic risk factors and obtaining insight into the disease-gene-environment relationship. The relative performance of these methods based on family-wise type 1 error rate and power depends on underlying disease-gene-environment associations, estimates of which may be biased in the presence of exposure misclassification. This simulation study expands on a previously published simulation study of methods for detecting GEI by evaluating the impact of exposure misclassification. We consider seven single step and modular screening methods for identifying GEI at a genome-wide level …

A History Of Undergraduate Education For Public Health: From Behind The Scenes To Center Stage., Richard Kenneth Riegelman, Susan Albertine, Randy Wykoff

GW Biostatistics Center

No abstract provided.

Scaling Down To Scale Up: A Health Economic Analysis Of Integrating Point-Of-Care Syphilis Testing Into Antenatal Care In Zambia During Pilot And National Rollout Implementation., Katharine D. Shelley, Éimhín M. Ansbro, Alexander Tshaka Ncube, Sedona Sweeney, Colette Fleischer, Grace Tembo Mumba, Michelle M. Gill, Susan Strasser, Rosanna W. Peeling, Fern Terris-Prestholt

GW Biostatistics Center

Maternal syphilis results in an estimated 500,000 stillbirths and neonatal deaths annually in Sub-Saharan Africa. Despite the existence of national guidelines for antenatal syphilis screening, syphilis testing is often limited by inadequate laboratory and staff services. Recent availability of inexpensive rapid point-of-care syphilis tests (RST) can improve access to antenatal syphilis screening. A 2010 pilot in Zambia explored the feasibility of integrating RST within prevention of mother-to-child-transmission of HIV services. Following successful demonstration, the Zambian Ministry of Health adopted RSTs into national policy in 2011. Cost data from the pilot and 2012 preliminary national rollout were extracted from project records, …

Treatment-Induced Changes In Plasma Adiponectin Do Not Reduce Urinary Albumin Excretion In The Diabetes Prevention Program Cohort., Kieren J. Mather, Qing Pan, William C. Knowler, Tohru Funahashi, George A. Bray, Et Al.

GW Biostatistics Center

BACKGROUND AND OBJECTIVES: Molecular data suggests that adiponectin may directly regulate urinary albumin excretion. In the Diabetes Prevention Program (DPP) we measured adiponectin and albuminuria before and after intervention, and we previously reported increases in adiponectin with interventions. Here we have used the DPP dataset to test the hypothesis that treatment-related increases in adiponectin may reduce albuminuria in obesity.

DESIGN, SETTING, PARTICIPANTS AND METHODS: We evaluated cross-sectional correlations between plasma adiponectin and urinary albumin excretion at baseline, and the relationship of treatment-related changes in adiponectin and albuminuria. Baseline and follow-up urine albumin to creatinine ratios (ACR (albumin to creatinine ratio)) …

The Cost-Effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study, William H. Herman

GW Biostatistics Center

Background

The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle …

Skin Collagen Advanced Glycation Endproducts (Ages) And The Long-Term Progression Of Sub-Clinical Cardiovascular Disease In Type 1 Diabetes, Vincent M. Monnier, Wanjie Sun, Xiaoyu Gao, David R. Sell, Patricia Cleary, John M. Lachin, Saul Genuth, The Dcct/Edic Research Group

GW Biostatistics Center

BACKGROUND:

We recently reported strong associations between eight skin collagen AGEs and two solubility markers from skin biopsies obtained at DCCT study closeout and the long-term progression of microvascular disease in EDIC, despite adjustment for mean glycemia. Herein we investigated the hypothesis that some of these AGEs (fluorescence to be reported elsewhere) correlate with long-term subclinical cardiovascular disease (CVD) measurements, i.e. coronary artery calcium score (CAC) at EDIC year 7-9 (n = 187), change of carotid intima-media thickness (IMT) from EDIC year 1 to year 6 and 12 (n = 127), and cardiac MRI outcomes at EDIC year 15-16 (n …

Quality Control Measures Over 30 Years In A Multicenter Clinical Study: Results From The Diabetes Control And Complications Trial / Epidemiology Of Diabetes Interventions And Complications (Dcct/Edic) Study., Gayle M Lorenzi, Barbara H Braffett, Valerie L Arends, Ronald P Danis, Lisa Diminick, Kandace A Klumpp, Anthony D Morrison, Elsayed Z Soliman, Michael W Steffes, Patricia A Cleary

GW Biostatistics Center

No abstract provided.

The Cost-Effectiveness Of Diabetes Prevention: Results From The Diabetes Prevention Program And The Diabetes Prevention Program Outcomes Study, William Herman

GW Biostatistics Center

Background

The Diabetes Prevention Program (DPP) was a randomized, controlled clinical trial. It demonstrated that among high-risk individuals with impaired glucose tolerance, diabetes incidence was reduced by 58 % with lifestyle intervention and 31 % with metformin compared to placebo. During the Diabetes Prevention Program Outcomes Study (DPPOS), all DPP participants were unmasked to their treatment assignments, the original lifestyle intervention group was offered additional lifestyle support, the metformin group continued metformin, and all three groups were offered a group-implemented lifestyle intervention. Over the 10 years of combined DPP/DPPOS follow-up, diabetes incidence was reduced by 34 % in the lifestyle …

Pregnant And Postpartum Women’S Experiences And Perspectives On The Acceptability And Feasibility Of Copackaged Medicine For Antenatal Care And Pmtct In Lesotho, Michelle M. Gill, Heather J. Hoffman, Appolinaire Tiam, Florence M. Mohai, Mokone Majoalane, Anthony Isavwa, Laura Guay, +4 Additional Authors

Epidemiology Faculty Publications

Objective. To improve PMTCT and antenatal care-related service delivery, a pack with centrally prepackaged medicine was rolled out to all pregnant women in Lesotho in 2011. This study assessed acceptability and feasibility of this copackaging mechanism for drug delivery among pregnant and postpartum women.

Methods. Acceptability and feasibility were assessed in a mixed method, cross-sectional study through structured interviews (SI) and semistructured interviews (SSI) conducted in 2012 and 2013.

Results. 290 HIV-negative women and 437 HIV-positive women (n=727) participated. Nearly all SI participants found prepackaged medicines acceptable, though modifications such as size reduction of the pack were …