School-Based Health Clinics: An Analysis of the Johns Hopkins Study. Research Developments.

ERIC Educational Resources Information Center

Demsko, Tobin W.

School-based health clinics, adolescent pregnancy prevention programs offering comprehensive health services, represent the latest initiative to reduce the incidence of teenage pregnancy. Researchers at Johns Hopkins University designed and administered a pregnancy prevention program which offered sexuality education and family planning services…

College Graduation before Age 19, Especially at Johns Hopkins University, 1876-1997.

ERIC Educational Resources Information Center

Stanley, Julian C.; Sandhofer, Lois S.

This paper describes some students, especially at Johns Hopkins University, Maryland, who have graduated from college 3 or more years before the usual age of 22 or older. Such early graduation is not common, but neither is it extremely rare. Some young graduates seem to have been propelled through college under parental pressure, while others have…

Psychometric validation of the Chinese version of the Johns Hopkins Fall Risk Assessment Tool for older Chinese inpatients.

PubMed

Zhang, Junhong; Wang, Min; Liu, Yu

2016-10-01

To culturally adapt and evaluate the reliability and validity of the Chinese version of the Johns Hopkins Fall Risk Assessment Tool among older inpatients in the mainland of China. Patient falls are an important safety consideration within hospitals among older inpatients. Nurses need specific risk assessment tools for older inpatients to reliably identify at-risk populations and guide interventions that highlight fixable risk factors for falls and consequent injuries. In China, a few tools have been developed to measure fall risk. However, they lack the solid psychometric development necessary to establish their validity and reliability, and they are not widely used for elderly inpatients. A cross-sectional study. A convenient sampling was used to recruit 201 older inpatients from two tertiary-level hospitals in Beijing and Xiamen, China. The Johns Hopkins Fall Risk Assessment Tool was translated using forward and backward translation procedures and was administered to these 201 older inpatients. Reliability of the tool was calculated by inter-rater reliability and Cronbach's alpha. Validity was analysed through content validity index and construct validity. The Inter-rater reliability of Chinese version of Johns Hopkins Fall Risk Assessment Tool was 97·14% agreement with Cohen's Kappa of 0·903. Cronbach's α was 0·703. Content of Validity Index was 0·833. Two factors represented intrinsic and extrinsic risk factors were explored that together explained 58·89% of the variance. This study provided evidence that Johns Hopkins Fall Risk Assessment Tool is an acceptable, valid and reliable tool to identify older inpatients at risk of falls and falls with injury. Further psychometric testing on criterion validity and evaluation of its advanced utility in geriatric clinical settings are warranted. The Chinese version of Johns Hopkins Fall Risk Assessment Tool may be useful for health care personnel to identify older Chinese inpatients at risk of falls and falls

Johns Hopkins University Announces Frederick CREST Classes for Fall 2016 | Poster

Cancer.gov

Johns Hopkins University’s (JHU) Advanced Academic Programs (AAP) division recently announced two classes that will be hosted at the Frederick Center for Research and Education in Science and Technology (CREST) this fall. According to a JHU press release, the classes are Biochemistry, which is part of the M.S. in Biotechnology program at JHU AAP, and Molecular Biology, a part of the M.S. in Bioinformatics program at JHU AAP.

William Henry Welch (1850–1934): the road to Johns Hopkins

PubMed Central

2011-01-01

William Henry Welch's selection in 1884 as the first faculty member of the new medical school at Johns Hopkins created the invigorating atmosphere that generated the revolutionary changes in medical training and laboratory medicine that transformed medicine in America. Dr. Welch's family traditions, his New England upbringing, Yale education, and German university experience prepared a unique individual to lead American medicine into the 20th century. PMID:21738298

Aflatoxin: An Old Carcinogen Teaches Us New Tricks | Division of Cancer Prevention

Cancer.gov

Speaker John D. Groopman, PhD Anna M. Baetjer Professor of Environmental Health Sciences Johns Hopkins Bloomberg School of Public Health Associate Director for Population Sciences Sidney Kimmel Comprehensive Cancer Center Johns Hopkins School of Medicine Baltimore, MD |

Neurology Falls. Patient Falls Risk Assessment, Neurology Clinic, Johns Hopkins Hospital, Baltimore, MD

DTIC Science & Technology

2009-07-06

currently valid ()MB control number. PLEASE DO NOT RETURN YOf IR FORM TO THE ABOVE ADDRESS. 1. REPORT DATE (DD-MM-YYYY) 21 JUL 2008 2. REPORT TYPE Final...Hospital, Baltimore, MD 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR( S ) LT John M Gardner, MSC, USN 5d. PROJECT...NUMBER 5e. TASK NUMBER 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME( S ) AND ADDRESS(ES) Johns Hopkins Hospital, Baltimore, MD Residency Site

Breast Cancer Epidemiology in Puerto Rico

DTIC Science & Technology

2010-06-01

cancer epidemiology. Dr. Rosario took a course on Social Epidemiology at Johns Hopkins Bloomberg School of Public Health Baltimore, MD. June 29 to...July 3, 2009. This course offered an overview of conceptual and methodological approaches relevant to the study of the impact of social factors on...conference call. 2. Training: a. Courses: i. Attended a course on Social Epidemiology at Johns Hopkins Bloomberg School of Public Health

Advanced Pediatric Brain Imaging Research and Training Program

DTIC Science & Technology

2012-10-01

approved by the Curriculum Committee of the Johns Hopkins University Bloomberg School of Public Health and is approved for 6 hours of academic ...approved by the Curriculum Committee of the Johns Hopkins University Bloomberg School of Public Health and is approved for 6 hours of academic credit...Impact of Session These workshops are designed to explain the guidelines for academic promotion and tenure review. Expectations, criteria and tools to

NREL, Johns Hopkins SAIS Develop Method to Quantify Life Cycle Land Use of

Science.gov Websites

Life Cycle Land Use of Electricity from Natural Gas News Release: NREL, Johns Hopkins SAIS Develop Method to Quantify Life Cycle Land Use of Electricity from Natural Gas October 2, 2017 A case study of time provides quantifiable information on the life cycle land use of generating electricity from

Tsinghua-Johns Hopkins Joint Center for Biomedical Engineering Research: scientific and cultural exchange in undergraduate engineering.

PubMed

Wisneski, Andrew D; Huang, Lixia; Hong, Bo; Wang, Xiaoqin

2011-01-01

A model for an international undergraduate biomedical engineering research exchange program is outlined. In 2008, the Johns Hopkins University in collaboration with Tsinghua University in Beijing, China established the Tsinghua-Johns Hopkins Joint Center for Biomedical Engineering Research. Undergraduate biomedical engineering students from both universities are offered the opportunity to participate in research at the overseas institution. Programs such as these will not only provide research experiences for undergraduates but valuable cultural exchange and enrichment as well. Currently, strict course scheduling and rigorous curricula in most biomedical engineering programs may present obstacles for students to partake in study abroad opportunities. Universities are encouraged to harbor abroad opportunities for undergraduate engineering students, for which this particular program can serve as a model.

The past, present, and future of paediatric cardiology training at the Johns Hopkins Hospital, in the tradition of Dr Helen Taussig.

PubMed

Beasley, Gary S; Murphy, Anne M; Brenner, Joel I; Ravekes, William J

2016-12-01

Johns Hopkins has been a leader in paediatric cardiology for over 85 years. In the 1940s, Dr Helen Taussig began training fellows in paediatric cardiology at Johns Hopkins at a time when the diagnosis and treatment of CHD were in the earliest stage. Under her leadership, the fellowship developed a strong foundation that has continued to evolve to meet the current needs of learners and educators. In the current era, the Johns Hopkins programme implements the current theories of adult education and actively engages our fellows in learning as well as teaching. The programme uses techniques such as flipped classroom, structured case-based small-group learning, observed and structured clinical examination, simulations, and innovative educational technology. These strategies combined with our faculty and rich history give our fellows a unique educational experience.

Walter E. Dandy: his contributions to pituitary surgery in the context of the overall Johns Hopkins Hospital experience

PubMed Central

Corsello, Andrea; Di Dalmazi, Giulia; Pani, Fabiana; Chalan, Paulina; Salvatori, Roberto

2017-01-01

Background Walter E. Dandy (1886–1946) was an outstanding neurosurgeon who spent his entire career at the Johns Hopkins Hospital. After graduating from medical school in 1910, he completed a research fellowship in the Hunterian laboratory with Harvey Cushing and then joined the Department of Surgery as resident, rising to the rank professor in 1931. Dandy made several contributions that helped building the neurosurgical specialty, most famously the introduction of pneumo-ventriculography to image brain lesions for which he received a Nobel prize nomination. He also performed many pituitary surgeries, although his role in this area is less known and overshadowed by that of Cushing’s. Purpose This retrospective cohort study was designed to unveil Dandy’s pituitary work and place it in the context of the overall pituitary surgeries performed at the Johns Hopkins Hospital. Methods Pituitary surgery data were obtained by screening the paper and electronic surgical pathology records of the Department of Pathology, as well as the general operating room log books of the Johns Hopkins Hospital housed in the Chesney Medical Archives. Results A total of 3211 pituitary surgeries associated with a pathological specimen were performed between February 1902 and July 2017 in 2847 patients. Most of the surgeries (2875 of 3211 89%) were done by 21 neurosurgeons. Dandy ranks 4th as number of surgeries, with 287 pituitary operations in 35 years of activity. He averaged 8 pituitary surgeries per year, a rate that positions him 6th among all Hopkins neurosurgeons. With the exception of his first operation done in July 1912 while Cushing was still at Hopkins, Dandy approached the pituitary gland transcranially, rather than transphenoidally. The majority of Dandy’s pituitary patients had a pathological diagnosis of pituitary adenomas, followed by craniopharyngiomas and sellar cysts. In the decades Dandy operated, pituitary surgeries represented 0.56% of the total Johns Hopkins

Development of global health education at Johns Hopkins University School of Medicine: a student-driven initiative.

PubMed

Moran, Dane; Edwardson, Jill; Cuneo, Charles Nicholas; Tackett, Sean; Aluri, James; Kironji, Antony; Cox, Jacob; Carroll, Bryn; Lie, Erina; Fofana, Mariam; Bollinger, Robert C; Ziegelstein, Roy C; Chen, Chi C G

2015-01-01

Global health is increasingly present in the formal educational curricula of medical schools across North America. In 2008, students at Johns Hopkins University School of Medicine (JHUSOM) perceived a lack of structured global health education in the existing curriculum and began working with the administration to enhance global health learning opportunities, particularly in resource-poor settings. Key events in the development of global health education have included the introduction of a global health intersession mandatory for all first-year students; required pre-departure ethics training for students before all international electives; and the development of a clinical global health elective (Global Health Leadership Program, GHLP). The main challenges to improving global health education for medical students have included securing funding, obtaining institutional support, and developing an interprofessional program that benefits from the resources of the Schools of Medicine, Public Health, and Nursing. Strategies used included objectively demonstrating the need for and barriers to more structured global health experiences; obtaining guidance and modifying existing resources from other institutions and relevant educational websites; and harnessing institution-specific strengths including the large Johns Hopkins global research footprint and existing interprofessional collaborations across the three schools. The Johns Hopkins experience demonstrates that with a supportive administration, students can play an important and effective role in improving global health educational opportunities. The strategies we used may be informative for other students and educators looking to implement global health programs at their own institutions.

Developing Therapies for Brain Tumors: The Impact of the Johns Hopkins Hunterian Neurosurgical Research Laboratory.

PubMed

Brem, Henry; Sankey, Eric W; Liu, Ann; Mangraviti, Antonella; Tyler, Betty M

2017-01-01

The Johns Hopkins Hunterian Neurosurgical Laboratory at the Johns Hopkins University School of Medicine was created in 1904 by Harvey Cushing and William Halsted and has had a long history of fostering surgical training, encouraging basis science research, and facilitating translational application. Over the past 30 years, the laboratory has addressed the paucity of brain tumor therapies. Pre-clinical work from the laboratory led to the development of carmustine wafers with initial US Food and Drug Administration (FDA) approval in 1996. Combining carmustine wafers, radiation, and temozolomide led to a significant increase in the median survival of patients with glioblastoma. The laboratory has also developed microchips and immunotherapy to further extend survival in this heretofore underserved population. These achievements were made possible by the dedication, commitment, and creativity of more than 300 trainees of the Hunterian Neurosurgical Laboratory. The laboratory demonstrates the beneficial influence of research experience as well its substantial impact on the field of biomedical research.

Hepatobiliary Hands of Hopkins.

PubMed

Pitt, Henry A

2018-02-01

This historical perspective documents the role that John L. Cameron played in advancing hepatobiliary research, education, and surgery at Johns Hopkins in the 1970s, 1980s, and 1990s. Dating back to William S. Halsted in the 19th century, leaders of the Department of Surgery at Johns Hopkins have been interested in hepatobiliary disease and surgery. John L. Cameron had broad hepato-pancreato-biliary (HPB) interests when he completed his surgical training. Over the next 3 decades, he focused on the pancreas. As a result, many faculty and trainee hepatobiliary careers were launched. This perspective is based on 18 years of service as a surgical resident and faculty member at Johns Hopkins. An extensive literature search on the hepatobiliary publications of Halsted, Trimble, Blalock, Longmire, Zuidema, and Cameron was undertaken for this manuscript. Numerous hepatobiliary publications from Johns Hopkins from the 1970s, 1980s, 1990s, and early 2000s were also reviewed. John L. Cameron's early biliary interests included stones, infections, malignancies, and strictures. He was innovative with respect to portal hypertension and Budd-Chiari surgery and supportive when liver transplantation emerged in the 1980s. Volume-outcome studies in the 1990s included hepatic and complex biliary surgery. He supported and encouraged studies of biliary lithotripsy, laparoscopic cholecystectomy, clinical pathways, hepatobiliary cysts, and gallstone pathogenesis. Lessons learned by many who worked with John L. Cameron included the importance of mentorship, innovation, friendship, and collaboration. He taught leadership and change management by example. He fostered a multidisciplinary approach and encouraged randomized controlled trials.

The Johns Hopkins Fall Risk Assessment Tool: A Study of Reliability and Validity.

PubMed

Poe, Stephanie S; Dawson, Patricia B; Cvach, Maria; Burnett, Margaret; Kumble, Sowmya; Lewis, Maureen; Thompson, Carol B; Hill, Elizabeth E

Patient falls and fall-related injury remain a safety concern. The Johns Hopkins Fall Risk Assessment Tool (JHFRAT) was developed to facilitate early detection of risk for anticipated physiologic falls in adult inpatients. Psychometric properties in acute care settings have not yet been fully established; this study sought to fill that gap. Results indicate that the JHFRAT is reliable, with high sensitivity and negative predictive validity. Specificity and positive predictive validity were lower than expected.

76 FR 67195 - Announcing the Award of a Single-Source Program Expansion Supplement Grant to the Johns Hopkins...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Announcing the... School of Public Health in Baltimore, MD, To Support the Development of a Human Services National... extend an award made to the Johns Hopkins University (JHU), Greenberg School of Public Health in...

Fellowship training at John Hopkins: programs leading to careers in librarianship and informatics as informaticians or informationists.

PubMed

Campbell, Jayne M; Roderer, Nancy K

2005-01-01

Preparing librarians to meet the information challenges faced in the current and future health care environments is critical. At Johns Hopkins University, three NLM-funded fellowship programs provide opportunities for librarians to utilize the rich environments of the Welch Medical Library and the Division of Health Sciences Informatics in support of life-long learning.

Implementation and evaluation of the Johns Hopkins University School of Medicine leadership program for women faculty.

PubMed

Levine, Rachel B; González-Fernández, Marlís; Bodurtha, Joann; Skarupski, Kimberly A; Fivush, Barbara

2015-05-01

Women continue to be underrepresented in top leadership roles in academic medicine. Leadership training programs for women are designed to enhance women's leadership skills and confidence and increase overall leadership diversity. The authors present a description and evaluation of a longitudinal, cohort-based, experiential leadership program for women faculty at the Johns Hopkins University School of Medicine. We compared pre- and post-program self-assessed ratings of 11 leadership skills and specific negotiation behaviors from 3 cohorts of leadership program participants (n=134) from 2010 to 2013. Women reported significant improvements in skills across 11 domains with the exceptions of 2 domains, Public Speaking and Working in Teams, both of which received high scores in the pre-program assessment. The greatest improvement in rankings occurred within the domain of negotiation skills. Although women reported an increase in their negotiation skills, we were not able to demonstrate an increase in the number of times that women negotiated for salary, space, or promotion following participation in the program. The Johns Hopkins School of Medicine Leadership Program for Women Faculty has demonstrable value for the professional development of participants and addresses institutional strategies to enhance leadership diversity and the advancement of women.

NCAR Johns Hopkins/CDC Climate and Health Summer Institute

NASA Technical Reports Server (NTRS)

Mearns, Linda O.

2005-01-01

The interactions between climate and health are rife with complexity and present many conceptual and methodological challenges. Possible effects of climate change on health are considered some of the most sensitive impacts of climate change and are a high priority for policy-makers and the public. As a first step toward improving tlit: quality of research, we developed a Climate and Health Workshop (Institute), geared toward teaching students various aspects of how to conduct integrated climate and health research. At the workshop scientists presented selected case studies of climate and health (e.g., heat mortality, vector-borne diseases), thus demonstrating a subset of key analytical tools and databases most useful to researchers in this field. Key research gaps in this research area were discussed. In this six-day Institute (21-28 July 2004, Boulder, Colorado), health scientists and students benefited from lectures and hands-on tools taught by top NCAR scientists. The attendees learned about health databases and epidemiologic methods from leading health scientists from CDC, Johns Hopkins, and other institutions from around the globe.

Enter-educate: new word from Johns Hopkins.

PubMed

Coleman, P L

1988-01-01

Social development communication activities are competing with all of the other communication activities for the attention of the audience. The Johns Hopkins University/Population Communication Services (JHU/PCS) strongly believes that one of the best ways to get the attention of a designated audience, and to keep it, is to entertain the audience and educate it at the same time. They call this concept enter-educate. The basic precepts of this approach include: 1) Choose the most appropriate medium to reach the intended audience; 2) Enlist professionals experienced in the chosen medium in order to have access to the best available resources; 3) Develop a high-quality product that will attract the commercial sector; 4) Use a medium which has a big regional or national audience; and 5) Make the program appealing by including entertainment elements appropriate for the intended audience and not obviously preachy. The most successful project that JHU/PCS has supported that incorporated the concept of enter-educate is the Communication for Young People project in Latin America, better known as the Tatiana and Johnny project. This project used popular music, and its spin offs, to reach young people in 11 Spanish-speaking countries with a sexual responsibility message. Other successful projects in Nigeria and Mali are also described. Nigeria used television shows with family planning skits; in Mali the traditional Koteba theatrical format was made into films for short cinema showings before the main feature.

Using the Johns Hopkins' Aggregated Diagnosis Groups (ADGs) to predict 1-year mortality in population-based cohorts of patients with diabetes in Ontario, Canada.

PubMed

Austin, P C; Shah, B R; Newman, A; Anderson, G M

2012-09-01

There are limited validated methods to ascertain comorbidities for risk adjustment in ambulatory populations of patients with diabetes using administrative health-care databases. The objective was to examine the ability of the Johns Hopkins' Aggregated Diagnosis Groups to predict mortality in population-based ambulatory samples of both incident and prevalent subjects with diabetes. Retrospective cohorts constructed using population-based administrative data. The incident cohort consisted of all 346,297 subjects diagnosed with diabetes between 1 April 2004 and 31 March 2008. The prevalent cohort consisted of all 879,849 subjects with pre-existing diabetes on 1 January, 2007. The outcome was death within 1 year of the subject's index date. A logistic regression model consisting of age, sex and indicator variables for 22 of the 32 Johns Hopkins' Aggregated Diagnosis Group categories had excellent discrimination for predicting mortality in incident diabetes patients: the c-statistic was 0.87 in an independent validation sample. A similar model had excellent discrimination for predicting mortality in prevalent diabetes patients: the c-statistic was 0.84 in an independent validation sample. Both models demonstrated very good calibration, denoting good agreement between observed and predicted mortality across the range of predicted mortality in which the large majority of subjects lay. For comparative purposes, regression models incorporating the Charlson comorbidity index, age and sex, age and sex, and age alone had poorer discrimination than the model that incorporated the Johns Hopkins' Aggregated Diagnosis Groups. Logistical regression models using age, sex and the John Hopkins' Aggregated Diagnosis Groups were able to accurately predict 1-year mortality in population-based samples of patients with diabetes. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

Biomedical research, development, and engineering at the Johns Hopkins University Applied Physics Laboratory. Annual report 1 October 1978-30 September 1979

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

Not Available

The Medical Institutions of The Johns Hopkins University and The Johns Hopkins University Applied Physics Laboratory have developed a vigorous collaborative program of biomedical research, development, and systems engineering. An important objective of the program is to apply the expertise in engineering, the physical sciences, and systems analysis acquired by APL in defense and space research and development to problems of medical research and health care delivery. This program has grown to include collaboration with many of the clinical and basic science departments of the medical divisions. Active collaborative projects exist in ophthalmology, neurosensory research and instrumentation development, cardiovascular systems,more » patient monitoring, therapeutic and rehabilitation systems, clinical information systems, and clinical engineering. This application of state-of-the-art technology has contributed to advances in many areas of basic medical research and in clinical diagnosis and therapy through improvement of instrumentation, techniques, and basic understanding.« less

Chemotherapy and treatment scheduling: the Johns Hopkins Oncology Center Outpatient Department.

PubMed Central

Majidi, F.; Enterline, J. P.; Ashley, B.; Fowler, M. E.; Ogorzalek, L. L.; Gaudette, R.; Stuart, G. J.; Fulton, M.; Ettinger, D. S.

1993-01-01

The Chemotherapy and Treatment Scheduling System provides integrated appointment and facility scheduling for very complex procedures. It is fully integrated with other scheduling systems at The Johns Hopkins Oncology Center and is supported by the Oncology Clinical Information System (OCIS). It provides a combined visual and textual environment for the scheduling of events that have multiple dimensions and dependencies on other scheduled events. It is also fully integrated with other clinical decision support and ancillary systems within OCIS. The system has resulted in better patient flow through the ambulatory care areas of the Center. Implementing the system required changes in behavior among physicians, staff, and patients. This system provides a working example of building a sophisticated rule-based scheduling system using a relatively simple paradigm. It also is an example of what can be achieved when there is total integration between the operational and clinical components of patient care automation. PMID:8130453

Examining Potential Predictors for Completion of the Gardasil Vaccine Sequence Based on Data Gathered at Clinics of Johns Hopkins Medical Institutions

ERIC Educational Resources Information Center

Barat, Christopher E.; Wright, Courtney; Chou, Betty

2011-01-01

This paper presents categorical data that were gathered at two urban clinics and two suburban clinics of Johns Hopkins in an effort to identify characteristics of young female patients who successfully complete the three-injection sequence of the Gardasil quadrivalent human papillomavirus vaccine (HPV4). Available categorical correlates included…

Transcultural adaptation of the Johns Hopkins Fall Risk Assessment Tool.

PubMed

Martinez, Maria Carmen; Iwamoto, Viviane Ernesto; Latorre, Maria do Rosário Dias de Oliveira; Noronha, Adriana Moreira; Oliveira, Ana Paula de Sousa; Cardoso, Carlos Eduardo Alves; Marques, Ifigenia Augusta Braga; Vendramim, Patrícia; Lopes, Paula Cristina; Sant'Ana, Thais Helena Saes de

2016-08-29

to perform the transcultural adaptation and content validity analysis of the Johns Hopkins Fall Risk Assessment Tool to assess both fall risk and fall-related injury risk for hospitalized elderly in Brazil. the transcultural adaptation consisted of translating the scale to Portuguese (Brazil), back-translating it into its language of origin, establishing a consensus version, and having an expert committee verify its transcultural equivalence. Content assessment was conducted by a committee of judges, ending with the calculation of the items and scales' content validity index. Nurses tested the tool. the scale's translated version went through two evaluation rounds by the judges, based on which, the items with unsatisfactory performance were changed. The content validity index for the items was ≥80.0% and the global index 97.1%. The experimental application showed the scale is user-friendly. the scale presents valid content for the assessment of fall risk and risk of fall-related injuries and is easy to use, with the potential to contribute to the proper identification of risks and the establishment of care actions. realizar a adaptação transcultural para uso no Brasil e a avaliação da validade de conteúdo da Johns Hopkins Fall Risk Assessment Tool para avaliação de risco de quedas e de danos por quedas em pacientes adultos hospitalizados. adaptação transcultural consistiu na tradução da escala para a língua portuguesa (Brasil), retrotradução para a língua de origem, versão de consenso e análise da equivalência transcultural por um comitê de especialistas. A avaliação do conteúdo foi realizada por meio de um comitê de juízes, finalizando com o cálculo do índice de validade de conteúdo dos itens e da escala. Foi realizada a aplicação experimental do instrumento por enfermeiros. a versão traduzida da escala passou por duas rodadas de avaliação pelos juízes, a partir das quais os itens com desempenho insatisfatório foram modificados

Johns Hopkins Perceptual Test; Technical Report 9. Disadvantaged Children and Their First School Experiences. ETS-Head Start Longitudinal Study. Technical Report Series.

ERIC Educational Resources Information Center

Gilbert, Lynn E.; Shipman, Virginia C.

The Johns Hopkins Perceptual Test, a brief measure of intelligence in children, requires the child to choose a form identical to a standard. It consists of 3 practice and 30 test items, all involving black geometric figures printed on white cards. There is one booklet for stimulus cards and one for response cards. The child is presented with a…

The Johns Hopkins Hospital: identifying and addressing risks and safety issues.

PubMed

Paine, Lori A; Baker, David R; Rosenstein, Beryl; Pronovost, Peter J

2004-10-01

At The Johns Hopkins Hospital (JHH), a culture of safety refers to the presence of characteristics such as the belief that harm is untenable and the use of a systems approach to analyzing safety issues. The leadership of JHH provides strategic planning guidance for safety and improvement initiatives, involves the patient safety committee in capital investment allocation decisions and in designing and planning new hospital facilities, and ensures that safety and quality head the agenda of board-of-trustees meetings. Although JHH takes a systems approach, structures such as monitoring staff behavior trends are used to hold people accountable for job performance. JHH encountered three major hurdles in implementing and sustaining a culture of safety. First, JHH's decentralized organizational structure contributes to a silo effect that limits the spread of ideas, practices, and culture. JHH intends to create an internal collaborative of departmental safety initiatives to foster opportunities for units to share ideas and results. Second, in response to the challenge of encouraging teams to think and act in an interdisciplinary fashion, communication and teamwork training are being used to enhance the effectiveness of interdisciplinary teams. Further development of valid and meaningful safety-related measurement and data collection methodologies is JHH's largest remaining challenge.

Educational research at Johns Hopkins University School of Medicine: a grassroots development.

PubMed

Thomas, Patricia A; Wright, Scott M; Kern, David E

2004-10-01

The Divisions of General Internal Medicine at Johns Hopkins University School of Medicine have been a rich source of educational research. To better understand the facilitators and barriers to educational research within the divisions, the authors reviewed published educational research from the divisions published between 1995-2004 and examined the history, leadership decisions, and sentinel events that have allowed educational scholarship within the divisions to grow. The authors' analysis suggests a grassroots model of programmatic growth that includes a growing cadre of clinician-educator scholars, effective mentorship, a faculty development program, access to learners, access to research expertise, protected time for scholarship, some funding, and an institutional culture that stimulates scholarship. A medical education fellowship was integral to the model; fellows were first authors for 47% of reviewed manuscripts. Extramural funding has helped build an infrastructure that supports educational scholarship; however, only 12% of the publications have had extramural funding. Protected time for faculty is the characteristic of this model most at risk. While there has been a move toward more institutional support of educational research, it is clear that further growth in the educational research program will require noninstitutional resources.

Enhanced Tobacco Control Initiative at Johns Hopkins Health System: Employee Fairness Perception.

PubMed

Durrani, Shabnum; Lucik, Meg; Safeer, Richard

2018-02-01

Organizations often fail to establish a clear awareness of what employees consider fair when implementing changes to employee benefits in the workplace. In 2016, the Johns Hopkins Health System (JHHS) enhanced their tobacco control efforts. In addition to enhanced smoking cessation benefits, employees were offered an increased reduction in their insurance premiums if they were nonsmokers. To qualify for the reduction, employees participated in testing rather than relying on self-reporting as had been done in the past. The shift to testing prompted a concern by some senior management at JHHS who did not want employees to feel they were not trusted. As the program unfolded at JHHS, the four-component model of procedural justice was applied to provide a framework for reviewing the implementation of the new voluntary tobacco testing at JHHS from a fairness lens. The purpose of this article is to illustrate the application of the four-component procedural model of justice to the tobacco testing process at JHHS. As approximately 75% of employees participated in the program, the experience at JHHS can be instructive to other employers who are looking to implement changes in their workplaces and how to minimize unintended consequences with their employees.

Aspects of Reading Acquisition; Proceedings of the Annual Hyman Blumberg Symposium on Research in Early Childhood Education (5th, Johns Hopkins University, Nov. 13-14, 1974).

ERIC Educational Resources Information Center

Guthrie, John T., Ed.

Papers collected in this volume were presented at the Fifth Annual Blumberg Symposium on Research in Early Childhood Education, held at Johns Hopkins University in 1974. Selections include "Alexia" (D. Frank Benson), "Young Children's Expectations for Reading" (Doris R. Entwisle), "Relations between Acquisition of…

On the shoulders of giants: Harvey Cushing's experience with acromegaly and gigantism at the Johns Hopkins Hospital, 1896-1912.

PubMed

Pendleton, Courtney; Adams, Hadie; Salvatori, Roberto; Wand, Gary; Quiñones-Hinojosa, Alfredo

2011-03-01

A review of Dr. Cushing's surgical cases at Johns Hopkins Hospital revealed new information about his early operative experience with acromegaly. Although in 1912 Cushing published selective case studies regarding this work, a review of all his operations for acromegaly during his early years has never been reported. We uncovered 37 patients who Cushing treated with surgical intervention directed at the pituitary gland. Of these, nine patients who presented with symptoms of acromegaly, and one with symptoms of gigantism were selected for further review. Two patients underwent transfrontal 'omega incision' approaches, and the remaining eight underwent transsphenoidal approaches. Of the 10 patients, 6 were male. The mean age was 38.0 years. The mean hospital stay was 39.4 days. There was one inpatient death during primary interventions (10%) and three patients were deceased at the time of last follow-up (33%). The mean time to death, calculated from the date of the primary surgical intervention, and including inpatient and outpatient deaths, was 11.3 months. The mean time to last follow-up, calculated from the day of discharge, was 59.3 months. At the time of last follow-up, two patients reported resolution of headache; four patients reported continued visual deficits, and two patients reported ongoing changes in mental status. This review analyzes the outcomes for 10 patients who underwent surgical intervention for acromegaly or gigantism, and offers an explanation for Cushing's transition from the transfrontal "omega incision" to the transsphenoidal approach while practicing at the Johns Hopkins Hospital.

One Hundred Years of Psychiatry at Johns Hopkins: A Story of Meyer to McHugh.

PubMed

DePaulo, J Raymond

2017-04-01

This article describes a history of clinical methods and constructs that guide Psychiatry at Johns Hopkins Phipps Clinic today. The contributions of Adolf Meyer and Paul McHugh are central and closely connected. Both emphasize the clinical examination as the central practice of psychiatry as a specialty within medicine. Meyer's comprehensive examination of the patient became the centerpiece of his approach and was the standard for psychiatrists in the English-speaking world. McHugh, with Phillip Slavney, developed a pluralistic and practical framework for interpreting that history and examination. Both argued against the uncritical use of the modern disease construct. McHugh argues that the disease construct, although fundamental, is but one of four useful "perspectives of psychiatry" and is, thus, an insufficient basis for psychiatric practice. The perspectives could be used as an organizing framework by all physicians who seek a practical and truly personalized approach to the care of patients.

AIDS: just the facts from specialists at Johns Hopkins.

PubMed

Finkbeiner, A

1985-12-01

This article, based on information from specialists at Johns Hopkins, poses and then answers 3 broad questions about the acquired immunodeficiency syndrome (AIDS). 1st, it is asked, "What is AIDS and how serious is it?" It is noted that AIDS is only 1 of several forms taken by infection with the human T-lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV). The earliest form of infection is believed to occur within a few weeks of exposure to the virus, and some patients develop an acute syndrome that resembles infectious mononucleosis. These symptoms disappear after 4-6 weeks, by which time the patient has developed antibodies to the virus. About 2-4%/year of asymptomatic carriers go on to develop AIDS-related complex (ARC), and 15-30% of ARC patients develop AIDS within 5 years. The 2nd question posed is, "How do you catch AIDS?" To cause infection, the virus must go directly into the blood, although the virus alone may not be enough to cause sickness. Previous viral infections such as hepatitis B, herpes, cytomegalovirus, and intestinal parasites have been suggested as co-factors of AIDS. Promiscuity increases the chances of contracting AIDS. Observations of the families of AIDS patients and health care personnel who work with AIDS patients suggest that AIDS cannot be caught by casual contact. Finally, it is asked, "What is being done about AIDS?" 4 strategies are outlined: 1) as a result of donor screening for antibodies to HTLV-III/LAV, AIDS has been completely removed from the blood banks; 2) virologists are attempting to understand the virus so that it can be attacked, and understanding has been advanced by the theory that HTLV-III might be what is called a "slow virus;" 3) education about AIDS is changing the sexual practices that transmit AIDS; and 4) epidemiologists are carefully following those who are at risk, have been exposed, or are already sick.

Learning by Doing--Teaching Systematic Review Methods in 8 Weeks

ERIC Educational Resources Information Center

Li, Tianjing; Saldanha, Ian J.; Vedula, S. Swaroop; Yu, Tsung; Rosman, Lori; Twose, Claire; Goodman, Steven N.; Dickersin, Kay

2014-01-01

Objective: The objective of this paper is to describe the course "Systematic Reviews and Meta-analysis" at the Johns Hopkins Bloomberg School of Public Health. Methods: A distinct feature of our course is a group project in which students, assigned to multi-disciplinary groups, conduct a systematic review. In-class sessions comprise…

John B. Watson's Alleged Sex Research: An Appraisal of the Evidence

ERIC Educational Resources Information Center

Benjamin, Ludy T. Jr.; Whitaker, Jodi L.; Ramsey, Russell M.; Zeve, Daniel R.

2007-01-01

In 1974, a story was published about clandestine research done by John B. Watson that was judged to be so reprehensible that it was offered as the real reason he was fired from his faculty position at Johns Hopkins University in 1920, at perhaps the peak of his academic career. Watson's dismissal from Johns Hopkins may have been the most important…

Welch, Sedgwick, and the Hopkins model of hygiene.

PubMed Central

Benson, K. R.

1999-01-01

William H. Welch and William T. Sedgwick, two of the founding fathers of American public health, were both early generation "Hopkins Men." Sedgwick was part of the first group of graduate students to attend Johns Hopkins University, and Welch was part of the initial faculty at the University's medical school. While they never worked together as colleagues at Hopkins, both became interested in the exciting new discoveries of the microbial nature of human disease and developed similar public health programs based on this information. Sedgwick expanded upon these investigations in the new sanitary science program at MIT, where academic public health first emerged in the United States following Sedgwick's appointment in 1883. Welch, who had been exposed to European research in microbiology, promoted microbial research in pathology in Baltimore in 1884. His laboratory-based investigations expanded until they led to the formation of the country's first school of public health in 1916. Thus, a "Hopkins Model" for hygiene and public health emerged from the efforts of both Welch and Sedgwick. PMID:11049162

Background and applications of astrodynamics for space missions of the johns hopkins applied physics laboratory.

PubMed

Dunham, David W; Farquhar, Robert W

2004-05-01

This paper describes astrodynamic techniques applied to develop special orbital designs for past and future space missions of the Applied Physics Laboratory (APL) of Johns Hopkins University, and background about those techniques. The paper does not describe the long history of low Earth-orbiting missions at APL, but rather concentrates on the astrodynamically more interesting high-altitude and interplanetary missions that APL has undertaken in recent years. The authors developed many of their techniques in preparation for, and during, the Third International Sun-Earth Explorer (ISEE-3) halo orbit mission while they worked for the Goddard Space Flight Center (GSFC) of NASA during the 1970s and 1980s. Later missions owed much to the ground breaking work of the trajectory designs for ISEE-3 (later known as the International Cometary Explorer, or ICE). This experience, and other new ideas, were applied to the APL near Earth asteroid rendezvous (NEAR) and comet nucleus tour (CONTOUR) discovery missions, as well as to APL's future MESSENGER, STEREO, and New Horizons missions. These will be described in the paper.

“No Clinical Puzzles More Interesting”: Harvey Cushing and Spinal Trauma, The Johns Hopkins Hospital 1896-1912

PubMed Central

Dasenbrock, Hormuzdiyar H.; Pendleton, Courtney; Cohen-Gadol, Aaron A.; Witham, Timothy F.; Gokaslan, Ziya L.; Quinones-Hinojosa, Alfredo; Bydon, Ali

2015-01-01

Although Harvey Cushing played a central role in the establishment of neurosurgery in the United States, his work on the spine remains largely unknown. This article is not only the first time that Cushing's spinal cases while he was at Johns Hopkins have been reported, but also the first time his management of spinal trauma has been described. We report on 12 patients that Cushing treated from 1898 to 1911 who have never been reported before, including blunt and penetrating injuries, complete and incomplete spinal cord lesions, and both immediate and delayed presentations. Cushing performed laminectomies within 24 hours on patients with immediate presentations—both complete and incomplete spinal cord lesions. Among those with delayed presentations, Cushing did laminectomies on patients with incomplete spinal cord injuries. By the end of his tenure at Hopkins, Cushing advocated nonoperative treatment for all patients with complete spinal cord lesions. Four patients died while an inpatient, with meningitis and cystitis leading to the death of 1 and 3 patients, respectively. Cystitis was treated with intravesicular irrigation; an indwelling catheter was placed by a suprapubic cystostomy in four. Cushing was one of the first to report the use of x-ray in a spine patient, in a case that may have been one factor leading to his interest in the nervous system; Cushing also routinely obtained radiographs in those with spinal trauma. These cases illustrate Cushing's dedication to and rapport with his patients, even in the face of a dismal prognosis. PMID:21135734

Academic Medical Centers Forming Accountable Care Organizations and Partnering With Community Providers: The Experience of the Johns Hopkins Medicine Alliance for Patients.

PubMed

Berkowitz, Scott A; Ishii, Lisa; Schulz, John; Poffenroth, Matt

2016-03-01

Academic medical centers (AMCs)--which include teaching hospital(s) and additional care delivery entities--that form accountable care organizations (ACOs) must decide whether to partner with other provider entities, such as community practices. Indeed, 67% (33/49) of AMC ACOs through the Medicare Shared Savings Program through 2014 are believed to include an outside community practice. There are opportunities for both the AMC and the community partners in pursuing such relationships, including possible alignment around shared goals and adding ACO beneficiaries. To create the Johns Hopkins Medicine Alliance for Patients (JMAP), in January 2014, Johns Hopkins Medicine chose to partner with two community primary care groups and one cardiology practice to support clinical integration while adding approximately 60 providers and 5,000 Medicare beneficiaries. The principal initial interventions within JMAP included care coordination for high-risk beneficiaries and later, in 2014, generating dashboards of ACO quality measures to facilitate quality improvement and early efforts at incorporating clinical pathways and Choosing Wisely recommendations. Additional interventions began in 2015.The principal initial challenges JMAP faced were data integration, generation of quality measure reports among disparate electronic medical records, receiving and then analyzing claims data, and seeking to achieve provider engagement; all these affected timely deployment of the early interventions. JMAP also created three regional advisory councils as a forum promoting engagement of local leadership. Network strategies among AMCs, including adding community practices in a nonemployment model, will continue to require thoughtful strategic planning and a keen understanding of local context.

Bayesian lead time estimation for the Johns Hopkins Lung Project data.

PubMed

Jang, Hyejeong; Kim, Seongho; Wu, Dongfeng

2013-09-01

Lung cancer screening using X-rays has been controversial for many years. A major concern is whether lung cancer screening really brings any survival benefits, which depends on effective treatment after early detection. The problem was analyzed from a different point of view and estimates were presented of the projected lead time for participants in a lung cancer screening program using the Johns Hopkins Lung Project (JHLP) data. The newly developed method of lead time estimation was applied where the lifetime T was treated as a random variable rather than a fixed value, resulting in the number of future screenings for a given individual is a random variable. Using the actuarial life table available from the United States Social Security Administration, the lifetime distribution was first obtained, then the lead time distribution was projected using the JHLP data. The data analysis with the JHLP data shows that, for a male heavy smoker with initial screening ages at 50, 60, and 70, the probability of no-early-detection with semiannual screens will be 32.16%, 32.45%, and 33.17%, respectively; while the mean lead time is 1.36, 1.33 and 1.23 years. The probability of no-early-detection increases monotonically when the screening interval increases, and it increases slightly as the initial age increases for the same screening interval. The mean lead time and its standard error decrease when the screening interval increases for all age groups, and both decrease when initial age increases with the same screening interval. The overall mean lead time estimated with a random lifetime T is slightly less than that with a fixed value of T. This result is hoped to be of benefit to improve current screening programs. Copyright © 2013 Ministry of Health, Saudi Arabia. Published by Elsevier Ltd. All rights reserved.

Nonhuman Animals, Public Health, and Ethics: A First Step, But….

PubMed

Akhtar, Aysha

2017-01-01

In December 2015, the Johns Hopkins Bloomberg School of Public Health held the first-ever summit on the intersection between nonhuman animal ethics and human health. The conference covered a variety of issues where animal health intersects with human health, including the wildlife trade, animal agriculture, and animal experimentation. This article provides a brief overview and critique of the summit.

Let's Get Physical! P.E. Struggles to Make the Grade

ERIC Educational Resources Information Center

LaFee, Scott

2008-01-01

Sixty-six percent of American adults are overweight or obese, and a new study by researchers at Johns Hopkins Bloomberg School of Public Health says it is only going to get worse. They predict the figure will be 75 percent by 2015. A report last year by the Cities, Counties and Schools Partnership cited that nearly 30 percent of children and teens…

The Johns Hopkins model of psychological first aid (RAPID-PFA): curriculum development and content validation.

PubMed

Everly, George S; Barnett, Daniel J; Links, Jonathan M

2012-01-01

There appears to be virtual universal endorsement of the need for and value of acute "psychological first aid" (PFA) in the wake of trauma and disasters. In this paper, we describe the development of the curriculum for The Johns Hopkins RAPID-PFA model of psychological first aid. We employed an adaptation of the basic framework for the development of a clinical science as recommended by Millon which entailed: historical review, theoretical development, and content validation. The process of content validation of the RAPID-PFA curriculum entailed the assessment of attitudes (confidence in the application of PFA interventions, preparedness in the application of PFA); knowledge related to the application of immediate mental health interventions; and behavior (the ability to recognize clinical markers in the field as assessed via a videotape recognition exercise). Results of the content validation phase suggest the six-hour RAPID-PFA curriculum, initially based upon structural modeling analysis, can improve confidence in the application of PFA interventions, preparedness in the application of PFA, knowledge related to the application of immediate mental health interventions, and the ability to recognize clinical markers in the field as assessed via a videotape recognition exercise.

Adaptability in the Development of Data Archiving Services at Johns Hopkins University

NASA Astrophysics Data System (ADS)

Petters, J.; DiLauro, T.; Fearon, D.; Pralle, B.

2015-12-01

Johns Hopkins University (JHU) Data Management Services provides archiving services for institutional researchers through the JHU Data Archive, thereby increasing the access to and use of their research data. From its inception our unit's archiving service has evolved considerably. While some of these changes have been internally driven so that our unit can archive quality data collections more efficiently, we have also developed archiving policies and procedures on the fly in response to researcher needs. Providing our archiving services for JHU research groups from a variety of research disciplines have surfaced different sets of expectations and needs. We have used each interaction to help us refine our services and quickly satisfy the researchers we serve (following the first agile principle). Here we discuss the development of our newest archiving service model, its implementation over the past several months, and the processes by which we have continued to refine and improve our archiving services since its implementation. Through this discussion we will illustrate the benefits of planning, structure and flexibility in development of archiving services that maximize the potential value of research data. We will describe interactions with research groups, including those from environmental engineering and international health, and how we were able to rapidly modify and develop our archiving services to meet their needs (e.g. in an 'agile' way). For example, our interactions with both of these research groups led first to discussion in regular standing meetings and eventually development of new archiving policies and procedures. These policies and procedures centered on limiting access to archived research data while associated manuscripts progress through peer-review and publication.

Lessons from the Johns Hopkins Multi-Disciplinary Venous Thromboembolism (VTE) Prevention Collaborative

PubMed Central

Streiff, Michael B; Carolan, Howard T; Hobson, Deborah B; Kraus, Peggy S; Holzmueller, Christine G; Demski, Renee; Lau, Brandyn D; Biscup-Horn, Paula; Pronovost, Peter J

2012-01-01

Problem Venous thromboembolism (VTE) is a common cause of potentially preventable mortality, morbidity, and increased medical costs. Risk-appropriate prophylaxis can prevent most VTE events, but only a small fraction of patients at risk receive this treatment. Design Prospective quality improvement programme. Setting Johns Hopkins Hospital, Baltimore, Maryland, USA. Strategies for change A multidisciplinary team established a VTE Prevention Collaborative in 2005. The collaborative applied the four step TRIP (translating research into practice) model to develop and implement a mandatory clinical decision support tool for VTE risk stratification and risk-appropriate VTE prophylaxis for all hospitalised adult patients. Initially, paper based VTE order sets were implemented, which were then converted into 16 specialty-specific, mandatory, computerised, clinical decision support modules. Key measures for improvement VTE risk stratification within 24 hours of hospital admission and provision of risk-appropriate, evidence based VTE prophylaxis. Effects of change The VTE team was able to increase VTE risk assessment and ordering of risk-appropriate prophylaxis with paper based order sets to a limited extent, but achieved higher compliance with a computerised clinical decision support tool and the data feedback which it enabled. Risk-appropriate VTE prophylaxis increased from 26% to 80% for surgical patients and from 25% to 92% for medical patients in 2011. Lessons learnt A computerised clinical decision support tool can increase VTE risk stratification and risk-appropriate VTE prophylaxis among hospitalised adult patients admitted to a large urban academic medical centre. It is important to ensure the tool is part of the clinician’s normal workflow, is mandatory (computerised forcing function), and offers the requisite modules needed for every clinical specialty. PMID:22718994

Compliance with Community Mitigation and Interventions in Pandemic Influenza: A Community Policing Strategy

DTIC Science & Technology

2007-09-01

Monica Schoch-Spana of the Bloomberg School of Public Health at Johns Hopkins University, in an article for the journal Confronting Biological Weapons ...Joseph Barbera et al., “Large-Scale Quarantine Following Biological Terrorism in the United States,” JAMA 286 (2001), http://jama.ama-assn.org/cgi/reprint...divergent practices. Mark Rothstein and others, writing for the Institute of Bioethics at the University of

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure (Publisher’s Version)

DTIC Science & Technology

2017-09-27

physical health (5) of service mem- bers. In addition, previous research indicates that exposure to combat may increase the likelihood of negative health ... physical , and behavioral health , studies have shown few negative effects of deployment with respect to posttraumatic stress disorder (PTSD) (10...American Journal of Epidemiology Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This

December 2014 HeartWeek issue of cardiology in the young: highlights of HeartWeek 2014: diseases of the cardiac valves from the foetus to the adult.

PubMed

Jacobs, Jeffrey P

2014-12-01

This December Issue of Cardiology in the Young represents the 12th annual publication generated from the two meetings that compose "HeartWeek in Florida". "HeartWeek in Florida", the joint collaborative project sponsored by the Cardiac Center at the Children's Hospital of Philadelphia, Pennsylvania, together with Johns Hopkins All Children's Heart Institute of Saint Petersburg, Florida, averages over 1000 attendees every year and is now recognised as one of the major planks of continuing medical and nursing education for those working in the fields of diagnosis and treatment of cardiac disease in the foetus, neonate, infant, child, and adult. "HeartWeek in Florida" combines the International Symposium on Congenital Heart Disease, organised by All Children's Hospital and Johns Hopkins Medicine and entering its 15th year, with the Annual Postgraduate Course in Pediatric Cardiovascular Disease, organised by The Children's Hospital of Philadelphia and entering its 18th year. This December, 2014 Issue of Cardiology in the Young features highlights of Johns Hopkins All Children's Heart Institute's 14th Annual International Symposium on Congenital Heart Disease, which was held at the Renaissance Vinoy Resort & Golf Club, Saint Petersburg, Florida, from 15-18 February, 2014. This Symposium was co-sponsored by The American Association for Thoracic Surgery (AATS) and had as its special focus " Diseases of the Cardiac Valves from the Fetus to the Adult ". We acknowledge the tremendous contributions made to paediatric and congenital cardiac care by Duke Cameron and Joel Brenner, and therefore we dedicate this December, 2014 HeartWeek Issue of Cardiology in the Young to them. Duke Cameron is Professor of Surgery at Johns Hopkins University and Cardiac Surgeon-in-Charge at The Johns Hopkins Hospital. Joel Brenner is Professor of Pediatrics at Johns Hopkins University and Director of the Taussig Heart Center at Bloomberg Children's Center, The Johns Hopkins Hospital. Together

Major Extremity Trauma Research Consortium (METRC) 2011 Annual Report

DTIC Science & Technology

2011-01-01

military treatment centers (MTFs). METRC is designed to meet these needs. Anchored by a Data Coordinating Center at the Johns Hopkins Bloomberg...talus or crush injuries only). Excluded from the registry are hip fractures in patients 60 years or older and fractures to the wrist, hand, ankle ...OUTLET: Outcomes following severe distal tibia, ankle and/or foot trauma: comparison of limb salvage vs. transtibial amputation STATUS: Master protocol

The Johns Hopkins Venous Thromboembolism Collaborative: Multidisciplinary team approach to achieve perfect prophylaxis.

PubMed

Streiff, Michael B; Lau, Brandyn D; Hobson, Deborah B; Kraus, Peggy S; Shermock, Kenneth M; Shaffer, Dauryne L; Popoola, Victor O; Aboagye, Jonathan K; Farrow, Norma A; Horn, Paula J; Shihab, Hasan M; Pronovost, Peter J; Haut, Elliott R

2016-12-01

Venous thromboembolism (VTE) is an important cause of preventable harm in hospitalized patients. The critical steps in delivery of optimal VTE prevention care include (1) assessment of VTE and bleeding risk for each patient, (2) prescription of risk-appropriate VTE prophylaxis, (3) administration of risk-appropriate VTE prophylaxis in a patient-centered manner, and (4) continuously monitoring outcomes to identify new opportunities for learning and performance improvement. To ensure that every hospitalized patient receives VTE prophylaxis consistent with their individual risk level and personal care preferences, we organized a multidisciplinary task force, the Johns Hopkins VTE Collaborative. To achieve the goal of perfect prophylaxis for every patient, we developed evidence-based, specialty-specific computerized clinical decision support VTE prophylaxis order sets that assist providers in ordering risk-appropriate VTE prevention. We developed novel strategies to improve provider VTE prevention ordering practices including face-to-face performance reviews, pay for performance, and provider VTE scorecards. When we discovered that prescription of risk-appropriate VTE prophylaxis does not ensure its administration, our multidisciplinary research team conducted in-depth surveys of patients, nurses, and physicians to design a multidisciplinary patient-centered educational intervention to eliminate missed doses of pharmacologic VTE prophylaxis that has been funded by the Patient Centered Outcomes Research Institute. We expect that the studies currently underway will bring us closer to the goal of perfect VTE prevention care for every patient. Our learning journey to eliminate harm from VTE can be applied to other types of harm. Journal of Hospital Medicine 2016;11:S8-S14. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Hashimoto's Thyroiditis: Celebrating the Centennial Through the Lens of the Johns Hopkins Hospital Surgical Pathology Records

PubMed Central

De Remigis, Alessandra; Chuang, Kelly; Dembele, Marieme; Iwama, Akiko; Iwama, Shintaro

2013-01-01

Hashimoto's thyroiditis is now considered the most prevalent autoimmune disease, as well as the most common endocrine disorder. It was initially described in 1912, but only rarely reported until the early 1950s. To celebrate this centennial, we reviewed the surgical pathology archives of the Johns Hopkins hospital for cases of Hashimoto's thyroiditis, spanning the period from May 1889 to October 2012. Approximately 15,000 thyroidectomies were performed at this hospital over 124 years. The first surgical case was reported in 1942, 30 years after the original description. Then, 867 cases of Hashimoto's thyroiditis were seen from 1942 to 2012, representing 6% of all thyroidectomies. Hashimoto's thyroiditis was the sole pathological finding in 462 cases; it accompanied other thyroid pathologies in the remaining 405 cases. The most commonly associated pathology was papillary thyroid cancer, an association that increased significantly during the last two decades. The most common indication for thyroidectomy was a thyroid nodule that was cytologically suspicious for malignancy. Hashimoto's thyroiditis remains a widespread, intriguing, and multifaceted disease of unknown etiology one century after its description. Advances in the understanding of its pathogenesis and preoperative diagnosis will improve recognition and treatment of this disorder, and may one day lead to its prevention. PMID:23151083

Using the CDC Worksite Health ScoreCard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine.

PubMed

Safeer, Richard; Bowen, Wendy; Maung, Zaw; Lucik, Meg

2018-02-01

The aim of this study was to determine whether the Centers for Disease Control and Prevention Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers. Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks. Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two. Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

The Johns Hopkins Hunterian Laboratory Philosophy: Mentoring Students in a Scientific Neurosurgical Research Laboratory.

PubMed

Tyler, Betty M; Liu, Ann; Sankey, Eric W; Mangraviti, Antonella; Barone, Michael A; Brem, Henry

2016-06-01

After over 50 years of scientific contribution under the leadership of Harvey Cushing and later Walter Dandy, the Johns Hopkins Hunterian Laboratory entered a period of dormancy between the 1960s and early 1980s. In 1984, Henry Brem reinstituted the Hunterian Neurosurgical Laboratory, with a new focus on localized delivery of therapies for brain tumors, leading to several discoveries such as new antiangiogenic agents and Gliadel chemotherapy wafers for the treatment of malignant gliomas. Since that time, it has been the training ground for 310 trainees who have dedicated their time to scientific exploration in the lab, resulting in numerous discoveries in the area of neurosurgical research. The Hunterian Neurosurgical Laboratory has been a unique example of successful mentoring in a translational research environment. The laboratory's philosophy emphasizes mentorship, independence, self-directed learning, creativity, and people-centered collaboration, while maintaining productivity with a focus on improving clinical outcomes. This focus has been served by the diverse backgrounds of its trainees, both in regard to educational status as well as culturally. Through this philosophy and strong legacy of scientific contribution, the Hunterian Laboratory has maintained a positive and productive research environment that supports highly motivated students and trainees. In this article, the authors discuss the laboratory's training philosophy, linked to the principles of adult learning (andragogy), as well as the successes and the limitations of including a wide educational range of students in a neurosurgical translational laboratory and the phenomenon of combining clinical expertise with rigorous scientific training.

The new and improved learning community at Johns Hopkins University School of Medicine resembles that at Hogwarts School of Witchcraft and Wizardry.

PubMed

Stewart, Rosalyn W; Barker, Allison R; Shochet, Robert B; Wright, Scott M

2007-05-01

In July 2005, a learning community was created at Johns Hopkins University School of Medicine (JHUSOM) to foster camaraderie, networking, advising, mentoring, professionalism, clinical skills, and scholarship--The Colleges. The cultural and structural changes that emerged with the creation of this program have resulted in JHUSOM bearing a resemblance to J. K. Rowling's fictional Hogwarts School of Witchcraft and Wizardry. This manuscript will describe the similarities between these two revered schools, and highlight the innovations and improvements made to JHUSOM's learning environment. The intense, stressful, and lengthy professional training required to achieve competency in the practice of medicine and in the practice of witchcraft (albeit fictional) have meaningful parallels. The supportive learning environment at these two schools should afford the next generation of graduates to have an even more enriching experience than those who have come before them.

Hopkins in Cupola

NASA Image and Video Library

2013-10-14

ISS037-E-011232 (14 Oct. 2013) --- NASA astronaut Mike Hopkins, Expedition 37 flight engineer, like all International Space Station inhabitants, enjoys time in the Cupola, which affords the most broad views of Earth. "Behind" Hopkins can be seen the northern coast of Brazil, including the Acarau River delta in the state of Ceara, just west of the city of Fortaleza (out of frame).

Epidemiology: Then and Now.

PubMed

Kuller, Lewis H

2016-03-01

Twenty-five years ago, on the 75th anniversary of the Johns Hopkins Bloomberg School of Public Health, I noted that epidemiologic research was moving away from the traditional approaches used to investigate "epidemics" and their close relationship with preventive medicine. Twenty-five years later, the role of epidemiology as an important contribution to human population research, preventive medicine, and public health is under substantial pressure because of the emphasis on "big data," phenomenology, and personalized medical therapies. Epidemiology is the study of epidemics. The primary role of epidemiology is to identify the epidemics and parameters of interest of host, agent, and environment and to generate and test hypotheses in search of causal pathways. Almost all diseases have a specific distribution in relation to time, place, and person and specific "causes" with high effect sizes. Epidemiology then uses such information to develop interventions and test (through clinical trials and natural experiments) their efficacy and effectiveness. Epidemiology is dependent on new technologies to evaluate improved measurements of host (genomics), epigenetics, identification of agents (metabolomics, proteomics), new technology to evaluate both physical and social environment, and modern methods of data collection. Epidemiology does poorly in studying anything other than epidemics and collections of numerators and denominators without specific hypotheses even with improved statistical methodologies. © 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.

The mortality risk score and the ADG score: two points-based scoring systems for the Johns Hopkins aggregated diagnosis groups to predict mortality in a general adult population cohort in Ontario, Canada.

PubMed

Austin, Peter C; Walraven, Carl van

2011-10-01

Logistic regression models that incorporated age, sex, and indicator variables for the Johns Hopkins' Aggregated Diagnosis Groups (ADGs) categories have been shown to accurately predict all-cause mortality in adults. To develop 2 different point-scoring systems using the ADGs. The Mortality Risk Score (MRS) collapses age, sex, and the ADGs to a single summary score that predicts the annual risk of all-cause death in adults. The ADG Score derives weights for the individual ADG diagnosis groups. : Retrospective cohort constructed using population-based administrative data. All 10,498,413 residents of Ontario, Canada, between the age of 20 and 100 years who were alive on their birthday in 2007, participated in this study. Participants were randomly divided into derivation and validation samples. : Death within 1 year. In the derivation cohort, the MRS ranged from -21 to 139 (median value 29, IQR 17 to 44). In the validation group, a logistic regression model with the MRS as the sole predictor significantly predicted the risk of 1-year mortality with a c-statistic of 0.917. A regression model with age, sex, and the ADG Score has similar performance. Both methods accurately predicted the risk of 1-year mortality across the 20 vigintiles of risk. The MRS combined values for a person's age, sex, and the John Hopkins ADGs to accurately predict 1-year mortality in adults. The ADG Score is a weighted score representing the presence or absence of the 32 ADG diagnosis groups. These scores will facilitate health services researchers conducting risk adjustment using administrative health care databases.

Profiling medical school learning environments in Malaysia: a validation study of the Johns Hopkins Learning Environment Scale.

PubMed

Tackett, Sean; Bakar, Hamidah Abu; Shilkofski, Nicole A; Coady, Niamh; Rampal, Krishna; Wright, Scott

2015-01-01

While a strong learning environment is critical to medical student education, the assessment of medical school learning environments has confounded researchers. Our goal was to assess the validity and utility of the Johns Hopkins Learning Environment Scale (JHLES) for preclinical students at three Malaysian medical schools with distinct educational and institutional models. Two schools were new international partnerships, and the third was school leaver program established without international partnership. First- and second-year students responded anonymously to surveys at the end of the academic year. The surveys included the JHLES, a 28-item survey using five-point Likert scale response options, the Dundee Ready Educational Environment Measure (DREEM), the most widely used method to assess learning environments internationally, a personal growth scale, and single-item global learning environment assessment variables. The overall response rate was 369/429 (86%). After adjusting for the medical school year, gender, and ethnicity of the respondents, the JHLES detected differences across institutions in four out of seven domains (57%), with each school having a unique domain profile. The DREEM detected differences in one out of five categories (20%). The JHLES was more strongly correlated than the DREEM to two thirds of the single-item variables and the personal growth scale. The JHLES showed high internal reliability for the total score (α=0.92) and the seven domains (α, 0.56-0.85). The JHLES detected variation between learning environment domains across three educational settings, thereby creating unique learning environment profiles. Interpretation of these profiles may allow schools to understand how they are currently supporting trainees and identify areas needing attention.

Profiling medical school learning environments in Malaysia: a validation study of the Johns Hopkins Learning Environment Scale

PubMed Central

Tackett, Sean; Bakar, Hamidah Abu; Shilkofski, Nicole A.; Coady, Niamh; Rampal, Krishna; Wright, Scott

2015-01-01

Purpose: While a strong learning environment is critical to medical student education, the assessment of medical school learning environments has confounded researchers. Our goal was to assess the validity and utility of the Johns Hopkins Learning Environment Scale (JHLES) for preclinical students at three Malaysian medical schools with distinct educational and institutional models. Two schools were new international partnerships, and the third was school leaver program established without international partnership. Methods: First- and second-year students responded anonymously to surveys at the end of the academic year. The surveys included the JHLES, a 28-item survey using five-point Likert scale response options, the Dundee Ready Educational Environment Measure (DREEM), the most widely used method to assess learning environments internationally, a personal growth scale, and single-item global learning environment assessment variables. Results: The overall response rate was 369/429 (86%). After adjusting for the medical school year, gender, and ethnicity of the respondents, the JHLES detected differences across institutions in four out of seven domains (57%), with each school having a unique domain profile. The DREEM detected differences in one out of five categories (20%). The JHLES was more strongly correlated than the DREEM to two thirds of the single-item variables and the personal growth scale. The JHLES showed high internal reliability for the total score (α=0.92) and the seven domains (α, 0.56-0.85). Conclusion: The JHLES detected variation between learning environment domains across three educational settings, thereby creating unique learning environment profiles. Interpretation of these profiles may allow schools to understand how they are currently supporting trainees and identify areas needing attention. PMID:26165949

In Brief: Rita Colwell receives National Medal of Science

NASA Astrophysics Data System (ADS)

Kumar, Mohi

2007-07-01

Rita Colwell, director of the U.S. National Science Foundation from 1998 to 2004, was awarded a U.S. National Medal of Science in a White House ceremony on 27 July 2007. Colwell, currently a professor of microbiology and biotechnology at the University of Maryland at College Park and a professor at Johns Hopkins University Bloomberg School of Public Health, received the award for her research on global infectious diseases and marine microbes, specifically the bacterium that causes pandemic cholera. The National Medal of Science is the United States' highest honor for scientific achievement. Colwell currently serves on AGU's development board.

The Effect of Viral Suppression on Cross Sectional Incidence Testing in the Johns Hopkins Hospital Emergency Department

PubMed Central

Laeyendecker, Oliver; Rothman, Richard E.; Henson, Charlamaine; Jo Horne, Bobbi; Ketlogetswe, Kerunne S.; Kraus, Chadd K.; Shahan, Judy; Kelen, Gabor. D.; Quinn, Thomas C.

2009-01-01

Objective(s) To determine the effect of viral suppression on cross sectional incidence testing. Methods In 2001 and 2003, patients entering the Johns Hopkins Hospital Emergency Department (JHHED) were enrolled into an interview based, identity unlinked serosurvey. All HIV positive samples were tested by the Vironostika-less sensitive (LS) EIA and an avidity assay to determine recent HIV infection. Additionally 16 samples from 8 previously characterized elite suppressors (ES) were tested by cross sectional incidence assays. Results HIV prevalence was 12% for the 2001 survey and 11% for the 2003 survey. Of the HIV infected subjects 18% did not know they were infected. Vironostika-LS EIA determined that 6% (11/183) and 7% (17/243) of HIV+ individuals in 2001and 2003, respectively, were recently infected. Avidity testing confirmed 6 of 11 in 2001, and 5 of 17 in 2003 were newly infected, leaving 17 discrepant samples. All 17 discrepant samples were western blot positive, viral load undetectable and 7/17 had antiretroviral drugs (ARVs) in their serum. Ten individuals were virally suppressed without ARVs, appeared incident by Vironostika-LS EIA but chronic by avidity. These 10 subjects had similar testing profiles to the known 16 ES samples, as 9 of 16 were incident by Vironostika-LS EIA, and 0/16 were incident by avidity. Conclusions By removing the viral load negative individuals and by confirming the initial Vironostika-LS EIA results by avidity, the incidence estimate was lowered from 1.73 to 0.94 percent/year in 2001 and from 1.90 to 0.56 percent/year in 2003. Viral suppression affects the performance of the cross sectional incidence tests which rely on antibody titer. In additional 2% (10/426) of all HIV infected individuals who use the JHHED for medical care appear to suppress HIV to undetectable levels without ARVs. PMID:18520680

The Center for Alternatives to Animal Testing - Europe (CAAT-EU): a transatlantic bridge for the paradigm shift in toxicology.

PubMed

Daneshian, Mardas; Leist, Marcel; Hartung, Thomas

2010-01-01

The Center for Alternatives to Animal Testing - Europe (CAAT-EU) was founded based collaboration between the Johns Hopkins Bloomberg School of Public Health and the University of Konstanz. CAAT-EU, housed at the University of Konstanz, will coordinate transatlantic activities to promote humane science in research and education, and participate, as partner or coordinator, in publicly and privately funded European projects. Thomas Hartung will serve as program liaison representing Johns Hopkins University and Marcel Leist as the University of Konstanz liaison. CAAT-EU aims to: 1) Set up transatlantic consortia for international research projects on alternative methods. 2) Establish a CAAT Europe faculty and advisory board composed of sponsor representatives and prominent academics from Europe . 3) Participate in the Transatlantic Think Tank for Toxicology (t4) devoted to conceptual work for the paradigm shift in toxicology. 4) Coordinate a series of information days in Europe on relevant developments in the US, similar to the 2009 series CAAT held in the US on EU issues (one on the 7th Amendment to the EU Cosmetics Directive and one on EU and US chemical regulation). 5) Support ALTEX as the official journal of CAAT and CAAT-EU. 6) Develop strategic projects with sponsors to promote humane science and new toxicology, especially with CAAT faculty members. 7) Develop a joint education program between Johns Hopkins and the University of Konstanz, such as e-courses and the existing Humane Science Certificate program developed by CAAT, a student exchange program, and collaboration with the International Graduate School "Cell-based Characterization of De- and Regeneration" in Konstanz.

Haircut for Hopkins

NASA Image and Video Library

2013-10-05

ISS037-E-006568 (5 Oct. 2013) --- Russian cosmonaut Fyodor Yurchikhin, Expedition 37 commander, trims the hair of NASA astronaut Michael Hopkins, flight engineer, in the Node 1 module, called Unity. Yurchikhin used hair clippers fashioned with a vacuum device to garner freshly cut hair.

Haircut for Hopkins

NASA Image and Video Library

2013-10-05

ISS037-E-006571 (5 Oct. 2013) --- Russian cosmonaut Fyodor Yurchikhin, Expedition 37 commander, trims the hair of NASA astronaut Michael Hopkins, flight engineer, in the Unity node of the International Space Station. Yurchikhin used hair clippers fashioned with a vacuum device to garner freshly cut hair.

Haircut for Hopkins

NASA Image and Video Library

2013-10-05

ISS037-E-006565 (5 Oct. 2013) --- Russian cosmonaut Fyodor Yurchikhin, Expedition 37 commander, trims the hair of NASA astronaut Michael Hopkins, flight engineer, in the Unity node of the International Space Station. Yurchikhin used hair clippers fashioned with a vacuum device to garner freshly cut hair.

Results of an academic promotion and career path survey of faculty at the Johns Hopkins University School of Medicine.

PubMed

Thomas, Patricia A; Diener-West, Marie; Canto, Marcia I; Martin, Don R; Post, Wendy S; Streiff, Michael B

2004-03-01

Clinician-educator faculty are increasing in numbers in academic medical centers, but their academic advancement is slower than that of research faculty. The authors sought to quantify the magnitude of this difference in career advancement and to explore the characteristics of faculty that might explain the difference. In 1999, a questionnaire was administered to all MD faculty at the rank of instructor and above (259) in the Department of Medicine at the Johns Hopkins University School of Medicine. A total of 180 (69%) faculty returned questionnaires. Of these, 178 identified with one of four career paths: basic researcher (46), clinical researcher (69), academic clinician (38), or teacher-clinician (25). Career path did not differ by age, gender, rank, years on faculty, hours worked per week, family responsibility, or global work satisfaction. After adjusting for age, gender, time at rank, and work satisfaction, the odds of being at a higher rank were 85% less for academic clinicians (odds ratio,.15; 95% confidence interval, 0.06-0.40) and 69% less for teacher-clinicians (odds ratio,.31; 95% confidence interval, 0.11-0.88) than for basic researchers. Clinical researchers did not differ from basic researchers in the likelihood of being at higher rank. Similarly, compared with basic research faculty, the adjusted odds of being more satisfied with progress towards academic promotion were 92% lower for academic clinicians and 87% lower for teacher-clinicians. Clinician-educator faculty were less likely to be at higher rank at this institution than were faculty in research paths. Differences in rank may be explained by lower rank at hire for faculty in these career paths, time available for scholarly activities, or other resources available to support scholarship. Retaining clinician-educators will require further exploration of barriers to promotion inherent to these career paths and methods of modifying these barriers.

On the Positive Side: Bloomberg and Klein Seek to Repair a Failure Factory

ERIC Educational Resources Information Center

Williams, Joe

2005-01-01

The history books will show that New York City mayor Michael Bloomberg seized control of the city's sprawling public school bureaucracy and its 1.1 million students on July 1, 2002. But it was 18 months later when New Yorkers got their first real taste of what mayoral control and accountability were supposed to be about: when reports of escalating…

Astronaut Mike Hopkins Visit to Maryland Science Center

NASA Image and Video Library

2014-06-09

NASA Astronaut Mike Hopkins explains what it was like to live on the International Space Station for 6 months to visitors at the Maryland Science Center in Baltimore, MD on Monday, June 9, 2014. Hopkins served on Expeditions 37 and 38 with Russian cosmonauts Oleg Kotov and Sergey Ryazanskiy and returned home in March, 2014. (Photo Credit: NASA/Aubrey Gemignani)

Gerard Manley Hopkins and the kinesthetics of conviction.

PubMed

Chambers, S

2008-01-01

This essay explores the link in Gerard Manley Hopkins's imagination between sensations of the body and the changing textures of intensity that characterize experiences of the mind. I argue that one of the first functions of Hopkins's stylistic experiments in The Wreck of the Deutschland and later poems is to call attention to the ways in which our experiences of knowing, reasoning, and believing have parallels in bodily sensations. Hopkins's manipulations of the kinesthetic properties of language - especially the capacity of syntax to evoke sensations of pressure, balance, momentum, and tension - are directed toward a mimesis of consciousness, in which the poet strives to represent the feeling in the mind as it cranes toward an insight or relishes the renewal of conviction.

A case of Pitt-Hopkins syndrome with absence of hyperventilation.

PubMed

Inati, Adlette; Abbas, Hussein A; Korjian, Serge; Daaboul, Yazan; Harajeily, Mohamad; Saab, Raya

2013-12-01

Pitt-Hopkins syndrome is characterized by mental retardation, hyperventilation, and dysmorphic features due to TCF4 mutations. We report a case of Pitt-Hopkins syndrome in a 2½-year-old boy presenting with psychomotor retardation, recurrent respiratory tract infections, and dysmorphic features with absence of hyperventilation or other breathing abnormalities. Comparative genomic hybridization and quantitative real-time polymerase chain reaction were used to confirm TCF4 haploinsufficiency. Pitt-Hopkins syndrome is a rare debilitating disease that should be in the differential diagnosis of other neurodevelopmental disorders characterized by mental retardation and hypotonicity despite the absence of hyperapnea and seizures. Quantitative real-time polymerase chain reaction is another method to identify TCF4 and to confirm Pitt-Hopkins syndrome diagnosis.

Astronaut Mike Hopkins Visit to Maryland Science Center

NASA Image and Video Library

2014-06-09

NASA Astronaut Mike Hopkins explains what it was like to live on the International Space Station for 6 months to seventh graders from Clear Spring Middle School at the Maryland Science Center in Baltimore, MD on Monday, June 9, 2014. Hopkins served on Expeditions 37 and 38 with Russian cosmonauts Oleg Kotov and Sergey Ryazanskiy and returned home in March, 2014. (Photo Credit: NASA/Aubrey Gemignani)

Current and Future Management of Bilateral Loss of Vestibular Sensation – An update on the Johns Hopkins Multichannel Vestibular Prosthesis Project

PubMed Central

Della Santina, Charles C.; Migliaccio, Americo A.; Hayden, Russell; Melvin, Thuy-Anh; Fridman, Gene Y.; Chiang, Bryce; Davidovics, Natan S.; Dai, Chenkai; Carey, John P.; Minor, Lloyd B.; Anderson, Iee-Ching; Park, HongJu; Lyford-Pike, Sofia; Tang, Shan

2012-01-01

Bilateral loss of vestibular sensation can disable individuals whose vestibular hair cells are injured by ototoxic medications, infection, Ménière’s disease or other insults to the labyrinth including surgical trauma during cochlear implantation. Without input to vestibulo-ocular and vestibulo-spinal reflexes that normally stabilize the eyes and body, affected patients suffer blurred vision during head movement, postural instability, and chronic disequilibrium. While individuals with some residual sensation often compensate for their loss through rehabilitation exercises, those who fail to do so are left with no adequate treatment options. An implantable neuroelectronic vestibular prosthesis that emulates the normal labyrinth by sensing head movement and modulating activity on appropriate branches of the vestibular nerve could significantly improve quality of life for these otherwise chronically dizzy patients. This brief review describes the impact and current management of bilateral loss of vestibular sensation, animal studies supporting the feasibility of prosthetic vestibular stimulation, and a vestibular prosthesis designed to restore sensation of head rotation in all directions. Similar to a cochlear implant in concept and size, the Johns Hopkins Multichannel Vestibular Prosthesis (MVP) includes miniature gyroscopes to sense head rotation, a microcontroller to process inputs and control stimulus timing, and current sources switched between pairs of electrodes implanted within the vestibular labyrinth. In rodents and rhesus monkeys rendered bilaterally vestibular-deficient via treatment with gentamicin and/or plugging of semicircular canals, the MVP partially restores the vestibulo-ocular reflex for head rotations about any axis of rotation in 3-dimensional space. Our efforts now focus on addressing issues prerequisite to human implantation, including refinement of electrode designs and surgical technique to enhance stimulus selectivity and preserve

The George W. Comstock Center for Public Health Research and Prevention: A Century of Collaboration, Innovation, and Translation

PubMed Central

Coresh, Josef; Platz, Elizabeth A.

2016-01-01

The Johns Hopkins Bloomberg School of Public Health has been engaged in public health research and practice in Washington County, Maryland, nearly since its inception a century ago. In 2005, the center housing this work was renamed the George W. Comstock Center for Public Health Research and Prevention to honor its pioneering leader. Principles that guided innovation and translation well in the past included: research synergies and opportunities for translation realized through longstanding connection with the community; integration of training with public health research; lifelong learning, mentorship, and teamwork; and efficiency through economies of scale. These principles are useful to consider as we face the challenges of improving the health of the population over the next 100 years. PMID:26872712

4. PHOTOCOPY OF MAP, G. M. HOPKINS, ATLAS OF HUDSON ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. PHOTOCOPY OF MAP, G. M. HOPKINS, ATLAS OF HUDSON COUNTY, NEW JERSEY. G. M. HOPKINS, PHILADELPHIA, PENNSYLVANIA, 1873. - Lembeck & Betz Eagle Brewery, 164-190 Ninth Street, 515-519 Luis Munez Marin Boulevard, Jersey City, Hudson County, NJ

Hopkins during ITCS PWR Retrieval

NASA Image and Video Library

2014-01-31

ISS038-E-040140 (31 Jan. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, uses the Fluid Servicing System (FSS) to refill Internal Thermal Control System (ITCS) loops with fresh coolant in the Destiny laboratory of the International Space Station.

Hopkins during ITCS PWR Retrieval

NASA Image and Video Library

2014-01-31

ISS038-E-040139 (31 Jan. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, uses the Fluid Servicing System (FSS) to refill Internal Thermal Control System (ITCS) loops with fresh coolant in the Destiny laboratory of the International Space Station.

6. PHOTOCOPY OF MAP, G. M. HOPKINS COMPANY, ATLAS OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. PHOTOCOPY OF MAP, G. M. HOPKINS COMPANY, ATLAS OF HUDSON COUNTY, NEW JERSEY, VOL. 1. G. M. HOPKINS AND COMPANY, PHILADELPHIA, PENNSYLVANIA, 1908. - Lembeck & Betz Eagle Brewery, 164-190 Ninth Street, 515-519 Luis Munez Marin Boulevard, Jersey City, Hudson County, NJ

7. PHOTOCOPY OF MAP, G. M. HOPKINS COMPANY, PLATBOOK OF ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. PHOTOCOPY OF MAP, G. M. HOPKINS COMPANY, PLATBOOK OF JERSEY CITY AND BAYONNE, HUDSON COUNTY, NEW JERSEY, VOL. 1. G. M. HOPKINS COMPANY, PHILADELPHIA, PENNSYLVANIA, 1919. - Lembeck & Betz Eagle Brewery, 164-190 Ninth Street, 515-519 Luis Munez Marin Boulevard, Jersey City, Hudson County, NJ

Hopkins installs wire harnesses

NASA Image and Video Library

2013-11-24

ISS038-E-008291 (24 Nov. 2013) --- NASA astronaut Michael Hopkins, Expedition 38 flight engineer, installs wire harnesses in the International Space Station?s Harmony node to support the installation of Ethernet video cables for the station?s local area network. These new cables will provide Ethernet connectivity to the visiting vehicles that dock to Harmony?s Earth-facing port.

Hopkins works with the MDCA hardware replacement, and CIR maintenance

NASA Image and Video Library

2013-12-31

ISS038-E-024145 (30 Dec. 2013) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, performs in-flight maintenance on combustion research hardware in the Destiny laboratory of the International Space Station. Hopkins replaced a Multi-user Droplet Combustion Apparatus (MDCA) fuel reservoir inside the Combustion Integrated Rack (CIR).

The Hopkins Ultraviolet Telescope Data Archive: Old Data in a New Format

NASA Astrophysics Data System (ADS)

Blair, William P.; Dixon, V.; Kruk, J.; Romelfanger, M.

2011-05-01

The Hopkins Ultraviolet Telescope (HUT) was a key component of the Astro Observatory, a package of telescopes that flew on the space shuttle as part of two dedicated astronomy missions, Astro-1 in December 1990 (STS-35), and Astro-2 in March 1995 (STS-67). HUT was a 0.9m telescope and prime-focus spectrograph operating primarily in the far-ultraviolet 900 - 1800 Angstrom spectral region, returning spectra with about 3 Angstrom resolution. Over 330 objects were observed during the two shuttle missions, and the data were originally archived at the NSSDC (NASA/GSFC), before moving to MAST, the Multimission Archive at Space Telescope. As part of a NASA Astrophysics Data Program grant, we are reprocessing and re-archiving this unique data set in a modern and more user-friendly format. Additional file-header keywords include the RA and Dec in J2000 coordinates, the aperture position angle, and target-magnitude and color information. A new data product, similar to the Intermediate Data Files developed for the FUSE mission, provides a flux- and wavelength-calibrated photon-event list with two-second time resolution. These files will allow users to customize their data extractions (e.g., to search for temporal variations in flux or exclude times of bad pointing). The reprocessed data are fully compliant with NVO specifications. They will be available from MAST starting in late 2011. We acknowledge support from NASA ADP grant NNX09AC70G to the Johns Hopkins University.

The development of a model of psychological first aid for non-mental health trained public health personnel: the Johns Hopkins RAPID-PFA.

PubMed

Everly, George S; Lee McCabe, O; Semon, Natalie L; Thompson, Carol B; Links, Jonathan M

2014-01-01

The Johns Hopkins Center for Public Health Preparedness, which houses the Centers for Disease Control and Prevention-funded Preparedness and Emergency Response Learning Center, has been addressing the challenge of disaster-caused behavioral health surge by conducting training programs in psychological first aid (PFA) for public health professionals. This report describes our approach, named RAPID-PFA, and summarizes training evaluation data to determine if relevant knowledge, skills, and attitudes are imparted to trainees to support effective PFA delivery. In the wake of disasters, there is an increase in psychological distress and dysfunction among survivors and first responders. To meet the challenges posed by this surge, a professional workforce trained in PFA is imperative. More than 1500 participants received a 1-day RAPID-PFA training. Pre-/postassessments were conducted to measure (a) required knowledge to apply PFA; (b) perceived self-efficacy, that is, belief in one's own ability, to apply PFA techniques; and (c) confidence in one's own resilience in a crisis context. Statistical techniques were used to validate the extent to which the survey successfully measured individual PFA constructs, that is, unidimensionality, and to quantify the reliability of the assessment tool. Statistically significant pre-/postimprovements were observed in (a) knowledge items supportive of PFA delivery, (b) perceived self-efficacy to apply PFA interventions, and (c) confidence about being a resilient PFA provider. Cronbach alpha coefficients ranging from 0.87 to 0.90 suggested that the self-reported measures possessed sufficient internal consistency. Findings were consistent with our pilot work, and with our complementary research initiatives validating a variant of RAPID-PFA with faith communities. The RAPID-PFA model promises to be a broadly applicable approach to extending community behavioral health surge capacity. Relevant next steps include evaluating the effectiveness

Hopkins in the A/L

NASA Image and Video Library

2013-12-18

View of Mike Hopkins, Expedition 38 Flight Engineer (FE), during remove and replace (R&R) of Hard Upper Torso (HUT) of Extravehicular Mobility Unit (EMU), in the airlock (A/L) during preparation for EVA-24. Photo was taken during Expedition 38. Image was released by astronaut on Twitter.

Epidemiologic Evidence to Guide the Understanding and Prevention of Gun Violence.

PubMed

Webster, Daniel W; Cerdá, Magdalena; Wintemute, Garen J; Cook, Philip J

2016-01-01

Gunfire from assaults, suicides, and unintentional shootings exacts an enormous burden on public health globally. The epidemiologic reviews in this special issue enhance our understanding of various forms of gun violence, inform interventions, and help chart directions for future research. The available science, however, is limited to answer many important questions necessary for mounting successful efforts to reduce gun violence. Certain data are lacking, and there are numerous analytical challenges to deriving unbiased estimates of policy impacts. Significant investments in research over the long term are warranted to answer questions central to successful prevention of gun violence. © The Author 2016. 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.

Invited Commentary: An Interdisciplinary Approach for Policy Evaluation.

PubMed

Hawkins, Summer Sherburne; Baum, Christopher F

2016-03-15

Evidence-based policymaking is becoming the norm, but how do we acquire the evidence to inform policies? In their article in the present issue of the Journal, Basu et al. (Am J Epidemiol. 2016;183(6):531-538) used difference-in-difference-in-differences models and a synthetic control approach to examine the effects of the 1996 welfare reforms on health outcomes among single mothers. In the present commentary, we discuss the limitations of observational studies for policy evaluation. Difference-in-differences models, from the field of economics, offer a rigorous approach to cope with those limitations. © The Author 2016. 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.

Hopkins using FSS to refill ITCS

NASA Image and Video Library

2014-01-31

ISS038-E-040111 (31 Jan. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, uses the Fluid Servicing System (FSS) to refill Internal Thermal Control System (ITCS) loops with fresh coolant in the Destiny laboratory of the International Space Station.

Genetics Home Reference: Pitt-Hopkins syndrome

MedlinePlus

... Hollander NS, Jongmans M, Kant SG, King MD, Lynch SA, McKee S, Midro AT, Park SM, Ricotti V, Tarantino E, Wessels M, Peippo M, Rauch A. Further delineation of Pitt-Hopkins syndrome: phenotypic and genotypic description of 16 novel patients. ...

Hopkins works on T2 COLBERT

NASA Image and Video Library

2014-02-12

ISS038-E-046404 (12 Feb. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, works on the COLBERT treadmill in the Unity node of the International Space Station. He replaced a failed accelerometer in the exercise device then activated COLBERT for a speed test.

Hopkins works on T2 COLBERT

NASA Image and Video Library

2014-02-12

ISS038-E-046401 (12 Feb. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, works on the COLBERT treadmill in the Unity node of the International Space Station. He replaced a failed accelerometer in the exercise device then activated COLBERT for a speed test.

Hopkins works on T2 COLBERT

NASA Image and Video Library

2014-02-12

ISS038-E-046405 (12 Feb. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, works on the COLBERT treadmill in the Unity node of the International Space Station. He replaced a failed accelerometer in the exercise device then activated COLBERT for a speed test.

Hopkins during BASS II Setup

NASA Image and Video Library

2014-02-12

ISS038-E-046393 (12 Feb. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, sets up the Microgravity Science Glovebox (MSG) for the Burning and Suppression of Solids (BASS-II) experiment in the Destiny laboratory of the International Space Station. BASS-II explores how different substances burn in microgravity with benefits for combustion on Earth and fire safety in space.

Hopkins during BASS II Setup

NASA Image and Video Library

2014-02-12

ISS038-E-046394 (12 Feb. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, sets up the Microgravity Science Glovebox (MSG) for the Burning and Suppression of Solids (BASS-II) experiment in the Destiny laboratory of the International Space Station. BASS-II explores how different substances burn in microgravity with benefits for combustion on Earth and fire safety in space.

Hopkins works with tanks from the ARFTA

NASA Image and Video Library

2013-11-24

ISS038-E-008287 (24 Nov. 2013) --- NASA astronaut Michael Hopkins, Expedition 38 flight engineer, works with tanks from the Advanced Recycle Filter Tank Assembly (ARFTA) in the Tranquility node of the International Space Station.

Hopkins works with tanks from the ARFTA

NASA Image and Video Library

2013-11-24

ISS038-E-008289 (24 Nov. 2013) --- NASA astronaut Michael Hopkins, Expedition 38 flight engineer, works with tanks from the Advanced Recycle Filter Tank Assembly (ARFTA) in the Tranquility node of the International Space Station.

Hopkins with SPHERES RINGS

NASA Image and Video Library

2013-11-04

ISS037-E-025870 (4 Nov. 2013) --- In the International Space Station?s Kibo laboratory, NASA astronaut Michael Hopkins, Expedition 37 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Surrounding the two SPHERES mini-satellites is ring-shaped hardware known as the Resonant Inductive Near-field Generation System, or RINGS. SPHERES-RINGS seeks to demonstrate wireless power transfer between satellites at a distance for enhanced operations.

Hopkins with SPHERES RINGS

NASA Image and Video Library

2013-11-04

ISS037-E-025868 (4 Nov. 2013) --- In the International Space Station?s Kibo laboratory, NASA astronaut Michael Hopkins, Expedition 37 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Surrounding the two SPHERES mini-satellites is ring-shaped hardware known as the Resonant Inductive Near-field Generation System, or RINGS. SPHERES-RINGS seeks to demonstrate wireless power transfer between satellites at a distance for enhanced operations.

Hopkins with SPHERES RINGS

NASA Image and Video Library

2013-11-04

ISS037-E-025866 (4 Nov. 2013) --- In the International Space Station?s Kibo laboratory, NASA astronaut Michael Hopkins, Expedition 37 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Surrounding the two SPHERES mini-satellites is ring-shaped hardware known as the Resonant Inductive Near-field Generation System, or RINGS. SPHERES-RINGS seeks to demonstrate wireless power transfer between satellites at a distance for enhanced operations.

Hopkins with SPHERES RINGS

NASA Image and Video Library

2013-11-04

ISS037-E-025872 (4 Nov. 2013) --- In the International Space Station?s Kibo laboratory, NASA astronaut Michael Hopkins, Expedition 37 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Surrounding the two SPHERES mini-satellites is ring-shaped hardware known as the Resonant Inductive Near-field Generation System, or RINGS. SPHERES-RINGS seeks to demonstrate wireless power transfer between satellites at a distance for enhanced operations.

Hopkins with SPHERES RINGS

NASA Image and Video Library

2013-11-04

ISS037-E-025879 (4 Nov. 2013) --- In the International Space Station?s Kibo laboratory, NASA astronaut Michael Hopkins, Expedition 37 flight engineer, conducts a session with a pair of bowling-ball-sized free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES. Surrounding the two SPHERES mini-satellites is ring-shaped hardware known as the Resonant Inductive Near-field Generation System, or RINGS. SPHERES-RINGS seeks to demonstrate wireless power transfer between satellites at a distance for enhanced operations.

Residential Proximity to Gasoline Stations and Risk of Childhood Leukemia.

PubMed

Infante, Peter F

2017-01-01

Significant elevations in the risk of childhood leukemia have been associated with environmental exposure to gasoline; aromatic hydrocarbons from refinery pollution, petroleum waste sites, and mobile sources (automobile exhaust); paints, paint products, and thinners; and secondary cigarette smoke in the home. These higher risks have also been associated with parental exposure to benzene, gasoline, motor vehicle-related jobs, painting, and rubber solvents. These exposures and jobs have 1 common chemical exposure-benzene, a recognized cause of acute leukemia in adults-and raise the question of whether children represent a subpopulation in which a higher risk of leukemia is associated with very low level exposure to environmental benzene. © The Author 2016. 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.

Hopkins during CFE-2 Experiment

NASA Image and Video Library

2013-11-20

ISS038-E-005962 (19 Nov. 2013) --- NASA astronaut Michael Hopkins, Expedition 38 flight engineer, conducts a session with the Capillary Flow Experiment (CFE-2) in the Harmony node of the International Space Station. CFE is a suite of fluid physics experiments that investigate how fluids behave in microgravity which could benefit water and fuel delivery systems on future spacecraft. Scientists designed the Capillary Flow Experiment-2 to study properties of fluids and bubbles inside containers with a specific 3-D geometry.

Invited Commentary: Beware the Test-Negative Design.

PubMed

Westreich, Daniel; Hudgens, Michael G

2016-09-01

In this issue of the Journal, Sullivan et al. (Am J Epidemiol. 2016;184(5):345-353) carefully examine the theoretical justification for use of the test-negative design, a common observational study design, in assessing the effectiveness of influenza vaccination. Using modern causal inference methods (in particular, directed acyclic graphs), they describe different threats to the validity of inferences drawn about the effect of vaccination from test-negative design studies. These threats include confounding, selection bias, and measurement error in either the exposure or the outcome. While confounding and measurement error are common in observational studies, the potential for selection bias inherent in the test-negative design brings into question the validity of inferences drawn from such studies. © The Author 2016. 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.

Invited Commentary: Continuing to Loosen the Constraints on Epidemiology in an Age of Change-A Comment on McMichael's "Prisoners of the Proximate".

PubMed

Galea, Sandro

2017-06-01

Published in 1999, McMichael's "Prisoners of the Proximate: Loosening the Constraints on Epidemiology in an Age of Change" (Am J Epidemiol. 1999;149(10):887-897) outlined an exciting vision for epidemiology as the field that that can help us better understand the drivers of population health so that we may intervene, paving the way for healthier populations. McMichael's paper remains today what it was when it was first published: clear, thoughtful, provocative, and usefully prescriptive in its call to action. McMichael identified 4 constraints facing epidemiology. The field has risen to this challenge and addressed some of these constraints. I discuss how successful (or not) we have been in addressing each of these 4 challenges. © 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.

Enhancing the Safe and Effective Management of Chronic Pain in Accountable Care Organization Primary Care Practices in Kentucky.

PubMed

Wubu, Selam; Hall, Laura Lee; Straub, Paula; Bair, Matthew J; Marsteller, Jill A; Hsu, Yea-Jen; Schneider, Doron; Hood, Gregory A

Chronic pain is a prevalent chronic condition with significant burden and economic impact in the United States. Chronic pain is particularly abundant in primary care, with an estimated 52% of chronic pain patients obtaining care from primary care physicians (PCPs). However, PCPs often lack adequate training and have limited time and resources to effectively manage chronic pain. Chronic pain management is complex in nature because of high co-occurrence of psychiatric disorders and other medical comorbidities in patients. This article describes a quality improvement initiative conducted by the American College of Physicians (ACP), in collaboration with the Kentucky ACP Chapter, and the Center for Health Services and Outcomes Research at the Johns Hopkins Bloomberg School of Public Health, to enhance chronic pain management in 8 primary care practices participating in Accountable Care Organizations in Kentucky, with a goal of enhancing the screening, diagnosis, and treatment of patients with chronic pain.

Impact of a New Palliative Care Program on Health System Finances: An Analysis of the Palliative Care Program Inpatient Unit and Consultations at Johns Hopkins Medical Institutions.

PubMed

Isenberg, Sarina R; Lu, Chunhua; McQuade, John; Chan, Kelvin K W; Gill, Natasha; Cardamone, Michael; Torto, Deirdre; Langbaum, Terry; Razzak, Rab; Smith, Thomas J

2017-05-01

Palliative care inpatient units (PCUs) can improve symptoms, family perception of care, and lower per-diem costs compared with usual care. In March 2013, Johns Hopkins Medical Institutions (JHMI) added a PCU to the palliative care (PC) program. We studied the financial impact of the PC program on JHMI from March 2013 to March 2014. This study considered three components of the PC program: PCU, PC consultations, and professional fees. Using 13 months of admissions data, the team calculated the per-day variable cost pre-PCU (ie, in another hospital unit) and after transfer to the PCU. These fees were multiplied by the number of patients transferred to the PCU and by the average length of stay in the PCU. Consultation savings were estimated using established methods. Professional fees assumed a collection rate of 50%. The total positive financial impact of the PC program was $3,488,863.17. There were 153 transfers to the PCU, 60% with cancer, and an average length of stay of 5.11 days. The daily loss pretransfer to the PCU of $1,797.67 was reduced to $1,345.34 in the PCU (-25%). The PCU saved JHMI $353,645.17 in variable costs, or $452.33 per transfer. Cost savings for PC consultations in the hospital, 60% with cancer, were estimated at $2,765,218. $370,000 was collected in professional fees savings. The PCU and PC program had a favorable impact on JHMI while providing expert patient-centered care. As JHMI moves to an accountable care organization model, value-based patient-centered care and increased intensive care unit availability are desirable.

Hopkins in U.S. Lab with FIR/FCF

NASA Image and Video Library

2013-10-15

ISS037-E-013951 (14 Oct. 2013) --- NASA astronaut Michael Hopkins, Expedition 37 flight engineer, works at the Light Microscopy Module (LMM) in the Fluids Integrated Rack / Fluids Combustion Facility (FIR/FCF) located in the Destiny laboratory of the International Space Station.

76 FR 62046 - Defense Science Board; Notice of Advisory Committee Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... University Applied Physics Laboratory, 11100 Johns Hopkins Road, Laurel, MD 20723. The mission of the Defense... Hopkins University Applied Physics Laboratory, 11100 Johns Hopkins Road, Laurel, MD 20723. FOR FURTHER...

Hill's Heuristics and Explanatory Coherentism in Epidemiology.

PubMed

Dammann, Olaf

2018-01-01

In this essay, I argue that Ted Poston's theory of explanatory coherentism is well-suited as a tool for causal explanation in the health sciences, particularly in epidemiology. Coherence has not only played a role in epidemiology for more than half a century as one of Hill's viewpoints, it can also provide background theory for the development of explanatory systems by integrating epidemiologic evidence with a diversity of other error-independent data. I propose that computational formalization of Hill's viewpoints in an explanatory coherentist framework would provide an excellent starting point for a formal epistemological (knowledge-theoretical) project designed to improve causal explanation in the health sciences. As an example, I briefly introduce Paul Thagard's ECHO system and offer my responses to possible objections to my proposal. © The Author(s) 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.

Invited Commentary: Can Issues With Reproducibility in Science Be Blamed on Hypothesis Testing?

PubMed

Weinberg, Clarice R

2017-09-15

In the accompanying article (Am J Epidemiol. 2017;186(6):646-647), Dr. Timothy Lash makes a forceful case that the problems with reproducibility in science stem from our "culture" of null hypothesis significance testing. He notes that when attention is selectively given to statistically significant findings, the estimated effects will be systematically biased away from the null. Here I revisit the recent history of genetic epidemiology and argue for retaining statistical testing as an important part of the tool kit. Particularly when many factors are considered in an agnostic way, in what Lash calls "innovative" research, investigators need a selection strategy to identify which findings are most likely to be genuine, and hence worthy of further study. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Invited Commentary: Indoor Tanning-A Melanoma Accelerator?

PubMed

Berwick, Marianne; Doré, Jean-François

2017-02-01

In this issue of the Journal, Ghiasvand et al. (Am J Epidemiol. 2017;185(3):147-156) present results from a longitudinal study of the association between indoor tanning and melanoma in a large cohort of Norwegian women. These new data further support previous findings on the damaging effects of tanning bed exposure on women, particularly young women. The authors present compelling evidence that early exposure to tanning beds advances the date of diagnosis of melanoma by at least 2 years. With a strong design and a large cohort followed for a mean of 13.7 years, this study lends additional support to previous evidence of the negative effects of tanning beds and provides further justification for stronger policy initiatives designed to reduce tanning bed use among young women. © The Author 2016. 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.

Hopkins and Mastracchio in the A/L

NASA Image and Video Library

2013-12-20

ISS038-E-019271 (20 Dec. 2013) --- In the Quest airlock onboard the Earth-orbiting International Space Station, on the eve of their first spacewalk together, NASA astronauts Rick Mastracchio, right, and Mike Hopkins are completely suited in their extravehicular mobility unit spacesuits. NASA has scheduled at least two sessions of extravehicular activity for the two flight engineers to troubleshoot a faulty coolant pump on the orbital outpost.

Hopkins during SODI-DCMIX 2 Experiment

NASA Image and Video Library

2013-11-30

ISS038-E-009255 (26 Nov. 2013) --- In the International Space Station?s Destiny laboratory, NASA astronaut Michael Hopkins, Expedition 38 flight engineer, prepares to install and activate the Selectable Optics Diagnostic Instrument (SODI) cell array two in the Microgravity Science Glovebox (MSG) for the Selectable Optics Diagnostic Instrument-Diffusion Coefficient in Mixtures 2 (SODI-DCMIX 2) experiment. SODI-DCMIX 2 is supporting research to determine diffusion coefficients in different petroleum field samples and refine petroleum reservoir models to help lead to more efficient extraction of oil resources.

Hopkins during SODI-DCMIX 2 Experiment

NASA Image and Video Library

2013-11-30

ISS038-E-009253 (26 Nov. 2013) --- In the International Space Station’s Destiny laboratory, NASA astronaut Michael Hopkins, Expedition 38 flight engineer, prepares to install and activate the Selectable Optics Diagnostic Instrument (SODI) cell array two in the Microgravity Science Glovebox (MSG) for the Selectable Optics Diagnostic Instrument-Diffusion Coefficient in Mixtures 2 (SODI-DCMIX 2) experiment. SODI-DCMIX 2 is supporting research to determine diffusion coefficients in different petroleum field samples and refine petroleum reservoir models to help lead to more efficient extraction of oil resources.

Hopkins during SPHERES Slosh Run

NASA Image and Video Library

2014-01-22

ISS038-E-033884 (22 Jan. 2014) --- In the International Space Station's Kibo laboratory, NASA astronaut Mike Hopkins, Expedition 38 flight engineer, holds a plastic container partially filled with green-colored water which will be used in a new experiment using the soccer-ball-sized, free-flying satellites known as Synchronized Position Hold, Engage, Reorient, Experimental Satellites, or SPHERES, which are already on the station. For the SPHERES-Slosh experiment, two SPHERES robots are attached to opposite ends of a metal frame holding the plastic tank with the green-colored water. The new hardware for the SPHERES-Slosh study was delivered to the station aboard Orbital Sciences' Cygnus cargo craft on Jan. 12.

Hopkins syndrome and phantom hernia: a rare association.

PubMed

Elizabeth, K E; Guruprasad, C S; Sindhu, T G

2011-06-01

Acute flaccid paralysis (AFP), other than paralytic poliomyelitis, are usually due to demyelination like Guillian Barre syndrome (GBS), transverse myelitis and traumatic neuritis. Poliomyelitis like illness, Hopkins syndrome or Post Asthmatic Amotrophy, associated with bronchial asthma and hyperIgEemia has been reported in literature. We present a two and a half year old child who developed AFP with phantom hernia following an episode of bronchial asthma.

Power, Language, and Literacy in "The Great Gilly Hopkins"

ERIC Educational Resources Information Center

Cairns, Sue Ann

2008-01-01

To compensate for her feelings of anger and helplessness over her mother's abandonment and subsequent displacements, the foster child Gilly Hopkins seeks power and agency through the primary means at her disposal: through the use of language and fairy tales. She constructs a Cinderella fantasy of an idealized mother who will rescue her. She also…

13. Historic American Buildings Survey Mr. Hopkins, Draftsman of Hebbard ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Historic American Buildings Survey Mr. Hopkins, Draftsman of Hebbard and Gill, Architects October 21, 1904 BLUEPRINT OF ORIGINAL DRAWING OF FIRST FLOOR PLAN From the Collection of the San Diego Historical Society - George W. Marston House, 3525 Seventh Avenue, San Diego, San Diego County, CA

14. Historic American Buildings Survey Mr. Hopkins, Draftsman of Hebbard ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

14. Historic American Buildings Survey Mr. Hopkins, Draftsman of Hebbard and Gill, Architects October 22, 1904 BLUEPRINT OF ORIGINAL DRAWING OF SECOND FLOOR PLAN From the Collection of the San Diego Historical Society - George W. Marston House, 3525 Seventh Avenue, San Diego, San Diego County, CA

What Happens If They Say No? Preserving Access to Critical Commercial Space Capabilities during Future Crises

DTIC Science & Technology

2014-12-01

SatelliteShortagesMayChokeOffMilitaryDroneExpansion.aspx; G. Ryan Faith and Mariel John , “Space Report 2011” in Authoritative Guide to Global Space Activity,” ed. Micah Walter-Range (Colorado Springs...Werner, “Cover Story”; John Walcott, “Chinese Espionage Campaign Targets U.S. Space Technology,” Bloomberg, 18 April 2012, http://www.bloomberg.com...frus1969-76v25.pdf; Walter J. Boyne , The Two O’Clock War: The 1973 Yom Kippur Conflict and the Airlift That Saved Israel, 1st ed. (New York: Thomas

Learning from New York City : a case study of public health policy practice in the Bloomberg administration.

PubMed

Isett, Kimberley Roussin; Laugesen, Miriam J; Cloud, David H

2015-01-01

To ascertain any lessons learned about how public health reforms undertaken in New York City during the Bloomberg Administration were shepherded through the public policy and administration gauntlet. The question is, how feasible is this approach and would it work outside of New York City? Using a theoretically grounded case study approach, 3 initiatives were examined that were proposed and/or implemented during a 10-year period of the Mayoralty of Michael Bloomberg (2002-2011): transfats restrictions, clean bus transportation policies, and a sugar-sweetened beverages tax (as a counterfactual). The investigation began by performing a comprehensive public documents search and was followed with interviews of 27 individuals involved in the selected policy initiatives. Interviews were coded in Nvivo using an iterative, grounded methodology. Using a theoretical lens, the case study illustrates that the multifaceted role of leadership was not confined to the executives in the City or the Agency. Instead, leadership extended to other administrative officials within the agency and the Board of Health. Second, New York City used reorganization and coordinative mechanisms strategically to ensure achievement of their goals. This included creation of new departments/bureaus and coordinating structures across the City. Evidence of the explicit use of incentives, as initially anticipated from the theoretical framework, was not found. While some aspects of this case study are unique to the context of New York City, 2 approaches used in New York City are feasible for other jurisdictions: harnessing the full scope and breadth of authority of the agency and its associated boards and commissions, and remobilizing existing workforce to explicitly focus on and coordinate targeted policies for issues of concern. Questions for further consideration are posed at the conclusion of the article.

Hopkins works with the Vaccine-21 GAP

NASA Image and Video Library

2014-01-15

ISS038-E-031400 (14 Jan. 2014) --- NASA astronaut Mike Hopkins, Expedition 38 flight engineer, accesses the Commercial Generic Bioprocessing Apparatus-2 (CGBA-2) while working with the Vaccine-21 Group Activation Pack (GAP) experiment in the Harmony node of the International Space Station. This experiment also referred to as Antibiotic Effectiveness in Space-1 (AES-1) tests the hypothesis that antibiotics used to treat bacterial grown in space will exhibit reduced efficacy and will be associated with specific changes in bacterial gene expression that correlate with cell survival.

Proceedings of the High Energy Density Matter (HEDM) Contractors’ Conference Held 1-3 June 1997 in Chantilly, VA.

DTIC Science & Technology

1998-03-01

David R. Yarkony, Johns Hopkins University 3:00 - 3:30 Break 3:30 - 4:00 Calorimetric Measurements of O Atom Recombination Dr. Peter Taborek and...University Stillwater, OK 74078 405-744-5174 405-744-6007 dlt@osuunx.ucc.okstate.edu Dr. David R. Yarkony Dept. of Chemistry Johns Hopkins...Chemistry Johns Hopkins University 3400 N. Charles St., Remsen Baltimore, MD 21218 410-516-4669 410-516-8420 yangxin@jhunix.hcf.jhu.edu Prof. David

A meteorological report for the Mt. Hopkins Observatory: 1968-1971. [Arizona

NASA Technical Reports Server (NTRS)

Pearlman, M. R.; Hogan, D.; Goodwin, K.; Kurtenbach, D.

1972-01-01

This document is a compilation of the weather data collected at the Mt. Hopkins Observatory in southern Arizona from 1968 to 1971. It is the second meteorological report aimed at assisting scientists in the scheduling of experiments at the Observatory site.

Phoretic symbionts of the mountain pine beetle (Dendroctonus ponderosae Hopkins)

Treesearch

Javier E. Mercado; Richard W. Hofstetter; Danielle M. Reboletti; Jose F. Negron

2014-01-01

During its life cycle, the tree-killing mountain pine beetle Dendroctonus ponderosae Hopkins interacts with phoretic organisms such as mites, nematodes, fungi, and bacteria. The types of associations these organisms establish with the mountain pine beetle (MPB) vary from mutualistic to antagonistic. The most studied of these interactions are those between beetle and...

Using Big Data to Emulate a Target Trial When a Randomized Trial Is Not Available.

PubMed

Hernán, Miguel A; Robins, James M

2016-04-15

Ideally, questions about comparative effectiveness or safety would be answered using an appropriately designed and conducted randomized experiment. When we cannot conduct a randomized experiment, we analyze observational data. Causal inference from large observational databases (big data) can be viewed as an attempt to emulate a randomized experiment-the target experiment or target trial-that would answer the question of interest. When the goal is to guide decisions among several strategies, causal analyses of observational data need to be evaluated with respect to how well they emulate a particular target trial. We outline a framework for comparative effectiveness research using big data that makes the target trial explicit. This framework channels counterfactual theory for comparing the effects of sustained treatment strategies, organizes analytic approaches, provides a structured process for the criticism of observational studies, and helps avoid common methodologic pitfalls. © The Author 2016. 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.

Risks of Death and Severe Disease in Patients With Middle East Respiratory Syndrome Coronavirus, 2012-2015.

PubMed

Rivers, Caitlin M; Majumder, Maimuna S; Lofgren, Eric T

2016-09-15

Middle East respiratory syndrome coronavirus (MERS-CoV) is an emerging pathogen, first recognized in 2012, with a high case fatality risk, no vaccine, and no treatment beyond supportive care. We estimated the relative risks of death and severe disease among MERS-CoV patients in the Middle East between 2012 and 2015 for several risk factors, using Poisson regression with robust variance and a bootstrap-based expectation maximization algorithm to handle extensive missing data. Increased age and underlying comorbidity were risk factors for both death and severe disease, while cases arising in Saudi Arabia were more likely to be severe. Cases occurring later in the emergence of MERS-CoV and among health-care workers were less serious. This study represents an attempt to estimate risk factors for an emerging infectious disease using open data and to address some of the uncertainty surrounding MERS-CoV epidemiology. © The Author 2016. 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.

Do generous unemployment benefit programs reduce suicide rates? A state fixed-effect analysis covering 1968-2008.

PubMed

Cylus, Jonathan; Glymour, M Maria; Avendano, Mauricio

2014-07-01

The recent economic recession has led to increases in suicide, but whether US state unemployment insurance programs ameliorate this association has not been examined. Exploiting US state variations in the generosity of benefit programs between 1968 and 2008, we tested the hypothesis that more generous unemployment benefit programs reduce the impact of economic downturns on suicide. Using state linear fixed-effect models, we found a negative additive interaction between unemployment rates and benefits among the US working-age (20-64 years) population (β = -0.57, 95% confidence interval: -0.86, -0.27; P < 0.001). The finding of a negative additive interaction was robust across multiple model specifications. Our results suggest that the impact of unemployment rates on suicide is offset by the presence of generous state unemployment benefit programs, though estimated effects are small in magnitude. © The Author 2014. 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.

Genetic Epidemiology and Public Health: The Evolution From Theory to Technology.

PubMed

Fallin, M Daniele; Duggal, Priya; Beaty, Terri H

2016-03-01

Genetic epidemiology represents a hybrid of epidemiologic designs and statistical models that explicitly consider both genetic and environmental risk factors for disease. It is a relatively new field in public health; the term was first coined only 35 years ago. In this short time, the field has been through a major evolution, changing from a field driven by theory, without the technology for genetic measurement or computational capacity to apply much of the designs and methods developed, to a field driven by rapidly expanding technology in genomic measurement and computational analyses while epidemiologic theory struggles to keep up. In this commentary, we describe 4 different eras of genetic epidemiology, spanning this evolution from theory to technology, what we have learned, what we have added to the broader field of public health, and what remains to be done. © The Author 2016. 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.

Mode and Intermediate Waters in Earth System Models

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

Gnanadesikan, Anand; Sarmiento, Jorge L.

This report describes work done as part of a joint Princeton-Johns Hopkins project to look at the impact of mode and intermediate waters in Earth System Models. The Johns Hopkins portion of this work focussed on the role of lateral mixing in ventilating such waters, with important implications for hypoxia, the uptake of anthropogenic carbon, the dynamics of El Nino and carbon pumps. The Johns Hopkins group also collaborated with the Princeton Group to help develop a watermass diagnostics framework.

The life, times, and health care of Harry L Hopkins: Presidential advisor and perpetual patient.

PubMed

Pappas, Theodore N; Swanson, Sven

2018-02-01

Harry Hopkins was the most important nontitled allied leader in World War II. He was the advisor to President Roosevelt who managed the diplomacy between Roosevelt, Churchill, and Stalin from 1941 to 1946. Throughout these times, Hopkins was ill and required transfusions, admissions to the hospital, and nutritional supplementation to keep him well enough to travel the world and manage the allied war diplomacy. There has been no unifying theory to account for all his symptoms and his reported pathologic and autopsy findings. In this paper, we will review his political and medical history and a differential diagnosis of his illness.

Whipple Procedure

MedlinePlus

... Sol Goldman Pancreatic Cancer Research Center For Patients & Family Cancer Clinic Cyst Clinic NFPTR Medical Professionals Donate Blog Expand All Collapse All Johns Hopkins & You Our Pledge to You Choosing Johns Hopkins Importance of Experienced Surgeon Our Multidisciplinary Approach Meet Our ...

Response of Dendroctonus mexicanus (Hopkins) to two optical isomers of verbenone

Treesearch

Vicente Diaz-Nunez; Guillermo Sanchez-Martinez; Nancy E. Gillette

2006-01-01

Given the need for diminishing the use of pesticides in natural environments, in this research we investigated the efficacy of two optical isomers of verbenone (4, 6, 6-trimethylbicyclo[3.1.1] hepto-3-en-e-1) as controls of the attack of Dendroctonus mexicanus (Hopkins) (Coleoptera: Curculionidae: Scolytinae).Two experiments were established in the...

Data Management Consulting at the Johns Hopkins University

ERIC Educational Resources Information Center

Varvel, Virgil E., Jr.; Shen, Yi

2013-01-01

As research data complexity and quantity grows and funding agency requirements for data management are articulated, there is a growing need for data management services (DMS). Within these services, one important role emerging is that of data management consultant (DMC). Roles were analyzed that these professionals play through case study analysis…

Meharry-Johns Hopkins Center for Prostate Cancer Research

DTIC Science & Technology

2014-08-01

and significance will be determined by a p-value less than 0.05. All analyses will be conducted using SAS version 9.1 (SAS Institute, Cary , NC...prostate cancer. · Each participant will receive a call from a trained interviewer who will ask questions about his health, health care, diet

Invited Commentary: Cassel's "The Contribution of the Social Environment to Host Resistance"-A Modern Classic.

PubMed

James, Sherman A

2017-06-01

John Cassel's 1976 paper "The Contribution of the Social Environment to Host Resistance" (Am J Epidemiol. 1976;104(2):107-123) is widely regarded as a classic in epidemiology. He makes the compelling argument that the quality of a person's social relationships, that is, the degree to which her relationships are more stressful than supportive (or vice versa) influences her susceptibility to disease independent of genetic endowment, diet, physical activity, etc. Cassel's provocative thesis was anchored in a cogent synthesis of findings from animal experiments and observational studies on diverse human populations. Beginning in the late 1970s, the paper stimulated an explosion of epidemiologic research on social support and human health. Beyond advancing epidemiologic theory, Cassel showed how findings from various epidemiologic study designs could be marshalled to build a persuasive causal argument that impaired social bonds increase the risk of premature disease and death. The paper also foreshadowed core ideas of later theoretical constructs, such as weathering and allostatic load, regarding the power of chronic environmental stressors to accelerate biological aging across multiple organ systems. Cassel's assessment of the research and practice implications of his conclusions has remarkable contemporary resonance for the field of epidemiology. © 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.

75 FR 62407 - Office of Administration; Single-Source Cooperative Agreement Award; Announcing the Award a...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-08

... Agreement to the Johns Hopkins University, Applied Physics Lab (APL) and School of Public Health, To Support... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Office of... a single-source cooperative agreement to the Johns Hopkins University (JHU), Applied Physics Lab...

77 FR 68831 - Notice of Lodging of Consent Decree Under the Comprehensive Environmental Response, Compensation...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-11-16

..., Inc., Rolls-Royce Corporation, Black & Decker (U.S.) Inc., Johns Hopkins University, Johns Hopkins University Applied Physics Laboratory, LLC, and Winter's Performance Products as defendants. The complaint... payment to: Consent Decree Library, U.S. DOJ--ENRD, P.O. Box 7611, Washington, DC 20044-7611. Please...

A Revised STONEMAN for Distributed Ada (Trademark) Support Environments.

DTIC Science & Technology

1984-01-01

MA 02154 San Diego, CA 92152 Chuck Waltrip Philip Myers Johns Hopkins University Dave Pasterchik Applied Physics Lab NRVELEX Johns Hopkins Road FLEX...Georgia Tech Atlanta, GA 30332 Reed Kotler Lockheed Missiles & Space Dick Drake 1111 Lockheed Way IBM Sunnyvale, CA 94086 Federal Systems Division 102/075

Invited Commentary: Evolution of Social Networks, Health, and the Role of Epidemiology.

PubMed

Aiello, Allison E

2017-06-01

Almost 40 years ago, Berkman and Syme demonstrated that social networks were related to the risk of early mortality (Am J Epidemiol. 1979;109(2):186-204). Their study was highly innovative because they directly measured and quantified social networks in a large prospective population-based survey with mortality follow-up. The results of the study showed robust network gradients, whereby those with fewer networks and weaker social ties had significantly higher mortality rates. The important influence of social networks that Berkman and Syme noted many years ago is likely to heighten in the future, as demographic characteristics shift and individuals become more inclined to socialize through online platforms instead of real-world interactions. Berkman and Syme's research in 1979 continues to play a key role in shaping recent efforts to uncover the influence of social networks on health. Looking back on their findings may help epidemiologists better understand the importance of both online and offline networks for population health today. © 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.

Building capacity for tobacco control research and policy

PubMed Central

Stillman, F; Yang, G; Figueiredo, V; Hernandez‐Avila, M; Samet, J

2006-01-01

The Fogarty International Center (FIC) initiative, “International Tobacco and Health Research Capacity Building Program” represents an important step in US government funding for global tobacco control. Low‐ and middle‐income countries of the world face a rising threat to public health from the rapidly escalating epidemic of tobacco use. Many are now parties to the Framework Convention on Tobacco Control (FCTC) and capacity development to meet FCTC provisions. One initial grant provided through the FIC was to the Institute for Global Tobacco Control (IGTC) at the Johns Hopkins Bloomberg School of Public Health (JHSPH) to support capacity building and research programmes in China, Brazil, and Mexico. The initiative's capacity building effort focused on: (1) building the evidence base for tobacco control, (2) expanding the infrastructure of each country to deliver tobacco control, and (3) developing the next generation of leaders as well as encouraging networking throughout the country and with neighbouring countries. This paper describes the approach taken and the research foci, as well some of the main outcomes and some identified challenges posed by the effort. Individual research papers are in progress to provide more in‐depth reporting of study results. PMID:16723670

Uber and Metropolitan Traffic Fatalities in the United States.

PubMed

Brazil, Noli; Kirk, David S

2016-08-01

Uber and similar rideshare services are rapidly dispersing in cities across the United States and beyond. Given the convenience and low cost, Uber has been characterized as a potential countermeasure for reducing the estimated 121 million episodes of drunk driving and the 10,000 resulting traffic fatalities that occur annually in the United States. We exploited differences in the timing of the deployment of Uber in US metropolitan counties from 2005 to 2014 to test the association between the availability of Uber's rideshare services and total, drunk driving-related, and weekend- and holiday-specific traffic fatalities in the 100 most populated metropolitan areas in the United States using negative binomial and Poisson regression models. We found that the deployment of Uber services in a given metropolitan county had no association with the number of subsequent traffic fatalities, whether measured in aggregate or specific to drunk-driving fatalities or fatalities during weekends and holidays. © The Author 2016. 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.

Epidemiology and the Tobacco Epidemic: How Research on Tobacco and Health Shaped Epidemiology.

PubMed

Samet, Jonathan M

2016-03-01

In this article, I provide a perspective on the tobacco epidemic and epidemiology, describing the impact of the tobacco-caused disease epidemic on the field of epidemiology. Although there is an enormous body of epidemiologic evidence on the associations of smoking with health, little systematic attention has been given to how decades of research have affected epidemiology and its practice. I address the many advances that resulted from epidemiologic research on smoking and health, such as demonstration of the utility of observational designs and important parameters (the odds ratio and the population attributable risk), guidelines for causal inference, and systematic review approaches. I also cover unintended and adverse consequences for the field, including the strategy of doubt creation and the recruitment of epidemiologists by the tobacco industry to serve its mission. The paradigm of evidence-based action for addressing noncommunicable diseases began with the need to address the epidemic of tobacco-caused disease, an imperative for action documented by epidemiologic research. © The Author 2016. 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.

Invited commentary: do-it-yourself modern epidemiology--at last!

PubMed

Morabia, Alfredo

2014-10-01

In this issue of the Journal, Keyes and Galea (Am J Epidemiol. 2014;180(7):661-668) propose "7 foundational steps" for introducing epidemiologic methods and concepts to beginners. Keyes and Galea's credo is that the methododological and conceptual components that comprise epidemiology, today scattered in textbook chapters, come together as an integrated and coherent methodological corpus in the process of designing studies. Thus, they expound, the process of designing studies should be the core of teaching epidemiology. Two aspects of their 7-steps-to-epidemiology, do-it-yourself user manual stand out as novel: 1) the approach, because of its emphasis on modern epidemiology's causal framework of a dynamic population in a steady state evolving across time, and 2) the ambition to teach modern epidemiology in introductory courses, instead of the popular mix of classical and modern epidemiology that is often used today to keep introductory courses simple. Both aspects are of potentially great significance for our discipline. © The Author 2014. 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.

Invited Commentary: Explaining the Relationship Between Attending Worship Services and Mortality-A Brief Excursion Into the Contribution of Social Relationships in Religious Institutions.

PubMed

Krause, Neal

2017-04-01

In this issue of the Journal, VanderWeele et al. (Am J Epidemiol. 2017;000(00):000-000) report that more frequent attendance at worship services is associated with a lower mortality risk. However, the underlying processes that might explain this relationship were not discussed fully. A problem arises because the potentially beneficial association between attending worship services and mortality risk may be due to a number of different factors. At least part of the explanation may be found by turning to social relationships that arise in religious institutions. Within this context, there are potentially important benefits of providing social support to others. Support can be provided in several ways that involve potentially important health-related associations. In this commentary, I briefly examine the possible relationships between religious social support systems and other dimensions of congregational life and health. In-depth conceptual analyses are needed to move research in religious involvement and mortality to the next level. © 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.

Taking Flight Internationally

ERIC Educational Resources Information Center

Roach, Ronald

2007-01-01

This article describes how Dr. Ben Vinson III, the new director of the Center for Africana Studies at Johns Hopkins University and a specialist in Latin American history, is strengthening the center's internationalist orientation. While it took more than three decades for Johns Hopkins University to approve a Black studies program in its arts and…

Hopkins works with the MDCA inside the CIR in the U.S. Laboratory

NASA Image and Video Library

2013-11-12

ISS038-E-001298 (12 Nov. 2013) --- NASA astronaut Michael Hopkins, Expedition 38 flight engineer, works with the Multi-user Drop Combustion Apparatus (MDCA) inside the Combustion Integrated Rack (CIR) in the Destiny laboratory of the International Space Station. The MDCA contains hardware and software to conduct unique droplet combustion experiments in space.

Web Connects K-12 Students with Scientists

ERIC Educational Resources Information Center

Cavanagh, Sean

2009-01-01

This article reports that Derek Cummings and Justin Lessler, Johns Hopkins University epidemiologists, have come to the Johns Hopkins Center for Talented Youth (CTY) to give a live webinar on the spread of swine flu. This web-based audio and video presentation is one of many efforts by universities and science organizations to put K-12 students in…

The autopsy was conducted "Under most inauspicious circumstances:" John Turner, Harvey Cushing's case XXXII, and his unwitting contributions to the early understanding of acromegaly.

PubMed

Pendleton, Courtney; Wand, Gary; Quinones-Hinojosa, Alfredo

2010-12-01

Harvey Cushing's monograph The Pituitary Body and Its Disorders describes Case XXXII, a 36-year-old man who presented with gigantism in 1910. The detailed post-mortem exam findings are prefaced with a cryptic statement, describing "inauspicious circumstances" surrounding the autopsy. Although contemporary biographies of Cushing have offered insight into these circumstances, the original surgical file for Case XXXII has not been previously reviewed. The original Johns Hopkins Hospital surgical records were reviewed, and the case of John Turner, who Cushing identified by name in his monograph The Pituitary Body and Its Disorders, was selected for further review. A review of the original surgical file revealed a typewritten note by Dr. Crowe, one of the surgeons who performed the post-mortem exam, with a handwritten addendum by Dr. Cushing. This document provides detail regarding the "inauspicious circumstances" surrounding the autopsy. Namely, the autopsy was conducted without permission of the family, during the funeral service, following a payment to the undertaker. The new information regarding the autopsy of John Turner offers insight into the previously incompletely described circumstances surrounding the autopsy. Additionally, the case illuminates the obligations and ethical quandaries that physician-scientists face.

Welfare effects of reduced milk production associated with Johne's disease on Johne's-positive versus Johne's-negative dairy operations.

PubMed

Losinger, Willard C

2006-08-01

An examination of the economic impacts of reduced milk production associated with Johne's disease on Johne's-positive and Johne's-negative dairy operations indicated that, if Johne's disease had not existed in US dairy cows in 1996, then the economic surplus of Johne's-negative operations would have been $600 million+/-$530 million lower, while the economic surplus of Johne's-positive operations would have been higher by $28 million+/-$79 million, which was not significantly different from zero. The data available for projecting changes in surplus were not sufficiently precise to allow an exact statement on whether Johne's-positive operations would have been better or worse off economically, in terms of the value received for producing more milk if they had not been affected by Johne's disease. The changes in producer surplus, based upon eliminating specific epidemiological risk factors for Johne's disease, were disaggregated between Johne's-positive dairy operations exposed to the risk factor and all other US dairy operations. Eliminating the risk factor of having any cows not born on the operation would have had a significant positive effect on the economic surplus of Johne's-positive operations that had any cows not born on the operation.

The UCD/FLWO extensive air shower array at Mt. Hopkins Arizona

NASA Astrophysics Data System (ADS)

Gillanders, G. H.; Fegan, D. J.; McKeown, P. K.; Weekes, T. C.

The design and operation of an extensive air shower (EAS) array being installed around the 10-m optical Cerenkov reflector at F.L. Whipple Observatory on Mt. Hopkins for high-energy gamma-ray astronomy are described. The advantages of an EAS array colocated with a Cerenkov facility at a mountain location are reviewed; the arrangement of the 13 1-sq m scintillation detectors in the array is indicated; the signal-processing and data-acquisition procedures are explained; and preliminary calibration data indicating an effective energy threshold of 60 TeV are presented.

Television microscopy for education and consultation in pathology via coaxial cable, laser beam, and COMSAT satellite.

PubMed

Frost, J K

1979-11-01

In this article, the author describes how the closed circuit TV microscopy system used at The Johns Hopkins Medical Institutions facilitates discussion and diagnosis in consultation and promotes continuing education in, and out, of the institutions. The research, development, implementation, and use of this system at The Johns Hopkins Medical Institutions is supported in part by a grant from The William Penn Foundation and NCI contract NIH-NO1-CB-92172.

Photochemical Ignition Studies. I. Laser Ignition of Flowing Premixed Gases

DTIC Science & Technology

1985-02-01

Combustion," Army Science Conference, West Point, 1984. 1 ? -A.W. Miziolek, R.C. Sausa, and A.J. Alfano , "Efficient Detection of Carbon Atoms Produced...Science Conference, West Point, 1984. 12. A.W. Miziolek, R.C. Sausa, and A.J. Alfano , "Efficient Detection of Carbon Atoms Produced by Argon...61801 Johns Hopkins University/APL Chemical Propulsion Information Agency ATTN: T.W. Christian Johns Hopkins Road Laurel, MD 20707

Methodological considerations in observational comparative effectiveness research for implantable medical devices: an epidemiologic perspective.

PubMed

Jalbert, Jessica J; Ritchey, Mary Elizabeth; Mi, Xiaojuan; Chen, Chih-Ying; Hammill, Bradley G; Curtis, Lesley H; Setoguchi, Soko

2014-11-01

Medical devices play a vital role in diagnosing, treating, and preventing diseases and are an integral part of the health-care system. Many devices, including implantable medical devices, enter the market through a regulatory pathway that was not designed to assure safety and effectiveness. Several recent studies and high-profile device recalls have demonstrated the need for well-designed, valid postmarketing studies of medical devices. Medical device epidemiology is a relatively new field compared with pharmacoepidemiology, which for decades has been developed to assess the safety and effectiveness of medications. Many methodological considerations in pharmacoepidemiology apply to medical device epidemiology. Fundamental differences in mechanisms of action and use and in how exposure data are captured mean that comparative effectiveness studies of medical devices often necessitate additional and different considerations. In this paper, we discuss some of the most salient issues encountered in conducting comparative effectiveness research on implantable devices. We discuss special methodological considerations regarding the use of data sources, exposure and outcome definitions, timing of exposure, and sources of bias. © The Author 2014. 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.

Formalizing the role of agent-based modeling in causal inference and epidemiology.

PubMed

Marshall, Brandon D L; Galea, Sandro

2015-01-15

Calls for the adoption of complex systems approaches, including agent-based modeling, in the field of epidemiology have largely centered on the potential for such methods to examine complex disease etiologies, which are characterized by feedback behavior, interference, threshold dynamics, and multiple interacting causal effects. However, considerable theoretical and practical issues impede the capacity of agent-based methods to examine and evaluate causal effects and thus illuminate new areas for intervention. We build on this work by describing how agent-based models can be used to simulate counterfactual outcomes in the presence of complexity. We show that these models are of particular utility when the hypothesized causal mechanisms exhibit a high degree of interdependence between multiple causal effects and when interference (i.e., one person's exposure affects the outcome of others) is present and of intrinsic scientific interest. Although not without challenges, agent-based modeling (and complex systems methods broadly) represent a promising novel approach to identify and evaluate complex causal effects, and they are thus well suited to complement other modern epidemiologic methods of etiologic inquiry. © The Author 2014. 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.

Current practices in teaching introductory epidemiology: how we got here, where to go.

PubMed

Keyes, Katherine M; Galea, Sandro

2014-10-01

The number of students and disciplines requiring basic instruction in epidemiologic methods is growing. As a field, we now have a lexicon of epidemiologic terminology and particular methods that have developed and become canonical through the historical development of the field. Yet, many of our basic concepts remain elusive to some students, particularly those not pursuing a career in epidemiology. Further, disagreement and redundancy across basic terms limit their utility in teaching epidemiology. Many approaches to teaching epidemiology generally start with labeling key concepts and then move on to explain them. We submit that an approach grounded not in labels but in foundational concepts may offer a useful adjunct to introductory epidemiology education. We propose 7 foundational steps in conducting an epidemiologic study and provide examples of how these steps can be operationalized, using simple graphics that articulate how populations are defined, samples are selected, and individuals are followed to count cases. A reorganization of introductory epidemiology around core first principles may be an effective way forward for educating the next generation of public health scientists. © The Author 2014. 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.

Invited commentary: recruiting for epidemiologic studies using social media.

PubMed

Allsworth, Jenifer E

2015-05-15

Social media-based recruitment for epidemiologic studies has the potential to expand the demographic and geographic reach of investigators and identify potential participants more cost-effectively than traditional approaches. In fact, social media are particularly appealing for their ability to engage traditionally "hard-to-reach" populations, including young adults and low-income populations. Despite their great promise as a tool for epidemiologists, social media-based recruitment approaches do not currently compare favorably with gold-standard probability-based sampling approaches. Sparse data on the demographic characteristics of social media users, patterns of social media use, and appropriate sampling frames limit our ability to implement probability-based sampling strategies. In a well-conducted study, Harris et al. (Am J Epidemiol. 2015;181(10):737-746) examined the cost-effectiveness of social media-based recruitment (advertisements and promotion) in the Contraceptive Use, Pregnancy Intention, and Decisions (CUPID) Study, a cohort study of 3,799 young adult Australian women, and the approximate representativeness of the CUPID cohort. Implications for social media-based recruitment strategies for cohort assembly, data accuracy, implementation, and human subjects concerns are discussed. © 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.

The Harm Done to Reproducibility by the Culture of Null Hypothesis Significance Testing.

PubMed

Lash, Timothy L

2017-09-15

In the last few years, stakeholders in the scientific community have raised alarms about a perceived lack of reproducibility of scientific results. In reaction, guidelines for journals have been promulgated and grant applicants have been asked to address the rigor and reproducibility of their proposed projects. Neither solution addresses a primary culprit, which is the culture of null hypothesis significance testing that dominates statistical analysis and inference. In an innovative research enterprise, selection of results for further evaluation based on null hypothesis significance testing is doomed to yield a low proportion of reproducible results and a high proportion of effects that are initially overestimated. In addition, the culture of null hypothesis significance testing discourages quantitative adjustments to account for systematic errors and quantitative incorporation of prior information. These strategies would otherwise improve reproducibility and have not been previously proposed in the widely cited literature on this topic. Without discarding the culture of null hypothesis significance testing and implementing these alternative methods for statistical analysis and inference, all other strategies for improving reproducibility will yield marginal gains at best. © The Author(s) 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.

Contemporaneous Social Environment and the Architecture of Late-Life Gene Expression Profiles.

PubMed

Levine, Morgan E; Crimmins, Eileen M; Weir, David R; Cole, Steve W

2017-09-01

Environmental or social challenges can stimulate a cascade of coordinated physiological changes in stress response systems. Unfortunately, chronic activation of these adaptations under conditions such as low socioeconomic status (SES) can have negative consequences for long-term health. While there is substantial evidence tying low SES to increased disease risk and reduced life expectancy, the underlying biology remains poorly understood. Using pilot data on 120 older adults from the Health and Retirement Study (United States, 2002-2010), we examined the associations between SES and gene expression levels in adulthood, with particular focus on a gene expression program known as the conserved transcriptional response to adversity. We also used a bioinformatics-based approach to assess the activity of specific gene regulation pathways involved in inflammation, antiviral responses, and stress-related neuroendocrine signaling. We found that low SES was related to increased expression of conserved transcriptional response to adversity genes and distinct patterns of proinflammatory, antiviral, and stress signaling (e.g., sympathetic nervous system and hypothalamic-pituitary-adrenal axis) transcription factor activation. © The Author(s) 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.

Invited Commentary: Little Steps Lead to Huge Steps-It's Time to Make Physical Inactivity Our Number 1 Public Health Enemy.

PubMed

Church, Timothy S

2016-11-01

The analysis plan and article in this issue of the Journal by Evenson et al. (Am J Epidemiol 2016;184(9):621-632) is well-conceived, thoughtfully conducted, and tightly written. The authors utilized the National Health and Nutrition Examination Survey data set to examine the association between accelerometer-measured physical activity level and mortality and found that meeting the 2013 federal Physical Activity Guidelines resulted in a 35% reduction in risk of mortality. The timing of these findings could not be better, given the ubiquitous nature of personal accelerometer devices. The masses are already equipped to routinely quantify their activity, and now we have the opportunity and responsibility to provide evidenced-based, tailored physical activity goals. We have evidenced-based physical activity guidelines, mass distribution of devices to track activity, and now scientific support indicating that meeting the physical activity goal, as assessed by these devices, has substantial health benefits. All of the pieces are in place to make physical inactivity a national priority, and we now have the opportunity to positively affect the health of millions of Americans. © The Author 2016. 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.

Correcting the Standard Errors of 2-Stage Residual Inclusion Estimators for Mendelian Randomization Studies.

PubMed

Palmer, Tom M; Holmes, Michael V; Keating, Brendan J; Sheehan, Nuala A

2017-11-01

Mendelian randomization studies use genotypes as instrumental variables to test for and estimate the causal effects of modifiable risk factors on outcomes. Two-stage residual inclusion (TSRI) estimators have been used when researchers are willing to make parametric assumptions. However, researchers are currently reporting uncorrected or heteroscedasticity-robust standard errors for these estimates. We compared several different forms of the standard error for linear and logistic TSRI estimates in simulations and in real-data examples. Among others, we consider standard errors modified from the approach of Newey (1987), Terza (2016), and bootstrapping. In our simulations Newey, Terza, bootstrap, and corrected 2-stage least squares (in the linear case) standard errors gave the best results in terms of coverage and type I error. In the real-data examples, the Newey standard errors were 0.5% and 2% larger than the unadjusted standard errors for the linear and logistic TSRI estimators, respectively. We show that TSRI estimators with modified standard errors have correct type I error under the null. Researchers should report TSRI estimates with modified standard errors instead of reporting unadjusted or heteroscedasticity-robust standard errors. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

White Blood Cell Count and Total and Cause-Specific Mortality in the Women's Health Initiative.

PubMed

Kabat, Geoffrey C; Kim, Mimi Y; Manson, JoAnn E; Lessin, Lawrence; Lin, Juan; Wassertheil-Smoller, Sylvia; Rohan, Thomas E

2017-07-01

White blood cell (WBC) count appears to predict total mortality and coronary heart disease (CHD) mortality, but it is unclear to what extent the association reflects confounding by smoking, underlying illness, or comorbid conditions. We used data from the Women's Health Initiative to examine the associations of WBC count with total mortality, CHD mortality, and cancer mortality. WBC count was measured at baseline in 160,117 postmenopausal women and again in year 3 in 74,375 participants. Participants were followed for a mean of 16 years. Cox proportional hazards models were used to estimate the relative mortality hazards associated with deciles of baseline WBC count and of the mean of baseline + year 3 WBC count. High deciles of both baseline and mean WBC count were positively associated with total mortality and CHD mortality, whereas the association with cancer mortality was weaker. The association of WBC count with mortality was independent of smoking and did not appear to be influenced by previous disease history. The potential clinical utility of this common laboratory test in predicting mortality risk warrants further study. © 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.

Computational fluid dynamic modeling of the summit of Mt. Hopkins for the MMT Observatory

NASA Astrophysics Data System (ADS)

Callahan, S.

2010-07-01

Over the past three decades, the staff of the MMT observatory used a variety of techniques to predict the summit wind characteristics including wind tunnel modeling and the release of smoke bombs. With the planned addition of a new instrument repair facility to be constructed on the summit of Mt. Hopkins, new computational fluid dynamic (CFD) models were made to determine the building's influence on the thermal environment around the telescope. The models compared the wind profiles and density contours above the telescope enclosure with and without the new building. The results show the steeply-sided Mount Hopkins dominates the summit wind profiles. In typical winds, the height of the telescope remains above the ground layer and is sufficiently separated from the new facility to insure the heat from the new building does not interfere with the telescope. The results also confirmed the observatories waste heat exhaust duct location needs to be relocated to prevent heat from being trapped in the wind shadow of the new building and lofting above the telescope. These useful models provide many insights into understanding the thermal environment of the summit.

Co-occurrence of Pacific sleeper sharks Somniosus pacificus and harbor seals Phoca vitulina in Glacier Bay

USGS Publications Warehouse

Taggart, S. James; Andrews, A.G.; Mondragon, Jennifer; Mathews, E.A.

2005-01-01

We present evidence that Pacific sleeper sharks Somniosus pacificus co-occur with harbor seals Phoca vitulina in Glacier Bay, Alaska, and that these sharks scavenge or prey on marine mammals. In 2002, 415 stations were fished throughout Glacier Bay on a systematic sampling grid. Pacific sleeper sharks were caught at 3 of the 415 stations, and at one station a Pacific halibut Hippoglossus stenolepis was caught with a fresh bite, identified as the bite of a sleeper shark. All 3 sharks and the shark-bitten halibut were caught at stations near the mouth of Johns Hopkins Inlet, a glacial fjord with the highest concentration of seals in Glacier Bay. Using a bootstrap technique, we estimated the probability of sampling the sharks (and the shark-bitten halibut) in the vicinity of Johns Hopkins Inlet. If sharks were randomly distributed in Glacier Bay, the probability of sampling all 4 pots at the mouth of Johns Hopkins Inlet was very low (P = 0.00002). The highly non-random distribution of the sleeper sharks located near the largest harbor seal pupping and breeding colony in Glacier Bay suggests that these 2 species co-occur and may interact ecologically in or near Johns Hopkins Inlet.

Photochemical Ignition Studies. 3. Ignition by Efficient and Resonant Multiphoton Photochemical Formation of Microplasmas

DTIC Science & Technology

1987-06-01

Fragments," Chem. Phys., Vol. 33, p. 161, 1978. 5. R.C. Sausa, A.J. Alfano , and A.W. Miziolek, "ArF Laser Photoproduction and Sensitive Detection of Carbon...Unlversity/APL Chemical Propulsion I Purdue University Information Agency Department of Chomistry ATTN: TW. Christian ATTN: H. Grant Johns Hopkins...of Chemistry ATTN: T.W. Christian ATTN: E. Grant Johns Hopkins Road West Lafayette, IN 47906 Laurel, MD 20707 2 Purdue University University of

The Israeli Nuclear Alert of 1973: Deterrence and Signaling in Crisis

DTIC Science & Technology

2013-04-01

limiting war, see Shlomo Aronson, Conflict and Bargaining in the Middle East (Baltimore: The Johns Hopkins University Press, 1978), 178-9; Shlomo Aronson...Ismail Fahmy, Negotiating for Peace in the Middle East (Baltimore: The Johns Hopkins University Press, 1983), 24-7. Indeed, Evron points out that...attaché. Yair Evron offered a similar report in Israel’s Nuclear Dilemma, 72. 50. See, for instance, Walter Boyne , The Two O’Clock War: The 1973 Yom

Validation of a Tibetan Translation of the Hopkins Symptom Checklist-25 and the Harvard Trauma Questionnaire

ERIC Educational Resources Information Center

Lhewa, Dechen; Banu, Sophia; Rosenfeld, Barry; Keller, Allen

2007-01-01

This study sought to translate and validate the Hopkins Symptom Checklist-25 (HSCL) and the Harvard Trauma Questionnaire (HTQ) in a Tibetan population. Translated questionnaires were administered to 57 Tibetan survivors of torture/human rights abuses living in the United States and receiving services in a torture treatment program. Participants…

John Twysden and John Palmer: 17th-century Northamptonshire astronomers

NASA Astrophysics Data System (ADS)

Frost, M. A.

2008-01-01

John Twysden (1607-1688) and John Palmer (1612-1679) were two astronomers in the circle of Samuel Foster (circa 1600-1652), the subject of a recent paper in this journal. John Twysden qualified in law and medicine and led a peripatetic life around England and Europe. John Palmer was Rector of Ecton, Northamptonshire and later Archdeacon of Northampton. The two astronomers catalogued observations made from Northamptonshire from the 1640s to the 1670s. In their later years Twysden and Palmer published works on a variety of topics, often astronomical. Palmer engaged in correspondence with Henry Oldenburg, the first secretary of the Royal Society, on topics in astronomy and mathematics.

Cases from the Osler Medical Service at Johns Hopkins University.

PubMed

Blank, Susan; Le, Dung; Hemnes, Anna

2004-07-01

PRESENTING FEATURES: An 18-year-old white man was admitted to the Osler Medical Service with the chief complaint of back pain. Two weeks prior to admission, the patient developed diffuse and aching upper back pain. Over the next couple of days, he also developed severe anterior chest pain that was somewhat pleuritic in nature but diffuse and extending bilaterally into the shoulders. One week prior to admission, he developed intermittent fevers and night sweats. The patient denied any lymphadenopathy, pharyngitis, sick contacts, shortness of breath, rash, or bleeding. He was seen by a physician and told that he had thrombocytopenia. There was no history of recent or remote unusual bleeding episodes. His medical history was unremarkable except for a childhood diagnosis of attention deficit/hyperactivity disorder. He was not taking any medications and had no history of tobacco, alcohol, or illicit drug use. He had no risk factors for human immunodeficiency virus infection. Physical examination showed that he was afebrile and had normal vital signs. He was a well-appearing man who was lying still because of pain. HEENT examination was unremarkable. There was no pharyngeal erythema or exudates. His lungs were clear. His neck was supple and without lymphadenopathy. Examination of his back and chest revealed no focal tenderness. There was no hepatosplenomegaly, and his skin was without petechiae or rashes. Examination of the patient's joints showed pain on passive and active movement of his shoulders bilaterally, but no frank arthritis. There was no rash, petechiae, or echymoses. Chest radiograph and electrocardiogram were unremarkable. On admission, the laboratory examination was notable for a hematocrit level of 32.5%, with a mean corpuscular volume of 79 fL, and white blood cell count of 2.8 x 10(3)/microL. Platelet count was 75 x 10(3)/microL. A white blood cell differential revealed 7% bands, 53% polys, 34% lymphs, 5% atypical lymphocytes, 2% nucleated red cells, and a few young unidentified cells. His chemistry studies were unremarkable. What is the diagnosis?

The Effects of a Comprehensive Coping Strategy on Clinical Outcomes in Breast Cancer Bone Marrow Transplant Patients and Primary Caregiver.

DTIC Science & Technology

1997-08-01

Doctoral Candidate Graduate Research Assistant Johns Hopkins University School of Nursing Joy P. Nanda , MS, MHS Johns Hopkins University School of...It takes about one year and 2 months for a complete set of data to be collected for each subject. Baseline data were collected by the clinical nurse ...also instructed to document their use of the CCSP in a diary. The CCSP was reinforced in the patient’s room by the research nurse participating in the

2005 Precision Strike Technology Symposium

DTIC Science & Technology

2005-10-20

Radars in  Production  Mission Computer  Software   Functionality to drive Mission System Requirements  Liquid  Cooling   Expanded  Cooling   Capability and Flow...Targeting Demonstration Using the APL Precision Target Locator Demonstrator, Mr. Ben Huguenin and Mr. Joe Schissler, Johns Hopkins University, Applied ...Forces October 18-20, 2005 Kossiakoff Conference Center The Johns Hopkins University/ Applied Physics Laboratory, Laurel, MD David K. Sanders

Loss of PTEN as a Predictive Biomarker of Response to Lithium Chloride, A Potential Targeted Treatment for Breast Cancer

DTIC Science & Technology

2013-11-01

COVERED (From - To) 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER...The grant was awarded on June 1st 2010. Dr. Higgins graduated from her Oncology Fellowship Program in Johns Hopkins Hospital on June 30th and... grant to support Dr. Higgins as she continued this work was submitted and processed in June 2010 in anticipation of this move. Johns Hopkins University

Atlantic Conjunctures in Anglo-American Neurology:

PubMed Central

Casper, Stephen T.

2008-01-01

Summary The emergence of neurology at Johns Hopkins presents a case study for reconsidering the international and institutional contexts of neurology generally. Using a variety of sources, Hopkins's interwar plans for neurology are presented and contextualized in the international environment of neurology, medical research, and philanthropy. During this period, neurology across the world, especially in Britain, was undergoing vast institutional changes. In order for Hopkins to remain at the forefront of excellence in both medicine and medical education, a program in neurology was deemed essential, and this would seem now to have been an unproblematic advance. Spearheading the project for the establishment of neurology at Hopkins was the dean of the medical school, Lewis H. Weed. Weed attempted from 1919 until 1942 to establish a department of neurology but had only limited success. The fact that finding support proved challenging for Weed and Johns Hopkins casts a provocative light on the broader historiography of neurology and illustrates the important role of the international context in defining neurology professionally. PMID:18791299

Evaluation of a five-year Bloomberg Global Road Safety Program in Turkey.

PubMed

Gupta, S; Hoe, C; Özkan, T; Lajunen, T J; Vursavas, F; Sener, S; Hyder, A A

2017-03-01

Turkey was included in the Bloomberg Philanthropies funded Global Road Safety Program (2010-14) with Ankara and Afyonkarahisar (Afyon) selected for interventions to manage speed and encourage seat-belt use. The objectives of this study are to present the monitoring and evaluation findings of seat-belt use and speed in Afyon and Ankara over the five years and to assess overall impact of the program on road traffic injury, and death rates in Turkey. Quasi-experimental before after without comparison. In collaboration with the Middle East Technical University, roadside observations and interviews were coupled with secondary data to monitor changes in risk factors and outcomes at the two intervention sites. The percentage of seat-belt use among drivers and front-seat passengers in Afyon and Ankara increased significantly between 2010 and 2014 with increased self-reported use and preceded by an increase in tickets (fines) for not using seat belts. There were uneven improvements in speed reduction. In Afyon, the average speed increased significantly from 46.3 km/h in 2012 to about 52.7 km/h in 2014 on roads where the speed limits were 50 km/h. In Ankara, the average speed remained less than 55 km/h during the program period (range: 50-54 km/h; P < 0.005) for roads where the speed limits were 50 km/h; however, the average speed on roads with speed limits of 70 km/h decreased significantly from 80.6 km/h in 2012 to 68.44 km/h in 2014 (P < 0.005). The program contributed to increase in seat-belt use in Afyon and Ankara and by drawing political attention to the issue can contribute to improvements in road safety. We are optimistic that the visible motivation within Turkey to substantially reduce road traffic injuries will lead to increased program implementation matched with a robust evaluation program, with suitable controls. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

"The most important professorship in the English-speaking domain": Adolf Meyer and the beginnings of clinical psychiatry in the United States.

PubMed

Lamb, Susan

2012-12-01

Historians recognize Adolf Meyer (1866-1950), first psychiatrist-in-chief at Johns Hopkins Hospital, as one of the principal architects of clinical psychiatry in the United States. This wholesale influence on the fledgling discipline had much to do with the authority he wielded as a Hopkins chief, but an important question remains: why was Meyer the obvious candidate to establish a department of psychiatry at the nation's foremost institution for medical research and teaching? Taking examples from Meyer's employment in three large American asylums before his appointment to Johns Hopkins in 1908, this article explores how he transformed an improvised set of practices into a clinical system for psychiatry that he implemented on a widespread scale, something that garnered him a reputation as a modernizer of outdated asylums and pegged him, in the minds of Hopkins authorities, as a psychiatric exemplar of commitment to pathological research and clinical teaching.

John Lewis | NREL

Science.gov Websites

Lewis John Lewis John Lewis Researcher IV-Chemical Engineering John.Lewis@nrel.gov | 303-275-3021 Education Ph.D. Chemical Engineering, California Institute of Technology, Pasadena, CA, 1996 M.S. Chemical Engineering, California Institute of Technology, Pasadena, CA, 1993 B.S. Chemical Engineering, Texas A&M

Air Force Project Competition

DTIC Science & Technology

2014-10-22

FA9550-11-1-0235 final report The Johns Hopkins University Dr Nathan Scott 7 Team BRX 2012-13: Will Crawford, Ben Wasser , Renata Smith, Danny Fisher...custom sock and braced with guy ropes. See Fig. 8. Fig. 8 Ben Wasser and Will Crawford testing the bridge in April 2013. FA9550-11-1-0235 final report...The Johns Hopkins University Dr Nathan Scott 8 Fig. 9 Ben Wasser carrying the folded, stowed bridge in its backpack. The pack weighed about 45lb

Air Force Project Competition

DTIC Science & Technology

2014-10-17

FA9550-11-1-0235 final report The Johns Hopkins University Dr Nathan Scott 7 Team BRX 2012-13: Will Crawford, Ben Wasser , Renata Smith, Danny Fisher...custom sock and braced with guy ropes. See Fig. 8. Fig. 8 Ben Wasser and Will Crawford testing the bridge in April 2013. FA9550-11-1-0235 final report...The Johns Hopkins University Dr Nathan Scott 8 Fig. 9 Ben Wasser carrying the folded, stowed bridge in its backpack. The pack weighed about 45lb

Medical device innovation and the value analysis process.

PubMed

Krantz, Heidi; Strain, Barbara; Torzewski, Jane

2017-09-01

Heidi A. Krantz, RN, BSN is the Director of Value Analysis at Johns Hopkins Bayview Medical Center in the Johns Hopkins Health System. Barbara Strain, MA, CVAHP is the Director of Value Management at the University of Virginia Health System. Jane Torzewski RN, MAN, MBA is a Senior Category Manager for the Mayo Clinic Physician Preference Contracting team. She previously was a Senior Clinical Value Analyst on the Mayo Clinic Value Analysis team. Copyright © 2018. Published by Elsevier Inc.

Final Report on A. R. A. P.’s Model for the Atmospheric Marine Environment

DTIC Science & Technology

1982-01-01

Around Airports," NASA CR-2752, prepared by A.R.A.P. for Marshall Space Center. 25. Brost , R.A. and Wyngaard, N.C., 1978: "A Model Study of the...FRANCE DR. R. A. BROST NCAR P.O. BOX 3000 BOULDER, CO 80307 JOHNS HOPKINS UNIV. APPLIED PHYSICS LAB R.E. GIBSON LIBRARY JOHNS HOPKINS ROAD...RESEARCH LABS BOULDER, CO 80303 DR. GEORGE L. HELLOR GEOPHYSICAL FLUID DYNAMICS LAE PRINCETON, NJ 08540 DR. TETSUJI YAMADA LOS ALAMOS NATIONAL LAB

Hazardous Chemical Fluorometer Development.

DTIC Science & Technology

1981-02-01

RD-0129 997 HAZARDOUS CHEMICAL FLUOROMETER DEYELOPNENT(U) JOHNS HOPKINS UNIV LAUREL RD APPLIED PHYSICS LAB 6 S KEYS FEB Bi JHU/RPL/EED-Bi-6B USCO-D...TEST CHART REr-CRT NO: Cr-n-79-81 Hazardous Chemical Fluorometer Development -- Gary S. Keys q Ft THE JOHNS HOPKINS UNIVERSITYqFt. ill) APPLIED PHYSICS...Connecticut 06340 - 0 I CG-D-79-81/ Ah 7_> Hazardous Chemical Fluorometer Development February 1981 88898 7. ,~rrro z 9. NO-0.C as, 0-a ., AII=q1. Wo

Commemorating John Dyson

NASA Astrophysics Data System (ADS)

Pittard, Julian M.

2015-03-01

John Dyson was born on the 7th January 1941 in Meltham Mills, West Yorkshire, England, and later grew up in Harrogate and Leeds. The proudest moment of John's early life was meeting Freddie Trueman, who became one of the greatest fast bowlers of English cricket. John used a state scholarship to study at Kings College London, after hearing a radio lecture by D. M. McKay. He received a first class BSc Special Honours Degree in Physics in 1962, and began a Ph.D. at the University of Manchester Department of Astronomy after being attracted to astronomy by an article of Zdenek Kopal in the semi-popular journal New Scientist. John soon started work with Franz Kahn, and studied the possibility that the broad emission lines seen from the Orion Nebula were due to flows driven by the photoevaporation of neutral globules embedded in a HII region. John's thesis was entitled ``The Age and Dynamics of the Orion Nebula`` and he passed his oral examination on 28th February 1966.

Laboratory assays of select candidate insecticides for control of Dendroctonus ponderosae Hopkins Pesticide Management Science 67: 548−555

Treesearch

C.J. Fettig; C.J. Hayes; S.R. McKelvey; S.R. Mori

2011-01-01

BACKGROUND: The mountain pine beetle, Dendroctonus ponderosaeHopkins (Coleoptera: Curculionidae, Scolytinae), is the most destructive bark beetle in western North America. Dendroctonus ponderosae can be prevented from successfully colonizing and killing individual trees by ground-based sprays of insecticides applied directly to...

Stand characteristics and downed woody debris accumulations associated with a mountain pine beetle (Dendroctonus ponderosae Hopkins) outbreak in Colorado

Treesearch

Jennifer G. Klutsch; Jose F. Negron; Sheryl L. Costello; Charles C. Rhoades; Daniel R. West; John Popp; Rick Caissie

2009-01-01

Lodgepole pine (Pinus contorta Dougl. ex Loud.)-dominated ecosystems in north-central Colorado are undergoing rapid and drastic changes associated with overstory tree mortality from a currentmountain pine beetle (Dendroctonus ponderosae Hopkins) outbreak. To characterize stand characteristics and downed woody debris loads during...

Comment on ''The velocity field due to an oscillating plate in an Oldroyd-B fluid'' by C.C. Hopkins and J.R. de Bruyn [Can. J. Phys. 92, 533 (2014)

DOE PAGES

Christov, Ivan C.

2015-09-11

We correct certain errors and ambiguities in the recent pedagogical article by Hopkins and de Bruyn. The early-time asymptotics of the solution to the transient version of Stokes’ second problem for an Oldroyd-B fluid in a half-space is presented, as Appendix A, to complement the late-time asymptotics given by Hopkins and de Bruyn.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, NASA’s MESSENGER spacecraft is secure after transfer to the work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, NASA’s MESSENGER spacecraft is secure after transfer to the work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, workers check the placement of NASA’s MESSENGER spacecraft on a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, workers check the placement of NASA’s MESSENGER spacecraft on a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers move NASA’s MESSENGER spacecraft into a high bay clean room. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers move NASA’s MESSENGER spacecraft into a high bay clean room. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, an overhead crane moves NASA’s MESSENGER spacecraft toward a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, an overhead crane moves NASA’s MESSENGER spacecraft toward a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, an overhead crane lowers NASA’s MESSENGER spacecraft onto a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, an overhead crane lowers NASA’s MESSENGER spacecraft onto a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, NASA’s MESSENGER spacecraft is revealed. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, NASA’s MESSENGER spacecraft is revealed. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

Flight periodicity of the Douglas-fir beetle, Dendroctonus pseudotsugae Hopkins (Coleoptera: Curculionidae: Scolytinae) in Colorado, U.S.A

Treesearch

Jose F. Negron; Willis C. Schaupp; Lee Pederson

2011-01-01

There are about 500 species of bark beetles (Coleoptera: Curculionidae: Scolytinae) in the United States (Wood 1982). A number of them are important disturbance agents in forested ecosystems, occasionally creating large tracts of dead trees. One eruptive species is the Douglas-fir beetle, Dendroctonus pseudotsugae Hopkins, which utilizes Douglas-fir, Pseudotsuga...

An improved synthetic attractant for the mountain pine beetle, Dendroctonus ponderosae Hopkins (Coleoptera: Curculionidae: Scolytinae), in northeastern California

Treesearch

Brian Strom; Sheri Smith; D.A. Wakarchuk

2008-01-01

The mountain pine beetle, Dendroctonus ponderosae Hopkins 1902, is found in pine forests throughout the western U.S., north to northern British Columbia and Alberta, Canada and south to Mexico. It causes high levels of pine mortality throughout its range. Hosts include many species of Pinus (Pinaceae); in northern California,

Increased levels of depressive symptoms among pregnant women in The Netherlands after the crash of flight MH17.

PubMed

Truijens, Sophie E M; Boerekamp, Carola A M; Spek, Viola; van Son, Maarten J M; Oei, S Guid; Pop, Victor J M

2015-09-01

On July 17, 2014, Malaysia Airlines flight MH17 was shot down, a tragedy that shocked the Dutch population. As part of a large longitudinal survey on mental health in pregnant women that had a study inclusion period of 19 months, we were able to evaluate the possible association of that incident with mood changes using pre- and postdisaster data. We compared mean Edinburgh Depression Scale (EDS) scores from a group of women (n = 126 cases) at 32 weeks' gestation during the first month after the crash with mean scores from a control group (n = 102) with similar characteristics who completed the EDS at 32 weeks' gestation during the same summer period in 2013. The mean EDS scores of the 126 case women in the first month after the crash were significantly higher than the scores of 102 control women. There were no differences in mean EDS scores between the 2 groups at the first and second trimesters. The present study is among the first in which perinatal mental health before and after the occurrence of a disaster has been investigated, and the results suggest that national disasters might lead to emotional responses. © 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.

Dynamic Variation in Sexual Contact Rates in a Cohort of HIV-Negative Gay Men.

PubMed

Romero-Severson, E O; Volz, E; Koopman, J S; Leitner, T; Ionides, E L

2015-08-01

Human immunodeficiency virus (HIV) transmission models that include variability in sexual behavior over time have shown increased incidence, prevalence, and acute-state transmission rates for a given population risk profile. This raises the question of whether dynamic variation in individual sexual behavior is a real phenomenon that can be observed and measured. To study this dynamic variation, we developed a model incorporating heterogeneity in both between-person and within-person sexual contact patterns. Using novel methodology that we call iterated filtering for longitudinal data, we fitted this model by maximum likelihood to longitudinal survey data from the Centers for Disease Control and Prevention's Collaborative HIV Seroincidence Study (1992-1995). We found evidence for individual heterogeneity in sexual behavior over time. We simulated an epidemic process and found that inclusion of empirically measured levels of dynamic variation in individual-level sexual behavior brought the theoretical predictions of HIV incidence into closer alignment with reality given the measured per-act probabilities of transmission. The methods developed here provide a framework for quantifying variation in sexual behaviors that helps in understanding the HIV epidemic among gay men. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Measuring the Impact of Disasters Using Publicly Available Data: Application to Hurricane Sandy (2012).

PubMed

Mongin, Steven J; Baron, Sherry L; Schwartz, Rebecca M; Liu, Bian; Taioli, Emanuela; Kim, Hyun

2017-12-01

The unexpected nature of disasters leaves little time or resources for organized health surveillance of the affected population, and even less for those who are unaffected. An ideal epidemiologic study would monitor both groups equally well, but would typically be decided against as infeasible or costly. Exposure and health outcome data at the level of the individual can be difficult to obtain. Despite these challenges, the health effects of a disaster can be approximated. Approaches include 1) the use of publicly available exposure data in geographic detail, 2) health outcomes data-collected before, during, and after the event, and 3) statistical modeling designed to compare the observed frequency of health outcomes with the counterfactual frequency hidden by the disaster itself. We applied these strategies to Hurricane Sandy, which struck the northeastern United States in October 2012. Hospital admissions data from the state of New York with information on primary payer as well as patient demographic characteristics were analyzed. To illustrate the method, we present multivariate logistic regression results for the first 2 months after the hurricane. Inferential implications of admissions data on nearly the entire target population in the wake of a disaster are discussed. © The Author(s) 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.

Accuracy of self-reported versus measured weight over adolescence and young adulthood: findings from the national longitudinal study of adolescent health, 1996-2008.

PubMed

Clarke, Philippa; Sastry, Narayan; Duffy, Denise; Ailshire, Jennifer

2014-07-15

Many studies rely on self-reports to capture population trends and trajectories in weight gain over adulthood, but the validity of self-reports is often considered a limitation. The purpose of this work was to examine long-term trajectories of self-reporting bias in a national sample of American youth. With 3 waves of data from the National Longitudinal Study of Adolescent Health (1996-2008), we used growth curve models to examine self-reporting bias in trajectories of weight gain across adolescence and early adulthood (ages 13-32 years). We investigated whether self-reporting bias is constant over time, or whether adolescents become more accurate in reporting their weight as they move into young adulthood, and we examined differences in self-reporting bias by sex, race/ethnicity, and attained education. Adolescent girls underreported their weight by 0.86 kg on average, and this rate of underreporting increased over early adulthood. In contrast, we found no evidence that boys underreported their weight either in adolescence or over the early adult years. For young men, self-reports of weight were unbiased estimates of measured weight among all racial/ethnic and educational subpopulations over adolescence and early adulthood. © The Author 2014. 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.

Probabilistic Multiple-Bias Modeling Applied to the Canadian Data From the Interphone Study of Mobile Phone Use and Risk of Glioma, Meningioma, Acoustic Neuroma, and Parotid Gland Tumors.

PubMed

Momoli, F; Siemiatycki, J; McBride, M L; Parent, M-É; Richardson, L; Bedard, D; Platt, R; Vrijheid, M; Cardis, E; Krewski, D

2017-10-01

We undertook a re-analysis of the Canadian data from the 13-country case-control Interphone Study (2001-2004), in which researchers evaluated the associations of mobile phone use with the risks of brain, acoustic neuroma, and parotid gland tumors. In the main publication of the multinational Interphone Study, investigators concluded that biases and errors prevented a causal interpretation. We applied a probabilistic multiple-bias model to address possible biases simultaneously, using validation data from billing records and nonparticipant questionnaires as information on recall error and selective participation. In our modeling, we sought to adjust for these sources of uncertainty and to facilitate interpretation. For glioma, when comparing those in the highest quartile of use (>558 lifetime hours) to those who were not regular users, the odds ratio was 2.0 (95% confidence interval: 1.2, 3.4). After adjustment for selection and recall biases, the odds ratio was 2.2 (95% limits: 1.3, 4.1). There was little evidence of an increase in the risk of meningioma, acoustic neuroma, or parotid gland tumors in relation to mobile phone use. Adjustments for selection and recall biases did not materially affect interpretation in our results from Canadian data. © The Author(s) 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.

Inverse association of plasma vanadium levels with newly diagnosed type 2 diabetes in a Chinese population.

PubMed

Wang, Xia; Sun, Taoping; Liu, Jun; Shan, Zhilei; Jin, Yilin; Chen, Sijing; Bao, Wei; Hu, Frank B; Liu, Liegang

2014-08-15

Vanadium compounds have been proposed to have beneficial effects on the pathogenesis and complications of type 2 diabetes. Our objective was to evaluate the association between plasma vanadium levels and type 2 diabetes. We performed a case-control study involving 1,598 Chinese subjects with or without newly diagnosed type 2 diabetes (December 2004-December 2007). Cases and controls were frequency-matched by age and sex. Plasma vanadium concentrations were measured and compared between groups. Analyses showed that plasma vanadium concentrations were significantly lower in cases with newly diagnosed type 2 diabetes than in controls (P = 0.001). Mean plasma vanadium levels in participants with and without diabetes were 1.0 μg/L and 1.2 μg/L, respectively. Participants in the highest quartile of plasma vanadium concentration had a notably lower risk of newly diagnosed type 2 diabetes (odds ratio = 0.26, 95% confidence interval: 0.19, 0.35; P < 0.001), compared with persons in the lowest quartile. The trend remained significant after adjustment for known risk factors and in further stratification analyses. Our results suggested that plasma vanadium concentrations were inversely associated with newly diagnosed type 2 diabetes in this Chinese population. © The Author 2014. 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.

Estimating the burden of recurrent events in the presence of competing risks: the method of mean cumulative count.

PubMed

Dong, Huiru; Robison, Leslie L; Leisenring, Wendy M; Martin, Leah J; Armstrong, Gregory T; Yasui, Yutaka

2015-04-01

Cumulative incidence has been widely used to estimate the cumulative probability of developing an event of interest by a given time, in the presence of competing risks. When it is of interest to measure the total burden of recurrent events in a population, however, the cumulative incidence method is not appropriate because it considers only the first occurrence of the event of interest for each individual in the analysis: Subsequent occurrences are not included. Here, we discuss a straightforward and intuitive method termed "mean cumulative count," which reflects a summarization of all events that occur in the population by a given time, not just the first event for each subject. We explore the mathematical relationship between mean cumulative count and cumulative incidence. Detailed calculation of mean cumulative count is described by using a simple hypothetical example, and the computation code with an illustrative example is provided. Using follow-up data from January 1975 to August 2009 collected in the Childhood Cancer Survivor Study, we show applications of mean cumulative count and cumulative incidence for the outcome of subsequent neoplasms to demonstrate different but complementary information obtained from the 2 approaches and the specific utility of the former. © 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.

Are Lowered Socioeconomic Circumstances Causally Related to Tooth Loss? A Natural Experiment Involving the 2011 Great East Japan Earthquake.

PubMed

Matsuyama, Yusuke; Aida, Jun; Tsuboya, Toru; Hikichi, Hiroyuki; Kondo, Katsunori; Kawachi, Ichiro; Osaka, Ken

2017-07-01

Oral health status is correlated with socioeconomic status. However, the causal nature of the relationship is not established. Here we describe a natural experiment involving deteriorating socioeconomic circumstances following exposure to the 2011 Great East Japan Earthquake and Tsunami. We investigated the relationship between subjective economic deterioration and housing damage due to the disaster and tooth loss in a cohort of community-dwelling residents (n = 3,039), from whom we obtained information about socioeconomic status and health status in 2010 (i.e., predating the disaster). A follow-up survey was performed in 2013 (postdisaster), and 82.1% of the 4,380 eligible survivors responded. We estimated the impact of subjective economic deterioration and housing damage due to the disaster on tooth loss by fitting an instrumental variable probit model. Subjective economic deterioration and housing damage due to the disaster were significantly associated with 8.1% and 1.7% increases in the probability of tooth loss (probit coefficients were 0.469 (95% confidence interval: 0.065, 0.872) and 0.103 (95% confidence interval: 0.011, 0.196), respectively). In this natural experiment, we confirmed the causal relationship between deteriorating socioeconomic circumstances and tooth loss. © 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.

Invited Commentary: Agent-Based Models-Bias in the Face of Discovery.

PubMed

Keyes, Katherine M; Tracy, Melissa; Mooney, Stephen J; Shev, Aaron; Cerdá, Magdalena

2017-07-15

Agent-based models (ABMs) have grown in popularity in epidemiologic applications, but the assumptions necessary for valid inference have only partially been articulated. In this issue, Murray et al. (Am J Epidemiol. 2017;186(2):131-142) provided a much-needed analysis of the consequence of some of these assumptions, comparing analysis using an ABM to a similar analysis using the parametric g-formula. In particular, their work focused on the biases that can arise in ABMs that use parameters drawn from distinct populations whose causal structures and baseline outcome risks differ. This demonstration of the quantitative issues that arise in transporting effects between populations has implications not only for ABMs but for all epidemiologic applications, because making use of epidemiologic results requires application beyond a study sample. Broadly, because health arises within complex, dynamic, and hierarchical systems, many research questions cannot be answered statistically without strong assumptions. It will require every tool in our store of methods to properly understand population dynamics if we wish to build an evidence base that is adequate for action. Murray et al.'s results provide insight into these assumptions that epidemiologists can use when selecting a modeling approach. © The Author(s) 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.

Parental Separation and Cardiometabolic Risk Factors in Late Adolescence: A Cross-Cohort Comparison.

PubMed

Soares, Ana Luiza Gonçalves; Gonçalves, Helen; Matijasevich, Alicia; Sequeira, Maija; Smith, George Davey; Menezes, Ana M B; Assunção, Maria Cecília; Wehrmeister, Fernando C; Fraser, Abigail; Howe, Laura D

2017-05-15

The aim of this study was to explore the association between parental separation during childhood (up to 18 years of age) and cardiometabolic risk factors (body mass index, fat mass index, blood pressure, physical activity, smoking, and alcohol consumption) in late adolescence using a cross-cohort comparison and to explore whether associations differ according to the age at which the parental separation occurred and the presence or absence of parental conflict prior to separation. Data from the Avon Longitudinal Study of Parents and Children (ALSPAC, United Kingdom) (1991-2011) and the 1993 Pelotas Birth Cohort (Brazil) (1993-2011) were used. The associations of parental separation with children's cardiometabolic risk factors were largely null. Higher odds of daily smoking were observed in both cohorts for those adolescents whose parents separated (for ALSPAC, odds ratio = 1.46; for Pelotas Birth Cohort, odds ratio = 1.98). Some additional associations were observed in the Pelotas Birth Cohort but were generally in the opposite direction to our a priori hypothesis: Parental separation was associated with lower blood pressure and fat mass index, and with more physical activity. No consistent differences were observed when analyses were stratified by child's age at parental separation or parental conflict. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Mammographic Density Reduction as a Prognostic Marker for Postmenopausal Breast Cancer: Results Using a Joint Longitudinal-Survival Modeling Approach.

PubMed

Andersson, Therese M-L; Crowther, Michael J; Czene, Kamila; Hall, Per; Humphreys, Keith

2017-11-01

Previous studies have linked reductions in mammographic density after a breast cancer diagnosis to an improved prognosis. These studies focused on short-term change, using a 2-stage process, treating estimated change as a fixed covariate in a survival model. We propose the use of a joint longitudinal-survival model. This enables us to model long-term trends in density while accounting for dropout as well as for measurement error. We studied the change in mammographic density after a breast cancer diagnosis and its association with prognosis (measured by cause-specific mortality), overall and with respect to hormone replacement therapy and tamoxifen treatment. We included 1,740 women aged 50-74 years, diagnosed with breast cancer in Sweden during 1993-1995, with follow-up until 2008. They had a total of 6,317 mammographic density measures available from the first 5 years of follow-up, including baseline measures. We found that the impact of the withdrawal of hormone replacement therapy on density reduction was larger than that of tamoxifen treatment. Unlike previous studies, we found that there was an association between density reduction and survival, both for tamoxifen-treated women and women who were not treated with tamoxifen. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

A Global Cancer Surveillance Framework Within Noncommunicable Disease Surveillance: Making the Case for Population-Based Cancer Registries.

PubMed

Piñeros, Marion; Znaor, Ariana; Mery, Les; Bray, Freddie

2017-01-01

The growing burden of cancer among several major noncommunicable diseases (NCDs) requires national implementation of tailored public health surveillance. For many emerging economies where emphasis has traditionally been placed on the surveillance of communicable diseases, it is critical to understand the specificities of NCD surveillance and, within it, of cancer surveillance. We propose a general framework for cancer surveillance that permits monitoring the core components of cancer control. We examine communalities in approaches to the surveillance of other major NCDs as well as communicable diseases, illustrating key differences in the function, coverage, and reporting in each system. Although risk factor surveys and vital statistics registration are the foundation of surveillance of NCDs, population-based cancer registries play a unique fundamental role specific to cancer surveillance, providing indicators of population-based incidence and survival. With an onus now placed on governments to collect these data as part of the monitoring of NCD targets, the integration of cancer registries into existing and future NCD surveillance strategies is a vital requirement in all countries worldwide. The Global Initiative for Cancer Registry Development, endorsed by the World Health Organization, provides a means to enhance cancer surveillance capacity in low- and middle-income countries. © 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.

Anticipate and communicate: Ethical management of incidental and secondary findings in the clinical, research, and direct-to-consumer contexts (December 2013 report of the Presidential Commission for the Study of Bioethical Issues).

PubMed

Weiner, Christine

2014-09-15

Genomic population research increases the possibility of finding genetic coding anomalies that are not the primary object of research but may have significance for the current and future medical care of research participants and progeny. The December 2013 Report of the Presidential Commission for the Study of Bioethical Issues (Anticipate and Communicate: Ethical Management of Incidental and Secondary Findings in the Clinical, Research, and Direct-to-Consumer Contexts (http://bioethics.gov/sites/default/files/FINALAnticipateCommunicate_PCSBI_0.pdf)) recommends that a researcher anticipate these findings and make a plan that addresses which findings will be communicated to research participants and how. Following these recommendations will be disruptive for both investigators and institutional review boards (IRBs) until the research community reaches consensus, or a mechanism for evolving consensus, on which results should be returned to research participants. A protocol-by-protocol approach, though laborious, makes sense for both investigators and IRBs as the research community thinks through the implications of genomic research. Epidemiologists will note that discussion of the return of results and the plan for communicating findings should be included in both the participant consent agreement and the research protocol submitted to the IRB. © The Author 2014. 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.

Improving public health surveillance using a dual-frame survey of landline and cell phone numbers.

PubMed

Hu, S Sean; Balluz, Lina; Battaglia, Michael P; Frankel, Martin R

2011-03-15

To meet challenges arising from increasing rates of noncoverage in US landline-based telephone samples due to cell-phone-only households, the Behavioral Risk Factor Surveillance System (BRFSS) expanded a traditional landline-based random digit dialing survey to a dual-frame survey of landline and cell phone numbers. In 2008, a survey of adults with cell phones only was conducted in parallel with an ongoing landline-based health survey in 18 states. The authors used the optimal approach to allocate samples into landline and cell-phone-only strata and used a new approach to weighting state-level landline and cell phone samples. They developed logistic models for each of 16 health indicators to examine whether exclusion of adults with cell phones only affected estimates after adjustment for demographic characteristics. The extents of the potential biases in landline telephone surveys that exclude cell phones were estimated. Biases resulting from exclusion of adults with cell phones only from the landline-based survey were found for 9 out of the 16 health indicators. Because landline noncoverage rates for adults with cell phones only continue to increase, these biases are likely to increase. Use of a dual-frame survey of landline and cell phone numbers assisted the BRFSS efforts in obtaining valid, reliable, and representative data. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2011.

A New Method for Estimating the Coverage of Mass Vaccination Campaigns Against Poliomyelitis From Surveillance Data.

PubMed

O'Reilly, K M; Cori, A; Durry, E; Wadood, M Z; Bosan, A; Aylward, R B; Grassly, N C

2015-12-01

Mass vaccination campaigns with the oral poliovirus vaccine targeting children aged <5 years are a critical component of the global poliomyelitis eradication effort. Monitoring the coverage of these campaigns is essential to allow corrective action, but current approaches are limited by their cross-sectional nature, nonrandom sampling, reporting biases, and accessibility issues. We describe a new Bayesian framework using data augmentation and Markov chain Monte Carlo methods to estimate variation in vaccination coverage from children's vaccination histories investigated during surveillance for acute flaccid paralysis. We tested the method using simulated data with at least 200 cases and were able to detect undervaccinated groups if they exceeded 10% of all children and temporal changes in coverage of ±10% with greater than 90% sensitivity. Application of the method to data from Pakistan for 2010-2011 identified undervaccinated groups within the Balochistan/Federally Administered Tribal Areas and Khyber Pakhtunkhwa regions, as well as temporal changes in coverage. The sizes of these groups are consistent with the multiple challenges faced by the program in these regions as a result of conflict and insecurity. Application of this new method to routinely collected data can be a useful tool for identifying poorly performing areas and assisting in eradication efforts. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Association of Aging-Related Endophenotypes With Mortality in 2 Cohort Studies: the Long Life Family Study and the Health, Aging and Body Composition Study.

PubMed

Singh, Jatinder; Schupf, Nicole; Boudreau, Robert; Matteini, Amy M; Prasad, Tanushree; Newman, Anne B; Liu, YongMei; Christensen, Kaare; Kammerer, Candace M

2015-12-01

One method by which to identify fundamental biological processes that may contribute to age-related disease and disability, instead of disease-specific processes, is to construct endophenotypes comprising linear combinations of physiological measures. Applying factor analyses methods to phenotypic data (2006-2009) on 28 traits representing 5 domains (cognitive, cardiovascular, metabolic, physical, and pulmonary) from 4,472 US and Danish individuals in 574 pedigrees from the Long Life Family Study (United States and Denmark), we constructed endophenotypes and assessed their relationship with mortality. The most dominant endophenotype primarily reflected the physical activity and pulmonary domains, was heritable, was significantly associated with mortality, and attenuated the association of age with mortality by 24.1%. Using data (1997-1998) on 1,794 Health, Aging and Body Composition Study participants from Memphis, Tennessee, and Pittsburgh, Pennsylvania, we obtained strikingly similar endophenotypes and relationships to mortality. We also reproduced the endophenotype constructs, especially the dominant physical activity and pulmonary endophenotype, within demographic subpopulations of these 2 cohorts. Thus, this endophenotype construct may represent an underlying phenotype related to aging. Additional genetic studies of this endophenotype may help identify genetic variants or networks that contribute to the aging process. © 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.

In-Work Poverty and Self-Rated Health in a Cohort of Working Germans: A Hybrid Approach for Decomposing Within-Person and Between-Persons Estimates of In-Work Poverty Status.

PubMed

Pförtner, Timo-Kolja; Schmidt-Catran, Alexander W

2017-02-15

In this study, we investigated whether self-rated health (SRH) can be predicted by in-work poverty and how between-persons and within-person differences in the poverty status of people who are working contribute to this relationship. We used a logistic random-effects model designed to test within-person and between-persons differences with data from a nationally representative German sample with 19 waves of data collection (1995-2013) to estimate effects of between-persons and within-person differences in working poverty status on poor SRH. Interactions by age and sex were tested, and models controlled for sociodemographic, socioeconomic, and work-related characteristics. We found significant differences in SRH between individuals with different working poverty status but no evidence that within-person differences in working poverty status are associated with poor SRH. The association between in-work poverty and SRH was significantly stronger for women but did not differ significantly by age. All findings were robust when including sociodemographic, socioeconomic, and working characteristics. In this sample of German adults, we found a polarization of poor SRH between the working nonpoor and the working poor but no causal association of within-person differences in working poverty status with SRH. © The Author 2016. 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.

Invited Commentary: Observing Neighborhood Physical Disorder in an Age of Technological Innovation.

PubMed

Hwang, Jackelyn

2017-08-01

Researchers across several disciplines have argued that the characteristics of neighborhood environments can affect a variety of individual- and neighborhood-level outcomes. Physical disorder is one feature of neighborhoods that scholars have argued is important, but data that capture physical disorder have been limited because of the time and resources required for in-person audits. The advent of Google Street View, which provides publicly available street-level imagery with nearly complete coverage of the United States, opens new possibilities for researchers. In this issue of the Journal, Mooney et al. (Am J Epidemiol. 2017;186(3):265-273) compare in-person and virtual audits in Detroit, Michigan, and demonstrate that virtual audits offer key advantages to measuring neighborhood physical disorder over in-person audits, including substantial reductions in time and resources with little to no loss of measurement precision. In this invited commentary, I welcome the use of virtual audits for advancing the study of neighborhoods and outline areas in which they can advance understanding of neighborhood effects. I also describe areas of caution in their implementation and outline how new innovations can advance the use of virtual audits for furthering understanding of neighborhood environments. © The Author(s) 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.

Association of Genetic Risk for Schizophrenia With Nonparticipation Over Time in a Population-Based Cohort Study.

PubMed

Martin, Joanna; Tilling, Kate; Hubbard, Leon; Stergiakouli, Evie; Thapar, Anita; Davey Smith, George; O'Donovan, Michael C; Zammit, Stanley

2016-06-15

Progress has recently been made in understanding the genetic basis of schizophrenia and other psychiatric disorders. Longitudinal studies are complicated by participant dropout, which could be related to the presence of psychiatric problems and associated genetic risk. We tested whether common genetic variants implicated in schizophrenia were associated with study nonparticipation among 7,867 children and 7,850 mothers from the Avon Longitudinal Study of Parents and Children (ALSPAC; 1991-2007), a longitudinal population cohort study. Higher polygenic risk scores for schizophrenia were consistently associated with noncompletion of questionnaires by study mothers and children and nonattendance at data collection throughout childhood and adolescence (ages 1-15 years). These associations persisted after adjustment for other potential correlates of nonparticipation. Results suggest that persons at higher genetic risk for schizophrenia are likely to be underrepresented in cohort studies, which will underestimate risk of this and related psychiatric, cognitive, and behavioral phenotypes in the population. Statistical power to detect associations with these phenotypes will be reduced, while analyses of schizophrenia-related phenotypes as outcomes may be biased by the nonrandom missingness of these phenotypes, even if multiple imputation is used. Similarly, in complete-case analyses, collider bias may affect associations between genetic risk and other factors associated with missingness. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

The sixteenth presentation of the John Adam Fleming medal to Thomas M. Donahue

NASA Astrophysics Data System (ADS)

Nagy, Andrew F.; Donahue, Thomas M.

Citations are supposed to begin with a statement of the sort ‘It is an honor and a pleasure for me to introduce…’ however, in the case of Tom Donahue I do not think that I have to introduce him, since most everyone here this evening already knows him. His 30-plus-year career spans a very broad field of scientific endeavors as well as numerous institutions. We at Michigan are lucky to have had him with us since 1974. He has made his lasting mark in the field of aeronomy through his publications, which number over 140, his many graduate students, postdocs, and colleagues who have had the good fortune to have worked with him. Sydney Chapman must have been thinking of someone like Tom Donahue when he coined the word aeronomy. Tom was born in Oklahoma, receive his B.A. from Rockhurst College in Kansas City and his Ph.D. from The Johns Hopkins University in 1947. Perhaps it is appropriate that he is now receiving the Fleming Award here in Baltimore, where his professional career began. His deep lifelong involvement in solar system studies really began when he moved to The University of Pittsburgh in 1951, and he has been going full steam ever since.

Osteopathic Manipulative Treatment Limits Chronic Constipation in a Child with Pitt-Hopkins Syndrome.

PubMed

Aquino, Alessandro; Perini, Mattia; Cosmai, Silvia; Zanon, Silvia; Pisa, Viviana; Castagna, Carmine; Uberti, Stefano

2017-01-01

Pitt-Hopkins Syndrome (PTHS) is a rare genetic disorder caused by insufficient expression of the TCF4 gene. Children with PTHS typically present with gastrointestinal disorders and early severe chronic constipation is frequently found (75%). Here we describe the case of a PTHS male 10-year-old patient with chronic constipation in whom Osteopathic Manipulative Treatment (OMT) resulted in improved bowel functions, as assessed by the diary, the QPGS-Form A Section C questionnaire, and the Paediatric Bristol Stool Form Scale. The authors suggested that OMT may be a valid tool to improve the defecation frequency and reduce enema administration in PTHS patients.

Interview: Professor Andrew Feinberg speaks to Epigenomics.

PubMed

Feinberg, Andrew

2009-10-01

Andrew Feinberg studied mathematics and humanities at Yale University (CT, USA) in the Directed Studies honors program, and he received his BA (1973) and MD (1976) from the accelerated medical program at Johns Hopkins University (MD, USA), as well as an MPH from Johns Hopkins (1981). He performed a postdoctoral fellowship in developmental biology at the University of California, San Diego (UCSD, CA, USA), clinical training in medicine and medical genetics at the University of Pennsylvania (PA, USA) and genetics research with Bert Vogelstein at Johns Hopkins, discovering altered DNA methylation in human cancer. Dr Feinberg continued to perform seminal work in cancer epigenetics as a Howard Hughes investigator at the University of Michigan (MI, USA), discovering human imprinted genes and loss of imprinting in cancer, and the molecular basis of Beckwith-Wiedemann syndrome. He returned to John Hopkins in 1994 as King Fahd Professor of Medicine, Molecular Biology & Genetics and Oncology, and he holds an Adjunct Professorship at the Karolinska Institute in Sweden. Dr Feinberg is Director of the Center for Epigenetics, a National Human Genome Research Institute-designated Center of Excellence in Genome Sciences. The Center is pioneering genome-scale tools in molecular, statistical and epidemiological epigenetics, and is applying them to the study of cancer, neuropsychiatric disease and aging. As part of the center, Dr Feinberg has organized a highly innovative program to bring gifted minority high-school students into genetics and genomics. Dr Feinberg has also invented a number of widely used molecular tools, including random priming. His honors include election to the American Society for Clinical Investigation, the Association of American Physicians, the Institute of Medicine of the National Academy of Sciences, and the American Academy of Arts and Sciences, as well as membership on the ISI most-cited authors list, a MERIT Award of the National Cancer Institute, a

Development, cognition, and behaviour in Pitt-Hopkins syndrome.

PubMed

Van Balkom, Ingrid D C; Vuijk, Pieter Jelle; Franssens, Marijke; Hoek, Hans W; Hennekam, Raoul C M

2012-10-01

The aim of the study was to collect detailed data on behavioural, adaptive, and psychological functioning in 10 individuals with Pitt-Hopkins syndrome (PTHS), with specific attention to manifestations of autism spectrum disorder (ASD). The participants (four females, six males), residing in the Netherlands and Belgium, were ascertained through the Dutch national PTHS support group. Median age of participants was 10 years, the age range was between 32 and 289 months. They underwent psychiatric examinations and neuropsychological measurements using a comprehensive assessment battery. Additionally, parental information was gathered through standardized interviews and questionnaires. Findings were compared with those from the literature. All participants showed profound intellectual disability, amiable demeanour with minimal maladaptive behaviours, severe impairments of communication and language, and intense, frequent motor stereotypies. Impairments in all participants were beyond what would be expected for cognitive abilities, fitting a classification of ASD. Patients with PTHS are characterized not only by specific physical and genetic manifestations but also by specific behavioural and cognitive characteristics. Studying behaviour and cognition may improve diagnosis and prognosis, allows recognition of comorbidities, and contributes to adequate counselling of families. © The Authors. Developmental Medicine & Child Neurology © 2012 Mac Keith Press.

Test of the decaying dark matter hypothesis using the Hopkins Ultraviolet Telescope

NASA Technical Reports Server (NTRS)

Davidsen, A. F.; Kriss, G. A.; Ferguson, H. C.; Blair, W. P.; Bowers, C. W.; Kimble, R. A.

1991-01-01

Sciama's hypothesis that the dark matter associated with galaxies, galaxy clusters, and the intergalactic medium consists of tau neutrinos of rest mass 28-30 eV whose decay generates ultraviolet photons of energy roughly 14-15 eV, has been tested using the Hopkins Ultraviolet Telescope flows aboard the Space Shuttle Columbia. A straightforward application of Sciama's model predicts that a spectral line from neutrino decay photons should be observed from the rich galaxy cluster Abell 665 with an SNR of about 30. No such emission was detected. For neutrinos in the mass range 27.2-32.1 eV, the observations set a lower lifetime limit significantly greater than Sciama's model requires.

[David H. Hubel, Torsten N. Wiesel, Nigel W. Daw: the creators of modern visual neurophysiology].

PubMed

Czepita, D

1999-01-01

Curriculum vitae as well as scientifical out-put of the Nobel Price winners--David Hunter Hubel and Torsten Nils Wiesel, and the Friedenwald Memorial Award laureate--Nigel Warwick Daw are described. D.H. Hubel was born in 1926 in Windsor, Canada. In 1951 he received a medical degree from McGill University. From 1955-1958 he worked at Walter Reed Army Institute of Research, from 1958-1959 at Johns Hopkins University, and since 1959 at Harvard University. T.N. Wiesel was born in 1924 in Uppsala, Sweden. In 1954 he received a medical degree from Karolinska Institute. From 1955-1959 he worked at Johns Hopkins University, from 1959-1982 at Harvard University, and since 1983 at the Rockefeller University, New York. N.W. Daw was born in 1933 in London, England. In 1961 he received a bachelor's degree in mathematics from Trinity College. In 1967 he became a doctor of philosophy in biophysics at Johns Hopkins University. From 1967-1969 he worked at Harvard University, from 1969-1992 at Washington University, and since 1992 at Yale University.

Isolation and characterization of 16 microsatellite loci in the mountain pine beetle, Dendroctonus ponderosae Hopkins (Coleoptera: Curculionidae: Scolytinae)

Treesearch

C. S. Davis; K. E. Mock; B. J. Bentz; S. M. Bromilow; N. V. Bartell; B. W. Murray; A. D. Roe; J. E. K. Cooke

2009-01-01

We isolated 16 polymorphic microsatellite loci in the mountain pine beetle (Dendroctonus ponderosae Hopkins) and developed conditions for amplifying these markers in four multiplex reactions. Three to 14 alleles were detected per locus across two sampled populations. Observed and expected heterozygosities ranged from 0.000 to 0.902 and from 0.100 to 0.830, respectively...

An Analysis of Emergency Department Overcrowding at The Johns Hopkins Hospital

DTIC Science & Technology

2001-06-20

Jefferson 3rd floor (JEF3), Medical Care Progressive Unit ( MPC4 ), Nelson 4th floor (NEL4), Osler 4th floor (OSL4), Osler 5th floor (OSL5), and Osler...ranged from a low of 73.78% for OSL5 to a high of 94.60% for JEF3. The LOS for the DOM units ranged from 2.89 days for HAL5 to 10.39 days for MPC4

The effect of race on incidence and clinical course in systemic lupus erythematosus: The Hopkins Lupus Cohort.

PubMed

Petri, M

1998-01-01

Systemic lupus erythematosus, a chronic autoimmune disease of young women, has a higher incidence and prevalence in African Americans. The Hopkins Lupus Cohort, a prospective longitudinal study of SLE outcomes, has shown that race is a major predictor of clinical manifestations, laboratory and serologic tests, and disease-related morbidity. The effect of race on musculoskeletal morbidity remains even after adjustment for education, insurance status, and smoking.

Lightening the Load

DTIC Science & Technology

2007-09-09

Research, Engineering and Systems) Dr. John C. Sommerer NRAC, Vice Chair; Director, S&T, Johns Hopkins Applied Physics Laboratory Dr. Walt...O’Donohue, Staff Officer General Dynamics Robotic Systems John H. Northrop & Associates Mr. John H. Northrop, Executive Director General Dynamics...Equipment, US Army LtCol John Lemondes, PM Soldier as a System LTL Efforts US Army Mr. Bob Conklin, Staff UK LTL Efforts Equipment Capability

Osteopathic Manipulative Treatment Limits Chronic Constipation in a Child with Pitt-Hopkins Syndrome

PubMed Central

Perini, Mattia; Pisa, Viviana

2017-01-01

Pitt-Hopkins Syndrome (PTHS) is a rare genetic disorder caused by insufficient expression of the TCF4 gene. Children with PTHS typically present with gastrointestinal disorders and early severe chronic constipation is frequently found (75%). Here we describe the case of a PTHS male 10-year-old patient with chronic constipation in whom Osteopathic Manipulative Treatment (OMT) resulted in improved bowel functions, as assessed by the diary, the QPGS-Form A Section C questionnaire, and the Paediatric Bristol Stool Form Scale. The authors suggested that OMT may be a valid tool to improve the defecation frequency and reduce enema administration in PTHS patients. PMID:28251008

The Armstrong Institute: An Academic Institute for Patient Safety and Quality Improvement, Research, Training, and Practice.

PubMed

Pronovost, Peter J; Holzmueller, Christine G; Molello, Nancy E; Paine, Lori; Winner, Laura; Marsteller, Jill A; Berenholtz, Sean M; Aboumatar, Hanan J; Demski, Renee; Armstrong, C Michael

2015-10-01

Academic medical centers (AMCs) could advance the science of health care delivery, improve patient safety and quality improvement, and enhance value, but many centers have fragmented efforts with little accountability. Johns Hopkins Medicine, the AMC under which the Johns Hopkins University School of Medicine and the Johns Hopkins Health System are organized, experienced similar challenges, with operational patient safety and quality leadership separate from safety and quality-related research efforts. To unite efforts and establish accountability, the Armstrong Institute for Patient Safety and Quality was created in 2011.The authors describe the development, purpose, governance, function, and challenges of the institute to help other AMCs replicate it and accelerate safety and quality improvement. The purpose is to partner with patients, their loved ones, and all interested parties to end preventable harm, continuously improve patient outcomes and experience, and eliminate waste in health care. A governance structure was created, with care mapped into seven categories, to oversee the quality and safety of all patients treated at a Johns Hopkins Medicine entity. The governance has a Patient Safety and Quality Board Committee that sets strategic goals, and the institute communicates these goals throughout the health system and supports personnel in meeting these goals. The institute is organized into 13 functional councils reflecting their behaviors and purpose. The institute works daily to build the capacity of clinicians trained in safety and quality through established programs, advance improvement science, and implement and evaluate interventions to improve the quality of care and safety of patients.

Analysis of field permeability and laboratory shear stress for Western Kentucky Parkway, milepost 18.240 to milepost 25.565, Caldwell-Hopkins counties

DOT National Transportation Integrated Search

2003-02-01

This report lists and discusses results of field permeability tests and laboratory shear tests on samples from a construction project on the Western Kentucky Parkway in Caldwell-Hopkins Counties. Approximately 6,500 tons of asphaltic concrete overlay...

Foreword: Sir John Pendry FRS Sir John Pendry FRS

NASA Astrophysics Data System (ADS)

Inglesfield, John; Echenique, Pedro

2008-07-01

John Pendry John Inglesfield and Pedro Echenique write: John Pendry's 65th birthday is on 4 July 2008, and this issue of the Journal of Physics: Condensed Matter is dedicated to him, with articles by friends, colleagues, and former students. By any standards, John Pendry is a great scientist, who has made—and continues to make—an enormous contribution to physics; the wide range of his interests is reflected in the scope of these articles. Not many scientists can establish a completely new and unexpected area of research, but this has been John's achievement in the last few years in the field of metamaterials, materials whose electromagnetic properties depend on their structure rather than the materials of which the structure is built. In this way, structures with effectively negative electrical permittivity and negative magnetic permeability can be constructed, demonstrating negative refraction; through metamaterials scientists now have access to properties not found in nature, and never previously explored experimentally. Never a week goes by without a potential new application of metamaterials, whether it is perfect lensing, or the cloak of invisibility. This has certainly led to tremendous visibility for John himself, with guest lectures all over the world, and radio and television appearances. John Pendry's first paper was published exactly 40 years ago, 'Analytic properties of pseudopotentials' [1], and since then he has published 310 articles at the latest count. But this first paper already reflected something of the way John works. His PhD project, with Volker Heine at the Cavendish Laboratory, was to interpret the scattering of low energy electrons from surfaces, the technique of LEED which was to become the method of choice for determining surface structure. Although the energy of the electrons in LEED is relatively low—say 50 eV—it is much higher than the energy of the conduction electrons, for which pseudopotentials had been devised, and John

St. John's Wort (image)

MedlinePlus

The herb St. John's Wort is believed to be helpful in relieving mild to moderate depression, but should only be taken under a physician's supervision. St. John's Wort may clash with other medications or ...

Jasper Johns' Painted Words.

ERIC Educational Resources Information Center

Levinger, Esther

1989-01-01

States that the painted words in Jasper Johns' art act in two different capacities: concealed words partake in the artist's interrogation of visual perception; and visible painted words question classical representation. Argues that words are Johns' means of critiquing modernism. (RS)

Instruction at the Hopkins Marine Station

DTIC Science & Technology

1992-07-29

foI homtadcodnaio.. caronavirus nucleocapsid protein. wheat germ bial ~ ~ %~H2A (5), mussel sperm nuclear protein 03 [6), and man chromofsome...wvpi,~Tninev PM"p Johne HiWA~aa Unuw~rsaty &Dio of Medicine, Balw,,.vv, Manh land 21205 The two germ -line- specific Sp histione classes Treatment of...composit conical morphology of the male pronucleus- Mal, pro- serine-proline adjacent to two basic amino acids (lyo hucl*I inhibite’d with I nsMGDMAP

Helen Brooke Taussig and Edwards Albert Park: the early years (1927-1930).

PubMed

Evans, William N

2010-08-01

The conventional history of paediatric cardiology teaches that it was Helen Taussig who founded the cardiac clinic for children at the Harriet Lane Home of the Johns Hopkins School of Medicine in 1930, when Edwards Park appointed her director of the clinic.1,2 However, the story was more complex than that, and involved the collaboration of institutions and the frustrations, doubts, and passions of both Park and Taussig. In this article, I explore the history in more depth through published works, and material preserved at the McGill University Archives, the Rockefeller Foundation Archives, and the Alan Chesney Medical Archives at Johns Hopkins.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers prepare NASA’s MESSENGER spacecraft for transfer to a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers prepare NASA’s MESSENGER spacecraft for transfer to a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, NASA’s MESSENGER spacecraft is lifted off the pallet for transfer to a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities, NASA’s MESSENGER spacecraft is lifted off the pallet for transfer to a work stand. There employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers remove the protective cover from NASA’s MESSENGER spacecraft. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers remove the protective cover from NASA’s MESSENGER spacecraft. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers get ready to remove the protective cover from NASA’s MESSENGER spacecraft. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers get ready to remove the protective cover from NASA’s MESSENGER spacecraft. Employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

Evidence for Shock-heated Gas in the Hopkins Ultraviolet Telescope Spectrum of NGC 1068: Erratum

NASA Astrophysics Data System (ADS)

Kriss, Gerard A.; Davidsen, Arthur F.; Blair, William P.; Ferguson, Henry C.; Long, Knox S.

1992-10-01

In the Letter "Evidence for Shock-heated Gas in the Hopkins Ultraviolet Telescope Spectrum of NGC 1068" by Gerard A. Kriss, Arthur F. Davidsen, William P. Blair, Henry C. Ferguson, and Knox S. Long (ApJ, 394, L37 C1992]), Figure 1 (Plate L5) was printed as a mirror image due to a printer's error. The figure has been reprinted correctly as Plate L10 of this issue. The Journal regrets the error. We also apologize for the incorrect spelling of Knox S. Long in the author list in the table of contents for the 1992 August 1 issue.

Cost-Effectiveness of Pertussis Vaccination During Pregnancy in the United States.

PubMed

Atkins, Katherine E; Fitzpatrick, Meagan C; Galvani, Alison P; Townsend, Jeffrey P

2016-06-15

Vaccination against pertussis has reduced the disease burden dramatically, but the most severe cases and almost all fatalities occur in infants too young to be vaccinated. Recent epidemiologic evidence suggests that targeted vaccination of mothers during pregnancy can reduce pertussis incidence in their infants. To evaluate the cost-effectiveness of antepartum maternal vaccination in the United States, we created an age-stratified transmission model, incorporating empirical data on US contact patterns and explicitly modeling parent-infant exposure. Antepartum maternal vaccination incurs costs of $114,000 (95% prediction interval: 82,000, 183,000) per quality-adjusted life-year, in comparison with the strategy of no adult vaccination, and is cost-effective in the United States according to World Health Organization criteria. By contrast, vaccinating a second parent is not cost-effective, and vaccination of either parent postpartum is strongly dominated by antepartum maternal vaccination. Nonetheless, postpartum vaccination of mothers who were not vaccinated antepartum improves upon the current recommendation of untargeted adult vaccination. Additionally, the temporary direct protection of the infant due to maternal antibody transfer has efficacy for infants comparable to that conferred to toddlers by the full primary vaccination series. Efficient protection against pertussis for infants begins before birth. We highly recommend antepartum vaccination for as many US mothers as possible. © The Author 2016. 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.

Theoretical Basis of the Test-Negative Study Design for Assessment of Influenza Vaccine Effectiveness.

PubMed

Sullivan, Sheena G; Tchetgen Tchetgen, Eric J; Cowling, Benjamin J

2016-09-01

Influenza viruses undergo frequent antigenic changes. As a result, the viruses circulating change within and between seasons, and the composition of the influenza vaccine is updated annually. Thus, estimation of the vaccine's effectiveness is not constant across seasons. In order to provide annual estimates of the influenza vaccine's effectiveness, health departments have increasingly adopted the "test-negative design," using enhanced data from routine surveillance systems. In this design, patients presenting to participating general practitioners with influenza-like illness are swabbed for laboratory testing; those testing positive for influenza virus are defined as cases, and those testing negative form the comparison group. Data on patients' vaccination histories and confounder profiles are also collected. Vaccine effectiveness is estimated from the odds ratio comparing the odds of testing positive for influenza among vaccinated patients and unvaccinated patients, adjusting for confounders. The test-negative design is purported to reduce bias associated with confounding by health-care-seeking behavior and misclassification of cases. In this paper, we use directed acyclic graphs to characterize potential biases in studies of influenza vaccine effectiveness using the test-negative design. We show how studies using this design can avoid or minimize bias and where bias may be introduced with particular study design variations. © The Author 2016. 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.

Airborne hazards exposure and respiratory health of Iraq and Afghanistan veterans.

PubMed

Falvo, Michael J; Osinubi, Omowunmi Y; Sotolongo, Anays M; Helmer, Drew A

2015-01-01

More than 2.6 million military personnel have been deployed to recent conflicts in Iraq and Afghanistan and were likely exposed to a variety of airborne hazards during deployment. Despite several epidemiologic reports of increased respiratory symptoms, whether or not these respiratory illnesses lead to reductions in lung function and/or specific pulmonary disease is unclear. We reviewed data published from 2001 to 2014 pertaining to respiratory health in military personnel deployed to Iraq and Afghanistan and found 19 unique studies. Study designs were primarily retrospective and observational in nature with patient symptom reporting and medical encounter data as primary outcome measures. Two case series reported on rare respiratory diseases, and one performed a standardized evaluation of new-onset respiratory symptoms. Respiratory outcomes in relation to proximity to a specific air pollution source (i.e., smoke from burning trash and sulfur mine fire) were described in 2 separate studies. Only 2 longitudinal investigations were identified comparing pre- and postdeployment measurement of exercise capacity. In summary, published data based on case reports and retrospective cohort studies suggest a higher prevalence of respiratory symptoms and respiratory illness consistent with airway obstruction. However, the association between chronic lung disease and airborne hazards exposure requires further longitudinal research studies with objective pulmonary assessments. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Analysis of the Strength of Legal Firearms Restrictions for Perpetrators of Domestic Violence and Their Association With Intimate Partner Homicide.

PubMed

Zeoli, April M; McCourt, Alexander; Buggs, Shani; Frattaroli, Shannon; Lilley, David; Webster, Daniel W

2017-11-29

In this research, we estimate the association of firearm restrictions for domestic violence offenders with intimate partner homicides (IPHs), based on the strength of the policies. We posit that the association of firearm laws with IPHs depends on the laws': 1) breadth of coverage of high-risk individuals and situations restricted; 2) power to compel firearm surrender or removal from prohibited persons; and 3) systems of accountability that prevent prohibited persons from obtaining guns. We conducted a quantitative policy evaluation using annual state-level data from 1980 through 2013 for 45 US states. Based on the results of a series of robust negative binomial regression models with state fixed effects, domestic violence restraining order firearm prohibition laws are associated with 9% reductions in IPH. Statistically significant protective associations were evident only when restraining order prohibitions covered dating partners (-10%) and ex parte orders (-12%). Laws prohibiting access to those convicted of non-specific violent misdemeanors were associated with a 23% reduction in IPH rates; there was no association when prohibitions were limited to domestic violence. Permit-to-purchase laws were associated with 10% reductions in IPHs. These findings should inform policymakers considering laws to maximize protections against intimate partner homicide. © The Author(s) 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.

Circulating Influenza Virus and Adverse Pregnancy Outcomes: A Time-Series Study.

PubMed

Fell, Deshayne B; Buckeridge, David L; Platt, Robert W; Kaufman, Jay S; Basso, Olga; Wilson, Kumanan

2016-08-01

Individual-level epidemiologic studies of pregnancy outcomes after maternal influenza are limited in number and quality and have produced inconsistent results. We used a time-series design to investigate whether fluctuation in influenza virus circulation was associated with short-term variation in population-level rates of preterm birth, stillbirth, and perinatal death in Ontario between 2003 and 2012. Using Poisson regression, we assessed the association between weekly levels of circulating influenza virus and counts of outcomes offset by the number of at-risk gestations during 3 gestational exposure windows. The rate of preterm birth was not associated with circulating influenza level in the week preceding birth (adjusted rate ratio = 1.01, 95% confidence interval: 1.00, 1.02) or in any other exposure window. These findings were robust to alternate specifications of the model and adjustment for potential confounding. Stillbirth and perinatal death rates were similarly not associated with gestational exposure to influenza circulation during late pregnancy. We could not assess mortality outcomes relative to early gestational exposure because of missing dates of conception for many stillbirths. In this time-series study, population-level influenza circulation was not associated with short-term variation in rates of preterm birth, stillbirth, or perinatal death. © The Author 2016. 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.

Assessment of Confounders in Comparative Effectiveness Studies From Secondary Databases.

PubMed

Franklin, Jessica M; Schneeweiss, Sebastian; Solomon, Daniel H

2017-03-15

Secondary clinical databases are an important and growing source of data for comparative effectiveness research (CER) studies. However, measurement of confounders, such as biomarker values or patient-reported health status, in secondary clinical databases may not align with the initiation of a new treatment. In many published CER analyses of registry data, investigators assessed confounders based on the first questionnaire in which the new exposure was recorded. However, it is known that adjustment for confounders measured after the start of exposure can lead to biased treatment effect estimates. In the present study, we conducted simulations to compare assessment strategies for a dynamic clinical confounder in a registry-based comparative effectiveness study of 2 therapies. As expected, we found that adjustment for the confounder value at the time of the first questionnaire after the start of exposure creates a biased estimate the total effect of exposure choice on outcome when the confounder mediates part of the effect. However, adjustment for the prior value can also be badly biased when measured long before exposure initiation. Thus, investigators should carefully consider the timing of confounder measurements relative to exposure initiation and the rate of change in the confounder in order to choose the most relevant measure for each patient. © 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.

Association Between Substance Use and Gun-Related Behaviors.

PubMed

Chen, Danhong; Wu, Li-Tzy

2016-01-01

Gun-related violence is a public health concern. This study synthesizes findings on associations between substance use and gun-related behaviors. Searches through PubMed, Embase, and PsycINFO located 66 studies published in English between 1992 and 2014. Most studies found a significant bivariate association between substance use and increased odds of gun-related behaviors. However, their association after adjustment was mixed, which could be attributed to a number of factors such as variations in definitions of substance use and gun activity, study design, sample demographics, and the specific covariates considered. Fewer studies identified a significant association between substance use and gun access/possession than other gun activities. The significant association between nonsubstance covariates (e.g., demographic covariates and other behavioral risk factors) and gun-related behaviors might have moderated the association between substance use and gun activities. Particularly, the strength of association between substance use and gun activities tended to reduce appreciably or to become nonsignificant after adjustment for mental disorders. Some studies indicated a positive association between the frequency of substance use and the odds of engaging in gun-related behaviors. Overall, the results suggest a need to consider substance use in research and prevention programs for gun-related violence. © The Author 2016. 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.

The Transmission of Gun and Other Weapon-Involved Violence Within Social Networks.

PubMed

Tracy, Melissa; Braga, Anthony A; Papachristos, Andrew V

2016-01-01

Fatal and nonfatal injuries resulting from gun violence remain a persistent problem in the United States. The available research suggests that gun violence diffuses among people and across places through social relationships. Understanding the relationship between gun violence within social networks and individual gun violence risk is critical in preventing the spread of gun violence within populations. This systematic review examines the existing scientific evidence on the transmission of gun and other weapon-related violence in household, intimate partner, peer, and co-offending networks. Our review identified 16 studies published between 1996 and 2015 that suggest that exposure to a victim or perpetrator of violence in one's interpersonal relationships and social networks increases the risk of individual victimization and perpetration. Formal network analyses find high concentrations of gun violence in small networks and that exposure to gun violence in one's networks is highly correlated with one's own probability of being a gunshot victim. Physical violence by parents and weapon use by intimate partners also increase risk for victimization and perpetration. Additional work is needed to better characterize the mechanisms through which network exposures increase individual risk for violence and to evaluate interventions aimed at disrupting the spread of gun and other weapon violence in high-risk social networks. © The Author 2016. 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.

Type- and Subtype-Specific Influenza Forecast.

PubMed

Kandula, Sasikiran; Yang, Wan; Shaman, Jeffrey

2017-03-01

Prediction of the growth and decline of infectious disease incidence has advanced considerably in recent years. As these forecasts improve, their public health utility should increase, particularly as interventions are developed that make explicit use of forecast information. It is the task of the research community to increase the content and improve the accuracy of these infectious disease predictions. Presently, operational real-time forecasts of total influenza incidence are produced at the municipal and state level in the United States. These forecasts are generated using ensemble simulations depicting local influenza transmission dynamics, which have been optimized prior to forecast with observations of influenza incidence and data assimilation methods. Here, we explore whether forecasts targeted to predict influenza by type and subtype during 2003-2015 in the United States were more or less accurate than forecasts targeted to predict total influenza incidence. We found that forecasts separated by type/subtype generally produced more accurate predictions and, when summed, produced more accurate predictions of total influenza incidence. These findings indicate that monitoring influenza by type and subtype not only provides more detailed observational content but supports more accurate forecasting. More accurate forecasting can help officials better respond to and plan for current and future influenza activity. © 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.

Conducting Privacy-Preserving Multivariable Propensity Score Analysis When Patient Covariate Information Is Stored in Separate Locations.

PubMed

Bohn, Justin; Eddings, Wesley; Schneeweiss, Sebastian

2017-03-15

Distributed networks of health-care data sources are increasingly being utilized to conduct pharmacoepidemiologic database studies. Such networks may contain data that are not physically pooled but instead are distributed horizontally (separate patients within each data source) or vertically (separate measures within each data source) in order to preserve patient privacy. While multivariable methods for the analysis of horizontally distributed data are frequently employed, few practical approaches have been put forth to deal with vertically distributed health-care databases. In this paper, we propose 2 propensity score-based approaches to vertically distributed data analysis and test their performance using 5 example studies. We found that these approaches produced point estimates close to what could be achieved without partitioning. We further found a performance benefit (i.e., lower mean squared error) for sequentially passing a propensity score through each data domain (called the "sequential approach") as compared with fitting separate domain-specific propensity scores (called the "parallel approach"). These results were validated in a small simulation study. This proof-of-concept study suggests a new multivariable analysis approach to vertically distributed health-care databases that is practical, preserves patient privacy, and warrants further investigation for use in clinical research applications that rely on health-care databases. © 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.

A Longitudinal Analysis of Changes in Job Control and Mental Health.

PubMed

Bentley, Rebecca J; Kavanagh, Anne; Krnjacki, Lauren; LaMontagne, Anthony D

2015-08-15

Deteriorating job control has been previously shown to predict poor mental health. The impact of improvement in job control on mental health is less well understood, yet it is of policy significance. We used fixed-effects longitudinal regression models to analyze 10 annual waves of data from a large Australian panel survey (2001-2010) to test within-person associations between change in self-reported job control and corresponding change in mental health as measured by the Mental Component Summary score of Short Form 36. We found evidence of a graded relationship; with each quintile increase in job control experienced by an individual, the person's mental health increased. The biggest improvement was a 1.55-point increase in mental health (95% confidence interval: 1.25, 1.84) for people moving from the lowest (worst) quintile of job control to the highest. Separate analyses of each of the component subscales of job control-decision authority and skill discretion-showed results consistent with those of the main analysis; both were significantly associated with mental health in the same direction, with a stronger association for decision authority. We conclude that as people's level of job control increased, so did their mental health, supporting the value of targeting improvements in job control through policy and practice interventions. © 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.

Invited commentary: Parental smoking as a risk factor for adult tobacco use: can maternal smoking during pregnancy be distinguished from the social environmental influence during childhood?

PubMed

Alberg, Anthony J; Korte, Jeffrey E

2014-06-15

Parental smoking is known to have prenatal health effects on developing fetuses, and postnatal exposure to secondhand smoke causes adverse health effects during childhood and beyond. Further, there is solid evidence that parental smoking during childhood is a potent risk factor for smoking in offspring. In this issue of the Journal, Rydell et al. (Am J Epidemiol. 2014;179(12):1409-1417) add to a growing body of evidence showing that maternal smoking during pregnancy is statistically associated with the long-term risk of tobacco use in offspring. The data revealed a strong signal between maternal smoking during pregnancy and tobacco use in young adulthood, an association that was largely concentrated in snus use but not cigarette smoking. This new study adds to a growing body of epidemiologic evidence that consistently points toward maternal smoking during pregnancy being associated with an increased risk of offspring tobacco use in later life. There is also evidence from animal models indicating that fetal exposure to maternal nicotine use in utero can have a durable impact on the neural pathways that affect lifetime sensitivity to nicotine. This is an important research topic that continues to yield a consistent signal despite an array of inferential challenges. © The Author 2014. 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.

Risks and Targeted Interventions: Firearms in Intimate Partner Violence.

PubMed

Zeoli, April M; Malinski, Rebecca; Turchan, Brandon

2016-01-01

The use of firearms in intimate partner violence (IPV) is widely recognized as an important public health threat. However, what we know about the risks of firearm access on IPV outcomes is limited. Therefore, we conducted a systematic review to determine the state of knowledge on 1) the risks of firearm access and use in IPV and 2) the effectiveness of interventions designed specifically to reduce firearm violence in intimate relationships. Only studies published in English in peer-reviewed journals from 1990 through 2014 were included. Results of the review suggest that, when violent intimates have access to firearms, IPV increases in severity and deadliness; however, increases in severity may not be due to firearm use. Additionally, statutes prohibiting persons under domestic violence restraining orders from accessing firearms are associated with reductions in intimate partner homicide, but certain provisions of these laws and their enforcement may impact their effectiveness. Future research should focus on elucidating the link between firearm access and increased IPV severity and on investigating whether and which specific provisions of domestic violence restraining order laws impact the laws' effectiveness. Additionally, more evaluations of initiatives designed to improve the enforcement of domestic violence restraining order firearm prohibitions are needed. © The Author 2016. 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.

Robust Tests for Additive Gene-Environment Interaction in Case-Control Studies Using Gene-Environment Independence.

PubMed

Liu, Gang; Mukherjee, Bhramar; Lee, Seunggeun; Lee, Alice W; Wu, Anna H; Bandera, Elisa V; Jensen, Allan; Rossing, Mary Anne; Moysich, Kirsten B; Chang-Claude, Jenny; Doherty, Jennifer A; Gentry-Maharaj, Aleksandra; Kiemeney, Lambertus; Gayther, Simon A; Modugno, Francesmary; Massuger, Leon; Goode, Ellen L; Fridley, Brooke L; Terry, Kathryn L; Cramer, Daniel W; Ramus, Susan J; Anton-Culver, Hoda; Ziogas, Argyrios; Tyrer, Jonathan P; Schildkraut, Joellen M; Kjaer, Susanne K; Webb, Penelope M; Ness, Roberta B; Menon, Usha; Berchuck, Andrew; Pharoah, Paul D; Risch, Harvey; Pearce, Celeste Leigh

2018-02-01

There have been recent proposals advocating the use of additive gene-environment interaction instead of the widely used multiplicative scale, as a more relevant public health measure. Using gene-environment independence enhances statistical power for testing multiplicative interaction in case-control studies. However, under departure from this assumption, substantial bias in the estimates and inflated type I error in the corresponding tests can occur. In this paper, we extend the empirical Bayes (EB) approach previously developed for multiplicative interaction, which trades off between bias and efficiency in a data-adaptive way, to the additive scale. An EB estimator of the relative excess risk due to interaction is derived, and the corresponding Wald test is proposed with a general regression setting under a retrospective likelihood framework. We study the impact of gene-environment association on the resultant test with case-control data. Our simulation studies suggest that the EB approach uses the gene-environment independence assumption in a data-adaptive way and provides a gain in power compared with the standard logistic regression analysis and better control of type I error when compared with the analysis assuming gene-environment independence. We illustrate the methods with data from the Ovarian Cancer Association Consortium. © The Author(s) 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.

Postgraduate training for trauma prevention, injury surveillance and research, Uganda.

PubMed

Bachani, Abdulgafoor M; Paichadze, Nino; Bentley, Jacob A; Tumwesigye, Nazarius Mbona; Bishai, David; Atuyambe, Lynn; Wegener, Stephen; Guwatudde, David; Kobusingye, Olive C; Hyder, Adnan A

2018-06-01

The burden of trauma and injuries in Uganda is substantial and growing. Two important gaps that need addressing are the shortage of trained people and a lack of national data on noncommunicable diseases and their risk factors in Uganda. We developed and implemented a new track within an existing master of public health programme, aimed at developing graduate-level capacity and promoting research on key national priorities for trauma and injuries. We also offered training opportunities to a wider audience and set up a high-level national injury forum to foster national dialogue on addressing the burden of trauma, injuries and disability. The Chronic Consequences of Trauma, Injuries and Disability in Uganda programme was implemented in 2012 at Makerere University School of Public Health in Kampala, Uganda, in conjunction with Johns Hopkins Bloomberg School of Public Health in Baltimore, United States of America. Over the years 2012 to 2017 we supported four cohorts of master's students, with a total of 14 students (9 females and 5 males; mean age 30 years). Over 1300 individuals participated in workshops and seminars of the short-term training component of the programme. The forum hosted three research symposia and two national injury forums. Institutional support and collaborative engagement is important for developing and implementing successful capacity development programmes. Integration of training components within existing academic structures is key to sustainability. Appropriate mentorship for highly motivated and talented students is valuable for guiding students through the programme.

Trends in the Relationship Between Obesity and Disability, 1988-2012.

PubMed

Chang, Virginia W; Alley, Dawn E; Dowd, Jennifer Beam

2017-09-15

Rising obesity rates, coupled with population aging, have elicited serious concern over the impact of obesity on disability in later life. Prior work showed a significant increase in the association between obesity and disability from 1988 to 2004, calling attention to disability as a cost of longer lifetime exposure to obesity. It is not known whether this trend has continued. We examined functional impairment and impairment in activities of daily living (ADL) (defined as severe or moderate to severe) for adults aged 60 years or older (n = 16,770) over 3 time periods in the National Health and Nutrition Examination Survey. The relative odds of impairment for obese individuals versus normal-weight individuals significantly increased from period 1 (1988-1994) to period 2 (1999-2004) for all outcomes. In period 3 (2005-2012), this association remained stable for functional and severe ADL impairment and decreased for moderate-to-severe ADL impairment. The fraction of population disability attributable to obesity followed a similar trend. The trend of an increasing association between obesity and disability has leveled off in more recent years, and is even improving for some measures. These findings suggest that public health and policy concerns that obesity would continue to become more disabling over time have not been borne out. © The Author(s) 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.

Cross-national comparisons of time trends in overweight inequality by socioeconomic status among women using repeated cross-sectional surveys from 37 developing countries, 1989-2007.

PubMed

Jones-Smith, Jessica C; Gordon-Larsen, Penny; Siddiqi, Arjumand; Popkin, Barry M

2011-03-15

Chronic diseases are now among the leading causes of morbidity and mortality in lower income countries. Although traditionally related to higher individual socioeconomic status (SES) in these contexts, the associations between SES and chronic disease may be actively changing. Furthermore, country-level contextual factors, such as economic development and income inequality, may influence the distribution of chronic disease by SES as well as how this distribution has changed over time. Using overweight status as a health indicator, the authors studied repeated cross-sectional data from women aged 18-49 years in 37 developing countries to assess within-country trends in overweight inequalities by SES between 1989 and 2007 (n=405,550). Meta-regression was used to examine the associations between gross domestic product and disproportionate increases in overweight prevalence by SES, with additional testing for modification by country-level income inequality. In 27 of 37 countries, higher SES (vs. lower) was associated with higher gains in overweight prevalence; in the remaining 10 countries, lower SES (vs. higher) was associated with higher gains in overweight prevalence. Gross domestic product was positively related to faster increase in overweight prevalence among the lower wealth groups. Among countries with a higher gross domestic product, lower income inequality was associated with faster overweight growth among the poor. © The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.

Evaluating the Population Impact on Racial/Ethnic Disparities in HIV in Adulthood of Intervening on Specific Targets: A Conceptual and Methodological Framework.

PubMed

Howe, Chanelle J; Dulin-Keita, Akilah; Cole, Stephen R; Hogan, Joseph W; Lau, Bryan; Moore, Richard D; Mathews, W Christopher; Crane, Heidi M; Drozd, Daniel R; Geng, Elvin; Boswell, Stephen L; Napravnik, Sonia; Eron, Joseph J; Mugavero, Michael J

2018-02-01

Reducing racial/ethnic disparities in human immunodeficiency virus (HIV) disease is a high priority. Reductions in HIV racial/ethnic disparities can potentially be achieved by intervening on important intermediate factors. The potential population impact of intervening on intermediates can be evaluated using observational data when certain conditions are met. However, using standard stratification-based approaches commonly employed in the observational HIV literature to estimate the potential population impact in this setting may yield results that do not accurately estimate quantities of interest. Here we describe a useful conceptual and methodological framework for using observational data to appropriately evaluate the impact on HIV racial/ethnic disparities of interventions. This framework reframes relevant scientific questions in terms of a controlled direct effect and estimates a corresponding proportion eliminated. We review methods and conditions sufficient for accurate estimation within the proposed framework. We use the framework to analyze data on 2,329 participants in the CFAR [Centers for AIDS Research] Network of Integrated Clinical Systems (2008-2014) to evaluate the potential impact of universal prescription of and ≥95% adherence to antiretroviral therapy on racial disparities in HIV virological suppression. We encourage the use of the described framework to appropriately evaluate the potential impact of targeted interventions in addressing HIV racial/ethnic disparities using observational data. © The Author(s) 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.

Erythrocyte superoxide dismutase, glutathione peroxidase, and catalase activities and risk of coronary heart disease in generally healthy women: a prospective study.

PubMed

Yang, Shuman; Jensen, Majken K; Rimm, Eric B; Willett, Walter; Wu, Tianying

2014-11-01

Erythrocyte antioxidant enzymes are major circulating antioxidant enzymes in the oxidative stress defense system. Few prospective studies have assessed the association between these enzymes and the risk of coronary heart disease (CHD) in generally healthy adults. We conducted a prospective nested case-control study of CHD among 32,826 women at baseline with 15 years of follow-up from 1989 to 2004 in the Nurses' Health Study. We investigated the association of baseline erythrocyte superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) activities with the risk of CHD. A total of 365 cases and 728 controls were included in the analysis. Overall, the relative risks of CHD associated with 1-standard deviation higher SOD, GPx, and CAT activities were 1.07 (95% confidence interval (CI): 0.94, 1.22), 1.04 (95% CI: 0.91, 1.18), and 1.04 (95% CI: 0.92, 1.17), respectively. Multivariable adjustments did not change the associations appreciably. Fasting status did not modify the associations, with the exception that SOD activity was positively associated with the risk of CHD among participants who provided blood samples within 12 hours of fasting. Overall, activities of SOD, GPx, and CAT were not associated with CHD among women who were generally healthy at the time of blood collection. © The Author 2014. 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.

Assessing the Potential for Bias From Nonresponse to a Study Follow-up Interview: An Example From the Agricultural Health Study.

PubMed

Rinsky, Jessica L; Richardson, David B; Wing, Steve; Beard, John D; Alavanja, Michael; Beane Freeman, Laura E; Chen, Honglei; Henneberger, Paul K; Kamel, Freya; Sandler, Dale P; Hoppin, Jane A

2017-08-15

Prospective cohort studies are important tools for identifying causes of disease. However, these studies are susceptible to attrition. When information collected after enrollment is through interview or exam, attrition leads to missing information for nonrespondents. The Agricultural Health Study enrolled 52,394 farmers in 1993-1997 and collected additional information during subsequent interviews. Forty-six percent of enrolled farmers responded to the 2005-2010 interview; 7% of farmers died prior to the interview. We examined whether response was related to attributes measured at enrollment. To characterize potential bias from attrition, we evaluated differences in associations between smoking and incidence of 3 cancer types between the enrolled cohort and the subcohort of 2005-2010 respondents, using cancer registry information. In the subcohort we evaluated the ability of inverse probability weighting (IPW) to reduce bias. Response was related to age, state, race/ethnicity, education, marital status, smoking, and alcohol consumption. When exposure and outcome were associated and case response was differential by exposure, some bias was observed; IPW conditional on exposure and covariates failed to correct estimates. When response was nondifferential, subcohort and full-cohort estimates were similar, making IPW unnecessary. This example provides a demonstration of investigating the influence of attrition in cohort studies using information that has been self-reported after enrollment. © The Author(s) 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.

Can Community Social Cohesion Prevent Posttraumatic Stress Disorder in the Aftermath of a Disaster? A Natural Experiment From the 2011 Tohoku Earthquake and Tsunami.

PubMed

Hikichi, Hiroyuki; Aida, Jun; Tsuboya, Toru; Kondo, Katsunori; Kawachi, Ichiro

2016-05-15

In the aftermath of a disaster, the risk of posttraumatic stress disorder (PTSD) is high. We sought to examine whether the predisaster level of community social cohesion was associated with a lower risk of PTSD after the earthquake and tsunami in Tohoku, Japan, on March 11, 2011. The baseline for our natural experiment was established in a survey of older community-dwelling adults who lived 80 kilometers west of the epicenter 7 months before the earthquake and tsunami. A follow-up survey was conducted approximately 2.5 years after the disaster. We used a spatial Durbin model to examine the association of community-level social cohesion with the individual risk of PTSD. Among our analytic sample (n = 3,567), 11.4% of respondents reported severe PTSD symptoms. In the spatial Durbin model, individual- and community-level social cohesion before the disaster were significantly associated with lower risks of PTSD symptoms (odds ratio = 0.87, 95% confidence interval: 0.77, 0.98 and odds ratio = 0.75, 95% confidence interval: 0.63, 0.90, respectively), even after adjustment for depression symptoms at baseline and experiences during the disaster (including loss of loved ones, housing damage, and interruption of access to health care). Community-level social cohesion strengthens the resilience of community residents in the aftermath of a disaster. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Applying Recovery Biomarkers to Calibrate Self-Report Measures of Energy and Protein in the Hispanic Community Health Study/Study of Latinos.

PubMed

Mossavar-Rahmani, Yasmin; Shaw, Pamela A; Wong, William W; Sotres-Alvarez, Daniela; Gellman, Marc D; Van Horn, Linda; Stoutenberg, Mark; Daviglus, Martha L; Wylie-Rosett, Judith; Siega-Riz, Anna Maria; Ou, Fang-Shu; Prentice, Ross L

2015-06-15

We investigated measurement error in the self-reported diets of US Hispanics/Latinos, who are prone to obesity and related comorbidities, by background (Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American) in 2010-2012. In 477 participants aged 18-74 years, doubly labeled water and urinary nitrogen were used as objective recovery biomarkers of energy and protein intakes. Self-report was captured from two 24-hour dietary recalls. All measures were repeated in a subsample of 98 individuals. We examined the bias of dietary recalls and their associations with participant characteristics using generalized estimating equations. Energy intake was underestimated by 25.3% (men, 21.8%; women, 27.3%), and protein intake was underestimated by 18.5% (men, 14.7%; women, 20.7%). Protein density was overestimated by 10.7% (men, 11.3%; women, 10.1%). Higher body mass index and Hispanic/Latino background were associated with underestimation of energy (P<0.05). For protein intake, higher body mass index, older age, nonsmoking, Spanish speaking, and Hispanic/Latino background were associated with underestimation (P<0.05). Systematic underreporting of energy and protein intakes and overreporting of protein density were found to vary significantly by Hispanic/Latino background. We developed calibration equations that correct for subject-specific error in reporting that can be used to reduce bias in diet-disease association studies. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

A New Method for Partial Correction of Residual Confounding in Time-Series and Other Observational Studies.

PubMed

Flanders, W Dana; Strickland, Matthew J; Klein, Mitchel

2017-05-15

Methods exist to detect residual confounding in epidemiologic studies. One requires a negative control exposure with 2 key properties: 1) conditional independence of the negative control and the outcome (given modeled variables) absent confounding and other model misspecification, and 2) associations of the negative control with uncontrolled confounders and the outcome. We present a new method to partially correct for residual confounding: When confounding is present and our assumptions hold, we argue that estimators from models that include a negative control exposure with these 2 properties tend to be less biased than those from models without it. Using regression theory, we provide theoretical arguments that support our claims. In simulations, we empirically evaluated the approach using a time-series study of ozone effects on asthma emergency department visits. In simulations, effect estimators from models that included the negative control exposure (ozone concentrations 1 day after the emergency department visit) had slightly or modestly less residual confounding than those from models without it. Theory and simulations show that including the negative control can reduce residual confounding, if our assumptions hold. Our method differs from available methods because it uses a regression approach involving an exposure-based indicator rather than a negative control outcome to partially correct for confounding. © 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.

Risk factors for homelessness among US veterans.

PubMed

Tsai, Jack; Rosenheck, Robert A

2015-01-01

Homelessness among US veterans has been a focus of research for over 3 decades. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this is the first systematic review to summarize research on risk factors for homelessness among US veterans and to evaluate the evidence for these risk factors. Thirty-one studies published from 1987 to 2014 were divided into 3 categories: more rigorous studies, less rigorous studies, and studies comparing homeless veterans with homeless nonveterans. The strongest and most consistent risk factors were substance use disorders and mental illness, followed by low income and other income-related factors. There was some evidence that social isolation, adverse childhood experiences, and past incarceration were also important risk factors. Veterans, especially those who served since the advent of the all-volunteer force, were at greater risk for homelessness than other adults. Homeless veterans were generally older, better educated, and more likely to be male, married/have been married, and to have health insurance coverage than other homeless adults. More studies simultaneously addressing premilitary, military, and postmilitary risk factors for veteran homelessness are needed. This review identifies substance use disorders, mental illness, and low income as targets for policies and programs in efforts to end homelessness among veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Advanced Maternal Age and the Risk of Low Birth Weight and Preterm Delivery: a Within-Family Analysis Using Finnish Population Registers.

PubMed

Goisis, Alice; Remes, Hanna; Barclay, Kieron; Martikainen, Pekka; Myrskylä, Mikko

2017-12-01

Advanced maternal age at birth is considered a major risk factor for birth outcomes. It is unclear to what extent this association is confounded by maternal characteristics. To test whether advanced maternal age at birth independently increases the risk of low birth weight (<2,500 g) and preterm birth (<37 weeks' gestation), we compared between-family models (children born to different mothers at different ages) with within-family models (children born to the same mother at different ages). The latter procedure reduces confounding by unobserved parental characteristics that are shared by siblings. We used Finnish population registers, including 124,098 children born during 1987-2000. When compared with maternal ages 25-29 years in between-family models, maternal ages of 35-39 years and ≥40 years were associated with percentage increases of 1.1 points (95% confidence intervals: 0.8, 1.4) and 2.2 points (95% confidence intervals: 1.4, 2.9), respectively, in the probability of low birth weight. The associations are similar for the risk of preterm delivery. In within-family models, the relationship between advanced maternal age and low birth weight or preterm birth is statistically and substantively negligible. In Finland, advanced maternal age is not independently associated with the risk of low birth weight or preterm delivery among mothers who have had at least 2 live births. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Protecting Confidentiality in Cancer Registry Data With Geographic Identifiers.

PubMed

Yu, Mandi; Reiter, Jerome Phillip; Zhu, Li; Liu, Benmei; Cronin, Kathleen A; Feuer, Eric J Rocky

2017-07-01

The National Cancer Institute's Surveillance, Epidemiology, and End Results Program releases research files of cancer registry data. These files include geographic information at the county level, but no finer. Access to finer geography, such as census tract identifiers, would enable richer analyses-for example, examination of health disparities across neighborhoods. To date, tract identifiers have been left off the research files because they could compromise the confidentiality of patients' identities. We present an approach to inclusion of tract identifiers based on multiply imputed, synthetic data. The idea is to build a predictive model of tract locations, given patient and tumor characteristics, and randomly simulate the tract of each patient by sampling from this model. For the predictive model, we use multivariate regression trees fitted to the latitude and longitude of the population centroid of each tract. We implement the approach in the registry data from California. The method results in synthetic data that reproduce a wide range (but not all) of analyses of census tract socioeconomic cancer disparities and have relatively low disclosure risks, which we assess by comparing individual patients' actual and synthetic tract locations. We conclude with a discussion of how synthetic data sets can be used by researchers with cancer registry data. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Evaluation of the Effectiveness and Cost-Effectiveness of Personalized Surveillance After Colorectal Adenomatous Polypectomy.

PubMed

McFerran, Ethna; O'Mahony, James F; Fallis, Richard; McVicar, Duncan; Zauber, Ann G; Kee, Frank

2017-01-01

Lifetime risk of developing colorectal cancer is 5%, and 5-year survival at early stage is 92%. Individuals with precancerous lesions removed at primary screening are typically recommended surveillance colonoscopy. Because greater benefits are anticipated for those with higher risk of colorectal cancer, scope for risk-specific surveillance recommendations exists. This review assesses published cost-effectiveness estimates of postpolypectomy surveillance to consider the potential for personalized recommendations by risk group. Meta-analyses of incidence of advanced neoplasia postpolypectomy for low-risk cases were comparable to those without adenoma, with both rates under the lifetime risk of 5%. This group may not benefit from intensive surveillance, which risks unnecessary harm and inefficient use of often scarce colonoscopy capacity. Therefore, greater personalization through deintensified strategies for low-risk individuals could be beneficial. The potential for noninvasive testing, such as fecal immunochemical tests, combined with primary prevention or chemoprevention may reserve colonoscopy for targeted use in personalized risk-stratified surveillance. This review appraised evidence supporting a program of personalized surveillance in patients with colorectal adenoma according to risk group and compared the effectiveness of surveillance colonoscopy with alternative prevention strategies. It assessed trade-offs among costs, benefits, and adverse effects that must be considered in a decision to adopt or reject personalized surveillance. © 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.

Effort-Reward Imbalance at Work and the Prevalence of Unsuccessfully Treated Hypertension Among White-Collar Workers.

PubMed

Trudel, Xavier; Milot, Alain; Gilbert-Ouimet, Mahée; Duchaine, Caroline; Guénette, Line; Dalens, Violaine; Brisson, Chantal

2017-08-15

We examined the association between effort-reward imbalance (ERI) exposure at work and unsuccessfully treated hypertension among white-collar workers from a large cohort in Quebec City, Canada. The study used a repeated cross-sectional design involving 3 waves of data collection (2000-2009). The study sample was composed of 474 workers treated for hypertension, accounting for 739 observations. At each observation, ERI was measured using validated scales, and ambulatory blood pressure (BP) was measured every 15 minutes during the working day. Unsuccessfully treated hypertension was defined as daytime ambulatory BP of at least 135/85 mm Hg and was further divided into masked and sustained hypertension. Adjusted prevalence ratios and 95% confidence intervals were estimated. Participants in the highest tertile of ERI exposure had a higher prevalence of unsuccessfully treated hypertension (prevalence ratio = 1.45, 95% confidence interval: 1.16, 1.81) after adjustment for gender, age, education, family history of cardiovascular diseases, body mass index, diabetes, smoking, sedentary behaviors, and alcohol intake. The present study supports the effect of adverse psychosocial work factors from the ERI model on BP control in treated workers. Reducing these frequent exposures at work might lead to substantial benefits on BP control at the population level. © The Author(s) 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.

Challenges in the Estimation of the Annual Risk of Mycobacterium tuberculosis Infection in Children Aged Less Than 5 Years.

PubMed

Khan, P Y; Glynn, Judith R; Mzembe, T; Mulawa, D; Chiumya, R; Crampin, Amelia C; Kranzer, Katharina; Fielding, Katherine L

2017-10-15

Accurate estimates of Mycobacterium tuberculosis infection in young children provide a critical indicator of ongoing community transmission of M. tuberculosis. Cross-reactions due to infection with environmental mycobacteria and/or bacille Calmette-Guérin (BCG) vaccination compromise the estimates derived from population-level tuberculin skin-test surveys using traditional cutoff methods. Newer statistical approaches are prone to failure of model convergence, especially in settings where the prevalence of M. tuberculosis infection is low and environmental sensitization is high. We conducted a tuberculin skin-test survey in 5,119 preschool children in the general population and among household contacts of tuberculosis cases in 2012-2014 in a district in northern Malawi where sensitization to environmental mycobacteria is common and almost all children are BCG-vaccinated. We compared different proposed methods of estimating M. tuberculosis prevalence, including a method described by Rust and Thomas more than 40 years ago. With the different methods, estimated prevalence in the general population was 0.7%-11.5% at ages <2 years and 0.8%-3.3% at ages 2-4 years. The Rust and Thomas method was the only method to give a lower estimate in the younger age group (0.7% vs 0.8%), suggesting that it was the only method that adjusted appropriately for the marked effect of BCG-attributable induration in the very young. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Partnering in research: a national research trial exemplifying effective collaboration with American Indian Nations and the Indian Health Service.

PubMed

Chadwick, Jennifer Q; Copeland, Kenneth C; Daniel, Mary R; Erb-Alvarez, Julie A; Felton, Beverly A; Khan, Sohail I; Saunkeah, Bobby R; Wharton, David F; Payan, Marisa L

2014-12-15

Despite the fact that numerous major public health problems have plagued American Indian communities for generations, American Indian participation in health research traditionally has been sporadic in many parts of the United States. In 2002, the University of Oklahoma Health Sciences Center (Oklahoma City, Oklahoma) and 5 Oklahoma American Indian research review boards (Oklahoma City Area Indian Health Service, Absentee Shawnee Tribe, Cherokee Nation, Chickasaw Nation, and Choctaw Nation) agreed to participate collectively in a national research trial, the Treatment Options for Type 2 Diabetes in Adolescence and Youth (TODAY) Study. During that process, numerous lessons were learned and processes developed that strengthened the partnerships and facilitated the research. Formal Memoranda of Agreement addressed issues related to community collaboration, venue, tribal authority, preferential hiring of American Indians, and indemnification. The agreements aided in uniting sovereign nations, the Indian Health Service, academics, and public health officials to conduct responsible and ethical research. For more than 10 years, this unique partnership has functioned effectively in recruiting and retaining American Indian participants, respecting cultural differences, and maintaining tribal autonomy through prereview of all study publications and local institutional review board review of all processes. The lessons learned may be of value to investigators conducting future research with American Indian communities. © The Author 2014. 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.

Economic Conditions During Pregnancy and Adverse Birth Outcomes Among Singleton Live Births in the United States, 1990-2013.

PubMed

Margerison-Zilko, Claire E; Li, Yu; Luo, Zhehui

2017-11-15

We know little about the relationship between the macroeconomy and birth outcomes, in part due to the methodological challenge of distinguishing effects of economic conditions on fetal health from effects of economic conditions on selection into live birth. We examined associations between state-level unemployment rates in the first 2 trimesters of pregnancy and adverse birth outcomes, using natality data on singleton live births in the United States during 1990-2013. We used fixed-effect logistic regression models and accounted for selection by adjusting for state-level unemployment before conception and maternal characteristics associated with both selection and birth outcomes. We also tested whether associations between macroeconomic conditions and birth outcomes differed during and after (compared with before) the Great Recession (2007-2009). Each 1-percentage-point increase in the first-trimester unemployment rate was associated with a 5% increase in odds of preterm birth, while second-trimester unemployment was associated with a 3% decrease in preterm birth odds. During the Great Recession, however, first-trimester unemployment was associated with a 16% increase in odds of preterm birth. These findings increase our understanding of the effects of the Great Recession on health and add to growing literature suggesting that macro-level social and economic factors contribute to perinatal health. © The Author(s) 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.

Tracing a Path to the Past: Exploring the Use of Commercial Credit Reporting Data to Construct Residential Histories for Epidemiologic Studies of Environmental Exposures.

PubMed

Hurley, Susan; Hertz, Andrew; Nelson, David O; Layefsky, Michael; Von Behren, Julie; Bernstein, Leslie; Deapen, Dennis; Reynolds, Peggy

2017-02-01

Large-scale environmental epidemiologic studies often rely on exposure estimates based on linkage to residential addresses. This approach, however, is limited by the lack of residential histories typically available for study participants. Our objective was to evaluate the feasibility of using address data from LexisNexis (a division of RELX, Inc., Dayton, Ohio), a commercially available credit reporting company, to construct residential histories for participants in the California Teachers Study (CTS), a prospective cohort study initiated in 1995-1996 to study breast cancer (n = 133,479). We evaluated the degree to which LexisNexis could provide retrospective addresses prior to study enrollment, as well as the concordance with existing prospective CTS addresses ascertained at the time of the completion of 4 self-administered questionnaires. For approximately 80% of CTS participants, LexisNexis provided at least 1 retrospective address, including nearly 25,000 addresses completely encompassed by time periods prior to enrollment. This approach more than doubled the proportion of the study population for whom we had an address of residence during the childbearing years-an important window of susceptibility for breast cancer risk. While overall concordance between the prospective addresses contained in these 2 data sources was good (85%), it was diminished among black women and women under the age of 40 years. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Instrumental Variable Methods for Continuous Outcomes That Accommodate Nonignorable Missing Baseline Values.

PubMed

Ertefaie, Ashkan; Flory, James H; Hennessy, Sean; Small, Dylan S

2017-06-15

Instrumental variable (IV) methods provide unbiased treatment effect estimation in the presence of unmeasured confounders under certain assumptions. To provide valid estimates of treatment effect, treatment effect confounders that are associated with the IV (IV-confounders) must be included in the analysis, and not including observations with missing values may lead to bias. Missing covariate data are particularly problematic when the probability that a value is missing is related to the value itself, which is known as nonignorable missingness. In such cases, imputation-based methods are biased. Using health-care provider preference as an IV method, we propose a 2-step procedure with which to estimate a valid treatment effect in the presence of baseline variables with nonignorable missing values. First, the provider preference IV value is estimated by performing a complete-case analysis using a random-effects model that includes IV-confounders. Second, the treatment effect is estimated using a 2-stage least squares IV approach that excludes IV-confounders with missing values. Simulation results are presented, and the method is applied to an analysis comparing the effects of sulfonylureas versus metformin on body mass index, where the variables baseline body mass index and glycosylated hemoglobin have missing values. Our result supports the association of sulfonylureas with weight gain. © 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.

Military service, deployments, and exposures in relation to amyotrophic lateral sclerosis etiology and survival.

PubMed

Beard, John D; Kamel, Freya

2015-01-01

Rates of amyotrophic lateral sclerosis (ALS) have been reported to be higher among US military veterans, who currently number more than 21 million, but the causal factor(s) has not been identified. We conducted a review to examine the weight of evidence for associations between military service, deployments, and exposures and ALS etiology and survival. Thirty articles or abstracts published through 2013 were reviewed. Although the current evidence suggests a positive association with ALS etiology, it is too limited to draw firm conclusions regarding associations between military service and ALS etiology or survival. Some evidence suggests that deployment to the 1990-1991 Persian Gulf War may be associated with ALS etiology, but there is currently no strong evidence that any particular military exposure is associated with ALS etiology. Future studies should address the limitations of previous ones, such as reliance on mortality as a surrogate for incidence, a dearth of survival analyses, lack of clinical data, low statistical power, and limited exposure assessment. The Genes and Environmental Exposures in Veterans with Amyotrophic Lateral Sclerosis (GENEVA) Study is one such study, but additional research is needed to determine whether military-related factors are associated with ALS and to assess potential prevention strategies. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

The Influence of Screening for Precancerous Lesions on Family-Based Genetic Association Tests: An Example of Colorectal Polyps and Cancer.

PubMed

Schmit, Stephanie L; Figueiredo, Jane C; Cortessis, Victoria K; Thomas, Duncan C

2015-10-15

Unintended consequences of secondary prevention include potential introduction of bias into epidemiologic studies estimating genotype-disease associations. To better understand such bias, we simulated a family-based study of colorectal cancer (CRC), which can be prevented by resecting screen-detected polyps. We simulated genes related to CRC development through risk of polyps (G1), risk of CRC but not polyps (G2), and progression from polyp to CRC (G3). Then, we examined 4 analytical strategies for studying diseases subject to secondary prevention, comparing the following: 1) CRC cases with all controls, without adjusting for polyp history; 2) CRC cases with controls, adjusting for polyp history; 3) CRC cases with only polyp-free controls; and 4) cases with either CRC or polyps with controls having neither. Strategy 1 yielded estimates of association between CRC and each G that were not substantially biased. Strategies 2-4 yielded biased estimates varying in direction according to analysis strategy and gene type. Type I errors were correct, but strategy 1 provided greater power for estimating associations with G2 and G3. We also applied each strategy to case-control data from the Colon Cancer Family Registry (1997-2007). Generally, the best analytical option balancing bias and power is to compare all CRC cases with all controls, ignoring polyps. © 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.

Short-term exposure to air pollution and digital vascular function.

PubMed

Ljungman, Petter L; Wilker, Elissa H; Rice, Mary B; Schwartz, Joel; Gold, Diane R; Koutrakis, Petros; Vita, Joseph A; Mitchell, Gary F; Vasan, Ramachandran S; Benjamin, Emelia J; Mittleman, Murray A; Hamburg, Naomi M

2014-09-01

We investigated associations between ambient air pollution and microvessel function measured by peripheral arterial tonometry between 2003 and 2008 in the Framingham Heart Study Offspring and Third Generation Cohorts. We measured particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), black carbon, sulfates, particle number, nitrogen oxides, and ozone by using fixed monitors, and we determined moving averages for 1-7 days preceding vascular testing. We examined associations between these exposures and hyperemic response to ischemia and baseline pulse amplitude, a measure of arterial tone (n = 2,369). Higher short-term exposure to air pollutants, including PM2.5, black carbon, and particle number was associated with higher baseline pulse amplitude. For example, higher 3-day average PM2.5 exposure was associated with 6.3% higher baseline pulse amplitude (95% confidence interval: 2.0, 10.9). However, there were no consistent associations between the air pollution exposures assessed and hyperemic response. Our findings in a community-based sample exposed to relatively low pollution levels suggest that short-term exposure to ambient particulate pollution is not associated with vasodilator response, but that particulate air pollution is associated with baseline pulse amplitude, suggesting potentially adverse alterations in baseline vascular tone or compliance. © The Author 2014. 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.

Body Mass Index Development and Asthma Throughout Childhood.

PubMed

Ekström, Sandra; Magnusson, Jessica; Kull, Inger; Andersson, Niklas; Bottai, Matteo; Besharat Pour, Mohsen; Melén, Erik; Bergström, Anna

2017-07-15

Several studies have found an association between overweight and asthma, yet the temporal relationship between their onsets remains unclear. We investigated the development of body mass index (BMI) from birth to adolescence among 2,818 children with and without asthma from a Swedish birth cohort study, the BAMSE (a Swedish acronym for "children, allergy, milieu, Stockholm, epidemiology") Project, during 1994-2013. Measured weight and height were available at 13 time points throughout childhood. Asthma phenotypes (transient, persistent, and late-onset) were defined by timing of onset and remission. Quantile regression was used to analyze percentiles of BMI, and generalized estimating equations were used to analyze the association between asthma phenotypes and the risk of high BMI. Among females, BMI development differed between children with and without asthma, with the highest BMI being seen among females with persistent asthma. The difference existed throughout childhood but increased with age. For example, females with persistent asthma had 2.33 times' (95% confidence interval: 1.21, 4.49) greater odds of having a BMI above the 85th percentile at age ≥15 years than females without asthma. Among males, no clear associations between asthma and BMI were observed. In this study, persistent asthma was associated with high BMI throughout childhood among females, whereas no consistent association was observed among males. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Fine particulate matter air pollution and cognitive function among older US adults.

PubMed

Ailshire, Jennifer A; Crimmins, Eileen M

2014-08-15

Existing research on the adverse health effects of exposure to pollution has devoted relatively little attention to the potential impact of ambient air pollution on cognitive function in older adults. We examined the cross-sectional association between residential concentrations of particulate matter with aerodynamic diameter of 2.5 μm or less (PM2.5) and cognitive function in older adults. Using hierarchical linear modeling, we analyzed data from the 2004 Health and Retirement Study, a large, nationally representative sample of US adults aged 50 years or older. We linked participant data with 2000 US Census tract data and 2004 census tract-level annual average PM2.5 concentrations. Older adults living in areas with higher PM2.5 concentrations had worse cognitive function (β = -0.26, 95% confidence interval: -0.47, -0.05) even after adjustment for community- and individual-level social and economic characteristics. Results suggest that the association is strongest for the episodic memory component of cognitive function. This study adds to a growing body of research highlighting the importance of air pollution to cognitive function in older adults. Improving air quality in large metropolitan areas, where much of the aging US population resides, may be an important mechanism for reducing age-related cognitive decline. © The Author 2014. 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.

Spatial Variability in ADHD-Related Behaviors Among Children Born to Mothers Residing Near the New Bedford Harbor Superfund Site.

PubMed

Vieira, Verónica M; Fabian, M Patricia; Webster, Thomas F; Levy, Jonathan I; Korrick, Susan A

2017-05-15

Attention-deficit/hyperactivity disorder (ADHD) has an uncertain etiology, with potential contributions from different risk factors such as prenatal environmental exposure to organochlorines and metals, social risk factors, and genetics. The degree to which geographic variability in ADHD is independent of, or explained by, risk factors may provide etiological insight. We investigated determinants of geographic variation in ADHD-related behaviors among children living near the polychlorinated biphenyl-contaminated New Bedford Harbor (NBH) Superfund site in Massachusetts. Participants were 573 children recruited at birth (1993-1998) who were born to mothers residing near the NBH site. We assessed ADHD-related behaviors at age 8 years using Conners' Teacher Rating Scale-Revised: Long Version. Adjusted generalized additive models were used to smooth the association of pregnancy residence with ADHD-related behaviors and assess whether prenatal organochlorine or metal exposures, sociodemographic factors, or other factors explained spatial patterns. Models that adjusted for child's age and sex displayed significantly increased ADHD-related behavior among children whose mothers resided west of the NBH site during pregnancy. These spatial patterns persisted after adjusting for prenatal exposure to organochlorines and metals but were no longer significant after controlling for sociodemographic factors. The findings underscore the value of spatial analysis in identifying high-risk subpopulations and evaluating candidate risk factors. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

A Comparison of Agent-Based Models and the Parametric G-Formula for Causal Inference.

PubMed

Murray, Eleanor J; Robins, James M; Seage, George R; Freedberg, Kenneth A; Hernán, Miguel A

2017-07-15

Decision-making requires choosing from treatments on the basis of correctly estimated outcome distributions under each treatment. In the absence of randomized trials, 2 possible approaches are the parametric g-formula and agent-based models (ABMs). The g-formula has been used exclusively to estimate effects in the population from which data were collected, whereas ABMs are commonly used to estimate effects in multiple populations, necessitating stronger assumptions. Here, we describe potential biases that arise when ABM assumptions do not hold. To do so, we estimated 12-month mortality risk in simulated populations differing in prevalence of an unknown common cause of mortality and a time-varying confounder. The ABM and g-formula correctly estimated mortality and causal effects when all inputs were from the target population. However, whenever any inputs came from another population, the ABM gave biased estimates of mortality-and often of causal effects even when the true effect was null. In the absence of unmeasured confounding and model misspecification, both methods produce valid causal inferences for a given population when all inputs are from that population. However, ABMs may result in bias when extrapolated to populations that differ on the distribution of unmeasured outcome determinants, even when the causal network linking variables is identical. © The Author(s) 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.

The Use of a Binary Composite Endpoint and Sample Size Requirement: Influence of Endpoints Overlap.

PubMed

Marsal, Josep-Ramon; Ferreira-González, Ignacio; Bertran, Sandra; Ribera, Aida; Permanyer-Miralda, Gaietà; García-Dorado, David; Gómez, Guadalupe

2017-05-01

Although composite endpoints (CE) are common in clinical trials, the impact of the relationship between the components of a binary CE on the sample size requirement (SSR) has not been addressed. We performed a computational study considering 2 treatments and a CE with 2 components: the relevant endpoint (RE) and the additional endpoint (AE). We assessed the strength of the components' interrelation by the degree of relative overlap between them, which was stratified into 5 groups. Within each stratum, SSR was computed for multiple scenarios by varying the events proportion and the effect of the therapy. A lower SSR using CE was defined as the best scenario for using the CE. In 25 of 66 scenarios the degree of relative overlap determined the benefit of using CE instead of the RE. Adding an AE with greater effect than the RE leads to lower SSR using the CE regardless of the AE proportion and the relative overlap. The influence of overlapping decreases when the effect on RE increases. Adding an AE with lower effect than the RE constitutes the most uncertain situation. In summary, the interrelationship between CE components, assessed by the relative overlap, can help to define the SSR in specific situations and it should be considered for SSR computation. © 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.

Childhood body weight in relation to morbidity from cardiovascular disease and cancer in older adulthood: 67-year follow-up of participants in the 1947 Scottish Mental Survey.

PubMed

Batty, G David; Calvin, Catherine M; Brett, Caroline E; Čukić, Iva; Deary, Ian J

2015-11-01

Although it has been well documented that elevated body weight in middle- and older-aged populations is associated with multiple morbidities, the influence of childhood body weight on health endpoints other than coronary heart disease is not well understood. Accordingly, using a subsample of 4,620 participants (2,288 women) from the Scottish Mental Survey of 1947, we examined the association between body mass index measured at 11 years of age and future risk of 9 independent health endpoints as ascertained from national hospital admissions and cancer registers until 2014 (up to age 77 years). Although there was some evidence of a relationship between elevated childhood body mass index and higher rates of peripheral vascular disease (per each 1-standard deviation increase in body mass index, hazard ratio = 1.21, 95% confidence interval: 1.07, 1.37) and smoking-related cancers (per each 1-standard deviation increase in body mass index, hazard ratio = 1.09, 95% confidence interval: 1.01, 1.17), there was no apparent association with coronary heart disease, stroke (including ischemic stroke), heart failure, or carcinomas of the colorectum, stomach, lung, prostate, or breast. In conclusion, a relationship between childhood body weight and later morbidity was largely lacking in the present study. © 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.

Impact of a Supportive Housing Program on Housing Stability and Sexually Transmitted Infections Among Young Adults in New York City Who Were Aging Out of Foster Care.

PubMed

Lim, Sungwoo; Singh, Tejinder P; Gwynn, R Charon

2017-08-01

Former foster youth are at increased risk of housing instability and sexually transmitted infections (STIs) during the transitional period following foster care. We measured housing stability using sequence analysis and assessed whether a supportive housing program in New York, New York, was effective in improving housing stability and reducing STIs among former foster youth. Matched administrative records identified 895 former foster youth who were eligible for the housing program during 2007-2010. The main outcomes included housing stability (as determined from episodes of homelessness, incarceration, hospitalization, and residence in supportive housing) and diagnosed STI case rates per 1,000 person-years during the 2 years after baseline. Marginal structural models were used to assess impacts of the program on these outcomes. Three housing stability patterns (unstable housing, stable housing, and rare institutional dwelling patterns) were identified. The housing program was positively associated with a pattern of stable housing (odds ratio = 4.4, 95% confidence interval: 2.9, 6.8), and negatively associated with diagnosed STI rates (relative risk = 0.3, 95% confidence interval: 0.2, 0.7). These positive impacts on housing stability and STIs highlight the importance of the supportive housing program for youths aging out of foster care and the need for such programs to continue. © The Author(s) 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.

Estimation of the standardized risk difference and ratio in a competing risks framework: application to injection drug use and progression to AIDS after initiation of antiretroviral therapy.

PubMed

Cole, Stephen R; Lau, Bryan; Eron, Joseph J; Brookhart, M Alan; Kitahata, Mari M; Martin, Jeffrey N; Mathews, William C; Mugavero, Michael J

2015-02-15

There are few published examples of absolute risk estimated from epidemiologic data subject to censoring and competing risks with adjustment for multiple confounders. We present an example estimating the effect of injection drug use on 6-year risk of acquired immunodeficiency syndrome (AIDS) after initiation of combination antiretroviral therapy between 1998 and 2012 in an 8-site US cohort study with death before AIDS as a competing risk. We estimate the risk standardized to the total study sample by combining inverse probability weights with the cumulative incidence function; estimates of precision are obtained by bootstrap. In 7,182 patients (83% male, 33% African American, median age of 38 years), we observed 6-year standardized AIDS risks of 16.75% among 1,143 injection drug users and 12.08% among 6,039 nonusers, yielding a standardized risk difference of 4.68 (95% confidence interval: 1.27, 8.08) and a standardized risk ratio of 1.39 (95% confidence interval: 1.12, 1.72). Results may be sensitive to the assumptions of exposure-version irrelevance, no measurement bias, and no unmeasured confounding. These limitations suggest that results be replicated with refined measurements of injection drug use. Nevertheless, estimating the standardized risk difference and ratio is straightforward, and injection drug use appears to increase the risk of AIDS. © The Author 2014. 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.

Coffee consumption and mortality from all causes, cardiovascular disease, and cancer: a dose-response meta-analysis.

PubMed

Crippa, Alessio; Discacciati, Andrea; Larsson, Susanna C; Wolk, Alicja; Orsini, Nicola

2014-10-15

Several studies have analyzed the relationship between coffee consumption and mortality, but the shape of the association remains unclear. We conducted a dose-response meta-analysis of prospective studies to examine the dose-response associations between coffee consumption and mortality from all causes, cardiovascular disease (CVD), and all cancers. Pertinent studies, published between 1966 and 2013, were identified by searching PubMed and by reviewing the reference lists of the selected articles. Prospective studies in which investigators reported relative risks of mortality from all causes, CVD, and all cancers for 3 or more categories of coffee consumption were eligible. Results from individual studies were pooled using a random-effects model. Twenty-one prospective studies, with 121,915 deaths and 997,464 participants, met the inclusion criteria. There was strong evidence of nonlinear associations between coffee consumption and mortality for all causes and CVD (P for nonlinearity < 0.001). The largest risk reductions were observed for 4 cups/day for all-cause mortality (16%, 95% confidence interval: 13, 18) and 3 cups/day for CVD mortality (21%, 95% confidence interval: 16, 26). Coffee consumption was not associated with cancer mortality. Findings from this meta-analysis indicate that coffee consumption is inversely associated with all-cause and CVD mortality. © The Author 2014. 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.

Types of Dual and Poly-Tobacco Users in the US Military.

PubMed

Little, Melissa A; Bursac, Zoran; Derefinko, Karen J; Ebbert, Jon O; Talcott, Gerald W; Hryshko-Mullen, Ann; Klesges, Robert C

2016-08-01

The present investigation was designed to determine the prevalence and types of dual and poly-use of tobacco products in the US Air Force, as well as characteristics and factors associated with these types. We conducted a cross-sectional assessment of tobacco-product use among 13,873 Air Force trainees from 2013 to 2014. The assessment included prevalence of the use of 10 different tobacco products and demographic and environmental factors, such as risk perceptions of tobacco use, peer use, and tobacco-company influences. Latent class analysis was carried out to determine types of poly-tobacco users. Tobacco-product use was reported by 27.1% of participants, and of those, over half reported using more than 1 tobacco product. Latent class analysis indicated 5 classes of poly-tobacco use. Factors associated with poly-tobacco (vs. mono-tobacco) use included lower confidence to remain tobacco-free, low harm perceptions, and receiving tobacco products free at bars or social events. Rates of dual and poly-tobacco use are high among trainees, and while these groups are similar to mono users in some ways, there are a number of differences that need to be considered when developing targeted interventions to address use of multiple tobacco products. © The Author 2016. 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.

Comparison of Health Examination Survey Methods in Brazil, Chile, Colombia, Mexico, England, Scotland, and the United States.

PubMed

Mindell, Jennifer S; Moody, Alison; Vecino-Ortiz, Andres I; Alfaro, Tania; Frenz, Patricia; Scholes, Shaun; Gonzalez, Silvia A; Margozzini, Paula; de Oliveira, Cesar; Sanchez Romero, Luz Maria; Alvarado, Andres; Cabrera, Sebastián; Sarmiento, Olga L; Triana, Camilo A; Barquera, Simón

2017-09-15

Comparability of population surveys across countries is key to appraising trends in population health. Achieving this requires deep understanding of the methods used in these surveys to examine the extent to which the measurements are comparable. In this study, we obtained detailed protocols of 8 nationally representative surveys from 2007-2013 from Brazil, Chile, Colombia, Mexico, the United Kingdom (England and Scotland), and the United States-countries that that differ in economic and inequity indicators. Data were collected on sampling frame, sample selection procedures, recruitment, data collection methods, content of interview and examination modules, and measurement protocols. We also assessed their adherence to the World Health Organization's "STEPwise Approach to Surveillance" framework for population health surveys. The surveys, which included half a million participants, were highly comparable on sampling methodology, survey questions, and anthropometric measurements. Heterogeneity was found for physical activity questionnaires and biological samples collection. The common age range included by the surveys was adults aged 18-64 years. The methods used in these surveys were similar enough to enable comparative analyses of the data across the 7 countries. This comparability is crucial in assessing and comparing national and subgroup population health, and to assisting the transfer of research and policy knowledge across countries. © The Author(s) 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.

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.

Using Decomposition Analysis to Identify Modifiable Racial Disparities in the Distribution of Blood Pressure in the United States.

PubMed

Basu, Sanjay; Hong, Anthony; Siddiqi, Arjumand

2015-08-15

To lower the prevalence of hypertension and racial disparities in hypertension, public health agencies have attempted to reduce modifiable risk factors for high blood pressure, such as excess sodium intake or high body mass index. In the present study, we used decomposition methods to identify how population-level reductions in key risk factors for hypertension could reshape entire population distributions of blood pressure and associated disparities among racial/ethnic groups. We compared blood pressure distributions among non-Hispanic white, non-Hispanic black, and Mexican-American persons using data from the US National Health and Nutrition Examination Survey (2003-2010). When using standard adjusted logistic regression analysis, we found that differences in body mass index were the only significant explanatory correlate to racial disparities in blood pressure. By contrast, our decomposition approach provided more nuanced revelations; we found that disparities in hypertension related to tobacco use might be masked by differences in body mass index that significantly increase the disparities between black and white participants. Analysis of disparities between white and Mexican-American participants also reveal hidden relationships between tobacco use, body mass index, and blood pressure. Decomposition offers an approach to understand how modifying risk factors might alter population-level health disparities in overall outcome distributions that can be obscured by standard regression analyses. © The Author 2015. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Improving Mental Health Through the Regeneration of Deprived Neighborhoods: A Natural Experiment.

PubMed

White, James; Greene, Giles; Farewell, Daniel; Dunstan, Frank; Rodgers, Sarah; Lyons, Ronan A; Humphreys, Ioan; John, Ann; Webster, Chris; Phillips, Ceri J; Fone, David

2017-08-15

Neighborhood-level interventions provide an opportunity to better understand the impact of neighborhoods on health. In 2001, the Welsh Government, United Kingdom, funded Communities First, a program of neighborhood regeneration delivered to the 100 most deprived of the 881 electoral wards in Wales. In this study, we examined the association between neighborhood regeneration and mental health. Information on regeneration activities in 35 intervention areas (n = 4,197 subjects) and 75 control areas (n = 6,695 subjects) was linked to data on mental health from a cohort study with assessments made in 2001 (before regeneration) and 2008 (after regeneration). Propensity score matching was used to estimate the change in mental health in intervention neighborhoods versus control neighborhoods. Baseline differences between intervention and control areas were of similar magnitude as produced by paired randomization of neighborhoods. Regeneration was associated with an improvement in the mental health of residents in intervention areas compared with control neighborhoods (β = 1.54, 95% confidence interval: 0.50, 2.59), suggesting a reduction in socioeconomic inequalities in mental health. There was a dose-response relationship between length of residence in regeneration neighborhoods and improvements in mental health (P-trend = 0.05). These results show that targeted regeneration of deprived neighborhoods can improve mental health. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Annual Crop-Yield Variation, Child Survival, and Nutrition Among Subsistence Farmers in Burkina Faso.

PubMed

Belesova, Kristine; Gasparrini, Antonio; Sié, Ali; Sauerborn, Rainer; Wilkinson, Paul

2018-02-01

Whether year-to-year variation in crop yields affects the nutrition, health, and survival of subsistence-farming populations is relevant to the understanding of the potential impacts of climate change. However, the empirical evidence is limited. We examined the associations of child survival with interannual variation in food crop yield and middle-upper arm circumference (MUAC) in a subsistence-farming population of rural Burkina Faso. The study was of 44,616 children aged <5 years included in the Nouna Health and Demographic Surveillance System, 1992-2012, whose survival was analyzed in relation to the food crop yield in the year of birth (which ranged from 65% to 120% of the period average) and, for a subset of 16,698 children, to MUAC, using shared-frailty Cox proportional hazards models. Survival was appreciably worse in children born in years with low yield (full-adjustment hazard ratio = 1.11 (95% confidence interval: 1.02, 1.20) for a 90th- to 10th-centile decrease in annual crop yield) and in children with small MUAC (hazard ratio = 2.72 (95% confidence interval: 2.15, 3.44) for a 90th- to 10th-centile decrease in MUAC). These results suggest an adverse impact of variations in crop yields, which could increase under climate change. © The Author(s) 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.

Identification of Homophily and Preferential Recruitment in Respondent-Driven Sampling.

PubMed

Crawford, Forrest W; Aronow, Peter M; Zeng, Li; Li, Jianghong

2018-01-01

Respondent-driven sampling (RDS) is a link-tracing procedure used in epidemiologic research on hidden or hard-to-reach populations in which subjects recruit others via their social networks. Estimates from RDS studies may have poor statistical properties due to statistical dependence in sampled subjects' traits. Two distinct mechanisms account for dependence in an RDS study: homophily, the tendency for individuals to share social ties with others exhibiting similar characteristics, and preferential recruitment, in which recruiters do not recruit uniformly at random from their network alters. The different effects of network homophily and preferential recruitment in RDS studies have been a source of confusion and controversy in methodological and empirical research in epidemiology. In this work, we gave formal definitions of homophily and preferential recruitment and showed that neither is identified in typical RDS studies. We derived nonparametric identification regions for homophily and preferential recruitment and showed that these parameters were not identified unless the network took a degenerate form. The results indicated that claims of homophily or recruitment bias measured from empirical RDS studies may not be credible. We applied our identification results to a study involving both a network census and RDS on a population of injection drug users in Hartford, Connecticut (2012-2013). © The Author(s) 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.

Time Spent Commuting to Work and Mental Health: Evidence From 13 Waves of an Australian Cohort Study.

PubMed

Milner, Allison; Badland, Hannah; Kavanagh, Anne; LaMontagne, Anthony D

2017-09-15

Time-related stressors, such as long working hours, are recognized as being detrimental to health. We considered whether time spent commuting to work was a risk factor for poor mental health. Data from the Household, Income Labour Dynamics in Australia Survey were used to conduct fixed-effects longitudinal regression analyses. The outcome variable was the Mental Health Inventory, and the main exposure represented hours per week traveling to and from a place of paid employment. Effect modifiers included sex, low job control, high demands, and low job security. Compared with when a person commuted for ≤2 hours per week, there was a small decline (coefficient = -0.33, 95% CI: -0.62, -0.04; P = 0.025) in the Mental Health Inventory score when they commuted for over 6 hours per week. Compared with persons with high job control, persons working in jobs with low job control experienced significantly greater declines in the Mental Health Inventory score when commuting 4 to 6 hours per week and when commuting over 6 hours per week. We found no influence from the other hypothesized effect modifiers. These results suggest the importance of considering commuting time as an additional work-related time stressor. © The Author(s) 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.

Comparison of Statistical Approaches for Dealing With Immortal Time Bias in Drug Effectiveness Studies.

PubMed

Karim, Mohammad Ehsanul; Gustafson, Paul; Petkau, John; Tremlett, Helen

2016-08-15

In time-to-event analyses of observational studies of drug effectiveness, incorrect handling of the period between cohort entry and first treatment exposure during follow-up may result in immortal time bias. This bias can be eliminated by acknowledging a change in treatment exposure status with time-dependent analyses, such as fitting a time-dependent Cox model. The prescription time-distribution matching (PTDM) method has been proposed as a simpler approach for controlling immortal time bias. Using simulation studies and theoretical quantification of bias, we compared the performance of the PTDM approach with that of the time-dependent Cox model in the presence of immortal time. Both assessments revealed that the PTDM approach did not adequately address immortal time bias. Based on our simulation results, another recently proposed observational data analysis technique, the sequential Cox approach, was found to be more useful than the PTDM approach (Cox: bias = -0.002, mean squared error = 0.025; PTDM: bias = -1.411, mean squared error = 2.011). We applied these approaches to investigate the association of β-interferon treatment with delaying disability progression in a multiple sclerosis cohort in British Columbia, Canada (Long-Term Benefits and Adverse Effects of Beta-Interferon for Multiple Sclerosis (BeAMS) Study, 1995-2008). © The Author 2016. 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.

Invited Commentary: Using Financial Credits as Instrumental Variables for Estimating the Causal Relationship Between Income and Health.

PubMed

Pega, Frank

2016-05-01

Social epidemiologists are interested in determining the causal relationship between income and health. Natural experiments in which individuals or groups receive income randomly or quasi-randomly from financial credits (e.g., tax credits or cash transfers) are increasingly being analyzed using instrumental variable analysis. For example, in this issue of the Journal, Hamad and Rehkopf (Am J Epidemiol. 2016;183(9):775-784) used an in-work tax credit called the Earned Income Tax Credit as an instrument to estimate the association between income and child development. However, under certain conditions, the use of financial credits as instruments could violate 2 key instrumental variable analytic assumptions. First, some financial credits may directly influence health, for example, through increasing a psychological sense of welfare security. Second, financial credits and health may have several unmeasured common causes, such as politics, other social policies, and the motivation to maximize the credit. If epidemiologists pursue such instrumental variable analyses, using the amount of an unconditional, universal credit that an individual or group has received as the instrument may produce the most conceptually convincing and generalizable evidence. However, other natural income experiments (e.g., lottery winnings) and other methods that allow better adjustment for confounding might be more promising approaches for estimating the causal relationship between income and health. © The Author 2016. 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.

On the Need for Quantitative Bias Analysis in the Peer-Review Process.

PubMed

Fox, Matthew P; Lash, Timothy L

2017-05-15

Peer review is central to the process through which epidemiologists generate evidence to inform public health and medical interventions. Reviewers thereby act as critical gatekeepers to high-quality research. They are asked to carefully consider the validity of the proposed work or research findings by paying careful attention to the methodology and critiquing the importance of the insight gained. However, although many have noted problems with the peer-review system for both manuscripts and grant submissions, few solutions have been proposed to improve the process. Quantitative bias analysis encompasses all methods used to quantify the impact of systematic error on estimates of effect in epidemiologic research. Reviewers who insist that quantitative bias analysis be incorporated into the design, conduct, presentation, and interpretation of epidemiologic research could substantially strengthen the process. In the present commentary, we demonstrate how quantitative bias analysis can be used by investigators and authors, reviewers, funding agencies, and editors. By utilizing quantitative bias analysis in the peer-review process, editors can potentially avoid unnecessary rejections, identify key areas for improvement, and improve discussion sections by shifting from speculation on the impact of sources of error to quantification of the impact those sources of bias may have had. © 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.

Potential for Bias When Estimating Critical Windows for Air Pollution in Children's Health.

PubMed

Wilson, Ander; Chiu, Yueh-Hsiu Mathilda; Hsu, Hsiao-Hsien Leon; Wright, Robert O; Wright, Rosalind J; Coull, Brent A

2017-12-01

Evidence supports an association between maternal exposure to air pollution during pregnancy and children's health outcomes. Recent interest has focused on identifying critical windows of vulnerability. An analysis based on a distributed lag model (DLM) can yield estimates of a critical window that are different from those from an analysis that regresses the outcome on each of the 3 trimester-average exposures (TAEs). Using a simulation study, we assessed bias in estimates of critical windows obtained using 3 regression approaches: 1) 3 separate models to estimate the association with each of the 3 TAEs; 2) a single model to jointly estimate the association between the outcome and all 3 TAEs; and 3) a DLM. We used weekly fine-particulate-matter exposure data for 238 births in a birth cohort in and around Boston, Massachusetts, and a simulated outcome and time-varying exposure effect. Estimates using separate models for each TAE were biased and identified incorrect windows. This bias arose from seasonal trends in particulate matter that induced correlation between TAEs. Including all TAEs in a single model reduced bias. DLM produced unbiased estimates and added flexibility to identify windows. Analysis of body mass index z score and fat mass in the same cohort highlighted inconsistent estimates from the 3 methods. © The Author(s) 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.

Deployment and Alcohol Use in a Military Cohort: Use of Combined Methods to Account for Exposure-Related Covariates and Heterogeneous Response to Exposure.

PubMed

Fink, David S; Keyes, Katherine M; Calabrese, Joseph R; Liberzon, Israel; Tamburrino, Marijo B; Cohen, Gregory H; Sampson, Laura; Galea, Sandro

2017-08-15

Studies have shown that combat-area deployment is associated with increases in alcohol use; however, studying the influence of deployment on alcohol use faces 2 complications. First, the military considers a confluence of factors before determining whether to deploy a service member, creating a nonignorable exposure and unbalanced comparison groups that inevitably complicate inference about the role of deployment itself. Second, regression analysis assumes that a single effect estimate can approximate the population's change in postdeployment alcohol use, which ignores previous studies that have documented that respondents tend to exhibit heterogeneous postdeployment drinking behaviors. Therefore, we used propensity score matching to balance baseline covariates for the 2 comparison groups (deployed and nondeployed), followed by a variable-oriented difference-in-differences approach to account for the confounding and a person-oriented approach using a latent growth mixture model to account for the heterogeneous response to deployment in this prospective cohort study of the US Army National Guard (2009-2014). We observed a nonsignificant increase in estimated monthly drinks in the first year after deployment that regressed to predeployment drinking levels 2 years after deployment. We found a 4-class model that fit these data best, suggesting that common regression analyses likely conceal substantial interindividual heterogeneity in postdeployment alcohol-use behaviors. © The Author(s) 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.

Reproducing Epidemiologic Research and Ensuring Transparency.

PubMed

Coughlin, Steven S

2017-08-15

Measures for ensuring that epidemiologic studies are reproducible include making data sets and software available to other researchers so they can verify published findings, conduct alternative analyses of the data, and check for statistical errors or programming errors. Recent developments related to the reproducibility and transparency of epidemiologic studies include the creation of a global platform for sharing data from clinical trials and the anticipated future extension of the global platform to non-clinical trial data. Government agencies and departments such as the US Department of Veterans Affairs Cooperative Studies Program have also enhanced their data repositories and data sharing resources. The Institute of Medicine and the International Committee of Medical Journal Editors released guidance on sharing clinical trial data. The US National Institutes of Health has updated their data-sharing policies. In this issue of the Journal, Shepherd et al. (Am J Epidemiol. 2017;186:387-392) outline a pragmatic approach for reproducible research with sensitive data for studies for which data cannot be shared because of legal or ethical restrictions. Their proposed quasi-reproducible approach facilitates the dissemination of statistical methods and codes to independent researchers. Both reproducibility and quasi-reproducibility can increase transparency for critical evaluation, further dissemination of study methods, and expedite the exchange of ideas among researchers. © The Author(s) 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.

Blood Lead, Bone Turnover, and Survival in Amyotrophic Lateral Sclerosis.

PubMed

Fang, Fang; Peters, Tracy L; Beard, John D; Umbach, David M; Keller, Jean; Mariosa, Daniela; Allen, Kelli D; Ye, Weimin; Sandler, Dale P; Schmidt, Silke; Kamel, Freya

2017-11-01

Blood lead and bone turnover may be associated with the risk of amyotrophic lateral sclerosis (ALS). We aimed to assess whether these factors were also associated with time from ALS diagnosis to death through a survival analysis of 145 ALS patients enrolled during 2007 in the National Registry of Veterans with ALS. Associations of survival time with blood lead and plasma biomarkers of bone resorption (C-terminal telopeptides of type I collagen (CTX)) and bone formation (procollagen type I amino-terminal peptide (PINP)) were estimated using Cox models adjusted for age at diagnosis, diagnostic certainty, diagnostic delay, site of onset, and score on the Revised ALS Functional Rating Scale. Hazard ratios were calculated for each doubling of biomarker concentration. Blood lead, plasma CTX, and plasma PINP were mutually adjusted for one another. Increased lead (hazard ratio (HR) = 1.38; 95% confidence interval (CI): 1.03, 1.84) and CTX (HR = 2.03; 95% CI: 1.42, 2.89) were both associated with shorter survival, whereas higher PINP was associated with longer survival (HR = 0.59; 95% CI: 0.42, 0.83), after ALS diagnosis. No interactions were observed between lead or bone turnover and other prognostic indicators. Lead toxicity and bone metabolism may be involved in ALS pathophysiology. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Is Sedentary Lifestyle Associated With Testicular Function? A Cross-Sectional Study of 1,210 Men.

PubMed

Priskorn, Lærke; Jensen, Tina Kold; Bang, Anne Kirstine; Nordkap, Loa; Joensen, Ulla Nordström; Lassen, Tina Harmer; Olesen, Inge Ahlmann; Swan, Shanna H; Skakkebaek, Niels E; Jørgensen, Niels

2016-08-15

Based on cross-sectional data on 1,210 healthy young Danish men, we investigated whether sedentary lifestyle was associated with testicular function (semen quality and reproductive hormones) independent of physical activity. The men were invited to participate in the study between 2008 and 2012, when they attended a compulsory medical examination to determine their fitness for military service. Information on sedentary behavior (television watching and computer time) and physical activity was obtained by questionnaire. The men had a physical examination, delivered a semen sample, and had a blood sample drawn. Time spent watching television, but not time sitting in front of a computer, was associated with lower sperm counts. Men who watched television more than 5 hours/day had an adjusted sperm concentration of 37 million/mL (95% confidence interval (CI): 30, 44) versus 52 million/mL (95% CI: 43, 62) among men who did not watch television; total sperm counts in those 2 groups were 104 million (95% CI: 84, 126) and 158 million (95% CI: 130, 189), respectively. Furthermore, an increase in follicle-stimulating hormone and decreases in testosterone and the testosterone/luteinizing hormone ratio were detected in men watching many hours of television. Self-rated physical fitness, but not time spent on physical activity, was positively associated with sperm counts. © The Author 2016. 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.

Job Strain and the Cortisol Diurnal Cycle in MESA: Accounting for Between- and Within-Day Variability.

PubMed

Rudolph, Kara E; Sánchez, Brisa N; Stuart, Elizabeth A; Greenberg, Benjamin; Fujishiro, Kaori; Wand, Gary S; Shrager, Sandi; Seeman, Teresa; Diez Roux, Ana V; Golden, Sherita H

2016-03-01

Evidence of the link between job strain and cortisol levels has been inconsistent. This could be due to failure to account for cortisol variability leading to underestimated standard errors. Our objective was to model the relationship between job strain and the whole cortisol curve, accounting for sources of cortisol variability. Our functional mixed-model approach incorporated all available data-18 samples over 3 days-and uncertainty in estimated relationships. We used employed participants from the Multi-Ethnic Study of Atherosclerosis Stress I Study and data collected between 2002 and 2006. We used propensity score matching on an extensive set of variables to control for sources of confounding. We found that job strain was associated with lower salivary cortisol levels and lower total area under the curve. We found no relationship between job strain and the cortisol awakening response. Our findings differed from those of several previous studies. It is plausible that our results were unique to middle- to older-aged racially, ethnically, and occupationally diverse adults and were therefore not inconsistent with previous research among younger, mostly white samples. However, it is also plausible that previous findings were influenced by residual confounding and failure to propagate uncertainty (i.e., account for the multiple sources of variability) in estimating cortisol features. © The Author 2016. 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.

Analyzing Seasonal Variations in Suicide With Fourier Poisson Time-Series Regression: A Registry-Based Study From Norway, 1969-2007.

PubMed

Bramness, Jørgen G; Walby, Fredrik A; Morken, Gunnar; Røislien, Jo

2015-08-01

Seasonal variation in the number of suicides has long been acknowledged. It has been suggested that this seasonality has declined in recent years, but studies have generally used statistical methods incapable of confirming this. We examined all suicides occurring in Norway during 1969-2007 (more than 20,000 suicides in total) to establish whether seasonality decreased over time. Fitting of additive Fourier Poisson time-series regression models allowed for formal testing of a possible linear decrease in seasonality, or a reduction at a specific point in time, while adjusting for a possible smooth nonlinear long-term change without having to categorize time into discrete yearly units. The models were compared using Akaike's Information Criterion and analysis of variance. A model with a seasonal pattern was significantly superior to a model without one. There was a reduction in seasonality during the period. Both the model assuming a linear decrease in seasonality and the model assuming a change at a specific point in time were both superior to a model assuming constant seasonality, thus confirming by formal statistical testing that the magnitude of the seasonality in suicides has diminished. The additive Fourier Poisson time-series regression model would also be useful for studying other temporal phenomena with seasonal components. © 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.

Alcohol Consumption and Breast Cancer Risk in Younger Women According to Family History of Breast Cancer and Folate Intake.

PubMed

Kim, Hyun Ja; Jung, Seungyoun; Eliassen, A Heather; Chen, Wendy Y; Willett, Walter C; Cho, Eunyoung

2017-09-01

To evaluate the association between alcohol consumption and breast cancer risk in younger women, overall and by family history of breast cancer and folate intake, we prospectively followed 93,835 US women aged 27-44 years in Nurses' Health Study II who had alcohol consumption data in 1991. Alcohol consumption and folate intake were measured by food frequency questionnaire every 4 years. We documented 2,866 incident cases of invasive breast cancer between 1991 and 2011. Alcohol consumption was not associated with breast cancer risk overall (for intake of ≥10 g/day vs. nondrinking, multivariate hazard ratio = 1.07, 95% confidence interval: 0.94, 1.22). When the association was stratified by family history and folate intake, a positive association between alcohol consumption and breast cancer was found among women with a family history and folate intake less than 400 μg/day (multivariate hazard ratio = 1.82, 95% confidence interval: 1.06, 3.12; P-trend = 0.08). Alcohol consumption was not associated with breast cancer in other categories of family history and folate intake (P-interaction = 0.55). In conclusion, in this population of younger women, higher alcohol consumption was associated with increased risk of breast cancer among those with both a family history of breast cancer and lower folate intake. © The Author(s) 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.

Best Practices for Gauging Evidence of Causality in Air Pollution Epidemiology.

PubMed

Dominici, Francesca; Zigler, Corwin

2017-12-15

The contentious political climate surrounding air pollution regulations has brought some researchers and policy-makers to argue that evidence of causality is necessary before implementing more stringent regulations. Recently, investigators in an increasing number of air pollution studies have purported to have used "causal analysis," generating the impression that studies not explicitly labeled as such are merely "associational" and therefore less rigorous. Using 3 prominent air pollution studies as examples, we review good practices for how to critically evaluate the extent to which an air pollution study provides evidence of causality. We argue that evidence of causality should be gauged by a critical evaluation of design decisions such as 1) what actions or exposure levels are being compared, 2) whether an adequate comparison group was constructed, and 3) how closely these design decisions approximate an idealized randomized study. We argue that air pollution studies that are more scientifically rigorous in terms of the decisions made to approximate a randomized experiment are more likely to provide evidence of causality and should be prioritized among the body of evidence for regulatory review accordingly. Our considerations, although presented in the context of air pollution epidemiology, can be broadly applied to other fields of epidemiology. © The Author(s) 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.

Flexible Mediation Analysis With Multiple Mediators.

PubMed

Steen, Johan; Loeys, Tom; Moerkerke, Beatrijs; Vansteelandt, Stijn

2017-07-15

The advent of counterfactual-based mediation analysis has triggered enormous progress on how, and under what assumptions, one may disentangle path-specific effects upon combining arbitrary (possibly nonlinear) models for mediator and outcome. However, current developments have largely focused on single mediators because required identification assumptions prohibit simple extensions to settings with multiple mediators that may depend on one another. In this article, we propose a procedure for obtaining fine-grained decompositions that may still be recovered from observed data in such complex settings. We first show that existing analytical approaches target specific instances of a more general set of decompositions and may therefore fail to provide a comprehensive assessment of the processes that underpin cause-effect relationships between exposure and outcome. We then outline conditions for obtaining the remaining set of decompositions. Because the number of targeted decompositions increases rapidly with the number of mediators, we introduce natural effects models along with estimation methods that allow for flexible and parsimonious modeling. Our procedure can easily be implemented using off-the-shelf software and is illustrated using a reanalysis of the World Health Organization's Large Analysis and Review of European Housing and Health Status (WHO-LARES) study on the effect of mold exposure on mental health (2002-2003). © The Author(s) 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.

Unequal Exposure or Unequal Vulnerability? Contributions of Neighborhood Conditions and Cardiovascular Risk Factors to Socioeconomic Inequality in Incident Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis.

PubMed

Hussein, Mustafa; Diez Roux, Ana V; Mujahid, Mahasin S; Hastert, Theresa A; Kershaw, Kiarri N; Bertoni, Alain G; Baylin, Ana

2017-11-23

Risk factors can drive socioeconomic inequalities in cardiovascular disease (CVD) through differential exposure and differential vulnerability. We show how econometric decomposition directly enables simultaneous, policy-oriented assessment of these two mechanisms. We specifically estimated contributions via these mechanisms of neighborhood environment and proximal risk factors to socioeconomic inequality in CVD incidence. We followed 5,608 participants in the Multi-Ethnic Study of Atherosclerosis (2000-2012) until the first CVD event (median follow-up 12.2 years). We used a summary measure of baseline socioeconomic position (SEP). Covariates included baseline demographics, neighborhood, psychosocial, behavioral, and biomedical risk factors. Using Poisson models, we decomposed the difference (inequality) in incidence rates between low- and high-SEP groups into contributions of 1) differences in covariate means (differential exposure), and 2) differences in CVD risk associated with covariates (differential vulnerability). Notwithstanding large uncertainty in neighborhood estimates, our analysis suggests that differential exposure to poorer neighborhood socioeconomic conditions, adverse social environment, diabetes, and hypertension accounts for most of inequality. Psychosocial and behavioral contributions were negligible. Further, neighborhood SEP, female gender, and White race were more strongly associated with CVD among low-SEP (vs. high-SEP) participants. These differentials in vulnerability also accounted for nontrivial portions of the inequality, and could have important implications for intervention. © The Author(s) 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.

Recruiting online: lessons from a longitudinal survey of contraception and pregnancy intentions of young Australian women.

PubMed

Harris, Melissa L; Loxton, Deborah; Wigginton, Britta; Lucke, Jayne C

2015-05-15

Recruitment of young people for epidemiologic research remains challenging, with marked decreases in the effectiveness of face-to-face, mail, and telephone recruitment methods. We report on the implementation and feasibility of an innovative and flexible approach used to recruit participants for a longitudinal cohort study about contraceptive use and pregnancy (the Contraceptive Use, Pregnancy Intention, and Decisions (CUPID) Study). Australian women aged 18-23 years were recruited using a range of online, networking, and offline methods, including social media (primarily Facebook (Facebook Inc., Menlo Park, California; http://www.facebook.com)), face-to-face events, distribution of promotional material, and media releases. Over the course of the 1-year recruitment period (beginning in September 2012), a total of 3,795 eligible women were recruited to complete the online survey, at a cost of approximately A$11 per participant. This sample was found to be broadly representative of the Australian population of women aged 18-23 years in terms of demographic characteristics, with the exception of an overrepresentation of tertiary-educated women (88.7% compared with 72.6%). This study demonstrated that although current recruitment strategies are required to be innovative and flexible in order to engage young people in epidemiologic research, representative samples can be achieved online at reasonable cost. © 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.

Maternal Influenza Immunization and Adverse Birth Outcomes: Using Data and Practice to Inform Theory and Research Design.

PubMed

Phadke, Varun K; Steinhoff, Mark C; Omer, Saad B; MacDonald, Noni E

2016-12-01

Maternal influenza immunization can reduce influenza-attributable morbidity and mortality among pregnant women and infants who are too young to be vaccinated. Data from empirical studies also support the hypothesis that immunization can protect the fetus against adverse outcomes if the mother is exposed to influenza. In their theoretical analysis in the Journal, Hutcheon et al. (Am J Epidemiol 2016;184(3):227-232) critiqued the existing evidence of the fetal benefits of maternal influenza immunization by calculating the sample sizes needed to demonstrate hypothetical reductions in risk and concluded that the benefits observed in empirical studies are likely implausible. However, in their analysis, they did not take into account multiple fundamental characteristics of influenza epidemiology, including the time-variable effects of influenza illness and vaccination during pregnancy, or well-known differences in disease epidemiology between seasons, populations, and geographic regions. Although these and other factors might affect the magnitude of fetal benefit conferred by maternal influenza immunization, studies in which investigators have accounted for influenza circulation have demonstrated a consistent protective effect against a variety of adverse birth outcomes; those studies include the only randomized controlled trial designed a priori and adequately powered to do so. Only a comprehensive and nuanced assessment of the evidence base will allow for effective translation of these data into a global immunization policy. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Application of an Individual-Based Transmission Hazard Model for Estimation of Influenza Vaccine Effectiveness in a Household Cohort.

PubMed

Petrie, Joshua G; Eisenberg, Marisa C; Ng, Sophia; Malosh, Ryan E; Lee, Kyu Han; Ohmit, Suzanne E; Monto, Arnold S

2017-12-15

Household cohort studies are an important design for the study of respiratory virus transmission. Inferences from these studies can be improved through the use of mechanistic models to account for household structure and risk as an alternative to traditional regression models. We adapted a previously described individual-based transmission hazard (TH) model and assessed its utility for analyzing data from a household cohort maintained in part for study of influenza vaccine effectiveness (VE). Households with ≥4 individuals, including ≥2 children <18 years of age, were enrolled and followed during the 2010-2011 influenza season. VE was estimated in both TH and Cox proportional hazards (PH) models. For each individual, TH models estimated hazards of infection from the community and each infected household contact. Influenza A(H3N2) infection was laboratory-confirmed in 58 (4%) subjects. VE estimates from both models were similarly low overall (Cox PH: 20%, 95% confidence interval: -57, 59; TH: 27%, 95% credible interval: -23, 58) and highest for children <9 years of age (Cox PH: 40%, 95% confidence interval: -49, 76; TH: 52%, 95% credible interval: 7, 75). VE estimates were robust to model choice, although the ability of the TH model to accurately describe transmission of influenza presents continued opportunity for analyses. © The Author(s) 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.

The Health System and Policy Implications of Changing Epidemiology for Oral Cavity and Oropharyngeal Cancers in the United States From 1995 to 2016.

PubMed

LeHew, Charles W; Weatherspoon, Darien J; Peterson, Caryn E; Goben, Abigail; Reitmajer, Karolina; Sroussi, Herve; Kaste, Linda M

2017-01-01

Oral cavity and oropharyngeal cancers are typically grouped under the general term, "oral cancer." Yet, the incidence of oropharyngeal cancers is increasing in the United States, while the incidence of oral cavity cancers has declined. These 2 distinct but conflated groups of oral cancers are attributed to different risk factors. Incidence and survival trends were examined across US population groups and by anatomical subsite. Disparities in incidence and survival by sex, race/ethnicity, and subsite were identified. Risk factors are complex, interactive, and not fully identified. Cancer control research illustrates health disparities in access to care and patient outcomes. Database and supplemental searches yielded 433 articles published between 1995 and 2016 characterizing aspects of oral cancer epidemiology relating to incidence, survival, risk, disparities, and cancer control. Oral cavity cancer survival in black men remains the most intractable burden. Although understanding of oral cancer etiology is improving, application to policy is limited. Cancer control efforts are diverse, sporadic, limited in scope, and generally lacking in success, and they need stratification by oral cavity cancers/oropharyngeal cancers. Further intervention and epidemiologic research, improved workforce capacity, and integrated care delivery are identified as important directions for public health policy. Sustained, multilevel campaigns modeled on tobacco control success are suggested. © 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.

Pneumonia Hospitalization Risk in the Elderly Attributable to Cold and Hot Temperatures in Hong Kong, China.

PubMed

Qiu, Hong; Sun, Shengzhi; Tang, Robert; Chan, King-Pan; Tian, Linwei

2016-10-15

The growth of pathogens potentially relevant to respiratory tract infection may be triggered by changes in ambient temperature. Few studies have examined the association between ambient temperature and pneumonia incidence, and no studies have focused on the susceptible elderly population. We aimed to examine the short-term association between ambient temperature and geriatric pneumonia and to assess the disease burden attributable to cold and hot temperatures in Hong Kong, China. Daily time-series data on emergency hospital admissions for geriatric pneumonia, mean temperature, relative humidity, and air pollution concentrations between January 2005 and December 2012 were collected. Distributed-lag nonlinear modeling integrated in quasi-Poisson regression was used to examine the exposure-lag-response relationship between temperature and pneumonia hospitalization. Measures of the risk attributable to nonoptimal temperature were calculated to summarize the disease burden. Subgroup analyses were conducted to examine the sex difference. We observed significant nonlinear and delayed associations of both cold and hot temperatures with pneumonia in the elderly, with cold temperatures having stronger effect estimates. Among the 10.7% of temperature-related pneumonia hospitalizations, 8.7% and 2.0% were attributed to cold and hot temperatures, respectively. Most of the temperature-related burden for pneumonia hospitalizations in Hong Kong was attributable to cold temperatures, and elderly men had greater susceptibility. © The Author 2016. 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.

Maniac Talk - John Mather

NASA Image and Video Library

2014-11-19

John Mather Maniac Lecture, November 19, 2014 Nobel Laureate John Mather presented a Maniac Talk entitled "Creating the Future: Building JWST, what it may find, and what comes next?" In this lecture, John takes a rear view look at how James Webb Space Telescope was started, what it can see and what it might discover. He describes the hardware, what it was designed to observe, and speculate about the surprises it might uncover. He also outlines a possible future of space observatories: what astronomers want to build, what we need to invent, and what they might find, even the chance of discovering life on planets around other stars.

Genetics Home Reference: Hennekam syndrome

MedlinePlus

... Primary Intestinal Lymphangiectasia Information Johns Hopkins Medicine: Lymphedema Management (PDF) VascularWeb: Lymphedema General Information from MedlinePlus (5 links) Diagnostic Tests Drug Therapy ...

John Dewey, an Appreciation

ERIC Educational Resources Information Center

Clopton, Robert W.

2015-01-01

The subject of the annual Presidential address of Phi Kappa Phi, presented on May 8, 1962, was John Dewey. Dewey is identified in the public mind chiefly as an educational philosopher. In this address, the author describes the life and work of John Dewey as an indefatigable student of life whose interests ranged, like those of Aristotle, over the…

Genetics Home Reference: MECP2-related severe neonatal encephalopathy

MedlinePlus

... Johns Hopkins Children's Center: Failure to Thrive Kennedy Krieger Institute: Epilepsy (Seizure Disorder) Kennedy Krieger Institute: Intellectual Disability MalaCards: mecp2-related severe neonatal ...

Conceptions of Childhood in the Educational Philosophies of John Locke and John Dewey

ERIC Educational Resources Information Center

Bynum, Gregory Lewis

2015-01-01

This article compares progressive conceptions of childhood in the educational philosophies of John Locke and John Dewey. Although the lives of the two philosophers were separated by an ocean and two centuries of history, they had in common the following things: (1) a relatively high level of experience working with, and observing, children that is…

Bloomberg's Way

ERIC Educational Resources Information Center

Samuels, Christina A.

2009-01-01

The nation's largest school district is engaged in a fierce debate over the merits and drawbacks of mayoral control as a legislative deadline looms for renewing the governance arrangement. The 2002 law that gave New York City's mayor authority over the school system will "sunset" on June 30 unless state lawmakers step in, as they are…

Archaeological Survey of Cooper Lake, Number 6, 1989. Cultural Resource Studies for Cooper Lake, Hopkins and Delta Counties, Texas

DTIC Science & Technology

1989-01-01

area in the Cooper Lake project are-a, ca. 145 kmf (90 mi) northerst of Dallas, Texas. The study area includes two recreatioa’al areas, South Sulphur...Number 6 study area, Delta and Hopkins counties, Texas, showing the locations of project segments defined for the geomorphological investigations...32 Figure 6-5 Representative stratigraphic profiles from the Finley Iranch, Branam Creek, and South Sulphur River floodplain project segments

LANDMARK-BASED SPEECH RECOGNITION: REPORT OF THE 2004 JOHNS HOPKINS SUMMER WORKSHOP.

PubMed

Hasegawa-Johnson, Mark; Baker, James; Borys, Sarah; Chen, Ken; Coogan, Emily; Greenberg, Steven; Juneja, Amit; Kirchhoff, Katrin; Livescu, Karen; Mohan, Srividya; Muller, Jennifer; Sonmez, Kemal; Wang, Tianyu

2005-01-01

Three research prototype speech recognition systems are described, all of which use recently developed methods from artificial intelligence (specifically support vector machines, dynamic Bayesian networks, and maximum entropy classification) in order to implement, in the form of an automatic speech recognizer, current theories of human speech perception and phonology (specifically landmark-based speech perception, nonlinear phonology, and articulatory phonology). All three systems begin with a high-dimensional multiframe acoustic-to-distinctive feature transformation, implemented using support vector machines trained to detect and classify acoustic phonetic landmarks. Distinctive feature probabilities estimated by the support vector machines are then integrated using one of three pronunciation models: a dynamic programming algorithm that assumes canonical pronunciation of each word, a dynamic Bayesian network implementation of articulatory phonology, or a discriminative pronunciation model trained using the methods of maximum entropy classification. Log probability scores computed by these models are then combined, using log-linear combination, with other word scores available in the lattice output of a first-pass recognizer, and the resulting combination score is used to compute a second-pass speech recognition output.

Case Study: The Venous Thromboembolism Collaborative Team at the Johns Hopkins Hospital

DTIC Science & Technology

2009-05-21

the use of evidence based medicine as well as a Collaborative of medical and administrative staff, the team developed a computer based decision...audits were conducted for some of the high-risk departments to validate adherence to compliance with evidence - based medicine supporting prevention

The Hopkins Ultraviolet Telescope: The Final Archive

NASA Technical Reports Server (NTRS)

Dixon, William V.; Blair, William P.; Kruk, Jeffrey W.; Romelfanger, Mary L.

2013-01-01

The Hopkins Ultraviolet Telescope (HUT) was a 0.9 m telescope and moderate-resolution (Delta)lambda equals 3 A) far-ultraviolet (820-1850 Å) spectrograph that flew twice on the space shuttle, in 1990 December (Astro-1, STS-35) and 1995 March (Astro-2, STS-67). The resulting spectra were originally archived in a nonstandard format that lacked important descriptive metadata. To increase their utility, we have modified the original datareduction software to produce a new and more user-friendly data product, a time-tagged photon list similar in format to the Intermediate Data Files (IDFs) produced by the Far Ultraviolet Spectroscopic Explorer calibration pipeline. We have transferred all relevant pointing and instrument-status information from locally-archived science and engineering databases into new FITS header keywords for each data set. Using this new pipeline, we have reprocessed the entire HUT archive from both missions, producing a new set of calibrated spectral products in a modern FITS format that is fully compliant with Virtual Observatory requirements. For each exposure, we have generated quicklook plots of the fully-calibrated spectrum and associated pointing history information. Finally, we have retrieved from our archives HUT TV guider images, which provide information on aperture positioning relative to guide stars, and converted them into FITS-format image files. All of these new data products are available in the new HUT section of the Mikulski Archive for Space Telescopes (MAST), along with historical and reference documents from both missions. In this article, we document the improved data-processing steps applied to the data and show examples of the new data products.

The Hopkins Ultraviolet Telescope: The Final Archive

NASA Astrophysics Data System (ADS)

Dixon, William V.; Blair, William P.; Kruk, Jeffrey W.; Romelfanger, Mary L.

2013-04-01

The Hopkins Ultraviolet Telescope (HUT) was a 0.9 m telescope and moderate-resolution (Δλ = 3 Å) far-ultraviolet (820-1850 Å) spectrograph that flew twice on the space shuttle, in 1990 December (Astro-1, STS-35) and 1995 March (Astro-2, STS-67). The resulting spectra were originally archived in a nonstandard format that lacked important descriptive metadata. To increase their utility, we have modified the original data-reduction software to produce a new and more user-friendly data product, a time-tagged photon list similar in format to the Intermediate Data Files (IDFs) produced by the Far Ultraviolet Spectroscopic Explorer calibration pipeline. We have transferred all relevant pointing and instrument-status information from locally-archived science and engineering databases into new FITS header keywords for each data set. Using this new pipeline, we have reprocessed the entire HUT archive from both missions, producing a new set of calibrated spectral products in a modern FITS format that is fully compliant with Virtual Observatory requirements. For each exposure, we have generated quick-look plots of the fully-calibrated spectrum and associated pointing history information. Finally, we have retrieved from our archives HUT TV guider images, which provide information on aperture positioning relative to guide stars, and converted them into FITS-format image files. All of these new data products are available in the new HUT section of the Mikulski Archive for Space Telescopes (MAST), along with historical and reference documents from both missions. In this article, we document the improved data-processing steps applied to the data and show examples of the new data products.

Celebrating John Glenn’s Legacy

NASA Image and Video Library

2012-03-02

Sen. John Glenn, left, shakes hands with former Astronaut Steve Lindsey as NASA Administrator Charles Bolden smiles at an event celebrating John Glenn's legacy and 50 years of americans in orbit held at the Cleveland State University Wolstein Center on Friday, March 3, 2012 in Cleveland, Ohio. In 1998 Lindsey flew onboard the space shuttle Discovery along with then 77 year-old Sen. John Glenn for the STS-95 mission. Glenn became the first American to orbit Earth in 1962. Photo Credit: (NASA/Bill Ingalls)

Hopkins Ultraviolet Telescope determination of the Io torus electron temperature

NASA Technical Reports Server (NTRS)

Hall, D. T.; Bednar, C. J.; Durrance, S. T.; Feldman, P. D.; Mcgrath, M. A.; Moos, H. W.; Strobel, D. F.

1994-01-01

Sulfur ion emissions from the Io plasma torus observed by the Hopkins Ultraviolet Telescope (HUT) in 1990 December have been analyzed to determine the effective temperature of the exciting electrons. Spectra were obtained with a long slit that extended from 3.1 to 8.7 Jupiter radii R(sub J) on both dawn and dusk torus ansae. The average temperature of electrons exciting S(2+) emissions from the dawn ansa is (4800 +/- 2400) K lower than on the dusk ansa, a dawn-dusk asymmetry comparable in both sign and magnitude to that measured by the Voyager Ultraviolet Spectrograph (UVS) experiment. Emissions from S(2+) ions are generated in a source region with electron temperatures in the range 32,000-56,000 K; S(3+) ion emissions are excited by electrons that average 20,000-40,000 K hotter. This distinct difference suggests that the S(3+) emission source region is spatially separate from the S(2+) source region. Estimated relative aperture filling factors suggest that the S(3+) emissions originate from a region more extended out of the centrifugal plane than the S(2+) emissions.

Observations of Comet Levy (1990c) with the Hopkins Ultraviolet Telescope

NASA Technical Reports Server (NTRS)

Feldman, P. D.; Davidsen, A. F.; Blair, W. P.; Bowers, C. W.; Dixon, W. V.; Durrance, S. T.; Henry, R. C.; Ferguson, H. C.; Kimble, R. A.; Gull, Theodore R.

1991-01-01

Observations of Comet Levy (1990c) were made with the Hopkins Ultraviolet Telescope during the Astro-1 Space Shuttle mission on December 10, 1990. The spectrum, covering the wavelength range 415-1850 A at a spectral resolution of 3 A, shows the presence of carbon monoxide and atomic hydrogen, carbon, and sulfur in the coma. Aside from H I Lyman-beta, no cometary features are detected below 1200 A, although cometary O I and O II would be masked by the same emissions present in the day airglow spectrum. The 9.4 x 116 arcsecond aperture corresponds to 12,000 x 148,000 km at the comet. The derived production rate of CO relative to water is 0.11 + or - 0.02, compared with 0.04 + or - 0.01 derived from IUE observations (made in September 1990) which sample a much smaller region of the coma. This suggests the presence of an extended source of CO, as was found in comet Halley. Upper limits on Ne and Ar abundance are within one order of magnitude of solar abundances.

The Hopkins Ultraviolet Telescope - Performance and calibration during the Astro-1 mission

NASA Technical Reports Server (NTRS)

Davidsen, Arthur F.; Long, Knox S.; Durrance, Samuel T.; Blair, William P.; Bowers, Charles W.; Conard, Steven J.; Feldman, Paul D.; Ferguson, Henry C.; Fountain, Glen H.; Kimble, Randy A.

1992-01-01

Results are reported of spectrophotometric observations, made with the Hopkins Ultraviolet Telescope (HUT), of 77 astronomical sources throughout the far-UV (912-1850 A) at a resolution of about 3 A, and, for a small number of sources, in the extreme UV (415-912 A) beyond the Lyman limit at a resolution of about 1.5 A. The HUT instrument and its performance in orbit are described. A HUT observation of the DA white dwarf G191-B2B is presented, and the photometric calibration curve for the instrument is derived from a comparison of the observation with a model stellar atmosphere. The sensitivity reaches a maximum at 1050 A, where 1 photon/sq cm s A yields 9.5 counts/s A, and remains within a factor of 2 of this value from 912 to 1600 A. The instrumental dark count measured on orbit was less than 0.001 counts/s A.

[Tunisian adaptation of Hopkins Verbal Learning Test , Form 1].

PubMed

Dellagi, Lamia; Ben Azouz, Olfa; Johnson, Ines; Kebir, Oussama; Amado, Isabelle; Tabbane, Karim

2009-10-01

Memory impairment and verbal learning are the most common cognitive deficits associated with schizophrenia. Hopkins Verbal Learning Test (HVLT) is considered to be the most reliable test to asses memory and verbal learning in this mental illness. to create one form of the HVLT which would suit our linguistic and cultural context and to study the characteristics of this test in a group of healthy subjects. The HVLT consists of a list of 12 words belonging to 3 semantic categories and which are read orally to the subject with an immediate and differed recall. The first part of this work was to select words from a lexical database in order to create the list of the HVLT. The test was then administered to 103 subjects aged from 17- to 45-years-old (mean=27,4; SD =7,3) and having between 1 and 20 years of education ( mean=12,2; SD=5,3). No statistical difference was found within performances of the HVLT across gender and sex. Whereas, years of education was found to have an impact on performances. Although statistically difference was found across level of education. Our study permitted us to create one form of the HVLT which well suits our Tunisian context and which we could use to evaluate memory functions among people suffering from schizophrenia.

Promising New Directions in Biochemistry

ERIC Educational Resources Information Center

Olivera, Baldomero M.

2003-01-01

"Biochemistry," by Lubert Stryer, has become one of the standard textbooks for the field. The Fifth Edition has two new authors: Jeremy Berg, Professor and Director of Biophysics and Biophysical Chemistry at Johns Hopkins University School of Medicine; and John Tymoczko, the Towsley Professor of Biology at Carleton College. The new edition does,…

Impairment of different protein domains causes variable clinical presentation within Pitt-Hopkins syndrome and suggests intragenic molecular syndromology of TCF4.

PubMed

Bedeschi, Maria Francesca; Marangi, Giuseppe; Calvello, Maria Rosaria; Ricciardi, Stefania; Leone, Francesca Pia Chiara; Baccarin, Marco; Guerneri, Silvana; Orteschi, Daniela; Murdolo, Marina; Lattante, Serena; Frangella, Silvia; Keena, Beth; Harr, Margaret H; Zackai, Elaine; Zollino, Marcella

2017-11-01

Pitt-Hopkins syndrome is a neurodevelopmental disorder characterized by severe intellectual disability and a distinctive facial gestalt. It is caused by haploinsufficiency of the TCF4 gene. The TCF4 protein has different functional domains, with the NLS (nuclear localization signal) domain coded by exons 7-8 and the bHLH (basic Helix-Loop-Helix) domain coded by exon 18. Several alternatively spliced TCF4 variants have been described, allowing for translation of variable protein isoforms. Typical PTHS patients have impairment of at least the bHLH domain. To which extent impairment of the remaining domains contributes to the final phenotype is not clear. There is recent evidence that certain loss-of-function variants disrupting TCF4 are associated with mild ID, but not with typical PTHS. We describe a frameshift-causing partial gene deletion encompassing exons 4-6 of TCF4 in an adult patient with mild ID and nonspecific facial dysmorphisms but without the typical features of PTHS, and a c.520C > T nonsense variant within exon 8 in a child presenting with a severe phenotype largely mimicking PTHS, but lacking the typical facial dysmorphism. Investigation on mRNA, along with literature review, led us to suggest a preliminary phenotypic map of loss-of-function variants affecting TCF4. An intragenic phenotypic map of loss-of-function variants in TCF4 is suggested here for the first time: variants within exons 1-4 and exons 4-6 give rise to a recurrent phenotype with mild ID not in the spectrum of Pitt-Hopkins syndrome (biallelic preservation of both the NLS and bHLH domains); variants within exons 7-8 cause a severe phenotype resembling PTHS but in absence of the typical facial dysmorphism (impairment limited to the NLS domain); variants within exons 9-19 cause typical Pitt-Hopkins syndrome (impairment of at least the bHLH domain). Understanding the TCF4 molecular syndromology can allow for proper nosology in the current era of whole genomic investigations. Copyright �

John Bahcall and the Solar Neutrino Problem

NASA Astrophysics Data System (ADS)

Bahcall, Neta

2016-03-01

``I feel like dancing'', cheered John Bahcall upon hearing the exciting news from the SNO experiment in 2001. The results confirmed, with remarkable accuracy, John's 40-year effort to predict the rate of neutrinos from the Sun based on sophisticated Solar models. What began in 1962 by John Bahcall and Ray Davis as a pioneering project to test and confirm how the Sun shines, quickly turned into a four-decade-long mystery of the `Solar Neutrino Problem': John's models predicted a higher rate of neutrinos than detected by Davis and follow-up experiments. Was the theory of the Sun wrong? Were John's calculations in error? Were the neutrino experiments wrong? John worked tirelessly to understand the physics behind the Solar Neutrino Problem; he led the efforts to greatly increase the accurately of the solar model, to understand its seismology and neutrino fluxes, to use the neutrino fluxes as a test for new physics, and to advocate for important new experiments. It slowly became clear that none of the then discussed possibilities --- error in the Solar model or neutrino experiments --- was the culprit. The SNO results revealed that John's calculations, and hence the theory of the Solar model, have been correct all along. Comparison of the data with John's theory demanded new physics --- neutrino oscillations. The Solar Neutrino saga is one of the most amazing scientific stories of the century: exploring a simple question of `How the Sun Shines?' led to the discovery of new physics. John's theoretical calculations are an integral part of this journey; they provide the foundation for the Solar Neutrino Problem, for confirming how the Sun shines, and for the need of neutrino oscillations. His tenacious persistence, dedication, enthusiasm and love for the project, and his leadership and advocacy of neutrino physics over many decades are a remarkable story of scientific triumph. I know John is smiling today.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers begin moving NASA’s MESSENGER spacecraft into the building MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - is being taken into a high bay clean room where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers begin moving NASA’s MESSENGER spacecraft into the building MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - is being taken into a high bay clean room where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, a lift begins lowering NASA’s MESSENGER spacecraft onto the ground. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, a lift begins lowering NASA’s MESSENGER spacecraft onto the ground. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers prepare to attach an overhead crane to NASA’s MESSENGER spacecraft. The spacecraft will be moved to a work stand where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers prepare to attach an overhead crane to NASA’s MESSENGER spacecraft. The spacecraft will be moved to a work stand where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers check the moveable pallet holding NASA’s MESSENGER spacecraft. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, workers check the moveable pallet holding NASA’s MESSENGER spacecraft. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, NASA’s MESSENGER spacecraft from NASA’s Goddard Space Flight Center in Greenbelt, Md., is offloaded. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, NASA’s MESSENGER spacecraft from NASA’s Goddard Space Flight Center in Greenbelt, Md., is offloaded. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers attach an overhead crane to NASA’s MESSENGER spacecraft. The spacecraft will be moved to a work stand where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - In the high bay clean room at the Astrotech Space Operations processing facilities near KSC, workers attach an overhead crane to NASA’s MESSENGER spacecraft. The spacecraft will be moved to a work stand where employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

Obituary: John Louis Perdrix, 1926-2005

NASA Astrophysics Data System (ADS)

Orchiston, D. Wayne

2006-12-01

John Perdrix, astronomical historian and co-founder of the Journal of Astronomical History and Heritage, died on 27 June 2005. John Louis Perdrix was born in Adelaide, Australia, on 30 June 1926. After studying chemistry at Melbourne Technical College and working in industry, he joined the Commonwealth Scientific and Industrial Research Organisation's Division of Minerals and Geochemistry. In 1974 the Division relocated to the Western Australian capital, Perth, and John spent the rest of his working life there involved in geochemical research. From his teenage years John had a passion for astronomy, which he fine-tuned through the Astronomical Society of Victoria and the Victorian Branch of the British Astronomical Association. He was very active in both groups, serving as President of the former and Secretary/Treasurer of the latter. He was also an FRAS, and a member of the AAS, the BAA parent body, and the IAU (Commission 41)?no mean feat for an Australian amateur astronomer. Throughout his life, he was a strong advocate of close amateur-professional relations. John's main research interest was history of astronomy, and over the years he wrote a succession of research papers, mainly about aspects of Australian astronomy. His well-researched and neatly-illustrated papers on the Melbourne Observatory and the Great Melbourne Telescope are classics, and when the Observatory's future was in the balance they played a key role in the State Government's decision to convert this unique facility into a museum precinct. To support his research activities, John built up an amazing library that developed its own distinctive personality and quickly took over his house and garage before invading commercial storage facilities! Apart from writing papers, John had an even greater passion for editing and publishing. From 1985 to 1997 he produced the Australian Journal of Astronomy, and in 1998 this was replaced by the Journal of Astronomical History and Heritage (JAH2). Both

Marcel Breuer at Saint John's

ERIC Educational Resources Information Center

Carlson, Scott

2008-01-01

A visitor to Saint John's University and Saint John's Abbey, in north-central Minnesota, sees something of Gothic heritage while standing in front of the abbey church, designed and built around 1960. The church's 112-foot campanile--a trapezoidal slab made of 2,500 tons of steel and concrete--stands boldly in front of a huge concrete honeycomb…

Demythologizing John Dewey

ERIC Educational Resources Information Center

Bhattacharya, N. C.

1974-01-01

This article takes a brief but critical look at John Dewey's version of pragmatism, his contribution to philosophical scholarship generally as well as his theory and practice of liberalism. (Author/RK)

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

Rodland, Karin

New research identifies critical proteins present in the tumors of women with ovarian cancer. Karin Rodland discusses the work led by PNNL and Johns Hopkins researchers, working with collaborators across the nation.

The Inner Workings of Ovarian Cancer

ScienceCinema

Rodland, Karin

2018-06-12

New research identifies critical proteins present in the tumors of women with ovarian cancer. Karin Rodland discusses the work led by PNNL and Johns Hopkins researchers, working with collaborators across the nation.

It's a Lot of Pun.

ERIC Educational Resources Information Center

Sugar, Leslye Donner

1986-01-01

Humor in college and university publications is helping editors and designers communicate to target audiences. Successful campus punmakers are identified at LaGuardia Community College, Brigham Young University, and Johns Hopkins. (MLW)

Aspects of Vitamin A

PubMed Central

Hedley-Whyte, John; Milamed, Debra R

2009-01-01

Musgrave Park Hospital in 1942 was the site of an Anglo-American Vitamin A caper. A threatened court-martial was pre-empted. Subsequently the Queen's lecturer in Anatomy, JW Millen, who was the other lecturer to the first editor of this journal, RH Hunter, did much distinguished work. The neurological effects of Vitamin A were elucidated. Further work on cerebrospinal fluid (CSF), placenta, thalidomide and poliomyelitis led to the pre-eminence in applied anatomy and teratology of now Reader James Wilson Millen and Professors JD Boyd and WJ Hamilton, all Queen's Medical School graduates. Training of RH Hunter, JH Biggart and JD Boyd at Johns Hopkins University profoundly influenced these seminal discoveries. The Garretts, a family of Lisburn, County Down origin, saved Johns Hopkins Hospital and Medical School from financial disaster. The Garretts founded a commercial and mercantile empire that took control of the Baltimore and Ohio (B and O) Railroad and enabled the Garretts to dictate that women should be admitted to the Hopkins Medical School and Hospital on exactly the same terms as men. All women and men should already be university honours graduates. Winston S Churchill on his progress up and down the B and O main line in March 1946, recounted to President Harry S Truman and Harry Hopkins his mother's tales of the Garrett boys' adventures. PMID:19907684

Alcohol and drug misuse, abuse, and dependence in women veterans.

PubMed

Hoggatt, Katherine J; Jamison, Andrea L; Lehavot, Keren; Cucciare, Michael A; Timko, Christine; Simpson, Tracy L

2015-01-01

We conducted a systematic literature review on substance misuse, abuse, and dependence in women veterans, including National Guard/reserve members. We identified 837 articles published between 1980 and 2013. Of 56 included studies, 32 reported rates of alcohol misuse, binge drinking, or other unhealthy alcohol use not meeting diagnostic criteria for abuse or dependence, and 33 reported rates of drug misuse or diagnosed alcohol or drug use disorders. Rates ranged from 4% to 37% for alcohol misuse and from 7% to 25% for binge drinking; among Veterans Health Administration (VA) health-care system outpatients, rates ranged from 3% to 16% for substance use disorder. Studies comparing women veterans and civilians reported no clear differences in binge or heavy drinking. Substance misuse rates were generally lower among women veterans than men veterans. Substance misuse was associated with higher rates of trauma, psychiatric and medical conditions, and increased mortality and suicide rates. Most studies included only VA patients, and many used only VA medical record data; therefore, the reported substance misuse rates likely do not reflect true prevalence. Rates also varied by assessment method, source of data, and the subgroups studied. Further efforts to develop epidemiologically valid prevalence estimates are needed to capture the true health burden of substance misuse in women veterans, particularly those not using VA care. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Maternal Lifetime Stress and Prenatal Psychological Functioning and Decreased Placental Mitochondrial DNA Copy Number in the PRISM Study.

PubMed

Brunst, Kelly J; Sanchez Guerra, Marco; Gennings, Chris; Hacker, Michele; Jara, Calvin; Bosquet Enlow, Michelle; Wright, Robert O; Baccarelli, Andrea; Wright, Rosalind J

2017-12-01

Psychosocial stress contributes to placental oxidative stress. Mitochondria are vulnerable to oxidative stress, which can lead to changes in mitochondrial DNA copy number (mtDNAcn). We examined associations of maternal lifetime stress, current negative life events, and depressive and posttraumatic-stress-disorder symptom scores with placental mtDNAcn in a racially/ethnically diverse sample (n = 147) from the Programming of Intergenerational Stress Mechanisms (PRISM) study (Massachusetts, March 2011 to August 2012). In linear regression analyses adjusted for maternal age, race/ethnicity, education, prenatal fine particulate matter exposure, prenatal smoking exposure, and the sex of the child, all measures of stress were associated with decreased placental mtDNAcn (all P values < 0.05). Weighted-quantile-sum (WQS) regression showed that higher lifetime stress and depressive symptoms accounted for most of the effect on mtDNAcn (WQS weights: 0.25 and 0.39, respectively). However, among white individuals, increased lifetime stress and posttraumatic stress disorder symptoms explained the majority of the effect (WQS weights: 0.20 and 0.62, respectively) while among nonwhite individuals, lifetime stress and depressive symptoms accounted for most of the effect (WQS weights: 0.27 and 0.55, respectively). These analyses are first to link increased maternal psychosocial stress with reduced placental mtDNAcn and add to literature documenting racial/ethnic differences in the psychological sequelae of chronic stress that may contribute to maternal-fetal health. © The Author(s) 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.

Association Between High Ambient Temperature and Risk of Stillbirth in California.

PubMed

Basu, Rupa; Sarovar, Varada; Malig, Brian J

2016-05-15

Recent studies have linked elevated apparent temperatures with adverse birth outcomes, such as preterm delivery, but other birth outcomes have not been well studied. We examined 8,510 fetal deaths (≥20 weeks' gestation) to estimate their association with mean apparent temperature, a combination of temperature and humidity, during the warm season in California (May-October) from 1999 to 2009. Mothers whose residential zip codes were within 10 km of a meteorological monitor were included. Meteorological data were provided by the California Irrigation Management Information System, the US Environmental Protection Agency, and the National Climatic Data Center, while the California Department of Public Health provided stillbirth data. Using a time-stratified case-crossover study design, we found a 10.4% change (95% confidence interval: 4.4, 16.8) in risk of stillbirth for every 10°F (5.6°C) increase in apparent temperature (cumulative average of lags 2-6 days). Risk varied by maternal race/ethnicity and was greater for younger mothers, less educated mothers, and male fetuses. The highest risks were observed during gestational weeks 20-25 and 31-33. No associations were found during the cold season (November-April), and the observed associations were independent of air pollutants. This study adds to the growing body of literature identifying pregnant women and their fetuses as subgroups vulnerable to heat exposure. © The Author 2016. 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.

Natural History of Dependency in the Elderly: A 24-Year Population-Based Study Using a Longitudinal Item Response Theory Model.

PubMed

Edjolo, Arlette; Proust-Lima, Cécile; Delva, Fleur; Dartigues, Jean-François; Pérès, Karine

2016-02-15

We aimed to describe the hierarchical structure of Instrumental Activities of Daily Living (IADL) and basic Activities of Daily Living (ADL) and trajectories of dependency before death in an elderly population using item response theory methodology. Data were obtained from a population-based French cohort study, the Personnes Agées QUID (PAQUID) Study, of persons aged ≥65 years at baseline in 1988 who were recruited from 75 randomly selected areas in Gironde and Dordogne. We evaluated IADL and ADL data collected at home every 2-3 years over a 24-year period (1988-2012) for 3,238 deceased participants (43.9% men). We used a longitudinal item response theory model to investigate the item sequence of 11 IADL and ADL combined into a single scale and functional trajectories adjusted for education, sex, and age at death. The findings confirmed the earliest losses in IADL (shopping, transporting, finances) at the partial limitation level, and then an overlapping of concomitant IADL and ADL, with bathing and dressing being the earliest ADL losses, and finally total losses for toileting, continence, eating, and transferring. Functional trajectories were sex-specific, with a benefit of high education that persisted until death in men but was only transient in women. An in-depth understanding of this sequence provides an early warning of functional decline for better adaptation of medical and social care in the elderly. © The Author 2016. 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.

Associations Between Air Quality Changes and Biomarkers of Systemic Inflammation During the 2014 Nanjing Youth Olympics: A Quasi-Experimental Study.

PubMed

Li, Huichu; Zhou, Lian; Wang, Cuicui; Chen, Renjie; Ma, Xiaoying; Xu, Bin; Xiong, Lilin; Ding, Zhen; Chen, Xiaodong; Zhou, Yun; Xu, Yan; Kan, Haidong

2017-06-15

There is increasing interest in quasi-experimental research to evaluate whether actions taken to improve air quality will benefit public health. We conducted a quasi-experimental study to evaluate inflammatory response to changes in air quality during the 2014 Nanjing Youth Olympics in China. We repeatedly measured 8 biomarkers of systemic inflammation in 31 healthy adults and obtained hourly air pollutant concentrations from a nearby fixed-site monitoring station. We used linear mixed-effect models to examine the associations between air quality changes and blood biomarkers. Air pollutant concentrations decreased apparently during the Youth Olympics. Concomitantly, we observed significant decreases in levels of soluble cluster of differentiation 40 (CD40) ligand and interleukin 1β (geometric means ratios were 0.45 and 0.24, respectively) from the pre-Olympic period to the intra-Olympic period. Afterwards, levels of C-reactive protein and vascular cell adhesion molecule 1 increased significantly (geometric means ratios were 2.22 and 1.29, respectively) in the post-Olympic period. Fine particulate matter and ozone were significantly associated with soluble CD40 ligand, P-selectin, interleukin 1β, intercellular adhesion molecule 1, and vascular cell adhesion molecule 1. Other pollutants showed positive but nonsignificant associations. Our study indicated that reduced air pollution, especially fine particulate matter and ozone, during the 2014 Nanjing Youth Olympics was associated with alleviated systemic inflammation in healthy adults. © 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.

The association between traumatic brain injury and suicide: are kids at risk?

PubMed

Richard, Yvonne F; Swaine, Bonnie R; Sylvestre, Marie-Pierre; Lesage, Alain; Zhang, Xun; Feldman, Debbie Ehrmann

2015-07-15

Traumatic brain injury (TBI) in late adolescence and adulthood is associated with a higher risk of suicide; however, it is unknown whether this association is also present in people who sustained a TBI during childhood. The purpose of the present study was to determine whether experiencing a TBI during childhood is a risk factor for suicide later in life and to examine whether the risk of suicide differs by sex or injury severity. A cohort of 135,703 children aged 0-17 years was identified from the Quebec population-based physician reimbursement database in 1987, and follow-up was conducted until 2008. Of the children in this cohort, 21,047 had sustained a TBI. Using a survival analysis with time-dependent indicators of TBI, we found a higher risk of suicide for people who sustained a TBI during childhood (hazard ratio (HR) = 1.49, 95% confidence interval (CI): 1.04, 2.14), adolescence (HR = 1.57, 95% CI: 1.09, 2.26), and adulthood (HR = 2.53, 95% CI: 1.79, 3.59). When compared with less severe injuries, such as concussions and cranial fractures, more severe injuries, such as intracranial hemorrhages, were associated with a higher risk of suicide (HR = 2.18 vs. 2.77, respectively). Repeated injuries were associated with higher risks of suicide in all age groups. © 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.

Importance of Survey Design for Studying the Epidemiology of Emerging Tobacco Product Use Among Youth.

PubMed

Delnevo, Cristine D; Gundersen, Daniel A; Manderski, Michelle T B; Giovenco, Daniel P; Giovino, Gary A

2017-08-15

Accurate surveillance is critical for monitoring the epidemiology of emerging tobacco products in the United States, and survey science suggests that survey response format can impact prevalence estimates. We utilized data from the 2014 New Jersey Youth Tobacco Survey (n = 3,909) to compare estimates of the prevalence of 4 behaviors (ever hookah use, current hookah use, ever e-cigarette use, and current e-cigarette use) among New Jersey high school students, as assessed using "check-all-that-apply" questions, with estimates measured by means of "forced-choice" questions. Measurement discrepancies were apparent for all 4 outcomes, with the forced-choice questions yielding prevalence estimates approximately twice those of the check-all-that-apply questions, and agreement was fair to moderate. The sensitivity of the check-all-that-apply questions, treating the forced-choice format as the "gold standard," ranged from 38.1% (current hookah use) to 58.3% (ever e-cigarette use), indicating substantial false-negative rates. These findings highlight the impact of question response format on prevalence estimates of emerging tobacco products among youth and suggest that estimates generated by means of check-all-that-apply questions may be biased downward. Alternative survey designs should be considered to avoid check-all-that-apply response formats, and researchers should use caution when interpreting tobacco use data obtained from check-all-that-apply formats. © The Author(s) 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.

Spatial-temporal modeling of neighborhood sociodemographic characteristics and food stores.

PubMed

Lamichhane, Archana P; Warren, Joshua L; Peterson, Marc; Rummo, Pasquale; Gordon-Larsen, Penny

2015-01-15

The literature on food stores, neighborhood poverty, and race/ethnicity is mixed and lacks methods of accounting for complex spatial and temporal clustering of food resources. We used quarterly data on supermarket and convenience store locations from Nielsen TDLinx (Nielsen Holdings N.V., New York, New York) spanning 7 years (2006-2012) and census tract-based neighborhood sociodemographic data from the American Community Survey (2006-2010) to assess associations between neighborhood sociodemographic characteristics and food store distributions in the Metropolitan Statistical Areas (MSAs) of 4 US cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and San Francisco, California). We fitted a space-time Poisson regression model that accounted for the complex spatial-temporal correlation structure of store locations by introducing space-time random effects in an intrinsic conditionally autoregressive model within a Bayesian framework. After accounting for census tract-level area, population, their interaction, and spatial and temporal variability, census tract poverty was significantly and positively associated with increasing expected numbers of supermarkets among tracts in all 4 MSAs. A similar positive association was observed for convenience stores in Birmingham, Minneapolis, and San Francisco; in Chicago, a positive association was observed only for predominantly white and predominantly black tracts. Our findings suggest a positive association between greater numbers of food stores and higher neighborhood poverty, with implications for policy approaches related to food store access by neighborhood poverty. © The Author 2014. 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.

Does Choice of Influenza Vaccine Type Change Disease Burden and Cost-Effectiveness in the United States? An Agent-Based Modeling Study.

PubMed

DePasse, Jay V; Smith, Kenneth J; Raviotta, Jonathan M; Shim, Eunha; Nowalk, Mary Patricia; Zimmerman, Richard K; Brown, Shawn T

2017-05-01

Offering a choice of influenza vaccine type may increase vaccine coverage and reduce disease burden, but it is more costly. This study calculated the public health impact and cost-effectiveness of 4 strategies: no choice, pediatric choice, adult choice, or choice for both age groups. Using agent-based modeling, individuals were simulated as they interacted with others, and influenza was tracked as it spread through a population in Washington, DC. Influenza vaccination coverage derived from data from the Centers for Disease Control and Prevention was increased by 6.5% (range, 3.25%-11.25%), reflecting changes due to vaccine choice. With moderate influenza infectivity, the number of cases averaged 1,117,285 for no choice, 1,083,126 for pediatric choice, 1,009,026 for adult choice, and 975,818 for choice for both age groups. Averted cases increased with increased coverage and were highest for the choice-for-both-age-groups strategy; adult choice also reduced cases in children. In cost-effectiveness analysis, choice for both age groups was dominant when choice increased vaccine coverage by ≥3.25%. Offering a choice of influenza vaccines, with reasonable resultant increases in coverage, decreased influenza cases by >100,000 with a favorable cost-effectiveness profile. Clinical trials testing the predictions made based on these simulation results and deliberation of policies and procedures to facilitate choice should be considered. © 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.

The Relationship Between Objectively Measured Walking and Risk of Pedestrian-Motor Vehicle Collision.

PubMed

Quistberg, D Alex; Howard, Eric J; Hurvitz, Philip M; Moudon, Anne V; Ebel, Beth E; Rivara, Frederick P; Saelens, Brian E

2017-05-01

Safe urban walking environments may improve health by encouraging physical activity, but the relationship between an individual's location and walking pattern and the risk of pedestrian-motor vehicle collision is unknown. We examined associations between individuals' walking bouts and walking risk, measured as mean exposure to the risk of pedestrian-vehicle collision. Walking bouts were ascertained through integrated accelerometry and global positioning system data and from individual travel-diary data obtained from adults in the Travel Assessment and Community Study (King County, Washington) in 2008-2009. Walking patterns were superimposed onto maps of the historical probabilities of pedestrian-vehicle collisions for intersections and midblock segments within Seattle, Washington. Mean risk of pedestrian-vehicle collision in specific walking locations was assessed according to walking exposure (duration, distance, and intensity) and participant demographic characteristics in linear mixed models. Participants typically walked in areas with low pedestrian collision risk when walking for recreation, walking at a faster pace, or taking longer-duration walks. Mean daily walking duration and distance were not associated with collision risk. Males walked in areas with higher collision risk compared with females, while vehicle owners, residents of single-family homes, and parents of young children walked in areas with lower collision risk. These findings may suggest that pedestrians moderate collision risk by using lower-risk routes. © 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.

Invited Commentary: Induced Abortion and the Risk of Preeclampsia in a Subsequent Pregnancy.

PubMed

Basso, Olga

2015-10-15

Although it is well established that a having a pregnancy that ends in a birth protects against subsequent preeclampsia, it is unclear whether a pregnancy ending in miscarriage or induced abortion confers any protection. In this issue of the Journal, Parker et al. (Am J Epidemiol. 2015;182(8):663-669) examine whether, in nulliparous women, a history of induced abortion is associated with a lower risk of preeclampsia in a later pregnancy, focusing on the hypothesis that endometrial injury facilitates later implantation. The authors take advantage of data obtained by linking several Finnish population-based registries that include detailed data on induced abortions, although information on miscarriages was of lower quality. Parker et al. found a modest reduction in risk among women with a history of induced abortion. However, there was little evidence that risk differed between women who had medical abortions and those who had surgical abortions (the latter of which is presumably associated with a higher degree of injury). History of miscarriage was not associated with preeclampsia risk. Although the study by Parker et al. adds to the evidence that suggests that women with a history of induced abortion have a lower risk of preeclampsia, it is difficult to evaluate whether the observed association is due to having had a previous pregnancy (however short) versus none, to confounding, or to an actual effect of induced abortion. © 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.

Mapping epidemiology's past to inform its future: metaknowledge analysis of epidemiologic topics in leading journals, 1974-2013.

PubMed

Trinquart, Ludovic; Galea, Sandro

2015-07-15

An empiric perspective on what epidemiology has studied over time might inform discussions about future directions for the discipline. We aimed to identify the main areas of epidemiologic inquiry and determine how they evolved over time in 5 high-impact epidemiologic journals. We analyzed the titles and abstracts of 20,895 articles that were published between 1974 and 2013. In 5 time periods that reflected approximately equal numbers of articles, we identified the main topics by clustering terms based on co-occurrence. Infectious disease and cardiovascular disease epidemiology were the prevailing topics over the 5 periods. Cancer epidemiology was a major topic from 1974 to 2001 but disappeared thereafter. Nutritional epidemiology gained relative importance from 1974 to 2013. Environmental epidemiology appeared during 1996-2001 and continued to be important, whereas 2 clusters related to methodology and meta-analysis in genetics appeared during 2008-2013. Several areas of epidemiology, including injury or psychiatric epidemiology, did not make an appearance as major topics at any time. In an ancillary analysis of 6 high-impact general medicine journals, we found patterns of epidemiologic articles that were overall consistent with the findings in epidemiologic journals. This metaknowledge investigation allowed identification of the dominant topics in and conversely those that were absent from 5 major epidemiologic journals. We discuss implications for the field. © 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.

Bayesian Correction of Misclassification of Pertussis in Vaccine Effectiveness Studies: How Much Does Underreporting Matter?

PubMed

Goldstein, Neal D; Burstyn, Igor; Newbern, E Claire; Tabb, Loni P; Gutowski, Jennifer; Welles, Seth L

2016-06-01

Diagnosis of pertussis remains a challenge, and consequently research on the risk of disease might be biased because of misclassification. We quantified this misclassification and corrected for it in a case-control study of children in Philadelphia, Pennsylvania, who were 3 months to 6 years of age and diagnosed with pertussis between 2011 and 2013. Vaccine effectiveness (VE; calculated as (1 - odds ratio) × 100) was used to describe the average reduction in reported pertussis incidence resulting from persons being up to date on pertussis-antigen containing vaccines. Bayesian techniques were used to correct for purported nondifferential misclassification by reclassifying the cases per the 2014 Council of State and Territorial Epidemiologists pertussis case definition. Naïve VE was 50% (95% confidence interval: 16%, 69%). After correcting for misclassification, VE ranged from 57% (95% credible interval: 30, 73) to 82% (95% credible interval: 43, 95), depending on the amount of underreporting of pertussis that was assumed to have occurred in the study period. Meaningful misclassification was observed in terms of false negatives detected after the incorporation of infant apnea to the 2014 case definition. Although specificity was nearly perfect, sensitivity of the case definition varied from 90% to 20%, depending on the assumption about missed cases. Knowing the degree of the underreporting is essential to the accurate evaluation of VE. © The Author 2016. 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.

Maternal Fatty Acid Status During Pregnancy and Child Autistic Traits: The Generation R Study.

PubMed

Steenweg-de Graaff, Jolien; Tiemeier, Henning; Ghassabian, Akhgar; Rijlaarsdam, Jolien; Jaddoe, Vincent W V; Verhulst, Frank C; Roza, Sabine J

2016-05-01

ω-3 and ω-6 polyunsaturated fatty acids are important for brain function and development. We examined whether maternal polyunsaturated fatty acid status during pregnancy affects risk of autistic traits in childhood. Within the Generation R cohort, we measured maternal plasma polyunsaturated fatty acid concentrations and the ω-3:ω-6 ratio in midpregnancy (Rotterdam, the Netherlands, 2001-2005). Child autistic traits at 6 years were assessed by using the Social Responsiveness Scale short form in 4,624 children. A lower maternal ω-3:ω-6 ratio during pregnancy was associated with more autistic traits in the offspring (β = -0.008, 95% confidence interval: -0.016, -0.001). In particular, a higher total ω-6 and linoleic acid status were associated with more autistic traits (all P's < 0.05). Associations were independent of child intelligence, suggesting that the fatty acid distribution specifically affects the development of autistic traits in addition to general neurodevelopment. Maternal plasma ω-3 status was not associated with child autistic traits and, consistently, neither was prenatal dietary fish intake. Our study shows that a lower prenatal ω-3:ω-6 ratio is associated with more child autistic traits, which is largely accounted for by higher ω-6 instead of lower ω-3 status. These results suggest a biological pathway between maternal fatty acid intake during pregnancy and autistic traits in the offspring. © The Author 2016. 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.

Birth order and suicide in adulthood: evidence from Swedish population data.

PubMed

Rostila, Mikael; Saarela, Jan; Kawachi, Ichiro

2014-06-15

Each year, almost 1 million people die from suicide, which is among the leading causes of death in young people. We studied how birth order was associated with suicide and other main causes of death. A follow-up study based on the Swedish population register was conducted for sibling groups born from 1932 to 1980 who were observed during the period 1981-2002. Focus was on the within-family variation in suicide risk, meaning that we studied sibling groups that consisted of 2 or more children in which at least 1 died from suicide. These family-fixed effects analyses revealed that each increase in birth order was related to an 18% higher suicide risk (95% confidence interval (CI): 1.14, 1.23, P = 0.000). The association was slightly lower among sibling groups born in 1932-1955 (hazard ratio = 1.13, 95% CI: 1.06, 1.21, P = 0.000) than among those born in 1967-1980 (hazard ratio = 1.24, 95% CI: 0.97, 1.57, P = 0.080). Further analyses suggested that the association between birth order and suicide was only modestly influenced by sex, birth spacing, size of the sibling group, own socioeconomic position, own marital status, and socioeconomic rank within the sibling group. Causes of death other than suicide and other external causes were not associated with birth order. © The Author 2014. 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.

A Decade of War: Prospective Trajectories of Posttraumatic Stress Disorder Symptoms Among Deployed US Military Personnel and the Influence of Combat Exposure.

PubMed

Donoho, Carrie J; Bonanno, George A; Porter, Ben; Kearney, Lauren; Powell, Teresa M

2017-12-15

Posttraumatic stress disorder (PTSD) is a common psychiatric disorder among service members and veterans. The clinical course of PTSD varies between individuals, and patterns of symptom development have yet to be clearly delineated. Previous studies have been limited by convenience sampling, short follow-up periods, and the inability to account for combat-related trauma. To determine the trajectories of PTSD symptoms among deployed military personnel with and without combat exposure, we used data from a population-based representative sample of 8,178 US service members who participated in the Millennium Cohort Study from 2001 to 2011. Using latent growth mixture modeling, trajectories of PTSD symptoms were determined in the total sample, as well as in individuals with and without combat exposure, respectively. Overall, 4 trajectories of PTSD were characterized: resilient, pre-existing, new-onset, and moderate stable. Across all trajectories, combat-deployed service members diverged from non-combat-deployed service members, even after a single deployment. The former also generally had higher PTSD symptoms. Based on the models, nearly 90% of those without combat exposure remained resilient over the 10-year period, compared with 80% of those with combat exposure. Findings demonstrate that although the clinical course of PTSD symptoms shows heterogeneous patterns of development, combat exposure is uniformly associated with poor mental health. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Assessment of the Status of Measles Elimination in the United States, 2001-2014.

PubMed

Gastañaduy, Paul A; Paul, Prabasaj; Fiebelkorn, Amy Parker; Redd, Susan B; Lopman, Ben A; Gambhir, Manoj; Wallace, Gregory S

2017-04-01

We assessed the status of measles elimination in the United States using outbreak notification data. Measles transmissibility was assessed by estimation of the reproduction number, R, the average number of secondary cases per infection, using 4 methods; elimination requires maintaining R at <1. Method 1 estimates R as 1 minus the proportion of cases that are imported. Methods 2 and 3 estimate R by fitting a model of the spread of infection to data on the sizes and generations of chains of transmission, respectively. Method 4 assesses transmissibility before public health interventions, by estimating R for the case with the earliest symptom onset in each cluster (Rindex). During 2001-2014, R and Rindex estimates obtained using methods 1-4 were 0.72 (95% confidence interval (CI): 0.68, 0.76), 0.66 (95% CI: 0.62, 0.70), 0.45 (95% CI: 0.40, 0.49), and 0.63 (95% CI: 0.57, 0.69), respectively. Year-to-year variability in the values of R and Rindex and an increase in transmissibility in recent years were noted with all methods. Elimination of endemic measles transmission is maintained in the United States. A suggested increase in measles transmissibility since elimination warrants continued monitoring and emphasizes the importance of high measles vaccination coverage throughout the population. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Risk Factors Associated With Suicide Completions Among US Enlisted Marines.

PubMed

Phillips, Christopher J; LeardMann, Cynthia A; Vyas, Kartavya J; Crum-Cianflone, Nancy F; White, Martin R

2017-09-15

US enlisted Marines have experienced a substantial increase in suicide rates. We sought to identify risk factors for suicide completions among male Marines who entered basic training in San Diego, California, between June 2001 and October 2010. Suicides that occurred during active-duty military service were counted from June 1, 2001, through June 30, 2012. A total of 108,930 male Marines (66,286 deployers and 42,644 never deployed) were followed for 467,857 person-years of active-duty service time. Of the 790 deaths, 123 (15.6%) were suicides. In the final multivariate hazard model, preservice characteristics of not being a high-school graduate (hazard ratio (HR) = 2.17, 95% confidence interval (CI): 1.28, 3.68) and being a smoker at the time of enlistment (HR = 1.91, 95% CI: 1.32, 2.76) were significantly associated with a higher risk for suicide completion. Diagnosed with traumatic brain injury (HR = 4.09, 95% CI: 2.08, 8.05), diagnosed with depression (HR = 2.36, 95% CI: 1.22, 4.58), and received relationship counseling (HR = 3.71, 95% CI: 1.44, 9.54) during military service were significant risks for suicide death. Deployment alone was not significantly associated with a risk for suicide death (HR = 0.53, 95% CI: 0.26, 1.05). Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Vaccination and all-cause child mortality from 1985 to 2011: global evidence from the Demographic and Health Surveys.

PubMed

McGovern, Mark E; Canning, David

2015-11-01

Based on models with calibrated parameters for infection, case fatality rates, and vaccine efficacy, basic childhood vaccinations have been estimated to be highly cost effective. We estimated the association of vaccination with mortality directly from survey data. Using 149 cross-sectional Demographic and Health Surveys, we determined the relationship between vaccination coverage and the probability of dying between birth and 5 years of age at the survey cluster level. Our data included approximately 1 million children in 68,490 clusters from 62 countries. We considered the childhood measles, bacillus Calmette-Guérin, diphtheria-pertussis-tetanus, polio, and maternal tetanus vaccinations. Using modified Poisson regression to estimate the relative risk of child mortality in each cluster, we also adjusted for selection bias that resulted from the vaccination status of dead children not being reported. Childhood vaccination, and in particular measles and tetanus vaccination, is associated with substantial reductions in childhood mortality. We estimated that children in clusters with complete vaccination coverage have a relative risk of mortality that is 0.73 (95% confidence interval: 0.68, 0.77) times that of children in a cluster with no vaccinations. Although widely used, basic vaccines still have coverage rates well below 100% in many countries, and our results emphasize the effectiveness of increasing coverage rates in order to reduce child mortality. © 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.

Associations of Neighborhood Crime and Safety and With Changes in Body Mass Index and Waist Circumference: The Multi-Ethnic Study of Atherosclerosis.

PubMed

Powell-Wiley, Tiffany M; Moore, Kari; Allen, Norrina; Block, Richard; Evenson, Kelly R; Mujahid, Mahasin; Diez Roux, Ana V

2017-08-01

Using data from the Multi-Ethnic Study of Atherosclerosis (MESA), we evaluated associations of neighborhood crime and safety with changes in adiposity (body mass index (BMI) and waist circumference). MESA is a longitudinal study of cardiovascular disease among adults aged 45-84 years at baseline in 2000-2002, from 6 US sites, with follow-up for MESA participants until 2012. Data for this study were limited to Chicago, Illinois, participants in the MESA Neighborhood Ancillary Study, for whom police-recorded crime data were available, and who had complete baseline data (n = 673). We estimated associations of individual-level safety, aggregated neighborhood-level safety, and police-recorded crime with baseline levels and trajectories of BMI and waist circumference over time using linear mixed modeling with random effects. We also estimated how changes in these factors related to changes in BMI and waist circumference using econometric fixed-effects models. At baseline, greater individual-level safety was associated with more adiposity. Increasing individual- and neighborhood-level safety over time were associated with decreasing BMI over the 10-year period, with a more pronounced effect observed in women for individual-level safety and men for neighborhood-level safety. Police-recorded crime was not associated with adiposity. Neighborhood-level safety likely influences adiposity change and subsequent cardiovascular risk in multiethnic populations. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Diet-Induced Overweight and Obesity and Periodontitis Risk: An Application of the Parametric G-Formula in the 1982 Pelotas Birth Cohort.

PubMed

Nascimento, Gustavo G; Peres, Marco A; Mittinty, Murthy N; Peres, Karen G; Do, Loc G; Horta, Bernardo L; Gigante, Denise P; Corrêa, Marcos B; Demarco, Flávio F

2017-03-15

We aimed to estimate hypothetical effects of habits (smoking, alcohol consumption, and fat and carbohydrates consumption) combined with diet-induced overweight/obesity on the risk of periodontitis. The risk of any periodontitis, moderate/severe periodontitis, and the combination of bleeding on probing (BOP) and clinical attachment loss (CAL) was estimated using the parametric g-formula in adults aged 31 years from the 1982 Pelotas Birth Cohort in Brazil. Individuals in this cohort have been followed since birth. Hypothetical conditions were set independently for each risk factor and in combination for the entire population. A total of 539 participants had oral examinations in 2013. The cumulative 31-year risk under no intervention was 33.3% for any periodontitis, 14.3%, for moderate/severe periodontitis, and 14.7%, for BOP and CAL. According to our statistical approach, diet-induced overweight/obesity increased the risk of all outcomes: 11% (overweight) and 22% (obesity) higher risk of periodontitis; 12% (overweight) and 27% (obesity) higher risk of moderate/severe periodontitis; 21% (overweight) and 57% (obesity) higher risk of CAL and BOP. When overweight/obesity was combined with other unhealthy habits, the risk was even greater. Our findings suggest that the combination of diet-induced obesity with other risk factors may increase the risk of periodontitis. Further research in the field is required to corroborate our study. © 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.

Healthy Lifestyle During Early Pregnancy and Risk of Gestational Diabetes Mellitus.

PubMed

Badon, Sylvia E; Enquobahrie, Daniel A; Wartko, Paige D; Miller, Raymond S; Qiu, Chunfang; Gelaye, Bizu; Sorensen, Tanya K; Williams, Michelle A

2017-08-01

Previous studies have found associations between individual healthy behaviors and reduced risk of gestational diabetes mellitus (GDM); however, the association of composite healthy lifestyle during pregnancy with GDM has not been examined. Participants in the Omega Study (n = 3,005), a pregnancy cohort study conducted in Washington State (1996-2008), reported information on diet, physical activity, smoking, and stress during early pregnancy. Lifestyle components were dichotomized into healthy/unhealthy and then combined into a total lifestyle score (range, 0-4). Regression models were used to determine relative risk of GDM (n = 140 cases) in relation to healthy lifestyle. Twenty percent of participants had a healthy diet, 66% were physically active, 95% were nonsmokers, and 55% had low stress. Each 1-point increase in lifestyle score was associated with a 21% lower risk of GDM (95% confidence interval: 0.65, 0.96) after adjustment for age, race, and nulliparity. Adjustment for prepregnancy body mass index, prepregnancy physical activity, and prepregnancy smoking attenuated the associations slightly. Associations were similar in normal-weight and overweight/obese women. In this study, a composite measure of healthy lifestyle during early pregnancy was associated with substantially lower GDM risk. Public health messaging and interventions promoting multiple aspects of a healthy lifestyle during early pregnancy should be considered for GDM prevention. © The Author(s) 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.

Acquired Color Vision Defects and Hexane Exposure: A Study of San Francisco Bay Area Automotive Mechanics.

PubMed

Beckman, Stella; Eisen, Ellen A; Bates, Michael N; Liu, Sa; Haegerstrom-Portnoy, Gunilla; Hammond, S Katharine

2016-06-01

Occupational exposure to solvents, including n-hexane, has been associated with acquired color vision defects. Blue-yellow defects are most common and may be due to neurotoxicity or retinal damage. Acetone may potentiate the neurotoxicity of n-hexane. We present results on nonhexane solvent and hexane exposure and color vision from a cross-sectional study of 835 automotive repair workers in the San Francisco Bay Area, California (2007-2013). Cumulative exposure was estimated from self-reported work history, and color vision was assessed using the Lanthony desaturated D-15 panel test. Log-binomial regression was used to estimate prevalence ratios for color vision defects. Acquired color vision defects were present in 29% of participants, of which 70% were blue-yellow. Elevated prevalence ratios were found for nonhexane solvent exposure, with a maximum of 1.31 (95% confidence interval (CI): 0.86, 2.00) for blue-yellow. Among participants aged ≤50 years, the prevalence ratio for blue-yellow defects was 2.17 (95% CI: 1.03, 4.56) in the highest quartile of nonhexane solvent exposure and 1.62 (95% CI: 0.97, 2.72) in the highest category of exposure to hexane with acetone coexposure. Cumulative exposures to hexane and nonhexane solvents in the highest exposure categories were associated with elevated prevalence ratios for color vision defects in younger participants. © The Author 2016. 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.

The Development of Extremely Preterm Infants Born to Women Who Had Genitourinary Infections During Pregnancy.

PubMed

Leviton, Alan; Allred, Elizabeth N; Kuban, Karl C K; O'Shea, T Michael; Paneth, Nigel; Onderdonk, Andrew B; Fichorova, Raina N; Dammann, Olaf

2016-01-01

Gestational genitourinary infections, which have been associated with neurodevelopmental impairments among infants born near term, have not been studied among very preterm infants. The mothers of 989 infants born before 28 weeks of gestation were interviewed about urine, bladder, or kidney infections (UTIs) and cervical or vaginal infections (CVIs) during pregnancy, as well as other exposures and characteristics, and their charts were reviewed for the Extremely Low Gestational Age Newborns (ELGAN) Study (2002-2004). At 2 years of age, these infants underwent a neurodevelopmental assessment. Generalized estimating equation logistic regression models of developmental adversities were used to adjust for potential confounders. Infants born to women who reported a UTI were less likely than were others to have a very low Mental Development Index (adjusted odds ratio = 0.5; 95% confidence interval: 0.3, 0.8), whereas infants born to women who reported a CVI were more likely than others to have a low Psychomotor Development Index (adjusted odds ratio = 1.7; 95% confidence interval: 1.04, 2.7). In this high-risk sample, maternal gestational CVI, but not UTI, was associated with a higher risk of impaired motor development at 2 years of age. The apparent protective effect of UTI might be spurious, reflect confounding due to untreated asymptomatic bacteriuria among women who were not given a diagnosis of UTI, or reflect preconditioning. © 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.

Evaluation of the 24-Hour Recall as a Reference Instrument for Calibrating Other Self-Report Instruments in Nutritional Cohort Studies: Evidence From the Validation Studies Pooling Project.

PubMed

Freedman, Laurence S; Commins, John M; Willett, Walter; Tinker, Lesley F; Spiegelman, Donna; Rhodes, Donna; Potischman, Nancy; Neuhouser, Marian L; Moshfegh, Alanna J; Kipnis, Victor; Baer, David J; Arab, Lenore; Prentice, Ross L; Subar, Amy F

2017-07-01

Calibrating dietary self-report instruments is recommended as a way to adjust for measurement error when estimating diet-disease associations. Because biomarkers available for calibration are limited, most investigators use self-reports (e.g., 24-hour recalls (24HRs)) as the reference instrument. We evaluated the performance of 24HRs as reference instruments for calibrating food frequency questionnaires (FFQs), using data from the Validation Studies Pooling Project, comprising 5 large validation studies using recovery biomarkers. Using 24HRs as reference instruments, we estimated attenuation factors, correlations with truth, and calibration equations for FFQ-reported intakes of energy and for protein, potassium, and sodium and their densities, and we compared them with values derived using biomarkers. Based on 24HRs, FFQ attenuation factors were substantially overestimated for energy and sodium intakes, less for protein and potassium, and minimally for nutrient densities. FFQ correlations with truth, based on 24HRs, were substantially overestimated for all dietary components. Calibration equations did not capture dependencies on body mass index. We also compared predicted bias in estimated relative risks adjusted using 24HRs as reference instruments with bias when making no adjustment. In disease models with energy and 1 or more nutrient intakes, predicted bias in estimated nutrient relative risks was reduced on average, but bias in the energy risk coefficient was unchanged. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Trauma, comorbidity, and mortality following diagnoses of severe stress and adjustment disorders: a nationwide cohort study.

PubMed

Gradus, Jaimie L; Antonsen, Sussie; Svensson, Elisabeth; Lash, Timothy L; Resick, Patricia A; Hansen, Jens Georg

2015-09-01

Longitudinal outcomes following stress or trauma diagnoses are receiving attention, yet population-based studies are few. The aims of the present cohort study were to examine the cumulative incidence of traumatic events and psychiatric diagnoses following diagnoses of severe stress and adjustment disorders categorized using International Classification of Diseases, Tenth Revision, codes and to examine associations of these diagnoses with all-cause mortality and suicide. Data came from a longitudinal cohort of all Danes who received a diagnosis of reaction to severe stress or adjustment disorders (International Classification of Diseases, Tenth Revision, code F43.x) between 1995 and 2011, and they were compared with data from a general-population cohort. Cumulative incidence curves were plotted to examine traumatic experiences and psychiatric diagnoses during the study period. A Cox proportional hazards regression model was used to examine the associations of the disorders with mortality and suicide. Participants with stress diagnoses had a higher incidence of traumatic events and psychiatric diagnoses than did the comparison group. Each disorder was associated with a higher rate of all-cause mortality than that seen in the comparison cohort, and strong associations with suicide were found after adjustment. This study provides a comprehensive assessment of the associations of stress disorders with a variety of outcomes, and we found that stress diagnoses may have long-lasting and potentially severe consequences. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

The Influence of Meteorological Factors and Atmospheric Pollutants on the Risk of Preterm Birth.

PubMed

Giorgis-Allemand, Lise; Pedersen, Marie; Bernard, Claire; Aguilera, Inmaculada; Beelen, Rob M J; Chatzi, Leda; Cirach, Marta; Danileviciute, Asta; Dedele, Audrius; van Eijsden, Manon; Estarlich, Marisa; Fernández-Somoano, Ana; Fernández, Mariana F; Forastiere, Francesco; Gehring, Ulrike; Grazuleviciene, Regina; Gruzieva, Olena; Heude, Barbara; Hoek, Gerard; de Hoogh, Kees; van den Hooven, Edith H; Håberg, Siri E; Iñiguez, Carmen; Jaddoe, Vincent W V; Korek, Michal; Lertxundi, Aitana; Lepeule, Johanna; Nafstad, Per; Nystad, Wenche; Patelarou, Evridiki; Porta, Daniela; Postma, Dirkje; Raaschou-Nielsen, Ole; Rudnai, Peter; Siroux, Valérie; Sunyer, Jordi; Stephanou, Euripides; Sørensen, Mette; Eriksen, Kirsten Thorup; Tuffnell, Derek; Varró, Mihály J; Vrijkotte, Tanja G M; Wijga, Alet; Wright, John; Nieuwenhuijsen, Mark J; Pershagen, Göran; Brunekreef, Bert; Kogevinas, Manolis; Slama, Rémy

2017-02-15

Atmospheric pollutants and meteorological conditions are suspected to be causes of preterm birth. We aimed to characterize their possible association with the risk of preterm birth (defined as birth occurring before 37 completed gestational weeks). We pooled individual data from 13 birth cohorts in 11 European countries (71,493 births from the period 1994-2011, European Study of Cohorts for Air Pollution Effects (ESCAPE)). City-specific meteorological data from routine monitors were averaged over time windows spanning from 1 week to the whole pregnancy. Atmospheric pollution measurements (nitrogen oxides and particulate matter) were combined with data from permanent monitors and land-use data into seasonally adjusted land-use regression models. Preterm birth risks associated with air pollution and meteorological factors were estimated using adjusted discrete-time Cox models. The frequency of preterm birth was 5.0%. Preterm birth risk tended to increase with first-trimester average atmospheric pressure (odds ratio per 5-mbar increase = 1.06, 95% confidence interval: 1.01, 1.11), which could not be distinguished from altitude. There was also some evidence of an increase in preterm birth risk with first-trimester average temperature in the -5°C to 15°C range, with a plateau afterwards (spline coding, P = 0.08). No evidence of adverse association with atmospheric pollutants was observed. Our study lends support for an increase in preterm birth risk with atmospheric pressure. © 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.

Are Early-Life Socioeconomic Conditions Directly Related to Birth Outcomes? Grandmaternal Education, Grandchild Birth Weight, and Associated Bias Analyses.

PubMed

Huang, Jonathan Y; Gavin, Amelia R; Richardson, Thomas S; Rowhani-Rahbar, Ali; Siscovick, David S; Enquobahrie, Daniel A

2015-10-01

Grandmaternal education may be related to grandchild birth weight (GBW) through maternal early-life development; however, conventional regression models may be endogenously confounded. Alternative models employing explicit structural assumptions may provide incrementally clearer evidence. We used data from the US National Longitudinal Study of Adolescent to Adult Health (1995-2009; 1,681 mother-child pairs) to estimate "direct effects" of grandmaternal educational level (less than high school, high school diploma or equivalent, or college degree) at the time of the mother's birth on GBW, adjusted for maternal life-course factors: maltreatment as a child, education and income as an adult, prepregnancy overweight, and prenatal smoking. Using conventional and marginal structural model (MSM) approaches, we estimated 54-g (95% confidence interval: -14.0, 122.1) and 87-g (95% confidence interval: 10.9, 162.5) higher GBWs per increase in educational level, respectively. The MSM allowed simultaneous mediation by and adjustment for prepregnancy overweight. Estimates were insensitive to alternate structural assumptions and mediator parameterizations. Bias analysis suggested that a single unmeasured confounder would have to have a strong influence on GBW (approximately 150 g) or be greatly imbalanced across exposure groups (approximately 25%) to completely explain the findings. Coupling an MSM with sensitivity analyses provides some evidence that maternal early-life socioeconomic environment is directly associated with offspring birth weight. © 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.

A disadvantaged advantage in walkability: findings from socioeconomic and geographical analysis of national built environment data in the United States.

PubMed

King, Katherine E; Clarke, Philippa J

2015-01-01

Urban form-the structure of the built environment-can influence physical activity, yet little is known about how walkable design differs according to neighborhood sociodemographic composition. We studied how walkable urban form varies by neighborhood sociodemographic composition, region, and urbanicity across the United States. Using linear regression models and 2000-2001 US Census data, we investigated the relationship between 5 neighborhood census characteristics (income, education, racial/ethnic composition, age distribution, and sex) and 5 walkability indicators in almost 65,000 census tracts in 48 states and the District of Columbia. Data on the built environment were obtained from the RAND Corporation's (Santa Monica, California) Center for Population Health and Health Disparities (median block length, street segment, and node density) and the US Geological Survey's National Land Cover Database (proportion open space and proportion highly developed). Disadvantaged neighborhoods and those with more educated residents were more walkable (i.e., shorter block length, greater street node density, more developed land use, and higher density of street segments). However, tracts with a higher proportion of children and older adults were less walkable (fewer street nodes and lower density of street segments), after adjustment for region and level of urbanicity. Research and policy on the walkability-health link should give nuanced attention to the gap between persons living in walkable areas and those for whom walkability has the most to offer. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

A longitudinal analysis of the influence of the neighborhood built environment on walking for transportation: the RESIDE study.

PubMed

Knuiman, Matthew W; Christian, Hayley E; Divitini, Mark L; Foster, Sarah A; Bull, Fiona C; Badland, Hannah M; Giles-Corti, Billie

2014-09-01

The purpose of the present analysis was to use longitudinal data collected over 7 years (from 4 surveys) in the Residential Environments (RESIDE) Study (Perth, Australia, 2003-2012) to more carefully examine the relationship of neighborhood walkability and destination accessibility with walking for transportation that has been seen in many cross-sectional studies. We compared effect estimates from 3 types of logistic regression models: 2 that utilize all available data (a population marginal model and a subject-level mixed model) and a third subject-level conditional model that exclusively uses within-person longitudinal evidence. The results support the evidence that neighborhood walkability (especially land-use mix and street connectivity), local access to public transit stops, and variety in the types of local destinations are important determinants of walking for transportation. The similarity of subject-level effect estimates from logistic mixed models and those from conditional logistic models indicates that there is little or no bias from uncontrolled time-constant residential preference (self-selection) factors; however, confounding by uncontrolled time-varying factors, such as health status, remains a possibility. These findings provide policy makers and urban planners with further evidence that certain features of the built environment may be important in the design of neighborhoods to increase walking for transportation and meet the health needs of residents. © The Author 2014. 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.

Poor, Unsafe, and Overweight: The Role of Feeling Unsafe at School in Mediating the Association Among Poverty Exposure, Youth Screen Time, Physical Activity, and Weight Status.

PubMed

Côté-Lussier, Carolyn; Fitzpatrick, Caroline; Séguin, Louise; Barnett, Tracie A

2015-07-01

This study applied socioecological and cumulative risk exposure frameworks to test the hypotheses that 1) the experience of poverty is associated with feeling less safe at school, and 2) feeling less safe is associated with engaging in poorer weight-related behaviors, as well as an increased probability of being overweight or obese. Data were from the ongoing Québec Longitudinal Study of Child Development, initiated in 1998 with a population-based cohort of 2,120 Québec (Canada) infants 5 months of age and their parent or primary caregiver. Measures of youths' (age, 13 years) self-reported feelings of safety, screen time, physical activity, and objectively assessed not overweight/obese (70%), overweight (22%), and obese (8%) weight status were collected in 2011. Family poverty trajectory from birth was assessed by using latent growth modeling. As hypothesized, exposure to poverty was associated with feeling less safe at school and, in turn, with an increased probability of being overweight or obese. The association was most pronounced for youths who experienced chronic poverty. Compared with youths who experienced no poverty and felt unsafe, those who experienced chronic poverty and felt unsafe were nearly 18% more likely to be obese (9.2% vs. 11.2%). Although feeling unsafe was associated with screen time, screen time did not predict weight status. © 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.

Experience of Sibling Death in Childhood and Risk of Death in Adulthood: A National Cohort Study From Sweden.

PubMed

Rostila, Mikael; Berg, Lisa; Saarela, Jan; Kawachi, Ichiro; Hjern, Anders

2017-06-15

Although there is some evidence of an association between loss of a sibling in adulthood and subsequent mortality, there have been no previous studies in which investigators have examined whether the death of a sibling in childhood is associated with adult mortality using total population data. Data on a national cohort born in Sweden in 1973-1982 (n = 717,723) were prospectively collected from the Cause of Death Register until 2013 (i.e., from the ages of 18 years to 31-40 years). Cox proportional hazards models were used to analyze the association between sibling loss during childhood and death in young adulthood. After adjustment for sociodemographic confounders and parental psychosocial covariates, the hazard ratio for all-cause mortality in bereaved siblings versus nonbereaved siblings was 1.39 (95% confidence interval: 1.14, 1.69). Risks were more pronounced for those who lost a noninfant sibling (i.e., >1 year of age) (hazard ratio = 1.53, 95% confidence interval: 1.18, 1.95) and those who lost a sibling in adolescence (i.e., between the ages of 12 and 18 years) (hazard ratio = 1.71, 95% confidence interval: 1.24, 2.35). Excess mortality risk was found for concordant causes of death (i.e., siblings dying from the same causes) but not for discordant causes. © 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.

Accounting for Life-Course Exposures in Epigenetic Biomarker Association Studies: Early Life Socioeconomic Position, Candidate Gene DNA Methylation, and Adult Cardiometabolic Risk.

PubMed

Huang, Jonathan Y; Gavin, Amelia R; Richardson, Thomas S; Rowhani-Rahbar, Ali; Siscovick, David S; Hochner, Hagit; Friedlander, Yechiel; Enquobahrie, Daniel A

2016-10-01

Recent studies suggest that epigenetic programming may mediate the relationship between early life environment, including parental socioeconomic position, and adult cardiometabolic health. However, interpreting associations between early environment and adult DNA methylation may be difficult because of time-dependent confounding by life-course exposures. Among 613 adult women (mean age = 32 years) of the Jerusalem Perinatal Study Family Follow-up (2007-2009), we investigated associations between early life socioeconomic position (paternal occupation and parental education) and mean adult DNA methylation at 5 frequently studied cardiometabolic and stress-response genes (ABCA1, INS-IGF2, LEP, HSD11B2, and NR3C1). We used multivariable linear regression and marginal structural models to estimate associations under 2 causal structures for life-course exposures and timing of methylation measurement. We also examined whether methylation was associated with adult cardiometabolic phenotype. Higher maternal education was consistently associated with higher HSD11B2 methylation (e.g., 0.5%-point higher in 9-12 years vs. ≤8 years, 95% confidence interval: 0.1, 0.8). Higher HSD11B2 methylation was also associated with lower adult weight and total and low-density lipoprotein cholesterol. We found that associations with early life socioeconomic position measures were insensitive to different causal assumption; however, exploratory analysis did not find evidence for a mediating role of methylation in socioeconomic position-cardiometabolic risk associations. © The Author 2016. 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.

Correcting for Measurement Error in Time-Varying Covariates in Marginal Structural Models.

PubMed

Kyle, Ryan P; Moodie, Erica E M; Klein, Marina B; Abrahamowicz, Michał

2016-08-01

Unbiased estimation of causal parameters from marginal structural models (MSMs) requires a fundamental assumption of no unmeasured confounding. Unfortunately, the time-varying covariates used to obtain inverse probability weights are often error-prone. Although substantial measurement error in important confounders is known to undermine control of confounders in conventional unweighted regression models, this issue has received comparatively limited attention in the MSM literature. Here we propose a novel application of the simulation-extrapolation (SIMEX) procedure to address measurement error in time-varying covariates, and we compare 2 approaches. The direct approach to SIMEX-based correction targets outcome model parameters, while the indirect approach corrects the weights estimated using the exposure model. We assess the performance of the proposed methods in simulations under different clinically plausible assumptions. The simulations demonstrate that measurement errors in time-dependent covariates may induce substantial bias in MSM estimators of causal effects of time-varying exposures, and that both proposed SIMEX approaches yield practically unbiased estimates in scenarios featuring low-to-moderate degrees of error. We illustrate the proposed approach in a simple analysis of the relationship between sustained virological response and liver fibrosis progression among persons infected with hepatitis C virus, while accounting for measurement error in γ-glutamyltransferase, using data collected in the Canadian Co-infection Cohort Study from 2003 to 2014. © The Author 2016. 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.

Dietary fiber intake and total mortality: a meta-analysis of prospective cohort studies.

PubMed

Kim, Youngyo; Je, Youjin

2014-09-15

Greater intake of dietary fiber has been associated with lower risk of several chronic diseases. Some observational studies have examined the association between dietary fiber intake and total mortality, but the results were inconclusive. We conducted a meta-analysis of data from prospective cohort studies to quantitatively assess the association. Eligible studies were identified by searching the PubMed and Embase databases for all articles published through November 30, 2013, and by reviewing the reference lists of retrieved articles. Study-specific estimates adjusting for potential confounders were combined to calculate a pooled relative risk and 95% confidence interval using a random-effects model. Seven prospective cohort studies of dietary fiber intake and total mortality, including 62,314 deaths among 908,135 participants, were identified. The pooled adjusted relative risk of total mortality for the highest category of dietary fiber intake versus the lowest was 0.77 (95% confidence interval: 0.74, 0.80). In a dose-response meta-analysis, the pooled adjusted relative risk for a 10-g/day increment of dietary fiber intake was 0.89 (95% confidence interval: 0.85, 0 92). By source of fiber, cereal and, to a lesser extent, vegetable fiber were significantly associated with lower total mortality, while fruit fiber showed no association. In conclusion, high dietary fiber intake may reduce the risk of total mortality. © The Author 2014. 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.

Hearing impairment and tinnitus: prevalence, risk factors, and outcomes in US service members and veterans deployed to the Iraq and Afghanistan wars.

PubMed

Theodoroff, Sarah M; Lewis, M Samantha; Folmer, Robert L; Henry, James A; Carlson, Kathleen F

2015-01-01

Hearing loss and tinnitus are the 2 most prevalent service-connected disabilities among veterans in the United States. Veterans of Operations Enduring Freedom, Iraqi Freedom, and New Dawn have been exposed to multiple hazards associated with these conditions, such as blasts/explosions, ototoxic chemicals, and most notably high levels of noise. We conducted a systematic literature review of evidence on 1) prevalence of, 2) risk and protective factors for, and 3) functional and quality-of-life outcomes of hearing impairment and tinnitus in US Operations Enduring Freedom, Iraqi Freedom, and New Dawn veterans and military personnel. We identified studies published from 2001 through 2013 using PubMed, PsycINFO, REHABDATA, Cochrane Library, pearling, and expert recommendation. Peer-reviewed English language articles describing studies of 30 or more adults were included if they informed one or more key questions. A total of 839 titles/abstracts were reviewed for relevance by investigators trained in critical analysis of literature; 14 studies met inclusion criteria. Of these, 13 studies presented data on prevalence and 4 on risk/protective factors, respectively. There were no included studies reporting on outcomes. Findings from this systematic review will help inform clinicians, researchers, and policy makers on future resource and research needs pertaining to hearing impairment and tinnitus in this newest generation of veterans. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Milk, Fruit and Vegetable, and Total Antioxidant Intakes in Relation to Mortality Rates: Cohort Studies in Women and Men.

PubMed

Michaëlsson, Karl; Wolk, Alicja; Melhus, Håkan; Byberg, Liisa

2017-03-01

High milk consumption might shorten life span through increased oxidative stress. We aimed to determine whether higher mortality rates with high milk consumption are modified by fruit and vegetable intake or total antioxidant intake (oxygen radical absorbance capacity). We used information from food frequency questionnaires completed by 61,420 women in a Swedish cohort (22,391 deaths from the 1987-1990 baseline onward), 36,714 women from a second survey (1997) of this cohort, and 45,280 Swedish men (15,478 deaths from the 1998 baseline onward). Compared with low consumption of milk (<1 glass/day) and high consumption of fruits/vegetables (≥5 servings/day), time-updated information revealed an adjusted hazard ratio for death of 2.79 (95% confidence interval (CI): 2.42, 3.21) in women who consumed ≥3 glasses of milk/day and <1 serving/day of fruit/vegetables and a hazard ratio of 1.60 (95% CI: 1.40, 1.82) in women who consumed the same amount of milk but ≥5 servings/day of fruits/vegetables. The same comparisons in men, based on a single food frequency questionnaire, displayed hazard ratios of 1.31 (95% CI: 1.14, 1.51) and 1.07 (95% CI: 0.97, 1.18), respectively. Total antioxidant consumption showed similar patterns as fruit/vegetable intakes. Dietary antioxidant intake, especially in women, seems to modify the elevated death rate associated with high milk consumption. © The Author 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Employment and disability pension after central nervous system infections in adults.

PubMed

Roed, Casper; Sørensen, Henrik Toft; Rothman, Kenneth J; Skinhøj, Peter; Obel, Niels

2015-05-15

In this nationwide population-based cohort study using national Danish registries, in the period 1980-2008, our aim was to study employment and receipt of disability pension after central nervous system infections. All patients diagnosed between 20 and 55 years of age with meningococcal (n = 451), pneumococcal (n = 553), or viral (n = 1,433) meningitis or with herpes simplex encephalitis (n = 115), who were alive 1 year after diagnosis, were identified. Comparison cohorts were drawn from the general population, and their members were individually matched on age and sex to patients. Five years after diagnosis, the differences in probability of being employed as a former patient with pneumococcal meningitis or herpes simplex encephalitis versus being a member of the comparison cohorts were -19.9% (95% confidence interval (CI): -24.7, -15.1) and -21.1% (95% CI: -33.0, -9.3), respectively, and the corresponding differences in probability of receiving disability pension were 20.2% (95% CI: 13.7, 26.7) and 16.2% (95% CI: 6.2, 26.3). The differences in probability of being employed or receiving disability pension in former meningococcal or viral meningitis patients versus members of the comparison cohorts were small. In conclusion, pneumococcal meningitis and herpes simplex encephalitis were associated with substantially decreased employment and increased need for disability pension. These associations did not seem to apply to meningococcal meningitis or viral meningitis. © 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.

Social inequalities in suicide: the role of selective serotonin reuptake inhibitors.

PubMed

Clouston, Sean A P; Rubin, Marcie S; Colen, Cynthia G; Link, Bruce G

2014-10-01

We aimed to examine the relationship between socioeconomic status (SES) and suicide associated with the introduction and diffusion of selective serotonin reuptake inhibitors (SSRIs). Negative binomial regression was used to estimate county-level suicide rates among persons aged 25 years or older using death certificate data collated by the National Center for Health Statistics from 1968 to 2009; SES was measured using the decennial US Census. The National Health and Nutrition Examination Survey and the Medical Expenditure Panel Survey were used to measure SSRI use. Once SSRIs became available in 1988, a 1% increase in SSRI usage was associated with a 0.5% lower suicide rate. Prior to the introduction of SSRIs, SES was not related to suicide. However, with each 1% increase in SSRI use, a 1-standard deviation (SD) higher SES was associated with a 0.6% lower suicide rate. In 2009, persons living in counties with SES 1 SD above the national average were 13.6% less likely to commit suicide than those living in counties with SES 1 SD below the national average--a difference of 1.9/100,000 adults aged ≥25 years. Higher SSRI use was associated with lower suicide rates among US residents aged ≥25 years; however, SES inequalities modified the association between SSRI use and suicide. © The Author 2014. 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.

Performance of Disease Risk Score Matching in Nested Case-Control Studies: A Simulation Study.

PubMed

Desai, Rishi J; Glynn, Robert J; Wang, Shirley; Gagne, Joshua J

2016-05-15

In a case-control study, matching on a disease risk score (DRS), which includes many confounders, should theoretically result in greater precision than matching on only a few confounders; however, this has not been investigated. We simulated 1,000 hypothetical cohorts with a binary exposure, a time-to-event outcome, and 13 covariates. Each cohort comprised 2 subcohorts of 10,000 patients each: a historical subcohort and a concurrent subcohort. DRS were estimated in the historical subcohorts and applied to the concurrent subcohorts. Nested case-control studies were conducted in the concurrent subcohorts using incidence density sampling with 2 strategies-matching on age and sex, with adjustment for additional confounders, and matching on DRS-followed by conditional logistic regression for 9 outcome-exposure incidence scenarios. In all scenarios, DRS matching yielded lower average standard errors and mean squared errors than did matching on age and sex. In 6 scenarios, DRS matching also resulted in greater empirical power. DRS matching resulted in less relative bias than did matching on age and sex at lower outcome incidences but more relative bias at higher incidences. Post-hoc analysis revealed that the effect of DRS model misspecification might be more pronounced at higher outcome incidences, resulting in higher relative bias. These results suggest that DRS matching might increase the statistical efficiency of case-control studies, particularly when the outcome is rare. © The Author 2016. 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.

Dietary Flavonoid and Lignan Intake and Mortality in Prospective Cohort Studies: Systematic Review and Dose-Response Meta-Analysis.

PubMed

Grosso, Giuseppe; Micek, Agnieszka; Godos, Justyna; Pajak, Andrzej; Sciacca, Salvatore; Galvano, Fabio; Giovannucci, Edward L

2017-06-15

Recent evidence has suggested that flavonoid and lignan intake may be associated with decreased risk of chronic and degenerative diseases. The aim of this meta-analysis was to assess the association between dietary flavonoid and lignan intake and all-cause and cardiovascular disease (CVD) mortality in prospective cohort studies. A systematic search was conducted in electronic databases to identify studies published from January 1996 to December 2015 that satisfied inclusion/exclusion criteria. Risk ratios and 95% confidence intervals were extracted and analyzed using a random-effects model. Nonlinear dose-response analysis was modeled by using restricted cubic splines. The inclusion criteria were met by 22 prospective studies exploring various flavonoid and lignan classes. Compared with lower intake, high consumption of total flavonoids was associated with decreased risk of all-cause mortality (risk ratio = 0.74, 95% confidence intervals: 0.55, 0.99), while a 100-mg/day increment in intake led to a (linear) decreased risk of 6% and 4% of all-cause and CVD mortality, respectively. Among flavonoid classes, significant results were obtained for intakes of flavonols, flavones, flavanones, anthocyanidins, and proanthocyanidins. Only limited evidence was available on flavonoid classes and lignans and all-cause mortality. Findings from this meta-analysis indicated that dietary flavonoids are associated with decreased risk of all-cause and CVD mortality. © 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.

Experiences of Discrimination and Incident Type 2 Diabetes Mellitus: The Multi-Ethnic Study of Atherosclerosis (MESA).

PubMed

Whitaker, Kara M; Everson-Rose, Susan A; Pankow, James S; Rodriguez, Carlos J; Lewis, Tené T; Kershaw, Kiarri N; Diez Roux, Ana V; Lutsey, Pamela L

2017-08-15

Experiences of discrimination are associated with increased risk of adverse health outcomes; however, it is unknown whether discrimination is related to incident type 2 diabetes mellitus (diabetes). We investigated the associations of major experiences of discrimination (unfair treatment in 6 situations) and everyday discrimination (frequency of day-to-day experiences of unfair treatment) with incident diabetes among 5,310 participants from the Multi-Ethnic Study of Atherosclerosis, enrolled in 2000-2002. Using Cox proportional hazards models, we estimated hazard ratios and confidence intervals, adjusting for demographic factors, depressive symptoms, stress, smoking, alcohol, physical activity, diet, waist circumference, and body mass index. Over a median follow-up of 9.4 years, 654 diabetes cases were accrued. Major experiences of discrimination were associated with greater risk of incident diabetes when modeled continuously (for each additional experience of discrimination, hazard ratio = 1.09, 95% confidence interval: 1.01, 1.17) or categorically (for ≥2 experiences vs. 0, hazard ratio = 1.34, 95% confidence interval: 1.08, 1.66). Similar patterns were observed when evaluating discrimination attributed to race/ethnicity or to a combination of other sources. Everyday discrimination was not associated with incident diabetes. In conclusion, major experiences of discrimination were associated with increased risk of incident diabetes, independent of obesity or behavioral and psychosocial factors. Future research is needed to explore the mechanisms of the discrimination-diabetes relationship. © The Author(s) 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.

Chronic exposure of grandparents to poverty and body mass index trajectories of grandchildren: a prospective intergenerational study.

PubMed

Li, Miao

2015-02-01

In this study, I used the growth curve model to examine the association between grandparents' (first generation (G1)) life-course exposure to chronic poverty and grandchildren's (third generation (G3)) body mass index (BMI; weight (kg)/height (m)(2)) growth trajectories. This association was estimated separately for male and female grandchildren. Analyses were based on prospective data from a US longitudinal survey, the Panel Study of Income Dynamics (1968-2011), and 2 of its supplemental studies: the Child Development Supplement (1997-2011) and the Transition into Adulthood Study (1997-2011). A prospectively enrolled nationally representative cohort of 2,613 G3 youth (1,323 male, 1,290 female) sampled in the 2 supplemental studies was linked to 1,719 grandparents from the Panel Study of Income Dynamics core sample. Chronic exposure to poverty among grandparents was prospectively ascertained annually over a 30-year period prior to the collection of data on grandchildren. Findings suggested that grandparents' chronic poverty exposure was positively associated with the slope of the BMI trajectory among granddaughters (β = 0.10, 95% confidence interval: 0.03, 0.17) but not among grandsons (β = 0.02, 95% confidence interval: -0.04, 0.08). The association between grandparents' chronic poverty exposure and granddaughters' BMI growth slope remained even after controlling for parental (second generation (G2)) socioeconomic status and BMI. © 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.

Measuring the Association Between Body Mass Index and All-Cause Mortality in the Presence of Missing Data: Analyses From the Scottish National Diabetes Register.

PubMed

Read, Stephanie H; Lewis, Steff C; Halbesma, Nynke; Wild, Sarah H

2017-04-15

Incorrectly handling missing data can lead to imprecise and biased estimates. We describe the effect of applying different approaches to handling missing data in an analysis of the association between body mass index and all-cause mortality among people with type 2 diabetes. We used data from the Scottish diabetes register that were linked to hospital admissions data and death registrations. The analysis was based on people diagnosed with type 2 diabetes between 2004 and 2011, with follow-up until May 31, 2014. The association between body mass index and mortality was investigated using Cox proportional hazards models. Findings were compared using 4 different missing-data methods: complete-case analysis, 2 multiple-imputation models, and nearest-neighbor imputation. There were 124,451 cases of type 2 diabetes, among which there were 17,085 deaths during 787,275 person-years of follow-up. Patients with missing data (24.8%) had higher mortality than those without missing data (adjusted hazard ratio = 1.36, 95% confidence interval: 1.31, 1.41). A U-shaped relationship between body mass index and mortality was observed, with the lowest hazard ratios occurring among moderately obese people, regardless of the chosen approach for handling missing data. Missing data may affect absolute and relative risk estimates differently and should be considered in analyses of routinely collected data. © 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.

African American race and HIV virological suppression: beyond disparities in clinic attendance.

PubMed

Howe, Chanelle J; Napravnik, Sonia; Cole, Stephen R; Kaufman, Jay S; Adimora, Adaora A; Elston, Beth; Eron, Joseph J; Mugavero, Michael J

2014-06-15

Racial disparities in clinic attendance may contribute to racial disparities in plasma human immunodeficiency virus type 1 : HIV-1) RNA levels among HIV-positive patients in care. Data from 946 African American and 535 Caucasian patients receiving HIV care at the University of North Carolina Center for AIDS Research HIV clinic between January 1, 1999, and August 1, 2012, were used to estimate the association between African American race and HIV virological suppression (i.e., undetectable HIV-1 RNA) when racial disparities in clinic attendance were lessened. Clinic attendance was measured as the proportion of scheduled clinic appointments attended (i.e., visit adherence) or the proportion of six 4-month intervals with at least 1 attended scheduled clinic appointment (i.e., visit constancy). In analyses accounting for patient characteristics, the risk ratio for achieving suppression when comparing African Americans with Caucasians was 0.91 (95% confidence interval: 0.85, 0.98). Lessening disparities in adherence or constancy lowered disparities in virological suppression by up to 44.4% and 11.1%, respectively. Interventions that lessen disparities in adherence may be more effective in eliminating disparities in suppression than interventions that lessen disparities in constancy. Given that gaps in care were limited to be no more than 2 years for both attendance measures, the impact of lessening disparities in adherence may be overstated. © The Author 2014. 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.

Direct Participation in and Indirect Exposure to the Occupy Central Movement and Depressive Symptoms: A Longitudinal Study of Hong Kong Adults.

PubMed

Ni, Michael Y; Li, Tom K; Pang, Herbert; Chan, Brandford H Y; Yuan, Betty Y; Kawachi, Ichiro; Schooling, C Mary; Leung, Gabriel M

2016-11-01

Despite the extensive history of social movements around the world, the evolution of population mental health before, during, and after a social movement remains sparsely documented. We sought to assess over time the prevalence of depressive symptoms during and after the Occupy Central movement in Hong Kong and to examine the associations of direct and indirect exposures to Occupy Central with depressive symptoms. We longitudinally administered interviews to 909 adults who were randomly sampled from the population-representative FAMILY Cohort at 6 time points from March 2009 to March 2015: twice each before, during, and after the Occupy Central protests. The Patient Health Questionnaire-9 was used to assess depressive symptoms and probable major depression (defined as Patient Health Questionnaire-9 score ≥10). The absolute prevalence of probable major depression increased by 7% after Occupy Central, regardless of personal involvement in the protests. Higher levels of depressive symptoms were associated with online and social media exposure to protest-related news (incidence rate ratio (IRR) = 1.28, 95% confidence interval (CI): 1.06, 1.55) and more frequent Facebook use (IRR = 1.38, 95% CI: 1.12, 1.71). Higher levels of intrafamilial sociopolitical conflict was associated with more depressive symptoms (IRR = 1.05, 95% CI: 1.01, 1.09). The Occupy Central protests resulted in substantial and sustained psychological distress in the community. © The Author 2016. 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.

Ozone and daily mortality rate in 21 cities of East Asia: how does season modify the association?

PubMed

Chen, Renjie; Cai, Jing; Meng, Xia; Kim, Ho; Honda, Yasushi; Guo, Yue Leon; Samoli, Evangelia; Yang, Xin; Kan, Haidong

2014-10-01

Previous studies in East Asia have revealed that the short-term associations between tropospheric ozone and daily mortality rate were strongest in winter, which is opposite to the findings in North America and Western Europe. Therefore, we investigated the season-varying association between ozone and daily mortality rate in 21 cities of East Asia from 1979 to 2010. Time-series Poisson regression models were used to analyze the association between ozone and daily nonaccidental mortality rate in each city, testing for different temperature lags. The best-fitting model was obtained after adjustment for temperature in the previous 2 weeks. Bayesian hierarchical models were applied to pool the city-specific estimates. An interquartile-range increase of the moving average concentrations of same-day and previous-day ozone was associated with an increase of 1.44% (95% posterior interval (PI): 1.08%, 1.80%) in daily total mortality rate after adjustment for temperature in the previous 2 weeks. The corresponding increases were 0.62% (95% PI: 0.08%, 1.16%) in winter, 1.46% (95% PI: 0.89%, 2.03%) in spring, 1.60% (95% PI: 1.03%, 2.17%) in summer, and 1.12% (95% PI: 0.73%, 1.51%) in fall. We found significant associations between short-term exposure to ozone and higher mortality rate in East Asia that varied considerably from season to season with a significant trough in winter. © The Author 2014. 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.

The Relationship Between School Holidays and Transmission of Influenza in England and Wales.

PubMed

Jackson, Charlotte; Vynnycky, Emilia; Mangtani, Punam

2016-11-01

School closure is often considered as an influenza control measure, but its effects on transmission are poorly understood. We used 2 approaches to estimate how school holidays affect the contact parameter (the per capita rate of contact sufficient for infection transmission) for influenza using primary care data from England and Wales (1967-2000). Firstly, we fitted an age-structured susceptible-infectious-recovered model to each year's data to estimate the proportional change in the contact parameter during school holidays as compared with termtime. Secondly, we calculated the percentage difference in the contact parameter between holidays and termtime from weekly values of the contact parameter, estimated directly from simple mass-action models. Estimates were combined using random-effects meta-analysis, where appropriate. From fitting to the data, the difference in the contact parameter among children aged 5-14 years during holidays as compared with termtime ranged from a 36% reduction to a 17% increase; estimates were too heterogeneous for meta-analysis. Based on the simple mass-action model, the contact parameter was 17% (95% confidence interval: 10, 25) lower during holidays than during termtime. Results were robust to the assumed proportions of infections that were reported and individuals who were susceptible when the influenza season started. We conclude that school closure may reduce transmission during influenza outbreaks. © The Author 2016. 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.

The Identification of a Threshold of Long Work Hours for Predicting Elevated Risks of Adverse Health Outcomes.

PubMed

Conway, Sadie H; Pompeii, Lisa A; Gimeno Ruiz de Porras, David; Follis, Jack L; Roberts, Robert E

2017-07-15

Working long hours has been associated with adverse health outcomes. However, a definition of long work hours relative to adverse health risk has not been established. Repeated measures of work hours among approximately 2,000 participants from the Panel Study of Income Dynamics (1986-2011), conducted in the United States, were retrospectively analyzed to derive statistically optimized cutpoints of long work hours that best predicted three health outcomes. Work-hours cutpoints were assessed for model fit, calibration, and discrimination separately for the outcomes of poor self-reported general health, incident cardiovascular disease, and incident cancer. For each outcome, the work-hours threshold that best predicted increased risk was 52 hours per week or more for a minimum of 10 years. Workers exposed at this level had a higher risk of poor self-reported general health (relative risk (RR) = 1.28; 95% confidence interval (CI): 1.06, 1.53), cardiovascular disease (RR = 1.42; 95% CI: 1.24, 1.63), and cancer (RR = 1.62; 95% CI: 1.22, 2.17) compared with those working 35-51 hours per week for the same duration. This study provides the first health risk-based definition of long work hours. Further examination of the predictive power of this cutpoint on other health outcomes and in other study populations is needed. © 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.

The Effect of Birth Weight on Academic Performance: Instrumental Variable Analysis.

PubMed

Lin, Shi Lin; Leung, Gabriel Matthew; Schooling, C Mary

2017-05-01

Observationally, lower birth weight is usually associated with poorer academic performance; whether this association is causal or the result of confounding is unknown. To investigate this question, we obtained an effect estimate, which can have a causal interpretation under specific assumptions, of birth weight on educational attainment using instrumental variable analysis based on single nucleotide polymorphisms determining birth weight combined with results from the Social Science Genetic Association Consortium study of 126,559 Caucasians. We similarly obtained an estimate of the effect of birth weight on academic performance in 4,067 adolescents from Hong Kong's (Chinese) Children of 1997 birth cohort (1997-2016), using twin status as an instrumental variable. Birth weight was not associated with years of schooling (per 100-g increase in birth weight, -0.006 years, 95% confidence interval (CI): -0.02, 0.01) or college completion (odds ratio = 1.00, 95% CI: 0.96, 1.03). Birth weight was also unrelated to academic performance in adolescents (per 100-g increase in birth weight, -0.004 grade, 95% CI: -0.04, 0.04) using instrumental variable analysis, although conventional regression gave a small positive association (0.02 higher grade, 95% CI: 0.01, 0.03). Observed associations of birth weight with academic performance may not be causal, suggesting that interventions should focus on the contextual factors generating this correlation. © 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.

Early-life school, neighborhood, and family influences on adult health: a multilevel cross-classified analysis of the Aberdeen children of the 1950s study.

PubMed

Dundas, Ruth; Leyland, Alastair H; Macintyre, Sally

2014-07-15

Lifetime exposures to adverse social environments influence adult health, as do exposures in early life. It is usual to examine the influences of school on teenage health and of adult area of residence on adult health. We examined the combined long-term association of the school attended, as well as the area of residence in childhood, with adult health. A total of 6,285 children from Aberdeen, Scotland, who were aged 5-12 years in 1962, were followed up at a mean age of 47 years in 2001. Cross-classified multilevel logistic regression was used to estimate the associations of family, school, and area of residence with self-reported adult health and mental health, adjusting for childhood family-, school-, and neighborhood-level factors, as well as current adult occupational position. Low early-life social position (as determined by the father's occupational level) was associated with poor adult self-rated health but not poor mental health. There were small contextual associations between childhood school environment (median odds ratio = 1.08) and neighborhood environment (median odds ratio = 1.05) and adult self-rated health. The share of the total variance in health at the family level was 10.1% compared with 89.6% at the individual level. Both socioeconomic context and composition in early life appear to have an influence on adult health, even after adjustment for current occupational position. © The Author 2014. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Residential Proximity to Heavy-Traffic Roads, Benzene Exposure, and Childhood Leukemia-The GEOCAP Study, 2002-2007.

PubMed

Houot, Jennifer; Marquant, Fabienne; Goujon, Stéphanie; Faure, Laure; Honoré, Cécile; Roth, Marie-Hélène; Hémon, Denis; Clavel, Jacqueline

2015-10-15

Childhood leukemia may be associated with traffic-related environmental exposure to benzene, and additional data are needed. The Géolocalisation des Cancers Pédiatriques (GEOCAP) Study, a nationwide French case-control study, was designed to avoid selection bias due to differential participation and misclassification. The study compared the 2,760 childhood leukemia cases diagnosed in France between 2002 and 2007 (including 2,275 cases of acute lymphoblastic leukemia (ALL) and 418 cases of acute myeloblastic leukemia (AML)) with 30,000 contemporaneous child population controls. The residence addresses were precisely geocoded, and 3 indicators of residential proximity to traffic were considered. Estimates of benzene concentrations were also available for the Île-de-France region (including Paris). A 300-m increase in major road length within 150 m of the geocoded address was significantly associated with AML (odds ratio = 1.2, 95% confidence interval: 1.0, 1.4) but not with ALL (odds ratio = 1.0, 95% confidence interval: 0.9, 1.1), and the association was reinforced in the Île-de-France region when this indicator was combined with benzene estimates. These results, which were free from any participation bias and based on objectively determined indices of exposure, showed an increased incidence of AML associated with heavy-traffic road density near a child's home. The results support a role for traffic-related benzene exposure in the etiology of childhood AML. © 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.

Increased Incidence Rate of Trauma- and Stressor-Related Disorders in Denmark After the September 11, 2001, Terrorist Attacks in the United States.

PubMed

Hansen, Bertel T; Østergaard, Søren D; Sønderskov, Kim M; Dinesen, Peter T

2016-10-01

The terrorist attacks that occurred on September 11, 2001 (hereafter referred to as 9/11) in the United States had a profound impact on the physical and mental health of Americans, but the effects beyond the United States are largely unknown. To understand the wider aftermath, we examined the consequences of the 9/11 attacks on mental disorders in the Kingdom of Denmark. Utilizing population data from the Danish Psychiatric Central Research Register from 1995 to 2012, we used a time-series intervention approach to estimate the change in the incidence rate of mental disorders after the 9/11 attacks. Based on analyses of 1,448,250 contacts with psychiatric services, we found that the attacks were followed by an immediate 16% increase in the incidence rate of trauma- and stressor-related disorders. This surge dissipated approximately a year after 9/11. In contrast, no similar increases were found for other disorders. This is consistent with the prominent role of external stressors in the etiology of trauma- and stressor-related disorders. The results indicate that the effects of 9/11 on mental disorders extended across the Atlantic Ocean to Denmark. Thus, the impact of terrorist attacks on mental health is likely not limited to inhabitants of the country under attack; it also extends to people far away and without immediate relation to it. © The Author 2016. 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.

Ancient Disease, Modern Epidemiology: A Century of Progress in Understanding and Fighting Tuberculosis.

PubMed

Zwerling, Alice; Hanrahan, Colleen; Dowdy, David W

2016-03-01

A century's worth of efforts to better understand the epidemiology of tuberculosis (TB) and to develop new vaccines, drugs, preventive interventions, and case-finding approaches have provided important insights and helped to advance the field of epidemiology as a whole. Wade Hampton Frost developed methods for cohort analysis that formed the early basis for adjustment of confounding variables. The streptomycin trial in the United Kingdom in the 1940s introduced random allocation for participants to either the treatment or control group, ensuring blinded treatment assignment and comparable treatment groups, which is now a key element in randomized clinical trials. Research into the bacille Calmette-Guérin vaccine demonstrated the importance of comparative analyses, potential difficulties in generalizability to populations not under study, and the role of meta-analysis for discrepant data-approaches now strongly recommended prior to implementing any novel public health intervention. George Comstock's work on preventive therapy for TB demonstrated the use of epidemiologic methods to evaluate interventions on a population level. Finally, studies from the Consortium to Respond Effectively to the AIDS/TB Epidemic focused on the evaluation of real-world effectiveness and of targeting of high-risk subpopulations. In this article, we discuss how TB research in each of these domains has helped to advance epidemiologic thinking and methodology over the past 100 years. © The Author 2016. 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.

Interactive effects of antioxidant genes and air pollution on respiratory function and airway disease: a HuGE review.

PubMed

Minelli, Cosetta; Wei, Igor; Sagoo, Gurdeep; Jarvis, Debbie; Shaheen, Seif; Burney, Peter

2011-03-15

Susceptibility to the respiratory effects of air pollution varies between individuals. Although some evidence suggests higher susceptibility for subjects carrying variants of antioxidant genes, findings from gene-pollution interaction studies conflict in terms of the presence and direction of interactions. The authors conducted a systematic review on antioxidant gene-pollution interactions which included 15 studies, with 12 supporting the presence of interactions. For the glutathione S-transferase M1 gene (GSTM1) (n=10 studies), only 1 study found interaction with the null genotype alone, although 5 observed interactions when GSTM1 was evaluated jointly with other genes (mainly NAD(P)H dehydrogenase [quinone] 1 (NQO1)). All studies on the glutathione S-transferase P1 (GSTP1) Ile105Val polymorphism (n=11) provided some evidence of interaction, but findings conflicted in terms of risk allele. Results were negative for glutathione S-transferase T1 (GSTT1) (n=3) and positive for heme oxygenase 1 (HMOX-1) (n=2). Meta-analysis could not be performed because there were insufficient data available for any specific gene-pollutant-outcome combination. Overall the evidence supports the presence of gene-pollution interactions, although which pollutant interacts with which gene is unclear. However, issues regarding multiple testing, selective reporting, and publication bias raise the possibility of false-positive findings. Larger studies with greater accuracy of pollution assessment and improved quality of conduct and reporting are required. © The Author 2011. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.

Semen Quality as a Predictor of Subsequent Morbidity: A Danish Cohort Study of 4,712 Men With Long-Term Follow-up.

PubMed

Latif, Tabassam; Kold Jensen, Tina; Mehlsen, Jesper; Holmboe, Stine Agergaard; Brinth, Louise; Pors, Kirsten; Skouby, Sven Olaf; Jørgensen, Niels; Lindahl-Jacobsen, Rune

2017-10-15

Semen quality has been suggested to be a biological marker of long-term morbidity and mortality; however, few studies have been conducted on this subject. We identified 5,370 men seen for infertility at Frederiksberg Hospital, Denmark, during 1977-2010, and 4,712 of these men were followed in the Danish National Patient Registry until first hospitalization, death, or the end of the study. We classified patients according to hospitalizations and the presence of cardiovascular disease, diabetes, testicular cancer, or prostate cancer. We found a clear association between sperm concentration below 15 million/mL and all-cause hospitalizations (hazard ratio = 1.5, 95% confidence interval: 1.4, 1.6) and cardiovascular disease (hazard ratio = 1.4, 95% confidence interval: 1.2, 1.6), compared with men with a concentration above 40 million/mL. The probabilities for hospitalizations were also higher with a low total sperm count and low motility. Men with a sperm concentration of 195-200 million/mL were, on average, hospitalized for the first time 7 years later than were men with a sperm concentration of 0-5 million/mL. Semen quality was associated with long-term morbidity, and a significantly higher risk of hospitalization was found, in particular for cardiovascular diseases and diabetes mellitus. Our study supports the suggestion that semen quality is a strong biomarker of general health. © The Author(s) 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.

Concordance With Prevention Guidelines and Subsequent Cancer, Cardiovascular Disease, and Mortality: A Longitudinal Study of Older Adults.

PubMed

Greenlee, Heather; Strizich, Garrett; Lovasi, Gina S; Kaplan, Robert C; Biggs, Mary L; Li, Christopher I; Richardson, John; Burke, Gregory L; Fitzpatrick, Annette L; Fretts, Amanda M; Psaty, Bruce M; Fried, Linda P

2017-11-15

Reports on the associations between multiple clinical and behavioral health indicators and major health outcomes among older adults are scarce. We prospectively examined concordance with guidelines from the American Cancer Society and American Heart Association for disease prevention in relation to cancer, cardiovascular disease (CVD), and mortality among Cardiovascular Health Study enrollees aged 65-98 years who, at baseline assessment in 1989-1996 (n = 3,491), were free of CVD and cancer. Total and cause-specific mortality, as well as incidence of cancer and CVD, were lower with higher guideline concordance. Independent of body mass index, blood pressure, total cholesterol, and fasting plasma glucose, better health behaviors (diet, physical activity, and alcohol consumption) were associated with lower mortality (2-sided P < 0.0001). Among individuals with ideal levels for 3-4 of these 4 cardiometabolic biomarkers, those with poor concordance with health behavior recommendations had higher mortality compared with those who had the highest concordance with these behavioral recommendations (adjusted mortality hazard ratio = 1.82, 95% confidence interval: 1.25, 2.67). Older adults who are concordant with recommendations for cancer and CVD prevention have reduced rates of chronic disease and mortality. Interventions to achieve and maintain healthy lifestyle behaviors may offer benefits both in the presence and absence of adverse traditional clinical risk factors. © The Author(s) 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.

Linkage of a Population-Based Cohort With Primary Data Collection to Medicare Claims: The Reasons for Geographic and Racial Differences in Stroke Study.

PubMed

Xie, Fenglong; Colantonio, Lisandro D; Curtis, Jeffrey R; Safford, Monika M; Levitan, Emily B; Howard, George; Muntner, Paul

2016-10-01

We described the linkage of primary data with administrative claims using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and Medicare. REGARDS study data were linked with Medicare claims by use of Social Security numbers. We compared REGARDS participants by Medicare linkage status, having fee-for-service (FFS) coverage or not, and with a 5% sample of Medicare beneficiaries who had FFS coverage in 2005, overall, by age (45-64 and ≥65 years), and by race. Among REGARDS participants who were ≥65 years of age, 80% had data linked to Medicare on their study-visit date (64% with FFS coverage). No differences except race and sex were present between REGARDS participants without Medicare linkage and those with data linked to Medicare with and without FFS coverage. After the age-sex-race adjustment, comorbid conditions and health-care utilization were similar for those with FFS coverage in the REGARDS study and the 5% sample of Medicare beneficiaries. Among REGARDS participants aged 45-64 years, 11% had FFS coverage on their study-visit date. In this age group, differences were present between participants with and without FFS coverage and the Medicare 5% sample with FFS coverage. In conclusion, REGARDS participants aged ≥65 years with FFS coverage are representative of the study cohort and the US population aged ≥65 years with FFS coverage. © The Author 2016. 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.

Beyond Access: Characteristics of the Food Environment and Risk of Diabetes.

PubMed

Mezuk, Briana; Li, Xinjun; Cederin, Klas; Rice, Kristen; Sundquist, Jan; Sundquist, Kristina

2016-06-15

Characteristics of the built environment, including access to unhealthy food outlets, are hypothesized to contribute to type 2 diabetes mellitus (T2D). Swedish nationwide registry data on 4,718,583 adults aged 35-80 years living in 9,353 neighborhoods, each with at least 1 food outlet, were geocoded and linked to commercial registers (e.g., restaurants and grocery stores). Multilevel logistic regression was used to examine the prospective relationship between characteristics of the food environment and T2D from 2005 to 2010. Relative access to health-harming food outlets was associated with greater likelihood of both prevalent and incident T2D in a curvilinear manner, with the highest risk being observed for environments in which one-third of outlets were health-harming. Relative to individuals whose food environment did not change, those who moved into areas with more health-harming food outlets had higher odds of developing T2D (odds ratio = 3.67, 95% confidence interval: 2.14, 6.30). Among those who did not move, living in an area that gained relative access to health-harming food outlets was also associated with higher odds of T2D (odds ratio = 1.72, 95% confidence interval: 1.27, 2.33). These results suggest that local food environment, including changes that result in greater access to unhealthy food outlets, is associated with T2D. © The Author 2016. 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.

The Local Food Environment and Fruit and Vegetable Intake: A Geographically Weighted Regression Approach in the ORiEL Study.

PubMed

Clary, Christelle; Lewis, Daniel J; Flint, Ellen; Smith, Neil R; Kestens, Yan; Cummins, Steven

2016-12-01

Studies that explore associations between the local food environment and diet routinely use global regression models, which assume that relationships are invariant across space, yet such stationarity assumptions have been little tested. We used global and geographically weighted regression models to explore associations between the residential food environment and fruit and vegetable intake. Analyses were performed in 4 boroughs of London, United Kingdom, using data collected between April 2012 and July 2012 from 969 adults in the Olympic Regeneration in East London Study. Exposures were assessed both as absolute densities of healthy and unhealthy outlets, taken separately, and as a relative measure (proportion of total outlets classified as healthy). Overall, local models performed better than global models (lower Akaike information criterion). Locally estimated coefficients varied across space, regardless of the type of exposure measure, although changes of sign were observed only when absolute measures were used. Despite findings from global models showing significant associations between the relative measure and fruit and vegetable intake (β = 0.022; P < 0.01) only, geographically weighted regression models using absolute measures outperformed models using relative measures. This study suggests that greater attention should be given to nonstationary relationships between the food environment and diet. It further challenges the idea that a single measure of exposure, whether relative or absolute, can reflect the many ways the food environment may shape health behaviors. © The Author 2016. 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.

Food Environment and Weight Change: Does Residential Mobility Matter?: The Diabetes Study of Northern California (DISTANCE).

PubMed

Laraia, Barbara A; Downing, Janelle M; Zhang, Y Tara; Dow, William H; Kelly, Maggi; Blanchard, Samuel D; Adler, Nancy; Schillinger, Dean; Moffet, Howard; Warton, E Margaret; Karter, Andrew J

2017-05-01

Associations between neighborhood food environment and adult body mass index (BMI; weight (kg)/height (m)2) derived using cross-sectional or longitudinal random-effects models may be biased due to unmeasured confounding and measurement and methodological limitations. In this study, we assessed the within-individual association between change in food environment from 2006 to 2011 and change in BMI among adults with type 2 diabetes using clinical data from the Kaiser Permanente Diabetes Registry collected from 2007 to 2011. Healthy food environment was measured using the kernel density of healthful food venues. Fixed-effects models with a 1-year-lagged BMI were estimated. Separate models were fitted for persons who moved and those who did not. Sensitivity analysis using different lag times and kernel density bandwidths were tested to establish the consistency of findings. On average, patients lost 1 pound (0.45 kg) for each standard-deviation improvement in their food environment. This relationship held for persons who remained in the same location throughout the 5-year study period but not among persons who moved. Proximity to food venues that promote nutritious foods alone may not translate into clinically meaningful diet-related health changes. Community-level policies for improving the food environment need multifaceted strategies to invoke clinically meaningful change in BMI among adult patients with diabetes. © 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.

History of Severe Sunburn and Risk of Skin Cancer Among Women and Men in 2 Prospective Cohort Studies.

PubMed

Wu, Shaowei; Cho, Eunyoung; Li, Wen-Qing; Weinstock, Martin A; Han, Jiali; Qureshi, Abrar A

2016-05-01

Few studies have assessed the relationship between sunburn and risk of different skin cancers (melanoma, squamous cell carcinoma (SCC), and basal cell carcinoma (BCC)) in prospective studies simultaneously, and little is known about the association of severe sunburns at different body sites with skin cancer risk. We used data on 87,166 women in the Nurses' Health Study (1982-2010) and 32,959 men in the Health Professionals Follow-up Study (1992-2010) to investigate skin cancer risk associated with history of severe sunburns at different body sites (face/arms, trunk, and lower limbs). After adjustment for other risk factors, overall baseline history of severe sunburn was more apparently associated with risk of melanoma than with risk of SCC and BCC in men (multivariable-adjusted hazard ratios were 2.41 (95% confidence interval (CI): 1.32, 4.41) for melanoma, 1.48 (95% CI: 1.08, 2.03) for SCC, and 1.18 (95% CI: 1.06, 1.32) for BCC) but not in women. Sunburn on the trunk appeared to be more closely associated with melanoma risk, but not risk of SCC and BCC, when compared with sunburns at other body sites (face/arms and lower limbs). These differences were more apparent in men than in women. Pending further investigation, our findings add novel insights to the existing literature on sunburn history and skin cancer risk. © The Author 2016. 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.

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.

Month of Conception and Learning Disabilities: A Record-Linkage Study of 801,592 Children.

PubMed

Mackay, Daniel F; Smith, Gordon C S; Cooper, Sally-Ann; Wood, Rachael; King, Albert; Clark, David N; Pell, Jill P

2016-10-01

Learning disabilities have profound, long-lasting health sequelae. Affected children born over the course of 1 year in the United States of America generated an estimated lifetime cost of $51.2 billion. Results from some studies have suggested that autistic spectrum disorder may vary by season of birth, but there have been few studies in which investigators examined whether this is also true of other causes of learning disabilities. We undertook Scotland-wide record linkage of education (annual pupil census) and maternity (Scottish Morbidity Record 02) databases for 801,592 singleton children attending Scottish schools in 2006-2011. We modeled monthly rates using principal sine and cosine transformations of the month number and demonstrated cyclicity in the percentage of children with special educational needs. Rates were highest among children conceived in the first quarter of the year (January-March) and lowest among those conceived in the third (July-September) (8.9% vs 7.6%; P < 0.001). Seasonal variations were specific to autistic spectrum disorder, intellectual disabilities, and learning difficulties (e.g., dyslexia) and were absent for sensory or motor/physical impairments and mental, physical, or communication problems. Seasonality accounted for 11.4% (95% confidence interval: 9.0, 13.7) of all cases. Some biologically plausible causes of this variation, such as infection and maternal vitamin D levels, are potentially amendable to intervention. © The Author 2016. 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.

Anthropometry and the Risk of Lung Cancer in EPIC.

PubMed

Dewi, Nikmah Utami; Boshuizen, Hendriek C; Johansson, Mattias; Vineis, Paolo; Kampman, Ellen; Steffen, Annika; Tjønneland, Anne; Halkjær, Jytte; Overvad, Kim; Severi, Gianluca; Fagherazzi, Guy; Boutron-Ruault, Marie-Christine; Kaaks, Rudolf; Li, Kuanrong; Boeing, Heiner; Trichopoulou, Antonia; Bamia, Christina; Klinaki, Eleni; Tumino, Rosario; Palli, Domenico; Mattiello, Amalia; Tagliabue, Giovanna; Peeters, Petra H; Vermeulen, Roel; Weiderpass, Elisabete; Torhild Gram, Inger; Huerta, José María; Agudo, Antonio; Sánchez, María-José; Ardanaz, Eva; Dorronsoro, Miren; Quirós, José Ramón; Sonestedt, Emily; Johansson, Mikael; Grankvist, Kjell; Key, Tim; Khaw, Kay-Tee; Wareham, Nick; Cross, Amanda J; Norat, Teresa; Riboli, Elio; Fanidi, Anouar; Muller, David; Bueno-de-Mesquita, H Bas

2016-07-15

The associations of body mass index (BMI) and other anthropometric measurements with lung cancer were examined in 348,108 participants in the European Investigation Into Cancer and Nutrition (EPIC) between 1992 and 2010. The study population included 2,400 case patients with incident lung cancer, and the average length of follow-up was 11 years. Hazard ratios were calculated using Cox proportional hazard models in which we modeled smoking variables with cubic splines. Overall, there was a significant inverse association between BMI (weight (kg)/height (m)(2)) and the risk of lung cancer after adjustment for smoking and other confounders (for BMI of 30.0-34.9 versus 18.5-25.0, hazard ratio = 0.72, 95% confidence interval: 0.62, 0.84). The strength of the association declined with increasing follow-up time. Conversely, after adjustment for BMI, waist circumference and waist-to-height ratio were significantly positively associated with lung cancer risk (for the highest category of waist circumference vs. the lowest, hazard ratio = 1.25, 95% confidence interval: 1.05, 1.50). Given the decline of the inverse association between BMI and lung cancer over time, the association is likely at least partly due to weight loss resulting from preclinical lung cancer that was present at baseline. Residual confounding by smoking could also have influenced our findings. © The Author 2016. 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.

Practical guidance for conducting mediation analysis with multiple mediators using inverse odds ratio weighting.

PubMed

Nguyen, Quynh C; Osypuk, Theresa L; Schmidt, Nicole M; Glymour, M Maria; Tchetgen Tchetgen, Eric J

2015-03-01

Despite the recent flourishing of mediation analysis techniques, many modern approaches are difficult to implement or applicable to only a restricted range of regression models. This report provides practical guidance for implementing a new technique utilizing inverse odds ratio weighting (IORW) to estimate natural direct and indirect effects for mediation analyses. IORW takes advantage of the odds ratio's invariance property and condenses information on the odds ratio for the relationship between the exposure (treatment) and multiple mediators, conditional on covariates, by regressing exposure on mediators and covariates. The inverse of the covariate-adjusted exposure-mediator odds ratio association is used to weight the primary analytical regression of the outcome on treatment. The treatment coefficient in such a weighted regression estimates the natural direct effect of treatment on the outcome, and indirect effects are identified by subtracting direct effects from total effects. Weighting renders treatment and mediators independent, thereby deactivating indirect pathways of the mediators. This new mediation technique accommodates multiple discrete or continuous mediators. IORW is easily implemented and is appropriate for any standard regression model, including quantile regression and survival analysis. An empirical example is given using data from the Moving to Opportunity (1994-2002) experiment, testing whether neighborhood context mediated the effects of a housing voucher program on obesity. Relevant Stata code (StataCorp LP, College Station, Texas) is provided. © 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.

Associations of Early- and Later-Childhood Poverty With Child Cognitive Function in Indonesia: Effect Decomposition in the Presence of Exposure-Induced Mediator-Outcome Confounding.

PubMed

Maika, Amelia; Mittinty, Murthy N; Brinkman, Sally; Lynch, John

2017-05-15

The amount of family financial resources available in early life influences child health and development. Using data from the 2000 and 2007 waves of the Indonesian Family Life Survey, we estimated the associations of early-life poverty (at age <7 years) and poverty in later childhood (at age 7-14 years) with cognitive function at age 7-14 years. Our analysis provided little support for the idea that an early intervention to support household income has a larger effect than intervention later in childhood; both seemed equally important. We also decomposed the effect of poverty at age <7 years into direct and indirect effects mediated through poverty and schooling/home environment at age 7-14 years. For decomposing the effects, we used 3 approaches: 1) joint mediators, 2) path-specific, and 3) intervention analog. Being exposed to poverty before age 7 years had a larger direct effect (difference in cognitive function z score) on child cognitive function at age 7-14 years (i.e., joint mediators β = -0.07, 95% confidence interval: -0.12, -0.02) than the indirect effects mediated through later poverty at age 7-14 years (β = -0.01, 95% confidence interval: -0.04, 0.01) and school attendance/home environment at age 7-14 years. The effect of poverty on cognitive function was small; nevertheless, financial intervention may still benefit children's cognitive function. © 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.

Invited commentary: boundless science--putting natural direct and indirect effects in a clearer empirical context.

PubMed

Naimi, Ashley I

2015-07-15

Epidemiologists are increasingly using natural effects for applied mediation analyses, yet 1 key identifying assumption is unintuitive and subject to some controversy. In this issue of the Journal, Jiang and VanderWeele (Am J Epidemiol. 2015;182(2):105-108) formalize the conditions under which the difference method can be used to estimate natural indirect effects. In this commentary, I discuss implications of the controversial "cross-worlds" independence assumption needed to identify natural effects. I argue that with a binary mediator, a simple modification of the authors' approach will provide bounds for natural direct and indirect effect estimates that better reflect the capacity of the available data to support empirical statements on the presence of mediated effects. I discuss complications encountered when odds ratios are used to decompose effects, as well as the implications of incorrectly assuming the absence of exposure-induced mediator-outcome confounders. I note that the former problem can be entirely resolved using collapsible measures of effect, such as risk ratios. In the Appendix, I use previous derivations for natural direct effect bounds on the risk difference scale to provide bounds on the odds ratio scale that accommodate 1) uncertainty due to the cross-world independence assumption and 2) uncertainty due to the cross-world independence assumption and the presence of exposure-induced mediator-outcome confounders. © 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.

Association of Facebook Use With Compromised Well-Being: A Longitudinal Study.

PubMed

Shakya, Holly B; Christakis, Nicholas A

2017-02-01

Face-to-face social interactions enhance well-being. With the ubiquity of social media, important questions have arisen about the impact of online social interactions. In the present study, we assessed the associations of both online and offline social networks with several subjective measures of well-being. We used 3 waves (2013, 2014, and 2015) of data from 5,208 subjects in the nationally representative Gallup Panel Social Network Study survey, including social network measures, in combination with objective measures of Facebook use. We investigated the associations of Facebook activity and real-world social network activity with self-reported physical health, self-reported mental health, self-reported life satisfaction, and body mass index. Our results showed that overall, the use of Facebook was negatively associated with well-being. For example, a 1-standard-deviation increase in "likes clicked" (clicking "like" on someone else's content), "links clicked" (clicking a link to another site or article), or "status updates" (updating one's own Facebook status) was associated with a decrease of 5%-8% of a standard deviation in self-reported mental health. These associations were robust to multivariate cross-sectional analyses, as well as to 2-wave prospective analyses. The negative associations of Facebook use were comparable to or greater in magnitude than the positive impact of offline interactions, which suggests a possible tradeoff between offline and online relationships. © 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.

Causal Effect of Parental Schooling on Early Childhood Undernutrition: Quasi-Experimental Evidence From Zimbabwe.

PubMed

De Neve, Jan-Walter; Subramanian, S V

2018-01-01

An estimated 3.1 million children die each year because of undernutrition. Although cross-sectional and longitudinal studies have found a protective association between greater parental education and undernutrition in their children, no randomized trial has identified a causal effect, to our knowledge. Using the 1980 education reform in Zimbabwe as a natural experiment, we estimated the causal effect of additional parental schooling on the probability of anthropometric failure in their children under 5 years of age (ages 3 through 59 months). Analyzing data on 8,243 children from the 1988, 1999, 2005-2006, and 2010-2011 Demographic and Health Surveys, we found no effect of parental schooling on early childhood undernutrition at the national level in Zimbabwe. Among households in the urban and high-wealth-index subsamples, each additional year of maternal schooling led to absolute reductions in the probability of a child's being wasted of 5.2 percentage points (95% confidence interval (CI): -9.3, -1.2) and 3.6 percentage points (95% CI: -6.9, -0.4), respectively. In the subsample of children between the ages of 3 and 23 months, each additional year of paternal schooling increased the probability of a child's being stunted by 9.6 percentage points (95% CI: 1.4, 17.9). Secondary schooling alone may not be enough to improve early childhood nutrition in low-resource settings. © The Author(s) 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.

Estimating Influenza Vaccine Effectiveness With the Test-Negative Design Using Alternative Control Groups: A Systematic Review and Meta-Analysis.

PubMed

Feng, Shuo; Cowling, Benjamin J; Kelly, Heath; Sullivan, Sheena G

2018-02-01

One important assumption in case-control studies is that control selection should be independent of exposure. Nevertheless, it has been hypothesized that virus interference might lead to a correlation between receipt of influenza vaccination and increased risk of infection with other respiratory viruses. We investigated whether such a phenomenon might affect a study design commonly used to estimate influenza vaccine effectiveness (VE). We searched publications in MEDLINE, PubMed, and Web of Science. We identified 12 studies using the test-negative design (2011-2017) that reported VE estimates separately derived by 3 alternative control groups: 1) all patients testing negative for influenza (FLU), VEFLU-; 2) patients who tested positive for other/another respiratory virus (ORV), VEORV+; and 3) patients who tested negative for all viruses in the panel (PAN), VEPAN-. These included VE estimates from 7 countries for all age groups from 2003/2004 to 2013/2014. We observed no difference in vaccination coverage between the ORV-positive and PAN-negative control groups. A total of 63 VEFLU- estimates, 62 VEORV+ estimates, and 33 VEPAN- estimates were extracted. Pooled estimates of the difference in VE (ΔVE) were very similar between groups. In meta-regression, no association was found between the selection of control group and VE estimates. In conclusion, we did not find any differences in VE estimates based on the choice of control group. © The Author(s) 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.

Building a Navigation System to Reduce Cancer Disparities in Urban Black Older Adults

PubMed Central

Bone, Lee; Edington, Kristen; Rosenberg, Jessica; Wenzel, Jennifer; Garza, Mary A.; Klein, Catherine; Schmitt, Lisa; Ford, Jean G.

2014-01-01

Background Although cancer outcomes have improved in recent decades, substantial disparities by race, ethnicity, income and education persist. Increasingly, patient navigation services are demonstrating success in improving cancer detection, treatment and care and in reducing cancer health disparities. To advance progress in developing patient navigation programs, extensive descriptions of each component of the program must be made available to researchers and health service providers. Objective To describe the components of a patient navigation program designed to improve cancer screening based on informed decision-making on cancer screening and cancer treatment services among predominantly Black older adults in Baltimore City. Methods A community-academic participatory approach was used to develop a patient navigation program in Baltimore, Maryland. The components of the patient navigation system included the development of a community academic (advisory) committee (CAC); recruitment and selection of community health workers (CHWs)/navigators and supervisory staff; initial training and continuing education of the CHWs/navigators; and evaluation of CHWs/navigators. The study was approved by the Johns Hopkins Bloomberg School of Public Health Institutional Review Board. Conclusions The incorporation of community-based participatory research (CPBR) principles into each facet of this patient navigation program facilitated the attainment of the intervention’s objectives. This patient navigation program successfully delivered cancer navigation services to 1302 urban Black older adults. Appropriately recruited, selected and trained CHWs monitored by an experienced supervisor and investigators are the key elements in a patient navigation program. This model has the potential to be adapted by research and health service providers. PMID:23793252

Odds per adjusted standard deviation: comparing strengths of associations for risk factors measured on different scales and across diseases and populations.

PubMed

Hopper, John L

2015-11-15

How can the "strengths" of risk factors, in the sense of how well they discriminate cases from controls, be compared when they are measured on different scales such as continuous, binary, and integer? Given that risk estimates take into account other fitted and design-related factors-and that is how risk gradients are interpreted-so should the presentation of risk gradients. Therefore, for each risk factor X0, I propose using appropriate regression techniques to derive from appropriate population data the best fitting relationship between the mean of X0 and all the other covariates fitted in the model or adjusted for by design (X1, X2, … , Xn). The odds per adjusted standard deviation (OPERA) presents the risk association for X0 in terms of the change in risk per s = standard deviation of X0 adjusted for X1, X2, … , Xn, rather than the unadjusted standard deviation of X0 itself. If the increased risk is relative risk (RR)-fold over A adjusted standard deviations, then OPERA = exp[ln(RR)/A] = RR(s). This unifying approach is illustrated by considering breast cancer and published risk estimates. OPERA estimates are by definition independent and can be used to compare the predictive strengths of risk factors across diseases and populations. © 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.

Steinmaus and Smith Respond to "Proximity to Gasoline Stations and Childhood Leukemia".

PubMed

Steinmaus, Craig; Smith, Martyn T

2017-01-01

Benzene is an established cause of adult leukemia, but its role in childhood leukemia is less clear. In a recent meta-analysis, we identified associations of childhood leukemia with occupational and household product benzene exposure and traffic-related pollution. Residential proximity to gasoline stations or automobile repair facilities may be another source of benzene, and in 3 studies assessing these sources, we identified a summary relative risk of 1.59 (95% confidence interval: 0.70, 3.62). Although not statistically significant, this summary relative risk was of a magnitude similar to that of our other positive findings. In this issue of the Journal (Am J Epidemiol 2017;185(1):5-7), Dr. Infante suggested that meta-analyses of studies on childhood leukemia and proximity to gasoline stations should involve some criteria that differ from those we used. These suggested criteria involved combining leukemia subtypes, excluding automobile repair facilities, and using nonleukemia cancers as control subjects. We redid our meta-analysis using these new criteria and obtained a summary relative risk of 2.42 (95% confidence interval: 1.51, 3.89). Overall, although this result should be interpreted in light of the relatively small sample size (3 studies) and its post-hoc nature, it provides additional new evidence for associations of childhood leukemia with both residential proximity to gasoline stations and exposure to benzene. © The Author 2016. 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.

Exposure-lag-response in Longitudinal Studies: Application of Distributed Lag Non-linear Models in an Occupational Cohort.

PubMed

Neophytou, Andreas M; Picciotto, Sally; Brown, Daniel M; Gallagher, Lisa E; Checkoway, Harvey; Eisen, Ellen A; Costello, Sadie

2018-02-13

Prolonged exposures can have complex relationships with health outcomes, as timing, duration, and intensity of exposure are all potentially relevant. Summary measures such as cumulative exposure or average intensity of exposure may not fully capture these relationships. We applied penalized and unpenalized distributed lag non-linear models (DLNMs) with flexible exposure-response and lag-response functions in order to examine the association between crystalline silica exposure and mortality from lung cancer and non-malignant respiratory disease in a cohort study of 2,342 California diatomaceous earth workers, followed 1942-2011. We also assessed associations using simple measures of cumulative exposure assuming linear exposure-response and constant lag-response. Measures of association from DLNMs were generally higher than from simpler models. Rate ratios from penalized DLNMs corresponding to average daily exposures of 0.4 mg/m3 during lag years 31-50 prior to the age of observed cases were 1.47 (95% confidence interval (CI) 0.92, 2.35) for lung cancer and 1.80 (95% CI: 1.14, 2.85) for non-malignant respiratory disease. Rate ratios from the simpler models for the same exposure scenario were 1.15 (95% CI: 0.89-1.48) and 1.23 (95% CI: 1.03-1.46) respectively. Longitudinal cohort studies of prolonged exposures and chronic health outcomes should explore methods allowing for flexibility and non-linearities in the exposure-lag-response. © The Author(s) 2018. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.

Hierarchical Distributed-Lag Models: Exploring Varying Geographic Scale and Magnitude in Associations Between the Built Environment and Health.

PubMed

Baek, Jonggyu; Sanchez-Vaznaugh, Emma V; Sánchez, Brisa N

2016-03-15

It is well known that associations between features of the built environment and health depend on the geographic scale used to construct environmental attributes. In the built environment literature, it has long been argued that geographic scales may vary across study locations. However, this hypothesized variation has not been systematically examined due to a lack of available statistical methods. We propose a hierarchical distributed-lag model (HDLM) for estimating the underlying overall shape of food environment-health associations as a function of distance from locations of interest. This method enables indirect assessment of relevant geographic scales and captures area-level heterogeneity in the magnitudes of associations, along with relevant distances within areas. The proposed model was used to systematically examine area-level variation in the association between availability of convenience stores around schools and children's weights. For this case study, body mass index (weight kg)/height (m)2) z scores (BMIz) for 7th grade children collected via California's 2001-2009 FitnessGram testing program were linked to a commercial database that contained locations of food outlets statewide. Findings suggested that convenience store availability may influence BMIz only in some places and at varying distances from schools. Future research should examine localized environmental or policy differences that may explain the heterogeneity in convenience store-BMIz associations. © The Author 2016. 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.

Association of Hemoglobin Concentration With Total and Cause-Specific Mortality in a Cohort of Postmenopausal Women.

PubMed

Kabat, Geoffrey C; Kim, Mimi Y; Verma, Amit K; Manson, JoAnn E; Lessin, Lawrence S; Kamensky, Victor; Lin, Juan; Wassertheil-Smoller, Sylvia; Rohan, Thomas E

2016-05-15

Anemia and low and high levels of hemoglobin have been associated with increased mortality and morbidity. However, most studies have measured hemoglobin at only 1 time point, and few studies have considered possible reverse causation. We used data from the Women's Health Initiative, in which baseline hemoglobin was measured in 160,081 postmenopausal women and year 3 hemoglobin was measured in 75,658 participants, to examine the associations of hemoglobin concentration with total mortality, coronary heart disease mortality, and cancer mortality. Women were enrolled from 1993 to 1998 and followed for a median of 16 years. Cox proportional hazards models were used to estimate the relative mortality hazards associated with deciles of baseline hemoglobin and the mean of baseline + year 3 hemoglobin. Both low and high deciles of baseline hemoglobin were positively associated with all 3 outcomes in the total cohort. In analyses restricted to women with 2 measurements, a low mean hemoglobin level was robustly and positively associated with all 3 outcomes, after exclusion of the early years of follow-up. High mean hemoglobin was also associated with increased risk of total mortality, whereas associations with heart disease mortality and cancer mortality were weaker and inconsistent. Our results provide evidence that low and high levels of hemoglobin are associated with increased risk of mortality in otherwise healthy women. © The Author 2016. 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.

Years of life lost due to influenza-attributable mortality in older adults in the Netherlands: a competing risks approach.

PubMed

McDonald, Scott A; van Wijhe, Maarten; van Asten, Liselotte; van der Hoek, Wim; Wallinga, Jacco

2018-02-06

We estimated the influenza mortality burden in adults 60 years of age and older in the Netherlands in terms of years of life lost, taking into account competing mortality risks. Weekly laboratory surveillance data for influenza and other respiratory pathogens and weekly extreme temperature served as covariates in Poisson regression models fitted to weekly age-group specific mortality data for the period 1999/2000 through 2012/13. Burden for age-groups 60-64 through 85-89 years was computed as years of life lost before age 90 (YLL90) using restricted mean lifetimes survival analysis and accounting for competing risks. Influenza-attributable mortality burden was greatest for persons aged 80-84 years, at 914 YLL90 per 100,000 persons (95% uncertainty interval:867, 963), followed by 85-89 years (787 YLL90/100,000; 95% uncertainty interval:741, 834). Ignoring competing mortality risks in the computation of influenza-attributable YLL90 would lead to substantial over-estimation of burden, from 3.5% for 60-64 years to 82% for persons aged 80-89 years at death. Failure to account for competing mortality risks has implications for accuracy of disease burden estimates, especially among persons aged 80 years and older. As the mortality burden borne by the elderly is notably high, prevention initiatives may benefit from being redesigned to more effectively prevent infection in the oldest age-groups. © The Author(s) 2018. 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.

Aggressive and violent behavior among military personnel deployed to Iraq and Afghanistan: prevalence and link with deployment and combat exposure.

PubMed

MacManus, Deirdre; Rona, Roberto; Dickson, Hannah; Somaini, Greta; Fear, Nicola; Wessely, Simon

2015-01-01

A systematic review and meta-analyses were conducted on studies of the prevalence of aggressive and violent behavior, as well as of violent offenses and convictions, among military personnel following deployment to Iraq and/or Afghanistan; the relationship with deployment and combat exposure; and the role that mental health problems, such as post-traumatic stress disorder (PTSD), have on the pathway between deployment and combat to violence. Seventeen studies published between January 1, 2001, and February 12, 2014, in the United States and the United Kingdom met the inclusion criteria. Despite methodological differences across studies, aggressive behavior was found to be prevalent among serving and formerly serving personnel, with pooled estimates of 10% (95% confidence interval (CI): 1, 20) for physical assault and 29% (95% CI: 25, 36) for all types of physical aggression in the last month, and worthy of further exploration. In both countries, rates were increased among combat-exposed, formerly serving personnel. The majority of studies suggested a small-to-moderate association between combat exposure and postdeployment physical aggression and violence, with a pooled estimate of the weighted odds ratio = 3.24 (95% CI: 2.75, 3.82), with several studies finding that violence increased with intensity and frequency of exposure to combat traumas. The review's findings support the mediating role of PTSD between combat and postdeployment violence and the importance of alcohol, especially if comorbid with PTSD. © 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.

John Leask Lumley: Whither Turbulence?

NASA Astrophysics Data System (ADS)

Leibovich, Sidney; Warhaft, Zellman

2018-01-01

John Lumley's contributions to the theory, modeling, and experiments on turbulent flows played a seminal role in the advancement of our understanding of this subject in the second half of the twentieth century. We discuss John's career and his personal style, including his love and deep knowledge of vintage wine and vintage cars. His intellectual contributions range from abstract theory to applied engineering. Here we discuss some of his major advances, focusing on second-order modeling, proper orthogonal decomposition, path-breaking experiments, research on geophysical turbulence, and important contributions to the understanding of drag reduction. John Lumley was also an influential teacher whose books and films have molded generations of students. These and other aspects of his professional career are described.

Microcosm to Cosmos: The Growth of a Divisional Computer Network

PubMed Central

Johannes, R.S.; Kahane, Stephen N.

1987-01-01

In 1982, we reported the deployment of a network of microcomputers in the Division of Gastroenterology[1]. This network was based upon Corvus Systems Omninet®. Corvus was one of the very first firms to offer networking products for PC's. This PC development occurred coincident with the planning phase of the Johns Hopkins Hospital's multisegment ethernet project. A rich communications infra-structure is now in place at the Johns Hopkins Medical Institutions[2,3]. Shortly after the hospital development under the direction of the Operational and Clinical Systems Division (OCS) development began, the Johns Hopkins School of Medicine began an Integrated Academic Information Management Systems (IAIMS) planning effort. We now present a model that uses aspects of all three planning efforts (PC networks, Hospital Information Systems & IAIMS) to build a divisional computing facility. This facility is viewed as a terminal leaf on then institutional network diagram. Nevertheless, it is noteworthy that this leaf, the divisional resource in the Division of Gastroenterology (GASNET), has a rich substructure and functionality of its own, perhaps revealing the recursive nature of network architecture. The current status, design and function of the GASNET computational facility is discussed. Among the major positive aspects of this design are the sharing and centralization of MS-DOS software, the high-speed DOS/Unix link that makes available most of the our institution's computing resources.

Logos Announced the Light of Salvation: Interpreting How John Presented His Message in John 1:1-18, According to Functional Grammar

ERIC Educational Resources Information Center

Pollinger, Seth

2014-01-01

This study of John 1:1-18 describes how John (the speaker) presented his message to his audience within their activity of verbal communication. By focusing on verbal meaning, this interpretation analyzes how John presented and expressed his meanings through language by interpreting this text based on the seamless interrelation between John's…

Obituary: John W. Firor (1927-2007)

NASA Astrophysics Data System (ADS)

Gilman, Peter A.

2009-12-01

John W. Firor, a former Director of the High Altitude Observatory and the National Center for Atmospheric Research, and a founder of the Solar Physics Division of the American Astronomical Society, died of Alzheimer's disease in Pullman, Washington on November 5, 2007, he was 80. He was born in Athens Georgia on October 18, 1927, where his father was a professor of agricultural economics. John had an unusually diverse scientific career. His interest in physics and astrophysics began while serving in the army, during which time he was assigned to the Los Alamos National Laboratory, where he guarded highly radioactive materials (many have heard him describe how informal the protections were compared to later times). After his service he returned to college and graduated in physics from Georgia Tech in 1949. He received his Ph.D. from the University of Chicago in 1954, writing his thesis on cosmic rays under John Simpson. John Firor would later remark that: "If you needed cosmic rays to actually do anything, you are sunk." That thought, partly in jest, may help explain his motivation for moving to so many new scientific and management pursuits. John moved from cosmic ray physics to radio astronomy (particularly of the Sun) when he began work at the Carnegie Institution of Washington's Department of Terrestrial Magnetism, where he remained until 1961. During this time, he met Walter Orr Roberts, then the Director of the High Altitude Observatory (HAO) in Boulder, Colorado. HAO was then affiliated with the University of Colorado. In 1959, a movement began to upgrade the atmospheric sciences in the United States by establishing a National Center, where the largest, most important atmospheric research problems could be addressed. Roberts became the first Director of NCAR, as well as the first president of the University Corporation for Atmospheric Research (UCAR), the consortium of universities that was commissioned to manage and staff the new Center. HAO became a

Genetics Home Reference: Saethre-Chotzen syndrome

MedlinePlus

... Saethre-Chotzen syndrome Johns Hopkins Collaboration for Craniofacial Development and Disorders MalaCards: saethre-chotzen syndrome Orphanet: Saethre-Chotzen syndrome Seattle Children's Hospital and Regional Medical Center Patient Support and Advocacy Resources (4 ...

A New Way to Manage TCGA Data - TCGA

Cancer.gov

Rachel Karchin, of Johns Hopkins University's Department of Biomedical Engineering, is developing a tool that will help researchers sort through the massive amounts of genomic data gathered from TCGA's ovarian cancer tumor samples.

The Small Body Mapping Tool (SBMT) for Accessing, Visualizing, and Analyzing Spacecraft Data in Three Dimensions

NASA Astrophysics Data System (ADS)

Barnouin, O. S.; Ernst, C. M.; Daly, R. T.

2018-04-01

The free, publicly available Small Body Mapping Tool (SBMT) developed at the Johns Hopkins University Applied Physics Laboratory is a powerful, easy-to-use tool for accessing and analyzing data from small bodies.

Training Postbac JHU | Center for Cancer Research

Cancer.gov

The Johns Hopkins University and the Center for Cancer Research (CCR) at the National Cancer Institute (NCI) have partnered to create a new concentration in the Master of Science in Biotechnology program, called

Center for Inherited Disease Research (CIDR)

Cancer.gov

The Center for Inherited Disease Research (CIDR) Program at The Johns Hopkins University provides high-quality next generation sequencing and genotyping services to investigators working to discover genes that contribute to common diseases.

Exceptional Scholarship and Democratic Agendas: Interviews with John Goodlad, John Hoyle, Joseph Murphy, and Thomas Sergiovanni

ERIC Educational Resources Information Center

Mullen, Carol A.

2006-01-01

This portraiture study of four exceptional scholars in education--John Goodlad, John Hoyle, Joseph Murphy, and Thomas Sergiovanni--provides insight into their scholarly work and life habits, direction and aspirations, assessment and analysis of major trends in the profession, and advice for aspiring leaders and academics. Telephone interviews with…

Exceptional Scholarship and Democratic Agendas: Interviews with John Goodlad, John Hoyle, Joseph Murphy, and Thomas Sergiovanni

ERIC Educational Resources Information Center

Mullen, Carol A.

2009-01-01

This portraiture study of four exceptional scholars in education--John Goodlad, John Hoyle, Joseph Murphy, and Thomas Sergiovanni--provides insight into their scholarly work and life habits, direction and aspirations, assessment and analysis of major trends in the profession, and advice for aspiring leaders and academics. Telephone interviews with…

Cochlear Implants Keep Twin Sisters Learning, Discovering Together

MedlinePlus

... University. Photo: Johns Hopkins University Keep Twin Sisters Learning, Discovering Together Mia and Isabelle Jeppsen, 10, share ... her mother, gratefully, "There's the obvious benefit of learning to read, write and communicate with facility and ...

Cecostomy

MedlinePlus

... a physician at another Johns Hopkins Member Hospital: Howard County General Sibley Memorial Hospital Suburban Hospital Connect ... Center: Pediatric Trauma Find Additional Treatment Centers at: Howard County General Sibley Memorial Hospital Suburban Hospital Maryland ...

Trustworthy Research Institutions: The Challenging Case of Studying the Genetics of Intelligence.

PubMed

Johnston, Josephine; Banerjee, Mohini P; Geller, Gail

2015-01-01

It is simple enough to claim that academic research institutions ought to be trustworthy. Building the culture and taking the steps necessary to earn and preserve institutional trust are, however, complex processes. The experience motivating this special report--a request for the Center for Talented Youth at Johns Hopkins University to collaborate on research regarding the genetics of intelligence--illustrates how ensuring institutional trustworthiness can be in tension with a commitment to fostering research. In this essay, we explore the historical context for biomedical research institutions like Johns Hopkins that have worked to build local community trust. In so doing, we consider how the example under focus in this special report can lead to greater consideration of how research institutions balance fostering trust with their other commitments. © 2015 The Hastings Center.

Recent Observations and Structural Analysis of Surge-Type Glaciers in the Glacier Bay Area

NASA Astrophysics Data System (ADS)

Mayer, H.; Herzfeld, U. C.

2003-12-01

The Chugach-St.-Elias Mountains in North America hold the largest non-polar connected glaciated area of the world. Most of its larger glaciers are surge-type glaciers. In the summer of 2003, we collected aerial photographic and GPS data over numerous glaciers in the eastern St. Elias Mountains, including the Glacier Bay area. Observed glaciers include Davidson, Casement, McBride, Riggs, Cushing, Carroll, Rendu, Tsirku, Grand Pacific, Melbern, Ferris, Margerie, Johns Hopkins, Lamplugh, Reid, Burroughs, Morse, Muir and Willard Glaciers, of which Carroll, Rendu, Ferris, Grand Pacific, Johns Hopkins and Margerie Glaciers are surge-type glaciers. Our approach utilizes a quantitative analysis of surface patterns, following the principles of structural geology for the analysis of brittle-deformation patterns (manifested in crevasses) and ductile deformation patterns (visible in folded moraines). First results will be presented.

Evaluation of the five-year Bloomberg Philanthropies Global Road Safety Program in the Russian Federation.

PubMed

Gupta, S; Paichadze, N; Gritsenko, E; Klyavin, V; Yurasova, E; Hyder, A A

2017-03-01

Road traffic injuries are a leading cause of morbidity and mortality in the world. In Russia, a road safety program was implemented in Lipetskaya and Ivanovskaya oblasts (regions) as part of a 10-country effort funded by Bloomberg Philanthropies. The program was focused on increasing seat belt and child restraint use and reducing speeding. The primary goals of this monitoring and evaluation study are to assess trends in seat belt use, child restraint use, and speed compliance in the two oblasts over the 5 years and to explore the overall impact of the program on road traffic injury and death rates. Primary data via roadside observations and interviews, and secondary data from official government sources were collected and analyzed for this study. Our results indicate significant improvements in seat belt wearing and child seat use rates and in prevalence of speeding in both intervention oblasts. The observations were consistent with the results from the roadside interviews. In Lipetskaya, restraint use by all occupants increased from 52.4% (baseline, October 2010) to 77.4% (final round, October 2014) and child restraint use increased from 20.9% to 54.1% during the same period. In Ivanovskaya, restraint use by all occupants increased from 48% (baseline, April 2012) to 88.7% (final round, October 2014) and child restraint use increased from 20.6% to 89.4% during the same period. In Lipetskaya, the overall prevalence of speeding (vehicles driving above speed limit) declined from 47.0% (baseline, July 2011) to 30.4% (final round, October 2014) and a similar pattern was observed in Ivanovskaya where the prevalence of speeding decreased from 54.6% (baseline, March 2012) to 46.6% (final round, October 2014). Through 2010-2014, the road traffic crash and injury rates per 100,000 population decreased in Lipetskaya oblast (191.5 and 246.9 in 2010 and 170.4 and 208.6 in 2014, respectively) and slightly increased in Ivanovskaya oblast (184.4 and 236.0 in 2010 and 186.7 and 243

Episiotomy - aftercare

MedlinePlus

... ed. Philadelphia, PA: Elsevier Mosby; 2011:chap 166. Review Date 5/16/2016 Updated by: Irina Burd, ... Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by ...

Introduction - NCS Dietary Assessment Literature Review

Cancer.gov

To assist in the planning of the National Children's Study, investigators at the NIH Office of Dietary Supplements, NCI and Johns Hopkins University contracted with Westat to conduct a comprehensive review of the scientific literature.

Celebrating John Glenn’s Legacy

NASA Image and Video Library

2012-03-02

Former NASA Astronaut Steve Lindsey gives remarks at an event celebrating John Glenn's legacy and 50 years of americans in orbit held at the Cleveland State University Wolstein Center on Friday, March 3, 2012 in Cleveland, Ohio. In 1998 Lindsey flew onboard the space shuttle Discovery along with then 77 year-old Sen. John Glenn for the STS-95 mission. Glenn became the first American to orbit Earth in 1962. Photo Credit: (NASA/Bill Ingalls)

Celebrating John Glenn’s Legacy

NASA Image and Video Library

2012-03-02

Wife of former astronaut and Senator John Glenn, Annie Glenn, listens intently to Cleveland State University Master of Music Major James Binion Jr. as he sings a musical tribute during an event celebrating John Glenn's legacy and 50 years of americans in orbit held at the university's Wolstein Center on Friday, March 3, 2012 in Cleveland, Ohio. Glenn became the first American to orbit Earth in 1962. Photo Credit: (NASA/Bill Ingalls)

Obituary: John Leroy Climenhaga, 1916-2008

NASA Astrophysics Data System (ADS)

Scarfe, Colin

2009-01-01

John Leroy Climenhaga was born on 7 November 1916 on a farm some 10 km from Delisle, a small town on the Canadian prairies, located about 50 km south-west of Saskatoon, Saskatchewan, and died at his home in Victoria, British Columbia, on 27 May 2008. His parents, Reuben and Elizabeth (nee Bert) Climenhaga, were farming folk, and he carried their honest and open attitude to the world throughout his life. John was the seventh born, and last to die, of their ten children. His father also served as an ordained minister of the Brethren in Christ. In early adulthood, John worked on his father's farm, but then attended the University of Saskatchewan, obtaining a B.A. with Honors in Mathematics and Physics and an M.A. in Physics, in 1945 and 1949 respectively. Between these events he worked as a Physics Instructor at Regina College from 1946 to 1948. In 1949 Climenhaga joined the faculty of Victoria College, as one of only two physicists in a small institution that was then part of the University of British Columbia. He remained in Victoria for the rest of his career, playing a major role in the College's growth into a full-fledged university, complete with thriving graduate programs in physics and astronomy as well as in many other fields. He served as Head of the Physics Department during the 1960s, a period which saw the College become the University of Victoria, with a full undergraduate program in Physics, and campaigned successfully for the establishment of a program in Astronomy, which began in 1965. From 1969 until 1972 he held the position of Dean of Arts and Science, and championed the university's participation in the Tri-University Meson Facility, whose high-current medium-energy beam was ideal for the production and study of mesons and their physics. That period was a turbulent one in the university's history, but John's integrity and his balanced and fair-minded approach to conflicts were of immeasurable importance in steering the young institution through it

John N Bahcall (1934 2005)

NASA Astrophysics Data System (ADS)

Bergström, Lars; Botner, Olga; Carlson, Per; Hulth, Per Olof; Ohlsson, Tommy

2005-01-01

John Norris Bahcall, passed away on August 17, 2005, in NewYork City, USA. He was born on December 30, 1934, in Shreveport, Louisiana, USA. He was Richard Black Professor of Astrophysics in the School of Natural Sciences at the Institute forAdvanced Study (IAS) in Princeton, New Jersey, USA and a recipient of the National Medal of Science. In addition, he was President of the American Astronomical Society, President-Elect of the American Physical Society, and a prominent leader of the astrophysics community. John had a long and prolific career in astronomy and astrophysics, spanning five decades and the publication of more than five hundred technical articles, books, and popular papers. John's most recognized scientific contribution was the novel proposal in 1964, together with Raymond Davis Jr, that scientific mysteries of our Sun `how it shines, how old it is, how hot it is' could be examined by measuring the number of neutrinos arriving on Earth from the Sun. Measuring the properties of these neutrinos tests both our understanding of how stars shine and our understanding of fundamental particle physics. However, in the 1960s and 1970s, the observations by Raymond Davis Jr showed a clear discrepancy between John's theoretical predictions, based on standard solar and particle physics models, and what was experimentally measured. This discrepancy, known as the `Solar Neutrino Problem', was examined by hundreds of physicists, chemists, and astronomers over the subsequent three decades. In the late 1990s through 2002, new large-scale neutrino experiments in Japan, Canada, Italy, and Russia culminated in the conclusion that the discrepancy between John's theoretical predictions and the experimental results required a modification of our understanding of particle physics: neutrinos must have a mass and `oscillate' among different particle states. In addition to neutrino astrophysics, John contributed to many areas of astrophysics including the study of dark matter in

SAO/NASA joint investigation of astronomical viewing quality at Mount Hopkins Observatory: 1969-1971

NASA Technical Reports Server (NTRS)

Pearlman, M. R.; Bufton, J. L.; Hogan, D.; Kurtenbach, D.; Goodwin, K.

1974-01-01

Quantitative measurements of the astronomical seeing conditions have been made with a stellar-image monitor system at the Mt. Hopkins Observatory in Arizona. The results of this joint SAO-NASA experiment indicate that for a 15-cm-diameter telescope, image motion is typically 1 arcsec or less and that intensity fluctuations due to scintillation have a coefficient of irradiance variance of less than 0.12 on the average. Correlations between seeing quality and local meteorological conditions were investigated. Local temperature fluctuations and temperature gradients were found to be indicators of image-motion conditions, while high-altitude-wind conditions were shown to be somewhat correlated with scintillation-spectrum bandwidth. The theoretical basis for the relationship of atmospheric turbulence to optical effects is discussed in some detail, along with a description of the equipment used in the experiment. General site-testing comments and applications of the seeing-test results are also included.

Obituary: John Louis Africano III, 1951-2006

NASA Astrophysics Data System (ADS)

Barker, Edwin, S.

2007-12-01

The orbital debris, space surveillance, and astronomical communities lost a valued and beloved friend when John L. Africano passed away on July 27, 2006, at the young age of 55. John passed away in Honolulu, Hawaii, from complications following a heart attack suffered while playing racquetball, which was his avocation in life. Born on February 8, 1951, in Saint Louis, Missouri, John graduated with a B.S. in Physics from the University of Missouri at Saint Louis in 1973, and received a Master's degree in Astronomy from Vanderbilt University in 1974. John had a real love for astronomical observing and for conveying his many years of experience to others. He encouraged many young astronomers and mentored them in the basics of photometry and astronomical instrumentation. John was author or co-author on nearly one-hundred refereed publications ranging from analyses of cool stars to the timing of occultations to space surveillance. He was honored for his contributions to minor planet research when the Jet Propulsion Laboratory named Minor Planet 6391 (Africano) after him. John held operational staff positions at several major observatories including McDonald Observatory in Texas, Kitt Peak National Observatory in Arizona, and the Cloudcroft Telescope Facility in New Mexico. He observed at numerous observatories worldwide, including Cerro Tololo Inter-American Observatory (CTIO) in Chile, developing a world-wide network of friends and colleagues. John's ability to build diverse teams through his managerial and technical skills, not to mention his smiling personality, resulted in numerous successes in the observational astronomy and space surveillance arenas. As an astronomer for Boeing LTS Inc., he worked for many years at the Advanced Maui Optical and Space Surveillance site (AMOS) on Maui, Hawaii, where he contributed his operational and instrumental expertise to both the astronomy and space surveillance communities. He was also the co-organizer of the annual AMOS

Women's health

MedlinePlus

... 9th ed. Philadelphia, PA: Elsevier; 2016:chap 25. Review Date 4/5/2016 Updated by: Irina Burd, ... Johns Hopkins University School of Medicine, Baltimore, MD. Review provided by VeriMed Healthcare Network. Also reviewed by ...

Imperforate hymen

MedlinePlus

... 149. Sucato GS, Murray PJ. Pediatric and adolescent gynecology. In: Zitelli, BJ, McIntire SC, Norwalk AJ, eds. ... by: Irina Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of ...

Preterm labor

MedlinePlus

... SG, Niebyl JR, Simpson JL, et al, eds. Obstetrics: Normal and Problem Pregnancies . 7th ed. Philadelphia, PA: ... Burd, MD, PhD, Associate Professor of Gynecology and Obstetrics at Johns Hopkins University School of Medicine, Baltimore, ...

How Far Can Autistic Children Go in Matters of Social Adaptation?

ERIC Educational Resources Information Center

Kanner, Leo; And Others

1972-01-01

The case histories of nine autistic children, eight boys and one girl, selected from a total of 96 so diagnosed at The John Hopkins Hospital prior to 1953, are presented in some detail and discussed. (Author)

Genetics Home Reference: immune thrombocytopenia

MedlinePlus

... spots of bleeding under the skin are called purpura and larger spots are called ecchymoses. People with ... links) Johns Hopkins Medicine MedlinePlus Encyclopedia: Idiopathic Thrombocytopenic Purpura (ITP) Seattle Children's Hospital General Information from MedlinePlus ( ...

Genetics Home Reference: X-linked cardiac valvular dysplasia

MedlinePlus

... inflammation of the inner lining of the heart (endocarditis), abnormal blood clots, or sudden death. X-linked ... Johns Hopkins Medicine: Mitral Valve Prolapse MedlinePlus Encyclopedia: Endocarditis MedlinePlus Encyclopedia: Mitral Valve Prolapse General Information from ...

Genetics Home Reference: small fiber neuropathy

MedlinePlus

... Small fiber neuropathy is considered a form of peripheral neuropathy because it affects the peripheral nervous system, which ... Page National Institute of Neurological Disorders and Stroke: Peripheral Neuropathy Information Page Educational Resources (4 links) Johns Hopkins ...

John locke on personal identity.

PubMed

Nimbalkar, Namita

2011-01-01

John Locke speaks of personal identity and survival of consciousness after death. A criterion of personal identity through time is given. Such a criterion specifies, insofar as that is possible, the necessary and sufficient conditions for the survival of persons. John Locke holds that personal identity is a matter of psychological continuity. He considered personal identity (or the self) to be founded on consciousness (viz. memory), and not on the substance of either the soul or the body.

Obituary: John Sulston (1942-2018).

PubMed

White, John

2018-05-08

John Sulston, a pioneer in the developmental studies of the nematode C. elegans who went on to spearhead the sequencing of the genome of this organism and ultimately the human genome, died on 6th March 2018, shortly after being diagnosed with stomach cancer. Here, I reflect on John's life and work, with a particular focus on his time working on the developmental genetics and lineage of C. elegans . © 2018. Published by The Company of Biologists Ltd.

SETI group let by Barney Oliver, John Wolfe and John Billingham (in middle standing) lead a 1976

NASA Technical Reports Server (NTRS)

1976-01-01

SETI group let by Barney Oliver, John Wolfe and John Billingham (in middle standing) lead a 1976 discussion on the best strategies in the Search for Extraterrestrial Intelligence. Joining the discussion are L-R; Charles Seeger, Dario Black, Mary Connors, (Oliver, Wolfe, Billingham) and Larry Lesyna, (seated) Mark Stull.

Celebrating John Glenn’s Legacy

NASA Image and Video Library

2012-03-02

Cleveland State University Master of Music Major James Binion Jr. sings a musical tribute during an event celebrating John Glenn's legacy and 50 years of americans in orbit held at the university's Wolstein Center on Friday, March 3, 2012 in Cleveland, Ohio. In 1998 Lindsey flew onboard the space shuttle Discovery along with then 77 year-old Sen. John Glenn for the STS-95 mission. Glenn became the first American to orbit Earth in 1962. Photo Credit: (NASA/Bill Ingalls)

Microgravity

NASA Image and Video Library

2001-01-24

Dr. Cila Herman, G.W.C. Whiting School of Engineering, Johns Hopkins University, Baltimore. She is the principal investigator for the Experimental Investigation of Pool Boiling Heat Transfer Enhancement in Microgravity in the Presence of Electric Fields.

A to Z with Jasper Johns

ERIC Educational Resources Information Center

Kirker, Sara Schmickle

2008-01-01

One contemporary artist that kindergarten students can easily relate to is Jasper Johns. In this article, the author discusses how she introduced John's numeric and alphabetic paintings to her kindergarten students. The young artists were amazed that art can be created from the familiar symbols that they are learning to make in their regular…

Artificial Neural Network Approaches in Guidance and Control (Les Reseaux Neuroniques Artificiels, Voie a Explorer dans le Domaine du Guidage et du Pilotage)

DTIC Science & Technology

1991-09-01

34 ofetworker eqmpleuoaorreation withbounethat basis vectors (Lawley & Maxwell , 1963). naletwk arn ungd eqatsi wthe boune E It is possible to think of the...passive sonar system IJCNN- signal Aerospace Technology Center, John 89 Washington proceedings Hopkins University) Analysis of hidden Succesful use of...establish the weighted equations and C3 applications interconnmctions of the net and electronic feedback based AUTH: A/CONNELL, JOHN C ., JR. CORP, Naval

John Henry--The Steel Driving Man

ERIC Educational Resources Information Center

Murphy, David E.; Gulley, Laura L.

2005-01-01

The story of John Henry provided the setting for sixth-grade class to participate in a John Henry Day of mathematics experiments. The students collected data from experiments where students competed against machines and technology. The student analyzed the data by comparing two box plots, a box plot of human data, and a box plot of machine or…

John C. Mather, the Big Bang, and the COBE

Science.gov Websites

Additional Information * Videos John C. Mather Courtesy of NASA "Dr. John C. Mather of NASA's Goddard excerpt from NASA Scientist Shares Nobel Prize for Physics 2Edited excerpt from John Mather: The Path to a Spacecraft Courtesy of Lawrence Berkeley National Laboratory Additional Web Pages: Dr. John C Mather, NASA

Investigating the relationship between weather and violence in Baltimore, Maryland, USA.

PubMed

Michel, Samuel J; Wang, Han; Selvarajah, Shalini; Canner, Joseph K; Murrill, Matthew; Chi, Albert; Efron, David T; Schneider, Eric B

2016-01-01

It is a common refrain at major urban trauma centers that caseloads increase in the heat of the summer. Several previous studies supported this assertion, finding trauma admissions and crime to correlate positively with temperature. We examined links between weather and violence in Baltimore, MD, through trauma presentation to Johns Hopkins Hospital and crime reports filed with the Baltimore Police Department. Crime data were obtained from the Baltimore City Police Department from January 1, 2008 to March 31, 2013. Trauma data were obtained from a prospectively collected registry of all trauma patients presenting to Johns Hopkins Hospital from January 1, 2007 to March 31, 2013. Weather data were obtained from the National Climatic Data Center. Correlation coefficients were calculated and negative binomial regression was used to elucidate the independent associations of weather and temporal variables with the trauma and crime data. When adjusting for temporal and meteorological factors, maximum daily temperature was positively associated with total trauma, intentional injury, and gunshot wounds presenting to Johns Hopkins Hospital along with total crime, violent crime, and homicides in Baltimore City. Associations of average wind speed, daily precipitation, and daily snowfall with trauma and crime were far weaker and, when significant, nearly universally negative. Maximum daily temperature is the most important weather factor associated with violence and trauma in our study period and location. Our findings suggest potential implications for hospital staffing to be explored in future studies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Design of the optical communication system for the asteroid impact mission

NASA Astrophysics Data System (ADS)

Heese, C.; Sodnik, Z.; Carnelli, I.

2017-09-01

The Asteroid Impact Mission (AIM) is part of the joint Asteroid Impact and Deflection Assessment (AIDA) project of ESA, DLR, Observatoire de la Côte d'Ázur, NASA, and Johns Hopkins University Applied Physics Laboratory (JHU/APL).

33 CFR 110.183 - St. Johns River, Florida.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false St. Johns River, Florida. 110.183... ANCHORAGE REGULATIONS Anchorage Grounds § 110.183 St. Johns River, Florida. (a) The anchorage grounds—(1... anchor in the St. Johns River, as depicted on NOAA chart 11491, between the entrance buoy (STJ) and the...

International surgical telementoring: our initial experience.

PubMed

Lee, B R; Caddedu, J A; Janetschek, G; Schulam, P; Docimo, S G; Moore, R G; Partin, A W; Kavoussi, L R

1998-01-01

Telesurgical laparoscopic telementoring has successfully been implemented between the Johns Hopkins Bayview Medical Center and the Johns Hopkins Hospital in 27 prior operations. In this previously reported series, telerobotic mentoring was achieved between two institutions 3.5 miles away. We report our experience in performing two international surgical telementoring operations. To determine the clinical utility of international surgical telementoring during laparoscopic surgical procedures. A laparoscopic adrenalectomy was telementored between Innsbruck, Austria (5,083 miles) and Baltimore, MD. As well, a laparoscopic varicocelectomy was telementored between Bangkok, Thailand and Baltimore, MD (10,880 miles) both over three ISDN lines (384 kbps) with an approximate 1 sec delay. Both procedures were successfully accomplished with an uneventful postoperative course. International telementoring is a viable method of instructing less experienced laparoscopic surgeons through potentially complex laparoscopic procedures, as well as potentially improving patient access to specialty care.

KSC-06pd0009

NASA Image and Video Library

2006-01-11

KENNEDY SPACE CENTER, FLA. - In the Vertical Integration Facility on Launch Complex 41, Cape Canaveral Air Force Station, Hal Weaver, New Horizons project scientist with the Johns Hopkins University Applied Physics Laboratory, signs the fairing enclosing the New Horizons spacecraft. The fairing protects the spacecraft during launch and flight through the atmosphere. Once out of the atmosphere, the fairing is jettisoned. The compact 1,060-pound New Horizons probe carries seven scientific instruments that will characterize the global geology and geomorphology of Pluto and its moon Charon, map their surface compositions and temperatures, and examine Pluto's complex atmosphere. New Horizons is the first mission in NASA's New Frontiers program of medium-class planetary missions. The spacecraft, designed for NASA by the Johns Hopkins University Applied Physics Laboratory in Laurel, Md., will fly by Pluto and Charon as early as summer 2015.

33 CFR 110.73 - St. Johns River, Fla.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false St. Johns River, Fla. 110.73... ANCHORAGE REGULATIONS Special Anchorage Areas § 110.73 St. Johns River, Fla. (a) Area A. The waters lying within an area bounded by a line beginning at a point located at the west bank of St. Johns River at...

Heavy Fermion Materials and Quantum Phase Transitions Workshop on Frontiers of the Kondo Effect

DTIC Science & Technology

2016-02-12

Stefan Kirchner (Max Planck) discussed the role of quantum criticality on the superconducting condensation in heavy-fermion superconductors , and...Collin Broholm (Johns Hopkins) discussed magnetic excitations of heavy fermion superconductors . The workshop concluded with a wide-ranging talk by

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, a lift helps offload NASA’s MESSENGER spacecraft shipped from NASA’s Goddard Space Flight Center in Greenbelt, Md. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

NASA Image and Video Library

2004-03-10

KENNEDY SPACE CENTER, FLA. - At the Astrotech Space Operations processing facilities near KSC, a lift helps offload NASA’s MESSENGER spacecraft shipped from NASA’s Goddard Space Flight Center in Greenbelt, Md. MESSENGER - short for MErcury Surface, Space ENvironment, GEochemistry and Ranging - will be taken into a high bay clean room and employees of the Johns Hopkins University Applied Physics Laboratory, builders of the spacecraft, will perform an initial state-of-health check. Then processing for launch can begin, including checkout of the power systems, communications systems and control systems. The thermal blankets will also be attached for flight. MESSENGER will be launched May 11 on a six-year mission aboard a Boeing Delta II rocket. Liftoff is targeted for 2:26 a.m. EDT on Tuesday, May 11.

Johns Hopkins nursing evidence-based practice Johns Hopkins nursing evidence-based practice Sandra L Dearholt and Deborah Dang Sigma Theta Tau International £24.70 256pp 9781935476764 1935476769 [Formula: see text].

PubMed

2012-10-26

EVIDENCE-BASED PRACTICE has become the accepted term for a systematic approach by all healthcare professionals to service provision. However, as this and other recent publications demonstrate, even though there is acceptance in theory that practice should be evidence based, making the concept a reality in clinical and educational settings still requires work.

Analysis performed in support of the Ad-Hoc Working Group of RTCA SC-159 on RAIM/FDE issues

DOT National Transportation Integrated Search

2002-01-01

In 1999, the FAA requested that RTCA SC-159 address one of the recommendations from the study performed by the Johns Hopkins University (JHU) Applied Physics Lab (APL) on the use of GPS and augmented GPS for aviation applications. This recommendation...

NHEXAS PHASE I MARYLAND STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (G01)

EPA Science Inventory

The purpose of this SOP is to develop a consistent method and style for all Emory University/Harvard University/Johns Hopkins University standard operating procedures. SOPs are necessary to document all procedures, methods, and techniques used in the NHEXAS investigations. Deve...

Pressure Points: Preventing and Controlling Hypertension

MedlinePlus

... lead author of a February 2006 report in Hypertension: Journal of the American Heart Association , which links healthier eating habits to lowered blood pressure. "While an individual's blood ... of high blood pressure," says Appel, a professor at Johns Hopkins University ...

Stephen Baylin, M.D., Explains Genetics and Epigenetics - TCGA

Cancer.gov

Stephen Baylin, M.D., at the Johns Hopkins Kimmel Cancer Center discusses the how alterations in the DNA code are deciphered in a combined effort with The Cancer Genome Atlas at the National Cancer Institute to decode the brain cancer genome.

The Cosmology Large Angular Scale Surveyor (CLASS) Telescope Architecture

NASA Technical Reports Server (NTRS)

Chuss, David T.; Ali, Aamir; Amiri, Mandana; Appel, John W.; Araujo, Derek; Bennett, Charles L.; Boone, Fletcher; Chan, Manwei; Cho, Hsiao-Mei; Colazo, Felipe;

Reflections on Reference Services.

ERIC Educational Resources Information Center

Brandt, Kerryn A.; And Others

1996-01-01

Describes programmatic changes in reference services at the Johns Hopkins University (Maryland) medical library and speculates on the future. Topics include institutional restructuring and consolidation; improvements in technology infrastructure; external economic pressure; and fiscal accountability, including library funding and cost center…

46 CFR 7.90 - St. Johns River, FL.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 1 2010-10-01 2010-10-01 false St. Johns River, FL. 7.90 Section 7.90 Shipping COAST... § 7.90 St. Johns River, FL. A line drawn from the southeasternmost extremity of Little Talbot (Spike) Island to latitude 30°23.8′ N. longitude 81°20.3′ W. (St. Johns Lighted Whistle Buoy “2 STJ”); thence to...

St. John's wort: a new alternative for depression?

PubMed

Josey, E S; Tackett, R L

1999-03-01

The primary purpose of this article is to review the existing literature concerning the therapeutic uses, adverse effects, and possible drug interactions of St. John's wort (Hypericum perforatum) as compared to other antidepressant medications. Reference material was obtained through database searches with time restrictions of 1985 to the present. Studies selected were those written in the English language which compared the role of St. John's wort, tricyclic antidepressants, monoamine oxidase inhibitors, and serotonin-selective reuptake inhibitors in the treatment of depression. Other studies were selected based on their evaluation of the safety and efficacy of St. John's wort as an antidepressant for a minimum of four weeks. A review of existing literature recognized nine clinical trials that reported the efficacy of St. John's wort as compared to placebo and to other antidepressant medications. Of these nine, four controlled studies were chosen based upon their large patient populations and their consistency in brand and dosage of St. John's wort used. These four studies demonstrated that St. John's wort was as effective as other antidepressant medications and more effective than placebo, as the clinical symptoms of depression greatly decreased upon administration of H. perforatum. The side-effect profile of H. perforatum at this time appears to be superior to any current U.S.-approved antidepressant medication. From the existing literature, St. John's wort appears to be a safe and effective alternative in the treatment of depression. Tricylic antidepressants and monoamine oxidase inhibitors can produce serious cardiac side-effects, such as tachycardia and postural hypotension, and many unwanted anticholinergic side-effects, including dry mouth and constipation. St. John's wort has proven to be free of any cardiac, as well as anticholinergic, side-effects normally seen with antidepressant medications. Based upon limited studies, St. John's wort appears to be an

John Carroll University

ERIC Educational Resources Information Center

Dean, Kathleen Lis; Rombalski, Patrick; O'Dell, Kyle

2009-01-01

John Carroll University (JCU) is a Jesuit Catholic institution located in University Heights, approximately 10 miles east of Cleveland, Ohio. Founded in 1888, the university has a population of 3,400 undergraduates and 800 graduate students. The Division of Student Affairs at JCU comprises 11 units. The mission of the division is the same as that…

33 CFR 117.325 - St. Johns River.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false St. Johns River. 117.325 Section 117.325 Navigation and Navigable Waters COAST GUARD, DEPARTMENT OF HOMELAND SECURITY BRIDGES DRAWBRIDGE OPERATION REGULATIONS Specific Requirements Florida § 117.325 St. Johns River. (a) The drawspan...

Obituary: John J. Hillman, 1938-2006

NASA Astrophysics Data System (ADS)

Chanover, Nancy

2007-12-01

John J. Hillman, a dedicated NASA civil servant, spectroscopist, astrophysicist, planetary scientist, and mentor, died on February 12, 2006 of ocular melanoma at his home in Columbia, Maryland. His professional and personal interests were wide-reaching and varied, and he devoted his career to the advancement of our understanding of the beauty and wonder in the world around us. His love of nature, art, and science made him a true Renaissance man. John was born in Fort Jay, New York, on November 22, 1938, and was raised in Washington, D.C. He received his B.S., M.S., and Ph.D. degrees in Physics from American University in 1967, 1970, and 1975, respectively. He began working at NASA's Goddard Space Flight Center, then in its infancy, in 1969, juggling a full-time position as a Research Physicist, the completion of his M.S. and Ph.D. degrees, and a young family. His background in molecular spectroscopy enabled him to apply his skills to numerous disciplines within NASA: infrared and radio astronomy; electronic, vibrational, and rotational structure of interstellar molecules; solar and stellar atmospheres; and planetary atmospheres. He published more than 70 journal papers in these disciplines. He was a frequent contributor to the Ohio State University International Symposium on Molecular Spectroscopy, and possessed a rare ability to bridge the gap between laboratory and remote sensing spectroscopy, bringing scientists from different disciplines together to understand our Universe. The last fifteen years of John's career were devoted to the development of acousto-optic tunable filter (AOTF) cameras. He championed this technology as a low-cost, low-power alternative to traditional imaging cameras for in situ or remotely sensed planetary exploration. It was within this context that I got to know John, and eventually worked closely with him on the demonstration and application of this technology for planetary science using ground-based telescopes in New Mexico, California

The Association Between Perceived Stress and Mortality Among People With Multimorbidity: A Prospective Population-Based Cohort Study.

PubMed

Prior, Anders; Fenger-Grøn, Morten; Larsen, Karen Kjær; Larsen, Finn Breinholt; Robinson, Kirstine Magtengaard; Nielsen, Marie Germund; Christensen, Kaj Sparle; Mercer, Stewart W; Vestergaard, Mogens

2016-08-01

Multimorbidity is common and is associated with poor mental health and high mortality. Nevertheless, no studies have evaluated whether mental health may affect the survival of people with multimorbidity. We investigated the association between perceived stress and mortality in people with multimorbidity by following a population-based cohort of 118,410 participants from the Danish National Health Survey 2010 for up to 4 years. Information on perceived stress and lifestyle was obtained from the survey. We assessed multimorbidity using nationwide register data on 39 conditions and identified 4,229 deaths for the 453,648 person-years at risk. Mortality rates rose with increasing levels of stress in a dose-response relationship (P-trend < 0.0001), independently of multimorbidity status. Mortality hazard ratios (highest stress quintile vs. lowest) were 1.51 (95% confidence interval (CI): 1.25, 1.84) among persons without multimorbidity, 1.39 (95% CI: 1.18, 1.64) among those with 2 or 3 conditions, and 1.43 (95% CI: 1.18, 1.73) among those with 4 or more conditions, when adjusted for disease severities, lifestyle, and socioeconomic status. The numbers of excess deaths associated with high stress were 69 among persons without multimorbidity, 128 among those with 2 or 3 conditions, and 255 among those with 4 or more conditions. Our findings suggested that perceived stress contributes significantly to higher mortality rates in a dose-response pattern, and more stress-associated deaths occurred in people with multimorbidity. © The Author 2016. 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.