An investigation of pertussis cases in a Texas county from 2008 through 2012

Background: Once thought to be eradicated, pertussis is now making a steady comeback throughout Texas and the United States. Pertussis can have an effect on all demographics, but infants have the greatest health concern as they suffer the highest case-fatality rate. The objective of this study was to create and report a comprehensive summary of confirmed or probable pertussis cases in a Texas County during the 2008 through 2012 time period.^ Methods: A cross-sectional study design was used to show at risk populations in a Texas county using descriptive statistics of data from probable and confirmed pertussis cases in this Texas County from 2008-2012. Data was collected during routine pertussis investigations conducted by the local health department of this Texas County.^ Results: There was a sharp increase in pertussis cases seen in this county in 2012. Hispanics made up the majority of cases (74.9%) as compared to 12.8% of cases among Whites, 3.1% of cases among Blacks and 9.2% of cases among unknown/other. The population of Hispanics within this county was 58.9%. Almost a quarter of cases (24.2%) in this study were hospitalized. There was no difference identified in the proportion of male sources of exposure (48.9%) as compared to female (51.1%). Household contacts were the main sources of exposure: siblings (29.2%), fathers (14.5%), children (14.6%), and mothers (12.5%).^ Conclusion: Prevention intervention needs to be designed to target vulnerable populations and reduce the effect of this sometimes fatal disease. These results show pertussis proportionally has a greater effect on Hispanics. Additional research needs to be conducted on risk factors such as household crowding and immunization status among Hispanics to identify if ethnicity plays a role in risk of transmission of pertussis. The results were limited due to the large amount of missing data in vaccination history and identification of source of exposure.^

Geochemistry of interstitial waters from ODP Leg 115 sites

As a part of the shipboard scientific program, interstitial waters were routinely analyzed for pH, alkalinity, salinity, chlorinity, calcium, and magnesium during Leg 116. Unfortunately, the tables containing these data for Sites 718 and 719 were inadvertently omitted from the Initial Results volume (Cochran, Stow et al., 1989, doi:10.2973/odp.proc.ir.116.1989). The missing data are presented here (Tables 1-3) along with the Site 717 data, reproduced for completeness.

Aerodynamic database reconstruction via gappy high order singular value decomposition

Esta Tesis se centra en el desarrollo de un método para la reconstrucción de bases de datos experimentales incompletas de más de dos dimensiones. Como idea general, consiste en la aplicación iterativa de la descomposición en valores singulares de alto orden sobre la base de datos incompleta. Este nuevo método se inspira en el que ha servido de base para la reconstrucción de huecos en bases de datos bidimensionales inventado por Everson y Sirovich (1995) que a su vez, ha sido mejorado por Beckers y Rixen (2003) y simultáneamente por Venturi y Karniadakis (2004). Además, se ha previsto la adaptación de este nuevo método para tratar el posible ruido característico de bases de datos experimentales y a su vez, bases de datos estructuradas cuya información no forma un hiperrectángulo perfecto. Se usará una base de datos tridimensional de muestra como modelo, obtenida a través de una función transcendental, para calibrar e ilustrar el método. A continuación se detalla un exhaustivo estudio del funcionamiento del método y sus variantes para distintas bases de datos aerodinámicas. En concreto, se usarán tres bases de datos tridimensionales que contienen la distribución de presiones sobre un ala. Una se ha generado a través de un método semi-analítico con la intención de estudiar distintos tipos de discretizaciones espaciales. El resto resultan de dos modelos numéricos calculados en C F D . Por último, el método se aplica a una base de datos experimental de más de tres dimensiones que contiene la medida de fuerzas de una configuración ala de Prandtl obtenida de una campaña de ensayos en túnel de viento, donde se estudiaba un amplio espacio de parámetros geométricos de la configuración que como resultado ha generado una base de datos donde la información está dispersa. ABSTRACT A method based on an iterative application of high order singular value decomposition is derived for the reconstruction of missing data in multidimensional databases. The method is inspired by a seminal gappy reconstruction method for two-dimensional databases invented by Everson and Sirovich (1995) and improved by Beckers and Rixen (2003) and Venturi and Karniadakis (2004). In addition, the method is adapted to treat both noisy and structured-but-nonrectangular databases. The method is calibrated and illustrated using a three-dimensional toy model database that is obtained by discretizing a transcendental function. The performance of the method is tested on three aerodynamic databases for the flow past a wing, one obtained by a semi-analytical method, and two resulting from computational fluid dynamics. The method is finally applied to an experimental database consisting in a non-exhaustive parameter space measurement of forces for a box-wing configuration.

Imputação de dados em experimentos multiambientais: novos algoritmos utilizando a decomposição por valores singulares

As análises biplot que utilizam os modelos de efeitos principais aditivos com inter- ação multiplicativa (AMMI) requerem matrizes de dados completas, mas, frequentemente os ensaios multiambientais apresentam dados faltantes. Nesta tese são propostas novas metodologias de imputação simples e múltipla que podem ser usadas para analisar da- dos desbalanceados em experimentos com interação genótipo por ambiente (G×E). A primeira, é uma nova extensão do método de validação cruzada por autovetor (Bro et al, 2008). A segunda, corresponde a um novo algoritmo não-paramétrico obtido por meio de modificações no método de imputação simples desenvolvido por Yan (2013). Também é incluído um estudo que considera sistemas de imputação recentemente relatados na literatura e os compara com o procedimento clássico recomendado para imputação em ensaios (G×E), ou seja, a combinação do algoritmo de Esperança-Maximização com os modelos AMMI ou EM-AMMI. Por último, são fornecidas generalizações da imputação simples descrita por Arciniegas-Alarcón et al. (2010) que mistura regressão com aproximação de posto inferior de uma matriz. Todas as metodologias têm como base a decomposição por valores singulares (DVS), portanto, são livres de pressuposições distribucionais ou estruturais. Para determinar o desempenho dos novos esquemas de imputação foram realizadas simulações baseadas em conjuntos de dados reais de diferentes espécies, com valores re- tirados aleatoriamente em diferentes porcentagens e a qualidade das imputações avaliada com distintas estatísticas. Concluiu-se que a DVS constitui uma ferramenta útil e flexível na construção de técnicas eficientes que contornem o problema de perda de informação em matrizes experimentais.

Limitaciones y recomendaciones metodológicas en las publicaciones sobre salud de la población inmigrante en España

El objetivo es describir las limitaciones y las recomendaciones metodológicas identificadas por los autores de artículos originales sobre inmigración y salud en España. Se realizó una revisión bibliográfica de artículos originales publicados en español e inglés entre 1998 y 2012, combinando descriptores de inmigración y salud. Se incluyeron 311 artículos; de ellos, 176 (56,6%) mencionaban limitaciones y 15 (4,8%) emitían recomendaciones. Entre las limitaciones más mencionadas destacan el reducido tamaño de las muestras, problemas de validez interna y representatividad de la muestra con infrarrepresentación o sobrerrepresentación de determinados grupos, problemas de validez de la información recogida y datos faltantes relacionados sobre todo con los instrumentos de medición, y ausencia de variables clave de ajuste o estratificación. En función de los resultados obtenidos, se proponen una serie de recomendaciones para minimizar las limitaciones habituales y avanzar en la calidad de los trabajos científicos sobre inmigración y salud en nuestro ámbito.

Eficiência do metotrexato na artrite psoriática

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Risk of Cerebral Venous Thrombosis in Obese Women.

IMPORTANCE Obesity is a risk factor for deep vein thrombosis of the leg and pulmonary embolism. To date, however, whether obesity is associated with adult cerebral venous thrombosis (CVT) has not been assessed. OBJECTIVE To assess whether obesity is a risk factor for CVT. DESIGN, SETTING, AND PARTICIPANTS A case-control study was performed in consecutive adult patients with CVT admitted from July 1, 2006 (Amsterdam), and October 1, 2009 (Berne), through December 31, 2014, to the Academic Medical Center in Amsterdam, the Netherlands, or Inselspital University Hospital in Berne, Switzerland. The control group was composed of individuals from the control population of the Multiple Environmental and Genetic Assessment of Risk Factors for Venous Thrombosis study, which was a large Dutch case-control study performed from March 1, 1999, to September 31, 2004, and in which risk factors for deep vein thrombosis and pulmonary embolism were assessed. Data analysis was performed from January 2 to July 12, 2015. MAIN OUTCOMES AND MEASURES Obesity was determined by body mass index (BMI). A BMI of 30 or greater was considered to indicate obesity, and a BMI of 25 to 29.99 was considered to indicate overweight. A multiple imputation procedure was used for missing data. We adjusted for sex, age, history of cancer, ethnicity, smoking status, and oral contraceptive use. Individuals with normal weight (BMI <25) were the reference category. RESULTS The study included 186 cases and 6134 controls. Cases were younger (median age, 40 vs 48 years), more often female (133 [71.5%] vs 3220 [52.5%]), more often used oral contraceptives (97 [72.9%] vs 758 [23.5%] of women), and more frequently had a history of cancer (17 [9.1%] vs 235 [3.8%]) compared with controls. Obesity (BMI ≥30) was associated with an increased risk of CVT (adjusted odds ratio [OR], 2.63; 95% CI, 1.53-4.54). Stratification by sex revealed a strong association between CVT and obesity in women (adjusted OR, 3.50; 95% CI, 2.00-6.14) but not in men (adjusted OR, 1.16; 95% CI, 0.25-5.30). Further stratification revealed that, in women who used oral contraceptives, overweight and obesity were associated with an increased risk of CVT in a dose-dependent manner (BMI 25.0-29.9: adjusted OR, 11.87; 95% CI, 5.94-23.74; BMI ≥30: adjusted OR, 29.26; 95% CI, 13.47-63.60). No association was found in women who did not use oral contraceptives. CONCLUSIONS AND RELEVANCE Obesity is a strong risk factor for CVT in women who use oral contraceptives.

“Dismissingness always matters”: An examination of tobacco smoking, frequency of visits to healthcare providers, and trust in the provider as potential mediators between attachment style dismissingness and diabetes health status

Thesis (Master's)--University of Washington, 2016-06

Implications of non-response of older women to a short form of the Center for Epidemiologic Studies Depression Scale

The Center for Epidemiologic Studies Depression Scale (CES-D) is frequently used in epidemiological surveys to screen for depression, especially among older adults. This article addresses the problem of non-completion of a short form of the CES-D (CESD-10) in a mailed survey of 73- to 78-year-old women enrolled in the Australian Longitudinal Study on Women's Health. Completers of the CESD-10 had more education, found it easier to manage on available income and reported better physical and mental health. The Medical Outcomes Study Short Form Health Survey (SF-36) scores for non-completers were intermediate between those for women classified as depressed and not depressed using the CESD-10. Indicators of depression had an inverted U-shaped relationship with the number of missing CESD- 10 items and were most frequent for women with two to seven items missing. Future research should pay particular attention to the level of missing data in depression scales and report its potential impact on estimates of depression.

Analysis of Melanoma Onset: Assessing Familial Aggregation by Using Estimating Equations and Fitting Variance Components via Bayesian Random Effects Models

We investigate whether relative contributions of genetic and shared environmental factors are associated with an increased risk in melanoma. Data from the Queensland Familial Melanoma Project comprising 15,907 subjects arising from 1912 families were analyzed to estimate the additive genetic, common and unique environmental contributions to variation in the age at onset of melanoma. Two complementary approaches for analyzing correlated time-to-onset family data were considered: the generalized estimating equations (GEE) method in which one can estimate relationship-specific dependence simultaneously with regression coefficients that describe the average population response to changing covariates; and a subject-specific Bayesian mixed model in which heterogeneity in regression parameters is explicitly modeled and the different components of variation may be estimated directly. The proportional hazards and Weibull models were utilized, as both produce natural frameworks for estimating relative risks while adjusting for simultaneous effects of other covariates. A simple Markov Chain Monte Carlo method for covariate imputation of missing data was used and the actual implementation of the Bayesian model was based on Gibbs sampling using the free ware package BUGS. In addition, we also used a Bayesian model to investigate the relative contribution of genetic and environmental effects on the expression of naevi and freckles, which are known risk factors for melanoma.

Protocols for listing threatened species can forecast extinction

Risk-ranking protocols are used widely to classify the conservation status of the world's species. Here we report on the first empirical assessment of their reliability by using a retrospective study of 18 pairs of bird and mammal species (one species extinct and the other extant) with eight different assessors. The performance of individual assessors varied substantially, but performance was improved by incorporating uncertainty in parameter estimates and consensus among the assessors. When this was done, the ranks from the protocols were consistent with the extinction outcome in 70-80% of pairs and there were mismatches in only 10-20% of cases. This performance was similar to the subjective judgements of the assessors after they had estimated the range and population parameters required by the protocols, and better than any single parameter. When used to inform subjective judgement, the protocols therefore offer a means of reducing unpredictable biases that may be associated with expert input and have the advantage of making the logic behind assessments explicit. We conclude that the protocols are useful for forecasting extinctions, although they are prone to some errors that have implications for conservation. Some level of error is to be expected, however, given the influence of chance on extinction. The performance of risk assessment protocols may be improved by providing training in the application of the protocols, incorporating uncertainty in parameter estimates and using consensus among multiple assessors, including some who are experts in the application of the protocols. Continued testing and refinement of the protocols may help to provide better absolute estimates of risk, particularly by re-evaluating how the protocols accommodate missing data.

Multiple imputation for body mass index: lessons from the Australian Longitudinal Study on Women's Health

In large epidemiological studies missing data can be a problem, especially if information is sought on a sensitive topic or when a composite measure is calculated from several variables each affected by missing values. Multiple imputation is the method of choice for 'filling in' missing data based on associations among variables. Using an example about body mass index from the Australian Longitudinal Study on Women's Health, we identify a subset of variables that are particularly useful for imputing values for the target variables. Then we illustrate two uses of multiple imputation. The first is to examine and correct for bias when data are not missing completely at random. The second is to impute missing values for an important covariate; in this case omission from the imputation process of variables to be used in the analysis may introduce bias. We conclude with several recommendations for handling issues of missing data. Copyright (C) 2004 John Wiley Sons, Ltd.

Comparability of skin screening histories obtained by telephone interviews and mailed questionnaires: A randomized crossover study

The comparability of information collected through telephone interviews and information collected through mailed questionnaires has not been well studied. As part of the first phase of a randomized controlled trial of population screening for melanoma in Queensland, Australia, the authors compared histories of skin examination reported in telephone interviews and self-administered mailed questionnaires. A total of 1,270 subjects each completed a telephone interview and a mailed questionnaire 1 month apart in 1999; 564 subjects received the interview first, and 706 received the mailed questionnaire first. Agreement between the two methods was 91.2% and 88.6% for whole-body skin examination by a physician in the last 12 months and the last 3 years, respectively, and 81.9% for whole-body skin self-examination in the last 12 months. Agreement was lower for any skin self-examination. Agreement between the two methods was similar regardless of whether the interview or the questionnaire was administered first. Missing data were less frequent for interviews (0.5%) than for mailed questionnaires (3.8%). Costs were estimated at A$9.55 (US$6.21) per completed interview and A$3.01 (US$1.96) per questionnaire. The similarity of results obtained using telephone interviews and mailed questionnaires, coupled with the substantially higher cost of telephone interviews, suggests that self-administered mailed questionnaires are an appropriate method of assessing this health behavior.

Using patients' and rheumatologists' opinions to specify a short form of the WOMAC function subscale

Background: The WOMAC ( Western Ontario and McMaster Universities) function subscale is widely used in clinical trials of hip and knee osteoarthritis. Reducing the number of items of the subscale would enhance efficiency and compliance, particularly for use in clinical practice applications. Objective: To develop a short form of the WOMAC function subscale based on patients' and experts' opinions ( WOMAC function short form). Methods: WOMAC function subscale data ( Likert version) were obtained from 1218 outpatients with painful hip or knee osteoarthritis. These patients and their rheumatologists selected the five items that they considered most in need of improvement. The rheumatologists were asked to select the five items for which patients in general are the most impaired. Items that were least important to patients and experts, those with a high proportion of missing data, and those with a response distribution showing a floor or ceiling response were excluded, along with one of a pair of items with a correlation coefficient >0.75. Results: The WOMAC function short form included items 1, 2, 3, 6, 7, 8, 9, and 15 of the long form. The short form did not differ substantially from the long form in responsiveness ( standardised response mean of 0.84 v 0.80). Conclusions: A short form of the WOMAC function subscale was developed according to the views of patients and rheumatologists, based on the responses of 1218 patients and 399 rheumatologists. The clinical relevance and applicability of this WOMAC function subscale short form require further evaluation.

Differences in mail and telephone responses to self-rated health: use of multiple imputation in correcting for response bias

Objectives: To estimate differences in self-rated health by mode of administration and to assess the value of multiple imputation to make self-rated health comparable for telephone and mail. Methods: In 1996, Survey 1 of the Australian Longitudinal Study on Women's Health was answered by mail. In 1998, 706 and 11,595 mid-age women answered Survey 2 by telephone and mail respectively. Self-rated health was measured by the physical and mental health scores of the SF-36. Mean change in SF-36 scores between Surveys 1 and 2 were compared for telephone and mail respondents to Survey 2, before and after adjustment for socio-demographic and health characteristics. Missing values and SF-36 scores for telephone respondents at Survey 2 were imputed from SF-36 mail responses and telephone and mail responses to socio-demographic and health questions. Results: At Survey 2, self-rated health improved for telephone respondents but not mail respondents. After adjustment, mean changes in physical health and mental health scores remained higher (0.4 and 1.6 respectively) for telephone respondents compared with mail respondents (-1.2 and 0.1 respectively). Multiple imputation yielded adjusted changes in SF-36 scores that were similar for telephone and mail respondents. Conclusions and Implications: The effect of mode of administration on the change in mental health is important given that a difference of two points in SF-36 scores is accepted as clinically meaningful. Health evaluators should be aware of and adjust for the effects of mode of administration on self-rated health. Multiple imputation is one method that may be used to adjust SF-36 scores for mode of administration bias.