Testing and referral patterns in the years surrounding the US Preventive Services Task Force recommendation against prostate-specific antigen screening.

PubMed

Hutchinson, Ryan; Akhtar, Abdulhadi; Haridas, Justin; Bhat, Deepa; Roehrborn, Claus; Lotan, Yair

2016-12-15

Since the US Preventive Services Task Force (USPSTF) recommended against prostate-specific antigen (PSA) screening, there have been conflicting reports regarding the impact on the behavior of providers. This study analyzed real-world data on PSA ordering and referral practices in the years surrounding the recommendation. A whole-institution sample of entered PSA orders and urology referrals was obtained from the electronic medical record. The study was performed at a tertiary referral center with a catchment in the southern United States. PSA examinations were defined as screening when they were ordered by providers with appointments in internal medicine, family medicine, or general internal medicine. Linear and quadratic regression analyses were performed, and joinpoint regression was used to assess for trend inflection points. Between January 2010 and July 2015, there were 275,784 unique ambulatory visits for men. There were 63,722 raw PSA orders, and 54,684 were evaluable. Primary care providers ordered 17,315 PSA tests and 858 urology referrals. The number of PSA tests per ambulatory visit, the number of referrals per ambulatory visit, the age at the time of the urology referral, and the proportion of PSA tests performed outside the recommended age range did not significantly change. The PSA value at the time of referral increased significantly (P = .022). Joinpoint analysis revealed no joinpoints in the analysis of total PSA orders, screening PSA tests, or examinations per 100 visits. In the years surrounding the USPSTF recommendation, PSA behavior did not change significantly. Patients were referred at progressively higher average PSA levels. The implications for prostate cancer outcomes from these trends warrant further research into provider variables associated with actual PSA utilization. Cancer 2016;122:3785-3793. © 2016 American Cancer Society. © 2016 American Cancer Society.

Consecutive Non-Significant Segments — Joinpoint Help System 4.4.0.0

Cancer.gov

Sometimes, the APC for one segment is significantly different from zero, but when an extra joinpoint in the segment is determined by the Joinpoint software, neither APCs for the two consecutive segments are significant. Why?

Analysis of cerebrovascular disease mortality trends in Andalusia (1980-2014).

PubMed

Cayuela, A; Cayuela, L; Rodríguez-Domínguez, S; González, A; Moniche, F

2017-03-15

In recent decades, mortality rates for cerebrovascular diseases (CVD) have decreased significantly in many countries. This study analyses recent tendencies in CVD mortality rates in Andalusia (1980-2014) to identify any changes in previously observed sex and age trends. CVD mortality and population data were obtained from Spain's National Statistics Institute database. We calculated age-specific and age-standardised mortality rates using the direct method (European standard population). Joinpoint regression analysis was used to estimate the annual percentage change in rates and identify significant changes in mortality trends. We also estimated rate ratios between Andalusia and Spain. Standardised rates for both males and females showed 3 periods in joinpoint regression analysis: an initial period of significant decline (1980-1997), a period of rate stabilisation (1997-2003), and another period of significant decline (2003-2014). Between 1997 and 2003, age-standardised rates stabilised in Andalusia but continued to decrease in Spain as a whole. This increased in the gap between CVD mortality rates in Andalusia and Spain for both sexes and most age groups. Copyright © 2017 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.

Variability and trends in the consumption of drugs for treating attention-deficit/hyperactivity disorder in Castile-La Mancha, Spain (1992-2015).

PubMed

Criado-Álvarez, J J; González González, J; Romo Barrientos, C; Mohedano Moriano, A; Montero Rubio, J C; Pérez Veiga, J P

2016-09-16

Attention-deficit/hyperactivity disorder (ADHD) is one of the most common behavioural disorders of childhood; its prevalence in Spain is estimated at 5-9%. Available treatments for this condition include methylphenidate, atomoxetine, and lisdexamfetamine, whose consumption increases each year. The prevalence of ADHD was estimated by calculating the defined daily dose per 1,000 population per day of each drug and the total doses (therapeutic group N06BA) between 1992 and 2015 in each of the provinces of Castile-La Mancha (Spain). Trends, joinpoints, and annual percentages of change were analysed using joinpoint regression models. The minimum prevalence of ADHD in the population of Castile-La Mancha aged 5 to 19 was estimated at 13.22 cases per 1,000 population per day; prevalence varied across provinces (p<.05). Overall consumption has increased from 1992 to 2015, with an annual percentages of change of 10.3% and several joinpoints (2000, 2009, and 2012). methylphenidate represents 89.6% of total drug consumption, followed by lisdexamfetamine at 8%. Analysing drug consumption enables us to estimate the distribution of ADHD patients in Castile-La Mancha. Our data show an increase in the consumption of these drugs as well as differences in drug consumption between provinces, which reflect differences in ADHD management in clinical practice. Copyright © 2016. Publicado por Elsevier España, S.L.U.

Trends in Lung Cancer Incidence in Delhi, India 1988-2012: Age-Period-Cohort and Joinpoint Analyses

PubMed

Malhotra, Rajeev Kumar; Manoharan, Nalliah; Nair, Omana; Deo, Suryanarayana; Rath, Goura Kishor

2018-06-25

Introduction: Lung cancer (LC) has been one of the most commonly diagnosed cancers worldwide, both in terms of new cases and mortality. Exponential growth of economic and industrial activities in recent decades in the Delhi urban area may have increased the incidence of LC. The primary objective of this study was to evaluate the time trend according to gender. Method: LC incidence data over 25 years were obtained from the population based urban Delhi cancer registry. Joinpoint regression analysis was applied for evaluating the time trend of age-standardized incidence rates. The age-period-cohort (APC) model was employed using Poisson distribution with a log link function and the intrinsic estimator method. Results: During the 25 years, 13,489 male and 3,259 female LC cases were registered, accounting for 9.78% of male and 2.53% of female total cancer cases. Joinpoint regression analysis revealed that LC incidence in males continued to increase during the entire period, a sharp acceleration being observed starting from 2009. In females the LC incidence rate remained a plateau during 1988-2002 and thereafter increased. The cumulative risks for 1988-2012 were 1.79% and 0.45%. The full APC (IE) model showed best fit for an age-period-cohort effect on LC incidence, with significant increase with age peaking at 70-74 years in males and 65-69 years in females. A rising period effect was observed after adjusting for age and cohort effects in both genders and a declining cohort effect was identified after controlling for age and period effects. Conclusion: The incidence of LC in urban Delhi showed increasing trend from 1988-2012. Known factors such as environmental conservation, tobacco control, physical activity awareness and medical security should be implemented more vigorously over the long term in our population. Creative Commons Attribution License

Significant social events and increasing use of life-sustaining treatment: trend analysis using extracorporeal membrane oxygenation as an example.

PubMed

Chen, Yen-Yuan; Chen, Likwang; Huang, Tien-Shang; Ko, Wen-Je; Chu, Tzong-Shinn; Ni, Yen-Hsuan; Chang, Shan-Chwen

2014-03-04

Most studies have examined the outcomes of patients supported by extracorporeal membrane oxygenation as a life-sustaining treatment. It is unclear whether significant social events are associated with the use of life-sustaining treatment. This study aimed to compare the trend of extracorporeal membrane oxygenation use in Taiwan with that in the world, and to examine the influence of significant social events on the trend of extracorporeal membrane oxygenation use in Taiwan. Taiwan's extracorporeal membrane oxygenation uses from 2000 to 2009 were collected from National Health Insurance Research Dataset. The number of the worldwide extracorporeal membrane oxygenation cases was mainly estimated using Extracorporeal Life Support Registry Report International Summary July 2012. The trend of Taiwan's crude annual incidence rate of extracorporeal membrane oxygenation use was compared with that of the rest of the world. Each trend of extracorporeal membrane oxygenation use was examined using joinpoint regression. The measurement was the crude annual incidence rate of extracorporeal membrane oxygenation use. Each of the Taiwan's crude annual incidence rates was much higher than the worldwide one in the same year. Both the trends of Taiwan's and worldwide crude annual incidence rates have significantly increased since 2000. Joinpoint regression selected the model of the Taiwan's trend with one joinpoint in 2006 as the best-fitted model, implying that the significant social events in 2006 were significantly associated with the trend change of extracorporeal membrane oxygenation use following 2006. In addition, significantly social events highlighted by the media are more likely to be associated with the increase of extracorporeal membrane oxygenation use than being fully covered by National Health Insurance. Significant social events, such as a well-known person's successful extracorporeal membrane oxygenation use highlighted by the mass media, are associated with the use of life-sustaining treatment such as extracorporeal membrane oxygenation.

Mortality from cystic fibrosis in Europe: 1994-2010.

PubMed

Quintana-Gallego, Esther; Ruiz-Ramos, Miguel; Delgado-Pecellin, Isabel; Calero, Carmen; Soriano, Joan B; Lopez-Campos, Jose Luis

2016-02-01

To date, available mortality trends due to cystic fibrosis (CF) have been limited to the analysis of certain countries in different parts of the world showing that mortality trends have been constantly decreasing. However, no studies have examined Europe as a whole. The present study aims to analyze CF mortality trends by gender within the European Union (EU) and to quantify potential years of life lost (PYLL). Deaths from the 27 EU countries were obtained from the statistical office of the EU from the years 1994-2010. Crude and age-standardized mortality rates (ASR) were estimated for women and men using the standard European population, expressed in deaths per 1,000,000 persons. The PYLL from ages 0 up to 30 years were estimated. Trends were studied by a joinpoint regression analysis. During the study period, 5,130 deaths (2,443 in males and 2,687 in females) were identified. Females had a slightly higher mortality rate than males, with a downward trend observed for both genders. In males, the ASR changed from 1.34 in 1994 to 1.03 in 2010. In females, the ASR changed from 1.42 in 1994 to 0.92 in 2010. The mean age at death and PYLL increased for both genders. The joinpoint analysis did not identify any significant joinpoint for either gender for ASR or PYLL. Our data suggest a continued downward trend of CF mortality throughout the EU, with differences by country and gender. © 2015 Wiley Periodicals, Inc.

Recent changes in the trends of teen birth rates, 1981-2006.

PubMed

Wingo, Phyllis A; Smith, Ruben A; Tevendale, Heather D; Ferré, Cynthia

2011-03-01

To explore trends in teen birth rates by selected demographics. We used birth certificate data and joinpoint regression to examine trends in teen birth rates by age (10-14, 15-17, and 18-19 years) and race during 1981-2006 and by age and Hispanic origin during 1990-2006. Joinpoint analysis describes changing trends over successive segments of time and uses annual percentage change (APC) to express the amount of increase or decrease within each segment. For teens younger than 18 years, the decline in birth rates began in 1994 and ended in 2003 (APC: -8.03% per year for ages 10-14 years; APC: -5.63% per year for ages 15-17 years). The downward trend for 18- and 19-year-old teens began earlier (1991) and ended 1 year later (2004) (APC: -2.37% per year). For each study population, the trend was approximately level during the most recent time segment, except for continuing declines for 18- and 19-year-old white and Asian/Pacific Islander teens. The only increasing trend in the most recent time segment was for 18- and 19-year-old Hispanic teens. During these declines, the age distribution of teens who gave birth shifted to slightly older ages, and the percentage whose current birth was at least their second birth decreased. Teen birth rates were generally level during 2003/2004-2006 after the long-term declines. Rates increased among older Hispanic teens. These results indicate a need for renewed attention to effective teen pregnancy prevention programs in specific populations. Copyright © 2011. Published by Elsevier Inc.

[Trends of cancer mortality rates in children and adolescents by level of marginalization in Mexico (1990-2009)].

PubMed

Escamilla-Santiago, Ricardo Antonio; Narro-Robles, José; Fajardo-Gutiérrez, Arturo; Rascón-Pacheco, Ramón Alberto; López-Cervantes, Malaquías

2012-01-01

To determine childhood and adolescent cancer mortality by the level of marginalization in Mexico. We used 1990-2009 death certificates estimating age-standardized rates. We calculated the Average Annual Percent Change (AAPC) using the Joinpoint Regression program available at the National Cancer Institute to assess tendency. Cancer mortality rates increased. AAPC were 0.87% male and 0.96% female children, and for adolescents were: males 1.22% and females 0.63%. The neoplasm pattern in infants was leukemia -central nervous system- lymphomas; and in adolescents it was leukemia -bone and articulation- lymphomas. The increase in cancer mortality corresponded to the high and highest marginated areas of each state. The increase in highly marginated areas may be partly explained by well-documented local registration of deaths. Further studies focusing on survival are required in order to better assess the effectiveness of cancer detection and medical treatment in our country.

Geographical, temporal and racial disparities in late-stage prostate cancer incidence across Florida: A multiscale joinpoint regression analysis

PubMed Central

2011-01-01

Background Although prostate cancer-related incidence and mortality have declined recently, striking racial/ethnic differences persist in the United States. Visualizing and modelling temporal trends of prostate cancer late-stage incidence, and how they vary according to geographic locations and race, should help explaining such disparities. Joinpoint regression is increasingly used to identify the timing and extent of changes in time series of health outcomes. Yet, most analyses of temporal trends are aspatial and conducted at the national level or for a single cancer registry. Methods Time series (1981-2007) of annual proportions of prostate cancer late-stage cases were analyzed for non-Hispanic Whites and non-Hispanic Blacks in each county of Florida. Noise in the data was first filtered by binomial kriging and results were modelled using joinpoint regression. A similar analysis was also conducted at the state level and for groups of metropolitan and non-metropolitan counties. Significant racial differences were detected using tests of parallelism and coincidence of time trends. A new disparity statistic was introduced to measure spatial and temporal changes in the frequency of racial disparities. Results State-level percentage of late-stage diagnosis decreased 50% since 1981; a decline that accelerated in the 90's when Prostate Specific Antigen (PSA) screening was introduced. Analysis at the metropolitan and non-metropolitan levels revealed that the frequency of late-stage diagnosis increased recently in urban areas, and this trend was significant for white males. The annual rate of decrease in late-stage diagnosis and the onset years for significant declines varied greatly among counties and racial groups. Most counties with non-significant average annual percent change (AAPC) were located in the Florida Panhandle for white males, whereas they clustered in South-eastern Florida for black males. The new disparity statistic indicated that the spatial extent of racial disparities reached a peak in 1990 because of an early decline in frequency of late-stage diagnosis observed for black males. Conclusions Analyzing temporal trends in cancer incidence and mortality rates outside a spatial framework is unsatisfactory, since it leads one to overlook significant geographical variation which can potentially generate new insights about the impact of various interventions. Differences observed among nested geographies in Florida show how the modifiable areal unit problem (MAUP) also impacts the analysis of temporal changes. PMID:22142274

Temporal trends in motor vehicle fatalities in the United States, 1968 to 2010 - a joinpoint regression analysis.

PubMed

Bandi, Priti; Silver, Diana; Mijanovich, Tod; Macinko, James

2015-12-01

In the past 40 years, a variety of factors might have impacted motor vehicle (MV) fatality trends in the US, including public health policies, engineering innovations, trauma care improvements, etc. These factors varied in their timing across states/localities, and many were targeted at particular population subgroups. In order to identify and quantify differential rates of change over time and differences in trend patterns between population subgroups, this study employed a novel analytic method to assess temporal trends in MV fatalities between 1968 and 2010, by age group and sex. Cause-specific MV fatality data from traffic injuries between 1968 and 2010, based on death certificates filed in the 50 states, and DC were obtained from Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER). Long-term (1968 to 2010) and short-term (log-linear piecewise segments) trends in fatality rates were compared for males and females overall and in four separate age groups using joinpoint regression. MV fatalities declined on average by 2.4% per year in males and 2.2% per year in females between 1968 and 2010, with significant declines observed in all age groups and in both sexes. In males overall and those 25 to 64 years, sharp declines between 1968 and mid-to-late 1990s were followed by a stalling until the mid-2000s, but rates in females experienced a long-term steady decline of a lesser magnitude than males during this time. Trends in those aged <1 to 14 years and 15 to 24 years were mostly steady over time, but males had a larger decline than females in the latter age group between 1968 and the mid-2000s. In ages 65+, short-term trends were similar between sexes. Despite significant long-term declines in MV fatalities, the application of Joinpoint Regression found that progress in young adult and middle-aged adult males stalled in recent decades and rates in males declined relatively more than in females in certain age groups. Future research is needed to establish the causes of these observed trends, including the potential role of contemporaneous MV-related policies and their repeal. Such research is needed in order to better inform the design and evaluation of future population interventions addressing MV fatalities nationally.

Geographical, temporal and racial disparities in late-stage prostate cancer incidence across Florida: a multiscale joinpoint regression analysis.

PubMed

Goovaerts, Pierre; Xiao, Hong

2011-12-05

Although prostate cancer-related incidence and mortality have declined recently, striking racial/ethnic differences persist in the United States. Visualizing and modelling temporal trends of prostate cancer late-stage incidence, and how they vary according to geographic locations and race, should help explaining such disparities. Joinpoint regression is increasingly used to identify the timing and extent of changes in time series of health outcomes. Yet, most analyses of temporal trends are aspatial and conducted at the national level or for a single cancer registry. Time series (1981-2007) of annual proportions of prostate cancer late-stage cases were analyzed for non-Hispanic Whites and non-Hispanic Blacks in each county of Florida. Noise in the data was first filtered by binomial kriging and results were modelled using joinpoint regression. A similar analysis was also conducted at the state level and for groups of metropolitan and non-metropolitan counties. Significant racial differences were detected using tests of parallelism and coincidence of time trends. A new disparity statistic was introduced to measure spatial and temporal changes in the frequency of racial disparities. State-level percentage of late-stage diagnosis decreased 50% since 1981; a decline that accelerated in the 90's when Prostate Specific Antigen (PSA) screening was introduced. Analysis at the metropolitan and non-metropolitan levels revealed that the frequency of late-stage diagnosis increased recently in urban areas, and this trend was significant for white males. The annual rate of decrease in late-stage diagnosis and the onset years for significant declines varied greatly among counties and racial groups. Most counties with non-significant average annual percent change (AAPC) were located in the Florida Panhandle for white males, whereas they clustered in South-eastern Florida for black males. The new disparity statistic indicated that the spatial extent of racial disparities reached a peak in 1990 because of an early decline in frequency of late-stage diagnosis observed for black males. Analyzing temporal trends in cancer incidence and mortality rates outside a spatial framework is unsatisfactory, since it leads one to overlook significant geographical variation which can potentially generate new insights about the impact of various interventions. Differences observed among nested geographies in Florida show how the modifiable areal unit problem (MAUP) also impacts the analysis of temporal changes.

A study of home deaths in Japan from 1951 to 2002

PubMed Central

Yang, Limin; Sakamoto, Naoko; Marui, Eiji

2006-01-01

Background Several surveys in Japan have indicated that most terminally ill Japanese patients would prefer to die at home or in a homelike setting. However, there is a great disparity between this stated preference and the reality, since most Japanese die in hospital. We report here national changes in home deaths in Japan over the last 5 decades. Using prefecture data, we also examined the factors in the medical service associated with home death in Japan. Methods Published data on place of death was obtained from the vital statistics compiled by the Ministry of Health, Labor and Welfare of Japan. We analyzed trends of home deaths from 1951 to 2002, and describe the changes in the proportion of home deaths by region, sex, age, and cause of death. Joinpoint regression analysis was used for trend analysis. Logistic regression analysis was performed to identify secular trends in home deaths, and the impact of age, sex, year of deaths and cause of deaths on home death. We also examined the association between home death and medical service factors by multiple regression analysis, using home death rate by prefectures in 2002 as a dependent variable. Results A significant decrease in the percentage of patients dying at home was observed in the results of joinpoint regression analysis. Older patients and males were more likely to die at home. Patients who died from cancer were less likely to die at home. The results of multiple regression analysis indicated that home death was related to the number of beds in hospital, ratio of daily occupied beds in general hospital, the number of families in which the elderly were living alone, and dwelling rooms. Conclusion The pattern of the place of death has not only been determined by social and demographic characteristics of the decedent, but also associated with the medical service in the community. PMID:16524485

Long-term trends of suicide by choice of method in Norway: a joinpoint regression analysis of data from 1969 to 2012.

PubMed

Puzo, Quirino; Qin, Ping; Mehlum, Lars

2016-03-11

Suicide mortality and the rates by specific methods in a population may change over time in response to concurrent changes in relevant factors in society. This study aimed to identify significant changing points in method-specific suicide mortality from 1969 to 2012 in Norway. Data on suicide mortality by specific methods and by sex and age were retrieved from the Norwegian Cause-of-Death Register. Long-term trends in age-standardized rates of suicide mortality were analyzed by using joinpoint regression analysis. The most frequently used suicide method in the total population was hanging, followed by poisoning and firearms. Men chose suicide by firearms more often than women, whereas poisoning and drowning were more frequently used by women. The joinpoint analysis revealed that the overall trend of suicide mortality significantly changed twice along the period of 1969 to 2012 for both sexes. The male age-standardized suicide rate increased by 3.1% per year until 1989, and decreased by 1.2% per year between 1994 and 2012. Among females the long-term suicide rate increased by 4.0% per year until 1988, decreased by 5.5% through 1995, and then stabilized. Both sexes experienced an upward trend for suicide by hanging during the 44-year observation period, with a particularly significant increase in 15-24 year old males. The most distinct change among men was seen for firearms after 1988 with a significant decrease through 2012 of around 5% per year. For women, significant reductions since 1985-88 were observed for suicide by drowning and poisoning. The present study demonstrates different time trends for different suicide methods with significant reductions in suicide by firearms, drowning and poisoning after the peak in the suicide rate in the late 1980s. Suicide by means of hanging continuously increased, but did not fully compensate for the reduced use of other methods. This lends some support for the effectiveness of method-specific suicide preventive measures, such as restrictions to the access to firearms, which had been implemented in Norway during the relevant time period.

Prostate cancer mortality in Serbia, 1991-2010: a joinpoint regression analysis.

PubMed

Ilic, Milena; Ilic, Irena

2016-06-01

The aim of this descriptive epidemiological study was to analyze the mortality trend of prostate cancer in Serbia (excluding the Kosovo and Metohia) from 1991 to 2010. The age-standardized prostate cancer mortality rates (per 100 000) were calculated by direct standardization, using the World Standard Population. Average annual percentage of change (AAPC) and the corresponding 95% confidence interval (CI) was computed for trend using the joinpoint regression analysis. Significantly increased trend in prostate cancer mortality was recorded in Serbia continuously from 1991 to 2010 (AAPC = +2.2, 95% CI = 1.6-2.9). Mortality rates for prostate cancer showed a significant upward trend in all men aged 50 and over: AAPC (95% CI) was +1.9% (0.1-3.8) in aged 50-59 years, +1.7% (0.9-2.6) in aged 60-69 years, +2.0% (1.2-2.9) in aged 70-79 years and +3.5% (2.4-4.6) in aged 80 years and over. According to comparability test, prostate cancer mortality trends in majority of age groups were parallel (final selected model failed to reject parallelism, P > 0.05). The increasing prostate cancer mortality trend implies the need for more effective measures of prevention, screening and early diagnosis, as well as prostate cancer treatment in Serbia. © The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Canadian firearms legislation and effects on homicide 1974 to 2008.

PubMed

Langmann, Caillin

2012-08-01

Canada has implemented legislation covering all firearms since 1977 and presents a model to examine incremental firearms control. The effect of legislation on homicide by firearm and the subcategory, spousal homicide, is controversial and has not been well studied to date. Legislative effects on homicide and spousal homicide were analyzed using data obtained from Statistics Canada from 1974 to 2008. Three statistical methods were applied to search for any associated effects of firearms legislation. Interrupted time series regression, ARIMA, and Joinpoint analysis were performed. Neither were any significant beneficial associations between firearms legislation and homicide or spousal homicide rates found after the passage of three Acts by the Canadian Parliament--Bill C-51 (1977), C-17 (1991), and C-68 (1995)--nor were effects found after the implementation of licensing in 2001 and the registration of rifles and shotguns in 2003. After the passage of C-68, a decrease in the rate of the decline of homicide by firearm was found by interrupted regression. Joinpoint analysis also found an increasing trend in homicide by firearm rate post the enactment of the licensing portion of C-68. Other factors found to be associated with homicide rates were median age, unemployment, immigration rates, percentage of population in low-income bracket, Gini index of income equality, population per police officer, and incarceration rate. This study failed to demonstrate a beneficial association between legislation and firearm homicide rates between 1974 and 2008.

Diabetes mortality in Serbia, 1991-2015 (a nationwide study): A joinpoint regression analysis.

PubMed

Ilic, Milena; Ilic, Irena

2017-02-01

The aim of this study was to analyze the mortality trends of diabetes mellitus in Serbia (excluding the Autonomous Province of Kosovo and Metohia). A population-based cross sectional study analyzing diabetes mortality in Serbia in the period 1991-2015 was carried out based on official data. The age-standardized mortality rates (per 100,000) were calculated by direct standardization, using the European Standard Population. Average annual percentage of change (AAPC) and the corresponding 95% confidence interval (CI) were computed using the joinpoint regression analysis. More than 63,000 (about 27,000 of men and 36,000 of women) diabetes deaths occurred in Serbia from 1991 to 2015. Death rates from diabetes were almost equal in men and in women (about 24.0 per 100,000) and places Serbia among the countries with the highest diabetes mortality rates in Europe. Since 1991, mortality from diabetes in men significantly increased by +1.2% per year (95% CI 0.7-1.7), but non-significantly increased in women by +0.2% per year (95% CI -0.4 to 0.7). Increased trends in diabetes type 1 mortality rates were significant in both genders in Serbia. Trends in mortality for diabetes type 2 showed a significant decrease in both genders since 2010. Given that diabetes mortality trends showed different patterns during the studied period, our results imply that further observation of trend is needed. Copyright © 2016 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

Impact of fecal immunochemical test-based screening programs on proximal and distal colorectal cancer surgery rates: A natural multiple-baseline experiment.

PubMed

Fedeli, Ugo; Zorzi, Manuel; Urso, Emanuele D L; Gennaro, Nicola; Dei Tos, Angelo P; Saugo, Mario

2015-11-15

Colorectal cancer (CRC) screening programs based on the fecal immunochemical test (FIT) were found to reduce overall CRC surgery rates, but to the authors' knowledge data by subsite are lacking. The objective of the current study was to assess the impact of FIT-based screening on proximal and distal CRC surgical resection rates. The Veneto region in Italy can be subdivided into 3 areas with staggered introduction of FIT-based screening programs: early (2002-2004), intermediate (2005-2007), and late (2008-2009) areas. Time series of proximal and distal CRC surgery were investigated in the 3 populations between 2001 and 2012 by Joinpoint regression analysis and segmented Poisson regression models. The impact of screening was similar in the study populations. Rates of distal CRC surgical resection were stable before screening, increased at the time of screening implementation (rate ratio [RR], 1.25; 95% confidence interval [95% CI], 1.14-1.37), and thereafter declined by 10% annually (RR, 0.90; 95% CI, 0.88-0.92). Rates of proximal CRC surgical resection increased by 4% annually before screening (RR, 1.04; 95% CI, 1.03-1.05) but, after a peak at the time of screening initiation, the trend was reversed. The percentage represented by proximal CRC surgery rose from 28% in 2001 to 41% in 2012. In this natural multiple-baseline experiment, consistent findings across each time series demonstrated that FIT-based screening programs have an impact both on proximal and distal CRC surgery rates. However, underlying preexisting epidemiological trends are leading to a rapidly increasing percentage of proximal CRC. © 2015 American Cancer Society.

Increasing incidence of thyroid cancer in the Nordic countries with main focus on Swedish data.

PubMed

Carlberg, Michael; Hedendahl, Lena; Ahonen, Mikko; Koppel, Tarmo; Hardell, Lennart

2016-07-07

Radiofrequency radiation in the frequency range 30 kHz-300 GHz was evaluated to be Group 2B, i.e. 'possibly' carcinogenic to humans, by the International Agency for Research on Cancer (IARC) at WHO in May 2011. Among the evaluated devices were mobile and cordless phones, since they emit radiofrequency electromagnetic fields (RF-EMF). In addition to the brain, another organ, the thyroid gland, also receives high exposure. The incidence of thyroid cancer is increasing in many countries, especially the papillary type that is the most radiosensitive type. We used the Swedish Cancer Register to study the incidence of thyroid cancer during 1970-2013 using joinpoint regression analysis. In women, the incidence increased statistically significantly during the whole study period; average annual percentage change (AAPC) +1.19 % (95 % confidence interval (CI) +0.56, +1.83 %). Two joinpoints were detected, 1979 and 2001, with a high increase of the incidence during the last period 2001-2013 with an annual percentage change (APC) of +5.34 % (95 % CI +3.93, +6.77 %). AAPC for all men during 1970-2013 was +0.77 % (95 % CI -0.03, +1.58 %). One joinpoint was detected in 2005 with a statistically significant increase in incidence during 2005-2013; APC +7.56 % (95 % CI +3.34, +11.96 %). Based on NORDCAN data, there was a statistically significant increase in the incidence of thyroid cancer in the Nordic countries during the same time period. In both women and men a joinpoint was detected in 2006. The incidence increased during 2006-2013 in women; APC +6.16 % (95 % CI +3.94, +8.42 %) and in men; APC +6.84 % (95 % CI +3.69, +10.08 %), thus showing similar results as the Swedish Cancer Register. Analyses based on data from the Cancer Register showed that the increasing trend in Sweden was mainly caused by thyroid cancer of the papillary type. We postulate that the whole increase cannot be attributed to better diagnostic procedures. Increasing exposure to ionizing radiation, e.g. medical computed tomography (CT) scans, and to RF-EMF (non-ionizing radiation) should be further studied. The design of our study does not permit conclusions regarding causality.

[Cancer mortality trends in Mexico, 1980-2011].

PubMed

Torres-Sánchez, Luisa E; Rojas-Martínez, Rosalba; Escamilla-Núñez, Consuelo; de la Vara-Salazar, Elvia; Lazcano-Ponce, Eduardo

2014-01-01

To evaluate trends in cancer mortality in Mexico between 1980-2011. Through direct method and using World Population 2010 as standard population, mortality rates for all cancers and the 15 most frequent locations, adjusted for age and sex were calculated. Trends in mortality rates and annual percentage change for each type of cancer were estimated by joinpoint regression model. As a result of the reduction in mortality from lung cancer (-3.2% -1.8% in men and in women), stomach (-2.1% -2.4% in men and in women) and cervix (-4.7%); since 2004 a significant (~1% per year) decline was observed in cancer mortality in general, in all ages, and in the group of 35-64 years of both sexes. Other cancers such as breast and ovarian cancer in women; as well as for prostate cancer in men, showed a steady increase. Some of the reductions in cancer mortality may be partially attributed to the effectiveness of prevention programs. However, adequate records of population-based cancer are needed to assess the real impact of these programs; as well as designing and evaluating innovative interventions to develop more cost-effective prevention policies.

Jump Model / Comparability Ratio Model — Joinpoint Help System 4.4.0.0

Cancer.gov

The Jump Model / Comparability Ratio Model in the Joinpoint software provides a direct estimation of trend data (e.g. cancer rates) where there is a systematic scale change, which causes a “jump” in the rates, but is assumed not to affect the underlying trend.

Recent lung cancer mortality trends in Europe: effect of national smoke-free legislation strengthening.

PubMed

López-Campos, Jose L; Ruiz-Ramos, Miguel; Fernandez, Esteve; Soriano, Joan B

2018-07-01

The impact of smoke-free legislation within European Union (EU) countries on lung cancer mortality has not been evaluated to date. We aimed to determine lung cancer mortality trends in the EU-27 by sex, age, and calendar year for the period of 1994 and 2012, and relate them with changes in tobacco legislation at the national level. Deaths by Eurostat in each European country were analyzed, focusing on ICD-10 codes C33 and C34 from the years 1994 to 2012. Age-standardized mortality rates (ASR) were estimated separately for women and men in the EU-27 total and within country for each one of the years studied, and the significance of changing trends was estimated by joinpoint regression analysis, exploring lag times after initiation of smoke-free legislation in every country, if any. From 1994 to 2012, there were 4 681 877 deaths from lung cancer in Europe (3 491 607 in men and 1 190 180 in women) and a nearly linear decrease in mortality rates because of lung cancer in men from was observed1994 to 2012, mirrored in women by an upward trend, narrowing the sex gap during the study period from 5.1 in 1994 to 2.8 in 2012. Joinpoint regression analysis identified a number of trend changes over time, but it appears that they were unrelated to the implementation of smoke-free legislations. A few years after the introduction of smoke-free legislations across Europe, trends of lung cancer mortality trends have not changed.

Oral cavity cancer trends over the past 25 years in Hong Kong: a multidirectional statistical analysis.

PubMed

Ushida, Keisuke; McGrath, Colman P; Lo, Edward C M; Zwahlen, Roger A

2015-07-24

Even though oral cavity cancer (OCC; ICD 10 codes C01, C02, C03, C04, C05, and C06) ranks eleventh among the world's most common cancers, accounting for approximately 2 % of all cancers, a trend analysis of OCC in Hong Kong is lacking. Hong Kong has experienced rapid economic growth with socio-cultural and environmental change after the Second World War. This together with the collected data in the cancer registry provides interesting ground for an epidemiological study on the influence of socio-cultural and environmental factors on OCC etiology. A multidirectional statistical analysis of the OCC trends over the past 25 years was performed using the databases of the Hong Kong Cancer Registry. The age, period, and cohort (APC) modeling was applied to determine age, period, and cohort effects on OCC development. Joinpoint regression analysis was used to find secular trend changes of both age-standardized and age-specific incidence rates. The APC model detected that OCC development in men was mainly dominated by the age effect, whereas in women an increasing linear period effect together with an age effect became evident. The joinpoint regression analysis showed a general downward trend of age-standardized incidence rates of OCC for men during the entire investigated period, whereas women demonstrated a significant upward trend from 2001 onwards. The results suggest that OCC incidence in Hong Kong appears to be associated with cumulative risk behaviors of the population, despite considerable socio-cultural and environmental changes after the Second World War.

Prediction of Cancer Incidence and Mortality in Korea, 2018.

PubMed

Jung, Kyu-Won; Won, Young-Joo; Kong, Hyun-Joo; Lee, Eun Sook

2018-04-01

This study aimed to report on cancer incidence and mortality for the year 2018 to estimate Korea's current cancer burden. Cancer incidence data from 1999 to 2015 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2016 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against observed years, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly, we only used the data of the latest trend. A total of 204,909 new cancer cases and 82,155 cancer deaths are expected to occur in Korea in 2018. The most common cancer sites were lung, followed by stomach, colorectal, breast and liver. These five cancers represent half of the overall burden of cancer in Korea. For mortality, the most common sites were lung cancer, followed by liver, colorectal, stomach and pancreas. The incidence rate of all cancer in Korea are estimated to decrease gradually, mainly due to decrease of thyroid cancer. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluation of cancer-control programs.

Breast Cancer Trend in Iran from 2000 to 2009 and Prediction till 2020 using a Trend Analysis Method.

PubMed

Zahmatkesh, Bibihajar; Keramat, Afsaneh; Alavi, Nasrinossadat; Khosravi, Ahmad; Kousha, Ahmad; Motlagh, Ali Ghanbari; Darman, Mahboobeh; Partovipour, Elham; Chaman, Reza

2016-01-01

Breast cancer is the most common cancer in women worldwide with a rising incidence rate in most countries. Considering the increase in life expectancy and change in lifestyle of Iranian women, this study investigated the age-adjusted trend of breast cancer incidence during 2000-2009 and predicted its incidence to 2020. The 1997 and 2006 census results were used for the projection of female population by age through the cohort-component method over the studied years. Data from the Iranian cancer registration system were used to calculate the annual incidence rate of breast cancer. The age-adjusted incidence rate was then calculated using the WHO standard population distribution. The five-year-age-specific incidence rates were also obtained for each year and future incidence was determined using the trend analysis method. Annual percentage change (APC) was calculated through the joinpoint regression method. The bias adjusted incidence rate of breast cancer increased from 16.7 per 100,000 women in 2000 to 33.6 per 100,000 women in 2009. The incidence of breast cancer had a growing trend in almost all age groups above 30 years over the studied years. In this period, the age groups of 45-65 years had the highest incidence. Investigation into the joinpoint curve showed that the curve had a steep slope with an APC of 23.4% before the first joinpoint, but became milder after this. From 2005 to 2009, the APC was calculated as 2.7%, through which the incidence of breast cancer in 2020 was predicted as 63.0 per 100,000 women. The age-adjusted incidence rate of breast cancer continues to increas in Iranian women. It is predicted that this trend will continue until 2020. Therefore, it seems necessary to prioritize the prevention, control and care for breast cancer in Iran.

Cervical Cancer Incidence in Young U.S. Females After Human Papillomavirus Vaccine Introduction.

PubMed

Guo, Fangjian; Cofie, Leslie E; Berenson, Abbey B

2018-05-30

Since 2006, human papillomavirus vaccine has been recommended for young females in the U.S. This study aimed to compare cervical cancer incidence among young women before and after the human papillomavirus vaccine was introduced. This cross-sectional study used data from the National Program for Cancer Registries and Surveillance, Epidemiology, and End Results Incidence-U.S. Cancer Statistics 2001-2014 database for U.S. females aged 15-34 years. This study compared the 4-year average annual incidence of invasive cervical cancer in the 4 years before human papillomavirus vaccine was introduced (2003-2006) and the 4 most recent years in the vaccine era (2011-2014). Joinpoint regression models of cervical incidence from 2001 to 2014 were fitted to identify the discrete joints (year) that represent statistically significant changes in the direction of the trend after the introduction of human papillomavirus vaccination in 2006. Data were collected in 2001-2014, released, and analyzed in 2017. The 4-year average annual incidence rates for cervical cancer in 2011-2014 were 29% lower than that in 2003-2006 (6.0 vs 8.4 per 1,000,000 people, rate ratio=0.71, 95% CI=0.64, 0.80) among females aged 15-24 years, and 13.0% lower among females aged 25-34 years. Joinpoint analyses of cervical cancer incidence among females aged 15-24 years revealed a significant joint at 2009 for both squamous cell carcinoma and non-squamous cell carcinoma. Among females aged 25-34 years, there was no significant decrease in cervical cancer incidence after 2006. A significant decrease in the incidence of cervical cancer among young females after the introduction of human papillomavirus vaccine may indicate early effects of human papillomavirus vaccination. Copyright © 2018 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Secular trend analysis of lung cancer incidence in Sihui city, China between 1987 and 2011.

PubMed

Du, Jin-Lin; Lin, Xiao; Zhang, Li-Fang; Li, Yan-Hua; Xie, Shang-Hang; Yang, Meng-Jie; Guo, Jie; Lin, Er-Hong; Liu, Qing; Hong, Ming-Huang; Huang, Qi-Hong; Liao, Zheng-Er; Cao, Su-Mei

2015-07-31

With industrial and econom ic development in recent decades in South China, cancer incidence may have changed due to the changing lifestyle and environment. However, the trends of lung cancer and the roles of smoking and other environmental risk factors in the development of lung cancer in rural areas of South China remain unclear. The purpose of this study was to explore the lung cancer incidence trends and the possible causes of these trends. Joinpoint regression analysis and the age-period-cohort (APC) model were used to analyze the lung cancer incidence trends in Sihui, Guangdong province, China between 1987 and 2011, and explore the possible causes of these trends. A total of 2,397 lung cancer patients were involved in this study. A 3-fold increase in the incidence of lung cancer in both sexes was observed over the 25-year period. Joinpoint regression analysis showed that while the incidence continued to increase steadily in females during the entire period, a sharp acceleration was observed in males starting in 2005. The full APC model was selected to describe age, period, and birth cohort effects on lung cancer incidence trends in Sihui. The age cohorts in both sexes showed a continuously significant increase in the relative risk (RR) of lung cancer, with a peak in the eldest age group (80-84 years). The RR of lung cancer showed a fluctuating curve in both sexes. The birth cohorts identified an increased trend in both males and females; however, males had a plateau in the youngest cohorts who were born during 1955-1969. Increasing trends of the incidence of lung cancer in Sihui were dominated by the effects of age and birth cohorts. Social aging, smoking, and environmental changes may play important roles in such trends.

[The effect of increasing tobacco tax on tobacco sales in Japan].

PubMed

Ito, Yuri; Nakamura, Masakazu

2013-09-01

Since the special tobacco tax was established in 1998, the tobacco tax and price of tobacco have increased thrice, in 2003, 2006, and 2010, respectively. We evaluated the effect of increases in tax on the consumption and sales of tobacco in Japan using the annual data on the number of tobacco products sold and the total sales from Japan Tobacco, Inc. We applied the number of tobacco products sold and the total sales per year to a joinpoint regression model to examine the trends in the data. This model could help identify the year in which a decrease or increase was apparent from the data. In addition, we examined the effect of each tax increase while also considering other factors that may have caused a decrease in the levels of tobacco consumption using the method proposed by Hirano et al. According to the joinpoint regression analysis, the number of tobacco products sold started decreasing in 1998, and the trends of decrease accelerated to 5% per year, from 2005. Owing to the tax increase, tobacco sales reduced by -2.4%, -2.9%, and -10.1% (corrected for the effect of the Tohoku Great Earthquake), and price elasticity was estimated as -0.30, -0.27, and -0.28 (corrected) in 2003, 2006, and 2010, respectively. The effect of tobacco tax increase on the decrease in tobacco sales was greatest in 2010, while the price elasticity remained almost the same as it was during the previous tax increase. The sharp hike in tobacco tax in 2010 decreased the number of tobacco products sold, while the price elasticity in 2010 was similar to that in 2003 and 2006. Our findings suggest that further increase in tobacco tax is needed to reduce the damage caused by smoking in the people of Japan.

Quantifying trends in disease impact to produce a consistent and reproducible definition of an emerging infectious disease.

PubMed

Funk, Sebastian; Bogich, Tiffany L; Jones, Kate E; Kilpatrick, A Marm; Daszak, Peter

2013-01-01

The proper allocation of public health resources for research and control requires quantification of both a disease's current burden and the trend in its impact. Infectious diseases that have been labeled as "emerging infectious diseases" (EIDs) have received heightened scientific and public attention and resources. However, the label 'emerging' is rarely backed by quantitative analysis and is often used subjectively. This can lead to over-allocation of resources to diseases that are incorrectly labelled "emerging," and insufficient allocation of resources to diseases for which evidence of an increasing or high sustained impact is strong. We suggest a simple quantitative approach, segmented regression, to characterize the trends and emergence of diseases. Segmented regression identifies one or more trends in a time series and determines the most statistically parsimonious split(s) (or joinpoints) in the time series. These joinpoints in the time series indicate time points when a change in trend occurred and may identify periods in which drivers of disease impact change. We illustrate the method by analyzing temporal patterns in incidence data for twelve diseases. This approach provides a way to classify a disease as currently emerging, re-emerging, receding, or stable based on temporal trends, as well as to pinpoint the time when the change in these trends happened. We argue that quantitative approaches to defining emergence based on the trend in impact of a disease can, with appropriate context, be used to prioritize resources for research and control. Implementing this more rigorous definition of an EID will require buy-in and enforcement from scientists, policy makers, peer reviewers and journal editors, but has the potential to improve resource allocation for global health.

Malignant Lymphatic and Hematopoietic Neoplasms Mortality in Serbia, 1991–2010: A Joinpoint Regression Analysis

PubMed Central

Ilic, Milena; Ilic, Irena

2014-01-01

Background Limited data on mortality from malignant lymphatic and hematopoietic neoplasms have been published for Serbia. Methods The study covered population of Serbia during the 1991–2010 period. Mortality trends were assessed using the joinpoint regression analysis. Results Trend for overall death rates from malignant lymphoid and haematopoietic neoplasms significantly decreased: by −2.16% per year from 1991 through 1998, and then significantly increased by +2.20% per year for the 1998–2010 period. The growth during the entire period was on average +0.8% per year (95% CI 0.3 to 1.3). Mortality was higher among males than among females in all age groups. According to the comparability test, mortality trends from malignant lymphoid and haematopoietic neoplasms in men and women were parallel (final selected model failed to reject parallelism, P = 0.232). Among younger Serbian population (0–44 years old) in both sexes: trends significantly declined in males for the entire period, while in females 15–44 years of age mortality rates significantly declined only from 2003 onwards. Mortality trend significantly increased in elderly in both genders (by +1.7% in males and +1.5% in females in the 60–69 age group, and +3.8% in males and +3.6% in females in the 70+ age group). According to the comparability test, mortality trend for Hodgkin's lymphoma differed significantly from mortality trends for all other types of malignant lymphoid and haematopoietic neoplasms (P<0.05). Conclusion Unfavourable mortality trend in Serbia requires targeted intervention for risk factors control, early diagnosis and modern therapy. PMID:25333862

Trends in esophageal cancer mortality in China during 1987-2009: age, period and birth cohort analyzes.

PubMed

Guo, Pi; Li, Ke

2012-04-01

Esophageal cancer is one of the most commonly diagnosed malignant tumors in China. The aim of this study was to provide the representative and comprehensive informations about the long-term mortality trends of this disease in China between 1987 and 2009, using joinpoint regression and generalized additive models (GAMs). Age-standardized mortality rates (ASMR), overall and truncated (35-64 years), were calculated using the direct calculation method, and joinpoint regression was performed to obtain the estimated annual percentage changes (EAPC). GAMs were fitted to study the effects of age, period and birth cohort on mortality trends. ASMR exhibited an overall remarked decline for rural females (EAPC=-2.3 95%CI: -3.3, -1.2), urban males (EAPC=-1.8 95%CI: -2.6, -1.0) and urban females (EAPC=-3.7 95%CI: -4.9, -2.4), but a small drop observed was not statistically significant for rural males (EAPC=-0.9 95%CI: -2.0, 0.3). The declines in ASMR were more noticeable for urban residents in recent years. Among all the residents, age effect showed an progressively increasing trend, whereas cohort effect declined steadily after the year corresponding to the maximum risk value. Period effect seemed to remain substantially unchanged throughout the years. Although variations in mortality rates were observed according to sex and area, the overall decreasing trends in esophageal cancer mortality were found in most Chinese people, aside from rural males. The findings could correspond to the changes in age- and cohort-related factors in the population. Further study is required to understand these potential factors. Copyright © 2011 Elsevier Ltd. All rights reserved.

The impact of OSHA recordkeeping regulation changes on occupational injury and illness trends in the US: a time-series analysis.

PubMed

Friedman, Lee S; Forst, Linda

2007-07-01

The Survey of Occupational Injuries and Illnesses (SOII), based on Occupational Safety and Health Administration (OSHA) logs, indicates that the number of occupational injuries and illnesses in the US has steadily declined by 35.8% between 1992-2003. However, major changes to the OSHA recordkeeping standard occurred in 1995 and 2001. The authors assessed the relation between changes in OSHA recordkeeping regulations and the trend in occupational injuries and illnesses. SOII data available from the Bureau of Labor Statistics for years 1992-2003 were collected. The authors assessed time series data using join-point regression models. Before the first major recordkeeping change in 1995, injuries and illnesses declined annually by 0.5%. In the period 1995-2000 the slope declined by 3.1% annually (95% CI -3.7% to -2.5%), followed by another more precipitous decline occurring in 2001-2003 (-8.3%; 95% CI -10.0% to -6.6%). When stratifying the data, the authors continued to observe significant changes occurring in 1995 and 2001. The substantial declines in the number of injuries and illnesses correspond directly with changes in OSHA recordkeeping rules. Changes in employment, productivity, OSHA enforcement activity and sampling error do not explain the large decline. Based on the baseline slope (join-point regression analysis, 1992-4), the authors expected a decline of 407 964 injuries and illnesses during the period of follow-up if no intervention occurred; they actually observed a decline of 2.4 million injuries and illnesses of which 2 million or 83% of the decline can be attributed to the change in the OSHA recordkeeping rules.

Research Trends in Evidence-Based Medicine: A Joinpoint Regression Analysis of More than 50 Years of Publication Data

PubMed Central

Hung, Bui The; Long, Nguyen Phuoc; Hung, Le Phi; Luan, Nguyen Thien; Anh, Nguyen Hoang; Nghi, Tran Diem; Van Hieu, Mai; Trang, Nguyen Thi Huyen; Rafidinarivo, Herizo Fabien; Anh, Nguyen Ky; Hawkes, David; Huy, Nguyen Tien; Hirayama, Kenji

2015-01-01

Background Evidence-based medicine (EBM) has developed as the dominant paradigm of assessment of evidence that is used in clinical practice. Since its development, EBM has been applied to integrate the best available research into diagnosis and treatment with the purpose of improving patient care. In the EBM era, a hierarchy of evidence has been proposed, including various types of research methods, such as meta-analysis (MA), systematic review (SRV), randomized controlled trial (RCT), case report (CR), practice guideline (PGL), and so on. Although there are numerous studies examining the impact and importance of specific cases of EBM in clinical practice, there is a lack of research quantitatively measuring publication trends in the growth and development of EBM. Therefore, a bibliometric analysis was constructed to determine the scientific productivity of EBM research over decades. Methods NCBI PubMed database was used to search, retrieve and classify publications according to research method and year of publication. Joinpoint regression analysis was undertaken to analyze trends in research productivity and the prevalence of individual research methods. Findings Analysis indicates that MA and SRV, which are classified as the highest ranking of evidence in the EBM, accounted for a relatively small but auspicious number of publications. For most research methods, the annual percent change (APC) indicates a consistent increase in publication frequency. MA, SRV and RCT show the highest rate of publication growth in the past twenty years. Only controlled clinical trials (CCT) shows a non-significant reduction in publications over the past ten years. Conclusions Higher quality research methods, such as MA, SRV and RCT, are showing continuous publication growth, which suggests an acknowledgement of the value of these methods. This study provides the first quantitative assessment of research method publication trends in EBM. PMID:25849641

Population-wide folic acid fortification and preterm birth: testing the folate depletion hypothesis.

PubMed

Naimi, Ashley I; Auger, Nathalie

2015-04-01

We assess whether population-wide folic acid fortification policies were followed by a reduction of preterm and early-term birth rates in Québec among women with short and optimal interpregnancy intervals. We extracted birth certificate data for 1.3 million births between 1981 and 2010 to compute age-adjusted preterm and early-term birth rates stratified by short and optimal interpregnancy intervals. We used Joinpoint regression to detect changes in the preterm and early term birth rates and assess whether these changes coincide with the implementation of population-wide folic acid fortification. A change in the preterm birth rate occurred in 2000 among women with short (95% confidence interval [CI] = 1994, 2005) and optimal (95% CI = 1995, 2008) interpregnancy intervals. Changes in early term birth rates did not coincide with the implementation of folic acid fortification. Our results do not indicate a link between folic acid fortification and early term birth but suggest an improvement in preterm birth rates after implementation of a nationwide folic acid fortification program.

Prediction of Cancer Incidence and Mortality in Korea, 2018

PubMed Central

Jung, Kyu-Won; Won, Young-Joo; Kong, Hyun-Joo; Lee, Eun Sook

2018-01-01

Purpose This study aimed to report on cancer incidence and mortality for the year 2018 to estimate Korea’s current cancer burden. Materials and Methods Cancer incidence data from 1999 to 2015 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2016 were acquired from Statistics Korea. Cancer incidence and mortality were projected by fitting a linear regression model to observed age-specific cancer rates against observed years, then multiplying the projected age-specific rates by the age-specific population. The Joinpoint regression model was used to determine at which year the linear trend changed significantly, we only used the data of the latest trend. Results A total of 204,909 new cancer cases and 82,155 cancer deaths are expected to occur in Korea in 2018. The most common cancer sites were lung, followed by stomach, colorectal, breast and liver. These five cancers represent half of the overall burden of cancer in Korea. For mortality, the most common sites were lung cancer, followed by liver, colorectal, stomach and pancreas. Conclusion The incidence rate of all cancer in Korea are estimated to decrease gradually, mainly due to decrease of thyroid cancer. These up-to-date estimates of the cancer burden in Korea could be an important resource for planning and evaluation of cancer-control programs. PMID:29566480

Colorectal cancer mortality trends in Córdoba, Argentina.

PubMed

Pou, Sonia Alejandra; Osella, Alberto Rubén; Eynard, Aldo Renato; Niclis, Camila; Diaz, María del Pilar

2009-12-01

Colorectal cancer is a leading cause of death worldwide for men and women, and one of the most commonly diagnosed in Córdoba, Argentina. The aim of this work was to provide an up-to-date approach to descriptive epidemiology of colorectal cancer in Córdoba throughout the estimation of mortality trends in the period 1986-2006, using Joinpoint and age-period-cohort (APC) models. Age-standardized (world population) mortality rates (ASMR), overall and truncated (35-64 years), were calculated and Joinpoint regression performed to compute the estimated annual percentage changes (EAPC). Poisson sequential models were fitted to estimate the effect of age (11 age groups), period (1986-1990, 1991-1995, 1996-2000 or 2001-2006) and cohort (13 ten-years cohorts overlapping each other by five-years) on colorectal cancer mortality rates. ASMR showed an overall significant decrease (EAPC -0.9 95%CI: -1.7, -0.2) for women, being more noticeable from 1996 onwards (EAPC -2.1 95%CI: -4.0, -0.1). Age-effect showed an important rise in both sexes, but more evident in males. Birth cohort- and period effects reflected increasing and decreasing tendencies for men and women, respectively. Differences in mortality rates were found according to sex and could be related to age-period-cohort effects linked to the ageing process, health care and lifestyle. Further research is needed to elucidate the specific age-, period- and cohort-related factors.

National trends in the recommendation of radiotherapy after prostatectomy for prostate cancer before and after the reporting of a survival benefit in March 2009.

PubMed

Mahal, Brandon A; Hoffman, Karen E; Efstathiou, Jason A; Nguyen, Paul L

2015-06-01

Three randomized trials demonstrated that postprostatectomy adjuvant radiotherapy improves biochemical disease-free survival for patients with adverse pathologic features, and 1 trial found adjuvant radiotherapy improves overall survival. We sought to determine whether postprostatectomy radiotherapy (PPRT) utilization changed after publication of the survival benefit in March 2009. The Surveillance, Epidemiology, and End Results database was used to identify men diagnosed with prostate cancer from 2004 to 2011 who met criteria for enrollment in the randomized trials (positive margins and/or pT3-4 disease at radical prostatectomy). Joinpoint regression identified inflection points in PPRT utilization. Logistic regression was used to evaluate factors associated with PPRT recommendation. Of 35,361 men, 5104 (14.4%) received a recommendation for PPRT. In joinpoint regression, 2009 was the inflection point in PPRT utilization. In multivariable analysis, PPRT recommendations were more likely after March 2009 than before 15.8% vs. 13.5%, adjusted odds ratio (AOR; 1.09; 95% confidence interval [CI], 1.02-1.16; P = .008), in men with pT3 (vs. pT2, AOR, 2.81; 95% CI, 2.53-3.11; P < .001), pT4 (vs. pT2 AOR, 4.62; 95% CI, 3.85-5.54; P < .001), or margin positive (AOR, 1.46; 95% CI, 1.34-1.58; P < .001) disease and in men who were younger (per year decrease, AOR, 1.02; 95% CI, 1.02-1.03; P < .001), married (AOR, 1.10; 95% CI, 1.02-1.19; P = .01), or lived in metropolitan areas (AOR, 1.30; 95% CI, 1.16-1.47; P < .001). PPRT recommendations increased after the reporting of a survival benefit in March 2009, but absolute utilization rates remain low, suggesting that the oncologic community remains unconvinced that PPRT is needed for most patients with adverse features. Further work is needed to identify patients who might benefit most from PPRT. Copyright © 2015 Elsevier Inc. All rights reserved.

Pancreatic cancer mortality in Serbia from 1991-2010 – a joinpoint analysis

PubMed Central

Ilić, Milena; Vlajinac, Hristina; Marinković, Jelena; Kocev, Nikola

2013-01-01

Aim To analyze the trends of pancreatic cancer mortality in Serbia. Methods The study covered the population of Serbia in the period 1991 to 2010. Mortality trends were assessed by the joinpoint regression analysis by age and sex. Results Age-standardized mortality rates ranged from 5.93 to 8.57 per 100 000 in men and from 3.51 to 5.79 per 100 000 in women. Pancreatic cancer mortality in all age groups was higher among men than among women. It was continuously increasing since 1991 by 1.6% (95% confidence interval [CI] 1.1 to 2.0) yearly in men and by 2.2% (95% CI 1.7 to 2.7) yearly in women. Changes in mortality were not significant in younger age groups for both sexes. In older men (≥55 years), mortality was increasing, although in age groups 70-74 and 80-84 the increase was not significant. In 65-69 years old men, the increase in mortality was significant only in the period 2004 to 2010. In ≥50 years old women, mortality significantly increased from 1991 onward. In 75-79 years old women, a non-significant decrease in the period 1991 to 2000 was followed by a significant increase from 2000 to 2010. Conclusion Serbia is one of the countries with the highest pancreatic cancer mortality in the world, with increasing mortality trend in both sexes and in most age groups. PMID:23986278

Tendency for age-specific mortality with hypertension in the European Union from 1980 to 2011.

PubMed

Tao, Lichan; Pu, Cunying; Shen, Shutong; Fang, Hongyi; Wang, Xiuzhi; Xuan, Qinkao; Xiao, Junjie; Li, Xinli

2015-01-01

Tendency for mortality in hypertension has not been well-characterized in European Union (EU). Mortality data from 1980 to 2011 in EU were used to calculate age-standardized mortality rate (ASMR, per 100,000), annual percentage change (APC) and average annual percentage change (AAPC). The Joinpoint Regression Program was used to compare the changes in tendency. Mortality rates in the most recent year studied vary between different countries, with the highest rates observed in Slovakia men and Estonia women. A downward trend in ASMR was demonstrated over all age groups. Robust decreases in ASMR were observed for both men (1991-1994, APC = -13.54) and women (1996-1999, APC = -14.80) aged 55-65 years. The tendency of systolic blood pressure (SBP) from 1980 to 2009 was consistent with ASMR, and the largest decrease was observed among Belgium men and France women. In conclusion, SBP associated ASMR decreased significantly on an annual basis from 1980 to 2009 while a slight increase was observed after 2009. Discrepancies in ASMR from one country to another in EU are significant during last three decades. With a better understanding of the tendency of the prevalence of hypertension and its mortality, efforts will be made to improve awareness and help strict control of hypertension.

Tendency for age-specific mortality with hypertension in the European Union from 1980 to 2011

PubMed Central

Tao, Lichan; Pu, Cunying; Shen, Shutong; Fang, Hongyi; Wang, Xiuzhi; Xuan, Qinkao; Xiao, Junjie; Li, Xinli

2015-01-01

Tendency for mortality in hypertension has not been well-characterized in European Union (EU). Mortality data from 1980 to 2011 in EU were used to calculate age-standardized mortality rate (ASMR, per 100,000), annual percentage change (APC) and average annual percentage change (AAPC). The Joinpoint Regression Program was used to compare the changes in tendency. Mortality rates in the most recent year studied vary between different countries, with the highest rates observed in Slovakia men and Estonia women. A downward trend in ASMR was demonstrated over all age groups. Robust decreases in ASMR were observed for both men (1991-1994, APC = -13.54) and women (1996-1999, APC = -14.80) aged 55-65 years. The tendency of systolic blood pressure (SBP) from 1980 to 2009 was consistent with ASMR, and the largest decrease was observed among Belgium men and France women. In conclusion, SBP associated ASMR decreased significantly on an annual basis from 1980 to 2009 while a slight increase was observed after 2009. Discrepancies in ASMR from one country to another in EU are significant during last three decades. With a better understanding of the tendency of the prevalence of hypertension and its mortality, efforts will be made to improve awareness and help strict control of hypertension. PMID:25932090

Trends in Suicide by Level of Urbanization - United States, 1999-2015.

PubMed

Kegler, Scott R; Stone, Deborah M; Holland, Kristin M

2017-03-17

Suicide is a major and continuing public health concern in the United States. During 1999-2015, approximately 600,000 U.S. residents died by suicide, with the highest annual rate occurring in 2015 (1). Annual county-level mortality data from the National Vital Statistics System (NVSS) and annual county-level population data from the U.S. Census Bureau were used to analyze suicide rate trends during 1999-2015, with special emphasis on comparing more urban and less urban areas. U.S. counties were grouped by level of urbanization using a six-level classification scheme. To evaluate rate trends, joinpoint regression methodology was applied to the time-series data for each level of urbanization. Suicide rates significantly increased over the study period for all county groupings and accelerated significantly in 2007-2008 for the medium metro, small metro, and non-metro groupings. Understanding suicide trends by urbanization level can help identify geographic areas of highest risk and focus prevention efforts. Communities can benefit from implementing policies, programs, and practices based on the best available evidence regarding suicide prevention and key risk factors. Many approaches are applicable regardless of urbanization level, whereas certain strategies might be particularly relevant in less urban areas affected by difficult economic conditions, limited access to helping services, and social isolation.

The devil is in the details: trends in avoidable hospitalization rates by geography in British Columbia, 1990–2000

PubMed Central

Cloutier-Fisher, Denise; Penning, Margaret J; Zheng, Chi; Druyts, Eric-Bené F

2006-01-01

Background Researchers and policy makers have focussed on the development of indicators to help monitor the success of regionalization, primary care reform and other health sector restructuring initiatives. Certain indicators are useful in examining issues of equity in service provision, especially among older populations, regardless of where they live. AHRs are used as an indicator of primary care system efficiency and thus reveal information about access to general practitioners. The purpose of this paper is to examine trends in avoidable hospitalization rates (AHRs) during a period of time characterized by several waves of health sector restructuring and regionalization in British Columbia. AHRs are examined in relation to non-avoidable and total hospitalization rates as well as by urban and rural geography across the province. Methods Analyses draw on linked administrative health data from the province of British Columbia for 1990 through 2000 for the population aged 50 and over. Joinpoint regression analyses and t-tests are used to detect and describe trends in the data. Results Generally speaking, non-avoidable hospitalizations constitute the vast majority of hospitalizations in a given year (i.e. around 95%) with AHRs constituting the remaining 5% of hospitalizations. Comparing rural areas and urban areas reveals that standardized rates of avoidable, non-avoidable and total hospitalizations are consistently higher in rural areas. Joinpoint regression results show significantly decreasing trends overall; lines are parallel in the case of avoidable hospitalizations, and lines are diverging for non-avoidable and total hospitalizations, with the gap between rural and urban areas being wider at the end of the time interval than at the beginning. Conclusion These data suggest that access to effective primary care in rural communities remains problematic in BC given that rural areas did not make any gains in AHRs relative to urban areas under recent health sector restructuring initiatives. It remains important to continue to monitor the discrepancy between them as a reflection of inequity in service provision. In addition, it is important to consider alternative explanations for the observed trends paying particular attention to the needs of rural and urban populations and the factors influencing local service provision. PMID:16914056

[Incidence and survival of esophageal cancer with different histological types in Linzhou between 2003 and 2012].

PubMed

Liu, S Z; Yu, L; Chen, Q; Quan, P L; Cao, X Q; Sun, X B

2017-05-06

Objective: To investigate the incidence and survival of esophageal cancer with different histological types and to understand the incidence trend and burden of esophageal cancer in Linzhou during 2003-2012. Methods: All incidence records of esophageal cancer and population reported were collected from Linzhou Cancer Registry during 2003-2012. Incidence rate was calculated using gender and histological types. Age standardized incidence rate was calculated according to world Segi's population and Chinese census data in 2000. Age standardized incidence rate by world population between 2003 and 2012 was analyzed with JoinPoint regression model and estimated annual percentage change (EAPC) was calculated. 5-year survival rate was calculated with Kaplan-Meier model. Results: There were 8 229 esophageal cancer cases in Linzhou during 2003-2012. The average annual incidence rate was 80.08/100 000 (8 229/10 276 481). Among all esophageal cancer cases, 7 019 (85.3%) were diagnosed as esophageal squamous cell carcinoma (ESCC). In Linzhou, the age standardized incidence rate by Chinese standard population and by world standard population was 80.92/100 000 and 81.85/100 000 in 2003, 67.97/100 000 and 68.63/100 000 in 2012. JoinPoint regression model showed that EAPC was-12.9% (95 %CI: -16.4%--9.1%) for other and unspecified histological type between 2003 and 2012. The EAPC was-5.5% (95 %CI: -9.2%--1.6%) for esophageal cancer between 2007 and 2012,-5.4% (95 %CI: -7.0%--3.9%) for esophageal cancer in female between 2006 and 2012,-4.9% (95 %CI: -9.5%--0.1%) for ESCC between 2007 and 2012. The 5-year prevalence of esophageal cancer was 215.49 per 100 000 (2 337/1 084 493), and 5 489 died within 5 years after incidence. 5-year survival rate of esophageal cancer was 34.6% (95 %CI: 33.5%-35.6%). Conclusion: Esophageal cancer had a decreasing trend in Linzhou. The survival rate was increasing. But, esophageal cancer was still a major burden in Linzhou. The major histological type was ESCC. ESCC had a similar decreasing trend with esophageal cancer.

Impact of the global financial crisis on low birth weight in Portugal: a time-trend analysis.

PubMed

Kana, Musa Abubakar; Correia, Sofia; Peleteiro, Barbara; Severo, Milton; Barros, Henrique

2017-01-01

The 2007-2008 global financial crisis had adverse consequences on population health of affected European countries. Few contemporary studies have studied its effect on perinatal indicators with long-lasting influence on adult health. Therefore, in this study, we investigated the impact of the 2007-2008 global financial crisis on low birth weight (LBW) in Portugal. Data on 2 045 155 singleton births of 1995-2014 were obtained from Statistics Portugal. Joinpoint regression analysis was performed to identify the years in which changes in LBW trends occurred, and to estimate the annual per cent changes (APC). LBW risk by time period expressed as prevalence ratios were computed using the Poisson regression. Contextual changes in sociodemographic and economic factors were provided by their trends. The joinpoint analysis identified 3 distinct periods (2 jointpoints) with different APC in LBW, corresponding to 1995-1999 (APC=4.4; 95% CI 3.2 to 5.6), 2000-2006 (APC=0.1; 95% CI -050 to 0.7) and 2007-2014 (APC=1.6; 95% CI 1.2 to 2.0). For non-Portuguese, it was, respectively, 1995-1999 (APC=1.4; 95% CI -3.9 to 7.0%), 2000-2007 (APC=-4.2; 95% CI -6.4 to -2.0) and 2008-2014 (APC=3.1; 95% CI 0.8 to 5.5). Compared with 1995-1999, all specific maternal characteristics had a 10-15% increase in LBW risk in 2000-2006 and a 20-25% increase in 2007-2014, except among migrants, for which LBW risk remained lower than in 1995-1999 but increased after the crisis. The increasing LBW risk coincides with a deceleration in gross domestic product growth rate, reduction in health expenditure, social protection allocation on family/children support and sickness. The 2007-2008 global financial crisis was associated with a significant increase in LBW, particularly among infants of non-Portuguese mothers. We recommend strengthening social policies aimed at maternity protection for vulnerable mothers and health system maintenance of social equity in perinatal healthcare.

Evolution of the use of noninvasive mechanical ventilation in chronic obstructive pulmonary disease in a Spanish region, 1997-2010.

PubMed

Carpe-Carpe, Bienvenida; Hernando-Arizaleta, Lauro; Ibáñez-Pérez, M Carmen; Palomar-Rodríguez, Joaquín A; Esquinas-Rodríguez, Antonio M

2013-08-01

Noninvasive mechanical ventilation (NIV) appeared in the 1980s as an alternative to invasive mechanical ventilation (IMV) in patients with acute respiratory failure. We evaluated the introduction of NIV and the results in patients with acute exacerbation of chronic obstructive pulmonary disease in the Region of Murcia (Spain). A retrospective observational study based on the minimum basic hospital discharge data of all patients hospitalised for this pathology in all public hospitals in the region between 1997 and 2010. We performed a time trend analysis on hospital attendance, the use of each ventilatory intervention and hospital mortality through joinpoint regression. We identified 30.027 hospital discharges. Joinpoint analysis: downward trend in attendance (annual percentage change [APC]=-3.4, 95% CI: - 4.8; -2.0, P <.05) and in the group without ventilatory intervention (APC=-4.2%, -5.6; -2.8, P <.05); upward trend in the use of NIV (APC=16.4, 12.0; 20. 9, P <.05), and downward trend that was not statistically significant in IMV (APC=-4.5%, -10.3; 1.7). We observed an upward trend without statistical significance in overall mortality (APC=0.5, -1.3; 2.4) and in the group without intervention (APC=0.1, -1.6; 1.9); downward trend with statistical significance in the NIV group (APC=-7.1, -11.7; -2.2, P <.05) and not statistically significant in the IMV group (APC=-0,8, -6, 1; 4.8). The mean stay did not change substantially. The introduction of NIV has reduced the group of patients not receiving assisted ventilation. No improvement in results was found in terms of mortality or length of stay. Copyright © 2012 SEPAR. Published by Elsevier Espana. All rights reserved.

Tumour stage distribution and survival of malignant melanoma in Germany 2002-2011.

PubMed

Schoffer, Olaf; Schülein, Stefanie; Arand, Gerlinde; Arnholdt, Hans; Baaske, Dieter; Bargou, Ralf C; Becker, Nikolaus; Beckmann, Matthias W; Bodack, Yves; Böhme, Beatrix; Bozkurt, Tayfun; Breitsprecher, Regine; Buchali, Andre; Burger, Elke; Burger, Ulrike; Dommisch, Klaus; Elsner, Gudrun; Fernschild, Karin; Flintzer, Ulrike; Funke, Uwe; Gerken, Michael; Göbel, Hubert; Grobe, Norbert; Gumpp, Vera; Heinzerling, Lucie; Kempfer, Lana Raffaela; Kiani, Alexander; Klinkhammer-Schalke, Monika; Klöcking, Sabine; Kreibich, Ute; Knabner, Katrin; Kuhn, Peter; Lutze, Stine; Mäder, Uwe; Maisel, Tanja; Maschke, Jan; Middeke, Martin; Neubauer, Andreas; Niedostatek, Antje; Opazo-Saez, Anabelle; Peters, Christoph; Schell, Beatrice; Schenkirsch, Gerhard; Schmalenberg, Harald; Schmidt, Peter; Schneider, Constanze; Schubotz, Birgit; Seide, Anika; Strecker, Paul; Taubenheim, Sabine; Wackes, Matthias; Weiß, Steffen; Welke, Claudia; Werner, Carmen; Wittekind, Christian; Wulff, Jörg; Zettl, Heike; Klug, Stefanie J

2016-12-05

Over the past two decades, there has been a rising trend in malignant melanoma incidence worldwide. In 2008, Germany introduced a nationwide skin cancer screening program starting at age 35. The aims of this study were to analyse the distribution of malignant melanoma tumour stages over time, as well as demographic and regional differences in stage distribution and survival of melanoma patients. Pooled data from 61 895 malignant melanoma patients diagnosed between 2002 and 2011 and documented in 28 German population-based and hospital-based clinical cancer registries were analysed using descriptive methods, joinpoint regression, logistic regression and relative survival. The number of annually documented cases increased by 53.2% between 2002 (N = 4 779) and 2011 (N = 7 320). There was a statistically significant continuous positive trend in the proportion of stage UICC I cases diagnosed between 2002 and 2011, compared to a negative trend for stage UICC II. No trends were found for stages UICC III and IV respectively. Age (OR 0.97, 95% CI 0.97-0.97), sex (OR 1.18, 95% CI 1.11-1.25), date of diagnosis (OR 1.05, 95% CI 1.04-1.06), 'diagnosis during screening' (OR 3.24, 95% CI 2.50-4.19) and place of residence (OR 1.23, 95% CI 1.16-1.30) had a statistically significant influence on the tumour stage at diagnosis. The overall 5-year relative survival for invasive cases was 83.4% (95% CI 82.8-83.9%). No distinct changes in the distribution of malignant melanoma tumour stages among those aged 35 and older were seen that could be directly attributed to the introduction of skin cancer screening in 2008.

Maternal education and age: inequalities in neonatal death.

PubMed

Fonseca, Sandra Costa; Flores, Patricia Viana Guimarães; Camargo, Kenneth Rochel; Pinheiro, Rejane Sobrino; Coeli, Claudia Medina

2017-11-17

Evaluate the interaction between maternal age and education level in neonatal mortality, as well as investigate the temporal evolution of neonatal mortality in each stratum formed by the combination of these two risk factors. A nonconcurrent cohort study, resulting from a probabilistic relationship between the Mortality Information System and the Live Birth Information System. To investigate the risk of neonatal death we performed a logistic regression, with an odds ratio estimate for the combined variable of maternal education and age, as well as the evaluation of additive and multiplicative interaction. The neonatal mortality rate time series, according to maternal education and age, was estimated by the Joinpoint Regression program. The neonatal mortality rate in the period was 8.09‰ and it was higher in newborns of mothers with low education levels: 12.7‰ (adolescent mothers) and 12.4‰ (mother 35 years old or older). Low level of education, without the age effect, increased the chance of neonatal death by 25% (OR = 1.25, 95%CI 1.14-1.36). The isolated effect of age on neonatal death was higher for adolescent mothers (OR = 1.39, 95%CI 1.33-1.46) than for mothers aged ≥ 35 years (OR = 1.16, 95%CI 1.09-1.23). In the time-trend analysis, no age group of women with low education levels presented a reduction in the neonatal mortality rate for the period, as opposed to women with intermediate or high levels of education, where the reduction was significant, around 4% annually. Two more vulnerable groups - adolescents with low levels of education and older women with low levels of education - were identified in relation to the risk of neonatal death and inequality in reducing the mortality rate.

Maternal education and age: inequalities in neonatal death

PubMed Central

Fonseca, Sandra Costa; Flores, Patricia Viana Guimarães; Camargo, Kenneth Rochel; Pinheiro, Rejane Sobrino; Coeli, Claudia Medina

2017-01-01

ABSTRACT OBJECTIVE Evaluate the interaction between maternal age and education level in neonatal mortality, as well as investigate the temporal evolution of neonatal mortality in each stratum formed by the combination of these two risk factors. METHODS A nonconcurrent cohort study, resulting from a probabilistic relationship between the Mortality Information System and the Live Birth Information System. To investigate the risk of neonatal death we performed a logistic regression, with an odds ratio estimate for the combined variable of maternal education and age, as well as the evaluation of additive and multiplicative interaction. The neonatal mortality rate time series, according to maternal education and age, was estimated by the Joinpoint Regression program. RESULTS The neonatal mortality rate in the period was 8.09‰ and it was higher in newborns of mothers with low education levels: 12.7‰ (adolescent mothers) and 12.4‰ (mother 35 years old or older). Low level of education, without the age effect, increased the chance of neonatal death by 25% (OR = 1.25, 95%CI 1.14–1.36). The isolated effect of age on neonatal death was higher for adolescent mothers (OR = 1.39, 95%CI 1.33–1.46) than for mothers aged ≥ 35 years (OR = 1.16, 95%CI 1.09–1.23). In the time-trend analysis, no age group of women with low education levels presented a reduction in the neonatal mortality rate for the period, as opposed to women with intermediate or high levels of education, where the reduction was significant, around 4% annually. CONCLUSIONS Two more vulnerable groups – adolescents with low levels of education and older women with low levels of education – were identified in relation to the risk of neonatal death and inequality in reducing the mortality rate. PMID:29166446

Trend of Suicide Rates According to Urbanity among Adolescents by Gender and Suicide Method in Korea, 1997-2012.

PubMed

Choi, Kyung-Hwa; Kim, Dong-Hyun

2015-05-13

This study aims to quantifiably evaluate the trend of the suicide rate among Korean adolescents from 1997 to 2012 according to urbanity. We used national death certificates and registration population data by administrative district for 15-19 years-old adolescents. The annual percent change (APC) and average annual percent change (AAPC) were estimated by the Joinpoint Regression Program. The suicide rate in the rural areas was higher than that in the urban areas in both genders (males (/100,000), 12.2 vs. 8.5; females (/100,000), 10.2 vs. 7.4 in 2012). However, the trend significantly increased only in the urban area (AAPC [95% CI]: males 2.6 [0.7, 4.6], females 3.3 [1.4, 5.2]). In urban areas, the suicide rate by jumping significantly increased in both genders (AAPC [95% CI]: males, 6.7 [4.3, 9.1]; females, 4.5 [3.0, 6.1]). In rural areas, the rate by self-poisoning significantly decreased by 7.9% per year for males (95% CI: -12.5, -3.0) and the rate by hanging significantly increased by 10.1% per year for females (95% CI: 2.6, 18.2). The trend and methods of suicide differ according to urbanity; therefore, a suicide prevention policy based on urbanity needs to be established for adolescents in Korea.

Trend of Suicide Rates According to Urbanity among Adolescents by Gender and Suicide Method in Korea, 1997–2012

PubMed Central

Choi, Kyung-Hwa; Kim, Dong-Hyun

2015-01-01

This study aims to quantifiably evaluate the trend of the suicide rate among Korean adolescents from 1997 to 2012 according to urbanity. We used national death certificates and registration population data by administrative district for 15–19 years-old adolescents. The annual percent change (APC) and average annual percent change (AAPC) were estimated by the Joinpoint Regression Program. The suicide rate in the rural areas was higher than that in the urban areas in both genders (males (/100,000), 12.2 vs. 8.5; females (/100,000), 10.2 vs. 7.4 in 2012). However, the trend significantly increased only in the urban area (AAPC [95% CI]: males 2.6 [0.7, 4.6], females 3.3 [1.4, 5.2]). In urban areas, the suicide rate by jumping significantly increased in both genders (AAPC [95% CI]: males, 6.7 [4.3, 9.1]; females, 4.5 [3.0, 6.1]). In rural areas, the rate by self-poisoning significantly decreased by 7.9% per year for males (95% CI: −12.5, −3.0) and the rate by hanging significantly increased by 10.1% per year for females (95% CI: 2.6, 18.2). The trend and methods of suicide differ according to urbanity; therefore, a suicide prevention policy based on urbanity needs to be established for adolescents in Korea. PMID:25985313

[Birth rates evolution in Spain. Birth trends in Spain from 1941 to 2010].

PubMed

Andrés de Llano, J M; Alberola López, S; Garmendia Leiza, J R; Quiñones Rubio, C; Cancho Candela, R; Ramalle-Gómara, E

2015-01-01

The aim of this study was to analyse trends of births in Spain and its Autonomous Communities (CCAA) over a 70 year period (1941-2010). The crude birth rates per 1,000 inhabitants/year were calculated by CCAA using Joinpoint regression models. Change points in trend and annual percentage of change (APC) were identified. The distribution of 38,160,305 births between 1941 and 2010 shows important changes in trends both nationally and among the CCAA. There is a general pattern for the whole country, with 5 turning points being identified with changes in trend and annual percentage change (APC). Differences are also found among regions. The analysis of trends in birth rates and the annual rates of change should enable public health authorities to properly plan pediatric care resources in our country. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Impact of the global financial crisis on low birth weight in Portugal: a time-trend analysis

PubMed Central

Kana, Musa Abubakar; Correia, Sofia; Peleteiro, Barbara; Severo, Milton; Barros, Henrique

2017-01-01

Background The 2007–2008 global financial crisis had adverse consequences on population health of affected European countries. Few contemporary studies have studied its effect on perinatal indicators with long-lasting influence on adult health. Therefore, in this study, we investigated the impact of the 2007–2008 global financial crisis on low birth weight (LBW) in Portugal. Methods Data on 2 045 155 singleton births of 1995–2014 were obtained from Statistics Portugal. Joinpoint regression analysis was performed to identify the years in which changes in LBW trends occurred, and to estimate the annual per cent changes (APC). LBW risk by time period expressed as prevalence ratios were computed using the Poisson regression. Contextual changes in sociodemographic and economic factors were provided by their trends. Results The joinpoint analysis identified 3 distinct periods (2 jointpoints) with different APC in LBW, corresponding to 1995–1999 (APC=4.4; 95% CI 3.2 to 5.6), 2000–2006 (APC=0.1; 95% CI −050 to 0.7) and 2007–2014 (APC=1.6; 95% CI 1.2 to 2.0). For non-Portuguese, it was, respectively, 1995–1999 (APC=1.4; 95% CI −3.9 to 7.0%), 2000–2007 (APC=−4.2; 95% CI −6.4 to −2.0) and 2008–2014 (APC=3.1; 95% CI 0.8 to 5.5). Compared with 1995–1999, all specific maternal characteristics had a 10–15% increase in LBW risk in 2000–2006 and a 20–25% increase in 2007–2014, except among migrants, for which LBW risk remained lower than in 1995–1999 but increased after the crisis. The increasing LBW risk coincides with a deceleration in gross domestic product growth rate, reduction in health expenditure, social protection allocation on family/children support and sickness. Conclusions The 2007–2008 global financial crisis was associated with a significant increase in LBW, particularly among infants of non-Portuguese mothers. We recommend strengthening social policies aimed at maternity protection for vulnerable mothers and health system maintenance of social equity in perinatal healthcare. PMID:28589009

The epidemiological and histological trend of bladder cancer in Iran.

PubMed

Rafiemanesh, Hosein; Lotfi, Zahra; Bakhtazad, Sima; Ghoncheh, Mahshid; Salehiniya, Hamid

2018-01-01

Bladder cancer is the ninth common cancer in the world, the third common cancer among men in the Arabic and Western Asian countries, and the second in some regions of Iran (a country in the Middle East). There was no study on the epidemiological and histological trend of bladder cancer in Iran. This study aimed to the epidemiological and histological trend of bladder cancer in Iran. In this study, data were extracted from annual cancer registry reports of Iranian Ministry of Health between 2003 and 2008. Standardized incidence rates were calculated using the world standard population and incidence rate was calculated by age groups, sex, and histological type. Data on epidemiologic trend and histology were analyzed using Joinpoint software package. A total of 23,291 cases were reported. Almost 17.70% (4127 cases) were women and 82.30% (19,170 cases) men. The sex ratio (male to female) was 4.65. Joinpoint analysis showed the significant increased trend of age-standardized incidence rate (ASIR) for both sexes. The annual percentage change of standardized incidence rate was 11.5 (confidence interval [CI]: 9.0-14.0) in women and 10.8 (CI: 8.0-13.6) in men. Two histological types of transitional cell carcinoma (TCC), not otherwise specified and papillary TCC included 43.89% and 49.86% of all cancer cases, respectively. According to this study the trend of ASIR of bladder cancer in Iran is rising, so it is necessary to conduct further researches in future to provide accurate information on the cancer and investigate related risk factors and implement prevention programs in Iran.

The present and the future of breast cancer burden in the Kingdom of Saudi Arabia.

PubMed

Ibrahim, Ezzeldin M; Zeeneldin, Ahmed A; Sadiq, Bakr Bin; Ezzat, Adnan A

2008-01-01

Despite the low cancer incidence in the Kingdom of Saudi Arabia (KSA), the country must be ready to face the challenge of foreseeable increase in cancer burden attributed to growth and aging of population. This work was designed to study female breast cancer as a model to assess future cancer burden and the impact on healthcare resources. Cancer statistics for the KSA were compared with that for the USA. The Joinpoint regression program was used to identify changes in secular trends, while the GLOBOCAN 2002 software projected future incidence and mortality. In the KSA, the age-standardized cancer rate (ASR) is 61 per 100,000 population, while the median age at diagnosis is 54 and 49 years for men and women, respectively. Fitting the ASR for breast cancer did not show any significant trend over a 10-year calendar period (16.2-18.2 per 100,000), a pattern that was similar to that for the USA in the prescreening mammography era. Considering the growth and aging of population and using conservative estimates for the annual percent change in incidence (increase) and mortality (decrease) by 2025, incidence and mortality cases are expected to increase by about 350% and 160%, respectively. In developing countries, future cancer rates could demonstrate a considerable increase and enormous demands on healthcare resources. The present work may provide an impetus to study other prevalent cancer types particularly in developing countries.

Past, present and future of colorectal cancer in the Kingdom of Saudi Arabia.

PubMed

Ibrahim, Ezzeldin M; Zeeneldin, Ahmed A; El-Khodary, Tawfik R; Al-Gahmi, Aboelkhair M; Bin Sadiq, Bakr M

2008-10-01

The crude frequency of colorectal cancer (CRC) is second to breast cancer in the Kingdom of Saudi Arabia (KSA). To assess the future burden of CRC in the country, we designed a model that takes into consideration the recent lifestyle pattern and the growth and aging of the population. We compared CRC statistics for KSA (using data from the National Cancer Registry) with that from the Surveillance, Epidemiology and End Results (SEER) databases of the United States of America (USA). We used the Joinpoint regression program to identify changes in secular trends, while the GLOBOCAN 2002 software was used to project future incidence and mortality. Between 1994 and 2003, age-standardized rates (ASRs) for CRC in KSA almost doubled, as compared to a nonsignificant decline in USA. Between 2001 and 2003, while the annual percent change (APC) of CRC incidence in the USA showed a nonsignificant decrease in females, APC in Saudi females showed a nonsignificant rise of six percent. On the other hand, the rising incidence among Saudi males, during the years 1999 to 2003, was significant, with an APC of 20.5%. The projection model suggested that the incidence of CRC in KSA could increase fourfold in both genders by the year 2030. In KSA, the present and expected increase in CRC rates is alarming. Pragmatic recommendations to face that challenge are discussed. The present work could serve as a model to study other prevalent types of cancer, particularly in developing countries.

The influence of intern home call on objectively measured perioperative outcomes.

PubMed

Kastenberg, Zachary J; Rhoads, Kim F; Melcher, Marc L; Wren, Sherry M

2013-04-01

In July 2011, surgical interns were prohibited from being on call from home by the new residency review committee guidelines on work hours. In support of the new Accreditation Council for Graduate Medical Education work-hour restrictions, we expected that a period of intern home call would correlate with increased rates of postoperative morbidity and mortality. Prospective cohort. University-affiliated tertiary Veterans Affairs Medical Center. All patients identified in the Veterans Affairs National Surgical Quality Improvement Program database who underwent an operation performed by general, vascular, urologic, or cardiac surgery services between fiscal years (FYs) 1999 and 2010 were included. During FYs 1999-2003, the first call for all patients went to an in-hospital intern. In the subsequent period (FYs 2004-2010), the first call went to an intern on home call. Thirty-day unadjusted morbidity and mortality rates and risk-adjusted observed to expected ratios were analyzed by univariate analysis and joinpoint regression, respectively. Unadjusted overall morbidity rates decreased between 1999-2003 and 2004-2010 (12.14% to 10.19%, P = .003). The risk-adjusted morbidity observed to expected ratios decreased at a uniform annual percentage change of -6.03% (P < .001). Unadjusted overall mortality rates also decreased between the 2 periods (1.76% to 1.26%; P = .05). There was no significant change in the risk-adjusted mortality observed to expected ratios during the study. The institution of an intern home call schedule was not associated with increased rates of postoperative morbidity or mortality.

Type 1 diabetes incidence and prevalence trends in a cohort of Canadian children and youth.

PubMed

Fox, Danya A; Islam, Nazrul; Sutherland, Jenny; Reimer, Kim; Amed, Shazhan

2018-05-01

Incidence rates of type 1 diabetes have long been on the rise across the globe, however, there is emerging evidence that the rate of rise may be slowing. The objective of this study was to describe trends in the incidence and prevalence of type 1 diabetes in a sample of Canadian children and youth. Cases were extracted using linked administrative datasets and a validated diabetes case-finding definition. Incidence and prevalence trends were analyzed using the JoinPoint regression analysis program. A small increase in the incidence of type 1 diabetes was observed over the 11-year period from 2002-2003 to 2012-2013. Total incident cases per year ranged from 201 (2005-2006) to 250 (2007-2008). Total prevalent cases per year ranged from 1790 (2002-2003) to 2264 (2012-2013). Incidence was highest among children aged 5 to 14 years, and lowest in the youngest (1-4 years) and oldest (15-19 years) age brackets. The most significant increase in incidence was in children aged 10 to 14 years. Age-standardized prevalence increased significantly throughout the study period. These results are similar to data from the United States but differ from European data with respect to the annual percent change for incidence as well as age-specific incidence trends. In keeping with the low mortality rates associated with type 1 diabetes, the prevalence continues to rise. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Gastric cancer mortality trends in Spain, 1976-2005, differences by autonomous region and sex

PubMed Central

2009-01-01

Background Gastric cancer is the second leading cause of oncologic death worldwide. One of the most noteworthy characteristics of this tumor's epidemiology is the marked decline reported in its incidence and mortality in almost every part of the globe in recent decades. This study sought to describe gastric cancer mortality time trends in Spain's regions for both sexes. Methods Mortality data for the period 1976 through 2005 were obtained from the Spanish National Statistics Institute. Cases were identified using the International Classification of Diseases 9th and 10th revision (codes 151 and C16, respectively). Crude and standardized mortality rates were calculated by geographic area, sex, and five-year period. Joinpoint regression analyses were performed to ascertain whether changes in gastric cancer mortality trends had occurred, and to estimate the annual percent change by sex and geographic area. Results Gastric cancer mortality decreased across the study period, with the downward trend being most pronounced in women and in certain regions situated in the interior and north of mainland Spain. Across the study period, there was an overall decrease of 2.90% per annum among men and 3.65% per annum among women. Generally, regions in which the rate of decline was sharpest were those that had initially registered the highest rates. However, the rate of decline was not constant throughout the study period: joinpoint analysis detected a shift in trend for both sexes in the early 1980s. Conclusion Gastric cancer mortality displayed in both sexes a downward trend during the study period, both nationally and regionally. The different trend in rates in the respective geographic areas translated as greater regional homogeneity in gastric cancer mortality by the end of the study period. In contrast, rates in women fell more than did those in men. The increasing differences between the sexes could indicate that some risk factors may be modifying the sex-specific pattern of this tumor. PMID:19785726

Trends in Mortality of Tuberculosis Patients in the United States: The Long-term Perspective

PubMed Central

Barnes, Richard F.W.; Moore, Maria Luisa; Garfein, Richard S.; Brodine, Stephanie; Strathdee, Steffanie A.; Rodwell, Timothy C.

2011-01-01

PURPOSE To describe long-term trends in TB mortality and to compare trends estimated from two different sources of public health surveillance data. METHODS Trends and changes in trend were estimated by joinpoint regression. Comparisons between datasets were made by fitting a Poisson regression model. RESULTS Since 1900, TB mortality rates estimated from death certificates have declined steeply, except for a period of no change in the 1980s. This decade had long-term consequences resulting in more TB deaths in later years than would have occurred had there been no flattening of the trend. Recent trends in TB mortality estimated from National Tuberculosis Surveillance System (NTSS) data, which record all-cause mortality, differed from trends based on death certificates. In particular, NTSS data showed TB mortality rates flattening since 2002. CONCLUSIONS Estimates of trends in TB mortality vary by data source, and therefore interpretation of the success of control efforts will depend upon the surveillance dataset used. The datasets may be subject to different biases that vary with time. One dataset showed a sustained improvement in the control of TB since the early 1990s while the other indicated that the rate of TB mortality was no longer declining. PMID:21820320

Malaria in the Americas: trends from 1959 to 2011.

PubMed

Carter, Keith H; Singh, Prabhjot; Mujica, Oscar J; Escalada, Rainier P; Ade, Maria Paz; Castellanos, Luis Gerardo; Espinal, Marcos A

2015-02-01

Malaria has declined in recent years in countries of the American continents. In 2011, 12 of 21 endemic countries had already met their 2015 Millennium Development Goal. However, this declining trend has not been adequately evaluated. An analysis of the number of cases per 100,000 people (annual parasite index [API]) and the percentage of positive blood slides (slide positivity rate [SPR]) during the period of 1959-2011 in 21 endemic countries was done using the joinpoint regression methodology. During 1960-1979, API and SPR increased significantly and peaked in the 1980s. Since the 1990s, there have been significant declining trends in both API and SPR. Additionally, both Plasmodium vivax and P. falciparum species-specific incidence have declined. With the exception of two countries, such a collectively declining malaria trend was not observed in previous decades. This presents a unique opportunity for the Americas to seriously consider malaria elimination as a final goal. © The American Society of Tropical Medicine and Hygiene.

Malaria in the Americas: Trends from 1959 to 2011

PubMed Central

Carter, Keith H.; Singh, Prabhjot; Mujica, Oscar J.; Escalada, Rainier P.; Ade, Maria Paz; Castellanos, Luis Gerardo; Espinal, Marcos A.

2015-01-01

Malaria has declined in recent years in countries of the American continents. In 2011, 12 of 21 endemic countries had already met their 2015 Millennium Development Goal. However, this declining trend has not been adequately evaluated. An analysis of the number of cases per 100,000 people (annual parasite index [API]) and the percentage of positive blood slides (slide positivity rate [SPR]) during the period of 1959–2011 in 21 endemic countries was done using the joinpoint regression methodology. During 1960–1979, API and SPR increased significantly and peaked in the 1980s. Since the 1990s, there have been significant declining trends in both API and SPR. Additionally, both Plasmodium vivax and P. falciparum species-specific incidence have declined. With the exception of two countries, such a collectively declining malaria trend was not observed in previous decades. This presents a unique opportunity for the Americas to seriously consider malaria elimination as a final goal. PMID:25548378

Epidemiological patterns of tick-borne encephalitis in Lithuania and clinical features in adults in the light of the high incidence in recent years: a retrospective study.

PubMed

Radzišauskienė, D; Žagminas, K; Ašoklienė, L; Jasionis, A; Mameniškienė, R; Ambrozaitis, A; Jančorienė, L; Jatužis, D; Petraitytė, I; Mockienė, E

2018-02-01

Lithuania is one of the countries with the highest incidence of tick-borne encephalitis (TBE) in Europe. The aim of this study was to describe the epidemiological patterns of TBE in Lithuania, and characterize clinical features in adults in the light of the high incidence in recent years. Surveillance data available on the website of the Centre for Communicable Diseases and AIDS of Lithuania were used to describe the epidemiological patterns of TBE. The retrospective study included 712 patients hospitalized in the Centre for Infectious Diseases and the Centre for Neurology of Vilnius University in the years 2005-2014. Tick-borne encephalitis incidence rates have been increasing by 8.5% per year for the 45-year period from 1970 to 2014. The joinpoint model finds two joinpoints at 1991 and 1994, with a significant decrease of 8.4% per year (P < 0.05) prior to the joinpoint at 1991, and a rise of 195.2% afterwards. TBE presented with meningoencephalitis in 556 cases (81.3%). A total of 129 patients (18%) had a severe case of the disease. The most common neurological signs were ataxia (579, 81.3%), meningeal signs (474, 66.5%) and tremor (338, 47.5%). Limb paresis was observed in 6.3% of patients. Five patients (0.7%) died, and 544 patients (76.7%) were discharged with sequelae. Intensified efforts in promoting TBE vaccination will be needed in the light of the high incidence and expanded spatial distribution. Significant prognostic factors for severe cases of the disease were age above 61 and delayed immune response of specific immunoglobulin G. © 2017 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

Ischaemic heart disease mortality in Serbia, 1991-2013; a joinpoint analysis

PubMed Central

Ilic, Milena; Ilic, Irena

2017-01-01

Background & objectives: Ischaemic heart disease (IHD) has been one of the leading causes of mortality in the world. In many European countries the mortality rates due to IHD have been rising rapidly. This study was aimed to assess the IHD mortality trend in Serbia. Methods: A population-based cross-sectional study analyzing IHD mortality in Serbia in the period 1991-2013 was carried out based on official data. The age-standardized rates (ASRs, per 100,000) were calculated using the direct method, according to the European standard population. Joinpoint analysis was used to estimate the average annual percentage change (AAPC) with the corresponding 95 per cent confidence interval (CI). Results: More than 253,000 people (143,420 men and 110,276 women) died due to IHD in Serbia during the observed period, and most of them (over 160,000 people) were patients with myocardial infarction (MI). Average annual ASR for IHD was 113.6/100,000. There was no overall significant trend for mortality due to IHD (AAPC=+0.1%, 95% CI −0.8-1.0), but there was one joinpoint: the trend significantly increased by +2.3 per cent per year from 1991 to 2006 and then significantly decreased by −6.4 per cent from 2006 to onwards. Significantly decreased mortality trends for MI in both genders were observed: according to the comparability test, mortality trends in men and women were parallel (final selected model failed to reject parallelism, P=0.0567). Interpretation & conclusions: No significant trend for mortality due to IHD was observed in Serbia during the study period. The substantial decline of mortality from IHD seen in most developed countries during the past decades was not observed in Serbia. Further efforts are required to reduce mortality from IHD in Serbian population. PMID:29664033

Characteristics and comparison of colorectal cancer incidence in Beijing with other regions in the world

PubMed Central

Li, Zhongmin; Yang, Lei; Du, Changzheng; Fang, Xuedong; Wang, Ning; Gu, Jin

2017-01-01

Background Population-based epidemiologic studies about colorectal cancer are lacking in China. This study aims to provide a basis for colorectal cancer screening and prevention, through analysis and comparisons the characteristics of the trends in colorectal cancer incidence in Beijing and selected representative regions. RESULTS The annual incidence rate in Beijing region increased significantly, from 9.40/100,000 in 1998 to 18.61/100,000 in 2012. The stratified rate showed that the incidence of distal colon adenocarcinoma increased substantially in men, especially in those aged > 75 years and residing in urban areas. Although the incidence rate in Beijing is still lower than in Shanghai, Jiashan, and Hong Kong in China, it is increasing rapidly. Further, the incidence rate in Beijing is lower than in New York, Oxford and Osaka, but higher than in Mumbai and Kyadondo. The incidence trend in Beijing is increasing especially in older groups, while in other regions such as New York, it is decreasing in these age groups. Materials and Methods Colorectal cancer incidence data were obtained from Beijing Cancer Registry and Cancer Incidence in Five Continents Plus database. All incidence rates were age-standardized according to Segi's world population. Incidence trends were characterized by calculating the annual percent changes using the Joinpoint Regression Program. Conclusions Compared with other regions, Beijing has a medium level of colorectal cancer incidence, however, it is increasing significantly. There are obvious differences in the cancer subsite, sex and age distributions between Beijing and other regions. Prevention and screening of colorectal cancer in Beijing should be strengthened. PMID:28445947

Characteristics and comparison of colorectal cancer incidence in Beijing with other regions in the world.

PubMed

Li, Zhongmin; Yang, Lei; Du, Changzheng; Fang, Xuedong; Wang, Ning; Gu, Jin

2017-04-11

Population-based epidemiologic studies about colorectal cancer are lacking in China. This study aims to provide a basis for colorectal cancer screening and prevention, through analysis and comparisons the characteristics of the trends in colorectal cancer incidence in Beijing and selected representative regions. The annual incidence rate in Beijing region increased significantly, from 9.40/100,000 in 1998 to 18.61/100,000 in 2012. The stratified rate showed that the incidence of distal colon adenocarcinoma increased substantially in men, especially in those aged > 75 years and residing in urban areas. Although the incidence rate in Beijing is still lower than in Shanghai, Jiashan, and Hong Kong in China, it is increasing rapidly. Further, the incidence rate in Beijing is lower than in New York, Oxford and Osaka, but higher than in Mumbai and Kyadondo. The incidence trend in Beijing is increasing especially in older groups, while in other regions such as New York, it is decreasing in these age groups. Colorectal cancer incidence data were obtained from Beijing Cancer Registry and Cancer Incidence in Five Continents Plus database. All incidence rates were age-standardized according to Segi's world population. Incidence trends were characterized by calculating the annual percent changes using the Joinpoint Regression Program. Compared with other regions, Beijing has a medium level of colorectal cancer incidence, however, it is increasing significantly. There are obvious differences in the cancer subsite, sex and age distributions between Beijing and other regions. Prevention and screening of colorectal cancer in Beijing should be strengthened.

Child maltreatment in Taiwan for 2004-2013: A shift in age group and forms of maltreatment.

PubMed

Chen, Chih-Tsai; Yang, Nan-Ping; Chou, Pesus

2016-02-01

Cases of child maltreatment are being increasingly reported in Taiwan. However, the trend or changes of child maltreatment in Taiwan are fragmentary and lack empirical evidence. This study analyzed the epidemiological characteristics of substantiated child maltreatment cases from the previous decade, using mortality as an indicator to investigate the care of children who experienced substantiated maltreatment in the past to determine any new developments. Data for analysis and estimates were retrieved from the Department of Statistics in the Ministry of the Interior from 2004 to 2013. Trend analyses were conducted using the Joinpoint Regression Program. The child maltreatment rate in Taiwan was found to have nearly tripled from 2004 to 2013. A greater increase in the maltreatment of girls than boys and the maltreatment of aboriginal children than non-aboriginal children was noted from 2004 to 2013. When stratified by age group, the increase in maltreatment was most pronounced in children aged 12-17 years, and girls aged 12-17 years experienced the greatest increase in maltreatment. In terms of the proportional changes of different maltreatment forms among substantiated child maltreatment cases, child neglect was decreasing. The increase in sexual abuse was higher than for any other form of maltreatment and surpassed neglect by the end of 2013. Furthermore, the mortality rate of children with substantiated maltreatment record is increasing in Taiwan, whereas the mortality rate among children without any substantiated maltreatment record is decreasing. The results of this study highlight the need for policy reform in Taiwan regarding child maltreatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

The effect of multiple primary rules on cancer incidence rates and trends

PubMed Central

Weir, Hannah K.; Johnson, Christopher J.; Ward, Kevin C.; Coleman, Michel P.

2018-01-01

Purpose An examination of multiple primary cancers can provide insight into the etiologic role of genes, the environment, and prior cancer treatment on a cancer patient’s risk of developing a subsequent cancer. Different rules for registering multiple primary cancers (MP) are used by cancer registries throughout the world making data comparisons difficult. Methods We evaluated the effect of SEER and IARC/IACR rules on cancer incidence rates and trends using data from the SEER Program. We estimated age-standardized incidence rate (ASIR) and trends (1975–2011) for the top 26 cancer categories using joinpoint regression analysis. Results ASIRs were higher using SEER compared to IARC/IACR rules for all cancers combined (3 %) and, in rank order, melanoma (9 %), female breast (7 %), urinary bladder (6 %), colon (4 %), kidney and renal pelvis (4 %), oral cavity and pharynx (3 %), lung and bronchus (2 %), and non-Hodgkin lymphoma (2 %). ASIR differences were largest for patients aged 65+ years. Trends were similar using both MP rules with the exception of cancers of the urinary bladder, and kidney and renal pelvis. Conclusions The choice of multiple primary coding rules effects incidence rates and trends. Compared to SEER MP coding rules, IARC/IACR rules are less complex, have not changed over time, and report fewer multiple primary cancers, particularly cancers that occur in paired organs, at the same anatomic site and with the same or related histologic type. Cancer registries collecting incidence data using SEER rules may want to consider including incidence rates and trends using IARC/IACR rules to facilitate international data comparisons. PMID:26809509

Impact of hepatitis B vaccination on acute hepatitis B epidemiology in European Union/European Economic Area countries, 2006 to 2014

PubMed Central

Miglietta, Alessandro; Quinten, Chantal; Lopalco, Pier Luigi; Duffell, Erika

2018-01-01

Hepatitis B prevention in European Union/European Economic Area (EU/EEA) countries relies on vaccination programmes. We describe the epidemiology of acute hepatitis B virus (HBV) at country and EU/EEA level during 2006–2014. Using a multi-level mixed-effects Poisson regression model we assessed differences in the acute HBV infection notification rates between groups of countries that started universal HBV vaccination before/in vs after 1995; implemented or not a catch-up strategy; reached a vaccine coverage ≥ 95% vs < 95% and had a hepatitis B surface antigen prevalence ≥ 1% vs < 1%. Joinpoint regression analysis was used to assess trends by groups of countries, and additional Poisson regression models to evaluate the association between three-dose HBV vaccine coverage and acute HBV infection notification rates at country and EU/EEA level. The EU/EEA acute HBV infection notification rate decreased from 1.6 per 100,000 population in 2006 to 0.7 in 2014. No differences (p > 0.05) were found in the acute HBV infection notification rates between groups of countries, while as vaccine coverage increased, such rates decreased (p < 0.01). Countries with universal HBV vaccination before 1995, a catch-up strategy, and a vaccine coverage ≥ 95% had significant decreasing trends (p < 0.01). Ending HBV transmission in Europe by 2030 will require high vaccine coverage delivered through universal programmes, supported, where appropriate, by catch-up vaccination campaigns. PMID:29439751

A Population-based Study of Invasive Cervical Cancer Patients in Beijing: 1993-2008.

PubMed

Wang, Tong; Wu, Ming-Hui; Wu, Yu-Mei; Zhang, Wei-Yuan

2015-12-20

In recent years, the incidence of cervical cancer has been rising, particularly in young adults, as the second most common gynecological cancer in China. The aim of this study was to explore the incidence change and the epidemiological characteristics of cervical cancer in Beijing over the past 16 years. All the cases of the study were limited to Beijing residents diagnosed with cervical cancer and registered in Beijing from January 1, 1993, to December 31, 2008. A total of 4100 patients with cervical cancer were obtained from the Statistics Database of Beijing Cancer Registry (BJCaR). According to the registered data, we retrospectively reviewed all original cases which we can acquired in reported hospital. Cervical situ cancer, cervical metastatic cancer, non-Beijing residents and repeatedly registered cases were excluded. Totally, 3641 registered cases were verified correctly. Meanwhile, we also collected the following data: Age, occupation, detected methods, histological type, and staging. The trends of incidence and mortality were analyzed by Joinpoint Regression Program 4.1.1.1 produced by National Cancer Institute (NCI, USA). The annual percent change (APC) was calculated using the Joinpoint regression model. The crude rates of incidence and mortality were 10.4 and 1.0 per 100,000 women, respectively during 1993 to 2008. The average WHO age-standardized incidence rates were 11.5 per 100,000 women. There was a decrease in incidence annually by 8.0% (P = 0.3) during 1993-1996 and a rapid increase annually by 18.9% after 1999 (P < 0.01). The median age was 67 years in 1993, but the median age decreased to 45 years in 2008. The peak of the age-specific incidence curve was at 40 years in the most recent period (2005-2008), which was 25-30 years earlier than that in previous periods (1993-1996). In the 2224 cases, the numbers of patients with stage I, II, III and IV were 910 (40.9%), 601 (27%), 542 (24.4%), 171 (7.7%), respectively. The percentage of patients with stage I was 7.6% (13/171) in 1993-1996, but the percentage increased to 51.6% (643/1247) in 2005-2008 (P < 0.01). Otherwise the percentage of advanced stage (stage III-IV) during the same period was dropped down significantly from 52.0% (89/171) to 22.5% (280/1247) (P < 0.01). Unemployed and housewife ranked first accounting for 27.3% of the total (607/2224). Urban low-income people such as worker ranked the second accounting for 17.0% (377/2224), the third place was farmer accounting for 14.0% (312/2224). Only 381 (17.1%, 381/2224) women in 2224 were first detected cervical cancer by routine screenings. Company staff (36.5%, 139/381), professional and technical personnel (22.6%, 86/381), national official (22.0%, 84/381) occupied the top three (total 81.1%) in the 381 patients detected cervical cancer by screening. The cervical cancer incidence has showed a continuous rise in Beijing since 1999. Government-led mass screening should target the low socioeconomic population primarily. Meanwhile the government should enhance public health education of cancer screening to increase the rate of screening.

Comparing methods of measuring geographic patterns in temporal trends: an application to county-level heart disease mortality in the United States, 1973 to 2010.

PubMed

Vaughan, Adam S; Kramer, Michael R; Waller, Lance A; Schieb, Linda J; Greer, Sophia; Casper, Michele

2015-05-01

To demonstrate the implications of choosing analytical methods for quantifying spatiotemporal trends, we compare the assumptions, implementation, and outcomes of popular methods using county-level heart disease mortality in the United States between 1973 and 2010. We applied four regression-based approaches (joinpoint regression, both aspatial and spatial generalized linear mixed models, and Bayesian space-time model) and compared resulting inferences for geographic patterns of local estimates of annual percent change and associated uncertainty. The average local percent change in heart disease mortality from each method was -4.5%, with the Bayesian model having the smallest range of values. The associated uncertainty in percent change differed markedly across the methods, with the Bayesian space-time model producing the narrowest range of variance (0.0-0.8). The geographic pattern of percent change was consistent across methods with smaller declines in the South Central United States and larger declines in the Northeast and Midwest. However, the geographic patterns of uncertainty differed markedly between methods. The similarity of results, including geographic patterns, for magnitude of percent change across these methods validates the underlying spatial pattern of declines in heart disease mortality. However, marked differences in degree of uncertainty indicate that Bayesian modeling offers substantially more precise estimates. Copyright © 2015 Elsevier Inc. All rights reserved.

Incidence and mortality of lung cancer: global trends and association with socioeconomic status.

PubMed

Wong, Martin C S; Lao, Xiang Qian; Ho, Kin-Fai; Goggins, William B; Tse, Shelly L A

2017-10-30

We examined the correlation between lung cancer incidence/mortality and country-specific socioeconomic development, and evaluated its most recent global trends. We retrieved its age-standardized incidence rates from the GLOBOCAN database, and temporal patterns were assessed from global databases. We employed simple linear regression analysis to evaluate their correlations with Human Development Index (HDI) and Gross Domestic Product (GDP) per capita. The average annual percent changes (AAPC) of the trends were evaluated from join-point regression analysis. Country-specific HDI was strongly correlated with age-standardized incidence (r = 0.70) and mortality (r = 0.67), and to a lesser extent GDP (r = 0.24 to 0.55). Among men, 22 and 30 (out of 38 and 36) countries showed declining incidence and mortality trends, respectively; whilst among women, 19 and 16 countries showed increasing incidence and mortality trends, respectively. Among men, the AAPCs ranged from -2.8 to -0.6 (incidence) and -3.6 to -1.1 (mortality) in countries with declining trend, whereas among women the AAPC range was 0.4 to 8.9 (incidence) and 1 to 4.4 (mortality) in countries with increasing trend. Among women, Brazil, Spain and Cyprus had the greatest incidence increase, and all countries in Western, Southern and Eastern Europe reported increasing mortality. These findings highlighted the need for targeted preventive measures.

Prediction of cancer incidence and mortality in Korea, 2014.

PubMed

Jung, Kyu-Won; Won, Young-Joo; Kong, Hyun-Joo; Oh, Chang-Mo; Lee, Duk Hyoung; Lee, Jin Soo

2014-04-01

We studied and reported on cancer incidence and mortality rates as projected for the year 2014 in order to estimate Korea's current cancer burden. Cancer incidence data from 1999 to 2011 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2012 were acquired from Statistics Korea. Cancer incidence in 2014 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was employed, except that a Joinpoint regression model was used to determine at which year the linear trend changed significantly. A total of 265,813 new cancer cases and 74,981 cancer deaths are expected to occur in Korea in 2014. Further, the crude incidence rate per 100,000 of all sites combined will likely reach 524.7 and the age-standardized incidence rate, 338.5. Meanwhile, the crude mortality rate of all sites combined and age-standardized rate are projected to be 148.0 and 84.6, respectively. Given the rapid rise in prostate cancer cases, it is anticipated to be the fourth most frequently occurring cancer site in men for the first time. Cancer has become the most prominent public health concern in Korea, and as the population ages, the nation's cancer burden will continue to increase.

Age- and Sex-Specific Trends in Lung Cancer Mortality over 62 Years in a Nation with a Low Effort in Cancer Prevention

PubMed Central

John, Ulrich; Hanke, Monika

2016-01-01

Background: A decrease in lung cancer mortality among females below 50 years of age has been reported for countries with significant tobacco control efforts. The aim of this study was to describe the lung cancer deaths, including the mortality rates and proportions among total deaths, for females and males by age at death in a country with a high smoking prevalence (Germany) over a time period of 62 years. Methods: The vital statistics data were analyzed using a joinpoint regression analysis stratified by age and sex. An age-period-cohort analysis was used to estimate the potential effects of sex and school education on mortality. Results: After an increase, lung cancer mortality among women aged 35–44 years remained stable from 1989 to 2009 and decreased by 10.8% per year from 2009 to 2013. Conclusions: Lung cancer mortality among females aged 35–44 years has decreased. The potential reasons include an increase in the number of never smokers, following significant increases in school education since 1950, particularly among females. PMID:27023582

Trends in fall-related injuries among older adults treated in emergency departments in the USA.

PubMed

Orces, Carlos H; Alamgir, Hasanat

2014-12-01

To examine national trends in fall-related injuries among older adults treated in emergency departments (ED) and project these injuries until the year 2030. The Web-based Injury Statistics Query and Reporting System was used to generate data on fall-related injuries treated in ED. Joinpoint regression analysis was used to examine the average annual change in injury rates over time. Fall-related injury and hospitalisation rates increased on average by 2% (95% CI 1.5% to 2.7%) and by 4% (95% CI 2.9% to 5.0%) per year, respectively. Assuming the increase in fall-related injury rates remains unchanged, the number of fall-related injuries may increase to 5.7 million by the year 2030. Fall-related injuries among older adults treated in ED increased in the USA during the study period. Moreover, a marked increase in the number of these injuries may occur over the next decades. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Sex Differences in Diabetes Mellitus Mortality Trends in Brazil, 1980-2012.

PubMed

Malhão, Thainá Alves; Brito, Alexandre Dos Santos; Pinheiro, Rejane Sobrino; Cabral, Cristiane da Silva; Camargo, Thais Medina Coeli Rochel de; Coeli, Claudia Medina

2016-01-01

To investigate the hypothesis that the change from the female predominance of diabetes mellitus to a standard of equality or even male preponderance can already be observed in Brazilian mortality statistics. Data on deaths for which diabetes mellitus was listed as the underlying cause were obtained from the Brazilian Mortality Information System for the years 1980 to 2012. The mortality data were also analyzed according to the multiple causes of death approach from 2001 to 2012. The population data came from the Brazilian Institute of Geography and Statistics. The mortality rates were standardized to the world population. We used a log-linear joinpoint regression to evaluate trends in age-standardized mortality rates (ASMR). From 1980 to 2012, we found a marked increment in the diabetes ASMR among Brazilian men and a less sharp increase in the rate among women, with the latter period (2003-2012) showing a slight decrease among women, though it was not statistically significant. The results of this study suggest that diabetes mellitus in Brazil has changed from a pattern of higher mortality among women compared to men to equality or even male predominance.

Geographic variation in trends and characteristics of teen childbearing among American Indians and Alaska Natives, 1990-2007.

PubMed

Wingo, Phyllis A; Lesesne, Catherine A; Smith, Ruben A; de Ravello, Lori; Espey, David K; Arambula Solomon, Teshia G; Tucker, Myra; Thierry, Judith

2012-12-01

To study teen birth rates, trends, and socio-demographic and pregnancy characteristics of AI/AN across geographic regions in the US. The birth rate for US teenagers 15-19 years reached a historic low in 2009 (39.1 per 1,000) and yet remains one of the highest teen birth rates among industrialized nations. In the US, teen birth rates among Hispanic, non-Hispanic black, and American Indian/Alaska Native (AI/AN) youth are consistently two to three times the rate among non-Hispanic white teens. Birth certificate data for females younger than age 20 were used to calculate birth rates (live births per 1,000 women) and joinpoint regression to describe trends in teen birth rates by age (<15, 15-17, 18-19) and region (Aberdeen, Alaska, Bemidji, Billings, California, Nashville, Oklahoma, Portland, Southwest). Birth rates for AI/AN teens varied across geographic regions. Among 15-19-year-old AI/AN, rates ranged from 24.35 (California) to 123.24 (Aberdeen). AI/AN teen birth rates declined from the early 1990s into the 2000s for all three age groups. Among 15-17-year-olds, trends were approximately level during the early 2000s-2007 in six regions and declined in the others. Among 18-19-year-olds, trends were significantly increasing during the early 2000s-2007 in three regions, significantly decreasing in one, and were level in the remaining regions. Among AI/AN, cesarean section rates were lower in Alaska (4.1%) than in other regions (16.4-26.6%). This is the first national study to describe regional variation in AI/AN teen birth rates. These data may be used to target limited resources for teen pregnancy intervention programs and guide research.

Early estimates of SEER cancer incidence, 2014.

PubMed

Lewis, Denise Riedel; Chen, Huann-Sheng; Cockburn, Myles G; Wu, Xiao-Cheng; Stroup, Antoinette M; Midthune, Douglas N; Zou, Zhaohui; Krapcho, Martin F; Miller, Daniel G; Feuer, Eric J

2017-07-01

Cancer incidence rates and trends for cases diagnosed through 2014 using data reported to the Surveillance, Epidemiology, and End Results (SEER) program in February 2016 and a validation of rates and trends for cases diagnosed through 2013 and submitted in February 2015 using the November 2015 submission are reported. New cancer sites include the pancreas, kidney and renal pelvis, corpus and uterus, and childhood cancer sites for ages birth to 19 years inclusive. A new reporting delay model is presented for these estimates for more consistent results with the model used for the usual November SEER submissions, adjusting for the large case undercount in the February submission. Joinpoint regression methodology was used to assess trends. Delay-adjusted rates and trends were checked for validity between the February 2016 and November 2016 submissions. Validation revealed that the delay model provides similar estimates of eventual counts using either February or November submission data. Trends declined through 2014 for prostate and colon and rectum cancer for males and females, male and female lung cancer, and cervical cancer. Thyroid cancer and liver and intrahepatic bile duct cancer increased. Pancreas (male and female) and corpus and uterus cancer demonstrated a modest increase. Slight increases occurred for male kidney and renal pelvis, and for all childhood cancer sites for ages birth to 19 years. Evaluating early cancer data submissions, adjusted for reporting delay, produces timely and valid incidence rates and trends. The results of the current study support using delay-adjusted February submission data for valid incidence rate and trend estimates over several data cycles. Cancer 2017;123:2524-34. © 2017 American Cancer Society. © 2017 American Cancer Society. This article has been contributed to by US Government employees and their work is in the public domain in the USA.

Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012

PubMed Central

Lam, Jennifer O.; Lim, Wei-Yen; Chow, Khuan-Yew; D’Souza, Gypsyamber

2015-01-01

In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV). Trends in HPV-associated cancers in Asia have not been as well described. We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968–2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC), 183 anal squamous cell carcinoma (ASCC) and 8,019 invasive cervical cancer (ICC) cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC) and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC) cases were included as comparators. Age-standardized incidence rates (ASR) were determined by gender and ethnicity (Chinese, Malay and Indian). Joinpoint regression was used to evaluate annual percentage change (APC) in incidence. OPSCC incidence increased in both genders (men 1993–2012, APC = 1.9%, p<0.001; women 1968–2012, APC = 2.0%, p = 0.01) and was 5 times higher in men than women. In contrast, non-OP HNC incidence declined between 1968–2012 among men (APC = -1.6%, p<0.001) and women (APC = -0.4%, p = 0.06). ASCC and ANSCC were rare (ASR = 0.2 and 0.7 per 100,000 person-years, respectively) and did not change significantly over time except for increasing ANSCCs in men (APC = 2.8%, p<0.001). ICC was the most common HPV-associated cancer (ASR = 19.9 per 100,000 person-years) but declined significantly between 1968–2012 (APC = -2.4%). Incidence of each cancer varied across ethnicities. Similar to trends in Western countries, OPSCC incidence increased in recent years, while non-OP HNC decreased. ICC remains the most common HPV-related cancer in Singapore, but Pap screening programs have led to consistently decreasing incidence. PMID:26720001

The effect of contextual factors on unintentional injury hospitalization: from the Korea National Hospital Discharge Survey.

PubMed

Lee, Hye Ah; Han, Hyejin; Lee, Seonhwa; Park, Bomi; Park, Bo Hyun; Lee, Won Kyung; Park, Ju Ok; Hong, Sungok; Kim, Young Taek; Park, Hyesook

2018-03-13

It has been suggested that health risks are affected by geographical area, but there are few studies on contextual effects using multilevel analysis, especially regarding unintentional injury. This study investigated trends in unintentional injury hospitalization rates over the past decade in Korea, and also examined community-level risk factors while controlling for individual-level factors. Using data from the 2004 to 2013 Korea National Hospital Discharge Survey (KNHDS), trends in age-adjusted injury hospitalization rate were conducted using the Joinpoint Regression Program. Based on the 2013 KNHDS, we collected community-level factors by linking various data sources and selected dominant factors related to injury hospitalization through a stepwise method. Multilevel analysis was performed to assess the community-level factors while controlling for individual-level factors. In 2004, the age-adjusted unintentional injury hospitalization rate was 1570.1 per 100,000 population and increased to 1887.1 per 100,000 population in 2013. The average annual percent change in rate of hospitalizations due to unintentional injury was 2.31% (95% confidence interval: 1.8-2.9). It was somewhat higher for females than for males (3.25% vs. 1.64%, respectively). Both community- and individual-level factors were found to significantly influence unintentional injury hospitalization risk. As community-level risk factors, finance utilization capacity of the local government and neighborhood socioeconomic status, were independently associated with unintentional injury hospitalization after controlling for individual-level factors, and accounted for 19.9% of community-level variation in unintentional injury hospitalization. Regional differences must be considered when creating policies and interventions. Further studies are required to evaluate specific factors related to injury mechanism.

[Breast cancer in México: a 10-year trend analysis on incidence and age at diagnosis].

PubMed

Salinas-Martínez, Ana María; Juárez-Ruiz, Abigail; Mathiew-Quirós, Álvaro; Guzmán-De la Garza, Francisco Javier; Santos-Lartigue, Adriana; Escobar-Moreno, César

2014-01-01

Breast cancer is an important public health problem. Some countries have achieved a downward trend while in others, continues ascending. In México, information on incidence and age at diagnosis is isolated in time, and knowledge on trend analysis is lacking. To examine the 2003-2012 trend of the incidence rate and age at diagnosis of breast cancer in the northeast of México. We also analyze the trend of positivity to nodes, hormone receptors and HER2; and its association with age at diagnosis. This is an epidemiological study of breast cancer patients in a tertiary care hospital in Monterrey, México (n = 3,488). Only new cases with a histology report were included; if this was not available, the cytology result was considered. Trend analysis was performed using the JoinPoint regression program Version 3.5. The breast cancer incidence rate increased from 26.7 to 49.8 per 100,000 between 2003 and 2011 (p < 0.05). The adjusted rate showed an annual percentage rate of change of +6.2% (95%CI 4.2, 8.2). The mean age was 55.7 ± 13.7 years and remained stable over time. Nodes, hormone receptors and HER2 positivity rate also remained stable over time. Age < 50 years increased twice the risk for positivity to nodes (OR 2.0, 95%CI 1.4, 2.7), ER-PR- (OR 1.8, 95% CI 1.4, 2.4) and ER-PR-HER2- (OR 1.9, 95%CI 1.5, 2.5). The 10-year analysis showed a significant upward trend. This study represents a first effort in our country, for determining patterns on incidence and age at diagnosis of breast cancer, as well as that of biomarkers.

Nasopharyngeal carcinoma incidence in North Tunisia: negative trends in adults but not adolescents, 1994-2006.

PubMed

Wided, Ben Ayoub Hizem; Hamouda, Boussen; Hamadi, Hsairi; Mansour, Ben Abdallah

2015-01-01

Nasopharyngeal carcinoma (NPC) is the second most common neoplasm of head and neck in Tunisia. The distribution is bimodal with a first period occurrence between 15 and 20 years old and a second peak at around 50 years of age. Undifferentiated carcinoma of nasopharynx type III (UCNT) is the predominant histological type (93.4%). Data of cancer registry of North Tunisia confirmed that it is an intermediate risk area for NPC with overall ASRs of 3.6 and 1.6/100,000 respectively in males and females. This study aimed to present the evolution of incidence rate of nasopharyngeal carcinoma over a period of 12 years (1994-2006). Data of cancer registry of North Tunisia (NTCR), covering half of the Tunisian population, were used to determine evolution of NPC incidence, calculated by 5 year periods. The estimated annual percentage change (EAPC) was used as an estimate of the trend. To best summarize the behavior or the data trend across years, we used a join-point regression program. Between 1994 and 2006, we observed negative annual average change of standardized incidence in men and women (-3.3% and -2.7%) also for the standardized incidences which showed a rather important decline (26.4% in males and 22.3% in females). The truncated age standardized incidence rate of NPC in adults aged of 30 years old and more (N=1209) decreased by -0.4% per year from 1994 to 2006 over time in north Tunisia dropping from 6.09 to 4.14 person-years. However, the rate was relatively stable during this period among youths aged 0-29 years (N=233) in both sexes. NPC demonstrated a favorable evolution from 1994-2006 probably due to a improvement in socioeconomic conditions.

Socioeconomic Factors Associated with Post-Mastectomy Immediate Reconstruction in a Contemporary Cohort of Breast Cancer Survivors.

PubMed

Schumacher, Jessica R; Taylor, Lauren J; Tucholka, Jennifer L; Poore, Samuel; Eggen, Amanda; Steiman, Jennifer; Wilke, Lee G; Greenberg, Caprice C; Neuman, Heather B

2017-10-01

Post-mastectomy reconstruction is a critical component of high-quality breast cancer care. Prior studies demonstrate socioeconomic disparity in receipt of reconstruction. Our objective was to evaluate trends in receipt of immediate reconstruction and examine socioeconomic factors associated with reconstruction in a contemporary cohort. Using the National Cancer Database, we identified women <75 years of age with stage 0-1 breast cancer treated with mastectomy (n = 297,121). Trends in immediate reconstruction rates (2004-2013) for the overall cohort and stratified by socioeconomic factors were examined using Join-point regression analysis, and annual percentage change (APC) was calculated. We then restricted our sample to a contemporary cohort (2010-2013, n = 145,577). Multivariable logistic regression identified socioeconomic factors associated with immediate reconstruction. Average adjusted predicted probabilities of receiving reconstruction were calculated. Immediate reconstruction rates increased from 27 to 48%. Although absolute rates of reconstruction for each stratification group increased, similar APCs across strata led to persistent gaps in receipt of reconstruction. On multivariable logistic regression using our contemporary cohort, race, income, education, and insurance type were all strongly associated with immediate reconstruction. Patients with the lowest predicted probability of receiving reconstruction were patients with Medicaid who lived in areas with the lowest rates of high-school graduation (Black 42.4% [95% CI 40.5-44.3], White 45.7% [95% CI 43.9-47.4]). Although reconstruction rates have increased dramatically over the past decade, lower rates persist for disadvantaged patients. Understanding how socioeconomic factors influence receipt of reconstruction, and identifying modifiable factors, are critical next steps towards identifying interventions to reduce disparities in breast cancer surgical care.

Trends in brain cancer mortality among U.S. Gulf War veterans: 21 year follow-up.

PubMed

Barth, Shannon K; Dursa, Erin K; Bossarte, Robert M; Schneiderman, Aaron I

2017-10-01

Previous mortality studies of U.S. Gulf War veterans through 2000 and 2004 have shown an increased risk of brain cancer mortality among some deployed individuals. When veterans possibly exposed to environmental contaminants associated with demolition of the Khamisiyah Ammunition Storage Facility at Khamisiyah, Iraq, have been compared to contemporaneously deployed unexposed veterans, the results have suggested increased risk for mortality from brain cancer among the exposed. Brain cancer mortality risk in this cohort has not been updated since 2004. This study analyzes the risk for brain cancer mortality between 1991-2011 through two series of comparisons: U.S. Gulf War deployed and non-deployed veterans from the same era; and veterans possibly exposed to environmental contaminants at Khamisiyah compared to contemporaneously deployed but unexposed U.S. Gulf War veterans. Risk of brain cancer mortality was determined using logistic regression. Life test hazard models were created to plot comparisons of annual hazard rates. Joinpoint regression models were applied to assess trends in hazard rates for brain cancer mortality. U.S. Army veterans possibly exposed at Khamisiyah had similar rates of brain cancer mortality compared to those not possibly exposed; however, veterans possibly exposed had a higher risk of brain cancer in the time period immediately following the Gulf War. Results from these analyses suggest that veterans possibly exposed at Khamisiyah experienced different patterns of brain cancer mortality risk compared to the other groups. Published by Elsevier Ltd.

Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids.

PubMed

McCall Jones, Christopher; Baldwin, Grant T; Compton, Wilson M

2017-03-01

To assess trends in cocaine overdose deaths and examine the role opioids play in these deaths. We used data on drug overdose deaths in the United States from 2000 to 2015 collected in the National Vital Statistics System to calculate annual rates and numbers of cocaine-related overdose deaths overall and deaths both involving and not involving opioids. We assessed statistically significant changes in trends with joinpoint regression. Rates of cocaine-related overdose deaths increased significantly from 1.26 to 2.50 per 100 000 population from 2000 to 2006, declined to 1.35 in 2010, and increased to 2.13 in 2015. Cocaine-related overdose deaths involving opioids increased from 0.37 to 0.91 from 2000 to 2006, declined to 0.57 in 2010, and then increased to 1.36 in 2015. Cocaine-related overdose deaths not involving opioids increased from 0.89 to 1.59 from 2000 to 2006 and then declined to 0.78 in 2015. Opioids, primarily heroin and synthetic opioids, have been driving the recent increase in cocaine-related overdose deaths. This corresponds to the growing supply and use of heroin and illicitly manufactured fentanyl in the United States.

Endometrial Cancer Trends by Race and Histology in the USA: Projecting the Number of New Cases from 2015 to 2040.

PubMed

Gaber, Charles; Meza, Rafael; Ruterbusch, Julie J; Cote, Michele L

2016-10-17

The aim of this study is to explore incidence and incidence-based mortality trends for endometrial cancer in the USA and project future incident cases, accounting for differences by race and histological subtype. Data on age-adjusted and age-specific incidence and mortality rates of endometrial cancer were obtained from the Surveillance, Epidemiology, and End Results 18 registries. Trends in rates were analyzed using Joinpoint regression, and average annual percent change (AAPC) in recent years (2006-2011) was computed for histological subtypes by race. Age, histological, and race-specific rates were applied to US Census Bureau population census estimates to project new cases from 2015 to 2040, accounting for observed AAPC trends, which were progressively attenuated for the future years. The annual number of cases is projected to increase substantially from 2015 to 2040 across all racial groups. Considerable variation in incidence and mortality trends was observed both between and within racial groups when considering histology. As the US population undergoes demographic changes, incidence of endometrial cancer is projected to rise. The increase will occur in all racial groups, but larger increases will be seen in aggressive histology subtypes that disproportionately affect black women.

Sex Differences in Diabetes Mellitus Mortality Trends in Brazil, 1980-2012

PubMed Central

Brito, Alexandre dos Santos; Pinheiro, Rejane Sobrino; Cabral, Cristiane da Silva; de Camargo, Thais Medina Coeli Rochel

2016-01-01

Aims To investigate the hypothesis that the change from the female predominance of diabetes mellitus to a standard of equality or even male preponderance can already be observed in Brazilian mortality statistics. Methods Data on deaths for which diabetes mellitus was listed as the underlying cause were obtained from the Brazilian Mortality Information System for the years 1980 to 2012. The mortality data were also analyzed according to the multiple causes of death approach from 2001 to 2012. The population data came from the Brazilian Institute of Geography and Statistics. The mortality rates were standardized to the world population. We used a log-linear joinpoint regression to evaluate trends in age-standardized mortality rates (ASMR). Results From 1980 to 2012, we found a marked increment in the diabetes ASMR among Brazilian men and a less sharp increase in the rate among women, with the latter period (2003–2012) showing a slight decrease among women, though it was not statistically significant. Conclusions The results of this study suggest that diabetes mellitus in Brazil has changed from a pattern of higher mortality among women compared to men to equality or even male predominance. PMID:27275600

[Homicides in Rio de Janeiro, Brazil: an analysis of lethal violence].

PubMed

Cardoso, Francisca Letícia Miranda Gadelha; Cecchetto, Fátima Regina; Corrêa, Juliana Silva; de Souza, Tiago Oliveira

2016-04-01

The evolution of rates were analyzed for the following categories: murder, larceny, bodily harm followed by death, homicide for resistance to police resulting in death, policeman killed, missing persons and dead bodies found in the state and city of Rio de Janeiro and in Integrated Public Security Area 16 (AISP 16). An ecological study was conducted for the period from 2002 to 2013, using data from the Public Security Institute. To analyze the time trend and evolution of murder charges, resistance to police resulting in death and missing persons rates, Joinpoint regression was performed, using these rates as the dependent variables and the calendar year as the independent variable. For the other categories only the time trends of the rates were analyzed for the relative change in rates at the beginning and end of the period. There were falls in rates in all categories, except for missing persons. The murder rate showed a significant downward trend in the three locations. The results contributed to definition of the pattern of violence in the three locations based on the dialogue between the social sciences, public health and safety that made it possible to establish subjective and objective aspects linked to the study findings.

National trends in utilization and outcomes of coronary revascularization procedures among people with and without type 2 diabetes in Spain (2001–2011)

PubMed Central

2014-01-01

Background Diabetes is associated with a high risk of death due to coronary artery disease (CAD). People with diabetes suffering from CAD are frequently treated with revascularization procedures. We aim to compare trends in the use and outcomes of coronary revascularization procedures in diabetic and non-diabetic patients in Spain between 2001 and 2011. Methods We identified all patients who had undergone coronary revascularization procedures, percutaneous coronary interventions (PCI) and coronary artery bypass graft (CABG) surgeries, using national hospital discharge data. Discharges were grouped by diabetes status: type 2 diabetes and no diabetes. The incidence of discharges attributed to coronary revascularization procedures were calculated stratified by diabetes status. We calculated length of stay and in-hospital mortality (IHM). We apply joinpoint log-linear regression to identify the years in which changes in tendency occurred in the use of PCI and CABG in diabetic and non-diabetic patients. Multivariate analysis was adjusted by age, sex, year and comorbidity (Charlson comorbidity index). Results From 2001 to 2011, 434,108 PCIs and 79,986 CABGs were performed. According to the results of the joinpoint analysis, we found that sex and age-adjusted use of PCI increased by 31.4% per year from 2001 to 2003, by 15.9% per year from 2003 to 2006 and by 3.8% per year from 2006 to 2011 in patients with diabetes. IHM among patients with diabetes who underwent a PCI did not change significantly over the entire study period (OR 0.99; 95% CI 0.97-1.00). Among patients with diabetes who underwent a CABG, the sex and age-adjusted CABG incidence rate increased by 10.4% per year from 2001 to 2003, and then decreased by 1.1% through 2011. Diabetic patients who underwent a CABG had a 0.67 (95% CI 0.63-0.71) times lower probability of dying during hospitalization than those without diabetes. Conclusions The annual percent change in PCI procedures increased in diabetic and non-diabetic patients. Higher comorbidity and the female gender are associated with a higher IHM in PCI procedures. In diabetic and non-diabetic patients, we found a decrease in the use of CABG procedures. IHM was higher in patients without diabetes than in those with diabetes. PMID:24383412

Long-term trends and survival analysis of esophageal and gastric cancer in Yangzhong, 1991-2013.

PubMed

Hua, Zhaolai; Zheng, Xianzhi; Xue, Hengchuan; Wang, Jianming; Yao, Jun

2017-01-01

To describe the long-term trends of the incidence, mortality and survival of upper digestive tract cancers in a high-risk area of China. We extracted esophageal and gastric cancer cases diagnosed from 1991 to 2013 through the Yangzhong Cancer Registry and calculated the crude and age-standardized incidence and mortality rates. Cancer trends were calculated using the Joinpoint Regression Program and were reported using the annual percentage change (APC). The cancer-specific survival rates were evaluated and compared between groups using the Kaplan-Meier method and log-rank test. The age-standardized incidence rate of esophageal cancer declined from 107.06 per 100,000 person-years (male: 118.05 per 100,000 person-years; female: 97.42 per 100,000 person-years) in 1991 to 37.04 per 100,000 person-years (male: 46.43 per 100,000 person-years; female: 27.26 per 100,000 person-years) in 2013, with an APC of -2.5% (95% confidence interval (CI): -3.4%, -1.5%) for males and -4.9% (95% CI:-5.8%, -3.9%) for females. The age-standardized incidence rate of gastric cancer was 165.11 per 100,000 person-years (male: 225.39 per 100,000 person-years; female: 113.34 per 100,000 person-years) in 1991 and 53.46 per 100,000 person-years (male: 76.51 per 100,000 person-years; female: 32.43 per 100,000 person-years) in 2013, with the APC of -3.6% (95% CI: -4.5%, -2.7%) for males and -4.8% (95% CI: -5.7%, -3.9%) for females. The median survival time was 3.0 years for patients with esophageal or gastric cancer. Cancer cases detected after 2004 had a better prognosis. The age-standardized incidence rates of both esophageal and gastric cancer continuously decreased since 1991 through 2013, whereas the mortality rate remained stable before 2004 and significantly declined following the massive endoscopic screening program initiated in 2004. The survival probability of patients with esophageal and gastric cancer has improved obviously in recent decades.

Association between sudden infant death syndrome and diphtheria-tetanus-pertussis immunisation: an ecological study.

PubMed

Müller-Nordhorn, Jacqueline; Hettler-Chen, Chih-Mei; Keil, Thomas; Muckelbauer, Rebecca

2015-01-28

Sudden infant death syndrome (SIDS) continues to be one of the main causes of infant mortality in the United States. The objective of this study was to analyse the association between diphtheria-tetanus-pertussis (DTP) immunisation and SIDS over time. The Centers for Disease Control and Prevention provided the number of cases of SIDS and live births per year (1968-2009), allowing the calculation of SIDS mortality rates. Immunisation coverage was based on (1) the United States Immunization Survey (1968-1985), (2) the National Health Interview Survey (1991-1993), and (3) the National Immunization Survey (1994-2009). We used sleep position data from the National Infant Sleep Position Survey. To determine the time points at which significant changes occurred and to estimate the annual percentage change in mortality rates, we performed joinpoint regression analyses. We fitted a Poisson regression model to determine the association between SIDS mortality rates and DTP immunisation coverage (1975-2009). SIDS mortality rates increased significantly from 1968 to 1971 (+27% annually), from 1971 to 1974 (+47%), and from 1974 to 1979 (+3%). They decreased from 1979 to 1991 (-1%) and from 1991 to 2001 (-8%). After 2001, mortality rates remained constant. DTP immunisation coverage was inversely associated with SIDS mortality rates. We observed an incidence rate ratio of 0.92 (95% confidence interval: 0.87 to 0.97) per 10% increase in DTP immunisation coverage after adjusting for infant sleep position. Increased DTP immunisation coverage is associated with decreased SIDS mortality. Current recommendations on timely DTP immunisation should be emphasised to prevent not only specific infectious diseases but also potentially SIDS.

Mortality trends for tuberculosis in European Union countries, 2000-2010.

PubMed

Al-Rahamneh, Moad J; Al-Rahamneh, Anas; Guillén-Grima, Francisco; Arnedo-Pena, Alberto; Aguinaga-Ontoso, Inés

The objective of this study was to update and analyze tuberculosis (TB) mortality data in the European Union between 2000 and 2010 separately for men and women and try to detect if there have been any changes in trends in each country and the association with the economic situation and inequalities. Data were extracted for tuberculosis deaths in 2000-2010 for 29 European Union countries and for Switzerland, via the World Health Organization (WHO) European detailed mortality database (DMDB), using the Mortality tabulation list 1 (MTL1) codes for men and women separately for one age group (20-85+). We estimated age-standardised mortality rates, and analyzed data using the Joinpoint Regression Program for men and women separately in the European Union overall and by individual country for each year. Between 2000 and 2010, there were 68,771 recorded tuberculosis deaths in the European Union and the mortality rates were higher for men than women in the entire study zone. Overall, TB mortality rates declined linearly for both genders, but more in women than in men (from 5.43/100,000 in 2000 to 2.59/100,000 in 2010 in men and from 1.37/100,000 in 2000 to 0.51/100,000 in 2010 in women). There was decline in both genders for the entire study period, with a significant Estimated Annual Percentage Change (EAPC) of -8.1 for women and -7 for men when alpha<0.05 and with a 95% confidence interval (CI). A higher tuberculosis mortality was associated with lower economic resources and greater inequalities. TB mortality rates in the European Union decreased overall in 2000-2010 for both genders. Men have higher TB mortality rates than women in all countries. Our findings were consistent with the downward TB mortality trend in many other countries worldwide. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

The long-term spatial-temporal trends and burden of esophageal cancer in one high-risk area: A population-registered study in Feicheng, China

PubMed Central

Sun, Xiubin; Zhao, Deli; Liu, Yi; Liu, Yunxia; Yuan, Zhongshang; Wang, Jialin; Xue, Fuzhong

2017-01-01

Background Feicheng County is a high-risk area for esophageal cancer in Shandong province, China. It is important to determine the long-term spatio-temporal trends in epidemiological characteristics and the burden of esophageal cancer, especially since the implementation of the national esophageal cancer screening program for early detection and treatment in 2005. Methods The data collected in Feicheng County from 2001 to 2012 was extracted from the whole-population cancer registry system. The incidence, mortality, disability-adjusted life years (DALY) and changing trends in esophageal cancer according to age and sex were calculated and described. Results The incidence rate of esophageal cancer in Feicheng was consistently high, and increased significantly for male, but not for female from 2001 to 2012, according to the joinpoint regression analysis. The highest and lowest yearly crude incidence rates were 160.78 and 95.97 per 100000 for males, and 81.36 and 52.17 per 100000 for females. The highest and lowest crude yearly mortality rates were 122.26 and 94.40 per 100000 for males, and 60.75 and 49.35 per 100000for females. Esophageal squamous cell carcinoma was the main pathology type and the tumor location changed significantly from 2001 to 2012. Overall, the DALY remained roughly stable and was estimated as 11.50 for males and 4.90 for females per 1000 people. The burden was mainly caused by premature death. There is an obvious spatial pattern in the distribution of incidence density and burden. Conclusion Esophageal cancer remains a public health issue in Feicheng County with a high incidence, mortality and disease burden. The incidence and burden have obvious spatial heterogeneity, and further studies should be conducted to identify geographical risk factors for precise local prevention and control measures. PMID:28267769

Ten-years trends in renal replacement therapy for end-stage renal disease in mainland France: Lessons from the French Renal Epidemiology and Information Network (REIN) registry.

PubMed

Vigneau, Cécile; Kolko, Anne; Stengel, Bénédicte; Jacquelinet, Christian; Landais, Paul; Rieu, Philippe; Bayat, Sahar; Couchoud, Cécile

2017-06-01

The incidence rate of renal replacement therapy (RRT) for end-stage renal disease (ESRD) is decreasing in several countries, but not in France. We studied the RRT trends in mainland France from 2005 to 2014 to understand the reasons for this discrepancy and determine the effects of ESRD management changes. Data were extracted from the French Renal Epidemiology and Information Network registry. Time trends of RRT incidence and prevalence rates, patients' clinical and treatment characteristics were analysed using the Joinpoint regression program and annual percentage changes. Survival within the first year of RRT was analysed using Kaplan-Meier estimates for 4 periods of time. The overall age- and gender-adjusted RRT incidence rate increased from 144 to 159 individuals per million inhabitants (pmi) (+0.8% per year; 95% CI: 0.5-1.2) and the prevalence from 903 to 1141 pmi (+2.4% per year; 95% CI: 2.2-2.7). This increase concerned exclusively ESRD associated with type 2 diabetes (+4.0%; 3.4-4.6) and mostly elderly men. Despite patient aging and increasing comorbidity burden and a persistent 30% rate of emergency dialysis start, the one-year survival rate slightly improved from 82.1% (81.4-82.8) to 83.8% (83.3-84.4). Pre-emptive wait listing for renal transplantation and the percentage of wait-listed patients within one year after dialysis start strongly increased (from 5.6% to 15.5% and from 29% to 39%, respectively). Kidney transplantation and survival significantly improved despite the heavier patient burden. However, the rise in type 2 diabetes-related ESRD and the stable high rate of emergency dialysis start remain major issues. Copyright © 2016 Association Société de néphrologie. Published by Elsevier Masson SAS. All rights reserved.

An ecological study of prostate cancer mortality in the USA and UK, 1975-2004: are divergent trends a consequence of treatment, screening or artefact?

PubMed Central

Collin, Simon M; Martin, Richard M; Metcalfe, Chris; Gunnell, David; Albertsen, Peter; Neal, David; Hamdy, Freddie; Stephens, Peter; Lane, J Athene; Moore, Rollo; Donovan, Jenny

2009-01-01

Background There is no conclusive evidence that screening based on prostate-specific antigen (PSA) tests reduces prostate cancer mortality. In the USA uptake of PSA testing has been rapid, but is much less common in the UK. Purpose To investigate trends in prostate cancer mortality and incidence in the USA and UK from 1975-2004, contrasting these with trends in screening and treatment. Methods Joinpoint regression analysis of cancer mortality statistics from Cancer Research UK and the USA National Cancer Institute Surveillance Epidemiology and End Results (SEER) program was used to estimate the annual percentage change in prostate cancer mortality in each country and the points in time when trends changed. Results Age-specific and age-adjusted prostate cancer mortality peaked in the early 1990s at almost identical rates in both countries, but age-adjusted mortality in the USA subsequently declined by 4.2% (95% CI 4.0-4.3%) per annum, four times the rate of decline in the UK (1.1%; 0.8-1.4%). The mortality decline in the USA was greatest and most sustained in those ≥75 years, whereas death rates had plateaued in this age group in the UK by 2000. Conclusion The striking decline in prostate cancer mortality in the USA compared with the UK between 1994-2004 coincided with much higher uptake of PSA screening in the USA. Explanations for the different trends in mortality include the possibility of an early impact of initial screening rounds on men with more aggressive asymptomatic disease in the USA, different approaches to treatment in the two countries, and bias related to the misattribution of cause of death. Speculation over the role of screening will continue until evidence from randomised controlled trials is published. PMID:18424233

Primary Vulvo-Vaginal Cancers: Trends in Incidence and Mortality in Poland (1999-2012).

PubMed

Banas, Tomasz; Pitynski, Kzimierz; Jach, Robert; Knafel, Anna; Ludwin, Artur; Juszczyk, Grzegorz; Nieweglowska, Dorota

2015-01-01

The aim of this study was to determine the incidence, mortality rates and trends of vulvar and vaginal cancers in Poland. Data were retrieved from the Polish National Cancer Registry. Age-standardised rates (ASRs) of cancer incidence and mortality were calculated by direct standardisation, and joinpoint regression was performed to describe the trends using the average annual percent change (AAPC). From 1999 to 2012, the number of diagnosed cases of vulvar cancer was 5,958, and the ASRs of incidence varied from 0.99 to 1.18, with a significant trend towards a decrease (AAPC -0.78; p < 0.05). The ASR of mortality varied from 0.39 to 0.62, with a slight but insignificant increase in trend (AAPC 0.72; p > 0.05). The ASR of vaginal cancer incidence varied from 0.21 to 0.31, while the ASR of mortality ranged from 0.09 to 0.22. This study also proved a significantly falling trend in vaginal cancer mortality (AAPC -4.69; p < 0.05) and a decreasing trend in vaginal cancer incidence (AAPC -1.67; p > 0.05). The rarity of vulvar and vaginal cancers as well as the decline in their incidence rates should not discourage further research on the epidemiology and treatment of these conditions. © 2015 S. Karger AG, Basel.

Trends in Guillain-Barré syndrome mortality in Spain from 1999 to 2013.

PubMed

Ruiz, Elena; Ramalle-Gómara, Enrique; Quiñones, Carmen; Martínez-Ochoa, Eva

2016-11-01

Guillain-Barré syndrome (GBS) is a rare disease that consists of a group of neuropathic conditions. Very few epidemiological studies of GBS have been carried out in Spain. The aim of this study was to determine the trends in GBS mortality in the total population of Spain for the period 1999 to 2013. Data on GBS deaths were drawn from the National Statistics Institute of Spain. Crude and overall age-standardised GBS mortality rates were calculated and joinpoint regression models were used to describe trend changes. Mean age of deceased by GBS each year was also assessed. The overall age-standardised GBS mortality rate was 0.71 per million in 1999 and 0.40 in 2013. It was higher in men, 1.08 vs. 0.42 in 1999 and 0.48 vs. 0.35 in 2013. There was a statistically significant decrease in mortality during the study period. All the age-standardised mortality rates decreased (overall and by gender) from 1999 to 2013. The mean age at death increased with time, from 73 years in 1999 to 77 years in 2013. GBS mortality has improved in Spain during the last 15 years. The age of death has risen and the mortality rate has decreased.

Temporal trends in chronic obstructive pulmonary disease mortality in Mexico, 1999-2014.

PubMed

Hernández-Garduño, E; Ocaña-Servín, H L

2017-03-01

Country of Mexico. To determine mortality trends due to chronic obstructive pulmonary disease (COPD) in Mexico between 1999 and 2014. COPD mortality data for persons aged ≥40 years from 1999 to 2014 were obtained from the official website of the Mexican Ministry of Health. Age-standardised mortality rates (ASMRs) were calculated, and joinpoint regression analysis was used to identify trends over time. The annual per cent change (APC) was determined for each trend. A total of 313,962 COPD deaths (crude rate 66.3 per 100,000 population) was reported. Between 1999 and 2014, overall ASMRs decreased from 75.5 to 62.2/100,000 (APC -0.6, P = 0.03): from 94 to 74.7 (APC -0.8, P = 0.004) in males and from 59.7 to 51.8 (APC -0.2, P = 0.4) in females. COPD mortality rates in Mexico are slowly declining overall and among males. The reduction in smoking prevalence over time, and the new cigarette taxes and smoking laws implemented during the study period, have had no immediate impact on mortality. The lack of a decline in COPD mortality among females needs to be further investigated, particularly in rural areas, where the prevalence of biomass smoke exposure remains high.

[The economic crisis at the beginning of the XXI century and mortality in Spain. Trend and impact on social inequalities. SESPAS Report 2014].

PubMed

Ruiz-Ramos, Miguel; Córdoba-Doña, Juan Antonio; Bacigalupe, Amaia; Juárez, Sol; Escolar-Pujolar, Antonio

2014-06-01

This study aimed to assess the impact of the current economic crisis on mortality trends in Spain and its effect on social inequalities in mortality in Andalusia. We used data from vital statistics and the Population Register for 1999 to 2011, as provided by the Spanish Institute of Statistics, to estimate general and sex- and age-specific mortality rates. The Longitudinal Database of the Andalusian Population (2001 census cohort) was used to estimate general mortality rates and ratios by educational level. The annual percentages of change and trends were calculated using Joinpoint regressions. No significant change in the mortality trend was observed in Spain from 2008 onward. A downward trend after 1999 was confirmed for all causes and both sexes, with the exception of nervous system-related diseases. The reduction in mortality due to traffic accidents accelerated after 2003, while the negative trend in suicide was unchanged throughout the period studied. In Andalusia, social inequalities in mortality have increased among men since the beginning of the crisis, mainly due to a more intense reduction in mortality among persons with a higher educational level. Among women, no changes were observed in the pattern of inequality. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Suicide in Greece 1992-2012: A time-series analysis.

PubMed

Papaslanis, Theodoros; Kontaxakis, Vassilis; Christodoulou, Christos; Konstantakopoulos, George; Kontaxaki, Maria-Irini; Papadimitriou, George N

2016-08-01

Since 2008, Greece has entered a long period of economic crisis with adverse effects on various aspects of daily life. In this frame, it is quite important to examine the suicide trends in Greece. Our analysis covered the period 1992-2012. 2012 was the last year for which official suicide data were available. The inclusion of data for pre-crisis period enabled us to assess trends in suicide preceding the economic crisis, starting in 2008. Trends in sex- and age-adjusted standardized suicide rates (SSR) were analyzed using joinpoint regression. Total SSR presented statistically significant annual decrease of 0.89% (95% confidence interval (CI): -1.7, -0.1) during the period 1992-2008. After 2009, the trend in total SSR increased statistically significant annual increase (12.48%; 95% CI: 0.3%, 26.1%). SSR in males presented an initial period of modest annual decrease (-0.84%; 95% CI: -1.6%, -0.1%), during the period 1992-2008. After 2009, an annual increase by 9.25% (95% CI: 2.7%, 16.3%) was revealed. No change in female SSR trend was observed during the studied period. According to the results of this study, there is clear evidence of an increase in the overall SSR and male SSR in Greece during the period of the current financial crisis. © The Author(s) 2016.

Exploring a potential impact of a social marketing campaign on reducing oral cancer incidences in Michigan: an ecological study

PubMed Central

Lim, Sungwoo; Spavik, Georgia; Ismail, Amid I

2015-01-01

Objectives/Aims: The social marketing campaign was launched in 2005–2007 to address excess risk of oral cancer in Detroit tri-county area, Michigan. We assessed the extent to which the campaign might have contributed to decreasing risk of oral cancer using the modified interrupted time-series design. Materials and Methods: Oral cancer incidence and mortality data came from Michigan Department of Community Health, and trends of age-adjusted rates during 1990–2009 were compared between intervention and comparison counties via joinpoint regression. Results: Although mortality rates in both areas decreased in parallel manner, incidence rates decreased during and after the campaign only in the intervention counties. A similar trend was observed in the race-specific analysis. Alternative explanations, including population profiles, health-care access and pre-existing trends, were examined, and these characteristics were comparable between two areas in 1990s and 2000s. Conclusions: These results suggested that the campaign was more likely to be associated with the decreasing trend of oral cancer incidence in the intervention counties than alternative explanations. Although oral cancer is a deadly disease, its awareness has been relatively low. This study highlights a potential impact of concerted efforts to improve the oral cancer awareness in the high-risk communities. PMID:29607059

Patterns and trends in accidental poisoning death rates in the US, 1979-2014.

PubMed

Buchanich, Jeanine M; Balmert, Lauren C; Pringle, Janice L; Williams, Karl E; Burke, Donald S; Marsh, Gary M

2016-08-01

The purpose of this study was to examine US accidental poisoning death rates by demographic and geographic factors from 1979 to 2014, including High Intensity Drug Trafficking Areas. Crude and age-adjusted death rates were formed for age group, race, sex, and county for accidental poisonings (ICD 9th revision: E850-E869; ICD 10th revision: X40-X49) from 1979 to 2014 using the Mortality and Population Data System housed at the University of Pittsburgh. Rate ratios were calculated comparing rates from 2014 to 1979, overall, by sex, age group, race, and county. Joinpoint regression detected changes in trends and calculated the average annual percentage change (AAPC) as a summary measure of trend. Drug poisoning mortality rates have risen an average of 6% per year since 1979. Increases are occurring in all ages 15+, and in all race-sex groups. HIDTA counties with the highest mortality rates were in Appalachia and New Mexico. Many of the HIDTA border counties had lower rates of mortality. The drug poisoning mortality epidemic is continuing to grow. While HIDTA resources are appropriately targeted at many areas in the US most affected, rates are also rapidly rising in some non-HIDTA areas. Copyright © 2016 Elsevier Inc. All rights reserved.

Trends in the leading causes of death in Korea, 1983-2012.

PubMed

Lim, Daroh; Ha, Mina; Song, Inmyung

2014-12-01

This study aimed to analyze trends in the 10 leading causes of death in Korea from 1983 to 2012. Death rates were derived from the Korean Statistics Information Service database and age-adjusted to the 2010 population. Joinpoint regression analysis was used to identify the points when statistically significant changes occurred in the trends. Between 1983 and 2012, the age-standardized death rate (ASR) from all causes decreased by 61.6% for men and 51.2% for women. ASRs from malignant neoplasms, diabetes mellitus, and transport accidents increased initially before decreasing. ASRs from hypertensive diseases, heart diseases, cerebrovascular diseases and diseases of the liver showed favorable trends (ASR % change: -94.4%, -53.8%, -76.0%, and -78.9% for men, and -77.1%, -36.5%, -67.8%, and -79.9% for women, respectively). ASRs from pneumonia decreased until the mid-1990s and thereafter increased. ASRs from intentional self-harm increased persistently since around 1990 (ASR % change: 122.0% for men and 217.4% for women). In conclusion, death rates from all causes in Korea decreased significantly in the last three decades except in the late 1990s. Despite the great strides made in the overall mortality, temporal trends varied widely by cause. Mortality trends for malignant neoplasms, diabetes mellitus, pneumonia and intentional self-harm were unfavorable.

Exploring a potential impact of a social marketing campaign on reducing oral cancer incidences in Michigan: an ecological study.

PubMed

Lim, Sungwoo; Spavik, Georgia; Ismail, Amid I

2015-01-01

The social marketing campaign was launched in 2005-2007 to address excess risk of oral cancer in Detroit tri-county area, Michigan. We assessed the extent to which the campaign might have contributed to decreasing risk of oral cancer using the modified interrupted time-series design. Oral cancer incidence and mortality data came from Michigan Department of Community Health, and trends of age-adjusted rates during 1990-2009 were compared between intervention and comparison counties via joinpoint regression. Although mortality rates in both areas decreased in parallel manner, incidence rates decreased during and after the campaign only in the intervention counties. A similar trend was observed in the race-specific analysis. Alternative explanations, including population profiles, health-care access and pre-existing trends, were examined, and these characteristics were comparable between two areas in 1990s and 2000s. These results suggested that the campaign was more likely to be associated with the decreasing trend of oral cancer incidence in the intervention counties than alternative explanations. Although oral cancer is a deadly disease, its awareness has been relatively low. This study highlights a potential impact of concerted efforts to improve the oral cancer awareness in the high-risk communities.

Incidence of oral cavity and pharynx cancer in New Hampshire, 1990-2007.

PubMed

Cherala, Sai S; Kelley, Kristina

2012-01-01

The purpose of this study is to describe trends of the statewide cancer and treatment-related characteristics of oral cavity and pharynx (OCP) cancer and prevalence of risk factors in New Hampshire residents from 1990-2007. This is a descriptive study on oral cavity and pharynx cancer using a state cancer registry dataset for 1990- 2007. The age-adjusted rates with 95% confidence intervals for cancer incidence rates and standard proportions for stage, treatment, and risk factors were calculated. The Joinpoint regression model was used for assessing linear trends for cancer rates. The overall differences for the period under study between age, female and male rate, and stage were analyzed using the test. During 1990-2007, oral cavity and pharynx cancer incidence rates for New Hampshire residents have remained stable. The cancer incidence rates have decreased for older age groups (greater than 59) and the 50-59 age group has shown increase in incidence rate of OCP cancer since 1990. There is significant increase in the late-stage diagnoses from 1990-2007. Early detection through periodic medical and dental examinations can reduce the risk of these cancers. Public health strategies that address the gaps identified by this study can reduce OCP cancer and protect the health of the New Hampshire population.

12-year trends in occupational class differences in short sickness absence among young women.

PubMed

Hilla, Sumanen; Jouni, Lahti; Eero, Lahelma; Olli, Pietiläinen; Ossi, Rahkonen

2015-06-01

Socioeconomic differences in sickness absence are well established among middle-aged employees but poorly known among younger employees, in particular for shorter spells. We examined trends in occupational class differences in short sickness absence among young women. The data were obtained from the registers of the City of Helsinki, Finland, and included female employees aged 18-34 years from 2002 to 2013. Self-certified (1-3 days) sickness absence spells were examined. Occupational class was classified into four hierarchical categories. Joinpoint regression models were used to identify major changes in sickness absence trends. Short sickness absence increased until 2008, after which it decreased in all occupational classes except manual workers. Differences in sickness absence between occupational classes remained over time. Routine non-manuals had the highest amount of short sickness absence, while managers and professionals had the smallest amount. Manual workers had somewhat less short sickness absence than routine non-manuals and semi-professionals. The socioeconomic differences in short sickness absence were clear among young women but not fully consistent as routine non-manuals tended to have more sickness absence than manual workers. Preventive measures are needed to narrow socioeconomic differences in young women's sickness absence especially among routine non-manuals. © 2015 the Nordic Societies of Public Health.

Mortality due to cardiovascular diseases in the Americas by region, 2000-2009.

PubMed

Gawryszewski, Vilma Pinheiro; Souza, Maria de Fatima Marinho de

2014-01-01

Cardiovascular diseases are the leading cause of death worldwide. The aim here was to evaluate trends in mortality due to cardiovascular diseases in three different regions of the Americas. This was a time series study in which mortality data from three different regions in the Americas from 2000 to the latest year available were analyzed. The source of data was the Mortality Information System of the Pan-American Health Organization (PAHO). Data from 27 countries were included. Joinpoint regression analysis was used to analyze trends. During the study period, the age-adjusted mortality rates for men were higher than those of females in all regions. North America (NA) showed lower rates than Latin America countries (LAC) and the Non-Latin Caribbean (NLC). Premature deaths (30-69 years old) accounted for 22.8% of all deaths in NA, 38.0% in LAC and 41.8% in NLC. The trend analysis also showed a significant decline in the three regions. NA accumulated the largest decline. The average annual percentage change (AAPC) and 95% confidence interval was -3.9% [-4.2; -3.7] in NA; -1.8% [-2.2; -1.5] in LAC; and -1.8% [-2.7; -0.9] in NLC. Different mortality rates and reductions were observed among the three regions.

Gender disparities in mortality from infectious diseases in Serbia, 1991-2014: a time of civil wars and global crisis.

PubMed

Ilic, M; Ilic, I

2016-09-01

Infectious diseases remain one of the leading causes of death worldwide. The aim of this descriptive epidemiological study was to analyse the trends in mortality from infectious diseases in Serbia (excluding the Autonomous Province of Kosovo & Metohia) from 1991 to 2014 using joinpoint regression analysis. The mortality rates from infectious diseases were found to have increased markedly from 1991 to 1994 (+12·4% per year), followed by a significant decline from 1994 to 2009 (-4·6% per year) and then another increase from 2009 to 2014 (+4·3% per year). Throughout the study period, mortality rates were consistently higher in men than in women. Although a substantial decline was observed for young people of both sexes, no consistent pattern was evident for the middle-aged nor the elderly. Since 1991, septicaemia has emerged as a leading cause of infectious disease mortality, particularly in older men. The Yugoslav civil wars in the 1990s and the global financial crisis in 2008 corresponded with changes in the trends in mortality from infectious diseases in Serbia, with the elderly showing particular vulnerability during those time periods. Data presented in this study might be useful to improve control of infectious diseases in Serbia.

The Feto-Maternal Health Cost of Intimate Partner Violence Among Delivery-Related Discharges in the United States, 2002-2009.

PubMed

Mogos, Mulubrhan F; Araya, Winta N; Masho, Saba W; Salemi, Jason L; Shieh, Carol; Salihu, Hamisu M

2016-02-01

Our purpose was to estimate the national prevalence of intimate partner violence (IPV) among delivery-related discharges and to investigate its association with adverse feto-maternal birth outcomes and delivery-related cost. A retrospective cross-sectional analysis of delivery-related hospital discharges from 2002 to 2009 was conducted using the Nationwide Inpatient Sample (NIS). We used ICD-9-CM codes to identify IPV, covariates, and outcomes. Multivariable logistic regression modeling was used to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the associations between IPV and each outcome. Joinpoint regression was used for trend analysis. During the study period, 3,649 delivery-related discharges were diagnosed with IPV (11.2 per 100,000; 95% CI = [10.0, 12.4]). IPV diagnosis during delivery is associated with stillbirth (AOR = 4.12, 95% CI = [2.75, 6.17]), preterm birth (AOR = 1.97, 95% CI = [1.59, 2.44]), fetal death (AOR = 3.34, 95% CI = [1.99, 5.61]), infant with poor intrauterine growth (AOR = 1.55, 95% CI = [1.01, 2.40]), and increased inpatient hospital care cost (US$5,438.2 vs. US$4,080.1) per each discharge, incurring an additional cost of US$4,955,707 during the study period. IPV occurring during pregnancy has a significant health burden to both the mother and infant. Education about IPV; screening at periodic intervals, including during obstetric visits; and ongoing clinical care could help to reduce or eliminate adverse effects of pregnancy-related IPV. Preventing the lifelong consequences associated with IPV can have a positive effect on the overall health of all women and delivery-related health care cost. © The Author(s) 2014.

Colorectal cancer among Koreans living in South Korea versus California: incidence, mortality, and screening rates.

PubMed

Ryu, So Yeon; Crespi, Catherine M; Maxwell, Annette E

2014-08-01

This study compared trends in colorectal cancer (CRC) incidence and mortality rates among Koreans in South Korea and Korean Americans and non-Hispanic whites in California between 1999 and 2009, and examined CRC screening rates and socio-demographic correlates of CRC screening in the two Korean populations. Age-standardized CRC incidence and mortality rates of Koreans in South Korea and Korean Americans and non-Hispanic whites in California for the years 1999-2009 were obtained from annual reports of cancer statistics and modeled using joinpoint regression. Using 2009 data from the Korean National Health and Nutrition Examination Survey and the California Health Interview Survey, we estimated and compared CRC screening rates and test modalities. We used multiple logistic regression to examine socio-demographic correlates of completion of CRC screening according to the guidelines among the two Korean populations. CRC incidence and mortality rates among South Koreans increased during 1999-2009 but more slowly during the late 2000s. In California, CRC incidence increased among Korean American females but decreased among non-Hispanic whites. About 37% of South Koreans and 60% of Korean Americans reported completion of CRC screening according to guidelines in 2009. Among South Koreans, married status, higher income, and private health insurance were associated with CRC screening, adjusting for other factors. Among Korean Americans, having health insurance was associated with CRC screening. Despite almost identical CRC screening guidelines in South Korea and the USA and substantially higher screening rates among Korean Americans as compared to South Koreans, disparities remain in both populations with respect to CRC statistics. Thus, efforts to promote primary and secondary prevention of CRC in both Korean populations are critically important in both countries.

Neuroblastoma among children in Southern and Eastern European cancer registries: Variations in incidence and temporal trends compared to US.

PubMed

Georgakis, Marios K; Dessypris, Nick; Baka, Margarita; Moschovi, Maria; Papadakis, Vassilios; Polychronopoulou, Sophia; Kourti, Maria; Hatzipantelis, Emmanuel; Stiakaki, Eftichia; Dana, Helen; Bouka, Evdoxia; Antunes, Luis; Bastos, Joana; Coza, Daniela; Demetriou, Anna; Agius, Domenic; Eser, Sultan; Gheorghiu, Raluca; Sekerija, Mario; Trojanowski, Maciej; Zagar, Tina; Zborovskaya, Anna; Ryzhov, Anton; Tragiannidis, Athanassios; Panagopoulou, Paraskevi; Steliarova-Foucher, Eva; Petridou, Eleni Th

2018-05-15

Neuroblastoma comprises the most common neoplasm during infancy (first year of life). Our study describes incidence of neuroblastoma in Southern-Eastern Europe (SEE), including - for the first time - the Nationwide Registry for Childhood Hematological Malignancies and Solid Tumors (NARECHEM-ST)/Greece, compared to the US population, while controlling for human development index (HDI). Age-adjusted incidence rates (AIR) were calculated for 1,859 childhood (0-14 years) neuroblastoma cases, retrieved from 13 collaborating SEE registries (1990-2016), and were compared to those of SEER/US (N = 3,166; 1990-2012); temporal trends were assessed using Poisson regression and Joinpoint analyses. The overall AIR was significantly lower in SEE (10.1/million) compared to SEER (11.7 per million); the difference was maximum during infancy (43.7 vs. 53.3 per million, respectively), when approximately one-third of cases were diagnosed. Incidence rates of neuroblastoma at ages <1 and 1-4 years were positively associated with HDI, whereas lower median age at diagnosis was correlated with higher overall AIR. Distribution of primary site and histology was similar in SEE and SEER. Neuroblastoma was slightly more common among males compared to females (male-to-female ratio: 1.1), mainly among SEE infants. Incidence trends decreased in infants in Slovenia, Cyprus and SEER and increased in Ukraine and Belarus. The lower incidence in SEE compared to SEER, especially in infants living in low HDI countries possibly indicates a lower level of overdiagnosis in SEE. Hence, increases in incidence rates in infancy noted in some subpopulations should be carefully monitored to avoid the unnecessary costs health impacts of tumors that could potentially spontaneously regress. © 2017 UICC.

Coronary angiography and myocardial revascularization following the first acute myocardial infarction in Norway during 2001-2009: Analyzing time trends and educational inequalities using data from the CVDNOR project.

PubMed

Sulo, Enxhela; Nygård, Ottar; Vollset, Stein Emil; Igland, Jannicke; Sulo, Gerhard; Ebbing, Marta; Egeland, Grace M; Hawkins, Nathaniel M; Tell, Grethe S

2016-06-01

We analyzed trends in the utilization of coronary angiography and revascularization - including percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) - related to the first AMI and explored potential educational inequalities in such procedures. All first AMI patients aged 35-89, hospitalized during 2001-2009 were retrieved from 'The Cardiovascular Disease in Norway' project. Information on education was obtained from The Norwegian Education Database. Gender and age group-specific trends in coronary procedures were analyzed using Joinpoint regression. Educational inequalities were explored using multivariable Poisson regression and reported as incidence rate ratios (IRR). A total of 104 836 patients (37.3% women) were included. Revascularization rates increased on average 9.0% and 15.4% per year among younger (35-64years) and older (65-89years) men. Corresponding increases among women were 5.6% and 16.6%. Compared to patients with primary education only, those with secondary and tertiary education had 8% (IRR=1.08, 95% CI; 1.06-1.10) and 12% (IRR=1.12, 95% CI; 1.09-1.14) higher revascularization rates. Educational inequalities were entirely driven by educational differences in receiving coronary angiography (IRR=1.10, 95% CI; 1.08-1.11 for secondary versus primary and IRR=1.14, 95% CI; 1.12-1.16 for tertiary versus primary education level.) Among diagnosed patients, no educational differences were observed in coronary revascularization rates. Revascularization rates increased whereas educational differences in revascularization decreased among AMI patients in Norway during 2001-2009. Lower coronary revascularization rates among patients with low education were explained by educational differences in receiving coronary angiography. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cancer epidemiology and trends in Sistan and Baluchestan province, Iran.

PubMed

Rafiemanesh, Hosein; Mehtarpoor, Mojtaba; Mohammadian-Hafshejani, Abdollah; Salehiniya, Hamid; Enayatrad, Mostafa; Khazaei, Salman

2015-01-01

Cancer is the second leading cause of death in developing countries. In Iran, cancer is the third cause of death. The present study aimed at providing the incidence rates (crude and agestandardized) of different types of cancers in Sistan and Baluchestan province (Southeastern of Iran). Data were collected retrospectively reviewing all new cancer patients registered in Cancer Registry Center of Health Heputy for Sistan and Baluchestan province. Common cancers were defined based on the number of cases and standardized incidence rates. To compute the annual percentage change (APC), joinpoint 4.1.1.1 software was applied. A total of 3535 cases of cancers registered during 2004-2009 were identified. Of these, 46.82% occurred in females and 53.18% in males. The most frequent cancer in women was breast cancer followed by esophagus, skin, colorectal and leukemia. The 5 most frequent cancers in men were stomach, skin, leukemia, esophagus and bladder. Joinpoint analyze showed a significant increasing trend for adjusted standard incidence rate (ASIR) for both sexes (p<0.05). According to The results of the present study and comparison to previous studies for other provinces in Iran, cancer incidence in Sistan and Baluchistan is less common but trends of cancers are increasing in Sistan and Baluchestan Province. It is necessary to have a comprehensive health policy for prevention and control of this problem.

Trends of mortality from Alzheimer's disease in the European Union, 1994-2013.

PubMed

Niu, H; Alvarez-Alvarez, I; Guillen-Grima, F; Al-Rahamneh, M J; Aguinaga-Ontoso, I

2017-06-01

In many countries, Alzheimer's disease (AD) has gradually become a common disease in elderly populations. The aim of this study was to analyse trends of mortality caused by AD in the 28 member countries in the European Union (EU) over the last two decades. We extracted data for AD deaths for the period 1994-2013 in the EU from the Eurostat and World Health Organization database. Age-standardized mortality rates per 100 000 were computed. Joinpoint regression was used to analyse the trends and compute the annual percent change in the EU as a whole and by country. Analyses by gender and by European regions were conducted. Mortality from AD has risen in the EU throughout the study period. Most of the countries showed upward trends, with the sharpest increases in Slovakia, Lithuania and Romania. We recorded statistically significant increases of 4.7% and 6.0% in mortality rates in men and women, respectively, in the whole EU. Several countries showed changing trends during the study period. According to the regional analysis, northern and eastern countries showed the steepest increases, whereas in the latter years mortality has declined in western countries. Our findings provide evidence that AD mortality has increased in the EU, especially in eastern and northern European countries and in the female population. Our results could be a reference for the development of primary prevention policies. © 2017 EAN.

Trends and predictors of publicly subsidized chiropractic service use among adults age 50+.

PubMed

Votova, Kristine; Penning, Margaret J; Zheng, Chi; Brackley, Moyra E

2010-09-01

This article examines trends in and predictors of publicly subsidized chiropractic use from 1991 to 2000, a decade characterized by health care system reforms throughout North America. The sample included adults age 50+ who visited a publicly subsidized chiropractor in the Canadian province of British Columbia during the study period. Administrative claims data for chiropractic service use were drawn from the Medical Services Plan (MSP) Master file in the British Columbia Linked Health Data resource. The MSP Master file contains claims reported for every provincially insured medical service and supplementary health benefit including chiropractic visits. Joinpoint regression analyses demonstrate that while annual rates of chiropractic users did not change over the decade, visit rates decreased during this period. Predictors of a greater number of chiropractic visits include increasing age, female gender, urban residence, low to moderate income, and use of chiropractic services earlier in the decade. The trend toward decreasing visit rates over the 1990s both conflicts with and is consistent with findings from other North American chiropractic studies using similar time periods. Results indicating that low and moderate income and advancing age predict more frequent chiropractic service are novel. However, given that lower income and older individuals were exempted from chiropractic service limits during this period, these results suggest support for the responsive nature of chiropractic use to financial barriers.

Nonlinear analysis of pupillary dynamics.

PubMed

Onorati, Francesco; Mainardi, Luca Tommaso; Sirca, Fabiola; Russo, Vincenzo; Barbieri, Riccardo

2016-02-01

Pupil size reflects autonomic response to different environmental and behavioral stimuli, and its dynamics have been linked to other autonomic correlates such as cardiac and respiratory rhythms. The aim of this study is to assess the nonlinear characteristics of pupil size of 25 normal subjects who participated in a psychophysiological experimental protocol with four experimental conditions, namely “baseline”, “anger”, “joy”, and “sadness”. Nonlinear measures, such as sample entropy, correlation dimension, and largest Lyapunov exponent, were computed on reconstructed signals of spontaneous fluctuations of pupil dilation. Nonparametric statistical tests were performed on surrogate data to verify that the nonlinear measures are an intrinsic characteristic of the signals. We then developed and applied a piecewise linear regression model to detrended fluctuation analysis (DFA). Two joinpoints and three scaling intervals were identified: slope α0, at slow time scales, represents a persistent nonstationary long-range correlation, whereas α1 and α2, at middle and fast time scales, respectively, represent long-range power-law correlations, similarly to DFA applied to heart rate variability signals. Of the computed complexity measures, α0 showed statistically significant differences among experimental conditions (p<0.001). Our results suggest that (a) pupil size at constant light condition is characterized by nonlinear dynamics, (b) three well-defined and distinct long-memory processes exist at different time scales, and (c) autonomic stimulation is partially reflected in nonlinear dynamics. (c) autonomic stimulation is partially reflected in nonlinear dynamics.

Differences between Men and Women in Time Trends in Lung Cancer Mortality in Spain (1980-2013).

PubMed

Martín-Sánchez, Juan Carlos; Clèries, Ramon; Lidón-Moyano, Cristina; González-de Paz, Luis; Martínez-Sánchez, Jose M

2016-06-01

The main risk factor for lung cancer is smoking, a habit that varies according to age and sex. The objective of this study was to explore trends in lung cancer mortality by sex and age from 1980 to 2013 in Spain. We used lung cancer mortality (International Classification of Diseases code 162 for the 9th edition, and codes C33 and C34 for 10th edition) and population data from the Spanish National Statistics Institute. Crude, truncated, age-adjusted mortality and age-specific mortality rates were assessed through joinpoint regression to estimate the annual percent change (APC). Age-adjusted mortality rate significantly increased from 1980 to 1991 among men (APC=3.12%) and significantly decreased between 2001 and 2013 (APC=-1.53%), a similar pattern was observed in age-specific rates. Among women, age-adjusted mortality rate increased from 1989 (APC 1989-1997=1.82%), with the greatest increase observed from 1997 until the end of the study in 2013 (APC=4.41%). Diverging trends in the prevalence of smoking could explain the increase in the rate of lung cancer-related mortality among Spanish women since the early 1990s. Public health policies should be implemented to reduce tobacco consumption in women and halt the increase in lung cancer mortality. Copyright © 2016 SEPAR. Published by Elsevier Espana. All rights reserved.

Cancer Incidence Trend in the Hebei Spirit Oil Spill Area, from 1999 to 2014: An Ecological Study

PubMed Central

Hur, Jong-Il

2018-01-01

The Hebei Spirit oil spill (HSOS) occurred in the Republic of Korea on 7 December 2007. We aimed to describe the cancer incidence trend in Taean County before and after the oil spill. Five major cancers and leukemia were analyzed. Cancer incidence data were obtained from the Korean National Cancer Center. We compared the standardized incidence rates in Taean with those observed nationwide and selected three coastal areas. Joinpoint regression analysis was used to examine the trends in the average annual percent change and perform comparisons. The incidence rate of prostate cancer increased from 2007 to 2009 at an annual average of 39.3% (95% confidence interval (CI): −25.9, 161.8), 13.5% (95% CI: 11.7, 15.4), and 15.6% (95% CI: 11.9, 19.5), respectively, in Taean, nationwide, and in the coastal areas. The incidence of leukemia among women increased at an annual average of 9.5% (95% CI: −26.6, 63.4) in Taean and 0.6% (95% CI: 0.2, 0.9) nationwide; the rate decreased by 1.9% (95% CI: −12.8, 10.4) in the coastal areas. The trends between Taean County and the coastal areas differed only for prostate cancer (p = 0.0004). The incidence of prostate cancer among Taean County residents has increased since the HSOS. PMID:29772806

Cancer Incidence Trend in the Hebei Spirit Oil Spill Area, from 1999 to 2014: An Ecological Study.

PubMed

Choi, Kyung-Hwa; Park, Myung-Sook; Ha, Mina; Hur, Jong-Il; Cheong, Hae-Kwan

2018-05-17

The Hebei Spirit oil spill (HSOS) occurred in the Republic of Korea on 7 December 2007. We aimed to describe the cancer incidence trend in Taean County before and after the oil spill. Five major cancers and leukemia were analyzed. Cancer incidence data were obtained from the Korean National Cancer Center. We compared the standardized incidence rates in Taean with those observed nationwide and selected three coastal areas. Joinpoint regression analysis was used to examine the trends in the average annual percent change and perform comparisons. The incidence rate of prostate cancer increased from 2007 to 2009 at an annual average of 39.3% (95% confidence interval (CI): -25.9, 161.8), 13.5% (95% CI: 11.7, 15.4), and 15.6% (95% CI: 11.9, 19.5), respectively, in Taean, nationwide, and in the coastal areas. The incidence of leukemia among women increased at an annual average of 9.5% (95% CI: -26.6, 63.4) in Taean and 0.6% (95% CI: 0.2, 0.9) nationwide; the rate decreased by 1.9% (95% CI: -12.8, 10.4) in the coastal areas. The trends between Taean County and the coastal areas differed only for prostate cancer ( p = 0.0004). The incidence of prostate cancer among Taean County residents has increased since the HSOS.

Burden of cancer mortality and differences attributable to demographic aging and risk factors in Argentina, 1986-2011.

PubMed

Pou, Sonia Alejandra; Tumas, Natalia; Coquet, Julia Becaria; Niclis, Camila; Román, María Dolores; Díaz, María Del Pilar

2017-03-09

The world faces an aging population that implies a large number of people affected with chronic diseases. Argentina has reached an advanced stage of demographic transition and presents a comparatively high rate of cancer mortality within Latin America. The objectives of this study were to examine cancer mortality trends in the province of Córdoba, Argentina, between 1986 and 2011, and to analyze the differences attributable to risk variations and demographic changes. Longitudinal series of age-standardized mortality rates for overall, breast and prostate cancers were modeled by Joinpoint regression to estimate the annual percent change. The Bashir & Estève method was used to split crude mortality rate variation into three components: mortality risk, population age structure and population size. A decreasing cancer age-standardized mortality rates trend was observed (1986-2011 annual percent change: -1.4, 95%CI: -1.6, -1.2 in men; -0.8, 95%CI: -1.0, -0.6 in women), with a significant shift in 1996. There were positive crude mortality rate net changes for overall female cancer, breast and prostate cancers, which were primarily attributable to demographic changes. Inversely, overall male cancer crude mortality rate showed a 9.15% decrease, mostly due to mortality risk. Despite favorable age-standardized mortality rates trends, the influence of population aging reinforces the challenge to control cancer in populations with an increasingly aged demographic structure.

Trends in Breast Cancer Stage and Mortality in Michigan (1992–2009) by Race, Socioeconomic Status, and Area Healthcare Resources

PubMed Central

Akinyemiju, Tomi F.; Soliman, Amr S.; Copeland, Glenn; Banerjee, Mousumi; Schwartz, Kendra; Merajver, Sofia D.

2013-01-01

The long-term effect of socioeconomic status (SES) and healthcare resources availability (HCA) on breast cancer stage of presentation and mortality rates among patients in Michigan is unclear. Using data from the Michigan Department of Community Health (MDCH) between 1992 and 2009, we calculated annual proportions of late-stage diagnosis and age-adjusted breast cancer mortality rates by race and zip code in Michigan. SES and HCA were defined at the zip-code level. Joinpoint regression was used to compare the Average Annual Percent Change (AAPC) in the median zip-code level percent late stage diagnosis and mortality rate for blacks and whites and for each level of SES and HCA. Between 1992 and 2009, the proportion of late stage diagnosis increased among white women [AAPC = 1.0 (0.4, 1.6)], but was statistically unchanged among black women [AAPC = −0.5 (−1.9, 0.8)]. The breast cancer mortality rate declined among whites [AAPC = −1.3% (−1.8,−0.8)], but remained statistically unchanged among blacks [AAPC = −0.3% (−0.3, 1.0)]. In all SES and HCA area types, disparities in percent late stage between blacks and whites appeared to narrow over time, while the differences in breast cancer mortality rates between blacks and whites appeared to increase over time. PMID:23637921

Self-Certified Sickness Absence among Young Municipal Employees-Changes from 2002 to 2016 and Occupational Class Differences.

PubMed

Sumanen, Hilla; Pietiläinen, Olli; Mänty, Minna

2017-09-26

We examined changes in self-certified, one-to-three day sickness absence (SA) among young employees from 2002 to 2016 and the magnitude of occupational class differences during that period. All 18-34-year-old employees of the City of Helsinki, Finland were included (2002-2016, n = ~11,725 per year). Employer's personnel and SA registers were used. Occupational class was categorized to four groups. Changes in self-certified SA from 2002 to 2016 were analyzed with Joinpoint regression and the magnitudes of occupational class differences were estimated with the relative index of inequality (RII). Most of the trends first increased and turned to decrease in 2007/2010. Managers and professionals had the least amount of SA, but steadily increasing trends were observed among men. Self-certified SA followed only partially the typical socioeconomic gradient, as routine non-manuals had the highest levels of SA. The magnitude of occupational class differences in self-certified SA was stable during the study period only among women. Self-certified SA and occupational class differences have increased in recent years among men in the lower occupational classes. Socioeconomic differences exist in self-certified SA among young employees, but gradient is only partial. Overall, high amounts of self-certified SA especially in the lower occupational classes require further studies and preventive measures.

Cystic fibrosis mortality trends in Spain among infants and young children: 1981-2004.

PubMed

Ramalle-Gomara, Enrique; Perucha, Milagros; González, María-Angeles; Quiñones, Carmen; Andrés, Jesús; Posada, Manuel

2008-01-01

This paper sought to analyse mortality trends among infants and young children who died with a diagnosis of cystic fibrosis (CF) in Spain, during the period 1981-2004. Descriptive observational study, using joinpoint regression models. Data on cystic fibrosis deaths were drawn from the National Statistics Institute (Instituto Nacional de Estadística), which collects data from all death certificates in Spain. During the period 1981-2004, overall CF mortality in Spain decreased by an annual average of 4% in both sexes. A breakdown by age showed that patients under 15 years registered a declining and those over 15 years a rising mortality rate over the study period. Mean and median age at death from CF increased with time, from a median of 4.4 years (males) and 3.8 years (females) in 1981 to 20.1 years (males) and 17.7 years (females) in 2004. The results of this study show that, as in other Western countries, CF is no longer a major cause of death in childhood, and that the challenge now lies in caring for adults who suffer from this disease. The fact that our study was descriptive meant that the reasons for the decrease in CF mortality in Spain could not be identified. Other authors have shown that this decrease is associated with improved treatment for pulmonary complications, better nutritional control and lung transplants.

Epidemiology characteristics and trends of incidence and morphology of stomach cancer in Iran.

PubMed

Almasi, Zeinab; Rafiemanesh, Hosein; Salehiniya, Hamid

2015-01-01

Stomach cancer is the fourth most common cancer and the second leading cause of cancer- related death through the world. It is predicted that the number of new cancer cases will be more than 15 million cases by 2020. Regarding the lack of studies on this topic in the country, we have thoroughly examined the patho-epidemiology of stomach cancer in Iran. In this cross- sectional study data were collected retrospectively reviewing all new stomach cancer patients in Cancer Registry Center report of health deputy for Iran during a 6-year period (2003-2008). The study also examined the morphology of common stomach cancers. Trends in incidence and morphology underwent joinpoint regression analysis. During the six-year period, a total of 35,171 cases of stomach cancer were registered. Average age standardized rate for females and males were equal to 7.1 and 15.1 per 100,000 persons, respectively. Most common histological type was adenocarcinoma, NOS with 21,980 cases (62.50%). The annual percentage change (APC) in age-standardized incidence rate (per 100,000) was increase in both females and males at 11.1 (CI: 4.3 to 18.3) and 9.2 (CI: 5.2 to 13.4), respectively. According to our results, the incidence of gastric cancer is increasing in Iran, so further epidemiological studies into the etiology and early detection are essential.

Trends in Hospital Admission for Diabetic Ketoacidosis in Adults With Type 1 and Type 2 Diabetes in England, 1998-2013: A Retrospective Cohort Study.

PubMed

Zhong, Victor W; Juhaeri, Juhaeri; Mayer-Davis, Elizabeth J

2018-01-31

This study determined trends in hospital admission for diabetic ketoacidosis (DKA) in adults with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) from 1998 to 2013 in England. The study population included 23,246 adults with T1DM and 241,441 adults with T2DM from the Clinical Practice Research Datalink and Hospital Episode Statistics. All hospital admissions for DKA as the primary diagnosis from 1998 to 2013 were identified. Trends in hospital admission for DKA in incidence, length of hospital stay, 30-day all-cause readmission rate, and 30-day and 1-year all-cause mortality rates were determined using joinpoint regression, negative binomial regression, and logistic regression models. For T1DM, the incidence of hospital admission for DKA increased between 1998 and 2007 and remained static until 2013. The incidence in 2013 was higher than that in 1998 (incidence rate ratio 1.53 [95% CI 1.09-2.16]). For T2DM, the incidence increased 4.24% (2.82-5.69) annually between 1998 and 2013. The length of hospital stay decreased over time for both diabetes types ( P ≤ 0.0004). Adults with T1DM were more likely to be discharged within 2 days compared with adults with T2DM (odds ratio [OR] 1.28 [1.07-1.53]). The 30-day readmission rate was higher in T1DM than in T2DM (OR 1.61 [1.04-2.50]) but remained unchanged for both diabetes types over time. Trends in 30-day and 1-year all-cause mortality rates were also stable, with no difference by diabetes type. In the previous 2 decades in England, hospitalization for DKA increased in adults with T1DM and in those with T2DM, and associated health care performance did not improve except decreased length of hospital stay. © 2018 by the American Diabetes Association.

Factors Affecting Regression-Discontinuity.

ERIC Educational Resources Information Center

Schumacker, Randall E.

The regression-discontinuity approach to evaluating educational programs is reviewed, and regression-discontinuity post-program mean differences under various conditions are discussed. The regression-discontinuity design is used to determine whether post-program differences exist between an experimental program and a control group. The difference…

Age-period-cohort analysis of the suicide rate in Korea.

PubMed

Park, Chiho; Jee, Yon Ho; Jung, Keum Ji

2016-04-01

The suicide rate has been increasing in Korea, and the country now has the highest rank in the world. This study aimed to present the long-term trends in Korea's suicide rate using Joinpoint analysis and age-period-cohort (APC) modeling. The population and the number of suicides for each five-year age group were obtained from the National Statistical Office for the period 1984-2013 for Koreans aged 10 years and older. We determined the changes in the trends in age-standardized mortality rates using Joinpoint. APC modeling was performed to describe the trends in the suicide rate using the intrinsic estimator method. The age-standardized suicide rate in men rapidly increased from 1989 to 2004, and slightly increased thereafter, whereas the suicide rate in women increased from 1989 to 2009 and then decreased thereafter. Within the same period, the suicide rate was higher among the older age groups than in the younger groups. Within the same birth cohort, the suicide rate of the older groups was also higher than that in the younger groups. Within the same age group, the suicide rate of the younger cohorts was higher than it was in the older cohorts. In the APC modeling, old age, recent period, and having been born before 1924 were associated with higher suicide rates. The accuracy and completeness of the suicide rate data may lead to bias. This study showed an increasing trend in the suicide rates for men and women after 1989. These trends may be mainly attributed to cohort effects. Copyright © 2016 Elsevier B.V. All rights reserved.

Adult brain cancer in the U.S. black population: a Surveillance, Epidemiology, and End Results (SEER) analysis of incidence, survival, and trends.

PubMed

Gabriel, Abigail; Batey, Jason; Capogreco, Joseph; Kimball, David; Walters, Andy; Tubbs, R Shane; Loukas, Marios

2014-08-25

Despite much epidemiological research on brain cancer in the United States, the etiology for the various subtypes remains elusive. The black population in the United States currently experiences lower incidence but higher survival rates when compared to other races. Thus, the aim of this study is to analyze the trends in incidence and survival for the 6 most common primary brain tumors in the black population of the United States. The Surveillance, Epidemiology, and End Results (SEER) database was utilized in this study to analyze the incidence and survival rates for the 6 most common brain tumor subtypes. Joinpoint 3.5.2 software was used to analyze trends in the incidence of diagnosis from 1973 to 2008. A Kaplan-Meier curve was generated to analyze mean time to death and survival at 60 months. Joinpoint analysis revealed that per year the incidence of brain cancer in the U.S. black population increased by 0.11 between 1973 and 1989. After this period, a moderate decrease by 0.06 per annum was observed from 1989 to 2008. Lymphoma was the most common primary tumor subtype for black individuals ages 20-34, and glioblastoma was identified as the most common tumor subtype for black individuals in the age groups of 35-49, 50-64, 65-79, and 80+. This population-based retrospective study of brain cancer in black adults in the United States revealed significant sex and age differences in the incidence of the 6 most common brain tumor subtypes from 1973 to 2008.

Annual Report to the Nation on the Status of Cancer, 1975–2005, Featuring Trends in Lung Cancer, Tobacco Use, and Tobacco Control

PubMed Central

Thun, Michael J.; Ries, Lynn A. G.; Howe, Holly L.; Weir, Hannah K.; Center, Melissa M.; Ward, Elizabeth; Wu, Xiao-Cheng; Eheman, Christie; Anderson, Robert; Ajani, Umed A.; Kohler, Betsy; Edwards, Brenda K.

2008-01-01

Background The American Cancer Society, the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updated information on cancer occurrence and trends in the United States. This year’s report includes trends in lung cancer incidence and death rates, tobacco use, and tobacco control by state of residence. Methods Information on invasive cancers was obtained from the NCI, CDC, and NAACCR and information on mortality from the CDC's National Center for Health Statistics. Annual percentage changes in the age-standardized incidence and death rates (2000 US population standard) for all cancers combined and for the top 15 cancers were estimated by joinpoint analysis of long-term (1975–2005) trends and by least squares linear regression of short-term (1996–2005) trends. All statistical tests were two-sided. Results Both incidence and death rates from all cancers combined decreased statistically significantly (P < .05) in men and women overall and in most racial and ethnic populations. These decreases were driven largely by declines in both incidence and death rates for the three most common cancers in men (lung, colorectum, and prostate) and for two of the three leading cancers in women (breast and colorectum), combined with a leveling off of lung cancer death rates in women. Although the national trend in female lung cancer death rates has stabilized since 2003, after increasing for several decades, there is prominent state and regional variation. Lung cancer incidence and/or death rates among women increased in 18 states, 16 of them in the South or Midwest, where, on average, the prevalence of smoking was higher and the annual percentage decrease in current smoking among adult women was lower than in the West and Northeast. California was the only state with decreasing lung cancer incidence and death rates in women. Conclusions Although the decrease in overall cancer incidence and death rates is encouraging, large state and regional differences in lung cancer trends among women underscore the need to maintain and strengthen many state tobacco control programs. PMID:19033571

The drinking water contamination crisis in Flint: Modeling temporal trends of lead level since returning to Detroit water system.

PubMed

Goovaerts, Pierre

2017-03-01

Since Flint returned to its pre-crisis source of drinking water close to 25,000 water samples have been collected and tested for lead and copper in >10,000 residences. This paper presents the first analysis and time trend modeling of lead data, providing new insights about the impact of this intervention. The analysis started with geocoding all water lead levels (WLL) measured during an 11-month period following the return to the Detroit water supply. Each data was allocated to the corresponding tax parcel unit and linked to secondary datasets, such as the composition of service lines, year built, or census tract poverty level. Only data collected on residential parcels within the City limits were used in the analysis. One key feature of Flint data is their collection through two different sampling initiatives: (i) voluntary or homeowner-driven sampling whereby concerned citizens decided to acquire a testing kit and conduct sampling on their own (non-sentinel sites), and (ii) State-controlled sampling where data were collected bi-weekly at selected sites after training of residents by technical teams (sentinel sites). Temporal trends modeled from these two datasets were found to be statistically different with fewer sentinel data exceeding WLL thresholds ranging from 10 to 50μg/L. Even after adjusting for housing characteristics the odds ratio (OR) of measuring WLL above 15μg/L at non-sentinel sites is significantly >1 (OR=1.480) and it increases with the threshold (OR=2.055 for 50μg/L). Joinpoint regression showed that the city-wide percentage of WLL data above 15μg/L displayed four successive trends since the return to Detroit Water System. Despite the recent improvement in water quality, the culprit for differences between sampling programs needs to be identified as it impacts exposure assessment and might influence whether there is compliance or not with the Lead and Copper Rule. Copyright © 2016 Elsevier B.V. All rights reserved.

Mortality with musculoskeletal disorders as underlying cause in Sweden 1997-2013: a time trend aggregate level study.

PubMed

Kiadaliri, Aliasghar A; Englund, Martin

2016-04-14

The aim was to assess time trend of mortality with musculoskeletal disorders (MSD) as underlying cause of death in Sweden from 1997 to 2013. We obtained data on MSD as underlying cause of death across age and sex groups from the National Board of Health and Welfare's Cause of Death Register. Age-standardized mortality rates per million population for all MSD, its six major subgroups, and all other ICD-10 (International Classification of Disease) chapters were calculated. We computed the average annual percent change (AAPC) in the mortality rates across age/sex groups using joinpoint regression analysis by fitting a regression line to the natural logarithm of the age-standardized mortality rates and calendar year as a predictor. There were a total of 7 976 deaths (0.5% of all causes deaths) with MSD as the underlying cause of death (32.5% of these deaths caused by rheumatoid arthritis [RA]). The overall age-standardized mortality rates (95% CI) were 16.0 (15.4 to 16.7) and 24.9 (24.1 to 25.7) per million among men and women, respectively (women/men rate ratio 1.55; 95%CI 1.47 to 1.63). On average, mortality rate declined by 2.3% per year and only circulatory system mortality had a more favourable decline than mortality with MSD as underlying cause. Among MSD the highest decline was observed in RA (3.7% per year) during study period. Across age groups, while there were generally stable or declining trends, spondylopathies and osteoporosis mortality among people ≥ 75 years increased by 2 and 1.5% per year, respectively. In overall, mortality with MSD as underlying cause has declined in Sweden over last two decades, with the highest decline for RA. However, there are variations across MSD subgroups which warrants further investigations.

European cancer mortality predictions for the year 2014.

PubMed

Malvezzi, M; Bertuccio, P; Levi, F; La Vecchia, C; Negri, E

2014-08-01

From most recent available data, we projected cancer mortality statistics for 2014, for the European Union (EU) and its six more populous countries. Specific attention was given to pancreatic cancer, the only major neoplasm showing unfavorable trends in both sexes. Population and death certification data from stomach, colorectum, pancreas, lung, breast, uterus, prostate, leukemias and total cancers were obtained from the World Health Organisation database and Eurostat. Figures were derived for the EU, France, Germany, Italy, Poland, Spain and the UK. Projected 2014 numbers of deaths by age group were obtained by linear regression on estimated numbers of deaths over the most recent time period identified by a joinpoint regression model. In the EU in 2014, 1,323,600 deaths from cancer are predicted (742,500 men and 581,100 women), corresponding to standardized death rates of 138.1/100,000 men and 84.7/100,000 women, falling by 7% and 5%, respectively, since 2009. In men, predicted rates for the three major cancers (lung, colorectum and prostate cancer) are lower than in 2009, falling by 8%, 4% and 10%, respectively. In women, breast and colorectal cancers had favorable trends (-9% and -7%), but female lung cancer rates are predicted to rise 8%. Pancreatic cancer is the only neoplasm with a negative outlook in both sexes. Only in the young (25-49 years), EU trends become more favorable in men, while women keep registering slight predicted rises. Cancer mortality predictions for 2014 confirm the overall favorable cancer mortality trend in the EU, translating to an overall 26% fall in men since its peak in 1988, and 20% in women, and the avoidance of over 250,000 deaths in 2014 compared with the peak rate. Notable exceptions are female lung cancer and pancreatic cancer in both sexes. © The Author 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

46-Year Trends in Systemic Lupus Erythematosus Mortality in the United States, 1968 to 2013: A Nationwide Population-Based Study.

PubMed

Yen, Eric Y; Shaheen, Magda; Woo, Jennifer M P; Mercer, Neil; Li, Ning; McCurdy, Deborah K; Karlamangla, Arun; Singh, Ram R

2017-12-05

No large population-based studies have been done on systemic lupus erythematosus (SLE) mortality trends in the United States. To identify secular trends and population characteristics associated with SLE mortality. Population-based study using a national mortality database and census data. United States. All U.S. residents, 1968 through 2013. Joinpoint trend analysis of annual age-standardized mortality rates (ASMRs) for SLE and non-SLE causes by sex, race/ethnicity, and geographic region; multiple logistic regression analysis to determine independent associations of demographic variables and period with SLE mortality. There were 50 249 SLE deaths and 100 851 288 non-SLE deaths from 1968 through 2013. Over this period, the SLE ASMR decreased less than the non-SLE ASMR, with a 34.6% cumulative increase in the ratio of the former to the latter. The non-SLE ASMR decreased every year starting in 1968, whereas the SLE ASMR decreased between 1968 and 1975, increased between 1975 and 1999, and decreased thereafter. Similar patterns were seen in both sexes, among black persons, and in the South. However, statistically significant increases in the SLE ASMR did not occur among white persons over the 46-year period. Females, black persons, and residents of the South had higher SLE ASMRs and larger cumulative increases in the ratio of the SLE to the non-SLE ASMR (31.4%, 62.5%, and 58.6%, respectively) than males, other racial/ethnic groups, and residents of other regions, respectively. Multiple logistic regression showed independent associations of sex, race, and region with SLE mortality risk and revealed significant racial/ethnic differences in associations of SLE mortality with sex and region. Underreporting of SLE on death certificates may have resulted in underestimates of SLE ASMRs. Accuracy of coding on death certificates is difficult to ascertain. Rates of SLE mortality have decreased since 1968 but remain high relative to non-SLE mortality, and significant sex, racial, and regional disparities persist. None.

National and regional breast cancer incidence and mortality trends in Mexico 2001-2011: Analysis of a population-based database.

PubMed

Soto-Perez-de-Celis, Enrique; Chavarri-Guerra, Yanin

2016-04-01

Breast cancer is the most common malignancy in Mexican women since 2006. However, due to a lack of cancer registries, data is scarce. We sought to describe breast cancer trends in Mexico using population-based data from a national database and to analyze geographical and age-related differences in incidence and mortality rates. All incident breast cancer cases reported to the National Epidemiological Surveillance System and all breast cancer deaths registered by the National Institute of Statistics and Geography in Mexico from 2001 to 2011 were included. Incidence and mortality rates were calculated for each age group and for 3 geographic regions of the country. Joinpoint regression analysis was performed to examine trends in BC incidence and mortality. We estimated annual percentage change (APC) using weighted least squares log-linear regression. We found an increase in the reported national incidence, with an APC of 5.9% (95% CI 4.1-7.7, p<0.05). Women aged 60-65 had the highest increase in incidence (APC 7.89%; 95% CI 5.5 -10.3, p<0.05). Reported incidence rates were significantly increased in the Center and in the South of the country, while in the North they remained stable. Mortality rates also showed a significant increase, with an APC of 0.4% (95% CI 0.1-0.7, p<0.05). Women 85 and older had the highest increase in mortality (APC 2.99%, 95% CI 1.9-4.1; p<0.05). The reporting of breast cancer cases in Mexico had a continuous increase, which could reflect population aging, increased availability of screening, an improvement in the number of clinical facilities and better reporting of cases. Although an improvement in the detection of cases is the most likely explanation for our findings, our results point towards an epidemiological transition in Mexico and should help in guiding national policy in developing countries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sexual content in video games: an analysis of the Entertainment Software Rating Board classification from 1994 to 2013.

PubMed

Vidaña-Pérez, Dèsirée; Braverman-Bronstein, Ariela; Basto-Abreu, Ana; Barrientos-Gutierrez, Inti; Hilscher, Rainer; Barrientos-Gutierrez, Tonatiuh

2018-01-11

Background: Video games are widely used by children and adolescents and have become a significant source of exposure to sexual content. Despite evidence of the important role of media in the development of sexual attitudes and behaviours, little attention has been paid to monitor sexual content in video games. Methods: Data was obtained about sexual content and rating for 23722 video games from 1994 to 2013 from the Entertainment Software Rating Board database; release dates and information on the top 100 selling video games was also obtained. A yearly prevalence of sexual content according to rating categories was calculated. Trends and comparisons were estimated using Joinpoint regression. Results: Sexual content was present in 13% of the video games. Games rated 'Mature' had the highest prevalence of sexual content (34.5%) followed by 'Teen' (30.7%) and 'E10+' (21.3%). Over time, sexual content decreased in the 'Everyone' category, 'E10+' maintained a low prevalence and 'Teen' and 'Mature' showed a marked increase. Both top and non-top video games showed constant increases, with top selling video games having 10.1% more sexual content across the period of study. Conclusion: Over the last 20 years, the prevalence of sexual content has increased in video games with a 'Teen' or 'Mature' rating. Further studies are needed to quantify the potential association between sexual content in video games and sexual behaviour in children and adolescents.

Trends in hip fracture-related mortality in Texas, 1990-2007.

PubMed

Orces, Carlos H; Alamgir, Abul H

2011-07-01

There are limited data about trends in hip fracture-related mortality. In this study, we examined temporal trends in hip fracture mortality rates among persons aged 50 years or older in Texas between 1990 and 2007. Hip fracture-related mortality was defined as a death on the multiple cause of death record for which hip fracture was listed as a contributing cause. Population estimates for Texas were used as the denominator to calculate mortality rates per 100,000 persons. The joinpoint regression analysis was used to identify points where a statistically significant change occurred in the linear slope of the rates. A total of 14,350 death certificates listed hip fracture as a contributing cause of death. Hip fracture rates decreased predominantly among men by 0.8% (95% CI, -1.5 to -0.1) per year. Conversely, age-adjusted rates among women increased by 0.3% (95% CI, -0.4 to 1.0) per year. By race/ethnicity, hip fracture mortality rates increased annually 2.2% (95% CI, -0.1 to 4.4) among blacks, whereas the rates among whites and Hispanics remained steady. Moreover, the proportion of death records that listed nursing homes and residence as a place of death increased by 2.2% (95% CI, 1.6 to 2.9) and 8.7% (95% CI, 6.3 to 11.0) per year, respectively. Hip fracture mortality rates decreased predominantly among men in Texas during the study period. Increasing hip fracture mortality rates among blacks and nursing home residents merit further research.

Prostate Cancer in Iran: Trends in Incidence and Morphological and Epidemiological Characteristics.

PubMed

Pakzad, Reza; Rafiemanesh, Hosein; Ghoncheh, Mahshid; Sarmad, Arezoo; Salehiniya, Hamid; Hosseini, Sayedehafagh; Sepehri, Zahra; Afshari-Moghadam, Amin

2016-01-01

Prostate cancer is second most common cancer in men overall in the world, whereas it is the third most common cancer in men and the sixth most common cancer in Iran. Few studies have been conducted on the epidemiology of prostate cancer in Iran. Since ethnicity of Iranian men is different from Asian people and given the epidemiologic and demographic transition taking place in Iran, this study aimed to investigate trends of incidence and morphology of prostate cancer during 2003 - 2008 in the country. Data were collected retrospectively reviewing all new prostate cancer patients in the Cancer Registry Center of the Health Deputy for Iran during a 6-year period. Also carcinoma, NOS and adenocarcinoma, NOS morphology were surveyed. Trends analysis of incidence and morphology was by joinpoint regression. During the six years a total of 16,071 cases of prostate cancer were recorded in Iran. Most were adenocarcinomas at 95.2 percent. Trend analysis of incidence (ASR) There was a significant increase incidence, with annual percentage change (APC) of 17.3% and for morphology change percentage trends there was a significant decrease in adenocarcinoma with an APC of -1.24%. Prostate cancer is a disease of older men and the incidence is increasing in Iran. The most common morphology is adenocarcinoma this appears to be decreasing over time. Due to the changing lifestyles and the aging of the population, epidemiological studies and planning assessment of the etiology of prostate cancer and its early detection are essential.

[Mortality from Suicide in the Municipalities of Mainland Portugal: Spatio-Temporal Evolution between 1980 and 2015].

PubMed

Loureiro, Adriana; Almendra, Ricardo; Costa, Cláudia; Santana, Paula

2018-01-31

Suicide is considered a public health priority. It is a complex phenomenon resulting from the interaction of several factors, which do not depend solely on individual conditions. This study analyzes the spatio-temporal evolution of suicide mortality between 1980 and 2015, identifying areas of high risk, and their variation, in the 278 municipalities of Continental Portugal. Based on the number of self-inflicted injuries and deaths from suicide and the resident population, the spatio-temporal evolution of the suicide mortality rate was assessed via: i) a Poisson joinpoint regression model, and ii) spatio-temporal clustering methods. The suicide mortality rate evolution showed statistically significant increases over three periods (1980 - 1984; 1999 - 2002 and 2006 - 2015) and two statistically significant periods of decrease (1984 - 1995 and 1995 - 1999). The spatio-temporal analysis identified five clusters of high suicide risk (relative risk >1) and four clusters of low suicide risk (relative risk < 1). The periods when suicide mortality increases seem to overlap with times of economic and financial instability. The geographical pattern of suicide risk has changed: presently, the suicide rates from the municipalities in the Center and North are showing more similarity with those seen in the South, thus increasing the ruralization of the phenomenon of suicide. Between 1980 and 2015 the spacio-temporal pattern of mortality from suicide has been changing and is a phenomenon that is currently experiencing a growing trend (since 2006) and is of higher risk in rural areas.

Declining death rates from hyperglycemic crisis among adults with diabetes, U.S., 1985-2002.

PubMed

Wang, Jing; Williams, Desmond E; Narayan, K M Venkat; Geiss, Linda S

2006-09-01

To examine trends in death rates for hyperglycemic crisis (diabetic ketoacidosis or hyperglycemic hyperosmolar state) among adults with diabetes in the U.S. from 1985 to 2002. Deaths with hyperglycemic crisis as the underlying cause were identified from national mortality data. Death rates were calculated using estimates of adults with diabetes from the National Health Interview Survey as the denominator and age adjusted to the 2000 U.S. population. The trends from 1985 to 2002 were tested using joinpoint regression analysis. Deaths due to hyperglycemic crisis dropped from 2,989 in 1985 to 2,459 in 2002. During the time period, age-adjusted death rates decreased from 42.4 to 23.8 per 100,000 adults with diabetes (4.4% decrease per year, P for trend <0.01). Death rates declined in all age-groups, with the greatest decrease occurring among individuals aged > or =65 years. Age-adjusted death rates fell for all race-sex subgroups, with black men experiencing the smallest decline. About one-fifth of deaths occurred at home or on arrival at the hospital, and the death rates for hyperglycemic crisis occurring at these places declined only modestly over time (2.1% decrease per year, P for trend = 0.049). Overall death rates due to hyperglycemic crisis among adults with diabetes have declined in the U.S. However, scope for further improvement remains, especially to further reduce death rates among black men and to prevent deaths occurring at home.

Trends in lung cancer death rates in Belgium and The Netherlands: a systematic analysis of temporal patterns.

PubMed

Van Hemelrijck, Mieke J J; Kabir, Zubair; Connolly, Gregory N

2009-06-01

Belgium and The Netherlands have fairly similar smoking prevalence patterns, but distinct tobacco control policies. It is our aim to use lung cancer death rates, especially among the youngest age groups (30-39 years), as indicators of past smoking behavioral patterns to evaluate recent tobacco control efforts in both countries. Lung cancer mortality rates from 1954 to 1997 and from 1950 to 2000 were investigated in Belgium and The Netherlands, respectively, using the joinpoint regression modeling technique (log-linear Poisson models) to calculate annual percent change in death rate. In the most recent period (1984-2000) overall male lung cancer death rates have been declining at a faster rate in The Netherlands than in Belgium. In contrast, overall female lung cancer death rates (between 1950 and 2000) have been increasing at a faster rate in The Netherlands than in Belgium. Since 1988, however, APCs in death rates among Dutch females have begun to level off. Interestingly, during this same period, a significant annual decline of 7.7% among the youngest Dutch women (30-39 years) has been observed. Tobacco use prevention and interventions seem to have an impact on smoking prevalence, especially among younger age groups. In The Netherlands, where aggressive anti-tobacco campaigns were introduced a few years earlier than in Belgium, male lung cancer mortality rates have been declining more rapidly, and female lung cancer mortality rates have begun to level off.

Sickness absence among young employees: trends from 2002 to 2013.

PubMed

Sumanen, Hilla; Pietiläinen, Olli; Lahti, Jouni; Lahelma, Eero; Rahkonen, Ossi

2015-01-01

Young adults entering employment are a key group in extending work careers, but there is a lack of research on trends in work ability among young employees. Prolonged sickness absence (SA) constitutes a risk for permanent work disability. We examined 12-year trends in SA spells among young female and male municipal employees. The data were obtained from the employers' registers in the City of Helsinki, Finland. The data included employees aged 18-24, 25-29, 30-34, and 35-54 from 2002 to 2013 (the average number for each year was 31,600). Self-certified (1-3 days) and medically certified intermediate (4-14 days) and long (15+ days) SAs were examined. Joinpoint regression models were used to identify major changes in SA trends. Younger employees had more short SAs but fewer long SAs than older employees. During the study period, SAs of almost any length first increased and later decreased among both genders, except for young men. The turning points for short SA were in 2007-2011 among younger and older employees. In intermediate and long SAs the respective turning points were in 2008-2009 and 2005-2009. Women had more SAs in all categories. Age is related to the length of absences. Given the relatively low chronic morbidity among younger employees, it is likely that reasons other than ill health account for increased SA. More evidence on factors behind the changing trends is needed in order to reduce SA and extend the working careers of young people.

The clinical and economic burden of a sustained increase in thyroid cancer incidence.

PubMed

Aschebrook-Kilfoy, Briseis; Schechter, Rebecca B; Shih, Ya-Chen Tina; Kaplan, Edwin L; Chiu, Brian C-H; Angelos, Peter; Grogan, Raymon H

2013-07-01

Thyroid cancer incidence is increasing worldwide at an alarming rate, yet little is known of the impact this increase will have on society. We sought to determine the clinical and economic burden of a sustained increase in thyroid cancer incidence in the United States and to understand how these burdens correlate with the National Cancer Institute's (NCI) prioritization of thyroid cancer research funding. We used the NCI's SEER 13 database (1992-2009) and Joinpoint regression software to identify the current clinical burden of thyroid cancer and to project future incidence through 2019. We combined Medicare reimbursement rates with American Thyroid Association guidelines, and our clinical practice to create an economic model of thyroid cancer. We obtained research-funding data from the NCI's Office of Budget and Finance. RESULTS; By 2019, papillary thyroid cancer will double in incidence and become the third most common cancer in women of all ages at a cost of $18 to $21 billion dollars in the United States. Despite these substantial clinical and economic burdens, thyroid cancer research remains significantly underfunded by comparison, and in 2009 received only $14.7 million (ranked 30th) from the NCI. The impact of thyroid cancer on society has been significantly underappreciated, as is evidenced by its low priority in national research funding levels. Increased awareness in the medical community and the general public of the societal burden of thyroid cancer, and substantial increases in research on thyroid cancer etiology, prevention, and treatment are needed to offset these growing concerns.

Cancer mortality in Brazil

PubMed Central

Barbosa, Isabelle R.; de Souza, Dyego L.B.; Bernal, María M.; Costa, Íris do C.C.

2015-01-01

Abstract Cancer is currently in the spotlight due to their heavy responsibility as main cause of death in both developed and developing countries. Analysis of the epidemiological situation is required as a support tool for the planning of public health measures for the most vulnerable groups. We analyzed cancer mortality trends in Brazil and geographic regions in the period 1996 to 2010 and calculate mortality predictions for the period 2011 to 2030. This is an epidemiological, demographic-based study that utilized information from the Mortality Information System on all deaths due to cancer in Brazil. Mortality trends were analyzed by the Joinpoint regression, and Nordpred was utilized for the calculation of predictions. Stability was verified for the female (annual percentage change [APC] = 0.4%) and male (APC = 0.5%) sexes. The North and Northeast regions present significant increasing trends for mortality in both sexes. Until 2030, female mortality trends will not present considerable variations, but there will be a decrease in mortality trends for the male sex. There will be increases in mortality rates until 2030 for the North and Northeast regions, whereas reductions will be verified for the remaining geographic regions. This variation will be explained by the demographic structure of regions until 2030. There are pronounced regional and sex differences in cancer mortality in Brazil, and these discrepancies will continue to increase until the year 2030, when the Northeast region will present the highest cancer mortality rates in Brazil. PMID:25906105

Leprosy and gender in Brazil: trends in an endemic area of the Northeast region, 2001-2014.

PubMed

Souza, Eliana Amorim de; Ferreira, Anderson Fuentes; Boigny, Reagan Nzundu; Alencar, Carlos Henrique; Heukelbach, Jorg; Martins-Melo, Francisco Rogerlândio; Barbosa, Jaqueline Caracas; Ramos, Alberto Novaes

2018-01-01

OBJECTIVE To analyze, stratifield by gender, trends of the new case leprosy detection rates in the general population and in children; of grade 2 disability, and of proportion of multibacillary cases, in the state of Bahia, Brazil from 2001 to 2014. METHODS A time series study based on leprosy data from the National Information System for Notifiable Diseases. The time trend analysis included Poisson regression models by infection points (Joinpoint) stratified by gender. RESULTS There was a total of 40,054 new leprosy cases with a downward trend of the overall detection rate (Average Annual Percent Change [AAPC = -0.4, 95%CI -2.8-1.9] and a non-significant increase in children under 15 years (AAPC = 0.2, 95%CI -3.9-4.5). The proportion of grade 2 disability among new cases increased significantly (AAPC = 4.0, 95%CI 1.3-6.8), as well as the proportion of multibacillary cases (AAPC = 2.2, 95%CI 0.1-4.3). Stratification by gender showed a downward trend of detection rates in females and no significant change in males; in females, there was a more pronounced upward trend of the proportion of multibacillary and grade 2 disability cases. CONCLUSIONS Leprosy is still highly endemic in the state of Bahia, with active transmission, late diagnosis, and a probable hidden endemic. There are different gender patterns, indicating the importance of early diagnosis and prompt treatment, specifically in males without neglecting the situation among females.

An exploratory analysis of changes in mood, anxiety and craving from pre- to post-single sessions of exercise, over 12 weeks, among patients with alcohol dependence.

PubMed

Brown, Richard A; Prince, Mark A; Minami, Haruka; Abrantes, Ana M

2016-10-01

Aerobic exercise is currently being studied as a relapse prevention strategy for individuals with alcohol use disorders. Negative affect and cravings predict relapse. The acute effects of moderate-intensity exercise have been shown to improve mood and reduce craving. The current study examined the acute effects of exercise on changes in mood, anxiety, and craving from pre- to post-exercise at each week of a 12-week moderate intensity exercise intervention with sedentary alcohol dependent adults. Twenty-six participants in the exercise condition of a larger randomized clinical trial (Brown et al., 2014) exercised in small groups at moderate intensity for 20 to 40 minutes per session. Participants rated mood, anxiety, and cravings in the present moment before and after each exercise session over the course of the 12-week intervention. Data analyses focused on effect size and interval estimation. Joinpoint analysis was used to model longitudinal trends. Increases in mood and decreases in anxiety and craving were apparent at every session. Effect size estimates revealed that average change from pre- to post-exercise was in the small to medium range with some individual sessions reaching the large range. Joinpoint analyses revealed that the pre-post exercise changes in mood increased, anxiety remained stable, and craving diminished across the 12 weeks. This study provides provisional support for a change in mood, anxiety and alcohol cravings for the role of exercise in the early recovery period for alcohol dependence. Acute single bouts of moderate-intensity exercise may help individuals with alcohol dependence manage mood, anxiety, and craving thereby reducing relapse risk, but further research is needed with a more rigorous study design.

[A SAS marco program for batch processing of univariate Cox regression analysis for great database].

PubMed

Yang, Rendong; Xiong, Jie; Peng, Yangqin; Peng, Xiaoning; Zeng, Xiaomin

2015-02-01

To realize batch processing of univariate Cox regression analysis for great database by SAS marco program. We wrote a SAS macro program, which can filter, integrate, and export P values to Excel by SAS9.2. The program was used for screening survival correlated RNA molecules of ovarian cancer. A SAS marco program could finish the batch processing of univariate Cox regression analysis, the selection and export of the results. The SAS macro program has potential applications in reducing the workload of statistical analysis and providing a basis for batch processing of univariate Cox regression analysis.

[Trends of Tobacco and Alcohol Consumption over 65 Years in Germany].

PubMed

John, Ulrich; Hanke, Monika

2018-02-01

No estimation was available for tobacco and for alcohol consumption in Germany based on sales data that were provided for public use and suited for time trend analysis. To estimate trends of tobacco and alcohol consumption rates for the years 1950-2014. Data on tobacco and alcohol consumption in the nation were retrieved from reports made by producers of beer, wine, or spirits to the Federal Statistics Office of Germany. Time trends over the 65 years were calculated using the program Joinpoint. Tobacco consumption rose from 1950 to 1972. Thereafter it decreased, mostly by 1.2-6.9 percentage points per year. Alcohol consumption rose until the year 1974 and decreased thereafter by 1.0 percentage points annually until the end of the time period under analysis in 2014. The findings may be explained, among others, by changes of social norms according to smoking and alcohol consumption after tax increases, nonsmoker and youth protection laws, and legislative measures against driving under the influence of alcohol. A steepening of the decrease in tobacco consumption occurred after laws including tax increases had come into effect. However, the tobacco and alcohol consumption levels were still high at the end of the observation period in 2014. Eigentümer und Copyright ©Georg Thieme Verlag KG 2018.

Recent trends in cutaneous melanoma incidence and death rates in the United States, 1992-2006.

PubMed

Jemal, Ahmedin; Saraiya, Mona; Patel, Pragna; Cherala, Sai S; Barnholtz-Sloan, Jill; Kim, Julian; Wiggins, Charles L; Wingo, Phyllis A

2011-11-01

Increasing cutaneous melanoma incidence rates in the United States have been attributed to heightened detection of thin (≤ 1-mm) lesions. We sought to describe melanoma incidence and mortality trends in the 12 cancer registries covered by the Surveillance, Epidemiology, and End Results program and to estimate the contribution of thin lesions to melanoma mortality. We used joinpoint analysis of Surveillance, Epidemiology, and End Results incidence and mortality data from 1992 to 2006. During 1992 through 2006, melanoma incidence rates among non-Hispanic whites increased for all ages and tumor thicknesses. Death rates increased for older (>65 years) but not younger persons. Between 1998 to 1999 and 2004 to 2005, melanoma death rates associated with thin lesions increased and accounted for about 30% of the total melanoma deaths. Availability of long-term incidence data for 14% of the US population was a limitation. The continued increases in melanoma death rates for older persons and for thin lesions suggest that the increases may partly reflect increased ultraviolet radiation exposure. The substantial contribution of thin lesions to melanoma mortality underscores the importance of standard wide excision techniques and the need for molecular characterization of the lesions for aggressive forms. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Regression Verification Using Impact Summaries

NASA Technical Reports Server (NTRS)

Backes, John; Person, Suzette J.; Rungta, Neha; Thachuk, Oksana

2013-01-01

Regression verification techniques are used to prove equivalence of syntactically similar programs. Checking equivalence of large programs, however, can be computationally expensive. Existing regression verification techniques rely on abstraction and decomposition techniques to reduce the computational effort of checking equivalence of the entire program. These techniques are sound but not complete. In this work, we propose a novel approach to improve scalability of regression verification by classifying the program behaviors generated during symbolic execution as either impacted or unimpacted. Our technique uses a combination of static analysis and symbolic execution to generate summaries of impacted program behaviors. The impact summaries are then checked for equivalence using an o-the-shelf decision procedure. We prove that our approach is both sound and complete for sequential programs, with respect to the depth bound of symbolic execution. Our evaluation on a set of sequential C artifacts shows that reducing the size of the summaries can help reduce the cost of software equivalence checking. Various reduction, abstraction, and compositional techniques have been developed to help scale software verification techniques to industrial-sized systems. Although such techniques have greatly increased the size and complexity of systems that can be checked, analysis of large software systems remains costly. Regression analysis techniques, e.g., regression testing [16], regression model checking [22], and regression verification [19], restrict the scope of the analysis by leveraging the differences between program versions. These techniques are based on the idea that if code is checked early in development, then subsequent versions can be checked against a prior (checked) version, leveraging the results of the previous analysis to reduce analysis cost of the current version. Regression verification addresses the problem of proving equivalence of closely related program versions [19]. These techniques compare two programs with a large degree of syntactic similarity to prove that portions of one program version are equivalent to the other. Regression verification can be used for guaranteeing backward compatibility, and for showing behavioral equivalence in programs with syntactic differences, e.g., when a program is refactored to improve its performance, maintainability, or readability. Existing regression verification techniques leverage similarities between program versions by using abstraction and decomposition techniques to improve scalability of the analysis [10, 12, 19]. The abstractions and decomposition in the these techniques, e.g., summaries of unchanged code [12] or semantically equivalent methods [19], compute an over-approximation of the program behaviors. The equivalence checking results of these techniques are sound but not complete-they may characterize programs as not functionally equivalent when, in fact, they are equivalent. In this work we describe a novel approach that leverages the impact of the differences between two programs for scaling regression verification. We partition program behaviors of each version into (a) behaviors impacted by the changes and (b) behaviors not impacted (unimpacted) by the changes. Only the impacted program behaviors are used during equivalence checking. We then prove that checking equivalence of the impacted program behaviors is equivalent to checking equivalence of all program behaviors for a given depth bound. In this work we use symbolic execution to generate the program behaviors and leverage control- and data-dependence information to facilitate the partitioning of program behaviors. The impacted program behaviors are termed as impact summaries. The dependence analyses that facilitate the generation of the impact summaries, we believe, could be used in conjunction with other abstraction and decomposition based approaches, [10, 12], as a complementary reduction technique. An evaluation of our regression verification technique shows that our approach is capable of leveraging similarities between program versions to reduce the size of the queries and the time required to check for logical equivalence. The main contributions of this work are: - A regression verification technique to generate impact summaries that can be checked for functional equivalence using an off-the-shelf decision procedure. - A proof that our approach is sound and complete with respect to the depth bound of symbolic execution. - An implementation of our technique using the LLVMcompiler infrastructure, the klee Symbolic Virtual Machine [4], and a variety of Satisfiability Modulo Theory (SMT) solvers, e.g., STP [7] and Z3 [6]. - An empirical evaluation on a set of C artifacts which shows that the use of impact summaries can reduce the cost of regression verification.

The remarkable geographical pattern of gastric cancer mortality in Ecuador.

PubMed

Montero-Oleas, Nadia; Núñez-González, Solange; Simancas-Racines, Daniel

2017-12-01

This study was aimed to describe the gastric cancer mortality trend, and to analyze the spatial distribution of gastric cancer mortality in Ecuador, between 2004 and 2015. Data were collected from the National Institute of Statistics and Census (INEC) database. Crude gastric cancer mortality rates, standardized mortality ratios (SMRs) and indirect standardized mortality rates (ISMRs) were calculated per 100,000 persons. For time trend analysis, joinpoint regression was used. The annual percentage rate change (APC) and the average annual percent change (AAPC) was computed for each province. Spatial age-adjusted analysis was used to detect high risk clusters of gastric cancer mortality, from 2010 to 2015, using Kulldorff spatial scan statistics. In Ecuador, between 2004 and 2015, gastric cancer caused a total of 19,115 deaths: 10,679 in men and 8436 in women. When crude rates were analyzed, a significant decline was detected (AAPC: -1.8%; p<0.001). ISMR also decreased, but this change was not statistically significant (APC: -0.53%; p=0.36). From 2004 to 2007 and from 2008 to 2011 the province with the highest ISMR was Carchi; and, from 2012 to 2015, was Cotopaxi. The most likely high occurrence cluster included Bolívar, Los Ríos, Chimborazo, Tungurahua, and Cotopaxi provinces, with a relative risk of 1.34 (p<0.001). There is a substantial geographic variation in gastric cancer mortality rates among Ecuadorian provinces. The spatial analysis indicates the presence of high occurrence clusters throughout the Andes Mountains. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Regional variation in coronary heart disease mortality trends in Portugal, 1981-2012.

PubMed

Araújo, Carla; Pereira, Marta; Viana, Marta; Rocha, Olga Laszczyńska; Bennett, Kathleen; Lunet, Nuno; Azevedo, Ana

2016-12-01

Information is scarce about the geographic variation in time trends of mortality from coronary heart disease (CHD). We aimed to describe trends in death rates, absolute number of deaths and years of life lost (YLL) due to CHD among men and women in Portugal, by region, from 1981 to 2012. The age-standardized mortality rates from CHD were estimated by sex and region. We used joinpoint regression analysis to calculate the annual percent change (APC) in mortality and to identify points of significant change in the trend. The YLL due to premature mortality for CHD were computed using the Global Burden of Disease method. The age-adjusted mortality from CHD decreased between 1981 and 2012, both in men and women, but with significantly different APC by region. Smaller declines in rates were observed in Alentejo (men: APC 1993-2012: -2.4%; women: APC 1991-2012: -2.4%). The greatest decline was observed in Madeira between 2003 and 2012, in men (APC: -7.6%) and women (APC: -9.7%). The decline in rates in Algarve started only after 2003, whereas it was consistent from 1981 in the North and started in the 1990s in most other regions. A decrease in the number of deaths was only observed after 2000. The YLL from CHD decreased from 1981 to 2012, mainly after 2000. In Portugal, between 1981 and 2012, relative declines of CHD mortality indicators were different by geographic region. Consistent decreases in mortality rates were only observed in the Centre, Lisbon and North, the most populated and urbanized regions. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

The change points of HbA(1C) for detection of retinopathy in Chinese type 2 diabetic patients.

PubMed

Hou, Jia-Ning; Bi, Yu-Fang; Xu, Min; Huang, Yun; Li, Xiao-Ying; Wang, Wei-Qing; Chen, Yu-Hong; Ning, Guang

2011-03-01

To investigate the change points of HbA(1C) for detection of retinopathy in Chinese type 2 diabetic patients. This cross-sectional investigation included 992 diagnosed type 2 diabetic patients, who received non-mydriatic digital fundus photography examination. Joinpoint regression software was adopted to identify the change points of HbA(1C) in association with retinopathy prevalence. The mean age of all patients was 59.1 ± 8.4 years and the duration of diabetes was 5.5 (95% CI: 5.2-5.9) years. The prevalence of retinopathy was 10.3% in total, and 4.1%, 7.4% and 19.6% in patients with different diabetes duration of ≤ 5 years, 5-10 years and >10 years, respectively. The change point of HbA(1C) was 6.5% (95%CI 5.8-7.5%), at which retinopathy prevalence began to rise sharply. Furthermore, in subjects with diabetes duration ≤ 5 years, 5-10 years and >10 years, the change points of HbA(1C) were 8.1% (95%CI 7.9-8.3%), 6.1% (95%CI 5.7-6.8%), 5.6% (95%CI 5.1-8.1%) for detection of retinopathy, respectively. The steepest increase in retinopathy prevalence occurred when HbA(1C) reached 6.5%. However, the duration of diabetes should be taken into concern, when using the change points of HbA(1C) for detection of retinopathy in diabetic patients. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Global patterns and trends in stomach cancer incidence: Age, period and birth cohort analysis.

PubMed

Luo, Ganfeng; Zhang, Yanting; Guo, Pi; Wang, Li; Huang, Yuanwei; Li, Ke

2017-10-01

The cases of stomach cancer (SC) incidence are increasing per year and the SC burden has remained very high in some countries. We aimed to evaluate the global geographical variation in SC incidence and temporal trends from 1978 to 2007, with an emphasis on the effect of birth cohort. Joinpoint regression and age-period-cohort model were applied. From 2003 to 2007, male rate were 1.5- to 3-fold higher than female in all countries. Rates were highest in Eastern Asian and South American countries. Except for Uganda, all countries showed favorable trends. Pronounced cohort-specific increases in risk for recent birth cohorts were seen in Brazil, Colombia, Iceland, New Zealand, Norway, Uganda and US white people for males and in Australia, Brazil, Colombia, Costa Rica, Czech Republic, Ecuador, Iceland, India, Malta, New Zealand, Norway, Switzerland, United Kingdom, Uganda, US black and white people for females. The cohort-specific ratio for male significantly decreased in Japan, Malta and Spain for cohorts born since 1950 and in Austria, China, Croatia, Ecuador, Russia, Switzerland and Thailand for cohorts born since 1960 and for female in Japan for cohorts born since 1950 and in Canada, China, Croatia, Latvia, Russia and Thailand for cohorts born since 1960. Disparities in incidence and carcinogenic risk persist worldwide. The favorable trends may be due to changes in environmental exposure and lifestyle, including decreased Helicobacter pylori prevalence, increased intake of fresh fruits and vegetables, the availability of refrigeration and decreased intake of salted and preserved food and smoking prevalence. © 2017 UICC.

Has information on suicide methods provided via the Internet negatively impacted suicide rates?

PubMed Central

Mergl, Roland; Hegerl, Ulrich

2017-01-01

Suicide rates in Germany consistently decreased from 1991 to 2006, but this trend was reversed in 2007. Underlying this reversal were large increases in suicides due to gassing in females and in being overrun in males. During a similar time period (2005–2013), Asian and some Western countries have also observed abrupt increases in suicides due to certain gasses, and the availability of “how-to” information on the Internet about these painless methods of suicide is thought to play a role in their increased use. This study used data from the Federal Statistics Office of Germany to examine current trends in overall suicide mortality in Germany (2007–2015) as well by age, gender, and suicide methods. Also assessed was whether suicides via newly emergent methods are associated with the frequency of corresponding Internet searches using data from Google Trends. Joinpoint regression analyses indicated significant increases in the overall suicide rate (Average Annual Percentage Change (AAPC) = 2.37%) for females, but not males. The largest annual increases were observed in gassing self-intoxication suicides (AAPC = 13.93%), the majority of which involved carbon monoxide. The increase in gassing suicides was larger in females (500%), compared to males (164%). The frequency of suicides by gassing was significantly associated with Internet searches for “carbon monoxide poisoning” for both male and female subgroups, independent of age group. This study provides the updated suicide surveillance data that are necessary for suicide prevention activities. Results are congruent with the recent abrupt rises in carbon monoxide suicides in other countries. PMID:29284015

Trends in the incidence of lower limb amputation after implementation of a Multidisciplinary Diabetic Foot Unit.

PubMed

Jiménez, Sara; Rubio, José Antonio; Álvarez, Julia; Ruiz-Grande, Fernando; Medina, Carlos

2017-04-01

Incidence of lower extremity amputations (LEA) in the population with and without diabetes mellitus (DM) was assessed after implementation of a Multidisciplinary Diabetic Foot Unit (MDFU) during 2008. Non-traumatic LEA were analyzed, and those performed before (2001-2007) and after (2008-2014) introduction of the MDFU were compared. LEA were grouped by age and sex. Their incidence was expressed as a rate per 100,000 population per year, adjusted to the standard European population. A total of 664 LEA were performed during the 2001-2014 period, 486 (73%) of them in patients with DM. Total LEA incidence was 11.2/10 5 population in DM versus 3.9/10 5 in the population without DM. Incidence of major LEA in patients with DM significantly decreased from 6.1/10 5 population in the 2001-2007 period to 4.5/10 5 in the 2008-2014 period (p=.03). Joinpoint regression analysis also showed a reduction in the trend of incidence of major LEA in patients with DM, with an annual percentage change of -3.3% [95% CI, -6.2-0.3] (p=.025). No significant differences were found for all other incidences and trends in the diabetic and non-diabetic populations. Implementation of a MDFU has been shown to be associated with a significant reduction in major amputation rate in the diabetic population, although the results are not optimal yet. Both results and work at the MDFU should be improved. Copyright © 2017 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.

Has information on suicide methods provided via the Internet negatively impacted suicide rates?

PubMed

Paul, Elise; Mergl, Roland; Hegerl, Ulrich

2017-01-01

Suicide rates in Germany consistently decreased from 1991 to 2006, but this trend was reversed in 2007. Underlying this reversal were large increases in suicides due to gassing in females and in being overrun in males. During a similar time period (2005-2013), Asian and some Western countries have also observed abrupt increases in suicides due to certain gasses, and the availability of "how-to" information on the Internet about these painless methods of suicide is thought to play a role in their increased use. This study used data from the Federal Statistics Office of Germany to examine current trends in overall suicide mortality in Germany (2007-2015) as well by age, gender, and suicide methods. Also assessed was whether suicides via newly emergent methods are associated with the frequency of corresponding Internet searches using data from Google Trends. Joinpoint regression analyses indicated significant increases in the overall suicide rate (Average Annual Percentage Change (AAPC) = 2.37%) for females, but not males. The largest annual increases were observed in gassing self-intoxication suicides (AAPC = 13.93%), the majority of which involved carbon monoxide. The increase in gassing suicides was larger in females (500%), compared to males (164%). The frequency of suicides by gassing was significantly associated with Internet searches for "carbon monoxide poisoning" for both male and female subgroups, independent of age group. This study provides the updated suicide surveillance data that are necessary for suicide prevention activities. Results are congruent with the recent abrupt rises in carbon monoxide suicides in other countries.

Gastric bypass surgeries in New Hampshire, 1996-2007.

PubMed

Cherala, Sai S

2012-01-01

Obesity is a national epidemic. Gastric bypass surgery may be the only option that provides significant long-term weight loss for people who are morbidly obese (body mass index [BMI] ≥ 40 kg/m²) or for people who have a BMI of 35 or higher and have an obesity-related comorbidity. The objective of this study was to assess trends in gastric bypass surgery in New Hampshire. Data from 1996 to 2007 from the New Hampshire Inpatient Hospital Discharge data set were analyzed. Records for patients with a gastric bypass surgery code were identified, and data on patients and hospitalizations were collected. A joinpoint regression model was used to analyze trends in surgery rates. Differences between patients and payer types were analyzed by using the Cochran-Mantel-Haenszel χ² test. The annual rate of gastric bypass surgery increased significantly from 3.3 to 22.4 per 100,000 adults between 1996 and 2007. The in-hospital death rate decreased significantly from 11% in 1996 to 1% in 2007. A greater proportion of women (78.1% during the study period) than men had this surgery. The average charge of a surgery decreased significantly from $44,484 in 1996 to $43,907 in 2007; by 2007, total annual charges were $13.9 million. Since 1996, private or "other" payers have been charged for nearly 80% of the total discharges. The number of gastric bypass surgeries has increased in New Hampshire, and so have their cost. These increases may reflect a shortage in effective primary care and preventive measures to address the obesity epidemic.

Trends and predictions to 2020 in breast cancer mortality in Europe.

PubMed

Carioli, Greta; Malvezzi, Matteo; Rodriguez, Teresa; Bertuccio, Paola; Negri, Eva; La Vecchia, Carlo

2017-12-01

We analyzed trends in mortality from breast cancer in women in 36 European countries and the European Union (EU) over the period 1970-2014, and predicted numbers of deaths and rates to 2020. We derived breast cancer death certification data and population figures from the World Health Organization and Eurostat databases. We obtained 2020 estimates using a joinpoint regression model. Overall, EU breast cancer mortality rates (world standard) declined from 17.9/100,000 in 2002 to 15.2 in 2012. The predicted 2020 rate is 13.4/100,000. The falls were largest in young women (20-49 years, -22% between 2002 and 2012). Within the EU, declines were larger in the United Kingdom (UK) and other northern and western European countries than in most central and eastern Europe. The UK has the second lowest predicted breast cancer mortality rate in 2020 (after Spain), starting from the highest one in 1970. Breast cancer mortality is predicted to rise in Poland, where the predicted 2020 rate is 15.3/100,000. We estimated that about 32,500 breast cancer deaths will be avoided in 2020 in the EU as compared to the peak rate of 1989, and a total of 475,000 breast cancer deaths over the period 1990-2020. The overall favourable breast cancer mortality trends are mainly due to a succession of improvements in the management and treatment of breast cancer, though early diagnosis and screening played a role, too. Improving breast cancer management in central and eastern Europe is a priority. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends in cervical cancer incidence and mortality in Poland: is there an impact of the introduction of the organised screening?

PubMed

Nowakowski, Andrzej; Wojciechowska, Urszula; Wieszczy, Paulina; Cybulski, Marek; Kamiński, Michał F; Didkowska, Joanna

2017-06-01

Aside from existing opportunistic screening, an organised screening programme (OSP) for cervical cancer (CC) was implemented in 2006/2007 in Poland. We applied joinpoint regression and age-period-cohort model to look for the impact of the OSP on CC incidence/mortality trends. Decline of age-standardised incidence rates (ASIRs) in the screening-age group (25-59 years) accelerated from -2.2% (95% CI -2.7 to -1.7%) between 1993 and 2008 to -6.1% (95% CI -7.7 to -4.4%) annually after 2008. In women aged 60+ years, ASIRs declined from 1986 until 2005 [annual percent change (APC) = -2.6%, 95% CI -2.9 to -2.4%] and stabilised thereafter. Decline of age-standardised mortality rates (ASMRs) in the screening-age group accelerated from -1.3% (95% CI -1.5 to -1.1%) between 1980 and 2005 to -4.7% (95% CI -5.6 to -3.8%) annually after 2005. In women aged 60+ ASMR declined between 1991 and 2004 (APC = -2.9%, 95% CI -3.5 to -2.3%) and stabilised thereafter. Relative risks of CC diagnosis and death were 0.63 (95% CI 0.62-0.65) and 0.61 (95% CI 0.59-0.63), respectively, for the most recent period compared to the reference around 1982. Implementation of the OSP possibly accelerated downward trends in the burden of CC in Polish women under the age of 60, but recent stabilisation of trends in older women requires actions.

Innovations in medical care and mortality trends from four circulatory diseases between 1970 and 2005.

PubMed

Hoffmann, Rasmus; Plug, Iris; McKee, Martin; Khoshaba, Bernadette; Westerling, Ragnar; Looman, Caspar; Rey, Gregoire; Jougla, Eric; Luis Alfonso, Jose; Lang, Katrin; Pärna, Kersti; Mackenbach, Johan P

2013-10-01

Governments have identified innovation in pharmaceuticals and medical technology as a priority for health policy. Although the contribution of medical care to health has been studied extensively in clinical settings, much less is known about its contribution to population health. We examine how innovations in the management of four circulatory disorders have influenced trends in cause-specific mortality at the population level. Based on literature reviews, we selected six medical innovations with proven effectiveness against hypertension, ischaemic heart disease, heart failure and cerebrovascular disease. We combined data on the timing of these innovations and cause-specific mortality trends (1970-2005) from seven European countries. We sought to identify associations between the introduction of innovations and favourable changes in mortality, using Joinpoint-models based on linear spline regression. For both ischaemic heart disease and cerebrovascular disease, the timing of medical innovations was associated with improved mortality in four out of five countries and five out of seven countries, respectively, depending on the innovation. This suggests that innovation has impacted positively on mortality at the population level. For hypertension and heart failure, such associations could not be identified. Although improvements in cause-specific mortality coincide with the introduction of some innovations, this is not invariably true. This is likely to reflect the incremental effects of many interventions, the time taken for them to be adopted fully and the presence of contemporaneous changes in disease incidence. Research on the impact of medical innovations on population health is limited by unreliable data on their introduction.

Breast cancer in South-Eastern European countries since 2000: Rising incidence and decreasing mortality at young and middle ages.

PubMed

Dimitrova, Nadya; Znaor, Ariana; Agius, Dominic; Eser, Sultan; Sekerija, Mario; Ryzhov, Anton; Primic-Žakelj, Maja; Coebergh, Jan Willem

2017-09-01

Marked variations exist in the incidence and mortality trends of major cancers in South-Eastern European (SEE) countries which have now been detailed by age for breast cancer (BC) to seek clues for improvement. We brought together and analysed data from 14 cancer registries (CRs), situated in SEE countries or directly adjacent. Age-standardised rate at world standard (ASRw) and truncated incidence and mortality rates during 2000-2010 by year, and for four age groups, were calculated. Average annual percentage change of rates was estimated using Joinpoint regression. Annual incidence rates increased significantly in countries and age groups, by 2-4% (15-39 years), 2-5% (40-49), 1-4% (50-69) and 1-6% (at 70+). Mortality rates decreased significantly in all age-groups in most countries, but increased up to 5% annually above age 55 in Ukraine, Serbia, Moldova and Cyprus. The BC data quality was evaluated by internationally agreed indicators which appeared suboptimal for Moldova, Bosnia and Herzegovina and Romania. The observed variations of incidence trends reflect the influence of risk factors, as well as levels of early detection activities (screening). While mortality rates were mostly decreasing, probably due to improved cancer care and introduction of more effective systemic treatment regimens, the worrying increasing mortality trends in the 55-plus age groups in some countries have to be addressed by health professionals and policymakers. In order to assess and monitor the effects of cancer control activities in the region, the CRs need substantial investments. Copyright © 2017 Elsevier Ltd. All rights reserved.

Worldwide trends in gastric cancer mortality (1980-2011), with predictions to 2015, and incidence by subtype.

PubMed

Ferro, Ana; Peleteiro, Bárbara; Malvezzi, Matteo; Bosetti, Cristina; Bertuccio, Paola; Levi, Fabio; Negri, Eva; La Vecchia, Carlo; Lunet, Nuno

2014-05-01

Gastric cancer incidence and mortality decreased substantially over the last decades in most countries worldwide, with differences in the trends and distribution of the main topographies across regions. To monitor recent mortality trends (1980-2011) and to compute short-term predictions (2015) of gastric cancer mortality in selected countries worldwide, we analysed mortality data provided by the World Health Organization. We also analysed incidence of cardia and non-cardia cancers using data from Cancer Incidence in Five Continents (2003-2007). The joinpoint regression over the most recent calendar periods gave estimated annual percent changes (EAPC) around -3% for the European Union (EU) and major European countries, as well as in Japan and Korea, and around -2% in North America and major Latin American countries. In the United States of America (USA), EU and other major countries worldwide, the EAPC, however, were lower than in previous years. The predictions for 2015 show that a levelling off of rates is expected in the USA and a few other countries. The relative contribution of cardia and non-cardia gastric cancers to the overall number of cases varies widely, with a generally higher proportion of cardia cancers in countries with lower gastric cancer incidence and mortality rates (e.g. the USA, Canada and Denmark). Despite the favourable mortality trends worldwide, in some countries the declines are becoming less marked. There still is the need to control Helicobacter pylori infection and other risk factors, as well as to improve diagnosis and management, to further reduce the burden of gastric cancer. Copyright © 2014 Elsevier Ltd. All rights reserved.

Leprosy and gender in Brazil: trends in an endemic area of the Northeast region, 2001–2014

PubMed Central

de Souza, Eliana Amorim; Ferreira, Anderson Fuentes; Boigny, Reagan Nzundu; Alencar, Carlos Henrique; Heukelbach, Jorg; Martins-Melo, Francisco Rogerlândio; Barbosa, Jaqueline Caracas; Ramos, Alberto Novaes

2018-01-01

ABSTRACT OBJECTIVE To analyze, stratifield by gender, trends of the new case leprosy detection rates in the general population and in children; of grade 2 disability, and of proportion of multibacillary cases, in the state of Bahia, Brazil from 2001 to 2014. METHODS A time series study based on leprosy data from the National Information System for Notifiable Diseases. The time trend analysis included Poisson regression models by infection points (Joinpoint) stratified by gender. RESULTS There was a total of 40,054 new leprosy cases with a downward trend of the overall detection rate (Average Annual Percent Change [AAPC = -0.4, 95%CI -2.8–1.9] and a non-significant increase in children under 15 years (AAPC = 0.2, 95%CI -3.9–4.5). The proportion of grade 2 disability among new cases increased significantly (AAPC = 4.0, 95%CI 1.3–6.8), as well as the proportion of multibacillary cases (AAPC = 2.2, 95%CI 0.1–4.3). Stratification by gender showed a downward trend of detection rates in females and no significant change in males; in females, there was a more pronounced upward trend of the proportion of multibacillary and grade 2 disability cases. CONCLUSIONS Leprosy is still highly endemic in the state of Bahia, with active transmission, late diagnosis, and a probable hidden endemic. There are different gender patterns, indicating the importance of early diagnosis and prompt treatment, specifically in males without neglecting the situation among females. PMID:29489990

Ridge: a computer program for calculating ridge regression estimates

Treesearch

Donald E. Hilt; Donald W. Seegrist

1977-01-01

Least-squares coefficients for multiple-regression models may be unstable when the independent variables are highly correlated. Ridge regression is a biased estimation procedure that produces stable estimates of the coefficients. Ridge regression is discussed, and a computer program for calculating the ridge coefficients is presented.

RAWS II: A MULTIPLE REGRESSION ANALYSIS PROGRAM,

DTIC Science & Technology

This memorandum gives instructions for the use and operation of a revised version of RAWS, a multiple regression analysis program. The program...of preprocessed data, the directed retention of variable, listing of the matrix of the normal equations and its inverse, and the bypassing of the regression analysis to provide the input variable statistics only. (Author)

SCI model structure determination program (OSR) user's guide. [optimal subset regression

NASA Technical Reports Server (NTRS)

1979-01-01

The computer program, OSR (Optimal Subset Regression) which estimates models for rotorcraft body and rotor force and moment coefficients is described. The technique used is based on the subset regression algorithm. Given time histories of aerodynamic coefficients, aerodynamic variables, and control inputs, the program computes correlation between various time histories. The model structure determination is based on these correlations. Inputs and outputs of the program are given.

Suicide rates in China, 2004-2014: comparing data from two sample-based mortality surveillance systems.

PubMed

Sha, Feng; Chang, Qingsong; Law, Yik Wa; Hong, Qi; Yip, Paul S F

2018-02-13

The decreasing suicide rate in China has been regarded as a major contributor to the decline of global suicide rate in the past decade. However, previous estimations on China's suicide rates might not be accurate, since often they were based on the data from the Ministry of Health's Vital Registration ("MOH-VR") System, which is biased towards the better-off population. This study aims to compare suicide data extracted from the MOH-VR System with a more representative mortality surveillance system, namely the Center for Disease Control and Prevention's Disease Surveillance Points ("CDC-DSP") System, and update China's national and subnational suicide rates in the period of 2004-2014. The CDC-DSP data are obtained from the National Cause-of-Death Surveillance Dataset (2004-2014) and the MOH-VR data are from the Chinese Health Statistics Yearbooks (2005-2012) and the China Health and Family Planning Statistics Yearbooks (2013-2015). First, a negative binomial regression model was used to test the associations between the source of data (CDC-DSP/MOH-VR) and suicide rates in 2004-2014. Joinpoint regression analyses and Kitagawa's decomposition method are then applied to analyze the trends of the crude suicide rates. Both systems indicated China's suicide rates decreased over the study period. However, before the two systems merged in 2013, the CDC-DSP System reported significantly higher national suicide rates (IRR = 1.18, 95% Confidence Interval [CI]: 1.13-1.24) and rural suicide rates (IRR = 1.29, 95% CI: 1.21-1.38) than the MOH-VR System. The CDC-DSP System also showed significant reversing points in 2011 (95% CI: 2006-2012) and 2006 (95% CI: 2006-2008) on the rural and urban suicide trends. Moreover, the suicide rates in the east and central urban regions were reversed in 2011 and 2008. The biased MOH-VR System underestimated China's national and rural suicide rates. Although not widely appreciated in the field of suicide research, the CDC-DSP System provides more accurate estimations on China's suicide rates and is recommended for future studies to monitor the reversing trends of suicide rates in China's more developed areas.

Treatment Utilization Among Adolescent Substance Users: Findings from the 2002 to 2013 National Survey on Drug Use and Health.

PubMed

Haughwout, Sarah P; Harford, Thomas C; Castle, I-Jen P; Grant, Bridget F

2016-08-01

Adolescent substance users face serious health and social consequences and benefit from early diagnosis and treatment. The objectives of this study were to observe trends in treatment utilization; examine correlates of treatment utilization and treatment types/settings among adolescent substance users with and without substance use disorder (SUD); and assess gender differences. National Survey on Drug Use and Health data were pooled across 2002 to 2013, with a combined sample of 79,885 past-year substance users ages 12 to 17 (17,510 with SUD and 62,375 without SUD). Treatment was defined as receiving treatment or counseling for use of alcohol or any drug, not counting cigarettes. Trends were assessed by joinpoint linear regression, and multivariable logistic regression assessed odds ratios of treatment utilization. Percentages of past-year treatment use did not change in 2002 to 2013. Treatment utilization was more prevalent among adolescents with SUD than without (11.4% vs. 1.4%) and among males than females. Among adolescents with and without SUD, criminal justice involvement and perceiving a need for treatment increased adolescent treatment utilization, while SUDs other than alcohol abuse, older age, and talking to parents increased treatment use among adolescents with SUD, and polysubstance use and male gender increased treatment among those without SUD. Treatment gaps persisted among non-Hispanic Blacks for both groups with and without SUD, male Hispanics with SUD, female non-Hispanic Asians without SUD, and private insurance coverages. Gender differences were observed in SUD, race/ethnicity, and insurance coverage. Most adolescents received treatment for both alcohol and drug use, and self-help group and outpatient rehabilitation facility were the most used treatment settings. Treatment utilization among adolescents with past-year substance use remained low and unimproved in 2002 to 2013. Treatment gaps among minority populations, insurance coverage, and in educating adolescents on seeking relevant treatment must be addressed. Using screening processes such as Screening, Brief Intervention, and Referral to Treatment, health professionals can help prevent lifelong SUD by recognizing and addressing substance misuse early. Copyright © 2016 by the Research Society on Alcoholism.

Nationwide summary of US Geological Survey regional regression equations for estimating magnitude and frequency of floods for ungaged sites, 1993

USGS Publications Warehouse

Jennings, M.E.; Thomas, W.O.; Riggs, H.C.

1994-01-01

For many years, the U.S. Geological Survey (USGS) has been involved in the development of regional regression equations for estimating flood magnitude and frequency at ungaged sites. These regression equations are used to transfer flood characteristics from gaged to ungaged sites through the use of watershed and climatic characteristics as explanatory or predictor variables. Generally these equations have been developed on a statewide or metropolitan area basis as part of cooperative study programs with specific State Departments of Transportation or specific cities. The USGS, in cooperation with the Federal Highway Administration and the Federal Emergency Management Agency, has compiled all the current (as of September 1993) statewide and metropolitan area regression equations into a micro-computer program titled the National Flood Frequency Program.This program includes regression equations for estimating flood-peak discharges and techniques for estimating a typical flood hydrograph for a given recurrence interval peak discharge for unregulated rural and urban watersheds. These techniques should be useful to engineers and hydrologists for planning and design applications. This report summarizes the statewide regression equations for rural watersheds in each State, summarizes the applicable metropolitan area or statewide regression equations for urban watersheds, describes the National Flood Frequency Program for making these computations, and provides much of the reference information on the extrapolation variables needed to run the program.

A primer for biomedical scientists on how to execute model II linear regression analysis.

PubMed

Ludbrook, John

2012-04-01

1. There are two very different ways of executing linear regression analysis. One is Model I, when the x-values are fixed by the experimenter. The other is Model II, in which the x-values are free to vary and are subject to error. 2. I have received numerous complaints from biomedical scientists that they have great difficulty in executing Model II linear regression analysis. This may explain the results of a Google Scholar search, which showed that the authors of articles in journals of physiology, pharmacology and biochemistry rarely use Model II regression analysis. 3. I repeat my previous arguments in favour of using least products linear regression analysis for Model II regressions. I review three methods for executing ordinary least products (OLP) and weighted least products (WLP) regression analysis: (i) scientific calculator and/or computer spreadsheet; (ii) specific purpose computer programs; and (iii) general purpose computer programs. 4. Using a scientific calculator and/or computer spreadsheet, it is easy to obtain correct values for OLP slope and intercept, but the corresponding 95% confidence intervals (CI) are inaccurate. 5. Using specific purpose computer programs, the freeware computer program smatr gives the correct OLP regression coefficients and obtains 95% CI by bootstrapping. In addition, smatr can be used to compare the slopes of OLP lines. 6. When using general purpose computer programs, I recommend the commercial programs systat and Statistica for those who regularly undertake linear regression analysis and I give step-by-step instructions in the Supplementary Information as to how to use loss functions. © 2011 The Author. Clinical and Experimental Pharmacology and Physiology. © 2011 Blackwell Publishing Asia Pty Ltd.

Disease Monitoring and Health Campaign Evaluation Using Google Search Activities for HIV and AIDS, Stroke, Colorectal Cancer, and Marijuana Use in Canada: A Retrospective Observational Study.

PubMed

Ling, Rebecca; Lee, Joon

2016-10-12

Infodemiology can offer practical and feasible health research applications through the practice of studying information available on the Web. Google Trends provides publicly accessible information regarding search behaviors in a population, which may be studied and used for health campaign evaluation and disease monitoring. Additional studies examining the use and effectiveness of Google Trends for these purposes remain warranted. The objective of our study was to explore the use of infodemiology in the context of health campaign evaluation and chronic disease monitoring. It was hypothesized that following a launch of a campaign, there would be an increase in information seeking behavior on the Web. Second, increasing and decreasing disease patterns in a population would be associated with search activity patterns. This study examined 4 different diseases: human immunodeficiency virus (HIV) infection, stroke, colorectal cancer, and marijuana use. Using Google Trends, relative search volume data were collected throughout the period of February 2004 to January 2015. Campaign information and disease statistics were obtained from governmental publications. Search activity trends were graphed and assessed with disease trends and the campaign interval. Pearson product correlation statistics and joinpoint methodology analyses were used to determine significance. Disease patterns and online activity across all 4 diseases were significantly correlated: HIV infection (r=.36, P<.001), stroke (r=.40, P<.001), colorectal cancer (r= -.41, P<.001), and substance use (r=.64, P<.001). Visual inspection and the joinpoint analysis showed significant correlations for the campaigns on colorectal cancer and marijuana use in stimulating search activity. No significant correlations were observed for the campaigns on stroke and HIV regarding search activity. The use of infoveillance shows promise as an alternative and inexpensive solution to disease surveillance and health campaign evaluation. Further research is needed to understand Google Trends as a valid and reliable tool for health research.

Trends in gastrointestinal cancer incidence in Iran, 2001-2010: a joinpoint analysis

PubMed Central

Motlagh, Ali; Karimi Jaberi, Maryam

2016-01-01

OBJECTIVES The main purpose of this study was to evaluate changes in the time trends of stomach, colorectal, and esophageal cancer during the past decade in Iran. METHODS Cancer incidence data for the years 2001 to 2010 were obtained from the cancer registration of the Ministry of Health. All incidence rates were directly age-standardized to the world standard population. In order to identified significant changes in time trends, we performed a joinpoint analysis. The annual percent change (APC) for each segment of the trends was then calculated. RESULTS The incidence of stomach cancer increased from 4.18 and 2.41 per 100,000 population in men and women, respectively, in 2001 to 17.06 (APC, 16.7%) and 8.85 (APC, 16.2%) per 100,000 population in 2010 for men and women, respectively. The corresponding values for colorectal cancer were 2.12 and 2.00 per 100,000 population for men and women, respectively, in 2001 and 11.28 (APC, 20.0%) and 10.33 (APC, 20.0%) per 100,000 in 2010. For esophageal cancer, the corresponding increase was from 3.25 and 2.10 per 100,000 population in 2001 to 5.57 (APC, 12.0%) and 5.62 (APC, 11.2%) per 100,000 population among men and women, respectively. The incidence increased most rapidly for stomach cancer in men and women aged 80 years and older (APC, 23.7% for men; APC, 18.6% for women), for colorectal cancer in men aged 60 to 69 years (APC, 24.2%) and in women aged 50 to 59 years (APC, 25.1%), and for esophageal cancer in men and women aged 80 years and older (APC, 17.5% for men; APC,15.3% for women) over the period of the study. CONCLUSIONS The incidence of gastrointestinal cancer significantly increased during the past decade. Therefore, monitoring the trends of cancer incidence can assist efforts for cancer prevention and control. PMID:27923268

Decline in new psychoactive substance use disorders following legislation targeting headshops: Evidence from national addiction treatment data.

PubMed

Smyth, Bobby P; Lyons, Suzi; Cullen, Walter

2017-09-01

New psychoactive substances (NPS) have hedonic effects that may lead to dependence. Headshops selling NPS increased in number in Ireland from late 2009. Legislation was enacted in May and August of 2010 that caused their closure. It is unknown whether such events impact the rate of NPS use disorders. We conducted a population-based study using the Irish national database of episodes of addiction treatment between 2009 and 2012. We examined trends in the rate of NPS-related treatment episodes among young adults. Joinpoint trend analysis software was used to identify significant changes in trend. Of the 31 284 episodes of addiction treatment commenced by adults aged 18 to 34 years, 756 (2.4%) were NPS related. In 2012, the 12-month moving average rate had fallen 48% from its peak in 2010, from 9.0/100 000 to 4.7/100 000. Joinpoint analysis indicated that the rate of NPS related episodes increased by 218% (95% confidence interval 86 to 445, P = 0.001) every 4 months until the first third of 2010. From that point, the rate declined by 9.8% (95% confidence interval -14.1 to -5.4, P = 0.001) per 4-month period. There was no significant trend change in the rate of non-NPS related treatment episodes. Over the 2 years after the enactment of prohibition-styled legislation targeting NPS and headshops, the rate of NPS related addiction treatment episodes among young adults declined progressively and substantially. We found no coinciding trend change in the rate of episodes linked to other drug groups. [Smyth BP, Lyons S, Cullen W. Decline in new psychoactive substance use disorders following legislation targeting headshops: Evidence fromnational addiction treatment data. Drug Alcohol Rev 2017;00:000-000]. © 2017 Australasian Professional Society on Alcohol and other Drugs.

Disease Monitoring and Health Campaign Evaluation Using Google Search Activities for HIV and AIDS, Stroke, Colorectal Cancer, and Marijuana Use in Canada: A Retrospective Observational Study

PubMed Central

2016-01-01

Background Infodemiology can offer practical and feasible health research applications through the practice of studying information available on the Web. Google Trends provides publicly accessible information regarding search behaviors in a population, which may be studied and used for health campaign evaluation and disease monitoring. Additional studies examining the use and effectiveness of Google Trends for these purposes remain warranted. Objective The objective of our study was to explore the use of infodemiology in the context of health campaign evaluation and chronic disease monitoring. It was hypothesized that following a launch of a campaign, there would be an increase in information seeking behavior on the Web. Second, increasing and decreasing disease patterns in a population would be associated with search activity patterns. This study examined 4 different diseases: human immunodeficiency virus (HIV) infection, stroke, colorectal cancer, and marijuana use. Methods Using Google Trends, relative search volume data were collected throughout the period of February 2004 to January 2015. Campaign information and disease statistics were obtained from governmental publications. Search activity trends were graphed and assessed with disease trends and the campaign interval. Pearson product correlation statistics and joinpoint methodology analyses were used to determine significance. Results Disease patterns and online activity across all 4 diseases were significantly correlated: HIV infection (r=.36, P<.001), stroke (r=.40, P<.001), colorectal cancer (r= −.41, P<.001), and substance use (r=.64, P<.001). Visual inspection and the joinpoint analysis showed significant correlations for the campaigns on colorectal cancer and marijuana use in stimulating search activity. No significant correlations were observed for the campaigns on stroke and HIV regarding search activity. Conclusions The use of infoveillance shows promise as an alternative and inexpensive solution to disease surveillance and health campaign evaluation. Further research is needed to understand Google Trends as a valid and reliable tool for health research. PMID:27733330

Internet search query analysis can be used to demonstrate the rapidly increasing public awareness of palliative care in the USA.

PubMed

McLean, Sarah; Lennon, Paul; Glare, Paul

2017-01-27

A lack of public awareness of palliative care (PC) has been identified as one of the main barriers to appropriate PC access. Internet search query analysis is a novel methodology, which has been effectively used in surveillance of infectious diseases, and can be used to monitor public awareness of health-related topics. We aimed to demonstrate the utility of internet search query analysis to evaluate changes in public awareness of PC in the USA between 2005 and 2015. Google Trends provides a referenced score for the popularity of a search term, for defined regions over defined time periods. The popularity of the search term 'palliative care' was measured monthly between 1/1/2005 and 31/12/2015 in the USA and in the UK. Results were analysed using independent t-tests and joinpoint analysis. The mean monthly popularity of the search term increased between 2008-2009 (p<0.001), 2011-2012 (p<0.001), 2013-2014 (p=0.004) and 2014-2015 (p=0.002) in the USA. Joinpoint analysis was used to evaluate the monthly percentage change (MPC) in the popularity of the search term. In the USA, the MPC increase was 0.6%/month (p<0.05); in the UK the MPC of 0.05% was non-significant. Although internet search query surveillance is a novel methodology, it is freely accessible and has significant potential to monitor health-seeking behaviour among the public. PC is rapidly growing in the USA, and the rapidly increasing public awareness of PC as demonstrated in this study, in comparison with the UK, where PC is relatively well established is encouraging in increasingly ensuring appropriate PC access for all. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

The impact of codeine re-scheduling on misuse: a retrospective review of calls to Australia's largest poisons centre.

PubMed

Cairns, Rose; Brown, Jared A; Buckley, Nicholas A

2016-10-01

Codeine is the most commonly used opioid in the world, and is available over the counter (OTC) in many countries, including Australia. Several countries are reconsidering codeine's OTC status due to concerns over addiction and misuse, with serious morbidity and mortality being reported. Australia's Therapeutic Goods Administration restricted codeine containing analgesics to 'Pharmacist Only' in 2010, and has recently been considering further up-scheduling to make codeine 'Prescription Only'. This paper estimated Australian trends of codeine misuse over the past 12 years, and examined whether trends changed following previous rescheduling efforts in 2010. A retrospective review of calls regarding codeine misuse made to the New South Wales Poisons Information Centre (NSWPIC, Australia's largest poisons centre), 2004-15. Joinpoint software was used to quantify the average annual change in calls, and whether there was a significant change in trend at any time, including following rescheduling. Australia. Four hundred patients about whom a call was made to the NSWPIC. Calls per year, patient age, gender, tablets taken per day, formulation used, symptom disposition. The NSWPIC database contained 400 cases of codeine combination analgesic misuse from 2004 to 2015. Joinpoint analysis showed that the frequency of cases increased significantly from 2004 to 2015, with an average annual percentage change (AAPC) of 19.5% [95% confidence interval (CI) = 13.8-25.5% P < 0.0001] for paracetamol/codeine and 17.9% (95% CI = 7.9-28.9%, P < 0.01) for ibuprofen/codeine. No significant change in trend was seen at any time, including following 2010 rescheduling. The median age of patients was 34 and 27 years for paracetamol/codeine and ibuprofen/codeine cases, respectively. Gender distribution was approximately equal. Clinical features reported were consistent with codeine, paracetamol and ibuprofen toxicity. Misuse of codeine combination products appears to be increasing in Australia. Limited rescheduling in 2010 failed to curb this increase. © 2016 Society for the Study of Addiction.

Trends in stroke hospitalisation rates in Extremadura between 2002 and 2014: Changing the notion of stroke as a disease of the elderly.

PubMed

Ramírez-Moreno, J M; Felix-Redondo, F J; Fernández-Bergés, D; Lozano-Mera, L

2016-10-21

The incidence of stroke in Spain has been evaluated in several studies, whose results are highly variable and not comparable. No studies of stroke have analysed epidemiological changes in younger patients. We conducted a retrospective observational study using the Spanish health system's Minimum Data Set and included all patients older than 19 hospitalised due to stroke (ICD-9-CM codes 434.01, 434.11, 434.91, 430, 431, 432.9, 436, and 435) between 2002 and 2013. The analysis was performed using joinpoint regression. A total of 39,321 patients were identified (47.25% were women); 3.73% were aged 20-44, 6.29% were 45-54, 11.49% were 55-64, 23.89% were 65-74, and 54.60% were > 74 years. The hospitalisation rate due to ischaemic stroke has increased significantly in men aged 45-54 (+6.7%; 95% CI, 3.3-10.2) and in women aged 20-44 and 45-54 (+6.1%; 95% CI, 0.8-11.7 and +5.7%; 95% CI, 3.0-8.4, respectively). We also observed a significant increase in the rate of hospitalisation due to ischaemic stroke in men aged over 74 (+4.2%; 95% CI, 1.3-7.2). The rate of hospitalisations due to transient ischaemic attack has also increased significantly whereas the rate of hospitalisations due to brain haemorrhage has stabilised over time. Our results provide indirect evidence that the epidemiological profile of stroke is changing based on the increase in hospitalisation rates in young adults. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital

PubMed Central

Yang, Dong

2016-01-01

Background Universal Zero-Markup Drug Policy (UZMDP) mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China’s National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST). Methods This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT) 2009–2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively. Results In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH) in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively) and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively), while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4%) and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%). Conclusion Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital. PMID:27627811

Firearm injuries in the United States.

PubMed

Fowler, Katherine A; Dahlberg, Linda L; Haileyesus, Tadesse; Annest, Joseph L

2015-10-01

This paper examines the epidemiology of fatal and nonfatal firearm violence in the United States. Trends over two decades in homicide, assault, self-directed and unintentional firearm injuries are described along with current demographic characteristics of victimization and health impact. Fatal firearm injury data were obtained from the National Vital Statistics System (NVSS). Nonfatal firearm injury data were obtained from the National Electronic Injury Surveillance System (NEISS). Trends were tested using Joinpoint regression analyses. CDC Cost of Injury modules were used to estimate costs associated with firearm deaths and injuries. More than 32,000 persons die and over 67,000 persons are injured by firearms each year. Case fatality rates are highest for self-harm related firearm injuries, followed by assault-related injuries. Males, racial/ethnic minority populations, and young Americans (with the exception of firearm suicide) are disproportionately affected. The severity of such injuries is distributed relatively evenly across outcomes from outpatient treatment to hospitalization to death. Firearm injuries result in over $48 billion in medical and work loss costs annually, particularly fatal firearm injuries. From 1993 to 1999, rates of firearm violence declined significantly. Declines were seen in both fatal and nonfatal firearm violence and across all types of intent. While unintentional firearm deaths continued to decline from 2000 to 2012, firearm suicides increased and nonfatal firearm assaults increased to their highest level since 1995. Firearm injuries are an important public health problem in the United States, contributing substantially each year to premature death, illness, and disability. Understanding the nature and impact of the problem is only a first step toward preventing firearm violence. A science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving measurable reductions in firearm violence. Published by Elsevier Inc.

Recent trends in breast cancer incidence in US white women by county-level urban/rural and poverty status.

PubMed

Hausauer, Amelia K; Keegan, Theresa H M; Chang, Ellen T; Glaser, Sally L; Howe, Holly; Clarke, Christina A

2009-06-26

Unprecedented declines in invasive breast cancer rates occurred in the United States between 2001 and 2004, particularly for estrogen receptor-positive tumors among non-Hispanic white women over 50 years. To understand the broader public health import of these reductions among previously unstudied populations, we utilized the largest available US cancer registry resource to describe age-adjusted invasive and in situ breast cancer incidence trends for non-Hispanic white women aged 50 to 74 years overall and by county-level rural/urban and poverty status. We obtained invasive and in situ breast cancer incidence data for the years 1997 to 2004 from 29 population-based cancer registries participating in the North American Association of Central Cancer Registries resource. Annual age-adjusted rates were examined overall and by rural/urban and poverty of patients' counties of residence at diagnosis. Joinpoint regression was used to assess trends by annual quarter of diagnosis. Between 2001 and 2004, overall invasive breast cancer incidence fell 13.2%, with greater reductions among women living in urban (-13.8%) versus rural (-7.5%) and low- (-13.0%) or middle- (-13.8%) versus high- (-9.6%) poverty counties. Most incidence rates peaked around 1999 then declined after second quarter 2002, although in rural counties, rates decreased monotonically after 1999. Similar but more attenuated patterns were seen for in situ cancers. Breast cancer rates fell more substantially in urban and low-poverty, affluent counties than in rural or high-poverty counties. These patterns likely reflect a major influence of reductions in hormone therapy use after July 2002 but cannot exclude possible effects due to screening patterns, particularly among rural populations where hormone therapy use was probably less prevalent.

Dialysis for end stage renal disease financed through the Brazilian National Health System, 2000 to 2012

PubMed Central

2014-01-01

Background Chronic kidney disease has become a public health problem worldwide. Its terminal stage requires renal replacement therapy – dialysis or transplantation – for the maintenance of life, resulting in high economic and social costs. Though the number of patients with end-stage renal disease treated by dialysis in Brazil is among the highest in the world, current estimates of incidence and prevalence are imprecise. Our aim is to describe incidence and prevalence trends and the epidemiologic profile of end-stage renal disease patients receiving publically-financed dialysis in Brazil between 2000 and 2012. Methods We internally linked records of the High Complexity Procedure Authorization/Renal Replacement Therapy (APAC/TRS) system so as to permit analyses of incidence and prevalence of dialysis over the period 2000-2012. We characterized temporal variations in the incidence and prevalence using Joinpoint regression. Results Over the period, 280,667 patients received publically-financed dialysis, 57.2% of these being male. The underlying disease causes listed were hypertension (20.8%), diabetes (12.0%) and glomerulonephritis (7.7%); for 42.3%, no specific cause was recorded. Hemodialysis was the therapeutic modality in 90.1%. Over this period, prevalence increased 47%, rising 3.6% (95% CI 3.2% - 4.0%)/year. Incidence increased 20%, or 1.8% (1.1% – 2.5%)/year. Incidence increased in both sexes, in all regions of the country and particularly in older age groups. Conclusions Incidence and prevalence of end-stage renal disease receiving publically-financed dialysis treatment has increased notably. The linkage approach developed will permit continuous future monitoring of these indicators. PMID:25008169

[Trends in mortality by assault in women in selected countries of Latin America, 2001-2011].

PubMed

Molinatti, Florencia; Acosta, Laura Débora

2015-05-01

Describe the trend in deaths by assault in women in Argentina, Brazil, Chile, Colombia, and Mexico between 2001 and 2011. Descriptive study. Mortality from assaults and undetermined intentional acts was calculated, adjusted for age, using the direct method and the World Health Organization's standard population. Joinpoint regression models were used to identify statistically significant changes. The male:female mortality ratio was compared and trends in the rates were calculated and adjusted for each of the two causes of death and the specific rates of mortality by assault in women by age group. The highest rates of assault of women were reported in Brazil, followed by Colombia, Mexico, Argentina, and Chile. Between 2001 and 2011, decreases were reported from Argentina and Colombia; in Brazil and Mexico the rates increased; and in Chile they remained stable. The highest specific rates were found in young women (15-29 years) and adults (30-44 and 45-59 years). In Colombia the rates declined in all groups, while in Mexico they increased in women aged 15 to 59 years. Only Colombia showed a decrease in mortality from undetermined intentional acts; in Argentina and Mexico there was a decrease at the beginning of the period with a later increase; in Brazil no variations were observed. Mortality from assaults on women in Brazil, Colombia, and Mexico between 2001 and 2011 was higher than the world average and the Latin American average; rates were lower in Argentina and Chile, with minor differences between the sexes. Progress must be made in terms of understanding the power relationships that underlie femicide, which should be included in national criminal legislation.

Is Patient Safety Improving? National Trends in Patient Safety Indicators: 1998–2007

PubMed Central

Downey, John R; Hernandez-Boussard, Tina; Banka, Gaurav; Morton, John M

2012-01-01

Context Emphasis has been placed on quality and patient safety in medicine; however, little is known about whether quality over time has actually improved in areas such as patient safety indicators (PSIs). Objective To determine whether national trends for hospital PSIs have improved from 1998 to 2007. Design, Setting, and Participants Using PSI criteria from the Agency for Healthcare Research and Quality, PSIs were identified in the Nationwide Inpatient Sample (NIS) for all eligible inpatient admissions between 1998 and 2007. Joinpoint regression was used to estimate annual percentage changes (APCs) for PSIs. Main Outcome Measure Annual percent change for PSIs. Results From 1998 to 2007, 7.6 million PSI events occurred for over 69 million hospitalizations. A total of 14 PSIs showed statistically significant trends. Seven PSIs had increasing APC: postoperative pulmonary embolism or deep vein thrombosis (8.94), postoperative physiological or metabolic derangement (7.67), postoperative sepsis (7.17), selected infections due to medical care (4.05), decubitus ulcer (3.05), accidental puncture or laceration (2.64), and postoperative respiratory failure (1.46). Seven PSIs showed decreasing APCs: birth trauma injury to neonate (−17.79), failure to rescue (−6.05), postoperative hip fracture (−5.86), obstetric trauma–vaginal without instrument (−5.69), obstetric trauma–vaginal with instrument (−4.11), iatrogenic pneumothorax (−2.5), and postoperative wound dehiscence (−1.8). Conclusion This is the first study to establish national trends of PSIs during the past decade indicating areas for potential quality improvement prioritization. While many factors influence these trends, the results indicate opportunities for either emulation or elimination of current patient safety trends. PMID:22150789

[Divergent Trends in Suicide Mortality in Navarra and Spain: 2000-2015].

PubMed

Delfrade, Josu; Sayón-Orea, Carmen; Teijeira-Álvarez, Rafael; Floristán-Floristán, Yugo; Moreno-Iribas, Conchi

2017-05-03

The aim of this study was to know the suicide mortality rates in Navarra and Spain and to compare their time trends during the period 2000-2015. Suicide data were obtained from the Instituto Nacional de Estadística [INE], Spain’s National Statistics Institute. During all the period, the coding of cause of death in Navarra was carried out using data from forensic autopsies, while in some Spanish regions this process started after 2010. A Joinpoint time series regression model was used to assess the time trend and estimate the annual percent change [APC] of the rates by sex and 4 age groups. Suicide mortality in Spain showed a significant downward trend in the overall rate between 2000-2011 [APC of -1.93% in males and -2.19% in females] followed by a significant increase in 2012-2015 [APC: 3.65% in men and 7.60% in women]. No inflection points were observed in men aged 25-44 [APC:1.26%], 45-64 [APC: 1.63%], and women over 65 years [APC:-2.18%]. In Navarra, global rates in men showed a non significant decrease [APC:-1.56%] and a significant decrease in the group of men between 25-44 years [APC:-3.19%]. Among women we observed a non significant increase [APC: 0.74%]. The rise in overall suicide rates observed in Spain since 2011, that was not observed in Navarre, could be influenced by the improvements in coding methods in several Spanish regions. However, this could not explain the decrease observed during the all period in men aged 25-44, that was even larger in Navarra.

Pneumonia Mortality in Children Aged <5 Years in 56 Countries: A Retrospective Analysis of Trends from 1960 to 2012.

PubMed

Wu, Jie; Yang, Shigui; Cao, Qing; Ding, Cheng; Cui, Yuanxia; Zhou, Yuqing; Li, Yiping; Deng, Min; Wang, Chencheng; Xu, Kaijin; Ruan, Bing; Li, Lanjuan

2017-10-30

Pneumonia is now the second leading cause of death for children aged <5 years worldwide. However, analyses of the long-term evolution of under-5 mortality from pneumonia are still scarce in the literature. We aimed to explore long-term trends of under-5 mortality from pneumonia in 56 countries from 1960 to 2012. Data on under-5 mortality from pneumonia were extracted from the World Health Organization mortality database. Long-term trends were assessed for 56 countries and for 4 national income transition groups. We also used joinpoint regression analysis to detect distinct period segments of long-term trends and estimate the annual percent of changes of each period segment. The average mortality rate from pneumonia for children aged 0-4 years in 56 countries declined from 163.0 per 100000 children (95% confidence interval [CI], 119.4 to 212.8) in 1960 to 9.9 per 100000 children (95% CI, 6.4 to 13.4) in 2012, with an average annual percent of change of -5.6% (95% CI, -7.2% to -3.9%). The temporal trends of childhood mortality were different between national income transition groups. Our findings suggest a striking overall downward trend in under-5 mortality from pneumonia between 1960 and 2012. However, the rate and absolute terms of decline differ by national income transition group. These variable patterns between national income transition groups may inform further intervention setting and priority setting. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Association of A1C and Fasting Plasma Glucose Levels With Diabetic Retinopathy Prevalence in the U.S. Population

PubMed Central

Cheng, Yiling J.; Gregg, Edward W.; Geiss, Linda S.; Imperatore, Giuseppina; Williams, Desmond E.; Zhang, Xinzhi; Albright, Ann L.; Cowie, Catherine C.; Klein, Ronald; Saaddine, Jinan B.

2009-01-01

OBJECTIVE To examine the association of A1C levels and fasting plasma glucose (FPG) with diabetic retinopathy in the U.S. population and to compare the ability of the two glycemic measures to discriminate between people with and without retinopathy. RESEARCH DESIGN AND METHODS This study included 1,066 individuals aged ≥40 years from the 2005–2006 National Health and Nutrition Examination Survey. A1C, FPG, and 45° color digital retinal images were assessed. Retinopathy was defined as a level ≥14 on the Early Treatment Diabetic Retinopathy Study severity scale. We used joinpoint regression to identify linear inflections of prevalence of retinopathy in the association between A1C and FPG. RESULTS The overall prevalence of retinopathy was 11%, which is appreciably lower than the prevalence in people with diagnosed diabetes (36%). There was a sharp increase in retinopathy prevalence in those with A1C ≥5.5% or FPG ≥5.8 mmol/l. After excluding 144 people using hypoglycemic medication, the change points for the greatest increase in retinopathy prevalence were A1C 5.5% and FPG 7.0 mmol/l. The coefficients of variation were 15.6 for A1C and 28.8 for FPG. Based on the areas under the receiver operating characteristic curves, A1C was a stronger discriminator of retinopathy (0.71 [95% CI 0.66–0.76]) than FPG (0.65 [0.60 – 0.70], P for difference = 0.009). CONCLUSIONS The steepest increase in retinopathy prevalence occurs among individuals with A1C ≥5.5% and FPG ≥5.8 mmol/l. A1C discriminates prevalence of retinopathy better than FPG. PMID:19875604

Brief Report: Rheumatoid Arthritis as the Underlying Cause of Death in Thirty-One Countries, 1987-2011: Trend Analysis of World Health Organization Mortality Database.

PubMed

Kiadaliri, Aliasghar A; Felson, David T; Neogi, Tuhina; Englund, Martin

2017-08-01

To examine trends in rheumatoid arthritis (RA) as an underlying cause of death (UCD) in 31 countries across the world from 1987 to 2011. Data on mortality and population were collected from the World Health Organization mortality database and from the United Nations Population Prospects database. Age-standardized mortality rates (ASMRs) were calculated by means of direct standardization. We applied joinpoint regression analysis to identify trends. Between-country disparities were examined using between-country variance and the Gini coefficient. Due to low numbers of deaths, we smoothed the ASMRs using a 3-year moving average. Changes in the number of RA deaths between 1987 and 2011 were decomposed using 2 counterfactual scenarios. The absolute number of deaths with RA registered as the UCD decreased from 9,281 (0.12% of all-cause deaths) in 1987 to 8,428 (0.09% of all-cause deaths) in 2011. The mean ASMR decreased from 7.1 million person-years in 1987-1989 to 3.7 million person-years in 2009-2011 (48.2% reduction). A reduction of ≥25% in the ASMR occurred in 21 countries, while a corresponding increase was observed in 3 countries. There was a persistent reduction in RA mortality, and on average, the ASMR declined by 3.0% per year. The absolute and relative between-country disparities decreased during the study period. The rates of mortality attributable to RA have declined globally. However, we observed substantial between-country disparities in RA mortality, although these disparities decreased over time. Population aging combined with a decline in RA mortality may lead to an increase in the economic burden of disease that should be taken into consideration in policy-making. © 2017, American College of Rheumatology.

The Trends in Cardiovascular Diseases and Respiratory Diseases Mortality in Urban and Rural China, 1990-2015.

PubMed

Sun, Weiwei; Zhou, Yun; Zhang, Zhuang; Cao, Limin; Chen, Weihong

2017-11-15

With the rapid development of the economy over the past 20 years, the mortality rates from cardiovascular diseases (CVDs) and respiratory diseases (RDs) have changed in China. This study aimed to analyze the trends of mortality rates and years of life lost (YLLs) from CVDs and RDs in the rural and urban population from 1990 to 2015. Using data from Chinese yearbooks, joinpoint regression analysis was employed to estimate the annual percent change (APC) of mortality rates from CVDs and RDs. YLLs due to CVDs and RDs were calculated by a standard method, adopting recommended standard life expectancy at birth values of 80 years for men and 82.5 years for women. Age-standardized mortality rates and YLL rates were calculated by using the direct method based on the Chinese population from the sixth population census of 2010. Age-standardized mortality rates from CVDs for urban residents and from RDs for both urban and rural residents showed decreasing trends in China from 1990 to 2015. Age-standardized mortality rates from CVDs among rural residents remained constant during above period and outstripped those among urban residents gradually. The age-standardized YLL rates of CVDs for urban and rural residents decreased 35.2% and 8.3% respectively. Additionally, the age-standardized YLL rates of RDs for urban and rural residents decreased 64.2% and 79.0% respectively. The age-standardized mortality and YLL rates from CVDs and RDs gradually decreased in China from 1990 to 2015. We observed more substantial declines of the mortality rates from CVDs in urban areas and from RDs in rural areas.

Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men.

PubMed

Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo

2016-12-05

Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984-2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): -3.1 (95% CI, -4.6 to -1.6)) and lung cancers decreased from 2002 to 2013 (APC -2.4 (95% CI -2.7 to -2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC -2.5 (95% CI -4.1 to -0.8)) and from 2002 to 2013 (APC -5.2 (95% CI -5.7 to -4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): -3.3 (95% CI -4.7 to -1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates.

Medical Expenditures Associated With Hypertension in the U.S., 2000-2013.

PubMed

Zhang, Donglan; Wang, Guijing; Zhang, Ping; Fang, Jing; Ayala, Carma

2017-12-01

Trends of prevalence, treatment, and control of hypertension have been documented in the U.S., but changes in medical expenditures associated with hypertension over time have not been evaluated. This study analyzed these expenditures during 2000-2013 among U.S. adults. Data from the Medical Expenditure Panel Survey were analyzed in 2016. The study population was non-institutionalized men and non-pregnant women aged ≥18 years. Hypertension was defined as ever been diagnosed with hypertension or currently taking antihypertensive medications. Medical expenditures included all payments to medical care providers. Expenditures associated with hypertension were estimated by two-part regression models and adjusted into 2015 U.S. dollars. Controlling variables included sociodemographic characteristics, marital status, insurance, region, smoking status, weight status, health status, and comorbidities. Trends were analyzed using joinpoint method. Total per-person annual expenditures associated with hypertension in 2000-2001 ($1,399) were not significantly different from those in 2012-2013 ($1,494) (average annual percent change [AAPC]= -0.6%, p=0.794), but annual national spending increased significantly from $58.7 billion to $109.1 billion (AAPC=8.3%, p=0.015), mainly because of the increase in the number of people treated for hypertension. Per-person outpatient payments were 22.7% higher in 2012-2013 than in 2000-2001 ($416 vs $322, p<0.05; AAPC=0.8%, p-trend=0.826). Payments for prescription medications took up a larger proportion of the medical expenditures associated with hypertension, compared to payments for outpatient or other services (33%-46%). During 2000-2013, annual national medical expenditures associated with hypertension increased significantly. Preventing hypertension could alleviate hypertension-associated economic burden. Copyright © 2017 American Journal of Preventive Medicine. All rights reserved.

Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men

PubMed Central

Jee, Yon Ho; Shin, Aesun; Lee, Jong-Keun; Oh, Chang-Mo

2016-01-01

Background: This study aimed to examine trends in smoking-related cancer mortality rates and to investigate the effect birth cohort on smoking-related cancer mortality in Korean men. Methods: The number of smoking-related cancer deaths and corresponding population numbers were obtained from Statistics Korea for the period 1984–2013. Joinpoint regression analysis was used to detect changes in trends in age-standardized mortality rates. Birth-cohort specific mortality rates were illustrated by 5 year age groups. Results: The age-standardized mortality rates for oropharyngeal decreased from 2003 to 2013 (annual percent change (APC): −3.1 (95% CI, −4.6 to −1.6)) and lung cancers decreased from 2002 to 2013 (APC −2.4 (95% CI −2.7 to −2.2)). The mortality rates for esophageal declined from 1994 to 2002 (APC −2.5 (95% CI −4.1 to −0.8)) and from 2002 to 2013 (APC −5.2 (95% CI −5.7 to −4.7)) and laryngeal cancer declined from 1995 to 2013 (average annual percent change (AAPC): −3.3 (95% CI −4.7 to −1.8)). By the age group, the trends for the smoking-related cancer mortality except for oropharyngeal cancer have changed earlier to decrease in the younger age group. The birth-cohort specific mortality rates and age-period-cohort analysis consistently showed that all birth cohorts born after 1930 showed reduced mortality of smoking-related cancers. Conclusions: In Korean men, smoking-related cancer mortality rates have decreased. Our findings also indicate that current decreases in smoking-related cancer mortality rates have mainly been due to a decrease in the birth cohort effect, which suggest that decrease in smoking rates. PMID:27929405

Using Hashimoto thyroiditis as gold standard to determine the upper limit value of thyroid stimulating hormone in a Chinese cohort.

PubMed

Li, Yu; Chen, Dong-Ning; Cui, Jing; Xin, Zhong; Yang, Guang-Ran; Niu, Ming-Jia; Yang, Jin-Kui

2016-11-06

Subclinical hypothyroidism, commonly caused by Hashimoto thyroiditis (HT), is a risk factor for cardiovascular diseases. This disorder is defined as merely having elevated serum thyroid stimulating hormone (TSH) levels. However, the upper limit of reference range for TSH is debated recently. This study was to determine the cutoff value for the upper normal limit of TSH in a cohort using the prevalence of Hashimoto thyroiditis as "gold" calibration standard. The research population was medical staff of 2856 individuals who took part in health examination annually. Serum free triiodothyronine (FT3), free thyroxine (FT4), TSH, thyroid peroxidase antibody (TPAb), thyroglobulin antibody (TGAb) and other biochemistry parameters were tested. Meanwhile, thyroid ultrasound examination was performed. The diagnosis of HT was based on presence of thyroid antibodies (TPAb and TGAb) and abnormalities of thyroid ultrasound examination. We used two different methods to estimate the cutoff point of TSH based on the prevalence of HT. Joinpoint regression showed the prevalence of HT increased significantly at the ninth decile of TSH value corresponding to 2.9 mU/L. ROC curve showed a TSH cutoff value of 2.6 mU/L with the maximized sensitivity and specificity in identifying HT. Using the newly defined cutoff value of TSH can detect patients with hyperlipidemia more efficiently, which may indicate our approach to define the upper limit of TSH can make more sense from the clinical point of view. A significant increase in the prevalence of HT occurred among individuals with a TSH of 2.6-2.9 mU/L made it possible to determine the cutoff value of normal upper limit of TSH.

The effectiveness of national guidance in changing analgesic prescribing in primary care from 2002 to 2009: An observational database study

PubMed Central

Bedson, J; Belcher, J; Martino, OI; Ndlovu, M; Rathod, T; Walters, K; Dunn, KM; Jordan, KP

2013-01-01

Background Numerous national guidelines have been issued to assist general practitioners’ safe analgesic prescribing. Their effectiveness is unclear. The objective of this study was to examine trends in general practitioners’ prescribing behaviour in relation to national guidelines. Methods This was a retrospective observational database study of registered adult patients prescribed an analgesic (2002–2009) from the Consultations in Primary Care Archive – 12 North Staffordshire general practices. Prescribing guidance from the UK Medicines Regulatory Health Authority (MHRA) regarding non-steroidal anti-inflammatory drugs (NSAIDs) and co-proxamol, and the National Institute for Health and Clinical Excellence (NICE) osteoarthritis (OA) management guidelines were considered. Analgesic prescribing rates were examined, arranged according to a classification of six equipotent medication groups: (1) basic analgesics; (2)–(5) increasingly potent opioids and (6) NSAIDs. In each quarter from 2002 to 2009, the number of patients per 10,000 registered population receiving a prescription for the first time from each group was determined. Quarters associated with significant changes in the underlying prescribing trend were determined using joinpoint regression. Results A significant decrease in incident co-proxamol and Cox-2 prescribing occurred around the time of the first MHRA advice to stop using them and were rarely prescribed thereafter. The new prescribing of weak analgesics (e.g., co-codamol 8/500) increased at this same time. Initiating topical NSAIDs significantly increased around the time of the NICE OA guidelines. Conclusions Significant prescribing changes occurred when national advice and guidelines were issued. The effectiveness of this advice may vary depending upon the content and method of dissemination. Further evaluation of the optimal methods for delivering prescribing guidance is required. PMID:22865816

The International Epidemiology of Lung Cancer: Latest Trends, Disparities, and Tumor Characteristics

PubMed Central

Cheng, Ting-Yuan David; Cramb, Susanna M.; Baade, Peter D.; Youlden, Danny R.; Nwogu, Chukwumere; Reid, Mary E.

2017-01-01

Introduction We aim to update global lung cancer epidemiology and describe changing trends and disparities. Methods We presented country-specific incidence and mortality from GLOBOCAN 2012, by region and socioeconomic factors via the Human Development Index (HDI). Between- and within-country incidence by histological type was analyzed from Cancer Incidence in Five Continents Volume X (IARC). Trend analyses including the IARC data, cancer registries, and the WHO Mortality database were conducted using Joinpoint regression. Survival was compared between and within countries, and by histology. Results In 2012, there were 1.82 and 1.59 million new cases and deaths of lung cancer worldwide, respectively. Incidence was highest in very high HDI countries and lowest in low HDI countries (42.2 vs. 7.9/100,000 for males and 21.8 vs. 3.1/100,000 for females, respectively). In most countries with a very high HDI, as male incidence decreased gradually (ranging from −0.3% in Spain to −2.5% in the USA each year), female incidence continued to increase (by 1.4% each year in Australia to 6.1% in recent years in Spain). While histology varied between countries, adenocarcinoma was more common than squamous cell carcinoma, particularly among females (e.g., in Chinese females, the adenocarcinoma-to-squamous cell carcinoma ratio=6.6). Five-year relative survival varied from 2% (Libya) to 30% (Japan), with substantial within-country differences. Conclusion Lung cancer will continue to be a major health problem well through the first half of this century. Preventive strategies, particularly tobacco control, tailored to populations at highest risk are key to reduce the global burden of lung cancer. PMID:27364315

Firearm injuries in the United States

PubMed Central

Fowler, Katherine A.; Dahlberg, Linda L.; Haileyesus, Tadesse; Annest, Joseph L.

2015-01-01

Objective This paper examines the epidemiology of fatal and nonfatal firearm violence in the United States. Trends over two decades in homicide, assault, self-directed and unintentional firearm injuries are described along with current demographic characteristics of victimization and health impact. Method Fatal firearm injury data were obtained from the National Vital Statistics System (NVSS). Nonfatal firearm injury data were obtained from the National Electronic Injury Surveillance System (NEISS). Trends were tested using Joinpoint regression analyses. CDC Cost of Injury modules were used to estimate costs associated with firearm deaths and injuries. Results More than 32,000 persons die and over 67,000 persons are injured by firearms each year. Case fatality rates are highest for self-harm related firearm injuries, followed by assault-related injuries. Males, racial/ethnic minority populations, and young Americans (with the exception of firearm suicide) are disproportionately affected. The severity of such injuries is distributed relatively evenly across outcomes from outpatient treatment to hospitalization to death. Firearm injuries result in over $48 billion in medical and work loss costs annually, particularly fatal firearm injuries. From 1993 to 1999, rates of firearm violence declined significantly. Declines were seen in both fatal and nonfatal firearm violence and across all types of intent. While unintentional firearm deaths continued to decline from 2000 to 2012, firearm suicides increased and nonfatal firearm assaults increased to their highest level since 1995. Conclusion Firearm injuries are an important public health problem in the United States, contributing substantially each year to premature death, illness, and disability. Understanding the nature and impact of the problem is only a first step toward preventing firearm violence. A science-driven approach to understand risk and protective factors and identify effective solutions is key to achieving measurable reductions in firearm violence. PMID:26116133

Medicaid Coverage for Tobacco Dependence Treatments in Massachusetts and Associated Decreases in Smoking Prevalence

PubMed Central

Land, Thomas; Warner, Donna; Paskowsky, Mark; Cammaerts, Ayesha; Wetherell, LeAnn; Kaufmann, Rachel; Zhang, Lei; Malarcher, Ann; Pechacek, Terry; Keithly, Lois

2010-01-01

Background Approximately 50% of smokers die prematurely from tobacco-related diseases. In July 2006, the Massachusetts health care reform law mandated tobacco cessation coverage for the Massachusetts Medicaid population. The new benefit included behavioral counseling and all medications approved for tobacco cessation treatment by the U.S. Food and Drug Administration (FDA). Between July 1, 2006 and December 31, 2008, a total of 70,140 unique Massachusetts Medicaid subscribers used the newly available benefit, which is approximately 37% of all Massachusetts Medicaid smokers. Given the high utilization rate, the objective of this study is to determine if smoking prevalence decreased significantly after the initiation of tobacco cessation coverage. Methods and Findings Smoking prevalence was evaluated pre- to post-benefit using 1999 through 2008 data from the Massachusetts Behavioral Risk Factor Survey (BRFSS). The crude smoking rate decreased from 38.3% (95% C.I. 33.6%–42.9%) in the pre-benefit period compared to 28.3% (95% C.I.: 24.0%–32.7%) in the post-benefit period, representing a decline of 26 percent. A demographically adjusted smoking rate showed a similar decrease in the post-benefit period. Trend analyses reflected prevalence decreases that accrued over time. Specifically, a joinpoint analysis of smoking prevalence among Massachusetts Medicaid benefit-eligible members (age 18–64) from 1999 through 2008 found a decreasing trend that was coincident with the implementation of the benefit. Finally, a logistic regression that controlled for demographic factors also showed that the trend in smoking decreased significantly from July 1, 2006 to December 31, 2008. Conclusion These findings suggest that a tobacco cessation benefit that includes coverage for medications and behavioral treatments, has few barriers to access, and involves broad promotion can significantly reduce smoking prevalence. PMID:20305787

Pancreatic cancer death rates by race among US men and women, 1970-2009.

PubMed

Ma, Jiemin; Siegel, Rebecca; Jemal, Ahmedin

2013-11-20

Few studies have examined trends in pancreatic cancer death rates in the United States, and there have been no studies examining recent trends using age-period-cohort analysis. Annual percentage change in pancreatic cancer death rates was calculated for 1970 to 2009 by sex and race among adults aged 35 to 84 years using US mortality data provided by the National Center for Health Statistics and Joinpoint Regression. Age-period-cohort modeling was performed to evaluate the changes in cohort and period effects. All statistical tests were two-sided. In white men, pancreatic cancer death rates decreased by 0.7% per year from 1970 to 1995 and then increased by 0.4% per year through 2009. Among white women, rates increased slightly from 1970 to 1984, stabilized until the late 1990s, then increased by 0.5% per year through 2009. In contrast, the rates among blacks increased between 1970 and the late 1980s (women) or early 1990s (men) and then decreased thereafter. Age-period-cohort analysis showed that pancreatic cancer death risk was highest for the 1900 to 1910 birth cohort in men and the 1920 to 1930 birth cohort in women and there was a statistically significant increase in period effects since the late 1990s in both white men and white women (two-sided Wald test, P < .001). In the United States, whites and blacks experienced opposite trends in pancreatic cancer death rates between 1970 and 2009 that are largely unexplainable by known risk factors. This study underscores the needs for urgent action to curb the increasing trends of pancreatic cancer in whites and for better understanding of the etiology of this disease.

Nationwide cohort study on the epidemiology and survival outcomes of thyroid cancer

PubMed Central

Liu, Fu-Chao; Lin, Huan-Tang; Lin, Shu-Fu; Kuo, Chang-Fu; Chung, Ting-Ting; Yu, Huang-Ping

2017-01-01

In the past three decades, the thyroid cancer incidence has surged globally. Herein, the Taiwan National Health Insurance database was used to identify thyroid cancer patients and to estimate the prevalence and incidence of thyroid cancer during 1997-2012. The Taiwan Cancer Registry and the National Death Registry databases were crosslinked to obtain information on the histological subtypes and survival rates. Joinpoint regression analysis was used for estimating the average annual percentage changes (APCs) in prevalence, incidence, and survival. The age-standardized incidence of thyroid cancer increased from 5.66 per 100,000 person-years in 1997 to 12.30 per 100,000 person-years in 2012, with an average APC of 5.1 (6.9 in males, 4.6 in females). Thyroid cancer was more prevalent in patients with high socioeconomic status and in urban areas. Papillary carcinoma was the most abundant subtype, with a 2.9-fold increase of incident cases noted during 1998-2012 (from 80.6% to 89.8% of all cases). Among the different treatments, partial thyroidectomy increased the most (average APC, 17.3). The overall survival rates by sex and subtype remained stable over time, with 5-year survival rates of 90.2% in 1997 and 92.4% in 2010. In conclusion, 2.2- and 4.2-fold increases in the incidence and prevalence of thyroid cancer, respectively, were observed during 1997-2012 in Taiwan. The surging incidence of thyroid cancer but stable survival rates, and mainly increased in the papillary subtype, altogether imply enhanced detection of subclinical lesions. A true increase due to environmental carcinogens might also be responsible, but warrant further investigations. PMID:29108240

Characteristics, survival and incidence rates and trends of primary cardiac malignancies in the United States.

PubMed

Saad, Anas M; Abushouk, Abdelrahman Ibrahim; Al-Husseini, Muneer J; Salahia, Sami; Alrefai, Anas; Afifi, Ahmed M; Abdel-Daim, Mohamed M

The available literature on the incidence, management and prognosis of primary malignant cardiac tumors [PMCTs] is limited to single-center studies, prone to small sample size and referral bias. We used data from the Surveillance, Epidemiology, and End Results [SEER]-18 registry (between 2000 and 2014) to investigate the distribution, incidence trends and the survival rates of PMCTs. We used SEER*Stat (version 8.3.4) and the National Cancer Institute's Joinpoint Regression software (version 4.5.0.1) to calculate the incidence rates and annual percentage changes [APC] of PMCTs, respectively. We later used SPSS software (version 23) to perform Kaplan-Meier survival tests and covariate-adjusted Cox models. We identified 497 patients with PMCTs, including angiosarcomas (27.3%) and Non-Hodgkin's lymphomas [NHL] (26.9%). Unlike the incidence rate of NHL (0.108 per 10 6 person-years) that increased significantly (APC=3.56%, 95% CI, [1.445 to 5.725], P=.003) over the study period, we detected no significant change (APC=1.73%, 95% CI [-3.354 to 7.081], P=.483) in the incidence of cardiac angiosarcomas (0.107 per 10 6 person-years). Moreover, our analysis showed that the overall survival of NHL is significantly better than angiosarcomas (P<.001). In addition, surgical treatment was associated with a significant improvement (P=.027) in the overall survival of PMCTs. Our analysis showed a significant increase in the incidence of cardiac-NHL over the past 14 years with a significantly better survival than angiosarcomas. To further characterize these rare tumors, future studies should report data on the medical history and diagnostic and treatment modalities in these patients. Copyright © 2017 Elsevier Inc. All rights reserved.

Trends in Sales of Flavored and Menthol Tobacco Products in the United States during 2011–2015

PubMed Central

Kuiper, Nicole M; Gammon, Doris; Loomis, Brett; Falvey, Kyle; Wang, Teresa W.; King, Brian A.; Rogers, Todd

2017-01-01

Introduction Flavors can mask the harshness of tobacco and make it appealing to young people. This study assessed flavored and menthol tobacco product sales at the national and state levels. Methods Universal Product Code (UPC) tobacco sales data collected by Nielsen were combined for convenience stores and all-outlets-combined during October 22, 2011–January 9, 2016. Products were characterized as flavored, menthol, or non-flavored/non-menthol. Total unit sales, and the proportion of flavored and menthol unit sales, were assessed nationally and by state for seven tobacco products. Joinpoint Regression was used to assess trends in average monthly percentage change. Results Nationally, the proportion of flavored and menthol sales in 2015 was as follows: cigarettes (32.5% menthol), large cigars (26.1% flavored), cigarillos (47.5% flavored, 0.2% menthol), little cigars (21.8% flavored, 19.4% menthol), chewing tobacco (1.4% flavored, 0.7% menthol), moist snuff (3.0% flavored, 57.0% menthol), and snus (88.5% menthol). From 2011-2015, sales increased for flavored cigarillos and chewing tobacco, as well as for menthol cigarettes, little cigars, moist snuff and snus. Sales decreased for flavored large cigars, moist snuff and snus, and for menthol chewing tobacco. State-level variations were observed by product; for example, flavored little cigar sales ranged from 4.4% (Maine) to 69.3% (Utah) and flavored cigarillo sales ranged from 26.6% (Maine) to 63.0% (Maryland). Conclusions Menthol and flavored sales have increased since 2011, particularly for the products with the highest number of units sold, and significant state variation exists. Efforts to restrict flavored tobacco product sales could reduce overall U.S. tobacco consumption. PMID:28575408

Mobile phone use and incidence of glioma in the Nordic countries 1979-2008: consistency check.

PubMed

Deltour, Isabelle; Auvinen, Anssi; Feychting, Maria; Johansen, Christoffer; Klaeboe, Lars; Sankila, Risto; Schüz, Joachim

2012-03-01

Some case-control studies have reported increased risks of glioma associated with mobile phone use. If true, this would ultimately affect the time trends for incidence rates (IRs). Correspondingly, lack of change in IRs would exclude certain magnitudes of risk. We investigated glioma IR trends in the Nordic countries, and compared the observed with expected incidence rates under various risk scenarios. We analyzed annual age-standardized incidence rates in men and women aged 20 to 79 years during 1979-2008 using joinpoint regression (35,250 glioma cases). Probabilities of detecting various levels of relative risk were computed using simulations. For the period 1979 through 2008, the annual percent change in incidence rates was 0.4% (95% confidence interval = 0.1% to 0.6%) among men and 0.3% (0.1% to 0.5%) among women. Incidence rates have decreased in young men (20-39 years) since 1987, remained stable in middle-aged men (40-59 years) throughout the 30-year study period, and increased slightly in older men (60-79 years). In simulations, assumed relative risks for all users of 2.0 for an induction time of up to 15 years, 1.5 for up to 10 years, and 1.2 for up to 5 years were incompatible with observed incidence time trends. For heavy users of mobile phones, risks of 2.0 for up to 5 years' induction were also incompatible. No clear trend change in glioma incidence rates was observed. Several of the risk increases seen in case-control studies appear to be incompatible with the observed lack of incidence rate increase in middle-aged men. This suggests longer induction periods than currently investigated, lower risks than reported from some case-control studies, or the absence of any association.

Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009.

PubMed

Rositch, Anne F; Nowak, Rebecca G; Gravitt, Patti E

2014-07-01

Invasive cervical cancer is thought to decline in women over 65 years old, the age at which cessation of routine cervical cancer screening is recommended. However, national cervical cancer incidence rates do not account for the high prevalence of hysterectomy in the United States. Using estimates of hysterectomy prevalence from the Behavioral Risk Factor Surveillance System (BRFSS), hysterectomy-corrected age-standardized and age-specific incidence rates of cervical cancer were calculated from the Surveillance, Epidemiology, and End Results (SEER) 18 registry in the United States from 2000 to 2009. Trends in corrected cervical cancer incidence across age were analyzed using Joinpoint regression. Unlike the relative decline in uncorrected rates, corrected rates continue to increase after age 35-39 (APC(CORRECTED) = 10.43) but at a slower rate than in 20-34 years (APC(CORRECTED) = 161.29). The highest corrected incidence was among 65- to 69-year-old women, with a rate of 27.4 cases per 100,000 women as opposed to the highest uncorrected rate of 15.6 cases per 100,000 aged 40 to 44 years. Correction for hysterectomy had the largest impact on older, black women given their high prevalence of hysterectomy. Correction for hysterectomy resulted in higher age-specific cervical cancer incidence rates, a shift in the peak incidence to older women, and an increase in the disparity in cervical cancer incidence between black and white women. Given the high and nondeclining rate of cervical cancer in women over the age of 60 to 65 years, when women are eligible to exit screening, risk and screening guidelines for cervical cancer in older women may need to be reconsidered. © 2014 American Cancer Society.

The Contribution of Reverse Shoulder Arthroplasty to Utilization of Primary Shoulder Arthroplasty

PubMed Central

Jain, Nitin B.; Yamaguchi, Ken

2014-01-01

Background We assessed the contribution of reverse shoulder arthroplasty to overall utilization of primary shoulder arthroplasty, and present age and sex stratified national rates of shoulder arthroplasty. We also assessed contemporary complication rates, mortality, and indications for shoulder arthroplasty, as well as estimates and indications for revision arthroplasty. Methods We used the Nationwide Inpatient Samples for 2009–2011 to calculate estimates of shoulder arthroplasty and assessed trends using joinpoint regression. Results The cumulative estimated utilization of primary shoulder arthroplasty (total anatomical, hemi, and reverse) increased significantly from 52,397 procedures (95% CI=47,093–57,701) in 2009 to 67,184 cases (95% CI=60,638–73,731) in 2011. Reverse shoulder arthroplasty accounted for 42% of all primary shoulder arthroplasty procedures in 2011. The diagnosis of concomitant diagnosis of osteoarthritis and rotator cuff impairment was found in only 29.8% of reverse shoulder arthroplasty cases. The highest rate of reverse shoulder arthroplasty was in the 75–84 year female sub-group (77; 95% CI=67–87). Revision cases were 8.8% and 8.2% of all shoulder arthroplasties in 2009 and 2011, respectively, and 35% of revision cases were secondary to mechanical complications/loosening while 18% were due to dislocation. Conclusions The utilization of primary shoulder arthroplasty significantly increased in just a three year time span, with a major contribution from reverse shoulder arthroplasty in 2011. Indications appear to have expanded as a large percentage of patients did not have rotator cuff pathology. The burden from revision arthroplasties was also substantial and efforts to optimize outcomes and longevity of primary shoulder arthroplasty are needed. Level of evidence Epidemiology Study, Database Analysis PMID:25304043

[Tobacco use by adolescents in Barcelona (Spain) and trends in the last 20 years].

PubMed

Ariza, Carles; García-Continente, Xavier; Villalbí, Joan Ramon; Sánchez-Martínez, Francesca; Pérez, Anna; Nebot, Manel

2014-01-01

Smoking is a preventable cause of early death and the habit starts in adolescence. The aim of this study was to describe tobacco consumption in secondary school students in 2008 and trends in the last 20 years in Barcelona. We analyzed the trend in tobacco consumption by comparing data from 8 surveys carried out between 1987 and 2008 in the 8th (2nd year of Compulsory Secondary Education), 10th (4th year of Compulsory Secondary Education) and 12th (2nd year of Compulsory Secondary Education) years of secondary school. The FRESC questionnaire was used. Data on regular and daily consumption and associated factors in 2008 were gathered and compared with those corresponding to the previous studies. Percentages of annual change were calculated with Joinpoint regression and data were stratified by sex and year of education. In 2008, 6.1% of boys and 4.5% of girls in the 8th year, 15.8% and 20.4% of those in the 10th year, respectively, and 26.1% and 33.1% of those in the 12th year, respectively, were regular smokers. A strong association was noted between regular smoking and cannabis consumption in three school years, as well as with having friends who were smokers and poor school performance. At 15-16 years old, the average annual decrease from 1996 to 2008 was 6.8% in girls and 6.1% in boys. Adolescent smoking has been decreasing in the last few years in Barcelona. There is a strong association between tobacco use and cannabis consumption. Copyright © 2013 SESPAS. Published by Elsevier Espana. All rights reserved.

Trends and predictions to 2020 in breast cancer mortality: Americas and Australasia.

PubMed

Carioli, Greta; Malvezzi, Matteo; Rodriguez, Teresa; Bertuccio, Paola; Negri, Eva; La Vecchia, Carlo

2018-02-01

We considered trends in breast cancer mortality for 12 American and 8 Australasian countries during 1970-2014, and predicted rates for 2020. We obtained official death certification data for breast cancer and population figures from the World Health Organization, Pan American Health Organization and United Nations databases. We derived age-standardized rates (world standard population), and predictions for 2020 using joinpoint regression. Breast cancer mortality trends were favourable in North America and Oceania, and a further 10% reduction in their overall rates is predicted for 2020, to reach values of 11-12/100,000 women, i.e. about 50% lower than their top rates in the later 1980's. Hong Kong, Japan and Korea did not show appreciable trends, but their rates remained below 10/100,000. Mexico, Chile, Colombia, Brazil also had stable rates, below or around 10/100,000. Breast cancer mortality was higher in Argentina, Cuba and Venezuela, and only Argentina showed some favourable trends over recent years, and predictions to 2020 around 16/100,000. Trends and predictions were less favourable in Israel, New Zealand, and the Philippines than in most other countries with predicted rates in 2020 between 13 and 16/100,000. In several high-income countries, the fall in breast cancer mortality, due to improved treatment and diagnosis, has been the major success in the management of any common cancer over the last three decades. There are, however, persistent disparities in the global decline in breast cancer, which call for urgent management improvements in several areas of the world, particularly in middle-income countries. Copyright © 2017 Elsevier Ltd. All rights reserved.

Incidence of Sudden Cardiac Death in a Young Active Population

PubMed Central

Farioli, Andrea; Christophi, Costas A; Quarta, Candida Cristina; Kales, Stefanos N

2015-01-01

Background Little is known about the burden of sudden cardiac death (SCD) among active, presumably healthy persons. We investigated the incidence of SCD among US male career firefighters. Methods and Results All on-duty SCDs among US male career firefighters between 1998 and 2012 were identified from the US Fire Administration and the US National Institute for Occupational Safety and Health databases. Age-specific incidence rates (IRs) of SCD with 95% CIs were computed. A joinpoint model was fitted to analyze the trend in IR and to help estimate the annual percentage change of SCD rates over the years. The effects of seasonality were assessed through a Poisson regression model. We identified 182 SCDs; based on 99 available autopsy reports, the leading underlying cause of death was coronary heart disease (79%). The overall IR was 18.1 SCDs per 100 000 person-years. The age-specific IRs of SCD ranged between 3.8 (for those aged 18 to 24 years) and 45.2 (for those aged 55 to 64 years) per 100 000 person-years. The annual rate of SCD steadily declined over time (annual percentage change −3.9%, 95% CI −5.8 to −2.0). SCD events were more frequent during January (peak-to-low ratio 1.70; 95% CI 1.09 to 2.65). In addition, the IR was 3 times higher during high-risk duties compared with low-risk duties. IRs among firefighters were lower than those observed among the US general population and US military personnel. Conclusions SCD risk in this active working population is overestimated using statistics from the general population. To address public health questions among these subpopulations, more specific studies of active adults should be conducted. PMID:26066031

Cancer in patients with rheumatic diseases exposed to TNF antagonists.

PubMed

Carmona, Loreto; Abasolo, Lydia; Descalzo, Miguel A; Pérez-Zafrilla, Beatriz; Sellas, Agustí; de Abajo, Francisco; Gomez-Reino, Juan J

2011-08-01

To describe the risk of cancer in patients exposed to tumor necrosis factor (TNF) antagonists. The following 2 clinical cohorts were studied: (1) BIOBADASER 2.0: a registry of patients suffering from rheumatic diseases exposed to TNF antagonists (2531 rheumatoid arthritis (RA), 1488 spondyloarthropathies, and 675 other rheumatic conditions); and (2) EMECAR: a cohort of 789 RA patients not exposed to TNF antagonists. Cancer incidence rates (IR) per 1000 patient-years and incidence rate ratios (IRR) were calculated for BIOBADASER 2.0 and EMECAR patients. The IR over time in BIOBADASER 2.0 patients was analyzed by joinpoint regression. The IRR was estimated to compare cancer rates in exposed versus nonexposed RA patients. Standardized incidence and mortality ratios (SIR, SMR) were also estimated. Risk factors for cancer in patients exposed to TNF antagonists were investigated by generalized linear models. The SMR for cancer in BIODASER 2.0 was 0.67 (95% CI: 0.51-0.86), and the SIR was 0.1 (95% CI 0.03-0.23). The IR in RA patients exposed to TNF antagonists was 5.8 (95% CI: 4.4-7.6), and the adjusted IRR was 0.48 (95% CI: 0.09-2.45). The IR in patients with previous cancer was 26.4 (95% CI: 4.1-171.5). Age, chronic obstructive pulmonary disease, and steroids were associated with a higher risk of developing cancer. The IR decreased after the first 4 months of exposure, without statistical significance. Overall cancer and mortality rates in patients with rheumatic diseases exposed to TNF antagonists are no higher than in the background Spanish population. However special attention should be paid to elderly patients, those with previous cancers, and patients treated with steroids. Copyright © 2011 Elsevier Inc. All rights reserved.

The burden of liver cancer in Asians and Pacific Islanders in the Greater San Francisco Bay Area, 1990 through 2004

PubMed Central

Chang, Ellen T.; Keegan, Theresa H. M.; Gomez, Scarlett L.; Le, Gem M.; Clarke, Christina A.; So, Samuel K. S.; Glaser, Sally L.

2009-01-01

Background No previous U.S. study has examined time trends in the incidence rate of liver cancer in the high-risk Asian/Pacific Islander population. We evaluated liver cancer incidence trends in Chinese, Filipino, Japanese, Korean, and Vietnamese males and females in the Greater San Francisco Bay Area of California between 1990 and 2004. Methods Populations at risk were estimated using the cohort component demographic method. Annual percentage changes (APCs) in age-adjusted incidence rates of primary liver cancer among Asians/Pacific Islanders in the Greater Bay Area Cancer Registry were calculated using joinpoint regression analysis. Results The incidence rate of liver cancer between 1990 and 2004 did not change significantly in Asian/Pacific Islander males or females overall. However, the incidence rate declined, albeit statistically non-significantly, in Chinese males (APC =−1.6% [95% confidence interval (CI) =−3.4%, 0.3%], Japanese males (APC = −4.9%, 95% CI =−10.7%, 1.2%), and Japanese females (APC =−3.6%, 95% CI =−8.9%, 2.0%). Incidence rates remained consistently high for Vietnamese, Korean, and Filipino males and females. Trends in the incidence rate of hepatocellular carcinoma were comparable to those for liver cancer. While disparities in liver cancer incidence between Asians/Pacific Islanders and other racial/ethnic groups diminished between 1990–1994 and 2000–2004, those among Asian subgroups increased. Conclusions Liver cancer continues to affect Asian/Pacific Islander Americans disproportionately, with consistently high incidence rates in most subgroups. Culturally targeted prevention methods are needed to reduce the high rates of liver cancer in this growing population in the U.S. PMID:17385214

Mortality from idiopathic pulmonary fibrosis: a temporal trend analysis in Brazil, 1979-2014

PubMed Central

Algranti, Eduardo; Saito, Cézar Akiyoshi; Silva, Diego Rodrigues Mendonça e; Carneiro, Ana Paula Scalia; Bussacos, Marco Antonio

2017-01-01

ABSTRACT Objective: To analyze mortality from idiopathic pulmonary fibrosis (IPF) in Brazil over the period 1979-2014. Methods: Microdata were extracted from the Brazilian National Ministry of Health Mortality Database. Only deaths for which the underlying cause was coded as International Classification of Diseases version 9 (ICD-9) 515 or 516.3 (until 1995) or as ICD version 10 (ICD-10) J84.1 (from 1996 onward) were included in our analysis. Standardized mortality rates were calculated for the 2010 Brazilian population. The annual trend in mortality rates was analyzed by joinpoint regression. We calculated risk ratios (RRs) by age group, time period of death, and gender, using a person-years denominator. Results: A total of 32,092 deaths were recorded in the study period. Standardized mortality rates trended upward, rising from 0.24/100,000 population in 1979 to 1.10/100,000 population in 2014. The annual upward trend in mortality rates had two inflection points, in 1992 and 2008, separating three distinct time segments with an annual growth of 2.2%, 6.8%, and 2.4%, respectively. The comparison of RRs for the age groups, using the 50- to 54-year age group as a reference, and for the study period, using 1979-1984 as a reference, were 16.14 (14.44-16.36) and 6.71 (6.34-7.12), respectively. Men compared with women had higher standardized mortality rates (per 100,000 person-years) in all age groups. Conclusion: Brazilian IPF mortality rates are lower than those of other countries, suggesting underdiagnosis or underreporting. The temporal trend is similar to those reported in the literature and is not explained solely by population aging. PMID:29340493

Esophageal Cancer Clinical Presentation: Trends in the Last 3 Decades in a Large Italian Series.

PubMed

Cavallin, Francesco; Scarpa, Marco; Cagol, Matteo; Alfieri, Rita; Ruol, Alberto; Sileni, Vanna Chiarion; Ancona, Ermanno; Castoro, Carlo

2018-01-01

The aim of this study was to investigate trends in patients' characteristics and comorbidities in esophageal cancer (EC) patients. Identifying changing pattern is essential to understand and predict further changes and to plan surgical procedures and resource allocation. Trends in patients' characteristics and comorbidities were evaluated in 4440 EC patients at the Center for Esophageal Diseases in Padova, Italy, during 1980 to 2011. Joinpoint regression analysis was performed to evaluate trends and to estimate annual percentage changes (APCs). During the study period, there has been a statistically significant increment of the rate of esophageal adenocarcinoma (APC 3.70). The rates of elderly and of asymptomatic patients increased over time (APCs 0.98 and 6.24), whereas the rates of malnutrition, alcoholic drinking, and gastric ulcer decreased (APCs -1.50, -1.72, and -5.20). Reflux rate increased until 1997 and decreased thereafter (APCs 6.96 and -4.48), whereas the rate of Barrett esophagus increased until 1992 (APC 35.84) and then leveled. The rates of patients with previous neoplasms increased over time (APCs 3.22 and 4.86). There have been significant changes in systemic comorbidities, with an increase of hypertension and cardiac disease (APCs 7.56 and 1.86) and a decrease of advanced liver disease and pulmonary disease (APCs -2.67 and -1.74). The current EC patient has more often an esophageal adenocarcinoma and is more frequently elderly, asymptomatic, a survivor of previous neoplasms, and a patient with hypertension and cardiac disease than 30 years ago. On the contrary, malnutrition, alcoholic drinking, gastric ulcer, pulmonary disease, and advanced liver disease decreased.

Comparison of oropharyngeal and oral cavity squamous cell cancer incidence and trends in New Zealand and Queensland, Australia.

PubMed

Elwood, J Mark; Youlden, Danny R; Chelimo, Carol; Ioannides, Sally J; Baade, Peter D

2014-02-01

Increases in the incidence of squamous cell oropharyngeal cancer (OPC) have been reported from some countries, but have not been assessed in Australia or New Zealand. This study examines trends for squamous cell OPC and squamous cell oral cavity cancer (OCC) in two similarly sized populations, New Zealand and Queensland, Australia. Incidence data for 1982-2010 were obtained from the respective population-based cancer registries for squamous cell OPC and OCC, by subsite, sex, and age. Time trends and annual percentage changes (APCs) were assessed by joinpoint regression. The incidence rates of squamous cell OPC in males in New Zealand since 2005 and Queensland since 2006 have increased rapidly, with APCs of 11.9% and 10.6% respectively. The trends were greatest at ages 50-69 and followed more gradual increases previously. In females, rates increased by 2.1% per year in New Zealand from 1982, but by only 0.9% (not significant) in Queensland. In contrast, incidence rates for OCC decreased by 1.2% per year in males in Queensland since 1982, but remained stable for females in Queensland and for both sexes in New Zealand. Overall, incidence rates for both OCC and OPC were substantially higher in Queensland than in New Zealand. In males in both areas, OPC incidence is now higher than that of OCC. Incidence rates of squamous cell OPC have increased rapidly in men, while rates of OCC have been stable or reducing, showing distinct etiologies. This has both clinical and public health importance, including implications for the extension of human papilloma virus (HPV) vaccination to males. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of the economic crisis on smoking prevalence and number of smokers in the USA.

PubMed

Gallus, Silvano; Ghislandi, Simone; Muttarak, Raya

2015-01-01

Scanty and controversial information is available on the impact of macroeconomic fluctuations on smoking behaviour. No study has quantified the effects of fiscal crises on smoking prevalence. This study aimed to investigate the effects of the 2007-2008 economic crisis on smoking prevalence and number of smokers in the USA. Using data from the repeated Behavioural Risk Factor Surveillance System (BRFSS) surveys in pre-crisis (2005-2007) and post-crisis (2009-2010) periods on a total of 1,981,607 US adults, we separated the expected (after allowance for the demographic growth of the US population, secular smoking prevalence trends and changes in sociodemographic characteristics) from the unexpected (assumed attributable to the economic crisis) changes in the number of smokers across different employment statuses. Joinpoint regression analysis revealed no significant changes in smoking prevalence trends over the period 2005-2010. The crisis resulted in an increase in the number of smokers in the US by 0.6 million. This is largely due to an unexpected decrease of 1.7 million smokers among employed and an increase of 2.4 million smokers among unemployed individuals, whose smoking prevalence also remains extremely high in the post-crisis period (32.6%). The 2008 financial crisis had a weak effect on smoking prevalence. The pro-cyclical relationship (ie, the crisis results in a lower number of smokers) found among the employed is offset by the counter-cyclical relationship (ie, the crisis results in a higher number of smokers) found among unemployed individuals. Public health interventions should specifically target those in unemployment, particularly in hard times. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Temporal Trends in Mortality from Ischemic and Hemorrhagic Stroke in Mexico, 1980-2012.

PubMed

Cruz, Copytzy; Campuzano-Rincón, Julio César; Calleja-Castillo, Juan Manuel; Hernández-Álvarez, Anaid; Parra, María Del Socorro; Moreno-Macias, Hortensia; Hernández-Girón, Carlos

2017-04-01

Over the past decades, the decline in mortality from stroke has been more pronounced in high-income countries than in low- and middle-income countries. We evaluated changes in temporal stroke mortality trends in Mexico according to sex and type of stroke. We assessed stroke mortality from Mexico's National Health Information System for the period from 1980 to 2012. We analyzed age-adjusted mortality rates by sex, type of stroke, and age group. The annual percentage change and the average annual percentage change (AAPC) in the slopes of the age-adjusted mortality trends were determined using joinpoint regression models. The age-adjusted mortality rates due to stroke decreased between 1980 and 2012, from 44.55 to 33.47 per 100,000 inhabitants, and the AAPC (95% confidence interval [CI]) was -.9 (-1.0 to -.7). The AAPC for females was -1.1 (-1.5 to -.7) and that for males was -.7 (-.9 to -.6). People older than 65 years showed the highest mortality throughout the period. Between 1980 and 2012, the AAPC (95% CI) for ischemic stroke was -3.8 (-4.8 to -2.8) and was -.5 (-.8 to -.2) for hemorrhagic stroke. For the same period, the AAPC for intracerebral hemorrhage (ICH) was -.7 (-1.6 to .2) and that for subarachnoid hemorrhage (SAH) was 1.6 (.4-2.8). The age-adjusted mortality rates of all strokes combined, ischemic stroke, hemorrhagic stroke, and ICH, decreased between 1980 and 2012 in Mexico. However, the increase in SAH mortality makes it necessary to explore the risk factors and clinical management of this type of stroke. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

Ulcerative colitis-associated hospitalization costs: A population-based study

PubMed Central

Coward, Stephanie; Heitman, Steven J; Clement, Fiona; Hubbard, James; Proulx, Marie-Claude; Zimmer, Scott; Panaccione, Remo; Seow, Cynthia; Leung, Yvette; Datta, Neel; Ghosh, Subrata; Myers, Robert P; Swain, Mark; Kaplan, Gilaad G

2015-01-01

BACKGROUND: Hospitalization costs for ulcerative colitis (UC) following the introduction of infliximab have not been evaluated. OBJECTIVE: To study predictors of costs for UC patients who were hospitalized for a flare or colectomy. METHODS: Population-based surveillance identified adults (≥18 years of age) admitted to hospital for UC flare or colectomy between 2001 and 2009 in the Calgary Health Zone (Alberta). Medical charts were reviewed and patients stratified into three admission types: responsive to inpatient medical therapy (n=307); emergent colectomy (n=227); and elective colectomy (n=208). The annual median cost with interquartile range (IQR) was calculated. Linear regression determined the effect of admission type on hospital charges after adjusting for age, sex, smoking, comorbidities, disease extent, medication use (eg, infliximab) and year. The adjusted cost increase was presented as the percent increase with 95% CIs. Joinpoint analysis assessed for an inflection point in hospital cost after the introduction of infliximab. RESULTS: Median hospitalization cost for UC flare, emergent colectomy and elective colectomy, respectively, were: $5,499 (IQR $3,374 to $8,904), $23,698 (IQR $17,981 to $32,385) and $14,316 (IQR $11,932 to $18,331). Adjusted hospitalization costs increased approximately 6.0% annually (95% CI 4.5% to 7.5%). Adjusted costs were higher for patients who underwent an elective colectomy (percent increase cost 179.8% [95% CI 151.6% to 211.1%]) or an emergent colectomy (percent increase cost 211.1% [95% CI 183.2% to 241.6%]) than medically responsive patients. Infliximab in hospital was an independent predictor of increased costs (percent increase cost 69.5% [95% CI 49.2% to 92.5%]). No inflection points were identified. CONCLUSION: Hospitalization costs for UC increased due to colectomy and infliximab. PMID:26079072

Descriptive Analysis on the Impacts of Universal Zero-Markup Drug Policy on a Chinese Urban Tertiary Hospital.

PubMed

Tian, Wei; Yuan, Jiangfan; Yang, Dong; Zhang, Lanjing

2016-01-01

Universal Zero-Markup Drug Policy (UZMDP) mandates no price mark-ups on any drug dispensed by a healthcare institution, and covers the medicines not included in the China's National Essential Medicine System. Five tertiary hospitals in Beijing, China implemented UZMDP in 2012. Its impacts on these hospitals are unknown. We described the effects of UZMDP on a participating hospital, Jishuitan Hospital, Beijing, China (JST). This retrospective longitudinal study examined the hospital-level data of JST and city-level data of tertiary hospitals of Beijing, China (BJT) 2009-2015. Rank-sum tests and join-point regression analyses were used to assess absolute changes and differences in trends, respectively. In absolute terms, after the UZDMP implementation, there were increased annual patient-visits and decreased ratios of medicine-to-healthcare-charges (RMOH) in JST outpatient and inpatient services; however, in outpatient service, physician work-days decreased and physician-workload and inflation-adjusted per-visit healthcare charges increased, while the inpatient physician work-days increased and inpatient mortality-rate reduced. Interestingly, the decreasing trend in inpatient mortality-rate was neutralized after UZDMP implementation. Compared with BJT and under influence of UZDMP, JST outpatient and inpatient services both had increasing trends in annual patient-visits (annual percentage changes[APC] = 8.1% and 6.5%, respectively) and decreasing trends in RMOH (APC = -4.3% and -5.4%, respectively), while JST outpatient services had increasing trend in inflation-adjusted per-visit healthcare charges (APC = 3.4%) and JST inpatient service had decreasing trend in inflation-adjusted per-visit medicine-charges (APC = -5.2%). Implementation of UZMDP seems to increase annual patient-visits, reduce RMOH and have different impacts on outpatient and inpatient services in a Chinese urban tertiary hospital.

Colorectal carcinoma mortality among Appalachian men and women, 1969-1999.

PubMed

Armstrong, Lori R; Thompson, Trevor; Hall, H Irene; Coughlin, Steven S; Steele, Brooke; Rogers, Joe D

2004-12-15

Colorectal carcinoma screening can reduce mortality, but residents of poor or medically underserved areas may face barriers to screening. The current study assessed colorectal carcinoma mortality in Appalachia, a historically underserved area, from 1969 to 1999. All counties within the 13-state Appalachian region, which stretches from southern New York to northern Mississippi, were used to calculate annual death rates for the 31-year period. Joinpoint regression analysis was used to examine trends by age and race for the Appalachian region and the remainder of the United States. Five-year rates for 1995-1999 age-adjusted to the 2000 U.S. standard population were calculated by race and age group for the Appalachian region and elsewhere in the United States. Trend analysis showed that colorectal carcinoma death rates among both racial and gender groups studied had declined in recent years. Despite this, the rates for white males and white females were still significantly higher in Appalachia than in the rest of the country at the end of the study period, 1999. Five-year colorectal carcinoma death rates among white males (ages < 50, 50-59, and 70-79 years) and white females (ages < 50, 50-59, 70-79, > or = 80 years) were significantly higher in Appalachia than elsewhere in the United States, whereas rates among black females 60-69 and 70-79 years old were significantly lower in Appalachia. The Appalachian region may benefit from targeted prevention efforts to eliminate disparities in the colorectal carcinoma death rates among subgroups. Further studies are needed to determine whether the higher death rates in specific Appalachian subgroups are related to a higher incidence of the disease, the cancer being at a later stage at diagnosis, poorer treatment, or other factors.

Mortality from Musculoskeletal Disorders Including Rheumatoid Arthritis in Southern Sweden: A Multiple-cause-of-death Analysis, 1998-2014.

PubMed

Kiadaliri, Aliasghar A; Turkiewicz, Aleksandra; Englund, Martin

2017-05-01

To assess mortality related to musculoskeletal (MSK) disorders and rheumatoid arthritis (RA), specifically, among adults (aged ≥ 20 yrs) in southern Sweden using the multiple-cause-of-death approach. All death certificates (DC; n = 201,488) from 1998 to 2014 for adults in the region of Skåne were analyzed when mortality from MSK disorders and RA was listed as the underlying and nonunderlying cause of death (UCD/NUCD). Trends in age-standardized mortality rates (ASMR) were evaluated using joinpoint regression, and associated causes were identified by age- and sex-adjusted observed/expected ratios. MSK (RA) was mentioned on 2.8% (0.8%) of all DC and selected as UCD in 0.6% (0.2%), with higher values among women. Proportion of MSK disorder deaths from all deaths increased from 2.7% in 1998 to 3.1% in 2014, and declined from 0.9% to 0.5% for RA. The mean age at death was higher in DC with mention of MSK/RA than in DC without. The mean ASMR for MSK (RA) was 15.5 (4.3) per 100,000 person-years and declined by 1.1% (3.8%) per year during 1998-2014. When MSK/RA were UCD, pneumonia and heart failure were the main NUCD. When MSK/RA were NUCD, the leading UCD were ischemic heart disease and neoplasms. The greatest observed/expected ratios were seen for infectious diseases (including sepsis) and blood diseases. We observed significant reduction in MSK and RA mortality rates and increase in the mean age at death. Further analyses are required to investigate determinants of these improvements in MSK/RA survival and their potential effect on the Swedish healthcare systems.

Bladder cancer mortality trends and patterns in Córdoba, Argentina (1986-2006).

PubMed

Pou, Sonia Alejandra; Osella, Alberto Ruben; Diaz, Maria Del Pilar

2011-03-01

Bladder cancer is common worldwide and the fourth most commonly diagnosed malignancy in men in Argentina. To describe bladder cancer mortality trends in Córdoba (1986-2006), considering the effect of age, period, and cohort, and to estimate the effect of arsenic exposure on bladder cancer, and its interaction with sex, while controlling by smoking habits and space and time variation of the rates. A joinpoint regression was performed to compute the estimated annual percentage changes (EAPC) of the age-standardized mortality rates (ASMR) in an adult population from Córdoba, Argentina. A Poisson model was fitted to estimate the effect of age, period, and cohort. The influence of gender, tobacco smoking (using lung cancer ASMR as surrogate), and arsenic in drinking water was examined using a hierarchical model. A favorable trend (1986-2006) in bladder cancer ASMR in both sexes was found: EAPC of -2.54 in men and -1.69 in women. There was a decreasing trend in relative risk (RR) for cohorts born in 1931 or after. The multilevel model showed an increasing risk for each increase in lung cancer ASMR unit (RR = 1.001) and a biological interaction between sex and arsenic exposure. RR was higher among men exposed to increasing As-exposure categories (RR male low exposure 3.14, RR male intermediate exposure 4.03, RR male high exposure 4.71 versus female low exposure). A non-random space-time distribution of the rates was observed. There has been a decreasing trend in ASMR for bladder cancer in Córdoba. This study confirms that bladder cancer is associated with age, gender, smoking habit, and exposure to arsenic. Moreover, an effect measure modification between exposure to arsenic and sex was found.

Musculoskeletal disorders as underlying cause of death in 58 countries, 1986-2011: trend analysis of WHO mortality database.

PubMed

Kiadaliri, Aliasghar A; Woolf, Anthony D; Englund, Martin

2017-02-02

Due to low mortality rate of musculoskeletal disorders (MSK) less attention has been paid to MSK as underlying cause of death in the general population. The aim was to examine trend in MSK as underlying cause of death in 58 countries across globe during 1986-2011. Data on mortality were collected from the WHO mortality database and population data were obtained from the United Nations. Annual sex-specific age-standardized mortality rates (ASMR) were calculated by means of direct standardization using the WHO world standard population. We applied joinpoint regression analysis for trend analysis. Between-country disparities were examined using between-country variance and Gini coefficient. The changes in number of MSK deaths between 1986 and 2011 were decomposed using two counterfactual scenarios. The number of MSK deaths increased by 67% between 1986 and 2011 mainly due to population aging. The mean ASMR changed from 17.2 and 26.6 per million in 1986 to 18.1 and 25.1 in 2011 among men and women, respectively (median: 7.3% increase in men and 9.0% reduction in women). Declines in ASMR of 25% or more were observed for men (women) in 13 (19) countries, while corresponding increases were seen for men (women) in 25 (14) countries. In both sexes, ASMR declined during 1986-1997, then increased during 1997-2001 and again declined over 2001-2011. Despite decline over time, there were substantial between-country disparities in MSK mortality and its temporal trend. We found substantial variations in MSK mortality and its trends between countries, regions and also between sex and age groups. Promoted awareness and better management of MSK might partly explain reduction in MSK mortality, but variations across countries warrant further investigations.

Increasing hip fracture rates among older adults in Ecuador: analysis of the National Hospital Discharge System, 1999-2016.

PubMed

Orces, Carlos H; Gavilanez, Enrique Lopez

2017-12-07

The Ecuadorian hospital discharge system examined trends in hip fracture hospitalization rates among older adults. A significant upward trend in hip fracture rates occurred in both genders over the study period. Previous research has reported increasing hip fracture rates in Ecuador. Thus, this study aimed to extend previous findings by examining the nationwide incidence of hip fractures among adults aged 65 years and older between 1999 and 2016. A secondary objective was to compare hip fracture trends among older Ecuadorians with their counterparts in the United States (U.S.). The National Hospital Discharge System and the Healthcare Cost and Utilization Project net were assessed to identify older adults hospitalized with a principal diagnosis of hip fractures in Ecuador and the U.S., respectively. The Joinpoint regression analysis software was used to examine the average annual percent change in hip fracture rates. A total of 20,091 adults with a mean age of 82.3 (SD 8.1) years were hospitalized with a principal diagnosis of hip fractures during the study period. After an adjustment for age, hip fracture rates increased annually on average by 4.6% (95% CI 3.8%, 5.4%) from 96.4/100,000 in 1999 to 173.1/100,000 persons in 2016. Between 1999 and 2014, hip fracture age-adjusted rates decreased on average by - 2.5% (95% CI - 2.7%, - 2.3%) among older adults in the U.S. while hip fracture rates steadily increased by 4.6% (95% CI, 3.6%, 5.7%) per year in their Ecuadorian counterparts. Hip fracture rates markedly increased among older adults in Ecuador. The present findings should alert public health authorities to implement policies of osteoporosis awareness and prevention in Ecuador.

Effects of MHRA drug safety advice on time trends in prescribing volume and indices of clinical toxicity for quinine

PubMed Central

Acheampong, Paul; Cooper, Gill; Khazaeli, Behshad; Lupton, David J; White, Sue; May, Margaret T; Thomas, Simon H L

2013-01-01

Aims To ascertain the effects of the Medicines and Healthcare products Regulatory Agency's (MHRA) safety update in June 2010 on the volume of prescribing of quinine and on indices of quinine toxicity. Methods We analysed quarterly primary care total and quinine prescribing data for England and quinine prescribing volume for individual Primary Care Trusts in the North East of England from 2007/8 to 2011/12 obtained from the ePACT.net database. We also analysed quinine toxicity enquiries to the National Poisons Information Service (NPIS) via Toxbase® and by telephone between 2004/5 and 2011/12. Joinpoint regression and Pearson's correlation tests were used to ascertain changes in trends in prescribing and indices of toxicity and associations between prescribing and indices of toxicity, respectively. Results Total prescribing continued to increase, but annual growth in quinine prescribing in England declined from 6.0 to −0.6% following the MHRA update [difference −0.04 (95% confidence interval −0.07 to −0.01) quinine prescriptions per 100 patients per quarter, P = 0.0111]. Much larger reductions were observed in Primary Care Trusts that introduced comprehensive prescribing reviews. The previously increasing trend in Toxbase® quinine searches was reversed [difference −19.76 (95% confidence interval −39.28 to −9.20) user sessions per quarter, P = 0.0575]. Telephone enquiries to NPIS for quinine have declined, with stabilization of the proportion of moderate to severe cases of quinine poisoning since the update. Conclusions The MHRA advice was followed by limited reductions in the growth in quinine prescribing and in indicators of quinine overdose and toxicity. Quinine prescribing, however, remains common, and further efforts are needed to reduce availability and use. PMID:23594200

Breast cancer in Asian Americans in California, 1988-2013: increasing incidence trends and recent data on breast cancer subtypes.

PubMed

Gomez, Scarlett Lin; Von Behren, Julie; McKinley, Meg; Clarke, Christina A; Shariff-Marco, Salma; Cheng, Iona; Reynolds, Peggy; Glaser, Sally L

2017-07-01

In contrast to other US racial/ethnic groups, Asian Americans (AA) have experienced steadily increasing breast cancer rates in recent decades. To better understand potential contributors to this increase, we examined incidence trends by age and stage among women from seven AA ethnic groups in California from 1988 to 2013, and incidence patterns by subtype and age at diagnosis for the years 2009 through 2013. Joinpoint regression was applied to California Cancer Registry data to calculate annual percentage change (APC) for incidence trends. Incidence rate ratios were used to compare rates for AA ethnic groups relative to non-Hispanic whites (NHW). All AA groups except Japanese experienced incidence increases, with the largest among Koreans in 1988-2006 (APC 4.7, 95% CI 3.8, 5.7) and Southeast Asians in 1988-2013 (APC 2.5, 95% CI 0.8, 4.2). Among women younger than age 50, large increases occurred for Vietnamese and other Southeast Asians; among women over age 50, increasing trends occurred in all AA ethnic groups. Rates increased for distant-stage disease among Filipinas (2.2% per year, 95% CI 0.4, 3.9). Compared to NHW, Filipinas and older Vietnamese had higher incidence rates of some HER2+ subtypes. Breast cancer incidence rates have risen rapidly among California AA, with the greatest increases in Koreans and Southeast Asians. Culturally tailored efforts to increase awareness of and attention to breast cancer risk factors are needed. Given the relatively higher rates of HER2-overexpressing subtypes in some AA ethnicities, research including these groups and their potentially unique exposures may help elucidate disease etiology.

Temporal Trends and Future Prediction of Breast Cancer Incidence Across Age Groups in Trivandrum, South India.

PubMed

Mathew, Aleyamma; George, Preethi Sara; Arjunan, Asha; Augustine, Paul; Kalavathy, Mc; Padmakumari, G; Mathew, Beela Sarah

2016-01-01

Increasing breast cancer (BC) incidence rates have been reported from India; causal factors for this increased incidence are not understood and diagnosis is mostly in advanced stages. Trivandrum exhibits the highest BC incidence rates in India. This study aimed to estimate trends in incidence by age from 2005- 2014, to predict rates through 2020 and to assess the stage at diagnosis of BC in Trivandrum. BC cases were obtained from the Population Based Cancer Registry, Trivandrum. Distribution of stage at diagnosis and incidence rates of BC [Age-specific (ASpR), crude (CR) and age-standardized (ASR)] are described and employed with a joinpoint regression model to estimate average annual percent changes (AAPC) and a Bayesian model to estimate predictive rates. BC accounts for 31% (2681/8737) of all female cancers in Trivandrum. Thirty-five percent (944/2681) are <50 years of age and only 9% present with stage I disease. Average age increased from 53 to 56.4 years (p=0.0001), CR (per 105 women) increased from 39 (ASR: 35.2) to 55.4 (ASR: 43.4), AAPC for CR was 5.0 (p=0.001) and ASR was 3.1 (p=0.001). Rates increased from 50 years. Predicted ASpR is 174 in 50-59 years, 231 in > 60 years and overall CR is 80 (ASR: 57) for 2019- 20. BC, mostly diagnosed in advanced stages, is rising rapidly in South India with large increases likely in the future; particularly among post-menopausal women. This increase might be due to aging and/or changes in lifestyle factors. Reasons for the increased incidence and late stage diagnosis need to be studied.

Time trends in lifetime incidence rates of first-time diagnosed anorexia nervosa and bulimia nervosa across 16 years in a Danish nationwide psychiatric registry study.

PubMed

Steinhausen, Hans-Christoph; Jensen, Christina Mohr

2015-11-01

To study recent time trends in the incidence of diagnosed anorexia nervosa (AN) and bulimia nervosa (BN) based on nationwide psychiatric register data. The Danish Psychiatric Central Research Registry was used to identify the incidence of diagnosed cases with AN and BN at the ages of 4-65 years from 1995 to 2010. Age- and sex-adjusted incidence rates per 100,000 person-years were calculated and were adjusted for time trends in the total number of people diagnosed in psychiatry. Time trends were analyzed using JoinPoint regression analysis. A total of N = 5,902 persons had a first-time incidence of AN, and a total of N = 5,113 had first-time incidence of BN. Incidence rates increased for AN from 6.4 to 12.6 per 100,000 person-years, and for BN from 6.3 to 7.2 per 100,000 person-years. In 2010, the male-to-female ratio was 1:8 for AN, and 1:20 for BN. There was an earlier onset for AN than for BN, and age at incidence decreased during the observation period for AN but not for BN. A sizeable part of the increasing incidence rates for AN and in particular, the younger AN age groups, could be attributed to an increase in the total number of N = 249,607 persons with first-time diagnoses in psychiatry. Incidence rates had increased slightly for AN, but were stable for BN across 16 years in this nationwide study and to a large extent were reflective of a general increase in diagnosed mental disorders. © 2015 Wiley Periodicals, Inc.

What has happened to suicides during the Greek economic crisis? Findings from an ecological study of suicides and their determinants (2003–2012)

PubMed Central

Rachiotis, George; Stuckler, David; McKee, Martin; Hadjichristodoulou, Christos

2015-01-01

Objectives There is a controversy about the impact of economic crisis on suicide rates in Greece. We analysed recent suicide data to identify who has been most affected and the relationships to economic and labour market indicators. Setting Greece. Primary and secondary outcome measures Age-specific and sex-specific suicide rates in Greece for the period 2003–2012 were calculated using data provided by the Hellenic Statistical Authority. We performed a join-point analysis to identify discontinuities in suicide trends between 2003 and 2010, prior to austerity, and in 2011–2012, during the period of austerity. Regression models were used to assess relationships between unemployment, Gross Domestic Product (GDP) and suicide rates for the entire period by age and sex. Results The mean suicide rate overall rose by 35% between 2010 and 2012, from 3.37 to 4.56/100 000 population. The suicide mortality rate for men increased from 5.75 (2003–2010) to 7.43/100 000 (2011–2012; p<0.01). Among women, the suicide rate also rose, albeit less markedly, from 1.17 to 1.55 (p=0.03). When differentiated by age group, suicide mortality increased among both sexes in the age groups 20–59 and >60 years. We found that each additional percentage point of unemployment was associated with a 0.19/100 000 population rise in suicides (95% CI 0.11 to 0.26) among working age men. Conclusions We found a clear increase in suicides among persons of working age, coinciding with austerity measures. These findings corroborate concerns that increased suicide risk in Greece is a health hazard associated with austerity measures. PMID:25807950

Preventable Hospitalization Rates and Neighborhood Poverty among New York City Residents, 2008-2013.

PubMed

Bocour, Angelica; Tria, Maryellen

2016-12-01

Knowing which demographic groups have higher rates of preventable hospitalizations can help identify geographic areas where improvements in primary care access and quality can be made. This study assessed whether preventable hospitalization rates by neighborhood poverty decreased from 2008 to 2013 and whether the gap between very high and low poverty neighborhoods changed. We examined trends in age-adjusted preventable hospitalization rates and rate ratios by neighborhood poverty overall and by sex using JoinPoint regression. Prevention Quality Indicators (PQIs) developed by the Agency for Healthcare Research and Quality were applied to inpatient hospitalization data from the New York State Department of Health's Statewide Planning and Research Cooperative System. PQIs were classified into composites. From 2008 to 2013, preventable hospitalization rates per 100,000 adults across each poverty group decreased. For very high poverty neighborhoods (ZIP codes with ≥30 % of persons living below the federal poverty level (FPL)), there were significant decreases overall (3430.56 to 2543.10, annual percent change [APC] = -5.91 %), for diabetes (676.15 to 500.83, APC = -5.75 %), respiratory (830.78 to 660.29, APC = -4.85 %), circulatory (995.69 to 701.81, APC = -7.24 %), and acute composites (928.18 to 680.17, APC = -5.62 %). The rate ratios also decreased over time; however, in 2013, the rates for very high poverty neighborhoods were two to four times higher than low poverty neighborhoods (ZIP codes with <10 % of persons below the FPL). While preventable hospitalization rates have decreased over time, disparities still exist. These findings underscore the need to ensure adequate access to quality and timely primary care among individuals living in high poverty neighborhoods.

Decreasing trends in cardiovascular mortality in Turkey between 1988 and 2008

PubMed Central

2013-01-01

Background Cardiovascular disease (CVD) mortality increased in developed countries until the 1970s then started to decline. Turkey is about to complete its demographic transition, which may also influence mortality trends. This study evaluated trends in coronary heart disease (CHD) and stroke mortality between 1988 and 2008. Methods The number of deaths by cause (ICD-8), age and sex were obtained from the Turkish Statistical Institute (TurkStat) annually between 1988 and 2008. Population statistics were based on census data (1990 and 2000) and Turkstat projections. European population standardised mortality rates for CHD and stroke were calculated for men and women over 35 years old. Joinpoint Regression was used to identify the points at which a statistically significant (p < 0.05) change of the trend occurred. Results The CHD mortality rate increased by 2.9% in men and 2.0% in women annually from 1988 to 1994, then started to decline. The annual rate of decline for men was 1.7% between 1994–2008, whilst in women it was 2.8% between 1994–2000 and 6.7% between 2005–2008 (p < 0.05 for all periods). Stroke mortality declined between 1990–1994 (annual fall of 3.8% in both sexes), followed by a slight increase between 1994–2004 (0.6% in men, 1.1% in women), then a further decline until 2008 (annual reduction of 4.4% in men, 7.9% in women) (p < 0.05 for all periods). Conclusions A decrease in CVD mortality was observed from 1995 onwards in Turkey. The causes need to be explored in detail to inform future policy priorities in noncommunicable disease control. PMID:24079269

Differences in Childhood Leukemia Incidence and Survival between Southern Thailand and the United States: A Population-Based Analysis

PubMed Central

Demanelis, Kathryn; Sriplung, Hutcha; Meza, Rafael; Wiangnon, Surapon; Rozek, Laura S.; Scheurer, Michael E.; Lupo, Philip J.

2015-01-01

BACKGROUND Childhood leukemia incidence and survival varies globally, and this variation may be attributed to environmental risk factors, genetics, and/or disparities in diagnosis and treatment. PROCEDURE We analyzed childhood leukemia incidence and survival trends in children age 0–19 years from 1990 to 2011 in Songkhla, Thailand (n=316) and compared these results to US data from the Surveillance, Epidemiology, and End Results (SEER) registry (n=6,738). We computed relative survival using Ederer II and estimated survival functions using the Kaplan-Meier method. Changes in incidence and five-year survival by year of diagnosis were evaluated using joinpoint regression and are reported as annual percent changes (APC). RESULTS The age-standardized incidence of leukemia was 3.2 and 4.1 cases per 100,000 in Songkhla and SEER-9, respectively. In Songkhla, incidence from 1990–2011 significantly increased for leukemia (APC=1.7%, p=0.031) and acute lymphoblastic leukemia (ALL) (APC=1.8%, p=0.033). Acute myeloid leukemia (AML) incidence significantly increased (APC=4.2%, p=0.044) and was significantly different from the US (p=0.026), where incidence was stable during the same period (APC=0.3%, p=0.541). The overall five-year relative survival for leukemia was lower than that reported in the US (43% vs. 79%). Five-year survival significantly improved by at least 2% per year from 1990–2011 in Songkhla for leukemia, ALL, and AML (p<0.050). CONCLUSIONS While leukemia and ALL incidence increased in Songkhla, differences in leukemia trends, particularly AML incidence, may suggest etiologic or diagnostic differences between Songkhla and the US. This work highlights the importance of evaluating childhood cancer trends in low- and middle-income countries. PMID:25962869

Epidemiology Characteristics and Trends of Lung Cancer Incidence in Iran.

PubMed

Almasi, Zeinab; Salehiniya, Hamid; Amoori, Neda; Enayatrad, Mostafa

2016-01-01

Lung cancer is one of the most common cancers in the world and a major cause of death from cancer. One of the important indicators to compare the prevalence and incidence of the disease is a change in the trend. The aim of this study was to investigate the changes in the incidence of lung cancer in Iran. This study was conducted based on existing data obtained from a national registry of cancer cases and the Disease Management Center of Ministry of Health in Iran. All cases registered in the country were included during 2003-2008. Incidence rates were reported based on the direct method and standard population of World Health Organization. The study also examined the morphology of common lung cancers. Trends in incidence underwent joinpoint regression analysis. Based on the results of this study, 14,403 cases of lung cancer have been recorded of which 10,582 cases were in men and 3,821 in women. Highest incidence rates were observed in the 80-84 age group. Considerable variation across provinces was evident. In females squamous cell carcinoma (SCC) demonstrated a reduction from 24% to 16% of lesions over the period of study, while adenocarcinoma rose from 21% to 29%. In males a similar reduction in SCC was apparent (42% to 29%, again with increase in AC (13 % to 18%). The results show that the increase in the incidence of lung cancer the trend is that more men than women and in men and may be caused by changes in smoking pattern. The incidence of lung cancer in the North West and West provinces was higher than in other regions.

Rising population of survivors of oral squamous cell cancer in the United States.

PubMed

Patel, Mira A; Blackford, Amanda L; Rettig, Eleni M; Richmon, Jeremy D; Eisele, David W; Fakhry, Carole

2016-05-01

The incidence of oropharyngeal cancer (OPC) and a subset of oral cavity cancer (OCC) is increasing in the United States. To the authors' knowledge, the presumed growing prevalence of survivors of OPC and OCC has not been investigated to date. Retrospective analysis of Surveillance, Epidemiology, and End Results data (1975-2012) estimated changes in incidence, 5-year cause-specific survival, and prevalence for OPC and OCC. Changes in incidence, cause-specific survival and prevalence were estimated by linear regression and expressed as the percentage change (B). Differences in incidence trends over time were determined by joinpoint analysis. The incidence of OPC increased by 62.6% from 1975 through 2012. Notable increases in OPC incidence were observed among men, white individuals, and those of younger ages. The 5-year survival for OPC increased significantly for all sexes, races, and individuals aged >30 years, with white individuals and males experiencing the largest increase in survival. By contrast, the incidence of OCC declined by 22.3% during the same time period. OCC incidence decreased across all groups but increased among individuals aged 30 to 39 years. Significant increases in survival were observed for OCC, except for those who were female, black, and aged <40 years. The prevalence of survivors of OPC increased from 2000 to 2012 (B, 115.1 per 100,000 individuals per year; P<.0001), whereas the prevalence of survivors of OCC significantly decreased (B, -15.8 per 100,000 individuals per year; P<.0001). The prevalence of survivors of OPC is increasing, whereas the prevalence of survivors of OCC is declining. These data portend significant implications for long-term care planning for survivors of OPC and OCC. Cancer 2016;122:1380-1387. © 2016 American Cancer Society. © 2016 American Cancer Society.

Kendall-Theil Robust Line (KTRLine--version 1.0)-A Visual Basic Program for Calculating and Graphing Robust Nonparametric Estimates of Linear-Regression Coefficients Between Two Continuous Variables

USGS Publications Warehouse

Granato, Gregory E.

2006-01-01

The Kendall-Theil Robust Line software (KTRLine-version 1.0) is a Visual Basic program that may be used with the Microsoft Windows operating system to calculate parameters for robust, nonparametric estimates of linear-regression coefficients between two continuous variables. The KTRLine software was developed by the U.S. Geological Survey, in cooperation with the Federal Highway Administration, for use in stochastic data modeling with local, regional, and national hydrologic data sets to develop planning-level estimates of potential effects of highway runoff on the quality of receiving waters. The Kendall-Theil robust line was selected because this robust nonparametric method is resistant to the effects of outliers and nonnormality in residuals that commonly characterize hydrologic data sets. The slope of the line is calculated as the median of all possible pairwise slopes between points. The intercept is calculated so that the line will run through the median of input data. A single-line model or a multisegment model may be specified. The program was developed to provide regression equations with an error component for stochastic data generation because nonparametric multisegment regression tools are not available with the software that is commonly used to develop regression models. The Kendall-Theil robust line is a median line and, therefore, may underestimate total mass, volume, or loads unless the error component or a bias correction factor is incorporated into the estimate. Regression statistics such as the median error, the median absolute deviation, the prediction error sum of squares, the root mean square error, the confidence interval for the slope, and the bias correction factor for median estimates are calculated by use of nonparametric methods. These statistics, however, may be used to formulate estimates of mass, volume, or total loads. The program is used to read a two- or three-column tab-delimited input file with variable names in the first row and data in subsequent rows. The user may choose the columns that contain the independent (X) and dependent (Y) variable. A third column, if present, may contain metadata such as the sample-collection location and date. The program screens the input files and plots the data. The KTRLine software is a graphical tool that facilitates development of regression models by use of graphs of the regression line with data, the regression residuals (with X or Y), and percentile plots of the cumulative frequency of the X variable, Y variable, and the regression residuals. The user may individually transform the independent and dependent variables to reduce heteroscedasticity and to linearize data. The program plots the data and the regression line. The program also prints model specifications and regression statistics to the screen. The user may save and print the regression results. The program can accept data sets that contain up to about 15,000 XY data points, but because the program must sort the array of all pairwise slopes, the program may be perceptibly slow with data sets that contain more than about 1,000 points.

Epidemiologic programs for computers and calculators. A microcomputer program for multiple logistic regression by unconditional and conditional maximum likelihood methods.

PubMed

Campos-Filho, N; Franco, E L

1989-02-01

A frequent procedure in matched case-control studies is to report results from the multivariate unmatched analyses if they do not differ substantially from the ones obtained after conditioning on the matching variables. Although conceptually simple, this rule requires that an extensive series of logistic regression models be evaluated by both the conditional and unconditional maximum likelihood methods. Most computer programs for logistic regression employ only one maximum likelihood method, which requires that the analyses be performed in separate steps. This paper describes a Pascal microcomputer (IBM PC) program that performs multiple logistic regression by both maximum likelihood estimation methods, which obviates the need for switching between programs to obtain relative risk estimates from both matched and unmatched analyses. The program calculates most standard statistics and allows factoring of categorical or continuous variables by two distinct methods of contrast. A built-in, descriptive statistics option allows the user to inspect the distribution of cases and controls across categories of any given variable.

Cost-effectiveness analysis of the diarrhea alleviation through zinc and oral rehydration therapy (DAZT) program in rural Gujarat India: an application of the net-benefit regression framework.

PubMed

Shillcutt, Samuel D; LeFevre, Amnesty E; Fischer-Walker, Christa L; Taneja, Sunita; Black, Robert E; Mazumder, Sarmila

2017-01-01

This study evaluates the cost-effectiveness of the DAZT program for scaling up treatment of acute child diarrhea in Gujarat India using a net-benefit regression framework. Costs were calculated from societal and caregivers' perspectives and effectiveness was assessed in terms of coverage of zinc and both zinc and Oral Rehydration Salt. Regression models were tested in simple linear regression, with a specified set of covariates, and with a specified set of covariates and interaction terms using linear regression with endogenous treatment effects was used as the reference case. The DAZT program was cost-effective with over 95% certainty above $5.50 and $7.50 per appropriately treated child in the unadjusted and adjusted models respectively, with specifications including interaction terms being cost-effective with 85-97% certainty. Findings from this study should be combined with other evidence when considering decisions to scale up programs such as the DAZT program to promote the use of ORS and zinc to treat child diarrhea.

An improved multiple linear regression and data analysis computer program package

NASA Technical Reports Server (NTRS)

Sidik, S. M.

1972-01-01

NEWRAP, an improved version of a previous multiple linear regression program called RAPIER, CREDUC, and CRSPLT, allows for a complete regression analysis including cross plots of the independent and dependent variables, correlation coefficients, regression coefficients, analysis of variance tables, t-statistics and their probability levels, rejection of independent variables, plots of residuals against the independent and dependent variables, and a canonical reduction of quadratic response functions useful in optimum seeking experimentation. A major improvement over RAPIER is that all regression calculations are done in double precision arithmetic.

Regression modeling of ground-water flow

USGS Publications Warehouse

Cooley, R.L.; Naff, R.L.

1985-01-01

Nonlinear multiple regression methods are developed to model and analyze groundwater flow systems. Complete descriptions of regression methodology as applied to groundwater flow models allow scientists and engineers engaged in flow modeling to apply the methods to a wide range of problems. Organization of the text proceeds from an introduction that discusses the general topic of groundwater flow modeling, to a review of basic statistics necessary to properly apply regression techniques, and then to the main topic: exposition and use of linear and nonlinear regression to model groundwater flow. Statistical procedures are given to analyze and use the regression models. A number of exercises and answers are included to exercise the student on nearly all the methods that are presented for modeling and statistical analysis. Three computer programs implement the more complex methods. These three are a general two-dimensional, steady-state regression model for flow in an anisotropic, heterogeneous porous medium, a program to calculate a measure of model nonlinearity with respect to the regression parameters, and a program to analyze model errors in computed dependent variables such as hydraulic head. (USGS)

MULGRES: a computer program for stepwise multiple regression analysis

Treesearch

A. Jeff Martin

1971-01-01

MULGRES is a computer program source deck that is designed for multiple regression analysis employing the technique of stepwise deletion in the search for most significant variables. The features of the program, along with inputs and outputs, are briefly described, with a note on machine compatibility.

Automating approximate Bayesian computation by local linear regression.

PubMed

Thornton, Kevin R

2009-07-07

In several biological contexts, parameter inference often relies on computationally-intensive techniques. "Approximate Bayesian Computation", or ABC, methods based on summary statistics have become increasingly popular. A particular flavor of ABC based on using a linear regression to approximate the posterior distribution of the parameters, conditional on the summary statistics, is computationally appealing, yet no standalone tool exists to automate the procedure. Here, I describe a program to implement the method. The software package ABCreg implements the local linear-regression approach to ABC. The advantages are: 1. The code is standalone, and fully-documented. 2. The program will automatically process multiple data sets, and create unique output files for each (which may be processed immediately in R), facilitating the testing of inference procedures on simulated data, or the analysis of multiple data sets. 3. The program implements two different transformation methods for the regression step. 4. Analysis options are controlled on the command line by the user, and the program is designed to output warnings for cases where the regression fails. 5. The program does not depend on any particular simulation machinery (coalescent, forward-time, etc.), and therefore is a general tool for processing the results from any simulation. 6. The code is open-source, and modular.Examples of applying the software to empirical data from Drosophila melanogaster, and testing the procedure on simulated data, are shown. In practice, the ABCreg simplifies implementing ABC based on local-linear regression.

Multiple linear regression analysis

NASA Technical Reports Server (NTRS)

Edwards, T. R.

1980-01-01

Program rapidly selects best-suited set of coefficients. User supplies only vectors of independent and dependent data and specifies confidence level required. Program uses stepwise statistical procedure for relating minimal set of variables to set of observations; final regression contains only most statistically significant coefficients. Program is written in FORTRAN IV for batch execution and has been implemented on NOVA 1200.

Two SPSS programs for interpreting multiple regression results.

PubMed

Lorenzo-Seva, Urbano; Ferrando, Pere J; Chico, Eliseo

2010-02-01

When multiple regression is used in explanation-oriented designs, it is very important to determine both the usefulness of the predictor variables and their relative importance. Standardized regression coefficients are routinely provided by commercial programs. However, they generally function rather poorly as indicators of relative importance, especially in the presence of substantially correlated predictors. We provide two user-friendly SPSS programs that implement currently recommended techniques and recent developments for assessing the relevance of the predictors. The programs also allow the user to take into account the effects of measurement error. The first program, MIMR-Corr.sps, uses a correlation matrix as input, whereas the second program, MIMR-Raw.sps, uses the raw data and computes bootstrap confidence intervals of different statistics. The SPSS syntax, a short manual, and data files related to this article are available as supplemental materials from http://brm.psychonomic-journals.org/content/supplemental.

Bringing a Perspective from Outside the Field: A Commentary on Davis et al.'s (2010) Use of a Modified Regression Discontinuity Design to Evaluate a Gifted Program

ERIC Educational Resources Information Center

Adelson, Jill L.; Kelcey, Benjamin

2016-01-01

In this commentary of "Evaluating the Gifted Program of an Urban School District Using a Modified Regression Discontinuity Design" by Davis, Engberg, Epple, Sieg, and Zimmer, we examine the background of the study, critique the methods used, and discuss the results and implications. The study used a fuzzy regression discontinuity design…

The microcomputer scientific software series 2: general linear model--regression.

Treesearch

Harold M. Rauscher

1983-01-01

The general linear model regression (GLMR) program provides the microcomputer user with a sophisticated regression analysis capability. The output provides a regression ANOVA table, estimators of the regression model coefficients, their confidence intervals, confidence intervals around the predicted Y-values, residuals for plotting, a check for multicollinearity, a...

Cancer incidence in northern Sweden before and after the Chernobyl nuclear power plant accident.

PubMed

Alinaghizadeh, Hassan; Tondel, Martin; Walinder, Robert

2014-08-01

Sweden received about 5 % of the total release of (137)Cs from the Chernobyl nuclear power plant accident in 1986. The distribution of the fallout mainly affected northern Sweden, where some parts of the population could have received an estimated annual effective dose of 1-2 mSv per year. It is disputed whether an increased incidence of cancer can be detected in epidemiological studies after the Chernobyl nuclear power plant accident outside the former Union of Soviet Socialist Republics. In the present paper, a possible exposure-response pattern between deposition of (137)Cs and cancer incidence after the Chernobyl nuclear power plant accident was investigated in the nine northernmost counties of Sweden (2.2 million inhabitants in 1986). The activity of (137)Cs from the fallout maps at 1986 was used as a proxy for the received dose of ionizing radiation. Diagnoses of cancer (ICD-7 code 140-209) from 1980 to 2009 were received from the Swedish Cancer Registry (273,222 cases). Age-adjusted incidence rate ratios, stratified by gender, were calculated with Poisson regression in two closed cohorts of the population in the nine counties 1980 and 1986, respectively. The follow-up periods were 1980-1985 and 1986-2009, respectively. The average surface-weighted deposition of (137)Cs at three geographical levels; county (n = 9), municipality (n = 95) and parish level (n = 612) was applied for the two cohorts to study the pre- and the post-Chernobyl periods separately. To analyze time trends, the age-standardized total cancer incidence was calculated for the general Swedish population and the population in the nine counties. Joinpoint regression was used to compare the average annual percent change in the general population and the study population within each gender. No obvious exposure-response pattern was seen in the age-adjusted total cancer incidence rate ratios. A spurious association between fallout and cancer incidence was present, where areas with the lowest incidence of cancer before the accident coincidentally had the lowest fallout of (137)Cs. Increasing the geographical resolution of exposure from nine county averages to 612 parish averages resulted in a two to three times higher value of variance in the regression model. There was a secular trend with an increase in age-standardized incidence of cancer in both genders from 1980 to 2009, but significant only in females. This trend was stronger and statistically significant for both genders in the general Swedish population compared to the nine counties. In conclusion, using both high quality cancer registry data and high resolution exposure maps of (137)Cs deposition, it was not possible to distinguish an effect of (137)Cs on cancer incidence after the Chernobyl nuclear power plant accident in Sweden.

Advantages of the net benefit regression framework for economic evaluations of interventions in the workplace: a case study of the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders.

PubMed

Hoch, Jeffrey S; Dewa, Carolyn S

2014-04-01

Economic evaluations commonly accompany trials of new treatments or interventions; however, regression methods and their corresponding advantages for the analysis of cost-effectiveness data are not well known. To illustrate regression-based economic evaluation, we present a case study investigating the cost-effectiveness of a collaborative mental health care program for people receiving short-term disability benefits for psychiatric disorders. We implement net benefit regression to illustrate its strengths and limitations. Net benefit regression offers a simple option for cost-effectiveness analyses of person-level data. By placing economic evaluation in a regression framework, regression-based techniques can facilitate the analysis and provide simple solutions to commonly encountered challenges. Economic evaluations of person-level data (eg, from a clinical trial) should use net benefit regression to facilitate analysis and enhance results.

Method for nonlinear exponential regression analysis

NASA Technical Reports Server (NTRS)

Junkin, B. G.

1972-01-01

Two computer programs developed according to two general types of exponential models for conducting nonlinear exponential regression analysis are described. Least squares procedure is used in which the nonlinear problem is linearized by expanding in a Taylor series. Program is written in FORTRAN 5 for the Univac 1108 computer.

cp-R, an interface the R programming language for clinical laboratory method comparisons.

PubMed

Holmes, Daniel T

2015-02-01

Clinical scientists frequently need to compare two different bioanalytical methods as part of assay validation/monitoring. As a matter necessity, regression methods for quantitative comparison in clinical chemistry, hematology and other clinical laboratory disciplines must allow for error in both the x and y variables. Traditionally the methods popularized by 1) Deming and 2) Passing and Bablok have been recommended. While commercial tools exist, no simple open source tool is available. The purpose of this work was to develop and entirely open-source GUI-driven program for bioanalytical method comparisons capable of performing these regression methods and able to produce highly customized graphical output. The GUI is written in python and PyQt4 with R scripts performing regression and graphical functions. The program can be run from source code or as a pre-compiled binary executable. The software performs three forms of regression and offers weighting where applicable. Confidence bands of the regression are calculated using bootstrapping for Deming and Passing Bablok methods. Users can customize regression plots according to the tools available in R and can produced output in any of: jpg, png, tiff, bmp at any desired resolution or ps and pdf vector formats. Bland Altman plots and some regression diagnostic plots are also generated. Correctness of regression parameter estimates was confirmed against existing R packages. The program allows for rapid and highly customizable graphical output capable of conforming to the publication requirements of any clinical chemistry journal. Quick method comparisons can also be performed and cut and paste into spreadsheet or word processing applications. We present a simple and intuitive open source tool for quantitative method comparison in a clinical laboratory environment. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Using Multiple and Logistic Regression to Estimate the Median WillCost and Probability of Cost and Schedule Overrun for Program Managers

DTIC Science & Technology

2017-03-23

PUBLIC RELEASE; DISTRIBUTION UNLIMITED Using Multiple and Logistic Regression to Estimate the Median Will- Cost and Probability of Cost and... Cost and Probability of Cost and Schedule Overrun for Program Managers Ryan C. Trudelle Follow this and additional works at: https://scholar.afit.edu...afit.edu. Recommended Citation Trudelle, Ryan C., "Using Multiple and Logistic Regression to Estimate the Median Will- Cost and Probability of Cost and

Applied Multiple Linear Regression: A General Research Strategy

ERIC Educational Resources Information Center

Smith, Brandon B.

1969-01-01

Illustrates some of the basic concepts and procedures for using regression analysis in experimental design, analysis of variance, analysis of covariance, and curvilinear regression. Applications to evaluation of instruction and vocational education programs are illustrated. (GR)

Fitting program for linear regressions according to Mahon (1996)

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

Trappitsch, Reto G.

2018-01-09

This program takes the users' Input data and fits a linear regression to it using the prescription presented by Mahon (1996). Compared to the commonly used York fit, this method has the correct prescription for measurement error propagation. This software should facilitate the proper fitting of measurements with a simple Interface.

7 CFR 275.23 - Determination of State agency program performance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... NUTRITION SERVICE, DEPARTMENT OF AGRICULTURE FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING... section, the adjusted regressed payment error rate shall be calculated to yield the State agency's payment error rate. The adjusted regressed payment error rate is given by r 1″ + r 2″. (ii) If FNS determines...

A mathematical programming method for formulating a fuzzy regression model based on distance criterion.

PubMed

Chen, Liang-Hsuan; Hsueh, Chan-Ching

2007-06-01

Fuzzy regression models are useful to investigate the relationship between explanatory and response variables with fuzzy observations. Different from previous studies, this correspondence proposes a mathematical programming method to construct a fuzzy regression model based on a distance criterion. The objective of the mathematical programming is to minimize the sum of distances between the estimated and observed responses on the X axis, such that the fuzzy regression model constructed has the minimal total estimation error in distance. Only several alpha-cuts of fuzzy observations are needed as inputs to the mathematical programming model; therefore, the applications are not restricted to triangular fuzzy numbers. Three examples, adopted in the previous studies, and a larger example, modified from the crisp case, are used to illustrate the performance of the proposed approach. The results indicate that the proposed model has better performance than those in the previous studies based on either distance criterion or Kim and Bishu's criterion. In addition, the efficiency and effectiveness for solving the larger example by the proposed model are also satisfactory.

The Trend in Histological Changes and the Incidence of Esophagus Cancer in Iran (2003-2008).

PubMed

Rafiemanesh, Hosein; Maleki, Farzad; Mohammadian-Hafshejani, Abdollah; Salemi, Morteza; Salehiniya, Hamid

2016-01-01

Esophageal cancer is the sixth cause of death in the world, there was a lack of population-based information on the trend and incidence rate of esophagus cancer, so this study aimed to determine the incidence and pathological changes of esophagus cancer in Iran. In this study, data were extracted from annual cancer registry reports of Iranian ministry of health between 2003 and 2008. Standardized incidence rates were calculated using the world standard population, and incidence rate was calculated by age groups, sex, and histological type. Data on epidemiologic trend and histology were analyzed using Joinpoint software package. In this study, there were 18,177 recorded cases of esophagus cancer. Of all cases, 45.72% were females and 54.28% were males. Sex ratio was 1.19. The most common histological types related to squamous cell carcinoma NOS and adenocarcinoma NOS were 64.53% and 10.37%, respectively. The trend of annual changes of incidence rate significantly increased in both sexes. The annual percentage changes, the incidence rate was 7.9 (95% confidence interval [CI]: 3.3-12.6) for women and 9.6 (95% CI: 6.0-13.2) for men. The histology type of SCC, large cell, nonkeratinizing and SCC, keratinizing and SCC, NOS had a significant decreasing trend in total population (P < 0.05). According to this study, the trend of age-standardized incidence rate of esophagus cancer in Iran is rising. Hence, to prevent and control this cancer, it is necessary to investigate related risk factors and implement prevention programs in Iran.

[Cervix uteri cancer in Poland--epidemiological opening balance and perspectives].

PubMed

Didkowska, Joanna; Wojciechowska, Urszula; Zatoński, Witold

2006-09-01

Cancer is one of the main causes of death among young and middle-aged females. In case of some cancer sites there is a possibility of undertaking an intervention, which would diminish the risk of death--to this group belongs first of all malignant neoplasm of cervix uteri. The date of beginning first cervix uteri cancer screening in Poland is approaching, therefore presenting epidemiological opening balance and possible scenarios of changes it worthwhile. This work uses data on morbidity and mortality due to malignant neoplasm of cervix uteri cancer in Polish population. Time trends analysis was based on so-called "breakpoint" (joinpoint analysis). Cervix uteri cancer mortality trend is characterized by two breakpoints (1971 and 1993). In the period of 1963-1970 there was an increase of mortality and then after the trend reversed: percentage decline was estimated at the level of 0.8% yearly in 1971-1992 and 2.4% yearly in 1993-2002. Hypothetical scenarios of changes in cervix uteri cancer mortality show, that lack of intervention will cause mortality among Polish females at the level recorded in Finland 25 years ago. Optimistic variant would allow on diminishing mortality in Poland down to the level observed currently in Finland, in around 30 years. Implementing preventive cervix uteri cancer screening is currently the most urgent challenge of public health. If the preventive screening program will still be in the phase of plans and projects, then in 30 years time Poland will be in the point which Finland reached in the end of 1970s, and our civilizing underdevelopment will reach half a century.

Increasing trends in the incidence and prevalence rates of type 1 diabetes among children and adolescents in the Netherlands.

PubMed

Fazeli Farsani, Soulmaz; Souverein, Patrick C; van der Vorst, Marja M J; Knibbe, Catherijne A J; Herings, Ron M C; de Boer, Anthonius; Mantel-Teeuwisse, Aukje K

2016-02-01

To assess the trends in the incidence and prevalence rates of type 1 diabetes (T1D) among children and adolescents in the Netherlands. A population-based cohort study was conducted in the Dutch PHARMO record linkage system (1998-2011). All children and adolescents aged ≤19 yr with at least one insulin dispensing (as a proxy for T1D) were identified and the numbers of incident and prevalent cases (numerators) were calculated. Overall age-adjusted (0-19 yr) incidence and prevalence rates together with age- and sex-specific rates of T1D and their 95% confidence intervals (CI) were calculated using data from the Dutch Central Bureau of Statistics as denominator. Trends over time were assessed using Joinpoint regression software (National Cancer Institute, Bethesda, MD, USA). In 2011, the overall age-adjusted incidence and prevalence rates of T1D were 25.2/100 000 (95% CI, 23.7-26.8) person-years (PY) and 174.4/100 000 (95% CI, 170.2-178.5) children, respectively. The average annual percentage change (AAPC) in the overall age-adjusted incidence and prevalence rate was 3.7% (95% CI, 1.8-5.7) and 3.8% (95% CI, 2.4-5.2), respectively. While during the study period the largest increases in the incidence and prevalence rates of T1D were observed for the oldest age groups (10-14 and 15-19 yr), a decreasing trend was detected for the 0- to 4-yr-old category (with AAPCs of -1.8 (95% CI, -9.9 to 7.1) and -6.9% (95% CI, -11.5 to -2.1) for incidence and prevalence, respectively). Age-adjusted incidence (1999-2011) and prevalence rates (1998-2011) of T1D in Dutch children (aged 0-19 yr) continued to increase and a shift was observed to a later onset of the disease. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Trends in incidence, mortality and survival of penile squamous cell carcinoma in Norway 1956-2015.

PubMed

Hansen, Bo T; Orumaa, Madleen; Lie, A Kathrine; Brennhovd, Bjørn; Nygård, Mari

2018-04-15

We examine trends in incidence, mortality and survival of penile squamous cell carcinoma (SCC) in Norway over 60 years. Data on all cases of penile cancer diagnosed in Norway during 1956-2015 were obtained from the Cancer Registry of Norway. Trends in age-standardized rates of penile SCC incidence, mortality and 5-year relative survival were assessed by the annual percentage change statistic and joinpoint regression. A total of 1,596 penile cancer cases were diagnosed during 1956-2015, among which 1,474 (92.4%) were SCC. During 2011-2015, the age-standardized incidence and mortality of penile SCC were 0.91 (95% confidence interval (CI): 0.78; 1.05) and 0.50 (0.42; 0.60) per 100,000, respectively, and the 5-year relative survival was 61.6% (41.9; 76.4). The incidence of SCC increased during 1956-2015, with an average annual percentage change (AAPC) of 0.80% (0.46; 1.15). The increase was strongest among men diagnosed at a relatively early age (age<=64 years; AAPC: 1.47% (0.90; 2.05)). Mortality also increased over the study period (AAPC: 0.47% (0.10; 0.85)), whereas 5-year relative survival did not change (AAPC: 0.08% (-0.19; 0.36)). We conclude that the incidence of penile SCC has increased at a moderate and constant rate during 1956-2015, and that the most consistent increase occurred among younger men. Mortality also increased during the study period. However, survival did not change, thus changes in diagnostics and treatment had little impact on survival from penile SCC. Since a substantial proportion of penile SCC is caused by human papillomavirus (HPV), the incidence increase may in part be attributed to increased exposure to HPV in the population. © 2017 The Authors International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

Reduction in Neisseria meningitidis infection in Italy after Meningococcal C conjugate vaccine introduction: A time trend analysis of 1994–2012 series

PubMed Central

de Waure, Chiara; Miglietta, Alessandro; Nedovic, Darko; Mereu, Giovanna; Ricciardi, Walter

2016-01-01

The incidence of invasive meningococcal disease (IMD) in Italy is among the lowest in Europe. Meningococcal C conjugate vaccine (MCC) was introduced in 2005 for 12 months old infants. The aim of this study was to describe the epidemiology of IMD in Italy from 1994 to 2012 and to evaluate the impact of MCC introduction. Data about Neisseria meningitidis (N. meningitidis) cases were drawn from the National Surveillance of Invasive Bacterial Diseases. The average incidence of IMD during 1994–2012 in Italy was 0.36 per 100,000 (95%CI 0.30; 0.40). N. meningitidis B was the most frequent serogroup and infants less than 12 months old were the most affected. Joinpoint analysis showed a statistically significant reduction in the incidence of N. meningitidis C related IMD after MCC introduction: the Annual Percentage Change declined from 21.8 (95%CI 15.1; 28.9) in 1994–2005 to −19.9 (95%CI −28.2; −10.7) afterwards. No changes were observed with respect to N. meningitidis B related IMD. Poisson regression showed a statistically significant reduction in the incidence of IMD both associated to N. meningitidis C (Incidence Rate Ratio 0.33; 95%CI 0.29; 0.37) and due to all serogroups (Incidence Rate Ratio 0.70; 95%CI 0.65; 0.75) in the post-vaccination period compared to the pre-vaccination one. On the other hand, the incidence of N. meningitidis B related IMD did not decrease. Our results suggest that MCC had an impact in decreasing the incidence of N. meningitidis C related IMD. However, data on typing are incomplete and efforts are needed to make them available for studying the need and the impact of other meningococcal vaccines. PMID:26308192

Trends in procedures for infertility and caesarean sections: was NICE disinvestment guidance implemented? NICE recommendation reminders.

PubMed

Chamberlain, Charlotte A; Martin, Richard M; Busby, John; Gilbert, Rebecca; Cahill, David J; Hollingworth, William

2013-02-06

National Institute for Health and Clinical Excellence (NICE) clinical guidelines and subsequent NICE issued 'recommendation reminders' advocate discontinuing two fertility procedures and caesarean sections in women with hepatitis. We assess whether NICE guidance in 2004 and recommendation reminders were associated with a change in the rate of clinical procedures performed. Routine inpatient Hospital Episode Statistics (HES) data were extracted from the HES database for 1st April 1998 to 31st March 2010 using OPCS procedure codes for varicocele operations in infertile men, endometrial biopsies in infertile women and caesarean sections in women with hepatitis B or C. We used Joinpoint regression to identify points in time when the trend in procedure rates changed markedly, to identify any influence of the release of NICE guidance. Between 1998-2010, planned caesarean sections in women with and without hepatitis B or C increased yearly (annual percentage change (APC) 4.9%, 95% CI 2.1% to 7.7%) in women with hepatitis, compared with women without (APC 4.0% [95% CI 2.7% to 5.3%] up to 2001, APC -0.6% [95% CI -2.8% to 1.8%] up to 2004 and 1.3% [95% CI 0.8% to 1.8%] up to 2010). In infertile women under 40 years of age, endometrial biopsies for investigation of infertility increased, APC 6.0% (95% CI 3.6% to 8.4%) up to 2003, APC 1.5% (95% CI -4.3% to 7.7%) to 2007 followed by APC 12.8% (95% CI 1.0% to 26.0%) to 2010. Varicocele procedures remained relatively static between 1998 and 2010 (APC -0.5%, 95% CI -2.3% to 1.3%). There was no decline in use of the three studied procedures, contrary to NICE guidance, and no change in uptake associated with the timing of NICE guidance or recommendation reminders. 'Do not do' recommendation reminders may be ineffective at improving clinical practice or achieving disinvestment.

Trends in annual sales and current use of cigarettes, cigars, roll-your-own tobacco, pipes, and smokeless tobacco among US adults, 2002-2012.

PubMed

Agaku, Israel T; Alpert, Hillel R

2016-07-01

Regulatory imbalances exist in the treatment of cigarettes and non-cigarette tobacco products in the USA. We assessed whether declines in cigarette consumption during 2002-2012 were offset by increased use of non-cigarette tobacco products-cigars, pipes, roll-your-own (RYO) and smokeless tobacco. Industry-reported taxable removals (actual sales) were converted into packs for cigarettes and cigarette pack equivalents (CPEs) for loose tobacco (RYO plus pipe tobacco) and moist snuff. Cigars were not converted to CPEs because of their heterogeneity in size/tobacco content. Per capita sales were calculated for the US adult population aged ≥18 years based on the US Census Bureau data. Self-reported data on current (past 30-day) tobacco use among US adults aged ≥18 years were from the National Survey on Drug Use and Health (NSDUH). Joinpoint and logistic regression were used to assess linear trends during 2002-2012. During 2002-2012, cigarette sales declined from 96.91 to 59.85 cigarette packs per capita; increases occurred for sale of cigars (30.51-57.42 cigars per capita), loose tobacco (2.50-5.63 CPEs per capita) and moist snuff (10.64-14.58 CPEs per capita; all p<0.05 for trend). Self-reported current cigarette smoking declined during 2002-2012 (27.4-23.6%); increases were noted for current RYO (2.6-3.6%) and smokeless tobacco use (3.5-3.7%; all p<0.05 for trend). The increase in non-cigarette tobacco consumption is a public health concern because all tobacco products are harmful. Eliminating imbalances in tax structure and regulations between cigarettes and non-cigarette tobacco products may help reduce aggregate tobacco consumption. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

What has happened to suicides during the Greek economic crisis? Findings from an ecological study of suicides and their determinants (2003-2012).

PubMed

Rachiotis, George; Stuckler, David; McKee, Martin; Hadjichristodoulou, Christos

2015-03-25

There is a controversy about the impact of economic crisis on suicide rates in Greece. We analysed recent suicide data to identify who has been most affected and the relationships to economic and labour market indicators. Greece. Age-specific and sex-specific suicide rates in Greece for the period 2003-2012 were calculated using data provided by the Hellenic Statistical Authority. We performed a join-point analysis to identify discontinuities in suicide trends between 2003 and 2010, prior to austerity, and in 2011-2012, during the period of austerity. Regression models were used to assess relationships between unemployment, Gross Domestic Product (GDP) and suicide rates for the entire period by age and sex. The mean suicide rate overall rose by 35% between 2010 and 2012, from 3.37 to 4.56/100,000 population. The suicide mortality rate for men increased from 5.75 (2003-2010) to 7.43/100,000 (2011-2012; p<0.01). Among women, the suicide rate also rose, albeit less markedly, from 1.17 to 1.55 (p=0.03). When differentiated by age group, suicide mortality increased among both sexes in the age groups 20-59 and >60 years. We found that each additional percentage point of unemployment was associated with a 0.19/100,000 population rise in suicides (95% CI 0.11 to 0.26) among working age men. We found a clear increase in suicides among persons of working age, coinciding with austerity measures. These findings corroborate concerns that increased suicide risk in Greece is a health hazard associated with austerity measures. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Trends in incidence, mortality and survival of penile squamous cell carcinoma in Norway 1956–2015

PubMed Central

Orumaa, Madleen; Lie, A. Kathrine; Brennhovd, Bjørn; Nygård, Mari

2017-01-01

We examine trends in incidence, mortality and survival of penile squamous cell carcinoma (SCC) in Norway over 60 years. Data on all cases of penile cancer diagnosed in Norway during 1956–2015 were obtained from the Cancer Registry of Norway. Trends in age‐standardized rates of penile SCC incidence, mortality and 5‐year relative survival were assessed by the annual percentage change statistic and joinpoint regression. A total of 1,596 penile cancer cases were diagnosed during 1956–2015, among which 1,474 (92.4%) were SCC. During 2011–2015, the age‐standardized incidence and mortality of penile SCC were 0.91 (95% confidence interval (CI): 0.78; 1.05) and 0.50 (0.42; 0.60) per 100,000, respectively, and the 5‐year relative survival was 61.6% (41.9; 76.4). The incidence of SCC increased during 1956–2015, with an average annual percentage change (AAPC) of 0.80% (0.46; 1.15). The increase was strongest among men diagnosed at a relatively early age (age<=64 years; AAPC: 1.47% (0.90; 2.05)). Mortality also increased over the study period (AAPC: 0.47% (0.10; 0.85)), whereas 5‐year relative survival did not change (AAPC: 0.08% (−0.19; 0.36)). We conclude that the incidence of penile SCC has increased at a moderate and constant rate during 1956–2015, and that the most consistent increase occurred among younger men. Mortality also increased during the study period. However, survival did not change, thus changes in diagnostics and treatment had little impact on survival from penile SCC. Since a substantial proportion of penile SCC is caused by human papillomavirus (HPV), the incidence increase may in part be attributed to increased exposure to HPV in the population. PMID:29205336

Estimating average annual per cent change in trend analysis

PubMed Central

Clegg, Limin X; Hankey, Benjamin F; Tiwari, Ram; Feuer, Eric J; Edwards, Brenda K

2009-01-01

Trends in incidence or mortality rates over a specified time interval are usually described by the conventional annual per cent change (cAPC), under the assumption of a constant rate of change. When this assumption does not hold over the entire time interval, the trend may be characterized using the annual per cent changes from segmented analysis (sAPCs). This approach assumes that the change in rates is constant over each time partition defined by the transition points, but varies among different time partitions. Different groups (e.g. racial subgroups), however, may have different transition points and thus different time partitions over which they have constant rates of change, making comparison of sAPCs problematic across groups over a common time interval of interest (e.g. the past 10 years). We propose a new measure, the average annual per cent change (AAPC), which uses sAPCs to summarize and compare trends for a specific time period. The advantage of the proposed AAPC is that it takes into account the trend transitions, whereas cAPC does not and can lead to erroneous conclusions. In addition, when the trend is constant over the entire time interval of interest, the AAPC has the advantage of reducing to both cAPC and sAPC. Moreover, because the estimated AAPC is based on the segmented analysis over the entire data series, any selected subinterval within a single time partition will yield the same AAPC estimate—that is it will be equal to the estimated sAPC for that time partition. The cAPC, however, is re-estimated using data only from that selected subinterval; thus, its estimate may be sensitive to the subinterval selected. The AAPC estimation has been incorporated into the segmented regression (free) software Joinpoint, which is used by many registries throughout the world for characterizing trends in cancer rates. Copyright © 2009 John Wiley & Sons, Ltd. PMID:19856324

Onset of a Declining Trend in Fatal Motor Vehicle Crashes Involving Drunk-driving in Japan

PubMed Central

Nakahara, Shinji; Katanoda, Kota; Ichikawa, Masao

2013-01-01

Background In Japan, introduction of severe drunk-driving penalties and a lower blood alcohol concentration (BAC) limit in June 2002 was followed by a substantial reduction in fatal alcohol-related crashes. However, previous research suggests that this reduction started before the legal amendments. The causes of the decrease have not been studied in detail. Methods Monthly police data on fatal road traffic crashes from January 1995 to August 2006 were analyzed using a joinpoint regression model to identify change-points in the trends of the proportion of drunk-driving among drivers primarily responsible for fatal crashes. We analyzed the data by BAC level (≥0.5 or <0.5 mg/ml), then conducted analyses stratified by vehicle type (car or motorcycle) and age group (<45 or ≥45 years) only for the proportion of those with a BAC of 0.5 mg/ml or higher. Results Among all drivers, the proportion of those with a BAC of 0.5 mg/ml or higher and those with a BAC greater than 0 but less than 0.5 mg/ml showed a change-point from increase to decrease in February 2000 and in May 2002, respectively. The proportion of those with a BAC of 0.5 mg/ml or higher showed a change-point from increase to decrease in October 1999 among car drivers and in April 2000 among drivers younger than 45 years. There was no change-point among motorcyclists. A change-point from no trend to a decrease in January 2002 was observed among those 45 years or older. Conclusions The change-point identified around the end of 1999 to the start of 2000 suggests that a high-profile fatal crash in November 1999, which drew media attention and provoked public debate, triggered subsequent changes in drunk-driving behavior. PMID:23604061

Declining death rates reflect progress against cancer.

PubMed

Jemal, Ahmedin; Ward, Elizabeth; Thun, Michael

2010-03-09

The success of the "war on cancer" initiated in 1971 continues to be debated, with trends in cancer mortality variably presented as evidence of progress or failure. We examined temporal trends in death rates from all-cancer and the 19 most common cancers in the United States from 1970-2006. We analyzed trends in age-standardized death rates (per 100,000) for all cancers combined, the four most common cancers, and 15 other sites from 1970-2006 in the United States using joinpoint regression model. The age-standardized death rate for all-cancers combined in men increased from 249.3 in 1970 to 279.8 in 1990, and then decreased to 221.1 in 2006, yielding a net decline of 21% and 11% from the 1990 and 1970 rates, respectively. Similarly, the all-cancer death rate in women increased from 163.0 in 1970 to 175.3 in 1991 and then decreased to 153.7 in 2006, a net decline of 12% and 6% from the 1991 and 1970 rates, respectively. These decreases since 1990/91 translate to preventing of 561,400 cancer deaths in men and 205,700 deaths in women. The decrease in death rates from all-cancers involved all ages and racial/ethnic groups. Death rates decreased for 15 of the 19 cancer sites, including the four major cancers, with lung, colorectum and prostate cancers in men and breast and colorectum cancers in women. Progress in reducing cancer death rates is evident whether measured against baseline rates in 1970 or in 1990. The downturn in cancer death rates since 1990 result mostly from reductions in tobacco use, increased screening allowing early detection of several cancers, and modest to large improvements in treatment for specific cancers. Continued and increased investment in cancer prevention and control, access to high quality health care, and research could accelerate this progress.

Declining Death Rates Reflect Progress against Cancer

PubMed Central

Jemal, Ahmedin; Ward, Elizabeth; Thun, Michael

2010-01-01

Background The success of the “war on cancer” initiated in 1971 continues to be debated, with trends in cancer mortality variably presented as evidence of progress or failure. We examined temporal trends in death rates from all-cancer and the 19 most common cancers in the United States from 1970–2006. Methodology/Principal Findings We analyzed trends in age-standardized death rates (per 100,000) for all cancers combined, the four most common cancers, and 15 other sites from 1970–2006 in the United States using joinpoint regression model. The age-standardized death rate for all-cancers combined in men increased from 249.3 in 1970 to 279.8 in 1990, and then decreased to 221.1 in 2006, yielding a net decline of 21% and 11% from the 1990 and 1970 rates, respectively. Similarly, the all-cancer death rate in women increased from 163.0 in 1970 to 175.3 in 1991 and then decreased to 153.7 in 2006, a net decline of 12% and 6% from the 1991 and 1970 rates, respectively. These decreases since 1990/91 translate to preventing of 561,400 cancer deaths in men and 205,700 deaths in women. The decrease in death rates from all-cancers involved all ages and racial/ethnic groups. Death rates decreased for 15 of the 19 cancer sites, including the four major cancers, with lung, colorectum and prostate cancers in men and breast and colorectum cancers in women. Conclusions/Significance Progress in reducing cancer death rates is evident whether measured against baseline rates in 1970 or in 1990. The downturn in cancer death rates since 1990 result mostly from reductions in tobacco use, increased screening allowing early detection of several cancers, and modest to large improvements in treatment for specific cancers. Continued and increased investment in cancer prevention and control, access to high quality health care, and research could accelerate this progress. PMID:20231893

Trends in AIDS-related mortality among people aged 60 years and older in Brazil: a nationwide population-based study.

PubMed

Lima, Mauricélia da Silveira; Firmo, Andréa Acioly Maia; Martins-Melo, Francisco Rogerlândio

2016-12-01

The success of antiretroviral therapy has led to an increase in the number of older people living with human immunodeficiency virus worldwide. This study analyzed the epidemiological patterns and time trends of acquired immunodeficiency syndrome (AIDS) related mortality in people aged 60 and older in Brazil from 2000 to 2011. Secondary mortality data from the Brazilian Mortality Information System was used to perform a nationwide population-based study, which included all AIDS-related deaths among people aged 60 years and older in Brazil from 2000 to 2011. Crude and age-adjusted mortality rates (per 100,000 inhabitants) were calculated by sex, age group and place of residence. Trends over time were assessed using joinpoint regression analysis. In the 12-year study period, 12,491,280 deaths were recorded in Brazil, of which 144,175 were AIDS-related deaths. A total of 8194 AIDS-related deaths was identified in people aged 60 years and older (0.12% of all deaths and 5.7% of AIDS-related deaths). The overall age-adjusted mortality rate for the period was 4.30 deaths/100,000 inhabitants (95% confidence interval: 3.99-4.64). Males (6.45 deaths/100,000 inhabitants), aged 60-64 years (6.63 deaths/100,000 inhabitants) and residing in the South region (5.94 deaths/100,000 inhabitants) had the highest mortality rates. We observed a significant increase in mortality at the national level and in all the Brazilian regions, with a sharper increase in the most socioeconomically disadvantaged regions of the country, such as the North and Northeast. The findings show that AIDS in older people is an increasing public health problem in Brazil, and reinforce the need to establish public policies for the prevention, early diagnosis and appropriate clinical treatment of this age group.

Time trend in incidence of malignant neoplasms of the central nervous system in relation to mobile phone use among young people in Japan.

PubMed

Sato, Yasuto; Kiyohara, Kosuke; Kojimahara, Noriko; Yamaguchi, Naohito

2016-07-01

The aim of this study was to examine whether incidence of malignant neoplasms of the central nervous system from 1993 to 2010 has increased among young people in Japan, and whether the increase could be explained by increase in mobile phone use. Joinpoint regression analysis of incidence data was performed. Subsequently, the expected incidence rate was calculated assuming that the relative risk was 1.4 for those who used mobile phones more than 1640 h cumulatively. Annual percent change was 3.9% (95% confidence interval [CI], 1.6-6.3) for men in their 20s from 1993 to 2010, 12.3% (95% CI, 3.3-22.1) for women in their 20s from 2002 to 2010, 2.7% (95% CI, 1.3-4.1) for men in their 30s from 1993 to 2010, and 3.0% (95% CI, 1.4-4.7) for women in their 30s from 1993 to 2010. Change in incidence rates from 1993 to 2010 was 0.92 per 100,000 people for men in their 20s, 0.83 for women in their 20s, 0.89 for men in their 30s, and 0.74 for women in their 30s. Change in expected incidence rates from 1993 to 2010 was 0.08 per 100,000 people for men in their 20s, 0.03 for women in their 20s, 0.15 for men in their 30s, and 0.05 for women in their 30s. Patterns in sex-, age-, and period-specific incidence increases are inconsistent with sex-, age-, and period-specific prevalence trends, suggesting the overall incidence increase cannot be explained by heavy mobile phone use. Bioelectromagnetics. 37:282-289, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Educational differences in sickness absence trends among young employees from 2002 to 2013 in Helsinki, Finland.

PubMed

Sumanen, Hilla; Lahelma, Eero; Lahti, Jouni; Pietiläinen, Olli; Rahkonen, Ossi

2016-05-06

Socioeconomic differences in sickness absence (SA) are well established among older employees but poorly understood among the young. Our aim was to examine 12-year trends in educational differences in SA among young female and male employees, and to assess the magnitude of the differences. We examined annual SA spells. The data were obtained from the employer's registers and linked to Statistics Finland's register data on completed education and qualifications. Education was classified into four hierarchical groups. Joinpoint regression models were used to identify turning points in SA trends. The magnitude of the relative educational differences was estimated in accordance with the relative index of inequality for 2002, 2008 and 2013. Employees of the City of Helsinki, Finland, in 2002-2013. The analyses covered female and male employees aged 25-34 years: employees aged 35-54 years were used as a reference group. SA spells. An educational gradient emerged among younger and older women and men. SA spells increased in the early 2000s, and downward turning points were located in 2007-2010 in all educational groups among women and in most groups among men. The magnitude of the differences remained broadly stable among younger women from 2002 to 2013, and decreased slightly among older women and more strongly among younger and older men. The educational differences were greater among men than women in the early 2000s, but similar among both at the end of the study period. The changes in SA spells may reflect the economic downturn started in 2008 and resulting job insecurity. Early preventive measures aimed at reducing educational differences in SA should be focused at an early stage on those with low levels of education in particular. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Fall-related mortality in southern Sweden: a multiple cause of death analysis, 1998-2014.

PubMed

Kiadaliri, Aliasghar A; Rosengren, Björn E; Englund, Martin

2017-10-22

To investigate temporal trend in fall mortality among adults (aged ≥20 years) in southern Sweden using multiple cause of death data. We examined all death certificates (DCs, n=2 01 488) in adults recorded in the Skåne region during 1998-2014. We identified all fall deaths using International Statistical Classification of Diseases (ICD)-10 codes (W00-W19) and calculated the mortality rates by age and sex. Temporal trends were evaluated using joinpoint regression and associated causes were identified by age-adjusted and sex-adjusted observed/expected ratios. Falls were mentioned on 1.0% and selected as underlying cause in 0.7% of all DCs, with the highest frequency among those aged ≥70 years. The majority (75.6%) of fall deaths were coded as unspecified fall (ICD-10 code: W19) followed by falling on or from stairs/steps (7.7%, ICD-10 code: W10) and other falls on the same level (6.3%, ICD-10 code: W18). The mean age at fall deaths increased from 77.5 years in 1998-2002 to 82.9 years in 2010-2014 while for other deaths it increased from 78.5 to 79.8 years over the same period. The overall mean age-standardised rate of fall mortality was 8.3 and 4.0 per 1 00 000 person-years in men and women, respectively, and increased by 1.7% per year in men and 0.8% per year in women during 1998-2014. Head injury and diseases of the circulatory system were recorded as contributing cause on 48.7% of fall deaths. There is an increasing trend of deaths due to falls in southern Sweden. Further investigations are required to explain this observation particularly among elderly men. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Effect of socioeconomic inequalities on cholecystectomy outcomes: a 10-year population-based analysis.

PubMed

Lu, Ping; Yang, Nan-Ping; Chang, Nien-Tzu; Lai, K Robert; Lin, Kai-Biao; Chan, Chien-Lung

2018-02-13

Although numerous epidemiological studies on cholecystectomy have been conducted worldwide, only a few have considered the effect of socioeconomic inequalities on cholecystectomy outcomes. Specifically, few studies have focused on the low-income population (LIP). A nationwide prospective study based on the Taiwan National Health Insurance dataset was conducted during 2003-2012. The International Classification of ICD-9-CM procedure codes 51.2 and 51.21-51.24 were identified as the inclusion criteria for cholecystectomy. Temporal trends were analyzed using a joinpoint regression, and the hierarchical linear modeling (HLM) method was used as an analytical strategy to evaluate the group-level and individual-level factors. Interactions between age, gender and SES were also tested in HLM model. Analyses were conducted on 225,558 patients. The incidence rates were 167.81 (95% CI: 159.78-175.83) per 100,000 individuals per year for the LIP and 123.24 (95% CI: 116.37-130.12) per 100,000 individuals per year for the general population (GP). After cholecystectomy, LIP patients showed higher rates of 30-day mortality, in-hospital complications, and readmission for complications, but a lower rate of routine discharge than GP patients. The hospital costs and length of stay for LIP patients were higher than those for GP patients. The multilevel analysis using HLM revealed that adverse socioeconomic status significantly negatively affects the outcomes of patients undergoing cholecystectomy. Additionally, male sex, advanced age, and high Charlson Comorbidity Index (CCI) scores were associated with higher rates of in-hospital complications and 30-day mortality. We also observed that the 30-day mortality rates for patients who underwent cholecystectomy in regional hospitals and district hospitals were significantly higher than those of patients receiving care in a medical center. Patients with a disadvantaged finance status appeared to be more vulnerable to cholecystectomy surgery. This result suggested that further interventions in the health care system are necessary to reduce this disparity.

Age-period-cohort analysis of suicide mortality by gender among white and black Americans, 1983-2012.

PubMed

Wang, Zhenkun; Yu, Chuanhua; Wang, Jinyao; Bao, Junzhe; Gao, Xudong; Xiang, Huiyun

2016-07-13

Previous studies suggested that the racial differences in U.S. suicide rates are decreasing, particularly for African Americans, but the cause behind the temporal variations has yet to be determined. This study aims to investigate the long-term trends in suicide mortality in the U.S. between 1983 and 2012 and to examine age-, period-, and cohort-specific effects by gender and race. Suicide mortality data were collected from the Web-based Injury Statistics Query and Reporting System (WISQARS) and analyzed with the Joinpoint regression and age-period-cohort (APC) analysis. We found that although age-standardized rate of suicide in white males, white females, black males, and black females all changed at different degrees, the overall situation almost has not changed since these changes offset each other. By APC analysis, while the age effect on suicide demonstrate an obvious difference between white males and females (with the peak at 75 to 79 for white males and 45 to 54 for white females), young black people are predominantly susceptible to suicide (risk peaks in early 20s for black males and late 20s for black females). Cohort effects all showed a descending trend, except that in white males and females which showed an obvious increase peaked in around cohort 1960. There was a similar period effect trend between different genders in the same race group, but between the races, differences were found in the period before 1990 and after 2000. We confirmed that the distinction in age-specific suicide rate patterns does exist by gender and by race after controlling for period and cohort effects, which suggested that minorities' age patterns of suicide may have been masked up by the white people in the whole population. The differences of period effects and cohort effects between white and black Americans were likely to be mainly explained by the difference in race susceptibility to economic depression.

Trends in gastric cancer mortality and in the prevalence of Helicobacter pylori infection in Portugal.

PubMed

Morais, Samantha; Ferro, Ana; Bastos, Ana; Castro, Clara; Lunet, Nuno; Peleteiro, Bárbara

2016-07-01

Portugal has the highest gastric cancer mortality rates in Western Europe, along with high prevalences of Helicobacter pylori infection. Monitoring their trends is essential to predict the burden of this cancer. We aimed to quantify time trends in gastric cancer mortality in Portugal and in each administrative region, and to compute short-term predictions, as well as to describe the prevalence of H. pylori infection, through a systematic review. Joinpoint analyses were used to identify significant changes in sex-specific trends in gastric cancer age-standardized mortality rates (ASMR) and to estimate annual percent changes (APC). The most recent trends were considered to compute estimates up to 2020 by adjusting Poisson regression models. We searched PubMed and IndexRMP to identify studies carried out in Portugal reporting the prevalence of H. pylori. Gastric cancer mortality has been decreasing in Portugal since 1971 in men (from ASMR=55.3/100 000; APC=-2.4, 95% confidence interval: -2.5 to -2.3) and since 1970 in women (from ASMR=28.0/100 000; APC=-2.8, 95% confidence interval: -2.9 to -2.7), although large regional differences were observed. Predicted ASMR for 2015 and 2020 were 18.8/100 000 and 16.7/100 000 for men and 8.5/100 000 and 7.4/100 000 for women, respectively. The prevalence of H. pylori varied from almost 5% at 0.5-2 years to just over 90% at 70 years or more. No consistent variation was observed since the 1990s. The downward trends in mortality rates are expected to remain in the next decades. The high prevalence of H. pylori infection across age groups and studies from different periods shows a large potential for decrease in the burden of gastric cancer in Portugal.

Was the economic crisis 1997-1998 responsible for rising suicide rates in East/Southeast Asia? A time-trend analysis for Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand.

PubMed

Chang, Shu-Sen; Gunnell, David; Sterne, Jonathan A C; Lu, Tsung-Hsueh; Cheng, Andrew T A

2009-04-01

In 1997-1998 a widespread economic crisis hit the economies of many East/Southeast Asian countries; its impact on suicide rates across the region has not been systematically documented. We investigated the impact of the Asian economic crisis (1997-1998) on suicide in Japan, Hong Kong, South Korea, Taiwan, Singapore and Thailand. Suicide and population data for the period 1985-2006 were extracted from the World Health Organisation's mortality database and Taiwanese mortality statistics. Sex-specific age-standardised suicide rates for people aged 15years or above were analysed using joinpoint regression. Trends in divorce, marriage, unemployment, gross domestic product (GDP) per capita and alcohol consumption were compared with trends in suicide rates graphically and using time-series analysis. Suicide mortality decreased in the late 1980s and early 1990s but subsequently increased markedly in all countries except Singapore, which had steadily declining suicide rates throughout the study period. Compared to 1997, male rates in 1998 rose by 39% in Japan, 44% in Hong Kong and 45% in Korea; rises in female rates were less marked. Male rates also rose in Thailand, but accurate data were incomplete. The economic crisis was associated with 10,400 more suicides in 1998 compared to 1997 in Japan, Hong Kong and Korea. Similar increases in suicide rates were not seen in Taiwan and Singapore, the two countries where the economic crisis had a smaller impact on GDP and unemployment. Time-series analyses indicated that some of the crisis's impact on male suicides was attributable to increases in unemployment. These findings suggest an association of the Asian economic crisis with a sharp increase in suicide mortality in some, but not all, East/Southeast Asian countries, and that these increases were most closely associated with rises in unemployment.

Global temporal patterns of pancreatic cancer and association with socioeconomic development.

PubMed

Wong, Martin C S; Jiang, Johnny Y; Liang, Miaoyin; Fang, Yuan; Yeung, Ming Sze; Sung, Joseph J Y

2017-06-09

Pancreatic cancer induces a substantial global burden. We examined its global incidence/mortality rates and their correlation with socioeconomic development (Human Development Index [HDI] and Gross Domestic Product [GDP] in 2000 as proxy measures). Data on age-standardized incidence/mortality rates in 2012 were retrieved from the GLOBOCAN database. Temporal patterns in 1998-2007 were assessed for 39 countries according to gender. The Average Annual Percent Change (AAPC) of the incidence/mortality trends was evaluated using joinpoint regression analysis. The age-standardized incidence ranged between 0.8-8.9/100,000. When compared among countries, Brazil (AAPC = 10.4, 95%C.I. = 0.8,21) and France (AAPC = 4.7, 95%C.I. = 3.6,5.9) reported the highest incidence rise in men. The greatest increase in women was reported in Thailand (AAPC = 7, 95%C.I. = 2.1,12.1) and Ecuador (AAPC = 4.3, 95%C.I. = 1.3,7.3). For mortality, the Philippines (APCC = 4.3, 95%C.I. = 2,6.6) and Croatia (AAPC = 2, 95% C.I. = 0,3.9) reported the biggest increase among men. The Philippines (AAPC = 5.8, 95% C.I. 4.5,7.2) and Slovakia (AAPC = 3.1, 95% C.I. 0.9,5.3) showed the most prominent rise among women. Its incidence was positively correlated with HDI (men: r = 0.66; women: r = 0.70) and GDP (men: r = 0.29; women: r = 0.28, all p < 0.05), and similarly for mortality (men: r = 0.67; women: r = 0.72 [HDI]; men: r = 0.23; women: r = 0.28 [GDP]). In summary, the incidence and mortality of pancreatic cancer were rising in many countries, requiring regular surveillance.

Trends of main indicators of leprosy in Brazilian municipalities with high risk of leprosy transmission, 2001-2012.

PubMed

Freitas, Lucia R S; Duarte, Elisabeth C; Garcia, Leila P

2016-09-05

Leprosy incidence has reduced in recent years in Brazil, although the disease still persists as a public health problem in some regions. To investigate the trends of selected leprosy indicators in Brazilian municipalities with high risk of transmission is essential to provide effective control of the disease, yet this area has not been investigated. This is an ecological time-series study with multiple groups using Notifiable Diseases Information System (SINAN) data. All 692 municipalities of the states of Mato Grosso, Tocantins, Rondônia, Pará and Maranhão were included. The incidence rates of leprosy were calculated, as well as incidence rates in children under 15 years per 100,000 inhabitants and rates of new cases presenting grade-2 disabilities per 100,000 inhabitants. Joinpoint Regression was used to analyse the time trends of the different indicators studied. The spatial distribution of temporal variations of the indicators in the period was presented. Between 2001 and 2012, 176,929 leprosy cases were notified in the area studied, this being equivalent to 34.6 % of total cases in Brazil. In the aggregate of municipalities, there was a reduction in incidence rate of leprosy from 89.10 to 56.98 new cases per 100,000 inhabitants between 2001 and 2012, with a significant reduction between 2003 and 2012 (APC: - 6.2 %, 95 % CI: -7.2 % to -5.2 %). The incidence rate in <15 years also reduced significantly between 2003 and 2012 (APC: -5.6 %; 95 % CI: -7.2 % to -4.1 %). The rate of new cases with grade 2 disability remained stable between 2001 and 2012 (APC: -1.3 %; 95 % CI: -2.6 % to 0.1 %). Despite the reduction in the leprosy incidence rate, strategies for controlling this disease need to be enhanced to enable early case detection, especially in hyperendemic municipalities, in order to prevent disability.

Inequalities in global health inequalities research: A 50-year bibliometric analysis (1966-2015)

PubMed Central

Pericàs, Juan M.; Benach, Joan

2018-01-01

Background Increasing evidence shows that health inequalities exist between and within countries, and emphasis has been placed on strengthening the production and use of the global health inequalities research, so as to improve capacities to act. Yet, a comprehensive overview of this evidence base is still needed, to determine what is known about the global and historical scientific production on health inequalities to date, how is it distributed in terms of country income groups and world regions, how has it changed over time, and what international collaboration dynamics exist. Methods A comprehensive bibliometric analysis of the global scientific production on health inequalities, from 1966 to 2015, was conducted using Scopus database. The historical and global evolution of the study of health inequalities was considered, and through joinpoint regression analysis and visualisation network maps, the preceding questions were examined. Findings 159 countries (via authorship affiliation) contributed to this scientific production, three times as many countries than previously found. Scientific output on health inequalities has exponentially grown over the last five decades, with several marked shift points, and a visible country-income group affiliation gradient in the initiation and consistent publication frequency. Higher income countries, especially Anglo-Saxon and European countries, disproportionately dominate first and co-authorship, and are at the core of the global collaborative research networks, with the Global South on the periphery. However, several country anomalies exist that suggest that the causes of these research inequalities, and potential underlying dependencies, run deeper than simply differences in country income and language. Conclusions Whilst the global evidence base has expanded, Global North-South research gaps exist, persist and, in some cases, are widening. Greater understanding of the structural determinants of these research inequalities and national research capacities is needed, to further strengthen the evidence base, and support the long term agenda for global health equity. PMID:29385197

Global Incidence and Mortality for Prostate Cancer: Analysis of Temporal Patterns and Trends in 36 Countries.

PubMed

Wong, Martin C S; Goggins, William B; Wang, Harry H X; Fung, Franklin D H; Leung, Colette; Wong, Samuel Y S; Ng, Chi Fai; Sung, Joseph J Y

2016-11-01

Prostate cancer (PCa) is a leading cause of mortality and morbidity globally, but its specific geographic patterns and temporal trends are under-researched. To test the hypotheses that PCa incidence is higher and PCa mortality is lower in countries with higher socioeconomic development, and that temporal trends for PCa incidence have increased while mortality has decreased over time. Data on age-standardized incidence and mortality rates in 2012 were retrieved from the GLOBOCAN database. Temporal patterns were assessed for 36 countries using data obtained from Cancer incidence in five continents volumes I-X and the World Health Organization mortality database. Correlations between incidence or mortality rates and socioeconomic indicators (human development index [HDI] and gross domestic product [GDP]) were evaluated. The average annual percent change in PCa incidence and mortality in the most recent 10 yr according to join-point regression. Reported PCa incidence rates varied more than 25-fold worldwide in 2012, with the highest incidence rates observed in Micronesia/Polynesia, the USA, and European countries. Mortality rates paralleled the incidence rates except for Africa, where PCa mortality rates were the highest. Countries with higher HDI (r=0.58) and per capita GDP (r=0.62) reported greater incidence rates. According to the most recent 10-yr temporal data available, most countries experienced increases in incidence, with sharp rises in incidence rates in Asia and Northern and Western Europe. A substantial reduction in mortality rates was reported in most countries, except in some Asian countries and Eastern Europe, where mortality increased. Data in regional registries could be underestimated. PCa incidence has increased while PCa mortality has decreased in most countries. The reported incidence was higher in countries with higher socioeconomic development. The incidence of prostate cancer has shown high variations geographically and over time, with smaller variations in mortality. Copyright © 2016 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Impact of Enhanced Detection on the Increase in Thyroid Cancer Incidence in the United States: Review of Incidence Trends by Socioeconomic Status Within the Surveillance, Epidemiology, and End Results Registry, 1980–2008

PubMed Central

Li, Nan; Du, Xianglin L.; Reitzel, Lorraine R.; Xu, Li

2013-01-01

Background In the past 3 decades, the incidence of thyroid cancer in the United States has been increasing. There has been debate on whether the increase is real or an artifact of improved diagnostic scrutiny. Our hypothesis is that both improved detection and a real increase have contributed to the increase. Methods Because socioeconomic status (SES) may be a surrogate for access to diagnostic technology, we compared thyroid cancer incidence trends between high- and low-SES counties within the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries. The incidence trends were assessed using joinpoint regression analysis. Results In high-SES counties, thyroid cancer incidence increased moderately (annual percentage change 1 [APC1]=2.5, p<0.05) before the late 1990s and more pronounced (APC2=6.3, p<0.05) after the late 1990s. In low-SES counties, incidence increased steadily with an APC of 3.5 (p<0.05) during the entire study period (1980–2008). For tumors ≤4.0 cm, incidence was higher in high-SES counties, and APC was higher for high- than low-SES counties after the late 1990s. For tumors >4.0 cm, high- and low-SES counties had similar increasing incidence trends. Similarly, for tumors ≤2.0 cm, the incidence trends differed between counties that are in or adjacent to metropolitan areas and counties that are in rural areas, whereas for tumors >2.0 cm, all counties regardless of area of residence had similar increasing trends. Conclusions Enhanced detection likely contributed to the increased thyroid cancer incidence in the past decades, but cannot fully explain the increase, suggesting that a true increase exists. Efforts should be made to identify the cause of this true increase. PMID:23043274

Impact of enhanced detection on the increase in thyroid cancer incidence in the United States: review of incidence trends by socioeconomic status within the surveillance, epidemiology, and end results registry, 1980-2008.

PubMed

Li, Nan; Du, Xianglin L; Reitzel, Lorraine R; Xu, Li; Sturgis, Erich M

2013-01-01

In the past 3 decades, the incidence of thyroid cancer in the United States has been increasing. There has been debate on whether the increase is real or an artifact of improved diagnostic scrutiny. Our hypothesis is that both improved detection and a real increase have contributed to the increase. Because socioeconomic status (SES) may be a surrogate for access to diagnostic technology, we compared thyroid cancer incidence trends between high- and low-SES counties within the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries. The incidence trends were assessed using joinpoint regression analysis. In high-SES counties, thyroid cancer incidence increased moderately (annual percentage change 1 [APC1]=2.5, p<0.05) before the late 1990s and more pronounced (APC2=6.3, p<0.05) after the late 1990s. In low-SES counties, incidence increased steadily with an APC of 3.5 (p<0.05) during the entire study period (1980-2008). For tumors ≤4.0 cm, incidence was higher in high-SES counties, and APC was higher for high- than low-SES counties after the late 1990s. For tumors >4.0 cm, high- and low-SES counties had similar increasing incidence trends. Similarly, for tumors ≤2.0 cm, the incidence trends differed between counties that are in or adjacent to metropolitan areas and counties that are in rural areas, whereas for tumors >2.0 cm, all counties regardless of area of residence had similar increasing trends. Enhanced detection likely contributed to the increased thyroid cancer incidence in the past decades, but cannot fully explain the increase, suggesting that a true increase exists. Efforts should be made to identify the cause of this true increase.

Central nervous system tumours among adolescents and young adults (15-39 years) in Southern and Eastern Europe: Registration improvements reveal higher incidence rates compared to the US.

PubMed

Georgakis, Marios K; Panagopoulou, Paraskevi; Papathoma, Paraskevi; Tragiannidis, Athanasios; Ryzhov, Anton; Zivkovic-Perisic, Snezana; Eser, Sultan; Taraszkiewicz, Łukasz; Sekerija, Mario; Žagar, Tina; Antunes, Luis; Zborovskaya, Anna; Bastos, Joana; Florea, Margareta; Coza, Daniela; Demetriou, Anna; Agius, Domenic; Strahinja, Rajko M; Sfakianos, Georgios; Nikas, Ioannis; Kosmidis, Sofia; Razis, Evangelia; Pourtsidis, Apostolos; Kantzanou, Maria; Dessypris, Nick; Petridou, Eleni Th

2017-11-01

To present incidence of central nervous system (CNS) tumours among adolescents and young adults (AYAs; 15-39 years) derived from registries of Southern and Eastern Europe (SEE) in comparison to the Surveillance, Epidemiology and End Results (SEER), US and explore changes due to etiological parameters or registration improvement via evaluating time trends. Diagnoses of 11,438 incident malignant CNS tumours in AYAs (1990-2014) were retrieved from 14 collaborating SEE cancer registries and 13,573 from the publicly available SEER database (1990-2012). Age-adjusted incidence rates (AIRs) were calculated; Poisson and joinpoint regression analyses were performed for temporal trends. The overall AIR of malignant CNS tumours among AYAs was higher in SEE (28.1/million) compared to SEER (24.7/million). Astrocytomas comprised almost half of the cases in both regions, albeit the higher proportion of unspecified cases in SEE registries (30% versus 2.5% in SEER). Similar were the age and gender distributions across SEE and SEER with a male-to-female ratio of 1.3 and an overall increase of incidence by age. Increasing temporal trends in incidence were documented in four SEE registries (Greater Poland, Portugal North, Turkey-Izmir and Ukraine) versus an annual decrease in Croatia (-2.5%) and a rather stable rate in SEER (-0.3%). This first report on descriptive epidemiology of AYAs malignant CNS tumours in the SEE area shows higher incidence rates as compared to the United States of America and variable temporal trends that may be linked to registration improvements. Hence, it emphasises the need for optimisation of cancer registration processes, as to enable the in-depth evaluation of the observed patterns by disease subtype. Copyright © 2017 Elsevier Ltd. All rights reserved.

Opposite trends in the consumption of manufactured and roll-your-own cigarettes in Spain (1991-2020).

PubMed

Fu, Marcela; Martínez-Sánchez, Jose M; Clèries, Ramon; Villalbí, Joan R; Daynard, Richard A; Connolly, Gregory N; Fernández, Esteve

2014-12-10

The aim of this study is to describe trends in the consumption of manufactured and roll-your-own cigarettes between 1991 and 2012 in Spain, and to project these trends up to 2020. We estimated daily consumption per capita during 1991-2012 using data on sales of manufactured cigarettes (20-packs) and rolling tobacco (kg) from the Tobacco Market Commission, and using data of the Spanish adult population from the National Statistics Institute. We considered different weights (0.5, 0.8 and 1 g) to compute the number of rolled cigarettes per capita. We computed the annual per cent of change and assessed possible changes in trends using joinpoint regression, and projected the consumption up to 2020 using Bayesian methods. Daily consumption per capita of manufactured cigarettes decreased on average by 3.0% per year in 1991-2012, from 7.6 to 3.8 units, with three trend changes. However, daily consumption per capita of roll-your-own cigarettes increased on average by 14.1% per year, from 0.07 to 0.92 units of 0.5 g, with unchanged trends. Together, daily consumption per capita decreased between 2.9% and 2.5%, depending on the weight of the roll-your-own cigarettes. Projections up to 2020 indicate a decrease of manufactured cigarettes (1.75 units per capita) but an increase of roll-your-own cigarettes (1.25 units per capita). While the consumption per capita of manufactured cigarettes has decreased in the past years in Spain, the consumption of roll-your-own cigarettes has increased at an annual rate around 14% over the past years. Whereas a net decrease in cigarette consumption is expected in the future, use of roll-your-own cigarettes will continue to increase. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

[Safety and health in workers employed in industry. Data from Industrial Accidents Compensation Board (INAIL) and National Social Security Institute (INPS), Veneto Region, 1994-2002].

PubMed

Mastrangelo, G; Carassai, Patrizia; Carletti, Claudia; Cattani, F; De Zorzi, Lia; Di Loreto, G; Dini, M; Mattioni, G; Mundo, Antonietta; Noceta, R; Ortolani, G; Piccioni, M; Sartori, Angela; Sereno, Antonella; Priolo, G; Scoizzato, L; Marangi, G; Marchiori, L

2008-01-01

A decreasing time trend for occupational injuries and sickness absence would be the effect of the new legislation (D.Lgs. 626/94 and successive laws) on prevention in occupational settings. Conversely, the reduction of INPS disability would reflect a health improvement due to non-occupational causes. The aim of the study was to investigate the efficacy of the new legislation among employees in industry (where the law was mainly applied), via the time trend of three standardized rates in the Veneto Region. The numerator for the rate of occupational accidents (cases occurring in industry workers in the Veneto Region, broken down for sex, age and calendar years) was supplied by INAIL. The denominator for the above rate, as well as numerators and denominators for disability and sickness absence were supplied by INPS. Data were available from 1994 to 2002 for accidents and disability, and from 1997 to 2002 for sickness absence. In every year from 1994 to 2002, the rates were standardized for age and sex with the direct method, using an internal "standard" population. The time trend of year-specific standardized rates was analyzed by Joinpoint regression software. Among industrial workers in the Veneto Region, occupational accidents increased by 0.4% yearly, while disability decreased by 2.56% from 1994 to 2002. Sick absence increased up to 1999, then decreased. This epidemiological pattern is difficult to explain. The increase in accidents could be due to the increase of non-European Union workers and/or to the fact that accidents on the way to or from work were recognized as occupational accidents by INAIL starting from 2000. Both these phenomena could have contributed to increase the rate that was otherwise diminishing. On the other hand, this same situation could be due to insufficient efficacy of the legislation (D.Lgs. 626/94 and successive laws) for preventing occupational accidents and diseases.

The National Flood Frequency Program, version 3 : a computer program for estimating magnitude and frequency of floods for ungaged sites

USGS Publications Warehouse

Ries, Kernell G.; Crouse, Michele Y.

2002-01-01

For many years, the U.S. Geological Survey (USGS) has been developing regional regression equations for estimating flood magnitude and frequency at ungaged sites. These regression equations are used to transfer flood characteristics from gaged to ungaged sites through the use of watershed and climatic characteristics as explanatory or predictor variables. Generally, these equations have been developed on a Statewide or metropolitan-area basis as part of cooperative study programs with specific State Departments of Transportation. In 1994, the USGS released a computer program titled the National Flood Frequency Program (NFF), which compiled all the USGS available regression equations for estimating the magnitude and frequency of floods in the United States and Puerto Rico. NFF was developed in cooperation with the Federal Highway Administration and the Federal Emergency Management Agency. Since the initial release of NFF, the USGS has produced new equations for many areas of the Nation. A new version of NFF has been developed that incorporates these new equations and provides additional functionality and ease of use. NFF version 3 provides regression-equation estimates of flood-peak discharges for unregulated rural and urban watersheds, flood-frequency plots, and plots of typical flood hydrographs for selected recurrence intervals. The Program also provides weighting techniques to improve estimates of flood-peak discharges for gaging stations and ungaged sites. The information provided by NFF should be useful to engineers and hydrologists for planning and design applications. This report describes the flood-regionalization techniques used in NFF and provides guidance on the applicability and limitations of the techniques. The NFF software and the documentation for the regression equations included in NFF are available at http://water.usgs.gov/software/nff.html.

Use of genetic programming, logistic regression, and artificial neural nets to predict readmission after coronary artery bypass surgery.

PubMed

Engoren, Milo; Habib, Robert H; Dooner, John J; Schwann, Thomas A

2013-08-01

As many as 14 % of patients undergoing coronary artery bypass surgery are readmitted within 30 days. Readmission is usually the result of morbidity and may lead to death. The purpose of this study is to develop and compare statistical and genetic programming models to predict readmission. Patients were divided into separate Construction and Validation populations. Using 88 variables, logistic regression, genetic programs, and artificial neural nets were used to develop predictive models. Models were first constructed and tested on the Construction populations, then validated on the Validation population. Areas under the receiver operator characteristic curves (AU ROC) were used to compare the models. Two hundred and two patients (7.6 %) in the 2,644 patient Construction group and 216 (8.0 %) of the 2,711 patient Validation group were re-admitted within 30 days of CABG surgery. Logistic regression predicted readmission with AU ROC = .675 ± .021 in the Construction group. Genetic programs significantly improved the accuracy, AU ROC = .767 ± .001, p < .001). Artificial neural nets were less accurate with AU ROC = 0.597 ± .001 in the Construction group. Predictive accuracy of all three techniques fell in the Validation group. However, the accuracy of genetic programming (AU ROC = .654 ± .001) was still trivially but statistically non-significantly better than that of the logistic regression (AU ROC = .644 ± .020, p = .61). Genetic programming and logistic regression provide alternative methods to predict readmission that are similarly accurate.

School Exits in the Milwaukee Parental Choice Program: Evidence of a Marketplace?

ERIC Educational Resources Information Center

Ford, Michael

2011-01-01

This article examines whether the large number of school exits from the Milwaukee school voucher program is evidence of a marketplace. Two logistic regression and multinomial logistic regression models tested the relation between the inability to draw large numbers of voucher students and the ability for a private school to remain viable. Data on…

Changing Trends of Types of Skin Cancer in Iran.

PubMed

Razi, Saeid; Rafiemanesh, Hosein; Ghoncheh, Mahshid; Khani, Yousef; Salehiniya, Hamid

2015-01-01

Skin cancer is the most common type of cancer worldwide. It has an increasing trend. This study investigated the epidemiological trend and morphological changes in skin cancer in Iran. This study was done using existing data, extracted from the National Cancer Registry System and the Disease Management Center of Iranian Ministry of Health between 2003 and 2008. Data on epidemiologic trend was analyzed using Joinpoint software package. The incidence of skin cancer is increasing in Iran, and more in men than women. There was a declining trend for basal cell carcinoma. Basal squamous cell carcinoma and melanoma had an increasing trend. The increase of skin cancer was related to squamous cell carcinoma. Our findings indicated that the increase of skin cancer was attributed to squamous cell carcinoma. It is necessary to be planning for the control and prevention of this disease as a priority for health policy makers.

Air Leakage of US Homes: Regression Analysis and Improvements from Retrofit

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

Chan, Wanyu R.; Joh, Jeffrey; Sherman, Max H.

2012-08-01

LBNL Residential Diagnostics Database (ResDB) contains blower door measurements and other diagnostic test results of homes in United States. Of these, approximately 134,000 single-family detached homes have sufficient information for the analysis of air leakage in relation to a number of housing characteristics. We performed regression analysis to consider the correlation between normalized leakage and a number of explanatory variables: IECC climate zone, floor area, height, year built, foundation type, duct location, and other characteristics. The regression model explains 68% of the observed variability in normalized leakage. ResDB also contains the before and after retrofit air leakage measurements of approximatelymore » 23,000 homes that participated in weatherization assistant programs (WAPs) or residential energy efficiency programs. The two types of programs achieve rather similar reductions in normalized leakage: 30% for WAPs and 20% for other energy programs.« less

The Application of the Cumulative Logistic Regression Model to Automated Essay Scoring

ERIC Educational Resources Information Center

Haberman, Shelby J.; Sinharay, Sandip

2010-01-01

Most automated essay scoring programs use a linear regression model to predict an essay score from several essay features. This article applied a cumulative logit model instead of the linear regression model to automated essay scoring. Comparison of the performances of the linear regression model and the cumulative logit model was performed on a…

The Prekindergarten Age-Cutoff Regression-Discontinuity Design: Methodological Issues and Implications for Application

ERIC Educational Resources Information Center

Lipsey, Mark W.; Weiland, Christina; Yoshikawa, Hirokazu; Wilson, Sandra Jo; Hofer, Kerry G.

2015-01-01

Much of the currently available evidence on the causal effects of public prekindergarten programs on school readiness outcomes comes from studies that use a regression-discontinuity design (RDD) with the age cutoff to enter a program in a given year as the basis for assignment to treatment and control conditions. Because the RDD has high internal…

The TUNEL assay suggests mandibular regression by programmed cell death during presoldier differentiation in the nasute termite Nasutitermes takasagoensis

NASA Astrophysics Data System (ADS)

Toga, Kouhei; Yoda, Shinichi; Maekawa, Kiyoto

2011-09-01

Termite soldiers are the most specialized caste of social insects in terms of their morphology and function. Soldier development requires increased juvenile hormone (JH) titer and the two molts via a presoldier stage. These molts are accompanied by dramatic morphological changes, including the exaggeration and regression of certain organs. Soldiers of the most apical termitid subfamily Nasutitermitinae possess not only a horn-like frontal tube, called the nasus, for the projection of defensive chemicals from the frontal gland reservoir but also regressed mandibles. Although candidate genes regulating soldier mandibular growth were reported in a relatively basal termite species, the regulatory mechanisms of mandibular regression remain unknown. To clarify these mechanisms, we performed morphological and histological examinations of the mandibles during soldier differentiation in Nasutitermes takasagoensis. Mandibular size reduced dramatically during soldier differentiation, and mandibular regression occurred just prior to the presoldier molt. Spotted TUNEL signals were observed in regressing mandibles of presoldiers, suggesting that the regression involved programmed cell death. Because soldiers of N. takasagoensis possess exaggerated organs (nasus and frontal gland), the present results suggest that JH-dependent regressive mechanisms exist in the mandibles without interfering with the formation of the exaggerated organs.

Estimating linear temporal trends from aggregated environmental monitoring data

USGS Publications Warehouse

Erickson, Richard A.; Gray, Brian R.; Eager, Eric A.

2017-01-01

Trend estimates are often used as part of environmental monitoring programs. These trends inform managers (e.g., are desired species increasing or undesired species decreasing?). Data collected from environmental monitoring programs is often aggregated (i.e., averaged), which confounds sampling and process variation. State-space models allow sampling variation and process variations to be separated. We used simulated time-series to compare linear trend estimations from three state-space models, a simple linear regression model, and an auto-regressive model. We also compared the performance of these five models to estimate trends from a long term monitoring program. We specifically estimated trends for two species of fish and four species of aquatic vegetation from the Upper Mississippi River system. We found that the simple linear regression had the best performance of all the given models because it was best able to recover parameters and had consistent numerical convergence. Conversely, the simple linear regression did the worst job estimating populations in a given year. The state-space models did not estimate trends well, but estimated population sizes best when the models converged. We found that a simple linear regression performed better than more complex autoregression and state-space models when used to analyze aggregated environmental monitoring data.

FIRE: an SPSS program for variable selection in multiple linear regression analysis via the relative importance of predictors.

PubMed

Lorenzo-Seva, Urbano; Ferrando, Pere J

2011-03-01

We provide an SPSS program that implements currently recommended techniques and recent developments for selecting variables in multiple linear regression analysis via the relative importance of predictors. The approach consists of: (1) optimally splitting the data for cross-validation, (2) selecting the final set of predictors to be retained in the equation regression, and (3) assessing the behavior of the chosen model using standard indices and procedures. The SPSS syntax, a short manual, and data files related to this article are available as supplemental materials from brm.psychonomic-journals.org/content/supplemental.

Use of a pretest strategy for physical therapist assistant programs to predict success rate on the national physical therapy exam.

PubMed

Sloas, Stacey B; Keith, Becky; Whitehead, Malcolm T

2013-01-01

This study investigated a pretest strategy that identified physical therapist assistant (PTA) students who were at risk of failure on the National Physical Therapy Examination (NPTE). Program assessment data from five cohorts of PTA students (2005-2009) were used to develop a stepwise multiple regression formula that predicted first-time NPTE licensure scores. Data used included the Nelson-Denny Reading Test, grades from eight core courses, grade point average upon admission to the program, and scores from three mock NPTE exams given during the program. Pearson correlation coefficients were calculated between each of the 15 variables and NPTE scores. Stepwise multiple regression analysis was performed using data collected at the ends of the first, second, and third (final) semesters of the program. Data from the class of 2010 were then used to validate the formula. The end-of-program formula accounted for the greatest variance (57%) in predicted scores. Those students scoring below a predicted scaled score of 620 were identified to be at risk of failure of the licensure exam. These students were counseled, and a remedial plan was developed based on regression predictions prior to them sitting for the licensure exam.

A Fast Solution of the Lindley Equations for the M-Group Regression Problem. Technical Report 78-3, October 1977 through May 1978.

ERIC Educational Resources Information Center

Molenaar, Ivo W.

The technical problems involved in obtaining Bayesian model estimates for the regression parameters in m similar groups are studied. The available computer programs, BPREP (BASIC), and BAYREG, both written in FORTRAN, require an amount of computer processing that does not encourage regular use. These programs are analyzed so that the performance…

Estimating the Counterfactual Impact of Conservation Programs on Land Cover Outcomes: The Role of Matching and Panel Regression Techniques

PubMed Central

Jones, Kelly W.; Lewis, David J.

2015-01-01

Deforestation and conversion of native habitats continues to be the leading driver of biodiversity and ecosystem service loss. A number of conservation policies and programs are implemented—from protected areas to payments for ecosystem services (PES)—to deter these losses. Currently, empirical evidence on whether these approaches stop or slow land cover change is lacking, but there is increasing interest in conducting rigorous, counterfactual impact evaluations, especially for many new conservation approaches, such as PES and REDD, which emphasize additionality. In addition, several new, globally available and free high-resolution remote sensing datasets have increased the ease of carrying out an impact evaluation on land cover change outcomes. While the number of conservation evaluations utilizing ‘matching’ to construct a valid control group is increasing, the majority of these studies use simple differences in means or linear cross-sectional regression to estimate the impact of the conservation program using this matched sample, with relatively few utilizing fixed effects panel methods—an alternative estimation method that relies on temporal variation in the data. In this paper we compare the advantages and limitations of (1) matching to construct the control group combined with differences in means and cross-sectional regression, which control for observable forms of bias in program evaluation, to (2) fixed effects panel methods, which control for observable and time-invariant unobservable forms of bias, with and without matching to create the control group. We then use these four approaches to estimate forest cover outcomes for two conservation programs: a PES program in Northeastern Ecuador and strict protected areas in European Russia. In the Russia case we find statistically significant differences across estimators—due to the presence of unobservable bias—that lead to differences in conclusions about effectiveness. The Ecuador case illustrates that if time-invariant unobservables are not present, matching combined with differences in means or cross-sectional regression leads to similar estimates of program effectiveness as matching combined with fixed effects panel regression. These results highlight the importance of considering observable and unobservable forms of bias and the methodological assumptions across estimators when designing an impact evaluation of conservation programs. PMID:26501964

Estimating the Counterfactual Impact of Conservation Programs on Land Cover Outcomes: The Role of Matching and Panel Regression Techniques.

PubMed

Jones, Kelly W; Lewis, David J

2015-01-01

Deforestation and conversion of native habitats continues to be the leading driver of biodiversity and ecosystem service loss. A number of conservation policies and programs are implemented--from protected areas to payments for ecosystem services (PES)--to deter these losses. Currently, empirical evidence on whether these approaches stop or slow land cover change is lacking, but there is increasing interest in conducting rigorous, counterfactual impact evaluations, especially for many new conservation approaches, such as PES and REDD, which emphasize additionality. In addition, several new, globally available and free high-resolution remote sensing datasets have increased the ease of carrying out an impact evaluation on land cover change outcomes. While the number of conservation evaluations utilizing 'matching' to construct a valid control group is increasing, the majority of these studies use simple differences in means or linear cross-sectional regression to estimate the impact of the conservation program using this matched sample, with relatively few utilizing fixed effects panel methods--an alternative estimation method that relies on temporal variation in the data. In this paper we compare the advantages and limitations of (1) matching to construct the control group combined with differences in means and cross-sectional regression, which control for observable forms of bias in program evaluation, to (2) fixed effects panel methods, which control for observable and time-invariant unobservable forms of bias, with and without matching to create the control group. We then use these four approaches to estimate forest cover outcomes for two conservation programs: a PES program in Northeastern Ecuador and strict protected areas in European Russia. In the Russia case we find statistically significant differences across estimators--due to the presence of unobservable bias--that lead to differences in conclusions about effectiveness. The Ecuador case illustrates that if time-invariant unobservables are not present, matching combined with differences in means or cross-sectional regression leads to similar estimates of program effectiveness as matching combined with fixed effects panel regression. These results highlight the importance of considering observable and unobservable forms of bias and the methodological assumptions across estimators when designing an impact evaluation of conservation programs.

A Practical Guide to Regression Discontinuity

ERIC Educational Resources Information Center

Jacob, Robin; Zhu, Pei; Somers, Marie-Andrée; Bloom, Howard

2012-01-01

Regression discontinuity (RD) analysis is a rigorous nonexperimental approach that can be used to estimate program impacts in situations in which candidates are selected for treatment based on whether their value for a numeric rating exceeds a designated threshold or cut-point. Over the last two decades, the regression discontinuity approach has…

Space shuttle propulsion parameter estimation using optional estimation techniques

NASA Technical Reports Server (NTRS)

1983-01-01

A regression analyses on tabular aerodynamic data provided. A representative aerodynamic model for coefficient estimation. It also reduced the storage requirements for the "normal' model used to check out the estimation algorithms. The results of the regression analyses are presented. The computer routines for the filter portion of the estimation algorithm and the :"bringing-up' of the SRB predictive program on the computer was developed. For the filter program, approximately 54 routines were developed. The routines were highly subsegmented to facilitate overlaying program segments within the partitioned storage space on the computer.

Ca analysis: An Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis☆

PubMed Central

Greensmith, David J.

2014-01-01

Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. PMID:24125908

Predicting Quantitative Traits With Regression Models for Dense Molecular Markers and Pedigree

PubMed Central

de los Campos, Gustavo; Naya, Hugo; Gianola, Daniel; Crossa, José; Legarra, Andrés; Manfredi, Eduardo; Weigel, Kent; Cotes, José Miguel

2009-01-01

The availability of genomewide dense markers brings opportunities and challenges to breeding programs. An important question concerns the ways in which dense markers and pedigrees, together with phenotypic records, should be used to arrive at predictions of genetic values for complex traits. If a large number of markers are included in a regression model, marker-specific shrinkage of regression coefficients may be needed. For this reason, the Bayesian least absolute shrinkage and selection operator (LASSO) (BL) appears to be an interesting approach for fitting marker effects in a regression model. This article adapts the BL to arrive at a regression model where markers, pedigrees, and covariates other than markers are considered jointly. Connections between BL and other marker-based regression models are discussed, and the sensitivity of BL with respect to the choice of prior distributions assigned to key parameters is evaluated using simulation. The proposed model was fitted to two data sets from wheat and mouse populations, and evaluated using cross-validation methods. Results indicate that inclusion of markers in the regression further improved the predictive ability of models. An R program that implements the proposed model is freely available. PMID:19293140

WALLY 1 ...A large, principal components regression program with varimax rotation of the factor weight matrix

Treesearch

James R. Wallis

1965-01-01

Written in Fortran IV and MAP, this computer program can handle up to 120 variables, and retain 40 principal components. It can perform simultaneous regression of up to 40 criterion variables upon the varimax rotated factor weight matrix. The columns and rows of all output matrices are labeled by six-character alphanumeric names. Data input can be from punch cards or...

Methods for identifying SNP interactions: a review on variations of Logic Regression, Random Forest and Bayesian logistic regression.

PubMed

Chen, Carla Chia-Ming; Schwender, Holger; Keith, Jonathan; Nunkesser, Robin; Mengersen, Kerrie; Macrossan, Paula

2011-01-01

Due to advancements in computational ability, enhanced technology and a reduction in the price of genotyping, more data are being generated for understanding genetic associations with diseases and disorders. However, with the availability of large data sets comes the inherent challenges of new methods of statistical analysis and modeling. Considering a complex phenotype may be the effect of a combination of multiple loci, various statistical methods have been developed for identifying genetic epistasis effects. Among these methods, logic regression (LR) is an intriguing approach incorporating tree-like structures. Various methods have built on the original LR to improve different aspects of the model. In this study, we review four variations of LR, namely Logic Feature Selection, Monte Carlo Logic Regression, Genetic Programming for Association Studies, and Modified Logic Regression-Gene Expression Programming, and investigate the performance of each method using simulated and real genotype data. We contrast these with another tree-like approach, namely Random Forests, and a Bayesian logistic regression with stochastic search variable selection.

Evaluating the Effectiveness of New York City Health Policy Initiatives in Reducing Cardiovascular Disease Mortality, 1990-2011.

PubMed

Ong, Paulina; Lovasi, Gina S; Madsen, Ann; Van Wye, Gretchen; Demmer, Ryan T

2017-09-01

Beginning in 2002, New York City (NYC) implemented numerous policies and programs targeting cardiovascular disease (CVD) risk factors. Using death certificates, we analyzed trends in NYC-specific and US mortality rates from 1990 to 2011 for all causes, any CVD, atherosclerotic CVD (ACVD), coronary artery disease (CAD), and stroke. Joinpoint analyses quantified annual percent change (APC) and evaluated whether decreases in CVD mortality accelerated after 2002 in either NYC or the total US population. Our analyses included 1,149,217 NYC decedents. The rates of decline in mortality from all causes, any CVD, and stroke in NYC did not change after 2002. Among men, the decline in ACVD mortality accelerated during 2002-2011 (APC = -4.8%, 95% confidence interval (CI): -6.1, -3.4) relative to 1990-2001 (APC = -2.3%, 95% CI: -3.1, -1.5). Among women, ACVD rates began declining more rapidly in 1993 (APC = -3.2%, 95% CI: -3.8, -2.7) and again in 2006 (APC = -6.6%, 95% CI: -8.9, -4.3) as compared with 1990-1992 (APC = 1.6%, 95% CI: -2.7, 6.0). In the US population, no acceleration of mortality decline was observed in either ACVD or CAD mortality rates after 2002. Relative to 1990-2001, atherosclerotic CVD and CAD rates began to decline more rapidly during the 2002-2011 period in both men and women-a pattern not observed in the total US population, suggesting that NYC initiatives might have had a measurable influence on delaying or reducing ACVD mortality. © 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.

Cancer Incidence and Survival Trends by Subtype Using Data from the Surveillance Epidemiology and End Results Program, 1992-2013.

PubMed

Noone, Anne-Michelle; Cronin, Kathleen A; Altekruse, Sean F; Howlader, Nadia; Lewis, Denise R; Petkov, Valentina I; Penberthy, Lynne

2017-04-01

Background: Cancers are heterogeneous, comprising distinct tumor subtypes. Therefore, presenting the burden of cancer in the population and trends over time by these tumor subtypes is important to identify patterns and differences in the occurrence of these subtypes, especially to generalize findings to the U.S. general population. Methods: Using SEER Cancer Registry Data, we present incidence rates according to subtypes for diagnosis years (1992-2013) among men and women for five major cancer sites: breast (female only), esophagus, kidney and renal pelvis, lung and bronchus, and thyroid. We also describe estimates of 5-year relative survival according to subtypes and diagnosis year (1992-2008). We used Joinpoint models to identify years when incidence rate trends changed slope. Finally, recent 5-year age-adjusted incidence rates (2009-2013) are presented for each subtype by race and age. Results: Hormone receptor-positive and HER2-negative was the most common subtype (about 74%) of breast cancers. Adenocarcinoma made up about 69% of esophagus cases among men. Adenocarcinoma also is the most common lung subtype (43% in men and 52% in women). Ninety percent of thyroid subtypes were papillary. Distinct incidence and survival patterns emerged by these subtypes over time among men and women. Conclusions: Histologic or molecular subtype revealed different incidence and/or survival trends that are masked when cancer is considered as a single disease on the basis of anatomic site. Impact: Presenting incidence and survival trends by subtype, whenever possible, is critical to provide more detailed and meaningful data to patients, providers, and the public. Cancer Epidemiol Biomarkers Prev; 26(4); 632-41. ©2016 AACR . ©2016 American Association for Cancer Research.

Fuzzy multinomial logistic regression analysis: A multi-objective programming approach

NASA Astrophysics Data System (ADS)

Abdalla, Hesham A.; El-Sayed, Amany A.; Hamed, Ramadan

2017-05-01

Parameter estimation for multinomial logistic regression is usually based on maximizing the likelihood function. For large well-balanced datasets, Maximum Likelihood (ML) estimation is a satisfactory approach. Unfortunately, ML can fail completely or at least produce poor results in terms of estimated probabilities and confidence intervals of parameters, specially for small datasets. In this study, a new approach based on fuzzy concepts is proposed to estimate parameters of the multinomial logistic regression. The study assumes that the parameters of multinomial logistic regression are fuzzy. Based on the extension principle stated by Zadeh and Bárdossy's proposition, a multi-objective programming approach is suggested to estimate these fuzzy parameters. A simulation study is used to evaluate the performance of the new approach versus Maximum likelihood (ML) approach. Results show that the new proposed model outperforms ML in cases of small datasets.

Genetic Programming Transforms in Linear Regression Situations

NASA Astrophysics Data System (ADS)

Castillo, Flor; Kordon, Arthur; Villa, Carlos

The chapter summarizes the use of Genetic Programming (GP) inMultiple Linear Regression (MLR) to address multicollinearity and Lack of Fit (LOF). The basis of the proposed method is applying appropriate input transforms (model respecification) that deal with these issues while preserving the information content of the original variables. The transforms are selected from symbolic regression models with optimal trade-off between accuracy of prediction and expressional complexity, generated by multiobjective Pareto-front GP. The chapter includes a comparative study of the GP-generated transforms with Ridge Regression, a variant of ordinary Multiple Linear Regression, which has been a useful and commonly employed approach for reducing multicollinearity. The advantages of GP-generated model respecification are clearly defined and demonstrated. Some recommendations for transforms selection are given as well. The application benefits of the proposed approach are illustrated with a real industrial application in one of the broadest empirical modeling areas in manufacturing - robust inferential sensors. The chapter contributes to increasing the awareness of the potential of GP in statistical model building by MLR.

Ca analysis: an Excel based program for the analysis of intracellular calcium transients including multiple, simultaneous regression analysis.

PubMed

Greensmith, David J

2014-01-01

Here I present an Excel based program for the analysis of intracellular Ca transients recorded using fluorescent indicators. The program can perform all the necessary steps which convert recorded raw voltage changes into meaningful physiological information. The program performs two fundamental processes. (1) It can prepare the raw signal by several methods. (2) It can then be used to analyze the prepared data to provide information such as absolute intracellular Ca levels. Also, the rates of change of Ca can be measured using multiple, simultaneous regression analysis. I demonstrate that this program performs equally well as commercially available software, but has numerous advantages, namely creating a simplified, self-contained analysis workflow. Copyright © 2013 The Author. Published by Elsevier Ireland Ltd.. All rights reserved.

Gifted Identification and the Role of Gifted Education: A Commentary on "Evaluating the Gifted Program of an Urban School District Using a Modified Regression Discontinuity Design"

ERIC Educational Resources Information Center

Steenbergen-Hu, Saiying; Olszewski-Kubilius, Paula

2016-01-01

The article by Davis, Engberg, Epple, Sieg, and Zimmer (2010) represents one of the recent research efforts from economists in evaluating the impact of gifted programs. It can serve as a worked example of the implementation of the regression discontinuity (RD) design method in gifted education research. In this commentary, we first illustrate the…

Curriculum emphasis and resident preparation in postgraduate general dentistry programs.

PubMed

Lefever, Karen H; Atchison, Kathryn A; Mito, Ronald S; Lin, Sylvia

2002-06-01

In 1999 HRSA contracted with the UCLA School of Dentistry to evaluate the impact of federal funding on postgraduate general dentistry programs. Part of that evaluation analyzed curriculum emphasis and preparation of incoming residents in advanced general dentistry programs over a five-year period. Directors of 208 civilian AEGD and GPR programs were surveyed about the curriculum content of their programs, increased or decreased emphasis in thirty subject areas, and resident preparation and quality (GPA and National Board scores). Results indicate that curriculum changes in AEGD and GPR programs over the time period have been responsive to the changing nature of general practice. At least half of all program directors reported that their residents were less than adequately prepared in fourteen curriculum areas. Sub-analyses were conducted for AEGD/GPR programs and HRSA-funded versus nonfunded programs. Multivariate regression identified lower student quality as the most important program variable in predicting a perceived need for resident remediation. Logistic regression showed that programs with higher resident GPA and National Board Part I scores had less difficulty filling resident positions.

Using Earned Value Data to Forecast the Duration of Department of Defense (DoD) Space Acquisition Programs

DTIC Science & Technology

2015-03-26

acquisition programs’ cost and schedule. Many prior studies have focused on the overall cost of programs (the cost estimate at completion (EAC)) ( Smoker ...regression ( Smoker , 2011), the Kalman Filter Forecasting Method (Kim, 2007), and analysis of the Integrated Master Schedule (IMS). All of the...A study by Smoker demonstrated this technique by first regressing the BCWP against months and the same approach for BAC (2011). In that study

A Growth Model for Academic Program Life Cycle (APLC): A Theoretical and Empirical Analysis

ERIC Educational Resources Information Center

Acquah, Edward H. K.

2010-01-01

Academic program life cycle concept states each program's life flows through several stages: introduction, growth, maturity, and decline. A mixed-influence diffusion growth model is fitted to enrolment data on academic programs to analyze the factors determining progress of academic programs through their life cycles. The regression analysis yield…

The Andrews’ Principles of Risk, Need, and Responsivity as Applied in Drug Abuse Treatment Programs: Meta-Analysis of Crime and Drug Use Outcomes

PubMed Central

Prendergast, Michael L.; Pearson, Frank S.; Podus, Deborah; Hamilton, Zachary K.; Greenwell, Lisa

2013-01-01

Objectives The purpose of the present meta-analysis was to answer the question: Can the Andrews principles of risk, needs, and responsivity, originally developed for programs that treat offenders, be extended to programs that treat drug abusers? Methods Drawing from a dataset that included 243 independent comparisons, we conducted random-effects meta-regression and ANOVA-analog meta-analyses to test the Andrews principles by averaging crime and drug use outcomes over a diverse set of programs for drug abuse problems. Results For crime outcomes, in the meta-regressions the point estimates for each of the principles were substantial, consistent with previous studies of the Andrews principles. There was also a substantial point estimate for programs exhibiting a greater number of the principles. However, almost all of the 95% confidence intervals included the zero point. For drug use outcomes, in the meta-regressions the point estimates for each of the principles was approximately zero; however, the point estimate for programs exhibiting a greater number of the principles was somewhat positive. All of the estimates for the drug use principles had confidence intervals that included the zero point. Conclusions This study supports previous findings from primary research studies targeting the Andrews principles that those principles are effective in reducing crime outcomes, here in meta-analytic research focused on drug treatment programs. By contrast, programs that follow the principles appear to have very little effect on drug use outcomes. Primary research studies that experimentally test the Andrews principles in drug treatment programs are recommended. PMID:24058325

Statistical power analyses using G*Power 3.1: tests for correlation and regression analyses.

PubMed

Faul, Franz; Erdfelder, Edgar; Buchner, Axel; Lang, Albert-Georg

2009-11-01

G*Power is a free power analysis program for a variety of statistical tests. We present extensions and improvements of the version introduced by Faul, Erdfelder, Lang, and Buchner (2007) in the domain of correlation and regression analyses. In the new version, we have added procedures to analyze the power of tests based on (1) single-sample tetrachoric correlations, (2) comparisons of dependent correlations, (3) bivariate linear regression, (4) multiple linear regression based on the random predictor model, (5) logistic regression, and (6) Poisson regression. We describe these new features and provide a brief introduction to their scope and handling.

Site-specific estimation of peak-streamflow frequency using generalized least-squares regression for natural basins in Texas

USGS Publications Warehouse

Asquith, William H.; Slade, R.M.

1999-01-01

The U.S. Geological Survey, in cooperation with the Texas Department of Transportation, has developed a computer program to estimate peak-streamflow frequency for ungaged sites in natural basins in Texas. Peak-streamflow frequency refers to the peak streamflows for recurrence intervals of 2, 5, 10, 25, 50, and 100 years. Peak-streamflow frequency estimates are needed by planners, managers, and design engineers for flood-plain management; for objective assessment of flood risk; for cost-effective design of roads and bridges; and also for the desin of culverts, dams, levees, and other flood-control structures. The program estimates peak-streamflow frequency using a site-specific approach and a multivariate generalized least-squares linear regression. A site-specific approach differs from a traditional regional regression approach by developing unique equations to estimate peak-streamflow frequency specifically for the ungaged site. The stations included in the regression are selected using an informal cluster analysis that compares the basin characteristics of the ungaged site to the basin characteristics of all the stations in the data base. The program provides several choices for selecting the stations. Selecting the stations using cluster analysis ensures that the stations included in the regression will have the most pertinent information about flooding characteristics of the ungaged site and therefore provide the basis for potentially improved peak-streamflow frequency estimation. An evaluation of the site-specific approach in estimating peak-streamflow frequency for gaged sites indicates that the site-specific approach is at least as accurate as a traditional regional regression approach.

The Impact of Prior Programming Knowledge on Lecture Attendance and Final Exam

ERIC Educational Resources Information Center

Veerasamy, Ashok Kumar; D'Souza, Daryl; Lindén, Rolf; Laakso, Mikko-Jussi

2018-01-01

In this article, we report the results of the impact of prior programming knowledge (PPK) on lecture attendance (LA) and on subsequent final programming exam performance in a university level introductory programming course. This study used Spearman's rank correlation coefficient, multiple regression, Kruskal-Wallis, and Bonferroni correction…

Creep-Rupture Data Analysis - Engineering Application of Regression Techniques. Ph.D. Thesis - North Carolina State Univ.

NASA Technical Reports Server (NTRS)

Rummler, D. R.

1976-01-01

The results are presented of investigations to apply regression techniques to the development of methodology for creep-rupture data analysis. Regression analysis techniques are applied to the explicit description of the creep behavior of materials for space shuttle thermal protection systems. A regression analysis technique is compared with five parametric methods for analyzing three simulated and twenty real data sets, and a computer program for the evaluation of creep-rupture data is presented.

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

PubMed

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

2012-08-01

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

What Works after School? The Relationship between After-School Program Quality, Program Attendance, and Academic Outcomes

ERIC Educational Resources Information Center

Leos-Urbel, Jacob

2015-01-01

This article examines the relationship between after-school program quality, program attendance, and academic outcomes for a sample of low-income after-school program participants. Regression and hierarchical linear modeling analyses use a unique longitudinal data set including 29 after-school programs that served 5,108 students in Grades 4 to 8…

HIV prevention costs and program scale: data from the PANCEA project in five low and middle-income countries.

PubMed

Marseille, Elliot; Dandona, Lalit; Marshall, Nell; Gaist, Paul; Bautista-Arredondo, Sergio; Rollins, Brandi; Bertozzi, Stefano M; Coovadia, Jerry; Saba, Joseph; Lioznov, Dmitry; Du Plessis, Jo-Ann; Krupitsky, Evgeny; Stanley, Nicci; Over, Mead; Peryshkina, Alena; Kumar, S G Prem; Muyingo, Sowedi; Pitter, Christian; Lundberg, Mattias; Kahn, James G

2007-07-12

Economic theory and limited empirical data suggest that costs per unit of HIV prevention program output (unit costs) will initially decrease as small programs expand. Unit costs may then reach a nadir and start to increase if expansion continues beyond the economically optimal size. Information on the relationship between scale and unit costs is critical to project the cost of global HIV prevention efforts and to allocate prevention resources efficiently. The "Prevent AIDS: Network for Cost-Effectiveness Analysis" (PANCEA) project collected 2003 and 2004 cost and output data from 206 HIV prevention programs of six types in five countries. The association between scale and efficiency for each intervention type was examined for each country. Our team characterized the direction, shape, and strength of this association by fitting bivariate regression lines to scatter plots of output levels and unit costs. We chose the regression forms with the highest explanatory power (R2). Efficiency increased with scale, across all countries and interventions. This association varied within intervention and within country, in terms of the range in scale and efficiency, the best fitting regression form, and the slope of the regression. The fraction of variation in efficiency explained by scale ranged from 26-96%. Doubling in scale resulted in reductions in unit costs averaging 34.2% (ranging from 2.4% to 58.0%). Two regression trends, in India, suggested an inflection point beyond which unit costs increased. Unit costs decrease with scale across a wide range of service types and volumes. These country and intervention-specific findings can inform projections of the global cost of scaling up HIV prevention efforts.

STATLIB: NSWC Library of Statistical Programs and Subroutines

DTIC Science & Technology

1989-08-01

Uncorrelated Weighted Polynomial Regression 41 .WEPORC Correlated Weighted Polynomial Regression 45 MROP Multiple Regression Using Orthogonal Polynomials ...could not and should not be con- NSWC TR 89-97 verted to the new general purpose computer (the current CDC 995). Some were designed tu compute...personal computers. They are referred to as SPSSPC+, BMDPC, and SASPC and in general are less comprehensive than their mainframe counterparts. The basic

Using regression equations built from summary data in the psychological assessment of the individual case: extension to multiple regression.

PubMed

Crawford, John R; Garthwaite, Paul H; Denham, Annie K; Chelune, Gordon J

2012-12-01

Regression equations have many useful roles in psychological assessment. Moreover, there is a large reservoir of published data that could be used to build regression equations; these equations could then be employed to test a wide variety of hypotheses concerning the functioning of individual cases. This resource is currently underused because (a) not all psychologists are aware that regression equations can be built not only from raw data but also using only basic summary data for a sample, and (b) the computations involved are tedious and prone to error. In an attempt to overcome these barriers, Crawford and Garthwaite (2007) provided methods to build and apply simple linear regression models using summary statistics as data. In the present study, we extend this work to set out the steps required to build multiple regression models from sample summary statistics and the further steps required to compute the associated statistics for drawing inferences concerning an individual case. We also develop, describe, and make available a computer program that implements these methods. Although there are caveats associated with the use of the methods, these need to be balanced against pragmatic considerations and against the alternative of either entirely ignoring a pertinent data set or using it informally to provide a clinical "guesstimate." Upgraded versions of earlier programs for regression in the single case are also provided; these add the point and interval estimates of effect size developed in the present article.

Service Content as a Determinant of Homeless Adults' Perceptions of Program Efficacy

ERIC Educational Resources Information Center

Sosin, Michael; George, Christine; Grossman, Susan

2012-01-01

This work analyzes the relationship between the services clients receive in treatment programs and client ratings of program efficacy. It relies on data from a random sample of clients served by Chicago's homelessness system (N = 554). Regressions utilizing that data suggest that ratings of program efficacy are positively predicted by program…

The Oklahoma's Promise Program: A National Model to Promote College Persistence

ERIC Educational Resources Information Center

Mendoza, Pilar; Mendez, Jesse P.

2013-01-01

Using a multi-method approach involving fixed effects and logistic regressions, this study examined the effect of the Oklahoma's Promise Program on student persistence in relation to the Pell and Stafford federal programs and according to socio-economic characteristics and class level. The Oklahoma's Promise is a hybrid state program that pays…

Factors Affecting Leave out of General Practitioners from Rural Family Physician Program: A Case of Kerman, Iran

PubMed Central

Amiresmaili, Mohammadreza; Khosravi, Sajad; Feyzabadi, Vahid Yazdi

2014-01-01

Background: Rural family physician program as the new reform in the Iranian health system has been implemented since 2005. Its success depends much on physicians’ retention. The present study aimed to identify influential factors on physicians’ willingness to leave out this program in Kerman province. Methods: The present cross-sectional study was performed in Kerman province in 2011. All family physicians working in this program (n = 271) were studied using a questionnaire. Data analysis was carried out using descriptive statistics and logistic regression through SPSS version 18.0. Results: Twenty-six percent (70) of the physicians had left out the program in the past. In addition, 77.3% (208) intended to leave out in the near future. Opportunity for continuing education, inappropriate and long working hours, unsuitable requirements of salary, irregular payments, lack of job security and high working responsibility were regarded as the most important reasons for leaving out the program in the past and intention to leave out in future orderly. According to univariate logistic regression, younger physicians (odds ratio [OR] =2.479; 95% confidence interval [CI]: 1.261-4.872) and physicians who had older children (OR = 4.743; 95% CI: 1.441-15.607) were more willing to leave out the plan in the near future, however it was not significant in multivariate logistic regression. Conclusions: Physician retention in family physician program is faced with serious doubts due to different reasons. The success of the program is endangered because of the pivotal role of human resources. Hence, the revision of human resources policies of the program seems necessary in order to reduce physicians leave out and improving its effectiveness. PMID:25400891

Do Developmental Mathematics Programs Have a Causal Impact on Student Retention? An Application of Discrete-Time Survival and Regression-Discontinuity Analysis

ERIC Educational Resources Information Center

Lesik, Sally A.

2007-01-01

The impact of academic programs--such as developmental mathematics programs--on student retention, has been a controversial topic for administrators, policy makers, and faculty in higher education. Despite deep interest in the effectiveness of these programs in retaining students, scholars have been unable to determine whether such programs have a…

Incidence and Trends in Hypoglycemia Hospitalization in Adults With Type 1 and Type 2 Diabetes in England, 1998-2013: A Retrospective Cohort Study.

PubMed

Zhong, Victor W; Juhaeri, Juhaeri; Cole, Stephen R; Kontopantelis, Evangelos; Shay, Christina M; Gordon-Larsen, Penny; Mayer-Davis, Elizabeth J

2017-12-01

To determine trends in hospitalization for hypoglycemia in adults with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM) in England. Adults with T1DM or T2DM were identified from 398 of the 684 practices within the Clinical Practice Research Datalink, for which linkage to the Hospital Episode Statistics was possible. Hypoglycemia as the primary reason for hospitalization between 1998 and 2013 was extracted. Trends were estimated using joinpoint regression models for adults with T1DM, young and middle-aged adults with T2DM (18-64 years), and elderly adults with T2DM (≥65 years), respectively. Among 23,246 adults with T1DM, 1,591 hypoglycemia hospitalizations occurred during 121,262 person-years. Among 241,441 adults with T2DM, 3,738 hypoglycemia hospitalizations occurred during 1,344,818 person-years. In adults with T1DM, the incidence increased 3.74% (95% CI 1.70-5.83) annually from 1998 to 2013. In young and middle-aged adults with T2DM, the annual incidence increase was 4.12% (0.61-7.75) from 1998 to 2013. In elderly adults with T2DM, the incidence increased 8.59% (5.76-11.50) annually from 1998 to 2009, and decreased 8.05% (-14.48 to -1.13) annually from 2009 to 2013, but the incidence was still higher in 2013 than 1998 (adjusted rate ratio 3.01 [1.76-5.14]). Trends in HbA 1c level did not parallel trends of hypoglycemia hospitalization for both diabetes types. A possible reason for declined hypoglycemia trend in 2009-2013 in elderly adults with T2DM may be continuously decreased sulfonylurea use after 2009, which was not seen in young and middle-aged adults with T2DM. Hypoglycemia requiring hospitalization has been an increasing burden in adults with T1DM and T2DM in England in the previous two decades, with the exception of the decline in elderly adults with T2DM starting in 2009. © 2017 by the American Diabetes Association.

Trends in procedures for infertility and caesarean sections: was NICE disinvestment guidance implemented? NICE recommendation reminders

PubMed Central

2013-01-01

Background National Institute for Health and Clinical Excellence (NICE) clinical guidelines and subsequent NICE issued ‘recommendation reminders’ advocate discontinuing two fertility procedures and caesarean sections in women with hepatitis. We assess whether NICE guidance in 2004 and recommendation reminders were associated with a change in the rate of clinical procedures performed. Methods Routine inpatient Hospital Episode Statistics (HES) data were extracted from the HES database for 1st April 1998 to 31st March 2010 using OPCS procedure codes for varicocele operations in infertile men, endometrial biopsies in infertile women and caesarean sections in women with hepatitis B or C. We used Joinpoint regression to identify points in time when the trend in procedure rates changed markedly, to identify any influence of the release of NICE guidance. Results Between 1998-2010, planned caesarean sections in women with and without hepatitis B or C increased yearly (annual percentage change (APC) 4.9%, 95% CI 2.1% to 7.7%) in women with hepatitis, compared with women without (APC 4.0% [95% CI 2.7% to 5.3%] up to 2001, APC -0.6% [95% CI -2.8% to 1.8%] up to 2004 and 1.3% [95% CI 0.8% to 1.8%] up to 2010). In infertile women under 40 years of age, endometrial biopsies for investigation of infertility increased, APC 6.0% (95% CI 3.6% to 8.4%) up to 2003, APC 1.5% (95% CI -4.3% to 7.7%) to 2007 followed by APC 12.8% (95% CI 1.0% to 26.0%) to 2010. Varicocele procedures remained relatively static between 1998 and 2010 (APC -0.5%, 95% CI -2.3% to 1.3%). Conclusions There was no decline in use of the three studied procedures, contrary to NICE guidance, and no change in uptake associated with the timing of NICE guidance or recommendation reminders. ‘Do not do’ recommendation reminders may be ineffective at improving clinical practice or achieving disinvestment. PMID:23388377

Incidence trends and patterns of breast cancer in Sri Lanka: an analysis of the national cancer database.

PubMed

Fernando, Ashan; Jayarajah, Umesh; Prabashani, Saumyakala; Fernando, Eshani A; Seneviratne, Sanjeewa A

2018-04-27

A gradual decline in the incidence of breast cancer is documented in developed countries especially over last two decades, while in developing countries the incidence continues to rise. We conducted this study to examine trends in incidence of breast cancer in a developing country, Sri Lanka. A retrospective cohort evaluation of patients with breast cancer during 2001-2010 was performed using population based data from the Sri Lanka National Cancer Registry. Trends in incidence were analysed using Joinpoint regression analysis. The age standardized incidence of female breast cancer in Sri Lanka appears to have increased from 17.3 per 100,000 in 2001 (95% confidence interval [95% CI] 16.5-18.2) to 24.7 per 100,000 in 2010 (95% CI 23.7-25.7); a 1.4-fold increase (p < 0.05) with an estimated annual percentage change (EAPC) of 4.4 (95% CI 3.3-5.5). Highest incidence of breast cancer was seen among women of 60 to 64-year age group which has increased from 68.1 to 100.2 per 100,000 over this period (EAPC 4.6%, 95% CI 3.9-5.2, p < 0.001 for trend). A substantially greater increase was observed among women older than 50 years (from 50.4 to 76.9 per 100,000; EAPC 5.5, 95% CI 4.1-7.0, p < 0.05) compared with women younger than 50 years (from 32.0 to 39.6 per 100,000; EAPC 2.3, 95% CI 1.1-3.5, p < 0.05). A gradual but a significant increase in the incidence of female breast cancer is observed in Sri Lanka. A rapid rise in the breast cancer incidence among post-menopausal women appears to be the major contributor towards this increase. Improving cancer data collection appears to have been a contributor to the observed increase. However, an inherent increase is also likely as differential rates of increase were observed by age groups. Further research is needed to identify the reasons for the observed increase which may help with future cancer control efforts in Sri Lanka.

The rise in metastasectomy across cancer types over the past decade.

PubMed

Bartlett, Edmund K; Simmons, Kristina D; Wachtel, Heather; Roses, Robert E; Fraker, Douglas L; Kelz, Rachel R; Karakousis, Giorgos C

2015-03-01

Although studies of metastasectomy have been limited primarily to institutional experiences, reports of favorable long-term outcomes have generated increasing interest. In the current study, the authors attempted to define the national practice patterns in metastasectomy for 4 common malignancies with varying responsiveness to systemic therapy. The National (Nationwide) Inpatient Sample was used to estimate the national incidence of metastasectomy for colorectal cancer, lung cancer, breast cancer, and melanoma from 2000 through 2011. Incidence-adjusted rates were determined for liver, lung, brain, small bowel, and adrenal metastasectomies. The average annual percentage change (AAPC) in metastasectomy by cancer type was calculated using joinpoint regression. Colorectal cancer was the most common indication for metastasectomy (87,407 cases; 95% confidence interval [95% CI], 86,307-88,507 cases) followed by lung cancer (58,245 cases; 95% CI, 57,453-59,036 cases), breast cancer (26,271 cases; 95% CI, 25,672-26,870 cases), and melanoma (20,298 cases; 95% CI, 19,897-20,699 cases). Metastasectomy increased significantly for all cancer types over the study period: colorectal cancer (AAPC, 6.83; 95% CI, 5.7-7.9), lung cancer (AAPC, 5.8; 95% CI, 5.1-6.4), breast cancer (AAPC, 5.5; 95% CI, 3.7-7.3), and melanoma (AAPC, 4.03; 95% CI, 2.1-6.0). Despite an increasing number of comorbidities in patients undergoing metastasectomy (P<.05 for each cancer type), inpatient mortality rates after metastasectomy fell for all cancer types, most significantly for colorectal (AAPC, -5.49; 95% CI, -8.2 to -2.7) and lung (AAPC, -6.2; 95% CI, -11.7 to -0.3) cancers. The increasing performance of metastasectomy was largely driven by high-volume institutions, in which patients had a lower mean number of comorbidities (P<.01 for all cancer types) and lower inpatient mortality (P<.01 for all cancers except melanoma). From 2000 through 2011, the performance of metastasectomy increased substantially across common cancer types, notwithstanding various advances in systemic therapies. Metastasectomy was performed more safely, despite increasing patient comorbidity. High-volume institutions appeared to drive practice patterns. © 2014 American Cancer Society.

Trends in Sales of Flavored and Menthol Tobacco Products in the United States During 2011-2015.

PubMed

Kuiper, Nicole M; Gammon, Doris; Loomis, Brett; Falvey, Kyle; Wang, Teresa W; King, Brian A; Rogers, Todd

2018-05-03

Flavors can mask the harshness of tobacco and make it appealing to young people. This study assessed flavored and menthol tobacco product sales at the national and state levels. Universal Product Code tobacco sales data collected by Nielsen were combined for convenience stores and all-outlets-combined during October 22, 2011-January 9, 2016. Products were characterized as flavored, menthol, or non-flavored/non-menthol. Total unit sales, and the proportion of flavored and menthol unit sales, were assessed nationally and by state for seven tobacco products. Joinpoint regression was used to assess trends in average monthly percentage change. Nationally, the proportion of flavored and menthol sales in 2015 was as follows: cigarettes (32.5% menthol), large cigars (26.1% flavored), cigarillos (47.5% flavored, 0.2% menthol), little cigars (21.8% flavored, 19.4% menthol), chewing tobacco (1.4% flavored, 0.7% menthol), moist snuff (3.0% flavored, 57.0% menthol), and snus (88.5% menthol). From 2011 to 2015, sales increased for flavored cigarillos and chewing tobacco, as well as for menthol cigarettes, little cigars, moist snuff, and snus. Sales decreased for flavored large cigars, moist snuff, and snus, and for menthol chewing tobacco. State-level variations were observed by product; for example, flavored little cigar sales ranged from 4.4% (Maine) to 69.3% (Utah) and flavored cigarillo sales ranged from 26.6% (Maine) to 63.0% (Maryland). Menthol and flavored sales have increased since 2011, particularly for the products with the highest number of units sold, and significant state variation exists. Efforts to restrict flavored tobacco product sales could reduce overall U.S. tobacco consumption. Flavors in tobacco products can mask the harshness of tobacco and make these products more appealing to young people. This is the first study to assess national and state-level trends in flavored and menthol tobacco product sales. These findings underscore the importance of population-based interventions to address flavored tobacco product use at the national, state, and local levels. Additionally, further monitoring of flavored and menthol tobacco product sales can inform potential future regulatory efforts at the national, state, and local levels.

Mortality and Case Fatality Due to Visceral Leishmaniasis in Brazil: A Nationwide Analysis of Epidemiology, Trends and Spatial Patterns

PubMed Central

Martins-Melo, Francisco Rogerlândio; Lima, Mauricélia da Silveira; Ramos, Alberto Novaes; Alencar, Carlos Henrique; Heukelbach, Jorg

2014-01-01

Background Visceral leishmaniasis (VL) is a significant public health problem in Brazil and several regions of the world. This study investigated the magnitude, temporal trends and spatial distribution of mortality related to VL in Brazil. Methods We performed a study based on secondary data obtained from the Brazilian Mortality Information System. We included all deaths in Brazil from 2000 to 2011, in which VL was recorded as cause of death. We present epidemiological characteristics, trend analysis of mortality and case fatality rates by joinpoint regression models, and spatial analysis using municipalities as geographical units of analysis. Results In the study period, 12,491,280 deaths were recorded in Brazil. VL was mentioned in 3,322 (0.03%) deaths. Average annual age-adjusted mortality rate was 0.15 deaths per 100,000 inhabitants and case fatality rate 8.1%. Highest mortality rates were observed in males (0.19 deaths/100,000 inhabitants), <1 year-olds (1.03 deaths/100,000 inhabitants) and residents in Northeast region (0.30 deaths/100,000 inhabitants). Highest case fatality rates were observed in males (8.8%), ≥70 year-olds (43.8%) and residents in South region (17.7%). Mortality and case fatality rates showed a significant increase in Brazil over the period, with different patterns between regions: increasing mortality rates in the North (Annual Percent Change – APC: 9.4%; 95% confidence interval – CI: 5.3 to 13.6), and Southeast (APC: 8.1%; 95% CI: 2.6 to 13.9); and increasing case fatality rates in the Northeast (APC: 4.0%; 95% CI: 0.8 to 7.4). Spatial analysis identified a major cluster of high mortality encompassing a wide geographic range in North and Northeast Brazil. Conclusions Despite ongoing control strategies, mortality related to VL in Brazil is increasing. Mortality and case fatality vary considerably between regions, and surveillance and control measures should be prioritized in high-risk clusters. Early diagnosis and treatment are fundamental strategies for reducing case fatality of VL in Brazil. PMID:24699517

Trends in Local Therapy Utilization and Cost for Early-Stage Breast Cancer in Older Women: Implications for Payment and Policy Reform

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

Shirvani, Shervin M.; Department of Radiation Oncology, Banner MD Anderson Cancer Center, Gilbert, Arizona; Jiang, Jing

Purpose: Older women with early-stage disease constitute the most rapidly growing breast cancer demographic, yet it is not known which local therapy strategies are most favored by this population in the current era. Understanding utilization trends and cost of local therapy is important for informing the design of bundled payment models as payers migrate away from fee-for-service models. We therefore used the Surveillance, Epidemiology, and End Results Medicare database to determine patterns of care and costs for local therapy among older women with breast cancer. Methods and Materials: Treatment strategy and covariables were determined in 55,327 women age ≥66 withmore » Tis-T2N0-1M0 breast cancer who underwent local therapy between 2000 and 2008. Trends in local therapy were characterized using Joinpoint. Polychotomous logistic regression determined predictors of local therapy. The median aggregate cost over the first 24 months after diagnosis was determined from Medicare claims through 2010 and reported in 2014 dollars. Results: The median age was 75. Local therapy distribution was as follows: 27,896 (50.3%) lumpectomy with external beam radiation, 18,356 (33.1%) mastectomy alone, 6159 (11.1%) lumpectomy alone, 1488 (2.7%) mastectomy with reconstruction, and 1455 (2.6%) lumpectomy with brachytherapy. Mastectomy alone declined from 39.0% in 2000 to 28.2% in 2008, and the use of breast conserving local therapies rose from 58.7% to 68.2%. Mastectomy with reconstruction was more common among the youngest, healthiest patients, whereas mastectomy alone was more common among patients living in rural low-income regions. By 2008, the costs were $36,749 for lumpectomy with brachytherapy, $35,030 for mastectomy with reconstruction, $31,388 for lumpectomy with external beam radiation, $21,993 for mastectomy alone, and $19,287 for lumpectomy alone. Conclusions: The use of mastectomy alone in older women declined in favor of breast conserving strategies between 2000 and 2008. Using these cost estimates, price points for local therapy bundles can be constructed to incentivize the treatment strategies that confer the highest value.« less

Mortality Trends for Neglected Tropical Diseases in the State of Sergipe, Brazil, 1980-2013.

PubMed

Costa de Albuquerque, Marcos Antônio; Dias, Danielle Menezes; Vieira, Lucas Teixeira; Lima, Carlos Anselmo; da Silva, Angela Maria

2017-02-08

Neglected Tropical Diseases are a set of communicable diseases that affect the population so low socioeconomic status, particularly 1.4 billion people who are living below the poverty level. This study has investigated the magnitude and mortality time trends for these diseases in the state of Sergipe, Northeast Region of Brazil. We conducted an ecological study of time series, based on secondary data derived from the Mortality Information System of the Ministry of Health. The mortality rates (crude, age-standardized rates and proportional ratio) were calculated from the deaths due to Neglected Tropical Diseases in the state of Sergipe, from 1980 to 2013. The time trends were obtained using the Joinpoint regression model. Three hundred six thousand and eight hundred seventy-two deaths were certified in the state and Neglected Tropical Diseases were mentioned as the underlying cause in 1,203 certificates (0.39%). Mean number of deaths was 35.38 per year, and crude and age-standardized mortality rates were, respectively: 2.16 per 100 000 inhabitants (95% CI: 1.45-2.87) and 2.87 per 100 000 inhabitants (95% CI: 1.93-3.82); the proportional mortality ratio was 0.41% (95% CI: 0.27-0.54). In that period, Schistosomiasis caused 654 deaths (54.36%), followed by Chagas disease, with 211 (17.54%), and by Leishmaniases, with 142 (11.80%) deaths. The other diseases totalized 196 deaths (16.30%). There were increasing mortality trends for Neglected Tropical Diseases, Schistosomiasis and Chagas disease in the last 15 years, according to the age-standardized rates, and stability of the mortality trends for Leishmaniases. The Neglected Tropical Diseases show increasing trends and are a real public health problem in the state of Sergipe, since they are responsible for significant mortality rates. The following diseases call attention for showing greater number of deaths in the period of study: Schistosomiasis, Chagas disease and Leishmaniases. We finally suggest that public managers take appropriate actions to develop new strategies in epidemiological and therapeutic surveillance, and in the follow-up of these patients.

Trends in HIV testing, prevalence among first-time testers, and incidence in most-at-risk populations in Spain: the EPI-VIH Study, 2000 to 2009.

PubMed

Diez, M; Bleda, M J; Varela, J R; Ordonana, J; Azpiri, M A; Vall, M; Santos, C; Viloria, L; de Armas, C; Urena, J M; Trullen, J; Pueyo, I; Martinez, B; Puerta, T; Vera, M; Sanz, I; Junquera, M L; Landa, M C; Martinez, E; Camara, M M; Belda, J; Bru, F J; Diaz, A

2014-11-27

During 2000 to 2009, data on people undergoing HIV testing and on those newly diagnosed with HIV were collected in a network of 20 Spanish clinics specialising in sexually transmitted infections and/or HIV testing and counselling. The number of tests performed, overall and disaggregated by different variables, was obtained. HIV prevalence among first-time testers and HIV incidence among repeat testers were calculated. To evaluate trends, joinpoint regression models were fitted. In total, 236,939 HIV tests were performed for 165,745 individuals. Overall HIV prevalence among persons seeking HIV testing was 2.5% (95% CI: 2.4 to 2.6). Prevalence was highest in male sex workers who had sex with other men (19.0% (95% CI: 16.7 to 21.4)) and was lowest in female sex workers (0.8% (95% CI: 0.7 to 0.9)). Significant trends in prevalence were observed in men who have sex with men (MSM) (increasing) and heterosexual individuals (decreasing). The incidence analysis included 30,679 persons, 64,104 person-years (py) of follow-up and 642 seroconversions. The overall incidence rate (IR) was 1.0/100 py (95% CI: 0.9/100 to 1.1/100). Incidence was significantly higher in men and transgender females than in women (1.8/100 py (95% CI: 1.6 to 1.9), 1.2/100 py (95% CI: 0.5 to 2.8) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively) and increased with age until 35–39 years. IRs in MSM and people who inject drugs were significantly greater than in heterosexual individuals (2.5/100 py (95% CI: 2.3 to 2.7), 1.6/100 py (95% CI: 1.1 to 2.2) and 0.1/100 py (95% CI: 0.09 to 0.2) respectively), and an upward trend was observed in MSM. Our results call for HIV prevention to be reinforced in MSM and transgender women in Spain.

Global incidence and outcome of testicular cancer

PubMed Central

Shanmugalingam, Thurkaa; Soultati, Aspasia; Chowdhury, Simon; Rudman, Sarah; Van Hemelrijck, Mieke

2013-01-01

Background Testicular cancer is a rare tumor type accounting for 1% of malignancies in men. It is, however, the most common cancer in young men in Western populations. The incidence of testicular cancer is increasing globally, although a decline in mortality rates has been reported in Western countries. It is important to identify whether the variations in trends observed between populations are linked to genetic or environmental factors. Methods Age-standardized incidence rates and age-standardized mortality rates for testicular cancer were obtained for men of all ages in ten countries from the Americas, Asia, Europe, and Oceania using the Cancer Incidence in Five Continents (CI5plus) and World Health Organization (WHO) mortality databases. The annual percent change was calculated using Joinpoint regression to assess temporal changes between geographical regions. Results Testicular cancer age-standardized incidence rates are highest in New Zealand (7.8), UK (6.3), Australia (6.1), Sweden (5.6), USA (5.2), Poland (4.9), and Spain (3.8) per 100,000 men. India, China, and Colombia had the lowest incidence (0.5, 1.3, and 2.2, respectively) per 100,000 men. The annual percent changes for overall testicular cancer incidence significantly increased in the European countries Sweden 2.4%, (2.2; 2.6); UK 2.9%, (2.2; 3.6); and Spain 5.0%, (1.7; 8.4), Australia 3.0%, (2.2; 3.7), and China 3.5%, (1.9; 5.1). India had the lowest overall testicular cancer incidence −1.7%, (−2.5; −0.8). Annual percent changes for overall testicular cancer mortality rates were decreasing in all study populations, with the greatest decline observed in Sweden −4.2%, (−4.8; −3.6) and China −4.9%, (−6.5; −3.3). Conclusion Testicular cancer is increasing in incidence in many countries; however, mortality rates remain low and most men are cured. An understanding of the risks and long-term side effects of treatment are important in managing men with this disease. PMID:24204171

European cancer mortality predictions for the year 2018 with focus on colorectal cancer.

PubMed

Malvezzi, M; Carioli, G; Bertuccio, P; Boffetta, P; Levi, F; La Vecchia, C; Negri, E

2018-04-01

We projected cancer mortality statistics for 2018 for the European Union (EU) and its six more populous countries, using the most recent available data. We focused on colorectal cancer. We obtained cancer death certification data from stomach, colorectum, pancreas, lung, breast, uterus, ovary, prostate, bladder, leukaemia, and total cancers from the World Health Organisation database and projected population data from Eurostat. We derived figures for France, Germany, Italy, Poland, Spain, the UK, and the EU in 1970-2012. We predicted death numbers by age group and age-standardized (world population) rates for 2018 through joinpoint regression models. EU total cancer mortality rates are predicted to decline by 10.3% in men between 2012 and 2018, reaching a predicted rate of 128.9/100 000, and by 5.0% in women with a rate of 83.6. The predicted total number of cancer deaths is 1 382 000 when compared with 1 333 362 in 2012 (+3.6%). We confirmed a further fall in male lung cancer, but an unfavourable trend in females, with a rate of 14.7/100 000 for 2018 (13.9 in 2012, +5.8%) and 94 500 expected deaths, higher than the rate of 13.7 and 92 700 deaths from breast cancer. Colorectal cancer predicted rates are 15.8/100 000 men (-6.7%) and 9.2 in women (-7.5%); declines are expected in all age groups. Pancreatic cancer is stable in men, but in women it rose +2.8% since 2012. Ovarian, uterine and bladder cancer rates are predicted to decline further. In 2018 alone, about 392 300 cancer deaths were avoided compared with peak rates in the late 1980s. We predicted continuing falls in mortality rates from major cancer sites in the EU and its major countries to 2018. Exceptions are pancreatic cancer and lung cancer in women. Improved treatment and-above age 50 years-organized screening may account for recent favourable colorectal cancer trends.

Estimating average alcohol consumption in the population using multiple sources: the case of Spain.

PubMed

Sordo, Luis; Barrio, Gregorio; Bravo, María J; Villalbí, Joan R; Espelt, Albert; Neira, Montserrat; Regidor, Enrique

2016-01-01

National estimates on per capita alcohol consumption are provided regularly by various sources and may have validity problems, so corrections are needed for monitoring and assessment purposes. Our objectives were to compare different alcohol availability estimates for Spain, to build the best estimate (actual consumption), characterize its time trend during 2001-2011, and quantify the extent to which other estimates (coverage) approximated actual consumption. Estimates were: alcohol availability from the Spanish Tax Agency (Tax Agency availability), World Health Organization (WHO availability) and other international agencies, self-reported purchases from the Spanish Food Consumption Panel, and self-reported consumption from population surveys. Analyses included calculating: between-agency discrepancy in availability, multisource availability (correcting Tax Agency availability by underestimation of wine and cider), actual consumption (adjusting multisource availability by unrecorded alcohol consumption/purchases and alcohol losses), and coverage of selected estimates. Sensitivity analyses were undertaken. Time trends were characterized by joinpoint regression. Between-agency discrepancy in alcohol availability remained high in 2011, mainly because of wine and spirits, although some decrease was observed during the study period. The actual consumption was 9.5 l of pure alcohol/person-year in 2011, decreasing 2.3 % annually, mainly due to wine and spirits. 2011 coverage of WHO availability, Tax Agency availability, self-reported purchases, and self-reported consumption was 99.5, 99.5, 66.3, and 28.0 %, respectively, generally with downward trends (last three estimates, especially self-reported consumption). The multisource availability overestimated actual consumption by 12.3 %, mainly due to tourism imbalance. Spanish estimates of per capita alcohol consumption show considerable weaknesses. Using uncorrected estimates, especially self-reported consumption, for monitoring or other purposes is misleading. To obtain conservative estimates of alcohol-attributable disease burden or heavy drinking prevalence, self-reported consumption should be shifted upwards by more than 85 % (91 % in 2011) of Tax Agency or WHO availability figures. The weaknesses identified can probably also be found worldwide, thus much empirical work remains to be done to improve estimates of per capita alcohol consumption.

Utilization of Radiation Therapy in Norway After the Implementation of The National Cancer Plan—A National, Population-Based Study

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

Åsli, Linn M., E-mail: linn.merete.asli@kreftregisteret.no; Kvaløy, Stein O.; Jetne, Vidar

2014-11-01

Purpose: To estimate actual utilization rates of radiation therapy (RT) in Norway, describe time trends (1997-2010), and compare these estimates with corresponding optimal RT rates. Methods and Materials: Data from the population-based Cancer Registry of Norway was used to identify all patients diagnosed with cancer and/or treated by RT for cancer in 1997-2010. Radiation therapy utilization rates (RURs) were calculated as (1) the proportion of incident cancer cases who received RT at least once within 1 year of diagnosis (RUR{sub 1Y}); and (2) the proportion who received RT within 5 years of diagnosis (RUR{sub 5Y}). The number of RT treatment courses per incidentmore » cancer case (TCI) was also calculated for all cancer sites combined. The actual RURs were compared with corresponding Australian and Canadian epidemiologic- and evidence-based model estimates and criterion-based benchmark estimates of optimal RURs. The TCIs were compared with TCI estimates from the 1997 Norwegian/National Cancer Plan (NCP). Joinpoint regression was used to identify changes in trends and to estimate annual percentage change (APC) in actual RUR{sub 1Y} and actual TCI. Results: The actual RUR{sub 5Y} (all sites) increased significantly to 29% in 2005 but still differed markedly from the Australian epidemiologic- and evidence-based model estimate of 48%. With the exception of RUR{sub 5Y} for breast cancer and RUR{sub 1Y} for lung cancers, all actual RURs were markedly lower than optimal RUR estimates. The actual TCI increased significantly during the study period, reaching 42.5% in 2010, but was still lower than the 54% recommended in the NCP. The trend for RUR{sub 1Y} (all sites) and TCI changed significantly, with the annual percentage change being largest during the first part of the study period. Conclusions: Utilization rates of RT in Norway increased after the NCP was implemented and RT capacity was increased, but they still seem to be lower than optimal levels.« less

Predictions of Performance in Career Education.

ERIC Educational Resources Information Center

Novick, M. R.; And Others

Prediction weights for educational programs in 22 vocational and technical fields are provided using ability scores from the American College Testing Program (ACT) Career Planning Profile and a Bayesian regression theory. The criterion variable studies was first-semester grade-point average. Each vocational-technical program analyzed was…

Regression Simulation Model. Appendix X. Users Manual,

DTIC Science & Technology

1981-03-01

change as the prediction equations become refined. Whereas no notice will be provided when the changes are made, the programs will be modified such that...NATIONAL BUREAU Of STANDARDS 1963 A ___,_ __ _ __ _ . APPENDIX X ( R4/ EGRESSION IMULATION ’jDEL. Ape’A ’) 7 USERS MANUA submitted to The Great River...regression analysis and to establish a prediction equation (model). The prediction equation contains the partial regression coefficients (B-weights) which

Fine and Gray competing risk regression model to study the cause-specific under-five child mortality in Bangladesh.

PubMed

Mohammad, Khandoker Akib; Fatima-Tuz-Zahura, Most; Bari, Wasimul

2017-01-28

The cause-specific under-five mortality of Bangladesh has been studied by fitting cumulative incidence function (CIF) based Fine and Gray competing risk regression model (1999). For the purpose of analysis, Bangladesh Demographic and Health Survey (BDHS), 2011 data set was used. Three types of mode of mortality for the under-five children are considered. These are disease, non-disease and other causes. Product-Limit survival probabilities for the under-five child mortality with log-rank test were used to select a set of covariates for the regression model. The covariates found to have significant association in bivariate analysis were only considered in the regression analysis. Potential determinants of under-five child mortality due to disease is size of child at birth, while gender of child, NGO (non-government organization) membership of mother, mother's education level, and size of child at birth are due to non-disease and age of mother at birth, NGO membership of mother, and mother's education level are for the mortality due to other causes. Female participation in the education programs needs to be increased because of the improvement of child health and government should arrange family and social awareness programs as well as health related programs for women so that they are aware of their child health.

Factor regression for interpreting genotype-environment interaction in bread-wheat trials.

PubMed

Baril, C P

1992-05-01

The French INRA wheat (Triticum aestivum L. em Thell.) breeding program is based on multilocation trials to produce high-yielding, adapted lines for a wide range of environments. Differential genotypic responses to variable environment conditions limit the accuracy of yield estimations. Factor regression was used to partition the genotype-environment (GE) interaction into four biologically interpretable terms. Yield data were analyzed from 34 wheat genotypes grown in four environments using 12 auxiliary agronomic traits as genotypic and environmental covariates. Most of the GE interaction (91%) was explained by the combination of only three traits: 1,000-kernel weight, lodging susceptibility and spike length. These traits are easily measured in breeding programs, therefore factor regression model can provide a convenient and useful prediction method of yield.

Soccer and sexual health education: a promising approach for reducing adolescent births in Haiti.

PubMed

Kaplan, Kathryn C; Lewis, Judy; Gebrian, Bette; Theall, Katherine

2015-05-01

To explore the effect of an innovative, integrative program in female sexual reproductive health (SRH) and soccer (or fútbol, in Haitian Creole) in rural Haiti by measuring the rate of births among program participants 15-19 years old and their nonparticipant peers. A retrospective cohort study using 2006-2009 data from the computerized data-tracking system of the Haitian Health Foundation (HHF), a U.S.-based nongovernmental organization serving urban and rural populations in Haiti, was used to assess births among girls 15-19 years old who participated in HHF's GenNext program, a combination education-soccer program for youth, based on SRH classes HHF nurses and community workers had been conducting in Haiti for mothers, fathers, and youth; girl-centered health screenings; and an all-female summer soccer league, during 2006-2009 (n = 4 251). Bivariate and multiple logistic regression analyses were carried out to assess differences in the rate of births among program participants according to their level of participation (SRH component only ("EDU") versus both the SRH and soccer components ("SO") compared to their village peers who did not participate. Hazard ratios (HRs) of birth rates were estimated using Cox regression analysis of childbearing data for the three different groups. In the multiple logistic regression analysis, only the girls in the "EDU" group had significantly fewer births than the nonparticipants after adjusting for confounders (odds ratio = 0.535; 95% confidence interval (CI) = 0.304, 0.940). The Cox regression analysis demonstrated that those in the EDU group (HR = 0.893; 95% CI = 0.802, 0.994) and to a greater degree those in the SO group (HR = 0.631; 95% CI = 0.558, 0.714) were significantly protected against childbearing between the ages of 15 and 19 years. HHF's GenNext program demonstrates the effectiveness of utilizing nurse educators, community mobilization, and youth participation in sports, education, and structured youth groups to promote and sustain health for adolescent girls and young women.

Determinants of Private Long-Term Care Insurance Purchase in Response to the Partnership Program.

PubMed

Lin, Haizhen; Prince, Jeffrey T

2016-04-01

To assess three possible determinants of individuals' response in their private insurance purchases to the availability of the Partnership for Long-Term Care (PLTC) insurance program: bequest motives, financial literacy, and program awareness. The health and retirement study (HRS) merged with data on states' implementation of the PLTC program. Individual-level decision on private long-term care insurance is regressed on whether the PLTC program is being implemented for a given state-year, asset dummies, policy determinant variable, two-way and three-way interactions of these variables, and other controls, using fixed effects panel regression. Analysis used a sample between 50 and 69 years of age from 2002 to 2010, resulting in 12,695 unique individuals with a total of 39,151 observations. We find mild evidence that intent to bequest influences individual purchase of insurance. We also find that program awareness is necessary for response, while financial literacy notably increases responsiveness. Increasing response to the PLTC program among the middle class (the stated target group) requires increased efforts to create awareness of the program's existence and increased education about the program's benefits, and more generally, about long-term care risks and needs. © Health Research and Educational Trust.

CatReg Software for Categorical Regression Analysis (May 2016)

EPA Science Inventory

CatReg 3.0 is a Microsoft Windows enhanced version of the Agency’s categorical regression analysis (CatReg) program. CatReg complements EPA’s existing Benchmark Dose Software (BMDS) by greatly enhancing a risk assessor’s ability to determine whether data from separate toxicologic...

Annual Report to the Nation on the Status of Cancer, 1975–2014, Featuring Survival

PubMed Central

Ward, Elizabeth M.; Johnson, Christopher J.; Cronin, Kathleen A.; Ma, Jiemin; Ryerson, A. Blythe; Mariotto, Angela; Lake, Andrew J.; Wilson, Reda; Sherman, Recinda L.; Anderson, Robert N.; Henley, S. Jane; Kohler, Betsy A.; Penberthy, Lynne; Feuer, Eric J.; Weir, Hannah K.

2017-01-01

Abstract Background: The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate to provide annual updates on cancer occurrence and trends in the United States. This Annual Report highlights survival rates. Methods: Data were from the CDC- and NCI-funded population-based cancer registry programs and compiled by NAACCR. Trends in age-standardized incidence and death rates for all cancers combined and for the leading cancer types by sex were estimated by joinpoint analysis and expressed as annual percent change. We used relative survival ratios and adjusted relative risk of death after a diagnosis of cancer (hazard ratios [HRs]) using Cox regression model to examine changes or differences in survival over time and by sociodemographic factors. Results: Overall cancer death rates from 2010 to 2014 decreased by 1.8% (95% confidence interval [CI] = –1.8 to –1.8) per year in men, by 1.4% (95% CI = –1.4 to –1.3) per year in women, and by 1.6% (95% CI = –2.0 to –1.3) per year in children. Death rates decreased for 11 of the 16 most common cancer types in men and for 13 of the 18 most common cancer types in women, including lung, colorectal, female breast, and prostate, whereas death rates increased for liver (men and women), pancreas (men), brain (men), and uterine cancers. In contrast, overall incidence rates from 2009 to 2013 decreased by 2.3% (95% CI = –3.1 to –1.4) per year in men but stabilized in women. For several but not all cancer types, survival statistically significantly improved over time for both early and late-stage diseases. Between 1975 and 1977, and 2006 and 2012, for example, five-year relative survival for distant-stage disease statistically significantly increased from 18.7% (95% CI = 16.9% to 20.6%) to 33.6% (95% CI = 32.2% to 35.0%) for female breast cancer but not for liver cancer (from 1.1%, 95% CI = 0.3% to 2.9%, to 2.3%, 95% CI = 1.6% to 3.2%). Survival varied by race/ethnicity and state. For example, the adjusted relative risk of death for all cancers combined was 33% (HR = 1.33, 95% CI = 1.32 to 1.34) higher in non-Hispanic blacks and 51% (HR = 1.51, 95% CI = 1.46 to 1.56) higher in non-Hispanic American Indian/Alaska Native compared with non-Hispanic whites. Conclusions: Cancer death rates continue to decrease in the United States. However, progress in reducing death rates and improving survival is limited for several cancer types, underscoring the need for intensified efforts to discover new strategies for prevention, early detection, and treatment and to apply proven preventive measures broadly and equitably. PMID:28376154

Problems and Solutions in Evaluating Child Outcomes of Large-Scale Educational Programs.

ERIC Educational Resources Information Center

Abrams, Allan S.; And Others

1979-01-01

Evaluation of large-scale programs is problematical because of inherent bias in assignment of treatment and control groups, resulting in serious regression artifacts even with the use of analysis of covariance designs. Nonuniformity of program implementation across sites and classrooms is also a problem. (Author/GSK)

Introductory Linear Regression Programs in Undergraduate Chemistry.

ERIC Educational Resources Information Center

Gale, Robert J.

1982-01-01

Presented are simple programs in BASIC and FORTRAN to apply the method of least squares. They calculate gradients and intercepts and express errors as standard deviations. An introduction of undergraduate students to such programs in a chemistry class is reviewed, and issues instructors should be aware of are noted. (MP)

Program Director Participation in a Leadership and Management Skills Fellowship and Characteristics of Program Quality.

PubMed

Carek, Peter J; Mims, Lisa D; Conry, Colleen M; Maxwell, Lisa; Greenwood, Vicki; Pugno, Perry A

2015-01-01

The association between a residency program director completing a leadership and management skills fellowship and characteristics of quality and innovation of his/her residency program has not been studied. Therefore, the aim of this study is to examine the association between a residency program director's completion of a specific fellowship addressing these skills (National Institute for Program Director Development or NIPDD) and characteristics of quality and innovation of the program they direct. Using information from the American Academy of Family Physicians (AAFP), National Resident Matching Program (NRMP) and FREIDA® program characteristics were obtained. Descriptive statistics were used to summarize the data. The relationship between programs with a NIPDD graduate as director and program quality measures and indicators of innovation was analyzed using both chi square and logistic regression. Initial analyses showed significant associations between the NIPDD graduate status of a program director and regional location, mean years of program director tenure, and the program's 5-year aggregate ABFM board pass rate from 2007--2011. After grouping the programs into tertiles, the regression model showed significant positive associations with programs offering international experiences and being a NIPDD graduate. Program director participation in a fellowship addressing leadership and management skills (ie, NIPDD) was found to be associated with higher pass rates of new graduates on a Board certification examination and predictive of programs being in the upper tertile of programs in terms of Board pass rates.

An Interactive Version of MULR04 With Enhanced Graphic Capability

ERIC Educational Resources Information Center

Burkholder, Joel H.

1978-01-01

An existing computer program for computing multiple regression analyses is made interactive in order to alleviate core storage requirements. Also, some improvements in the graphics aspects of the program are included. (JKS)

BIODEGRADATION PROBABILITY PROGRAM (BIODEG)

EPA Science Inventory

The Biodegradation Probability Program (BIODEG) calculates the probability that a chemical under aerobic conditions with mixed cultures of microorganisms will biodegrade rapidly or slowly. It uses fragment constants developed using multiple linear and non-linear regressions and d...

The Use of Linear Programming for Prediction.

ERIC Educational Resources Information Center

Schnittjer, Carl J.

The purpose of the study was to develop a linear programming model to be used for prediction, test the accuracy of the predictions, and compare the accuracy with that produced by curvilinear multiple regression analysis. (Author)

[Regression on order statistics and its application in estimating nondetects for food exposure assessment].

PubMed

Yu, Xiaojin; Liu, Pei; Min, Jie; Chen, Qiguang

2009-01-01

To explore the application of regression on order statistics (ROS) in estimating nondetects for food exposure assessment. Regression on order statistics was adopted in analysis of cadmium residual data set from global food contaminant monitoring, the mean residual was estimated basing SAS programming and compared with the results from substitution methods. The results show that ROS method performs better obviously than substitution methods for being robust and convenient for posterior analysis. Regression on order statistics is worth to adopt,but more efforts should be make for details of application of this method.

Pass rates on the American Board of Family Medicine Certification Exam by residency location and size.

PubMed

Falcone, John L; Middleton, Donald B

2013-01-01

The Accreditation Council for Graduate Medical Education (ACGME) sets residency performance standards for the American Board of Family Medicine Certification Examination. This study aims are to describe the compliance of residency programs with ACGME standards and to determine whether residency pass rates depend on program size and location. In this retrospective cohort study, residency performance from 2007 to 2011 was compared with the ACGME performance standards. Simple linear regression was performed to see whether program pass rates were dependent on program size. Regional differences in performance were compared with χ(2) tests, using an α level of 0.05. Of 429 total residency programs, there were 205 (47.8%) that violate ACGME performance standards. Linear regression showed that program pass rates were positively correlated and dependent on program size (P < .001). The median pass rate per state was 86.4% (interquartile range, 82.0-90.8. χ(2) Tests showed that states in the West performed higher than the other 3 US Census Bureau Regions (all P < .001). Approximately half of the family medicine training programs do not meet the ACGME examination performance standards. Pass rates are associated with residency program size, and regional variation occurs. These findings have the potential to affect ACGME policy and residency program application patterns.

Daily values flow comparison and estimates using program HYCOMP, version 1.0

USGS Publications Warehouse

Sanders, Curtis L.

2002-01-01

A method used by the U.S. Geological Survey for quality control in computing daily value flow records is to compare hydrographs of computed flows at a station under review to hydrographs of computed flows at a selected index station. The hydrographs are placed on top of each other (as hydrograph overlays) on a light table, compared, and missing daily flow data estimated. This method, however, is subjective and can produce inconsistent results, because hydrographers can differ when calculating acceptable limits of deviation between observed and estimated flows. Selection of appropriate index stations also is judgemental, giving no consideration to the mathematical correlation between the review station and the index station(s). To address the limitation of the hydrograph overlay method, a set of software programs, written in the SAS macrolanguage, was developed and designated Program HYDCOMP. The program automatically selects statistically comparable index stations by correlation and regression, and performs hydrographic comparisons and estimates of missing data by regressing daily mean flows at the review station against -8 to +8 lagged flows at one or two index stations and day-of-week. Another advantage that HYDCOMP has over the graphical method is that estimated flows, the criteria for determining the quality of the data, and the selection of index stations are determined statistically, and are reproducible from one user to another. HYDCOMP will load the most-correlated index stations into another file containing the ?best index stations,? but will not overwrite stations already in the file. A knowledgeable user should delete unsuitable index stations from this file based on standard error of estimate, hydrologic similarity of candidate index stations to the review station, and knowledge of the individual station characteristics. Also, the user can add index stations not selected by HYDCOMP, if desired. Once the file of best-index stations is created, a user may do hydrographic comparison and data estimates by entering the number of the review station, selecting an index station, and specifying the periods to be used for regression and plotting. For example, the user can restrict the regression to ice-free periods of the year to exclude flows estimated during iced conditions. However, the regression could still be used to estimate flow during iced conditions. HYDCOMP produces the standard error of estimate as a measure of the central scatter of the regression and R-square (coefficient of determination) for evaluating the accuracy of the regression. Output from HYDCOMP includes plots of percent residuals against (1) time within the regression and plot periods, (2) month and day of the year for evaluating seasonal bias in the regression, and (3) the magnitude of flow. For hydrographic comparisons, it plots 2-month segments of hydrographs over the selected plot period showing the observed flows, the regressed flows, the 95 percent confidence limit flows, flow measurements, and regression limits. If the observed flows at the review station remain outside the 95 percent confidence limits for a prolonged period, there may be some error in the flows at the review station or at the index station(s). In addition, daily minimum and maximum temperatures and daily rainfall are shown on the hydrographs, if available, to help indicate whether an apparent change in flow may result from rainfall or from changes in backwater from melting ice or freezing water. HYDCOMP statistically smooths estimated flows from non-missing flows at the edges of the gaps in data into regressed flows at the center of the gaps using the Kalman smoothing algorithm. Missing flows are automatically estimated by HYDCOMP, but the user also can specify that periods of erroneous, but nonmissing flows, be estimated by the program.

A PHARMACOKINETIC PROGRAM (PKFIT) FOR R

EPA Science Inventory

The purpose of this study was to create a nonlinear regression (including a genetic algorithm) program (R script) to deal with data fitting for pharmacokinetics (PK) in R environment using its available packages. We call this tool as PKfit.

Property Differencing for Incremental Checking

NASA Technical Reports Server (NTRS)

Yang, Guowei; Khurshid, Sarfraz; Person, Suzette; Rungta, Neha

2014-01-01

This paper introduces iProperty, a novel approach that facilitates incremental checking of programs based on a property di erencing technique. Speci cally, iProperty aims to reduce the cost of checking properties as they are initially developed and as they co-evolve with the program. The key novelty of iProperty is to compute the di erences between the new and old versions of expected properties to reduce the number and size of the properties that need to be checked during the initial development of the properties. Furthermore, property di erencing is used in synergy with program behavior di erencing techniques to optimize common regression scenarios, such as detecting regression errors or checking feature additions for conformance to new expected properties. Experimental results in the context of symbolic execution of Java programs annotated with properties written as assertions show the e ectiveness of iProperty in utilizing change information to enable more ecient checking.

The Colorectal Cancer Mortality-to-Incidence Ratio as an Indicator of Global Cancer Screening and Care

PubMed Central

Sunkara, Vasu; Hébert, James R.

2015-01-01

BACKGROUND Disparities in cancer screening, incidence, treatment, and survival are worsening globally. The mortality-to-incidence ratio (MIR) has been used previously to evaluate such disparities. METHODS The MIR for colorectal cancer is calculated for all Organisation for Economic Cooperation and Development (OECD) countries using the 2012 GLOBOCAN incidence and mortality statistics. Health system rankings were obtained from the World Health Organization. Two linear regression models were fit with the MIR as the dependent variable and health system ranking as the independent variable; one included all countries and one model had the “divergents” removed. RESULTS The regression model for all countries explained 24% of the total variance in the MIR. Nine countries were found to have regression-calculated MIRs that differed from the actual MIR by >20%. Countries with lower-than-expected MIRs were found to have strong national health systems characterized by formal colorectal cancer screening programs. Conversely, countries with higher-than-expected MIRs lack screening programs. When these divergent points were removed from the data set, the recalculated regression model explained 60% of the total variance in the MIR. CONCLUSIONS The MIR proved useful for identifying disparities in cancer screening and treatment internationally. It has potential as an indicator of the long-term success of cancer surveillance programs and may be extended to other cancer types for these purposes. PMID:25572676

The colorectal cancer mortality-to-incidence ratio as an indicator of global cancer screening and care.

PubMed

Sunkara, Vasu; Hébert, James R

2015-05-15

Disparities in cancer screening, incidence, treatment, and survival are worsening globally. The mortality-to-incidence ratio (MIR) has been used previously to evaluate such disparities. The MIR for colorectal cancer is calculated for all Organisation for Economic Cooperation and Development (OECD) countries using the 2012 GLOBOCAN incidence and mortality statistics. Health system rankings were obtained from the World Health Organization. Two linear regression models were fit with the MIR as the dependent variable and health system ranking as the independent variable; one included all countries and one model had the "divergents" removed. The regression model for all countries explained 24% of the total variance in the MIR. Nine countries were found to have regression-calculated MIRs that differed from the actual MIR by >20%. Countries with lower-than-expected MIRs were found to have strong national health systems characterized by formal colorectal cancer screening programs. Conversely, countries with higher-than-expected MIRs lack screening programs. When these divergent points were removed from the data set, the recalculated regression model explained 60% of the total variance in the MIR. The MIR proved useful for identifying disparities in cancer screening and treatment internationally. It has potential as an indicator of the long-term success of cancer surveillance programs and may be extended to other cancer types for these purposes. © 2015 American Cancer Society.

CART (Classification and Regression Trees) Program: The Implementation of the CART Program and Its Application to Estimating Attrition Rates.

DTIC Science & Technology

1985-12-01

consists of the node t and all descendants of t in T. (3) Definition 3. Pruning a branch Tt from a tree T con- sists of deleting from T all...The default is 1.0 so that actually, this keyword did not need to appear in the above file. (5) DELETE . This keyword does not appear in our example, but...when it is used associated with some variable names, it indicates that we want to delete these vari- ables from the regression. If this keyword is

Distributional effects of environmental policies in Greece

NASA Astrophysics Data System (ADS)

Lekakis, Joseph N.

1990-07-01

Environmental protection policies generate an equity question concerning the fair allocation of environmental benefits and costs. This paper presents evidence from Greece during the 1980s. The findings reveal that Greek environmental policies, in the form of government self-regulatory programs, are mostly regressive in nature. At the regional level these programs combine all forms of vertical equity. Since the public sector finances the majority of related expenditures out of taxes, the regressive elements of environmental policies have been reinforced by discretionary fiscal measures and tax evasion, accompanied by inflation, which have distorted the country's progressive tax system.

Finding the Perfect Match: Factors That Influence Family Medicine Residency Selection.

PubMed

Wright, Katherine M; Ryan, Elizabeth R; Gatta, John L; Anderson, Lauren; Clements, Deborah S

2016-04-01

Residency program selection is a significant experience for emerging physicians, yet there is limited information about how applicants narrow their list of potential programs. This study examines factors that influence residency program selection among medical students interested in family medicine at the time of application. Medical students with an expressed interest in family medicine were invited to participate in a 37-item, online survey. Students were asked to rate factors that may impact residency selection on a 6-point Likert scale in addition to three open-ended qualitative questions. Mean values were calculated for each survey item and were used to determine a rank order for selection criteria. Logistic regression analysis was performed to identify factors that predict a strong interest in urban, suburban, and rural residency programs. Logistic regression was also used to identify factors that predict a strong interest in academic health center-based residencies, community-based residencies, and community-based residencies with an academic affiliation. A total of 705 medical students from 32 states across the country completed the survey. Location, work/life balance, and program structure (curriculum, schedule) were rated the most important factors for residency selection. Logistic regression analysis was used to refine our understanding of how each factor relates to specific types of residencies. These findings have implications for how to best advise students in selecting a residency, as well as marketing residencies to the right candidates. Refining the recruitment process will ensure a better fit between applicants and potential programs. Limited recruitment resources may be better utilized by focusing on targeted dissemination strategies.

Progressive and Regressive Aspects of Information Technology in Society: A Third Sector Perspective

ERIC Educational Resources Information Center

Miller, Kandace R.

2009-01-01

This dissertation explores the impact of information technology on progressive and regressive values in society from the perspective of one international foundation and four of its technology-related programs. Through a critical interpretive approach employing an instrumental multiple-case method, a framework to help explain the influence of…

Efficiency Analysis: Enhancing the Statistical and Evaluative Power of the Regression-Discontinuity Design.

ERIC Educational Resources Information Center

Madhere, Serge

An analytic procedure, efficiency analysis, is proposed for improving the utility of quantitative program evaluation for decision making. The three features of the procedure are explained: (1) for statistical control, it adopts and extends the regression-discontinuity design; (2) for statistical inferences, it de-emphasizes hypothesis testing in…

A FORTRAN technique for correlating a circular environmental variable with a linear physiological variable in the sugar maple.

PubMed

Pease, J M; Morselli, M F

1987-01-01

This paper deals with a computer program adapted to a statistical method for analyzing an unlimited quantity of binary recorded data of an independent circular variable (e.g. wind direction), and a linear variable (e.g. maple sap flow volume). Circular variables cannot be statistically analyzed with linear methods, unless they have been transformed. The program calculates a critical quantity, the acrophase angle (PHI, phi o). The technique is adapted from original mathematics [1] and is written in Fortran 77 for easier conversion between computer networks. Correlation analysis can be performed following the program or regression which, because of the circular nature of the independent variable, becomes periodic regression. The technique was tested on a file of approximately 4050 data pairs.

The discovery of indicator variables for QSAR using inductive logic programming

NASA Astrophysics Data System (ADS)

King, Ross D.; Srinivasan, Ashwin

1997-11-01

A central problem in forming accurate regression equations in QSAR studies isthe selection of appropriate descriptors for the compounds under study. Wedescribe a novel procedure for using inductive logic programming (ILP) todiscover new indicator variables (attributes) for QSAR problems, and show thatthese improve the accuracy of the derived regression equations. ILP techniqueshave previously been shown to work well on drug design problems where thereis a large structural component or where clear comprehensible rules arerequired. However, ILP techniques have had the disadvantage of only being ableto make qualitative predictions (e.g. active, inactive) and not to predictreal numbers (regression). We unify ILP and linear regression techniques togive a QSAR method that has the strength of ILP at describing stericstructure, with the familiarity and power of linear regression. We evaluatedthe utility of this new QSAR technique by examining the prediction ofbiological activity with and without the addition of new structural indicatorvariables formed by ILP. In three out of five datasets examined the additionof ILP variables produced statistically better results (P < 0.01) over theoriginal description. The new ILP variables did not increase the overallcomplexity of the derived QSAR equations and added insight into possiblemechanisms of action. We conclude that ILP can aid in the process of drugdesign.

SPSS and SAS programs for comparing Pearson correlations and OLS regression coefficients.

PubMed

Weaver, Bruce; Wuensch, Karl L

2013-09-01

Several procedures that use summary data to test hypotheses about Pearson correlations and ordinary least squares regression coefficients have been described in various books and articles. To our knowledge, however, no single resource describes all of the most common tests. Furthermore, many of these tests have not yet been implemented in popular statistical software packages such as SPSS and SAS. In this article, we describe all of the most common tests and provide SPSS and SAS programs to perform them. When they are applicable, our code also computes 100 × (1 - α)% confidence intervals corresponding to the tests. For testing hypotheses about independent regression coefficients, we demonstrate one method that uses summary data and another that uses raw data (i.e., Potthoff analysis). When the raw data are available, the latter method is preferred, because use of summary data entails some loss of precision due to rounding.

A Regression Model Approach to First-Year Honors Program Admissions Serving a High-Minority Population

ERIC Educational Resources Information Center

Rhea, David M.

2017-01-01

Many honors programs make admissions decisions based on student high school GPA and a standardized test score. However, McKay argued that standardized test scores can be a barrier to honors program participation, particularly for minority students. Minority students, particularly Hispanic and African American students, are apt to have lower…

Students' Outcome Expectation on Spiritual and Religious Competency: A Hierarchical Regression Analysis

ERIC Educational Resources Information Center

Lu, Junfei; Woo, Hongryun

2017-01-01

In this study, 74 master's-level counseling students from various programs completed a questionnaire inquiring about their perceived program environment in relation to the topics of spirituality and religion (S/R), program emphasis on nine specific S/R competencies, as well as their outcome expectations toward being S/R competent through training.…

A Welcomed Intrusion: A Response to Card and Giuliano's Evaluation of a Gifted Program

ERIC Educational Resources Information Center

Warne, Russell T.

2016-01-01

Card and Giuliano conducted a regression discontinuity study in a large Florida school district to investigate the magnitude of academic benefits of the district's gifted program. They found that for children identified as gifted through an intelligence test, the program provided few or no benefits. But children who were admitted to the gifted…

Exploring the Perceptions of College Instructors towards Computer Simulation Software Programs: A Quantitative Study

ERIC Educational Resources Information Center

Punch, Raymond J.

2012-01-01

The purpose of the quantitative regression study was to explore and to identify relationships between attitudes toward use and perceptions of value of computer-based simulation programs, of college instructors, toward computer based simulation programs. A relationship has been reported between attitudes toward use and perceptions of the value of…

The Effects of "Girl-Friendly" Schools: Evidence from the BRIGHT School Construction Program in Burkina Faso. NBER Working Paper No. 18115

ERIC Educational Resources Information Center

Kazianga, Harounan; Levy, Dan; Linden, Leigh L.; Sloan, Matt

2012-01-01

We evaluate the causal effects of a program that constructed high quality "girl-friendly" primary schools in Burkina Faso, using a regression discontinuity design 2.5 years after the program started. We find that the program increased enrollment of all children between the ages of 5 and 12 by 20 percentage points and increased their test…

Estimating parasitic sea lamprey abundance in Lake Huron from heterogenous data sources

USGS Publications Warehouse

Young, Robert J.; Jones, Michael L.; Bence, James R.; McDonald, Rodney B.; Mullett, Katherine M.; Bergstedt, Roger A.

2003-01-01

The Great Lakes Fishery Commission uses time series of transformer, parasitic, and spawning population estimates to evaluate the effectiveness of its sea lamprey (Petromyzon marinus) control program. This study used an inverse variance weighting method to integrate Lake Huron sea lamprey population estimates derived from two estimation procedures: 1) prediction of the lake-wide spawning population from a regression model based on stream size and, 2) whole-lake mark and recapture estimates. In addition, we used a re-sampling procedure to evaluate the effect of trading off sampling effort between the regression and mark-recapture models. Population estimates derived from the regression model ranged from 132,000 to 377,000 while mark-recapture estimates of marked recently metamorphosed juveniles and parasitic sea lampreys ranged from 536,000 to 634,000 and 484,000 to 1,608,000, respectively. The precision of the estimates varied greatly among estimation procedures and years. The integrated estimate of the mark-recapture and spawner regression procedures ranged from 252,000 to 702,000 transformers. The re-sampling procedure indicated that the regression model is more sensitive to reduction in sampling effort than the mark-recapture model. Reliance on either the regression or mark-recapture model alone could produce misleading estimates of abundance of sea lampreys and the effect of the control program on sea lamprey abundance. These analyses indicate that the precision of the lakewide population estimate can be maximized by re-allocating sampling effort from marking sea lampreys to trapping additional streams.

Evaluation and prediction of shrub cover in coastal Oregon forests (USA)

Treesearch

Becky K. Kerns; Janet L. Ohmann

2004-01-01

We used data from regional forest inventories and research programs, coupled with mapped climatic and topographic information, to explore relationships and develop multiple linear regression (MLR) and regression tree models for total and deciduous shrub cover in the Oregon coastal province. Results from both types of models indicate that forest structure variables were...

Isolating the Effects of Training Using Simple Regression Analysis: An Example of the Procedure.

ERIC Educational Resources Information Center

Waugh, C. Keith

This paper provides a case example of simple regression analysis, a forecasting procedure used to isolate the effects of training from an identified extraneous variable. This case example focuses on results of a three-day sales training program to improve bank loan officers' knowledge, skill-level, and attitude regarding solicitation and sale of…

Assessing the Generalizability of Estimates of Causal Effects from Regression Discontinuity Designs

ERIC Educational Resources Information Center

Bloom, Howard S.; Porter, Kristin E.

2012-01-01

In recent years, the regression discontinuity design (RDD) has gained widespread recognition as a quasi-experimental method that when used correctly, can produce internally valid estimates of causal effects of a treatment, a program or an intervention (hereafter referred to as treatment effects). In an RDD study, subjects or groups of subjects…

Computer Simulation of Human Service Program Evaluations.

ERIC Educational Resources Information Center

Trochim, William M. K.; Davis, James E.

1985-01-01

Describes uses of computer simulations for the context of human service program evaluation. Presents simple mathematical models for most commonly used human service outcome evaluation designs (pretest-posttest randomized experiment, pretest-posttest nonequivalent groups design, and regression-discontinuity design). Translates models into single…

Accelerated test design

NASA Technical Reports Server (NTRS)

Mcdermott, P. P.

1980-01-01

The design of an accelerated life test program for electric batteries is discussed. A number of observations and suggestions on the procedures and objectives for conducting an accelerated life test program are presented. Equations based on nonlinear regression analysis for predicting the accelerated life test parameters are discussed.

Subsonic Aircraft With Regression and Neural-Network Approximators Designed

NASA Technical Reports Server (NTRS)

Patnaik, Surya N.; Hopkins, Dale A.

2004-01-01

At the NASA Glenn Research Center, NASA Langley Research Center's Flight Optimization System (FLOPS) and the design optimization testbed COMETBOARDS with regression and neural-network-analysis approximators have been coupled to obtain a preliminary aircraft design methodology. For a subsonic aircraft, the optimal design, that is the airframe-engine combination, is obtained by the simulation. The aircraft is powered by two high-bypass-ratio engines with a nominal thrust of about 35,000 lbf. It is to carry 150 passengers at a cruise speed of Mach 0.8 over a range of 3000 n mi and to operate on a 6000-ft runway. The aircraft design utilized a neural network and a regression-approximations-based analysis tool, along with a multioptimizer cascade algorithm that uses sequential linear programming, sequential quadratic programming, the method of feasible directions, and then sequential quadratic programming again. Optimal aircraft weight versus the number of design iterations is shown. The central processing unit (CPU) time to solution is given. It is shown that the regression-method-based analyzer exhibited a smoother convergence pattern than the FLOPS code. The optimum weight obtained by the approximation technique and the FLOPS code differed by 1.3 percent. Prediction by the approximation technique exhibited no error for the aircraft wing area and turbine entry temperature, whereas it was within 2 percent for most other parameters. Cascade strategy was required by FLOPS as well as the approximators. The regression method had a tendency to hug the data points, whereas the neural network exhibited a propensity to follow a mean path. The performance of the neural network and regression methods was considered adequate. It was at about the same level for small, standard, and large models with redundancy ratios (defined as the number of input-output pairs to the number of unknown coefficients) of 14, 28, and 57, respectively. In an SGI octane workstation (Silicon Graphics, Inc., Mountainview, CA), the regression training required a fraction of a CPU second, whereas neural network training was between 1 and 9 min, as given. For a single analysis cycle, the 3-sec CPU time required by the FLOPS code was reduced to milliseconds by the approximators. For design calculations, the time with the FLOPS code was 34 min. It was reduced to 2 sec with the regression method and to 4 min by the neural network technique. The performance of the regression and neural network methods was found to be satisfactory for the analysis and design optimization of the subsonic aircraft.

The effect of the Family Case Management Program on 1996 birth outcomes in Illinois.

PubMed

Keeton, Kristie; Saunders, Stephen E; Koltun, David

2004-03-01

The purpose of this study was to determine if birth outcomes for Medicaid recipients were improved with participation in the Illinois Family Case Management Program. Health program data files were linked with the 1996 Illinois Vital Records linked birth-death certificate file. Logistic regression was used to characterize the variation in birth outcomes as a function of Family Case Management participation while statistically controlling for measurable factors found to be confounders. Results of the logistic regression analysis show that women who participated in the Family Care Management Program were significantly less likely to give birth to very low birth weight infants (odds ratio [OR] = 0.86, 95% confidence interval [CI] = 0.75, 0.99) and low birth weight infants (OR = 0.83, CI = 0.79, 0.89). For infant mortality, however, the adjusted OR (OR = 0.98, CI = 0.82, 1.17), although under 1, was not statistically significant. These results suggest that the Family Case Management Program may be effective in reducing very low birth weight and low birth weight rates among infants born to low-income women.

TWSVR: Regression via Twin Support Vector Machine.

PubMed

Khemchandani, Reshma; Goyal, Keshav; Chandra, Suresh

2016-02-01

Taking motivation from Twin Support Vector Machine (TWSVM) formulation, Peng (2010) attempted to propose Twin Support Vector Regression (TSVR) where the regressor is obtained via solving a pair of quadratic programming problems (QPPs). In this paper we argue that TSVR formulation is not in the true spirit of TWSVM. Further, taking motivation from Bi and Bennett (2003), we propose an alternative approach to find a formulation for Twin Support Vector Regression (TWSVR) which is in the true spirit of TWSVM. We show that our proposed TWSVR can be derived from TWSVM for an appropriately constructed classification problem. To check the efficacy of our proposed TWSVR we compare its performance with TSVR and classical Support Vector Regression(SVR) on various regression datasets. Copyright © 2015 Elsevier Ltd. All rights reserved.

Developing a predictive tropospheric ozone model for Tabriz

NASA Astrophysics Data System (ADS)

Khatibi, Rahman; Naghipour, Leila; Ghorbani, Mohammad A.; Smith, Michael S.; Karimi, Vahid; Farhoudi, Reza; Delafrouz, Hadi; Arvanaghi, Hadi

2013-04-01

Predictive ozone models are becoming indispensable tools by providing a capability for pollution alerts to serve people who are vulnerable to the risks. We have developed a tropospheric ozone prediction capability for Tabriz, Iran, by using the following five modeling strategies: three regression-type methods: Multiple Linear Regression (MLR), Artificial Neural Networks (ANNs), and Gene Expression Programming (GEP); and two auto-regression-type models: Nonlinear Local Prediction (NLP) to implement chaos theory and Auto-Regressive Integrated Moving Average (ARIMA) models. The regression-type modeling strategies explain the data in terms of: temperature, solar radiation, dew point temperature, and wind speed, by regressing present ozone values to their past values. The ozone time series are available at various time intervals, including hourly intervals, from August 2010 to March 2011. The results for MLR, ANN and GEP models are not overly good but those produced by NLP and ARIMA are promising for the establishing a forecasting capability.

The Effect of Participating in Indiana's Twenty-First Century Scholars Program on College Enrollments

ERIC Educational Resources Information Center

Toutkoushian, Robert K.; Hossler, Don; DesJardins, Stephen L.; McCall, Brian; Gonzalez Canche, Manuel S.

2015-01-01

Our study adds to prior work on Indiana's Twenty-first Century Scholars(TFCS) program by focusing on whether participating in--rather than completing--the program affects the likelihood of students going to college and where they initially enrolled. We first employ binary and multinomial logistic regression to obtain estimates of the impact of the…

CATREG SOFTWARE FOR CATEGORICAL REGRESSION ANALYSIS

EPA Science Inventory

CatReg is a computer program, written in the R (http://cran.r-project.org) programming language, to support the conduct of exposure-response analyses by toxicologists and health scientists. CatReg can be used to perform categorical regressi...

Trend Analysis Using Microcomputers.

ERIC Educational Resources Information Center

Berger, Carl F.

A trend analysis statistical package and additional programs for the Apple microcomputer are presented. They illustrate strategies of data analysis suitable to the graphics and processing capabilities of the microcomputer. The programs analyze data sets using examples of: (1) analysis of variance with multiple linear regression; (2) exponential…

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

PubMed

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

2016-01-01

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

Perl-speaks-NONMEM (PsN)--a Perl module for NONMEM related programming.

PubMed

Lindbom, Lars; Ribbing, Jakob; Jonsson, E Niclas

2004-08-01

The NONMEM program is the most widely used nonlinear regression software in population pharmacokinetic/pharmacodynamic (PK/PD) analyses. In this article we describe a programming library, Perl-speaks-NONMEM (PsN), intended for programmers that aim at using the computational capability of NONMEM in external applications. The library is object oriented and written in the programming language Perl. The classes of the library are built around NONMEM's data, model and output files. The specification of the NONMEM model is easily set or changed through the model and data file classes while the output from a model fit is accessed through the output file class. The classes have methods that help the programmer perform common repetitive tasks, e.g. summarising the output from a NONMEM run, setting the initial estimates of a model based on a previous run or truncating values over a certain threshold in the data file. PsN creates a basis for the development of high-level software using NONMEM as the regression tool.

The effect of dual accreditation on family medicine residency programs.

PubMed

Mims, Lisa D; Bressler, Lindsey C; Wannamaker, Louise R; Carek, Peter J

2015-04-01

In 1985, the American Osteopathic Association (AOA) Board of Trustees agreed to allow residency programs to become dually accredited by the AOA and Accreditation Council for Graduate Medical Education (ACGME). Despite the increase in such programs, there has been minimal research comparing these programs to exclusively ACGME-accredited residencies. This study examines the association between dual accreditation and suggested markers of quality. Standard characteristics such as regional location, program structure (community or university based), postgraduate year one (PGY-1) positions offered, and salary (PGY-1) were obtained for each residency program. In addition, the faculty to resident ratio in the family medicine clinic and the number of half days residents spent in the clinic each week were recorded. Initial Match rates and pass rates of new graduates on the ABFM examination from 2009 to 2013 were also obtained. Variables were analyzed using chi-square and Student's t test. Logistic regression models were then created to predict a program's 5-year aggregate initial Match rate and Board pass rate in the top tertile as compared to the lowest tertile. Dual accreditation was obtained by 117 (27.0%) of programs. Initial analyses revealed associations between dually accredited programs and mean year of initial ACGME program accreditation, regional location, program structure, tracks, and alternative medicine curriculum. When evaluated in logistic regression, dual accreditation status was not associated with Match rates or ABFM pass rates. By examining suggested markers of program quality for dually accredited programs in comparison to ACGME-only accredited programs, this study successfully established both differences and similarities among the two types.

SPSS and SAS programming for the testing of mediation models.

PubMed

Dudley, William N; Benuzillo, Jose G; Carrico, Mineh S

2004-01-01

Mediation modeling can explain the nature of the relation among three or more variables. In addition, it can be used to show how a variable mediates the relation between levels of intervention and outcome. The Sobel test, developed in 1990, provides a statistical method for determining the influence of a mediator on an intervention or outcome. Although interactive Web-based and stand-alone methods exist for computing the Sobel test, SPSS and SAS programs that automatically run the required regression analyses and computations increase the accessibility of mediation modeling to nursing researchers. To illustrate the utility of the Sobel test and to make this programming available to the Nursing Research audience in both SAS and SPSS. The history, logic, and technical aspects of mediation testing are introduced. The syntax files sobel.sps and sobel.sas, created to automate the computation of the regression analysis and test statistic, are available from the corresponding author. The reported programming allows the user to complete mediation testing with the user's own data in a single-step fashion. A technical manual included with the programming provides instruction on program use and interpretation of the output. Mediation modeling is a useful tool for describing the relation between three or more variables. Programming and manuals for using this model are made available.

A Plate Waste Evaluation of the Farm to School Program.

PubMed

Kropp, Jaclyn D; Abarca-Orozco, Saul J; Israel, Glenn D; Diehl, David C; Galindo-Gonzalez, Sebastian; Headrick, Lauren B; Shelnutt, Karla P

2018-04-01

To investigate the impacts of the Farm to School (FTS) Program on the selection and consumption of fruits and vegetables. Plate waste data were recorded using the visual inspection method before and after implementation of the program. Six elementary schools in Florida: 3 treatment and 3 control schools. A total of 11,262 meal observations of National School Lunch Program (NSLP) participants in grades 1-5. The FTS Program, specifically local procurement of NSLP offerings, began in treatment schools in November, 2015 after the researchers collected preintervention data. The NSLP participants' selection and consumption of fruits and vegetables. Data were analyzed using Mann-Whitney U and proportions tests and difference-in-difference regressions. The NSLP participants at the treatment schools consumed, on average, 0.061 (P = .002) more servings of vegetables and 0.055 (P = .05) more servings of fruit after implementation of the FTS Program. When school-level fixed effects are included, ordinary least squares and tobit regression results indicated that NSLP participants at the treatment schools respectively consumed 0.107 (P < .001) and 0.086 (P < .001) more servings of vegetables, on average, after implementation of the FTS Program. Local procurement positively affected healthy eating. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

A Comparison of Logistic Regression, Neural Networks, and Classification Trees Predicting Success of Actuarial Students

ERIC Educational Resources Information Center

Schumacher, Phyllis; Olinsky, Alan; Quinn, John; Smith, Richard

2010-01-01

The authors extended previous research by 2 of the authors who conducted a study designed to predict the successful completion of students enrolled in an actuarial program. They used logistic regression to determine the probability of an actuarial student graduating in the major or dropping out. They compared the results of this study with those…

A Comparative Study of Classification and Regression Algorithms for Modelling Students' Academic Performance

ERIC Educational Resources Information Center

Strecht, Pedro; Cruz, Luís; Soares, Carlos; Mendes-Moreira, João; Abreu, Rui

2015-01-01

Predicting the success or failure of a student in a course or program is a problem that has recently been addressed using data mining techniques. In this paper we evaluate some of the most popular classification and regression algorithms on this problem. We address two problems: prediction of approval/failure and prediction of grade. The former is…

Two-Year versus One-Year Head Start Program Impact: Addressing Selection Bias by Comparing Regression Modeling with Propensity Score Analysis

ERIC Educational Resources Information Center

Leow, Christine; Wen, Xiaoli; Korfmacher, Jon

2015-01-01

This article compares regression modeling and propensity score analysis as different types of statistical techniques used in addressing selection bias when estimating the impact of two-year versus one-year Head Start on children's school readiness. The analyses were based on the national Head Start secondary dataset. After controlling for…

Regressive Imagery in Creative Problem-Solving: Comparing Verbal Protocols of Expert and Novice Visual Artists and Computer Programmers

ERIC Educational Resources Information Center

Kozbelt, Aaron; Dexter, Scott; Dolese, Melissa; Meredith, Daniel; Ostrofsky, Justin

2015-01-01

We applied computer-based text analyses of regressive imagery to verbal protocols of individuals engaged in creative problem-solving in two domains: visual art (23 experts, 23 novices) and computer programming (14 experts, 14 novices). Percentages of words involving primary process and secondary process thought, plus emotion-related words, were…

Financial Aid and First-Year Collegiate GPA: A Regression Discontinuity Approach

ERIC Educational Resources Information Center

Curs, Bradley R.; Harper, Casandra E.

2012-01-01

Using a regression discontinuity design, we investigate whether a merit-based financial aid program has a causal effect on the first-year grade point average of first-time out-of-state freshmen at the University of Oregon. Our results indicate that merit-based financial aid has a positive and significant effect on first-year collegiate grade point…

Multiple regression technique for Pth degree polynominals with and without linear cross products

NASA Technical Reports Server (NTRS)

Davis, J. W.

1973-01-01

A multiple regression technique was developed by which the nonlinear behavior of specified independent variables can be related to a given dependent variable. The polynomial expression can be of Pth degree and can incorporate N independent variables. Two cases are treated such that mathematical models can be studied both with and without linear cross products. The resulting surface fits can be used to summarize trends for a given phenomenon and provide a mathematical relationship for subsequent analysis. To implement this technique, separate computer programs were developed for the case without linear cross products and for the case incorporating such cross products which evaluate the various constants in the model regression equation. In addition, the significance of the estimated regression equation is considered and the standard deviation, the F statistic, the maximum absolute percent error, and the average of the absolute values of the percent of error evaluated. The computer programs and their manner of utilization are described. Sample problems are included to illustrate the use and capability of the technique which show the output formats and typical plots comparing computer results to each set of input data.

Engine With Regression and Neural Network Approximators Designed

NASA Technical Reports Server (NTRS)

Patnaik, Surya N.; Hopkins, Dale A.

2001-01-01

At the NASA Glenn Research Center, the NASA engine performance program (NEPP, ref. 1) and the design optimization testbed COMETBOARDS (ref. 2) with regression and neural network analysis-approximators have been coupled to obtain a preliminary engine design methodology. The solution to a high-bypass-ratio subsonic waverotor-topped turbofan engine, which is shown in the preceding figure, was obtained by the simulation depicted in the following figure. This engine is made of 16 components mounted on two shafts with 21 flow stations. The engine is designed for a flight envelope with 47 operating points. The design optimization utilized both neural network and regression approximations, along with the cascade strategy (ref. 3). The cascade used three algorithms in sequence: the method of feasible directions, the sequence of unconstrained minimizations technique, and sequential quadratic programming. The normalized optimum thrusts obtained by the three methods are shown in the following figure: the cascade algorithm with regression approximation is represented by a triangle, a circle is shown for the neural network solution, and a solid line indicates original NEPP results. The solutions obtained from both approximate methods lie within one standard deviation of the benchmark solution for each operating point. The simulation improved the maximum thrust by 5 percent. The performance of the linear regression and neural network methods as alternate engine analyzers was found to be satisfactory for the analysis and operation optimization of air-breathing propulsion engines (ref. 4).

Use of Time-Series, ARIMA Designs to Assess Program Efficacy.

ERIC Educational Resources Information Center

Braden, Jeffery P.; And Others

1990-01-01

Illustrates use of time-series designs for determining efficacy of interventions with fictitious data describing drug-abuse prevention program. Discusses problems and procedures associated with time-series data analysis using Auto Regressive Integrated Moving Averages (ARIMA) models. Example illustrates application of ARIMA analysis for…

U.S. Marine Corps Enlistment Bonus Program

DTIC Science & Technology

1983-01-01

Bonus Groups to Alternative Question ...... -1 B-2 Responses to Attitude Questions For Bonus Groups ....... -2 C-1 Calculation of Enlistment Supply ...can be used to measure the effect of changes in bonus levels on enlistment supply . Alternatively , we can measure the effect of the bonus program...EBP (Enlistment Bonus Program) EniisteJ Personnel, EnltsteA Supply , marine corps Personnel, Questionnaires, Recruiting, Regression Aalysis, Response

The Competitive Effects of the Louisiana Scholarship Program on Public School Performance. Louisiana Scholarship Program Evaluation Report #4. Technical Report

ERIC Educational Resources Information Center

Egalite, Anna J.

2016-01-01

Given the significant growth rate and geographic expansion of private school choice programs over the past two decades, it is important to examine how traditional public schools respond to the sudden injection of competition for students and resources. This article uses: (1) a school fixed effects approach; and (2) a regression discontinuity…

Regional changes in charcoal-burning suicide rates in East/Southeast Asia from 1995 to 2011: a time trend analysis.

PubMed

Chang, Shu-Sen; Chen, Ying-Yeh; Yip, Paul S F; Lee, Won Jin; Hagihara, Akihito; Gunnell, David

2014-04-01

Suicides by carbon monoxide poisoning resulting from burning barbecue charcoal reached epidemic levels in Hong Kong and Taiwan within 5 y of the first reported cases in the early 2000s. The objectives of this analysis were to investigate (i) time trends and regional patterns of charcoal-burning suicide throughout East/Southeast Asia during the time period 1995-2011 and (ii) whether any rises in use of this method were associated with increases in overall suicide rates. Sex- and age-specific trends over time were also examined to identify the demographic groups showing the greatest increases in charcoal-burning suicide rates across different countries. We used data on suicides by gases other than domestic gas for Hong Kong, Japan, the Republic of Korea, Taiwan, and Singapore in the years 1995/1996-2011. Similar data for Malaysia, the Philippines, and Thailand were also extracted but were incomplete. Graphical and joinpoint regression analyses were used to examine time trends in suicide, and negative binomial regression analysis to study sex- and age-specific patterns. In 1995/1996, charcoal-burning suicides accounted for <1% of all suicides in all study countries, except in Japan (5%), but they increased to account for 13%, 24%, 10%, 7%, and 5% of all suicides in Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore, respectively, in 2011. Rises were first seen in Hong Kong after 1998 (95% CI 1997-1999), followed by Singapore in 1999 (95% CI 1998-2001), Taiwan in 2000 (95% CI 1999-2001), Japan in 2002 (95% CI 1999-2003), and the Republic of Korea in 2007 (95% CI 2006-2008). No marked increases were seen in Malaysia, the Philippines, or Thailand. There was some evidence that charcoal-burning suicides were associated with an increase in overall suicide rates in Hong Kong, Taiwan, and Japan (for females), but not in Japan (for males), the Republic of Korea, and Singapore. Rates of change in charcoal-burning suicide rate did not differ by sex/age group in Taiwan and Hong Kong but appeared to be greatest in people aged 15-24 y in Japan and people aged 25-64 y in the Republic of Korea. The lack of specific codes for charcoal-burning suicide in the International Classification of Diseases and variations in coding practice in different countries are potential limitations of this study. Charcoal-burning suicides increased markedly in some East/Southeast Asian countries (Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore) in the first decade of the 21st century, but such rises were not experienced by all countries in the region. In countries with a rise in charcoal-burning suicide rates, the timing, scale, and sex/age pattern of increases varied by country. Factors underlying these variations require further investigation, but may include differences in culture or in media portrayals of the method. Please see later in the article for the Editors' Summary.

C-17 Centerlining - Analysis of Paratrooper Trajectory

DTIC Science & Technology

2005-06-01

Linear Regression Models. 4th ed. McGraw Hill, 2004. Kuntavanish, Mark. Program Engineer for C-17 System Program Office. Briefing to US Army...Airdrop Risk Assessment Using Bootstrap Sampling, MS AFIT Thesis AFIT/GOR/ENS/96D-01, Dec 1996. Kutner, Michael, C. Nachtsheim, and J. Neter. Applied

A Computer Program for Preliminary Data Analysis

Treesearch

Dennis L. Schweitzer

1967-01-01

ABSTRACT. -- A computer program written in FORTRAN has been designed to summarize data. Class frequencies, means, and standard deviations are printed for as many as 100 independent variables. Cross-classifications of an observed dependent variable and of a dependent variable predicted by a multiple regression equation can also be generated.

Effective Teacher Retention Bonuses: Evidence From Tennessee

ERIC Educational Resources Information Center

Springer, Matthew G.; Swain, Walker A.; Rodriguez, Luis A.

2016-01-01

We report findings from a quasi-experimental evaluation of the recently implemented US$5,000 retention bonus program for effective teachers in Tennessee's Priority Schools. We estimate the impact of the program on teacher retention using a fuzzy regression discontinuity design by exploiting a discontinuity in the probability of treatment…

Social-Emotional Effects of Early Childhood Education Programs in Tulsa

ERIC Educational Resources Information Center

Gormley, William T., Jr.; Phillips, Deborah A.; Newmark, Katie; Welti, Kate; Adelstein, Shirley

2011-01-01

This article assesses the effects of Tulsa, Oklahoma's early childhood education programs on social-emotional outcomes, examining teacher ratings of children's behavior from the Adjustment Scales for Preschool Intervention and a measure of attentiveness using fixed effects regressions with propensity score matching. The sample includes 2,832…

CatReg Software for Categorical Regression Analysis (Jul 2012)

EPA Science Inventory

CatReg is a computer program, written in the R (http://cran.r-project.org) programming language, to support the conduct of exposure-response analyses by toxicologists and health scientists. CatReg can be used to perform categorical regressi...

CatReg Software for Categorical Regression Analysis (Nov 2006)

EPA Science Inventory

CatReg is a computer program, written in the R (http://cran.r-project.org) programming language, to support the conduct of exposure-response analyses by toxicologists and health scientists. CatReg can be used to perform categorical regressi...

CatReg Software for Categorical Regression Analysis (Feb 2011)

EPA Science Inventory

CatReg is a computer program, written in the R (http://cran.r-project.org) programming language, to support the conduct of exposure-response analyses by toxicologists and health scientists. CatReg can be used to perform categorical regressi...

How a Regression Artifact Makes ICFs/MR Look Ineffective.

ERIC Educational Resources Information Center

Crinella, Francis M.; McCleary, Richard; Swanson, James M.

1998-01-01

Criticizes the research design in "The Small ICF/MR program: Dimensions of Quality and Cost" (Conroy), that found small Intermediate Care Facilities (ICF) for individuals with mental retardation are inferior to other community programs. Discusses the problem in selecting a control group on the basis of pretest matching. (CR)

Computer Series, 65. Bits and Pieces, 26.

ERIC Educational Resources Information Center

Moore, John W., Ed.

1985-01-01

Describes: (l) a microcomputer-based system for filing test questions and assembling examinations; (2) microcomputer use in practical and simulated experiments of gamma rays scattering by outer shell electrons; (3) an interactive, screen-oriented, general linear regression program; and (4) graphics drill and game programs for benzene synthesis.…

Probability of Corporal Punishment: Lack of Resources and Vulnerable Students

ERIC Educational Resources Information Center

Han, Seunghee

2011-01-01

The author examined corporal punishment practices in the United States based on data from 362 public school principals where corporal punishment is available. Results from multiple regression analyses show that schools with multiple student violence prevention programs and teacher training programs had fewer possibilities of use corporal…

[The Influence of Subjective Health Status, Post-Traumatic Growth, and Social Support on Successful Aging in Middle-Aged Women].

PubMed

Lee, Seung Hee; Jang, Hyung Suk; Yang, Young Hee

2016-10-01

This study was done to investigate factors influencing successful aging in middle-aged women. A convenience sample of 103 middle-aged women was selected from the community. Data were collected using a structured questionnaire and analyzed using descriptive statistics, two-sample t-test, one-way ANOVA, Kruskal Wallis test, Pearson correlations, Spearman correlations and multiple regression analysis with the SPSS/WIN 22.0 program. Results of regression analysis showed that significant factors influencing successful aging were post-traumatic growth and social support. This regression model explained 48% of the variance in successful aging. Findings show that the concept 'post-traumatic growth' is an important factor influencing successful aging in middle-aged women. In addition, social support from friends/co-workers had greater influence on successful aging than social support from family. Thus, we need to consider the positive impact of post-traumatic growth and increase the chances of social participation in a successful aging program for middle-aged women.

Predicting Student Success on the Texas Chemistry STAAR Test: A Logistic Regression Analysis

ERIC Educational Resources Information Center

Johnson, William L.; Johnson, Annabel M.; Johnson, Jared

2012-01-01

Background: The context is the new Texas STAAR end-of-course testing program. Purpose: The authors developed a logistic regression model to predict who would pass-or-fail the new Texas chemistry STAAR end-of-course exam. Setting: Robert E. Lee High School (5A) with an enrollment of 2700 students, Tyler, Texas. Date of the study was the 2011-2012…

Epidemiology of bronchiolitis: a description of emergency department visits and hospitalizations in Puerto Rico, 2010-2014.

PubMed

Rivera-Sepulveda, Andrea; Garcia-Rivera, Enid J

2017-01-01

Little is known about the epidemiology of bronchiolitis as a clinical diagnosis and its impact on emergency department visits and hospitalizations in tropical and semitropical regions. We described the epidemiology of bronchiolitis emergency visits and hospitalizations, its temporal trend and geographic distribution in Puerto Rico between 2010 and 2014. We performed a retrospective descriptive analysis of a representative sample of privately insured children with bronchiolitis from January 2010 to December 2014. Data was provided by the largest private health insurer in Puerto Rico and identified children < 24 months of age with bronchiolitis by International Classification of Diseases, Ninth Revision code 466, 466.11, and 466.19. Chi-square and one-way ANOVA compared sex, age, diagnosis, and severity across the years. Joinpoint Poisson regression analysis evaluated the temporal trend distribution of bronchiolitis hospitalizations per calendar year. A P value less than 0.05 was statistically significant. During the study period, the annual proportion of emergency department visits and hospitalizations due to bronchiolitis increased from 3 to 5%, and 26 to 38%, respectively. The annual incidence rate of hospitalizations was 3.2 per 1000 privately insured children < 24 months. Non-RSV bronchiolitis was the most frequent diagnosis (51%). Hospitalizations occurred year-round, but increased significantly from August through December. Most children hospitalized resided in the metropolitan San Juan (35%) and surrounding urban areas. Total hospital charges decreased from $3.78 to $3.74 million, with an average cost per hospitalization of $4320.12 (11.3% increase; P  = 0.0015). This is the first study that evaluates the epidemiological characteristics of bronchiolitis in a primarily Hispanic population, living in a tropical country, and using data from a privately insured population. We found a small but significant increase in proportion of emergency visits and hospitalizations. Temporal trend shows year-round hospitalizations with an earlier seasonal peak and longer duration, consistent with Puerto Rico's seasonal rainfall throughout the study period. Further studies are needed to elucidate whether this epidemiologic pattern can also be seen in publicly insured children and whether Hispanic ethnicity is a risk factor for increased hospitalizations or is related to health disparities in the US healthcare system.

Oral cancer incidence and survival rates in the Republic of Ireland, 1994-2009.

PubMed

Ali, Hala; Sinnott, Sarah-Jo; Corcoran, Paul; Deady, Sandra; Sharp, Linda; Kabir, Zubair

2016-12-20

Oral cancer is a significant public health problem world-wide and exerts high economic, social, psychological, and physical burdens on patients, their families, and on their primary care providers. We set out to describe the changing trends in incidence and survival rates of oral cancer in Ireland between 1994 and 2009. National data on incident oral cancers [ICD 10 codes C01-C06] were obtained from the National Cancer Registry Ireland from 1994 to 2009. We estimated annual percentage change (APC) in oral cancer incidence during 1994-2009 using joinpoint regression software (version 4.2.0.2). The lifetime risk of oral cancer to age 79 was estimated using Irish incidence and population data from 2007 to 2009. Survival rates were also examined using Kaplan-Meier curves and Cox proportional hazard models to explore the influence of several demographic/lifestyle covariates with follow-up to end 2012. Data were obtained on 2,147 oral cancer incident cases. Men accounted for two-thirds of oral cancer cases (n = 1,430). Annual rates in men decreased significantly during 1994-2001 (APC = -4.8 %, 95 % CI: -8.7 to -0.7) and then increased moderately (APC = 2.3 %, 95 % CI: -0.9 to 5.6). In contrast, annual incidence increased significantly in women throughout the study period (APC = 3.2 %, 95 % CI: 1.9 to 4.6). There was an elevated risk of death among oral cancer patients who were: older than 60 years of age; smokers; unemployed or retired; those living in the most deprived areas; and those whose tumour was sited in the base of the tongue. Being married and diagnosed in more recent years were associated with reduced risk of death. Oral cancer increased significantly in both sexes between 1999 and 2009 in Ireland. Our analyses demonstrate the influence of measured factors such as smoking, time of diagnosis and age on observed trends. Unmeasured factors such as alcohol use, HPV and dietary factors may also be contributing to increased trends. Several of these are modifiable risk factors which are crucial for informing public health policies, and thus more research is needed.

Patient Stratification Using Electronic Health Records from a Chronic Disease Management Program.

PubMed

Chen, Robert; Sun, Jimeng; Dittus, Robert S; Fabbri, Daniel; Kirby, Jacqueline; Laffer, Cheryl L; McNaughton, Candace D; Malin, Bradley

2016-01-04

The goal of this study is to devise a machine learning framework to assist care coordination programs in prognostic stratification to design and deliver personalized care plans and to allocate financial and medical resources effectively. This study is based on a de-identified cohort of 2,521 hypertension patients from a chronic care coordination program at the Vanderbilt University Medical Center. Patients were modeled as vectors of features derived from electronic health records (EHRs) over a six-year period. We applied a stepwise regression to identify risk factors associated with a decrease in mean arterial pressure of at least 2 mmHg after program enrollment. The resulting features were subsequently validated via a logistic regression classifier. Finally, risk factors were applied to group the patients through model-based clustering. We identified a set of predictive features that consisted of a mix of demographic, medication, and diagnostic concepts. Logistic regression over these features yielded an area under the ROC curve (AUC) of 0.71 (95% CI: [0.67, 0.76]). Based on these features, four clinically meaningful groups are identified through clustering - two of which represented patients with more severe disease profiles, while the remaining represented patients with mild disease profiles. Patients with hypertension can exhibit significant variation in their blood pressure control status and responsiveness to therapy. Yet this work shows that a clustering analysis can generate more homogeneous patient groups, which may aid clinicians in designing and implementing customized care programs. The study shows that predictive modeling and clustering using EHR data can be beneficial for providing a systematic, generalized approach for care providers to tailor their management approach based upon patient-level factors.

STEP and STEPSPL: Computer programs for aerodynamic model structure determination and parameter estimation

NASA Technical Reports Server (NTRS)

Batterson, J. G.

1986-01-01

The successful parametric modeling of the aerodynamics for an airplane operating at high angles of attack or sideslip is performed in two phases. First the aerodynamic model structure must be determined and second the associated aerodynamic parameters (stability and control derivatives) must be estimated for that model. The purpose of this paper is to document two versions of a stepwise regression computer program which were developed for the determination of airplane aerodynamic model structure and to provide two examples of their use on computer generated data. References are provided for the application of the programs to real flight data. The two computer programs that are the subject of this report, STEP and STEPSPL, are written in FORTRAN IV (ANSI l966) compatible with a CDC FTN4 compiler. Both programs are adaptations of a standard forward stepwise regression algorithm. The purpose of the adaptation is to facilitate the selection of a adequate mathematical model of the aerodynamic force and moment coefficients of an airplane from flight test data. The major difference between STEP and STEPSPL is in the basis for the model. The basis for the model in STEP is the standard polynomial Taylor's series expansion of the aerodynamic function about some steady-state trim condition. Program STEPSPL utilizes a set of spline basis functions.

Implementation of Motivational Interviewing in Substance Use Disorder Treatment: Research Network Participation and Organizational Compatibility.

PubMed

Rieckmann, Traci R; Abraham, Amanda J; Bride, Brian E

Despite considerable empirical evidence that psychosocial interventions improve addiction treatment outcomes across populations, implementation remains problematic. A small body of research points to the importance of research network participation as a facilitator of implementation; however, studies examined limited numbers of evidence-based practices. To address this gap, the present study examined factors impacting implementation of motivational interviewing (MI). This study used data from a national sample of privately funded treatment programs (n = 345) and programs participating in the National Drug Abuse Treatment Clinical Trials Network (CTN) (n = 156). Data were collected via face-to-face interviews with program administrators and clinical directors (2007-2009). Analysis included bivariate t tests and chi-square tests to compare private and CTN programs, and multivariable logistic regression of MI implementation. A majority (68.0%) of treatment programs reported use of MI. Treatment programs participating in the CTN (88.9%) were significantly more likely to report use of MI compared with non-CTN programs (58.5%; P < 0.01). CTN programs (82.1%) also were more likely to use trainers from the Motivational Interviewing Network of Trainers as compared with private programs (56.1%; P < 0.05). Multivariable logistic regression models reveal that CTN-affiliated programs and programs with a psychiatrist on staff were more likely to use MI. Programs that used the Stages of Change Readiness and Treatment Eagerness Scale assessment tool were more likely to use MI, whereas programs placing greater emphasis on confrontational group therapy were less likely to use MI. Findings suggest the critical role of research network participation, access to psychiatrists, and organizational compatibility in adoption and sustained use of MI.

WINPEPI updated: computer programs for epidemiologists, and their teaching potential

PubMed Central

2011-01-01

Background The WINPEPI computer programs for epidemiologists are designed for use in practice and research in the health field and as learning or teaching aids. The programs are free, and can be downloaded from the Internet. Numerous additions have been made in recent years. Implementation There are now seven WINPEPI programs: DESCRIBE, for use in descriptive epidemiology; COMPARE2, for use in comparisons of two independent groups or samples; PAIRSetc, for use in comparisons of paired and other matched observations; LOGISTIC, for logistic regression analysis; POISSON, for Poisson regression analysis; WHATIS, a "ready reckoner" utility program; and ETCETERA, for miscellaneous other procedures. The programs now contain 122 modules, each of which provides a number, sometimes a large number, of statistical procedures. The programs are accompanied by a Finder that indicates which modules are appropriate for different purposes. The manuals explain the uses, limitations and applicability of the procedures, and furnish formulae and references. Conclusions WINPEPI is a handy resource for a wide variety of statistical routines used by epidemiologists. Because of its ready availability, portability, ease of use, and versatility, WINPEPI has a considerable potential as a learning and teaching aid, both with respect to practical procedures in the planning and analysis of epidemiological studies, and with respect to important epidemiological concepts. It can also be used as an aid in the teaching of general basic statistics. PMID:21288353

Evaluating Federal Information Technology Program Success Based on Earned Value Management

ERIC Educational Resources Information Center

Moy, Mae N.

2016-01-01

Despite the use of earned value management (EVM) techniques to track development progress, federal information (IT) software programs continue to fail by not meeting identified business requirements. The purpose of this logistic regression study was to examine, using IT software data from federal agencies from 2011 to 2014, whether a relationship…

An Examination of Relationships between Precollege Outreach Programs and College Attendance Patterns among Minority Participants

ERIC Educational Resources Information Center

Alhaddab, Taghreed A.; Aquino, Katherine C.

2017-01-01

This study is an examination of the relationship between participation in precollege outreach programs and students' college access patterns (i.e., enrollment patterns and timing in postsecondary institutions), comparing different racial/ ethnic groups. The study included a series of logistic regression models to investigate relationships between…

Computer-Assisted, Programmed Text, and Lecture Modes of Instruction in Three Medical Training Courses: Comparative Evaluation. Final Report.

ERIC Educational Resources Information Center

Deignan, Gerard M.; And Others

This report contains a comparative analysis of the differential effectiveness of computer-assisted instruction (CAI), programmed instructional text (PIT), and lecture methods of instruction in three medical courses--Medical Laboratory, Radiology, and Dental. The summative evaluation includes (1) multiple regression analyses conducted to predict…

Exploring Milk and Yogurt Selection in an Urban Universal School Breakfast Program

ERIC Educational Resources Information Center

Miller, M. Elizabeth; Kwon, Sockju

2015-01-01

Purpose/Objectives: The purpose of this study was to explore milk and yogurt selection among students participating in a School Breakfast Program. Methods: Researchers observed breakfast selection of milk, juice and yogurt in six elementary and four secondary schools. Data were analyzed using descriptive statistics and logistic regression to…

Association between Travel Times and Food Procurement Practices among Female Supplemental Nutrition Assistance Program Participants in Eastern North Carolina

ERIC Educational Resources Information Center

Jilcott, Stephanie B.; Moore, Justin B.; Wall-Bassett, Elizabeth D.; Liu, Haiyong; Saelens, Brian E.

2011-01-01

Objective: To examine associations between self-reported vehicular travel behaviors, perceived stress, food procurement practices, and body mass index among female Supplemental Nutrition Assistance Program (SNAP) participants. Analysis: The authors used correlation and regression analyses to examine cross-sectional associations between travel time…

Student Assistance Program Outcomes for Students at Risk for Suicide

ERIC Educational Resources Information Center

Biddle, Virginia Sue; Kern, John, III; Brent, David A.; Thurkettle, Mary Ann; Puskar, Kathryn R.; Sekula, L. Kathleen

2014-01-01

Pennsylvania's response to adolescent suicide is its Student Assistance Program (SAP). SAP has been funded for 27 years although no statewide outcome studies using case-level data have been conducted. This study used logistic regression to examine drug-/alcohol-related behaviors and suspensions of suicidal students who participated in SAP. Of the…

Assessing the Effectiveness of Statistical Classification Techniques in Predicting Future Employment of Participants in the Temporary Assistance for Needy Families Program

ERIC Educational Resources Information Center

Montoya, Isaac D.

2008-01-01

Three classification techniques (Chi-square Automatic Interaction Detection [CHAID], Classification and Regression Tree [CART], and discriminant analysis) were tested to determine their accuracy in predicting Temporary Assistance for Needy Families program recipients' future employment. Technique evaluation was based on proportion of correctly…

The Impact of Chile's School Feeding Program on Education Outcomes

ERIC Educational Resources Information Center

McEwan, Patrick J.

2013-01-01

Chile operates one of the oldest and largest school feeding programs in Latin America, targeting higher-calorie meals to relatively poorer schools. This paper evaluates the impact of higher-calorie meals on the education outcomes of public, rural schools and their students. It applies a regression-discontinuity design to administrative data,…

Analyzing Preservice Teachers' Technological Pedagogical Content Knowledge Development in the Context of a Multidimensional Teacher Preparation Program

ERIC Educational Resources Information Center

Shinas, Valerie Harlow; Karchmer-Klein, Rachel; Mouza, Chrystalla; Yilmaz-Ozden, Sule; Glutting, Joseph J.

2015-01-01

In this quantitative study, correlational and multiple regression analyses were conducted to examine the technological pedagogical content knowledge (TPACK) development of 299 preservice teachers in response to the technology preparation they received during their initial teacher licensure program. Survey data were analyzed to determine the…

Why Are Economists Evaluating the Impact of Gifted Education?

ERIC Educational Resources Information Center

Kettler, Todd

2016-01-01

Bui, Craig, and Imberman assessed the impact of gifted and talented programs on student achievement using regression discontinuity and random assignment to gifted magnet schools. In both analyses, they found minimal impact of the gifted and talented programs on student achievement. This commentary addresses two concerns associated with the study.…

The microcomputer scientific software series 5: the BIOMASS user's guide.

Treesearch

George E. Host; Stephen C. Westin; William G. Cole; Kurt S. Pregitzer

1989-01-01

BIOMASS is an interactive microcomputer program that uses allometric regression equations to calculate aboveground biomass of common tree species of the Lake States. The equations are species-specific and most use both diameter and height as independent variables. The program accommodates fixed area and variable radius sample designs and produces both individual tree...

A comparison of fitness-case sampling methods for genetic programming

NASA Astrophysics Data System (ADS)

Martínez, Yuliana; Naredo, Enrique; Trujillo, Leonardo; Legrand, Pierrick; López, Uriel

2017-11-01

Genetic programming (GP) is an evolutionary computation paradigm for automatic program induction. GP has produced impressive results but it still needs to overcome some practical limitations, particularly its high computational cost, overfitting and excessive code growth. Recently, many researchers have proposed fitness-case sampling methods to overcome some of these problems, with mixed results in several limited tests. This paper presents an extensive comparative study of four fitness-case sampling methods, namely: Interleaved Sampling, Random Interleaved Sampling, Lexicase Selection and Keep-Worst Interleaved Sampling. The algorithms are compared on 11 symbolic regression problems and 11 supervised classification problems, using 10 synthetic benchmarks and 12 real-world data-sets. They are evaluated based on test performance, overfitting and average program size, comparing them with a standard GP search. Comparisons are carried out using non-parametric multigroup tests and post hoc pairwise statistical tests. The experimental results suggest that fitness-case sampling methods are particularly useful for difficult real-world symbolic regression problems, improving performance, reducing overfitting and limiting code growth. On the other hand, it seems that fitness-case sampling cannot improve upon GP performance when considering supervised binary classification.

Disparities in Cancer Mortality and Incidence Among American Indians and Alaska Natives in the United States

PubMed Central

Espey, David K.; Swan, Judith; Wiggins, Charles L.; Eheman, Christie; Kaur, Judith S.

2014-01-01

Objectives. We used improved data on American Indian and Alaska Native (AI/AN) ancestry to provide an updated and comprehensive description of cancer mortality and incidence among AI/AN populations from 1990 to 2009. Methods. We linked the National Death Index and central cancer registry records independently to the Indian Health Service (IHS) patient registration database to improve identification of AI/AN persons in cancer mortality and incidence data, respectively. Analyses were restricted to non-Hispanic persons residing in Contract Health Service Delivery Area counties in 6 geographic regions of the United States. We compared age-adjusted mortality and incidence rates for AI/AN populations with White populations using rate ratios and mortality-to-incidence ratios. Trends were described using joinpoint analysis. Results. Cancer mortality and incidence rates for AI/AN persons compared with Whites varied by region and type of cancer. Trends in death rates showed that greater progress in cancer control was achieved for White populations compared with AI/AN populations over the last 2 decades. Conclusions. Spatial variations in mortality and incidence by type of cancer demonstrated both persistent and emerging challenges for cancer control in AI/AN populations. PMID:24754660

Examining Preservice Science Teacher Understanding of Nature of Science: Discriminating Variables on the Aspects of Nature of Science

NASA Astrophysics Data System (ADS)

Jones, William I.

This study examined the understanding of nature of science among participants in their final year of a 4-year undergraduate teacher education program at a Midwest liberal arts university. The Logic Model Process was used as an integrative framework to focus the collection, organization, analysis, and interpretation of the data for the purpose of (1) describing participant understanding of NOS and (2) to identify participant characteristics and teacher education program features related to those understandings. The Views of Nature of Science Questionnaire form C (VNOS-C) was used to survey participant understanding of 7 target aspects of Nature of Science (NOS). A rubric was developed from a review of the literature to categorize and score participant understanding of the target aspects of NOS. Participants' high school and college transcripts, planning guides for their respective teacher education program majors, and science content and science teaching methods course syllabi were examined to identify and categorize participant characteristics and teacher education program features. The R software (R Project for Statistical Computing, 2010) was used to conduct an exploratory analysis to determine correlations of the antecedent and transaction predictor variables with participants' scores on the 7 target aspects of NOS. Fourteen participant characteristics and teacher education program features were moderately and significantly ( p < .01) correlated with participant scores on the target aspects of NOS. The 6 antecedent predictor variables were entered into multiple regression analyses to determine the best-fit model of antecedent predictor variables for each target NOS aspect. The transaction predictor variables were entered into separate multiple regression analyses to determine the best-fit model of transaction predictor variables for each target NOS aspect. Variables from the best-fit antecedent and best-fit transaction models for each target aspect of NOS were then combined. A regression analysis for each of the combined models was conducted to determine the relative effect of these variables on the target aspects of NOS. Findings from the multiple regression analyses revealed that each of the fourteen predictor variables was present in the best-fit model for at least 1 of the 7 target aspects of NOS. However, not all of the predictor variables were statistically significant (p < .007) in the models and their effect (beta) varied. Participants in the teacher education program who had higher ACT Math scores, completed more high school science credits, and were enrolled either in the Middle Childhood with a science concentration program major or in the Adolescent/Young Adult Science Education program major were more likely to have an informed understanding on each of the 7 target aspects of NOS. Analyses of the planning guides and the course syllabi in each teacher education program major revealed differences between the program majors that may account for the results.

Publically accessible decision support system of the spatially referenced regressions on watershed attributes (SPARROW) model and model enhancements in South Carolina

Treesearch

Celeste Journey; Anne B. Hoos; David E. Ladd; John W. brakebill; Richard A. Smith

2016-01-01

The U.S. Geological Survey (USGS) National Water Quality Assessment program has developed a web-based decision support system (DSS) to provide free public access to the steady-stateSPAtially Referenced Regressions On Watershed attributes (SPARROW) model simulation results on nutrient conditions in streams and rivers and to offer scenario testing capabilities for...

Examining the Association between Patient-Reported Symptoms of Attention and Memory Dysfunction with Objective Cognitive Performance: A Latent Regression Rasch Model Approach.

PubMed

Li, Yuelin; Root, James C; Atkinson, Thomas M; Ahles, Tim A

2016-06-01

Patient-reported cognition generally exhibits poor concordance with objectively assessed cognitive performance. In this article, we introduce latent regression Rasch modeling and provide a step-by-step tutorial for applying Rasch methods as an alternative to traditional correlation to better clarify the relationship of self-report and objective cognitive performance. An example analysis using these methods is also included. Introduction to latent regression Rasch modeling is provided together with a tutorial on implementing it using the JAGS programming language for the Bayesian posterior parameter estimates. In an example analysis, data from a longitudinal neurocognitive outcomes study of 132 breast cancer patients and 45 non-cancer matched controls that included self-report and objective performance measures pre- and post-treatment were analyzed using both conventional and latent regression Rasch model approaches. Consistent with previous research, conventional analysis and correlations between neurocognitive decline and self-reported problems were generally near zero. In contrast, application of latent regression Rasch modeling found statistically reliable associations between objective attention and processing speed measures with self-reported Attention and Memory scores. Latent regression Rasch modeling, together with correlation of specific self-reported cognitive domains with neurocognitive measures, helps to clarify the relationship of self-report with objective performance. While the majority of patients attribute their cognitive difficulties to memory decline, the Rash modeling suggests the importance of processing speed and initial learning. To encourage the use of this method, a step-by-step guide and programming language for implementation is provided. Implications of this method in cognitive outcomes research are discussed. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Optimal design application on the advanced aeroelastic rotor blade

NASA Technical Reports Server (NTRS)

Wei, F. S.; Jones, R.

1985-01-01

The vibration and performance optimization procedure using regression analysis was successfully applied to an advanced aeroelastic blade design study. The major advantage of this regression technique is that multiple optimizations can be performed to evaluate the effects of various objective functions and constraint functions. The data bases obtained from the rotorcraft flight simulation program C81 and Myklestad mode shape program are analytically determined as a function of each design variable. This approach has been verified for various blade radial ballast weight locations and blade planforms. This method can also be utilized to ascertain the effect of a particular cost function which is composed of several objective functions with different weighting factors for various mission requirements without any additional effort.

A seismic survey of the Manson disturbed area

NASA Technical Reports Server (NTRS)

Sendlein, L. V. A.; Smith, T. A.

1971-01-01

The region in north-central Iowa referred to as the Manson disturbed area was investigated with the seismic refraction method and the bedrock configuration mapped. The area is approximately 30 km in diameter and is not detectable from the surface topography; however, water wells that penetrate the bedrock indicate that the bedrock is composed of disturbed Cretaceous sediments with a central region approximately 6 km in diameter composed of Precambrian crystalline rock. Seismic velocity differences between the overlying glacial till and the Cretaceous sediments were so small that a statistical program was developed to analyze the data. The program developed utilizes existing 2 segment regression analyses and extends the method to fit 3 or more regression lines to seismic data.

Informal Training in Staff Networks to Support Dissemination of Health Promotion Programs

PubMed Central

Ramanadhan, Shoba; Wiecha, Jean L.; Gortmaker, Steven L.; Emmons, Karen M.; Viswanath, Kasisomayajula

2011-01-01

Purpose To study informal skill transfer via staff networks as a complement to formal training among afterschool childcare providers implementing a health promotion program. Design Cross-sectional, sociometric network analysis. Setting Boston Young Men’s Christian Association (YMCA) afterschool programs implementing the iPLAY program. Participants All 91 staff members at 20 sites were eligible; 80 completed the survey (88% response rate). Measures At the network level, network density measured system-level connectedness. At the staff level, the independent variable was out degree, the number of individuals to whom respondents noted a program-related connection. The dependent variable was skill gains, the number of key implementation skills gained from the network. Analysis We mapped the staff program-related social network. We utilized multiple linear regression to estimate the relationship between out degree and skill gains, and we adjusted for clustering of staff in sites. Results Most staff (77%) reported gaining at least one skill from the network, but only 2% of potential network connections were established. The regression model showed that out degree (i.e., number of program-related contacts) was significantly associated with skill gains (β = .48, p < .01) independent of other variables. Conclusion Informal skill transfer in staff networks may be a useful complement to formal training for implementation of health promotion programs, but informal skill transfer was likely underutilized in this network. Future research employing longitudinal and/or multisite data should examine these findings in greater detail. PMID:20809826

Examining the Impact of a Highly Targeted State Administered Merit Aid Program on Brain Drain: Evidence from a Regression Discontinuity Analysis of Missouri's Bright Flight Program

ERIC Educational Resources Information Center

Harrington, James R.; Muñoz, José; Curs, Bradley R.; Ehlert, Mark

2016-01-01

The adoption of state-funded merit-based aid programs has become increasingly popular among policy-makers, particularly in the southeastern part of the United States. One of the primary rationales of state-funded merit-based aid is to provide scholarships to the best and brightest students as a means to retain high quality human capital in the…

An Examination of the Demographic and Career Progression of Air Force Institute of Technology Cost Analysis Graduates.

DTIC Science & Technology

1997-09-01

program include the ACEIT software training and the combination of Department of Defense (DOD) application, regression, and statistics. The weaknesses...and Integrated Tools ( ACEIT ) software and training could not be praised enough. AFIT vs. Civilian Institutions. The GCA program provides a Department...very useful to the graduates and beneficial to their careers. The main strengths of the program include the ACEIT software training and the combination

Whole-genome regression and prediction methods applied to plant and animal breeding.

PubMed

de Los Campos, Gustavo; Hickey, John M; Pong-Wong, Ricardo; Daetwyler, Hans D; Calus, Mario P L

2013-02-01

Genomic-enabled prediction is becoming increasingly important in animal and plant breeding and is also receiving attention in human genetics. Deriving accurate predictions of complex traits requires implementing whole-genome regression (WGR) models where phenotypes are regressed on thousands of markers concurrently. Methods exist that allow implementing these large-p with small-n regressions, and genome-enabled selection (GS) is being implemented in several plant and animal breeding programs. The list of available methods is long, and the relationships between them have not been fully addressed. In this article we provide an overview of available methods for implementing parametric WGR models, discuss selected topics that emerge in applications, and present a general discussion of lessons learned from simulation and empirical data analysis in the last decade.

Whole-Genome Regression and Prediction Methods Applied to Plant and Animal Breeding

PubMed Central

de los Campos, Gustavo; Hickey, John M.; Pong-Wong, Ricardo; Daetwyler, Hans D.; Calus, Mario P. L.

2013-01-01

Genomic-enabled prediction is becoming increasingly important in animal and plant breeding and is also receiving attention in human genetics. Deriving accurate predictions of complex traits requires implementing whole-genome regression (WGR) models where phenotypes are regressed on thousands of markers concurrently. Methods exist that allow implementing these large-p with small-n regressions, and genome-enabled selection (GS) is being implemented in several plant and animal breeding programs. The list of available methods is long, and the relationships between them have not been fully addressed. In this article we provide an overview of available methods for implementing parametric WGR models, discuss selected topics that emerge in applications, and present a general discussion of lessons learned from simulation and empirical data analysis in the last decade. PMID:22745228

Acculturation and healthy lifestyle habits among Hispanics in United States-Mexico border communities.

PubMed

Ghaddar, Suad; Brown, Cynthia J; Pagán, José A; Díaz, Violeta

2010-09-01

To explore the relationship between acculturation and healthy lifestyle habits in the largely Hispanic populations living in underserved communities in the United States of America along the U.S.-Mexico border. A cross-sectional study was conducted from April 2006 to June 2008 using survey data from the Alliance for a Healthy Border, a program designed to reduce health disparities in the U.S.-Mexico border region by funding nutrition and physical activity education programs at 12 federally qualified community health centers in Arizona, California, New Mexico, and Texas. The survey included questions on acculturation, diet, exercise, and demographic factors and was completed by 2,381 Alliance program participants, of whom 95.3% were Hispanic and 45.4% were under the U.S. poverty level for 2007. Chi-square (χ2) and Student's t tests were used for bivariate comparisons between acculturation and dietary and physical activity measures. Linear regression and binary logistic regression were used to control for factors associated with nutrition and exercise. Based on univariate tests and confirmed by regression analysis controlling for sociodemographic and health variables, less acculturated survey respondents reported a significantly higher frequency of fruit and vegetable consumption and healthier dietary habits than those who were more acculturated. Adjusted binary logistic regression confirmed that individuals with low language acculturation were less likely to engage in physical activity than those with moderate to high acculturation (odds ratio 0.75, 95% confidence interval 0.59-0.95). Findings confirmed an association between acculturation and healthy lifestyle habits and supported the hypothesis that acculturation in border community populations tends to decrease the practice of some healthy dietary habits while increasing exposure to and awareness of the importance of other healthy behaviors.

Hox-C9 activates the intrinsic pathway of apoptosis and is associated with spontaneous regression in neuroblastoma.

PubMed

Kocak, H; Ackermann, S; Hero, B; Kahlert, Y; Oberthuer, A; Juraeva, D; Roels, F; Theissen, J; Westermann, F; Deubzer, H; Ehemann, V; Brors, B; Odenthal, M; Berthold, F; Fischer, M

2013-04-11

Neuroblastoma is an embryonal malignancy of the sympathetic nervous system. Spontaneous regression and differentiation of neuroblastoma is observed in a subset of patients, and has been suggested to represent delayed activation of physiologic molecular programs of fetal neuroblasts. Homeobox genes constitute an important family of transcription factors, which play a fundamental role in morphogenesis and cell differentiation during embryogenesis. In this study, we demonstrate that expression of the majority of the human HOX class I homeobox genes is significantly associated with clinical covariates in neuroblastoma using microarray expression data of 649 primary tumors. Moreover, a HOX gene expression-based classifier predicted neuroblastoma patient outcome independently of age, stage and MYCN amplification status. Among all HOX genes, HOXC9 expression was most prominently associated with favorable prognostic markers. Most notably, elevated HOXC9 expression was significantly associated with spontaneous regression in infant neuroblastoma. Re-expression of HOXC9 in three neuroblastoma cell lines led to a significant reduction in cell viability, and abrogated tumor growth almost completely in neuroblastoma xenografts. Neuroblastoma growth arrest was related to the induction of programmed cell death, as indicated by an increase in the sub-G1 fraction and translocation of phosphatidylserine to the outer membrane. Programmed cell death was associated with the release of cytochrome c from the mitochondria into the cytosol and activation of the intrinsic cascade of caspases, indicating that HOXC9 re-expression triggers the intrinsic apoptotic pathway. Collectively, our results show a strong prognostic impact of HOX gene expression in neuroblastoma, and may point towards a role of Hox-C9 in neuroblastoma spontaneous regression.

A manual-based group program to improve mental health: what kind of teachers are interested and who stands to benefit from this program?

PubMed

Unterbrink, Thomas; Pfeifer, Ruth; Krippeit, Lorena; Zimmermann, Linda; Rose, Uwe; Joos, Andreas; Hartmann, Armin; Wirsching, Michael; Bauer, Joachim

2014-01-01

In order to evaluate a manual-based group program for teachers aiming at strengthening mental health, we examined (1) whether the teachers interested in participating differ from their colleagues without interest and (2) whether there is evidence of subgroups benefiting more than others among those who participated. Out of a basic sample of 949 schoolteachers, 337 teachers declared interest in a group program. All teachers were surveyed with the "General Health Questionnaire", the "Maslach Burnout Inventory" and the "Effort Reward Imbalance Questionnaire". In addition, participating teachers were screened with the "Symptom Checklist 27" T and χ(2)-tests were calculated to detect differences between those interested in the program and the remaining 612 teachers. Six factors were established and used for a regression analysis that identified specific parameters more or less correlating with health benefits of those who participated in the program. Findings showed that those declaring interest in the intervention displayed a higher degree of occupational stress according to all health parameters examined. Teachers interested in the program were significantly younger, more frequently female and single. The regression analysis showed that the baseline scores of the six health parameters were the strongest predictors for improvement. Worse scores before the beginning of the intervention correlated with a more positive effect. Intervention programs aiming at alleviating the mental stress of teachers find the interest of those who need it most. More importantly, the latter are the ones who--at least if our program is applied-benefit best.

Quasi-experimental evaluation without regression analysis.

PubMed

Rohrer, James E

2009-01-01

Evaluators of public health programs in field settings cannot always randomize subjects into experimental or control groups. By default, they may choose to employ the weakest study design available: the pretest, posttest approach without a comparison group. This essay argues that natural experiments involving comparison groups are within reach of public health program managers. Methods for analyzing natural experiments are discussed.

FIRES: Fire Information Retrieval and Evaluation System - A program for fire danger rating analysis

Treesearch

Patricia L. Andrews; Larry S. Bradshaw

1997-01-01

A computer program, FIRES: Fire Information Retrieval and Evaluation System, provides methods for evaluating the performance of fire danger rating indexes. The relationship between fire danger indexes and historical fire occurrence and size is examined through logistic regression and percentiles. Historical seasonal trends of fire danger and fire occurrence can be...

An Evaluation of Project iRead: A Program Created to Improve Sight Word Recognition

ERIC Educational Resources Information Center

Marshall, Theresa Meade

2014-01-01

This program evaluation was undertaken to examine the relationship between participation in Project iRead and student gains in word recognition, fluency, and comprehension as measured by the Phonological Awareness Literacy Screening (PALS) Test. Linear regressions compared the 2012-13 PALS results from 5,140 first and second grade students at…

Parent Support for Breakfast after the Bell Programs in a State with Very Low Breakfast Participation

ERIC Educational Resources Information Center

Haines, Amanda; Spruance, Lori Andersen

2018-01-01

Purpose/Objectives: The study aim was to evaluate parent support for breakfast after the bell programs (BABPs). Methods: Data were collected through an online survey from parents (n=488) of school-aged children enrolled in public schools in Utah. Data were analyzed using generalized estimating equation (GEE) regression methods. Results: Parents…

Comparison of Outcomes for Youth Apprenticeship Projects and Youth Career Development Projects. Supplementary Report.

ERIC Educational Resources Information Center

Richards, James M., Jr.; And Others

The New Youth Initiatives in Apprenticeship Program (YAP) was compared with the Youth Career Development Program (YCD). Data for 1979 and 1980 came from an evaluation of YAP projects by CSR, Incorporated, and an evaluation of the YCD projects by the Educational Testing Service. A multiple regression approach was used to compare student…

Testing the Efficacy of a Scholarship Program for Single Parent, Post-Freshmen, Full Time Undergraduates

ERIC Educational Resources Information Center

Carpenter, Dick M., II; Kaka, Sarah J.; Tygret, Jennifer A.; Cathcart, Katy

2018-01-01

This study examines the efficacy of a scholarship program designed to assist single parent, post-freshmen, full time undergraduate students and predictors of success among a sample of said students, where success is defined as progress toward completion, academic achievement, and degree completion. Results of fixed effects regression and…

Accountability with Voucher Threats, Responses, and the Test-Taking Population: Regression Discontinuity Evidence from Florida

ERIC Educational Resources Information Center

Chakrabarti, Rajashri

2013-01-01

Florida's 1999 A-plus program was a consequential accountability program that embedded vouchers in an accountability regime. Under Florida rules, scores of students in several special education (ESE) and limited English proficient (LEP) categories were not included in the computation of school grades. One might expect these rules to induce F…

High-Quality School-Based Pre-K Can Boost Early Learning for Children with Special Needs

ERIC Educational Resources Information Center

Phillips, Deborah A.; Meloy, Mary E.

2012-01-01

This article assesses the effects of Tulsa, Oklahoma's school-based prekindergarten program on the school readiness of children with special needs using a regression discontinuity design. Participation in the pre-K program was associated with significant gains for children with special needs in early literacy scores, but not in math scores. These…

Who Stays and for How Long: Examining Attrition in Canadian Graduate Programs

ERIC Educational Resources Information Center

DeClou, Lindsay

2016-01-01

Attrition from Canadian graduate programs is a point of concern on a societal, institutional, and individual level. To improve retention in graduate school, a better understanding of what leads to withdrawal needs to be reached. This paper uses logistic regression and discrete-time survival analysis with time-varying covariates to analyze data…

Predictors of HIV/AIDS Programming in African American Churches: Implications for HIV Prevention, Testing, and Care

ERIC Educational Resources Information Center

Stewart, Jennifer M.; Hanlon, Alexandra; Brawner, Bridgette M.

2017-01-01

Using data from the National Congregational Study, we examined predictors of having an HIV/AIDS program in predominately African American churches across the United States. We conducted regression analyses of Wave II data (N = 1,506) isolating the sample to churches with a predominately African American membership. The dependent variable asked…

Predictors of Attrition and Achievement in a Tertiary Bridging Program

ERIC Educational Resources Information Center

Whannell, Robert

2013-01-01

This study examines the attrition and achievement of a sample of 295 students in an on-campus tertiary bridging program at a regional university. A logistic regression analysis using enrolment status, age and the number of absences from scheduled classes at week three of the semester as predictor variables correctly predicted 92.8 percent of…

The Effect of Continuing Education Participation on Outcomes of Male and Female Agricultural Workers in the USA

ERIC Educational Resources Information Center

Pena, Anita Alves

2015-01-01

Job training and employment assistance programs aim to assist migrant and seasonal farmworkers and their dependents locate steady employment and develop job skills. This study investigates effects of educational programs on wages, annual time allocations, and poverty of male and female farmworkers and their families using regression analysis in…

GDF v2.0, an enhanced version of GDF

NASA Astrophysics Data System (ADS)

Tsoulos, Ioannis G.; Gavrilis, Dimitris; Dermatas, Evangelos

2007-12-01

An improved version of the function estimation program GDF is presented. The main enhancements of the new version include: multi-output function estimation, capability of defining custom functions in the grammar and selection of the error function. The new version has been evaluated on a series of classification and regression datasets, that are widely used for the evaluation of such methods. It is compared to two known neural networks and outperforms them in 5 (out of 10) datasets. Program summaryTitle of program: GDF v2.0 Catalogue identifier: ADXC_v2_0 Program summary URL:http://cpc.cs.qub.ac.uk/summaries/ADXC_v2_0.html Program obtainable from: CPC Program Library, Queen's University, Belfast, N. Ireland Licensing provisions: Standard CPC licence, http://cpc.cs.qub.ac.uk/licence/licence.html No. of lines in distributed program, including test data, etc.: 98 147 No. of bytes in distributed program, including test data, etc.: 2 040 684 Distribution format: tar.gz Programming language: GNU C++ Computer: The program is designed to be portable in all systems running the GNU C++ compiler Operating system: Linux, Solaris, FreeBSD RAM: 200000 bytes Classification: 4.9 Does the new version supersede the previous version?: Yes Nature of problem: The technique of function estimation tries to discover from a series of input data a functional form that best describes them. This can be performed with the use of parametric models, whose parameters can adapt according to the input data. Solution method: Functional forms are being created by genetic programming which are approximations for the symbolic regression problem. Reasons for new version: The GDF package was extended in order to be more flexible and user customizable than the old package. The user can extend the package by defining his own error functions and he can extend the grammar of the package by adding new functions to the function repertoire. Also, the new version can perform function estimation of multi-output functions and it can be used for classification problems. Summary of revisions: The following features have been added to the package GDF: Multi-output function approximation. The package can now approximate any function f:R→R. This feature gives also to the package the capability of performing classification and not only regression. User defined function can be added to the repertoire of the grammar, extending the regression capabilities of the package. This feature is limited to 3 functions, but easily this number can be increased. Capability of selecting the error function. The package offers now to the user apart from the mean square error other error functions such as: mean absolute square error, maximum square error. Also, user defined error functions can be added to the set of error functions. More verbose output. The main program displays more information to the user as well as the default values for the parameters. Also, the package gives to the user the capability to define an output file, where the output of the gdf program for the testing set will be stored after the termination of the process. Additional comments: A technical report describing the revisions, experiments and test runs is packaged with the source code. Running time: Depending on the train data.

Support Vector Machine algorithm for regression and classification

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

Yu, Chenggang; Zavaljevski, Nela

2001-08-01

The software is an implementation of the Support Vector Machine (SVM) algorithm that was invented and developed by Vladimir Vapnik and his co-workers at AT&T Bell Laboratories. The specific implementation reported here is an Active Set method for solving a quadratic optimization problem that forms the major part of any SVM program. The implementation is tuned to specific constraints generated in the SVM learning. Thus, it is more efficient than general-purpose quadratic optimization programs. A decomposition method has been implemented in the software that enables processing large data sets. The size of the learning data is virtually unlimited by themore » capacity of the computer physical memory. The software is flexible and extensible. Two upper bounds are implemented to regulate the SVM learning for classification, which allow users to adjust the false positive and false negative rates. The software can be used either as a standalone, general-purpose SVM regression or classification program, or be embedded into a larger software system.« less

A non-linear regression analysis program for describing electrophysiological data with multiple functions using Microsoft Excel.

PubMed

Brown, Angus M

2006-04-01

The objective of this present study was to demonstrate a method for fitting complex electrophysiological data with multiple functions using the SOLVER add-in of the ubiquitous spreadsheet Microsoft Excel. SOLVER minimizes the difference between the sum of the squares of the data to be fit and the function(s) describing the data using an iterative generalized reduced gradient method. While it is a straightforward procedure to fit data with linear functions, and we have previously demonstrated a method of non-linear regression analysis of experimental data based upon a single function, it is more complex to fit data with multiple functions, usually requiring specialized expensive computer software. In this paper we describe an easily understood program for fitting experimentally acquired data, in this case the stimulus-evoked compound action potential from the mouse optic nerve, with multiple Gaussian functions. The program is flexible and can be applied to describe data with a wide variety of user-input functions.

Weight loss efficacy of a novel mobile Diabetes Prevention Program delivery platform with human coaching

PubMed Central

Michaelides, Andreas; Raby, Christine; Wood, Meghan; Farr, Kit

2016-01-01

Objective To evaluate the weight loss efficacy of a novel mobile platform delivering the Diabetes Prevention Program. Research Design and Methods 43 overweight or obese adult participants with a diagnosis of prediabetes signed-up to receive a 24-week virtual Diabetes Prevention Program with human coaching, through a mobile platform. Weight loss and engagement were the main outcomes, evaluated by repeated measures analysis of variance, backward regression, and mediation regression. Results Weight loss at 16 and 24 weeks was significant, with 56% of starters and 64% of completers losing over 5% body weight. Mean weight loss at 24 weeks was 6.58% in starters and 7.5% in completers. Participants were highly engaged, with 84% of the sample completing 9 lessons or more. In-app actions related to self-monitoring significantly predicted weight loss. Conclusions Our findings support the effectiveness of a uniquely mobile prediabetes intervention, producing weight loss comparable to studies with high engagement, with potential for scalable population health management. PMID:27651911

Global correlation of topographic heights and gravity anomalies

NASA Technical Reports Server (NTRS)

Roufosse, M. C.

1977-01-01

The short wavelength features were obtained by subtracting a calculated 24th-degree-and-order field from observed data written in 1 deg x 1 deg squares. The correlation between the two residual fields was examined by a program of linear regression. When run on a worldwide scale over oceans and continents separately, the program did not exhibit any correlation; this can be explained by the fact that the worldwide autocorrelation function for residual gravity anomalies falls off much faster as a function of distance than does that for residual topographic heights. The situation was different when the program was used in restricted areas, of the order of 5 deg x 5 deg square. For 30% of the world,fair-to-good correlations were observed, mostly over continents. The slopes of the regression lines are proportional to apparent densities, which offer a large spectrum of values that are being interpreted in terms of features in the upper mantle consistent with available heat-flow, gravity, and seismic data.

A study on industrial accident rate forecasting and program development of estimated zero accident time in Korea.

PubMed

Kim, Tae-gu; Kang, Young-sig; Lee, Hyung-won

2011-01-01

To begin a zero accident campaign for industry, the first thing is to estimate the industrial accident rate and the zero accident time systematically. This paper considers the social and technical change of the business environment after beginning the zero accident campaign through quantitative time series analysis methods. These methods include sum of squared errors (SSE), regression analysis method (RAM), exponential smoothing method (ESM), double exponential smoothing method (DESM), auto-regressive integrated moving average (ARIMA) model, and the proposed analytic function method (AFM). The program is developed to estimate the accident rate, zero accident time and achievement probability of an efficient industrial environment. In this paper, MFC (Microsoft Foundation Class) software of Visual Studio 2008 was used to develop a zero accident program. The results of this paper will provide major information for industrial accident prevention and be an important part of stimulating the zero accident campaign within all industrial environments.

A proposed streamflow-data program for Utah

USGS Publications Warehouse

Whitaker, G.L.

1970-01-01

An evaluation of the streamflow data available in Utah was made to provide guidelines for planning future programs. The basic steps in the evaluation procedure were (1) definition of the long- term goals of the streamflow-data program in quantitative form, (2) examination and analysis of all available data to determine which goals have already been met, and (3) consideration of alternate programs and techniques to meet the remaining objectives. The principal goals are (1) to provide current streamflow data where needed for water management and (2) to define streamflow characteristics at any point on any stream within a specified accuracy. It was found that the first goal generally is being satisfied but that flow characteristics at ungaged sites cannot be estimated within the specified accuracy by regression analysis with the existing data and model now available. This latter finding indicates the need for some changes in the present data program so that the accuracy goals can be approached by alternate methods. The regression method may be more successful at a future time if a more suitable model can be developed, and if an adequate sample of streamflow records can be obtained in all areas. In the meantime, methods of transferring flow characteristics which require some information at the ungaged site may be used. A modified streamflow-data program based on this study is proposed.

Evidence-based treatment practices for drug-involved adults in the criminal justice system.

PubMed

Friedmann, Peter D; Taxman, Faye S; Henderson, Craig E

2007-04-01

The aim of this study was to estimate the extent and organizational correlates of evidence-based practices (EBPs) in correctional facilities and community-based substance abuse treatment programs that manage drug-involved adult offenders. Correctional administrators and treatment program directors affiliated with a national sample of 384 criminal justice and community-based programs providing substance abuse treatment to adult offenders in the United States were surveyed in 2004. Correctional administrators reported the availability of up to 13 specified EBPs, and treatment directors up to 15. The sum total of EBPs indicates their extent. Linear models regress the extent of EBPs on variables measuring structure and leadership, culture and climate, administrator attitudes, and network connectedness of the organization. Most programs offer fewer than 60% of the specified EBPs to drug-involved offenders. In multiple regression models, offender treatment programs that provided more EBPs were community based, accredited, and network connected, with a performance-oriented, nonpunitive culture, more training resources, and leadership with a background in human services, a high regard for the value of substance abuse treatment, and an understanding of EBPs. The use of EBPs among facility- and community-based programs that serve drug-involved adult offenders has room for improvement. Initiatives to disseminate EBPs might target these institutional and environmental domains, but further research is needed to determine whether such organization interventions can promote the uptake of EBPs.

EVIDENCE-BASED TREATMENT PRACTICES FOR DRUG-INVOLVED ADULTS IN THE CRIMINAL JUSTICE SYSTEM

PubMed Central

Friedmann, Peter D.; Taxman, Faye S.; Henderson, Craig E.

2007-01-01

OBJECTIVE To estimate the extent and organizational correlates of evidence-based practices (EBPs) in correctional facilities and community-based substance abuse treatment programs that manage drug-involved adult offenders. METHODS Correctional administrators and treatment program directors affiliated with a national sample of 384 criminal justice and community-based programs providing substance abuse treatment to adult offenders in the United States were surveyed in 2004. Correctional administrators reported the availability of up to 13 specified EBPs and treatment directors up to 15. The sum total of EBPs indicates their extent. Linear models regress the extent of EBPs on variables measuring structure and leadership, culture and climate, administrator attitudes and network connectedness of the organization. RESULTS Most programs offer fewer than 60% of the specified EBPs to drug-involved offenders. In multiple regression models, offender treatment programs that provided more EBPs were community-based, accredited, and network-connected; with a performance-oriented, non-punitive culture, more training resources; and leadership with a background in human services, a high regard for the value of substance abuse treatment and an understanding of EBPs. CONCLUSIONS The use of EBPs among facility- and community-based programs that serve drug-involved adult offenders has room for improvement. Initiatives to disseminate EBPs might target these institutional and environmental domains, but further research is needed to determine whether such organization interventions can promote the uptake of EBPs. PMID:17383551

A pre-admission program for underrepresented minority and disadvantaged students: application, acceptance, graduation rates and timeliness of graduating from medical school.

PubMed

Strayhorn, G

2000-04-01

To determine whether students' performances in a pre-admission program predicted whether participants would (1) apply to medical school, (2) get accepted, and (3) graduate. Using prospectively collected data from participants in the University of North Carolina at Chapel Hill's Medical Education Development Program (MEDP) and data from the Association of American Colleges Student and Applicant Information Management System, the author identified 371 underrepresented minority (URM) students who were full-time participants and completed the program between 1984 and 1989, prior to their acceptance into medical school. Logistic regression analysis was used to determine whether MEDP performance significantly predicted (after statistically controlling for traditional predictors of these outcomes) the proportions of URM participants who applied to medical school and were accepted, the timeliness of graduating, and the proportion graduating. Odds ratios with 95% confidence intervals were calculated to determine the associations between the independent and outcome variables. In separate logistic regression models, MEDP performance predicted the study's outcomes after statistically controlling for traditional predictors with 95% confidence intervals. Pre-admission programs with similar outcomes can improve the diversity of the physician workforce and the access to health care for underrepresented minority and economically disadvantaged populations.

Incentives, Program Configuration, and Employee Uptake of Workplace Wellness Programs.

PubMed

Huang, Haijing; Mattke, Soeren; Batorsky, Benajmin; Miles, Jeremy; Liu, Hangsheng; Taylor, Erin

2016-01-01

The aim of this study was to determine the effect of wellness program configurations and financial incentives on employee participation rate. We analyze a nationally representative survey on workplace wellness programs from 407 employers using cluster analysis and multivariable regression analysis. Employers who offer incentives and provide a comprehensive set of program offerings have higher participation rates. The effect of incentives differs by program configuration, with the strongest effect found for comprehensive and prevention-focused programs. Among intervention-focused programs, incentives are not associated with higher participation. Wellness programs can be grouped into distinct configurations, which have different workplace health focuses. Although monetary incentives can be effective in improving employee participation, the magnitude and significance of the effect is greater for some program configurations than others.

Factors associated with the implementation of programs for drug abuse prevention in schools

PubMed Central

Pereira, Ana Paula Dias; Paes, Ângela Tavares; Sanchez, Zila M

2016-01-01

ABSTRACT OBJECTIVE To analyze if characteristics of managers, schools, and curriculum are associated with the implementation of programs for drug abuse prevention in elementary and high schools. METHODS Cross-sectional study, with random sample of 263 school managers. Data were collected between 2012 and 2013 by a program that sends forms via internet. A closed self-filling questionnaire was applied online. Statistical analysis included Chi-square tests and logistic regression models. The outcome variable was the presence of program for drug abuse prevention inserted in the daily life and educational program of the school. The explanatory variables were divided into: demographic data of the manager; characteristics of the school and of the curriculum; health education; and drug use in the school. RESULTS We found that 42.5% (95%CI 36.1–49.1) of the evaluated schools had programs for drug abuse prevention. With the multiple logistic regression model, we observed that the more time the manager has worked with education, the chance of the school having a program increased at about 4.0%. Experimenting with innovative teaching techniques also increased at about six times the chance of the school developing a program for drug abuse prevention. The difficulties in the implementation of the programs were more present in state and municipal schools, when compared with private schools, due to, for instance: lack of teaching materials, lack of money, and competing demands for teaching other subjects. CONCLUSIONS The implementation of programs for drug abuse prevention in the city of Sao Paulo is associated with the experience of the manager in education and with the teaching strategies of the school. PMID:27509010

Asthma disease management: regression to the mean or better?

PubMed

Tinkelman, David; Wilson, Steve

2004-12-01

To assess the effectiveness of disease management as an adjunct to treatment for chronic illnesses, such as asthma, and to evaluate whether the statistical phenomenon of regression to the mean is responsible for many of the benefits commonly attributed to disease management. This study evaluated an asthma disease management intervention in a Colorado population covered by Medicaid. The outcomes are presented with the intervention group serving as its own control (baseline and postintervention measurements) and are compared with a matched control group during the same periods. In the intervention group, 388 asthmatics entered and 258 completed the 6-month program; 446 subjects participated in the control group. Facilities charges were compared for both groups during the baseline and program periods. Both groups were well matched demographically and for costs at baseline. Using the intervention group as its own control revealed a 49.1% savings. The control group savings were 30.7%. Therefore, the net savings were 18.4% (P < .001) for the intervention group vs controls. Although the demonstrated savings were less using a control group to correct for regression to the mean, they were statistically significant and clinically relevant. When using a control group to control for the statistical effects of regression to the mean, a disease management intervention for asthma in a population covered by Medicaid is effective in reducing healthcare costs.

Community-Based Juvenile Reentry Services: The Effects of Service Dosage on Juvenile and Adult Recidivism

ERIC Educational Resources Information Center

Abrams, Laura S.; Terry, Diane; Franke, Todd M.

2011-01-01

In this study the authors examined the influence of length of participation in a community-based reentry program on the odds of reconviction in the juvenile and adult criminal justice systems. A structured telephone survey of reentry program alumni was conducted with 75 transition-age (18-25 year-old) young men. Binary logistic regression analysis…

Factors That Contribute to the Completion of Programs of Study at Arkansas Institutions of Higher Education for African American Males

ERIC Educational Resources Information Center

Petty, Barrett Wade McCoy

2015-01-01

The study examined factors that predicted the completion of programs of study at Arkansas institutions of higher education for African American males. Astin's (1993a) Input-Environment-Output (I-E-O) Model was used as the theoretical foundation. Descriptive analyses and hierarchical logistic regression analyses were performed on the data. The…

Using Neural Network and Logistic Regression Analysis to Predict Prospective Mathematics Teachers' Academic Success upon Entering Graduate Education

ERIC Educational Resources Information Center

Bahadir, Elif

2016-01-01

The ability to predict the success of students when they enter a graduate program is critical for educational institutions because it allows them to develop strategic programs that will help improve students' performances during their stay at an institution. In this study, we present the results of an experimental comparison study of Logistic…

Statistical Package User’s Guide.

DTIC Science & Technology

1980-08-01

261 C. STACH Nonparametric Descriptive Statistics ... ......... ... 265 D. CHIRA Coefficient of Concordance...135 I.- -a - - W 7- Test Data: This program was tested using data from John Neter and William Wasserman, Applied Linear Statistical Models: Regression...length of data file e. new fileý name (not same as raw data file) 5. Printout as optioned for only. Comments: Ranked data are used for program CHIRA

Farmers' Participation in Extension Programs and Technology Adoption in Rural Nepal: A Logistic Regression Analysis

ERIC Educational Resources Information Center

Suvedi, Murari; Ghimire, Raju; Kaplowitz, Michael

2017-01-01

Purpose: This paper examines the factors affecting farmers' participation in extension programs and adoption of improved seed varieties in the hills of rural Nepal. Methodology/approach: Cross-sectional farm-level data were collected during July and August 2014. A sample of 198 farm households was selected for interviewing by using a multistage,…

An Examination on the Effect of Prior Knowledge, Personal Goals, and Incentive in an Online Employee Training Program

ERIC Educational Resources Information Center

Zha, Shenghua; Adams, Andrea Harpine; Calcagno-Roach, Jamie Marie; Stringham, David A.

2017-01-01

This study explored factors that predicted learners' transformative learning in an online employee training program in a higher education institution in the U.S. A multivariate multiple regression analysis was conducted with a sample of 74 adult learners on their learning of a new learning management system. Four types of participants' behaviors…

Parental Empowerment in Mexico: Randomized Experiment of the "Apoyos a La Gestion Escolar (Age)" Program in Rural Primary Schools in Mexico

ERIC Educational Resources Information Center

Gertler, Paul; Patrinos, Harry Anthony; Rodriguez-Oreggia, Eduardo

2012-01-01

Previous evaluations from Mexico are limited. The urban school-based management program, Programa Escuelas de Calidad (PEC), was analyzed using panel data regression analysis and propensity score matching. Participation in PEC is found to lead to decreases in dropout, failure and repetition rates. An evaluation of the rural parental empowerment…

JROTC as a Substitute for PE: Really?

PubMed Central

Lounsbery, Monica A. F.; Holt, Kathryn A.; Monnat, Shannon A.; McKenzie, Thomas L.; Funk, Brian

2014-01-01

Purpose Even though physical education (PE) is an evidence-based strategy for providing and promoting physical activity, alternative programs such as Junior Reserve Officer Training Corps (JROTC) are commonly substituted for PE in many states. The purpose of this study was to compare student physical activity and lesson contexts during high school PE and JROTC sessions. Method SOFIT (System for Observing Fitness Instruction Time) was used to assess PE and JROTC sessions (N=38 each) in 4 high schools that provided both programs. Data were analyzed using t-tests, negative binomial regression, and logistic regression. Results Students engaged in significantly more moderate to vigorous physical activity during PE than JROTC sessions and they were significantly less sedentary. Significant differences between the two program types were also found among lesson contexts. Conclusions PE and JROTC provide substantially different content and contexts and students in them engage in substantially different amounts of moderate to vigorous physical activity. Students in JROTC, and perhaps other alternative programs, are less likely to accrue health-supporting physical activity and engage in fewer opportunities to be physically fit and motorically skilled. Policies and practices for providing substitutions for PE should be carefully examined. PMID:25141093

Users manual for flight control design programs

NASA Technical Reports Server (NTRS)

Nalbandian, J. Y.

1975-01-01

Computer programs for the design of analog and digital flight control systems are documented. The program DIGADAPT uses linear-quadratic-gaussian synthesis algorithms in the design of command response controllers and state estimators, and it applies covariance propagation analysis to the selection of sampling intervals for digital systems. Program SCHED executes correlation and regression analyses for the development of gain and trim schedules to be used in open-loop explicit-adaptive control laws. A linear-time-varying simulation of aircraft motions is provided by the program TVHIS, which includes guidance and control logic, as well as models for control actuator dynamics. The programs are coded in FORTRAN and are compiled and executed on both IBM and CDC computers.

Simple linear and multivariate regression models.

PubMed

Rodríguez del Águila, M M; Benítez-Parejo, N

2011-01-01

In biomedical research it is common to find problems in which we wish to relate a response variable to one or more variables capable of describing the behaviour of the former variable by means of mathematical models. Regression techniques are used to this effect, in which an equation is determined relating the two variables. While such equations can have different forms, linear equations are the most widely used form and are easy to interpret. The present article describes simple and multiple linear regression models, how they are calculated, and how their applicability assumptions are checked. Illustrative examples are provided, based on the use of the freely accessible R program. Copyright © 2011 SEICAP. Published by Elsevier Espana. All rights reserved.

Educational intervention on physical restraint use in long-term care facilities - Systematic review and meta-analysis.

PubMed

Lan, Shao-Huan; Lu, Li-Chin; Lan, Shou-Jen; Chen, Jong-Chen; Wu, Wen-Jun; Chang, Shen-Peng; Lin, Long-Yau

2017-08-01

"Physical restraint" formerly used as a measure of protection for psychiatric patients is now widely used. However, existing studies showed that physical restraint not only has inadequate effect of protection but also has negative effects on residents. To analyzes the impact of educational program on the physical restraint use in long-term care facilities. A systematic review with meta-analysis and meta-regression. Eight databases, including Cochrane Library, ProQuest, PubMed, EMBASE, EBSCO, Web of Science, Ovid Medline and Physiotherapy Evidence Database (PEDro), were searched up to January 2017. Eligible studies were classified by intervention and accessed for quality using the Quality Assessment Tool for quantitative studies. Sixteen research articles were eligible in the final review; 10 randomize control trail studies were included in the analysis. The meta-analysis revealed that the use of physical restraint was significantly less often in the experimental (education) group (OR = 0.55, 95% CI: 0.39 to 0.78, p < 0.001) compared to the control group. Meta-regression revealed the period of post education would have decreased the effect of the restraint educational program (β: 0.08, p = 0.002); instead, the longer education period and more times of education would have a stronger effect of reducing the use of physical restraint (β: -0.07, p < 0.001; β: -0.04, p = 0.056). The educational program had an effect on the reduced use of physical restraint. The results of meta-regression suggest that long-term care facilities should provide a continuous education program of physical restraint for caregivers. Copyright © 2017. Published by Elsevier Taiwan.

Evaluation of Visual Field Progression in Glaucoma: Quasar Regression Program and Event Analysis.

PubMed

Díaz-Alemán, Valentín T; González-Hernández, Marta; Perera-Sanz, Daniel; Armas-Domínguez, Karintia

2016-01-01

To determine the sensitivity, specificity and agreement between the Quasar program, glaucoma progression analysis (GPA II) event analysis and expert opinion in the detection of glaucomatous progression. The Quasar program is based on linear regression analysis of both mean defect (MD) and pattern standard deviation (PSD). Each series of visual fields was evaluated by three methods; Quasar, GPA II and four experts. The sensitivity, specificity and agreement (kappa) for each method was calculated, using expert opinion as the reference standard. The study included 439 SITA Standard visual fields of 56 eyes of 42 patients, with a mean of 7.8 ± 0.8 visual fields per eye. When suspected cases of progression were considered stable, sensitivity and specificity of Quasar, GPA II and the experts were 86.6% and 70.7%, 26.6% and 95.1%, and 86.6% and 92.6% respectively. When suspected cases of progression were considered as progressing, sensitivity and specificity of Quasar, GPA II and the experts were 79.1% and 81.2%, 45.8% and 90.6%, and 85.4% and 90.6% respectively. The agreement between Quasar and GPA II when suspected cases were considered stable or progressing was 0.03 and 0.28 respectively. The degree of agreement between Quasar and the experts when suspected cases were considered stable or progressing was 0.472 and 0.507. The degree of agreement between GPA II and the experts when suspected cases were considered stable or progressing was 0.262 and 0.342. The combination of MD and PSD regression analysis in the Quasar program showed better agreement with the experts and higher sensitivity than GPA II.

Identifying Strategies Programs Adopt to Meet Healthy Eating and Physical Activity Standards in Afterschool Programs.

PubMed

Weaver, Robert G; Moore, Justin B; Turner-McGrievy, Brie; Saunders, Ruth; Beighle, Aaron; Khan, M Mahmud; Chandler, Jessica; Brazendale, Keith; Randell, Allison; Webster, Collin; Beets, Michael W

2017-08-01

The YMCA of USA has adopted Healthy Eating and Physical Activity (HEPA) Standards for its afterschool programs (ASPs). Little is known about strategies YMCA ASPs are implementing to achieve Standards and these strategies' effectiveness. (1) Identify strategies implemented in YMCA ASPs and (2) evaluate the relationship between strategy implementation and meeting Standards. HEPA was measured via accelerometer (moderate-to-vigorous-physical-activity [MVPA]) and direct observation (snacks served) in 20 ASPs. Strategies were identified and mapped onto a capacity building framework ( Strategies To Enhance Practice [STEPs]). Mixed-effects regression estimated increases in HEPA outcomes as implementation increased. Model-implied estimates were calculated for high (i.e., highest implementation score achieved), moderate (median implementation score across programs), and low (lowest implementation score achieved) implementation for both HEPA separately. Programs implemented a variety of strategies identified in STEPs. For every 1-point increase in implementation score 1.45% (95% confidence interval = 0.33% to 2.55%, p ≤ .001) more girls accumulated 30 min/day of MVPA and fruits and/or vegetables were served on 0.11 more days (95% confidence interval = 0.11-0.45, p ≤ .01). Relationships between implementation and other HEPA outcomes did not reach statistical significance. Still regression estimates indicated that desserts are served on 1.94 fewer days (i.e., 0.40 vs. 2.34) in the highest implementing program than the lowest implementing program and water is served 0.73 more days (i.e., 2.37 vs. 1.64). Adopting HEPA Standards at the national level does not lead to changes in routine practice in all programs. Practical strategies that programs could adopt to more fully comply with the HEPA Standards are identified.