Data mining of tree-based models to analyze freeway accident frequency.

PubMed

Chang, Li-Yen; Chen, Wen-Chieh

2005-01-01

Statistical models, such as Poisson or negative binomial regression models, have been employed to analyze vehicle accident frequency for many years. However, these models have their own model assumptions and pre-defined underlying relationship between dependent and independent variables. If these assumptions are violated, the model could lead to erroneous estimation of accident likelihood. Classification and Regression Tree (CART), one of the most widely applied data mining techniques, has been commonly employed in business administration, industry, and engineering. CART does not require any pre-defined underlying relationship between target (dependent) variable and predictors (independent variables) and has been shown to be a powerful tool, particularly for dealing with prediction and classification problems. This study collected the 2001-2002 accident data of National Freeway 1 in Taiwan. A CART model and a negative binomial regression model were developed to establish the empirical relationship between traffic accidents and highway geometric variables, traffic characteristics, and environmental factors. The CART findings indicated that the average daily traffic volume and precipitation variables were the key determinants for freeway accident frequencies. By comparing the prediction performance between the CART and the negative binomial regression models, this study demonstrates that CART is a good alternative method for analyzing freeway accident frequencies. By comparing the prediction performance between the CART and the negative binomial regression models, this study demonstrates that CART is a good alternative method for analyzing freeway accident frequencies.

Comparison of multiplicity distributions to the negative binomial distribution in muon-proton scattering

NASA Astrophysics Data System (ADS)

Arneodo, M.; Arvidson, A.; Aubert, J. J.; Badełek, B.; Beaufays, J.; Bee, C. P.; Benchouk, C.; Berghoff, G.; Bird, I.; Blum, D.; Böhm, E.; de Bouard, X.; Brasse, F. W.; Braun, H.; Broll, C.; Brown, S.; Brück, H.; Calen, H.; Chima, J. S.; Ciborowski, J.; Clifft, R.; Coignet, G.; Combley, F.; Coughlan, J.; D'Agostini, G.; Dahlgren, S.; Dengler, F.; Derado, I.; Dreyer, T.; Drees, J.; Düren, M.; Eckardt, V.; Edwards, A.; Edwards, M.; Ernst, T.; Eszes, G.; Favier, J.; Ferrero, M. I.; Figiel, J.; Flauger, W.; Foster, J.; Ftáčnik, J.; Gabathuler, E.; Gajewski, J.; Gamet, R.; Gayler, J.; Geddes, N.; Grafström, P.; Grard, F.; Haas, J.; Hagberg, E.; Hasert, F. J.; Hayman, P.; Heusse, P.; Jaffré, M.; Jachołkowska, A.; Janata, F.; Jancsó, G.; Johnson, A. S.; Kabuss, E. M.; Kellner, G.; Korbel, V.; Krüger, J.; Kullander, S.; Landgraf, U.; Lanske, D.; Loken, J.; Long, K.; Maire, M.; Malecki, P.; Manz, A.; Maselli, S.; Mohr, W.; Montanet, F.; Montgomery, H. E.; Nagy, E.; Nassalski, J.; Norton, P. R.; Oakham, F. G.; Osborne, A. M.; Pascaud, C.; Pawlik, B.; Payre, P.; Peroni, C.; Peschel, H.; Pessard, H.; Pettinghale, J.; Pietrzyk, B.; Pietrzyk, U.; Pönsgen, B.; Pötsch, M.; Renton, P.; Ribarics, P.; Rith, K.; Rondio, E.; Sandacz, A.; Scheer, M.; Schlagböhmer, A.; Schiemann, H.; Schmitz, N.; Schneegans, M.; Schneider, A.; Scholz, M.; Schröder, T.; Schultze, K.; Sloan, T.; Stier, H. E.; Studt, M.; Taylor, G. N.; Thénard, J. M.; Thompson, J. C.; de La Torre, A.; Toth, J.; Urban, L.; Urban, L.; Wallucks, W.; Whalley, M.; Wheeler, S.; Williams, W. S. C.; Wimpenny, S. J.; Windmolders, R.; Wolf, G.

1987-09-01

The multiplicity distributions of charged hadrons produced in the deep inelastic muon-proton scattering at 280 GeV are analysed in various rapidity intervals, as a function of the total hadronic centre of mass energy W ranging from 4 20 GeV. Multiplicity distributions for the backward and forward hemispheres are also analysed separately. The data can be well parameterized by binomial distributions, extending their range of applicability to the case of lepton-proton scattering. The energy and the rapidity dependence of the parameters is presented and a smooth transition from the negative binomial distribution via Poissonian to the ordinary binomial is observed.

Comparison of robustness to outliers between robust poisson models and log-binomial models when estimating relative risks for common binary outcomes: a simulation study.

PubMed

Chen, Wansu; Shi, Jiaxiao; Qian, Lei; Azen, Stanley P

2014-06-26

To estimate relative risks or risk ratios for common binary outcomes, the most popular model-based methods are the robust (also known as modified) Poisson and the log-binomial regression. Of the two methods, it is believed that the log-binomial regression yields more efficient estimators because it is maximum likelihood based, while the robust Poisson model may be less affected by outliers. Evidence to support the robustness of robust Poisson models in comparison with log-binomial models is very limited. In this study a simulation was conducted to evaluate the performance of the two methods in several scenarios where outliers existed. The findings indicate that for data coming from a population where the relationship between the outcome and the covariate was in a simple form (e.g. log-linear), the two models yielded comparable biases and mean square errors. However, if the true relationship contained a higher order term, the robust Poisson models consistently outperformed the log-binomial models even when the level of contamination is low. The robust Poisson models are more robust (or less sensitive) to outliers compared to the log-binomial models when estimating relative risks or risk ratios for common binary outcomes. Users should be aware of the limitations when choosing appropriate models to estimate relative risks or risk ratios.

Cocoa Farmers’ Compliance with Safety Precautions in Spraying Agrochemicals and Use of Personal Protective Equipment (PPE) in Cameroon

PubMed Central

2018-01-01

The inability of farmers to comply with essential precautions in the course of spraying agrochemicals remains a policy dilemma, especially in developing countries. The objectives of this paper were to assess compliance of cocoa farmers with agrochemical safety measures, analyse the factors explaining involvement of cocoa farmers in the practice of reusing agrochemical containers and wearing of personal protective equipment (PPE). Data were collected with structured questionnaires from 667 cocoa farmers from the Centre and South West regions in Cameroon. Data analyses were carried out with Probit regression and Negative Binomial regression models. The results showed that average cocoa farm sizes were 3.55 ha and 2.82 ha in South West and Centre regions, respectively, and 89.80% and 42.64% complied with manufacturers’ instructions in the use of insecticides. Eating or drinking while spraying insecticides and fungicides was reported by 4.20% and 5.10% of all farmers in the two regions, respectively. However, 37.78% and 57.57% of all farmers wore hand gloves and safety boots while spraying insecticides in the South West and Centre regions of Cameroon, respectively. In addition, 7.80% of all the farmers would wash agrochemical containers and use them at home, while 42.43% would wash and use them on their farms. Probit regression results showed that probability of reusing agrochemical containers was significantly influenced (p < 0.05) by region of residence of cocoa farmers, gender, possession of formal education and farming as primary occupation. The Negative Binomial regression results showed that the log of number PPE worn was significantly influenced (p < 0.10) by region, marital status, attainment of formal education, good health, awareness of manufacturers’ instructions, land area and contact index. It was among others concluded that efforts to train farmers on the need to be familiar with manufacturers’ instructions and use PPE would enhance their safety in the course of spraying agrochemicals. PMID:29438333

Cocoa Farmers' Compliance with Safety Precautions in Spraying Agrochemicals and Use of Personal Protective Equipment (PPE) in Cameroon.

PubMed

Oyekale, Abayomi Samuel

2018-02-13

The inability of farmers to comply with essential precautions in the course of spraying agrochemicals remains a policy dilemma, especially in developing countries. The objectives of this paper were to assess compliance of cocoa farmers with agrochemical safety measures, analyse the factors explaining involvement of cocoa farmers in the practice of reusing agrochemical containers and wearing of personal protective equipment (PPE). Data were collected with structured questionnaires from 667 cocoa farmers from the Centre and South West regions in Cameroon. Data analyses were carried out with Probit regression and Negative Binomial regression models. The results showed that average cocoa farm sizes were 3.55 ha and 2.82 ha in South West and Centre regions, respectively, and 89.80% and 42.64% complied with manufacturers' instructions in the use of insecticides. Eating or drinking while spraying insecticides and fungicides was reported by 4.20% and 5.10% of all farmers in the two regions, respectively. However, 37.78% and 57.57% of all farmers wore hand gloves and safety boots while spraying insecticides in the South West and Centre regions of Cameroon, respectively. In addition, 7.80% of all the farmers would wash agrochemical containers and use them at home, while 42.43% would wash and use them on their farms. Probit regression results showed that probability of reusing agrochemical containers was significantly influenced ( p < 0.05) by region of residence of cocoa farmers, gender, possession of formal education and farming as primary occupation. The Negative Binomial regression results showed that the log of number PPE worn was significantly influenced ( p < 0.10) by region, marital status, attainment of formal education, good health, awareness of manufacturers' instructions, land area and contact index. It was among others concluded that efforts to train farmers on the need to be familiar with manufacturers' instructions and use PPE would enhance their safety in the course of spraying agrochemicals.

Choosing a Transformation in Analyses of Insect Counts from Contagious Distributions with Low Means

Treesearch

W.D. Pepper; S.J. Zarnoch; G.L. DeBarr; P. de Groot; C.D. Tangren

1997-01-01

Guidelines based on computer simulation are suggested for choosing a transformation of insect counts from negative binomial distributions with low mean counts and high levels of contagion. Typical values and ranges of negative binomial model parameters were determined by fitting the model to data from 19 entomological field studies. Random sampling of negative binomial...

A Model Comparison for Count Data with a Positively Skewed Distribution with an Application to the Number of University Mathematics Courses Completed

ERIC Educational Resources Information Center

Liou, Pey-Yan

2009-01-01

The current study examines three regression models: OLS (ordinary least square) linear regression, Poisson regression, and negative binomial regression for analyzing count data. Simulation results show that the OLS regression model performed better than the others, since it did not produce more false statistically significant relationships than…

Population heterogeneity in the salience of multiple risk factors for adolescent delinquency.

PubMed

Lanza, Stephanie T; Cooper, Brittany R; Bray, Bethany C

2014-03-01

To present mixture regression analysis as an alternative to more standard regression analysis for predicting adolescent delinquency. We demonstrate how mixture regression analysis allows for the identification of population subgroups defined by the salience of multiple risk factors. We identified population subgroups (i.e., latent classes) of individuals based on their coefficients in a regression model predicting adolescent delinquency from eight previously established risk indices drawn from the community, school, family, peer, and individual levels. The study included N = 37,763 10th-grade adolescents who participated in the Communities That Care Youth Survey. Standard, zero-inflated, and mixture Poisson and negative binomial regression models were considered. Standard and mixture negative binomial regression models were selected as optimal. The five-class regression model was interpreted based on the class-specific regression coefficients, indicating that risk factors had varying salience across classes of adolescents. Standard regression showed that all risk factors were significantly associated with delinquency. Mixture regression provided more nuanced information, suggesting a unique set of risk factors that were salient for different subgroups of adolescents. Implications for the design of subgroup-specific interventions are discussed. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Factors Associated with Dental Caries in a Group of American Indian Children at age 36 Months

PubMed Central

Warren, John J.; Blanchette, Derek; Dawson, Deborah V.; Marshall, Teresa A.; Phipps, Kathy R.; Starr, Delores; Drake, David R.

2015-01-01

Objectives Early childhood caries (ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This paper reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study. Methods Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28 and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary and behavioral factors. Non-parametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts). Results Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only non-cavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant (p<0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts. Conclusions By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size and maternal factors, but further analyses are needed to better understand caries in this population. PMID:26544674

Plant selection for ethnobotanical uses on the Amalfi Coast (Southern Italy).

PubMed

Savo, V; Joy, R; Caneva, G; McClatchey, W C

2015-07-15

Many ethnobotanical studies have investigated selection criteria for medicinal and non-medicinal plants. In this paper we test several statistical methods using different ethnobotanical datasets in order to 1) define to which extent the nature of the datasets can affect the interpretation of results; 2) determine if the selection for different plant uses is based on phylogeny, or other selection criteria. We considered three different ethnobotanical datasets: two datasets of medicinal plants and a dataset of non-medicinal plants (handicraft production, domestic and agro-pastoral practices) and two floras of the Amalfi Coast. We performed residual analysis from linear regression, the binomial test and the Bayesian approach for calculating under-used and over-used plant families within ethnobotanical datasets. Percentages of agreement were calculated to compare the results of the analyses. We also analyzed the relationship between plant selection and phylogeny, chorology, life form and habitat using the chi-square test. Pearson's residuals for each of the significant chi-square analyses were examined for investigating alternative hypotheses of plant selection criteria. The three statistical analysis methods differed within the same dataset, and between different datasets and floras, but with some similarities. In the two medicinal datasets, only Lamiaceae was identified in both floras as an over-used family by all three statistical methods. All statistical methods in one flora agreed that Malvaceae was over-used and Poaceae under-used, but this was not found to be consistent with results of the second flora in which one statistical result was non-significant. All other families had some discrepancy in significance across methods, or floras. Significant over- or under-use was observed in only a minority of cases. The chi-square analyses were significant for phylogeny, life form and habitat. Pearson's residuals indicated a non-random selection of woody species for non-medicinal uses and an under-use of plants of temperate forests for medicinal uses. Our study showed that selection criteria for plant uses (including medicinal) are not always based on phylogeny. The comparison of different statistical methods (regression, binomial and Bayesian) under different conditions led to the conclusion that the most conservative results are obtained using regression analysis.

The effect of consumers’ perception to the satisfaction of use of traditional medicines in Medan

NASA Astrophysics Data System (ADS)

Siregar, R. S.; Supriana, T.; Haryanti, S.

2018-02-01

Consumption of chemical medicines fluctuated in 2009-2014, whereas the consumption of solid traditional medicine increased in 2009-2014. The purpose of this study is to analyse the influence of consumers’s perception on the consumption of traditional medicinal plants. The data was analysed by using a binomial logit regression analysis. It is found that the consumers’s perceptions affect customer satisfaction simultaneously are the health benefits variable, quality of traditional medicine variable, price of traditional medicine and available product; the health benefits variable and quality of traditional medicine variable partially have significant effects to customers’s satisfaction simultaneously satisfaction partially; the health benefit variable and quality of traditional medicine is found to have a marginal effect of 7% and 4%, respectively.

Zero adjusted models with applications to analysing helminths count data.

PubMed

Chipeta, Michael G; Ngwira, Bagrey M; Simoonga, Christopher; Kazembe, Lawrence N

2014-11-27

It is common in public health and epidemiology that the outcome of interest is counts of events occurrence. Analysing these data using classical linear models is mostly inappropriate, even after transformation of outcome variables due to overdispersion. Zero-adjusted mixture count models such as zero-inflated and hurdle count models are applied to count data when over-dispersion and excess zeros exist. Main objective of the current paper is to apply such models to analyse risk factors associated with human helminths (S. haematobium) particularly in a case where there's a high proportion of zero counts. The data were collected during a community-based randomised control trial assessing the impact of mass drug administration (MDA) with praziquantel in Malawi, and a school-based cross sectional epidemiology survey in Zambia. Count data models including traditional (Poisson and negative binomial) models, zero modified models (zero inflated Poisson and zero inflated negative binomial) and hurdle models (Poisson logit hurdle and negative binomial logit hurdle) were fitted and compared. Using Akaike information criteria (AIC), the negative binomial logit hurdle (NBLH) and zero inflated negative binomial (ZINB) showed best performance in both datasets. With regards to zero count capturing, these models performed better than other models. This paper showed that zero modified NBLH and ZINB models are more appropriate methods for the analysis of data with excess zeros. The choice between the hurdle and zero-inflated models should be based on the aim and endpoints of the study.

Statistical methods for the beta-binomial model in teratology.

PubMed Central

Yamamoto, E; Yanagimoto, T

1994-01-01

The beta-binomial model is widely used for analyzing teratological data involving littermates. Recent developments in statistical analyses of teratological data are briefly reviewed with emphasis on the model. For statistical inference of the parameters in the beta-binomial distribution, separation of the likelihood introduces an likelihood inference. This leads to reducing biases of estimators and also to improving accuracy of empirical significance levels of tests. Separate inference of the parameters can be conducted in a unified way. PMID:8187716

Binomial outcomes in dataset with some clusters of size two: can the dependence of twins be accounted for? A simulation study comparing the reliability of statistical methods based on a dataset of preterm infants.

PubMed

Sauzet, Odile; Peacock, Janet L

2017-07-20

The analysis of perinatal outcomes often involves datasets with some multiple births. These are datasets mostly formed of independent observations and a limited number of clusters of size two (twins) and maybe of size three or more. This non-independence needs to be accounted for in the statistical analysis. Using simulated data based on a dataset of preterm infants we have previously investigated the performance of several approaches to the analysis of continuous outcomes in the presence of some clusters of size two. Mixed models have been developed for binomial outcomes but very little is known about their reliability when only a limited number of small clusters are present. Using simulated data based on a dataset of preterm infants we investigated the performance of several approaches to the analysis of binomial outcomes in the presence of some clusters of size two. Logistic models, several methods of estimation for the logistic random intercept models and generalised estimating equations were compared. The presence of even a small percentage of twins means that a logistic regression model will underestimate all parameters but a logistic random intercept model fails to estimate the correlation between siblings if the percentage of twins is too small and will provide similar estimates to logistic regression. The method which seems to provide the best balance between estimation of the standard error and the parameter for any percentage of twins is the generalised estimating equations. This study has shown that the number of covariates or the level two variance do not necessarily affect the performance of the various methods used to analyse datasets containing twins but when the percentage of small clusters is too small, mixed models cannot capture the dependence between siblings.

Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts

PubMed Central

Preisser, John S.; Long, D. Leann; Stamm, John W.

2017-01-01

Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two datasets, one consisting of fictional dmft counts in two groups and the other on DMFS among schoolchildren from a randomized clinical trial (RCT) comparing three toothpaste formulations to prevent incident dental caries, are analysed with negative binomial hurdle (NBH), zero-inflated negative binomial (ZINB), and marginalized zero-inflated negative binomial (MZINB) models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the RCT were similar despite their distinctive interpretations. Choice of statistical model class should match the study’s purpose, while accounting for the broad decline in children’s caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. PMID:28291962

Dental enamel defects, caries experience and oral health-related quality of life: a cohort study.

PubMed

Arrow, P

2017-06-01

The impact of enamel defects of the first permanent molars on caries experience and child oral health-related quality of life was evaluated in a cohort study. Children who participated in a study of enamel defects of the first permanent molars 8 years earlier were invited for a follow-up assessment. Consenting children completed the Child Perception Questionnaire and the faces Modified Child Dental Anxiety Scale, and were examined by two calibrated examiners. ANOVA, Kruskal-Wallis, negative binomial and logistic regression were used for data analyses. One hundred and eleven children returned a completed questionnaire and 91 were clinically examined. Negative binomial regression found that oral health impacts were associated with gender (boys, risk ratio (RR) = 0.73, P = 0.03) and decayed, missing or filled permanent teeth (DMFT) (RR = 1.1, P = 0.04). The mean DMFT of children were sound (0.9, standard deviation (SD) = 1.4), diffuse defects (0.8, SD = 1.7), demarcated defects (1.5, SD = 1.4) and pit defects (1.3, SD = 2.3) (Kruskal-Wallis, P = 0.05). Logistic regression of first permanent molar caries found higher odds of caries experience with baseline primary tooth caries experience (odds ratio (OR) = 1.5, P = 0.01), the number of teeth affected by enamel defects (OR = 1.9, P = 0.05) and lower odds with the presence of diffuse enamel defects (OR = 0.1, P = 0.04). The presence of diffuse enamel defects was associated with lower odds of caries experience. © 2016 Australian Dental Association.

New diagnostic index for sarcopenia in patients with cardiovascular diseases

PubMed Central

Kai, Hisashi; Shibata, Rei; Niiyama, Hiroshi; Nishiyama, Yasuhiro; Murohara, Toyoaki; Yoshida, Noriko; Katoh, Atsushi; Ikeda, Hisao

2017-01-01

Background Sarcopenia is an aging and disease-related syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, with the risk of frailty and poor quality of life. Sarcopenia is diagnosed by a decrease in skeletal muscle index (SMI) and reduction of either handgrip strength or gait speed. However, measurement of SMI is difficult for general physicians because it requires special equipment for bioelectrical impedance assay or dual-energy X-ray absorptiometry. The purpose of this study was, therefore, to explore a novel, simple diagnostic method of sarcopenia evaluation in patients with cardiovascular diseases (CVD). Methods We retrospectively investigated 132 inpatients with CVD (age: 72±12 years, age range: 27–93 years, males: 61%) Binomial logistic regression and correlation analyses were used to assess the associations of sarcopenia with simple physical data and biomarkers, including muscle-related inflammation makers and nutritional markers. Results Sarcopenia was present in 29.5% of the study population. Serum concentrations of adiponectin and sialic acid were significantly higher in sarcopenic than non-sarcopenic CVD patients. Stepwise multivariate binomial logistic regression analysis revealed that adiponectin, sialic acid, sex, age, and body mass index were independent factors for sarcopenia detection. Sarcopenia index, obtained from the diagnostic regression formula for sarcopenia detection including the five independent factors, indicated a high accuracy in ROC curve analysis (sensitivity 94.9%, specificity 69.9%) and the cutoff value for sarcopenia detection was -1.6134. Sarcopenia index had a significant correlation with the conventional diagnostic parameters of sarcopenia. Conclusions Our new sarcopenia index using simple parameters would be useful for diagnosing sarcopenia in CVD patients. PMID:28542531

Use of clinical practice guidelines by dentists: findings from the Japanese dental practice-based research network.

PubMed

Kakudate, Naoki; Yokoyama, Yoko; Sumida, Futoshi; Matsumoto, Yuki; Gordan, Valeria V; Gilbert, Gregg H

2017-02-01

The objectives of this study were to: (1) examine differences in the use of dental clinical practice guidelines among Japanese dentists, and (2) identify characteristics associated with the number of guidelines used by participating dentists. We conducted a cross-sectional study consisting of a questionnaire survey in Japan between July 2014 and May 2015. The study queried dentists working in outpatient dental practices who are affiliated with the Dental Practice-Based Research Network Japan (n = 148). They were asked whether they have used each of 15 Japanese dental clinical guidelines. Associations between the number of guidelines used by participants and specific characteristics were analysed via negative binomial regression analysis. The mean number of guidelines used by participating dentists was 2.5 ± 2.9 [standard deviation (SD)]. Rate of use of guidelines showed substantial variation, from 5% to 34% among dentists. The proportion of dentists that used guidelines was the highest among oral medicine specialists, who had the highest proportion for 10 of 15 guidelines. Negative binomial regression analysis identified three factors significantly associated with the number of guidelines used: 'years since graduation from dental school', 'specialty practice' and 'practice busyness'. These results suggest that the use of clinical practice guidelines by Japanese dentists may still be inadequate. Training in the use of the guidelines could be given to dental students as undergraduate education and to young clinicians as continuing education. © 2016 John Wiley & Sons, Ltd.

A comparison of different ways of including baseline counts in negative binomial models for data from falls prevention trials.

PubMed

Zheng, Han; Kimber, Alan; Goodwin, Victoria A; Pickering, Ruth M

2018-01-01

A common design for a falls prevention trial is to assess falling at baseline, randomize participants into an intervention or control group, and ask them to record the number of falls they experience during a follow-up period of time. This paper addresses how best to include the baseline count in the analysis of the follow-up count of falls in negative binomial (NB) regression. We examine the performance of various approaches in simulated datasets where both counts are generated from a mixed Poisson distribution with shared random subject effect. Including the baseline count after log-transformation as a regressor in NB regression (NB-logged) or as an offset (NB-offset) resulted in greater power than including the untransformed baseline count (NB-unlogged). Cook and Wei's conditional negative binomial (CNB) model replicates the underlying process generating the data. In our motivating dataset, a statistically significant intervention effect resulted from the NB-logged, NB-offset, and CNB models, but not from NB-unlogged, and large, outlying baseline counts were overly influential in NB-unlogged but not in NB-logged. We conclude that there is little to lose by including the log-transformed baseline count in standard NB regression compared to CNB for moderate to larger sized datasets. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

On Models for Binomial Data with Random Numbers of Trials

PubMed Central

Comulada, W. Scott; Weiss, Robert E.

2010-01-01

Summary A binomial outcome is a count s of the number of successes out of the total number of independent trials n = s + f, where f is a count of the failures. The n are random variables not fixed by design in many studies. Joint modeling of (s, f) can provide additional insight into the science and into the probability π of success that cannot be directly incorporated by the logistic regression model. Observations where n = 0 are excluded from the binomial analysis yet may be important to understanding how π is influenced by covariates. Correlation between s and f may exist and be of direct interest. We propose Bayesian multivariate Poisson models for the bivariate response (s, f), correlated through random effects. We extend our models to the analysis of longitudinal and multivariate longitudinal binomial outcomes. Our methodology was motivated by two disparate examples, one from teratology and one from an HIV tertiary intervention study. PMID:17688514

Drivers of multidimensional eco-innovation: empirical evidence from the Brazilian industry.

PubMed

da Silva Rabêlo, Olivan; de Azevedo Melo, Andrea Sales Soares

2018-03-08

The study analyses the relationships between the main drivers of eco-innovation introduced by innovative industries, focused on cooperation strategy. Eco-innovation is analysed by means of a multidimensional identification strategy, showing the relationships between the independent variables and the variable of interest. The literature discussing environmental innovation is different from the one discussing other types of innovation inasmuch as it seeks to grasp its determinants and to mostly highlight the relevance of environmental regulation. The key feature of this paper is that it ascribes special relevance to cooperation strategy with external partners and to the propensity of innovative industry introducing eco-innovation. A sample of 35,060 Brazilian industries were analysed, between 2003 and 2011, by means of Binomial, Multinomial and Ordinal logistic regressions with microdata collected with the research and innovation department (PINTEC) from the Brazilian Institute of Geography and Statistics (Instituto Brasileiro de Geografia e Estatística). The econometric results estimated by the Logit Multinomial method suggest that the cooperation with external partners practiced by innovative industries facilitates the adoption of eco-innovation in dimension 01 with probability of 64.59%, 57.63% in dimension 02 and 81.02% in dimension 03. The data reveal that the higher the degree of eco-innovation complexity, the harder industries seek to obtain cooperation with external partners. When calculating with the Logit Ordinal and Binomial models, cooperation increases the probability that the industry is eco-innovative in 65.09% and 89.34%, respectively. Environmental regulation and innovation in product and information management were also positively correlated as drivers of eco-innovation.

Factors associated with dental caries in a group of American Indian children at age 36 months.

PubMed

Warren, John J; Blanchette, Derek; Dawson, Deborah V; Marshall, Teresa A; Phipps, Kathy R; Starr, Delores; Drake, David R

2016-04-01

Early childhood caries (ECC) is rampant among American Indian children, but there has been relatively little study of this problem. This article reports on risk factors for caries for a group of American Indian children at age 36 months as part of a longitudinal study. Pregnant women from a Northern Plains Tribal community were recruited to participate in a longitudinal study of caries and caries risk factors. Standardized dental examinations were completed on children, and questionnaires were completed by mothers at baseline and when children were 4, 8, 12, 16, 22, 28, and 36 months of age. Examinations were surface-specific for dental caries, and the questionnaires collected data on demographic, dietary, and behavioral factors. Nonparametric bivariate tests and logistic regression models were used to identify risk factors for caries at 36 months, and negative binomial regression was used to identify factors related to caries severity (dmf counts). Among the 232 children, and caries prevalence for cavitated lesions was 80%, with an additional 15% having only noncavitated lesions. The mean dmfs was 9.6, and of the total dmfs, nearly 62% of affected surfaces were decayed, 31% were missing, and 7% were filled. Logistic regression identified higher added-sugar beverage consumption, younger maternal age at baseline, higher maternal DMFS at baseline, and greater number of people in the household as significant (P < 0.05) risk factors. Negative binomial regression found that only maternal DMFS was associated with child dmf counts. By the age of 36 months, dental caries is nearly universal in this population of American Indian children. Caries risk factors included sugared beverage consumption, greater household size, and maternal factors, but further analyses are needed to better understand caries in this population. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Meta-analysis of studies with bivariate binary outcomes: a marginal beta-binomial model approach

PubMed Central

Chen, Yong; Hong, Chuan; Ning, Yang; Su, Xiao

2018-01-01

When conducting a meta-analysis of studies with bivariate binary outcomes, challenges arise when the within-study correlation and between-study heterogeneity should be taken into account. In this paper, we propose a marginal beta-binomial model for the meta-analysis of studies with binary outcomes. This model is based on the composite likelihood approach, and has several attractive features compared to the existing models such as bivariate generalized linear mixed model (Chu and Cole, 2006) and Sarmanov beta-binomial model (Chen et al., 2012). The advantages of the proposed marginal model include modeling the probabilities in the original scale, not requiring any transformation of probabilities or any link function, having closed-form expression of likelihood function, and no constraints on the correlation parameter. More importantly, since the marginal beta-binomial model is only based on the marginal distributions, it does not suffer from potential misspecification of the joint distribution of bivariate study-specific probabilities. Such misspecification is difficult to detect and can lead to biased inference using currents methods. We compare the performance of the marginal beta-binomial model with the bivariate generalized linear mixed model and the Sarmanov beta-binomial model by simulation studies. Interestingly, the results show that the marginal beta-binomial model performs better than the Sarmanov beta-binomial model, whether or not the true model is Sarmanov beta-binomial, and the marginal beta-binomial model is more robust than the bivariate generalized linear mixed model under model misspecifications. Two meta-analyses of diagnostic accuracy studies and a meta-analysis of case-control studies are conducted for illustration. PMID:26303591

Variability in results from negative binomial models for Lyme disease measured at different spatial scales.

PubMed

Tran, Phoebe; Waller, Lance

2015-01-01

Lyme disease has been the subject of many studies due to increasing incidence rates year after year and the severe complications that can arise in later stages of the disease. Negative binomial models have been used to model Lyme disease in the past with some success. However, there has been little focus on the reliability and consistency of these models when they are used to study Lyme disease at multiple spatial scales. This study seeks to explore how sensitive/consistent negative binomial models are when they are used to study Lyme disease at different spatial scales (at the regional and sub-regional levels). The study area includes the thirteen states in the Northeastern United States with the highest Lyme disease incidence during the 2002-2006 period. Lyme disease incidence at county level for the period of 2002-2006 was linked with several previously identified key landscape and climatic variables in a negative binomial regression model for the Northeastern region and two smaller sub-regions (the New England sub-region and the Mid-Atlantic sub-region). This study found that negative binomial models, indeed, were sensitive/inconsistent when used at different spatial scales. We discuss various plausible explanations for such behavior of negative binomial models. Further investigation of the inconsistency and sensitivity of negative binomial models when used at different spatial scales is important for not only future Lyme disease studies and Lyme disease risk assessment/management but any study that requires use of this model type in a spatial context. Copyright © 2014 Elsevier Inc. All rights reserved.

Categorical Data Analysis Using a Skewed Weibull Regression Model

NASA Astrophysics Data System (ADS)

Caron, Renault; Sinha, Debajyoti; Dey, Dipak; Polpo, Adriano

2018-03-01

In this paper, we present a Weibull link (skewed) model for categorical response data arising from binomial as well as multinomial model. We show that, for such types of categorical data, the most commonly used models (logit, probit and complementary log-log) can be obtained as limiting cases. We further compare the proposed model with some other asymmetrical models. The Bayesian as well as frequentist estimation procedures for binomial and multinomial data responses are presented in details. The analysis of two data sets to show the efficiency of the proposed model is performed.

Meta-analysis of studies with bivariate binary outcomes: a marginal beta-binomial model approach.

PubMed

Chen, Yong; Hong, Chuan; Ning, Yang; Su, Xiao

2016-01-15

When conducting a meta-analysis of studies with bivariate binary outcomes, challenges arise when the within-study correlation and between-study heterogeneity should be taken into account. In this paper, we propose a marginal beta-binomial model for the meta-analysis of studies with binary outcomes. This model is based on the composite likelihood approach and has several attractive features compared with the existing models such as bivariate generalized linear mixed model (Chu and Cole, 2006) and Sarmanov beta-binomial model (Chen et al., 2012). The advantages of the proposed marginal model include modeling the probabilities in the original scale, not requiring any transformation of probabilities or any link function, having closed-form expression of likelihood function, and no constraints on the correlation parameter. More importantly, because the marginal beta-binomial model is only based on the marginal distributions, it does not suffer from potential misspecification of the joint distribution of bivariate study-specific probabilities. Such misspecification is difficult to detect and can lead to biased inference using currents methods. We compare the performance of the marginal beta-binomial model with the bivariate generalized linear mixed model and the Sarmanov beta-binomial model by simulation studies. Interestingly, the results show that the marginal beta-binomial model performs better than the Sarmanov beta-binomial model, whether or not the true model is Sarmanov beta-binomial, and the marginal beta-binomial model is more robust than the bivariate generalized linear mixed model under model misspecifications. Two meta-analyses of diagnostic accuracy studies and a meta-analysis of case-control studies are conducted for illustration. Copyright © 2015 John Wiley & Sons, Ltd.

Indicators of Terrorism Vulnerability in Africa

DTIC Science & Technology

2015-03-26

the terror threat and vulnerabilities across Africa. Key words: Terrorism, Africa, Negative Binomial Regression, Classification Tree iv I would like...31 Metrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32 Log -likelihood...70 viii Page 5.3 Classification Tree Description

The Effect of Exposure to Ultraviolet Radiation in Infancy on Melanoma Risk.

PubMed

Gefeller, Olaf; Fiessler, Cornelia; Radespiel-Tröger, Martin; Uter, Wolfgang; Pfahlberg, Annette B

2016-01-01

Evidence on the effect of ultraviolet radiation (UVR) exposure in infancy on melanoma risk in later life is scarce. Three recent studies suffering from methodological shortcomings suggested that people born in spring carry a higher melanoma risk. Data from the Bavarian population-based cancer registry on 28374 incident melanoma cases between 2002 and 2012 were analyzed to reexamine this finding. Crude and adjusted analyses - using negative binomial regression models - were performed addressing the relationship. In the crude analysis, the birth months March - May were significantly overrepresented among melanoma cases. However, after additionally adjusting for the birth month distribution of the Bavarian population, the ostensible seasonal effect disappeared. Similar results emerged in all subgroup analyses. Our large registry-based study provides no evidence that people born in spring carry a higher risk for developing melanoma in later life and thus lends no support to the hypothesis of higher UVR-susceptibility during the first months of life.

Study of the uses of Information and Communication Technologies by Pain Treatment Unit Physicians.

PubMed

Muriel Fernandez, Jorge; Sánchez Ledesma, María José; López Millan, Manuel; García Cenador, María Begoña

2017-05-01

Adequate use of Information and Communication Technologies (ICTs) in health has been shown to save the patient and caregiver time, improve access to the health system, improve diagnosis and control of disease or treatment. All this results in cost savings, and more importantly, they help improve the quality of service and the lives of patients. The purpose of this study is to analyse the differences in the uses of this ICTs between those physicians that belong to Pain Treatment Units (PU) and other physicians that work in pain not linked to these PUs. An online survey, generated by Netquest online survey tool, was sent to both groups of professionals and the data collected was statistical analysed through a logistic regression methodology which is the Logit binomial model. Our results show that those physicians that belong to PUs use ICTs more frequently and consider it more relevant to their clinical practice.

Estimating relative risks in multicenter studies with a small number of centers - which methods to use? A simulation study.

PubMed

Pedroza, Claudia; Truong, Van Thi Thanh

2017-11-02

Analyses of multicenter studies often need to account for center clustering to ensure valid inference. For binary outcomes, it is particularly challenging to properly adjust for center when the number of centers or total sample size is small, or when there are few events per center. Our objective was to evaluate the performance of generalized estimating equation (GEE) log-binomial and Poisson models, generalized linear mixed models (GLMMs) assuming binomial and Poisson distributions, and a Bayesian binomial GLMM to account for center effect in these scenarios. We conducted a simulation study with few centers (≤30) and 50 or fewer subjects per center, using both a randomized controlled trial and an observational study design to estimate relative risk. We compared the GEE and GLMM models with a log-binomial model without adjustment for clustering in terms of bias, root mean square error (RMSE), and coverage. For the Bayesian GLMM, we used informative neutral priors that are skeptical of large treatment effects that are almost never observed in studies of medical interventions. All frequentist methods exhibited little bias, and the RMSE was very similar across the models. The binomial GLMM had poor convergence rates, ranging from 27% to 85%, but performed well otherwise. The results show that both GEE models need to use small sample corrections for robust SEs to achieve proper coverage of 95% CIs. The Bayesian GLMM had similar convergence rates but resulted in slightly more biased estimates for the smallest sample sizes. However, it had the smallest RMSE and good coverage across all scenarios. These results were very similar for both study designs. For the analyses of multicenter studies with a binary outcome and few centers, we recommend adjustment for center with either a GEE log-binomial or Poisson model with appropriate small sample corrections or a Bayesian binomial GLMM with informative priors.

Accounting for non-independent detection when estimating abundance of organisms with a Bayesian approach

USGS Publications Warehouse

Martin, Julien; Royle, J. Andrew; MacKenzie, Darryl I.; Edwards, Holly H.; Kery, Marc; Gardner, Beth

2011-01-01

Summary 1. Binomial mixture models use repeated count data to estimate abundance. They are becoming increasingly popular because they provide a simple and cost-effective way to account for imperfect detection. However, these models assume that individuals are detected independently of each other. This assumption may often be violated in the field. For instance, manatees (Trichechus manatus latirostris) may surface in turbid water (i.e. become available for detection during aerial surveys) in a correlated manner (i.e. in groups). However, correlated behaviour, affecting the non-independence of individual detections, may also be relevant in other systems (e.g. correlated patterns of singing in birds and amphibians). 2. We extend binomial mixture models to account for correlated behaviour and therefore to account for non-independent detection of individuals. We simulated correlated behaviour using beta-binomial random variables. Our approach can be used to simultaneously estimate abundance, detection probability and a correlation parameter. 3. Fitting binomial mixture models to data that followed a beta-binomial distribution resulted in an overestimation of abundance even for moderate levels of correlation. In contrast, the beta-binomial mixture model performed considerably better in our simulation scenarios. We also present a goodness-of-fit procedure to evaluate the fit of beta-binomial mixture models. 4. We illustrate our approach by fitting both binomial and beta-binomial mixture models to aerial survey data of manatees in Florida. We found that the binomial mixture model did not fit the data, whereas there was no evidence of lack of fit for the beta-binomial mixture model. This example helps illustrate the importance of using simulations and assessing goodness-of-fit when analysing ecological data with N-mixture models. Indeed, both the simulations and the goodness-of-fit procedure highlighted the limitations of the standard binomial mixture model for aerial manatee surveys. 5. Overestimation of abundance by binomial mixture models owing to non-independent detections is problematic for ecological studies, but also for conservation. For example, in the case of endangered species, it could lead to inappropriate management decisions, such as downlisting. These issues will be increasingly relevant as more ecologists apply flexible N-mixture models to ecological data.

Environmental, Spatial, and Sociodemographic Factors Associated with Nonfatal Injuries in Indonesia.

PubMed

Irianti, Sri; Prasetyoputra, Puguh

2017-01-01

Background . The determinants of injuries and their reoccurrence in Indonesia are not well understood, despite their importance in the prevention of injuries. Therefore, this study seeks to investigate the environmental, spatial, and sociodemographic factors associated with the reoccurrence of injuries among Indonesian people. Methods . Data from the 2013 round of the Indonesia Baseline Health Research (IBHR 2013) were analysed using a two-part hurdle regression model. A logit regression model was chosen for the zero-hurdle part , while a zero-truncated negative binomial regression model was selected for the counts part . Odds ratio (OR) and incidence rate ratio (IRR) were the measures of association, respectively. Results . The results suggest that living in a household with distant drinking water source, residing in slum areas, residing in Eastern Indonesia, having low educational attainment, being men, and being poorer are positively related to the likelihood of experiencing injury. Moreover, being a farmer or fishermen, having low educational attainment, and being men are positively associated with the frequency of injuries. Conclusion . This study would be useful to prioritise injury prevention programs in Indonesia based on the environmental, spatial, and sociodemographic characteristics.

The association between major depression prevalence and sex becomes weaker with age.

PubMed

Patten, Scott B; Williams, Jeanne V A; Lavorato, Dina H; Wang, Jian Li; Bulloch, Andrew G M; Sajobi, Tolulope

2016-02-01

Women have a higher prevalence of major depressive episodes (MDE) than men, and the annual prevalence of MDE declines with age. Age by sex interactions may occur (a weakening of the sex effect with age), but are easily overlooked since individual studies lack statistical power to detect interactions. The objective of this study was to evaluate age by sex interactions in MDE prevalence. In Canada, a series of 10 national surveys conducted between 1996 and 2013 assessed MDE prevalence in respondents over the age of 14. Treating age as a continuous variable, binomial and linear regression was used to model age by sex interactions in each survey. To increase power, the survey-specific interaction coefficients were then pooled using meta-analytic methods. The estimated interaction terms were homogeneous. In the binomial regression model I (2) was 31.2 % and was not statistically significant (Q statistic = 13.1, df = 9, p = 0.159). The pooled estimate (-0.004) was significant (z = 3.13, p = 0.002), indicating that the effect of sex became weaker with increasing age. This resulted in near disappearance of the sex difference in the 75+ age group. This finding was also supported by an examination of age- and sex-specific estimates pooled across the surveys. The association of MDE prevalence with sex becomes weaker with age. The interaction may reflect biological effect modification. Investigators should test for, and consider inclusion of age by sex interactions in epidemiological analyses of MDE prevalence.

The Association between Romantic Relationships and Delinquency in Adolescence and Young Adulthood

PubMed Central

Cui, Ming; Ueno, Koji; Fincham, Frank D.; Donnellan, M. Brent; Wickrama, K. A. S.

2011-01-01

This study examined the association between romantic relationships and delinquency in adolescence and young adulthood. Using a large, longitudinal, and nationally representative sample, results from negative binomial regressions showed a positive association between romantic involvement and delinquency in adolescence. Further, the cumulative number of romantic relationships from adolescence to young adulthood was positively related to delinquency in young adulthood even controlling for earlier delinquency in adolescence. These analyses also controlled for the effects of participant gender, age at initial assessment, puberty, race/ethnicity, and other demographic characteristics (e.g., family structure and parents’ education). Findings are discussed in terms of their implications for understanding the role of romantic relationships in the development of young people and for stimulating future research questions. PMID:22984343

Interrelationships Between Receiver/Relative Operating Characteristics Display, Binomial, Logit, and Bayes' Rule Probability of Detection Methodologies

NASA Technical Reports Server (NTRS)

Generazio, Edward R.

2014-01-01

Unknown risks are introduced into failure critical systems when probability of detection (POD) capabilities are accepted without a complete understanding of the statistical method applied and the interpretation of the statistical results. The presence of this risk in the nondestructive evaluation (NDE) community is revealed in common statements about POD. These statements are often interpreted in a variety of ways and therefore, the very existence of the statements identifies the need for a more comprehensive understanding of POD methodologies. Statistical methodologies have data requirements to be met, procedures to be followed, and requirements for validation or demonstration of adequacy of the POD estimates. Risks are further enhanced due to the wide range of statistical methodologies used for determining the POD capability. Receiver/Relative Operating Characteristics (ROC) Display, simple binomial, logistic regression, and Bayes' rule POD methodologies are widely used in determining POD capability. This work focuses on Hit-Miss data to reveal the framework of the interrelationships between Receiver/Relative Operating Characteristics Display, simple binomial, logistic regression, and Bayes' Rule methodologies as they are applied to POD. Knowledge of these interrelationships leads to an intuitive and global understanding of the statistical data, procedural and validation requirements for establishing credible POD estimates.

Introductory Statistics in the Garden

ERIC Educational Resources Information Center

Wagaman, John C.

2017-01-01

This article describes four semesters of introductory statistics courses that incorporate service learning and gardening into the curriculum with applications of the binomial distribution, least squares regression and hypothesis testing. The activities span multiple semesters and are iterative in nature.

Phase transition and information cascade in a voting model

NASA Astrophysics Data System (ADS)

Hisakado, M.; Mori, S.

2010-08-01

In this paper, we introduce a voting model that is similar to a Keynesian beauty contest and analyse it from a mathematical point of view. There are two types of voters—copycat and independent—and two candidates. Our voting model is a binomial distribution (independent voters) doped in a beta binomial distribution (copycat voters). We find that the phase transition in this system is at the upper limit of t, where t is the time (or the number of the votes). Our model contains three phases. If copycats constitute a majority or even half of the total voters, the voting rate converges more slowly than it would in a binomial distribution. If independents constitute the majority of voters, the voting rate converges at the same rate as it would in a binomial distribution. We also study why it is difficult to estimate the conclusion of a Keynesian beauty contest when there is an information cascade.

Mental health status and healthcare utilization among community dwelling older adults.

PubMed

Adepoju, Omolola; Lin, Szu-Hsuan; Mileski, Michael; Kruse, Clemens Scott; Mask, Andrew

2018-04-27

Shifts in mental health utilization patterns are necessary to allow for meaningful access to care for vulnerable populations. There have been long standing issues in how mental health is provided, which has caused problems in that care being efficacious for those seeking it. To assess the relationship between mental health status and healthcare utilization among adults ≥65 years. A negative binomial regression model was used to assess the relationship between mental health status and healthcare utilization related to office-based physician visits, while a two-part model, consisting of logistic regression and negative binomial regression, was used to separately model emergency visits and inpatient services. The receipt of care in office-based settings were marginally higher for subjects with mental health difficulties. Both probabilities and counts of inpatient hospitalizations were similar across mental health categories. The count of ER visits was similar across mental health categories; however, the probability of having an emergency department visit was marginally higher for older adults who reported mental health difficulties in 2012. These findings are encouraging and lend promise to the recent initiatives on addressing gaps in mental healthcare services.

An examination of sources of sensitivity of consumer surplus estimates in travel cost models.

PubMed

Blaine, Thomas W; Lichtkoppler, Frank R; Bader, Timothy J; Hartman, Travis J; Lucente, Joseph E

2015-03-15

We examine sensitivity of estimates of recreation demand using the Travel Cost Method (TCM) to four factors. Three of the four have been routinely and widely discussed in the TCM literature: a) Poisson verses negative binomial regression; b) application of Englin correction to account for endogenous stratification; c) truncation of the data set to eliminate outliers. A fourth issue we address has not been widely modeled: the potential effect on recreation demand of the interaction between income and travel cost. We provide a straightforward comparison of all four factors, analyzing the impact of each on regression parameters and consumer surplus estimates. Truncation has a modest effect on estimates obtained from the Poisson models but a radical effect on the estimates obtained by way of the negative binomial. Inclusion of an income-travel cost interaction term generally produces a more conservative but not a statistically significantly different estimate of consumer surplus in both Poisson and negative binomial models. It also generates broader confidence intervals. Application of truncation, the Englin correction and the income-travel cost interaction produced the most conservative estimates of consumer surplus and eliminated the statistical difference between the Poisson and the negative binomial. Use of the income-travel cost interaction term reveals that for visitors who face relatively low travel costs, the relationship between income and travel demand is negative, while it is positive for those who face high travel costs. This provides an explanation of the ambiguities on the findings regarding the role of income widely observed in the TCM literature. Our results suggest that policies that reduce access to publicly owned resources inordinately impact local low income recreationists and are contrary to environmental justice. Copyright © 2014 Elsevier Ltd. All rights reserved.

Univariate and bivariate likelihood-based meta-analysis methods performed comparably when marginal sensitivity and specificity were the targets of inference.

PubMed

Dahabreh, Issa J; Trikalinos, Thomas A; Lau, Joseph; Schmid, Christopher H

2017-03-01

To compare statistical methods for meta-analysis of sensitivity and specificity of medical tests (e.g., diagnostic or screening tests). We constructed a database of PubMed-indexed meta-analyses of test performance from which 2 × 2 tables for each included study could be extracted. We reanalyzed the data using univariate and bivariate random effects models fit with inverse variance and maximum likelihood methods. Analyses were performed using both normal and binomial likelihoods to describe within-study variability. The bivariate model using the binomial likelihood was also fit using a fully Bayesian approach. We use two worked examples-thoracic computerized tomography to detect aortic injury and rapid prescreening of Papanicolaou smears to detect cytological abnormalities-to highlight that different meta-analysis approaches can produce different results. We also present results from reanalysis of 308 meta-analyses of sensitivity and specificity. Models using the normal approximation produced sensitivity and specificity estimates closer to 50% and smaller standard errors compared to models using the binomial likelihood; absolute differences of 5% or greater were observed in 12% and 5% of meta-analyses for sensitivity and specificity, respectively. Results from univariate and bivariate random effects models were similar, regardless of estimation method. Maximum likelihood and Bayesian methods produced almost identical summary estimates under the bivariate model; however, Bayesian analyses indicated greater uncertainty around those estimates. Bivariate models produced imprecise estimates of the between-study correlation of sensitivity and specificity. Differences between methods were larger with increasing proportion of studies that were small or required a continuity correction. The binomial likelihood should be used to model within-study variability. Univariate and bivariate models give similar estimates of the marginal distributions for sensitivity and specificity. Bayesian methods fully quantify uncertainty and their ability to incorporate external evidence may be useful for imprecisely estimated parameters. Copyright © 2017 Elsevier Inc. All rights reserved.

Development of a mobbing short scale in the Gutenberg Health Study.

PubMed

Garthus-Niegel, Susan; Nübling, Matthias; Letzel, Stephan; Hegewald, Janice; Wagner, Mandy; Wild, Philipp S; Blettner, Maria; Zwiener, Isabella; Latza, Ute; Jankowiak, Sylvia; Liebers, Falk; Seidler, Andreas

2016-01-01

Despite its highly detrimental potential, most standard questionnaires assessing psychosocial stress at work do not include mobbing as a risk factor. In the German standard version of COPSOQ, mobbing is assessed with a single item. In the Gutenberg Health Study, this version was used together with a newly developed short scale based on the Leymann Inventory of Psychological Terror. The purpose of the present study was to evaluate the psychometric properties of these two measures, to compare them and to test their differential impact on relevant outcome parameters. This analysis is based on a population-based sample of 1441 employees participating in the Gutenberg Health Study. Exploratory and confirmatory factor analyses and reliability analyses were used to assess the mobbing scale. To determine their predictive validities, multiple linear regression analyses with six outcome parameters and log-binomial regression models for two of the outcome aspects were run. Factor analyses of the five-item scale confirmed a one-factor solution, reliability was α = 0.65. Both the single-item and the five-item scales were associated with all six outcome scales. Effect sizes were similar for both mobbing measures. Mobbing is an important risk factor for health-related outcomes. For the purpose of psychosocial risk assessment in the workplace, both the single-item and the five-item constructs were psychometrically appropriate. Associations with outcomes were about equivalent. However, the single item has the advantage of parsimony, whereas the five-item construct depicts several distinct forms of mobbing.

Evaluation of logistic regression models and effect of covariates for case-control study in RNA-Seq analysis.

PubMed

Choi, Seung Hoan; Labadorf, Adam T; Myers, Richard H; Lunetta, Kathryn L; Dupuis, Josée; DeStefano, Anita L

2017-02-06

Next generation sequencing provides a count of RNA molecules in the form of short reads, yielding discrete, often highly non-normally distributed gene expression measurements. Although Negative Binomial (NB) regression has been generally accepted in the analysis of RNA sequencing (RNA-Seq) data, its appropriateness has not been exhaustively evaluated. We explore logistic regression as an alternative method for RNA-Seq studies designed to compare cases and controls, where disease status is modeled as a function of RNA-Seq reads using simulated and Huntington disease data. We evaluate the effect of adjusting for covariates that have an unknown relationship with gene expression. Finally, we incorporate the data adaptive method in order to compare false positive rates. When the sample size is small or the expression levels of a gene are highly dispersed, the NB regression shows inflated Type-I error rates but the Classical logistic and Bayes logistic (BL) regressions are conservative. Firth's logistic (FL) regression performs well or is slightly conservative. Large sample size and low dispersion generally make Type-I error rates of all methods close to nominal alpha levels of 0.05 and 0.01. However, Type-I error rates are controlled after applying the data adaptive method. The NB, BL, and FL regressions gain increased power with large sample size, large log2 fold-change, and low dispersion. The FL regression has comparable power to NB regression. We conclude that implementing the data adaptive method appropriately controls Type-I error rates in RNA-Seq analysis. Firth's logistic regression provides a concise statistical inference process and reduces spurious associations from inaccurately estimated dispersion parameters in the negative binomial framework.

Metaprop: a Stata command to perform meta-analysis of binomial data.

PubMed

Nyaga, Victoria N; Arbyn, Marc; Aerts, Marc

2014-01-01

Meta-analyses have become an essential tool in synthesizing evidence on clinical and epidemiological questions derived from a multitude of similar studies assessing the particular issue. Appropriate and accessible statistical software is needed to produce the summary statistic of interest. Metaprop is a statistical program implemented to perform meta-analyses of proportions in Stata. It builds further on the existing Stata procedure metan which is typically used to pool effects (risk ratios, odds ratios, differences of risks or means) but which is also used to pool proportions. Metaprop implements procedures which are specific to binomial data and allows computation of exact binomial and score test-based confidence intervals. It provides appropriate methods for dealing with proportions close to or at the margins where the normal approximation procedures often break down, by use of the binomial distribution to model the within-study variability or by allowing Freeman-Tukey double arcsine transformation to stabilize the variances. Metaprop was applied on two published meta-analyses: 1) prevalence of HPV-infection in women with a Pap smear showing ASC-US; 2) cure rate after treatment for cervical precancer using cold coagulation. The first meta-analysis showed a pooled HPV-prevalence of 43% (95% CI: 38%-48%). In the second meta-analysis, the pooled percentage of cured women was 94% (95% CI: 86%-97%). By using metaprop, no studies with 0% or 100% proportions were excluded from the meta-analysis. Furthermore, study specific and pooled confidence intervals always were within admissible values, contrary to the original publication, where metan was used.

Gingival recession and associated factors in a homogeneous Mexican adult male population: A cross-sectional study

PubMed Central

Minaya-Sánchez, Mirna; Medina-Solís, Carlo E.; Vallejos-Sánchez, Ana A.; Marquez-Corona, Maria L.; Pontigo-Loyola, América P.; Islas-Granillo, Horacio; Maupomé, Gerardo

2012-01-01

Background: Diverse variables are implicated in the pathogenesis of gingival recession; more detailed knowledge about the relationship between the clinical presentation of gingival recession and assorted risk indicators may lead to improved patient monitoring, early intervention, and subsequent prevention. The objective was to evaluate clinically gingival recession in a homogeneous Mexican adult male population and to determine the strength of association with related factors. Method: A cross-sectional study was carried out in a largely homogeneous group in terms of ethnic background, socioeconomic status, gender, occupation, and medical/dental insurance, in Campeche, Mexico. Periodontal examinations were undertaken to determine diverse clinical dental variables. All periodontal clinical examinations were assessed using the Florida Probe System, a dental chair and one examiner. Questionnaires were used to collect diverse risk indicators. Statistical analyses were undertaken with negative binomial regression models. Results: The mean number of sites with gingival recession per subject was 6.73±5.81; the prevalence was 87.6%. In the negative binomial regression model we observed that for (i) each year of age, and (ii) each percentage unit of increase in sites with plaque, and (iii) with suppuration, mean sites with gingival recession increased 2.9%, 1.0% and 13.0%, respectively. Having a spouse was associated with gingival recession. Conclusions: We observed association between gingival recession, and sociodemographic and clinical parameters. Patients need to be educated about risk indicators for gingival recession as well as the preventive maneuvers that may be implemented to minimize its occurrence. The potential of improved oral self-care to prevent a largely benign condition such as gingival recession is important, given the associated disorders that may ensue root exposure, such as root caries and root hypersensitivity. Key words:Oral health, periodontal health, gingival recession, adults, Mexico. PMID:22549678

Influence of prehospital airway management on neurological outcome in patients transferred to a heart attack centre following out-of-hospital cardiac arrest.

PubMed

Edwards, Timothy; Williams, Julia; Cottee, Michaela

2018-05-11

To describe the association between prehospital airway management and neurological outcomes in patients transferred by the ambulance service directly to a heart attack centre (HAC) post-return of spontaneous circulation (ROSC). A retrospective observational cohort study in which ambulance records were reviewed to determine prehospital airway management strategy and collect physiological and demographic data. HAC notes were obtained to determine in-hospital management and quantify neurological outcome via the cerebral performance category (CPC) scale. Statistical analyses were performed via χ 2 -test, Mann-Whitney U-test, odds ratios and binomial logistic regression. Two hundred and twenty patients were included between August 2013 and August 2014, with complete outcome data obtained for 209. Median age of patients with complete outcome data was 67 years and 71.3% were male (n = 149). Airway management was provided using a supraglottic airway (SGA) in 72.7% of cases (n = 152) with the remainder undergoing endotracheal intubation (ETI). There was no significant difference in the proportion of patients who had a good neurological outcome (CPC 1 and 2) at discharge between the SGA and ETI groups (P = 0.29). Binomial logistic regression incorporating factors known to influence outcome demonstrated no significant difference in neurological outcomes between the SGA and ETI groups (adjusted OR 0.73, 95% CI 0.34-1.56). In this observational study, there was no significant difference in the proportion of good neurological outcomes in patients managed with SGA versus ETI during cardiac arrest and in the post-ROSC transfer phase. Further research is required to provide more definitive evidence in relation to the optimal airway management strategy in out-of-hospital cardiac arrest. © 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Recurrent suicide attempts in patients with depressive and anxiety disorders: the role of borderline personality traits.

PubMed

Stringer, Barbara; van Meijel, Berno; Eikelenboom, Merijn; Koekkoek, Bauke; Licht, Carmilla M M; Kerkhof, Ad J F M; Penninx, Brenda W J H; Beekman, Aartjan T F

2013-10-01

The presence of a comorbid borderline personality disorder (BPD) may be associated with an increase of suicidal behaviors in patients with depressive and anxiety disorders. The aim of this study is to examine the role of borderline personality traits on recurrent suicide attempts. The Netherlands Study on Depression and Anxiety included 1838 respondents with lifetime depressive and/or anxiety disorders, of whom 309 reported at least one previous suicide attempt. A univariable negative binomial regression analysis was performed to examine the association between comorbid borderline personality traits and suicide attempts. Univariable and multivariable negative binomial regression analyses were performed to identify risk factors for the number of recurrent suicide attempts in four clusters (type and severity of axis-I disorders, BPD traits, determinants of suicide attempts and socio-demographics). In the total sample the suicide attempt rate ratio increased with 33% for every unit increase in BPD traits. A lifetime diagnosis of dysthymia and comorbid BPD traits, especially the symptoms anger and fights, were independently and significantly associated with recurrent suicide attempts in the final model (n=309). The screening of personality disorders was added to the NESDA assessments at the 4-year follow-up for the first time. Therefore we were not able to examine the influence of comorbid BPD traits on suicide attempts over time. Persons with a lifetime diagnosis of dysthymia combined with borderline personality traits especially difficulties in coping with anger seemed to be at high risk for recurrent suicide attempts. For clinical practice, it is recommended to screen for comorbid borderline personality traits and to strengthen the patient's coping skills with regard to anger. © 2013 Elsevier B.V. All rights reserved.

Predictors of the number of under-five malnourished children in Bangladesh: application of the generalized poisson regression model

PubMed Central

2013-01-01

Background Malnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and (ii) to find some predictors of this outcome variable. Methods The data is extracted from the Bangladesh Demographic and Health Survey (BDHS) 2007. Briefly, this survey employs a nationally representative sample which is based on a two-stage stratified sample of households. A total of 4,460 under-five children is analysed using various statistical techniques namely Chi-square test and GPR model. Results The GPR model (as compared to the standard Poisson regression and negative Binomial regression) is found to be justified to study the above-mentioned outcome variable because of its under-dispersion (variance < mean) property. Our study also identify several significant predictors of the outcome variable namely mother’s education, father’s education, wealth index, sanitation status, source of drinking water, and total number of children ever born to a woman. Conclusions Consistencies of our findings in light of many other studies suggest that the GPR model is an ideal alternative of other statistical models to analyse the number of under-five malnourished children in a family. Strategies based on significant predictors may improve the nutritional status of children in Bangladesh. PMID:23297699

Logistic quantile regression provides improved estimates for bounded avian counts: a case study of California Spotted Owl fledgling production

Treesearch

Brian S. Cade; Barry R. Noon; Rick D. Scherer; John J. Keane

2017-01-01

Counts of avian fledglings, nestlings, or clutch size that are bounded below by zero and above by some small integer form a discrete random variable distribution that is not approximated well by conventional parametric count distributions such as the Poisson or negative binomial. We developed a logistic quantile regression model to provide estimates of the empirical...

Goodness-of-fit tests and model diagnostics for negative binomial regression of RNA sequencing data.

PubMed

Mi, Gu; Di, Yanming; Schafer, Daniel W

2015-01-01

This work is about assessing model adequacy for negative binomial (NB) regression, particularly (1) assessing the adequacy of the NB assumption, and (2) assessing the appropriateness of models for NB dispersion parameters. Tools for the first are appropriate for NB regression generally; those for the second are primarily intended for RNA sequencing (RNA-Seq) data analysis. The typically small number of biological samples and large number of genes in RNA-Seq analysis motivate us to address the trade-offs between robustness and statistical power using NB regression models. One widely-used power-saving strategy, for example, is to assume some commonalities of NB dispersion parameters across genes via simple models relating them to mean expression rates, and many such models have been proposed. As RNA-Seq analysis is becoming ever more popular, it is appropriate to make more thorough investigations into power and robustness of the resulting methods, and into practical tools for model assessment. In this article, we propose simulation-based statistical tests and diagnostic graphics to address model adequacy. We provide simulated and real data examples to illustrate that our proposed methods are effective for detecting the misspecification of the NB mean-variance relationship as well as judging the adequacy of fit of several NB dispersion models.

Understanding logistic regression analysis.

PubMed

Sperandei, Sandro

2014-01-01

Logistic regression is used to obtain odds ratio in the presence of more than one explanatory variable. The procedure is quite similar to multiple linear regression, with the exception that the response variable is binomial. The result is the impact of each variable on the odds ratio of the observed event of interest. The main advantage is to avoid confounding effects by analyzing the association of all variables together. In this article, we explain the logistic regression procedure using examples to make it as simple as possible. After definition of the technique, the basic interpretation of the results is highlighted and then some special issues are discussed.

Partners and Clients of Female Sex Workers in an Informal Urban Settlement in Nairobi, Kenya

PubMed Central

Ngugi, Elizabeth; Benoit, Cecilia; Hallgrimsdottir, Helga; Jansson, Mikael; Roth, Eric Abella

2013-01-01

This paper compares and contrasts number of partners and condom use behaviour for female sex workers (FSWs) and a sample of women working in other economic activities, with both samples drawn from the large informal settlement of Kibera, Nairobi, Kenya. As expected, univariate analysis revealed much higher numbers of overall sexual partners and higher levels of condom use among FSWs compared to Kibera women in other occupations. An unexpected finding, however, was that FSWs with a romantic partner had significantly fewer sexual partners per unit time than FSWs without such a partner. This finding held for multivariate analysis, with negative binomial regression analyses showing that having a romantic partner was significantly associated with reductions in total number of both sexual partners overall and with sexual partners who did not use condoms. In contrast, HIV status, education, number of immediate family members, and levels of alcohol consumption were non-significant factors for both regression analyses. Results suggest that FSWs’ romantic partners act as more than sources of possible HIV infection; rather, romantic partners appear to also have an important positive impact on health. We discuss this finding in light of possible harm reduction programmes focusing on FSWs and their romantic partners. PMID:21936649

A modified chain binomial model to analyse the ongoing measles epidemic in Greece, July 2017 to February 2018

PubMed Central

Lytras, Theodore; Georgakopoulou, Theano; Tsiodras, Sotirios

2018-01-01

Greece is currently experiencing a large measles outbreak, in the context of multiple similar outbreaks across Europe. We devised and applied a modified chain-binomial epidemic model, requiring very simple data, to estimate the transmission parameters of this outbreak. Model results indicate sustained measles transmission among the Greek Roma population, necessitating a targeted mass vaccination campaign to halt further spread of the epidemic. Our model may be useful for other countries facing similar measles outbreaks. PMID:29717695

A modified chain binomial model to analyse the ongoing measles epidemic in Greece, July 2017 to February 2018.

PubMed

Lytras, Theodore; Georgakopoulou, Theano; Tsiodras, Sotirios

2018-04-01

Greece is currently experiencing a large measles outbreak, in the context of multiple similar outbreaks across Europe. We devised and applied a modified chain-binomial epidemic model, requiring very simple data, to estimate the transmission parameters of this outbreak. Model results indicate sustained measles transmission among the Greek Roma population, necessitating a targeted mass vaccination campaign to halt further spread of the epidemic. Our model may be useful for other countries facing similar measles outbreaks.

Comparing Environmental Influences on Coral Bleaching Across and within Species using Clustered Binomial Regression

EPA Science Inventory

Differential susceptibility among reef-building coral species can lead to community shifts and loss of diversity as a result of temperature-induced mass bleaching events. However, the influence of the local environment on species-specific bleaching susceptibilities has not been ...

Functional limitations as potential mediators of the effects of self-reported vision status on fall risk of older adults.

PubMed

Steinman, Bernard A; Allen, Susan M; Chen, Jie; Pynoos, Jon

2015-02-01

To test whether limitations in mobility and large-muscle functioning mediate self-reported vision status to increase fall risk among respondents age 65 and above. This study used two waves from the Health and Retirement Study. We conducted binary logistic and negative binomial regression analyses to test indirect paths leading from self-reported vision status to falls, via indices of mobility and large-muscle functioning. Limited evidence was found for a mediating effect among women; however, large-muscle groups were implicated as partially mediating risk factors for falls among men with fair self-reported vision status. Implications of these findings are discussed including the need for prioritizing improved muscle strength of older men and women with poor vision as a preventive measure against falls. © The Author(s) 2014.

School Violence: The Role of Parental and Community Involvement

ERIC Educational Resources Information Center

Lesneskie, Eric; Block, Steven

2017-01-01

This study utilizes the School Survey on Crime and Safety to identify variables that predict lower levels of violence from four domains: school security, school climate, parental involvement, and community involvement. Negative binomial regression was performed and the findings indicate that statistically significant results come from all four…

Predicting Children's Asthma Hospitalizations: Rural and Urban Differences in Texas

ERIC Educational Resources Information Center

Grineski, Sara E.

2009-01-01

Asthma is the number one chronic health condition facing children today; however, little is known about rural-urban inequalities in asthma. This "area effects on health" study examines rural-urban differences in childhood asthma hospitalizations within the state of Texas using negative binomial regression models. Effects associated with…

Antibiotic Resistances in Livestock: A Comparative Approach to Identify an Appropriate Regression Model for Count Data

PubMed Central

Hüls, Anke; Frömke, Cornelia; Ickstadt, Katja; Hille, Katja; Hering, Johanna; von Münchhausen, Christiane; Hartmann, Maria; Kreienbrock, Lothar

2017-01-01

Antimicrobial resistance in livestock is a matter of general concern. To develop hygiene measures and methods for resistance prevention and control, epidemiological studies on a population level are needed to detect factors associated with antimicrobial resistance in livestock holdings. In general, regression models are used to describe these relationships between environmental factors and resistance outcome. Besides the study design, the correlation structures of the different outcomes of antibiotic resistance and structural zero measurements on the resistance outcome as well as on the exposure side are challenges for the epidemiological model building process. The use of appropriate regression models that acknowledge these complexities is essential to assure valid epidemiological interpretations. The aims of this paper are (i) to explain the model building process comparing several competing models for count data (negative binomial model, quasi-Poisson model, zero-inflated model, and hurdle model) and (ii) to compare these models using data from a cross-sectional study on antibiotic resistance in animal husbandry. These goals are essential to evaluate which model is most suitable to identify potential prevention measures. The dataset used as an example in our analyses was generated initially to study the prevalence and associated factors for the appearance of cefotaxime-resistant Escherichia coli in 48 German fattening pig farms. For each farm, the outcome was the count of samples with resistant bacteria. There was almost no overdispersion and only moderate evidence of excess zeros in the data. Our analyses show that it is essential to evaluate regression models in studies analyzing the relationship between environmental factors and antibiotic resistances in livestock. After model comparison based on evaluation of model predictions, Akaike information criterion, and Pearson residuals, here the hurdle model was judged to be the most appropriate model. PMID:28620609

Determinants of The Grade A Embryos in Infertile Women; Zero-Inflated Regression Model.

PubMed

Almasi-Hashiani, Amir; Ghaheri, Azadeh; Omani Samani, Reza

2017-10-01

In assisted reproductive technology, it is important to choose high quality embryos for embryo transfer. The aim of the present study was to determine the grade A embryo count and factors related to it in infertile women. This historical cohort study included 996 infertile women. The main outcome was the number of grade A embryos. Zero-Inflated Poisson (ZIP) regression and Zero-Inflated Negative Binomial (ZINB) regression were used to model the count data as it contained excessive zeros. Stata software, version 13 (Stata Corp, College Station, TX, USA) was used for all statistical analyses. After adjusting for potential confounders, results from the ZINB model show that for each unit increase in the number 2 pronuclear (2PN) zygotes, we get an increase of 1.45 times as incidence rate ratio (95% confidence interval (CI): 1.23-1.69, P=0.001) in the expected grade A embryo count number, and for each increase in the cleavage day we get a decrease 0.35 times (95% CI: 0.20-0.61, P=0.001) in expected grade A embryo count. There is a significant association between both the number of 2PN zygotes and cleavage day with the number of grade A embryos in both ZINB and ZIP regression models. The estimated coefficients are more plausible than values found in earlier studies using less relevant models. Copyright© by Royan Institute. All rights reserved.

Gaussian Process Regression Model in Spatial Logistic Regression

NASA Astrophysics Data System (ADS)

Sofro, A.; Oktaviarina, A.

2018-01-01

Spatial analysis has developed very quickly in the last decade. One of the favorite approaches is based on the neighbourhood of the region. Unfortunately, there are some limitations such as difficulty in prediction. Therefore, we offer Gaussian process regression (GPR) to accommodate the issue. In this paper, we will focus on spatial modeling with GPR for binomial data with logit link function. The performance of the model will be investigated. We will discuss the inference of how to estimate the parameters and hyper-parameters and to predict as well. Furthermore, simulation studies will be explained in the last section.

Depressive symptoms in HIV-infected and seronegative control subjects in Cameroon: Effect of age, education and gender

PubMed Central

Kanmogne, Georgette D.; Qiu, Fang; Ntone, Félicien E.; Fonsah, Julius Y.; Njamnshi, Dora M.; Kuate, Callixte T.; Doh, Roland F.; Kengne, Anne M.; Tagny, Claude T.; Nchindap, Emilienne; Kenmogne, Léopoldine; Mbanya, Dora; Cherner, Mariana; Heaton, Robert K.; Njamnshi, Alfred K.

2017-01-01

Depression is a leading cause of HIV/AIDS disease burden; it worsens health outcomes and quality of life. Addressing this problem requires accurate quantification of the extra burden of depression to HIV/AIDS in a given population, and knowledge of the baseline depression prevalence in the general population. There has been no previous study of depression in the general Cameroonian population. The current study attempts to address that important need. We used the Beck Depression Inventory-II to assess the prevalence and severity of depressive symptoms in 270 HIV-infected and seronegative Cameroonians. Univariate analyses showed a trend toward higher depressive symptoms among cases, compared to controls (p = 0.055), and among older subjects (>40 years), compared to younger subjects (≤40 years) (p = 0.059). Analysis of depression severity showed that 33.73% of cases had moderate-to-severe depressive symptoms, compared to 19.8% of controls (p<0.01). However, multivariable negative binomial regression analyses showed no effect of age, HIV status, CD4 levels, viral loads, ART, or opportunistic infections on the risk of depressive symptoms. Both univariate and multivariable regression analyses showed significantly higher risk of depressive symptoms among females compared to males; this was significant for both female controls and female cases. Female cases had significantly higher CD4 cell counts and lower viral loads, compared to males. Both univariate and multivariable regression analyses showed that lower education (≤10 years) was associated with increased risk of depressive symptoms. This study shows a high prevalence of depressive symptoms among seronegative controls and HIV-infected Cameroonians. Integrating care for mental disorders such as depression into primary health care and existing HIV/AIDS treatment programs in Cameroon may improve the wellbeing of the general population and could lower the HIV/AIDS burden. PMID:28231258

Depressive symptoms in HIV-infected and seronegative control subjects in Cameroon: Effect of age, education and gender.

PubMed

Kanmogne, Georgette D; Qiu, Fang; Ntone, Félicien E; Fonsah, Julius Y; Njamnshi, Dora M; Kuate, Callixte T; Doh, Roland F; Kengne, Anne M; Tagny, Claude T; Nchindap, Emilienne; Kenmogne, Léopoldine; Mbanya, Dora; Cherner, Mariana; Heaton, Robert K; Njamnshi, Alfred K

2017-01-01

Depression is a leading cause of HIV/AIDS disease burden; it worsens health outcomes and quality of life. Addressing this problem requires accurate quantification of the extra burden of depression to HIV/AIDS in a given population, and knowledge of the baseline depression prevalence in the general population. There has been no previous study of depression in the general Cameroonian population. The current study attempts to address that important need. We used the Beck Depression Inventory-II to assess the prevalence and severity of depressive symptoms in 270 HIV-infected and seronegative Cameroonians. Univariate analyses showed a trend toward higher depressive symptoms among cases, compared to controls (p = 0.055), and among older subjects (>40 years), compared to younger subjects (≤40 years) (p = 0.059). Analysis of depression severity showed that 33.73% of cases had moderate-to-severe depressive symptoms, compared to 19.8% of controls (p<0.01). However, multivariable negative binomial regression analyses showed no effect of age, HIV status, CD4 levels, viral loads, ART, or opportunistic infections on the risk of depressive symptoms. Both univariate and multivariable regression analyses showed significantly higher risk of depressive symptoms among females compared to males; this was significant for both female controls and female cases. Female cases had significantly higher CD4 cell counts and lower viral loads, compared to males. Both univariate and multivariable regression analyses showed that lower education (≤10 years) was associated with increased risk of depressive symptoms. This study shows a high prevalence of depressive symptoms among seronegative controls and HIV-infected Cameroonians. Integrating care for mental disorders such as depression into primary health care and existing HIV/AIDS treatment programs in Cameroon may improve the wellbeing of the general population and could lower the HIV/AIDS burden.

Using exceedance probabilities to detect anomalies in routinely recorded animal health data, with particular reference to foot-and-mouth disease in Viet Nam.

PubMed

Richards, K K; Hazelton, M L; Stevenson, M A; Lockhart, C Y; Pinto, J; Nguyen, L

2014-10-01

The widespread availability of computer hardware and software for recording and storing disease event information means that, in theory, we have the necessary information to carry out detailed analyses of factors influencing the spatial distribution of disease in animal populations. However, the reliability of such analyses depends on data quality, with anomalous records having the potential to introduce significant bias and lead to inappropriate decision making. In this paper we promote the use of exceedance probabilities as a tool for detecting anomalies when applying hierarchical spatio-temporal models to animal health data. We illustrate this methodology through a case study data on outbreaks of foot-and-mouth disease (FMD) in Viet Nam for the period 2006-2008. A flexible binomial logistic regression was employed to model the number of FMD infected communes within each province of the country. Standard analyses of the residuals from this model failed to identify problems, but exceedance probabilities identified provinces in which the number of reported FMD outbreaks was unexpectedly low. This finding is interesting given that these provinces are on major cattle movement pathways through Viet Nam. Copyright © 2014 Elsevier Ltd. All rights reserved.

Estimating relative risks for common outcome using PROC NLP.

PubMed

Yu, Binbing; Wang, Zhuoqiao

2008-05-01

In cross-sectional or cohort studies with binary outcomes, it is biologically interpretable and of interest to estimate the relative risk or prevalence ratio, especially when the response rates are not rare. Several methods have been used to estimate the relative risk, among which the log-binomial models yield the maximum likelihood estimate (MLE) of the parameters. Because of restrictions on the parameter space, the log-binomial models often run into convergence problems. Some remedies, e.g., the Poisson and Cox regressions, have been proposed. However, these methods may give out-of-bound predicted response probabilities. In this paper, a new computation method using the SAS Nonlinear Programming (NLP) procedure is proposed to find the MLEs. The proposed NLP method was compared to the COPY method, a modified method to fit the log-binomial model. Issues in the implementation are discussed. For illustration, both methods were applied to data on the prevalence of microalbuminuria (micro-protein leakage into urine) for kidney disease patients from the Diabetes Control and Complications Trial. The sample SAS macro for calculating relative risk is provided in the appendix.

Football goal distributions and extremal statistics

NASA Astrophysics Data System (ADS)

Greenhough, J.; Birch, P. C.; Chapman, S. C.; Rowlands, G.

2002-12-01

We analyse the distributions of the number of goals scored by home teams, away teams, and the total scored in the match, in domestic football games from 169 countries between 1999 and 2001. The probability density functions (PDFs) of goals scored are too heavy-tailed to be fitted over their entire ranges by Poisson or negative binomial distributions which would be expected for uncorrelated processes. Log-normal distributions cannot include zero scores and here we find that the PDFs are consistent with those arising from extremal statistics. In addition, we show that it is sufficient to model English top division and FA Cup matches in the seasons of 1970/71-2000/01 on Poisson or negative binomial distributions, as reported in analyses of earlier seasons, and that these are not consistent with extremal statistics.

An analysis of first-time blood donors return behaviour using regression models.

PubMed

Kheiri, S; Alibeigi, Z

2015-08-01

Blood products have a vital role in saving many patients' lives. The aim of this study was to analyse blood donor return behaviour. Using a cross-sectional follow-up design of 5-year duration, 864 first-time donors who had donated blood were selected using a systematic sampling. The behaviours of donors via three response variables, return to donation, frequency of return to donation and the time interval between donations, were analysed based on logistic regression, negative binomial regression and Cox's shared frailty model for recurrent events respectively. Successful return to donation rated at 49·1% and the deferral rate was 13·3%. There was a significant reverse relationship between the frequency of return to donation and the time interval between donations. Sex, body weight and job had an effect on return to donation; weight and frequency of donation during the first year had a direct effect on the total frequency of donations. Age, weight and job had a significant effect on the time intervals between donations. Aging decreases the chances of return to donation and increases the time interval between donations. Body weight affects the three response variables, i.e. the higher the weight, the more the chances of return to donation and the shorter the time interval between donations. There is a positive correlation between the frequency of donations in the first year and the total number of return to donations. Also, the shorter the time interval between donations is, the higher the frequency of donations. © 2015 British Blood Transfusion Society.

Time series regression model for infectious disease and weather.

PubMed

Imai, Chisato; Armstrong, Ben; Chalabi, Zaid; Mangtani, Punam; Hashizume, Masahiro

2015-10-01

Time series regression has been developed and long used to evaluate the short-term associations of air pollution and weather with mortality or morbidity of non-infectious diseases. The application of the regression approaches from this tradition to infectious diseases, however, is less well explored and raises some new issues. We discuss and present potential solutions for five issues often arising in such analyses: changes in immune population, strong autocorrelations, a wide range of plausible lag structures and association patterns, seasonality adjustments, and large overdispersion. The potential approaches are illustrated with datasets of cholera cases and rainfall from Bangladesh and influenza and temperature in Tokyo. Though this article focuses on the application of the traditional time series regression to infectious diseases and weather factors, we also briefly introduce alternative approaches, including mathematical modeling, wavelet analysis, and autoregressive integrated moving average (ARIMA) models. Modifications proposed to standard time series regression practice include using sums of past cases as proxies for the immune population, and using the logarithm of lagged disease counts to control autocorrelation due to true contagion, both of which are motivated from "susceptible-infectious-recovered" (SIR) models. The complexity of lag structures and association patterns can often be informed by biological mechanisms and explored by using distributed lag non-linear models. For overdispersed models, alternative distribution models such as quasi-Poisson and negative binomial should be considered. Time series regression can be used to investigate dependence of infectious diseases on weather, but may need modifying to allow for features specific to this context. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Racial Threat and White Opposition to Bilingual Education in Texas

ERIC Educational Resources Information Center

Hempel, Lynn M.; Dowling, Julie A.; Boardman, Jason D.; Ellison, Christopher G.

2013-01-01

This study examines local contextual conditions that influence opposition to bilingual education among non-Hispanic Whites, net of individual-level characteristics. Data from the Texas Poll (N = 615) are used in conjunction with U.S. Census data to test five competing hypotheses using binomial and multinomial logistic regression models. Our…

The Effectiveness of an Electronic Security Management System in a Privately Owned Apartment Complex

ERIC Educational Resources Information Center

Greenberg, David F.; Roush, Jeffrey B.

2009-01-01

Poisson and negative binomial regression methods are used to analyze the monthly time series data to determine the effects of introducing an integrated security management system including closed-circuit television (CCTV), door alarm monitoring, proximity card access, and emergency call boxes to a large privately-owned complex of apartment…

Campaign Strategies and Voter Approval of School Referenda: A Mixed Methods Analysis

ERIC Educational Resources Information Center

Johnson, Paul A.; Ingle, William Kyle

2009-01-01

Drawing from state administrative data and surveys of superintendents in Ohio, this mixed methods study examined factors associated with voters' approval of local school levies. Utilizing binomial logistic regression, this study found that new levies and poverty rates were significantly associated with a decrease in the likelihood of passage.…

Socio-environmental predictors of Barmah forest virus transmission in coastal areas, Queensland, Australia.

PubMed

Naish, Suchithra; Hu, Wenbiao; Nicholls, Neville; Mackenzie, John S; Dale, Pat; McMichael, Anthony J; Tong, Shilu

2009-02-01

To assess the socio-environmental predictors of Barmah forest virus (BFV) transmission in coastal areas, Queensland, Australia. Data on BFV notified cases, climate, tidal levels and socioeconomic index for area (SEIFA) in six coastal cities, Queensland, for the period 1992-2001 were obtained from the relevant government agencies. Negative binomial regression models were used to assess the socio-environmental predictors of BFV transmission. The results show that maximum and minimum temperature, rainfall, relative humidity, high and low tide were statistically significantly associated with BFV incidence at lags 0-2 months. The fitted negative binomial regression models indicate a significant independent association of each of maximum temperature (beta = 0.139, P = 0.000), high tide (beta = 0.005, P = 0.000) and SEIFA index (beta = -0.010, P = 0.000) with BFV transmission after adjustment for confounding variables. The transmission of BFV disease in Queensland coastal areas seemed to be determined by a combination of local social and environmental factors. The model developed in this study may have applications in the control and prevention of BFV disease in these areas.

Assessment of DSM-5 Section II Personality Disorders With the MMPI-2-RF in a Nonclinical Sample.

PubMed

Sellbom, Martin; Smith, Alexander

2017-01-01

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 / 2011 ) is frequently used in clinical practice. However, there has been a dearth of literature on how well this instrument can assess symptoms associated with personality disorders (PDs). This investigation examined a range of hypothesized MMPI-2-RF scales in predicting PD symptoms. We evaluated these associations in a sample of 397 university students who had been administered the MMPI-2-RF and the Structured Clinical Interview for DSM-IV Axis II Disorders-Personality Questionnaire (First, Gibbon, Spitzer, Williams, & Benjamin, 1997 ). Zero-order correlation analyses and negative binomial regression models indicated that a wide range of MMPI-2-RF scale hypotheses were supported; however, the least support was available for predicting schizoid and obsessive-compulsive PDs. Implications for MMPI-2-RF interpretation and PD diagnosis are discussed.

Changes in the labour market and health inequalities during the years of the recent economic downturn in Italy.

PubMed

Sarti, Simone; Zella, Sara

2016-05-01

There is widespread concern that episodes of unemployment and unstable working conditions adversely affect health. We add to the debate by focusing on the relationship between work trajectory and the self-reported health of Italian men and women during the present economic downturn. Relying on Italian data in the EU-SILC project (from 2007 to 2010), our sample includes all individuals aged 30 to 60 in 2010, and uses multivariate binomial regression models for preliminary analyses and the Structural Equations modelling (SEM) to observe the cumulative effects of health status according to different job trajectories. Our main findings show similar pictures for men and women. Individuals who are unemployed, ejected or in precarious occupational positions have a higher risk of worsening their health status during these years. Copyright © 2016 Elsevier Inc. All rights reserved.

A Nationwide Study of Discrimination and Chronic Health Conditions Among Asian Americans

PubMed Central

Gee, Gilbert C.; Spencer, Michael S.; Chen, Juan; Takeuchi, David

2007-01-01

Objectives. We examined whether self-reported everyday discrimination was associated with chronic health conditions among a nationally representative sample of Asian Americans. Methods. Data were from the Asian American subsample (n = 2095) of the National Latino and Asian American Study conducted in 2002 and 2003. Regression techniques (negative binomial and logistic) were used to examine the association between discrimination and chronic health conditions. Analyses were conducted for the entire sample and 3 Asian subgroups (Chinese, Vietnamese, and Filipino). Results. Reports of everyday discrimination were associated with many chronic conditions, after we controlled for age, gender, region, per capita income, education, employment, and social desirability bias. Discrimination was also associated with indicators of heart disease, pain, and respiratory illnesses. There were some differences by Asian subgroup. Conclusions. Everyday discrimination may contribute to stress experienced by racial/ethnic minorities and could lead to chronic illness. PMID:17538055

Clinical reasoning in feline epilepsy: Which combination of clinical information is useful?

PubMed

Stanciu, Gabriela-Dumitrita; Packer, Rowena Mary Anne; Pakozdy, Akos; Solcan, Gheorghe; Volk, Holger Andreas

2017-07-01

We sought to identify the association between clinical risk factors and the diagnosis of idiopathic epilepsy (IE) or structural epilepsy (SE) in cats, using statistical models to identify combinations of discrete parameters from the patient signalment, history and neurological examination findings that could suggest the most likely diagnosis. Data for 138 cats with recurrent seizures were reviewed, of which 110 were valid for inclusion. Seizure aetiology was classified as IE in 57% and SE in 43% of cats. Binomial logistic regression analyses demonstrated that pedigree status, older age at seizure onset (particularly >7years old), abnormal neurological examinations, and ictal vocalisation were associated with a diagnosis of SE compared to IE, and that ictal salivation was more likely to be associated with a diagnosis of IE than SE. These findings support the importance of considering inter-ictal neurological deficits and seizure history in clinical reasoning. Copyright © 2017 Elsevier Ltd. All rights reserved.

Does the Organized Sexual Murderer Better Delay and Avoid Detection?

PubMed

Beauregard, Eric; Martineau, Melissa

2016-01-01

According to the organized-disorganized model, organized sexual murderers adopt specific behaviors during the commission of their crimes that contribute to avoiding police detection. The current study examines the effect of sexual murderers' organized behaviors on their ability to both delay and/or avoid police detection. Using a combination of negative binomial and logistic regression analyses on a sample of 350 sexual murder cases, findings showed that although both measures of delaying and avoiding detection are positively correlated, different behavioral patterns were observed. For instance, offenders who moved the victim's body were more likely to avoid detection but the victim's body was likely to be recovered faster. Moreover, victim characteristics have an impact on both measures; however, this effect disappears for the measure of delaying detection once the organized behaviors are introduced. Implications of the findings are discussed. © The Author(s) 2014.

A preliminary investigation of the relationships between historical crash and naturalistic driving.

PubMed

Pande, Anurag; Chand, Sai; Saxena, Neeraj; Dixit, Vinayak; Loy, James; Wolshon, Brian; Kent, Joshua D

2017-04-01

This paper describes a project that was undertaken using naturalistic driving data collected via Global Positioning System (GPS) devices to demonstrate a proof-of-concept for proactive safety assessments of crash-prone locations. The main hypothesis for the study is that the segments where drivers have to apply hard braking (higher jerks) more frequently might be the "unsafe" segments with more crashes over a long-term. The linear referencing methodology in ArcMap was used to link the GPS data with roadway characteristic data of US Highway 101 northbound (NB) and southbound (SB) in San Luis Obispo, California. The process used to merge GPS data with quarter-mile freeway segments for traditional crash frequency analysis is also discussed in the paper. A negative binomial regression analyses showed that proportion of high magnitude jerks while decelerating on freeway segments (from the driving data) was significantly related with the long-term crash frequency of those segments. A random parameter negative binomial model with uniformly distributed parameter for ADT and a fixed parameter for jerk provided a statistically significant estimate for quarter-mile segments. The results also indicated that roadway curvature and the presence of auxiliary lane are not significantly related with crash frequency for the highway segments under consideration. The results from this exploration are promising since the data used to derive the explanatory variable(s) can be collected using most off-the-shelf GPS devices, including many smartphones. Copyright © 2017 Elsevier Ltd. All rights reserved.

Analyzing hospitalization data: potential limitations of Poisson regression.

PubMed

Weaver, Colin G; Ravani, Pietro; Oliver, Matthew J; Austin, Peter C; Quinn, Robert R

2015-08-01

Poisson regression is commonly used to analyze hospitalization data when outcomes are expressed as counts (e.g. number of days in hospital). However, data often violate the assumptions on which Poisson regression is based. More appropriate extensions of this model, while available, are rarely used. We compared hospitalization data between 206 patients treated with hemodialysis (HD) and 107 treated with peritoneal dialysis (PD) using Poisson regression and compared results from standard Poisson regression with those obtained using three other approaches for modeling count data: negative binomial (NB) regression, zero-inflated Poisson (ZIP) regression and zero-inflated negative binomial (ZINB) regression. We examined the appropriateness of each model and compared the results obtained with each approach. During a mean 1.9 years of follow-up, 183 of 313 patients (58%) were never hospitalized (indicating an excess of 'zeros'). The data also displayed overdispersion (variance greater than mean), violating another assumption of the Poisson model. Using four criteria, we determined that the NB and ZINB models performed best. According to these two models, patients treated with HD experienced similar hospitalization rates as those receiving PD {NB rate ratio (RR): 1.04 [bootstrapped 95% confidence interval (CI): 0.49-2.20]; ZINB summary RR: 1.21 (bootstrapped 95% CI 0.60-2.46)}. Poisson and ZIP models fit the data poorly and had much larger point estimates than the NB and ZINB models [Poisson RR: 1.93 (bootstrapped 95% CI 0.88-4.23); ZIP summary RR: 1.84 (bootstrapped 95% CI 0.88-3.84)]. We found substantially different results when modeling hospitalization data, depending on the approach used. Our results argue strongly for a sound model selection process and improved reporting around statistical methods used for modeling count data. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Factors associated with the frequency of monitoring of liver enzymes, renal function and lipid laboratory markers among individuals initiating combination antiretroviral therapy: a cohort study.

PubMed

Gillis, Jennifer; Bayoumi, Ahmed M; Burchell, Ann N; Cooper, Curtis; Klein, Marina B; Loutfy, Mona; Machouf, Nima; Montaner, Julio Sg; Tsoukas, Chris; Hogg, Robert S; Raboud, Janet

2015-10-26

As the average age of the HIV-positive population increases, there is increasing need to monitor patients for the development of comorbidities as well as for drug toxicities. We examined factors associated with the frequency of measurement of liver enzymes, renal function tests, and lipid levels among participants of the Canadian Observational Cohort (CANOC) collaboration which follows people who initiated HIV antiretroviral therapy in 2000 or later. We used zero-inflated negative binomial regression models to examine the associations of demographic and clinical characteristics with the rates of measurement during follow-up. Generalized estimating equations with a logit link were used to examine factors associated with gaps of 12 months or more between measurements. Electronic laboratory data were available for 3940 of 7718 CANOC participants. The median duration of electronic follow-up was 3.5 years. The median (interquartile) rates of tests per year were 2.76 (1.60, 3.73), 2.55 (1.44, 3.38) and 1.42 (0.50, 2.52) for liver, renal and lipid parameters, respectively. In multivariable zero-inflated negative binomial regression models, individuals infected through injection drug use (IDU) were significantly less likely to have any measurements. Among participants with at least one measurement, rates of measurement of liver, renal and lipid tests were significantly lower for younger individuals and Aboriginal Peoples. Hepatitis C co-infected individuals with a history of IDU had lower rates of measurement and were at greater risk of having 12 month gaps between measurements. Hepatitis C co-infected participants infected through IDU were at increased risk of gaps in testing, despite publicly funded health care and increased risk of comorbid conditions. This should be taken into consideration in analyses examining factors associated with outcomes based on laboratory parameters.

The role of vaspin as a predictor of coronary angiography result in SCAD (stable coronary artery disease) patients.

PubMed

Stančík, Matej; Ságová, Ivana; Kantorová, Ema; Mokáň, Marián

2017-05-08

The role of vaspin in the pathogenesis of stable coronary artery disease (SCAD) have been repeatedly addressed in clinical studies. However, from the point of view of clinical practice, the results of earlier studies are still inconclusive. The data of 106 SCAD patients who received coronary angiography and 85 coronary artery disease-free controls were collected and analysed. The patients were divided into subgroups according to their pre-test probability (PTP) and according to the result of coronary angiography. Fasting vaspin concentrations were compared between subgroups of SCAD patients and between target group and controls. The effect of age and smoking on the result of coronary angiography was compared to the effect of vaspin using the binomial regression. We did not find significant difference in vaspin level between target group and controls. Unless the pre-test probability was taken into account, we did not find vaspin difference in the target group, when dividing patients on the basis of presence/absence of significant coronary stenosis. In the subgroup of SCAD patients with PTP between 15% - 65%, those with significant coronary stenoses had higher mean vaspin concentration (0,579 ± 0,898 ng/ml) than patients without significant stenoses. (0,379 ± 0,732 ng/ml) (t = -2595; p = 0,012; d = 0,658; 1-β = 0,850). Age, smoking status and vaspin significantly contributed to the HSCS prediction in binomial regression model in patients with low PTP (OR: 1.1, 4.9, 8.7, respectively). According to our results, vaspin cannot be used as an independent marker for the presence of CAD in general population. However, our results indicate that measuring vaspin in SCAD patients might be clinically useful in patients with PTP below 66%.

Perceived Prevalence of Teasing and Bullying Predicts High School Dropout Rates

ERIC Educational Resources Information Center

Cornell, Dewey; Gregory, Anne; Huang, Francis; Fan, Xitao

2013-01-01

This prospective study of 276 Virginia public high schools found that the prevalence of teasing and bullying (PTB) as perceived by both 9th-grade students and teachers was predictive of dropout rates for this cohort 4 years later. Negative binomial regression indicated that one standard deviation increases in student- and teacher-reported PTB were…

A statistical model to estimate the impact of a hepatitis A vaccination programme.

PubMed

Oviedo, Manuel; Pilar Muñoz, M; Domínguez, Angela; Borras, Eva; Carmona, Gloria

2008-11-11

A program of routine hepatitis A+B vaccination in preadolescents was introduced in 1998 in Catalonia, a region situated in the northeast of Spain. The objective of this study was to quantify the reduction in the incidence of hepatitis A in order to differentiate the natural reduction of the incidence of hepatitis A from that produced due to the vaccination programme and to predict the evolution of the disease in forthcoming years. A generalized linear model (GLM) using negative binomial regression was used to estimate the incidence rates of hepatitis A in Catalonia by year, age group and vaccination. Introduction of the vaccine reduced cases by 5.5 by year (p-value<0.001), but there was a significant interaction between the year of report and vaccination that smoothed this reduction (p-value<0.001). The reduction was not equal in all age groups, being greater in the 12-18 years age group, which fell from a mean rate of 8.15 per 100,000 person/years in the pre-vaccination period (1992-1998) to 1.4 in the vaccination period (1999-2005). The model predicts the evolution accurately for the group of vaccinated subjects. Negative binomial regression is more appropriate than Poisson regression when observed variance exceeds the observed mean (overdispersed count data), can cause a variable apparently contribute more on the model of what really makes it.

Regular exercise and related factors in patients with Parkinson's disease: Applying zero-inflated negative binomial modeling of exercise count data.

PubMed

Lee, JuHee; Park, Chang Gi; Choi, Moonki

2016-05-01

This study was conducted to identify risk factors that influence regular exercise among patients with Parkinson's disease in Korea. Parkinson's disease is prevalent in the elderly, and may lead to a sedentary lifestyle. Exercise can enhance physical and psychological health. However, patients with Parkinson's disease are less likely to exercise than are other populations due to physical disability. A secondary data analysis and cross-sectional descriptive study were conducted. A convenience sample of 106 patients with Parkinson's disease was recruited at an outpatient neurology clinic of a tertiary hospital in Korea. Demographic characteristics, disease-related characteristics (including disease duration and motor symptoms), self-efficacy for exercise, balance, and exercise level were investigated. Negative binomial regression and zero-inflated negative binomial regression for exercise count data were utilized to determine factors involved in exercise. The mean age of participants was 65.85 ± 8.77 years, and the mean duration of Parkinson's disease was 7.23 ± 6.02 years. Most participants indicated that they engaged in regular exercise (80.19%). Approximately half of participants exercised at least 5 days per week for 30 min, as recommended (51.9%). Motor symptoms were a significant predictor of exercise in the count model, and self-efficacy for exercise was a significant predictor of exercise in the zero model. Severity of motor symptoms was related to frequency of exercise. Self-efficacy contributed to the probability of exercise. Symptom management and improvement of self-efficacy for exercise are important to encourage regular exercise in patients with Parkinson's disease. Copyright © 2015 Elsevier Inc. All rights reserved.

Stability of a Model Explaining Selected Extramusical Influences on Solo and Small-Ensemble Festival Ratings

ERIC Educational Resources Information Center

Bergee, Martin J.; Westfall, Claude R.

2005-01-01

This is the third study in a line of inquiry whose purpose has been to develop a theoretical model of selected extra musical variables' influence on solo and small-ensemble festival ratings. Authors of the second of these (Bergee & McWhirter, 2005) had used binomial logistic regression as the basis for their model-formulation strategy. Their…

A Negative Binomial Regression Model for Accuracy Tests

ERIC Educational Resources Information Center

Hung, Lai-Fa

2012-01-01

Rasch used a Poisson model to analyze errors and speed in reading tests. An important property of the Poisson distribution is that the mean and variance are equal. However, in social science research, it is very common for the variance to be greater than the mean (i.e., the data are overdispersed). This study embeds the Rasch model within an…

Which Types of Televised Anti-Tobacco Campaigns Prompt More Quitline Calls from Disadvantaged Groups?

ERIC Educational Resources Information Center

Durkin, Sarah J.; Wakefield, Melanie A.; Spittal, Matthew J.

2011-01-01

To examine the efficacy of different types of mass media ads in driving lower socio-economic smokers (SES) to utilize quitlines. This study collected all 33 719 calls to the Victorian quitline in Australia over a 2-year period. Negative binomial regressions examined the relationship between weekly levels of exposure to different types of…

A Time Series Analysis: Weather Factors, Human Migration and Malaria Cases in Endemic Area of Purworejo, Indonesia, 2005–2014

PubMed Central

REJEKI, Dwi Sarwani Sri; NURHAYATI, Nunung; AJI, Budi; MURHANDARWATI, E. Elsa Herdiana; KUSNANTO, Hari

2018-01-01

Background: Climatic and weather factors become important determinants of vector-borne diseases transmission like malaria. This study aimed to prove relationships between weather factors with considering human migration and previous case findings and malaria cases in endemic areas in Purworejo during 2005–2014. Methods: This study employed ecological time series analysis by using monthly data. The independent variables were the maximum temperature, minimum temperature, maximum humidity, minimum humidity, precipitation, human migration, and previous malaria cases, while the dependent variable was positive malaria cases. Three models of count data regression analysis i.e. Poisson model, quasi-Poisson model, and negative binomial model were applied to measure the relationship. The least Akaike Information Criteria (AIC) value was also performed to find the best model. Negative binomial regression analysis was considered as the best model. Results: The model showed that humidity (lag 2), precipitation (lag 3), precipitation (lag 12), migration (lag1) and previous malaria cases (lag 12) had a significant relationship with malaria cases. Conclusion: Weather, migration and previous malaria cases factors need to be considered as prominent indicators for the increase of malaria case projection. PMID:29900134

Does a birthday predispose to vascular events?

PubMed

Saposnik, Gustavo; Baibergenova, Akerke; Dang, Jason; Hachinski, Vladimir

2006-07-25

To examine the influence of birthdays on the onset and course of vascular events such as stroke, TIA, and acute myocardial infarction (AMI). This population-based study included all emergency department (ED) admissions due to ischemic stroke, TIA, or AMI from April 2002 to March 2004 in Ontario, Canada. All cases were identified through the National Ambulatory Care Reporting System. Calculations of daily and weekly numbers of events were centered on the patient's birthday and the week of the birthday. Statistical analyses include binomial tests and logistic regression. During the study period, there were 24,315 ED admissions with acute stroke, 16,088 with TIAs, and 29,090 with AMI. The observed number of vascular events during the birthday was higher than the expected daily number of visits for stroke (87 vs 67; p = 0.009), TIA (58 vs 44; p = 0.02), and AMI (97 vs 80; p = 0.027) but not for selected control conditions (asthma, appendicitis, head trauma). Vascular events were more likely to occur on birthday (242 vs 191; odds ratio [OR] = 1.27). No significant differences were observed during the birthday week for any of the conditions. Multivariate logistic regression showed that birthday vascular events were more likely to occur in patients with a history of hypertension (OR = 1.88; 95% CI 1.09 to 3.24). Sensitivity analyses with alternative definitions of birthday week did not alter the results. Stress associated with birthdays may trigger vascular events in patients with predisposing conditions.

Spiritual and ceremonial plants in North America: an assessment of Moerman's ethnobotanical database comparing Residual, Binomial, Bayesian and Imprecise Dirichlet Model (IDM) analysis.

PubMed

Turi, Christina E; Murch, Susan J

2013-07-09

Ethnobotanical research and the study of plants used for rituals, ceremonies and to connect with the spirit world have led to the discovery of many novel psychoactive compounds such as nicotine, caffeine, and cocaine. In North America, spiritual and ceremonial uses of plants are well documented and can be accessed online via the University of Michigan's Native American Ethnobotany Database. The objective of the study was to compare Residual, Bayesian, Binomial and Imprecise Dirichlet Model (IDM) analyses of ritual, ceremonial and spiritual plants in Moerman's ethnobotanical database and to identify genera that may be good candidates for the discovery of novel psychoactive compounds. The database was queried with the following format "Family Name AND Ceremonial OR Spiritual" for 263 North American botanical families. Spiritual and ceremonial flora consisted of 86 families with 517 species belonging to 292 genera. Spiritual taxa were then grouped further into ceremonial medicines and items categories. Residual, Bayesian, Binomial and IDM analysis were performed to identify over and under-utilized families. The 4 statistical approaches were in good agreement when identifying under-utilized families but large families (>393 species) were underemphasized by Binomial, Bayesian and IDM approaches for over-utilization. Residual, Binomial, and IDM analysis identified similar families as over-utilized in the medium (92-392 species) and small (<92 species) classes. The families Apiaceae, Asteraceae, Ericacea, Pinaceae and Salicaceae were identified as significantly over-utilized as ceremonial medicines in medium and large sized families. Analysis of genera within the Apiaceae and Asteraceae suggest that the genus Ligusticum and Artemisia are good candidates for facilitating the discovery of novel psychoactive compounds. The 4 statistical approaches were not consistent in the selection of over-utilization of flora. Residual analysis revealed overall trends that were supported by Binomial analysis when separated into small, medium and large families. The Bayesian, Binomial and IDM approaches identified different genera as potentially important. Species belonging to the genus Artemisia and Ligusticum were most consistently identified and may be valuable in future studies of the ethnopharmacology. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

A crash-prediction model for multilane roads.

PubMed

Caliendo, Ciro; Guida, Maurizio; Parisi, Alessandra

2007-07-01

Considerable research has been carried out in recent years to establish relationships between crashes and traffic flow, geometric infrastructure characteristics and environmental factors for two-lane rural roads. Crash-prediction models focused on multilane rural roads, however, have rarely been investigated. In addition, most research has paid but little attention to the safety effects of variables such as stopping sight distance and pavement surface characteristics. Moreover, the statistical approaches have generally included Poisson and Negative Binomial regression models, whilst Negative Multinomial regression model has been used to a lesser extent. Finally, as far as the authors are aware, prediction models involving all the above-mentioned factors have still not been developed in Italy for multilane roads, such as motorways. Thus, in this paper crash-prediction models for a four-lane median-divided Italian motorway were set up on the basis of accident data observed during a 5-year monitoring period extending between 1999 and 2003. The Poisson, Negative Binomial and Negative Multinomial regression models, applied separately to tangents and curves, were used to model the frequency of accident occurrence. Model parameters were estimated by the Maximum Likelihood Method, and the Generalized Likelihood Ratio Test was applied to detect the significant variables to be included in the model equation. Goodness-of-fit was measured by means of both the explained fraction of total variation and the explained fraction of systematic variation. The Cumulative Residuals Method was also used to test the adequacy of a regression model throughout the range of each variable. The candidate set of explanatory variables was: length (L), curvature (1/R), annual average daily traffic (AADT), sight distance (SD), side friction coefficient (SFC), longitudinal slope (LS) and the presence of a junction (J). Separate prediction models for total crashes and for fatal and injury crashes only were considered. For curves it is shown that significant variables are L, 1/R and AADT, whereas for tangents they are L, AADT and junctions. The effect of rain precipitation was analysed on the basis of hourly rainfall data and assumptions about drying time. It is shown that a wet pavement significantly increases the number of crashes. The models developed in this paper for Italian motorways appear to be useful for many applications such as the detection of critical factors, the estimation of accident reduction due to infrastructure and pavement improvement, and the predictions of accidents counts when comparing different design options. Thus this research may represent a point of reference for engineers in adjusting or designing multilane roads.

Some considerations for excess zeroes in substance abuse research.

PubMed

Bandyopadhyay, Dipankar; DeSantis, Stacia M; Korte, Jeffrey E; Brady, Kathleen T

2011-09-01

Count data collected in substance abuse research often come with an excess of "zeroes," which are typically handled using zero-inflated regression models. However, there is a need to consider the design aspects of those studies before using such a statistical model to ascertain the sources of zeroes. We sought to illustrate hurdle models as alternatives to zero-inflated models to validate a two-stage decision-making process in situations of "excess zeroes." We use data from a study of 45 cocaine-dependent subjects where the primary scientific question was to evaluate whether study participation influences drug-seeking behavior. The outcome, "the frequency (count) of cocaine use days per week," is bounded (ranging from 0 to 7). We fit and compare binomial, Poisson, negative binomial, and the hurdle version of these models to study the effect of gender, age, time, and study participation on cocaine use. The hurdle binomial model provides the best fit. Gender and time are not predictive of use. Higher odds of use versus no use are associated with age; however once use is experienced, odds of further use decrease with increase in age. Participation was associated with higher odds of no-cocaine use; once there is use, participation reduced the odds of further use. Age and study participation are significantly predictive of cocaine-use behavior. The two-stage decision process as modeled by a hurdle binomial model (appropriate for bounded count data with excess zeroes) provides interesting insights into the study of covariate effects on count responses of substance use, when all enrolled subjects are believed to be "at-risk" of use.

Hopelessness as a Predictor of Suicide Ideation in Depressed Male and Female Adolescent Youth.

PubMed

Wolfe, Kristin L; Nakonezny, Paul A; Owen, Victoria J; Rial, Katherine V; Moorehead, Alexandra P; Kennard, Beth D; Emslie, Graham J

2017-12-21

We examined hopelessness as a predictor of suicide ideation in depressed youth after acute medication treatment. A total of 158 depressed adolescents were administered the Children's Depression Rating Scale-Revised (CDRS-R) and Columbia Suicide Severity Rating Scale (C-SSRS) as part of a larger battery at baseline and at weekly visits across 6 weeks of acute fluoxetine treatment. The Beck Hopelessness Scale (BHS) was administered at baseline and week 6. A negative binomial regression model via a generalized estimating equation analysis of repeated measures was used to estimate suicide ideation over the 6 weeks of acute treatment from baseline measure of hopelessness. Depression severity and gender were included as covariates in the model. The negative binomial analysis was also conducted separately for the sample of males and females (in a gender-stratified analysis). Mean CDRS-R total scores were 60.30 ± 8.93 at baseline and 34.65 ± 10.41 at week 6. Mean baseline and week 6 BHS scores were 9.57 ± 5.51 and 5.59 ± 5.38, respectively. Per the C-SSRS, 43.04% and 83.54% reported having no suicide ideation at baseline and at week 6, respectively. The analyses revealed that baseline hopelessness was positively related to suicide ideation over treatment (p = .0027), independent of changes in depression severity. This significant finding persisted only for females (p = .0024). These results indicate the importance of early identification of hopelessness. © 2017 The American Association of Suicidology.

The Effect of Sharrows, Painted Bicycle Lanes and Physically Protected Paths on the Severity of Bicycle Injuries Caused by Motor Vehicles.

PubMed

Wall, Stephen P; Lee, David C; Frangos, Spiros G; Sethi, Monica; Heyer, Jessica H; Ayoung-Chee, Patricia; DiMaggio, Charles J

2016-01-01

We conducted individual and ecologic analyses of prospectively collected data from 839 injured bicyclists who collided with motorized vehicles and presented to Bellevue Hospital, an urban Level-1 trauma center in New York City, from December 2008 to August 2014. Variables included demographics, scene information, rider behaviors, bicycle route availability, and whether the collision occurred before the road segment was converted to a bicycle route. We used negative binomial modeling to assess the risk of injury occurrence following bicycle path or lane implementation. We dichotomized U.S. National Trauma Data Bank Injury Severity Scores (ISS) into none/mild (0-8) versus moderate, severe, or critical (>8) and used adjusted multivariable logistic regression to model the association of ISS with collision proximity to sharrows (i.e., bicycle lanes designated for sharing with cars), painted bicycle lanes, or physically protected paths. Negative binomial modeling of monthly counts, while adjusting for pedestrian activity, revealed that physically protected paths were associated with 23% fewer injuries. Painted bicycle lanes reduced injury risk by nearly 90% (IDR 0.09, 95% CI 0.02-0.33). Holding all else equal, compared to no bicycle route, a bicycle injury nearby sharrows was nearly twice as likely to be moderate, severe, or critical (adjusted odds ratio 1.94; 95% confidence interval (CI) 0.91-4.15). Painted bicycle lanes and physically protected paths were 1.52 (95% CI 0.85-2.71) and 1.66 (95% CI 0.85-3.22) times as likely to be associated with more than mild injury respectively.

Poor, persecuted, young, and alone: Toward explaining the elevated risk of alcohol problems among Black and Latino men who drink.

PubMed

Zemore, Sarah E; Ye, Yu; Mulia, Nina; Martinez, Priscilla; Jones-Webb, Rhonda; Karriker-Jaffe, Katherine

2016-06-01

Even given equivalent drinking patterns, Black and Latino men experience substantially more dependence symptoms and other consequences than White men, particularly at low/no heavy drinking. No known studies have identified factors driving these disparities. The current study examines this question. The 2005 and 2010 National Alcohol Surveys were pooled. Surveys are nationally representative, telephone interviews of the U.S. including Black and Latino oversamples; male drinkers were analyzed (N=4182). Preliminary analyses included negative binomial regressions of dependence symptom and consequence counts testing whether effects for race/ethnicity were diminished when entering potential explanatory factors individually. Additional analyses re-examined effects for race/ethnicity when using propensity score weighting to weight Blacks to Whites, and Latinos to Whites, first on heavy drinking alone, and then on heavy drinking and all explanatory factors supported by preliminary analyses. Preliminary regressions suggested roles for lower individual SES, greater prejudice and unfair treatment, and younger age in the elevated risk of alcohol problems among Black and Latino (vs. White) men at low heavy drinking levels; additional support emerged for single (vs. married) status among Blacks and neighborhood disadvantage among Latinos. When Blacks and Latinos were weighted to Whites on the above variables, effects for race/ethnicity on dependence counts were reduced to nonsignificance, while racial/ethnic disparities in consequence counts were attenuated (by >43% overall). Heavy drinking may be especially risky for those who are poor, exposed to prejudice and unfair treatment, young, and unmarried, and these factors may contribute to explaining racial/ethnic disparities in alcohol problems. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Poor, persecuted, young, and alone: Toward explaining the elevated risk of alcohol problems among Black and Latino men who drink

PubMed Central

Zemore, Sarah E.; Ye, Yu; Mulia, Nina; Martinez, Priscilla; Jones-Webb, Rhonda; Karriker-Jaffe, Katherine

2016-01-01

Background Even given equivalent drinking patterns, Black and Latino men experience substantially more dependence symptoms and other consequences than White men, particularly at low/no heavy drinking. No known studies have identified factors driving these disparities. The current study examines this question. Methods The 2005 and 2010 National Alcohol Surveys were pooled. Surveys are nationally representative, telephone interviews of the U.S. including Black and Latino oversamples; male drinkers were analyzed (N = 4182). Preliminary analyses included negative binomial regressions of dependence symptom and consequence counts testing whether effects for race/ethnicity were diminished when entering potential explanatory factors individually. Additional analyses re-examined effects for race/ethnicity when using propensity score weighting to weight Blacks to Whites, and Latinos to Whites, first on heavy drinking alone, and then on heavy drinking and all explanatory factors supported by preliminary analyses. Results Preliminary regressions suggested roles for lower individual SES, greater prejudice and unfair treatment, and younger age in the elevated risk of alcohol problems among Black and Latino (vs. White) men at low heavy drinking levels; additional support emerged for single (vs. married) status among Blacks and neighborhood disadvantage among Latinos. When Blacks and Latinos were weighted to Whites on the above variables, effects for race/ethnicity on dependence counts were reduced to nonsignificance, while racial/ethnic disparities in consequence counts were attenuated (by >43% overall). Conclusions Heavy drinking may be especially risky for those who are poor, exposed to prejudice and unfair treatment, young, and unmarried, and these factors may contribute to explaining racial/ethnic disparities in alcohol problems. PMID:27107846

Do Barriers to Crime Prevention Moderate the Effects of Situational Crime Prevention Policies on Violent Crime in High Schools?

ERIC Educational Resources Information Center

Sevigny, Eric L.; Zhang, Gary

2018-01-01

This study investigates how barriers to school-based crime prevention programming moderate the effects of situational crime prevention (SCP) policies on levels of violent crime in U.S. public high schools. Using data from the 2008 School Survey on Crime and Safety, we estimate a series of negative binomial regression models with interactions to…

Continuity Between DSM-5 Section II and III Personality Disorders in a Dutch Clinical Sample.

PubMed

Orbons, Irene M J; Rossi, Gina; Verheul, Roel; Schoutrop, Mirjam J A; Derksen, Jan L L; Segal, Daniel L; van Alphen, Sebastiaan P J

2018-05-14

The goal of this study was to evaluate the continuity across the Section II personality disorders (PDs) and the proposed Section III model of PDs in the Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013a ). More specifically, we analyzed association between the DSM-5 Section III pathological trait facets and Section II PDs among 110 Dutch adults (M age = 35.8 years, range = 19-60 years) receiving mental health care. We administered the Structured Clinical Interview for DSM-IV Axis II Disorders to all participants. Participants also completed the self-report Personality Inventory for DSM-5 (PID-5) as a measure of pathological trait facets. The distributions underlying the dependent variable were modeled as criterion counts, using negative binomial regression. The results provided some support for the validity of the PID-5 and the DSM-5 Section III Alternative Model, although analyses did not show a perfect match. Both at the trait level and the domain level, analyses showed mixed evidence of significant relationships between the PID-5 trait facets and domains with the traditional DSM-IV PDs.

Relationship between suicide rate and economic growth and stock market in the People's Republic of China: 2004-2013.

PubMed

Yin, Honglei; Xu, Lin; Shao, Yechang; Li, Liping; Wan, Chengsong

2016-01-01

The objective of this study was to estimate the features of suicide rate and its association with economic development and stock market during the past decade in the People's Republic of China. Official data were gathered and analyzed in the People's Republic of China during the period 2004-2013. Nationwide suicide rate was stratified by four year age-groups, sex, urban/rural areas, and regions (East, Central, and West). Annual economic indexes including gross domestic product (GDP) per capita and rural and urban income per capita were all adjusted for inflation. Variation coefficient of market index (VCMI) was also included as an economic index to measure the fluctuation of the stock market. Negative binomial regression was performed to examine the time trend of region-level suicide rates and effects of sex, age, urban/rural area, region, and economic index on the suicide rates. Suicide rates of each age-group, sex, urban/rural area, and region were generally decreased from 2004 to 2013, while annual GDP per capita and rural and urban income per capita were generally increased by year. VCMI fluctuated largely, which peaked around 2009 and decreased after that time. Negative binomial regression showed that the decreased suicide rate in East and Central rural areas was the main cause of the decrease in suicide rate in the People's Republic of China. Suicide rate in the People's Republic of China for the study period increased with age and was higher in rural than in urban area, higher in males than in females, and the highest in the Central region. When GDP per capita increased by 2,787 RMB, the suicide rate decreased by 0.498 times. VCMI showed no significant relationship with suicide rate in the negative binomial regression. Suicide rate decreased in 2004-2013; varied among different age-groups, sex, urban/rural areas, and regions; and was negatively associated with the economic growth in the People's Republic of China. Stock market showed no relationship with suicide rate, but this finding needs to be verified in a future study.

Relationship between suicide rate and economic growth and stock market in the People’s Republic of China: 2004–2013

PubMed Central

Yin, Honglei; Xu, Lin; Shao, Yechang; Li, Liping; Wan, Chengsong

2016-01-01

Objectives The objective of this study was to estimate the features of suicide rate and its association with economic development and stock market during the past decade in the People’s Republic of China. Methods Official data were gathered and analyzed in the People’s Republic of China during the period 2004–2013. Nationwide suicide rate was stratified by four year age-groups, sex, urban/rural areas, and regions (East, Central, and West). Annual economic indexes including gross domestic product (GDP) per capita and rural and urban income per capita were all adjusted for inflation. Variation coefficient of market index (VCMI) was also included as an economic index to measure the fluctuation of the stock market. Negative binomial regression was performed to examine the time trend of region-level suicide rates and effects of sex, age, urban/rural area, region, and economic index on the suicide rates. Results Suicide rates of each age-group, sex, urban/rural area, and region were generally decreased from 2004 to 2013, while annual GDP per capita and rural and urban income per capita were generally increased by year. VCMI fluctuated largely, which peaked around 2009 and decreased after that time. Negative binomial regression showed that the decreased suicide rate in East and Central rural areas was the main cause of the decrease in suicide rate in the People’s Republic of China. Suicide rate in the People’s Republic of China for the study period increased with age and was higher in rural than in urban area, higher in males than in females, and the highest in the Central region. When GDP per capita increased by 2,787 RMB, the suicide rate decreased by 0.498 times. VCMI showed no significant relationship with suicide rate in the negative binomial regression. Conclusion Suicide rate decreased in 2004–2013; varied among different age-groups, sex, urban/rural areas, and regions; and was negatively associated with the economic growth in the People’s Republic of China. Stock market showed no relationship with suicide rate, but this finding needs to be verified in a future study. PMID:27994468

Developing a dengue forecast model using machine learning: A case study in China.

PubMed

Guo, Pi; Liu, Tao; Zhang, Qin; Wang, Li; Xiao, Jianpeng; Zhang, Qingying; Luo, Ganfeng; Li, Zhihao; He, Jianfeng; Zhang, Yonghui; Ma, Wenjun

2017-10-01

In China, dengue remains an important public health issue with expanded areas and increased incidence recently. Accurate and timely forecasts of dengue incidence in China are still lacking. We aimed to use the state-of-the-art machine learning algorithms to develop an accurate predictive model of dengue. Weekly dengue cases, Baidu search queries and climate factors (mean temperature, relative humidity and rainfall) during 2011-2014 in Guangdong were gathered. A dengue search index was constructed for developing the predictive models in combination with climate factors. The observed year and week were also included in the models to control for the long-term trend and seasonality. Several machine learning algorithms, including the support vector regression (SVR) algorithm, step-down linear regression model, gradient boosted regression tree algorithm (GBM), negative binomial regression model (NBM), least absolute shrinkage and selection operator (LASSO) linear regression model and generalized additive model (GAM), were used as candidate models to predict dengue incidence. Performance and goodness of fit of the models were assessed using the root-mean-square error (RMSE) and R-squared measures. The residuals of the models were examined using the autocorrelation and partial autocorrelation function analyses to check the validity of the models. The models were further validated using dengue surveillance data from five other provinces. The epidemics during the last 12 weeks and the peak of the 2014 large outbreak were accurately forecasted by the SVR model selected by a cross-validation technique. Moreover, the SVR model had the consistently smallest prediction error rates for tracking the dynamics of dengue and forecasting the outbreaks in other areas in China. The proposed SVR model achieved a superior performance in comparison with other forecasting techniques assessed in this study. The findings can help the government and community respond early to dengue epidemics.

Understanding poisson regression.

PubMed

Hayat, Matthew J; Higgins, Melinda

2014-04-01

Nurse investigators often collect study data in the form of counts. Traditional methods of data analysis have historically approached analysis of count data either as if the count data were continuous and normally distributed or with dichotomization of the counts into the categories of occurred or did not occur. These outdated methods for analyzing count data have been replaced with more appropriate statistical methods that make use of the Poisson probability distribution, which is useful for analyzing count data. The purpose of this article is to provide an overview of the Poisson distribution and its use in Poisson regression. Assumption violations for the standard Poisson regression model are addressed with alternative approaches, including addition of an overdispersion parameter or negative binomial regression. An illustrative example is presented with an application from the ENSPIRE study, and regression modeling of comorbidity data is included for illustrative purposes. Copyright 2014, SLACK Incorporated.

Spatiotemporal analysis of the relationship between socioeconomic factors and stroke in the Portuguese mainland population under 65 years old.

PubMed

Oliveira, André; Cabral, António J R; Mendes, Jorge M; Martins, Maria R O; Cabral, Pedro

2015-11-04

Stroke risk has been shown to display varying patterns of geographic distribution amongst countries but also between regions of the same country. Traditionally a disease of older persons, a global 25% increase in incidence instead was noticed between 1990 and 2010 in persons aged 20-≤64 years, particularly in low- and medium-income countries. Understanding spatial disparities in the association between socioeconomic factors and stroke is critical to target public health initiatives aiming to mitigate or prevent this disease, including in younger persons. We aimed to identify socioeconomic determinants of geographic disparities of stroke risk in people <65 years old, in municipalities of mainland Portugal, and the spatiotemporal variation of the association between these determinants and stroke risk during two study periods (1992-1996 and 2002-2006). Poisson and negative binomial global regression models were used to explore determinants of disease risk. Geographically weighted regression (GWR) represents a distinctive approach, allowing estimation of local regression coefficients. Models for both study periods were identified. Significant variables included education attainment, work hours per week and unemployment. Local Poisson GWR models achieved the best fit and evidenced spatially varying regression coefficients. Spatiotemporal inequalities were observed in significant variables, with dissimilarities between men and women. This study contributes to a better understanding of the relationship between stroke and socioeconomic factors in the population <65 years of age, one age group seldom analysed separately. It can thus help to improve the targeting of public health initiatives, even more in a context of economic crisis.

An empirical study of statistical properties of variance partition coefficients for multi-level logistic regression models

USGS Publications Warehouse

Li, Ji; Gray, B.R.; Bates, D.M.

2008-01-01

Partitioning the variance of a response by design levels is challenging for binomial and other discrete outcomes. Goldstein (2003) proposed four definitions for variance partitioning coefficients (VPC) under a two-level logistic regression model. In this study, we explicitly derived formulae for multi-level logistic regression model and subsequently studied the distributional properties of the calculated VPCs. Using simulations and a vegetation dataset, we demonstrated associations between different VPC definitions, the importance of methods for estimating VPCs (by comparing VPC obtained using Laplace and penalized quasilikehood methods), and bivariate dependence between VPCs calculated at different levels. Such an empirical study lends an immediate support to wider applications of VPC in scientific data analysis.

The relationship between non-communicable disease occurrence and poverty-evidence from demographic surveillance in Matlab, Bangladesh.

PubMed

Mirelman, Andrew J; Rose, Sherri; Khan, Jahangir Am; Ahmed, Sayem; Peters, David H; Niessen, Louis W; Trujillo, Antonio J

2016-07-01

In low-income countries, a growing proportion of the disease burden is attributable to non-communicable diseases (NCDs). There is little knowledge, however, of their impact on wealth, human capital, economic growth or household poverty. This article estimates the risk of being poor after an NCD death in the rural, low-income area of Matlab, Bangladesh. In a matched cohort study, we estimated the 2-year relative risk (RR) of being poor in Matlab households with an NCD death in 2010. Three separate measures of household economic status were used as outcomes: an asset-based index, self-rated household economic condition and total household landholding. Several estimation methods were used including contingency tables, log-binomial regression and regression standardization and machine learning. Households with an NCD death had a large and significant risk of being poor. The unadjusted RR of being poor after death was 1.19, 1.14 and 1.10 for the asset quintile, self-rated condition and landholding outcomes. Adjusting for household and individual level independent variables with log-binomial regression gave RRs of 1.19 [standard error (SE) 0.09], 1.16 (SE 0.07) and 1.14 (SE 0.06), which were found to be exactly the same using regression standardization (SE: 0.09, 0.05, 0.03). Machine learning-based standardization produced slightly smaller RRs though still in the same order of magnitude. The findings show that efforts to address the burden of NCD may also combat household poverty and provide a return beyond improved health. Future work should attempt to disentangle the mechanisms through which economic impacts from an NCD death occur. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Cell Phone Use While Driving: Prospective Association with Emerging Adult Use.

PubMed

Trivedi, Neha; Haynie, Denise; Bible, Joe; Liu, Danping; Simons-Morton, Bruce

2017-09-01

Secondary task engagement such as cell phone use while driving is a common behavior among adolescents and emerging adults. Texting and other distracting cell phone use in this population contributes to the high rate of fatal car crashes. Peer engagement in similar risky driving behaviors, such as texting, could socially influence driver phone use behavior. The present study investigates the prospective association between peer and emerging adult texting while driving the first year after high school. Surveys were conducted with a national sample of emerging adults and their nominated peers. Binomial logistic regression analyses, adjusting for gender, race/ethnicity, parental education, and family affluence, showed that participants (n=212) with peers (n=675) who reported frequently texting while driving, were significantly more likely to text while driving the following year (odds ratio, 3.01; 95% CI, 1.19-7.59; P=0.05). The findings are consistent with the idea that peer texting behavior influences the prevalence of texting while driving among emerging adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

Regional Differences in the Growing Incidence of Dengue Fever in Vietnam Explained by Weather Variability

PubMed Central

Vu, Ha Hai; Okumura, Junko; Hashizume, Masahiro; Tran, Duong Nhu; Yamamoto, Taro

2014-01-01

Dengue fever is a major health problem in Vietnam, but its incidence differs from province to province. To understand this at the local level, we assessed the effect of four weather components (humidity, rainfall, temperature and sunshine) on the number of dengue cases in nine provinces of Vietnam. Monthly data from 1999 to 2009 were analysed by time-series regression using negative binomial models. A test for heterogeneity was applied to assess the weather-dengue association in the provinces. Those associations were significantly heterogeneous (for temperature, humidity, and sunshine: P < 0.001 heterogeneity test; for rainfall: P = 0.018 heterogeneity test). This confirms that weather components strongly affect dengue transmission at a lag time of 0 to 3 months, with considerable variation in their influence among different areas in Vietnam. This finding may promote the strategic prevention of dengue disease by suggesting specific plans at the local level, rather than a nationally unified approach. PMID:24808744

Self-reported discrimination and health-related quality of life among Whites, Blacks, Mexicans and Central Americans.

PubMed

Otiniano, Angie Denisse; Gee, Gilbert C

2012-04-01

This study investigates whether self-reported racial discrimination is related to poor health-related quality of life (HRQoL). Analyses focused on Whites (n = 52,571), Blacks (n = 4,343), Mexicans (n = 12,336), Central Americans (n = 1,504), Multi-ethnic Latinos (n = 1,102), and Other Latinos (n = 1,828) who participated in the 2003 and 2005 California Health Interview survey. Logistic and negative binomial regression was used to examine the association between HRQoL (assessed with the CDC unhealthy days measures) and self-reported racial discrimination. Discrimination was reported by 10% of Whites, 57% of Blacks, and 24-31% of the Latino groups. These reports were associated with increased number of unhealthy days, disability days, and poor self-rated health, even after, controlling for education and other factors. This association did not consistently vary by race/ethnicity. Racial discrimination may be a risk factor for poor HRQoL among diverse groups. Future research should examine the factors that may reduce potential exposure to racial discrimination.

[Multidimensional measurement of precarious employment: social distribution and its association with health in Catalonia (Spain)].

PubMed

Benach, Joan; Julià, Mireia; Tarafa, Gemma; Mir, Jordi; Molinero, Emilia; Vives, Alejandra

2015-01-01

To show the prevalence of precarious employment in Catalonia (Spain) for the first time and its association with mental and self-rated health, measured with a multidimensional scale. A cross-sectional study was conducted using data from the II Catalan Working Conditions Survey (2010) with a subsample of employed workers with a contract. The prevalence of precarious employment using a multidimensional scale and its association with health was calculated using multivariate log-binomial regression stratified by gender. The prevalence of precarious employment in Catalonia was high (42.6%). We found higher precariousness in women, youth, immigrants, and manual and less educated workers. There was a positive gradient in the association between precarious employment and poor health. Precarious employment is associated with poor health in the working population. Working conditions surveys should include questions on precarious employment and health indicators, which would allow monitoring and subsequent analyses of health inequalities. Copyright © 2015 SESPAS. Published by Elsevier Espana. All rights reserved.

Hope and Hopelessness: The Role of Hope in Buffering the Impact of Hopelessness on Suicidal Ideation.

PubMed

Huen, Jenny M Y; Ip, Brian Y T; Ho, Samuel M Y; Yip, Paul S F

2015-01-01

The present study investigated whether hope and hopelessness are better conceptualized as a single construct of bipolar spectrum or two distinct constructs and whether hope can moderate the relationship between hopelessness and suicidal ideation. Hope, hopelessness, and suicidal ideation were measured in a community sample of 2106 participants through a population-based household survey. Confirmatory factor analyses showed that a measurement model with separate, correlated second-order factors of hope and hopelessness provided a good fit to the data and was significantly better than that of the model collapsing hope and hopelessness into a single second-order factor. Negative binomial regression showed that hope and hopelessness interacted such that the effect of hopelessness on suicidal ideation was lower in individuals with higher hope than individuals with lower hope. Hope and hopelessness are two distinct but correlated constructs. Hope can act as a resilience factor that buffers the impact of hopelessness on suicidal ideation. Inducing hope in people may be a promising avenue for suicide prevention.

Contingency Management Voucher Redemption as an Indicator of Delayed Gratification

PubMed Central

Fletcher, Jesse B.; Dierst-Davies, Rhodri; Reback, Cathy J.

2014-01-01

This prospective analysis tested whether frequency of voucher redemptions during a contingency management (CM) substance use intervention was significantly associated with participants’ ongoing substance use. Homeless, substance-dependent men who have sex with men (N=131) were randomized into either a “full” or “lite” voucher-based CM intervention. All participants earned vouchers for attendance and participation; participants in the CM-full condition also received vouchers for substance abstinence and enactment of prosocial and/or health-promoting behaviors. Multivariate longitudinal negative binomial regression analyses (n = 118) assessed the association between substance use during the intervention and frequency of voucher redemptions. Participants who used methamphetamine (IRR = 0.66; 95% CI=0.44–0.99) and/or opiates (IRR=0.60; 95% CI=0.40–0.99) during the intervention exhibited less time between voucher redemptions than individuals who achieved abstinence from these substances. Voucher redemption logs can be cost-effective and unobtrusive tools for measuring study participants’ tendency to delay gratification. PMID:24674235

Spatial distribution of psychotic disorders in an urban area of France: an ecological study.

PubMed

Pignon, Baptiste; Schürhoff, Franck; Baudin, Grégoire; Ferchiou, Aziz; Richard, Jean-Romain; Saba, Ghassen; Leboyer, Marion; Kirkbride, James B; Szöke, Andrei

2016-05-18

Previous analyses of neighbourhood variations of non-affective psychotic disorders (NAPD) have focused mainly on incidence. However, prevalence studies provide important insights on factors associated with disease evolution as well as for healthcare resource allocation. This study aimed to investigate the distribution of prevalent NAPD cases in an urban area in France. The number of cases in each neighbourhood was modelled as a function of potential confounders and ecological variables, namely: migrant density, economic deprivation and social fragmentation. This was modelled using statistical models of increasing complexity: frequentist models (using Poisson and negative binomial regressions), and several Bayesian models. For each model, assumptions validity were checked and compared as to how this fitted to the data, in order to test for possible spatial variation in prevalence. Data showed significant overdispersion (invalidating the Poisson regression model) and residual autocorrelation (suggesting the need to use Bayesian models). The best Bayesian model was Leroux's model (i.e. a model with both strong correlation between neighbouring areas and weaker correlation between areas further apart), with economic deprivation as an explanatory variable (OR = 1.13, 95% CI [1.02-1.25]). In comparison with frequentist methods, the Bayesian model showed a better fit. The number of cases showed non-random spatial distribution and was linked to economic deprivation.

Developing a case mix classification for child and adolescent mental health services: the influence of presenting problems, complexity factors and service providers on number of appointments.

PubMed

Martin, Peter; Davies, Roger; Macdougall, Amy; Ritchie, Benjamin; Vostanis, Panos; Whale, Andy; Wolpert, Miranda

2017-09-01

Case-mix classification is a focus of international attention in considering how best to manage and fund services, by providing a basis for fairer comparison of resource utilization. Yet there is little evidence of the best ways to establish case mix for child and adolescent mental health services (CAMHS). To develop a case mix classification for CAMHS that is clinically meaningful and predictive of number of appointments attended and to investigate the influence of presenting problems, context and complexity factors and provider variation. We analysed 4573 completed episodes of outpatient care from 11 English CAMHS. Cluster analysis, regression trees and a conceptual classification based on clinical best practice guidelines were compared regarding their ability to predict number of appointments, using mixed effects negative binomial regression. The conceptual classification is clinically meaningful and did as well as data-driven classifications in accounting for number of appointments. There was little evidence for effects of complexity or context factors, with the possible exception of school attendance problems. Substantial variation in resource provision between providers was not explained well by case mix. The conceptually-derived classification merits further testing and development in the context of collaborative decision making.

Modelling infant mortality rate in Central Java, Indonesia use generalized poisson regression method

NASA Astrophysics Data System (ADS)

Prahutama, Alan; Sudarno

2018-05-01

The infant mortality rate is the number of deaths under one year of age occurring among the live births in a given geographical area during a given year, per 1,000 live births occurring among the population of the given geographical area during the same year. This problem needs to be addressed because it is an important element of a country’s economic development. High infant mortality rate will disrupt the stability of a country as it relates to the sustainability of the population in the country. One of regression model that can be used to analyze the relationship between dependent variable Y in the form of discrete data and independent variable X is Poisson regression model. Recently The regression modeling used for data with dependent variable is discrete, among others, poisson regression, negative binomial regression and generalized poisson regression. In this research, generalized poisson regression modeling gives better AIC value than poisson regression. The most significant variable is the Number of health facilities (X1), while the variable that gives the most influence to infant mortality rate is the average breastfeeding (X9).

Maternal Early Life Factors Associated with Hormone Levels and the Risk of Having a Child with an Autism Spectrum Disorder in the Nurses Health Study II

ERIC Educational Resources Information Center

Lyall, Kristen; Pauls, David L.; Santangelo, Susan; Spiegelman, Donna; Ascherio, Alberto

2011-01-01

It is not known whether reproductive factors early in the mother's life influence risk of autism spectrum disorders (ASD). We assessed maternal age at menarche, menstrual cycle characteristics during adolescence, oral contraceptive use prior to first birth, body shape, and body mass index (BMI) in association with ASD using binomial regression in…

Oral health of schoolchildren in Western Australia.

PubMed

Arrow, P

2016-09-01

The West Australian School Dental Service (SDS) provides free, statewide, primary dental care to schoolchildren aged 5-17 years. This study reports on an evaluation of the oral health of children examined during the 2014 calendar year. Children were sampled, based on their date of birth, and SDS clinicians collected the clinical information. Weighted mean values of caries experience were presented. Negative binomial regression modelling was undertaken to test for factors of significance in the rate of caries occurrence. Data from children aged 5-15 years were used (girls = 4616, boys = 4900). Mean dmft (5-10-year-olds), 1.42 SE 0.03; mean DMFT (6-15-year-olds), 0.51 SE 0.01. Negative binomial regression model of permanent tooth caries found higher rates of caries in children who were from non-fluoridated areas (RR 2.1); Aboriginal (RR 2.4); had gingival inflammation (RR 1.5); lower ICSEA level (RR 1.4); and recalled at more than 24-month interval (RR 1.8). The study highlighted poor dental health associated with living in non-fluoridated areas, Aboriginal identity, poor oral hygiene, lower socioeconomic level and having extended intervals between dental checkups. Timely assessments and preventive measures targeted at groups, including extending community water fluoridation, may assist in further improving the oral health of children in Western Australia. © 2015 Australian Dental Association.

Recent patterns in antibiotic use for children with group A streptococcal infections in Japan.

PubMed

Okubo, Yusuke; Michihata, Nobuaki; Morisaki, Naho; Kinoshita, Noriko; Miyairi, Isao; Urayama, Kevin Y; Yasunaga, Hideo

2017-11-13

Antibiotics are the most frequently prescribed medicines for children, however inappropriate antibiotic prescribing is prevalent. This study investigated recent trends in antibiotic use and factors associated with appropriate antibiotic selection among children with group A streptococcal infections in Japan. Records of outpatients aged <18years with a diagnosis of group A streptococcal infection were obtained using the Japan Medical Data Center database. Prescription patterns for antibiotics were investigated and factors associated with penicillin use were evaluated using a multivariable log-binomial regression model. Overall, 5030 patients with a diagnosis of group A streptococcal infection were identified. The most commonly prescribed antibiotics were third-generation cephalosporins (53.3%), followed by penicillins (40.1%). In the multivariable log-binomial regression analysis, out-of-hours visits were independently associated with penicillin prescriptions [prevalence ratio (PR)=1.10, 95% confidence interval (CI) 1.03-1.18], whereas clinical departments other than paediatrics and internal medicine were related to non-penicillin prescriptions (PR=0.57, 95% CI 0.46-0.71). Third-generation cephalosporins were overprescribed for children with group A streptococcal infections. This investigation provides important information for promoting education for physicians and for constructing health policies for appropriate antibiotic prescription. Copyright © 2017. Published by Elsevier Ltd.

Community covariates of malnutrition based mortality among older adults.

PubMed

Lee, Matthew R; Berthelot, Emily R

2010-05-01

The purpose of this study was to identify community level covariates of malnutrition-based mortality among older adults. A community level framework was delineated which explains rates of malnutrition-related mortality among older adults as a function of community levels of socioeconomic disadvantage, disability, and social isolation among members of this group. County level data on malnutrition mortality of people 65 years of age and older for the period 2000-2003 were drawn from the CDC WONDER system databases. County level measures of older adult socioeconomic disadvantage, disability, and social isolation were derived from the 2000 US Census of Population and Housing. Negative binomial regression models adjusting for the size of the population at risk, racial composition, urbanism, and region were estimated to assess the relationships among these indicators. Results from negative binomial regression analysis yielded the following: a standard deviation increase in socioeconomic/physical disadvantage was associated with a 12% increase in the rate of malnutrition mortality among older adults (p < 0.001), whereas a standard deviation increase in social isolation was associated with a 5% increase in malnutrition mortality among older adults (p < 0.05). Community patterns of malnutrition based mortality among older adults are partly a function of levels of socioeconomic and physical disadvantage and social isolation among older adults. 2010 Elsevier Inc. All rights reserved.

Association between adherence to physical activity guidelines and health-related quality of life among individuals with physician-diagnosed arthritis.

PubMed

Austin, Shamly; Qu, Haiyan; Shewchuk, Richard M

2012-10-01

To examine the association between adherence to physical activity guidelines and health-related quality of life (HRQOL) among individuals with arthritis. A cross-sectional sample with 33,071 US adults, 45 years or older with physician-diagnosed arthritis was obtained from 2007 Behavioral Risk Factor Surveillance System survey. We conducted negative binomial regression analysis to examine HRQOL as a function of adherence to physical activity guidelines controlling for physicians' recommendations for physical activity, age, sex, race, education, marital status, employment, annual income, health insurance, personal physician, emotional support, body mass index, activity limitations, health status, and co-morbidities based on Behavioral Model of Health Services Utilization. Descriptive statistics showed that 60% adults with arthritis did not adhere to physical activity guidelines, mean physically and mentally unhealthy days were 7.7 and 4.4 days, respectively. Results from negative binomial regression indicated that individuals who did not adhere to physical activity guidelines had 1.14 days more physically unhealthy days and 1.12 days more mentally unhealthy days than those who adhered controlling for covariates. Adherence to physical activity is important to improve HRQOL for individuals with arthritis. However, adherence is low among this population. Interventions are required to engage individuals with arthritis in physical activity.

Factors Associated with Hospital Length of Stay among Cancer Patients with Febrile Neutropenia

PubMed Central

Rosa, Regis G.; Goldani, Luciano Z.

2014-01-01

Purpose This study sought to evaluate factors associated with hospital length of stay in cancer patients with febrile neutropenia. Methods A prospective cohort study was performed at a single tertiary referral hospital in southern Brazil from October 2009 to August 2011. All adult cancer patients with febrile neutropenia admitted to the hematology ward were evaluated. Stepwise random-effects negative binomial regression was performed to identify risk factors for prolonged length of hospital stay. Results In total, 307 cases of febrile neutropenia were evaluated. The overall median length of hospital stay was 16 days (interquartile range 18 days). According to multiple negative binomial regression analysis, hematologic neoplasms (P = 0.003), high-dose chemotherapy regimens (P<0.001), duration of neutropenia (P<0.001), and bloodstream infection involving Gram-negative multi-drug-resistant bacteria (P = 0.003) were positively associated with prolonged hospital length of stay in patients with febrile neutropenia. The condition index showed no evidence of multi-collinearity effect among the independent variables. Conclusions Hematologic neoplasms, high-dose chemotherapy regimens, prolonged periods of neutropenia, and bloodstream infection with Gram-negative multi-drug-resistant bacteria are predictors of prolonged length hospital of stay among adult cancer patients with febrile neutropenia. PMID:25285790

Accounting for autocorrelation in multi-drug resistant tuberculosis predictors using a set of parsimonious orthogonal eigenvectors aggregated in geographic space.

PubMed

Jacob, Benjamin J; Krapp, Fiorella; Ponce, Mario; Gottuzzo, Eduardo; Griffith, Daniel A; Novak, Robert J

2010-05-01

Spatial autocorrelation is problematic for classical hierarchical cluster detection tests commonly used in multi-drug resistant tuberculosis (MDR-TB) analyses as considerable random error can occur. Therefore, when MDRTB clusters are spatially autocorrelated the assumption that the clusters are independently random is invalid. In this research, a product moment correlation coefficient (i.e., the Moran's coefficient) was used to quantify local spatial variation in multiple clinical and environmental predictor variables sampled in San Juan de Lurigancho, Lima, Peru. Initially, QuickBird 0.61 m data, encompassing visible bands and the near infra-red bands, were selected to synthesize images of land cover attributes of the study site. Data of residential addresses of individual patients with smear-positive MDR-TB were geocoded, prevalence rates calculated and then digitally overlaid onto the satellite data within a 2 km buffer of 31 georeferenced health centers, using a 10 m2 grid-based algorithm. Geographical information system (GIS)-gridded measurements of each health center were generated based on preliminary base maps of the georeferenced data aggregated to block groups and census tracts within each buffered area. A three-dimensional model of the study site was constructed based on a digital elevation model (DEM) to determine terrain covariates associated with the sampled MDR-TB covariates. Pearson's correlation was used to evaluate the linear relationship between the DEM and the sampled MDR-TB data. A SAS/GIS(R) module was then used to calculate univariate statistics and to perform linear and non-linear regression analyses using the sampled predictor variables. The estimates generated from a global autocorrelation analyses were then spatially decomposed into empirical orthogonal bases using a negative binomial regression with a non-homogeneous mean. Results of the DEM analyses indicated a statistically non-significant, linear relationship between georeferenced health centers and the sampled covariate elevation. The data exhibited positive spatial autocorrelation and the decomposition of Moran's coefficient into uncorrelated, orthogonal map pattern components revealed global spatial heterogeneities necessary to capture latent autocorrelation in the MDR-TB model. It was thus shown that Poisson regression analyses and spatial eigenvector mapping can elucidate the mechanics of MDR-TB transmission by prioritizing clinical and environmental-sampled predictor variables for identifying high risk populations.

Temporal acceleration of spatially distributed kinetic Monte Carlo simulations

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chatterjee, Abhijit; Vlachos, Dionisios G.

The computational intensity of kinetic Monte Carlo (KMC) simulation is a major impediment in simulating large length and time scales. In recent work, an approximate method for KMC simulation of spatially uniform systems, termed the binomial {tau}-leap method, was introduced [A. Chatterjee, D.G. Vlachos, M.A. Katsoulakis, Binomial distribution based {tau}-leap accelerated stochastic simulation, J. Chem. Phys. 122 (2005) 024112], where molecular bundles instead of individual processes are executed over coarse-grained time increments. This temporal coarse-graining can lead to significant computational savings but its generalization to spatially lattice KMC simulation has not been realized yet. Here we extend the binomial {tau}-leapmore » method to lattice KMC simulations by combining it with spatially adaptive coarse-graining. Absolute stability and computational speed-up analyses for spatial systems along with simulations provide insights into the conditions where accuracy and substantial acceleration of the new spatio-temporal coarse-graining method are ensured. Model systems demonstrate that the r-time increment criterion of Chatterjee et al. obeys the absolute stability limit for values of r up to near 1.« less

A workforce-based study of occupational exposures and asthma symptoms in cleaning workers.

PubMed

Vizcaya, David; Mirabelli, Maria C; Antó, Josep-Maria; Orriols, Ramon; Burgos, Felip; Arjona, Lourdes; Zock, Jan-Paul

2011-12-01

To study associations between use of cleaning products and asthma symptoms in cleaning workers. Information on respiratory symptoms, history of asthma, workplaces, use of cleaning products and acute inhalation incidents were obtained through a self-administered questionnaire. 917 employees of 37 cleaning companies in Barcelona were studied. 761 (83%) were current cleaners, 86 (9%) former cleaners and 70 (8%) had never worked as cleaners. Multivariable logistic regression analyses were used to evaluate the associations between specific exposures among current cleaners and wheeze without having a cold, chronic cough and current asthma. Associations with an asthma symptom score were also studied using negative binomial regression analyses to report mean ratios. After adjusting for sex, age, nationality and smoking status, the prevalence of current asthma was non-significantly higher among current (OR 1.9; 95% CI 0.5 to 7.8) and former cleaners (OR 1.9; CI 0.6 to 5.5) than in never cleaners. Cleaners working in hospitals during the last year had a significantly increased prevalence of wheeze, current asthma and a 1.8 (95% CI 1.2 to 2.8) times higher mean asthma score. Use of hydrochloric acid was strongly associated with asthma score (mean ratio 1.7; 95% CI 1.1 to 2.6). Use of ammonia, degreasers, multiple purpose products and waxes was also associated with asthma score. Cleaning work in places with high demand for disinfection, high cleaning standards and use of cleaning products containing respiratory irritants is associated with higher risk of asthma symptoms. This suggests irritants have an important role in cleaning-related asthma.

Emotional Support, Negative Interaction and DSM IV Lifetime Disorders among Older African Americans: Findings from the National Survey of American Life (NSAL)

PubMed Central

Lincoln, Karen D.; Taylor, Robert Joseph; Bullard, Kai McKeever; Chatters, Linda M.; Himle, Joseph A.; Woodward, Amanda Toler; Jackson, James S.

2010-01-01

Objectives Both emotional support and negative interaction with family members have been linked to mental health. However, few studies have examined the associations between emotional support and negative interaction and psychiatric disorders in late life. This study investigated the relationship between emotional support and negative interaction on lifetime prevalence of mood and anxiety disorders among older African Americans. Design The analyses utilized the National Survey of American Life. Methods Logistic regression and negative binomial regression analyses were used to examine the effect of emotional support and negative interaction with family members on the prevalence of lifetime DSM-IV mood and anxiety disorders. Participants Data from 786 African Americans aged 55 years and older were used. Measurement The DSM-IV World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to assess mental disorders. Three dependent variables were investigated: the prevalence of lifetime mood disorders, the prevalence of lifetime anxiety disorders, and the total number of lifetime mood and anxiety disorders. Results Multivariate analysis found that emotional support was not associated with any of the three dependent variables. Negative interaction was significantly and positively associated with the odds of having a lifetime mood disorder, a lifetime anxiety disorder and the number of lifetime mood and anxiety disorders. Conclusions This is the first study to investigate the relationship between emotional support, negative interaction with family members and psychiatric disorders among older African Americans. Negative interaction was a risk factor for mood and anxiety disorders among older African Americans, whereas emotional support was not significant. PMID:20157904

Time-dependent summary receiver operating characteristics for meta-analysis of prognostic studies.

PubMed

Hattori, Satoshi; Zhou, Xiao-Hua

2016-11-20

Prognostic studies are widely conducted to examine whether biomarkers are associated with patient's prognoses and play important roles in medical decisions. Because findings from one prognostic study may be very limited, meta-analyses may be useful to obtain sound evidence. However, prognostic studies are often analyzed by relying on a study-specific cut-off value, which can lead to difficulty in applying the standard meta-analysis techniques. In this paper, we propose two methods to estimate a time-dependent version of the summary receiver operating characteristics curve for meta-analyses of prognostic studies with a right-censored time-to-event outcome. We introduce a bivariate normal model for the pair of time-dependent sensitivity and specificity and propose a method to form inferences based on summary statistics reported in published papers. This method provides a valid inference asymptotically. In addition, we consider a bivariate binomial model. To draw inferences from this bivariate binomial model, we introduce a multiple imputation method. The multiple imputation is found to be approximately proper multiple imputation, and thus the standard Rubin's variance formula is justified from a Bayesian view point. Our simulation study and application to a real dataset revealed that both methods work well with a moderate or large number of studies and the bivariate binomial model coupled with the multiple imputation outperforms the bivariate normal model with a small number of studies. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The role of lifetime anxiety history in the course of bipolar spectrum disorders.

PubMed

Titone, Madison K; Freed, Rachel D; O'Garro-Moore, Jared K; Gepty, Andrew; Ng, Tommy H; Stange, Jonathan P; Abramson, Lyn Y; Alloy, Lauren B

2018-06-01

Individuals with bipolar spectrum disorder (BSD) frequently meet criteria for comorbid anxiety disorders, and anxiety may be an important factor in the etiology and course of BSDs. The current study examined the association of lifetime anxiety disorders with prospective manic/hypomanic versus major depressive episodes. Participants were 244 young adults (aged 17-26) with milder forms of BSDs (i.e., bipolar-II, cyclothymia, BD-NOS). First, bivariate analyses assessed differences in baseline clinical characteristics between participants with and without DSM-IV anxiety diagnoses. Second, negative binomial regression analyses tested whether lifetime anxiety predicted number of manic/hypomanic or major depressive episodes developed during the study. Third, survival analyses evaluated whether lifetime anxiety predicted time to onset of manic/hypomanic and major depressive episodes. Results indicated that anxiety history was associated with greater illness severity at baseline. Over follow-up, anxiety history predicted fewer manic/hypomanic episodes, but did not predict number of major depressive episodes. Anxiety history also was associated with longer time to onset of manic/hypomanic episodes, but shorter time to onset of depressive episodes. Findings corroborate past studies implicating anxiety disorders as salient influences on the course of BSDs. Moreover, results extend prior research by indicating that anxiety disorders may be linked with reduced manic/hypomanic phases of illness. Copyright © 2018 Elsevier B.V. All rights reserved.

Statistical inference involving binomial and negative binomial parameters.

PubMed

García-Pérez, Miguel A; Núñez-Antón, Vicente

2009-05-01

Statistical inference about two binomial parameters implies that they are both estimated by binomial sampling. There are occasions in which one aims at testing the equality of two binomial parameters before and after the occurrence of the first success along a sequence of Bernoulli trials. In these cases, the binomial parameter before the first success is estimated by negative binomial sampling whereas that after the first success is estimated by binomial sampling, and both estimates are related. This paper derives statistical tools to test two hypotheses, namely, that both binomial parameters equal some specified value and that both parameters are equal though unknown. Simulation studies are used to show that in small samples both tests are accurate in keeping the nominal Type-I error rates, and also to determine sample size requirements to detect large, medium, and small effects with adequate power. Additional simulations also show that the tests are sufficiently robust to certain violations of their assumptions.

Trends in incidence of occupational asthma, contact dermatitis, noise-induced hearing loss, carpal tunnel syndrome and upper limb musculoskeletal disorders in European countries from 2000 to 2012.

PubMed

Stocks, S Jill; McNamee, Roseanne; van der Molen, Henk F; Paris, Christophe; Urban, Pavel; Campo, Giuseppe; Sauni, Riitta; Martínez Jarreta, Begoña; Valenty, Madeleine; Godderis, Lode; Miedinger, David; Jacquetin, Pascal; Gravseth, Hans M; Bonneterre, Vincent; Telle-Lamberton, Maylis; Bensefa-Colas, Lynda; Faye, Serge; Mylle, Godewina; Wannag, Axel; Samant, Yogindra; Pal, Teake; Scholz-Odermatt, Stefan; Papale, Adriano; Schouteden, Martijn; Colosio, Claudio; Mattioli, Stefano; Agius, Raymond

2015-04-01

The European Union (EU) strategy for health and safety at work underlines the need to reduce the incidence of occupational diseases (OD), but European statistics to evaluate this common goal are scarce. We aim to estimate and compare changes in incidence over time for occupational asthma, contact dermatitis, noise-induced hearing loss (NIHL), carpal tunnel syndrome (CTS) and upper limb musculoskeletal disorders across 10 European countries. OD surveillance systems that potentially reflected nationally representative trends in incidence within Belgium, the Czech Republic, Finland, France, Italy, the Netherlands, Norway, Spain, Switzerland and the UK provided data. Case counts were analysed using a negative binomial regression model with year as the main covariate. Many systems collected data from networks of 'centres', requiring the use of a multilevel negative binomial model. Some models made allowance for changes in compensation or reporting rules. Reports of contact dermatitis and asthma, conditions with shorter time between exposure to causal substances and OD, were consistently declining with only a few exceptions. For OD with physical causal exposures there was more variation between countries. Reported NIHL was increasing in Belgium, Spain, Switzerland and the Netherlands and decreasing elsewhere. Trends in CTS and upper limb musculoskeletal disorders varied widely within and between countries. This is the first direct comparison of trends in OD within Europe and is consistent with a positive impact of European initiatives addressing exposures relevant to asthma and contact dermatitis. Taking a more flexible approach allowed comparisons of surveillance data between and within countries without harmonisation of data collection methods. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Predicting length of stay from an electronic patient record system: a primary total knee replacement example.

PubMed

Carter, Evelene M; Potts, Henry W W

2014-04-04

To investigate whether factors can be identified that significantly affect hospital length of stay from those available in an electronic patient record system, using primary total knee replacements as an example. To investigate whether a model can be produced to predict the length of stay based on these factors to help resource planning and patient expectations on their length of stay. Data were extracted from the electronic patient record system for discharges from primary total knee operations from January 2007 to December 2011 (n=2,130) at one UK hospital and analysed for their effect on length of stay using Mann-Whitney and Kruskal-Wallis tests for discrete data and Spearman's correlation coefficient for continuous data. Models for predicting length of stay for primary total knee replacements were tested using the Poisson regression and the negative binomial modelling techniques. Factors found to have a significant effect on length of stay were age, gender, consultant, discharge destination, deprivation and ethnicity. Applying a negative binomial model to these variables was successful. The model predicted the length of stay of those patients who stayed 4-6 days (~50% of admissions) with 75% accuracy within 2 days (model data). Overall, the model predicted the total days stayed over 5 years to be only 88 days more than actual, a 6.9% uplift (test data). Valuable information can be found about length of stay from the analysis of variables easily extracted from an electronic patient record system. Models can be successfully created to help improve resource planning and from which a simple decision support system can be produced to help patient expectation on their length of stay.

Impact of cigarette smoking on utilization of nursing home services.

PubMed

Warner, Kenneth E; McCammon, Ryan J; Fries, Brant E; Langa, Kenneth M

2013-11-01

Few studies have examined the effects of smoking on nursing home utilization, generally using poor data on smoking status. No previous study has distinguished utilization for recent from long-term quitters. Using the Health and Retirement Study, we assessed nursing home utilization by never-smokers, long-term quitters (quit >3 years), recent quitters (quit ≤3 years), and current smokers. We used logistic regression to evaluate the likelihood of a nursing home admission. For those with an admission, we used negative binomial regression on the number of nursing home nights. Finally, we employed zero-inflated negative binomial regression to estimate nights for the full sample. Controlling for other variables, compared with never-smokers, long-term quitters have an odds ratio (OR) for nursing home admission of 1.18 (95% CI: 1.07-1.2), current smokers 1.39 (1.23-1.57), and recent quitters 1.55 (1.29-1.87). The probability of admission rises rapidly with age and is lower for African Americans and Hispanics, more affluent respondents, respondents with a spouse present in the home, and respondents with a living child. Given admission, smoking status is not associated with length of stay (LOS). LOS is longer for older respondents and women and shorter for more affluent respondents and those with spouses present. Compared with otherwise identical never-smokers, former and current smokers have a significantly increased risk of nursing home admission. That recent quitters are at greatest risk of admission is consistent with evidence that many stop smoking because they are sick, often due to smoking.

Robust inference in the negative binomial regression model with an application to falls data.

PubMed

Aeberhard, William H; Cantoni, Eva; Heritier, Stephane

2014-12-01

A popular way to model overdispersed count data, such as the number of falls reported during intervention studies, is by means of the negative binomial (NB) distribution. Classical estimating methods are well-known to be sensitive to model misspecifications, taking the form of patients falling much more than expected in such intervention studies where the NB regression model is used. We extend in this article two approaches for building robust M-estimators of the regression parameters in the class of generalized linear models to the NB distribution. The first approach achieves robustness in the response by applying a bounded function on the Pearson residuals arising in the maximum likelihood estimating equations, while the second approach achieves robustness by bounding the unscaled deviance components. For both approaches, we explore different choices for the bounding functions. Through a unified notation, we show how close these approaches may actually be as long as the bounding functions are chosen and tuned appropriately, and provide the asymptotic distributions of the resulting estimators. Moreover, we introduce a robust weighted maximum likelihood estimator for the overdispersion parameter, specific to the NB distribution. Simulations under various settings show that redescending bounding functions yield estimates with smaller biases under contamination while keeping high efficiency at the assumed model, and this for both approaches. We present an application to a recent randomized controlled trial measuring the effectiveness of an exercise program at reducing the number of falls among people suffering from Parkinsons disease to illustrate the diagnostic use of such robust procedures and their need for reliable inference. © 2014, The International Biometric Society.

Sickness absence and psychosocial job quality: an analysis from a longitudinal survey of working Australians, 2005-2012.

PubMed

Milner, Allison; Butterworth, Peter; Bentley, Rebecca; Kavanagh, Anne M; LaMontagne, Anthony D

2015-05-15

Sickness absence is associated with adverse health, organizational, and societal outcomes. Using data from a longitudinal cohort study of working Australians (the Household, Income and Labour Dynamics in Australia (HILDA) Survey), we examined the relationship between changes in individuals' overall psychosocial job quality and variation in sickness absence. The outcome variables were paid sickness absence (yes/no) and number of days of paid sickness absence in the past year (2005-2012). The main exposure variable was psychosocial job quality, measured using a psychosocial job quality index (levels of job control, demands and complexity, insecurity, and perceptions of unfair pay). Analysis was conducted using longitudinal fixed-effects logistic regression models and negative binomial regression models. There was a dose-response relationship between the number of psychosocial job stressors reported by an individual and the odds of paid sickness absence (1 adversity: odds ratio (OR) = 1.26, 95% confidence interval (CI): 1.09, 1.45 (P = 0.002); 2 adversities: OR = 1.28, 95% CI: 1.09, 1.51 (P = 0.002); ≥3 adversities: OR = 1.58, 95% CI: 1.29, 1.94 (P < 0.001)). The negative binomial regression models also indicated that respondents reported a greater number of days of sickness absence in response to worsening psychosocial job quality. These results suggest that workplace interventions aiming to improve the quality of work could help reduce sickness absence. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Zero-truncated negative binomial - Erlang distribution

NASA Astrophysics Data System (ADS)

Bodhisuwan, Winai; Pudprommarat, Chookait; Bodhisuwan, Rujira; Saothayanun, Luckhana

2017-11-01

The zero-truncated negative binomial-Erlang distribution is introduced. It is developed from negative binomial-Erlang distribution. In this work, the probability mass function is derived and some properties are included. The parameters of the zero-truncated negative binomial-Erlang distribution are estimated by using the maximum likelihood estimation. Finally, the proposed distribution is applied to real data, the number of methamphetamine in the Bangkok, Thailand. Based on the results, it shows that the zero-truncated negative binomial-Erlang distribution provided a better fit than the zero-truncated Poisson, zero-truncated negative binomial, zero-truncated generalized negative-binomial and zero-truncated Poisson-Lindley distributions for this data.

Diagnostic test accuracy and prevalence inferences based on joint and sequential testing with finite population sampling.

PubMed

Su, Chun-Lung; Gardner, Ian A; Johnson, Wesley O

2004-07-30

The two-test two-population model, originally formulated by Hui and Walter, for estimation of test accuracy and prevalence estimation assumes conditionally independent tests, constant accuracy across populations and binomial sampling. The binomial assumption is incorrect if all individuals in a population e.g. child-care centre, village in Africa, or a cattle herd are sampled or if the sample size is large relative to population size. In this paper, we develop statistical methods for evaluating diagnostic test accuracy and prevalence estimation based on finite sample data in the absence of a gold standard. Moreover, two tests are often applied simultaneously for the purpose of obtaining a 'joint' testing strategy that has either higher overall sensitivity or specificity than either of the two tests considered singly. Sequential versions of such strategies are often applied in order to reduce the cost of testing. We thus discuss joint (simultaneous and sequential) testing strategies and inference for them. Using the developed methods, we analyse two real and one simulated data sets, and we compare 'hypergeometric' and 'binomial-based' inferences. Our findings indicate that the posterior standard deviations for prevalence (but not sensitivity and specificity) based on finite population sampling tend to be smaller than their counterparts for infinite population sampling. Finally, we make recommendations about how small the sample size should be relative to the population size to warrant use of the binomial model for prevalence estimation. Copyright 2004 John Wiley & Sons, Ltd.

Predictors for hospitalization and outpatient visits in patients with inflammatory bowel disease: results from the Swiss Inflammatory Bowel Disease Cohort Study.

PubMed

Sulz, Michael C; Siebert, Uwe; Arvandi, Marjan; Gothe, Raffaella M; Wurm, Johannes; von Känel, Roland; Vavricka, Stephan R; Meyenberger, Christa; Sagmeister, Markus

2013-07-01

Patients with inflammatory bowel disease (IBD) have a high resource consumption, with considerable costs for the healthcare system. In a system with sparse resources, treatment is influenced not only by clinical judgement but also by resource consumption. We aimed to determine the resource consumption of IBD patients and to identify its significant predictors. Data from the prospective Swiss Inflammatory Bowel Disease Cohort Study were analysed for the resource consumption endpoints hospitalization and outpatient consultations at enrolment [1187 patients; 41.1% ulcerative colitis (UC), 58.9% Crohn's disease (CD)] and at 1-year follow-up (794 patients). Predictors of interest were chosen through an expert panel and a review of the relevant literature. Logistic regressions were used for binary endpoints, and negative binomial regressions and zero-inflated Poisson regressions were used for count data. For CD, fistula, use of biologics and disease activity were significant predictors for hospitalization days (all P-values <0.001); age, sex, steroid therapy and biologics were significant predictors for the number of outpatient visits (P=0.0368, 0.023, 0.0002, 0.0003, respectively). For UC, biologics, C-reactive protein, smoke quitters, age and sex were significantly predictive for hospitalization days (P=0.0167, 0.0003, 0.0003, 0.0076 and 0.0175 respectively); disease activity and immunosuppressive therapy predicted the number of outpatient visits (P=0.0009 and 0.0017, respectively). The results of multivariate regressions are shown in detail. Several highly significant clinical predictors for resource consumption in IBD were identified that might be considered in medical decision-making. In terms of resource consumption and its predictors, CD and UC show a different behaviour.

Analysis of Binary Adherence Data in the Setting of Polypharmacy: A Comparison of Different Approaches

PubMed Central

Esserman, Denise A.; Moore, Charity G.; Roth, Mary T.

2009-01-01

Older community dwelling adults often take multiple medications for numerous chronic diseases. Non-adherence to these medications can have a large public health impact. Therefore, the measurement and modeling of medication adherence in the setting of polypharmacy is an important area of research. We apply a variety of different modeling techniques (standard linear regression; weighted linear regression; adjusted linear regression; naïve logistic regression; beta-binomial (BB) regression; generalized estimating equations (GEE)) to binary medication adherence data from a study in a North Carolina based population of older adults, where each medication an individual was taking was classified as adherent or non-adherent. In addition, through simulation we compare these different methods based on Type I error rates, bias, power, empirical 95% coverage, and goodness of fit. We find that estimation and inference using GEE is robust to a wide variety of scenarios and we recommend using this in the setting of polypharmacy when adherence is dichotomously measured for multiple medications per person. PMID:20414358

Racial/ethnic variations in associations between socioeconomic factors and tooth loss.

PubMed

Jimenez, Monik; Dietrich, Thomas; Shih, Mei-Chiung; Li, Yi; Joshipura, Kaumudi J

2009-06-01

To compare the associations between socioeconomic factors and tooth loss among White, Black, and Mexican-American people. Analyses were conducted on 16,821 adults, using data from the National Health and Nutrition Examination Survey-III. Age- and multivariate-adjusted negative binomial regressions were used to explore the relation of socioeconomic factors, region of residence, gender, and foreign birth with the number of missing teeth. Effect modification by race/ethnicity was assessed by the inclusion of interaction terms. In multivariate-adjusted analyses, non-Hispanic White people with 9-12 years of education exhibited 71% higher mean number of missing teeth than those with >12 years of education [incidence rate ratio (IRR) = 1.71, 95% confidence interval (CI): 1.52-1.92]. Education was unrelated to the number of teeth among non-Hispanic Black people (IRR = 1.16; 95% CI: 1.00-1.35) or Mexican-Americans (IRR = 1.10, 95% CI: 0.93-1.31). The poorest White people exhibited 39% more missing teeth, on average, than the most affluent White people, but no association between poverty and number of teeth was observed among Black or Mexican-American people. The associations between socioeconomic factors and tooth loss vary across race/ethnicity. This suggests that the health benefits associated with high socioeconomic status are not equally shared across racial/ethnic groups.

Reducing falls after hospital discharge: a protocol for a randomised controlled trial evaluating an individualised multimodal falls education programme for older adults

PubMed Central

Hill, Anne-Marie; Etherton-Beer, Christopher; McPhail, Steven M; Morris, Meg E; Flicker, Leon; Bulsara, Max; Lee, Den-Ching; Francis-Coad, Jacqueline; Waldron, Nicholas; Boudville, Amanda; Haines, Terry

2017-01-01

Introduction Older adults frequently fall after discharge from hospital. Older people may have low self-perceived risk of falls and poor knowledge about falls prevention. The primary aim of the study is to evaluate the effect of providing tailored falls prevention education in addition to usual care on falls rates in older people after discharge from hospital compared to providing a social intervention in addition to usual care. Methods and analyses The ‘Back to My Best’ study is a multisite, single blind, parallel-group randomised controlled trial with blinded outcome assessment and intention-to-treat analysis, adhering to CONSORT guidelines. Patients (n=390) (aged 60 years or older; score more than 7/10 on the Abbreviated Mental Test Score; discharged to community settings) from aged care rehabilitation wards in three hospitals will be recruited and randomly assigned to one of two groups. Participants allocated to the control group shall receive usual care plus a social visit. Participants allocated to the experimental group shall receive usual care and a falls prevention programme incorporating a video, workbook and individualised follow-up from an expert health professional to foster capability and motivation to engage in falls prevention strategies. The primary outcome is falls rates in the first 6 months after discharge, analysed using negative binomial regression with adjustment for participant's length of observation in the study. Secondary outcomes are injurious falls rates, the proportion of people who become fallers, functional status and health-related quality of life. Healthcare resource use will be captured from four sources for 6 months after discharge. The study is powered to detect a 30% relative reduction in the rate of falls (negative binomial incidence ratio 0.70) for a control rate of 0.80 falls per person over 6 months. Ethics and dissemination Results will be presented in peer-reviewed journals and at conferences worldwide. This study is approved by hospital and university Human Research Ethics Committees. Trial registration number ACTRN12615000784516. PMID:28153933

[Spatial epidemiological study on malaria epidemics in Hainan province].

PubMed

Wen, Liang; Shi, Run-He; Fang, Li-Qun; Xu, De-Zhong; Li, Cheng-Yi; Wang, Yong; Yuan, Zheng-Quan; Zhang, Hui

2008-06-01

To better understand the characteristics of spatial distribution of malaria epidemics in Hainan province and to explore the relationship between malaria epidemics and environmental factors, as well to develop prediction model on malaria epidemics. Data on Malaria and meteorological factors were collected in all 19 counties in Hainan province from May to Oct., 2000, and the proportion of land use types of these counties in this period were extracted from digital map of land use in Hainan province. Land surface temperatures (LST) were extracted from MODIS images and elevations of these counties were extracted from DEM of Hainan province. The coefficients of correlation of malaria incidences and these environmental factors were then calculated with SPSS 13.0, and negative binomial regression analysis were done using SAS 9.0. The incidence of malaria showed (1) positive correlations to elevation, proportion of forest land area and grassland area; (2) negative correlations to the proportion of cultivated area, urban and rural residents and to industrial enterprise area, LST; (3) no correlations to meteorological factors, proportion of water area, and unemployed land area. The prediction model of malaria which came from negative binomial regression analysis was: I (monthly, unit: 1/1,000,000) = exp (-1.672-0.399xLST). Spatial distribution of malaria epidemics was associated with some environmental factors, and prediction model of malaria epidemic could be developed with indexes which extracted from satellite remote sensing images.

The gap between suicide characteristics in the print media and in the population.

PubMed

Niederkrotenthaler, Thomas; Till, Benedikt; Herberth, Arno; Voracek, Martin; Kapusta, Nestor D; Etzersdorfer, Elmar; Strauss, Markus; Sonneck, Gernot

2009-08-01

Programmes to educate media professionals about suicide are increasingly established, but information about which suicide cases are most likely to be reported in the mass media is sparse. We applied binomial tests to compare frequencies of social characteristics of all domestic suicides in the 13 largest Austrian print media in 2005 with frequencies of suicide characteristics in the population. Additionally, each reported suicide case was linked to its respective entry in the suicide database. We performed a logistic regression analysis, with presence of an article as outcome, and sex of the suicide case, age, religious affiliation, family status, conduction of an autopsy and location of the suicide as explaining variables. Time of the year and federal state where the suicide happened was controlled for. Binomial tests showed that suicides involving murder or murder attempt were over-represented in the media. Reporting on mental disorders was under-represented. In the regression analysis, the likelihood of a report was negatively associated with the age of suicide cases. Foreign citizenship was a further predictor of a suicide report. The methods of drowning, jumping, shooting and rare methods were more likely to be reported than hanging, which is the most frequent suicide method in Austria. Suicide characteristics in the media are not representative of the population. The identified discrepancies provide a basis for tailor-made education of mass media professionals.

Non-stochastic sampling error in quantal analyses for Campylobacter species on poultry products

USDA-ARS?s Scientific Manuscript database

Using primers and fluorescent probes specific for the most common foodborne Campylobacter species (C. jejuni = Cj and C. coli = Cc), we developed a multiplex, most probable number (MPN) assay using quantitative PCR (qPCR) as the determinant for binomial detection: number of p positives out of n = 6 ...

Logistic regression for dichotomized counts.

PubMed

Preisser, John S; Das, Kalyan; Benecha, Habtamu; Stamm, John W

2016-12-01

Sometimes there is interest in a dichotomized outcome indicating whether a count variable is positive or zero. Under this scenario, the application of ordinary logistic regression may result in efficiency loss, which is quantifiable under an assumed model for the counts. In such situations, a shared-parameter hurdle model is investigated for more efficient estimation of regression parameters relating to overall effects of covariates on the dichotomous outcome, while handling count data with many zeroes. One model part provides a logistic regression containing marginal log odds ratio effects of primary interest, while an ancillary model part describes the mean count of a Poisson or negative binomial process in terms of nuisance regression parameters. Asymptotic efficiency of the logistic model parameter estimators of the two-part models is evaluated with respect to ordinary logistic regression. Simulations are used to assess the properties of the models with respect to power and Type I error, the latter investigated under both misspecified and correctly specified models. The methods are applied to data from a randomized clinical trial of three toothpaste formulations to prevent incident dental caries in a large population of Scottish schoolchildren. © The Author(s) 2014.

Race/Ethnicity and Success in Academic Medicine: Findings From a Longitudinal Multi-Institutional Study.

PubMed

Kaplan, Samantha E; Raj, Anita; Carr, Phyllis L; Terrin, Norma; Breeze, Janis L; Freund, Karen M

2017-10-24

To understand differences in productivity, advancement, retention, satisfaction, and compensation comparing underrepresented medical (URM) faculty with other faculty at multiple institutions. A 17-year follow-up was conducted of the National Faculty Survey, a random sample from 24 U.S. medical schools, oversampled for URM faculty. The authors examined academic productivity, advancement, retention, satisfaction, and compensation, comparing white, URM, and non-URM faculty. Retention, productivity, and advancement data were obtained from public sources for nonrespondents. Covariates included gender, specialty, time distribution, and years in academia. Negative binomial regression was used for count data, logistic regression for binary outcomes, and linear regression for continuous outcomes. In productivity analyses, advancement, and retention, 1,270 participants were included; 604 participants responded to the compensation and satisfaction survey. Response rates were lower for African American (26%) and Hispanic faculty (39%) than white faculty (52%, P < .0001). URM faculty had lower rates of peer-reviewed publications (relative number 0.64; 95% CI: 0.51, 0.79), promotion to professor (OR = 0.53; CI: 0.30, 0.93), and retention in academic medicine (OR = 0.49; CI: 0.32, 0.75). No differences were identified in federal grant acquisition, senior leadership roles, career satisfaction, or compensation between URM and white faculty. URM and white faculty had similar career satisfaction, grant support, leadership, and compensation; URM faculty had fewer publications and were less likely to be promoted and retained in academic careers. Successful retention of URM faculty requires comprehensive institutional commitment to changing the academic climate and deliberative programming to support productivity and advancement.

Longitudinal Analysis of Gender Differences in Academic Productivity among Medical Faculty across 24 Medical Schools in the United States

PubMed Central

Raj, Anita; Carr, Phyllis L.; Kaplan, Samantha E.; Terrin, Norma; Breeze, Janis L.; Freund, Karen M.

2017-01-01

Purpose This study examines gender differences in academic productivity, as indicated by publications and federal grant funding acquisition, among a longitudinal cohort of medical faculty from 24 medical schools across the United States, 1995 to 2012. Method Data for this research was taken from the National Faculty Study involving a survey with medical faculty recruited from medical schools in 1995, and followed up in 2012. Data included surveys and publication and grant funding databases. Outcomes were number of publications, h-index and principal investigator on a federal grant in the prior two years. Gender differences were assessed using negative binomial regression models for publication and h-index outcomes, and logistic regression for the grant funding outcome; analyses adjusted for race/ethnicity, rank, specialty area and years since first academic appointment. Results Data were available for 1,244 of the 1,275 (98%) subjects eligible for the follow up study. Men were significantly more likely than women to be married/partnered, have children, and hold the rank of professor (P < .0001). Adjusted regression models document that women have a lower rate of publication (relative number = .71; 95% CI = .63, .81; P < .0001) and h-index (relative number = .81; 95% CI = .73, .90; P < .0001) relative to men, though there was no gender difference in grant funding. Conclusions Women faculty acquire federal funding at similar rates as male faculty, yet lag behind in terms of publications and their impact. Medical academia must consider how to help address ongoing gender disparities in publication records. PMID:27276002

The influence of marital status on the stage at diagnosis, treatment, and survival of adult patients with gastric cancer: a population-based study.

PubMed

Zhang, Jieyun; Gan, Lu; Wu, Zhenhua; Yan, Shican; Liu, Xiyu; Guo, Weijian

2017-04-04

Marital status was reported as a prognostic factor in many cancers. However, its role in gastric cancer (GC) hasn't been thoroughly explored. In this study, we aimed to investigate the effect of marital status on survival, stage, treatment, and survival in subgroups. We used the Surveillance, Epidemiology and End Results (SEER) database and identified 16910 GC patients. These patients were categorized into married (58.44%) and unmarred (41.56%) groups. Pearson chi-square, Wilcoxon-Mann-Whitney, Log-rank, multivariate Cox regression, univariate and multivariate binomial or multinomial logistic regression analysis were used in our analysis. Subgroup analyses of married versus unmarried patients were summarized in a forest plot. Married patients had better 5-year overall survival (OS) (32.09% VS 24.61%, P<0.001) and 5-year cancer-caused special survival (CSS) (37.74% VS 32.79%, P<0.001) than unmarried ones. Then we studied several underlying mechanisms. Firstly, married patients weren't in earlier stage at diagnosis (P=0.159). Secondly, married patients were more likely to receive surgery (P < 0.001) or radiotherapy (P < 0.001) compared with the unmarried. Thirdly, in subgroup analyses, married patients still had survival advantage in subgroups with stage II-IV and no radiotherapy. These results showed that marital status was an independently prognostic factor for both OS and CSS in GC patients. Undertreatment and lack of social support in unmarried patients were potential explanations. With the knowledge of heterogeneous effects of marriage in subgroups, we can target unmarried patients with better social support, especially who are diagnosed at late stage and undergo no treatment.

The influence of marital status on the stage at diagnosis, treatment, and survival of adult patients with gastric cancer: a population-based study

PubMed Central

Yan, Shican; Liu, Xiyu; Guo, Weijian

2017-01-01

Background & Aims Marital status was reported as a prognostic factor in many cancers. However, its role in gastric cancer (GC) hasn't been thoroughly explored. In this study, we aimed to investigate the effect of marital status on survival, stage, treatment, and survival in subgroups. Methods We used the Surveillance, Epidemiology and End Results (SEER) database and identified 16910 GC patients. These patients were categorized into married (58.44%) and unmarred (41.56%) groups. Pearson chi-square, Wilcoxon-Mann-Whitney, Log-rank, multivariate Cox regression, univariate and multivariate binomial or multinomial logistic regression analysis were used in our analysis. Subgroup analyses of married versus unmarried patients were summarized in a forest plot. Results Married patients had better 5-year overall survival (OS) (32.09% VS 24.61%, P<0.001) and 5-year cancer-caused special survival (CSS) (37.74% VS 32.79%, P<0.001) than unmarried ones. Then we studied several underlying mechanisms. Firstly, married patients weren't in earlier stage at diagnosis (P=0.159). Secondly, married patients were more likely to receive surgery (P < 0.001) or radiotherapy (P < 0.001) compared with the unmarried. Thirdly, in subgroup analyses, married patients still had survival advantage in subgroups with stage II-IV and no radiotherapy. Conclusions These results showed that marital status was an independently prognostic factor for both OS and CSS in GC patients. Undertreatment and lack of social support in unmarried patients were potential explanations. With the knowledge of heterogeneous effects of marriage in subgroups, we can target unmarried patients with better social support, especially who are diagnosed at late stage and undergo no treatment. PMID:26894860

Predictors of insubordinate aggression among captive female rhesus macaques.

PubMed

Seil, Shannon K; Hannibal, Darcy L; Beisner, Brianne A; McCowan, Brenda

2017-11-01

Cercopithicine primates tend to have nepotistic hierarchies characterized by predictable, kinship-based dominance. Although aggression is typically directed down the hierarchy, insubordinate aggression does occur. Insubordination is important to understand because it can precipitate social upheaval and undermine group stability; however, the factors underlying it are not well understood. We test whether key social and demographic variables predict insubordination among captive female rhesus macaques. To identify factors influencing insubordination, multivariate analyses of 10,821 dyadic conflicts among rhesus macaque females were conducted, using data from six captive groups. A segmented regression analysis was used to identify dyads with insubordination. Negative binomial regression analyses and an information theoretic approach were used to assess predictors of insubordination among dyads. In the best models, weight difference (w = 1.0; IRR = 0.930), age (dominant: w = 1.0, IRR = 0.681; subordinate: w = 1.0, IRR = 1.069), the subordinate's total number of allies (w = 0.727, IRR = 1.060) or non-kin allies (w = 0.273, IRR = 1.165), the interaction of the dominant's kin allies and weight difference (w = 0.938, IRR = 1.046), violation of youngest ascendancy (w = 1.0; IRR = 2.727), and the subordinate's maternal support (w = 1.0; IRR = 2.928), are important predictors of insubordination. These results show that both intrinsic and social factors influence insubordinate behavior. This adds to evidence of the importance of intrinsic factors and flexibility in a social structure thought to be rigid and predetermined by external factors. Further, because insubordination can precipitate social overthrow, determining predictors of insubordination will shed light on mechanisms underlying stability in nepotistic societies. © 2017 Wiley Periodicals, Inc.

Educational attainment has a limited impact on disease management outcomes in heart failure.

PubMed

Smith, Brad; Forkner, Emma; Krasuski, Richard A; Galbreath, Autumn Dawn; Freeman, Gregory L

2006-06-01

The objective of this study was to assess whether educational attainment moderates outcomes in the intervention group in a trial of disease management in heart failure (HF). Data were collected from a sample of 654 patients enrolled in the disease management arm of a community- based study of HF patients. The full sample was used to analyze two primary outcomes- all-cause mortality and cardiac event-free survival. Two other primary outcomes- rates of HF-related emergency department (ED) visits and inpatient admissions-and secondary outcomes (patient self-confidence in managing HF symptoms and daily dietary sodium intake in milligrams) were analyzed in a smaller sample of 602 patients who completed at least 6 months of disease management. One-way analysis of variance and chi (2) tests were used to assess differences in baseline demographic and clinical characteristics. Survival analyses were conducted with proportional hazards regression, while negative binomial regression was used to assess educational differences in ED usage and inpatient admissions. Repeated measures analysis of variance models were used to assess whether secondary outcomes differed across educational strata and/or over time. All outcome analyses were adjusted for confounders. Patients with the least education fared the poorest for all-cause mortality, but education- related differences failed to achieve statistical significance. No education-related differences were observed for cardiac event-free survival, or for the rates of inpatient admission and ED usage. For secondary outcomes, sodium intake differed significantly by education (p = 0.04), with the largest drop (-838 mg/day) observed in the least well-educated group. Confidence increased an approximately equal amount (2.1-3.0 points on a 100-point scale) across all educational strata (p = ns). Low educational attainment may not be a barrier to effective disease management.

Multivariate random-parameters zero-inflated negative binomial regression model: an application to estimate crash frequencies at intersections.

PubMed

Dong, Chunjiao; Clarke, David B; Yan, Xuedong; Khattak, Asad; Huang, Baoshan

2014-09-01

Crash data are collected through police reports and integrated with road inventory data for further analysis. Integrated police reports and inventory data yield correlated multivariate data for roadway entities (e.g., segments or intersections). Analysis of such data reveals important relationships that can help focus on high-risk situations and coming up with safety countermeasures. To understand relationships between crash frequencies and associated variables, while taking full advantage of the available data, multivariate random-parameters models are appropriate since they can simultaneously consider the correlation among the specific crash types and account for unobserved heterogeneity. However, a key issue that arises with correlated multivariate data is the number of crash-free samples increases, as crash counts have many categories. In this paper, we describe a multivariate random-parameters zero-inflated negative binomial (MRZINB) regression model for jointly modeling crash counts. The full Bayesian method is employed to estimate the model parameters. Crash frequencies at urban signalized intersections in Tennessee are analyzed. The paper investigates the performance of MZINB and MRZINB regression models in establishing the relationship between crash frequencies, pavement conditions, traffic factors, and geometric design features of roadway intersections. Compared to the MZINB model, the MRZINB model identifies additional statistically significant factors and provides better goodness of fit in developing the relationships. The empirical results show that MRZINB model possesses most of the desirable statistical properties in terms of its ability to accommodate unobserved heterogeneity and excess zero counts in correlated data. Notably, in the random-parameters MZINB model, the estimated parameters vary significantly across intersections for different crash types. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prediction of different ovarian responses using anti-Müllerian hormone following a long agonist treatment protocol for IVF.

PubMed

Heidar, Z; Bakhtiyari, M; Mirzamoradi, M; Zadehmodarres, S; Sarfjoo, F S; Mansournia, M A

2015-09-01

The purpose of this study was to predict the poor and excessive ovarian response using anti-Müllerian hormone (AMH) levels following a long agonist protocol in IVF candidates. Through a prospective cohort study, the type of relationship and appropriate scale for AMH were determined using the fractional polynomial regression. To determine the effect of AMH on the outcomes of ovarian stimulation and different ovarian responses, the multi-nominal and negative binomial regression models were fitted using backward stepwise method. The ovarian response of study subject who entered a standard long-term treatment cycle with GnRH agonist was evaluated using prediction model, separately and in combined models with (ROC) curves. The use of standard long-term treatments with GnRH agonist led to positive pregnancy test results in 30% of treated patients. With each unit increase in the log of AMH, the odds ratio of having poor response compared to normal response decreases by 64% (OR 0.36, 95% CI 0.19-0.68). Also the results of negative binomial regression model indicated that for one unit increase in the log of AMH blood levels, the odds of releasing an oocyte increased 24% (OR 1.24, 95% CI 1.14-1.35). The optimal cut-off points of AMH for predicting excessive and poor ovarian responses were 3.4 and 1.2 ng/ml, respectively, with area under curves of 0.69 (0.60-0.77) and 0.76 (0.66-0.86), respectively. By considering the age of the patient undergoing infertility treatment as a variable affecting ovulation, use of AMH levels showed to be a good test to discriminate between different ovarian responses.

Interpersonal Trust across Six Asia-Pacific Countries: Testing and Extending the ‘High Trust Society’ and ‘Low Trust Society’ Theory

PubMed Central

Ward, Paul R.; Mamerow, Loreen; Meyer, Samantha B.

2014-01-01

Background Trust is regarded as a necessary component for the smooth running of society, although societal and political modernising processes have been linked to an increase in mistrust, potentially signalling social and economic problems. Fukuyama developed the notion of ‘high trust’ and ‘low trust’ societies, as a way of understanding trust within different societies. The purpose of this paper is to empirically test and extend Fukuyama’s theory utilising data on interpersonal trust in Taiwan, Hong Kong, South Korea, Japan, Australia and Thailand. This paper focuses on trust in family, neighbours, strangers, foreigners and people with a different religion. Methods Cross-sectional surveys were undertaken in 2009–10, with an overall sample of 6331. Analyses of differences in overall levels of trust between countries were undertaken using Chi square analyses. Multivariate binomial logistic regression analysis was undertaken to identify socio-demographic predictors of trust in each country. Results Our data indicate a tripartite trust model: ‘high trust’ in Australia and Hong Kong; ‘medium trust’ in Japan and Taiwan; and ‘low trust’ in South Korea and Thailand. Trust in family and neighbours were very high across all countries, although trust in people with a different religion, trust in strangers and trust in foreigners varied considerably between countries. The regression models found a consistent group of subpopulations with low trust across the countries: people on low incomes, younger people and people with poor self-rated health. The results were conflicting for gender: females had lower trust in Thailand and Hong Kong, although in Australia, males had lower trust in strangers, whereas females had lower trust in foreigners. Conclusion This paper identifies high, medium and low trust societies, in addition to high and low trusting population subgroups. Our analyses extend the seminal work of Fukuyama, providing both corroboration and refutation for his theory. PMID:24760052

Occupational injury among hospital patient-care workers: what is the association with workplace verbal abuse?

PubMed

Sabbath, Erika L; Hurtado, David A; Okechukwu, Cassandra A; Tamers, Sara L; Nelson, Candace; Kim, Seung-Sup; Wagner, Gregory; Sorenson, Glorian

2014-02-01

To test the association between workplace abuse exposure and injury risk among hospital workers. We hypothesized that exposed workers would have higher injury rates than unexposed workers. Survey of direct-care workers (n = 1,497) in two hospitals. Exposure to workplace abuse was assessed through self-report; occupational injury reports were extracted from employee records. We tested associations between non-physical workplace violence and injury using log-binomial regression and multilevel modeling. Adjusted prevalence ratio (PR) for injury associated with being yelled at was 1.52 (95% CI 1.19, 1.95); for experiencing hostile/offensive gestures 1.43 (1.11, 1.82); and for being sworn at 1.41 (1.09, 1.81). In analyses by injury subtypes, musculoskeletal injuries were more strongly associated with abuse than were acute traumatic injuries. Associations operated on group and individual levels and were most consistently associated with abuse perpetrated by patients. Exposure to workplace abuse may be a risk factor for injuries among hospital workers. © 2013 Wiley Periodicals, Inc.

Hope and Hopelessness: The Role of Hope in Buffering the Impact of Hopelessness on Suicidal Ideation

PubMed Central

Huen, Jenny M. Y.; Ip, Brian Y. T.; Ho, Samuel M. Y.; Yip, Paul S. F.

2015-01-01

Objectives The present study investigated whether hope and hopelessness are better conceptualized as a single construct of bipolar spectrum or two distinct constructs and whether hope can moderate the relationship between hopelessness and suicidal ideation. Methods Hope, hopelessness, and suicidal ideation were measured in a community sample of 2106 participants through a population-based household survey. Results Confirmatory factor analyses showed that a measurement model with separate, correlated second-order factors of hope and hopelessness provided a good fit to the data and was significantly better than that of the model collapsing hope and hopelessness into a single second-order factor. Negative binomial regression showed that hope and hopelessness interacted such that the effect of hopelessness on suicidal ideation was lower in individuals with higher hope than individuals with lower hope. Conclusions Hope and hopelessness are two distinct but correlated constructs. Hope can act as a resilience factor that buffers the impact of hopelessness on suicidal ideation. Inducing hope in people may be a promising avenue for suicide prevention. PMID:26107687

Resources predicting positive and negative affect during the experience of stress: a study of older Asian Indian immigrants in the United States.

PubMed

Diwan, Sadhna; Jonnalagadda, Satya S; Balaswamy, Shantha

2004-10-01

Using the life stress model of psychological well-being, in this study we examined risks and resources predicting the occurrence of both positive and negative affect among older Asian Indian immigrants who experienced stressful life events. We collected data through a telephone survey of 226 respondents (aged 50 years and older) in the Southeastern United States. We used hierarchical, negative binomial regression analyses to examine correlates of positive and negative affect. Different coping resources influenced positive and negative affect when stressful life events were controlled for. Being female was a common risk factor for poorer positive and increased negative affect. Satisfaction with friendships and a cultural or ethnic identity that is either bicultural or more American were predictive of greater positive affect. Greater religiosity and increased mastery were resources predicting less negative affect. Cognitive and structural interventions that increase opportunities for social integration, increasing mastery, and addressing spiritual concerns are discussed as ways of coping with stress to improve the well-being of individuals in this immigrant community.

The interplay of parental monitoring and socioeconomic status in predicting minor delinquency between and within adolescents.

PubMed

Rekker, Roderik; Keijsers, Loes; Branje, Susan; Koot, Hans; Meeus, Wim

2017-08-01

This six-wave multi-informant longitudinal study on Dutch adolescents (N = 824; age 12-18) examined the interplay of socioeconomic status with parental monitoring in predicting minor delinquency. Fixed-effects negative binomial regression analyses revealed that this interplay is different within adolescents across time than between adolescents. Between individuals, parental solicitation and control were not significantly associated with delinquency after controlling for SES: Adolescents whose parents exercised more monitoring did not offend less than others. Within individuals, higher levels of parental control were unexpectedly associated with more delinquency, but this relation was dependent on SES: Low-SES adolescents, but not high-SES adolescents, offended more during periods in which their parents exercised more control than during other periods with less control. In contrast to earlier work, this finding suggests that monitoring could be least effective when needed most. Low-SES parents might not use monitoring effectively and become overcontrolling when their child goes astray. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Social vulnerability and the natural and built environment: a model of flood casualties in Texas.

PubMed

Zahran, Sammy; Brody, Samuel D; Peacock, Walter Gillis; Vedlitz, Arnold; Grover, Himanshu

2008-12-01

Studies on the impacts of hurricanes, tropical storms, and tornados indicate that poor communities of colour suffer disproportionately in human death and injury.(2) Few quantitative studies have been conducted on the degree to which flood events affect socially vulnerable populations. We address this research void by analysing 832 countywide flood events in Texas from 1997-2001. Specifically, we examine whether geographic localities characterised by high percentages of socially vulnerable populations experience significantly more casualties due to flood events, adjusting for characteristics of the natural and built environment. Zero-inflated negative binomial regression models indicate that the odds of a flood casualty increase with the level of precipitation on the day of a flood event, flood duration, property damage caused by the flood, population density, and the presence of socially vulnerable populations. Odds decrease with the number of dams, the level of precipitation on the day before a recorded flood event, and the extent to which localities have enacted flood mitigation strategies. The study concludes with comments on hazard-resilient communities and protection of casualty-prone populations.

Should the poor have no medicines to cure? A study on the association between social class and social security among the rural migrant workers in urban China.

PubMed

Guan, Ming

2017-11-07

The rampant urbanization and medical marketization in China have resulted in increased vulnerabilities to health and socioeconomic disparities among the rural migrant workers in urban China. In the Chinese context, the socioeconomic characteristics of rural migrant workers have attracted considerable research attention in the recent past years. However, to date, no previous studies have explored the association between the socioeconomic factors and social security among the rural migrant workers in urban China. This study aims to explore the association between socioeconomic inequity and social security inequity and the subsequent associations with medical inequity and reimbursement rejection. Data from a regionally representative sample of 2009 Survey of Migrant Workers in Pearl River Delta in China were used for analyses. Multiple logistic regressions were used to analyze the impacts of socioeconomic factors on the eight dimensions of social security (sick pay, paid leave, maternity pay, medical insurance, pension insurance, occupational injury insurance, unemployment insurance, and maternity insurance) and the impacts of social security on medical reimbursement rejection. The zero-inflated negative binomial regression model (ZINB regression) was adopted to explore the relationship between socioeconomic factors and hospital visits among the rural migrant workers with social security. The study population consisted of 848 rural migrant workers with high income who were young and middle-aged, low-educated, and covered by social security. Reimbursement rejection and abusive supervision for the rural migrant workers were observed. Logistic regression analysis showed that there were significant associations between socioeconomic factors and social security. ZINB regression showed that there were significant associations between socioeconomic factors and hospital visits among the rural migrant workers. Also, several dimensions of social security had significant associations with reimbursement rejections. This study showed that social security inequity, medical inequity, and reimbursement inequity happened to the rural migrant workers simultaneously. Future policy should strengthen health justice and enterprises' medical responsibilities to the employed rural migrant workers.

Developing a dengue forecast model using machine learning: A case study in China

PubMed Central

Zhang, Qin; Wang, Li; Xiao, Jianpeng; Zhang, Qingying; Luo, Ganfeng; Li, Zhihao; He, Jianfeng; Zhang, Yonghui; Ma, Wenjun

2017-01-01

Background In China, dengue remains an important public health issue with expanded areas and increased incidence recently. Accurate and timely forecasts of dengue incidence in China are still lacking. We aimed to use the state-of-the-art machine learning algorithms to develop an accurate predictive model of dengue. Methodology/Principal findings Weekly dengue cases, Baidu search queries and climate factors (mean temperature, relative humidity and rainfall) during 2011–2014 in Guangdong were gathered. A dengue search index was constructed for developing the predictive models in combination with climate factors. The observed year and week were also included in the models to control for the long-term trend and seasonality. Several machine learning algorithms, including the support vector regression (SVR) algorithm, step-down linear regression model, gradient boosted regression tree algorithm (GBM), negative binomial regression model (NBM), least absolute shrinkage and selection operator (LASSO) linear regression model and generalized additive model (GAM), were used as candidate models to predict dengue incidence. Performance and goodness of fit of the models were assessed using the root-mean-square error (RMSE) and R-squared measures. The residuals of the models were examined using the autocorrelation and partial autocorrelation function analyses to check the validity of the models. The models were further validated using dengue surveillance data from five other provinces. The epidemics during the last 12 weeks and the peak of the 2014 large outbreak were accurately forecasted by the SVR model selected by a cross-validation technique. Moreover, the SVR model had the consistently smallest prediction error rates for tracking the dynamics of dengue and forecasting the outbreaks in other areas in China. Conclusion and significance The proposed SVR model achieved a superior performance in comparison with other forecasting techniques assessed in this study. The findings can help the government and community respond early to dengue epidemics. PMID:29036169

Distinguishing between Binomial, Hypergeometric and Negative Binomial Distributions

ERIC Educational Resources Information Center

Wroughton, Jacqueline; Cole, Tarah

2013-01-01

Recognizing the differences between three discrete distributions (Binomial, Hypergeometric and Negative Binomial) can be challenging for students. We present an activity designed to help students differentiate among these distributions. In addition, we present assessment results in the form of pre- and post-tests that were designed to assess the…

Library Book Circulation and the Beta-Binomial Distribution.

ERIC Educational Resources Information Center

Gelman, E.; Sichel, H. S.

1987-01-01

Argues that library book circulation is a binomial rather than a Poisson process, and that individual book popularities are continuous beta distributions. Three examples demonstrate the superiority of beta over negative binomial distribution, and it is suggested that a bivariate-binomial process would be helpful in predicting future book…

Racial disparities in diabetes mortality in the 50 most populous US cities.

PubMed

Rosenstock, Summer; Whitman, Steve; West, Joseph F; Balkin, Michael

2014-10-01

While studies have consistently shown that in the USA, non-Hispanic Blacks (Blacks) have higher diabetes prevalence, complication and death rates than non-Hispanic Whites (Whites), there are no studies that compare disparities in diabetes mortality across the largest US cities. This study presents and compares Black/White age-adjusted diabetes mortality rate ratios (RRs), calculated using national death files and census data, for the 50 most populous US cities. Relationships between city-level diabetes mortality RRs and 12 ecological variables were explored using bivariate correlation analyses. Multivariate analyses were conducted using negative binomial regression to examine how much of the disparity could be explained by these variables. Blacks had statistically significantly higher mortality rates compared to Whites in 39 of the 41 cities included in analyses, with statistically significant rate ratios ranging from 1.57 (95 % CI: 1.33-1.86) in Baltimore to 3.78 (95 % CI: 2.84-5.02) in Washington, DC. Analyses showed that economic inequality was strongly correlated with the diabetes mortality disparity, driven by differences in White poverty levels. This was followed by segregation. Multivariate analyses showed that adjusting for Black/White poverty alone explained 58.5 % of the disparity. Adjusting for Black/White poverty and segregation explained 72.6 % of the disparity. This study emphasizes the role that inequalities in social and economic determinants, rather than for example poverty on its own, play in Black/White diabetes mortality disparities. It also highlights how the magnitude of the disparity and the factors that influence it can vary greatly across cities, underscoring the importance of using local data to identify context specific barriers and develop effective interventions to eliminate health disparities.

Matching the Statistical Model to the Research Question for Dental Caries Indices with Many Zero Counts.

PubMed

Preisser, John S; Long, D Leann; Stamm, John W

2017-01-01

Marginalized zero-inflated count regression models have recently been introduced for the statistical analysis of dental caries indices and other zero-inflated count data as alternatives to traditional zero-inflated and hurdle models. Unlike the standard approaches, the marginalized models directly estimate overall exposure or treatment effects by relating covariates to the marginal mean count. This article discusses model interpretation and model class choice according to the research question being addressed in caries research. Two data sets, one consisting of fictional dmft counts in 2 groups and the other on DMFS among schoolchildren from a randomized clinical trial comparing 3 toothpaste formulations to prevent incident dental caries, are analyzed with negative binomial hurdle, zero-inflated negative binomial, and marginalized zero-inflated negative binomial models. In the first example, estimates of treatment effects vary according to the type of incidence rate ratio (IRR) estimated by the model. Estimates of IRRs in the analysis of the randomized clinical trial were similar despite their distinctive interpretations. The choice of statistical model class should match the study's purpose, while accounting for the broad decline in children's caries experience, such that dmft and DMFS indices more frequently generate zero counts. Marginalized (marginal mean) models for zero-inflated count data should be considered for direct assessment of exposure effects on the marginal mean dental caries count in the presence of high frequencies of zero counts. © 2017 S. Karger AG, Basel.

Development of binomial sequential sampling plans for forecasting Listronotus maculicollis (Coleoptera: Curculionidae) larvae based on the relationship to adult counts and turfgrass damage.

PubMed

McGraw, Benjamin A; Koppenhöfer, Albrecht M

2009-06-01

Binomial sequential sampling plans were developed to forecast weevil Listronotus maculicollis Kirby (Coleoptera: Curculionidae), larval damage to golf course turfgrass and aid in the development of integrated pest management programs for the weevil. Populations of emerging overwintered adults were sampled over a 2-yr period to determine the relationship between adult counts, larval density, and turfgrass damage. Larval density and composition of preferred host plants (Poa annua L.) significantly affected the expression of turfgrass damage. Multiple regression indicates that damage may occur in moderately mixed P. annua stands with as few as 10 larvae per 0.09 m2. However, > 150 larvae were required before damage became apparent in pure Agrostis stolonifera L. plots. Adult counts during peaks in emergence as well as cumulative counts across the emergence period were significantly correlated to future densities of larvae. Eight binomial sequential sampling plans based on two tally thresholds for classifying infestation (T = 1 and two adults) and four adult density thresholds (0.5, 0.85, 1.15, and 1.35 per 3.34 m2) were developed to forecast the likelihood of turfgrass damage by using adult counts during peak emergence. Resampling for validation of sample plans software was used to validate sampling plans with field-collected data sets. All sampling plans were found to deliver accurate classifications (correct decisions were made between 84.4 and 96.8%) in a practical timeframe (average sampling cost < 22.7 min).

Music and Its Significance in Children Favourite Audiovisuals

ERIC Educational Resources Information Center

Porta, Amparo; Herrera, Lucía

2017-01-01

Audiovisual media are part of children's daily life. They build and/or replace a part of the reality that is sometimes preceded. This paper is interested in one of the elements of the audiovisual binomial, the soundtrack, in order to analyse its meaning and sense from the children's point of view. The objectives are: to determine if the…

P-Hacking in Orthopaedic Literature: A Twist to the Tail.

PubMed

Bin Abd Razak, Hamid Rahmatullah; Ang, Jin-Guang Ernest; Attal, Hersh; Howe, Tet-Sen; Allen, John Carson

2016-10-19

"P-hacking" occurs when researchers preferentially select data or statistical analyses until nonsignificant results become significant. We wanted to evaluate if the phenomenon of p-hacking was evident in orthopaedic literature. We text-mined through all articles published in three top orthopaedic journals in 2015. For anonymity, we cipher-coded the three journals. We included all studies that reported a single p value to answer their main hypothesis. These p values were then charted and frequency graphs were generated to illustrate any evidence of p-hacking. Binomial tests were employed to look for evidence of evidential value and significance of p-hacking. Frequency plots for all three journals revealed evidence of p-hacking. Binomial tests for all three journals were significant for evidence of evidential value (p < 0.0001 for all). However, the binomial test for p-hacking was significant only for one journal (p = 0.0092). P-hacking is an evolving phenomenon that threatens to jeopardize the evidence-based practice of medicine. Although our results show that there is good evidential value for orthopaedic literature published in our top journals, there is some evidence of p-hacking of which authors and readers should be wary. Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

Analysing recurrent hospitalizations in heart failure: a review of statistical methodology, with application to CHARM-Preserved.

PubMed

Rogers, Jennifer K; Pocock, Stuart J; McMurray, John J V; Granger, Christopher B; Michelson, Eric L; Östergren, Jan; Pfeffer, Marc A; Solomon, Scott D; Swedberg, Karl; Yusuf, Salim

2014-01-01

Heart failure is characterized by recurrent hospitalizations, but often only the first event is considered in clinical trial reports. In chronic diseases, such as heart failure, analysing all events gives a more complete picture of treatment benefit. We describe methods of analysing repeat hospitalizations, and illustrate their value in one major trial. The Candesartan in Heart failure Assessment of Reduction in Mortality and morbidity (CHARM)-Preserved study compared candesartan with placebo in 3023 patients with heart failure and preserved systolic function. The heart failure hospitalization rates were 12.5 and 8.9 per 100 patient-years in the placebo and candesartan groups, respectively. The repeat hospitalizations were analysed using the Andersen-Gill, Poisson, and negative binomial methods. Death was incorporated into analyses by treating it as an additional event. The win ratio method and a method that jointly models hospitalizations and mortality were also considered. Using repeat events gave larger treatment benefits than time to first event analysis. The negative binomial method for the composite of recurrent heart failure hospitalizations and cardiovascular death gave a rate ratio of 0.75 [95% confidence interval (CI) 0.62-0.91, P = 0.003], whereas the hazard ratio for time to first heart failure hospitalization or cardiovascular death was 0.86 (95% CI 0.74-1.00, P = 0.050). In patients with preserved EF, candesartan reduces the rate of admissions for worsening heart failure, to a greater extent than apparent from analysing only first hospitalizations. Recurrent events should be routinely incorporated into the analysis of future clinical trials in heart failure. © 2013 The Authors. European Journal of Heart Failure © 2013 European Society of Cardiology.

Enrollment Management in Medical School Admissions: A Novel Evidence-Based Approach at One Institution.

PubMed

Burkhardt, John C; DesJardins, Stephen L; Teener, Carol A; Gay, Steven E; Santen, Sally A

2016-11-01

In higher education, enrollment management has been developed to accurately predict the likelihood of enrollment of admitted students. This allows evidence to dictate numbers of interviews scheduled, offers of admission, and financial aid package distribution. The applicability of enrollment management techniques for use in medical education was tested through creation of a predictive enrollment model at the University of Michigan Medical School (U-M). U-M and American Medical College Application Service data (2006-2014) were combined to create a database including applicant demographics, academic application scores, institutional financial aid offer, and choice of school attended. Binomial logistic regression and multinomial logistic regression models were estimated in order to study factors related to enrollment at the local institution versus elsewhere and to groupings of competing peer institutions. A predictive analytic "dashboard" was created for practical use. Both models were significant at P < .001 and had similar predictive performance. In the binomial model female, underrepresented minority students, grade point average, Medical College Admission Test score, admissions committee desirability score, and most individual financial aid offers were significant (P < .05). The significant covariates were similar in the multinomial model (excluding female) and provided separate likelihoods of students enrolling at different institutional types. An enrollment-management-based approach would allow medical schools to better manage the number of students they admit and target recruitment efforts to improve their likelihood of success. It also performs a key institutional research function for understanding failed recruitment of highly desirable candidates.

Not in My Back Yard: A Comparative Analysis of Crime Around Publicly Funded Drug Treatment Centers, Liquor Stores, Convenience Stores, and Corner Stores in One Mid-Atlantic City.

PubMed

Furr-Holden, C Debra M; Milam, Adam J; Nesoff, Elizabeth D; Johnson, Renee M; Fakunle, David O; Jennings, Jacky M; Thorpe, Roland J

2016-01-01

This research examined whether publicly funded drug treatment centers (DTCs) were associated with violent crime in excess of the violence happening around other commercial businesses. Violent crime data and locations of community entities were geocoded and mapped. DTCs and other retail outlets were matched based on a Neighborhood Disadvantage score at the census tract level. Street network buffers ranging from 100 to 1,400 feet were placed around each location. Negative binomial regression models were used to estimate the relationship between the count of violent crimes and the distance from each business type. Compared with the mean count of violent crime around drug treatment centers, the mean count of violent crime (M = 2.87) was significantly higher around liquor stores (M = 3.98; t test; p < .01) and corner stores (M = 3.78; t test; p < .01), and there was no statistically significant difference between the count around convenience stores (M = 2.65; t test; p = .32). In the adjusted negative binomial regression models, there was a negative and significant relationship between the count of violent crime and the distance from drug treatment centers (β = -.069, p < .01), liquor stores (β = -.081, p < .01), corner stores (β = -.116, p < .01), and convenience stores (β = -.154, p < .01). Violent crime associated with drug treatment centers is similar to that associated with liquor stores and is less frequent than that associated with convenience stores and corner stores.

[Epidemiology of scrub typhus and influencing factors in Yunnan province, 2006-2013].

PubMed

Sun, Y; Shi, C; Li, X L; Fang, L Q; Cao, W C

2018-01-10

Objective: To understand the epidemiological characteristics of scrub typhu s and influencing factors in Yunnan province, and provide further information for the prevention and control of scrub typhus. Methods: Based on the incidence data of scrub typhus reported in Yunnan from 2006 to 2013, the epidemiological characteristics of scrub typhus were analyzed and related environmental factors were identified with panel negative binomial regression model. Results: A total of 8 980 scrub typhus cases were reported during 2006-2013 in Yunnan. The average annual incidence was 2.46/100 000, with an uptrend observed. Natural focus expansion was found, affecting 71.3% of the counties in 2013. The epidemic mainly occurred in summer and autumn with the incidence peak during July-October. The annual incidence was higher in females than in males. More cases occurred in children and farmers, the proportions of cases in farmers and pre-school aged children showed an obvious increase. Panel negative binomial regression model indicated that the transmission risk of scrub typhus was positive associated with monthly temperature and monthly relative humidity. Furthermore, an "U" pattern between the risk and the increased coverage of cropland and grassland as well as an "inverted-U" pattern between the risk and increased coverage of shrub were observed. Conclusion: It is necessary to strengthen the scrub typhus surveillance in warm and moist areas as well as the areas with high coverage of cropland and grassland in Yunnan, and the health education in children and farmers who are at high risk.

Variable selection for zero-inflated and overdispersed data with application to health care demand in Germany

PubMed Central

Wang, Zhu; Shuangge, Ma; Wang, Ching-Yun

2017-01-01

In health services and outcome research, count outcomes are frequently encountered and often have a large proportion of zeros. The zero-inflated negative binomial (ZINB) regression model has important applications for this type of data. With many possible candidate risk factors, this paper proposes new variable selection methods for the ZINB model. We consider maximum likelihood function plus a penalty including the least absolute shrinkage and selection operator (LASSO), smoothly clipped absolute deviation (SCAD) and minimax concave penalty (MCP). An EM (expectation-maximization) algorithm is proposed for estimating the model parameters and conducting variable selection simultaneously. This algorithm consists of estimating penalized weighted negative binomial models and penalized logistic models via the coordinated descent algorithm. Furthermore, statistical properties including the standard error formulae are provided. A simulation study shows that the new algorithm not only has more accurate or at least comparable estimation, also is more robust than the traditional stepwise variable selection. The proposed methods are applied to analyze the health care demand in Germany using an open-source R package mpath. PMID:26059498

Assessment of Alcohol and Tobacco Use Disorders Among Religious Users of Ayahuasca

PubMed Central

Barbosa, Paulo Cesar Ribeiro; Tófoli, Luís F.; Bogenschutz, Michael P.; Hoy, Robert; Berro, Lais F.; Marinho, Eduardo A. V.; Areco, Kelsy N.; Winkelman, Michael J.

2018-01-01

The aims of this study were to assess the impact of ceremonial use of ayahuasca—a psychedelic brew containing N,N-dimethyltryptamine (DMT) and β-carboline —and attendance at União do Vegetal (UDV) meetings on substance abuse; here we report the findings related to alcohol and tobacco use disorder. A total of 1,947 members of UDV 18+ years old were evaluated in terms of years of membership and ceremonial attendance during the previous 12 months. Participants were recruited from 10 states from all major regions of Brazil. Alcohol and tobacco use was evaluated through questionnaires first developed by the World Health Organization and the Substance Abuse and Mental Health Services Administration. Analyses compared levels of alcohol and tobacco use disorder between the UDV and a national normative sample (n = 7,939). Binomial tests for proportions indicated that lifetime use of alcohol and tobacco was higher in UDV sample compared to the Brazilian norms for age ranges of 25–34 and over 34 years old, but not for the age range of 18–24 years old. However, current use disorders for alcohol and tobacco were significantly lower in the UDV sample than the Brazilian norms. Regression analyses revealed a significant impact of attendance at ayahuasca ceremonies during the previous 12 months and years of UDV membership on the reduction of alcohol and tobacco use disorder. PMID:29740355

Predictors of experiences of discrimination and positive treatment in people with mental health problems: findings from an Australian national survey.

PubMed

Reavley, Nicola J; Morgan, Amy J; Jorm, Anthony F

2017-03-01

The aim of the study was to assess the factors predicting experiences of avoidance, discrimination and positive treatment in people with mental health problems. In 2014, telephone interviews were carried out with 5220 Australians aged 18+, 1381 of whom reported a mental health problem or scored highly on a symptom screening questionnaire. Questions covered experiences of avoidance, discrimination and positive treatment by friends, spouse, other family, workplace, educational institution and others in the community; as well as disclosure of mental health problems. Avoidance, discrimination and positive treatment scores were calculated by counting the number of domains in which each occurred. Predictors of avoidance, discrimination and positive treatment were modelled with negative binomial regression analyses. After adjusting for the effects of other predictors in multivariate analyses, symptom severity and a diagnosis of 'any other disorder' (most commonly psychotic disorders or eating disorders) predicted experiences of both avoidance and discrimination but not positive treatment. Disclosing a mental health problem in more settings was also associated with higher rates of avoidance and discrimination, but also with positive treatment. Disclosure of mental health problems to others may increases experiences of discrimination, but may also increase experiences of positive treatment. These findings can help to inform decision making by people with mental health problems about disclosure, particularly in the case of more severe or low-prevalence disorders.

Serum Vitamin D Levels and Markers of Severity of Childhood Asthma in Costa Rica

PubMed Central

Brehm, John M.; Celedón, Juan C.; Soto-Quiros, Manuel E.; Avila, Lydiana; Hunninghake, Gary M.; Forno, Erick; Laskey, Daniel; Sylvia, Jody S.; Hollis, Bruce W.; Weiss, Scott T.; Litonjua, Augusto A.

2009-01-01

Rationale: Maternal vitamin D intake during pregnancy has been inversely associated with asthma symptoms in early childhood. However, no study has examined the relationship between measured vitamin D levels and markers of asthma severity in childhood. Objectives: To determine the relationship between measured vitamin D levels and both markers of asthma severity and allergy in childhood. Methods: We examined the relation between 25-hydroxyvitamin D levels (the major circulating form of vitamin D) and markers of allergy and asthma severity in a cross-sectional study of 616 Costa Rican children between the ages of 6 and 14 years. Linear, logistic, and negative binomial regressions were used for the univariate and multivariate analyses. Measurements and Main Results: Of the 616 children with asthma, 175 (28%) had insufficient levels of vitamin D (<30 ng/ml). In multivariate linear regression models, vitamin D levels were significantly and inversely associated with total IgE and eosinophil count. In multivariate logistic regression models, a log10 unit increase in vitamin D levels was associated with reduced odds of any hospitalization in the previous year (odds ratio [OR], 0.05; 95% confidence interval [CI], 0.004–0.71; P = 0.03), any use of antiinflammatory medications in the previous year (OR, 0.18; 95% CI, 0.05–0.67; P = 0.01), and increased airway responsiveness (a ≤8.58-μmol provocative dose of methacholine producing a 20% fall in baseline FEV1 [OR, 0.15; 95% CI, 0.024–0.97; P = 0.05]). Conclusions: Our results suggest that vitamin D insufficiency is relatively frequent in an equatorial population of children with asthma. In these children, lower vitamin D levels are associated with increased markers of allergy and asthma severity. PMID:19179486

Black Clouds vs Random Variation in Hospital Admissions.

PubMed

Ong, Luei Wern; Dawson, Jeffrey D; Ely, John W

2018-06-01

Physicians often accuse their peers of being "black clouds" if they repeatedly have more than the average number of hospital admissions while on call. Our purpose was to determine whether the black-cloud phenomenon is real or explainable by random variation. We analyzed hospital admissions to the University of Iowa family medicine service from July 1, 2010 to June 30, 2015. Analyses were stratified by peer group (eg, night shift attending physicians, day shift senior residents). We analyzed admission numbers to find evidence of black-cloud physicians (those with significantly more admissions than their peers) and white-cloud physicians (those with significantly fewer admissions). The statistical significance of whether there were actual differences across physicians was tested with mixed-effects negative binomial regression. The 5-year study included 96 physicians and 6,194 admissions. The number of daytime admissions ranged from 0 to 10 (mean 2.17, SD 1.63). Night admissions ranged from 0 to 11 (mean 1.23, SD 1.22). Admissions increased from 1,016 in the first year to 1,523 in the fifth year. We found 18 white-cloud and 16 black-cloud physicians in simple regression models that did not control for this upward trend. After including study year and other potential confounding variables in the regression models, there were no significant associations between physicians and admission numbers and therefore no true black or white clouds. In this study, apparent black-cloud and white-cloud physicians could be explained by random variation in hospital admissions. However, this randomness incorporated a wide range in workload among physicians, with potential impact on resident education at the low end and patient safety at the high end.

Reliability studies of Integrated Modular Engine system designs

NASA Technical Reports Server (NTRS)

Hardy, Terry L.; Rapp, Douglas C.

1993-01-01

A study was performed to evaluate the reliability of Integrated Modular Engine (IME) concepts. Comparisons were made between networked IME systems and non-networked discrete systems using expander cycle configurations. Both redundant and non-redundant systems were analyzed. Binomial approximation and Markov analysis techniques were employed to evaluate total system reliability. In addition, Failure Modes and Effects Analyses (FMEA), Preliminary Hazard Analyses (PHA), and Fault Tree Analysis (FTA) were performed to allow detailed evaluation of the IME concept. A discussion of these system reliability concepts is also presented.

Reliability studies of integrated modular engine system designs

NASA Technical Reports Server (NTRS)

Hardy, Terry L.; Rapp, Douglas C.

1993-01-01

A study was performed to evaluate the reliability of Integrated Modular Engine (IME) concepts. Comparisons were made between networked IME systems and non-networked discrete systems using expander cycle configurations. Both redundant and non-redundant systems were analyzed. Binomial approximation and Markov analysis techniques were employed to evaluate total system reliability. In addition, Failure Modes and Effects Analyses (FMEA), Preliminary Hazard Analyses (PHA), and Fault Tree Analysis (FTA) were performed to allow detailed evaluation of the IME concept. A discussion of these system reliability concepts is also presented.

Reliability studies of integrated modular engine system designs

NASA Astrophysics Data System (ADS)

Hardy, Terry L.; Rapp, Douglas C.

1993-06-01

A study was performed to evaluate the reliability of Integrated Modular Engine (IME) concepts. Comparisons were made between networked IME systems and non-networked discrete systems using expander cycle configurations. Both redundant and non-redundant systems were analyzed. Binomial approximation and Markov analysis techniques were employed to evaluate total system reliability. In addition, Failure Modes and Effects Analyses (FMEA), Preliminary Hazard Analyses (PHA), and Fault Tree Analysis (FTA) were performed to allow detailed evaluation of the IME concept. A discussion of these system reliability concepts is also presented.

Reliability studies of Integrated Modular Engine system designs

NASA Astrophysics Data System (ADS)

Hardy, Terry L.; Rapp, Douglas C.

1993-06-01

A study was performed to evaluate the reliability of Integrated Modular Engine (IME) concepts. Comparisons were made between networked IME systems and non-networked discrete systems using expander cycle configurations. Both redundant and non-redundant systems were analyzed. Binomial approximation and Markov analysis techniques were employed to evaluate total system reliability. In addition, Failure Modes and Effects Analyses (FMEA), Preliminary Hazard Analyses (PHA), and Fault Tree Analysis (FTA) were performed to allow detailed evaluation of the IME concept. A discussion of these system reliability concepts is also presented.

What is the effect of a combined physical activity and fall prevention intervention enhanced with health coaching and pedometers on older adults' physical activity levels and mobility-related goals? Study protocol for a randomised controlled trial.

PubMed

Tiedemann, Anne; Paul, Serene; Ramsay, Elisabeth; O'Rourke, Sandra D; Chamberlain, Kathryn; Kirkham, Catherine; Merom, Dafna; Fairhall, Nicola; Oliveira, Juliana S; Hassett, Leanne; Sherrington, Catherine

2015-05-09

Physical inactivity and falls in older people are important public health problems. Health conditions that could be ameliorated with physical activity are particularly common in older people. One in three people aged 65 years and over fall at least once annually, often resulting in significant injuries and ongoing disability. These problems need to be urgently addressed as the population proportion of older people is rapidly rising. This trial aims to establish the impact of a combined physical activity and fall prevention intervention compared to an advice brochure on objectively measured physical activity participation and mobility-related goal attainment among people aged 60+. A randomised controlled trial involving 130 consenting community-dwelling older people will be conducted. Participants will be individually randomised to a control group (n = 65) and receive a fall prevention brochure, or to an intervention group (n = 65) and receive the brochure plus physical activity promotion and fall prevention intervention enhanced with health coaching and a pedometer. Primary outcomes will be objectively measured physical activity and mobility-related goal attainment, measured at both six and 12 months post randomisation. Secondary outcomes will include: falls, the proportion of people meeting the physical activity guidelines, quality of life, fear of falling, mood, and mobility limitation. Barriers and enablers to physical activity participation will be measured 6 months after randomisation. General linear models will be used to assess the effect of group allocation on the continuously-scored primary and secondary outcome measures, after adjusting for baseline scores. Between-group differences in goal attainment (primary outcome) will be analysed with ordinal regression. The number of falls per person-year will be analysed using negative binomial regression models to estimate the between-group difference in fall rates after one year (secondary outcome). Modified Poisson regression models will compare groups on dichotomous outcome measures. Analyses will be pre-planned, conducted while masked to group allocation and will use an intention-to-treat approach. This trial will address a key gap in evidence regarding physical activity and fall prevention for older people and will evaluate a program that could be directly implemented within Australian health services. ACTRN12614000016639, 7/01/2014.

Behavioral Health Treatment Patterns Among Employer-Insured Adults in Same- and Different-Gender Marriages and Domestic Partnerships.

PubMed

Tran, Linda Diem; Xu, Haiyong; Azocar, Francisca; Ettner, Susan L

2018-05-01

This study examined specialty behavioral health treatment patterns among employer-insured adults in same- and different-gender domestic partnerships and marriages. The study used behavioral health service claims (2008-2013) from Optum to estimate gender-stratified penetration rates of behavioral health service use by couple type and partnership status among partnered adults ages 18-64 (N=12,727,292 person-years) and levels of use among those with any use (conditional analyses). Least-squares, logistic, and zero-truncated negative binomial regression analyses adjusted for age, employer and plan characteristics, and provider supply and for sociodemographic factors in sensitivity analyses. Generalized estimating equations were used to address within-group correlation of adults clustered in employer groups. Both women and men in same-gender marriages or domestic partnerships had higher rates of behavioral health service use, particularly diagnostic evaluation, individual psychotherapy, and medication management, and those in treatment had, on average, more psychotherapy visits than those in different-gender marriages. Behavioral health treatment patterns were similar between women in same-gender domestic partnerships and same-gender marriages, but they diverged between men in same-gender domestic partnerships and same-gender marriages. Moderation analysis results indicated that adults with same-gender partners living in states with fewer legal protections for lesbian, gay, bisexual, and transgender persons were less likely than adults with same-gender partners in LGBT-friendly states to receive behavioral health treatment. Sensitivity analyses did not affect findings. Behavioral health treatment patterns varied by couple type, partnership status, and gender. Results highlight the importance of increasing service acceptability and delivering inclusive, culturally relevant behavioral health treatment for lesbian, gay, and bisexual persons.

Tobit analysis of vehicle accident rates on interstate highways.

PubMed

Anastasopoulos, Panagiotis Ch; Tarko, Andrew P; Mannering, Fred L

2008-03-01

There has been an abundance of research that has used Poisson models and its variants (negative binomial and zero-inflated models) to improve our understanding of the factors that affect accident frequencies on roadway segments. This study explores the application of an alternate method, tobit regression, by viewing vehicle accident rates directly (instead of frequencies) as a continuous variable that is left-censored at zero. Using data from vehicle accidents on Indiana interstates, the estimation results show that many factors relating to pavement condition, roadway geometrics and traffic characteristics significantly affect vehicle accident rates.

Reliability of environmental sampling culture results using the negative binomial intraclass correlation coefficient.

PubMed

Aly, Sharif S; Zhao, Jianyang; Li, Ben; Jiang, Jiming

2014-01-01

The Intraclass Correlation Coefficient (ICC) is commonly used to estimate the similarity between quantitative measures obtained from different sources. Overdispersed data is traditionally transformed so that linear mixed model (LMM) based ICC can be estimated. A common transformation used is the natural logarithm. The reliability of environmental sampling of fecal slurry on freestall pens has been estimated for Mycobacterium avium subsp. paratuberculosis using the natural logarithm transformed culture results. Recently, the negative binomial ICC was defined based on a generalized linear mixed model for negative binomial distributed data. The current study reports on the negative binomial ICC estimate which includes fixed effects using culture results of environmental samples. Simulations using a wide variety of inputs and negative binomial distribution parameters (r; p) showed better performance of the new negative binomial ICC compared to the ICC based on LMM even when negative binomial data was logarithm, and square root transformed. A second comparison that targeted a wider range of ICC values showed that the mean of estimated ICC closely approximated the true ICC.

Family and parenting characteristics associated with marijuana use by Chilean adolescents

PubMed Central

Bares, Cristina B; Delva, Jorge; Grogan-Kaylor, Andrew; Andrade, Fernando

2011-01-01

Objective Family involvement and several characteristics of parenting have been suggested to be protective factors for adolescent substance use. Some parenting behaviors may have stronger relationships with adolescent behavior while others may have associations with undesirable behavior among youth. Although it is generally acknowledged that families play an important role in the lives of Chilean adolescents, scant research exists on how different family and parenting factors may be associated with marijuana use and related problems in this population which has one of the highest rates of drug use in Latin America. Methods Using logistic regression and negative binomial regression, we examined whether a large number of family and parenting variables were associated with the possibility of Chilean adolescents ever using marijuana, and with marijuana-related problems. Analyses controlled for a number of demographic and peer-related variables. Results Controlling for other parenting and family variables, adolescent reports of parental marijuana use showed a significant and positive association with adolescent marijuana use. The multivariate models also revealed that harsh parenting by fathers was the only family variable associated with the number of marijuana-related problems youth experienced. Conclusion Of all the family and parenting variables studied, perceptions of parental use of marijuana and harsh parenting by fathers were predictors for marijuana use, and the experience of marijuana-related problems. Prevention interventions need to continue emphasizing the critical socializing role that parental behavior plays in their children’s development and potential use of marijuana. PMID:21660209

The differences in healthcare utilization for dental caries based on the implementation of water fluoridation in South Korea.

PubMed

Cho, Myung-Soo; Han, Kyu-Tae; Park, Sohee; Moon, Ki Tae; Park, Eun-Cheol

2016-11-08

There were some debates about the water fluoridation program in South Korea, even if the program had generally substantial effectiveness. Because the out-of-pocket expenditures for dental care were higher in South Korea than in other countries, an efficient solution was needed. Therefore, we examined the relationship between the implementation of water fluoridation and the utilization of dental care. We used the National Health Insurance Service National Sample Cohort. In this study, data finally included 472,250 patients who were newly diagnosed with dental caries during 2003-2013. We performed survival analysis using cox proportional hazard model, negative binomial-regression, and regression analyses using generalized estimating equation models. There were 48.49 % outpatient dental care visit during study period. Individuals with water fluoridation had a lower risk of dental care visits (HR = 0.949, 95 % CI = 0.928-0.971). Among the individuals who experienced a dental care visit, those with water fluoridation program had a lower number of dental care visits (β = -0.029), and the period of water fluoridation had an inverse association with the dental care expenditures. The implementation of water fluoridation programs and these periods are associated with reducing the utilization of dental health care. Considering these positive impacts, healthcare professionals must consider preventive strategies for activating water fluoridation programs, such as changes in public perception and relations, for the effective management of dental care in South Korea.

Consumption of fast food, sugar-sweetened beverages, artificially-sweetened beverages and allostatic load among young adults.

PubMed

van Draanen, Jenna; Prelip, Michael; Upchurch, Dawn M

2018-06-01

This study investigates the associations between recent consumption of fast foods, sugar-sweetened beverages, and artificially-sweetened beverages on level of allostatic load, a measure of cumulative biological risk, in young adults in the US. Data from Wave IV of the National Longitudinal Study of Adolescent to Adult Health were analyzed. Negative binomial regression models were used to estimate the associations between consumption of fast foods, sugar-sweetened, and artificially-sweetened beverages and allostatic load. Poisson and logistic regression models were used to estimate the associations between these diet parameters and combined biomarkers of physiological subsystems that comprise our measure of allostatic load. All analyses were weighted and findings are representative of young adults in the US, ages 24-34 in 2008 (n = 11,562). Consumption of fast foods, sugar-sweetened, and artificially-sweetened beverages were associated with higher allostatic load at a bivariate level. Accounting for demographics and medication use, only artificially-sweetened beverages remained significantly associated with allostatic load. When all three dietary components were simultaneously included in a model, both sugar- and artificially-sweetened beverage consumption were associated with higher allostatic load. Differences in allostatic load emerge early in the life course and young adults consuming sugar- or artificially-sweetened beverages have higher allostatic load, net of demographics and medication use. Public health messages to young adults may need to include cautions about both sugar- and artificially-sweetened beverages.

Health-related productivity losses increase when the health condition is co-morbid with psychological distress: findings from a large cross-sectional sample of working Australians.

PubMed

Holden, Libby; Scuffham, Paul A; Hilton, Michael F; Ware, Robert S; Vecchio, Nerina; Whiteford, Harvey A

2011-05-31

The health condition of workers is known to impact on productivity outcomes. The relationship between health and productivity is of increasing interest amid the need to increase productivity to meet global financial challenges. Prevalence of psychological distress is also of growing concern in Australia with a two-fold increase in the prevalence of psychological distress in Australia from 1997-2005. We used the cross-sectional data set from the Australian Work Outcomes Research Cost-benefit (WORC) study to explore the impacts of health conditions with and without co-morbid psychological distress, compared to those with neither condition, in a sample of approximately 78,000 working Australians. The World Health Organisation Health and Performance Questionnaire was used which provided data on demographic characteristics, health condition and working conditions. Data were analysed using negative binomial logistic regression and multinomial logistic regression models for absenteeism and presenteeism respectively. For both absenteeism and presenteeism productivity measures there was a greater risk of productivity loss associated when health conditions were co-morbid with psychological distress. For some conditions this risk was much greater for those with co-morbid psychological distress compared to those without. Co-morbid psychological distress demonstrates an increased risk of productivity loss for a range of health conditions. These findings highlight the need for further research to determine whether co-morbid psychological distress potentially exacerbates lost productivity.

The effects of combat exposure, abusive violence, and sense of coherence on PTSD and depression in Portuguese colonial war veterans.

PubMed

Ferrajão, Paulo Correia; Oliveira, Rui Aragão

2016-01-01

We analyzed the effects of 3 war components-combat exposure (CES), observation of abusive violence (OBS), and participation in abusive violence (PARTC)-and sense of coherence (SOC) on the development of both posttraumatic stress disorder (PTSD) and depression among a sample of war veterans. We also analyzed the role of SOC as a mediator of the effects of CES, OBS, and PARTC on both depression and PTSD symptoms. Sample was composed of 120 Portuguese Colonial War veterans. A binomial logistic regression analysis was performed to determine the effects of these variables on depression and PTSD diagnosis. Mediation test was performed by conducting several hierarchical regression analyses. Results showed that OBS and PARTC, and lower levels of SOC were associated with increased odds for exceeding the clinical cutoff scores for diagnosis of depression. All variables were associated with increased odds for exceeding the clinical cutoff scores for diagnosis of PTSD. In mediation analysis, at first step, PARTC was not a significant predictor of both PTSD and depression symptoms, and PARTC did not enter in subsequent analysis. SOC was a full mediator of the effects of OBS and CES on both depression and PTSD symptoms. We propose that treatment of war veterans should aim the reconciliation of traumatic incongruent experiences in veterans' personal schemas to strengthen veterans' sense of coherence, especially for those exposed to acts of abusive violence. (c) 2016 APA, all rights reserved).

Trend estimation in populations with imperfect detection

USGS Publications Warehouse

Kery, Marc; Dorazio, Robert M.; Soldaat, Leo; Van Strien, Arco; Zuiderwijk, Annie; Royle, J. Andrew

2009-01-01

1. Trends of animal populations are of great interest in ecology but cannot be directly observed owing to imperfect detection. Binomial mixture models use replicated counts to estimate abundance, corrected for detection, in demographically closed populations. Here, we extend these models to open populations and illustrate them using sand lizard Lacerta agilis counts from the national Dutch reptile monitoring scheme. 2. Our model requires replicated counts from multiple sites in each of several periods, within which population closure is assumed. Counts are described by a hierarchical generalized linear model, where the state model deals with spatio-temporal patterns in true abundance and the observation model with imperfect counts, given that true state. We used WinBUGS to fit the model to lizard counts from 208 transects with 1–10 (mean 3) replicate surveys during each spring 1994–2005. 3. Our state model for abundance contained two independent log-linear Poisson regressions on year for coastal and inland sites, and random site effects to account for unexplained heterogeneity. The observation model for detection of an individual lizard contained effects of region, survey date, temperature, observer experience and random survey effects. 4. Lizard populations increased in both regions but more steeply on the coast. Detectability increased over the first few years of the study, was greater on the coast and for the most experienced observers, and highest around 1 June. Interestingly, the population increase inland was not detectable when the observed counts were analysed without account of detectability. The proportional increase between 1994 and 2005 in total lizard abundance across all sites was estimated at 86% (95% CRI 35–151). 5. Synthesis and applications. Open-population binomial mixture models are attractive for studying true population dynamics while explicitly accounting for the observation process, i.e. imperfect detection. We emphasize the important conceptual benefit provided by temporal replicate observations in terms of the interpretability of animal counts.

Does age modify the association between psychosocial factors at work and deterioration of self-rated health?

PubMed

Burr, Hermann; Hasselhorn, Hans Martin; Kersten, Norbert; Pohrt, Anne; Rugulies, Reiner

2017-09-01

Objectives Few epidemiological studies have examined whether associations of psychosocial working conditions with risk of poor health differ by age. Based on results from mostly cross-sectional studies, we test whether (i) psychosocial relational factors (social support) are more strongly associated with declining health of older than younger employees and (ii) psychosocial job factors (workpace, influence, possibilities for development) are more strongly associated with declining health of younger than older employees. Methods We extracted two cohorts from the Danish Work Environment Cohort Study (DWECS): the 2000-2005 and 2005-2010 cohorts. The participating 5281 employees with good self-rated health (SRH) at baseline were observed in 6585 5-year time windows. Using log-binomial regression analyses, we analysed whether psychosocial factors at work predicted 5-year deterioration of SRH. Effect modification by age was estimated by calculating relative excess risk due to interaction (RERI). Results High workpace among men, low influence at work as well as low social support from colleagues among women, and low possibilities for development and low social support from supervisors among both genders predicted 5-year decline in SRH. Of the 20 interaction analyses, only 1 was statistically significant and in the opposite direction of what was hypothesized (higher risk for declining SRH among middle-aged men with low possibilities for development compared to the young men with high possibilities for development). Conclusions Psychosocial working conditions predicted decline in SRH in this 5-year follow-up study. The model did not support our hypotheses about modifying effects by age.

A comparison of observation-level random effect and Beta-Binomial models for modelling overdispersion in Binomial data in ecology & evolution.

PubMed

Harrison, Xavier A

2015-01-01

Overdispersion is a common feature of models of biological data, but researchers often fail to model the excess variation driving the overdispersion, resulting in biased parameter estimates and standard errors. Quantifying and modeling overdispersion when it is present is therefore critical for robust biological inference. One means to account for overdispersion is to add an observation-level random effect (OLRE) to a model, where each data point receives a unique level of a random effect that can absorb the extra-parametric variation in the data. Although some studies have investigated the utility of OLRE to model overdispersion in Poisson count data, studies doing so for Binomial proportion data are scarce. Here I use a simulation approach to investigate the ability of both OLRE models and Beta-Binomial models to recover unbiased parameter estimates in mixed effects models of Binomial data under various degrees of overdispersion. In addition, as ecologists often fit random intercept terms to models when the random effect sample size is low (<5 levels), I investigate the performance of both model types under a range of random effect sample sizes when overdispersion is present. Simulation results revealed that the efficacy of OLRE depends on the process that generated the overdispersion; OLRE failed to cope with overdispersion generated from a Beta-Binomial mixture model, leading to biased slope and intercept estimates, but performed well for overdispersion generated by adding random noise to the linear predictor. Comparison of parameter estimates from an OLRE model with those from its corresponding Beta-Binomial model readily identified when OLRE were performing poorly due to disagreement between effect sizes, and this strategy should be employed whenever OLRE are used for Binomial data to assess their reliability. Beta-Binomial models performed well across all contexts, but showed a tendency to underestimate effect sizes when modelling non-Beta-Binomial data. Finally, both OLRE and Beta-Binomial models performed poorly when models contained <5 levels of the random intercept term, especially for estimating variance components, and this effect appeared independent of total sample size. These results suggest that OLRE are a useful tool for modelling overdispersion in Binomial data, but that they do not perform well in all circumstances and researchers should take care to verify the robustness of parameter estimates of OLRE models.

Review and Recommendations for Zero-inflated Count Regression Modeling of Dental Caries Indices in Epidemiological Studies

PubMed Central

Stamm, John W.; Long, D. Leann; Kincade, Megan E.

2012-01-01

Over the past five to ten years, zero-inflated count regression models have been increasingly applied to the analysis of dental caries indices (e.g., DMFT, dfms, etc). The main reason for that is linked to the broad decline in children’s caries experience, such that dmf and DMF indices more frequently generate low or even zero counts. This article specifically reviews the application of zero-inflated Poisson and zero-inflated negative binomial regression models to dental caries, with emphasis on the description of the models and the interpretation of fitted model results given the study goals. The review finds that interpretations provided in the published caries research are often imprecise or inadvertently misleading, particularly with respect to failing to discriminate between inference for the class of susceptible persons defined by such models and inference for the sampled population in terms of overall exposure effects. Recommendations are provided to enhance the use as well as the interpretation and reporting of results of count regression models when applied to epidemiological studies of dental caries. PMID:22710271

M-Bonomial Coefficients and Their Identities

ERIC Educational Resources Information Center

Asiru, Muniru A.

2010-01-01

In this note, we introduce M-bonomial coefficients or (M-bonacci binomial coefficients). These are similar to the binomial and the Fibonomial (or Fibonacci-binomial) coefficients and can be displayed in a triangle similar to Pascal's triangle from which some identities become obvious.

Logit and probit model in toll sensitivity analysis of Solo-Ngawi, Kartasura-Palang Joglo segment based on Willingness to Pay (WTP)

NASA Astrophysics Data System (ADS)

Handayani, Dewi; Cahyaning Putri, Hera; Mahmudah, AMH

2017-12-01

Solo-Ngawi toll road project is part of the mega project of the Trans Java toll road development initiated by the government and is still under construction until now. PT Solo Ngawi Jaya (SNJ) as the Solo-Ngawi toll management company needs to determine the toll fare that is in accordance with the business plan. The determination of appropriate toll rates will affect progress in regional economic sustainability and decrease the traffic congestion. These policy instruments is crucial for achieving environmentally sustainable transport. Therefore, the objective of this research is to find out how the toll fare sensitivity of Solo-Ngawi toll road based on Willingness To Pay (WTP). Primary data was obtained by distributing stated preference questionnaires to four wheeled vehicle users in Kartasura-Palang Joglo artery road segment. Further data obtained will be analysed with logit and probit model. Based on the analysis, it is found that the effect of fare change on the amount of WTP on the binomial logit model is more sensitive than the probit model on the same travel conditions. The range of tariff change against values of WTP on the binomial logit model is 20% greater than the range of values in the probit model . On the other hand, the probability results of the binomial logit model and the binary probit have no significant difference (less than 1%).

Predictors of birth-related post-traumatic stress symptoms: secondary analysis of a cohort study.

PubMed

Furuta, Marie; Sandall, Jane; Cooper, Derek; Bick, Debra

2016-12-01

This study aimed to identify factors associated with birth-related post-traumatic stress symptoms during the early postnatal period. Secondary analysis was conducted using data from a prospective cohort study of 1824 women who gave birth in one large hospital in England. Post-traumatic stress symptoms were measured by the Impact of Event Scale at 6 to 8 weeks postpartum. Zero-inflated negative binomial regression models were developed for analyses. Results showed that post-traumatic stress symptoms were more frequently observed in black women and in women who had a higher pre-pregnancy BMI compared to those with a lower BMI. Women who have a history of mental illness as well as those who gave birth before arriving at the hospital, underwent an emergency caesarean section or experienced severe maternal morbidity or neonatal complications also showed symptoms. Women's perceived control during labour and birth significantly reduced the effects of some risk factors. A higher level of perceived social support during the postnatal period also reduced the risk of post-traumatic stress symptoms. From the perspective of clinical practice, improving women's sense of control during labour and birth appears to be important, as does providing social support following the birth.

Work hours and absenteeism among police officers.

PubMed

Fekedulegn, Desta; Burchfiel, Cecil M; Hartley, Tara A; Baughman, Penelope; Charles, Luenda E; Andrew, Michael E; Violanti, John M

2013-01-01

In this study, the cross-sectional association of paid work hours with episodes of work absence was examined in a cohort of police officers. Study subjects were participants from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study examined between 2004 and 2009. Among 395 study participants with complete data, day-by-day work history records during the one-year period prior to date of examination were used to determine episodes of one-day and three day work absence. The Negative binomial regression analysis was used to examine rate ratios (RR) of work absence. Analyses were also stratified by gender. A one-hour increase in total work hours was associated with 5% reduction in rate of one-day work absence (RR = 0.95, 95% CI: 0.92 - 0.98) and with 8% reduction in rate of three-day work absence (RR = 0.92, 95% CI: 0.89 - 0.95). The association of total work hours with episodes of one-day work absence was significant only in men while the association with episodes of three-day work absence was evident in men and women. In conclusion, in this cohort of police officers, work hours were negatively associated with both durations of work absence (one-day, > or = 3 consecutive days).

Socio-Economic and Environmental Factors Associated with Overweight and Obesity in Children Aged 6-8 Years Living in Five Italian Cities (the MAPEC_LIFE Cohort).

PubMed

Grassi, Tiziana; De Donno, Antonella; Bagordo, Francesco; Serio, Francesca; Piscitelli, Prisco; Ceretti, Elisabetta; Zani, Claudia; Viola, Gaia C V; Villarini, Milena; Moretti, Massimo; Levorato, Sara; Carducci, Annalaura; Verani, Marco; Donzelli, Gabriele; Bonetta, Sara; Bonetta, Silvia; Carraro, Elisabetta; Bonizzoni, Silvia; Bonetti, Alberto; Gelatti, Umberto

2016-10-11

The prevalence of obesity among Italian children has reached such alarming levels as to require detailed studies of the causes of the phenomenon. A cross-sectional study was carried out in order to assess the weight status of 1164 Italian children aged 6-8 years (the Monitoring Air Pollution Effects on Children for Supporting Public Health Policy (MAPEC_LIFE) cohort) and to identify any associations between selected socio-economic and environmental factors and overweight/obesity. The data were obtained by means of a questionnaire given to parents, and any associations were examined by binomial logistic regression analyses. Overweight was found to be positively associated with male gender, parents of non-Italian origin, and parents who smoke, and negatively associated with the parents' level of education and employment. In addition, the frequency of overweight varied in relation to the geographical area of residence, with a greater prevalence of overweight children in the cities of central-southern Italy. This study highlights the need to implement appropriate obesity prevention programs in Italy, which should include educational measures concerning lifestyle for parents from the earliest stages of their child's life.

Depressive Symptoms, Religious Coping, and Cigarette Smoking Among Post-secondary Vocational Students

PubMed Central

Horton, Karissa D.; Loukas, Alexandra

2014-01-01

Depressive symptoms are associated with increased levels of cigarette smoking, yet not every individual experiencing depressive symptoms smokes. This study examined whether religious coping moderated the impact of depressive symptoms on past 30-day cigarette use among a racially/ethnically diverse sample of 963 post-secondary vocational students (46.8% women; mean age = 25 years). Results from negative binomial regression analyses indicated that depressive symptoms increased the likelihood of cigarette smoking (quantity-frequency measure of cigarette use) for female students, whereas positive religious coping decreased the likelihood of smoking for female students. Consistent with religious coping theory and as expected, negative religious coping moderated the depressive symptoms-smoking relationship such that negative religious coping exacerbated the impact of depressive symptoms on cigarette smoking among females. Positive religious coping also moderated the depressive symptoms-cigarette smoking relationship for females. However, contrary to expectations, high levels of positive religious coping exacerbated the likelihood of cigarette smoking among females with high levels of depressive symptoms. Surprisingly, neither depressive symptoms nor positive or negative religious coping contributed to the likelihood of males’ smoking. Study limitations and suggestions for directions in future research are discussed. PMID:23276324

Formal Home Care Utilization Patterns by Rural–Urban Community Residence

PubMed Central

Spector, William; Van Nostrand, Joan

2009-01-01

Background We examined formal home care utilization among civilian adults across metro and nonmetro residential categories before and after adjustment for predisposing, enabling, and need variables. Methods Two years of the Medical Expenditure Panel Survey (MEPS) were combined to produce a nationally representative sample of adults who resided in the community for a calendar year. We established 6 rural–urban categories based upon Urban Influence Codes and examined 2 dependent variables: (a) likelihood of using any formal home care and (b) number of provider days received by users. The Area Resource File provided county-level information. Logistic and negative binomial regression analyses were employed, with adjustments for the MEPS complex sampling design and the combined years. Results Under controls for predisposing, enabling, and need variables, differences in likelihood of any formal home care use disappear, but differences in number of provider days received by users emerged, with fewer provider days in remote areas than in metro and several other nonmetro types. Conclusions It is important to fully account for predisposing, enabling, and need factors when assessing rural and urban home care utilization patterns. The limited provider days in remote counties under controls suggest a possible access problem for adults in these areas. PMID:19196690

Bus accident analysis of routes with/without bus priority.

PubMed

Goh, Kelvin Chun Keong; Currie, Graham; Sarvi, Majid; Logan, David

2014-04-01

This paper summarises findings on road safety performance and bus-involved accidents in Melbourne along roads where bus priority measures had been applied. Results from an empirical analysis of the accident types revealed significant reduction in the proportion of accidents involving buses hitting stationary objects and vehicles, which suggests the effect of bus priority in addressing manoeuvrability issues for buses. A mixed-effects negative binomial (MENB) regression and back-propagation neural network (BPNN) modelling of bus accidents considering wider influences on accident rates at a route section level also revealed significant safety benefits when bus priority is provided. Sensitivity analyses done on the BPNN model showed general agreement in the predicted accident frequency between both models. The slightly better performance recorded by the MENB model results suggests merits in adopting a mixed effects modelling approach for accident count prediction in practice given its capability to account for unobserved location and time-specific factors. A major implication of this research is that bus priority in Melbourne's context acts to improve road safety and should be a major consideration for road management agencies when implementing bus priority and road schemes. Copyright © 2013 Elsevier Ltd. All rights reserved.

Meteorological factors affecting scrub typhus occurrence: a retrospective study of Yamagata Prefecture, Japan, 1984-2014.

PubMed

Seto, J; Suzuki, Y; Nakao, R; Otani, K; Yahagi, K; Mizuta, K

2017-02-01

Climate change, by its influence on the ecology of vectors might affect the occurrence of vector-borne diseases. This study examines the effects of meteorological factors in Japan on the occurrence of scrub typhus, a mite-borne zoonosis caused by Orientia tsutsugamushi. Using negative binomial regression, we analysed the relationships between meteorological factors (including temperature, rainfall, snowfall) and spring-early summer cases of scrub typhus in Yamagata Prefecture, Japan, during 1984-2014. The average temperature in July and August of the previous year, cumulative rainfall in September of the previous year, snowfall throughout the winter, and maximum depth of snow cover in January and February were positively correlated with the number of scrub typhus cases. By contrast, cumulative rainfall in July of the previous year showed a negative relationship to the number of cases. These associations can be explained by the life-cycle of Leptotrombidium pallidum, a predominant vector of spring-early summer cases of scrub typhus in northern Japan. Our findings show that several meteorological factors are useful to estimate the number of scrub typhus cases before the endemic period. They are applicable to establish an early warning system for scrub typhus in northern Japan.

Dispersion models and sampling of cacao mirid bug Sahlbergella singularis (Hemiptera: Miridae) on Theobroma Cacao in southern Cameroon.

PubMed

Bisseleua, D H B; Vidal, Stefan

2011-02-01

The spatio-temporal distribution of Sahlbergella singularis Haglung, a major pest of cacao trees (Theobroma cacao) (Malvaceae), was studied for 2 yr in traditional cacao forest gardens in the humid forest area of southern Cameroon. The first objective was to analyze the dispersion of this insect on cacao trees. The second objective was to develop sampling plans based on fixed levels of precision for estimating S. singularis populations. The following models were used to analyze the data: Taylor's power law, Iwao's patchiness regression, the Nachman model, and the negative binomial distribution. Our results document that Taylor's power law was a better fit for the data than the Iwao and Nachman models. Taylor's b and Iwao's β were both significantly >1, indicating that S. singularis aggregated on specific trees. This result was further supported by the calculated common k of 1.75444. Iwao's α was significantly <0, indicating that the basic distribution component of S. singularis was the individual insect. Comparison of negative binomial (NBD) and Nachman models indicated that the NBD model was appropriate for studying S. singularis distribution. Optimal sample sizes for fixed precision levels of 0.10, 0.15, and 0.25 were estimated with Taylor's regression coefficients. Required sample sizes increased dramatically with increasing levels of precision. This is the first study on S. singularis dispersion in cacao plantations. Sampling plans, presented here, should be a tool for research on population dynamics and pest management decisions of mirid bugs on cacao. © 2011 Entomological Society of America

Individual-level exposure to disaster, neighborhood environmental characteristics, and their independent and combined associations with depressive symptoms in women.

PubMed

Gaston, Symielle A; Volaufova, Julia; Peters, Edward S; Ferguson, Tekeda F; Robinson, William T; Nugent, Nicole; Trapido, Edward J; Rung, Ariane L

2017-09-01

The severity of the stress response to experiencing disaster depends on individual exposure and background stress prior to the event. To date, there is limited research on the interaction between neighborhood environmental stress and experiencing an oil spill, and their effects on depression. The objective of the current study was to assess if the association between exposure to the Deepwater Horizon Oil Spill (DHOS) and depressive symptoms varied by neighborhood characteristics. US Census data (2010) and longitudinal data collected in two waves (2012-2014 and 2014-2016) from female residents [N = 889 (Wave I), 737 (Wave II)] of an area highly affected by the DHOS were analyzed. Multilevel and individual-level negative binomial regressions were performed to estimate associations with depressive symptoms in both waves. An interaction term was included to estimate effect modification of the association between DHOS exposure and depressive symptoms by neighborhood characteristics. Generalized estimating equations were applied to the negative binomial regression testing longitudinal associations. Census tract-level neighborhood characteristics were not associated with depressive symptoms. Exposure to the DHOS and neighborhood physical disorder were associated with depressive symptoms cross-sectionally. There was no evidence of effect modification; however, physical/environmental exposure to the DHOS was associated with increased depressive symptoms only among women living in areas with physical disorder. Exposure to the DHOS remained associated with depressive symptoms over time. Findings support the enduring consequences of disaster exposure on depressive symptoms in women and identify potential targets for post-disaster intervention based on residential characteristics.

Not in My Back Yard: A Comparative Analysis of Crime Around Publicly Funded Drug Treatment Centers, Liquor Stores, Convenience Stores, and Corner Stores in One Mid-Atlantic City

PubMed Central

Furr-Holden, C. Debra M.; Milam, Adam J.; Nesoff, Elizabeth D.; Johnson, Renee M.; Fakunle, David O.; Jennings, Jacky M.; Thorpe, Roland J.

2016-01-01

Objective: This research examined whether publicly funded drug treatment centers (DTCs) were associated with violent crime in excess of the violence happening around other commercial businesses. Method: Violent crime data and locations of community entities were geocoded and mapped. DTCs and other retail outlets were matched based on a Neighborhood Disadvantage score at the census tract level. Street network buffers ranging from 100 to 1,400 feet were placed around each location. Negative binomial regression models were used to estimate the relationship between the count of violent crimes and the distance from each business type. Results: Compared with the mean count of violent crime around drug treatment centers, the mean count of violent crime (M = 2.87) was significantly higher around liquor stores (M = 3.98; t test; p < .01) and corner stores (M = 3.78; t test; p < .01), and there was no statistically significant difference between the count around convenience stores (M = 2.65; t test; p = .32). In the adjusted negative binomial regression models, there was a negative and significant relationship between the count of violent crime and the distance from drug treatment centers (β = -.069, p < .01), liquor stores (β = -.081, p < .01), corner stores (β = -.116, p < .01), and convenience stores (β = -.154, p < .01). Conclusions: Violent crime associated with drug treatment centers is similar to that associated with liquor stores and is less frequent than that associated with convenience stores and corner stores. PMID:26751351

Performance and structure of single-mode bosonic codes

NASA Astrophysics Data System (ADS)

Albert, Victor V.; Noh, Kyungjoo; Duivenvoorden, Kasper; Young, Dylan J.; Brierley, R. T.; Reinhold, Philip; Vuillot, Christophe; Li, Linshu; Shen, Chao; Girvin, S. M.; Terhal, Barbara M.; Jiang, Liang

2018-03-01

The early Gottesman, Kitaev, and Preskill (GKP) proposal for encoding a qubit in an oscillator has recently been followed by cat- and binomial-code proposals. Numerically optimized codes have also been proposed, and we introduce codes of this type here. These codes have yet to be compared using the same error model; we provide such a comparison by determining the entanglement fidelity of all codes with respect to the bosonic pure-loss channel (i.e., photon loss) after the optimal recovery operation. We then compare achievable communication rates of the combined encoding-error-recovery channel by calculating the channel's hashing bound for each code. Cat and binomial codes perform similarly, with binomial codes outperforming cat codes at small loss rates. Despite not being designed to protect against the pure-loss channel, GKP codes significantly outperform all other codes for most values of the loss rate. We show that the performance of GKP and some binomial codes increases monotonically with increasing average photon number of the codes. In order to corroborate our numerical evidence of the cat-binomial-GKP order of performance occurring at small loss rates, we analytically evaluate the quantum error-correction conditions of those codes. For GKP codes, we find an essential singularity in the entanglement fidelity in the limit of vanishing loss rate. In addition to comparing the codes, we draw parallels between binomial codes and discrete-variable systems. First, we characterize one- and two-mode binomial as well as multiqubit permutation-invariant codes in terms of spin-coherent states. Such a characterization allows us to introduce check operators and error-correction procedures for binomial codes. Second, we introduce a generalization of spin-coherent states, extending our characterization to qudit binomial codes and yielding a multiqudit code.

Quantifying the safety effects of horizontal curves on two-way, two-lane rural roads.

PubMed

Gooch, Jeffrey P; Gayah, Vikash V; Donnell, Eric T

2016-07-01

The objective of this study is to quantify the safety performance of horizontal curves on two-way, two-lane rural roads relative to tangent segments. Past research is limited by small samples sizes, outdated statistical evaluation methods, and unreported standard errors. This study overcomes these drawbacks by using the propensity scores-potential outcomes framework. The impact of adjacent curves on horizontal curve safety is also explored using a cross-sectional regression model of only horizontal curves. The models estimated in the present study used eight years of crash data (2005-2012) obtained from over 10,000 miles of state-owned two-lane rural roads in Pennsylvania. These data included information on roadway geometry (e.g., horizontal curvature, lane width, and shoulder width), traffic volume, roadside hazard rating, and the presence of various low-cost safety countermeasures (e.g., centerline and shoulder rumble strips, curve and intersection warning pavement markings, and aggressive driving pavement dots). Crash prediction is performed by means of mixed effects negative binomial regression using the explanatory variables noted previously, as well as attributes of adjacent horizontal curves. The results indicate that both the presence of a horizontal curve and its degree of curvature must be considered when predicting the frequency of total crashes on horizontal curves. Both are associated with an increase in crash frequency, which is consistent with previous findings in the literature. Mixed effects negative binomial regression models for total crash frequency on horizontal curves indicate that the distance to adjacent curves is not statistically significant. However, the degree of curvature of adjacent curves in close proximity (within 0.75 miles) was found to be statistically significant and negatively correlated with crash frequency on the subject curve. This is logical, as drivers exiting a sharp curve are likely to be driving slower and with more awareness as they approach the next horizontal curve. Copyright © 2016 Elsevier Ltd. All rights reserved.

Adjusting for overdispersion in piecewise exponential regression models to estimate excess mortality rate in population-based research.

PubMed

Luque-Fernandez, Miguel Angel; Belot, Aurélien; Quaresma, Manuela; Maringe, Camille; Coleman, Michel P; Rachet, Bernard

2016-10-01

In population-based cancer research, piecewise exponential regression models are used to derive adjusted estimates of excess mortality due to cancer using the Poisson generalized linear modelling framework. However, the assumption that the conditional mean and variance of the rate parameter given the set of covariates x i are equal is strong and may fail to account for overdispersion given the variability of the rate parameter (the variance exceeds the mean). Using an empirical example, we aimed to describe simple methods to test and correct for overdispersion. We used a regression-based score test for overdispersion under the relative survival framework and proposed different approaches to correct for overdispersion including a quasi-likelihood, robust standard errors estimation, negative binomial regression and flexible piecewise modelling. All piecewise exponential regression models showed the presence of significant inherent overdispersion (p-value <0.001). However, the flexible piecewise exponential model showed the smallest overdispersion parameter (3.2 versus 21.3) for non-flexible piecewise exponential models. We showed that there were no major differences between methods. However, using a flexible piecewise regression modelling, with either a quasi-likelihood or robust standard errors, was the best approach as it deals with both, overdispersion due to model misspecification and true or inherent overdispersion.

Estimating a Logistic Discrimination Functions When One of the Training Samples Is Subject to Misclassification: A Maximum Likelihood Approach.

PubMed

Nagelkerke, Nico; Fidler, Vaclav

2015-01-01

The problem of discrimination and classification is central to much of epidemiology. Here we consider the estimation of a logistic regression/discrimination function from training samples, when one of the training samples is subject to misclassification or mislabeling, e.g. diseased individuals are incorrectly classified/labeled as healthy controls. We show that this leads to zero-inflated binomial model with a defective logistic regression or discrimination function, whose parameters can be estimated using standard statistical methods such as maximum likelihood. These parameters can be used to estimate the probability of true group membership among those, possibly erroneously, classified as controls. Two examples are analyzed and discussed. A simulation study explores properties of the maximum likelihood parameter estimates and the estimates of the number of mislabeled observations.

QNB: differential RNA methylation analysis for count-based small-sample sequencing data with a quad-negative binomial model.

PubMed

Liu, Lian; Zhang, Shao-Wu; Huang, Yufei; Meng, Jia

2017-08-31

As a newly emerged research area, RNA epigenetics has drawn increasing attention recently for the participation of RNA methylation and other modifications in a number of crucial biological processes. Thanks to high throughput sequencing techniques, such as, MeRIP-Seq, transcriptome-wide RNA methylation profile is now available in the form of count-based data, with which it is often of interests to study the dynamics at epitranscriptomic layer. However, the sample size of RNA methylation experiment is usually very small due to its costs; and additionally, there usually exist a large number of genes whose methylation level cannot be accurately estimated due to their low expression level, making differential RNA methylation analysis a difficult task. We present QNB, a statistical approach for differential RNA methylation analysis with count-based small-sample sequencing data. Compared with previous approaches such as DRME model based on a statistical test covering the IP samples only with 2 negative binomial distributions, QNB is based on 4 independent negative binomial distributions with their variances and means linked by local regressions, and in the way, the input control samples are also properly taken care of. In addition, different from DRME approach, which relies only the input control sample only for estimating the background, QNB uses a more robust estimator for gene expression by combining information from both input and IP samples, which could largely improve the testing performance for very lowly expressed genes. QNB showed improved performance on both simulated and real MeRIP-Seq datasets when compared with competing algorithms. And the QNB model is also applicable to other datasets related RNA modifications, including but not limited to RNA bisulfite sequencing, m 1 A-Seq, Par-CLIP, RIP-Seq, etc.

Neighborhood educational disparities in active commuting among women: the effect of distance between the place of residence and the place of work/study (an ACTI-Cités study).

PubMed

Perchoux, Camille; Nazare, Julie-Anne; Benmarhnia, Tarik; Salze, Paul; Feuillet, Thierry; Hercberg, Serge; Hess, Franck; Menai, Mehdi; Weber, Christiane; Charreire, Hélène; Enaux, Christophe; Oppert, Jean-Michel; Simon, Chantal

2017-06-12

Active transportation has been associated with favorable health outcomes. Previous research highlighted the influence of neighborhood educational level on active transportation. However, little is known regarding the effect of commuting distance on social disparities in active commuting. In this regard, women have been poorly studied. The objective of this paper was to evaluate the relationship between neighborhood educational level and active commuting, and to assess whether the commuting distance modifies this relationship in adult women. This cross-sectional study is based on a subsample of women from the Nutrinet-Santé web-cohort (N = 1169). Binomial, log-binomial and negative binomial regressions were used to assess the associations between neighborhood education level and (i) the likelihood of reporting any active commuting time, and (ii) the share of commuting time made by active transportation modes. Potential effect measure modification of distance to work on the previous associations was assessed both on the additive and the multiplicative scales. Neighborhood education level was positively associated with the probability of reporting any active commuting time (relative risk = 1.774; p < 0.05) and the share of commuting time spent active (relative risk = 1.423; p < 0.05). The impact of neighborhood education was greater at long distances to work for both outcomes. Our results suggest that neighborhood educational disparities in active commuting tend to increase with commuting distance among women. Further research is needed to provide geographically driven guidance for health promotion intervention aiming at reducing disparities in active transportation among socioeconomic groups.

Problems on Divisibility of Binomial Coefficients

ERIC Educational Resources Information Center

Osler, Thomas J.; Smoak, James

2004-01-01

Twelve unusual problems involving divisibility of the binomial coefficients are represented in this article. The problems are listed in "The Problems" section. All twelve problems have short solutions which are listed in "The Solutions" section. These problems could be assigned to students in any course in which the binomial theorem and Pascal's…

Application of binomial-edited CPMG to shale characterization

USGS Publications Warehouse

Washburn, Kathryn E.; Birdwell, Justin E.

2014-01-01

Unconventional shale resources may contain a significant amount of hydrogen in organic solids such as kerogen, but it is not possible to directly detect these solids with many NMR systems. Binomial-edited pulse sequences capitalize on magnetization transfer between solids, semi-solids, and liquids to provide an indirect method of detecting solid organic materials in shales. When the organic solids can be directly measured, binomial-editing helps distinguish between different phases. We applied a binomial-edited CPMG pulse sequence to a range of natural and experimentally-altered shale samples. The most substantial signal loss is seen in shales rich in organic solids while fluids associated with inorganic pores seem essentially unaffected. This suggests that binomial-editing is a potential method for determining fluid locations, solid organic content, and kerogen–bitumen discrimination.

The effect of a major cigarette price change on smoking behavior in california: a zero-inflated negative binomial model.

PubMed

Sheu, Mei-Ling; Hu, Teh-Wei; Keeler, Theodore E; Ong, Michael; Sung, Hai-Yen

2004-08-01

The objective of this paper is to determine the price sensitivity of smokers in their consumption of cigarettes, using evidence from a major increase in California cigarette prices due to Proposition 10 and the Tobacco Settlement. The study sample consists of individual survey data from Behavioral Risk Factor Survey (BRFS) and price data from the Bureau of Labor Statistics between 1996 and 1999. A zero-inflated negative binomial (ZINB) regression model was applied for the statistical analysis. The statistical model showed that price did not have an effect on reducing the estimated prevalence of smoking. However, it indicated that among smokers the price elasticity was at the level of -0.46 and statistically significant. Since smoking prevalence is significantly lower than it was a decade ago, price increases are becoming less effective as an inducement for hard-core smokers to quit, although they may respond by decreasing consumption. For those who only smoke occasionally (many of them being young adults) price increases alone may not be an effective inducement to quit smoking. Additional underlying behavioral factors need to be identified so that more effective anti-smoking strategies can be developed.

Variable selection for zero-inflated and overdispersed data with application to health care demand in Germany.

PubMed

Wang, Zhu; Ma, Shuangge; Wang, Ching-Yun

2015-09-01

In health services and outcome research, count outcomes are frequently encountered and often have a large proportion of zeros. The zero-inflated negative binomial (ZINB) regression model has important applications for this type of data. With many possible candidate risk factors, this paper proposes new variable selection methods for the ZINB model. We consider maximum likelihood function plus a penalty including the least absolute shrinkage and selection operator (LASSO), smoothly clipped absolute deviation (SCAD), and minimax concave penalty (MCP). An EM (expectation-maximization) algorithm is proposed for estimating the model parameters and conducting variable selection simultaneously. This algorithm consists of estimating penalized weighted negative binomial models and penalized logistic models via the coordinated descent algorithm. Furthermore, statistical properties including the standard error formulae are provided. A simulation study shows that the new algorithm not only has more accurate or at least comparable estimation, but also is more robust than the traditional stepwise variable selection. The proposed methods are applied to analyze the health care demand in Germany using the open-source R package mpath. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The influence of neighborhood characteristics on the relationship between discrimination and increased drug-using social ties among illicit drug users.

PubMed

Crawford, Natalie D; Borrell, Luisa N; Galea, Sandro; Ford, Chandra; Latkin, Carl; Fuller, Crystal M

2013-04-01

Social discrimination may isolate drug users into higher risk relationships, particularly in disadvantaged neighborhood environments where drug trade occurs. We used negative binomial regression accounting for clustering of individuals within their recruitment neighborhood to investigate the relationship between high-risk drug ties with various forms of social discrimination, neighborhood minority composition, poverty and education. Results show that experiencing discrimination due to drug use is significantly associated with more drug ties in neighborhoods with fewer blacks. Future social network and discrimination research should assess the role of neighborhood social cohesion.

Educational inequalities in hospital care for mortally ill patients in Norway.

PubMed

Elstad, Jon Ivar

2018-02-01

Health care should be allocated fairly, irrespective of patients' social standing. Previous research suggests that highly educated patients are prioritized in Norwegian hospitals. This study examines this contentious issue by a design which addresses two methodological challenges. Control for differences in medical needs is approximated by analysing patients who died from same causes of death. Area fixed effects are used for avoiding that observed educational inequalities are contaminated by geographical differences. Men and women who died 2009-2011 at age 55-94 were examined ( N=103,000) with register data from Statistics Norway and the Norwegian Patient Registry. Educational differences in quantity of hospital-based medical care during the 12-24 months before death were analysed, separate for main causes of death. Multivariate negative binomial regression models were estimated, with fixed effects for residential areas. High-educated patients who died from cancers had significantly more outpatient consultations at somatic hospitals than low-educated patients during an average observation period of 18 months prior to death. Similar, but weaker, educational inequalities appeared for outpatient visits for patients whose deaths were due to other causes. Also, educational inequalities in number of hospital admissions were marked for those who died from cancers, but insignificant for patients who died from other causes. Even when medical needs are similar for mortally ill patients, those with high education tend to receive more medical services in Norwegian somatic hospitals than patients with low education. The roles played by physicians and patients in generating these patterns should be explored further.

Nutrition education, farm production diversity, and commercialization on household and individual dietary diversity in Zimbabwe.

PubMed

Murendo, Conrad; Nhau, Brighton; Mazvimavi, Kizito; Khanye, Thamsanqa; Gwara, Simon

2018-01-01

Nutrition education is crucial for improved nutrition outcomes. However, there are no studies to the best of our knowledge that have jointly analysed the roles of nutrition education, farm production diversity and commercialization on household, women and child dietary diversity. This article jointly analyses the role of nutrition education, farm production diversity and commercialization on household, women and children dietary diversity in Zimbabwe. In addition, we analyze separately the roles of crop and livestock diversity and individual agricultural practices on dietary diversity. Data were collected from 2,815 households randomly selected in eight districts. Negative binomial regression was used for model estimations. Nutrition education increased household, women, and child dietary diversity by 3, 9 and 24%, respectively. Farm production diversity had a strong and positive association with household and women dietary diversity. Crop diversification led to a 4 and 5% increase in household and women dietary diversity, respectively. Furthermore, livestock diversification and market participation were positively associated with household, women, and children dietary diversity. The cultivation of pulses and fruits increased household, women, and children dietary diversity. Vegetable production and goat rearing increased household and women dietary diversity. Nutrition education and improving access to markets are promising strategies to improve dietary diversity at both household and individual level. Results demonstrate the value of promoting nutrition education; farm production diversity; small livestock; pulses, vegetables and fruits; crop-livestock integration; and market access for improved nutrition.

Rural Idaho family physicians' scope of practice.

PubMed

Baker, Ed; Schmitz, David; Epperly, Ted; Nukui, Ayaka; Miller, Carissa Moffat

2010-01-01

Scope of practice is an important factor in both training and recruiting rural family physicians. To assess rural Idaho family physicians' scope of practice and to examine variations in scope of practice across variables such as gender, age and employment status. A survey instrument was developed based on a literature review and was validated by physician educators, practicing family physicians and executives at the state hospital association. This survey was mailed to rural family physicians practicing in Idaho counties with populations of less than 50,000. Descriptive, bivariate and multivariate analyses were employed to describe and compare scope of practice patterns. Responses were obtained from 92 of 248 physicians (37.1% response rate). Idaho rural family physicians reported providing obstetrical services in the areas of prenatal care (57.6%), vaginal delivery (52.2%) and C-sections (37.0%); other operating room services (43.5%); esophagogastroduodenoscopy (EGD) or colonoscopy services (22.5%); emergency room coverage (48.9%); inpatient admissions (88.9%); mental health services (90.1%); nursing home services (88.0%); and supervision to midlevel care providers (72.5%). Bivariate analyses showed differences in scope of practice patterns across gender, age group and employment status. Binomial logistic regression models indicated that younger physicians were roughly 3 times more likely to provide prenatal care and perform vaginal deliveries than older physicians in rural areas. Idaho practicing rural family physicians report a broad scope of practice. Younger, employed and female rural family medicine physicians are important subgroups for further study.

Nutrition education, farm production diversity, and commercialization on household and individual dietary diversity in Zimbabwe

PubMed Central

Murendo, Conrad; Nhau, Brighton; Mazvimavi, Kizito; Khanye, Thamsanqa; Gwara, Simon

2018-01-01

Background Nutrition education is crucial for improved nutrition outcomes. However, there are no studies to the best of our knowledge that have jointly analysed the roles of nutrition education, farm production diversity and commercialization on household, women and child dietary diversity. Objective This article jointly analyses the role of nutrition education, farm production diversity and commercialization on household, women and children dietary diversity in Zimbabwe. In addition, we analyze separately the roles of crop and livestock diversity and individual agricultural practices on dietary diversity. Design Data were collected from 2,815 households randomly selected in eight districts. Negative binomial regression was used for model estimations. Results Nutrition education increased household, women, and child dietary diversity by 3, 9 and 24%, respectively. Farm production diversity had a strong and positive association with household and women dietary diversity. Crop diversification led to a 4 and 5% increase in household and women dietary diversity, respectively. Furthermore, livestock diversification and market participation were positively associated with household, women, and children dietary diversity. The cultivation of pulses and fruits increased household, women, and children dietary diversity. Vegetable production and goat rearing increased household and women dietary diversity. Conclusions Nutrition education and improving access to markets are promising strategies to improve dietary diversity at both household and individual level. Results demonstrate the value of promoting nutrition education; farm production diversity; small livestock; pulses, vegetables and fruits; crop-livestock integration; and market access for improved nutrition.

Association between study design and citation counts of articles published in the American Journal of Orthodontics and Dentofacial Orthopedics and Angle Orthodontist.

PubMed

Allareddy, Veerasathpurush; Lee, Min Kyeong; Shah, Andrea; Elangovan, Satheesh; Lin, Chin-Yu

2012-01-01

The scientific community views meta-analyses and systematic reviews, in addition to well-designed randomized controlled clinical trials, as the highest echelon in the continuum of hierarchy of evidence. The objective of this study was to examine the association between different study designs and citation counts of articles published in the American Journal of Orthodontics and Dentofacial Orthopedics and Angle Orthodontist. All articles, excluding editorial comments, letters to the editor, commentaries, and special articles, that were published in the American Journal of Orthodontics and Dentofacial Orthopedics and Angle Orthodontist during the years 2004 and 2005 were examined in this study. The number of times an article was cited in the first 24 months after its publication was computed. The PubMed database was used to index the study design of the articles. The association between study design and citation counts was examined using the Kruskal-Wallis test. A multivariable negative binomial regression model was used to examine the association between citation count and study design along with several other confounding variables. A total of 624 articles were selected for analysis. Of these, there were 25 meta-analyses or review articles, 42 randomized clinical trials, 59 clinical trials, 48 animal studies, 64 case reports, and 386 quasiexperimental/miscellaneous study designs. The mean ± SD citation count was 1.04 ± 1.46. Nearly half of the articles (n = 311) were not cited even once during the observation period. Case reports were cited less frequently than meta-analyses or reviews (incident risk ratio, 0.37; 95% confidence interval, 0.19 to 0.72; P = .003), even after adjusting for other independent variables. Among various study designs, meta-analyses and review articles are more likely to be cited in the first 24 months after publication. This study demonstrates the importance of publishing more meta-analyses and review articles for quicker dissemination of research findings.

A Three-Parameter Generalisation of the Beta-Binomial Distribution with Applications

DTIC Science & Technology

1987-07-01

York. Rust, R.T. and Klompmaker, J.E. (1981). Improving the estimation procedure for the beta binomial t.v. exposure model. Journal of Marketing ... Research . 18, 442-448. Sabavala, D.J. and Morrison, D.G. (1977). Television show loyalty: a beta- binomial model using recall data. Journal of Advertiuing

Distribution-free Inference of Zero-inated Binomial Data for Longitudinal Studies.

PubMed

He, H; Wang, W J; Hu, J; Gallop, R; Crits-Christoph, P; Xia, Y L

2015-10-01

Count reponses with structural zeros are very common in medical and psychosocial research, especially in alcohol and HIV research, and the zero-inflated poisson (ZIP) and zero-inflated negative binomial (ZINB) models are widely used for modeling such outcomes. However, as alcohol drinking outcomes such as days of drinkings are counts within a given period, their distributions are bounded above by an upper limit (total days in the period) and thus inherently follow a binomial or zero-inflated binomial (ZIB) distribution, rather than a Poisson or zero-inflated Poisson (ZIP) distribution, in the presence of structural zeros. In this paper, we develop a new semiparametric approach for modeling zero-inflated binomial (ZIB)-like count responses for cross-sectional as well as longitudinal data. We illustrate this approach with both simulated and real study data.

Jump-and-return sandwiches: A new family of binomial-like selective inversion sequences with improved performance

NASA Astrophysics Data System (ADS)

Brenner, Tom; Chen, Johnny; Stait-Gardner, Tim; Zheng, Gang; Matsukawa, Shingo; Price, William S.

2018-03-01

A new family of binomial-like inversion sequences, named jump-and-return sandwiches (JRS), has been developed by inserting a binomial-like sequence into a standard jump-and-return sequence, discovered through use of a stochastic Genetic Algorithm optimisation. Compared to currently used binomial-like inversion sequences (e.g., 3-9-19 and W5), the new sequences afford wider inversion bands and narrower non-inversion bands with an equal number of pulses. As an example, two jump-and-return sandwich 10-pulse sequences achieved 95% inversion at offsets corresponding to 9.4% and 10.3% of the non-inversion band spacing, compared to 14.7% for the binomial-like W5 inversion sequence, i.e., they afforded non-inversion bands about two thirds the width of the W5 non-inversion band.

Powder Cocaine and Crack Use in the United States: An Examination of Risk for Arrest and Socioeconomic Disparities in Use

PubMed Central

Palamar, Joseph J.; Davies, Shelby; Ompad, Danielle C.; Cleland, Charles M.; Weitzman, Michael

2015-01-01

Background In light of the current sentencing disparity (18:1) between crack and powder cocaine possession in the United States, we examined socioeconomic correlates of use of each, and relations between use and arrest, to determine who may be at highest risk for arrest and imprisonment. Methods We conducted secondary data analyses on the National Survey on Drug Use and Health, 2009–2012. Data were analyzed for adults age ≥18 to determine associations between use and arrest. Socioeconomic correlates of lifetime and annual use of powder cocaine and of crack were delineated using multivariable logistic regression and correlates of frequency of recent use were examined using generalized negative binomial regression. Results Crack users were at higher risk than powder cocaine users for reporting a lifetime arrest or multiple recent arrests. Racial minorities were at low risk for powder cocaine use and Hispanics were at low risk for crack use. Blacks were at increased risk for lifetime and recent crack use, but not when controlling for other socioeconomic variables. However, blacks who did use either powder cocaine or crack tended to use at higher frequencies. Higher education and higher family income were negatively associated with crack use although these factors were sometimes risk factors for powder cocaine use. Conclusions Crack users are at higher risk of arrest and tend to be of lower socioeconomic status compared to powder cocaine users. These findings can inform US Congress as they review the proposed Smarter Sentencing Act of 2014, which would help eliminate cocaine-related sentencing disparities. PMID:25702933

Teaching surgery takes time: the impact of surgical education on time in the operating room

PubMed Central

Vinden, Christopher; Malthaner, Richard; McGee, Jacob; McClure, J. Andrew; Winick-Ng, Jennifer; Liu, Kuan; Nash, Danielle M.; Welk, Blayne; Dubois, Luc

2016-01-01

Background It is generally accepted that surgical training is associated with increased surgical duration. The purpose of this study was to determine the magnitude of this increase for common surgical procedures by comparing surgery duration in teaching and nonteaching hospitals. Methods This retrospective population-based cohort study included all adult residents of Ontario, Canada, who underwent 1 of 14 surgical procedures between 2002 and 2012. We used several linked administrative databases to identify the study cohort in addition to patient-, surgeon- and procedure-related variables. We determined surgery duration using anesthesiology billing records. Negative binomial regression was used to model the association between teaching versus nonteaching hospital status and surgery duration. Results Of the 713 573 surgical cases included in this study, 20.8% were performed in a teaching hospital. For each procedure, the mean surgery duration was significantly longer for teaching hospitals, with differences ranging from 5 to 62 minutes across individual procedures in unadjusted analyses (all p < 0.001). In regression analysis, procedures performed in teaching hospitals were associated with an overall 22% (95% confidence interval 20%–24%) increase in surgery duration, adjusting for patient-, surgeon- and procedure-related variables as well as the clustering of patients within surgeons and hospitals. Conclusion Our results show that a wide range of surgical procedures require significantly more time to perform in teaching than nonteaching hospitals. Given the magnitude of this difference, the impact of surgical training on health care costs and clinical outcomes should be a priority for future studies. PMID:27007088

The association between current unemployment and clinically determined poor oral health.

PubMed

Al-Sudani, Fouad Y H; Vehkalahti, Miira M; Suominen, Anna L

2015-08-01

The aim of this study was to assess whether current unemployment was associated with poor oral health and whether there was a difference in oral health according to the duration of the current unemployment. As part of the Health 2000 Survey in Finland (a nationwide comprehensive health examination survey), we used its data based on interviews, questionnaires, and clinical oral examinations of the 30- to 63-year-old respondents (n = 4773). Current employment status was measured in its dichotomous form, employed versus unemployed, and length of current unemployment was classified into four categories. We measured oral health in terms of numbers of missing teeth, of sound teeth, of filled teeth, of decayed teeth, and of teeth with deepened periodontal pockets (≥4 mm, ≥6 mm). Poisson regression models were fitted for all oral health outcomes except number of decayed teeth, for which negative binomial regression model was used. Oral health-related behaviors and sociodemographic and socioeconomic factors were added to the analyses. The unemployed subjects had higher numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets than the employed ones. The association remained consistent even after adjustments. Oral health-related behaviors seemed to mediate the association. We found no association between unemployment and number of sound teeth. Current long-term unemployment showed stronger association with poor oral health than short-term among women. The unemployed can be considered as a risk group for poor oral health. Oral healthcare should be reoriented toward those who are unemployed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Statistical methods for meta-analyses including information from studies without any events-add nothing to nothing and succeed nevertheless.

PubMed

Kuss, O

2015-03-30

Meta-analyses with rare events, especially those that include studies with no event in one ('single-zero') or even both ('double-zero') treatment arms, are still a statistical challenge. In the case of double-zero studies, researchers in general delete these studies or use continuity corrections to avoid them. A number of arguments against both options has been given, and statistical methods that use the information from double-zero studies without using continuity corrections have been proposed. In this paper, we collect them and compare them by simulation. This simulation study tries to mirror real-life situations as completely as possible by deriving true underlying parameters from empirical data on actually performed meta-analyses. It is shown that for each of the commonly encountered effect estimators valid statistical methods are available that use the information from double-zero studies without using continuity corrections. Interestingly, all of them are truly random effects models, and so also the current standard method for very sparse data as recommended from the Cochrane collaboration, the Yusuf-Peto odds ratio, can be improved on. For actual analysis, we recommend to use beta-binomial regression methods to arrive at summary estimates for the odds ratio, the relative risk, or the risk difference. Methods that ignore information from double-zero studies or use continuity corrections should no longer be used. We illustrate the situation with an example where the original analysis ignores 35 double-zero studies, and a superior analysis discovers a clinically relevant advantage of off-pump surgery in coronary artery bypass grafting. Copyright © 2014 John Wiley & Sons, Ltd.

The impact of poor psychosocial work environment on non-work-related sickness absence.

PubMed

Catalina-Romero, C; Sainz, J C; Pastrana-Jiménez, J I; García-Diéguez, N; Irízar-Muñoz, I; Aleixandre-Chiva, J L; Gonzalez-Quintela, A; Calvo-Bonacho, E

2015-08-01

We aimed to analyse the impact of psychosocial work environment on non-work-related sickness absence (NWRSA) among a prospective cohort study, stratified using a random sampling technique. Psychosocial variables were assessed among 15,643 healthy workers using a brief version of the Spanish adaptation of Copenhagen Psychosocial Questionnaire. A one year follow-up assessed the total count of NWRSA days. Zero-inflated negative binomial regression was used for multivariate analyses. After adjusting for covariates, low levels of job control and possibilities for development (Odds Ratio [OR]: 1.17; 95% CI: 1.01-1.36 [men]; OR: 1.39 95% CI: 1.09-1.77 [women]), poor social support and quality of leadership (OR: 1.29; 95% CI: 1.11-1.50 [men]; OR: 1.28; 95% CI: 1.01-1.63 [women]), and poor rewards (OR: 1.34; 95% CI: 1.14-1.57 [men]; OR: 1.30; 95% CI: 1.01-1.66 [women]) predicted a total count of sickness absence greater than zero, in both men and women. Double presence was also significantly associated with NWRSA different than 0, but only among women (OR: 1.40; 95% CI: 1.08-1.81). Analyses found no association between psychosocial risk factors at work and the total count (i.e., number of days) of sickness absences. The results suggest that work-related psychosocial factors may increase the likelihood of initiating an NWRSA episode, but were not associated with the length of the sickness absence episode. Among our large cohort we observed that some associations were gender-dependent, suggesting that future research should consider gender when designing psychosocial interventions aimed at decreasing sickness absences. Copyright © 2015 Elsevier Ltd. All rights reserved.

Revealing Word Order: Using Serial Position in Binomials to Predict Properties of the Speaker

ERIC Educational Resources Information Center

Iliev, Rumen; Smirnova, Anastasia

2016-01-01

Three studies test the link between word order in binomials and psychological and demographic characteristics of a speaker. While linguists have already suggested that psychological, cultural and societal factors are important in choosing word order in binomials, the vast majority of relevant research was focused on general factors and on broadly…

Jump-and-return sandwiches: A new family of binomial-like selective inversion sequences with improved performance.

PubMed

Brenner, Tom; Chen, Johnny; Stait-Gardner, Tim; Zheng, Gang; Matsukawa, Shingo; Price, William S

2018-03-01

A new family of binomial-like inversion sequences, named jump-and-return sandwiches (JRS), has been developed by inserting a binomial-like sequence into a standard jump-and-return sequence, discovered through use of a stochastic Genetic Algorithm optimisation. Compared to currently used binomial-like inversion sequences (e.g., 3-9-19 and W5), the new sequences afford wider inversion bands and narrower non-inversion bands with an equal number of pulses. As an example, two jump-and-return sandwich 10-pulse sequences achieved 95% inversion at offsets corresponding to 9.4% and 10.3% of the non-inversion band spacing, compared to 14.7% for the binomial-like W5 inversion sequence, i.e., they afforded non-inversion bands about two thirds the width of the W5 non-inversion band. Copyright © 2018 Elsevier Inc. All rights reserved.

Risk Factors for Proximal Junctional Kyphosis Associated With Dual-rod Growing-rod Surgery for Early-onset Scoliosis.

PubMed

Watanabe, Kota; Uno, Koki; Suzuki, Teppei; Kawakami, Noriaki; Tsuji, Taichi; Yanagida, Haruhisa; Ito, Manabu; Hirano, Toru; Yamazaki, Ken; Minami, Shohei; Taneichi, Hiroshi; Imagama, Shiro; Takeshita, Katsushi; Yamamoto, Takuya; Matsumoto, Morio

2016-10-01

A retrospective, multicenter study. To identify risk factors for proximal junctional kyphosis (PJK) when treating early-onset scoliosis (EOS) with dual-rod growing-rod (GR) procedure. The risk factors for PJK associated with GR treatment for EOS have not been adequately studied. We evaluated clinical and radiographic results from 88 patients with EOS who underwent dual-rod GR surgery in 12 spine centers in Japan. The mean age at the time of the initial surgery was 6.5±2.2 years (range, 1.5-9.8 y), and the mean follow-up period was 3.9±2.6 years (range, 2.0-12.0 y). Risk factors for PJK were analyzed by binomial multiple logistic regression analysis. The potential factors analyzed were sex, etiology, age, the number of rod-lengthening procedures, coronal and sagittal parameters on radiographs, the type of foundation (pedicle screws or hooks), the uppermost level of the proximal foundation, and the lowermost level of the distal foundation. PJK developed in 23 patients (26%); in 19 of these, the proximal foundation became dislodged following PJK. Binomial multiple logistic regression analysis identified the following significant independent risk factors for PJK: a lower instrumented vertebra at or cranial to L3 [odds ratio (OR), 3.32], a proximal thoracic scoliosis of ≥40 degrees (OR, 2.95), and a main thoracic kyphosis of ≥60 degrees (OR, 5.08). The significant independent risk factors for PJK during dual-rod GR treatment for EOS were a lower instrumented vertebra at or cranial to L3, a proximal thoracic scoliosis of ≥40 degrees, and a main thoracic kyphosis of ≥60 degrees.

Making sense of the noise: The effect of hydrology on silver carp eDNA detection in the Chicago area waterway system.

PubMed

Song, Jeffery W; Small, Mitchell J; Casman, Elizabeth A

2017-12-15

Environmental DNA (eDNA) sampling is an emerging tool for monitoring the spread of aquatic invasive species. One confounding factor when interpreting eDNA sampling evidence is that eDNA can be present in the water in the absence of living target organisms, originating from excreta, dead tissue, boats, or sewage effluent, etc. In the Chicago Area Waterway System (CAWS), electric fish dispersal barriers were built to prevent non-native Asian carp species from invading Lake Michigan, and yet Asian carp eDNA has been detected above the barriers sporadically since 2009. In this paper the influence of stream flow characteristics in the CAWS on the probability of invasive Asian carp eDNA detection in the CAWS from 2009 to 2012 was examined. In the CAWS, the direction of stream flow is mostly away from Lake Michigan, though there are infrequent reversals in flow direction towards Lake Michigan during dry spells. We find that the flow reversal volume into the Lake has a statistically significant positive relationship with eDNA detection probability, while other covariates, like gage height, precipitation, season, water temperature, dissolved oxygen concentration, pH and chlorophyll concentration do not. This suggests that stream flow direction is highly influential on eDNA detection in the CAWS and should be considered when interpreting eDNA evidence. We also find that the beta-binomial regression model provides a stronger fit for eDNA detection probability compared to a binomial regression model. This paper provides a statistical modeling framework for interpreting eDNA sampling evidence and for evaluating covariates influencing eDNA detection. Copyright © 2017 Elsevier B.V. All rights reserved.

Dental plaque, preventive care, and tooth brushing associated with dental caries in primary teeth in schoolchildren ages 6–9 years of Leon, Nicaragua

PubMed Central

del Socorro Herrera, Miriam; Medina-Solis, Carlo Eduardo; Minaya-Sánchez, Mirna; Pontigo-Loyola, América Patricia; Villalobos-Rodelo, Juan José; Islas-Granillo, Horacio; de la Rosa-Santillana, Rubén; Maupomé, Gerardo

2013-01-01

Background Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. Material/Methods A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. Results Mean age was 7.49±1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54±3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. Conclusions The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators. PMID:24247119

[Association between cesarean birth and the risk of obesity in 6-17 year-olds].

PubMed

Wang, Z H; Xu, R B; Dong, Y H; Yang, Y D; Wang, S; Wang, X J; Yang, Z G; Zou, Z Y; Ma, J

2017-12-10

Objective: To explore the association between cesarean section and obesity in child and adolescent. Methods: In this study, a total number of 42 758 primary and middle school students aged between 6 and 17 were selected, using the stratified cluster sampling method in 93 primary and middle schools in Hunan, Ningxia, Tianjin, Chongqing, Liaoning, Shanghai and Guangdong provinces and autonomous regions. Log-Binomial regression model was used to analyze the association between cesarean section and obesity in childhood or adolescent. Results: Mean age of the subjects was (10.5±3.2) years. The overall rate of cesarean section among subjects attending primary or secondary schools was 42.3%, with 55.9% in boys and, 40.6% in girls respectively and with difference statistically significant ( P <0.001). The rate on obesity among those that received cesarean section (17.6%) was significantly higher than those who experienced vaginal delivery (10.2%) ( P <0.001). Results from the log-binomial regression model showed that cesarean section significantly increased the risk of obesity in child and adolescent ( OR =1.72, 95% CI : 1.63-1.82; P <0.001). After adjusting for factors as sex, residential areas (urban or rural), feeding patterns, frequencies of milk-feeding, eating high-energy foods, eating fried foods and the levels of parental education, family income, parental obesity, physical activity levels, gestational age and birth weight etc ., the differences were still statistically significant ( OR =1.48, 95% CI : 1.39-1.57; P <0.001). Conclusion: The rate of cesarean section among pregnant women in China appeared high which may significantly increase the risk of obesity in child or adolescent.

Quality of maternity care and its determinants along the continuum in Kenya: A structural equation modeling analysis

PubMed Central

Mendez, Bomar Rojas

2017-01-01

Background Improving access to delivery services does not guarantee access to quality obstetric care and better survival, and therefore, concerns for quality of maternal and newborn care in low- and middle-income countries have been raised. Our study explored characteristics associated with the quality of initial assessment, intrapartum, and immediate postpartum and newborn care, and further assessed the relationships along the continuum of care. Methods The 2010 Service Provision Assessment data of Kenya for 627 routine deliveries of women aged 15–49 were used. Quality of care measures were assessed using recently validated quality of care measures during initial assessment, intrapartum, and postpartum periods. Data were analyzed with negative binomial regression and structural equation modeling technique. Results The negative binomial regression results identified a number of determinants of quality, such as the level of health facilities, managing authority, presence of delivery fee, central electricity supply and clinical guideline for maternal and neonatal care. Our structural equation modeling (SEM) further demonstrated that facility characteristics were important determinants of quality for initial assessment and postpartum care, while characteristics at the provider level became more important in shaping the quality of intrapartum care. Furthermore we also noted that quality of initial assessment had a positive association with quality of intrapartum care (β = 0.71, p < 0.001), which in turn was positively associated with the quality of newborn and immediate postpartum care (β = 1.29, p = 0.004). Conclusions A continued focus on quality of care along the continuum of maternity care is important not only to mothers but also their newborns. Policymakers should therefore ensure that required resources, as well as adequate supervision and emphasis on the quality of obstetric care, are available. PMID:28520771

Homicide mortality rates in Canada, 2000-2009: Youth at increased risk.

PubMed

Basham, C Andrew; Snider, Carolyn

2016-10-20

To estimate and compare Canadian homicide mortality rates (HMRs) and trends in HMRs across age groups, with a focus on trends for youth. Data for the period of 2000 to 2009 were collected from Statistics Canada's CANSIM (Canadian Statistical Information Management) Table 102-0540 with the following ICD-10-CA coded external causes of death: X85 to Y09 (assault) and Y87.1 (sequelae of assault). Annual population counts from 2000 to 2009 were obtained from Statistics Canada's CANSIM Table 051-0001. Both death and population counts were organized into five-year age groups. A random effects negative binomial regression analysis was conducted to estimate age group-specific rates, rate ratios, and trends in homicide mortality. There were 9,878 homicide deaths in Canada during the study period. The increase in the overall homicide mortality rate (HMR) of 0.3% per year was not statistically significant (95% CI: -1.1% to +1.8%). Canadians aged 15-19 years and 20-24 years had the highest HMRs during the study period, and experienced statistically significant annual increases in their HMRs of 3% and 4% respectively (p < 0.05). A general, though not statistically significant, decrease in the HMR was observed for all age groups 50+ years. A fixed effects negative binomial regression model showed that the HMR for males was higher than for females over the study period [RRfemale/male = 0.473 (95% CI: 0.361, 0.621)], but no significant difference in sex-specific trends in the HMR was found. An increasing risk of homicide mortality was identified among Canadian youth, ages 15-24, over the 10-year study period. Research that seeks to understand the reasons for the increased homicide risk facing Canada's youth, and public policy responses to reduce this risk, are warranted.

Dental plaque, preventive care, and tooth brushing associated with dental caries in primary teeth in schoolchildren ages 6-9 years of Leon, Nicaragua.

PubMed

Herrera, Miriam del Socorro; Medina-Solís, Carlo Eduardo; Minaya-Sánchez, Mirna; Pontigo-Loyola, América Patricia; Villalobos-Rodelo, Juan José; Islas-Granillo, Horacio; de la Rosa-Santillana, Rubén; Maupomé, Gerardo

2013-11-19

Our study aimed to evaluate the effect of various risk indicators for dental caries on primary teeth of Nicaraguan children (from Leon, Nicaragua) ages 6 to 9, using the negative binomial regression model. A cross-sectional study was carried out to collect clinical, demographic, socioeconomic, and behavioral data from 794 schoolchildren ages 6 to 9 years, randomly selected from 25 schools in the city of León, Nicaragua. Clinical examinations for dental caries (dmft index) were performed by 2 trained and standardized examiners. Socio-demographic, socioeconomic, and behavioral data were self-reported using questionnaires. Multivariate negative binomial regression (NBR) analysis was used. Mean age was 7.49 ± 1.12 years. Boys accounted for 50.1% of the sample. Mean dmft was 3.54 ± 3.13 and caries prevalence (dmft >0) was 77.6%. In the NBR multivariate model (p<0.05), for each year of age, the expected mean dmft decreased by 7.5%. Brushing teeth at least once a day and having received preventive dental care in the last year before data collection were associated with declines in the expected mean dmft by 19.5% and 69.6%, respectively. Presence of dental plaque increased the expected mean dmft by 395.5%. The proportion of students with caries in this sample was high. We found associations between dental caries in the primary dentition and dental plaque, brushing teeth at least once a day, and having received preventive dental care. To improve oral health, school programs and/or age-appropriate interventions need to be developed based on the specific profile of caries experience and the associated risk indicators.

Modeling the frequency of opposing left-turn conflicts at signalized intersections using generalized linear regression models.

PubMed

Zhang, Xin; Liu, Pan; Chen, Yuguang; Bai, Lu; Wang, Wei

2014-01-01

The primary objective of this study was to identify whether the frequency of traffic conflicts at signalized intersections can be modeled. The opposing left-turn conflicts were selected for the development of conflict predictive models. Using data collected at 30 approaches at 20 signalized intersections, the underlying distributions of the conflicts under different traffic conditions were examined. Different conflict-predictive models were developed to relate the frequency of opposing left-turn conflicts to various explanatory variables. The models considered include a linear regression model, a negative binomial model, and separate models developed for four traffic scenarios. The prediction performance of different models was compared. The frequency of traffic conflicts follows a negative binominal distribution. The linear regression model is not appropriate for the conflict frequency data. In addition, drivers behaved differently under different traffic conditions. Accordingly, the effects of conflicting traffic volumes on conflict frequency vary across different traffic conditions. The occurrences of traffic conflicts at signalized intersections can be modeled using generalized linear regression models. The use of conflict predictive models has potential to expand the uses of surrogate safety measures in safety estimation and evaluation.

Work-related injuries involving a hand or fingers among union carpenters in Washington State, 1989 to 2008.

PubMed

Lipscomb, Hester J; Schoenfisch, Ashley; Cameron, Wilfrid

2013-07-01

We evaluated work-related injuries involving a hand or fingers and associated costs among a cohort of 24,830 carpenters between 1989 and 2008. Injury rates and rate ratios were calculated by using Poisson regression to explore higher risk on the basis of age, sex, time in the union, predominant work, and calendar time. Negative binomial regression was used to model dollars paid per claim after adjustment for inflation and discounting. Hand injuries accounted for 21.1% of reported injuries and 9.5% of paid lost time injuries. Older carpenters had proportionately more amputations, fractures, and multiple injuries, but their rates of these more severe injuries were not higher. Costs exceeded $21 million, a cost burden of $0.11 per hour worked. Older carpenters' higher proportion of serious injuries in the absence of higher rates likely reflects age-related reporting differences.

Mental Health Symptoms Among Student Service Members/Veterans and Civilian College Students.

PubMed

Cleveland, Sandi D; Branscum, Adam J; Bovbjerg, Viktor E; Thorburn, Sheryl

2015-01-01

The aim of this study was to investigate if and to what extent student service members/veterans differ from civilian college students in the prevalence of self-reported symptoms of poor mental health. The Fall 2011 implementation of the American College Health Association-National College Health Assessment included 27,774 respondents from 44 colleges and universities. Participants were matched using propensity scores, and the prevalence of symptoms was compared using logistic regression and zero-inflated negative binomial regression models. The odds of feeling overwhelmed in the last 12 months were significantly lower among student service members/veterans with a history of hazardous duty (odd ratio [OR] = 0.46, adjusted p value <.05) compared with civilian students. Military service, with and without hazardous duty deployment, was not a significant predictor of the total number of symptoms of poor mental health. Current student service members/veterans may not be disproportionately affected by poor psychological functioning.

Work performance decrements are associated with Australian working conditions, particularly the demand to work longer hours.

PubMed

Holden, Libby; Scuffham, Paul A; Hilton, Michael F; Vecchio, Nerina N; Whiteford, Harvey A

2010-03-01

To demonstrate the importance of including a range of working conditions in models exploring the association between health- and work-related performance. The Australian Work Outcomes Research Cost-benefit study cross-sectional screening data set was used to explore health-related absenteeism and work performance losses on a sample of approximately 78,000 working Australians, including available demographic and working condition factors. Data collected using the World Health Organization Health and Productivity Questionnaire were analyzed with negative binomial logistic regression and multinomial logistic regressions for absenteeism and work performance, respectively. Hours expected to work, annual wage, and job insecurity play a vital role in the association between health- and work-related performance for both work attendance and self-reported work performance. Australian working conditions are contributing to both absenteeism and low work performance, regardless of health status.

Perceived health status and daily activity participation of older Malaysians.

PubMed

Ng, Sor Tho; Tengku-Aizan, Hamid; Tey, Nai Peng

2011-07-01

This article investigates the influence of perceived health status on the daily activity participation of older Malaysians. Data from the Survey on Perceptions of Needs and Problems of the Elderly, which was conducted in 1999, were used. The negative binomial regression results show that older persons with good perceived health status reported more varieties of daily activity participation, especially among the uneducated and those with below-average self-esteem. The multinomial logistic regression model suggests that older persons with good perceived health status tended to engage daily in paid work only or with leisure activities, whereas those perceived to have poor health were more likely to engage in leisure activities only or leisure and family role activities. Promotion of a healthy lifestyle at a younger age encourages every person to monitor and take responsibility for their own health, which is a necessary strategy to ensure active participation at an older age, and thus improve their well-being.

Adjusted Wald Confidence Interval for a Difference of Binomial Proportions Based on Paired Data

ERIC Educational Resources Information Center

Bonett, Douglas G.; Price, Robert M.

2012-01-01

Adjusted Wald intervals for binomial proportions in one-sample and two-sample designs have been shown to perform about as well as the best available methods. The adjusted Wald intervals are easy to compute and have been incorporated into introductory statistics courses. An adjusted Wald interval for paired binomial proportions is proposed here and…

On the p, q-binomial distribution and the Ising model

NASA Astrophysics Data System (ADS)

Lundow, P. H.; Rosengren, A.

2010-08-01

We employ p, q-binomial coefficients, a generalisation of the binomial coefficients, to describe the magnetisation distributions of the Ising model. For the complete graph this distribution corresponds exactly to the limit case p = q. We apply our investigation to the simple d-dimensional lattices for d = 1, 2, 3, 4, 5 and fit p, q-binomial distributions to our data, some of which are exact but most are sampled. For d = 1 and d = 5, the magnetisation distributions are remarkably well-fitted by p,q-binomial distributions. For d = 4 we are only slightly less successful, while for d = 2, 3 we see some deviations (with exceptions!) between the p, q-binomial and the Ising distribution. However, at certain temperatures near T c the statistical moments of the fitted distribution agree with the moments of the sampled data within the precision of sampling. We begin the paper by giving results of the behaviour of the p, q-distribution and its moment growth exponents given a certain parameterisation of p, q. Since the moment exponents are known for the Ising model (or at least approximately for d = 3) we can predict how p, q should behave and compare this to our measured p, q. The results speak in favour of the p, q-binomial distribution's correctness regarding its general behaviour in comparison to the Ising model. The full extent to which they correctly model the Ising distribution, however, is not settled.

Immigrants from Mexico experience serious behavioral and psychiatric problems at far lower rates than US-born Americans.

PubMed

Salas-Wright, Christopher P; Vaughn, Michael G; Goings, Trenette Clark

2017-10-01

To examine the prevalence of self-reported criminal and violent behavior, substance use disorders, and mental disorders among Mexican immigrants vis-à-vis the US born. Study findings are based on national data collected between 2012 and 2013. Binomial logistic regression was employed to examine the relationship between immigrant status and behavioral/psychiatric outcomes. Mexican immigrants report substantially lower levels of criminal and violent behaviors, substance use disorders, and mental disorders compared to US-born individuals. While some immigrants from Mexico have serious behavioral and psychiatric problems, Mexican immigrants in general experience such problems at far lower rates than US-born individuals.

Understanding Phlebotomus perniciosus abundance in south-east Spain: assessing the role of environmental and anthropic factors.

PubMed

Risueño, José; Muñoz, Clara; Pérez-Cutillas, Pedro; Goyena, Elena; Gonzálvez, Moisés; Ortuño, María; Bernal, Luis Jesús; Ortiz, Juana; Alten, Bulent; Berriatua, Eduardo

2017-04-19

Leishmaniosis is associated with Phlebotomus sand fly vector density, but our knowledge of the environmental framework that regulates highly overdispersed vector abundance distributions is limited. We used a standardized sampling procedure in the bioclimatically diverse Murcia Region in Spain and multilevel regression models for count data to estimate P. perniciosus abundance in relation to environmental and anthropic factors. Twenty-five dog and sheep premises were sampled for sand flies using adhesive and light-attraction traps, from late May to early October 2015. Temperature, relative humidity and other animal- and premise-related data recorded on site and other environmental data were extracted from digital databases using a geographical information system. The relationship between sand fly abundance and explanatory variables was analysed using binomial regression models. The total number of sand flies captured, mostly with light-attraction traps, was 3,644 specimens, including 80% P. perniciosus, the main L. infantum vector in Spain. Abundance varied between and within zones and was positively associated with increasing altitude from 0 to 900 m above sea level, except from 500 to 700 m where it was low. Populations peaked in July and especially during a 3-day heat wave when relative humidity and wind speed plummeted. Regression models indicated that climate and not land use or soil characteristics have the greatest impact on this species density on a large geographical scale. In contrast, micro-environmental factors such as animal building characteristics and husbandry practices affect sand fly population size on a smaller scale. A standardised sampling procedure and statistical analysis for highly overdispersed distributions allow reliable estimation of P. perniciosus abundance and identification of environmental drivers. While climatic variables have the greatest impact at macro-environmental scale, anthropic factors may be determinant at a micro-geographical scale. These finding may be used to elaborate predictive distribution maps useful for vector and pathogen control programs.

Is housing quality associated with malaria incidence among young children and mosquito vector numbers? Evidence from Korogwe, Tanzania.

PubMed

Liu, Jenny X; Bousema, Teun; Zelman, Brittany; Gesase, Samwel; Hashim, Ramadhan; Maxwell, Caroline; Chandramohan, Daniel; Gosling, Roly

2014-01-01

Several studies conducted in Northeast Tanzania have documented declines in malaria transmission even before interventions were scaled up. One explanation for these reductions may be the changes in socio-environmental conditions associated with economic development, and in particular improvements in housing construction. This analysis seeks to identify (1) risk factors for malaria incidence among young children and (2) household and environmental factors associated with mosquito vector numbers collected in the child's sleeping area. Both analyses focus on housing construction quality as a key determinant. For 435 children enrolled in a larger trial of intermittent preventive treatment for malaria in infants in the Korogwe District in Tanga, Northeastern Tanzania, detailed information on their dwelling characteristics were collected in the last year of the trial. Principal components analysis was used to construct an index of housing structure quality and converted to quintile units for regression analysis. Univariate and multivariate random effects negative binomial regressions were used to predict risk factors for child malaria incidence and the mean total number of indoor female Anopheles gambiae and funestus mosquitoes collected per household across three occasions. Building materials have substantially improved in Korogwe over time. Multivariate regressions showed that residing in rural areas (versus urban) increased malaria incidence rates by over three-fold and mean indoor female A. gambiae and funestus numbers by nearly two-fold. Compared to those residing in the lowest quality houses, children residing in the highest quality houses had one-third lower malaria incidence rates, even when wealth and rural residence were controlled for. Living in the highest quality houses reduced vector numbers while having cattle near the house significantly increased them. Results corroborate findings from other studies that show associations between malaria incidence and housing quality; associations were concentrated amongst the highest quality houses.

Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China.

PubMed

Wang, Jingting; Shen, Nanping; Zhang, Xiaoyan; Shen, Min; Xie, Anwei; Howell, Doris; Yuan, Changrong

2017-12-01

Caring for children with acute lymphoblastic leukemia (ALL) is a distressing experience for parents without medical training. The experience can lead to parents' care burden. This study explored care burden among parents of children with ALL and its related factors. A total of 130 parents were surveyed with the Zarit Burden Inventory (ZBI), Perceived Social Support Scale (PSSS), Zung's Self-rating Anxiety Scale (SAS), Zung's Self-rating Depression Scale (SDS), Medical Outcome Study Short Form 36 (SF-36), and a study specific demographic information questionnaire. Independent-samples T test, one-way ANOVA, Pearson correlation analysis and multivariate linear regression analysis (stepwise method), and binomial logistic regression were used in data analysis. The mean score of parents' care burden overall was 37.74 ± 16.57, 17 (13.08%) had little or no burden, 57 (43.85%) had mild-to-moderate burden, 44 (33.84%) had moderate-to-severe burden, and 12 (9.23%) had severe burden. Regression analyses indicated daily care time, anxiety, general health, average monthly family income, social support, and number of co-caregivers were factors associated with care burden. These variables accounted for 51% of the variance in care burden. Other demographic information of parents and children, depression, and other dimensions of SF-36 were not related to care burden. The severe burden level was associated the increase risk of emotional distress compared with little or no burden group (OR = 37.500, 95% CI = 4.515-311.348, P = 0.001). The results indicated that care burden in parents of children newly diagnosed with ALL is high. Parents with lower levels of care burden tend to have less daily care time, more co-caregivers, higher income, less anxiety, better general health, and social support. Strategies are needed to help reduce parents' care burden.

Effects of Clostridium difficile infection in patients with alcoholic hepatitis.

PubMed

Sundaram, Vinay; May, Folasade P; Manne, Vignan; Saab, Sammy

2014-10-01

Infection increases mortality in patients with alcoholic hepatitis (AH). Little is known about the association between Clostridium difficile infection (CDI) and AH. We examined the prevalence and effects of CDI in patients with AH, compared with those of other infections. We performed a cross-sectional analysis using data collected from the Nationwide Inpatient Sample, from 2008 through 2011. International Classification of Diseases, 9th revision, Clinical Modification codes were used to identify patients with AH. We used multivariable logistic regression to determine risk factors that affect mortality, negative binomial regression to evaluate the effects of CDI on predicted length of stay (LOS), and Poisson regression to determine the effects of CDI on predicted hospital charges. Chi-square and Wilcoxon rank-sum analyses were used to compare mortality, LOS, and hospital charges associated with CDI with those associated with urinary tract infection (UTI) and spontaneous bacterial peritonitis (SBP). Of 10,939 patients with AH, 177 had CDI (1.62%). Patients with AH and CDI had increased odds of inpatient mortality (adjusted odds ratio, 1.75; P = .04), a longer predicted LOS (10.63 vs 5.75 d; P < .001), and greater predicted hospital charges ($36,924.30 vs $29,136.58; P < .001), compared with those without CDI. Compared with UTI, CDI was associated with similar mortality but greater LOS (9 vs 6 d; P < .001) and hospital charges ($45,607 vs $32,087; P < .001). SBP was associated with higher mortality than CDI (17.3% vs 10.1%; P = .045), but similar LOS and hospital charges. In patients with AH, CDI is associated with greater mortality and health care use. These effects appear similar to those for UTI and SBP. We propose further studies to determine the cost effectiveness of screening for CDI among patients with AH. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights reserved.

Health care utilization and receipt of preventive care for patients seen at federally funded health centers compared to other sites of primary care.

PubMed

Laiteerapong, Neda; Kirby, James; Gao, Yue; Yu, Tzy-Chyi; Sharma, Ravi; Nocon, Robert; Lee, Sang Mee; Chin, Marshall H; Nathan, Aviva G; Ngo-Metzger, Quyen; Huang, Elbert S

2014-10-01

To compare utilization and preventive care receipt among patients of federal Section 330 health centers (HCs) versus patients of other settings. A nationally representative sample of adults from the Medical Expenditure Panel Survey (2004-2008). HC patients were defined as those with ≥50 percent of outpatient visits at HCs in the first panel year. Outcomes included utilization and preventive care receipt from the second panel year. We used negative binomial and logistic regression models with propensity score adjustment for confounding differences between HC and non-HC patients. Compared to non-HC patients, HC patients had fewer office visits (adjusted incidence rate ratio [aIRR], 0.63) and hospitalizations (aIRR, 0.43) (both p < .001). HC patients were more likely to receive breast cancer screening than non-HC patients (adjusted odds ratio [aOR] 2.78, p < .01). In subgroup analyses, uninsured HC patients had fewer outpatient and emergency room visits and were more likely to receive dietary advice and breast cancer screening compared to non-HC patients. Health centers add value to the health care system by providing socially and medically disadvantaged patients with care that results in lower utilization and maintained or improved preventive care. © Health Research and Educational Trust.

Hypersexual behavior and HIV sex risk among young gay and bisexual men

PubMed Central

Yeagley, Emily; Hickok, Andrew; Bauermeister, José A.

2013-01-01

Hypersexual behavior has been identified as a sexual risk correlate among gay and bisexual men (GBM). The Hypersexual Behavior Inventory (HBI) has been shown to be a reliable and valid measure of hypersexual behavior in clinical populations, yet it has not been used to assess hypersexual behavior in non-clinical samples. We examined the psychometric properties of the HBI with survey data recorded between December 2009 and March 2010 in a sample of young men (N=366, M = 21.46 years old, SD = 1.95) who self-identified as gay (89%) or bisexual (11%), and assessed its association with unprotected receptive anal intercourse (URAI) partners and occasions. Using cross-sectional data of single, sexually active young GBM (YGBM), we used confirmatory factor analyses to test the HBI’s three-factor structure. Using negative binomial regressions, we then tested the association between the HBI subscales and sexual risk. After accounting for covariates, we found that sexual Control was a risk-factor for URAI partners and occasions, and Coping was found to be a protective factor for URAI occasions. In light of our findings, we discuss the importance of re-examining the theoretical assumptions of hypersexual behavior and propose HIV prevention strategies that may reduce young GBM’s vulnerability to HIV infection. PMID:24112113

Induced abortion in a Southern European region: examining inequalities between native and immigrant women.

PubMed

Rodriguez-Alvarez, Elena; Borrell, Luisa N; González-Rábago, Yolanda; Martín, Unai; Lanborena, Nerea

2016-09-01

To examine induced abortion (IA) inequalities between native and immigrant women in a Southern European region and whether these inequalities depend on a 2010 Law facilitating IA. We conducted two analyses: (1) prevalence of total IAs, repeat and second trimester IA, in native and immigrant women aged 12-49 years for years 2009-2013 according to country of origin; and (2) log-binomial regression was used to quantify the association of place of origin with repeat and second trimester IAs among women with IAs. Immigrants were more likely to have an IA than Spanish women, with the highest probability in Sub-Saharan Africa (PR 8.32 95 % CI 3.66-18.92). Immigrant women with an IA from countries other than Maghreb and Asia have higher probabilities of a repeat IA than women from Spain. Women from Europe non-EU/Romania were 50 % (95 % CI 0.30-0.79) less likely to have a second trimester IA, while women from Central America/Caribbean were 45 % (95 % CI 1.11-1.89) more likely than Spanish women. The 2010 Law did not affect these associations. There is a need for parenthood planning programs and more information and access to contraception methods especially in immigrant women to help decrease IAs.

Effects of undercover police stings of gun dealers on the supply of new guns to criminals

PubMed Central

Webster, D W; Bulzacchelli, M T; Zeoli, A M; Vernick, J S

2006-01-01

Objective To assess the effects of undercover police stings and lawsuits against gun dealers suspected of facilitating illegal gun sales in three US cities (Chicago, Detroit, Gary) on the flow of new firearms to criminals. Methods An interrupted time series design and negative binomial regression analyses were used to test for temporal change in the recovery of guns used in crimes within one year of retail sale in both intervention and comparison cities. Results The stings were associated with an abrupt 46.4% reduction in the flow of new guns to criminals in Chicago (95% confidence interval, −58.6% to −30.5%), and with a gradual reduction in new crime guns recovered in Detroit. There was no significant change associated with the stings in Gary, and no change in comparison cities that was coincident with the stings in Chicago and Detroit. Conclusions The announcement of police stings and lawsuits against suspect gun dealers appeared to have reduced the supply of new guns to criminals in Chicago significantly, and may have contributed to beneficial effects in Detroit. Given the important role that gun stores play in supplying guns to criminals in the US, further efforts of this type are warranted and should be evaluated. PMID:16887943

Daylight savings time and myocardial infarction.

PubMed

Sandhu, Amneet; Seth, Milan; Gurm, Hitinder S

2014-01-01

Prior research has shown a transient increase in the incidence of acute myocardial infarction (AMI) after daylight savings time (DST) in the spring as well as a decrease in AMI after returning to standard time in the fall. These findings have not been verified in a broader population and if extant, may have significant public health and policy implications. We assessed changes in admissions for AMI undergoing percutaneous coronary intervention (PCI) in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) database for the weeks following the four spring and three fall DST changes between March 2010 and September 2013. A negative binomial regression model was used to adjust for trend and seasonal variation. There was no difference in the total weekly number of PCIs performed for AMI for either the fall or spring time changes in the time period analysed. After adjustment for trend and seasonal effects, the Monday following spring time changes was associated with a 24% increase in daily AMI counts (p=0.011), and the Tuesday following fall changes was conversely associated with a 21% reduction (p=0.044). No other weekdays in the weeks following DST changes demonstrated significant associations. In the week following the seasonal time change, DST impacts the timing of presentations for AMI but does not influence the overall incidence of this disease.

Influx of multidrug-resistant organisms by country-to-country transfer of patients.

PubMed

Mutters, Nico T; Günther, Frank; Sander, Anja; Mischnik, Alexander; Frank, Uwe

2015-10-28

Multidrug-resistant organisms (MDRO) are a worldwide problem. International migration and travel facilitate the spread of MDRO. Therefore the goal of our study was to assess the risk of influx of MDRO from patients transferred to one of Central Europe's largest hospitals from abroad. A mono-centre study was conducted. All patients transferred from other countries were screened; additional data was collected on comorbidities, etc. Presence of carbapenemases of multidrug-resistant Gram-negatives was confirmed by PCR. The association between length of stay, being colonized and/or infected by a MDRO, country of origin, diagnosis and other factors was assessed by binomial regression analyses. From 2012 to 2013, one fifth of all patients were colonized with MDRO (Methicillin-resistant Staphylococcus aureus [4.1 %], Vancomycin-resistant Enterococci [2.9 %], multidrug-resistant Gram-negatives [12.8 %] and extensively drug-resistant Gram-negatives [3.4 %]). The Gram-negatives carried a variety of carbapenemases including OXA, VIM, KPC and NDM. The length of stay was significantly prolonged by 77.2 % in patients colonized with a MDRO, compared to those not colonized (p<0.0001). Country-to-Country transfer of patients to European hospitals represents a high risk of introduction of MDRO and infection control specialists should endorse containment and screening measures.

Ethnic inequalities in periodontal disease among British adults.

PubMed

Delgado-Angulo, Elsa K; Bernabé, Eduardo; Marcenes, Wagner

2016-11-01

To explore ethnic inequalities in periodontal disease among British adults, and the role of socioeconomic position (SEP) in those inequalities. We analysed data on 1925 adults aged 16-65 years, from the East London Oral Health Inequality (ELOHI) Study, which included a random sample of adults living in an ethnically diverse and socially deprived area. Participants completed a questionnaire and were clinically examined for the number of teeth with periodontal pocket depth (PPD)≥4 mm and loss of attachment (LOA)≥4 mm. Ethnic inequalities in periodontal measures were assessed in negative binomial regression models before and after adjustment for demographic (gender and age groups) and SEP indicators (education and socioeconomic classification). Compared to White British, Pakistani, Indian, Bangladeshi and Asian Others had more teeth with PPD≥4 mm whereas White East European, Black African and Bangladeshi had more teeth with LOA≥4 mm, after adjustments for demographic and SEP measures. The association of ethnicity with periodontal disease was moderated by education, but not by socioeconomic classification. Stratified analysis showed that ethnic disparities in the two periodontal measures were limited to more educated groups. This study showed considerable ethnic disparities in periodontal disease between and within the major ethnic categories. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Household food insecurity during childhood and adolescent misconduct.

PubMed

Jackson, Dylan B; Vaughn, Michael G

2017-03-01

A large body of research has found that household food insecurity can interfere with the healthy development of children. The link between household food insecurity during childhood and misbehaviors during adolescence, however, is not commonly explored. The objective of the current study is to assess whether household food insecurity across childhood predicts four different forms of misconduct during early adolescence. Data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K), a nationally representative sample of U.S. children, were employed in the present study. Associations between household food insecurity during childhood and adolescent misconduct were examined using Logistic and Negative Binomial Regression. Analyses were performed separately for males and females. The results revealed that household food insecurity and food insecurity persistence were predictive of most forms of misconduct for males, and were consistently predictive of engagement in multiple forms of misconduct and a greater variety of forms of misconduct for males. For females, however, household food insecurity generally failed to predict adolescent misconduct. The behavioral development of males during adolescence appears to be sensitive to the presence and persistence of household food insecurity during childhood. Future research should seek to replicate and extend the present findings to late adolescence and adulthood. Copyright © 2017 Elsevier Inc. All rights reserved.

Social-environmental factors and protective sexual behavior among sex workers: the Encontros intervention in Brazil.

PubMed

Lippman, Sheri A; Donini, Angela; Díaz, Juan; Chinaglia, Magda; Reingold, Arthur; Kerrigan, Deanna

2010-04-01

We sought to determine the association of social-environmental factors with condom use and sexually transmitted infections (STIs) among 420 sex workers participating in an STI/HIV prevention study in Corumbá, Brazil, to inform future intervention efforts. Participants provided urine samples for polymerase chain reaction testing of chlamydia and gonorrhea and responded to multi-item scales addressing perceived social cohesion, participation in networks, and access to and management of resources. We conducted multivariate log-linear and negative binomial regression analyses of these data. Increased social cohesion was inversely associated with number of unprotected sex acts in the preceding week among women (adjusted incidence rate ratio [IRR] = 0.80; P < .01), and there was a marginal association among men (adjusted IRR = 0.41; P = .08). Women's increased participation in social networks was associated with a decrease in frequency of unprotected sex acts (adjusted IRR = 0.83; P = .04), as was men's access to and management of social and material resources (IRR = 0.15; P = .01). Social-environmental factors were not associated with STIs. The social context within which populations negotiate sexual behaviors is associated with condom use. Future efforts to prevent STI/HIV should incorporate strategies to modify the social environment.

Social-Environmental Factors and Protective Sexual Behavior Among Sex Workers: The Encontros Intervention in Brazil

PubMed Central

Donini, Angela; Díaz, Juan; Chinaglia, Magda; Reingold, Arthur; Kerrigan, Deanna

2010-01-01

Objectives. We sought to determine the association of social–environmental factors with condom use and sexually transmitted infections (STIs) among 420 sex workers participating in an STI/HIV prevention study in Corumbá, Brazil, to inform future intervention efforts. Methods. Participants provided urine samples for polymerase chain reaction testing of chlamydia and gonorrhea and responded to multi-item scales addressing perceived social cohesion, participation in networks, and access to and management of resources. We conducted multivariate log-linear and negative binomial regression analyses of these data. Results. Increased social cohesion was inversely associated with number of unprotected sex acts in the preceding week among women (adjusted incidence rate ratio [IRR] = 0.80; P < .01), and there was a marginal association among men (adjusted IRR = 0.41; P = .08). Women's increased participation in social networks was associated with a decrease in frequency of unprotected sex acts (adjusted IRR = 0.83; P = .04), as was men's access to and management of social and material resources (IRR = 0.15; P = .01). Social–environmental factors were not associated with STIs. Conclusions. The social context within which populations negotiate sexual behaviors is associated with condom use. Future efforts to prevent STI/HIV should incorporate strategies to modify the social environment. PMID:19762673

Is the impact of depressive complaints on the use of general health care services dependent on severity of somatic morbidity?

PubMed

Koopmans, Gerrit T; Lamers, Leida M

2006-07-01

The aim of this study was to examine the effects of depressive complaints and chronic medical illnesses on prospective somatic health care utilization and the possible heterogeneity of the effect of depressive complaints across levels of medical illness severity. Data from a community-based sample of adults (n=9428) were used, of whom a health survey and claims data, indicating health care use, were available. Assessments of depressive complaints and somatic illnesses were based on self-report. Binomial regression analyses were used to study the expected relations. Depressive complaints and somatic morbidity were both positively related to general health care utilization. Somatic morbidity has an attenuating effect on the impact of depressive complaints: If it becomes more severe, the impact of depressive complaints on utilization is reduced. Depressive complaints are especially related to the use of paramedic services, use of prescription drugs, and consultations of medical specialists. Depressive complaints predict somatic health care utilization, but somatic morbidity attenuates this relation. Future research on this subject should include interaction effects of depressive complaints and somatic morbidity. Interventions aiming to reduce excess use related to mental distress should be primarily targeted on subjects with mental distress who have no comorbid somatic morbidity.

Are qualitative and quantitative sleep problems associated with delinquency when controlling for psychopathic features and parental supervision?

PubMed

Backman, Heidi; Laajasalo, Taina; Saukkonen, Suvi; Salmi, Venla; Kivivuori, Janne; Aronen, Eeva T

2015-10-01

The aim of this study was to explore the relationship between sleep, including both qualitative and quantitative aspects, and delinquent behaviour while controlling for psychopathic features of adolescents and parental supervision at bedtime. We analysed data from a nationally representative sample of 4855 Finnish adolescents (mean age 15.3 years, 51% females). Sleep problems, hours of sleep and delinquency were evaluated via self-report. Psychopathic features were measured with the Antisocial Process Screening Device - Self-Report. In negative binomial regressions, gender and sleep-related variables acted as predictors for both property and violent crime after controlling for psychopathic features and parental supervision at bedtime. The results suggest that both sleep problems (at least three times per week, at least for a year) and an insufficient amount of sleep (less than 7 h) are associated with property crime and violent behaviour, and the relationship is not explained by gender, degree of parental supervision at bedtime or co-occurring psychopathic features. These results suggest that sleep difficulties and insufficient amount of sleep are associated with delinquent behaviour in adolescents. The significance of addressing sleep-related problems, both qualitative and quantitative, among adolescents is thus highlighted. Implications for a prevention technique of delinquent behaviour are discussed. © 2015 European Sleep Research Society.

Older maternal age is associated with depression, anxiety, and stress symptoms in young adult female offspring.

PubMed

Tearne, Jessica E; Robinson, Monique; Jacoby, Peter; Allen, Karina L; Cunningham, Nadia K; Li, Jianghong; McLean, Neil J

2016-01-01

The evidence regarding older parental age and incidence of mood disorder symptoms in offspring is limited, and that which exists is mixed. We sought to clarify these relationships by using data from the Western Australian Pregnancy Cohort (Raine) Study. The Raine Study provided comprehensive data from 2,900 pregnancies, resulting in 2,868 live born children. A total of 1,220 participants completed the short form of the Depression Anxiety Stress Scale (DASS-21) at the 20-year cohort follow-up. We used negative binomial regression analyses with log link and with adjustment for known perinatal risk factors to examine the extent to which maternal and paternal age at childbirth predicted continuous DASS-21 index scores. In the final multivariate models, a maternal age of 30-34 years was associated with significant increases in stress DASS-21 scores in female offspring relative to female offspring of 25- to 29-year-old mothers. A maternal age of 35 years and over was associated with increased scores on all DASS-21 scales in female offspring. Our results indicate that older maternal age is associated with depression, anxiety, and stress symptoms in young adult females. Further research into the mechanisms underpinning this relationship is needed. (c) 2016 APA, all rights reserved.

Suicide Risk across Latent Class Subgroups: A Test of the Generalizability of the Interpersonal Psychological Theory of Suicide.

PubMed

Ma, Jennifer S; Batterham, Philip J; Calear, Alison L; Han, Jin

2018-01-06

It remains unclear whether the Interpersonal Psychological Theory of Suicide (IPTS; Joiner, ) is generalizable to the population or holds more explanatory power for certain subgroups compared to others. The aim of this study was to (1) identify subgroups of individuals who endorsed suicide ideation in the past month based on a range of mental health and demographic variables, (2) compare levels of the IPTS constructs within these subgroups, and (3) test the IPTS predictions for suicide ideation and suicide attempt for each group. Latent class, negative binomial, linear, and logistic regression analyses were conducted on population-based data obtained from 1,321 adults recruited from Facebook. Among participants reporting suicide ideation, four distinct patterns of risk factors emerged based on age and severity of mental health symptoms. Groups with highly elevated mental health symptoms reported the highest levels of thwarted belongingness and perceived burdensomeness. Tests of the IPTS interactions provided partial support for the theory, primarily in young adults with elevated mental health symptoms. Lack of support found for the IPTS predictions across the subgroups and full sample in this study raise some questions around the broad applicability of the theory. © 2018 The American Association of Suicidology.

Perceived discrimination and self-rated health in the immigrant population of the Basque Country, Spain.

PubMed

Rodríguez-Álvarez, Elena; González-Rábago, Yolanda; Borrell, Luisa N; Lanborena, Nerea

To examine the effect of perceived discrimination and self-rated health among the immigrant population in the Basque Country, Spain, and determine whether this effect varies according to region of origin, age, sex and education. Descriptive cross-sectional study. The study population included immigrants aged 18 and older residing in the Basque Country. Data from the 2014 Foreign Immigrant Population Survey (n=3,456) were used. Log-binomial regression was used to quantify the association between perceived discrimination and self-rated health before and after checking for the selected characteristics. Almost 1 in 10 immigrant adults reports perceiving discrimination. In adjusted analyses, the immigrants perceiving discrimination were almost were 1.92 more likely to rate their health as poor (prevalence ratio: 1.92; 95% CI: 1.44-2.56) than those who did not report discrimination. This association did not vary according to region of origin, age, sex or educational level. Perceived discrimination shows a consistent relationship with perceived health. Moreover, this association did not depend on the region of origin, age, sex or educational level of immigrants. These results show the need for implementing inclusive policies to eliminate individual and institutional discrimination and reduce health inequalities between the immigrant and native populations. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Individual and Environmental Correlates to Quality of Life in Park Users in Colombia

PubMed Central

Camargo, Diana Marina

2017-01-01

Purpose: To explore individual and environmental correlates to quality of life (QoL) in park users in Colombia. Methods: A cross-sectional study with face-to-face interviews was conducted with 1392 park users from ten parks in Colombia. The survey included sociodemographic questions, health condition assessed with EuroQuol-5-Dimensions-5-Levels; in addition, questions about accessibility to the parks and perceptions about quality of infrastructure and green areas were asked. The Spanish version of the questionnaire EUROHIS-QOL-8 items was applied to assess QoL. Log-binomial regression models were applied for analyses. Results: Years of schooling, visits to the park with a companion, active use of the park, a maximum score for quality of trees and walking paths, and the perception of safety on the way to the park were positively associated with a better QoL (p < 0.05). Health conditions related to problems in the ability to perform activities of daily living and anxiety/depression showed negative associations. Conclusions: The present study contributes to the Latin American studies by providing information on how parks in an intermediate city may contribute to increased QoL of park users through safety in neighborhoods, social support, active use, and aesthetics, cleanliness, and care of green areas. PMID:29048373

Work Hours and Absenteeism Among Police Officers

PubMed Central

Fekedulegn, Desta; Burchfiel, Cecil M.; Hartley, Tara A.; Baughman, Penelope; Charles, Luenda E.; Andrew, Michael E.; Violanti, John M.

2015-01-01

In this study, the cross-sectional association of paid work hours with episodes of work absence was examined in a cohort of police officers. Study subjects were participants from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study examined between 2004 and 2009. Among 395 study participants with complete data, day-by-day work history records during the one-year period prior to date of examination were used to determine episodes of one-day and three day work absence. The Negative binomial regression analysis was used to examine rate ratios (RR) of work absence. Analyses were also by gender. A one-hour increase in total work hours was associated with 5% reduction in rate of stratified one-day work absence (RR = 0.95, 95% CI: 0.92 – 0.98) and with 8% reduction in rate of three-day work absence (RR = 0.92, 95% CI: 0.89 – 0.95). The association of total work hours with episodes of one-day work absence was significant only in men while the association with episodes of three-day work absence was evident in men and women. In conclusion, in this cohort of police officers, work hours were negatively associated with both durations of work absence (one-day, ≥ 3 consecutive days). PMID:24707589

Area characteristics and admission rates of people with schizophrenia and affective disorders in a German rural catchment area.

PubMed

Losert, C; Schmauß, M; Becker, T; Kilian, R

2012-12-01

Studies in urban areas identified environmental risk factors for mental illness, but little research on this topic has been performed in rural areas. Hospital admission rates were computed for 174 rural municipalities in the catchment area of the state psychiatric hospital in Günzburg in years 2006 to 2009 and combined with structural and socio-economic data. Relationships of overall and diagnosis-specific admission rates with municipality characteristics were analysed by means of negative binomial regression models. Admission rates of patients with a diagnosis of schizophrenia and affective disorder combined decrease with increasing population growth, population density, average income and green areas, while admission rates are positively correlated with commuter balance, income inequality, unemployment rates and traffic areas. Admission rates for schizophrenia are negatively related to population growth, average income and agricultural areas, but positively related to mobility index, income inequality and unemployment rate. Admission rates for affective disorders are negatively related to population growth, population density, average income and green areas, while higher admission rates are correlated with commuter balance, high income inequality, unemployment rate and traffic-related areas. Effects of wealth, economic inequality, population density and structural area characteristics influence psychiatric admission rates also in rural areas.

Attachment to employment and education before work disability pension due to a mental disorder among young adults.

PubMed

Mattila-Holappa, Pauliina; Joensuu, Matti; Ahola, Kirsi; Vahtera, Jussi; Virtanen, Marianna

2016-05-13

We examined attachment to employment and education among young adults before they were granted a fixed-term work disability pension due to psychiatric diagnosis, and the factors associated with this attachment. The data comprised all persons aged 18-34 who received a new-onset fixed-term disability pension compensation due to a mental disorder in Finland in 2008 (N = 1163). The data were derived from pension applications and the enclosed medical records, and were linked to employment records from a period of three years before the disability pension. We analysed the factors associated with attachment to employment or education with log-binomial regression analysis. Fifty percent of the participants were attached to employment or education before work disability pension. The attached were more often women; had higher basic and vocational education; had mood disorder rather than psychosis diagnosis as a primary diagnosis; and had no record of harmful alcohol use or drug use, or recorded symptoms of mental disorders already at school-age. The level of attachment to employment or education before work disability pension is low among young adults with mental disorders and several risk factors predict poor attachment; severe or comorbid mental disorder, early-life psychiatric morbidity, substance use, male sex, low basic education, and lacking vocational education.

Acute Rejection in Renal Transplant Patients of a Hospital in Bogota, Colombia

PubMed Central

García, P.; Huerfano, M; Rodríguez, M; Caicedo, A; Berrío, F; Gonzalez, C

2016-01-01

Background: Renal transplantation is the best treatment for end stage renal disease. Acute graft rejection is one of the main complications and may influence graft survival. Objective: To determine the incidence and features of acute cellular rejection (ACR) episodes confirmed by biopsy. Methods: We studied a cohort of 175 patients who underwent renal transplantation between 2004 and 2012 to determine the cumulative incidence of ACR confirmed by biopsy and to identify the associated risk factors using multivariate analysis. Results: The one-year patient survival was 96.6%; the graft survival was 93.7%. The incidence of ACR within one year was 14.3%, of which 46% were observed within 6 months following transplantation. The most frequently observed ACR type was 1B according to the Banff classification system (42%). A relationship between ACR and receipt of a kidney from expanded criteria donors was observed, both in univariate and adjusted multiple log-binomial regression analyses, but only 6.3% of patients received extended criteria donor kidneys. No other relationships between variables were found. Conclusion: ACR frequency in this study was similar to that of other cohorts reported previously. We need a bigger sample of renal transplants from expanded criteria donors, PRA and DSA test to support the results. PMID:27721962

Characterizing environmental risk factors for West Nile virus in Quebec, Canada, using clinical data in humans and serology in pet dogs.

PubMed

Rocheleau, J P; Michel, P; Lindsay, L R; Drebot, M; Dibernardo, A; Ogden, N H; Fortin, A; Arsenault, J

2017-10-01

The identification of specific environments sustaining emerging arbovirus amplification and transmission to humans is a key component of public health intervention planning. This study aimed at identifying environmental factors associated with West Nile virus (WNV) infections in southern Quebec, Canada, by modelling and jointly interpreting aggregated clinical data in humans and serological data in pet dogs. Environmental risk factors were estimated in humans by negative binomial regression based on a dataset of 191 human WNV clinical cases reported in the study area between 2011 and 2014. Risk factors for infection in dogs were evaluated by logistic and negative binomial models based on a dataset including WNV serological results from 1442 dogs sampled from the same geographical area in 2013. Forested lands were identified as low-risk environments in humans. Agricultural lands represented higher risk environments for dogs. Environments identified as impacting risk in the current study were somewhat different from those identified in other studies conducted in north-eastern USA, which reported higher risk in suburban environments. In the context of the current study, combining human and animal data allowed a more comprehensive and possibly a more accurate view of environmental WNV risk factors to be obtained than by studying aggregated human data alone.

Accident prediction model for public highway-rail grade crossings.

PubMed

Lu, Pan; Tolliver, Denver

2016-05-01

Considerable research has focused on roadway accident frequency analysis, but relatively little research has examined safety evaluation at highway-rail grade crossings. Highway-rail grade crossings are critical spatial locations of utmost importance for transportation safety because traffic crashes at highway-rail grade crossings are often catastrophic with serious consequences. The Poisson regression model has been employed to analyze vehicle accident frequency as a good starting point for many years. The most commonly applied variations of Poisson including negative binomial, and zero-inflated Poisson. These models are used to deal with common crash data issues such as over-dispersion (sample variance is larger than the sample mean) and preponderance of zeros (low sample mean and small sample size). On rare occasions traffic crash data have been shown to be under-dispersed (sample variance is smaller than the sample mean) and traditional distributions such as Poisson or negative binomial cannot handle under-dispersion well. The objective of this study is to investigate and compare various alternate highway-rail grade crossing accident frequency models that can handle the under-dispersion issue. The contributions of the paper are two-fold: (1) application of probability models to deal with under-dispersion issues and (2) obtain insights regarding to vehicle crashes at public highway-rail grade crossings. Copyright © 2016 Elsevier Ltd. All rights reserved.

C-5A Cargo Deck Low-Frequency Vibration Environment

DTIC Science & Technology

1975-02-01

SAMPLE VIBRATION CALCULATIONS 13 1. Normal Distribution 13 2. Binomial Distribution 15 IV CONCLUSIONS 17 -! V REFERENCES 18 t: FEiCENDIJJ PAGS 2LANKNOT...Calculation for Binomial Distribution 108 (Vertical Acceleration, Right Rear Cargo Deck) xi I. INTRODUCTION The availability of large transport...the end of taxi. These peaks could then be used directly to compile the probability of occurrence of specific values of acceleration using the binomial

Identifiability in N-mixture models: a large-scale screening test with bird data.

PubMed

Kéry, Marc

2018-02-01

Binomial N-mixture models have proven very useful in ecology, conservation, and monitoring: they allow estimation and modeling of abundance separately from detection probability using simple counts. Recently, doubts about parameter identifiability have been voiced. I conducted a large-scale screening test with 137 bird data sets from 2,037 sites. I found virtually no identifiability problems for Poisson and zero-inflated Poisson (ZIP) binomial N-mixture models, but negative-binomial (NB) models had problems in 25% of all data sets. The corresponding multinomial N-mixture models had no problems. Parameter estimates under Poisson and ZIP binomial and multinomial N-mixture models were extremely similar. Identifiability problems became a little more frequent with smaller sample sizes (267 and 50 sites), but were unaffected by whether the models did or did not include covariates. Hence, binomial N-mixture model parameters with Poisson and ZIP mixtures typically appeared identifiable. In contrast, NB mixtures were often unidentifiable, which is worrying since these were often selected by Akaike's information criterion. Identifiability of binomial N-mixture models should always be checked. If problems are found, simpler models, integrated models that combine different observation models or the use of external information via informative priors or penalized likelihoods, may help. © 2017 by the Ecological Society of America.

Reducing falls after hospital discharge: a protocol for a randomised controlled trial evaluating an individualised multimodal falls education programme for older adults.

PubMed

Hill, Anne-Marie; Etherton-Beer, Christopher; McPhail, Steven M; Morris, Meg E; Flicker, Leon; Shorr, Ronald; Bulsara, Max; Lee, Den-Ching; Francis-Coad, Jacqueline; Waldron, Nicholas; Boudville, Amanda; Haines, Terry

2017-02-02

Older adults frequently fall after discharge from hospital. Older people may have low self-perceived risk of falls and poor knowledge about falls prevention. The primary aim of the study is to evaluate the effect of providing tailored falls prevention education in addition to usual care on falls rates in older people after discharge from hospital compared to providing a social intervention in addition to usual care. The 'Back to My Best' study is a multisite, single blind, parallel-group randomised controlled trial with blinded outcome assessment and intention-to-treat analysis, adhering to CONSORT guidelines. Patients (n=390) (aged 60 years or older; score more than 7/10 on the Abbreviated Mental Test Score; discharged to community settings) from aged care rehabilitation wards in three hospitals will be recruited and randomly assigned to one of two groups. Participants allocated to the control group shall receive usual care plus a social visit. Participants allocated to the experimental group shall receive usual care and a falls prevention programme incorporating a video, workbook and individualised follow-up from an expert health professional to foster capability and motivation to engage in falls prevention strategies. The primary outcome is falls rates in the first 6 months after discharge, analysed using negative binomial regression with adjustment for participant's length of observation in the study. Secondary outcomes are injurious falls rates, the proportion of people who become fallers, functional status and health-related quality of life. Healthcare resource use will be captured from four sources for 6 months after discharge. The study is powered to detect a 30% relative reduction in the rate of falls (negative binomial incidence ratio 0.70) for a control rate of 0.80 falls per person over 6 months. Results will be presented in peer-reviewed journals and at conferences worldwide. This study is approved by hospital and university Human Research Ethics Committees. ACTRN12615000784516. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance

PubMed Central

2014-01-01

Background Greater use of antibiotics during the past 50 years has exerted selective pressure on susceptible bacteria and may have favoured the survival of resistant strains. Existing information on antibiotic resistance patterns from pathogens circulating among community-based patients is substantially less than from hospitalized patients on whom guidelines are often based. We therefore chose to assess the relationship between the antibiotic resistance pattern of bacteria circulating in the community and the consumption of antibiotics in the community. Methods Both gray literature and published scientific literature in English and other European languages was examined. Multiple regression analysis was used to analyse whether studies found a positive relationship between antibiotic consumption and resistance. A subsequent meta-analysis and meta-regression was conducted for studies for which a common effect size measure (odds ratio) could be calculated. Results Electronic searches identified 974 studies but only 243 studies were considered eligible for inclusion by the two independent reviewers who extracted the data. A binomial test revealed a positive relationship between antibiotic consumption and resistance (p < .001) but multiple regression modelling did not produce any significant predictors of study outcome. The meta-analysis generated a significant pooled odds ratio of 2.3 (95% confidence interval 2.2 to 2.5) with a meta-regression producing several significant predictors (F(10,77) = 5.82, p < .01). Countries in southern Europe produced a stronger link between consumption and resistance than other regions. Conclusions Using a large set of studies we found that antibiotic consumption is associated with the development of antibiotic resistance. A subsequent meta-analysis, with a subsample of the studies, generated several significant predictors. Countries in southern Europe produced a stronger link between consumption and resistance than other regions so efforts at reducing antibiotic consumption may need to be strengthened in this area. Increased consumption of antibiotics may not only produce greater resistance at the individual patient level but may also produce greater resistance at the community, country, and regional levels, which can harm individual patients. PMID:24405683

Hydrological modeling of geophysical parameters of arboviral and protozoan disease vectors in Internally Displaced People camps in Gulu, Uganda.

PubMed

Jacob, Benjamin G; Muturi, Ephantus J; Caamano, Erick X; Gunter, James T; Mpanga, Enoch; Ayine, Robert; Okelloonen, Joseph; Nyeko, Jack Pen-Mogi; Shililu, Josephat I; Githure, John I; Regens, James L; Novak, Robert J; Kakoma, Ibulaimu

2008-03-14

The aim of this study was to determine if remotely sensed data and Digital Elevation Model (DEM) can test relationships between Culex quinquefasciatus and Anopheles gambiae s.l. larval habitats and environmental parameters within Internally Displaced People (IDP) campgrounds in Gulu, Uganda. A total of 65 georeferenced aquatic habitats in various IDP camps were studied to compare the larval abundance of Cx. quinquefasciatus and An. gambiae s.l. The aquatic habitat dataset were overlaid onto Land Use Land Cover (LULC) maps retrieved from Landsat imagery with 150 m x 150 m grid cells stratified by levels of drainage. The LULC change was estimated over a period of 14 years. Poisson regression analyses and Moran's I statistics were used to model relationships between larval abundance and environmental predictors. Individual larval habitat data were further evaluated in terms of their covariations with spatial autocorrelation by regressing them on candidate spatial filter eigenvectors. Multispectral QuickBird imagery classification and DEM-based GIS methods were generated to evaluate stream flow direction and accumulation for identification of immature Cx. quinquefasciatus and An. gambiae s.l. and abundance. The main LULC change in urban Gulu IDP camps was non-urban to urban, which included about 71.5 % of the land cover. The regression models indicate that counts of An. gambiae s.l. larvae were associated with shade while Cx. quinquefasciatus were associated with floating vegetation. Moran's I and the General G statistics for mosquito density by species and instars, identified significant clusters of high densities of Anopheles; larvae, however, Culex are not consistently clustered. A stepwise negative binomial regression decomposed the immature An. gambiae s.l. data into empirical orthogonal bases. The data suggest the presence of roughly 11% to 28 % redundant information in the larval count samples. The DEM suggest a positive correlation for Culex (0.24) while for Anopheles there was a negative correlation (-0.23) for a local model distance to stream. These data demonstrate that optical remote sensing; geostatistics and DEMs can be used to identify parameters associated with Culex and Anopheles aquatic habitats.

Hydrological modeling of geophysical parameters of arboviral and protozoan disease vectors in Internally Displaced People camps in Gulu, Uganda

PubMed Central

Jacob, Benjamin G; Muturi, Ephantus J; Caamano, Erick X; Gunter, James T; Mpanga, Enoch; Ayine, Robert; Okelloonen, Joseph; Nyeko, Jack Pen-Mogi; Shililu, Josephat I; Githure, John I; Regens, James L; Novak, Robert J; Kakoma, Ibulaimu

2008-01-01

Background The aim of this study was to determine if remotely sensed data and Digital Elevation Model (DEM) can test relationships between Culex quinquefasciatus and Anopheles gambiae s.l. larval habitats and environmental parameters within Internally Displaced People (IDP) campgrounds in Gulu, Uganda. A total of 65 georeferenced aquatic habitats in various IDP camps were studied to compare the larval abundance of Cx. quinquefasciatus and An. gambiae s.l. The aquatic habitat dataset were overlaid onto Land Use Land Cover (LULC) maps retrieved from Landsat imagery with 150 m × 150 m grid cells stratified by levels of drainage. The LULC change was estimated over a period of 14 years. Poisson regression analyses and Moran's I statistics were used to model relationships between larval abundance and environmental predictors. Individual larval habitat data were further evaluated in terms of their covariations with spatial autocorrelation by regressing them on candidate spatial filter eigenvectors. Multispectral QuickBird imagery classification and DEM-based GIS methods were generated to evaluate stream flow direction and accumulation for identification of immature Cx. quinquefasciatus and An. gambiae s.l. and abundance. Results The main LULC change in urban Gulu IDP camps was non-urban to urban, which included about 71.5 % of the land cover. The regression models indicate that counts of An. gambiae s.l. larvae were associated with shade while Cx. quinquefasciatus were associated with floating vegetation. Moran's I and the General G statistics for mosquito density by species and instars, identified significant clusters of high densities of Anopheles; larvae, however, Culex are not consistently clustered. A stepwise negative binomial regression decomposed the immature An. gambiae s.l. data into empirical orthogonal bases. The data suggest the presence of roughly 11% to 28 % redundant information in the larval count samples. The DEM suggest a positive correlation for Culex (0.24) while for Anopheles there was a negative correlation (-0.23) for a local model distance to stream. Conclusion These data demonstrate that optical remote sensing; geostatistics and DEMs can be used to identify parameters associated with Culex and Anopheles aquatic habitats. PMID:18341699

Estimation of the cure rate in Iranian breast cancer patients.

PubMed

Rahimzadeh, Mitra; Baghestani, Ahmad Reza; Gohari, Mahmood Reza; Pourhoseingholi, Mohamad Amin

2014-01-01

Although the Cox's proportional hazard model is the popular approach for survival analysis to investigate significant risk factors of cancer patient survival, it is not appropriate in the case of log-term disease free survival. Recently, cure rate models have been introduced to distinguish between clinical determinants of cure and variables associated with the time to event of interest. The aim of this study was to use a cure rate model to determine the clinical associated factors for cure rates of patients with breast cancer (BC). This prospective cohort study covered 305 patients with BC, admitted at Shahid Faiazbakhsh Hospital, Tehran, during 2006 to 2008 and followed until April 2012. Cases of patient death were confirmed by telephone contact. For data analysis, a non-mixed cure rate model with Poisson distribution and negative binomial distribution were employed. All analyses were carried out using a developed Macro in WinBugs. Deviance information criteria (DIC) were employed to find the best model. The overall 1-year, 3-year and 5-year relative survival rates were 97%, 89% and 74%. Metastasis and stage of BC were the significant factors, but age was significant only in negative binomial model. The DIC also showed that the negative binomial model had a better fit. This study indicated that, metastasis and stage of BC were identified as the clinical criteria for cure rates. There are limited studies on BC survival which employed these cure rate models to identify the clinical factors associated with cure. These models are better than Cox, in the case of long-term survival.

Estimating spatial and temporal components of variation in count data using negative binomial mixed models

USGS Publications Warehouse

Irwin, Brian J.; Wagner, Tyler; Bence, James R.; Kepler, Megan V.; Liu, Weihai; Hayes, Daniel B.

2013-01-01

Partitioning total variability into its component temporal and spatial sources is a powerful way to better understand time series and elucidate trends. The data available for such analyses of fish and other populations are usually nonnegative integer counts of the number of organisms, often dominated by many low values with few observations of relatively high abundance. These characteristics are not well approximated by the Gaussian distribution. We present a detailed description of a negative binomial mixed-model framework that can be used to model count data and quantify temporal and spatial variability. We applied these models to data from four fishery-independent surveys of Walleyes Sander vitreus across the Great Lakes basin. Specifically, we fitted models to gill-net catches from Wisconsin waters of Lake Superior; Oneida Lake, New York; Saginaw Bay in Lake Huron, Michigan; and Ohio waters of Lake Erie. These long-term monitoring surveys varied in overall sampling intensity, the total catch of Walleyes, and the proportion of zero catches. Parameter estimation included the negative binomial scaling parameter, and we quantified the random effects as the variations among gill-net sampling sites, the variations among sampled years, and site × year interactions. This framework (i.e., the application of a mixed model appropriate for count data in a variance-partitioning context) represents a flexible approach that has implications for monitoring programs (e.g., trend detection) and for examining the potential of individual variance components to serve as response metrics to large-scale anthropogenic perturbations or ecological changes.

Relationships of organizational social capital with the presence of "gossip and slander," "quarrels and conflicts," sick leave, and poor work ability in nursing homes.

PubMed

Kiss, Philippe; De Meester, Marc; Kristensen, Tage S; Braeckman, Lutgart

2014-11-01

This study aimed to explore the associations of organizational social capital (OSC) with the presence of "gossip and slander," the presence of "conflicts and quarrels," sick leave prevalence, and prevalence of poor work ability in frontline working personnel of nursing homes. A total of 239 subjects (81 % participation), working in 11 different nursing homes, took part in a cross-sectional questionnaire study. Following end points were considered, they are as follows: prevalence of "gossip and slander," "conflicts and quarrels," sick leave, and poor work ability. Associations with OSC were explored at individual level (binomial log-linear regression analysis) and on group level (Kendall's tau correlation coefficients). Significant associations were found between OSC and "gossip and slander," sick leave, and poor work ability, both in the individual- and group-level analyses. The associations showed a higher significance level in the group-level analyses, with the strongest association found between mean OSC of the workplace and the prevalence of poor work ability at the workplace (τ = -0.722; p = 0.002). This study demonstrated significant associations of OSC with three end points that are relevant within the framework of well-being at work in nursing homes. The results are suggestive that OSC should be treated as a characteristic of the entire workplace, rather than as an individually experienced characteristic. The strikingly strong association between OSC and prevalence of poor work ability is suggestive for an important role of OSC within the context of maintaining work ability.

Intermediate vaginal flora is associated with HIV prevalence as strongly as bacterial vaginosis in a cross-sectional study of participants screened for a randomised controlled trial.

PubMed

Guédou, Fernand Aimé; Van Damme, Lut; Mirembe, Florence; Solomon, Suniti; Becker, Marissa; Deese, Jennifer; Crucitti, Tania; Alary, Michel

2012-11-01

The authors analysed data from female sex workers screened prior to participation in a microbicide trial to examine the association between prevalent vaginal flora abnormalities and HIV infection, with special emphasis on the role of the intermediate vaginal flora (IVF) in this association. Data from the Kampala, Cotonou, Chennai and Mudhol/Jamkhandi sites were analysed. Participants were interviewed and provided blood for HIV and syphilis antibody testing, genital samples for the diagnosis of vaginal flora abnormalities (using Nugent score) and other reproductive tract infections. Log-binomial regression was used to estimate the HIV prevalence ratio (PR) in relation to IVF and bacterial vaginosis (BV). Among 1367 women, BV, IVF and HIV prevalences were 47.6% (95% CI=45.0% to 50.3%), 19.2% (95% CI=17.1% to 21.2%) and 27.0% (95% CI=24.6% to 29.3%), respectively. In multivariate analysis, adjusting for study site, age, years of education, occupation, female sterilisation, oral sex, past history of sexually transmitted infection, gonorrhoea and candidiasis, IVF was significantly associated with HIV infection with a PR similar to that of BV (adjusted PR=1.56 (95% CI=1.22 to 1.98) and 1.48 (95% CI=1.20 to 1.84), respectively). Though the cross-sectional design of the study precludes directional interpretation of the findings, the data do suggest that IVF may be as important as BV in HIV acquisition. The authors recommend prospective research to better understand the association between IVF and HIV acquisition.

Temporal Trends and Changing Racial/ethnic Disparities in Alcohol Problems: Results from the 2000 to 2010 National Alcohol Surveys.

PubMed

Zemore, Sarah E; Karriker-Jaffe, Katherine J; Mulia, Nina

2013-09-28

Economic conditions and drinking norms have been in considerable flux over the past 10 years. Accordingly, research is needed to evaluate both overall trends in alcohol problems during this period and whether changes within racial/ethnic groups have affected racial/ethnic disparities. We used 3 cross-sectional waves of National Alcohol Survey data (2000, 2005, and 2010) to examine a) temporal trends in alcohol dependence and consequences overall and by race/ethnicity, and b) the effects of temporal changes on racial/ethnic disparities. Analyses involved bivariate tests and multivariate negative binomial regressions testing the effects of race/ethnicity, survey year, and their interaction on problem measures. Both women and men overall showed significant increases in dependence symptoms in 2010 (vs. 2000); women also reported increases in alcohol-related consequences in 2010 (vs. 2000). (Problem rates were equivalent across 2005 and 2000.) However, increases in problems were most dramatic among Whites, and dependence symptoms actually decreased among Latinos of both genders in 2010. Consequently, the long-standing disparity in dependence between Latino and White men was substantially reduced in 2010. Post-hoc analyses suggested that changes in drinking norms at least partially drove increased problem rates among Whites. Results constitute an important contribution to the literature on racial/ethnic disparities in alcohol problems. Findings are not inconsistent with the macroeconomic literature suggesting increases in alcohol problems during economic recession, but the pattern of effects across race/ethnicity and findings regarding norms together suggest, at the least, a revised understanding of how recessions affect drinking patterns and problems.

Hot hands, cold feet? Investigating effects of interacting constraints on place kicking performance at the 2015 Rugby Union World Cup.

PubMed

Pocock, Chris; Bezodis, Neil E; Davids, Keith; North, Jamie S

2018-06-23

Place kicks in Rugby Union present valuable opportunities to score points outside the spatiotemporal dynamics of open play but are executed under varying performance constraints. We analysed effects of specific task constraints and relevant contextual factors on place kick performance in the 2015 Rugby Union World Cup. Data were collected from television broadcasts for each place kick. In addition to kick outcomes, contextual factors, including time of the kick in the match, score margin at the time of the kick, and outcome of the kicker's previous kick, were recorded. Effects of spatial task constraints were analysed for each kick, using distance (m) and angle (°) of the kick to the goalposts. A binomial logistic regression model revealed that distance from, and angle to, the goalposts were significant predictors of place kick outcome. Furthermore, the success percentage of kickers who missed their previous kick was 7% lower than those who scored their previous kick. Place kick success percentage in the 10 minutes before half-time was 8% lower than the mean tournament success percentage, which was 75% (95% CI 71-78%). The highest kick success percentage was recorded when scores were level (83%; 95% CI 72-91%). Our data highlighted how subtle changes in task constraints and contextual factors can influence performance outcomes in elite performers in international competition. Fluctuations in place kick success suggested that individual constraints, such as thoughts, emotions and fatigue, induced during competition, could interact with perceptions to influence emergent performance behaviours.

Urinary symptoms following external beam radiotherapy of the prostate: Dose-symptom correlates with multiple-event and event-count models.

PubMed

Yahya, Noorazrul; Ebert, Martin A; Bulsara, Max; House, Michael J; Kennedy, Angel; Joseph, David J; Denham, James W

2015-11-01

This study aimed to compare urinary dose-symptom correlates after external beam radiotherapy of the prostate using commonly utilised peak-symptom models to multiple-event and event-count models which account for repeated events. Urinary symptoms (dysuria, haematuria, incontinence and frequency) from 754 participants from TROG 03.04-RADAR trial were analysed. Relative (R1-R75 Gy) and absolute (A60-A75Gy) bladder dose-surface area receiving more than a threshold dose and equivalent uniform dose using exponent a (range: a ∈[1 … 100]) were derived. The dose-symptom correlates were analysed using; peak-symptom (logistic), multiple-event (generalised estimating equation) and event-count (negative binomial regression) models. Stronger dose-symptom correlates were found for incontinence and frequency using multiple-event and/or event-count models. For dysuria and haematuria, similar or better relationships were found using peak-symptom models. Dysuria, haematuria and high grade (⩾ 2) incontinence were associated to high dose (R61-R71 Gy). Frequency and low grade (⩾ 1) incontinence were associated to low and intermediate dose-surface parameters (R13-R41Gy). Frequency showed a parallel behaviour (a=1) while dysuria, haematuria and incontinence showed a more serial behaviour (a=4 to a ⩾ 100). Relative dose-surface showed stronger dose-symptom associations. For certain endpoints, the multiple-event and event-count models provide stronger correlates over peak-symptom models. Accounting for multiple events may be advantageous for a more complete understanding of urinary dose-symptom relationships. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Inference for binomial probability based on dependent Bernoulli random variables with applications to meta‐analysis and group level studies

PubMed Central

Bakbergenuly, Ilyas; Morgenthaler, Stephan

2016-01-01

We study bias arising as a result of nonlinear transformations of random variables in random or mixed effects models and its effect on inference in group‐level studies or in meta‐analysis. The findings are illustrated on the example of overdispersed binomial distributions, where we demonstrate considerable biases arising from standard log‐odds and arcsine transformations of the estimated probability p^, both for single‐group studies and in combining results from several groups or studies in meta‐analysis. Our simulations confirm that these biases are linear in ρ, for small values of ρ, the intracluster correlation coefficient. These biases do not depend on the sample sizes or the number of studies K in a meta‐analysis and result in abysmal coverage of the combined effect for large K. We also propose bias‐correction for the arcsine transformation. Our simulations demonstrate that this bias‐correction works well for small values of the intraclass correlation. The methods are applied to two examples of meta‐analyses of prevalence. PMID:27192062

Binomial Baseball.

ERIC Educational Resources Information Center

Levin, Eugene M.

1981-01-01

Student access to programmable calculators and computer terminals, coupled with a familiarity with baseball, provides opportunities to enhance their understanding of the binomial distribution and other aspects of analysis. (MP)

The Social Acceptance of Community Solar: A Portland Case Study

NASA Astrophysics Data System (ADS)

Weaver, Anne

Community solar is a renewable energy practice that's been adopted by multiple U.S. states and is being considered by many more, including the state of Oregon. A recent senate bill in Oregon, called the "Clean Electricity and Coal Transition Plan", includes a provision that directs the Oregon Public Utility Commission to establish a community solar program for investor-owned utilities by late 2017. Thus, energy consumers in Portland will be offered participation in community solar projects in the near future. Community solar is a mechanism that allows ratepayers to experience both the costs and benefits of solar energy while also helping to offset the proportion of fossil-fuel generated electricity in utility grids, thus aiding climate change mitigation. For community solar to achieve market success in the residential sector of Portland, ratepayers of investor-owned utilities must socially accept this energy practice. The aim of this study was to forecast the potential social acceptance of community solar among Portland residents by measuring willingness to participate in these projects. Additionally, consumer characteristics, attitudes, awareness, and knowledge were captured to assess the influence of these factors on intent to enroll in community solar. The theory of planned behavior, as well as the social acceptance, diffusion of innovation, and dual-interest theories were frameworks used to inform the analysis of community solar adoption. These research objectives were addressed through a mixed-mode survey of Portland residents, using a stratified random sample of Portland neighborhoods to acquire a gradient of demographics. 330 questionnaires were completed, yielding a 34.2% response rate. Descriptive statistics, binomial logistic regression models, and mean willingness to pay were the analyses conducted to measure the influence of project factors and demographic characteristics on likelihood of community solar participation. Roughly 60% of respondents exhibited interest in community solar enrollment. The logistic regression model revealed the percent change in utility bill (essentially the rate of return on the community solar investment) as a dramatically influential variable predicting willingness to participate. Community solar project scenarios also had a strong influence on willingness to participate: larger, cheaper, and distant projects were preferred over small and expensive local projects. Results indicate that community solar project features that accentuate affordability are most important to energy consumers. Additionally, demographic characteristics that were strongly correlated with willingness to enroll were politically liberal ideologies, higher incomes, current enrollment in green utility programs, and membership in an environmental organization. Thus, the market acceptance of community solar in Portland will potentially be broadened by emphasizing affordability over other features, such as community and locality. Additionally, I explored attitudinal influences on interest in community solar by conducting exploratory factor analysis on attitudes towards energy, climate change, and solar barriers and subsequently conducting binomial logistic regression models. Results found that perceiving renewable energy as environmentally beneficial was positively correlated with intent to enroll in community solar, which supported the notion that environmental attitudes will lead to environmental behaviors. The logistic regression model also revealed a negative correlation between community solar interest and negative attitudes towards renewable energy. Perceptions of solar barriers were mild, indicating that lack of an enabling mechanism may be the reason solar continues to be underutilized in this region.

Poisson, Poisson-gamma and zero-inflated regression models of motor vehicle crashes: balancing statistical fit and theory.

PubMed

Lord, Dominique; Washington, Simon P; Ivan, John N

2005-01-01

There has been considerable research conducted over the last 20 years focused on predicting motor vehicle crashes on transportation facilities. The range of statistical models commonly applied includes binomial, Poisson, Poisson-gamma (or negative binomial), zero-inflated Poisson and negative binomial models (ZIP and ZINB), and multinomial probability models. Given the range of possible modeling approaches and the host of assumptions with each modeling approach, making an intelligent choice for modeling motor vehicle crash data is difficult. There is little discussion in the literature comparing different statistical modeling approaches, identifying which statistical models are most appropriate for modeling crash data, and providing a strong justification from basic crash principles. In the recent literature, it has been suggested that the motor vehicle crash process can successfully be modeled by assuming a dual-state data-generating process, which implies that entities (e.g., intersections, road segments, pedestrian crossings, etc.) exist in one of two states-perfectly safe and unsafe. As a result, the ZIP and ZINB are two models that have been applied to account for the preponderance of "excess" zeros frequently observed in crash count data. The objective of this study is to provide defensible guidance on how to appropriate model crash data. We first examine the motor vehicle crash process using theoretical principles and a basic understanding of the crash process. It is shown that the fundamental crash process follows a Bernoulli trial with unequal probability of independent events, also known as Poisson trials. We examine the evolution of statistical models as they apply to the motor vehicle crash process, and indicate how well they statistically approximate the crash process. We also present the theory behind dual-state process count models, and note why they have become popular for modeling crash data. A simulation experiment is then conducted to demonstrate how crash data give rise to "excess" zeros frequently observed in crash data. It is shown that the Poisson and other mixed probabilistic structures are approximations assumed for modeling the motor vehicle crash process. Furthermore, it is demonstrated that under certain (fairly common) circumstances excess zeros are observed-and that these circumstances arise from low exposure and/or inappropriate selection of time/space scales and not an underlying dual state process. In conclusion, carefully selecting the time/space scales for analysis, including an improved set of explanatory variables and/or unobserved heterogeneity effects in count regression models, or applying small-area statistical methods (observations with low exposure) represent the most defensible modeling approaches for datasets with a preponderance of zeros.

Employment status at time of first hospitalization for heart failure is associated with a higher risk of death and rehospitalization for heart failure.

PubMed

Rørth, Rasmus; Fosbøl, Emil L; Mogensen, Ulrik M; Kragholm, Kristian; Numé, Anna-Karin; Gislason, Gunnar H; Jhund, Pardeep S; Petrie, Mark C; McMurray, John J V; Torp-Pedersen, Christian; Køber, Lars; Kristensen, Søren L

2018-02-01

Employment status at time of first heart failure (HF) hospitalization may be an indicator of both self-perceived and objective health status. In this study, we examined the association between employment status and the risk of all-cause mortality and recurrent HF hospitalization in a nationwide cohort of patients with HF. We identified all patients of working age (18-60 years) with a first HF hospitalization in the period 1997-2015 in Denmark, categorized according to whether or not they were part of the workforce at time of the index admission. The primary outcome was death from any cause and the secondary outcome was readmission for HF. Cumulative incidence curves, binomial regression and Cox regression models were used to assess outcomes. Of 25 571 patients with a first hospitalization for HF, 15 428 (60%) were part of the workforce at baseline. Patients in the workforce were significantly younger (53 vs. 55 years) more likely to be male (75% vs 64%) and less likely to have diabetes (13% vs 22%) and chronic obstructive pulmonary disease (5% vs 10%) (all P < 0.0001). Not being part of the workforce was associated with a significantly higher risk of death [hazard ratio (HR) 1.59; 95% confidence interval (CI) 1.50-1.68] and rehospitalization for HF (HR 1.09; 95% CI 1.05-1.14), in analyses adjusted for age, sex, co-morbidities, education level, calendar time, and duration of first HF hospitalization. Not being part of the workforce at time of first HF hospitalization was independently associated with increased mortality and recurrent HF hospitalization. © 2017 The Authors. European Journal of Heart Failure © 2017 European Society of Cardiology.

SWI or T2*: which MRI sequence to use in the detection of cerebral microbleeds? The Karolinska Imaging Dementia Study.

PubMed

Shams, S; Martola, J; Cavallin, L; Granberg, T; Shams, M; Aspelin, P; Wahlund, L O; Kristoffersen-Wiberg, M

2015-06-01

Cerebral microbleeds are thought to have potentially important clinical implications in dementia and stroke. However, the use of both T2* and SWI MR imaging sequences for microbleed detection has complicated the cross-comparison of study results. We aimed to determine the impact of microbleed sequences on microbleed detection and associated clinical parameters. Patients from our memory clinic (n = 246; 53% female; mean age, 62) prospectively underwent 3T MR imaging, with conventional thick-section T2*, thick-section SWI, and conventional thin-section SWI. Microbleeds were assessed separately on thick-section SWI, thin-section SWI, and T2* by 3 raters, with varying neuroradiologic experience. Clinical and radiologic parameters from the dementia investigation were analyzed in association with the number of microbleeds in negative binomial regression analyses. Prevalence and number of microbleeds were higher on thick-/thin-section SWI (20/21%) compared with T2*(17%). There was no difference in microbleed prevalence/number between thick- and thin-section SWI. Interrater agreement was excellent for all raters and sequences. Univariate comparisons of clinical parameters between patients with and without microbleeds yielded no difference across sequences. In the regression analysis, only minor differences in clinical associations with the number of microbleeds were noted across sequences. Due to the increased detection of microbleeds, we recommend SWI as the sequence of choice in microbleed detection. Microbleeds and their association with clinical parameters are robust to the effects of varying MR imaging sequences, suggesting that comparison of results across studies is possible, despite differing microbleed sequences. © 2015 by American Journal of Neuroradiology.

Ethnic Disparities in Oral Health Related Quality of Life among Adults in London, England.

PubMed

Abdelrahim, R; Delgado-Angulo, E K; Gallagher, J E; Bernabé, E

2017-06-01

To explore ethnic disparities in oral health related quality of life (OHQoL) among adults, and the role that socioeconomic factors play in that association. Data from 705 adults from a socially deprived, ethnically diverse metropolitan area of London (England) were analysed for this study. Ethnicity was self-assigned based on the 2001 UK Census categories. OHQoL was measured using the Oral Health Impact Profile (OHIP-14), which provides information on the prevalence, extent and intensity of oral impacts on quality of life in the previous 12 months. Ethnic disparities were assessed in logistic regression models for prevalence of oral impacts and negative binomial regression models for extent and intensity of oral impacts. The prevalence of oral impacts was 12.7% (95% CI: 10.2-15.1) and the mean OHIP-14 extent and severity scores were 0.27 (95% CI: 0.20-0.34) and 4.19 (95% CI: 3.74-4.64), respectively. Black adults showed greater and Asian adults lower prevalence, extent and severity of oral impacts than White adults. However, significant differences were only found for the extent of oral impacts; Black adults reporting more and Asian adults fewer OHIP-14 items affected than their White counterparts. After adjustments for socioeconomic factors, Asian adults had significantly fewer OHIP-14 items affected than White adults (rate ratio: 0.28; 95%CI: 0.08-0.94). This study found disparities in OHQoL between the three main ethnic groups in South East London. Asian adults had better and Black adults had similar OHQoL than White adults after accounting for demographic and social factors. Copyright© 2017 Dennis Barber Ltd.

A prospective study of mental health care for comorbid depressed mood in older adults with painful osteoarthritis

PubMed Central

2011-01-01

Background Comorbid depression is common among adults with painful osteoarthritis (OA). We evaluated the relationship between depressed mood and receipt of mental health (MH) care services. Methods In a cohort with OA, annual interviews assessed comorbidity, arthritis severity, and MH (SF-36 mental health score). Surveys were linked to administrative health databases to identify mental health-related visits to physicians in the two years following the baseline interview (1996-98). Prescriptions for anti-depressants were ascertained for participants aged 65+ years (eligible for drug benefits). The relationship between MH scores and MH-related physician visits was assessed using zero-inflated negative binomial regression, adjusting for confounders. For those aged 65+ years, logistic regression examined the probability of receiving any MH-related care (physician visit or anti-depressant prescription). Results Analyses were based on 2,005 (90.1%) individuals (mean age 70.8 years). Of 576 (28.7%) with probable depression (MH score < 60/100), 42.5% experienced one or more MH-related physician visits during follow-up. The likelihood of a physician visit was associated with sex (adjusted OR women vs. men = 5.87, p = 0.005) and MH score (adjusted OR per 10-point decrease in MH score = 1.63, p = 0.003). Among those aged 65+, 56.7% with probable depression received any MH care. The likelihood of receiving any MH care exhibited a significant interaction between MH score and self-reported health status (p = 0.0009); with good general health, worsening MH was associated with increased likelihood of MH care; as general health declined, this effect was attenuated. Conclusions Among older adults with painful OA, more than one-quarter had depressed mood, but almost half received no mental health care, suggesting a care gap. PMID:21910895

Differences in musculoskeletal health due to gender in a rural multiethnic cohort: a Project FRONTIER study.

PubMed

Brismée, J M; Yang, S; Lambert, M E; Chyu, M C; Tsai, P; Zhang, Y; Han, J; Hudson, C; Chung, Eunhee; Shen, C L

2016-04-26

Very few studies have investigated differences in musculoskeletal health due to gender in a large rural population. The aim of this study is to investigate factors affecting musculoskeletal health in terms of hand grip strength, musculoskeletal discomfort, and gait disturbance in a rural-dwelling, multi-ethnic cohort. Data for 1117 participants (40 years and older, 70% female) of an ongoing rural healthcare study, Project FRONTIER, were analyzed. Subjects with a history of neurological disease, stroke and movement disorder were excluded. Dominant hand grip strength was assessed by dynamometry. Gait disturbance including stiff, spastic, narrow-based, wide-based, unstable or shuffling gait was rated. Musculoskeletal discomfort was assessed by self-reported survey. Data were analyzed by linear, logistic regression and negative binomial regressions as appropriate. Demographic and socioeconomic factors were adjusted in the multiple variable analyses. In both genders, advanced age was a risk factor for weaker hand grip strength; arthritis was positively associated with musculoskeletal discomfort, and fair or poor health was significantly associated with increased risk of gait disturbance. Greater waist circumference was associated with greater musculoskeletal discomfort in males only. In females, advanced age is the risk factor for musculoskeletal discomfort as well as gait disturbance. Females with fair or poor health had weaker hand grip strength. Higher C-reactive protein and HbA1c levels were also positively associated with gait disturbance in females, but not in males. This cross-sectional study demonstrates how gender affects hand grip strength, musculoskeletal discomfort, and gait in a rural-dwelling multi-ethnic cohort. Our results suggest that musculoskeletal health may need to be assessed differently between males and females.

Prevalence and associations of anisometropia with spherical ametropia, cylindrical power, age, and sex in refractive surgery candidates.

PubMed

Linke, Stephan J; Richard, Gisbert; Katz, Toam

2011-09-29

To analyze the prevalence and associations of anisometropia with spherical ametropia, astigmatism, age, and sex in a refractive surgery population. Medical records of 27,070 eyes of 13,535 refractive surgery candidates were reviewed. Anisometropia, defined as the absolute difference in mean spherical equivalent powers between right and left eyes, was analyzed for subjective (A(subj)) and cycloplegic refraction (A(cycl)). Correlations between anisometropia (>1 diopter) and spherical ametropia, cylindrical power, age, and sex, were analyzed using χ² and nonparametric Kruskal-Wallis or Mann-Whitney tests and binomial logistic regression analyses. Power vector analysis was applied for further analysis of cylindrical power. Prevalence of A(subj) was 18.5% and of A(cycl) was 19.3%. In hyperopes, logistic regression analysis revealed that only spherical refractive error (odds ratio [OR], 0.72) and age (OR, 0.97) were independently associated with anisometropia. A(subj) decreased with increasing spherical ametropia and advancing age. Cylindrical power and sex did not significantly affect A(subj). In myopes all explanatory variables (spherical power OR, 0.93; cylindrical power OR, 0.75; age OR, 1.02; sex OR, 0.8) were independently associated with anisometropia. Cylindrical power was most strongly associated with anisometropia. Advancing age and increasing spherical/cylindrical power correlated positively with increasing anisometropia in myopic subjects. Female sex was more closely associated with anisometropia. This large-scale retrospective analysis confirmed an independent association between anisometropia and both spherical ametropia and age in refractive surgery candidates. Notably, an inverse relationship between these parameters in hyperopes was observed. Cylindrical power and female sex were independently associated with anisometropia in myopes.

Corporate governance and the adoption of health information technology within integrated delivery systems.

PubMed

Baird, Aaron; Furukawa, Michael F; Rahman, Bushra; Schneller, Eugene S

2014-01-01

Although several previous studies have found "system affiliation" to be a significant and positive predictor of health information technology (IT) adoption, little is known about the association between corporate governance practices and adoption of IT within U.S. integrated delivery systems (IDSs). Rooted in agency theory and corporate governance research, this study examines the association between corporate governance practices (centralization of IT decision rights and strategic alignment between business and IT strategy) and IT adoption, standardization, and innovation within IDSs. Cross-sectional, retrospective analyses using data from the 2011 Health Information and Management Systems Society Analytics Database on adoption within IDSs (N = 485) is used to analyze the correlation between two corporate governance constructs (centralization of IT decision rights and strategic alignment) and three IT constructs (adoption, standardization, and innovation) for clinical and supply chain IT. Multivariate fractional logit, probit, and negative binomial regressions are applied. Multivariate regressions controlling for IDS and market characteristics find that measures of IT adoption, IT standardization, and innovative IT adoption are significantly associated with centralization of IT decision rights and strategic alignment. Specifically, centralization of IT decision rights is associated with 22% higher adoption of Bar Coding for Materials Management and 30%-35% fewer IT vendors for Clinical Data Repositories and Materials Management Information Systems. A combination of centralization and clinical IT strategic alignment is associated with 50% higher Computerized Physician Order Entry adoption, and centralization along with supply chain IT strategic alignment is significantly negatively correlated with Radio Frequency Identification adoption : Although IT adoption and standardization are likely to benefit from corporate governance practices within IDSs, innovation is likely to be delayed. In addition, corporate governance is not one-size-fits-all, and contingencies are important considerations.

Modified 30-second Sit to Stand test predicts falls in a cohort of institutionalized older veterans

PubMed Central

Chassé, Kathleen

2017-01-01

Physical function performance tests, including sit to stand tests and Timed Up and Go, assess the functional capacity of older adults. Their ability to predict falls warrants further investigation. The objective was to determine if a modified 30-second Sit to Stand test that allowed upper extremity use and Timed Up and Go test predicted falls in institutionalized Veterans. Fifty-three older adult Veterans (mean age = 91 years, 49 men) residing in a long-term care hospital completed modified 30-second Sit to Stand and Timed Up and Go tests. The number of falls over one year was collected. The ability of modified 30-second Sit to Stand or Timed Up and Go to predict if participants had fallen was examined using logistic regression. The ability of these tests to predict the number of falls was examined using negative binomial regression. Both analyses controlled for age, history of falls, cognition, and comorbidities. The modified 30-second Sit to Stand was significantly (p < 0.05) related to if participants fell (odds ratio = 0.75, 95% confidence interval = 0.58, 0.97) and the number of falls (incidence rate ratio = 0.82, 95% confidence interval = 0.68, 0.98); decreased repetitions were associated with increased number of falls. Timed Up and Go was not significantly (p > 0.05) related to if participants fell (odds ratio = 1.03, 95% confidence interval = 0.96, 1.10) or the number of falls (incidence rate ratio = 1.01, 95% confidence interval = 0.98, 1.05). The modified 30-second Sit to Stand that allowed upper extremity use offers an alternative method to screen for fall risk in older adults in long-term care. PMID:28464024

Elevated depressive symptoms and adolescent injury: examining associations by injury frequency, injury type, and gender

PubMed Central

2014-01-01

Background Key risk factors for adolescent injury have been well documented, and include structural, behavioural, and psychosocial indicators. While psychiatric distress has been associated with suicidal behaviour and related self-harm, very little research has examined the role of depression in shaping adolescent injury. This study examines the association of elevated depressive symptoms with injury, including total number of injuries and injury type. Gender differences are also considered. Methods Data were drawn in 2010–11 from a representative sample of 2,989 high school students (14 to18 years of age) from Nova Scotia, Canada. Self-reported injury outcomes were examined using the 17-item Adolescent Injury Checklist, which captures past six-month injuries. Elevated depressive symptoms were assessed using the Centers for Epidemiological Studies Depression scale. Associations of elevated depressive symptoms with total number of injuries were estimated with negative binomial regression, while associations with specific injury types were estimated with logistic regression. Analyses were conducted in 2012. Results Adolescents with elevated depressive symptoms experienced a 40% increase in the total number of injury events occurring in the past six months. The association of elevated depressive symptoms with injury was consistent across injury type; violence-related (OR 2.21, 95% CI 1.61 to 3.03), transport-related (OR 1.53, 95% CI 1.10 to 2.13), and unintentional injuries (OR 1.65, 95% CI 1.20 to 2.27). Gender differences were also observed. Conclusion Elevated depressive symptoms play a role in shaping adolescent injury. Interventions aimed at reducing adolescent injury should look to minimize psychosocial antecedents, such as poor mental health, that put adolescents at an elevated risk. PMID:24555802

Discriminating modes of toxic action in mice using toxicity in BALB/c mouse fibroblast (3T3) cells.

PubMed

Huang, Tao; Yan, Lichen; Zheng, Shanshan; Wang, Yue; Wang, Xiaohong; Fan, Lingyun; Li, Chao; Zhao, Yuanhui; Martyniuk, Christopher J

2017-12-01

The objective of this study was to determine whether toxicity in mouse fibroblast cells (3T3 cells) could predict toxicity in mice. Synthesized data on toxicity was subjected to regression analysis and it was observed that relationship of toxicities between mice and 3T3 cells was not strong (R 2  = 0.41). Inclusion of molecular descriptors (e.g. ionization, pKa) improved the regression to R 2  = 0.56, indicating that this relationship is influenced by kinetic processes of chemicals or specific toxic mechanisms associated to the compounds. However, to determine if we were able to discriminate modes of action (MOAs) in mice using the toxicities generated from 3T3 cells, compounds were first classified into "baseline" and "reactive" guided by the toxic ratio (TR) for each compound in mice. Sequence, binomial and recursive partitioning analyses provided strong predictions of MOAs in mice based upon toxicities in 3T3 cells. The correct classification of MOAs based on these methods was 86%. Nearly all the baseline compounds predicted from toxicities in 3T3 cells were identified as baseline compounds from the TR in mice. The incorrect assignment of MOAs for some compounds is hypothesized to be due to experimental uncertainty that exists in toxicity assays for both mice and 3T3 cells. Conversely, lack of assignment can also arise because some reactive compounds have MOAs that are different in mice compared to 3T3 cells. The methods developed here are novel and contribute to efforts to reduce animal numbers in toxicity tests that are used to evaluate risks associated with organic pollutants in the environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

Associations between displayed alcohol references on Facebook and problem drinking among college students

PubMed Central

Moreno, Megan A; Christakis, Dimitri A; Egan, Katie G; Brockman, Libby N; Becker, Tara

2011-01-01

Objective Alcohol screening is uncommon among college students; however, many students display references to alcohol on Facebook. The objective of this study was to examine associations between displayed alcohol use and intoxication/problem drinking (I/PD) references on Facebook and self-reported problem drinking using a clinical scale. Design Content analysis and cross-sectional survey Setting www.Facebook.com Participants Undergraduate students from two state universities between the ages of 18 and 20 with public Facebook profiles Main exposures Profiles were categorized into one of three distinct categories: Non-Displayers, Alcohol Displayers and Intoxication/Problem Drinking (I/PD) Displayers. Outcome measures An online survey measured problem drinking using the AUDIT scale. Analyses examined associations between alcohol display category and 1) AUDIT problem drinking category using logistic regression, 2) AUDIT score using negative binomial regression, and 3) alcohol-related injury using Fisher’s exact test. Results Of 307 profiles identified, 224 participants completed the survey (73% response rate). The average age was 18.8 years, 122 (54%) were female, 152 (68%) were Caucasian, and approximately half were from each university. Profile owners who displayed I/PD were more likely (OR=4.4 [95% CI 2.0-9.4]) to score in the problem drinking category of the AUDIT scale, had 64% (IRR=1.64 [95% CI: 1.27-11.0] higher AUDIT scores overall and were more likely to report an alcohol-related injury in the past year (p=0.002). Conclusions Displayed references to I/PD were positively associated with AUDIT scores suggesting problem drinking as well as alcohol-related injury. Results suggest that clinical criteria for problem drinking can be applied to Facebook alcohol references. PMID:21969360

Modified 30-second Sit to Stand test predicts falls in a cohort of institutionalized older veterans.

PubMed

Applebaum, Eva V; Breton, Dominic; Feng, Zhuo Wei; Ta, An-Tchi; Walsh, Kayley; Chassé, Kathleen; Robbins, Shawn M

2017-01-01

Physical function performance tests, including sit to stand tests and Timed Up and Go, assess the functional capacity of older adults. Their ability to predict falls warrants further investigation. The objective was to determine if a modified 30-second Sit to Stand test that allowed upper extremity use and Timed Up and Go test predicted falls in institutionalized Veterans. Fifty-three older adult Veterans (mean age = 91 years, 49 men) residing in a long-term care hospital completed modified 30-second Sit to Stand and Timed Up and Go tests. The number of falls over one year was collected. The ability of modified 30-second Sit to Stand or Timed Up and Go to predict if participants had fallen was examined using logistic regression. The ability of these tests to predict the number of falls was examined using negative binomial regression. Both analyses controlled for age, history of falls, cognition, and comorbidities. The modified 30-second Sit to Stand was significantly (p < 0.05) related to if participants fell (odds ratio = 0.75, 95% confidence interval = 0.58, 0.97) and the number of falls (incidence rate ratio = 0.82, 95% confidence interval = 0.68, 0.98); decreased repetitions were associated with increased number of falls. Timed Up and Go was not significantly (p > 0.05) related to if participants fell (odds ratio = 1.03, 95% confidence interval = 0.96, 1.10) or the number of falls (incidence rate ratio = 1.01, 95% confidence interval = 0.98, 1.05). The modified 30-second Sit to Stand that allowed upper extremity use offers an alternative method to screen for fall risk in older adults in long-term care.

New Class of Quantum Error-Correcting Codes for a Bosonic Mode

NASA Astrophysics Data System (ADS)

Michael, Marios H.; Silveri, Matti; Brierley, R. T.; Albert, Victor V.; Salmilehto, Juha; Jiang, Liang; Girvin, S. M.

2016-07-01

We construct a new class of quantum error-correcting codes for a bosonic mode, which are advantageous for applications in quantum memories, communication, and scalable computation. These "binomial quantum codes" are formed from a finite superposition of Fock states weighted with binomial coefficients. The binomial codes can exactly correct errors that are polynomial up to a specific degree in bosonic creation and annihilation operators, including amplitude damping and displacement noise as well as boson addition and dephasing errors. For realistic continuous-time dissipative evolution, the codes can perform approximate quantum error correction to any given order in the time step between error detection measurements. We present an explicit approximate quantum error recovery operation based on projective measurements and unitary operations. The binomial codes are tailored for detecting boson loss and gain errors by means of measurements of the generalized number parity. We discuss optimization of the binomial codes and demonstrate that by relaxing the parity structure, codes with even lower unrecoverable error rates can be achieved. The binomial codes are related to existing two-mode bosonic codes, but offer the advantage of requiring only a single bosonic mode to correct amplitude damping as well as the ability to correct other errors. Our codes are similar in spirit to "cat codes" based on superpositions of the coherent states but offer several advantages such as smaller mean boson number, exact rather than approximate orthonormality of the code words, and an explicit unitary operation for repumping energy into the bosonic mode. The binomial quantum codes are realizable with current superconducting circuit technology, and they should prove useful in other quantum technologies, including bosonic quantum memories, photonic quantum communication, and optical-to-microwave up- and down-conversion.

Speech-discrimination scores modeled as a binomial variable.

PubMed

Thornton, A R; Raffin, M J

1978-09-01

Many studies have reported variability data for tests of speech discrimination, and the disparate results of these studies have not been given a simple explanation. Arguments over the relative merits of 25- vs 50-word tests have ignored the basic mathematical properties inherent in the use of percentage scores. The present study models performance on clinical tests of speech discrimination as a binomial variable. A binomial model was developed, and some of its characteristics were tested against data from 4120 scores obtained on the CID Auditory Test W-22. A table for determining significant deviations between scores was generated and compared to observed differences in half-list scores for the W-22 tests. Good agreement was found between predicted and observed values. Implications of the binomial characteristics of speech-discrimination scores are discussed.

Possibility and Challenges of Conversion of Current Virus Species Names to Linnaean Binomials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Postler, Thomas S.; Clawson, Anna N.; Amarasinghe, Gaya K.

Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authorsmore » of this article expected when conceiving the experiment. [Arenaviridae; binomials; ICTV; International Committee on Taxonomy of Viruses; Mononegavirales; virus nomenclature; virus taxonomy.]« less

Modeling factors influencing the demand for emergency department services in Ontario: a comparison of methods.

PubMed

Moineddin, Rahim; Meaney, Christopher; Agha, Mohammad; Zagorski, Brandon; Glazier, Richard Henry

2011-08-19

Emergency departments are medical treatment facilities, designed to provide episodic care to patients suffering from acute injuries and illnesses as well as patients who are experiencing sporadic flare-ups of underlying chronic medical conditions which require immediate attention. Supply and demand for emergency department services varies across geographic regions and time. Some persons do not rely on the service at all whereas; others use the service on repeated occasions. Issues regarding increased wait times for services and crowding illustrate the need to investigate which factors are associated with increased frequency of emergency department utilization. The evidence from this study can help inform policy makers on the appropriate mix of supply and demand targeted health care policies necessary to ensure that patients receive appropriate health care delivery in an efficient and cost-effective manner. The purpose of this report is to assess those factors resulting in increased demand for emergency department services in Ontario. We assess how utilization rates vary according to the severity of patient presentation in the emergency department. We are specifically interested in the impact that access to primary care physicians has on the demand for emergency department services. Additionally, we wish to investigate these trends using a series of novel regression models for count outcomes which have yet to be employed in the domain of emergency medical research. Data regarding the frequency of emergency department visits for the respondents of Canadian Community Health Survey (CCHS) during our study interval (2003-2005) are obtained from the National Ambulatory Care Reporting System (NACRS). Patients' emergency department utilizations were linked with information from the Canadian Community Health Survey (CCHS) which provides individual level medical, socio-demographic, psychological and behavioral information for investigating predictors of increased emergency department utilization. Six different multiple regression models for count data were fitted to assess the influence of predictors on demand for emergency department services, including: Poisson, Negative Binomial, Zero-Inflated Poisson, Zero-Inflated Negative Binomial, Hurdle Poisson, and Hurdle Negative Binomial. Comparison of competing models was assessed by the Vuong test statistic. The CCHS cycle 2.1 respondents were a roughly equal mix of males (50.4%) and females (49.6%). The majority (86.2%) were young-middle aged adults between the ages of 20-64, living in predominantly urban environments (85.9%), with mid-high household incomes (92.2%) and well-educated, receiving at least a high-school diploma (84.1%). Many participants reported no chronic disease (51.9%), fell into a small number (0-5) of ambulatory diagnostic groups (62.3%), and perceived their health status as good/excellent (88.1%); however, were projected to have high Resource Utilization Band levels of health resource utilization (68.2%). These factors were largely stable for CCHS cycle 3.1 respondents. Factors influencing demand for emergency department services varied according to the severity of triage scores at initial presentation. For example, although a non-significant predictor of the odds of emergency department utilization in high severity cases, access to a primary care physician was a statistically significant predictor of the likelihood of emergency department utilization (OR: 0.69; 95% CI OR: 0.63-0.75) and the rate of emergency department utilization (RR: 0.57; 95% CI RR: 0.50-0.66) in low severity cases. Using a theoretically appropriate hurdle negative binomial regression model this unique study illustrates that access to a primary care physician is an important predictor of both the odds and rate of emergency department utilization in Ontario. Restructuring primary care services, with aims of increasing access to undersupplied populations may result in decreased emergency department utilization rates by approximately 43% for low severity triage level cases.

A Monte Carlo Risk Analysis of Life Cycle Cost Prediction.

DTIC Science & Technology

1975-09-01

process which occurs with each FLU failure. With this in mind there is no alternative other than the binomial distribution. 24 GOR/SM/75D-6 With all of...Weibull distribution of failures as selected by user. For each failure of the ith FLU, the model then samples from the binomial distribution to deter- mine...which is sampled from the binomial . Neither of the two conditions for normality are met, i.e., that RTS Ie close to .5 and the number of samples close

Discrimination of Picea chihuahuana Martinez populations on the basis of climatic, edaphic, dendrometric, genetic and population traits

PubMed Central

Dominguez-Guerrero, Iliana Karina; del Rocío Mariscal-Lucero, Samantha; Hernández-Díaz, José Ciro; Heinze, Berthold; Prieto-Ruiz, José Ángel

2017-01-01

Background Picea chihuahuana, which is endemic to Mexico, is currently listed as “Endangered” on the Red List. Chihuahua spruce is only found in the Sierra Madre Occidental (SMO), Mexico. About 42,600 individuals are distributed in forty populations. These populations are fragmented and can be classified into three geographically distinct clusters in the SMO. The total area covered by P. chihuahuana populations is less than 300 ha. A recent study suggested assisted migration as an alternative to the ex situ conservation of P. chihuahuana, taking into consideration the genetic structure and diversity of the populations and the predictions regarding the future climate of the habitat. However, detailed background information is required to enable development of plans for protecting and conserving species and for successful assisted migration. Thus, it is important to identify differences between populations in relation to environmental conditions. The genetic diversity of populations, which affect vigor, evolution and adaptability of the species, must also be considered. In this study, we examined 14 populations of P. chihuahuana, with the overall aim of discriminating the populations and form clusters of this species. Methods Each population was represented by one 50 × 50 m plot established in the center of its respective location. Climate, soil, dasometric, density variables and genetic and species diversities were assessed in these plots for further analyses. The putatively neutral and adaptive AFLP markers were used to calculate genetic diversity. Affinity Propagation (AP) clustering technique and k-means clustering algorithm were used to classify the populations in the optimal number of clusters. Later stepwise binomial logistic regression was applied to test for significant differences in variables of the southern and northern P. chihuahuana populations. Spearman’s correlation test was used to analyze the relationships among all variables studied. Results The binomial logistic regression analysis revealed that seven climate variables, the geographical longitude and sand proportion in the soil separated the southern from northern populations. The northern populations grow in more arid and continental conditions and on soils with lower sand proportion. The mean genetic diversity using all AFLP studied of P. chihuahuana was significantly correlated with the mean temperature in the warmest month, where warmer temperatures are associated to larger genetic diversity. Genetic diversity of P. chihuahuana calculated with putatively adaptive AFLP was not statistically significantly correlated with any environmental factor. Discussion Future reforestation programs should take into account that at least two different groups (the northern and southern cluster) of P. chihuahuana exist, as local adaptation takes place because of different environmental conditions. PMID:28626616

Traumatic Brain Injury among US Active Duty Military Personnel and Negative Drinking-Related Consequences

PubMed Central

Adams, Rachel Sayko; Larson, Mary Jo; Corrigan, John D.; Ritter, Grant A.; Williams, Thomas V.

2013-01-01

This study used the 2008 Department of Defense Survey of Health Related Behaviors among Active Duty Military Personnel to determine whether traumatic brain injury (TBI) is associated with past year drinking-related consequences. The study sample included currently-drinking personnel who had a combat deployment in the past year and were home for ≥6 months (N = 3,350). Negative binomial regression models were used to assess the incidence rate ratios of consequences, by TBI-level. Experiencing a TBI with a loss of consciousness >20 minutes was significantly associated with consequences independent of demographics, combat exposure, posttraumatic stress disorder, and binge drinking. The study’s limitations are noted. PMID:23869456

[A study on the relationship between postmortem interval and the changes of DNA content in the kidney cellule of rat].

PubMed

Liu, L; Peng, D B; Liu, Y; Deng, W N; Liu, Y L; Li, J J

2001-05-01

To study changes of DNA content in the kidney cellule of rats and relationship with the postmortem interval. This experiment chose seven parameter of cell nuclear, including the area and integral optical density, determined the changes of DNA content in the kidney cellule of 15 rats at different intervals between 0 and 48 h postmortem with auto-TV-image system. The degradation rate of DNA in nuclear has a certainty relationship to early PMI(in 48 h) of rat, and get binomial regress equation. Determining the quantity of DNA in nuclear should be an objective and exact way to estimate the PMI.

Utilization of accident databases and fuzzy sets to estimate frequency of HazMat transport accidents.

PubMed

Qiao, Yuanhua; Keren, Nir; Mannan, M Sam

2009-08-15

Risk assessment and management of transportation of hazardous materials (HazMat) require the estimation of accident frequency. This paper presents a methodology to estimate hazardous materials transportation accident frequency by utilizing publicly available databases and expert knowledge. The estimation process addresses route-dependent and route-independent variables. Negative binomial regression is applied to an analysis of the Department of Public Safety (DPS) accident database to derive basic accident frequency as a function of route-dependent variables, while the effects of route-independent variables are modeled by fuzzy logic. The integrated methodology provides the basis for an overall transportation risk analysis, which can be used later to develop a decision support system.

Statistical procedures for analyzing mental health services data.

PubMed

Elhai, Jon D; Calhoun, Patrick S; Ford, Julian D

2008-08-15

In mental health services research, analyzing service utilization data often poses serious problems, given the presence of substantially skewed data distributions. This article presents a non-technical introduction to statistical methods specifically designed to handle the complexly distributed datasets that represent mental health service use, including Poisson, negative binomial, zero-inflated, and zero-truncated regression models. A flowchart is provided to assist the investigator in selecting the most appropriate method. Finally, a dataset of mental health service use reported by medical patients is described, and a comparison of results across several different statistical methods is presented. Implications of matching data analytic techniques appropriately with the often complexly distributed datasets of mental health services utilization variables are discussed.

The Impact of a Pay-for-Performance Program on Central Line-Associated Blood Stream Infections in Pennsylvania.

PubMed

Bastian, Nathaniel D; Kang, Hyojung; Nembhard, Harriet B; Bloschichak, Andrew; Griffin, Paul M

2016-01-01

Healthcare associated infections have significantly contributed to the rising cost of hospital care in the United States. The implementation of pay-for-performance (P4P) programs has been one approach to improve quality at a reduced cost. We quantify the impact of Highmark's Quality Blue (QB) hospital P4P program on central line-associated blood stream infections (CLABSI) in Pennsylvania. The impact of years of participation in QB on CLABSI is also evaluated. Data from 149 Pennsylvania hospitals on CLABSI from 2008-2013 are used. Negative binomial regression and fixed effects panel regression are performed. Hospitals participating in QB have 0.727 times the CLABSI as those hospitals that do not participate. Hospitals participating for four or more years have on average 3.13 fewer CLABSI per year compared to those participating for less than four years. Highmark's P4P program has shown improved outcomes with regards to CLABSI, but further research is needed to determine if QB is cost effective.

Early-life mortality risks in opposite-sex and same-sex twins: a Danish cohort study of the twin testosterone transfer hypothesis

PubMed Central

Ahrenfeldt, Linda Juel; Larsen, Lisbeth Aagaard; Lindahl-Jacobsen, Rune; Skytthe, Axel; Hjelmborg, Jacob v.B.; Möller, Sören; Christensen, Kaare

2017-01-01

Purpose To investigate the twin testosterone transfer (TTT) hypothesis by comparing early-life mortality risks of opposite-sex (OS) and same-sex (SS) twins during the first 15 years of life. Methods We performed a population-based cohort study to compare mortality in OS and SS twins. We included 68,629 live-born Danish twins from 1973 to 2009 identified through the Danish Twin Registry and performed piecewise stratified Cox regression and log-binomial regression. Results Among 1933 deaths, we found significantly higher mortality for twin boys than for twin girls. For both sexes, OS twins had lower mortality than SS twins; the difference persisted for the first year of life for boys and for the first week of life for girls. Conclusions Although the mortality risk for OS boys was in the expected direction according to the TTT hypothesis, the results for OS girls pointed in the opposite direction, providing no clear evidence for the TTT hypothesis. PMID:28024904

Investigation of shipping accident injury severity and mortality.

PubMed

Weng, Jinxian; Yang, Dong

2015-03-01

Shipping movements are operated in a complex and high-risk environment. Fatal shipping accidents are the nightmares of seafarers. With ten years' worldwide ship accident data, this study develops a binary logistic regression model and a zero-truncated binomial regression model to predict the probability of fatal shipping accidents and corresponding mortalities. The model results show that both the probability of fatal accidents and mortalities are greater for collision, fire/explosion, contact, grounding, sinking accidents occurred in adverse weather conditions and darkness conditions. Sinking has the largest effects on the increment of fatal accident probability and mortalities. The results also show that the bigger number of mortalities is associated with shipping accidents occurred far away from the coastal area/harbor/port. In addition, cruise ships are found to have more mortalities than non-cruise ships. The results of this study are beneficial for policy-makers in proposing efficient strategies to prevent fatal shipping accidents. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Effects of climate and grazing on the vegetation cover change in Xilinguole League of Inner Mongolia, North China].

PubMed

Wang, Hai-Mei; Li, Zheng-Hai; Wang, Zhen

2013-01-01

Based on the monthly temperature and precipitation data of 15 meteorological stations and the statistical data of livestock density in Xilinguole League in 1981-2007, and by using ArcGIS, this paper analyzed the spatial distribution of the climate aridity and livestock density in the League, and in combining with the ten-day data of the normalized difference vegetation index (NDVI) in 1981-2007, the driving factors of the vegetation cover change in the League were discussed. In the study period, there was a satisfactory linear regression relationship between the climate aridity and the vegetation coverage. The NDVI and the livestock density had a favorable binomial regression relationship. With the increase of NDVI, the livestock density increased first and decreased then. The vegetation coverage had a complex linear relationship with livestock density and climate aridity. The NDVI had a positive correlation with climate aridity, but a negative correlation with livestock density. Compared with livestock density, climate aridity had far greater effects on the NDVI.

Effect of a fall prevention program on balance maintenance using a quasi-experimental design in real-world settings.

PubMed

Robitaille, Yvonne; Fournier, Michel; Laforest, Sophie; Gauvin, Lise; Filiatrault, Johanne; Corriveau, Hélène

2012-08-01

To examine the effect of a fall prevention program offered under real-world conditions on balance maintenance several months after the program. To explore the program's impact on falls. A quasi-experimental study was conducted among community-dwelling seniors, with pre- and postintervention measures of balance performance and self-reported falls. Ten community-based organizations offered the intervention (98 participants) and 7 recruited participants to the study's control arm (102 participants). An earlier study examined balance immediately after the 12-week program. The present study focuses on the 12-month effect. Linear regression (balance) and negative binomial regression (falls) procedures were performed.falls. During the 12-month study period, experimental participants improved and maintained their balance as reflected by their scores on three performance tests. There was no evidence of an effect on falls.falls. Structured group exercise programs offered in community-based settings can maintain selected components of balance for several months after the program's end.

Analysis of generalized negative binomial distributions attached to hyperbolic Landau levels

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chhaiba, Hassan, E-mail: chhaiba.hassan@gmail.com; Demni, Nizar, E-mail: nizar.demni@univ-rennes1.fr; Mouayn, Zouhair, E-mail: mouayn@fstbm.ac.ma

2016-07-15

To each hyperbolic Landau level of the Poincaré disc is attached a generalized negative binomial distribution. In this paper, we compute the moment generating function of this distribution and supply its atomic decomposition as a perturbation of the negative binomial distribution by a finitely supported measure. Using the Mandel parameter, we also discuss the nonclassical nature of the associated coherent states. Next, we derive a Lévy-Khintchine-type representation of its characteristic function when the latter does not vanish and deduce that it is quasi-infinitely divisible except for the lowest hyperbolic Landau level corresponding to the negative binomial distribution. By considering themore » total variation of the obtained quasi-Lévy measure, we introduce a new infinitely divisible distribution for which we derive the characteristic function.« less

Binomial leap methods for simulating stochastic chemical kinetics.

PubMed

Tian, Tianhai; Burrage, Kevin

2004-12-01

This paper discusses efficient simulation methods for stochastic chemical kinetics. Based on the tau-leap and midpoint tau-leap methods of Gillespie [D. T. Gillespie, J. Chem. Phys. 115, 1716 (2001)], binomial random variables are used in these leap methods rather than Poisson random variables. The motivation for this approach is to improve the efficiency of the Poisson leap methods by using larger stepsizes. Unlike Poisson random variables whose range of sample values is from zero to infinity, binomial random variables have a finite range of sample values. This probabilistic property has been used to restrict possible reaction numbers and to avoid negative molecular numbers in stochastic simulations when larger stepsize is used. In this approach a binomial random variable is defined for a single reaction channel in order to keep the reaction number of this channel below the numbers of molecules that undergo this reaction channel. A sampling technique is also designed for the total reaction number of a reactant species that undergoes two or more reaction channels. Samples for the total reaction number are not greater than the molecular number of this species. In addition, probability properties of the binomial random variables provide stepsize conditions for restricting reaction numbers in a chosen time interval. These stepsize conditions are important properties of robust leap control strategies. Numerical results indicate that the proposed binomial leap methods can be applied to a wide range of chemical reaction systems with very good accuracy and significant improvement on efficiency over existing approaches. (c) 2004 American Institute of Physics.

How conservative is Fisher's exact test? A quantitative evaluation of the two-sample comparative binomial trial.

PubMed

Crans, Gerald G; Shuster, Jonathan J

2008-08-15

The debate as to which statistical methodology is most appropriate for the analysis of the two-sample comparative binomial trial has persisted for decades. Practitioners who favor the conditional methods of Fisher, Fisher's exact test (FET), claim that only experimental outcomes containing the same amount of information should be considered when performing analyses. Hence, the total number of successes should be fixed at its observed level in hypothetical repetitions of the experiment. Using conditional methods in clinical settings can pose interpretation difficulties, since results are derived using conditional sample spaces rather than the set of all possible outcomes. Perhaps more importantly from a clinical trial design perspective, this test can be too conservative, resulting in greater resource requirements and more subjects exposed to an experimental treatment. The actual significance level attained by FET (the size of the test) has not been reported in the statistical literature. Berger (J. R. Statist. Soc. D (The Statistician) 2001; 50:79-85) proposed assessing the conservativeness of conditional methods using p-value confidence intervals. In this paper we develop a numerical algorithm that calculates the size of FET for sample sizes, n, up to 125 per group at the two-sided significance level, alpha = 0.05. Additionally, this numerical method is used to define new significance levels alpha(*) = alpha+epsilon, where epsilon is a small positive number, for each n, such that the size of the test is as close as possible to the pre-specified alpha (0.05 for the current work) without exceeding it. Lastly, a sample size and power calculation example are presented, which demonstrates the statistical advantages of implementing the adjustment to FET (using alpha(*) instead of alpha) in the two-sample comparative binomial trial. 2008 John Wiley & Sons, Ltd

Coronary artery calcium distributions in older persons in the AGES-Reykjavik study

PubMed Central

Gudmundsson, Elias Freyr; Gudnason, Vilmundur; Sigurdsson, Sigurdur; Launer, Lenore J.; Harris, Tamara B.; Aspelund, Thor

2013-01-01

Coronary Artery Calcium (CAC) is a sign of advanced atherosclerosis and an independent risk factor for cardiac events. Here, we describe CAC-distributions in an unselected aged population and compare modelling methods to characterize CAC-distribution. CAC is difficult to model because it has a skewed and zero inflated distribution with over-dispersion. Data are from the AGES-Reykjavik sample, a large population based study [2002-2006] in Iceland of 5,764 persons aged 66-96 years. Linear regressions using logarithmic- and Box-Cox transformations on CAC+1, quantile regression and a Zero-Inflated Negative Binomial model (ZINB) were applied. Methods were compared visually and with the PRESS-statistic, R2 and number of detected associations with concurrently measured variables. There were pronounced differences in CAC according to sex, age, history of coronary events and presence of plaque in the carotid artery. Associations with conventional coronary artery disease (CAD) risk factors varied between the sexes. The ZINB model provided the best results with respect to the PRESS-statistic, R2, and predicted proportion of zero scores. The ZINB model detected similar numbers of associations as the linear regression on ln(CAC+1) and usually with the same risk factors. PMID:22990371

The Binomial Distribution in Shooting

ERIC Educational Resources Information Center

Chalikias, Miltiadis S.

2009-01-01

The binomial distribution is used to predict the winner of the 49th International Shooting Sport Federation World Championship in double trap shooting held in 2006 in Zagreb, Croatia. The outcome of the competition was definitely unexpected.

Association between early childhood caries and maternal caries status: A cross-section study in São Luís, Maranhão, Brazil

PubMed Central

de Souza, Pedrita Mara do Espírito Santo; Mello Proença, Mariana Almeida; Franco, Mayra Moura; Rodrigues, Vandilson Pinheiro; Costa, José Ferreira; Costa, Elizabeth Lima

2015-01-01

Objective: This study aims to evaluate the association between early childhood caries (ECC) and maternal caries status, and the maternal perception of ECC risk factors. Materials and Methods: A cross-sectional study was carried out with 77 mother-child pairs, the children ranging from 12 to 36 months of age and their mothers, who were seeking dental care at a health center in São Luís, Maranhão, Brazil. Data collection was conducted using a specific questionnaire for mothers. Oral clinical examination of the mother-child binomial to assess caries incidence, gingival bleeding (GB) and visible plaque was done. Home visits were performed in 10% of the sample in order to observe the environmental conditions, dietary habits and dental hygiene practices. Results: The findings showed that the caries prevalence in children was 22.5 times higher in the mother who had decayed tooth (prevalence ratio [PR] = 22.5, confidence interval [CI] 95% = 3.2–156.6, P < 0.001). GB also was observed in 14 mothers and children, the PR in pair was 12.2 (CI95% = 1.6–88.9, P < 0.001). The variables are related for the mother-child binomial in regression linear analysis. Conclusion: The maternal caries status was associated with ECC. PMID:25713495

Magnitude of virologic blips is associated with a higher risk for virologic rebound in HIV-infected individuals: a recurrent events analysis.

PubMed

Grennan, J Troy; Loutfy, Mona R; Su, DeSheng; Harrigan, P Richard; Cooper, Curtis; Klein, Marina; Machouf, Nima; Montaner, Julio S G; Rourke, Sean; Tsoukas, Christos; Hogg, Bob; Raboud, Janet

2012-04-15

The importance of human immunodeficiency virus (HIV) blip magnitude on virologic rebound has been raised in clinical guidelines relating to viral load assays. Antiretroviral-naive individuals initiating combination antiretroviral therapy (cART) after 1 January 2000 and achieving virologic suppression were studied. Negative binomial models were used to identify blip correlates. Recurrent event models were used to determine the association between blips and rebound by incorporating multiple periods of virologic suppression per individual. 3550 participants (82% male; median age, 40 years) were included. In a multivariable negative binomial regression model, the Amplicor assay was associated with a lower blip rate than branched DNA (rate ratio, 0.69; P < .01), controlling for age, sex, region, baseline HIV-1 RNA and CD4 count, AIDS-defining illnesses, year of cART initiation, cART type, and HIV-1 RNA testing frequency. In a multivariable recurrent event model controlling for age, sex, intravenous drug use, cART start year, cART type, assay type, and HIV-1 RNA testing frequency, blips of 500-999 copies/mL were associated with virologic rebound (hazard ratio, 2.70; P = .002), whereas blips of 50-499 were not. HIV-1 RNA assay was an important determinant of blip rates and should be considered in clinical guidelines. Blips ≥500 copies/mL were associated with increased rebound risk.

Predictors and outcomes of non-adherence in patients receiving maintenance hemodialysis.

PubMed

Tohme, Fadi; Mor, Maria K; Pena-Polanco, Julio; Green, Jamie A; Fine, Michael J; Palevsky, Paul M; Weisbord, Steven D

2017-08-01

Predictors of and outcomes associated with non-adherent behavior among patients on chronic hemodialysis (HD) have been incompletely elucidated. We conducted a post hoc analysis of data from the SMILE trial to identify patient factors associated with non-adherence to dialysis-related treatments and the associations of non-adherence with clinical outcomes. We defined non-adherence as missed HD and abbreviated HD. We used negative binomial regression to model the associations of demographic and clinical factors with measures of non-adherence, and negative binomial and Cox regression to analyze the associations of non-adherence with hospitalizations and mortality, respectively. We followed 286 patients for up to 24 months. Factors independently associated with missing HD included Tuesday/Thursday/Saturday HD schedule [incident rate ratio (IRR) 1.85, p < 0.01], current smoking (IRR 2.22, p < 0.01), higher pain score (IRR 1.04, p < 0.01), lower healthy literacy (IRR 3.01, p < 0.01), lower baseline quality of life (IRR 0.89, p = 0.01), and younger age (IRR 1.35, p < 0.01). Factors independently associated with abbreviating HD included dialysis vintage (IRR 1.07, p < 0.01), higher pain score (IRR 1.02, p < 0.01), current non-smoking (IRR 1.32, p = 0.03), and younger age (IRR 1.22, p < 0.01). Abbreviating HD was independently associated with an increased number of total (IRR 1.70, p < 0.01) and ESRD-related (IRR 1.66, p < 0.01) hospitalizations, while missing HD was independently associated with mortality (HR 2.36, p = 0.04). We identified several previously described and novel factors independently associated with non-adherence to HD-related treatments, and independent associations of non-adherence with hospitalization and mortality. These findings should inform the development and implementation of interventions to improve adherence and reduce health resource utilization.

Estimating influenza and respiratory syncytial virus-associated mortality in Western Kenya using health and demographic surveillance system data, 2007-2013.

PubMed

Emukule, Gideon O; Spreeuwenberg, Peter; Chaves, Sandra S; Mott, Joshua A; Tempia, Stefano; Bigogo, Godfrey; Nyawanda, Bryan; Nyaguara, Amek; Widdowson, Marc-Alain; van der Velden, Koos; Paget, John W

2017-01-01

Influenza and respiratory syncytial virus (RSV) associated mortality has not been well-established in tropical Africa. We used the negative binomial regression method and the rate-difference method (i.e. deaths during low and high influenza/RSV activity months), to estimate excess mortality attributable to influenza and RSV using verbal autopsy data collected through a health and demographic surveillance system in Western Kenya, 2007-2013. Excess mortality rates were calculated for a) all-cause mortality, b) respiratory deaths (including pneumonia), c) HIV-related deaths, and d) pulmonary tuberculosis (TB) related deaths. Using the negative binomial regression method, the mean annual all-cause excess mortality rate associated with influenza and RSV was 14.1 (95% confidence interval [CI] 0.0-93.3) and 17.1 (95% CI 0.0-111.5) per 100,000 person-years (PY) respectively; and 10.5 (95% CI 0.0-28.5) and 7.3 (95% CI 0.0-27.3) per 100,000 PY for respiratory deaths, respectively. Highest mortality rates associated with influenza were among ≥50 years, particularly among persons with TB (41.6[95% CI 0.0-122.7]); and with RSV were among <5 years. Using the rate-difference method, the excess mortality rate for influenza and RSV was 44.8 (95% CI 36.8-54.4) and 19.7 (95% CI 14.7-26.5) per 100,000 PY, respectively, for all-cause deaths; and 9.6 (95% CI 6.3-14.7) and 6.6 (95% CI 3.9-11.0) per 100,000 PY, respectively, for respiratory deaths. Our study shows a substantial excess mortality associated with influenza and RSV in Western Kenya, especially among children <5 years and older persons with TB, supporting recommendations for influenza vaccination and efforts to develop RSV vaccines.

levels and sociodemographic correlates of accelerometer-based physical activity in Irish children: a cross-sectional study.

PubMed

Li, Xia; Kearney, Patricia M; Keane, Eimear; Harrington, Janas M; Fitzgerald, Anthony P

2017-06-01

The aim of this study was to explore levels and sociodemographic correlates of physical activity (PA) over 1 week using accelerometer data. Accelerometer data was collected over 1 week from 1075 8-11-year-old children in the cross-sectional Cork Children's Lifestyle Study. Threshold values were used to categorise activity intensity as sedentary, light, moderate or vigorous. Questionnaires collected data on demographic factors. Smoothed curves were used to display minute by minute variations. Binomial regression was used to identify factors correlated with the probability of meeting WHO 60 min moderate to vigorous PA guidelines. Overall, 830 children (mean (SD) age: 9.9(0.7) years, 56.3% boys) were included. From the binomial multiple regression analysis, boys were found more likely to meet guidelines (probability ratio 1.17, 95% CI 1.06 to 1.28) than girls. Older children were less likely to meet guidelines than younger children (probability ratio 0.91, CI 0.87 to 0.95). Normal weight children were more likely than overweight and obese children to meet guidelines (probability ratio 1.25, CI 1.16 to 1.34). Children in urban areas were more likely to meet guidelines than those in rural areas (probability ratio 1.19, CI 1.07 to 1.33). Longer daylight length days were associated with greater probability of meeting guidelines compared to shorter daylight length days. PA levels differed by individual factors including age, gender and weight status as well as by environmental factors including residence and daylight length. Less than one-quarter of children (26.8% boys, 16.2% girls) meet guidelines. Effective intervention policies are urgently needed to increase PA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Effect of Breastfeeding Promotion on Early Childhood Caries and Breastfeeding Duration among 5 Year Old Children in Eastern Uganda: A Cluster Randomized Trial.

PubMed

Birungi, Nancy; Fadnes, Lars T; Okullo, Isaac; Kasangaki, Arabat; Nankabirwa, Victoria; Ndeezi, Grace; Tumwine, James K; Tylleskär, Thorkild; Lie, Stein Atle; Åstrøm, Anne Nordrehaug

2015-01-01

Although several studies have shown short term health benefits of exclusive breastfeeding (EBF), its long term consequences have not been studied extensively in low-income contexts. This study assessed the impact of an EBF promotion initiative for 6 months on early childhood caries (ECC) and breastfeeding duration in children aged 5 years in Mbale, Eastern Uganda. Participants were recruited from the Ugandan site of the PROMISE- EBF cluster randomised trial (ClinicalTrials.gov no: NCT00397150). A total of 765 pregnant women from 24 clusters were included in the ratio 1:1 to receive peer counselled promotion of EBF as the intervention or standard of care. At the 5 year follow-up, ECC was recorded under field conditions using the World Health Organization's decayed missing filled tooth (dmft) index. Adjusted negative binomial and linear regression were used in the analysis. Mean breastfeeding duration in the intervention and control groups (n=417) were 21.8 (CI 20.7-22.9) and 21.3(CI 20.7-21.9) months, respectively. The mean dmft was 1.5 (standard deviation [SD] 2.9) and 1.7 (SD 2.9) in the intervention and control groups, respectively. Corresponding prevalence estimates of ECC were 38% and 41%. Negative binomial regression analysis adjusted for cluster effects and loss-to-follow-up by inverse probability weights (IPW) showed an incidence-rate ratio (IRR) of 0.91 (95% CI 0.65-1.2). Comparing the effect of the trial arm on breastfeeding duration showed a difference in months of 0.48 (-0.72 to 1.7). PROMISE EBF trial did not impact on early childhood caries or breastfeeding duration at 5 years of age. This study contributes to the body of evidence that promotion of exclusive breastfeeding does not raise oral health concerns. However, the high burden of caries calls for efforts to improve the oral health condition in this setting. ClinicalTrials.gov NCT00397150.

Seroprevalence of HCV and HIV infection among clients of the nation's longest-standing statewide syringe exchange program: A cross-sectional study of Community Health Outreach Work to Prevent AIDS (CHOW).

PubMed

Salek, Thomas P; Katz, Alan R; Lenze, Stacy M; Lusk, Heather M; Li, Dongmei; Des Jarlais, Don C

2017-10-01

The Community Health Outreach Work to Prevent AIDS (CHOW) Project is the first and longest-standing statewide integrated and funded needle and syringe exchange program (SEP) in the US. Initiated on O'ahu in 1990, CHOW expanded statewide in 1993. The purpose of this study is to estimate the prevalences of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection, and to characterize risk behaviors associated with infection among clients of a long-standing SEP through the analysis of the 2012 CHOW evaluation data. A cross-sectional sample of 130 CHOW Project clients was selected from January 1, 2012 through December 31, 2012. Questionnaires captured self-reported exposure information. HIV and HCV antibodies were detected via rapid, point-of-care FDA-approved tests. Log-binomial regressions were used to estimate prevalence proportion ratios (PPRs). A piecewise linear log-binomial regression model containing 1 spline knot was used to fit the age-HCV relationship. The estimated seroprevalence of HCV was 67.7% (95% confidence interval [CI]=59.5-75.8%). HIV seroprevalence was 2.3% (95% CI=0-4.9%). Anti-HCV prevalence demonstrated age-specific patterns, ranging from 31.6% through 90.9% in people who inject drugs (PWID) <30 to ≥60 years respectively. Age (continuous/year) prior to spline knot at 51.5 years (adjusted PPR [APPR]=1.03; 95% CI=1.02-1.05) and months exchanging syringes (quartiles) (APPR=1.92; 95% CI=1.3-3.29) were independently associated with anti-HCV prevalence. In Hawai'i, HCV prevalence among PWID is hyperendemic demonstrating age- and SEP duration-specific trends. Relatively low HIV prevalence compared with HCV prevalence reflects differences in transmissibility of these 2 blood-borne pathogens and suggests much greater efficacy of SEP for HIV prevention. Copyright © 2017 Elsevier B.V. All rights reserved.

Detection of influenza-like illness aberrations by directly monitoring Pearson residuals of fitted negative binomial regression models.

PubMed

Chan, Ta-Chien; Teng, Yung-Chu; Hwang, Jing-Shiang

2015-02-21

Emerging novel influenza outbreaks have increasingly been a threat to the public and a major concern of public health departments. Real-time data in seamless surveillance systems such as health insurance claims data for influenza-like illnesses (ILI) are ready for analysis, making it highly desirable to develop practical techniques to analyze such readymade data for outbreak detection so that the public can receive timely influenza epidemic warnings. This study proposes a simple and effective approach to analyze area-based health insurance claims data including outpatient and emergency department (ED) visits for early detection of any aberrations of ILI. The health insurance claims data during 2004-2009 from a national health insurance research database were used for developing early detection methods. The proposed approach fitted the daily new ILI visits and monitored the Pearson residuals directly for aberration detection. First, negative binomial regression was used for both outpatient and ED visits to adjust for potentially influential factors such as holidays, weekends, seasons, temporal dependence and temperature. Second, if the Pearson residuals exceeded 1.96, aberration signals were issued. The empirical validation of the model was done in 2008 and 2009. In addition, we designed a simulation study to compare the time of outbreak detection, non-detection probability and false alarm rate between the proposed method and modified CUSUM. The model successfully detected the aberrations of 2009 pandemic (H1N1) influenza virus in northern, central and southern Taiwan. The proposed approach was more sensitive in identifying aberrations in ED visits than those in outpatient visits. Simulation studies demonstrated that the proposed approach could detect the aberrations earlier, and with lower non-detection probability and mean false alarm rate in detecting aberrations compared to modified CUSUM methods. The proposed simple approach was able to filter out temporal trends, adjust for temperature, and issue warning signals for the first wave of the influenza epidemic in a timely and accurate manner.

The 6-min push test is reliable and predicts low fitness in spinal cord injury.

PubMed

Cowan, Rachel E; Callahan, Morgan K; Nash, Mark S

2012-10-01

The objective of this study is to assess 6-min push test (6MPT) reliability, determine whether the 6MPT is sensitive to fitness differences, and assess if 6MPT distance predicts fitness level in persons with spinal cord injury (SCI) or disease. Forty individuals with SCI who could self-propel a manual wheelchair completed an incremental arm crank peak oxygen consumption assessment and two 6MPTs across 3 d (37% tetraplegia (TP), 63% paraplegia (PP), 85% men, 70% white, 63% Hispanic, mean age = 34 ± 10 yr, mean duration of injury = 13 ± 10 yr, and mean body mass index = 24 ± 5 kg.m). Intraclass correlation and Bland-Altman plots assessed 6MPT distance (m) reliability. Mann-Whitney U test compared 6MPT distance (m) of high and low fitness groups for TP and PP. The fitness status prediction was developed using N = 30 and validated in N = 10 (validation group (VG)). A nonstatistical prediction approach, below or above a threshold distance (TP = 445 m and PP = 604 m), was validated statistically by binomial logistic regression. Accuracy, sensitivity, and specificity were computed to evaluate the threshold approach. Intraclass correlation coefficients exceeded 0.90 for the whole sample and the TP/PP subsets. High fitness persons propelled farther than low fitness persons for both TP/PP (both P < 0.05). Binomial logistic regression (P < 0.008) predicted the same fitness levels in the VG as the threshold approach. In the VG, overall accuracy was 70%. Eighty-six percent of low fitness persons were correctly identified (sensitivity), and 33% of high fitness persons were correctly identified (specificity). The 6MPT may be a useful tool for SCI clinicians and researchers. 6MPT distance demonstrates excellent reliability and is sensitive to differences in fitness level. 6MPT distances less than a threshold distance may be an effective approach to identify low fitness in person with SCI.

Factors associated with stigma attitude towards people living with HIV among general individuals in Heilongjiang, Northeast China.

PubMed

Li, Xin; Yuan, Lili; Li, Xiaoxia; Shi, Jingli; Jiang, Liying; Zhang, Chundi; Yang, Xiujing; Zhang, Yeli; Zhao, Donghui; Zhao, Yashuang

2017-02-17

HIV-related stigma always is major obstacles to an effective HIV response worldwide. The effect of HIV-related stigma on HIV prevention and treatment is particularly serious in China. This study was to examine stigma attitude towards people living with HIV/AIDS (PLWHA) among general individuals in Heilongjiang Province, Northeast China and the factors associated with stigma attitude, including socio-demographic factors and HIV/AIDS Knowledge. A cross-sectional survey was carried out in Heilongjiang Province, China. A total of 4050 general individuals with age 15-69 years in four villages in rural areas and two communities in urban areas were drawn using stratified cluster sampling. Standardized questionnaire interviews were administered. Univariate and multivariate log-binomial regression were performed to assess factors affecting stigma attitude towards PLWHA. The proportions of participants holding stigma attitude towards PLWHA were 49.6% among rural respondents and 37.0% among urban respondents (P < 0.001). Multivariate log binomial regression analysis among both rural participants (RR = 0.89, 95% CI: 0.87-0.91, P < 0.001) and urban participants (RR = 0.89, 95% CI: 0.87-0.91, P < 0.001) showed that greater knowledge of HIV transmission misconceptions was significantly associated with lower stigma attitude towards people living with HIV. And among urban participants, higher education level (high school vs. primary school or less: RR = 0.73, 95%CI: 0.62-0.87, P < 0.001; middle school vs. primary school or less: RR = 0.83, 95%CI: 0.71-0.97, P = 0.018) were also significantly associated with lower stigma attitude towards PLWHA. The level of stigma attitude towards PLWHA is higher in rural areas than in urban areas in Heilongjiang. Meanwhile, individuals who better were aware of HIV/AIDS transmission misconceptions may hold lower stigma attitude toward PLWHA whether among rural or urban residents.

The Predisposing Factors between Dental Caries and Deviations from Normal Weight.

PubMed

Chopra, Amandeep; Rao, Nanak Chand; Gupta, Nidhi; Vashisth, Shelja; Lakhanpal, Manav

2015-04-01

Dental caries and deviations from normal weight are two conditions which share several broadly predisposing factors. So it's important to understand any relationship between dental state and body weight if either is to be managed appropriately. The study was done to find out the correlation between body mass index (BMI), diet, and dental caries among 12-15-year-old schoolgoing children in Panchkula District. A multistage sample of 12-15-year-old school children (n = 810) in Panchkula district, Haryana was considered. Child demographic details and diet history for 5 days was recorded. Data regarding dental caries status was collected using World Health Organization (1997) format. BMI was calculated and categorized according to the World Health Organization classification system for BMI. The data were subjected to statistical analysis using chi-square test and binomial regression developed using the Statistical Package for Social Sciences (SPSS) 20.0. The mean Decayed Missing Filled Teeth (DMFT) score was found to be 1.72 with decayed, missing, and filled teeth to be 1.22, 0.04, and 0.44, respectively. When the sample was assessed based on type of diet, it was found that vegetarians had higher mean DMFT (1.72) as compared to children having mixed diet. Overweight children had highest DMFT (3.21) which was followed by underweight (2.31) and obese children (2.23). Binomial regression revealed that females were 1.293 times at risk of developing caries as compared to males. Fair and poor Simplified-Oral Hygiene Index (OHI-S) showed 3.920 and 4.297 times risk of developing caries as compared to good oral hygiene, respectively. Upper high socioeconomic status (SES) is at most risk of developing caries. Underweight, overweight, and obese are at 2.7, 2.5, and 3 times risk of developing caries as compared to children with normal BMI, respectively. Dental caries and deviations from normal weight are two conditions which share several broadly predisposing factors such as diet, SES, lifestyle and other environmental factors.

The magnetisation distribution of the Ising model - a new approach

NASA Astrophysics Data System (ADS)

Hakan Lundow, Per; Rosengren, Anders

2010-03-01

A completely new approach to the Ising model in 1 to 5 dimensions is developed. We employ a generalisation of the binomial coefficients to describe the magnetisation distributions of the Ising model. For the complete graph this distribution is exact. For simple lattices of dimensions d=1 and d=5 the magnetisation distributions are remarkably well-fitted by the generalized binomial distributions. For d=4 we are only slightly less successful, while for d=2,3 we see some deviations (with exceptions!) between the generalized binomial and the Ising distribution. The results speak in favour of the generalized binomial distribution's correctness regarding their general behaviour in comparison to the Ising model. A theoretical analysis of the distribution's moments also lends support their being correct asymptotically, including the logarithmic corrections in d=4. The full extent to which they correctly model the Ising distribution, and for which graph families, is not settled though.

Abstract knowledge versus direct experience in processing of binomial expressions

PubMed Central

Morgan, Emily; Levy, Roger

2016-01-01

We ask whether word order preferences for binomial expressions of the form A and B (e.g. bread and butter) are driven by abstract linguistic knowledge of ordering constraints referencing the semantic, phonological, and lexical properties of the constituent words, or by prior direct experience with the specific items in questions. Using forced-choice and self-paced reading tasks, we demonstrate that online processing of never-before-seen binomials is influenced by abstract knowledge of ordering constraints, which we estimate with a probabilistic model. In contrast, online processing of highly frequent binomials is primarily driven by direct experience, which we estimate from corpus frequency counts. We propose a trade-off wherein processing of novel expressions relies upon abstract knowledge, while reliance upon direct experience increases with increased exposure to an expression. Our findings support theories of language processing in which both compositional generation and direct, holistic reuse of multi-word expressions play crucial roles. PMID:27776281

Ethnic inequalities in dental caries among adults in East London.

PubMed

Delgado-Angulo, Elsa K; Bernabé, Eduardo; Marcenes, Wagner

2016-06-01

This study explored ethnic inequalities in dental caries among adults and assessed the role of socioeconomic position (SEP) in explaining those inequalities. We analysed data on 2013 adults aged 16-65 years, from the East London Oral Health Inequality (ELOHI) Study, which included a random sample of adults and children living in East London in 2009-10. Participants completed a questionnaire and were clinically examined for dental caries at home. Dental caries was measured using the number of decayed, missing and filled teeth or DMFT index. Ethnic inequalities in dental caries were assessed in negative binomial regression models before and after adjustment for demographic (sex and age groups) and SEP measures (education and socioeconomic classification). White Eastern European and White Other had higher DMFT, whereas all Asian (Pakistani, Indian, Bangladeshi and Other) and all Black (African, Caribbean and Other) ethnic groups had lower DMFT than White British. Similar inequalities were found for the number of filled and missing teeth, but there were no differences in the number of decayed teeth between ethnic groups. This study showed considerable disparities in dental caries between and within the major ethnic categories, which were independent of demographics and SEP. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Food insecurity is associated with unhealthy dietary practices among US veterans in California.

PubMed

Becerra, Monideepa B; Hassija, Christina M; Becerra, Benjamin J

2017-10-01

US veterans (hereafter, 'veterans') are at risk for being overweight or obese and associated unhealthy behaviours, including poor diet; although limited studies have examined the underlying factors associated with such outcomes. As such, the present study evaluated the association between food insecurity and dietary practices among veterans. A secondary analysis of cross-sectional data from the California Health Interview Survey (2009, 2011/2012) was conducted. Survey weights were applied to identify univariate means, population estimates and weighted percentages. Bivariate analyses followed by survey-weighted negative binomial regression were used to model the association between food insecurity and dietary practices of fruit, vegetable, fast food and soda intakes. California Health Interview Survey 2009-2011/2012. The present study included a total of 11 011 veterans from California. Nearly 5 % of the studied veteran population reported living in poverty with food insecurity. Compared with those at or above the poverty level and those in poverty but food secure, the mean intakes of fruits and vegetables were lower, while the mean intakes of soda and fast foods (P for trend <0·05) were higher among veterans living in poverty with food insecurity. Food insecurity was associated with 24 and 142 % higher average consumption of fast foods and soda, respectively, and 24 % lower fruit intake. Food insecurity remains a burden among veterans and is associated with unhealthy dietary practices. Targeted interventions to improve diet quality are imperative.

Community Determinants of Latinos’ Use of Mental Health Services

PubMed Central

Aguilera, Adrian; Regeser López, Steven

2014-01-01

Objective This study examined the role of community in understanding Latino adults’ (18–64 years of age) use of community mental health services. Methods Service utilization data from the Los Angeles County Department of Mental Health were analyzed from 2003 in two service provider areas. Demographic data, including foreign-born status, language, education, and income for the Latino population, were obtained from the 2000 U.S. Census. The study sample consisted of 4,133 consumers of mental health services in 413 census tracts from an established immigrant community and 4,156 consumers of mental health services in 204 census tracts from a recent immigrant community. Negative binomial regression analyses were conducted to examine associations between locales, community characteristics, and use of services. Results Community of residence and foreign-born status were significantly associated with Latinos’ service use. Latinos from the established immigrant community were more likely to use services than Latinos from the recent immigrant community. Across both communities, census tracts with a higher percentage of foreign-born noncitizen residents showed lower service use. Within the established immigrant community, as income levels increased there was little change in utilization. In contrast, in the recent immigrant community, as income levels increased utilization rates increased as well (β=.001, p<.001). Conclusions The findings point out the importance of locale and community determinants in understanding Latinos’ use of public mental health services. PMID:18378840

Food Insecurity and Health Care Expenditures in the United States, 2011-2013.

PubMed

Berkowitz, Seth A; Basu, Sanjay; Meigs, James B; Seligman, Hilary K

2018-06-01

To determine whether food insecurity, limited or uncertain food access owing to cost, is associated with greater health care expenditures. Nationally representative sample of the civilian noninstitutionalized population of the United States (2011 National Health Interview Survey [NHIS] linked to 2012-2013 Medication Expenditure Panel Survey [MEPS]). Longitudinal retrospective cohort. A total of 16,663 individuals underwent assessment of food insecurity, using the 10-item adult 30-day food security module, in the 2011 NHIS. Their total health care expenditures in 2012 and 2013 were recorded in MEPS. Expenditure data were analyzed using zero-inflated negative binomial regression and adjusted for age, gender, race/ethnicity, education, income, insurance, and residence area. Fourteen percent of individuals reported food insecurity, representing 41,616,255 Americans. Mean annualized total expenditures were $4,113 (standard error $115); 9.2 percent of all individuals had no health care expenditures. In multivariable analyses, those with food insecurity had significantly greater estimated mean annualized health care expenditures ($6,072 vs. $4,208, p < .0001), an extra $1,863 in health care expenditure per year, or $77.5 billion in additional health care expenditure annually. Food insecurity was associated with greater subsequent health care expenditures. Future studies should determine whether food insecurity interventions can improve health and reduce health care costs. © Health Research and Educational Trust.

Associations between alcohol outlets and emergency department injury presentations: effects of distance from the central business district.

PubMed

Hobday, Michelle; Meuleners, Lynn; Liang, Wenbin; Gilmore, William; Chikritzhs, Tanya

2016-02-01

To examine the effects of licensed outlets and sales on levels of alcohol-related injuries presenting to emergency departments (EDs) in the Inner, Middle and Outer postcode zones of Perth, Australia. Using panel data (2002-2010), a surrogate measure (based on day of week and time of day of presentation) was used to identify alcohol-related injuries presenting at EDs. Postcodes were grouped according to their distance from the central business district (CBD). Numbers of alcohol outlets and their sales were the primary explanatory variables. Data were analysed using negative binomial regression with random effects. In the Inner and Outer postcode zones, counts of on-site outlets were positively associated with alcohol-related injury (IRR: 1.008; 95%CI 1.003-1.013 and IRR: 1.021; 95%CI 1.013-1.030 respectively). An additional off-site outlet was associated with 6.8% fewer alcohol-related injuries (95%CI 0.887-0.980). In the Middle postcode zone, mean off-site sales were positively associated with injury (IRR: 1.024; 95%CI 1.003-1.044). Associations between alcohol availability variables and injury differed by outlet type and distance from the CBD. These findings provide further evidence to support stronger controls on liquor licensing, and indicate the need for different controls according to the location and type of licence. © 2015 Public Health Association of Australia.

Disclosure of HIV serostatus to male partner and use of modern contraceptives among women receiving HIV care services in Kampala, Uganda.

PubMed

Zalwango, Vivian W; Tweheyo, Raymond; Makumbi, Fredrick

2013-11-01

To investigate whether disclosure of HIV status is associated with use of modern contraceptives (MCs) among women attending HIV care services at an AIDS Information Center (AIC) in an urban setting in Uganda. In a cross-sectional study between March and April 2010, HIV-positive married women aged 15-49years who had received their HIV-positive serostatus results at least 4weeks previously were interviewed at the AIC, Kampala, Uganda. Female use of MCs was compared by HIV disclosure to male marital partners. Log-binomial regression models were used to obtain crude and adjusted prevalence risk ratios (PRRs) and corresponding 95% confidence intervals (CIs). Nearly three-quarters (72.6%) of the women had disclosed their HIV-positive status to their partner. Overall, use of MCs was reported by 41.0% of the participants. Use of only 1 MC method was similar between those disclosing (81.1%) and those not disclosing (84.3%), but use of dual methods tended to be higher among disclosers (14.4%) than among non-disclosers (10.8%). In adjusted analyses, MC use was 41.0% lower among disclosers than among non-disclosers (adjusted PRR, 0.59; 95% CI, 0.46-0.77). HIV serostatus disclosure was associated with lower use of MCs among HIV-positive women in Kampala, Uganda. © 2013.

Daylight savings time and myocardial infarction

PubMed Central

Sandhu, Amneet; Seth, Milan; Gurm, Hitinder S

2014-01-01

Background Prior research has shown a transient increase in the incidence of acute myocardial infarction (AMI) after daylight savings time (DST) in the spring as well as a decrease in AMI after returning to standard time in the fall. These findings have not been verified in a broader population and if extant, may have significant public health and policy implications. Methods We assessed changes in admissions for AMI undergoing percutaneous coronary intervention (PCI) in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) database for the weeks following the four spring and three fall DST changes between March 2010 and September 2013. A negative binomial regression model was used to adjust for trend and seasonal variation. Results There was no difference in the total weekly number of PCIs performed for AMI for either the fall or spring time changes in the time period analysed. After adjustment for trend and seasonal effects, the Monday following spring time changes was associated with a 24% increase in daily AMI counts (p=0.011), and the Tuesday following fall changes was conversely associated with a 21% reduction (p=0.044). No other weekdays in the weeks following DST changes demonstrated significant associations. Conclusions In the week following the seasonal time change, DST impacts the timing of presentations for AMI but does not influence the overall incidence of this disease. PMID:25332784

Relationship Between Nutritional Knowledge and the Amount of Sugar-Sweetened Beverages Consumed in Los Angeles County.

PubMed

Gase, Lauren N; Robles, Brenda; Barragan, Noel C; Kuo, Tony

2014-08-01

Although consumption of sugar-sweetened beverages (SSBs) is associated with many negative health outcomes, including obesity, diabetes, and cardiovascular disease, the relationship between consumer nutritional knowledge and the amount consumed is poorly understood. The objective of this study was to examine the relationship between knowledge of daily calorie recommendations and the amount of SSBs consumed in a large, economically and racially diverse sample of adults recruited at selected Metro subway and bus shelters in Los Angeles County. In June 2012, the Los Angeles County Department of Public Health conducted street intercept surveys to assess food attitudes and consumption behaviors and public opinions related to a recent 8-week health marketing campaign targeting SSB consumption. Descriptive and comparative analyses were conducted, including a negative binomial regression model, to examine the relationship between knowledge of the daily calorie recommendations and the amount of SSBs consumed. Among survey respondents (n = 1,041), less than one third correctly identified the daily calorie recommendations for a typical adult. After controlling for sociodemographics and weight status, respondents who correctly identified recommended calorie needs reported, on average, drinking nine fewer SSBs per month than respondents who did not. Results suggest that efforts to reduce SSB consumption might benefit from the inclusion of educational interventions that empower consumers to make healthy choices. © 2014 Society for Public Health Education.

Playgroup Participation and Social Support Outcomes for Mothers of Young Children: A Longitudinal Cohort Study

PubMed Central

Hancock, Kirsten J.; Cunningham, Nadia K.; Lawrence, David; Zarb, David; Zubrick, Stephen R.

2015-01-01

Objective This study aimed to examine friendship networks and social support outcomes for mothers according to patterns of playgroup participation. Methods Data from the Longitudinal Study of Australian Children were used to examine the extent to which patterns of playgroup participation across the ages of 3–19 months (Wave 1) and 2–3 years (Wave 2) were associated with social support outcomes for mothers at Wave 3 (4–5 years) and four years later at Wave 5 (8–9 years). Analyses were adjusted for initial friendship attachments at Wave 1 and other socio-demographic characteristics. Results Log-binomial regression models estimating relative risks showed that mothers who never participated in a playgroup, or who participated at either Wave 1 or Wave 2 only, were 1.7 and 1.8 times as likely to report having no support from friends when the child was 4–5 years, and 2.0 times as likely to have no support at age 8–9 years, compared with mothers who persistently participated in playgroup at both Wave 1 and Wave 2. Conclusion These results provide evidence that persistent playgroup participation may acts as a protective factor against poor social support outcomes. Socially isolated parents may find playgroups a useful resource to build their social support networks. PMID:26181426

Driving kids to smoke? Children's reported exposure to smoke in cars and early smoking initiation.

PubMed

Glover, Marewa; Scragg, Robert; Min, Sandar; Kira, Anette; Nosa, Vili; McCool, Judith; Bullen, Chris

2011-11-01

The health risks associated with second hand smoke (SHS) are well-known. However, little is known about exposure to SHS in cars and risk of smoking uptake. This paper investigates the association between pre-adolescents reported exposure to smoking in cars and prevalence of early stage smoking activity. Data from Keeping Kids Smokefree baseline surveys of students were used to investigate smoking status and reported exposure to smoking in cars. Log binomial regression analyses were used to investigate if reported exposure to SHS in cars was associated with smoking prevalence. 83% of 5676 students invited took part. After controlling for all variables reported exposure to smoking in cars and homes were significantly associated with increased risk of initiated smoking (RR 1.87, 95% CI 1.43-2.44, and RR 1.5, 95% CI 1.13-1.97, respectively). Exposure to smoking in cars was substantially and significantly associated with risk of current smoking (RR 3.21, 95% CI 1.45-7.08). Early smoking uptake is associated with students' reported exposure to smoking in cars which confirms the importance of protecting children from SHS. Smoking in cars is under parental control and therefore modifiable. Moreover, children's reports of SHlS exposure offer a simple way of identifying families who can be targeted for tobacco control interventions. Copyright © 2011 Elsevier Ltd. All rights reserved.

Timeliness and completeness of vaccination and risk factors for low and late vaccine uptake in young children living in rural southern Tanzania.

PubMed

Le Polain de Waroux, Olivier; Schellenberg, Joanna R Armstrong; Manzi, Fatuma; Mrisho, Mwifadhi; Shirima, Kizito; Mshinda, Hassan; Alonso, Pedro; Tanner, Marcel; Schellenberg, David M

2013-06-01

We studied coverage and timeliness of vaccination and risk factors for low and delayed vaccine uptake in children aged <2 years in rural Tanzania. We used data from a cluster survey conducted in 2004, which included 1403 children. Risk factors were analysed by log-binomial regression adjusted for the clustering. The analysis was restricted to BCG, first and third dose of Diphtheria-Tetanus-Pertussis vaccines (DTP-1 and DTP-3) and first dose of measles-containing vaccine (MCV-1). Coverage for BCG, DTP-1, DTP-3 and MCV-1 was 94%, 96%, 90% and 86%, respectively. Delayed vaccination (>1 month after the recommended age) occurred in 398/1205 (33%) children for BCG, 404/1189 (34%) for DTP-1, 683/990 (69%) for DTP-3 and 296/643 (46%) for MCV-1. Coverage was lower for all vaccines except DTP-1 in children living ≥5 km from a healthcare facility. Delayed uptake was associated with poverty. Low and delayed MCV-1 vaccination was associated with low maternal education. Delayed BCG vaccination was associated with ethnicity and rainy season. Despite reasonably high vaccination coverage, we observed substantial vaccination delays, particularly for DTP-3 and MCV-1. We found specific factors associated with low and/or delayed vaccine uptake. These findings can help to improve strategies to reach children who remain inadequately protected.

How timely closure can reduce outbreak duration: gastroenteritis in care homes in North West England, 2012-2016.

PubMed

Inns, Thomas; Keenan, Alex; Huyton, Rita; Harris, John; Iturriza-Gomara, Miren; O'Brien, Sarah J; Vivancos, Roberto

2018-04-12

Data on outbreaks of infectious gastroenteritis in care homes have been collected using an internet-based surveillance system in North West England since 2012. We analysed the burden and characteristics of care home outbreaks to inform future public health decision-making. We described characteristics of care homes and summary measures of the outbreaks such as attack rate, duration and pathogen identified. The primary analysis outcome was duration of closure following an outbreak. We used negative binomial regression to estimate Incidence Rate Ratios (IRR) and confidence intervals (CI) for each explanatory variable. We recorded 795 outbreaks from 379 care homes (37.1 outbreaks per 100 care homes per year). In total 11,568 cases, 75 hospitalisations and 29 deaths were reported. Closure within three days of the first case (IRR = 0.442, 95%CI 0.366-0.534) was significantly associated with reduced duration of closure. The total size of the home (IRR = 1.426, 95%CI = 1.275-1.595) and the total attack rate (IRR = 1.434, 95%CI = 1.257-1.595) were significantly associated with increased duration of closure. Care homes that closed promptly had outbreaks of shorter duration. Care home providers, and those advising them on infection control, should aim to close homes quickly to prevent lengthy disruption to services.

Human Norovirus prevalence in Africa: a review of studies from 1990 to 2013.

PubMed

Kabue, Jean Pierre; Meader, Emma; Hunter, Paul R; Potgieter, Natasha

2016-01-01

To assess the contribution of Human Norovirus to diarrhoeal diseases in Africa. We conducted a systematic review of the PubMed and EMBASE databases for published articles of Human Norovirus in Africa between 1990 and 2013. Data were extracted from selected studies and analysed. A total of 208 eligible studies were identified, of which 55 (from 19 countries) met the inclusion criteria. Many cases were of sporadic gastroenteritis (70.9%) in children (82%), 65.4% of which were seen in an outpatient setting. Over half (59.4%) of the affected children were under 5 years of age. The pooled prevalence rate of Human NoV was 11% (95% CI 8-14%), and the meta-analysis indicated significant heterogeneity between the studies. However, the conditional negative binomial regression could not clearly find the factors affecting the Human NoV prevalence rates reported. A close relationship was found between Human Norovirus strains from environmental and clinical samples. Unreported sporadic gastroenteritis cases of Human Norovirus are common in Africa. Most are community-associated infections. Possible environmental transmission routes have been documented. Combined environmental and clinical studies are required for targeted actions to control transmission of Human Norovirus in Africa. Systematic surveillance of Human Norovirus is needed to measure the burden of Norovirus-induced gastroenteritis in Africa and support any requirements for vaccine development. © 2015 John Wiley & Sons Ltd.

Community organization moderates the effect of alcohol outlet density on violence.

PubMed

Pridemore, William Alex; Grubesic, Tony H

2012-12-01

There is growing evidence from multiple disciplines that alcohol outlet density is associated with community levels of assault. Based on the theoretical and empirical literatures on social organization and crime, we tested the hypothesis that the association between alcohol outlet density and neighbourhood violence rates is moderated by social organization. Using geocoded police data on assaults, geocoded data on the location of alcohol outlets, and controlling for several structural factors thought to be associated with violence rates, we tested this hypothesis employing negative binomial regression with our sample of 298 block groups in Cincinnati. Our results revealed direct effects of alcohol outlet density and social organization on assault density, and these effects held for different outlet types (i.e., off-premise, bars, restaurants) and levels of harm (i.e., simple and aggravated assaults). More importantly, we found that the strength of the outlet-assault association was significantly weaker in more socially organized communities. Subsequent analyses by level of organization revealed no effects of alcohol outlet density on aggravated assaults in organized block groups, but significant effects in disorganized block groups. We found no association between social (dis)organization and outlet density. These results clarify the community-level relationship between alcohol outlets and violence and have important implications for municipal-level alcohol policies. © London School of Economics and Political Science 2012.

Does distrust in providers affect health-care utilization in China?

PubMed Central

Duckett, Jane; Hunt, Kate; Munro, Neil; Sutton, Matt

2016-01-01

How trust affects health-care utilization is not well-understood, especially in low- and middle-income countries. This article focuses on China, a middle-income country where low trust in health-care settings has become a prominent issue, but actual levels of distrust and their implications for utilization are unknown. We conducted a nationally representative survey of the Chinese population (November 2012 to January 2013), which resulted in a sample of 3680 adult men and women. Respondents rated their trust in different types of health-care providers. Using multivariate logistic and negative binomial regression models, we estimated the association between distrust in clinics and respondents’ hospital visits in the last year; whether they had sought hospital treatment first for two common symptoms (headache, cold) in the last 2 months; and whether they said they would go first to a hospital if they had a minor or major illness. We analysed these associations before and after adjusting for performance evaluations of clinics and hospitals, controlling for sex, age, education, income, insurance status, household registration and self-assessed health. We found that distrust in hospitals is low, but distrust in clinics is high and strongly associated with increased hospital utilization, especially for minor symptoms and illnesses. Further research is needed to understand the reasons for distrust in clinics because its effects are not fully accounted for by poor evaluations of their competence. PMID:27117483

The gambler's fallacy in penalty shootouts.

PubMed

Braun, Sebastian; Schmidt, Ulrich

2015-07-20

A well-known bias in subjective perceptions of chance is the gambler's fallacy: people typically believe that a streak generated by a series of independent random draws, such as a coin toss, becomes increasingly more likely to break when the streak becomes longer. In a fascinating study, Misirlisoy and Haggard analysed sequential behavior of kickers and goalkeepers in penalty shootouts. They report that goalkeepers are prone to the gambler's fallacy: after a series of three kicks in the same direction, goalkeepers are more likely to dive in the opposite direction at the next kick. Here we argue, first, that a binomial test is more appropriate for testing gambler's fallacy than the tests employed by Misirlisoy and Haggard, and second, that penalty shootouts may not be well-suited to analyze the gambler's fallacy. Using a binomial test, we neither find statistically significant evidence for gambler's fallacy in Misirlisoy and Haggard's original data, nor in extended data, nor in data from an idealised laboratory experiment that we ran to address the second point. In line with Misirlisoy and Haggard's original result, we do, however, find evidence for a systematic pattern of goalkeeper's behavior that kickers could exploit. Copyright © 2015 Elsevier Ltd. All rights reserved.

Inference for binomial probability based on dependent Bernoulli random variables with applications to meta-analysis and group level studies.

PubMed

Bakbergenuly, Ilyas; Kulinskaya, Elena; Morgenthaler, Stephan

2016-07-01

We study bias arising as a result of nonlinear transformations of random variables in random or mixed effects models and its effect on inference in group-level studies or in meta-analysis. The findings are illustrated on the example of overdispersed binomial distributions, where we demonstrate considerable biases arising from standard log-odds and arcsine transformations of the estimated probability p̂, both for single-group studies and in combining results from several groups or studies in meta-analysis. Our simulations confirm that these biases are linear in ρ, for small values of ρ, the intracluster correlation coefficient. These biases do not depend on the sample sizes or the number of studies K in a meta-analysis and result in abysmal coverage of the combined effect for large K. We also propose bias-correction for the arcsine transformation. Our simulations demonstrate that this bias-correction works well for small values of the intraclass correlation. The methods are applied to two examples of meta-analyses of prevalence. © 2016 The Authors. Biometrical Journal Published by Wiley-VCH Verlag GmbH & Co. KGaA.

Effectiveness on Early Childhood Caries of an Oral Health Promotion Program for Medical Providers

PubMed Central

Widmer-Racich, Katina; Sevick, Carter; Starzyk, Erin J.; Mauritson, Katya; Hambidge, Simon J.

2017-01-01

Objectives. To assess an oral health promotion (OHP) intervention for medical providers’ impact on early childhood caries (ECC). Methods. We implemented a quasiexperimental OHP intervention in 8 federally qualified health centers that trained medical providers on ECC risk assessment, oral examination and instruction, dental referral, and fluoride varnish applications (FVAs). We measured OHP delivery by FVA count at medical visits. We measured the intervention’s impact on ECC in 3 unique cohorts of children aged 3 to 4 years in 2009 (preintervention; n = 202), 2011 (midintervention; n = 420), and 2015 (≥ 4 FVAs; n = 153). We compared numbers of decayed, missing, and filled tooth surfaces using adjusted zero-inflated negative binomial models. Results. Across 3 unique cohorts, the FVA mean (range) count was 0.0 (0), 1.1 (0–7), and 4.5 (4–7) in 2009, 2011, and 2015, respectively. In adjusted zero-inflated negative binomial models analyses, children in the 2015 cohort had significantly fewer decayed, missing, and filled tooth surfaces than did children in previous cohorts. Conclusions. An OHP intervention targeting medical providers reduced ECC when children received 4 or more FVAs at a medical visit by age 3 years. PMID:28661802

Co-Infestation and Spatial Distribution of Bactrocera carambolae and Anastrepha spp. (Diptera: Tephritidae) in Common Guava in the Eastern Amazon

PubMed Central

Deus, E. G.; Godoy, W. A. C.; Sousa, M. S. M.; Lopes, G. N.; Jesus-Barros, C. R.; Silva, J. G.; Adaime, R.

2016-01-01

Field infestation and spatial distribution of introduced Bactrocera carambolae Drew and Hancock and native species of Anastrepha in common guavas [Psidium guajava (L.)] were investigated in the eastern Amazon. Fruit sampling was carried out in the municipalities of Calçoene and Oiapoque in the state of Amapá, Brazil. The frequency distribution of larvae in fruit was fitted to the negative binomial distribution. Anastrepha striata was more abundant in both sampled areas in comparison to Anastrepha fraterculus (Wiedemann) and B. carambolae. The frequency distribution analysis of adults revealed an aggregated pattern for B. carambolae as well as for A. fraterculus and Anastrepha striata Schiner, described by the negative binomial distribution. Although the populations of Anastrepha spp. may have suffered some impact due to the presence of B. carambolae, the results are still not robust enough to indicate effective reduction in the abundance of Anastrepha spp. caused by B. carambolae in a general sense. The high degree of aggregation observed for both species suggests interspecific co-occurrence with the simultaneous presence of both species in the analysed fruit. Moreover, a significant fraction of uninfested guavas also indicated absence of competitive displacement. PMID:27638949

Chiropractors' characteristics associated with physician referrals: results from a survey of Canadian doctors of chiropractic.

PubMed

Blanchette, Marc-André; Rivard, Michèle; Dionne, Clermont E; Cassidy, J David

2015-01-01

The purpose of this study was to identify characteristics of Canadian doctors of chiropractic (DCs) associated with the number of patients referred by medical doctors (MDs). Secondary data analyses were performed on the 2011 cross-sectional survey of the Canadian Chiropractic Resources Databank. The Canadian Chiropractic Resources Databank survey included 81 questions about the practice of DCs. Of the 6533 mailed questionnaires, 2529 (38.7%) were returned and 489 did not meet our inclusion criteria. Our analyzed sample included 2040 respondents. Bivariate analyses were conducted between predetermined potential predictors and the annual number of patients referred by MDs, and negative binomial multivariate regression was performed. On average, DCs reported receiving 15.6 (standard deviation, 31.3) patient referrals from MDs per year and nearly one-third did not receive any. The type of clinic (multidisciplinary with MD), the province of practice (Atlantic provinces), the number of treatments provided per week, the number of practicing hours, rehabilitation and sports injuries as the main sector of activity, prescription of exercises, use of heat packs and ultrasound, and the percentage of patients referred to other health care providers were associated with a higher number of MD referrals to DCs. The percentage of patients with somatovisceral conditions, using a particular chiropractic technique (hole in one and Thompson), taking his/her own radiographs, being the client of a chiropractic management service, and considering maintenance/wellness care as a main sector of activity were associated with fewer MD referrals. Canadian DCs who interacted with other health care workers and who focus their practice on musculoskeletal conditions reported more referrals from MDs. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Exploring lifetime occupational exposure and SLE flare: a patient-focussed pilot study

PubMed Central

Squance, Marline L; Guest, Maya; Reeves, Glenn; Attia, John; Bridgman, Howard

2014-01-01

Introduction Environmental effectors, such as ultraviolet radiation exposure, infection and stress, have been established as having a role in exacerbating lupus symptoms. However, unpredictable patterns of flare events still remain a mystery. Occupational effectors have also been suggested as having a contributing role; however, they are not widely researched. In this paper we report a pilot study designed to generate focus areas for future research regarding occupational exposures and systemic lupus erythematosus (SLE). Methods The study explored potential links between exposures and the occurrence of patient-reported flare events in 80 Australian women with SLE (American College of Rheumatology (ACR) criteria classified). Specifically, the study assessed the hypothesis that occupational exposure is associated with significant changes in the likelihood of lupus flares. Lifetime employment history was analysed with the Finnish Job Exposure Matrix (FINJEM), 40 different semiquantified exposure class estimates for a wide number of occupations based on probability of exposure (p≥5%=exposed) were analysed with the construction of negative binomial regression models to test relationships between occupational agents and flare days. A backward stepwise elimination was used to generate a parsimonious model. Results Significant associations were noted for exposure classes of manual handling burden, (p=0.02, incidence rate ratio (IRR) 1.01), Iron (p=0.00, IRR 1.37), wood dust (p=0.00, IRR 3.34) and asbestos (p=0.03, IRR 2.48). Conclusion Exposure assessment results indicated that occupations, such as nursing, with a high manual handling burden, posed increased risk to patients with SLE, however, the greatest risk was associated with wood dust and iron exposure with teachers and specialist labourers. PMID:25379190

Outpatient Utilization by Infants Auto-assigned to Medicaid Managed Care Plans

PubMed Central

Cohn, Lisa M.; Clark, Sarah J.

2013-01-01

To test the hypothesis that infants auto-assigned to a Medicaid managed care plan would have lower primary care and higher emergency department (ED) utilization compared to infants with a chosen plan. Retrospective cohort study. Medicaid administrative data were used to identify all children 0–3 months of age at enrollment in Michigan Medicaid managed care in 2005–2008 with 18-months of subsequent enrollment. Medicaid encounter and state immunization registry data were then acquired. Auto-assigned infants were compared versus chosen plan infants on: (1) well-child visits (WCVs); (2) immunizations; (3) acute office visits; and (4) ED visits. Chi squared and rank-sum tests and logistic and negative binomial regression were used in bivariate and multivariable analyses for dichotomous and count data, respectively. 18 % of infants were auto-assigned. Auto-assigned infants were less likely to meet goal number of WCVs in 18-months of managed care enrollment (32 vs. 53 %, p < 0.001) and to be up-to-date on immunizations at 12 months of age (75 vs. 85 %, p < 0.001). Auto-assigned infants had fewer acute office visits (median: 4 vs. 5, p < 0.001) but were only slightly more likely to have 2 or more ED visits (51 vs. 46 %, p < 0.001) in 18-months of enrollment. All results were significant in multivariable analyses. Auto-assigned infants were less likely to use preventive and acute primary care but only slightly more likely to use emergency care. Future work is needed to understand mechanisms of differences in utilization, but auto-assigned children may represent a target group for efforts to promote pediatric preventive care in Medicaid. PMID:23775252

Outpatient utilization by infants auto-assigned to Medicaid managed care plans.

PubMed

Zickafoose, Joseph S; Cohn, Lisa M; Clark, Sarah J

2014-04-01

To test the hypothesis that infants auto-assigned to a Medicaid managed care plan would have lower primary care and higher emergency department (ED) utilization compared to infants with a chosen plan. Retrospective cohort study. Medicaid administrative data were used to identify all children 0-3 months of age at enrollment in Michigan Medicaid managed care in 2005-2008 with 18-months of subsequent enrollment. Medicaid encounter and state immunization registry data were then acquired. Auto-assigned infants were compared versus chosen plan infants on: (1) well-child visits (WCVs); (2) immunizations; (3) acute office visits; and (4) ED visits. Chi squared and rank-sum tests and logistic and negative binomial regression were used in bivariate and multivariable analyses for dichotomous and count data, respectively. 18% of infants were auto-assigned. Auto-assigned infants were less likely to meet goal number of WCVs in 18-months of managed care enrollment (32 vs. 53%, p < 0.001) and to be up-to-date on immunizations at 12 months of age (75 vs. 85%, p < 0.001). Auto-assigned infants had fewer acute office visits (median: 4 vs. 5, p < 0.001) but were only slightly more likely to have 2 or more ED visits (51 vs. 46%, p < 0.001) in 18-months of enrollment. All results were significant in multivariable analyses. Auto-assigned infants were less likely to use preventive and acute primary care but only slightly more likely to use emergency care. Future work is needed to understand mechanisms of differences in utilization, but auto-assigned children may represent a target group for efforts to promote pediatric preventive care in Medicaid.

Working in tandem: The contribution of remedial programs and roadside licence suspensions to drinking and driving deterrence in Ontario.

PubMed

Ma, Tracey; Byrne, Patrick A; Haya, Maryam; Elzohairy, Yoassry

2015-12-01

In 1998, Ontario implemented a remedial program called "Back On Track" (BOT) for individuals convicted of alcohol-impaired driving. Drivers convicted before October 2000 were exposed to a single-component program ("Edu BOT"); those convicted after participated in a multi-component program ("Full BOT"). We evaluated the impact of BOT, and the preceding 90-day roadside licence suspension, on drinking and driving recidivism, an outcome yet to be examined, using population-wide driver records. A Chi Square Test was used to compare the three-year cumulative incidence of recidivism between three historically-defined cohorts: No BOT, Edu BOT, and Full BOT. Stratified analyses by completion status and by age were also conducted. Analyses of the roadside suspension were conducted using an interrupted time series approach based on segmented Poisson/negative binomial regression. The roadside suspension was associated with a 65.2% reduction in drinking driving recidivism. In combination with indefinite suspensions for non-completion, the BOT program was also associated with a 21% decrease in drinking and driving recidivism in the three years following a CCC driving prohibition, from 8.5% to 6.7%. This reduction cannot be explained by pre-existing trends in recidivism. Conversion of the BOT program from the single-component version to the multi-component program further reduced the three-year cumulative incidence of recidivism to 5.5% (a total reduction of 35% from pre-BOT). Results provide strong converging evidence that remedial alcohol education/treatment programs in combination with other sanctions can produce substantial increases in road safety. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Influences on preschool children's oral health-related quality of life as reported by English and Spanish-speaking parents and caregivers.

PubMed

Born, Catherine D; Divaris, Kimon; Zeldin, Leslie P; Rozier, R Gary

2016-09-01

This study examined young, preschool children's oral health-related quality of life (OHRQoL) among a community-based cohort of English and Spanish-speaking parent-child dyads in North Carolina, and sought to quantify the association of parent/caregiver characteristics, including spoken language, with OHRQoL impacts. Data from structured interviews with 1,111 parents of children aged 6-23 months enrolled in the Zero-Out Early Childhood Caries study in 2010-2012 were used. OHRQoL was measured using the overall score (range: 0-52) of the Early Childhood Oral Health Impact Scale (ECOHIS). We examined associations with parents' sociodemographic characteristics, spoken language, self-reported oral and general health, oral health knowledge, children's dental attendance, and dental care needs. Analyses included descriptive, bivariate, and multivariate methods based upon zero-inflated negative binomial regression. To determine differences between English and Spanish speakers, language-stratified model estimates were contrasted using homogeneity χ 2 tests. The mean overall ECOHIS score was 3.9 [95% confidence interval (CI) = 3.6-4.2]; 4.7 among English-speakers and 1.5 among Spanish speakers. In multivariate analyses, caregivers' education showed a positive association with OHRQoL impacts among Spanish speakers [prevalence ratio (PR) = 1.12 (95% CI = 1.03-1.22), for every added year of schooling], whereas caregivers' fair/poor oral health showed a positive association among English speakers (PR = 1.20; 95% CI = 1.02-1.41). The overall severity of ECOHIS impacts was low among this population-based sample of young, preschool children, and substantially lower among Spanish versus English speakers. Further studies are warranted to identify sources of these differences in - actual or reported - OHRQoL impacts. © 2016 American Association of Public Health Dentistry.

Impact of MenAfriVac in nine countries of the African meningitis belt, 2010-15: an analysis of surveillance data.

PubMed

Trotter, Caroline L; Lingani, Clément; Fernandez, Katya; Cooper, Laura V; Bita, André; Tevi-Benissan, Carol; Ronveaux, Olivier; Préziosi, Marie-Pierre; Stuart, James M

2017-08-01

In preparation for the introduction of MenAfriVac, a meningococcal group A conjugate vaccine developed for the African meningitis belt, an enhanced meningitis surveillance network was established. We analysed surveillance data on suspected and confirmed cases of meningitis to quantify vaccine impact. We compiled and analysed surveillance data for nine countries in the meningitis belt (Benin, Burkina Faso, Chad, Côte d'Ivoire, Ghana, Mali, Niger, Nigeria, and Togo) collected and curated by the WHO Inter-country Support Team between 2005 and 2015. The incidence rate ratios (IRRs) of suspected and confirmed cases in vaccinated and unvaccinated populations were estimated with negative binomial regression models. The relative risk of districts reaching the epidemic threshold of ten per 100 000 per week was estimated according to district vaccination status. The incidence of suspected meningitis cases declined by 57% (95% CI 55-59) in vaccinated compared with unvaccinated populations, with some heterogeneity observed by country. We observed a similar 59% decline in the risk of a district reaching the epidemic threshold. In fully vaccinated populations, the incidence of confirmed group A disease was reduced by more than 99%. The IRR for non-A serogroups was higher after completion of MenAfriVac campaigns (IRR 2·76, 95% CI 1·21-6·30). MenAfriVac introduction has led to substantial reductions in the incidence of suspected meningitis and epidemic risk, and a substantial effect on confirmed group A meningococcal meningitis. It is important to continue strengthening surveillance to monitor vaccine performance and remain vigilant against threats from other meningococcal serogroups and other pathogens. World Health Organization. Copyright © 2017 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Epidemiology of enteric disease in C-EnterNet’s pilot site – Waterloo region, Ontario, 1990 to 2004

PubMed Central

Keegan, Victoria A; Majowicz, Shannon E; Pearl, David L; Marshall, Barbara J; Sittler, Nancy; Knowles, Lewinda; Wilson, Jeffery B

2009-01-01

OBJECTIVE: The objective of the present study was to describe the epidemiology of reportable enteric illness in Ontario’s Waterloo region, including comparing calculated incidence rates with published rates, and adjusting for under-reporting to determine the number of community cases, where published data were available. METHODS: Descriptive analyses were performed on reportable disease data for 13 enteric diseases collected in the Waterloo region from 1990 to 2004. Poisson and negative binomial regression analyses were used to investigate differences in incidence rates among age, sex, the 15 years of data and seasons. Disease-specific incidence rates were calculated and compared with the literature, where possible. Under-reporting ratios from the literature were applied to estimate the number of cases of campylobacteriosis, nontyphoidal salmonellosis and verotoxigenic Escherichia coli infection at the community level. RESULTS: Over the study period, the average annual age- and sex-adjusted incidence rates per 100,000 population were highest for campylobacteriosis (49.69 cases), followed by giardiasis (31.87 cases) and nontyphoidal salmonellosis (25.97 cases). The incidence of most enteric illnesses peaked in the summer. The highest incidence occurred in young children, followed by adults in their 20s. Diarrhea (85.4%) was the most frequently reported symptom, food (57.4%) was the most commonly reported probable source, and home (41.7%) and travel (37.0%) were the two most frequently reported risk settings. CONCLUSIONS: Enteric illness was a significant health burden in the Waterloo region from 1990 to 2004. Because reportable disease data are subject to under-reporting, it is likely that the true burden is greater than estimated in the present study. PMID:20808465

A self-management approach using self-initiated action plans for symptoms with ongoing nurse support in patients with Chronic Obstructive Pulmonary Disease (COPD) and comorbidities: the COPE-III study protocol.

PubMed

Lenferink, Anke; Frith, Peter; van der Valk, Paul; Buckman, Julie; Sladek, Ruth; Cafarella, Paul; van der Palen, Job; Effing, Tanja

2013-09-01

Chronic Obstructive Pulmonary Disease (COPD) frequently coexists with other diseases. Whereas COPD action plans are currently part of usual care, they are less suitable and potentially unsafe for use in the presence of comorbidities. This study evaluates whether an innovative treatment approach directed towards COPD and frequently existing comorbidities can reduce COPD exacerbation days. We hypothesise that this approach, which combines self-initiated action plans and nurse support, will accelerate proper treatment actions and lead to better control of deteriorating symptoms. In this multicenter randomised controlled trial we aim to include 300 patients with COPD (GOLD II-IV), and with at least one comorbidity (cardiovascular disease, diabetes, anxiety and/or depression). Patients will be recruited from hospitals in the Netherlands (n = 150) and Australia (n = 150) and will be assigned to an intervention or control group. All patients will learn to complete daily symptom diaries for 12-months. Intervention group patients will participate in self-management training sessions to learn the use of individualised action plans for COPD and comorbidities, linked to the diary. The primary outcome is the number of COPD exacerbation days. Secondary outcomes include hospitalisations, quality of life, self-efficacy, adherence, patient's satisfaction and confidence, health care use and cost data. Intention-to-treat analyses (random effect negative binomial regression and random effect mixed models) and cost-effectiveness analyses will be performed. Prudence should be employed before extrapolating the use of COPD specific action plans in patients with comorbidities. This study evaluates the efficacy of tailored action plans for both COPD and common comorbidities. Copyright © 2013 Elsevier Inc. All rights reserved.

Temporal analyses of coral snakebite severity published in the American Association of Poison Control Centers' Annual Reports from 1983 through 2007.

PubMed

Walter, Frank G; Stolz, Uwe; Shirazi, Farshad; McNally, Jude

2010-01-01

The only U.S. Food and Drug Administration-approved coral snake antivenom was officially discontinued in 2007, causing ever-diminishing supplies. This study describes the severity of U.S. coral snakebites during the last 25 years to determine trends in annual rates of these bites' medical outcomes. This study retrospectively analyzed all human coral snakebites voluntarily reported by the public and/or health care professionals to poison centers that were subsequently published in the Annual Reports of the American Association of Poison Control Centers (AAPCC) from 1983 through 2007. Annual rates of medical outcomes from coral snakebites were calculated by dividing the annual number of people bitten by coral snakes who developed fatal, major, moderate, minor, or no effect outcomes by the total annual number of people bitten by coral snakes. Negative binomial regression was used to examine trends in annual rates. From 1983 through 2007, the incidence rate of coral snakebites producing no effects significantly decreased by 4.7% per year [incidence rate ratio (IRR) = 0.953; 95% confidence interval (CI) = 0.920-0.987]. From 1985 through 2007, the incidence rates of minor and major outcomes did not significantly change; however, moderate outcomes significantly increased by 3.4% per year (IRR = 1.034; 95% CI = 1.004-1.064). No fatalities were reported from 1983 through 2007. Annual rates of coral snakebites producing no effects significantly decreased and those producing moderate outcomes significantly increased in our analyses of data from the last 25 years of published AAPCC Annual Reports. This study has important limitations that must be considered when interpreting these conclusions.

Prospective associations of exercise and depressive symptoms in older adults: the role of apolipoprotein E4.

PubMed

Ku, Po-Wen; Steptoe, Andrew; Chen, Li-Jung

2017-07-01

Exercise is associated with reduced risk of depressive symptoms at older ages, while recent work suggests that the apolipoprotein E type 4 allele (APOE-e4) may increase risk. There are no studies of whether APOE-e4 moderates the relationship between exercise and later life depressive symptoms. This study aimed to explore whether the prospective associations between exercise and subsequent depressive symptoms were distinct between APOE-e4 carriers and non-carriers using nationwide data. Data from 639 participants (mean age = 66.14, SD = 7.26) in 2000 with 6 years of follow-up were studied. Depressive symptoms were assessed using the Center for Epidemiologic Studies-Depression Scale. Exercise and the APOE genotype were also assessed at baseline. Negative binomial regression models were conducted to examine the combined effects of exercise and APOE-e4 status on subsequent depressive symptoms when controlling for baseline depressive symptoms and other covariates. Sensitivity analyses to test for confounding, reverse causality, and attrition were conducted. Among APOE-e4 carriers, there was no significant difference in depressive symptoms between high active and low active groups. In contrast, high active APOE-e4 non-carriers had fewer depressive symptoms than low active APOE-e4 non-carriers. The beneficial effect of exercise on depressive symptoms is restricted to APOE-e4 non-carriers. Sensitivity analyses provided further support for the robustness of these findings. This is the first prospective study investigating whether APOE-e4 moderates the association between exercise and depressive symptoms. It proposes that genetic variation in APOE may influence the effect of exercise on depressive symptoms.

Musculoskeletal injuries in professional modern dancers: a prospective cohort study of 15 years.

PubMed

Bronner, Shaw; McBride, Caroline; Gill, Allison

2018-08-01

We analysed work-related musculoskeletal injuries (WMSI) in two modern dance companies to determine whether injury rates decreased and patterns altered compared to previous 3-yr and 6-yr audits (0.48 and 0.25/1000-hrs exposure respectively). In this prospectively designed 15-yr cohort study, data were collected in 30-dancer Company-1 and 12-dancer Company-2. In-house physical therapists tracked WMSI and time-loss-injuries for 159 dancers (42 dancers/yr). 15-yrs were grouped into five 3-yr blocks for comparison with prior audits. Negative binomial logistic regression analyses were conducted with exposure-hrs converted to the natural log and used as the offset variable. Block and company were categorical predictors for dependent variables: WMSI, time-loss-injuries, trauma-injuries and overuse-injuries (p < 0.05). 69% of dancers reported WMSI; 45% sustained at least one time-loss-injury. Company-1, with greater annual exposure, was 1.6-times more likely to sustain time-loss-injuries (p = 0.016, CI = 1.095-2.422) and 5.6-times more likely to sustain time-loss overuse-injuries (p = 0.003, CI = 1.812-17.327). Compared to Block-1, WMSI and time-loss-injuries decreased in Blocks-2, 3, and 5 (p ≤ 0.027). The ratio of time-loss overuse to trauma-injuries was reversed, with trauma-injuries accounting for over 80% of injuries by Block 5. Time-loss-injuries averaged 0.16 injuries/1000-hrs, lower than rates in ballet and sports. Decreased injury rates and changed injury patterns demonstrate efficacious injury management and prevention programming.

Neonatal thyroid hormone levels in association with autism spectrum disorder.

PubMed

Lyall, Kristen; Anderson, Meredith; Kharrazi, Martin; Windham, Gayle C

2017-04-01

Thyroid hormones (TH) are critical in early neurodevelopment, but few studies have examined whether neonatal TH levels influence risk of autism spectrum disorder (ASD). This study linked California neonatal screening data with live birth and Department of Developmental Services records to examine newborn TH levels in relation to ASD. Thyroxine (T4) and thyroid-stimulating hormone (TSH) levels were measured in newborn bloodspots as part of routine screening, in 1996 and 2002, respectively. Mean levels of T4 and TSH were compared between ASD cases and non-cases. Four hundred forty-seven thousand, fifty-nine screened, singleton births from 1996 and 446,424 from 2002 were examined, including 4,818 ASD cases. Binomial regression, using categories of T4 and TSH percentiles was used to calculate crude and adjusted risk ratios (RR). Covariates included maternal and child factors, gestational age, and age at blood draw. No significant associations were found with TSH levels and ASD in crude or adjusted analyses. ASD cases had significantly lower mean T4 levels than non-cases, but this association was no longer significant in adjusted analyses (RR in individuals in lowest 5th percentile of T4 levels = 1.13, 95% 0.93-1.37). However, this association appeared stronger in certain subgroup analyses, particularly among neonates with blood draw ≥48 hr from birth (RR = 1.67, 95% CI 1.08, 2.60), when TH levels become more stable. Thus, results from this large, population-based study did not suggest strong associations between neonatal TH and ASD, but certain subgroups of newborns with the lowest T4 levels may have modestly increased ASD risk. Autism Res 2016. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 585-592. © 2016 International Society for Autism Research, Wiley Periodicals, Inc. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

On extinction time of a generalized endemic chain-binomial model.

PubMed

Aydogmus, Ozgur

2016-09-01

We considered a chain-binomial epidemic model not conferring immunity after infection. Mean field dynamics of the model has been analyzed and conditions for the existence of a stable endemic equilibrium are determined. The behavior of the chain-binomial process is probabilistically linked to the mean field equation. As a result of this link, we were able to show that the mean extinction time of the epidemic increases at least exponentially as the population size grows. We also present simulation results for the process to validate our analytical findings. Copyright © 2016 Elsevier Inc. All rights reserved.

Solar San Diego: The Impact of Binomial Rate Structures on Real PV Systems; Preprint

DOE Office of Scientific and Technical Information (OSTI.GOV)

VanGeet, O.; Brown, E.; Blair, T.

2008-05-01

There is confusion in the marketplace regarding the impact of solar photovoltaics (PV) on the user's actual electricity bill under California Net Energy Metering, particularly with binomial tariffs (those that include both demand and energy charges) and time-of-use (TOU) rate structures. The City of San Diego has extensive real-time electrical metering on most of its buildings and PV systems, with interval data for overall consumption and PV electrical production available for multiple years. This paper uses 2007 PV-system data from two city facilities to illustrate the impacts of binomial rate designs. The analysis will determine the energy and demand savingsmore » that the PV systems are achieving relative to the absence of systems. A financial analysis of PV-system performance under various rate structures is presented. The data revealed that actual demand and energy use benefits of binomial tariffs increase in summer months, when solar resources allow for maximized electricity production. In a binomial tariff system, varying on- and semi-peak times can result in approximately $1,100 change in demand charges per month over not having a PV system in place, an approximate 30% cost savings. The PV systems are also shown to have a 30%-50% reduction in facility energy charges in 2007.« less

Applied Prevalence Ratio estimation with different Regression models: An example from a cross-national study on substance use research.

PubMed

Espelt, Albert; Marí-Dell'Olmo, Marc; Penelo, Eva; Bosque-Prous, Marina

2016-06-14

To examine the differences between Prevalence Ratio (PR) and Odds Ratio (OR) in a cross-sectional study and to provide tools to calculate PR using two statistical packages widely used in substance use research (STATA and R). We used cross-sectional data from 41,263 participants of 16 European countries participating in the Survey on Health, Ageing and Retirement in Europe (SHARE). The dependent variable, hazardous drinking, was calculated using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C). The main independent variable was gender. Other variables used were: age, educational level and country of residence. PR of hazardous drinking in men with relation to women was estimated using Mantel-Haenszel method, log-binomial regression models and poisson regression models with robust variance. These estimations were compared to the OR calculated using logistic regression models. Prevalence of hazardous drinkers varied among countries. Generally, men have higher prevalence of hazardous drinking than women [PR=1.43 (1.38-1.47)]. Estimated PR was identical independently of the method and the statistical package used. However, OR overestimated PR, depending on the prevalence of hazardous drinking in the country. In cross-sectional studies, where comparisons between countries with differences in the prevalence of the disease or condition are made, it is advisable to use PR instead of OR.

Quasi-Likelihood Techniques in a Logistic Regression Equation for Identifying Simulium damnosum s.l. Larval Habitats Intra-cluster Covariates in Togo.

PubMed

Jacob, Benjamin G; Novak, Robert J; Toe, Laurent; Sanfo, Moussa S; Afriyie, Abena N; Ibrahim, Mohammed A; Griffith, Daniel A; Unnasch, Thomas R

2012-01-01

The standard methods for regression analyses of clustered riverine larval habitat data of Simulium damnosum s.l. a major black-fly vector of Onchoceriasis, postulate models relating observational ecological-sampled parameter estimators to prolific habitats without accounting for residual intra-cluster error correlation effects. Generally, this correlation comes from two sources: (1) the design of the random effects and their assumed covariance from the multiple levels within the regression model; and, (2) the correlation structure of the residuals. Unfortunately, inconspicuous errors in residual intra-cluster correlation estimates can overstate precision in forecasted S.damnosum s.l. riverine larval habitat explanatory attributes regardless how they are treated (e.g., independent, autoregressive, Toeplitz, etc). In this research, the geographical locations for multiple riverine-based S. damnosum s.l. larval ecosystem habitats sampled from 2 pre-established epidemiological sites in Togo were identified and recorded from July 2009 to June 2010. Initially the data was aggregated into proc genmod. An agglomerative hierarchical residual cluster-based analysis was then performed. The sampled clustered study site data was then analyzed for statistical correlations using Monthly Biting Rates (MBR). Euclidean distance measurements and terrain-related geomorphological statistics were then generated in ArcGIS. A digital overlay was then performed also in ArcGIS using the georeferenced ground coordinates of high and low density clusters stratified by Annual Biting Rates (ABR). This data was overlain onto multitemporal sub-meter pixel resolution satellite data (i.e., QuickBird 0.61m wavbands ). Orthogonal spatial filter eigenvectors were then generated in SAS/GIS. Univariate and non-linear regression-based models (i.e., Logistic, Poisson and Negative Binomial) were also employed to determine probability distributions and to identify statistically significant parameter estimators from the sampled data. Thereafter, Durbin-Watson test statistics were used to test the null hypothesis that the regression residuals were not autocorrelated against the alternative that the residuals followed an autoregressive process in AUTOREG. Bayesian uncertainty matrices were also constructed employing normal priors for each of the sampled estimators in PROC MCMC. The residuals revealed both spatially structured and unstructured error effects in the high and low ABR-stratified clusters. The analyses also revealed that the estimators, levels of turbidity and presence of rocks were statistically significant for the high-ABR-stratified clusters, while the estimators distance between habitats and floating vegetation were important for the low-ABR-stratified cluster. Varying and constant coefficient regression models, ABR- stratified GIS-generated clusters, sub-meter resolution satellite imagery, a robust residual intra-cluster diagnostic test, MBR-based histograms, eigendecomposition spatial filter algorithms and Bayesian matrices can enable accurate autoregressive estimation of latent uncertainity affects and other residual error probabilities (i.e., heteroskedasticity) for testing correlations between georeferenced S. damnosum s.l. riverine larval habitat estimators. The asymptotic distribution of the resulting residual adjusted intra-cluster predictor error autocovariate coefficients can thereafter be established while estimates of the asymptotic variance can lead to the construction of approximate confidence intervals for accurately targeting productive S. damnosum s.l habitats based on spatiotemporal field-sampled count data.

Using Financial Ratios to Select Companies for Tax Auditing: A Preliminary Study

NASA Astrophysics Data System (ADS)

Marghescu, Dorina; Kallio, Minna; Back, Barbro

Tax auditing procedures include an investigation of the accounting records of a company and of other sources of information in order to assess whether the taxation has been based on correct and complete information. When there are found discrepancies between the accounting information and the real situation, the taxation should be corrected so that the eventual tax defaults are assessed and debited. The paper analyzes to what extent the financial performance of a company can be used as an indicator of tax defaults. We focus on one type of tax, namely employer's contribution, and four financial ratios. We evaluate the model in a study of Finnish companies by using a binomial logistic regression analysis. The study is exploratory and at a preliminary stage.

Factors affecting road mortality of white-tailed deer in eastern South Dakota

USGS Publications Warehouse

Grovenburg, Troy W.; Jenks, Jonathan A.; Klaver, Robert W.; Monteith, Kevin L.; Galster, Dwight H.; Schauer, Ron J.; Morlock, Wilbert W.; Delger, Joshua A.

2008-01-01

White-tailed deer (Odocoileus virginianus) mortalities (n = 4,433) caused by collisions with automobiles during 2003 were modeled in 35 counties in eastern South Dakota. Seventeen independent variables and 5 independent variable interactions were evaluated to explain deer mortalities. A negative binomial regression model (Ln Y = 1.25 – 0.12 [percentage tree coverage] + 0.0002 [county area] + 5.39 [county hunter success rate] + 0.0023 [vehicle proxy 96–104 km/hr roads], model deviance = 33.43, χ2 = 27.53, df = 27) was chosen using a combination of a priori model selection and AICc. Management options include use of the model to predict road mortalities and to increase the number of hunting licenses, which could result in fewer DVCs.

Spatial distribution of single-nucleotide polymorphisms related to fungicide resistance and implications for sampling.

PubMed

Van der Heyden, H; Dutilleul, P; Brodeur, L; Carisse, O

2014-06-01

Spatial distribution of single-nucleotide polymorphisms (SNPs) related to fungicide resistance was studied for Botrytis cinerea populations in vineyards and for B. squamosa populations in onion fields. Heterogeneity in this distribution was characterized by performing geostatistical analyses based on semivariograms and through the fitting of discrete probability distributions. Two SNPs known to be responsible for boscalid resistance (H272R and H272Y), both located on the B subunit of the succinate dehydrogenase gene, and one SNP known to be responsible for dicarboximide resistance (I365S) were chosen for B. cinerea in grape. For B. squamosa in onion, one SNP responsible for dicarboximide resistance (I365S homologous) was chosen. One onion field was sampled in 2009 and another one was sampled in 2010 for B. squamosa, and two vineyards were sampled in 2011 for B. cinerea, for a total of four sampled sites. Cluster sampling was carried on a 10-by-10 grid, each of the 100 nodes being the center of a 10-by-10-m quadrat. In each quadrat, 10 samples were collected and analyzed by restriction fragment length polymorphism polymerase chain reaction (PCR) or allele specific PCR. Mean SNP incidence varied from 16 to 68%, with an overall mean incidence of 43%. In the geostatistical analyses, omnidirectional variograms showed spatial autocorrelation characterized by ranges of 21 to 1 m. Various levels of anisotropy were detected, however, with variograms computed in four directions (at 0°, 45°, 90°, and 135° from the within-row direction used as reference), indicating that spatial autocorrelation was prevalent or characterized by a longer range in one direction. For all eight data sets, the β-binomial distribution was found to fit the data better than the binomial distribution. This indicates local aggregation of fungicide resistance among sampling units, as supported by estimates of the parameter θ of the β-binomial distribution of 0.09 to 0.23 (overall median value = 0.20). On the basis of the observed spatial distribution patterns of SNP incidence, sampling curves were computed for different levels of reliability, emphasizing the importance of sample size for the detection of mutation incidence below the risk threshold for control failure.

Comparison and Field Validation of Binomial Sampling Plans for Oligonychus perseae (Acari: Tetranychidae) on Hass Avocado in Southern California.

PubMed

Lara, Jesus R; Hoddle, Mark S

2015-08-01

Oligonychus perseae Tuttle, Baker, & Abatiello is a foliar pest of 'Hass' avocados [Persea americana Miller (Lauraceae)]. The recommended action threshold is 50-100 motile mites per leaf, but this count range and other ecological factors associated with O. perseae infestations limit the application of enumerative sampling plans in the field. Consequently, a comprehensive modeling approach was implemented to compare the practical application of various binomial sampling models for decision-making of O. perseae in California. An initial set of sequential binomial sampling models were developed using three mean-proportion modeling techniques (i.e., Taylor's power law, maximum likelihood, and an empirical model) in combination with two-leaf infestation tally thresholds of either one or two mites. Model performance was evaluated using a robust mite count database consisting of >20,000 Hass avocado leaves infested with varying densities of O. perseae and collected from multiple locations. Operating characteristic and average sample number results for sequential binomial models were used as the basis to develop and validate a standardized fixed-size binomial sampling model with guidelines on sample tree and leaf selection within blocks of avocado trees. This final validated model requires a leaf sampling cost of 30 leaves and takes into account the spatial dynamics of O. perseae to make reliable mite density classifications for a 50-mite action threshold. Recommendations for implementing this fixed-size binomial sampling plan to assess densities of O. perseae in commercial California avocado orchards are discussed. © The Authors 2015. Published by Oxford University Press on behalf of Entomological Society of America. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Using the Binomial Series to Prove the Arithmetic Mean-Geometric Mean Inequality

ERIC Educational Resources Information Center

Persky, Ronald L.

2003-01-01

In 1968, Leon Gerber compared (1 + x)[superscript a] to its kth partial sum as a binomial series. His result is stated and, as an application of this result, a proof of the arithmetic mean-geometric mean inequality is presented.

Four Bootstrap Confidence Intervals for the Binomial-Error Model.

ERIC Educational Resources Information Center

Lin, Miao-Hsiang; Hsiung, Chao A.

1992-01-01

Four bootstrap methods are identified for constructing confidence intervals for the binomial-error model. The extent to which similar results are obtained and the theoretical foundation of each method and its relevance and ranges of modeling the true score uncertainty are discussed. (SLD)

Possibility and Challenges of Conversion of Current Virus Species Names to Linnaean Binomials.

PubMed

Postler, Thomas S; Clawson, Anna N; Amarasinghe, Gaya K; Basler, Christopher F; Bavari, Sbina; Benko, Mária; Blasdell, Kim R; Briese, Thomas; Buchmeier, Michael J; Bukreyev, Alexander; Calisher, Charles H; Chandran, Kartik; Charrel, Rémi; Clegg, Christopher S; Collins, Peter L; Juan Carlos, De La Torre; Derisi, Joseph L; Dietzgen, Ralf G; Dolnik, Olga; Dürrwald, Ralf; Dye, John M; Easton, Andrew J; Emonet, Sébastian; Formenty, Pierre; Fouchier, Ron A M; Ghedin, Elodie; Gonzalez, Jean-Paul; Harrach, Balázs; Hewson, Roger; Horie, Masayuki; Jiang, Dàohóng; Kobinger, Gary; Kondo, Hideki; Kropinski, Andrew M; Krupovic, Mart; Kurath, Gael; Lamb, Robert A; Leroy, Eric M; Lukashevich, Igor S; Maisner, Andrea; Mushegian, Arcady R; Netesov, Sergey V; Nowotny, Norbert; Patterson, Jean L; Payne, Susan L; PaWeska, Janusz T; Peters, Clarence J; Radoshitzky, Sheli R; Rima, Bertus K; Romanowski, Victor; Rubbenstroth, Dennis; Sabanadzovic, Sead; Sanfaçon, Hélène; Salvato, Maria S; Schwemmle, Martin; Smither, Sophie J; Stenglein, Mark D; Stone, David M; Takada, Ayato; Tesh, Robert B; Tomonaga, Keizo; Tordo, Noël; Towner, Jonathan S; Vasilakis, Nikos; Volchkov, Viktor E; Wahl-Jensen, Victoria; Walker, Peter J; Wang, Lin-Fa; Varsani, Arvind; Whitfield, Anna E; Zerbini, F Murilo; Kuhn, Jens H

2017-05-01

Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authors of this article expected when conceiving the experiment. [Arenaviridae; binomials; ICTV; International Committee on Taxonomy of Viruses; Mononegavirales; virus nomenclature; virus taxonomy.]. Published by Oxford University Press on behalf of Society of Systematic Biologists 2016. This work is written by a US Government employee and is in the public domain in the US.

[The reentrant binomial model of nuclear anomalies growth in rhabdomyosarcoma RA-23 cell populations under increasing doze of rare ionizing radiation].

PubMed

Alekseeva, N P; Alekseev, A O; Vakhtin, Iu B; Kravtsov, V Iu; Kuzovatov, S N; Skorikova, T I

2008-01-01

Distributions of nuclear morphology anomalies in transplantable rabdomiosarcoma RA-23 cell populations were investigated under effect of ionizing radiation from 0 to 45 Gy. Internuclear bridges, nuclear protrusions and dumbbell-shaped nuclei were accepted for morphological anomalies. Empirical distributions of the number of anomalies per 100 nuclei were used. The adequate model of reentrant binomial distribution has been found. The sum of binomial random variables with binomial number of summands has such distribution. Averages of these random variables were named, accordingly, internal and external average reentrant components. Their maximum likelihood estimations were received. Statistical properties of these estimations were investigated by means of statistical modeling. It has been received that at equally significant correlation between the radiation dose and the average of nuclear anomalies in cell populations after two-three cellular cycles from the moment of irradiation in vivo the irradiation doze significantly correlates with internal average reentrant component, and in remote descendants of cell transplants irradiated in vitro - with external one.

The Difference Calculus and The NEgative Binomial Distribution

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bowman, Kimiko o; Shenton, LR

2007-01-01

In a previous paper we state the dominant term in the third central moment of the maximum likelihood estimator k of the parameter k in the negative binomial probability function where the probability generating function is (p + 1 - pt){sup -k}. A partial sum of the series {Sigma}1/(k + x){sup 3} is involved, where x is a negative binomial random variate. In expectation this sum can only be found numerically using the computer. Here we give a simple definite integral in (0,1) for the generalized case. This means that now we do have a valid expression for {radical}{beta}{sub 11}(k)more » and {radical}{beta}{sub 11}(p). In addition we use the finite difference operator {Delta}, and E = 1 + {Delta} to set up formulas for low order moments. Other examples of the operators are quoted relating to the orthogonal set of polynomials associated with the negative binomial probability function used as a weight function.« less

Sampling--how big a sample?

PubMed

Aitken, C G

1999-07-01

It is thought that, in a consignment of discrete units, a certain proportion of the units contain illegal material. A sample of the consignment is to be inspected. Various methods for the determination of the sample size are compared. The consignment will be considered as a random sample from some super-population of units, a certain proportion of which contain drugs. For large consignments, a probability distribution, known as the beta distribution, for the proportion of the consignment which contains illegal material is obtained. This distribution is based on prior beliefs about the proportion. Under certain specific conditions the beta distribution gives the same numerical results as an approach based on the binomial distribution. The binomial distribution provides a probability for the number of units in a sample which contain illegal material, conditional on knowing the proportion of the consignment which contains illegal material. This is in contrast to the beta distribution which provides probabilities for the proportion of a consignment which contains illegal material, conditional on knowing the number of units in the sample which contain illegal material. The interpretation when the beta distribution is used is much more intuitively satisfactory. It is also much more flexible in its ability to cater for prior beliefs which may vary given the different circumstances of different crimes. For small consignments, a distribution, known as the beta-binomial distribution, for the number of units in the consignment which are found to contain illegal material, is obtained, based on prior beliefs about the number of units in the consignment which are thought to contain illegal material. As with the beta and binomial distributions for large samples, it is shown that, in certain specific conditions, the beta-binomial and hypergeometric distributions give the same numerical results. However, the beta-binomial distribution, as with the beta distribution, has a more intuitively satisfactory interpretation and greater flexibility. The beta and the beta-binomial distributions provide methods for the determination of the minimum sample size to be taken from a consignment in order to satisfy a certain criterion. The criterion requires the specification of a proportion and a probability.

Selecting Tools to Model Integer and Binomial Multiplication

ERIC Educational Resources Information Center

Pratt, Sarah Smitherman; Eddy, Colleen M.

2017-01-01

Mathematics teachers frequently provide concrete manipulatives to students during instruction; however, the rationale for using certain manipulatives in conjunction with concepts may not be explored. This article focuses on area models that are currently used in classrooms to provide concrete examples of integer and binomial multiplication. The…

Topics in Bayesian Hierarchical Modeling and its Monte Carlo Computations

NASA Astrophysics Data System (ADS)

Tak, Hyung Suk

The first chapter addresses a Beta-Binomial-Logit model that is a Beta-Binomial conjugate hierarchical model with covariate information incorporated via a logistic regression. Various researchers in the literature have unknowingly used improper posterior distributions or have given incorrect statements about posterior propriety because checking posterior propriety can be challenging due to the complicated functional form of a Beta-Binomial-Logit model. We derive data-dependent necessary and sufficient conditions for posterior propriety within a class of hyper-prior distributions that encompass those used in previous studies. Frequency coverage properties of several hyper-prior distributions are also investigated to see when and whether Bayesian interval estimates of random effects meet their nominal confidence levels. The second chapter deals with a time delay estimation problem in astrophysics. When the gravitational field of an intervening galaxy between a quasar and the Earth is strong enough to split light into two or more images, the time delay is defined as the difference between their travel times. The time delay can be used to constrain cosmological parameters and can be inferred from the time series of brightness data of each image. To estimate the time delay, we construct a Gaussian hierarchical model based on a state-space representation for irregularly observed time series generated by a latent continuous-time Ornstein-Uhlenbeck process. Our Bayesian approach jointly infers model parameters via a Gibbs sampler. We also introduce a profile likelihood of the time delay as an approximation of its marginal posterior distribution. The last chapter specifies a repelling-attracting Metropolis algorithm, a new Markov chain Monte Carlo method to explore multi-modal distributions in a simple and fast manner. This algorithm is essentially a Metropolis-Hastings algorithm with a proposal that consists of a downhill move in density that aims to make local modes repelling, followed by an uphill move in density that aims to make local modes attracting. The downhill move is achieved via a reciprocal Metropolis ratio so that the algorithm prefers downward movement. The uphill move does the opposite using the standard Metropolis ratio which prefers upward movement. This down-up movement in density increases the probability of a proposed move to a different mode.

Enumerative and binomial sampling plans for citrus mealybug (Homoptera: pseudococcidae) in citrus groves.

PubMed

Martínez-Ferrer, María Teresa; Ripollés, José Luís; Garcia-Marí, Ferran

2006-06-01

The spatial distribution of the citrus mealybug, Planococcus citri (Risso) (Homoptera: Pseudococcidae), was studied in citrus groves in northeastern Spain. Constant precision sampling plans were designed for all developmental stages of citrus mealybug under the fruit calyx, for late stages on fruit, and for females on trunks and main branches; more than 66, 286, and 101 data sets, respectively, were collected from nine commercial fields during 1992-1998. Dispersion parameters were determined using Taylor's power law, giving aggregated spatial patterns for citrus mealybug populations in three locations of the tree sampled. A significant relationship between the number of insects per organ and the percentage of occupied organs was established using either Wilson and Room's binomial model or Kono and Sugino's empirical formula. Constant precision (E = 0.25) sampling plans (i.e., enumerative plans) for estimating mean densities were developed using Green's equation and the two binomial models. For making management decisions, enumerative counts may be less labor-intensive than binomial sampling. Therefore, we recommend enumerative sampling plans for the use in an integrated pest management program in citrus. Required sample sizes for the range of population densities near current management thresholds, in the three plant locations calyx, fruit, and trunk were 50, 110-330, and 30, respectively. Binomial sampling, especially the empirical model, required a higher sample size to achieve equivalent levels of precision.

Demonstrating the Safety and Reliability of a New System or Spacecraft: Incorporating Analyses and Reviews of the Design and Processing in Determining the Number of Tests to be Conducted

NASA Technical Reports Server (NTRS)

Vesely, William E.; Colon, Alfredo E.

2010-01-01

Design Safety/Reliability is associated with the probability of no failure-causing faults existing in a design. Confidence in the non-existence of failure-causing faults is increased by performing tests with no failure. Reliability-Growth testing requirements are based on initial assurance and fault detection probability. Using binomial tables generally gives too many required tests compared to reliability-growth requirements. Reliability-Growth testing requirements are based on reliability principles and factors and should be used.

Bayesian propensity scores for high-dimensional causal inference: A comparison of drug-eluting to bare-metal coronary stents.

PubMed

Spertus, Jacob V; Normand, Sharon-Lise T

2018-04-23

High-dimensional data provide many potential confounders that may bolster the plausibility of the ignorability assumption in causal inference problems. Propensity score methods are powerful causal inference tools, which are popular in health care research and are particularly useful for high-dimensional data. Recent interest has surrounded a Bayesian treatment of propensity scores in order to flexibly model the treatment assignment mechanism and summarize posterior quantities while incorporating variance from the treatment model. We discuss methods for Bayesian propensity score analysis of binary treatments, focusing on modern methods for high-dimensional Bayesian regression and the propagation of uncertainty. We introduce a novel and simple estimator for the average treatment effect that capitalizes on conjugacy of the beta and binomial distributions. Through simulations, we show the utility of horseshoe priors and Bayesian additive regression trees paired with our new estimator, while demonstrating the importance of including variance from the treatment regression model. An application to cardiac stent data with almost 500 confounders and 9000 patients illustrates approaches and facilitates comparison with existing alternatives. As measured by a falsifiability endpoint, we improved confounder adjustment compared with past observational research of the same problem. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

A semi-nonparametric Poisson regression model for analyzing motor vehicle crash data.

PubMed

Ye, Xin; Wang, Ke; Zou, Yajie; Lord, Dominique

2018-01-01

This paper develops a semi-nonparametric Poisson regression model to analyze motor vehicle crash frequency data collected from rural multilane highway segments in California, US. Motor vehicle crash frequency on rural highway is a topic of interest in the area of transportation safety due to higher driving speeds and the resultant severity level. Unlike the traditional Negative Binomial (NB) model, the semi-nonparametric Poisson regression model can accommodate an unobserved heterogeneity following a highly flexible semi-nonparametric (SNP) distribution. Simulation experiments are conducted to demonstrate that the SNP distribution can well mimic a large family of distributions, including normal distributions, log-gamma distributions, bimodal and trimodal distributions. Empirical estimation results show that such flexibility offered by the SNP distribution can greatly improve model precision and the overall goodness-of-fit. The semi-nonparametric distribution can provide a better understanding of crash data structure through its ability to capture potential multimodality in the distribution of unobserved heterogeneity. When estimated coefficients in empirical models are compared, SNP and NB models are found to have a substantially different coefficient for the dummy variable indicating the lane width. The SNP model with better statistical performance suggests that the NB model overestimates the effect of lane width on crash frequency reduction by 83.1%.

Differences in spousal influence on smoking cessation by gender and education among Japanese couples.

PubMed

Takagi, Daisuke; Kondo, Naoki; Takada, Misato; Hashimoto, Hideki

2014-11-19

Previous studies have reported that spousal non-smoking has a spillover effect on the partner's cessation. However, discussion is lacking on the factors modifying that association. We examined whether the spillover effect of spousal non-smoking was associated with the couple's educational attainment. We used paired marital data from the Japanese Study on Stratification, Health, Income, and Neighborhood (J-SHINE), which targeted residents aged 25-50 years in four Japanese municipalities. We selected a spouse smoker at the time of marriage (target respondent), and set his/her smoking status change (continued or quit smoking after marriage) as an outcome, regressed on the counterpart's smoking status (continued smoking or non-smoking) and combinations of each couple's educational attainment as explanatory variables using log-binomial regression models (n =1001 targets; 708 men and 293 women). Regression results showed that a counterpart who previously quit smoking or was a never-smoker was associated with the target male spouse's subsequent cessation. However, for women, the association between husband's non-smoking and their own cessation was significant only for couples in which both spouses were highly educated. Our findings suggest that a spouse's smoking status is important for smoking cessation interventions in men. For women, however, a couple's combined educational attainment may matter in the interventions.

Evaluation of the Use of Zero-Augmented Regression Techniques to Model Incidence of Campylobacter Infections in FoodNet.

PubMed

Tremblay, Marlène; Crim, Stacy M; Cole, Dana J; Hoekstra, Robert M; Henao, Olga L; Döpfer, Dörte

2017-10-01

The Foodborne Diseases Active Surveillance Network (FoodNet) is currently using a negative binomial (NB) regression model to estimate temporal changes in the incidence of Campylobacter infection. FoodNet active surveillance in 483 counties collected data on 40,212 Campylobacter cases between years 2004 and 2011. We explored models that disaggregated these data to allow us to account for demographic, geographic, and seasonal factors when examining changes in incidence of Campylobacter infection. We hypothesized that modeling structural zeros and including demographic variables would increase the fit of FoodNet's Campylobacter incidence regression models. Five different models were compared: NB without demographic covariates, NB with demographic covariates, hurdle NB with covariates in the count component only, hurdle NB with covariates in both zero and count components, and zero-inflated NB with covariates in the count component only. Of the models evaluated, the nonzero-augmented NB model with demographic variables provided the best fit. Results suggest that even though zero inflation was not present at this level, individualizing the level of aggregation and using different model structures and predictors per site might be required to correctly distinguish between structural and observational zeros and account for risk factors that vary geographically.

Ecological and pest-management implications of sex differences in scarab landing patterns on grape vines

PubMed Central

Boyer, Stéphane; Lefort, Marie-Caroline; Nboyine, Jerry; Wratten, Steve D.

2017-01-01

Background Melolonthinae beetles, comprising different white grub species, are a globally-distributed pest group. Their larvae feed on roots of several crop and forestry species, and adults can cause severe defoliation. In New Zealand, the endemic scarab pest Costelytra zealandica (White) causes severe defoliation on different horticultural crops, including grape vines (Vitis vinifera). Understanding flight and landing behaviours of this pest can help inform pest management decisions. Methods Adult beetles were counted and then removed from 96 grape vine plants from 21:30 until 23:00 h, every day from October 26 until December 2, during 2014 and 2015. Also, adults were removed from the grape vine foliage at dusk 5, 10, 15, 20 and 25 min after flight started on 2015. Statistical analyses were performed using generalised linear models with a beta-binomial distribution to analyse proportions and with a negative binomial distribution for beetle abundance. Results By analysing C. zealandica sex ratios during its entire flight season, it is clear that the proportion of males is higher at the beginning of the season, gradually declining towards its end. When adults were successively removed from the grape vines at 5-min intervals after flight activity begun, the mean proportion of males ranged from 6–28%. The male proportion suggests males were attracted to females that had already landed on grape vines, probably through pheromone release. Discussion The seasonal and daily changes in adult C. zealandica sex ratio throughout its flight season are presented for the first time. Although seasonal changes in sex ratio have been reported for other melolonthines, changes during their daily flight activity have not been analysed so far. Sex-ratio changes can have important consequences for the management of this pest species, and possibly for other melolonthines, as it has been previously suggested that C. zealandica females land on plants that produce a silhouette against the sky. Therefore, long-term management might evaluate the effect of different plant heights and architecture on female melolonthine landing patterns, with consequences for male distribution, and subsequently overall damage within horticultural areas. PMID:28462026

Ecological and pest-management implications of sex differences in scarab landing patterns on grape vines.

PubMed

González-Chang, Mauricio; Boyer, Stéphane; Lefort, Marie-Caroline; Nboyine, Jerry; Wratten, Steve D

2017-01-01

Melolonthinae beetles, comprising different white grub species, are a globally-distributed pest group. Their larvae feed on roots of several crop and forestry species, and adults can cause severe defoliation. In New Zealand, the endemic scarab pest Costelytra zealandica (White) causes severe defoliation on different horticultural crops, including grape vines ( Vitis vinifera ). Understanding flight and landing behaviours of this pest can help inform pest management decisions. Adult beetles were counted and then removed from 96 grape vine plants from 21:30 until 23:00 h, every day from October 26 until December 2, during 2014 and 2015. Also, adults were removed from the grape vine foliage at dusk 5, 10, 15, 20 and 25 min after flight started on 2015. Statistical analyses were performed using generalised linear models with a beta-binomial distribution to analyse proportions and with a negative binomial distribution for beetle abundance. By analysing C. zealandica sex ratios during its entire flight season, it is clear that the proportion of males is higher at the beginning of the season, gradually declining towards its end. When adults were successively removed from the grape vines at 5-min intervals after flight activity begun, the mean proportion of males ranged from 6-28%. The male proportion suggests males were attracted to females that had already landed on grape vines, probably through pheromone release. The seasonal and daily changes in adult C. zealandica sex ratio throughout its flight season are presented for the first time. Although seasonal changes in sex ratio have been reported for other melolonthines, changes during their daily flight activity have not been analysed so far. Sex-ratio changes can have important consequences for the management of this pest species, and possibly for other melolonthines, as it has been previously suggested that C. zealandica females land on plants that produce a silhouette against the sky. Therefore, long-term management might evaluate the effect of different plant heights and architecture on female melolonthine landing patterns, with consequences for male distribution, and subsequently overall damage within horticultural areas.

Estimating the Parameters of the Beta-Binomial Distribution.

ERIC Educational Resources Information Center

Wilcox, Rand R.

1979-01-01

For some situations the beta-binomial distribution might be used to describe the marginal distribution of test scores for a particular population of examinees. Several different methods of approximating the maximum likelihood estimate were investigated, and it was found that the Newton-Raphson method should be used when it yields admissable…

Loneliness as a public health issue: the impact of loneliness on health care utilization among older adults.

PubMed

Gerst-Emerson, Kerstin; Jayawardhana, Jayani

2015-05-01

We aimed to determine whether loneliness is associated with higher health care utilization among older adults in the United States. We used panel data from the Health and Retirement Study (2008 and 2012) to examine the long-term impact of loneliness on health care use. The sample was limited to community-dwelling persons in the United States aged 60 years and older. We used negative binomial regression models to determine the impact of loneliness on physician visits and hospitalizations. Under 2 definitions of loneliness, we found that a sizable proportion of those aged 60 years and older in the United States reported loneliness. Regression results showed that chronic loneliness (those lonely both in 2008 and 4 years later) was significantly and positively associated with physician visits (β = 0.075, SE = 0.034). Loneliness was not significantly associated with hospitalizations. Loneliness is a significant public health concern among elders. In addition to easing a potential source of suffering, the identification and targeting of interventions for lonely elders may significantly decrease physician visits and health care costs.

Contributory factors to traffic crashes at signalized intersections in Hong Kong.

PubMed

Wong, S C; Sze, N N; Li, Y C

2007-11-01

Efficient geometric design and signal timing not only improve operational performance at signalized intersections by expanding capacity and reducing traffic delays, but also result in an appreciable reduction in traffic conflicts, and thus better road safety. Information on the incidence of crashes, traffic flow, geometric design, road environment, and traffic control at 262 signalized intersections in Hong Kong during 2002 and 2003 are incorporated into a crash prediction model. Poisson regression and negative binomial regression are used to quantify the influence of possible contributory factors on the incidence of killed and severe injury (KSI) crashes and slight injury crashes, respectively, while possible interventions by traffic flow are controlled. The results for the incidence of slight injury crashes reveal that the road environment, degree of curvature, and presence of tram stops are significant factors, and that traffic volume has a diminishing effect on the crash risk. The presence of tram stops, number of pedestrian streams, road environment, proportion of commercial vehicles, average lane width, and degree of curvature increase the risk of KSI crashes, but the effect of traffic volume is negligible.

Statistical guides to estimating the number of undiscovered mineral deposits: an example with porphyry copper deposits

USGS Publications Warehouse

Singer, Donald A.; Menzie, W.D.; Cheng, Qiuming; Bonham-Carter, G. F.

2005-01-01

Estimating numbers of undiscovered mineral deposits is a fundamental part of assessing mineral resources. Some statistical tools can act as guides to low variance, unbiased estimates of the number of deposits. The primary guide is that the estimates must be consistent with the grade and tonnage models. Another statistical guide is the deposit density (i.e., the number of deposits per unit area of permissive rock in well-explored control areas). Preliminary estimates and confidence limits of the number of undiscovered deposits in a tract of given area may be calculated using linear regression and refined using frequency distributions with appropriate parameters. A Poisson distribution leads to estimates having lower relative variances than the regression estimates and implies a random distribution of deposits. Coefficients of variation are used to compare uncertainties of negative binomial, Poisson, or MARK3 empirical distributions that have the same expected number of deposits as the deposit density. Statistical guides presented here allow simple yet robust estimation of the number of undiscovered deposits in permissive terranes. 

Early-life mortality risks in opposite-sex and same-sex twins: a Danish cohort study of the twin testosterone transfer hypothesis.

PubMed

Ahrenfeldt, Linda Juel; Larsen, Lisbeth Aagaard; Lindahl-Jacobsen, Rune; Skytthe, Axel; Hjelmborg, Jacob V B; Möller, Sören; Christensen, Kaare

2017-02-01

To investigate the twin testosterone transfer (TTT) hypothesis by comparing early-life mortality risks of opposite-sex (OS) and same-sex (SS) twins during the first 15 years of life. We performed a population-based cohort study to compare mortality in OS and SS twins. We included 68,629 live-born Danish twins from 1973 to 2009 identified through the Danish Twin Registry and performed piecewise stratified Cox regression and log-binomial regression. Among 1933 deaths, we found significantly higher mortality for twin boys than for twin girls. For both sexes, OS twins had lower mortality than SS twins; the difference persisted for the first year of life for boys and for the first week of life for girls. Although the mortality risk for OS boys was in the expected direction according to the TTT hypothesis, the results for OS girls pointed in the opposite direction, providing no clear evidence for the TTT hypothesis. Copyright © 2016 Elsevier Inc. All rights reserved.

The association between depression and anxiety and use of oral health services and tooth loss.

PubMed

Okoro, Catherine A; Strine, Tara W; Eke, Paul I; Dhingra, Satvinder S; Balluz, Lina S

2012-04-01

The purpose of this study is to examine the associations among depression, anxiety, use of oral health services, and tooth loss. Data were analysed for 80 486 noninstitutionalized adults in 16 states who participated in the 2008 Behavioral Risk Factor Surveillance System. Binomial and multinomial logistic regression analyses were used to estimate predicted marginals, adjusted prevalence ratios, adjusted odds ratios (AOR) and their 95% confidence intervals (CI). The unadjusted prevalence for use of oral health services in the past year was 73.1% [standard error (SE), 0.3%]. The unadjusted prevalence by level of tooth loss was 56.1% (SE, 0.4%) for no tooth loss, 29.6% (SE, 0.3%) for 1-5 missing teeth, 9.7% (SE, 0.2%) for 6-31 missing teeth and 4.6% (SE, 0.1%) for total tooth loss. Adults with current depression had a significantly higher prevalence of nonuse of oral health services in the past year than those without this disorder (P < 0.001), after adjustment for age, sex, race/ethnicity, education, marital status, employment status, adverse health behaviours, chronic conditions, body mass index, assistive technology use and perceived social support. In logistic regression analyses employing tooth loss as a dichotomous outcome (0 versus ≥1) and as a nominal outcome (0 versus 1-5, 6-31, or all), adults with depression and anxiety were more likely to have tooth loss. Adults with current depression, lifetime diagnosed depression and lifetime diagnosed anxiety were significantly more likely to have had at least one tooth removed than those without each of these disorders (P < 0.001 for all), after fully adjusting for evaluated confounders (including use of oral health services). The adjusted odds of being in the 1-5 teeth removed, 6-31 teeth removed, or all teeth removed categories versus 0 teeth removed category were increased for adults with current depression versus those without (AOR = 1.35; 95% CI = 1.14-1.59; AOR = 1.83; 95% CI = 1.51-2.22; and AOR = 1.44; 95% CI = 1.11-1.86, respectively). The adjusted odds of being in the 1-5 teeth removed and 6-31 teeth removed categories versus 0 teeth removed category were also increased for adults with lifetime diagnosed depression or anxiety versus those without each of these disorders. Use of oral health services and tooth loss was associated with depression and anxiety after controlling for multiple confounders. © 2011 John Wiley & Sons A/S.

Albumin, a marker for post-operative myocardial damage in cardiac surgery.

PubMed

van Beek, Dianne E C; van der Horst, Iwan C C; de Geus, A Fred; Mariani, Massimo A; Scheeren, Thomas W L

2018-06-06

Low serum albumin (SA) is a prognostic factor for poor outcome after cardiac surgery. The aim of this study was to estimate the association between pre-operative SA, early post-operative SA and postoperative myocardial injury. This single center cohort study included adult patients undergoing cardiac surgery during 4 consecutive years. Postoperative myocardial damage was defined by calculating the area under the curve (AUC) of troponin (Tn) values during the first 72 h after surgery and its association with SA analyzed using linear regression and with multivariable linear regression to account for patient related and procedural confounders. The association between SA and the secondary outcomes (peri-operative myocardial infarction [PMI], requiring ventilation >24 h, rhythm disturbances, 30-day mortality) was studied using (multivariable) log binomial regression analysis. In total 2757 patients were included. The mean pre-operative SA was 29 ± 13 g/l and the mean post-operative SA was 26 ± 6 g/l. Post-operative SA levels (on average 26 min after surgery) were inversely associated with postoperative myocardial damage in both univariable analysis (regression coefficient - 0.019, 95%CI -0.022/-0.015, p < 0.005) and after adjustment for patient related and surgical confounders (regression coefficient - 0.014 [95% CI -0.020/-0.008], p < 0.0005). Post-operative albumin levels were significantly correlated with the amount of postoperative myocardial damage in patients undergoing cardiac surgery independent of typical confounders. Copyright © 2018. Published by Elsevier Inc.

Possibility and Challenges of Conversion of Current Virus Species Names to Linnaean Binomials

PubMed Central

Postler, Thomas S.; Clawson, Anna N.; Amarasinghe, Gaya K.; Basler, Christopher F.; Bavari, Sbina; Benkő, Mária; Blasdell, Kim R.; Briese, Thomas; Buchmeier, Michael J.; Bukreyev, Alexander; Calisher, Charles H.; Chandran, Kartik; Charrel, Rémi; Clegg, Christopher S.; Collins, Peter L.; Juan Carlos, De La Torre; Derisi, Joseph L.; Dietzgen, Ralf G.; Dolnik, Olga; Dürrwald, Ralf; Dye, John M.; Easton, Andrew J.; Emonet, Sébastian; Formenty, Pierre; Fouchier, Ron A. M.; Ghedin, Elodie; Gonzalez, Jean-Paul; Harrach, Balázs; Hewson, Roger; Horie, Masayuki; Jiāng, Dàohóng; Kobinger, Gary; Kondo, Hideki; Kropinski, Andrew M.; Krupovic, Mart; Kurath, Gael; Lamb, Robert A.; Leroy, Eric M.; Lukashevich, Igor S.; Maisner, Andrea; Mushegian, Arcady R.; Netesov, Sergey V.; Nowotny, Norbert; Patterson, Jean L.; Payne, Susan L.; PaWeska, Janusz T.; Peters, Clarence J.; Radoshitzky, Sheli R.; Rima, Bertus K.; Romanowski, Victor; Rubbenstroth, Dennis; Sabanadzovic, Sead; Sanfaçon, Hélène; Salvato, Maria S.; Schwemmle, Martin; Smither, Sophie J.; Stenglein, Mark D.; Stone, David M.; Takada, Ayato; Tesh, Robert B.; Tomonaga, Keizo; Tordo, Noël; Towner, Jonathan S.; Vasilakis, Nikos; Volchkov, Viktor E.; Wahl-Jensen, Victoria; Walker, Peter J.; Wang, Lin-Fa; Varsani, Arvind; Whitfield, Anna E.; Zerbini, F. Murilo; Kuhn, Jens H.

2017-01-01

Abstract Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authors of this article expected when conceiving the experiment. PMID:27798405

Crime Seasonality: Examining the Temporal Fluctuations of Property Crime in Cities With Varying Climates.

PubMed

Linning, Shannon J; Andresen, Martin A; Brantingham, Paul J

2017-12-01

This study investigates whether crime patterns fluctuate periodically throughout the year using data containing different property crime types in two Canadian cities with differing climates. Using police report data, a series of ordinary least squares (OLS; Vancouver, British Columbia) and negative binomial (Ottawa, Ontario) regressions were employed to examine the corresponding temporal patterns of property crime in Vancouver (2003-2013) and Ottawa (2006-2008). Moreover, both aggregate and disaggregate models were run to examine whether different weather and temporal variables had a distinctive impact on particular offences. Overall, results suggest that cities that experience greater variations in weather throughout the year have more distinct increases of property offences in the summer months and that different climate variables affect certain crime types, thus advocating for disaggregate analysis in the future.

The impact of texting bans on motor vehicle crash-related hospitalizations.

PubMed

Ferdinand, Alva O; Menachemi, Nir; Blackburn, Justin L; Sen, Bisakha; Nelson, Leonard; Morrisey, Michael

2015-05-01

We used a panel design and the Nationwide Inpatient Sample from 19 states between 2003 and 2010 to examine the impact of texting bans on crash-related hospitalizations. We conducted conditional negative binomial regressions with state, year, and month fixed effects to examine changes in crash-related hospitalizations in states after the enactment of a texting ban relative to those in states without such bans. Results indicate that texting bans were associated with a 7% reduction in crash-related hospitalizations among all age groups. Texting bans were significantly associated with reductions in hospitalizations among those aged 22 to 64 years and those aged 65 years or older. Marginal reductions were seen among adolescents. States that have not passed strict texting bans should consider doing so.

Linking crime guns: the impact of ballistics imaging technology on the productivity of the Boston Police Department's Ballistics Unit.

PubMed

Braga, Anthony A; Pierce, Glenn L

2004-07-01

Ballistics imaging technology has received national attention as a potent tool for moving the law enforcement response to violent gun criminals forward by linking multiple crime scenes to one firearm. This study examines the impact of ballistics imaging technology on the productivity of the Boston Police Department's Ballistics Unit. Using negative binomial regression models to analyze times series data on ballistics matches, we find that ballistics imaging technology was associated with a more than sixfold increase in the monthly number of ballistics matches made by the Boston Police Department's Ballistics Unit. Cost-effectiveness estimates and qualitative evidence also suggest that ballistics imaging technology allows law enforcement agencies to make hits that would not have been possible using traditional ballistics methods.

Unmarried Mothers’ Postnatal School Enrollment: The Role and Intersection of Demographic and Socioeconomic Characteristics

PubMed Central

Radey, Melissa

2017-01-01

Drawing from a theoretical model of educational decisions and intersectionality theory, this study examined demographic, socioeconomic, and public assistance characteristics that influence unmarried mothers’ postnatal enrollment. Using the Fragile Families and Child Wellbeing Study (FFCWS), binomial and multinomial regression techniques were used to examine unmarried mothers’ enrollment in their child’s first nine years. Results showed unmarried mothers’ educational commitment coupled with the influence of race and class indicate that they need additional opportunities to optimize their educations and job opportunities. Targeting outreach and enrollment assistance to underrepresented groups can reduce social-origin inequalities. Important directions for future research include understanding unmarried mothers’ rationale for school enrollment and considering how race and class work in combination to support or deter enrollment. PMID:29151656

Civic communities and urban violence.

PubMed

Doucet, Jessica M; Lee, Matthew R

2015-07-01

Civic communities have a spirit of entrepreneurialism, a locally invested population and an institutional structure fostering civic engagement. Prior research, mainly confined to studying rural communities and fairly large geographic areas, has demonstrated that civic communities have lower rates of violence. The current study analyzes the associations between the components of civic communities and homicide rates for New Orleans neighborhoods (census tracts) in the years following Hurricane Katrina. Results from negative binomial regression models adjusting for spatial autocorrelation reveal that community homicide rates are lower where an entrepreneurial business climate is more pronounced and where there is more local investment. Additionally, an interaction between the availability of civic institutions and resource disadvantage reveals that the protective effects of civic institutions are only evident in disadvantaged communities. Copyright © 2015 Elsevier Inc. All rights reserved.

Infant Mortality and Income in 4 World Cities: New York, London, Paris, and Tokyo

PubMed Central

Rodwin, Victor G.; Neuberg, Leland G.

2005-01-01

Objectives. We investigated the association between average income or deprivation and infant mortality rate across neighborhoods of 4 world cities. Methods. Using a maximum likelihood negative binomial regression model that controls for births, we analyzed data for 1988–1992 and 1993–1997. Results. In Manhattan, for both periods, we found an association (.05% significance level) between income and infant mortality. In Tokyo, for both periods, and in Paris and London for period 1, we found none (5% significance level). For period 2, the association just missed statistical significance for Paris, whereas for London it was significant (5% level). Conclusions. In stark contrast to Tokyo, Paris, and London, the association of income and infant mortality rate was strongly evident in Manhattan. PMID:15623865

The Impact of Texting Bans on Motor Vehicle Crash–Related Hospitalizations

PubMed Central

Menachemi, Nir; Blackburn, Justin L.; Sen, Bisakha; Nelson, Leonard; Morrisey, Michael

2015-01-01

We used a panel design and the Nationwide Inpatient Sample from 19 states between 2003 and 2010 to examine the impact of texting bans on crash-related hospitalizations. We conducted conditional negative binomial regressions with state, year, and month fixed effects to examine changes in crash-related hospitalizations in states after the enactment of a texting ban relative to those in states without such bans. Results indicate that texting bans were associated with a 7% reduction in crash-related hospitalizations among all age groups. Texting bans were significantly associated with reductions in hospitalizations among those aged 22 to 64 years and those aged 65 years or older. Marginal reductions were seen among adolescents. States that have not passed strict texting bans should consider doing so. PMID:25790409

Willingness to pay for non angler recreation at the lower Snake River reservoirs

USGS Publications Warehouse

McKean, J.R.; Johnson, D.; Taylor, R.G.; Johnson, Richard L.

2005-01-01

This study applied the travel cost method to estimate demand for non angler recreation at the impounded Snake River in eastern Washington. Net value per person per recreation trip is estimated for the full non angler sample and separately for camping, boating, water-skiing, and swimming/picnicking. Certain recreation activities would be reduced or eliminated and new activities would be added if the dams were breached to protect endangered salmon and steelhead. The effect of breaching on non angling benefits was found by subtracting our benefits estimate from the projected non angling benefits with breaching. Major issues in demand model specification and definition of the price variables are discussed. The estimation method selected was truncated negative binomial regression with adjustment for self selection bias.

Binomial Coefficients Modulo a Prime--A Visualization Approach to Undergraduate Research

ERIC Educational Resources Information Center

Bardzell, Michael; Poimenidou, Eirini

2011-01-01

In this article we present, as a case study, results of undergraduate research involving binomial coefficients modulo a prime "p." We will discuss how undergraduates were involved in the project, even with a minimal mathematical background beforehand. There are two main avenues of exploration described to discover these binomial…

Using the β-binomial distribution to characterize forest health

Treesearch

S.J. Zarnoch; R.L. Anderson; R.M. Sheffield

1995-01-01

The β-binomial distribution is suggested as a model for describing and analyzing the dichotomous data obtained from programs monitoring the health of forests in the United States. Maximum likelihood estimation of the parameters is given as well as asymptotic likelihood ratio tests. The procedure is illustrated with data on dogwood anthracnose infection (caused...

Integer Solutions of Binomial Coefficients

ERIC Educational Resources Information Center

Gilbertson, Nicholas J.

2016-01-01

A good formula is like a good story, rich in description, powerful in communication, and eye-opening to readers. The formula presented in this article for determining the coefficients of the binomial expansion of (x + y)n is one such "good read." The beauty of this formula is in its simplicity--both describing a quantitative situation…

Confidence Intervals for Weighted Composite Scores under the Compound Binomial Error Model

ERIC Educational Resources Information Center

Kim, Kyung Yong; Lee, Won-Chan

2018-01-01

Reporting confidence intervals with test scores helps test users make important decisions about examinees by providing information about the precision of test scores. Although a variety of estimation procedures based on the binomial error model are available for computing intervals for test scores, these procedures assume that items are randomly…

Macro-level pedestrian and bicycle crash analysis: Incorporating spatial spillover effects in dual state count models.

PubMed

Cai, Qing; Lee, Jaeyoung; Eluru, Naveen; Abdel-Aty, Mohamed

2016-08-01

This study attempts to explore the viability of dual-state models (i.e., zero-inflated and hurdle models) for traffic analysis zones (TAZs) based pedestrian and bicycle crash frequency analysis. Additionally, spatial spillover effects are explored in the models by employing exogenous variables from neighboring zones. The dual-state models such as zero-inflated negative binomial and hurdle negative binomial models (with and without spatial effects) are compared with the conventional single-state model (i.e., negative binomial). The model comparison for pedestrian and bicycle crashes revealed that the models that considered observed spatial effects perform better than the models that did not consider the observed spatial effects. Across the models with spatial spillover effects, the dual-state models especially zero-inflated negative binomial model offered better performance compared to single-state models. Moreover, the model results clearly highlighted the importance of various traffic, roadway, and sociodemographic characteristics of the TAZ as well as neighboring TAZs on pedestrian and bicycle crash frequency. Copyright © 2016 Elsevier Ltd. All rights reserved.

A comparison of different statistical methods analyzing hypoglycemia data using bootstrap simulations.

PubMed

Jiang, Honghua; Ni, Xiao; Huster, William; Heilmann, Cory

2015-01-01

Hypoglycemia has long been recognized as a major barrier to achieving normoglycemia with intensive diabetic therapies. It is a common safety concern for the diabetes patients. Therefore, it is important to apply appropriate statistical methods when analyzing hypoglycemia data. Here, we carried out bootstrap simulations to investigate the performance of the four commonly used statistical models (Poisson, negative binomial, analysis of covariance [ANCOVA], and rank ANCOVA) based on the data from a diabetes clinical trial. Zero-inflated Poisson (ZIP) model and zero-inflated negative binomial (ZINB) model were also evaluated. Simulation results showed that Poisson model inflated type I error, while negative binomial model was overly conservative. However, after adjusting for dispersion, both Poisson and negative binomial models yielded slightly inflated type I errors, which were close to the nominal level and reasonable power. Reasonable control of type I error was associated with ANCOVA model. Rank ANCOVA model was associated with the greatest power and with reasonable control of type I error. Inflated type I error was observed with ZIP and ZINB models.

Pricing American Asian options with higher moments in the underlying distribution

NASA Astrophysics Data System (ADS)

Lo, Keng-Hsin; Wang, Kehluh; Hsu, Ming-Feng

2009-01-01

We develop a modified Edgeworth binomial model with higher moment consideration for pricing American Asian options. With lognormal underlying distribution for benchmark comparison, our algorithm is as precise as that of Chalasani et al. [P. Chalasani, S. Jha, F. Egriboyun, A. Varikooty, A refined binomial lattice for pricing American Asian options, Rev. Derivatives Res. 3 (1) (1999) 85-105] if the number of the time steps increases. If the underlying distribution displays negative skewness and leptokurtosis as often observed for stock index returns, our estimates can work better than those in Chalasani et al. [P. Chalasani, S. Jha, F. Egriboyun, A. Varikooty, A refined binomial lattice for pricing American Asian options, Rev. Derivatives Res. 3 (1) (1999) 85-105] and are very similar to the benchmarks in Hull and White [J. Hull, A. White, Efficient procedures for valuing European and American path-dependent options, J. Derivatives 1 (Fall) (1993) 21-31]. The numerical analysis shows that our modified Edgeworth binomial model can value American Asian options with greater accuracy and speed given higher moments in their underlying distribution.

Discrimination of numerical proportions: A comparison of binomial and Gaussian models.

PubMed

Raidvee, Aire; Lember, Jüri; Allik, Jüri

2017-01-01

Observers discriminated the numerical proportion of two sets of elements (N = 9, 13, 33, and 65) that differed either by color or orientation. According to the standard Thurstonian approach, the accuracy of proportion discrimination is determined by irreducible noise in the nervous system that stochastically transforms the number of presented visual elements onto a continuum of psychological states representing numerosity. As an alternative to this customary approach, we propose a Thurstonian-binomial model, which assumes discrete perceptual states, each of which is associated with a certain visual element. It is shown that the probability β with which each visual element can be noticed and registered by the perceptual system can explain data of numerical proportion discrimination at least as well as the continuous Thurstonian-Gaussian model, and better, if the greater parsimony of the Thurstonian-binomial model is taken into account using AIC model selection. We conclude that Gaussian and binomial models represent two different fundamental principles-internal noise vs. using only a fraction of available information-which are both plausible descriptions of visual perception.

The Bright Side and Dark Side of Workplace Social Capital: Opposing Effects of Gender on Overweight among Japanese Employees

PubMed Central

Kobayashi, Tomoko; Suzuki, Etsuji; Oksanen, Tuula; Kawachi, Ichiro; Takao, Soshi

2014-01-01

Background A growing number of studies have sought to examine the health associations of workplace social capital; however, evidence of associations with overweight is sparse. We examined the association between individual perceptions of workplace social capital and overweight among Japanese male and female employees. Methodology/Principal Findings We conducted a cross-sectional survey among full-time employees at a company in Osaka prefecture in February 2012. We used an 8-item measure to assess overall and sub-dimensions of workplace social capital, divided into tertiles. Of 1050 employees, 849 responded, and 750 (624 men and 126 women) could be linked to annual health check-up data in the analysis. Binomial logistic regression models were used to calculate odds ratios and 95% confidence intervals for overweight (body mass index: ≥25 kg/m2, calculated from measured weight and height) separately for men and women. The prevalence of overweight was 24.5% among men and 14.3% among women. Among men, low levels of bonding and linking social capital in the workplace were associated with a nearly 2-fold risk of overweight compared to high corresponding dimensions of social capital when adjusted for age, sleep hours, physiological distress, and lifestyle. In contrast, among women we found lower overall and linking social capital to be associated with lower odds for overweight even after covariate adjustment. Subsequently, we used multinomial logistic regression analyses to assess the relationships between a 1 standard deviation (SD) decrease in mean social capital and odds of underweight/overweight relative to normal weight. Among men, a 1-SD decrease in overall, bonding, and linking social capital was significantly associated with higher odds of overweight, but not with underweight. Among women, no significant associations were found for either overweight or underweight. Conclusions/Significance We found opposite gender relationships between perceived low linking workplace social capital and overweight among Japanese employees. PMID:24498248

Household Implementation of Smoke-Free Rules in Homes and Cars: A Focus on Adolescent Smoking Behavior and Secondhand Smoke Exposure.

PubMed

Parks, Michael J; Kingsbury, John H; Boyle, Raymond G; Evered, Sharrilyn

2018-01-01

This study addresses the dearth of population-based research on how comprehensive household smoke-free rules (ie, in the home and car) relate to tobacco use and secondhand smoke (SHS) exposure among adolescents. Analysis of 2014 Minnesota Youth Tobacco Survey. Representative sample of Minnesota youth. A total of 1287 youth who lived with a smoker. Measures included household smoke-free rules (no rules, partial rules-home or car, but not both-and comprehensive rules), lifetime and 30-day cigarette use, 30-day cigarette and other product use, and SHS exposure in past 7 days in home and car. Weighted multivariate logistic, zero-inflated Poisson, and zero-inflated negative binomial regressions were used. Compared to comprehensive rules, partial and no smoke-free rules were significantly and positively related to lifetime cigarette use (respectively, adjusted odds ratio [AOR] = 1.80, 95% confidence interval [CI] = 1.24-2.61; AOR = 2.87, 95% CI = 1.93-4.25), and a similar significant pattern was found for 30-day cigarette use (respectively, AOR = 2.20, 95% CI = 1.21-4.02; AOR = 2.45, 95% CI = 1.34-4.50). No smoke-free rules significantly predicted using cigarettes and other tobacco products compared to comprehensive rules. In both descriptive and regression analyses, we found SHS exposure rates in both the home and car were significantly lower among youth whose household implemented comprehensive smoke-free rules. Comprehensive smoke-free rules protect youth from the harms of caregiver tobacco use. Relative to both partial and no smoke-free rules, comprehensive smoke-free rules have a marked impact on tobacco use and SHS exposure among youth who live with a smoker. Health promotion efforts should promote comprehensive smoke-free rules among all households and particularly households with children and adolescents.

Expanding Paramedicine in the Community (EPIC): study protocol for a randomized controlled trial.

PubMed

Drennan, Ian R; Dainty, Katie N; Hoogeveen, Paul; Atzema, Clare L; Barrette, Norm; Hawker, Gillian; Hoch, Jeffrey S; Isaranuwatchai, Wanrudee; Philpott, Jane; Spearen, Chris; Tavares, Walter; Turner, Linda; Farrell, Melissa; Filosa, Tom; Kane, Jennifer; Kiss, Alex; Morrison, Laurie J

2014-12-02

The incidence of chronic diseases, including diabetes mellitus (DM), heart failure (HF) and chronic obstructive pulmonary disease (COPD) is on the rise. The existing health care system must evolve to meet the growing needs of patients with these chronic diseases and reduce the strain on both acute care and hospital-based health care resources. Paramedics are an allied health care resource consisting of highly-trained practitioners who are comfortable working independently and in collaboration with other resources in the out-of-hospital setting. Expanding the paramedic's scope of practice to include community-based care may decrease the utilization of acute care and hospital-based health care resources by patients with chronic disease. This will be a pragmatic, randomized controlled trial comparing a community paramedic intervention to standard of care for patients with one of three chronic diseases. The objective of the trial is to determine whether community paramedics conducting regular home visits, including health assessments and evidence-based treatments, in partnership with primary care physicians and other community based resources, will decrease the rate of hospitalization and emergency department use for patients with DM, HF and COPD. The primary outcome measure will be the rate of hospitalization at one year. Secondary outcomes will include measures of health system utilization, overall health status, and cost-effectiveness of the intervention over the same time period. Outcome measures will be assessed using both Poisson regression and negative binomial regression analyses to assess the primary outcome. The results of this study will be used to inform decisions around the implementation of community paramedic programs. If successful in preventing hospitalizations, it has the ability to be scaled up to other regions, both nationally and internationally. The methods described in this paper will serve as a basis for future work related to this study. ClinicalTrials.gov: NCT02034045. Date: 9 January 2014.

The bright side and dark side of workplace social capital: opposing effects of gender on overweight among Japanese employees.

PubMed

Kobayashi, Tomoko; Suzuki, Etsuji; Oksanen, Tuula; Kawachi, Ichiro; Takao, Soshi

2014-01-01

A growing number of studies have sought to examine the health associations of workplace social capital; however, evidence of associations with overweight is sparse. We examined the association between individual perceptions of workplace social capital and overweight among Japanese male and female employees. We conducted a cross-sectional survey among full-time employees at a company in Osaka prefecture in February 2012. We used an 8-item measure to assess overall and sub-dimensions of workplace social capital, divided into tertiles. Of 1050 employees, 849 responded, and 750 (624 men and 126 women) could be linked to annual health check-up data in the analysis. Binomial logistic regression models were used to calculate odds ratios and 95% confidence intervals for overweight (body mass index: ≥ 25 kg/m(2), calculated from measured weight and height) separately for men and women. The prevalence of overweight was 24.5% among men and 14.3% among women. Among men, low levels of bonding and linking social capital in the workplace were associated with a nearly 2-fold risk of overweight compared to high corresponding dimensions of social capital when adjusted for age, sleep hours, physiological distress, and lifestyle. In contrast, among women we found lower overall and linking social capital to be associated with lower odds for overweight even after covariate adjustment. Subsequently, we used multinomial logistic regression analyses to assess the relationships between a 1 standard deviation (SD) decrease in mean social capital and odds of underweight/overweight relative to normal weight. Among men, a 1-SD decrease in overall, bonding, and linking social capital was significantly associated with higher odds of overweight, but not with underweight. Among women, no significant associations were found for either overweight or underweight. We found opposite gender relationships between perceived low linking workplace social capital and overweight among Japanese employees.

Frequent emergency department presentations among people who inject drugs: A record linkage study.

PubMed

Nambiar, Dhanya; Stoové, Mark; Dietze, Paul

2017-06-01

People who inject drugs (PWID) have been described as frequent users of health services such as emergency departments (EDs), however few studies have described demographic factors, patterns of substance use and previous health service use associated with frequent use of EDs in this population. Using a combination of self-reported data from a cohort of PWID and administrative ED data obtained through record linkage, we identified longitudinal factors associated with the use of ED services. Bivariate and multivariate analyses were conducted using negative binomial regression to identify exposures associated with both cumulative ED presentations, and logistic regression to identify exposures of frequent ED presentations (defined as three or more annual presentations). Among 612 PWID, over half (58%) presented to EDs at least once and over a third (36%) presented frequently between January 2008 and June 2013. Frequent and cumulative ED presentations were associated with reporting the main drug of choice as cannabis (AOR:1.42, 95%CI:1.07-1.89 and AIRR:2.96, 95%CI:1.44-6.07 respectively) or methamphetamine (AOR:1.62, 95%CI:1.17-2.2 and AIRR:2.42, 95%CI:1.08-5.46 respectively) compared to heroin, and past month use of mental health (AOR:1.42, 95%CI:1.08-1.85 and AIRR:3.32, 95%CI:1.69-6.53 respectively) and outpatient services (AOR:1.47, 95%CI: 1.00-2.16 and AIRR:0.95, 95%CI 1.52-10.28 respectively). PWID who are frequent users of EDs are likely to have complex health and substance use-related needs. EDs should actively refer people who present with cannabis and methamphetamine dependence to harm reduction services. Harm reduction services should ensure people referred from EDs are screened for co-occurring mental health conditions and receive adequate support. Copyright © 2017 Elsevier B.V. All rights reserved.

Identifying socioeconomic, epidemiological and operational scenarios for tuberculosis control in Brazil: an ecological study.

PubMed

Pelissari, Daniele Maria; Rocha, Marli Souza; Bartholomay, Patricia; Sanchez, Mauro Niskier; Duarte, Elisabeth Carmen; Arakaki-Sanchez, Denise; Dantas, Cíntia Oliveira; Jacobs, Marina Gasino; Andrade, Kleydson Bonfim; Codenotti, Stefano Barbosa; Andrade, Elaine Silva Nascimento; Araújo, Wildo Navegantes de; Costa, Fernanda Dockhorn; Ramalho, Walter Massa; Diaz-Quijano, Fredi Alexander

2018-06-06

To identify scenarios based on socioeconomic, epidemiological and operational healthcare factors associated with tuberculosis incidence in Brazil. Ecological study. The study was based on new patients with tuberculosis and epidemiological/operational variables of the disease from the Brazilian National Information System for Notifiable Diseases and the Mortality Information System. We also analysed socioeconomic and demographic variables. The units of analysis were the Brazilian municipalities, which in 2015 numbered 5570 but 5 were excluded due to the absence of socioeconomic information. Tuberculosis incidence rate in 2015. We evaluated as independent variables the socioeconomic (2010), epidemiological and operational healthcare indicators of tuberculosis (2014 or 2015) using negative binomial regression. Municipalities were clustered by the k-means method considering the variables identified in multiple regression models. We identified two clusters according to socioeconomic variables associated with the tuberculosis incidence rate (unemployment rate and household crowding): a higher socioeconomic scenario (n=3482 municipalities) with a mean tuberculosis incidence rate of 16.3/100 000 population and a lower socioeconomic scenario (2083 municipalities) with a mean tuberculosis incidence rate of 22.1/100 000 population. In a second stage of clusterisation, we defined four subgroups in each of the socioeconomic scenarios using epidemiological and operational variables such as tuberculosis mortality rate, AIDS case detection rate and proportion of vulnerable population among patients with tuberculosis. Some of the subscenarios identified were characterised by fragility in their information systems, while others were characterised by the concentration of tuberculosis cases in key populations. Clustering municipalities in scenarios allowed us to classify them according to the socioeconomic, epidemiological and operational variables associated with tuberculosis risk. This classification can support targeted evidence-based decisions such as monitoring data quality for improving the information system or establishing integrative social protective policies for key populations. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effect of Flexible Duty Hour Policies on Length of Stay for Complex Intra-Abdominal Operations: A Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) Trial Analysis.

PubMed

Stulberg, Jonah J; Pavey, Emily S; Cohen, Mark E; Ko, Clifford Y; Hoyt, David B; Bilimoria, Karl Y

2017-02-01

Changes to resident duty hour policies in the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial could impact hospitalized patients' length of stay (LOS) by altering care coordination. Length of stay can also serve as a reflection of all complications, particularly those not captured in the FIRST trial (eg pneumothorax from central line). Programs were randomized to either maintaining current ACGME duty hour policies (Standard arm) or more flexible policies waiving rules on maximum shift lengths and time off between shifts (Flexible arm). Our objective was to determine whether flexibility in resident duty hours affected LOS in patients undergoing high-risk surgical operations. Patients were identified who underwent hepatectomy, pancreatectomy, laparoscopic colectomy, open colectomy, or ventral hernia repair (2014-2015 academic year) at 154 hospitals participating in the FIRST trial. Two procedure-stratified evaluations of LOS were undertaken: multivariable negative binomial regression analysis on LOS and a multivariable logistic regression analysis on the likelihood of a prolonged LOS (>75 th percentile). Before any adjustments, there was no statistically significant difference in overall mean LOS between study arms (Flexible Policy: mean [SD] LOS 6.03 [5.78] days vs Standard Policy: mean LOS 6.21 [5.82] days; p = 0.74). In adjusted analyses, there was no statistically significant difference in LOS between study arms overall (incidence rate ratio for Flexible vs Standard: 0.982; 95% CI, 0.939-1.026; p = 0.41) or for any individual procedures. In addition, there was no statistically significant difference in the proportion of patients with prolonged LOS between study arms overall (Flexible vs Standard: odds ratio = 1.028; 95% CI, 0.871-1.212) or for any individual procedures. Duty hour flexibility had no statistically significant effect on LOS in patients undergoing complex intra-abdominal operations. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

Evaluation of an operational malaria outbreak identification and response system in Mpumalanga Province, South Africa.

PubMed

Coleman, Marlize; Coleman, Michael; Mabuza, Aaron M; Kok, Gerdalize; Coetzee, Maureen; Durrheim, David N

2008-04-27

To evaluate the performance of a novel malaria outbreak identification system in the epidemic prone rural area of Mpumalanga Province, South Africa, for timely identification of malaria outbreaks and guiding integrated public health responses. Using five years of historical notification data, two binomial thresholds were determined for each primary health care facility in the highest malaria risk area of Mpumalanga province. Whenever the thresholds were exceeded at health facility level (tier 1), primary health care staff notified the malaria control programme, which then confirmed adequate stocks of malaria treatment to manage potential increased cases. The cases were followed up at household level to verify the likely source of infection. The binomial thresholds were reviewed at village/town level (tier 2) to determine whether additional response measures were required. In addition, an automated electronic outbreak identification system at town/village level (tier 2) was integrated into the case notification database (tier 3) to ensure that unexpected increases in case notification were not missed.The performance of these binomial outbreak thresholds was evaluated against other currently recommended thresholds using retrospective data. The acceptability of the system at primary health care level was evaluated through structured interviews with health facility staff. Eighty four percent of health facilities reported outbreaks within 24 hours (n = 95), 92% (n = 104) within 48 hours and 100% (n = 113) within 72 hours. Appropriate response to all malaria outbreaks (n = 113, tier 1, n = 46, tier 2) were achieved within 24 hours. The system was positively viewed by all health facility staff. When compared to other epidemiological systems for a specified 12 month outbreak season (June 2003 to July 2004) the binomial exact thresholds produced one false weekly outbreak, the C-sum 12 weekly outbreaks and the mean + 2 SD nine false weekly outbreaks. Exceeding the binomial level 1 threshold triggered an alert four weeks prior to an outbreak, but exceeding the binomial level 2 threshold identified an outbreak as it occurred. The malaria outbreak surveillance system using binomial thresholds achieved its primary goal of identifying outbreaks early facilitating appropriate local public health responses aimed at averting a possible large-scale epidemic in a low, and unstable, malaria transmission setting.

'Whose atlas I use, his song I sing?' - The impact of anatomical atlases on fiber tract contributions to cognitive deficits after stroke.

PubMed

de Haan, Bianca; Karnath, Hans-Otto

2017-12-01

Nowadays, different anatomical atlases exist for the anatomical interpretation of the results from neuroimaging and lesion analysis studies that investigate the contribution of white matter fiber tract integrity to cognitive (dys)function. A major problem with the use of different atlases in different studies, however, is that the anatomical interpretation of neuroimaging and lesion analysis results might vary as a function of the atlas used. This issue might be particularly prominent in studies that investigate the contribution of white matter fiber tract integrity to cognitive (dys)function. We used a single large-sample dataset of right brain damaged stroke patients with and without cognitive deficit (here: spatial neglect) to systematically compare the influence of three different, widely-used white matter fiber tract atlases (1 histology-based atlas and 2 DTI tractography-based atlases) on conclusions concerning the involvement of white matter fiber tracts in the pathogenesis of cognitive dysfunction. We both calculated the overlap between the statistical lesion analysis results and each long association fiber tract (topological analyses) and performed logistic regressions on the extent of fiber tract damage in each individual for each long association white matter fiber tract (hodological analyses). For the topological analyses, our results suggest that studies that use tractography-based atlases are more likely to conclude that white matter integrity is critical for a cognitive (dys)function than studies that use a histology-based atlas. The DTI tractography-based atlases classified approximately 10 times as many voxels of the statistical map as being located in a long association white matter fiber tract than the histology-based atlas. For hodological analyses on the other hand, we observed that the conclusions concerning the overall importance of long association fiber tract integrity to cognitive function do not necessarily depend on the white matter atlas used, but conclusions may vary as a function of atlas used at the level of individual fiber tracts. Moreover, these analyses revealed that hodological studies that express the individual extent of injury to each fiber tract as a binomial variable are more likely to conclude that white matter integrity is critical for a cognitive function than studies that express the individual extent of injury to each fiber tract as a continuous variable. Copyright © 2017 Elsevier Inc. All rights reserved.

Smisc - A collection of miscellaneous functions

DOE Office of Scientific and Technical Information (OSTI.GOV)

Landon Sego, PNNL

2015-08-31

A collection of functions for statistical computing and data manipulation. These include routines for rapidly aggregating heterogeneous matrices, manipulating file names, loading R objects, sourcing multiple R files, formatting datetimes, multi-core parallel computing, stream editing, specialized plotting, etc. Smisc-package A collection of miscellaneous functions allMissing Identifies missing rows or columns in a data frame or matrix as.numericSilent Silent wrapper for coercing a vector to numeric comboList Produces all possible combinations of a set of linear model predictors cumMax Computes the maximum of the vector up to the current index cumsumNA Computes the cummulative sum of a vector without propogating NAsmore » d2binom Probability functions for the sum of two independent binomials dataIn A flexible way to import data into R. dbb The Beta-Binomial Distribution df2list Row-wise conversion of a data frame to a list dfplapply Parallelized single row processing of a data frame dframeEquiv Examines the equivalence of two dataframes or matrices dkbinom Probability functions for the sum of k independent binomials factor2character Converts all factor variables in a dataframe to character variables findDepMat Identify linearly dependent rows or columns in a matrix formatDT Converts date or datetime strings into alternate formats getExtension Filename manipulations: remove the extension or path, extract the extension or path getPath Filename manipulations: remove the extension or path, extract the extension or path grabLast Filename manipulations: remove the extension or path, extract the extension or path ifelse1 Non-vectorized version of ifelse integ Simple numerical integration routine interactionPlot Two-way Interaction Plot with Error Bar linearMap Linear mapping of a numerical vector or scalar list2df Convert a list to a data frame loadObject Loads and returns the object(s) in an ".Rdata" file more Display the contents of a file to the R terminal movAvg2 Calculate the moving average using a 2-sided window openDevice Opens a graphics device based on the filename extension p2binom Probability functions for the sum of two independent binomials padZero Pad a vector of numbers with zeros parseJob Parses a collection of elements into (almost) equal sized groups pbb The Beta-Binomial Distribution pcbinom A continuous version of the binomial cdf pkbinom Probability functions for the sum of k independent binomials plapply Simple parallelization of lapply plotFun Plot one or more functions on a single plot PowerData An example of power data pvar Prints the name and value of one or more objects qbb The Beta-Binomial Distribution rbb And numerous others (space limits reporting).« less

Can SLE classification rules be effectively applied to diagnose unclear SLE cases?

PubMed Central

Mesa, Annia; Fernandez, Mitch; Wu, Wensong; Narasimhan, Giri; Greidinger, Eric L.; Mills, DeEtta K.

2016-01-01

Summary Objective Develop a novel classification criteria to distinguish between unclear SLE and MCTD cases. Methods A total of 205 variables from 111 SLE and 55 MCTD patients were evaluated to uncover unique molecular and clinical markers for each disease. Binomial logistic regressions (BLR) were performed on currently used SLE and MCTD classification criteria sets to obtain six reduced models with power to discriminate between unclear SLE and MCTD patients which were confirmed by Receiving Operating Characteristic (ROC) curve. Decision trees were employed to delineate novel classification rules to discriminate between unclear SLE and MCTD patients. Results SLE and MCTD patients exhibited contrasting molecular markers and clinical manifestations. Furthermore, reduced models highlighted SLE patients exhibit prevalence of skin rashes and renal disease while MCTD cases show dominance of myositis and muscle weakness. Additionally decision trees analyses revealed a novel classification rule tailored to differentiate unclear SLE and MCTD patients (Lu-vs-M) with an overall accuracy of 88%. Conclusions Validation of our novel proposed classification rule (Lu-vs-M) includes novel contrasting characteristics (calcinosis, CPK elevated and anti-IgM reactivity for U1-70K, U1A and U1C) between SLE and MCTD patients and showed a 33% improvement in distinguishing these disorders when compare to currently used classification criteria sets. Pending additional validation, our novel classification rule is a promising method to distinguish between patients with unclear SLE and MCTD diagnosis. PMID:27353506

The Influence of Confidence on Associations Among Personal Attitudes, Perceived Injunctive Norms, and Alcohol Consumption

PubMed Central

Neighbors, Clayton; Lindgren, Kristen P.; Knee, C. Raymond; Fossos, Nicole; DiBello, Angelo

2011-01-01

Social norms theories hold that perceptions of the degree of approval for a behavior have a strong influence on one’s private attitudes and public behavior. In particular, being more approving of drinking and perceiving peers as more approving of drinking, are strongly associated with one’s own drinking. However, previous research has not considered that students may vary considerably in the confidence in their estimates of peer approval and in the confidence in their estimates of their own approval of drinking. The present research was designed to evaluate confidence as a moderator of associations among perceived injunctive norms, own attitudes, and drinking. We expected perceived injunctive norms and own attitudes would be more strongly associated with drinking among students who felt more confident in their estimates of peer approval and own attitudes. We were also interested in whether this might differ by gender. Injunctive norms and self-reported alcohol consumption were measured in a sample of 708 college students. Findings from negative binomial regression analyses supported moderation hypotheses for confidence and perceived injunction norms but not for personal attitudes. Thus, perceived injunctive norms were more strongly associated with own drinking among students who felt more confident in their estimates of friends’ approval of drinking. A three-way interaction further revealed that this was primarily true among women. Implications for norms and peer influence theories as well as interventions are discussed. PMID:21928864

The failure rate of adhesively retained composite core build-ups in comparison with metal-added glass ionomer core build-ups.

PubMed

Stober, Thomas; Rammelsberg, P

2005-01-01

The purpose of this study was to evaluate the clinical performance of two adhesively retained composite core materials and compare them with a metal-added glass ionomer. The main objective evaluated was total or partial loss of build-ups during the treatment prior to crown cementation. In 187 patients, 315 vital and non-vital teeth were built up after randomisation with either Rebilda D (RD), Rebilda SC (RSC) or Ketac Silver Aplicap (KSA). The composites were applied in the total-etch-technique with the corresponding dentin bonding agent. The metal-added glass ionomer was used with a conditioner. One group of patients was treated by experienced dentists, the other by dental students, in order to evaluate the effects of different levels of experience. Data were analysed using Mann-Whitney-U-Test and binomial logistic regression. The early failure rate (partial or total loss) of core build-ups before crown cementation was significantly higher for KSA (28.8%), as compared to RSC (15.3%, p=0.037) and RD (15%, p=0.025). Most failures were observed during the removal of the temporary crowns. The rate of replacements was between 3.0 (RD/dentists) and 20.4% (KSA/students). Furthermore, we found that build-ups made by students had a significantly higher risk of loss than those made by dentists (p=0.028). Adhesively retained self-curing composites show a better clinical short-term performance and can be recommended as core build-up materials.

Waist circumference cut-off in relation to body mass index and percentage of body fat in adult women from Merida, Mexico.

PubMed

Datta Banik, Sudip; Dickinson, Federico

2015-01-01

Waist circumference (WC) as an index of central obesity is related to body mass index (BMI) and percent body fat (PBF). Waist circumference data were analyzed to identify a WC cut-off for adult women with respect to BMI-based obesity (≥ 30 kg/m²) and PBF. The sample was 138 women aged 22 to 41 years with Maya ancestry (based on surnames) in Merida, Yucatan, measured during 2011 - 2013. Anthropometric parameters included height, body weight (BW), and BMI. The PBF was estimated by bioelectrical impedance. Estimated cut-offs per centimeter WC (80 - 99 cm) were predicted by BMI for obesity (≥ 30 kg m⁻²; binomial: Yes = 1, No = 0) and PBF (continuous variable) using binary logistic regression analyses. Mean age was 32 years, mean BMI was 29 kg m(-2) and mean WC was 89 cm. The sample exhibited high PBF (44 %), and high rates of overweight (44%) and obesity (40%). The threshold WC (≥ 93 cm) had high sensitivity (80%), specificity (82%), Youden Index value (0.62), and correct classification rate (82%). The area under the receiver operating characteristic curve was 88 %. The WC ≥ 93 cm cut-off had corresponding values for mean BMI (34 kg m⁻²) and PBF (47%). The optimal WC cut-off at 93 cm significantly identified central obesity for BMI ≥ 30 kg m⁻² and PBF for this sample.

Gambling frequency and symptoms of attention-deficit hyperactivity disorder in relation to problem gambling among Swedish adolescents: a population-based study.

PubMed

Hellström, Charlotta; Wagner, Philippe; Nilsson, Kent W; Leppert, Jerzy; Åslund, Cecilia

2017-06-01

To investigate the associations between gambling frequency, attention-deficit hyperactivity disorder (ADHD) symptoms, and problem gambling among adolescent boys and girls. One hypothesis was that adolescents with increased ADHD symptoms have a higher frequency of gambling compared to adolescents with fewer ADHD symptoms. A population-based sample of adolescents (aged 15-18 years) completed a questionnaire on demographics, gambling habits, ADHD symptoms, and problematic gambling; 1412 adolescents (from 4440 sampled) with gambling experience were included in the final sample. A zero-inflated negative binomial regression analysis revealed that increased ADHD symptoms, higher gambling frequency, and higher age were associated with lower odds for being non-susceptible to gambling problems. Moreover, gambling frequency interacted with ADHD symptoms in predicting probability of being non-susceptible to gambling problems. However, when analysing those already susceptible to problem gambling, ADHD symptoms did not modify the effect of gambling frequency on the expected magnitude of gambling problems. In susceptible individuals, problem gambling increased with both increased ADHD symptoms and increased gambling frequency, but the level of problems due to gambling frequency did not change depending on the ADHD symptom level. There was an interaction effect between sex and gambling frequency in relation to gambling problems. Adolescents with ADHD symptoms seem to be more sensitive to gambling, in terms of being susceptible to developing gambling problems. However, once susceptible, adolescents with ADHD symptoms are affected by gambling frequency similarly to other susceptible participants.

Missed Work Due to Occupational Illness among Hispanic Horse Workers.

PubMed

Bush, Ashley M; Westneat, Susan; Browning, Steven R; Swanberg, Jennifer

2018-05-07

Occupational illnesses are inadequately reported for agriculture, an industry dominated by a vulnerable Hispanic population and high fatal and nonfatal injury rates. Work-related illnesses can contribute to missed work, caused by a combination of personal and work factors, with costs to the individual, employer, and society. To better understand agricultural occupational illnesses, 225 Hispanic horse workers were interviewed via community-based convenience sampling. Descriptive statistics, bivariate analyses, and log binomial regression modeling were used to: (1) describe the prevalence of missed work due to work-related illnesses among Hispanic horse workers, (2) examine work-related and personal factors associated with missed work, and (3) identify health symptoms and work-related characteristics potentially associated with missed work. Key findings reveal that having at least one child (PR = 1.71, 95% CI = 1.03, 2.84), having poor self-reported general health (PR = 0.72, 95% CI = 0.48, 1.08), experiencing stress during a typical workday (PR = 2.58, 95% CI = 1.25, 5.32), or spending less time with horses (PR = 1.87, 95% CI = 1.15, 3.05) are significant predictors of missing work. Interventions can be designed to identify workers most susceptible to missing work and provide resources to reduce absenteeism. Future research should examine work-related illness in agricultural horse production, including personal and work-related factors, in order to diminish occupational health disparities among these workers, who are more likely to be employed in hazardous agricultural work. Copyright© by the American Society of Agricultural Engineers.

Association Between Age at Menarche and Gestational Diabetes Mellitus: The Australian Longitudinal Study on Women's Health.

PubMed

Schoenaker, Danielle A J M; Mishra, Gita D

2017-04-01

In this study, we aimed to examine the association between age at menarche and gestational diabetes mellitus (GDM). Data were from 4,749 women participating in the Australian Longitudinal Study on Women's Health between 2000 and 2012. Age at menarche was reported at baseline in 2000 when women were aged 22-27 years. During 12 years of follow-up, information on GDM diagnosis was obtained for each live birth. Log-binomial regression analysis was used to estimate relative risks and 95% confidence intervals. Analyses adjusted for mother's highest completed educational qualification, nulliparity, polycystic ovary syndrome, physical activity, and body mass index. Mean age at menarche was 12.9 years (standard deviation, 1.4). A first diagnosis of GDM was reported by 357 women (7.5%). Compared with women with menarche at age 13 years, women who had their first menstruation at age ≤11 years had a 51% higher risk of developing GDM (95% confidence interval: 1.10, 2.07) after adjustment for GDM risk factors. Our findings indicate that a young age at menarche may identify women at higher risk of GDM. Further prospective studies are needed to confirm our findings and to elucidate the role of early-life exposures in age at menarche and subsequent GDM risk. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Barroom Aggression Among Australian Men: Associations With Heavy Episodic Drinking, Conformity to Masculine Norms, and Personal and Perceived Peer Approval of Barroom Aggression.

PubMed

Miller, Peter; Zinkiewicz, Lucy; Hayley, Alexa; Sonderlund, Anders; Litherland, Steven; Medew-Ewen, Tess; Wells, Samantha; Graham, Kathryn

2016-05-01

Research suggests that heavy episodic drinking (HED), perceived peer norms, and personal approval of aggression influence male barroom aggression (MBA). Qualitative research suggests that conformity to hegemonic masculine gender norms also influences MBA; however, quantitative research on the direct and indirect influence of masculinity on MBA is limited. This study tested the relationships between HED, conformity to masculine gender norms, and personal approval and peer approval of MBA on MBA perpetration, as well as the indirect effect of masculine norms on MBA via HED. A convenience sample of Australian men (N = 322; mean age = 21.05 years, SD = 1.95; 76.9% university students) completed an online questionnaire, assessing HED and MBA over the previous year, and subscales of the Beliefs and Attitudes Towards Male Alcohol-Related Aggression Inventory and Conformity to Masculine Norms Inventory-46. Negative binomial regression analyses found that, overall, HED, male peer approval, and personal approval of MBA directly predicted increased risk of verbal and physical MBA perpetration. Greater conformity to specific masculine norms also increased (Power Over Women) and decreased (Emotional Control, Heterosexual Self-Presentation) risk of MBA perpetration. The masculine norms Risk Taking, Playboy, and Emotional Control were found to be indirect predictors of MBA via HED. Risk of MBA perpetration is increased primarily by HED as a direct, but also mediating, predictor. Personal and male peer approval of MBA, and specific masculine norms, further increase this risk whereas other masculine norms appear protective.

Examining Fire Department Injury Data as a Tool for Epidemiological Investigation

PubMed Central

Perry, Elise C.; Shields, Wendy C.; O’Brocki, Raymond; Bishai, David; Frattaroli, Shannon; Jones, Vanya; Gielen, Andrea C.

2014-01-01

Objective Residential fires, while constituting a small fraction of fire incidents, are responsible for the majority of civilian fire-related injuries. This study investigates census tract neighborhood socioeconomic factors as correlates of civilian injuries occurring during residential fires in Baltimore, Maryland between 2004 and 2007. Methods Civilian residential-fire related injuries were geocoded and linked to the American Community Survey 2005–2009 data. Negative binomial regression was used to analyze the relationship between fire-injury rates and neighborhood socioeconomic indicators including household income and percentages of households below the poverty line, persons 25 years or older with at least a bachelor’s degree, homes built in 1939 or earlier, vacant properties, and owner occupied homes. Results Between January 2004 and July 2007, there were 482 civilian fire-related injuries that occurred during 309 fires. At the census tract level, a ten percent increase in the number of vacant homes was associated with an increase in injury rates by a factor of 1.28 (95% CI 1.05, 1.55). A ten percent increase in persons over 25 years with at least a bachelor’s degree was associated with a decrease in injury rates by a factor of 0.86 (95% CI 0.77, 0.96). Conclusions Neighborhood measures of education and housing age proved good indicators for identifying areas with a higher burden of fire-related injuries. Such analyses can be useful for fire department planning. PMID:24823338

Ethnicity, migration status and dental caries experience among adults in East London.

PubMed

Delgado-Angulo, Elsa K; Marcenes, Wagner; Harding, Seeromanie; Bernabé, Eduardo

2018-05-16

To assess the interrelationship between ethnicity, migration status and dental caries experience among adults in East London. We analysed data from 1910 adults (16-65 years) representing 9 ethnic groups, who took part in a community-based health survey in East London. Participants completed a supervised questionnaire and were clinically examined by trained dentists. Dental caries was assessed with the number of decayed, missing and filled teeth (DMFT). The association of ethnicity, nativity status and migration history with DMFT was assessed in negative binomial regression models controlling for demographic, socioeconomic and behavioural factors. White migrants had greater DMFT than UK-born adults, whereas every Asian and Black migrant group had lower DMFT than adults of the same ethnic group born in the UK (albeit significant only for Black Caribbean and Asian Others). Among foreign-born adults, age at arrival (Rate Ratio: 1.03; 95% Confidence Interval: 1.01-1.05) and length of residence (1.04; 95% CI: 1.02-1.06) were positively associated with DMFT. A significant interaction between both factors was also found, with more pronounced differences between older and younger migrants at longer stay in the UK for White Others, Black Caribbean and Asian Others. Large inequalities in caries experience were found between foreign- and UK-born adults, with considerable variation across ethnic groups. Looking beyond cultural explanations, in favour of social and environmental factors, may help to explain those inequalities. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Insomnia brings soldiers into mental health treatment, predicts treatment engagement, and outperforms other suicide-related symptoms as a predictor of major depressive episodes.

PubMed

Hom, Melanie A; Lim, Ingrid C; Stanley, Ian H; Chiurliza, Bruno; Podlogar, Matthew C; Michaels, Matthew S; Buchman-Schmitt, Jennifer M; Silva, Caroline; Ribeiro, Jessica D; Joiner, Thomas E

2016-08-01

Given the high rates of suicide among military personnel and the need to characterize suicide risk factors associated with mental health service use, this study aimed to identify suicide-relevant factors that predict: (1) treatment engagement and treatment adherence, and (2) suicide attempts, suicidal ideation, and major depressive episodes in a military sample. Army recruiters (N = 2596) completed a battery of self-report measures upon study enrollment. Eighteen months later, information regarding suicide attempts, suicidal ideation, major depressive episodes, and mental health visits were obtained from participants' military medical records. Suicide attempts and suicidal ideation were very rare in this sample; negative binomial regression analyses with robust estimation were used to assess correlates and predictors of mental health treatment visits and major depressive episodes. More severe insomnia and agitation were significantly associated with mental health visits at baseline and over the 18-month study period. In contrast, suicide-specific hopelessness was significantly associated with fewer mental health visits. Insomnia severity was the only significant predictor of major depressive episodes. Findings suggest that assessment of sleep problems might be useful in identifying at-risk military service members who may engage in mental health treatment. Additional research is warranted to examine the predictive validity of these suicide-related symptom measures in a more representative, higher suicide risk military sample. Copyright © 2016 Elsevier Ltd. All rights reserved.

Masculine discrepancy stress, substance use, assault and injury in a survey of US men

PubMed Central

Reidy, Dennis E; Berke, Danielle S; Gentile, Brittany; Zeichner, Amos

2018-01-01

To understand and ultimately prevent injury and behavioural health outcomes associated with masculinity, we assessed the influence of masculine discrepancy stress (stress that occurs when men perceive themselves as falling short of the traditional gender norms) on the propensity to engage in stereotypically masculine behaviours (eg, substance use, risk taking and violence) as a means of demonstrating masculinity. Six-hundred men from the USA were recruited via Amazon’s Mechanical Turk (MTurk) online data collection site to complete surveys assessing self-perceptions of gender role discrepancy and consequent discrepancy stress, substance use/abuse, driving while intoxicated (DWI) and violent assaults. Negative binomial regression analyses indicated significant interactive effects wherein men high on gender role discrepancy and attendant discrepancy stress reported significantly more assaults with a weapon (B=1.01; SE=0.63; IRR=2.74; p=0.05) and assaults causing injury (B=1.01; SE=0.51; IRR=2.74; p<0.05). There was no association of discrepancy stress to substance abuse, but there was a protective effect of gender role discrepancy for DWI among men low on discrepancy stress (B=−1.19, SE=0.48; IRR=0.30; p=0.01). These findings suggest that gender role discrepancy and associated discrepancy stress, in particular, represent important injury risk factors and that prevention of discrepancy stress may prevent acts of violence with the greatest consequences and costs to the victim, offender and society. PMID:26303670

Race/Ethnicity, Socioeconomic Status, and Healthcare Intensity at the End of Life.

PubMed

Brown, Crystal E; Engelberg, Ruth A; Sharma, Rashmi; Downey, Lois; Fausto, James A; Sibley, James; Lober, William; Khandelwal, Nita; Loggers, Elizabeth T; Curtis, J Randall

2018-06-12

Although racial/ethnic minorities receive more intense, nonbeneficial healthcare at the end of life, the role of race/ethnicity independent of other social determinants of health is not well understood. Examine the association between race/ethnicity, other key social determinants of health, and healthcare intensity in the last 30 days of life for those with chronic, life-limiting illness. We identified 22,068 decedents with chronic illness cared for at a single healthcare system in Washington State who died between 2010 and 2015 and linked electronic health records to death certificate data. Binomial regression models were used to test associations of healthcare intensity with race/ethnicity, insurance status, education, and median income by zip code. Path analyses tested direct and indirect effects of race/ethnicity with insurance, education, and median income by zip code used as mediators. We examined three measures of healthcare intensity: (1) intensive care unit admission, (2) use of mechanical ventilation, and (3) receipt of cardiopulmonary resuscitation. Minority race/ethnicity, lower income and educational attainment, and Medicaid and military insurance were associated with higher intensity care. Socioeconomic disadvantage accounted for some of the higher intensity in racial/ethnic minorities, but most of the effects were direct effects of race/ethnicity. The effects of minority race/ethnicity on healthcare intensity at the end of life are only partly mediated by other social determinants of health. Future interventions should address the factors driving both direct and indirect effects of race/ethnicity on healthcare intensity.

Maternal veterinary occupation and adverse birth outcomes in Washington State, 1992-2014: a population-based retrospective cohort study.

PubMed

Meisner, Julianne; Vora, Manali V; Fuller, Mackenzie S; Phipps, Amanda I; Rabinowitz, Peter M

2018-05-01

Women in veterinary occupations are routinely exposed to potential reproductive hazards, yet research into their birth outcomes is limited. We conducted a population-based retrospective cohort study of the association between maternal veterinary occupation and adverse birth outcomes. Using Washington State birth certificate, fetal death certificate and hospital discharge data from 1992 to 2014, we compared birth outcomes of mothers in veterinary professions (n=2662) with those in mothers in dental professions (n=10 653) and other employed mothers (n=8082). Relative risks (RRs) and 95% CIs were estimated using log binomial regression. Outcomes studied were premature birth (<37 weeks), small for gestational age (SGA), malformations and fetal death (death at ≥20 weeks gestation). Subgroup analyses evaluated risk of these outcomes among veterinarians and veterinary support staff separately. While no statistically significant associations were found, we noted a trend for SGA births in all veterinary mothers compared with dental mothers (RR=1.16, 95% CI 0.99 to 1.36) and in veterinarians compared with other employed mothers (RR=1.37, 95% CI 0.96 to 1.96). Positive but non-significant association was found for malformations among children of veterinary support staff. These results support the need for further study of the association between veterinary occupation and adverse birth outcomes. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Health coaching and pedometers to enhance physical activity and prevent falls in community-dwelling people aged 60 years and over: study protocol for the Coaching for Healthy AGEing (CHAnGE) cluster randomised controlled trial.

PubMed

Tiedemann, Anne; Rissel, Chris; Howard, Kirsten; Tong, Allison; Merom, Dafna; Smith, Stuart; Wickham, James; Bauman, Adrian; Lord, Stephen R; Vogler, Constance; Lindley, Richard I; Simpson, Judy M; Allman-Farinelli, Margaret; Sherrington, Catherine

2016-05-10

Prevention of falls and promotion of physical activity are essential for maximising well-being in older age. However, there is evidence that promoting physical activity among older people without providing fall prevention advice may increase fall rates. This trial aims to establish the impact of a physical activity and fall prevention programme compared with a healthy eating programme on physical activity and falls among people aged 60+ years. This cluster randomised controlled trial will involve 60 groups of community-dwelling people aged 60+ years. Participating groups will be randomised to: (1) a physical activity and fall prevention intervention (30 groups), involving written information, fall risk assessment and prevention advice, a pedometer-based physical activity tracker and telephone-based health coaching; or (2) a healthy eating intervention (30 groups) involving written information and telephone-based dietary coaching. Primary outcomes will be objectively measured physical activity at 12 months post-randomisation and self-reported falls throughout the 12-month trial period. Secondary outcomes include: the proportion of fallers, the proportion of people meeting the Australian physical activity guidelines, body mass index, eating habits, mobility goal attainment, mobility-related confidence, quality of life, fear of falling, risk-taking behaviour, mood, well-being, self-reported physical activity, disability, and health and community service use. The between-group difference in the number of falls per person-year will be analysed using negative binomial regression models. For the continuously scored primary and secondary outcome measures, linear regression adjusted for corresponding baseline scores will assess the effect of group allocation. Analyses will be preplanned, conducted while masked to group allocation, will take into account cluster randomisation, and will use an intention-to-treat approach. Protocol has been approved by the Human Research Ethics Committee at The University of Sydney, Australia (number 2015/517). Results will be disseminated via peer-reviewed journal articles, international conference presentations and participants' newsletters. ACTRN12615001190594. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Power of Food Scale in association with weight outcomes and dieting in a nationally representative cohort of U.S. young adults.

PubMed

Lipsky, L M; Nansel, T R; Haynie, D L; Liu, D; Eisenberg, M H; Simons-Morton, B

2016-10-01

Food reward sensitivity may influence susceptibility to overeating in a permissive food environment, contributing to unintended weight gain and intentional weight loss behavior. This study examined associations of food reward sensitivity, assessed by the Power of Food Scale (PFS), with weight outcomes and dieting in a nationally representative cohort of U.S. emerging adults. Wave 5 (W5, 5th year of follow-up) respondents from the NEXT Generation Health Study were included (N = 2202, W5 age = 20.3 ± 0.02 years). Baseline and W5 BMI, W5 weight status (normal weight = 18.5 ≤ BMI < 25, overweight = 25 ≤ BMI < 30, obese = BMI ≥ 30), BMI change (W5-baseline BMI) and onset of overweight or obesity (OWOB) were calculated from self-reported height and weight. PFS (aggregate and 3 domain scores: food available, present, and tasted) and dieting for weight-loss were assessed at W5. Adjusted linear regressions estimated associations of PFS with W5 BMI and BMI change. Log-binomial regressions estimated associations of high W5 BMI (≥25), OWOB onset and dieting with PFS. Post hoc analyses estimated associations of PFS with W5 perceived weight status (overweight vs. about right or underweight). W5 BMI = 25.73 ± 0.32 kg/m(2), and OWOB onset occurred in 27.7% of participants. The PFS-food available score was associated with BMI change, β ± SE = 0.41 ± 0.19. Other PFS scores were not associated with weight outcomes. Dieting prevalence was higher in participants with high versus low W5 BMI (61% versus 32%), and was positively associated with all PFS scores except the PFS-food tasted score, e.g., relative risk (RR) of dieting for PFS-aggregate = 1.13, 95%CI [1.01-1.26]. Post-hoc analyses indicated perceived overweight was positively associated with PFS-food available, 1.12, [1.01-1.24], and PFS-food present, 1.13, [1.03-1.24]. PFS was positively related to dieting and perceived overweight, but not concurrent or change in weight status in a representative cohort of U.S. emerging adults. Published by Elsevier Ltd.

I Remember You: Independence and the Binomial Model

ERIC Educational Resources Information Center

Levine, Douglas W.; Rockhill, Beverly

2006-01-01

We focus on the problem of ignoring statistical independence. A binomial experiment is used to determine whether judges could match, based on looks alone, dogs to their owners. The experimental design introduces dependencies such that the probability of a given judge correctly matching a dog and an owner changes from trial to trial. We show how…

Possibility and challenges of conversion of current virus species names to Linnaean binomials

USGS Publications Warehouse

Thomas, Postler; Clawson, Anna N.; Amarasinghe, Gaya K.; Basler, Christopher F.; Bavari, Sina; Benko, Maria; Blasdell, Kim R.; Briese, Thomas; Buchmeier, Michael J.; Bukreyev, Alexander; Calisher, Charles H.; Chandran, Kartik; Charrel, Remi; Clegg, Christopher S.; Collins, Peter L.; De la Torre, Juan Carlos; DeRisi, Joseph L.; Dietzgen, Ralf G.; Dolnik, Olga; Durrwald, Ralf; Dye, John M.; Easton, Andrew J.; Emonet, Sebastian; Formenty, Pierre; Fouchier, Ron A. M.; Ghedin, Elodie; Gonzalez, Jean-Paul; Harrach, Balazs; Hewson, Roger; Horie, Masayuki; Jiang, Daohong; Kobinger, Gary P.; Kondo, Hideki; Kropinski, Andrew; Krupovic, Mart; Kurath, Gael; Lamb, Robert A.; Leroy, Eric M.; Lukashevich, Igor S.; Maisner, Andrea; Mushegian, Arcady; Netesov, Sergey V.; Nowotny, Norbert; Patterson, Jean L.; Payne, Susan L.; Paweska, Janusz T.; Peters, C.J.; Radoshitzky, Sheli; Rima, Bertus K.; Romanowski, Victor; Rubbenstroth, Dennis; Sabanadzovic, Sead; Sanfacon, Helene; Salvato , Maria; Schwemmle, Martin; Smither, Sophie J.; Stenglein, Mark; Stone, D.M.; Takada , Ayato; Tesh, Robert B.; Tomonaga, Keizo; Tordo, N.; Towner, Jonathan S.; Vasilakis, Nikos; Volchkov, Victor E.; Jensen, Victoria; Walker, Peter J.; Wang, Lin-Fa; Varsani, Arvind; Whitfield , Anna E.; Zerbini, Francisco Murilo; Kuhn, Jens H.

2017-01-01

Botanical, mycological, zoological, and prokaryotic species names follow the Linnaean format, consisting of an italicized Latinized binomen with a capitalized genus name and a lower case species epithet (e.g., Homo sapiens). Virus species names, however, do not follow a uniform format, and, even when binomial, are not Linnaean in style. In this thought exercise, we attempted to convert all currently official names of species included in the virus family Arenaviridae and the virus order Mononegavirales to Linnaean binomials, and to identify and address associated challenges and concerns. Surprisingly, this endeavor was not as complicated or time-consuming as even the authors of this article expected when conceiving the experiment.

The role of ENSO in understanding changes in Colombia's annual malaria burden by region, 1960–2006

PubMed Central

Mantilla, Gilma; Oliveros, Hugo; Barnston, Anthony G

2009-01-01

Background Malaria remains a serious problem in Colombia. The number of malaria cases is governed by multiple climatic and non-climatic factors. Malaria control policies, and climate controls such as rainfall and temperature variations associated with the El Niño/Southern Oscillation (ENSO), have been associated with malaria case numbers. Using historical climate data and annual malaria case number data from 1960 to 2006, statistical models are developed to isolate the effects of climate in each of Colombia's five contrasting geographical regions. Methods Because year to year climate variability associated with ENSO causes interannual variability in malaria case numbers, while changes in population and institutional control policy result in more gradual trends, the chosen predictors in the models are annual indices of the ENSO state (sea surface temperature [SST] in the tropical Pacific Ocean) and time reference indices keyed to two major malaria trends during the study period. Two models were used: a Poisson and a Negative Binomial regression model. Two ENSO indices, two time reference indices, and one dummy variable are chosen as candidate predictors. The analysis was conducted using the five geographical regions to match the similar aggregation used by the National Institute of Health for its official reports. Results The Negative Binomial regression model is found better suited to the malaria cases in Colombia. Both the trend variables and the ENSO measures are significant predictors of malaria case numbers in Colombia as a whole, and in two of the five regions. A one degree Celsius change in SST (indicating a weak to moderate ENSO event) is seen to translate to an approximate 20% increase in malaria cases, holding other variables constant. Conclusion Regional differentiation in the role of ENSO in understanding changes in Colombia's annual malaria burden during 1960–2006 was found, constituting a new approach to use ENSO as a significant predictor of the malaria cases in Colombia. These results naturally point to additional needed work: (1) refining the regional and seasonal dependence of climate on the ENSO state, and of malaria on the climate variables; (2) incorporating ENSO-related climate variability into dynamic malaria models. PMID:19133152

Period prevalence and factors associated with road traffic crashes among young adults in Kuwait.

PubMed

Aldhafeeri, Eisa; Alshammari, Farah; Jafar, Hana; Malhas, Haya; Botras, Marina; Alnasrallah, Noor; Akhtar, Saeed

2018-05-01

This cross-sectional study assessed one-year period prevalence of road traffic crashes (RTCs) and examined the factors associated with RTCs among young adults in Kuwait. During December 2016, 1500 students enrolled in 15 colleges of Kuwait University were invited to participate in the study. Students 18 years old or older and who drive by themselves were eligible. Data were collected using a structured self-administered questionnaire. One-year period prevalence of RTCs (≥1 vs. none) was computed. Multivariable log-binomial regression model was used to identify the risk factors associated with one-year period prevalence of RTCs. Of 1500 invited individuals, 1465 (97.7%) participated, of which 71.4% (1046/1465) were female, 56.4% (804/1426) were aged between 21 and 25 years, and 67.1% (980/1460) were Kuwaitis. One-year period prevalence of RTC was 38.9%. The final multivariable log-binomial regression model showed that after adjusting for the influences of other variables in the model, participants were more likely to have had at least one RTC during the past year, if they habitually sped over limit (adjusted PR = 1.19; 95% confidence interval (CI): 1.04-1.36), crossed a red light (adjusted PR = 1.33; 95% CI: 1.16-1.52), or if they have had three or more speeding tickets (adjusted PR = 1.40; 95% CI: 1.13-1.73) compared to those who reportedly had no RTC during the same period. One-year period prevalence of RTCs among university students in Kuwait, though relatively lower than the reported figures in similar populations elsewhere in the region, is yet high enough to warrant diligent attention. Habitual speeding, having had three or more speeding tickets, and the practice of crossing a red light were significantly and independently associated with at least one RTC during the past year. Targeted education and enforcement of existing traffic laws may reduce the RTCs frequency in this relatively young population. Future studies may look at impact of such interventions. Copyright © 2018 Elsevier Ltd. All rights reserved.

Effect of Breastfeeding Promotion on Early Childhood Caries and Breastfeeding Duration among 5 Year Old Children in Eastern Uganda: A Cluster Randomized Trial

PubMed Central

Birungi, Nancy; Fadnes, Lars T.; Okullo, Isaac; Kasangaki, Arabat; Nankabirwa, Victoria; Ndeezi, Grace; Tumwine, James K.; Tylleskär, Thorkild; Lie, Stein Atle; Åstrøm, Anne Nordrehaug

2015-01-01

Background Although several studies have shown short term health benefits of exclusive breastfeeding (EBF), its long term consequences have not been studied extensively in low-income contexts. This study assessed the impact of an EBF promotion initiative for 6 months on early childhood caries (ECC) and breastfeeding duration in children aged 5 years in Mbale, Eastern Uganda. Methods Participants were recruited from the Ugandan site of the PROMISE- EBF cluster randomised trial (ClinicalTrials.gov no: NCT00397150). A total of 765 pregnant women from 24 clusters were included in the ratio 1:1 to receive peer counselled promotion of EBF as the intervention or standard of care. At the 5 year follow-up, ECC was recorded under field conditions using the World Health Organization’s decayed missing filled tooth (dmft) index. Adjusted negative binomial and linear regression were used in the analysis. Results Mean breastfeeding duration in the intervention and control groups (n=417) were 21.8 (CI 20.7–22.9) and 21.3(CI 20.7–21.9) months, respectively. The mean dmft was 1.5 (standard deviation [SD] 2.9) and 1.7 (SD 2.9) in the intervention and control groups, respectively. Corresponding prevalence estimates of ECC were 38% and 41%. Negative binomial regression analysis adjusted for cluster effects and loss-to-follow-up by inverse probability weights (IPW) showed an incidence-rate ratio (IRR) of 0.91 (95% CI 0.65–1.2). Comparing the effect of the trial arm on breastfeeding duration showed a difference in months of 0.48 (-0.72 to 1.7). Conclusion PROMISE EBF trial did not impact on early childhood caries or breastfeeding duration at 5 years of age. This study contributes to the body of evidence that promotion of exclusive breastfeeding does not raise oral health concerns. However, the high burden of caries calls for efforts to improve the oral health condition in this setting. Trial Registration ClinicalTrials.gov NCT00397150 PMID:25938681

An empirical tool to evaluate the safety of cyclists: Community based, macro-level collision prediction models using negative binomial regression.

PubMed

Wei, Feng; Lovegrove, Gordon

2013-12-01

Today, North American governments are more willing to consider compact neighborhoods with increased use of sustainable transportation modes. Bicycling, one of the most effective modes for short trips with distances less than 5km is being encouraged. However, as vulnerable road users (VRUs), cyclists are more likely to be injured when involved in collisions. In order to create a safe road environment for them, evaluating cyclists' road safety at a macro level in a proactive way is necessary. In this paper, different generalized linear regression methods for collision prediction model (CPM) development are reviewed and previous studies on micro-level and macro-level bicycle-related CPMs are summarized. On the basis of insights gained in the exploration stage, this paper also reports on efforts to develop negative binomial models for bicycle-auto collisions at a community-based, macro-level. Data came from the Central Okanagan Regional District (CORD), of British Columbia, Canada. The model results revealed two types of statistical associations between collisions and each explanatory variable: (1) An increase in bicycle-auto collisions is associated with an increase in total lane kilometers (TLKM), bicycle lane kilometers (BLKM), bus stops (BS), traffic signals (SIG), intersection density (INTD), and arterial-local intersection percentage (IALP). (2) A decrease in bicycle collisions was found to be associated with an increase in the number of drive commuters (DRIVE), and in the percentage of drive commuters (DRP). These results support our hypothesis that in North America, with its current low levels of bicycle use (<4%), we can initially expect to see an increase in bicycle collisions as cycle mode share increases. However, as bicycle mode share increases beyond some unknown 'critical' level, our hypothesis also predicts a net safety improvement. To test this hypothesis and to further explore the statistical relationships between bicycle mode split and overall road safety, future research needs to pursue further development and application of community-based, macro-level CPMs. Copyright © 2012. Published by Elsevier Ltd.

Effects of health intervention programs and arsenic exposure on child mortality from acute lower respiratory infections in rural Bangladesh.

PubMed

Jochem, Warren C; Razzaque, Abdur; Root, Elisabeth Dowling

2016-09-01

Respiratory infections continue to be a public health threat, particularly to young children in developing countries. Understanding the geographic patterns of diseases and the role of potential risk factors can help improve future mitigation efforts. Toward this goal, this paper applies a spatial scan statistic combined with a zero-inflated negative-binomial regression to re-examine the impacts of a community-based treatment program on the geographic patterns of acute lower respiratory infection (ALRI) mortality in an area of rural Bangladesh. Exposure to arsenic-contaminated drinking water is also a serious threat to the health of children in this area, and the variation in exposure to arsenic must be considered when evaluating the health interventions. ALRI mortality data were obtained for children under 2 years old from 1989 to 1996 in the Matlab Health and Demographic Surveillance System. This study period covers the years immediately following the implementation of an ALRI control program. A zero-inflated negative binomial (ZINB) regression model was first used to simultaneously estimate mortality rates and the likelihood of no deaths in groups of related households while controlling for socioeconomic status, potential arsenic exposure, and access to care. Next a spatial scan statistic was used to assess the location and magnitude of clusters of ALRI mortality. The ZINB model was used to adjust the scan statistic for multiple social and environmental risk factors. The results of the ZINB models and spatial scan statistic suggest that the ALRI control program was successful in reducing child mortality in the study area. Exposure to arsenic-contaminated drinking water was not associated with increased mortality. Higher socioeconomic status also significantly reduced mortality rates, even among households who were in the treatment program area. Community-based ALRI interventions can be effective at reducing child mortality, though socioeconomic factors may continue to influence mortality patterns. The combination of spatial and non-spatial methods used in this paper has not been applied previously in the literature, and this study demonstrates the importance of such approaches for evaluating and improving public health intervention programs.

Raw and Central Moments of Binomial Random Variables via Stirling Numbers

ERIC Educational Resources Information Center

Griffiths, Martin

2013-01-01

We consider here the problem of calculating the moments of binomial random variables. It is shown how formulae for both the raw and the central moments of such random variables may be obtained in a recursive manner utilizing Stirling numbers of the first kind. Suggestions are also provided as to how students might be encouraged to explore this…

A Mixed-Effects Heterogeneous Negative Binomial Model for Postfire Conifer Regeneration in Northeastern California, USA

Treesearch

Justin S. Crotteau; Martin W. Ritchie; J. Morgan Varner

2014-01-01

Many western USA fire regimes are typified by mixed-severity fire, which compounds the variability inherent to natural regeneration densities in associated forests. Tree regeneration data are often discrete and nonnegative; accordingly, we fit a series of Poisson and negative binomial variation models to conifer seedling counts across four distinct burn severities and...

A review of statistical estimators for risk-adjusted length of stay: analysis of the Australian and new Zealand Intensive Care Adult Patient Data-Base, 2008-2009.

PubMed

Moran, John L; Solomon, Patricia J

2012-05-16

For the analysis of length-of-stay (LOS) data, which is characteristically right-skewed, a number of statistical estimators have been proposed as alternatives to the traditional ordinary least squares (OLS) regression with log dependent variable. Using a cohort of patients identified in the Australian and New Zealand Intensive Care Society Adult Patient Database, 2008-2009, 12 different methods were used for estimation of intensive care (ICU) length of stay. These encompassed risk-adjusted regression analysis of firstly: log LOS using OLS, linear mixed model [LMM], treatment effects, skew-normal and skew-t models; and secondly: unmodified (raw) LOS via OLS, generalised linear models [GLMs] with log-link and 4 different distributions [Poisson, gamma, negative binomial and inverse-Gaussian], extended estimating equations [EEE] and a finite mixture model including a gamma distribution. A fixed covariate list and ICU-site clustering with robust variance were utilised for model fitting with split-sample determination (80%) and validation (20%) data sets, and model simulation was undertaken to establish over-fitting (Copas test). Indices of model specification using Bayesian information criterion [BIC: lower values preferred] and residual analysis as well as predictive performance (R2, concordance correlation coefficient (CCC), mean absolute error [MAE]) were established for each estimator. The data-set consisted of 111663 patients from 131 ICUs; with mean(SD) age 60.6(18.8) years, 43.0% were female, 40.7% were mechanically ventilated and ICU mortality was 7.8%. ICU length-of-stay was 3.4(5.1) (median 1.8, range (0.17-60)) days and demonstrated marked kurtosis and right skew (29.4 and 4.4 respectively). BIC showed considerable spread, from a maximum of 509801 (OLS-raw scale) to a minimum of 210286 (LMM). R2 ranged from 0.22 (LMM) to 0.17 and the CCC from 0.334 (LMM) to 0.149, with MAE 2.2-2.4. Superior residual behaviour was established for the log-scale estimators. There was a general tendency for over-prediction (negative residuals) and for over-fitting, the exception being the GLM negative binomial estimator. The mean-variance function was best approximated by a quadratic function, consistent with log-scale estimation; the link function was estimated (EEE) as 0.152(0.019, 0.285), consistent with a fractional-root function. For ICU length of stay, log-scale estimation, in particular the LMM, appeared to be the most consistently performing estimator(s). Neither the GLM variants nor the skew-regression estimators dominated.

Impact of early childhood caries on oral health-related quality of life of preschool children.

PubMed

Li, M Y; Zhi, Q H; Zhou, Y; Qiu, R M; Lin, H C

2015-03-01

Child oral health-related quality of life (COHRQoL) has been assessed in developed areas; however, it remains unstudied in mainland China. Studies on COHRQoL would benefit a large number of children in China suffering from oral health problems such as dental caries. This study explored the relationship between COHRQoL and early childhood caries, adjusted by socioeconomic factors, in 3- to 4-year-old children in a region of southern China. In this study, 1062 children aged 3-4 years were recruited by cluster sampling and their oral health statuses were examined by a trained dentist. The Chinese version of the Early Childhood Oral Health Impact Scale (ECOHIS) and questions about the children's socioeconomic conditions were completed by the children's parents. A negative binomial regression analysis was used to assess the prevalence of early childhood caries among the children and its influence on COHRQoL. The total ECOHIS scores of the returned scale sets ranged from 0 to 31, and their average scores was 3.1±5.1. The negative binomial analysis showed that the dmfs indices were significantly associated with the ECOHIS score and subscale scores (P<0.05). The multivariate adjusted model showed that a higher dmft index was associated with greater negative impact on COHRQoL (RR = 1.10; 95% CI = 1.07, 1.13; P < 0.05). However, demographic and socioeconomic factors were not associated with COHRQoL (P>0.05). The severity of early childhood caries has a negative impact on the oral health-related quality of life of preschool children and their parents.

Measuring women's cumulative neighborhood deprivation exposure using longitudinally linked vital records: a method for life course MCH research.

PubMed

Kramer, Michael R; Dunlop, Anne L; Hogue, Carol J R

2014-02-01

A life course conceptual framework for MCH research demands new tools for understanding population health and measuring exposures. We propose a method for measuring population-based socio-environmental trajectories for women of reproductive age. We merged maternal longitudinally-linked births to Georgia-resident women from 1994 to 2007 with census economic and social measures using residential geocodes to create woman-centered socio-environmental trajectories. We calculated a woman's neighborhood deprivation index (NDI) at the time of each of her births and, from these, we calculated a cumulative NDI. We fit Loess curves to describe average life course NDI trajectories and binomial regression models to test specific life course theory hypotheses relating cumulative NDI to risk for preterm birth. Of the 1,815,944 total live births, we linked 1,000,437 live births to 413,048 unique women with two or more births. Record linkage had high specificity but relatively low sensitivity which appears non-differential with respect to maternal characteristics. Georgia women on average experienced upward mobility across the life course, although differences by race, early life neighborhood quality, and age at first birth produced differences in cumulative NDI. Adjusted binomial models found evidence for modification of the effect of history of prior preterm birth and advancing age on risk for preterm birth by cumulative NDI. The creation of trajectories from geocoded maternal longitudinally-linked vital records is one method to carry out life course MCH research. We discuss approaches for investigating the impact of truncation of the life course, selection bias from migration, and misclassification of cumulative exposure.

Clinicians' adherence to clinical practice guidelines for cardiac function monitoring during antipsychotic treatment: a retrospective report on 434 patients with severe mental illness.

PubMed

Manchia, Mirko; Firinu, Giorgio; Carpiniello, Bernardo; Pinna, Federica

2017-03-31

Severe mental illness (SMI) has considerable excess morbidity and mortality, a proportion of which is explained by cardiovascular diseases, caused in part by antipsychotic (AP) induced QT-related arrhythmias and sudden death by Torsade de Point (TdP). The implementation of evidence-based recommendations for cardiac function monitoring might reduce the incidence of these AP-related adverse events. To investigate clinicians' adherence to cardiac function monitoring before and after starting AP, we performed a retrospective assessment of 434 AP-treated SMI patients longitudinally followed-up for 5 years at an academic community mental health center. We classified antipsychotics according to their risk of inducing QT-related arrhythmias and TdP (Center for Research on Therapeutics, University of Arizona). We used univariate tests and multinomial or binary logistic regression model for data analysis. Univariate and multinomial regression analysis showed that psychiatrists were more likely to perform pre-treatment electrocardiogram (ECG) and electrolyte testing with AP carrying higher cardiovascular risk, but not on the basis of AP pharmacological class. Univariate and binomial regression analysis showed that cardiac function parameters (ECG and electrolyte balance) were more frequently monitored during treatment with second generation AP than with first generation AP. Our data show the presence of weaknesses in the cardiac function monitoring of AP-treated SMI patients, and might guide future interventions to tackle them.

[Optimal extraction of effective constituents from Aralia elata by central composite design and response surface methodology].

PubMed

Lv, Shao-Wa; Liu, Dong; Hu, Pan-Pan; Ye, Xu-Yan; Xiao, Hong-Bin; Kuang, Hai-Xue

2010-03-01

To optimize the process of extracting effective constituents from Aralia elata by response surface methodology. The independent variables were ethanol concentration, reflux time and solvent fold, the dependent variable was extraction rate of total saponins in Aralia elata. Linear or no-linear mathematic models were used to estimate the relationship between independent and dependent variables. Response surface methodology was used to optimize the process of extraction. The prediction was carried out through comparing the observed and predicted values. Regression coefficient of binomial fitting complex model was as high as 0.9617, the optimum conditions of extraction process were 70% ethanol, 2.5 hours for reflux, 20-fold solvent and 3 times for extraction. The bias between observed and predicted values was -2.41%. It shows the optimum model is highly predictive.

Morbidity and Health Risk Factors Among New Mexico Miners: A Comparison Across Mining Sectors.

PubMed

Shumate, Alice M; Yeoman, Kristin; Victoroff, Tristan; Evans, Kandace; Karr, Roger; Sanchez, Tami; Sood, Akshay; Laney, Anthony Scott

2017-08-01

This study examines differences in chronic health outcomes between coal, uranium, metal, and nonmetal miners. In a cross-sectional study using data from a health screening program for current and former New Mexico miners, log-binomial logistic regression models were used to estimate relative risks of respiratory and heart disease, cancer, osteoarthritis, and back pain associated with mining in each sector as compared with coal, adjusting for other relevant risk factors. Differential risks in angina, pulmonary symptoms, asthma, cancer, osteoarthritis, and back pain between mining sectors were found. New Mexico miners experience different chronic health challenges across sectors. These results demonstrate the importance of using comparable data to understand how health risks differ across mining sectors. Further investigation among a broader geographic population of miners will help identify the health priorities and needs in each sector.

Are autism spectrum conditions more prevalent in an information-technology region? A school-based study of three regions in the Netherlands.

PubMed

Roelfsema, Martine T; Hoekstra, Rosa A; Allison, Carrie; Wheelwright, Sally; Brayne, Carol; Matthews, Fiona E; Baron-Cohen, Simon

2012-05-01

We tested for differences in the prevalence of autism spectrum conditions (ASC) in school-aged children in three geographical regions in the Netherlands. Schools were asked to provide the number of children enrolled, the number having a clinical diagnosis of ASC and/or two control neurodevelopmental conditions. Prevalence was evaluated by negative binomial regression and adjustments were made for non-response and size of the schools. The prevalence estimates of ASC in Eindhoven was 229 per 10,000, significantly higher than in Haarlem (84 per 10,000) and Utrecht (57 per 10,000), whilst the prevalence for the control conditions were similar in all regions. Phase two is planned to validate school-reported cases using standardized diagnostic methods and to explore the possible causes for these differences.

Anaemia prevalence and associated sociodemographic and dietary factors among Palestinian adolescents in the West Bank.

PubMed

Mikki, N; Abdul-Rahim, H F; Stigum, H; Holmboe-Ottesen, G

2011-03-01

Anaemia still persists among children and women of childbearing age in Palestine. We investigated the prevalence of anaemia and associated factors among Palestinian school adolescents (aged 13-15 years) in Ramallah and Hebron governorates. Haemoglobin levels were measured to assess the prevalence of anaemia. The prevalence of anaemia was significantly higher in Hebron than in Ramallah among boys (22.5% versus 6.0% respectively), while among girls the figures were similar (9.2% and 9.3% respectively). Linear binomial regression analysis showed that among boys, anaemia was independently associated with residence in Hebron and higher standard of living, while among girls, anaemia was associated with higher father's education. Consumption of iron-rich foods, as recorded in food frequency questionnaires, had no significant effects on anaemia prevalence in both boys and girls.

Employee resistance and injury during commercial robberies.

PubMed

Jones, Jennifer; Casteel, Carri; Peek-Asa, Corinne

2015-05-01

To examine the association between employee resistance and injury and examine whether type or location of property stolen was associated with employee resistance during commercial robberies in a large metropolitan city. Robbery data were abstracted from police crime reports between 2008 and 2012. Log binomial regression models were used to identify predictors of employee resistance and to evaluate the association between employee resistance and injury. Employees resisted a robber in nearly half of all robbery events. Active employee resistance was significantly associated with employee injury (Adj PR: 1.49, 95% confidence interval, 1.34 to 1.65). Goods being stolen were associated with active employee resistance and employee injury, whereas cash only being stolen was inversely associated with employee injury. Results suggest that employee training in nonresistance can be an important strategy in protecting employees working with the exchange of cash and goods.

Causes and implications of the unforeseen 2016 extreme yield loss in the breadbasket of France.

PubMed

Ben-Ari, Tamara; Boé, Julien; Ciais, Philippe; Lecerf, Remi; Van der Velde, Marijn; Makowski, David

2018-04-24

In 2016, France, one of the leading wheat-producing and wheat-exporting regions in the world suffered its most extreme yield loss in over half a century. Yet, yield forecasting systems failed to anticipate this event. We show that this unprecedented event is a new type of compound extreme with a conjunction of abnormally warm temperatures in late autumn and abnormally wet conditions in the following spring. A binomial logistic regression accounting for fall and spring conditions is able to capture key yield loss events since 1959. Based on climate projections, we show that the conditions that led to the 2016 wheat yield loss are projected to become more frequent in the future. The increased likelihood of such compound extreme events poses a challenge: farming systems and yield forecasting systems, which often support them, must adapt.

Child Schooling in Ethiopia: The Role of Maternal Autonomy.

PubMed

Gebremedhin, Tesfaye Alemayehu; Mohanty, Itismita

2016-01-01

This paper examines the effects of maternal autonomy on child schooling outcomes in Ethiopia using a nationally representative Ethiopian Demographic and Health survey for 2011. The empirical strategy uses a Hurdle Negative Binomial Regression model to estimate years of schooling. An ordered probit model is also estimated to examine age grade distortion using a trichotomous dependent variable that captures three states of child schooling. The large sample size and the range of questions available in this dataset allow us to explore the influence of individual and household level social, economic and cultural factors on child schooling. The analysis finds statistically significant effects of maternal autonomy variables on child schooling in Ethiopia. The roles of maternal autonomy and other household-level factors on child schooling are important issues in Ethiopia, where health and education outcomes are poor for large segments of the population.

Firearm homicide in Australia, Canada, and New Zealand: what can we learn from long-term international comparisons?

PubMed

McPhedran, Samara; Baker, Jeanine; Singh, Pooja

2011-01-01

Although firearm homicide remains a topic of interest within criminological and policy discourse, existing research does not generally undertake longitudinal comparisons between countries. However, cross-country comparisons provide insight into whether "local" trends (e.g., declines in firearm homicide in one particular country) differ from broader, international trends. This in turn can improve knowledge about the role of factors such as policing practices and socioeconomic variables in the incidence of lethal violence using firearms. The current study compares long-term firearm homicide trends in three countries with similar social histories but different legislative regimes: Australia, Canada, and New Zealand. Using negative binomial regression, the study found that the most pronounced decline in firearm homicide over the past two decades occurred in New Zealand. Connections between social disadvantage, policing policy, and violence are discussed.

Factors associated with the relationship between motorcycle deaths and economic growth.

PubMed

Law, Teik Hua; Noland, Robert B; Evans, Andrew W

2009-03-01

This paper examines the Kuznets curve relationship for motorcycle deaths. The Kuznets curve describes the inverted U-shape relationship between economic development and, in this case, motorcycle deaths. In early stages of development we expect deaths to increase with increasing motorization. Eventually deaths decrease as technical, policy and political institutions respond to demands for increased safety. We examine this effect as well as some of the factors which might explain the Kuznets relationship: in particular motorcycle helmet laws, medical care and technology improvements, and variables representing the quality of political institutions. We apply a fixed effects negative binomial regression analysis on a panel of 25 countries covering the period 1970-1999. Our results broadly suggest that implementation of road safety regulation, improvement in the quality of political institutions, and medical care and technology developments have contributed to reduced motorcycle deaths.

Use of the negative binomial-truncated Poisson distribution in thunderstorm prediction

NASA Technical Reports Server (NTRS)

Cohen, A. C.

1971-01-01

A probability model is presented for the distribution of thunderstorms over a small area given that thunderstorm events (1 or more thunderstorms) are occurring over a larger area. The model incorporates the negative binomial and truncated Poisson distributions. Probability tables for Cape Kennedy for spring, summer, and fall months and seasons are presented. The computer program used to compute these probabilities is appended.

Orchestrating Semiotic Leaps from Tacit to Cultural Quantitative Reasoning--The Case of Anticipating Experimental Outcomes of a Quasi-Binomial Random Generator

ERIC Educational Resources Information Center

Abrahamson, Dor

2009-01-01

This article reports on a case study from a design-based research project that investigated how students make sense of the disciplinary tools they are taught to use, and specifically, what personal, interpersonal, and material resources support this process. The probability topic of binomial distribution was selected due to robust documentation of…

Response of selected binomial coefficients to varying degrees of matrix sparseness and to matrices with known data interrelationships

USGS Publications Warehouse

Archer, A.W.; Maples, C.G.

1989-01-01

Numerous departures from ideal relationships are revealed by Monte Carlo simulations of widely accepted binomial coefficients. For example, simulations incorporating varying levels of matrix sparseness (presence of zeros indicating lack of data) and computation of expected values reveal that not only are all common coefficients influenced by zero data, but also that some coefficients do not discriminate between sparse or dense matrices (few zero data). Such coefficients computationally merge mutually shared and mutually absent information and do not exploit all the information incorporated within the standard 2 ?? 2 contingency table; therefore, the commonly used formulae for such coefficients are more complicated than the actual range of values produced. Other coefficients do differentiate between mutual presences and absences; however, a number of these coefficients do not demonstrate a linear relationship to matrix sparseness. Finally, simulations using nonrandom matrices with known degrees of row-by-row similarities signify that several coefficients either do not display a reasonable range of values or are nonlinear with respect to known relationships within the data. Analyses with nonrandom matrices yield clues as to the utility of certain coefficients for specific applications. For example, coefficients such as Jaccard, Dice, and Baroni-Urbani and Buser are useful if correction of sparseness is desired, whereas the Russell-Rao coefficient is useful when sparseness correction is not desired. ?? 1989 International Association for Mathematical Geology.

Olfactory function and neurocognitive outcomes in old age: The Atherosclerosis Risk in Communities Neurocognitive Study.

PubMed

Palta, Priya; Chen, Honglei; Deal, Jennifer A; Sharrett, A Richey; Gross, Alden; Knopman, David; Griswold, Michael; Heiss, Gerardo; Mosley, Thomas H

2018-03-30

We tested the hypothesis that poor sense of smell is associated with lower cognitive function and higher mild cognitive impairment (MCI) prevalence. Olfaction, measured by the Sniffin' Sticks test, was categorized as olfactory impairment (OI) (score ≤6) or no OI (score >6). MCI was adjudicated based on review of a neuropsychological examination. Linear regression estimated the mean difference in cognitive factor scores, and log-binomial regression quantified MCI prevalence among participants with versus without OI. Participants with OI had lower mean factor scores (memory: -0.27 standard deviation [SD], 95% confidence interval [CI]: -0.35 to -0.19; language: -0.24 SD, 95% CI: -0.30 to -0.17; executive function/processing speed: -0.09 SD, 95% CI: -0.12 to -0.06; and general cognitive performance: -0.25 SD, 95% CI: -0.30 to -0.20). OI was also associated with MCI (n = 204; prevalence ratio = 1.56, 95% CI: 1.37, 1.78). An impaired sense of smell may serve as a readily accessible early marker of neurodegeneration and improve upon the prevailing delayed diagnoses and underascertainment of MCI/dementia. Copyright © 2018 the Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

Nursing home quality and financial performance: does the racial composition of residents matter?

PubMed

Chisholm, Latarsha; Weech-Maldonado, Robert; Laberge, Alex; Lin, Feng-Chang; Hyer, Kathryn

2013-12-01

To examine the effects of the racial composition of residents on nursing homes' financial and quality performance. The study examined Medicare and Medicaid-certified nursing homes across the United States that submitted Medicare cost reports between the years 1999 and 2004 (11,472 average per year). Data were obtained from the Minimum Data Set, the On-Line Survey Certification and Reporting, Medicare Cost Reports, and the Area Resource File. Panel data regression with random intercepts and negative binomial regression were conducted with state and year fixed effects. Financial and quality performance differed between nursing homes with high proportions of black residents and nursing homes with no or medium proportions of black residents. Nursing homes with no black residents had higher revenues and higher operating margins and total profit margins and they exhibited better processes and outcomes than nursing homes with high proportions of black residents. Nursing homes' financial viability and quality of care are influenced by the racial composition of residents. Policy makers should consider initiatives to improve both the financial and quality performance of nursing homes serving predominantly black residents. © Health Research and Educational Trust.

Loneliness as a Public Health Issue: The Impact of Loneliness on Health Care Utilization Among Older Adults

PubMed Central

Jayawardhana, Jayani

2015-01-01

Objectives. We aimed to determine whether loneliness is associated with higher health care utilization among older adults in the United States. Methods. We used panel data from the Health and Retirement Study (2008 and 2012) to examine the long-term impact of loneliness on health care use. The sample was limited to community-dwelling persons in the United States aged 60 years and older. We used negative binomial regression models to determine the impact of loneliness on physician visits and hospitalizations. Results. Under 2 definitions of loneliness, we found that a sizable proportion of those aged 60 years and older in the United States reported loneliness. Regression results showed that chronic loneliness (those lonely both in 2008 and 4 years later) was significantly and positively associated with physician visits (β = 0.075, SE = 0.034). Loneliness was not significantly associated with hospitalizations. Conclusions. Loneliness is a significant public health concern among elders. In addition to easing a potential source of suffering, the identification and targeting of interventions for lonely elders may significantly decrease physician visits and health care costs. PMID:25790413

Consideration of species community composition in statistical ...

EPA Pesticide Factsheets

Diseases are increasing in marine ecosystems, and these increases have been attributed to a number of environmental factors including climate change, pollution, and overfishing. However, many studies pool disease prevalence into taxonomic groups, disregarding host species composition when comparing sites or assessing environmental impacts on patterns of disease presence. We used simulated data under a known environmental effect to assess the ability of standard statistical methods (binomial and linear regression, ANOVA) to detect a significant environmental effect on pooled disease prevalence with varying species abundance distributions and relative susceptibilities to disease. When one species was more susceptible to a disease and both species only partially overlapped in their distributions, models tended to produce a greater number of false positives (Type I error). Differences in disease risk between regions or along an environmental gradient tended to be underestimated, or even in the wrong direction, when highly susceptible taxa had reduced abundances in impacted sites, a situation likely to be common in nature. Including relative abundance as an additional variable in regressions improved model accuracy, but tended to be conservative, producing more false negatives (Type II error) when species abundance was strongly correlated with the environmental effect. Investigators should be cautious of underlying assumptions of species similarity in susceptib

JROTC as a Substitute for PE: Really?

PubMed Central

Lounsbery, Monica A. F.; Holt, Kathryn A.; Monnat, Shannon A.; McKenzie, Thomas L.; Funk, Brian

2014-01-01

Purpose Even though physical education (PE) is an evidence-based strategy for providing and promoting physical activity, alternative programs such as Junior Reserve Officer Training Corps (JROTC) are commonly substituted for PE in many states. The purpose of this study was to compare student physical activity and lesson contexts during high school PE and JROTC sessions. Method SOFIT (System for Observing Fitness Instruction Time) was used to assess PE and JROTC sessions (N=38 each) in 4 high schools that provided both programs. Data were analyzed using t-tests, negative binomial regression, and logistic regression. Results Students engaged in significantly more moderate to vigorous physical activity during PE than JROTC sessions and they were significantly less sedentary. Significant differences between the two program types were also found among lesson contexts. Conclusions PE and JROTC provide substantially different content and contexts and students in them engage in substantially different amounts of moderate to vigorous physical activity. Students in JROTC, and perhaps other alternative programs, are less likely to accrue health-supporting physical activity and engage in fewer opportunities to be physically fit and motorically skilled. Policies and practices for providing substitutions for PE should be carefully examined. PMID:25141093

Resistant to the recession: low-income adults' maintenance of cooking and away-from-home eating behaviors during times of economic turbulence.

PubMed

Smith, Lindsey P; Ng, Shu Wen; Popkin, Barry M

2014-05-01

We examined the effects of state-level unemployment rates during the recession of 2008 on patterns of home food preparation and away-from-home (AFH) eating among low-income and minority populations. We analyzed pooled cross-sectional data on 118 635 adults aged 18 years or older who took part in the American Time Use Study. Multinomial logistic regression models stratified by gender were used to evaluate the associations between state-level unemployment, poverty, race/ethnicity, and time spent cooking, and log binomial regression was used to assess respondents' AFH consumption patterns. High state-level unemployment was associated with only trivial increases in respondents' cooking patterns and virtually no change in their AFH eating patterns. Low-income and racial/ethnic minority groups were not disproportionately affected by the recession. Even during a major economic downturn, US adults are resistant to food-related behavior change. More work is needed to understand whether this reluctance to change is attributable to time limits, lack of knowledge or skill related to food preparation, or lack of access to fresh produce and raw ingredients.

Resistant to the Recession: Low-Income Adults’ Maintenance of Cooking and Away-From-Home Eating Behaviors During Times of Economic Turbulence

PubMed Central

Smith, Lindsey P.; Ng, Shu Wen

2014-01-01

Objectives. We examined the effects of state-level unemployment rates during the recession of 2008 on patterns of home food preparation and away-from-home (AFH) eating among low-income and minority populations. Methods. We analyzed pooled cross-sectional data on 118 635 adults aged 18 years or older who took part in the American Time Use Study. Multinomial logistic regression models stratified by gender were used to evaluate the associations between state-level unemployment, poverty, race/ethnicity, and time spent cooking, and log binomial regression was used to assess respondents’ AFH consumption patterns. Results. High state-level unemployment was associated with only trivial increases in respondents’ cooking patterns and virtually no change in their AFH eating patterns. Low-income and racial/ethnic minority groups were not disproportionately affected by the recession. Conclusions. Even during a major economic downturn, US adults are resistant to food-related behavior change. More work is needed to understand whether this reluctance to change is attributable to time limits, lack of knowledge or skill related to food preparation, or lack of access to fresh produce and raw ingredients. PMID:24625145

Exploring Audiologists' Language and Hearing Aid Uptake in Initial Rehabilitation Appointments.

PubMed

Sciacca, Anna; Meyer, Carly; Ekberg, Katie; Barr, Caitlin; Hickson, Louise

2017-06-13

The study aimed (a) to profile audiologists' language during the diagnosis and management planning phase of hearing assessment appointments and (b) to explore associations between audiologists' language and patients' decisions to obtain hearing aids. Sixty-two audiologist-patient dyads participated. Patient participants were aged 55 years or older. Hearing assessment appointments were audiovisually recorded and transcribed for analysis. Audiologists' language was profiled using two measures: general language complexity and use of jargon. A binomial, multivariate logistic regression analysis was conducted to investigate the associations between these language measures and hearing aid uptake. The logistic regression model revealed that the Flesch-Kincaid reading grade level of audiologists' language was significantly associated with hearing aid uptake. Patients were less likely to obtain hearing aids when audiologists' language was at a higher reading grade level. No associations were found between audiologists' use of jargon and hearing aid uptake. Audiologists' use of complex language may present a barrier for patients to understand hearing rehabilitation recommendations. Reduced understanding may limit patient participation in the decision-making process and result in patients being less willing to trial hearing aids. Clear, concise language is recommended to facilitate shared decision making.

Enumerative and binomial sequential sampling plans for the multicolored Asian lady beetle (Coleoptera: Coccinellidae) in wine grapes.

PubMed

Galvan, T L; Burkness, E C; Hutchison, W D

2007-06-01

To develop a practical integrated pest management (IPM) system for the multicolored Asian lady beetle, Harmonia axyridis (Pallas) (Coleoptera: Coccinellidae), in wine grapes, we assessed the spatial distribution of H. axyridis and developed eight sampling plans to estimate adult density or infestation level in grape clusters. We used 49 data sets collected from commercial vineyards in 2004 and 2005, in Minnesota and Wisconsin. Enumerative plans were developed using two precision levels (0.10 and 0.25); the six binomial plans reflected six unique action thresholds (3, 7, 12, 18, 22, and 31% of cluster samples infested with at least one H. axyridis). The spatial distribution of H. axyridis in wine grapes was aggregated, independent of cultivar and year, but it was more randomly distributed as mean density declined. The average sample number (ASN) for each sampling plan was determined using resampling software. For research purposes, an enumerative plan with a precision level of 0.10 (SE/X) resulted in a mean ASN of 546 clusters. For IPM applications, the enumerative plan with a precision level of 0.25 resulted in a mean ASN of 180 clusters. In contrast, the binomial plans resulted in much lower ASNs and provided high probabilities of arriving at correct "treat or no-treat" decisions, making these plans more efficient for IPM applications. For a tally threshold of one adult per cluster, the operating characteristic curves for the six action thresholds provided binomial sequential sampling plans with mean ASNs of only 19-26 clusters, and probabilities of making correct decisions between 83 and 96%. The benefits of the binomial sampling plans are discussed within the context of improving IPM programs for wine grapes.

Smoke-free legislation and paediatric hospitalisations for acute respiratory tract infections: national quasi-experimental study with unexpected findings and important methodological implications.

PubMed

Been, Jasper V; Mackay, Daniel F; Millett, Christopher; Soyiri, Ireneous; van Schayck, Constant P; Pell, Jill P; Sheikh, Aziz

2017-10-27

We investigated whether Scottish implementation of smoke-free legislation was associated with a reduction in unplanned hospitalisations or deaths ('events') due to respiratory tract infections (RTIs) among children. Interrupted time series (ITS). Children aged 0-12 years living in Scotland during 1996-2012. National comprehensive smoke-free legislation (March 2006). Acute RTI events in the Scottish Morbidity Record-01 and/or National Records of Scotland Death Records. 135 134 RTI events were observed over 155 million patient-months. In our prespecified negative binomial regression model accounting for underlying temporal trends, seasonality, sex, age group, region, urbanisation level, socioeconomic status and seven-valent pneumococcal vaccination status, smoke-free legislation was associated with an immediate rise in RTI events (incidence rate ratio (IRR)=1.24, 95% CI 1.20 to 1.28) and an additional gradual increase (IRR=1.05/year, 95% CI 1.05 to 1.06). Given this unanticipated finding, we conducted a number of post hoc exploratory analyses. Among these, automatic break point detection indicated that the rise in RTI events actually preceded the smoke-free law by 16 months. When accounting for this break point, smoke-free legislation was associated with a gradual decrease in acute RTI events: IRR=0.91/year, 95% CI 0.87 to 0.96. Our prespecified ITS approach suggested that implementation of smoke-free legislation in Scotland was associated with an increase in paediatric RTI events. We were concerned that this result, which contradicted published evidence, was spurious. The association was indeed reversed when accounting for an unanticipated antecedent break point in the temporal trend, suggesting that the legislation may in fact be protective. ITS analyses should be subjected to comprehensive robustness checks to assess consistency. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Job adjustment and absence from work in mid-pregnancy in the Norwegian Mother and Child Cohort Study (MoBa).

PubMed

Kristensen, P; Nordhagen, R; Wergeland, E; Bjerkedal, T

2008-08-01

Pregnant women at work have special needs, and sick leave is common. However, job adjustment in pregnancy is addressed in European legislation. Our main objective was to examine if job adjustment was associated with reduced absence. This study is based on the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. 28,611 employed women filled in questionnaires in weeks 17 and 30 in pregnancy. The risk of absence for more than 2 weeks was studied among those who were not absent in week 17 (n = 22,932), and the probability of return to work in week 30 among those who were absent in week 17 (n = 5679). Data were based on self-report. The influence of job adjustment (three categories: not needed, needed but not obtained, needed and obtained) was analysed in additive models in multivariable binomial regression. Associations with other job characteristics and work environment factors were also analysed. The risk of absence for more than 2 weeks was 0.308 and the probability of return to work was 0.137. Compared with women who needed but did not achieve job adjustment, obtained job adjustment was associated with a 0.107 decreased risk of absence (95% confidence interval 0.090 to 0.125) in a model including other job characteristics and work environment factors. Job adjustment was correspondingly associated with a 0.041 (0.023 to 0.059) increased probability of return to work. Absence was associated with adverse work environment, whereas the opposite pattern was found for return to work among those who started off being absent. Job adjustment was associated with reduced absence from work in pregnancy. Results should be interpreted cautiously because of low participation in MoBa and potential information bias from self-reported data.

A meta-analysis of rate ratios for nocturnal confirmed hypoglycaemia with insulin degludec vs. insulin glargine using different definitions for hypoglycaemia.

PubMed

Heller, S; Mathieu, C; Kapur, R; Wolden, M L; Zinman, B

2016-04-01

A prospective meta-analysis of phase 3 trials showed lower rates of nocturnal hypoglycaemia with insulin degludec vs. insulin glargine. We investigated the consistency of the results across different definitions of hypoglycaemia. This post-hoc, patient-level meta-analysis included six randomized, controlled, 26- or 52-week phase 3a trials in insulin-naïve participants with Type 2 diabetes mellitus (Type 2 diabetesinsulin naïve ), participants with Type 2 diabetes mellitus using basal-bolus therapy (Type 2 diabetesBB ) and those with Type 1 diabetes mellitus. We used three definitions of hypoglycaemia and different timescales for the nocturnal period. Rates were analysed for the entire core trial period, the 'maintenance period' only, and the extension trial set population. Analyses utilized a negative binomial regression model. In Type 2 diabetesinsulin naïve participants, risk of nocturnal hypoglycaemia was significantly lower with insulin degludec vs. insulin glargine for all hypoglycaemia definitions and trial periods. Risk was also lower for the timescale 21.59-05.59, but not 00.01-07.59. For Type 2 diabetesBB , nocturnal hypoglycaemia rates were lower with insulin degludec vs. insulin glargine across all definitions, timescales and trial periods, with one exception. For individuals with Type 1 diabetes mellitus, nocturnal hypoglycaemia risk was significantly lower with insulin degludec during the maintenance period for the original definition (plasma glucose < 3.1 mmol/l, timescale 00.01-05.59) and in the extension trial set population for all hypoglycaemia definitions except for the nocturnal timescale 00.01-07.59. Compared with insulin glargine, insulin degludec is associated with lower rates of nocturnal hypoglycaemia in people with Type 2 diabetes mellitus, and similar or lower rates in Type 1 diabetes mellitus, across different definitions. © 2015 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

Is the quality of brief motivational interventions for drug use in primary care associated with subsequent drug use?

PubMed

Palfai, Tibor P; Cheng, Debbie M; Bernstein, Judith A; Palmisano, Joseph; Lloyd-Travaglini, Christine A; Goodness, Tracie; Saitz, Richard

2016-05-01

Although a number of brief intervention approaches for drug use are based on motivational interviewing (MI), relatively little is known about whether the quality of motivational interviewing skills is associated with intervention outcomes. The current study examined whether indices of motivational interviewing skill were associated with subsequent drug use outcomes following two different MI-based brief interventions delivered in primary care; a 15 min Brief Negotiated Interview (BNI) and a 45 min adaptation of motivational interviewing (MOTIV). Audio recordings from 351 participants in a randomized controlled trial for drug use in primary care were coded using the Motivational Interviewing Treatment Integrity Scale, (MITI Version 3.1.1). Separate negative binomial regression analyses, stratified by intervention condition, were used to examine the associations between six MITI skill variables and the number of days that the participant used his/her main drug 6 weeks after study entry. Only one of the MITI variables (% reflections to questions) was significantly associated with the frequency of drug use in the MOTIV condition and this was opposite to the hypothesized direction (global p=0.01, adjusted IRR 1.50, 95%CI: 1.03-2.20 for middle vs. lowest tertile [higher skill, more drug use]. None were significantly associated with drug use in the BNI condition. Secondary analyses similarly failed to find consistent predictors of better drug outcomes. Overall, this study provides little evidence to suggest that the level of MI intervention skills are linked with better drug use outcomes among people who use drugs and receive brief interventions in primary care. Findings should be considered in light of the fact that data from the study are from negative trial of SBI and was limited to primary care patients. Future work should consider alternative ways of examining these process variables (i.e., comparing thresholds of proficient versus non-proficient skills) or considering alternative methods of coding intervention skills. Copyright © 2016 Elsevier Ltd. All rights reserved.

Fall risk as a function of time after admission to sub-acute geriatric hospital units.

PubMed

Rapp, Kilian; Ravindren, Johannes; Becker, Clemens; Lindemann, Ulrich; Jaensch, Andrea; Klenk, Jochen

2016-10-07

There is evidence about time-dependent fracture rates in different settings and situations. Lacking are data about underlying time-dependent fall risk patterns. The objective of the study was to analyse fall rates as a function of time after admission to sub-acute hospital units and to evaluate the time-dependent impact of clinical factors at baseline on fall risk. This retrospective cohort study used data of 5,255 patients admitted to sub-acute units in a geriatric rehabilitation clinic in Germany between 2010 and 2014. Falls, personal characteristics and functional status at admission were extracted from the hospital information system. The rehabilitation stay was divided in 3-day time-intervals. The fall rate was calculated for each time-interval in all patients combined and in subgroups of patients. To analyse the influence of covariates on fall risk over time multivariate negative binomial regression models were applied for each of 5 time-intervals. The overall fall rate was 10.2 falls/1,000 person-days with highest fall risks during the first week and decreasing risks within the following weeks. A particularly pronounced risk pattern with high fall risks during the first days and decreasing risks thereafter was observed in men, disoriented people, and people with a low functional status or impaired cognition. In disoriented patients, for example, the fall rate decreased from 24.6 falls/1,000 person-days in day 2-4 to about 13 falls/1,000 person-days 2 weeks later. The incidence rate ratio of baseline characteristics changed also over time. Fall risk differs considerably over time during sub-acute hospitalisation. The strongest association between time and fall risk was observed in functionally limited patients with high risks during the first days after admission and declining risks thereafter. This should be considered in the planning and application of fall prevention measures.

Hospital admissions for severe mental illness in England: changes in equity of utilisation at the small area level between 2006 and 2010.

PubMed

White, Jonathan; Gutacker, Nils; Jacobs, Rowena; Mason, Anne

2014-11-01

Severe Mental Illness (SMI) encompasses a range of chronic conditions including schizophrenia, bipolar disorder and psychoses. Patients with SMI often require inpatient psychiatric care. Despite equity being a key objective in the English National Health Service (NHS) and in many other health care systems worldwide, little is known about the socio-economic equity of hospital care utilisation for patients with SMI and how it has changed over time. This analysis seeks to address that gap in the evidence base. We exploit a five-year (2006-2010) panel dataset of admission rates at small area level (n=162,410). The choice of control variables was informed by a systematic literature search. To assess changes in socio-economic equity of utilisation, OLS-based standardisation was first used to conduct analysis of discrete deprivation groups. Geographical inequity was then illustrated by plotting standardised and crude admission rates at local purchaser level. Lastly, formal statistical tests for changes in socio-economic equity of utilisation were applied to a continuous measure of deprivation using pooled negative binomial regression analysis, adjusting for a range of risk factors. Our results suggest that one additional percentage point of area income deprivation is associated with a 1.5% (p<0.001) increase in admissions for SMI after controlling for population size, age, sex, prevalence of SMI in the local population, as well as other need and supply factors. This finding is robust to sensitivity analyses, suggesting that a pro-poor inequality in utilisation exists for SMI-related inpatient services. One possible explanation is that the supply or quality of primary, community or social care for people with mental health problems is suboptimal in deprived areas. Although there is some evidence that inequity has reduced over time, the changes are small and not always robust to sensitivity analyses. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Developing leading indicators from OHS management audit data: Determining the measurement properties of audit data from the field.

PubMed

Robson, Lynda S; Ibrahim, Selahadin; Hogg-Johnson, Sheilah; Steenstra, Ivan A; Van Eerd, Dwayne; Amick, Benjamin C

2017-06-01

OHS management audits are one means of obtaining data that may serve as leading indicators. The measurement properties of such data are therefore important. This study used data from Workwell audit program in Ontario, a Canadian province. The audit instrument consisted of 122 items related to 17 OHS management elements. The study sought answers regarding (a) the ability of audit-based scores to predict workers' compensation claims outcomes, (b) structural characteristics of the data in relation to the organization of the audit instrument, and (c) internal consistency of items within audit elements. The sample consisted of audit and claims data from 1240 unique firms that had completed one or two OHS management audits during 2007-2010. Predictors derived from the audit results were used in multivariable negative binomial regression modeling of workers' compensation claims outcomes. Confirmatory factor analyses were used to examine the instrument's structural characteristics. Kuder-Richardson coefficients of internal consistency were calculated for each audit element. The ability of audit scores to predict subsequent claims data could not be established. Factor analysis supported the audit instrument's element-based structure. KR-20 values were high (≥0.83). The Workwell audit data display structural validity and high internal consistency, but not, to date, construct validity, since the audit scores are generally not predictive of subsequent firm claim experience. Audit scores should not be treated as leading indicators of workplace OHS performance without supporting empirical data. Analyses of the measurement properties of audit data can inform decisionmakers about the operation of an audit program, possible future directions in audit instrument development, and the appropriate use of audit data. In particular, decision-makers should be cautious in their use of audit scores as leading indicators, in the absence of supporting empirical data. Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.

Identifying Vulnerable Populations Using a Social Determinants of Health Framework: Analysis of National Survey Data across Six Asia-Pacific Countries

PubMed Central

Ward, Paul R.; Mamerow, Loreen; Meyer, Samantha B.

2013-01-01

Background In order to improve the health of the most vulnerable groups in society, the WHO called for research on the multiple and inter-linking factors shaping the social determinants of health (SDH). This paper analyses four key SDH (social cohesion, social inclusion, social empowerment and socioeconomic security) across six Asia-Pacific countries: Australia, Hong Kong, Japan, South Korea, Taiwan, and Thailand. Methods Population surveys were undertaken using a validated instrument in 2009-10, with sample sizes around 1000 in each country. The four SDH were analysed using multivariate binomial logistic regression to identify socio-demographic predictors in each country. Results Low socio-economic security was associated with low income in all six study countries and with poor subjective health in Japan, South Korea and Thailand and with being married or cohabiting in Australia and Hong Kong. Low social cohesion was associated with low income in all countries and with undertaking household duties in South Korea, Thailand and Taiwan. Low social inclusion was associated with low income in Australia, South Korea and Taiwan and with poor subjective health in Australia, Japan and South Korea. Older people had lower social inclusion in Taiwan (50-59 years) and Hong Kong (retired), younger people in Japan and South Korea (20-29 years in both countries) and younger and middle-aged people in Australia. Low social empowerment was associated with low income in Australia, Thailand and Taiwan, with being aged 60 years or over in Australia, Hong Kong and South Korea, and over 50 years in Thailand. Conclusions This paper provides baseline measures for identifying where and how policy should be altered to improve the SDH. Furthermore, these data can be used for future policy evaluation to identify whether changes in policy have indeed improved the SDH, particularly for marginalised and vulnerable populations. PMID:24349417

Variations in Mortality in Children Admitted with Pneumonia to Kenyan Hospitals

PubMed Central

Ayieko, Philip; Okiro, Emelda A.; Edwards, Tansy; Nyamai, Rachel; English, Mike

2012-01-01

Background The existing case fatality estimates of inpatient childhood pneumonia in developing countries are largely from periods preceding routine use of conjugate vaccines for infant immunization and such primary studies rarely explore hospital variations in mortality. We analysed case fatality rates of children admitted to nine Kenyan hospitals with pneumonia during the era of routine infant immunization with Hib conjugate vaccine to determine if significant variations exist between hospitals. Methods Pneumonia admissions and outcomes in paediatric wards are described using data collected over two time periods: a one-year period (2007–2008) in nine hospitals, and data from a 9.25-year period (1999-March 2008) in one of the participating hospitals. Hospital case fatality rates for inpatient pneumonia during 2007 to 2008 were modeled using a fixed effect binomial regression model with a logit link. Using an interrupted time series design, data from one hospital were analysed for trends in pneumonia mortality during the period between 1997 and March 2008. Results Overall, 195 (5.9%) children admitted to all 9 hospitals with pneumonia from March 2007 to March 2008 died in hospital. After adjusting for child’s sex, comorbidity, and hospital effect, mortality was significantly associated with child’s age (p<0.001) and pneumonia severity (p<0.001). There was evidence of significant variations in mortality between hospitals (LR χ2 = 52.19; p<0.001). Pneumonia mortality remained stable in the periods before (trend −0.03, 95% CI −0.1 to 0.02) and after Hib introduction (trend 0.04, 95% CI −0.04 to 0.11). Conclusions There are important variations in hospital-pneumonia case fatality in Kenya and these variations are not attributed to temporal changes. Such variations in mortality are not addressed by existing epidemiological models and need to be considered in allocating resources to improve child health. PMID:23139752