Access to Better Education: The School Choice Experience of Families Served by Low-Performing Elementary Public Schools in Miami-Dade County

Public school choice education policy attempts to create an education marketplace. Although school choice research has focused on the parent role in the school choice process, little is known about parents served by low-performing schools. Following market theory, students attending low-performing schools should be the primary students attempting to use school choice policy to access high performing schools rather than moving to a better school. However, students remain in these low-performing schools. This study took place in Miami-Dade County, which offers a wide variety of school choice options through charter schools, magnet schools, and open-choice schools. This dissertation utilized a mixed-methods design to examine the decision-making process and school choice options utilized by the parents of students served by low-performing elementary schools in Miami-Dade County. Twenty-two semi-structured interviews were conducted with the parents of students served by low-performing schools. Binary logistic regression models were fitted to the data to compare the demographic characteristics, academic achievement and distance from alternative schooling options between transfers and non-transfers. Multinomial logistic regression models were fitted to the data to evaluate how demographic characteristics, distance to transfer school, and transfer school grade influenced the type of school a transfer student chose. A geographic analysis was conducted to determine how many miles students lived from alternative schooling options and the miles transfer students lived away from their transfer school. The findings of the interview data illustrated that parents’ perceived needs are not being adequately addressed by state policy and county programs. The statistical analysis found that students from higher socioeconomic social groups were not more likely to transfer than students from lower socioeconomic social groups. Additionally, students who did transfer were not likely to end up at a high achieving school. The findings of the binary logistic regression demonstrated that transfer students were significantly more likely to live near alternative school options.

Genome-wide association study reveals greater polygenic loading for schizophrenia in cases with a family history of illness

Genome-wide association studies (GWAS) of schizophrenia have yielded more than 100 common susceptibility variants, and strongly support a substantial polygenic contribution of a large number of small allelic effects. It has been hypothesized that familial schizophrenia is largely a consequence of inherited rather than environmental factors. We investigated the extent to which familiality of schizophrenia is associated with enrichment for common risk variants detectable in a large GWAS. We analyzed single nucleotide polymorphism (SNP) data for cases reporting a family history of psychotic illness (N = 978), cases reporting no such family history (N = 4,503), and unscreened controls (N = 8,285) from the Psychiatric Genomics Consortium (PGC1) study of schizophrenia. We used a multinomial logistic regression approach with model-fitting to detect allelic effects specific to either family history subgroup. We also considered a polygenic model, in which we tested whether family history positive subjects carried more schizophrenia risk alleles than family history negative subjects, on average. Several individual SNPs attained suggestive but not genome-wide significant association with either family history subgroup. Comparison of genome-wide polygenic risk scores based on GWAS summary statistics indicated a significant enrichment for SNP effects among family history positive compared to family history negative cases (Nagelkerke's R(2 ) = 0.0021; P = 0.00331; P-value threshold <0.4). Estimates of variability in disease liability attributable to the aggregate effect of genome-wide SNPs were significantly greater for family history positive compared to family history negative cases (0.32 and 0.22, respectively; P = 0.031). We found suggestive evidence of allelic effects detectable in large GWAS of schizophrenia that might be specific to particular family history subgroups. However, consideration of a polygenic risk score indicated a significant enrichment among family history positive cases for common allelic effects. Familial illness might, therefore, represent a more heritable form of schizophrenia, as suggested by previous epidemiological studies.

Mapeamento projetivo, associação de palavras e escala hedônica como instrumentos de avaliação da percepção de produtos de pescado por crianças da rede pública de ensino

Brazil is a country that is characterized by its low consumption of fish. With consumption records of 10.6 kg/ inhabitant/ year, it is lower than the recommended by the UN, that is 12 kg/ inhabitant/ year. The regular consumption of fish provides health gain for people and their introduction into the school feeding is an important strategy for the insertion of this food consumption habits in a population. In this context, the objective of this study was to understand the perception of fish with children from the public school system through the technical Projective Mapping (MP) and Association of Words (AP); and evaluate the acceptability of fish derivative in school meals. In the first instance with the intention to better understand the perception of children from different ages about the fish-based products, Projective Mapping techniques were applied through the use of food figures and word association. A total of 149 children from three public schools from Pato Branco, Paraná State, Brazil, took part in this study. Three groups of children aged 5-6, 7-8 and 9-10 years old were interviewed individually by six monitors experienced in applied sensory methods. Ten figures with healthy foods drawings (sushi, salad, fruit, fish, chicken), and less healthy foods (pizza, pudding, cake, hamburger, fries) were distributed to the children, who were asked to paste the figures in A3 sheet, so that the products they considered similar stayed near each other, and the ones considered very different stayed apart. After this, the children described the images and the image groups (Ultra Flash Profile). The results revealed that the MP technique was easily operated and understood by all the children and the use of images made its implementation easier. The results analysis also revealed different perceptions came from children from different ages and hedonic perceptions regarding the fish-based products had a greater weight in the percentage from older children. AP technique proved to be an important tool to understand the perception of fish by children, and strengthened the results previously obtained by the MP. In a second step it was evaluated the acceptance of fish burger (tilapia) in school meals. For this task, the school cooks were trained to prepare the hamburgers. For the evaluation of acceptance, the hedonic scale was used with 5 facial ratings (1 = disliked very much to 5 = liked a lot). Students from both genders, between 5 to 10 years old (n = 142) proved the burgers at lunchtime, representing the protein portion of the meal. The tilapia derivative products shown to be foods with important nutritional value and low calorie value. For the application of the multinomial logistic regression analysis there was no significant effect from the age and gender variation in the acceptance by children. However, statistical significance was determined in the interaction between these two variables. With 87 % acceptance rate there was potential for consumption of fish burgers in school meals.

Incidence of Chronic and Other Knee Pain in Relation to Occupational Risk Factors in a Large Working Population.

International audience

Factors Influencing Children’s Full Immunization in Ethiopia

Child morbidity and mortality in Ethiopia is mainly due to vaccine preventable diseases. Although numerous interventions have been made since the 1980’s to increase vaccination coverage, the level of full immunization is low in the country. This study examines factors influencing children’s full immunization based on data on 1927 children aged 12-23 months extracted from the 2011 Ethiopian Demographic and Health Survey. Multinomial logistic regression model was fitted to identify predictors of full immunization. The result shows that only 24.3% of the children were fully immunized. There was significant difference between regions in immunization coverage in which Tigray, Dire Dawa, and Addis Ababa performed well. In Oromia, Afar, Somali, Benishangul-Gumuz, and Gambela regions, the likelihood of children’s full immunization was significantly lower. Children born to mothers living in households with better socio-economic status, with frequent access to media, and who visit health facilities for antenatal care were more likely to be fully immunized. The results imply the importance of narrowing regional differences, improving women’s socio-economic status and utilization of antenatal care services, and strengthening culture-sensitive media campaign as a means of achieving full immunization of all children

Work stress, smoking status and smoking intensity: an observational study of 46 190 employees

Study objective: To examine the relationship between work stress, as indicated by the job strain model and the effort-reward imbalance model, and smoking. Setting: Ten municipalities and 21 hospitals in Finland. Design and Participants: Binary logistic regression models for the prevalence of smoking were related to survey responses of 37 309 female and 8881 male Finnish public sector employees aged 17-65. Separate multinomial logistic regression models were calculated for smoking intensity for 8130 smokers. In addition, binary logistic regression models for ex-smoking were fitted among 16 277 former and current smokers. In all analyses, adjustments were made for age, basic education, occupational status, type of employment and marital status. Main results: Respondents with high effort-reward imbalance or lower rewards were more likely to be smokers. Among smokers, an increased likelihood of higher intensity of smoking was associated with higher job strain and higher effort-reward imbalance and their components such as low job control and low rewards. Smoking intensity was also higher in active jobs in women, in passive jobs and among employees with low effort expenditure. Among former and current smokers, high job strain, high effort-reward imbalance and high job demands were associated with a higher likelihood of being a current smoker. Lower effort was associated with a higher likelihood of ex-smoking. Conclusions: This evidence suggests an association between work stress and smoking and implies that smoking cessation programs may benefit from the taking into account the modification of stressful features of work environment. Key words: effort-reward imbalance; job strain; smoking. Abbreviations: OR, odds ratio; CI, confidence interval; SES, socioeconomic status

Effort-reward imbalance at work and the co-occurrence of lifestyle risk factors: cross-sectional survey in a sample of 36,127 public sector employees

Background In occupational life, a mismatch between high expenditure of effort and receiving few rewards may promote the co-occurrence of lifestyle risk factors, however, there is insufficient evidence to support or refute this hypothesis. The aim of this study is to examine the extent to which the dimensions of the Effort-Reward Imbalance (ERI) model – effort, rewards and ERI – are associated with the co-occurrence of lifestyle risk factors. Methods Based on data from the Finnish Public Sector Study, cross-sectional analyses were performed for 28,894 women and 7233 men. ERI was conceptualized as a ratio of effort and rewards. To control for individual differences in response styles, such as a personal disposition to answer negatively to questionnaires, occupational and organizational -level ecological ERI scores were constructed in addition to individual-level ERI scores. Risk factors included current smoking, heavy drinking, body mass index ≥25 kg/m2, and physical inactivity. Multinomial logistic regression models were used to estimate the likelihood of having one risk factor, two risk factors, and three or four risk factors. The associations between ERI and single risk factors were explored using binary logistic regression models. Results After adjustment for age, socioeconomic position, marital status, and type of job contract, women and men with high ecological ERI were 40% more likely to have simultaneously ≥3 lifestyle risk factors (vs. 0 risk factors) compared with their counterparts with low ERI. When examined separately, both low ecological effort and low ecological rewards were also associated with an elevated prevalence of risk factor co-occurrence. The results obtained with the individual-level scores were in the same direction. The associations of ecological ERI with single risk factors were generally less marked than the associations with the co-occurrence of risk factors. Conclusion This study suggests that a high ratio of occupational efforts relative to rewards may be associated with an elevated risk of having multiple lifestyle risk factors. However, an unexpected association between low effort and a higher likelihood of risk factor co-occurrence as well as the absence of data on overcommitment (and thereby a lack of full test of the ERI model) warrant caution in regard to the extent to which the entire ERI model is supported by our evidence.

Women empowerment and the current use of long acting and permanent contraceptive: Evidence from 2010 Malawi Demographic and Health Survey

Background Both contraceptive use and fertility rates are high fertility in Malawi. Status of women remains low and is believed to affect reproductive health decisions including use of Long Acting and Permanent Contraceptives Method (LAPCM). Objective This study seeks to examine the relationship between women empowerment and LAPCM. A measure of women’s empowerment is derived from the women’s responses to questions on the number of household decisions in which the respondent participates, employment status, type of earnings, women’s control over cash earnings and level of education. Methods The study is based on a sub sample of 5,948 married women from the 2010 Malawi Demographic and Health Survey. Data was analysed using descriptive statistics, Chi-square and multinomial logistic regression models (α=5%). Results The prevalence of current use of LAPCM was 20.0% and increases with increasing empowerment level (p<0.001). Mean age and empowerment score of women who are currently using LAPCM were 38.53±6.2 years and 6.80±2.9 respectively. Urban women (22.2%) were more currently using LAPCM than rural women (19.4%) p<0.001. Women who belong to Seven Day Adventists/Baptist were 1.51(C.I=1.058-2.153; p=0.023) more likely and Muslims were 0.58(C.I=0.410-0.809; p=0.001) less likely to currently use LAPCM than Catholic women. Being in the richest wealth quintile (OR=1.91; C.I=1.362-2.665; p<0.001) promotes current use of LAPCM than poorest. The likelihood of currently using LAPCM was higher among women who have access to FP programmes on media and increases consistently with increasing women empowerment level even when other potential confounding variables were used as control. Conclusion In Malawi, LAPCM is still underutilized and more than half of the women are not adequately empowered. Women empowerment, wealth quintile and access to FP programmes are key factors influencing the use of LAPCM. Programmes that address these determinants are urgently needed in Malawi.

Residuals for log-Burr XII regression models in survival analysis

In this paper, we compare three residuals to assess departures from the error assumptions as well as to detect outlying observations in log-Burr XII regression models with censored observations. These residuals can also be used for the log-logistic regression model, which is a special case of the log-Burr XII regression model. For different parameter settings, sample sizes and censoring percentages, various simulation studies are performed and the empirical distribution of each residual is displayed and compared with the standard normal distribution. These studies suggest that the residual analysis usually performed in normal linear regression models can be straightforwardly extended to the modified martingale-type residual in log-Burr XII regression models with censored data.

Survival and Predictive Factors of Lethality in Hemodyalisis: D/I Polymorphism of The Angiotensin I-Converting Enzyme and of the Angiotensinogen M235T Genes

Background: End-stage kidney disease patients continue to have markedly increased cardiovascular disease morbidity and mortality. Analysis of genetic factors connected with the renin-angiotensin system that influences the survival of the patients with end-stage kidney disease supports the ongoing search for improved outcomes. Objective: To assess survival and its association with the polymorphism of renin-angiotensin system genes: angiotensin I-converting enzyme insertion/deletion and angiotensinogen M235T in patients undergoing hemodialysis. Methods: Our study was designed to examine the role of renin-angiotensin system genes. It was an observational study. We analyzed 473 chronic hemodialysis patients in four dialysis units in the state of Rio de Janeiro. Survival rates were calculated by the Kaplan-Meier method and the differences between the curves were evaluated by Tarone-Ware, Peto-Prentice, and log rank tests. We also used logistic regression analysis and the multinomial model. A p value ≤ 0.05 was considered to be statistically significant. The local medical ethics committee gave their approval to this study. Results: The mean age of patients was 45.8 years old. The overall survival rate was 48% at 11 years. The major causes of death were cardiovascular diseases (34%) and infections (15%). Logistic regression analysis found statistical significance for the following variables: age (p = 0.000038), TT angiotensinogen (p = 0.08261), and family income greater than five times the minimum wage (p = 0.03089), the latter being a protective factor. Conclusions: The survival of hemodialysis patients is likely to be influenced by the TT of the angiotensinogen M235T gene.

Alcohol and nonlethal injuries: a Swiss emergency department study on the risk relationship between acute alcohol consumption and type of injury.

BACKGROUND: Acute alcohol consumption has been reported to be an important risk factor for injury, but clear scientific evidence on issues such as injury type is not available. The present study aims to improve the knowledge of the importance of alcohol consumption as an injury determinant with regards to two dimensions of the type of injury, namely the nature and the body region involved. METHODS: Risk relationships between two injury type components and acute alcohol use were estimated through multinomial and logistic regression models based on data from 7,529 patients-among whom 3,682 had injury diagnoses-gathered in a Swiss emergency department. RESULTS: Depending on the type of injury, between 31.1% and 48.7% of casualties report alcohol use before emergency department attendance. The multinomial regression models show that even low alcohol levels are consistently associated with nearly all natures of injury and body regions. A persistent dose-response effect between alcohol levels and risk associations was observed for almost all injury types. CONCLUSIONS: The results highlight the importance and consistency of the risk association between low and moderate levels of acute alcohol consumption and all types of injury. None of the body regions and natures of injury could pride on absence of association between alcohol and injury. Public health, prevention, and care implications are considered.

Prediction of 18-month survival in patients with primary myelodysplastic syndrome. A regression model and scoring system based on the combination of chromosome findings and the Bournemouth score.

The predictive potential of six selected factors was assessed in 72 patients with primary myelodysplastic syndrome using univariate and multivariate logistic regression analysis of survival at 18 months. Factors were age (above median of 69 years), dysplastic features in the three myeloid bone marrow cell lineages, presence of chromosome defects, all metaphases abnormal, double or complex chromosome defects (C23), and a Bournemouth score of 2, 3, or 4 (B234). In the multivariate approach, B234 and C23 proved to be significantly associated with a reduction in the survival probability. The similarity of the regression coefficients associated with these two factors means that they have about the same weight. Consequently, the model was simplified by counting the number of factors (0, 1, or 2) present in each patient, thus generating a scoring system called the Lausanne-Bournemouth score (LB score). The LB score combines the well-recognized and easy-to-use Bournemouth score (B score) with the chromosome defect complexity, C23 constituting an additional indicator of patient outcome. The predicted risk of death within 18 months calculated from the model is as follows: 7.1% (confidence interval: 1.7-24.8) for patients with an LB score of 0, 60.1% (44.7-73.8) for an LB score of 1, and 96.8% (84.5-99.4) for an LB score of 2. The scoring system presented here has several interesting features. The LB score may improve the predictive value of the B score, as it is able to recognize two prognostic groups in the intermediate risk category of patients with B scores of 2 or 3. It has also the ability to identify two distinct prognostic subclasses among RAEB and possibly CMML patients. In addition to its above-described usefulness in the prognostic evaluation, the LB score may bring new insights into the understanding of evolution patterns in MDS. We used the combination of the B score and chromosome complexity to define four classes which may be considered four possible states of myelodysplasia and which describe two distinct evolutional pathways.

Systematic analysis of factors associated with progression and regression of ulcerative colitis in 918 patients.

BACKGROUND: Studies that systematically assess change in ulcerative colitis (UC) extent over time in adult patients are scarce. AIM: To assess changes in disease extent over time and to evaluate clinical parameters associated with this change. METHODS: Data from the Swiss IBD cohort study were analysed. We used logistic regression modelling to identify factors associated with a change in disease extent. RESULTS: A total of 918 UC patients (45.3% females) were included. At diagnosis, UC patients presented with the following disease extent: proctitis [199 patients (21.7%)], left-sided colitis [338 patients (36.8%)] and extensive colitis/pancolitis [381 (41.5%)]. During a median disease duration of 9 [4-16] years, progression and regression was documented in 145 patients (15.8%) and 149 patients (16.2%) respectively. In addition, 624 patients (68.0%) had a stable disease extent. The following factors were identified to be associated with disease progression: treatment with systemic glucocorticoids [odds ratio (OR) 1.704, P = 0.025] and calcineurin inhibitors (OR: 2.716, P = 0.005). No specific factors were found to be associated with disease regression. CONCLUSIONS: Over a median disease duration of 9 [4-16] years, about two-thirds of UC patients maintained the initial disease extent; the remaining one-third had experienced either progression or regression of the disease extent.

Developmental trajectories of body mass index in early childhood : an 8-year longitudinal study

Trajectoires développementales de l’IMC durant l’enfance: Une étude longitudinale sur 8 ans. Introduction : L’obésité infantile, origine de nombreux problèmes de santé, représente un grand défi en santé publique. Récemment, l’importance d’étudier l’évolution du surpoids durant l’enfance ainsi que les facteurs de risques précoces pour l’obésité a été reconnue. Les trajectoires développementales d’indice de masse corporelle (IMC) chez les jeunes représentent une approche innovatrice qui nous permet de mieux comprendre cette problématique importante. Objectifs: 1) Identifier des trajectoires développementales distinctes de groupes d’enfants selon leur IMC durant l’enfance, et 2) Explorer les facteurs de risques précoces qui prédisent l’appartenance de l’enfant à la trajectoire d’IMC le plus élevé Hypothèses: 1) On s’attend à retrouver un groupe d’enfants qui suit une trajectoire d’IMC élevée durant l’enfance. 2) On s’attend à ce que certaines caractéristiques de la mère (ex : tabac pendant la grossesse et IMC élevé), soient associées à l’appartenance de l’enfant au groupe ayant la trajectoire «IMC élevé ». Méthodes: Estimation des trajectoires développementales d’IMC d’enfants, dans un échantillon populationnel (n=1957) au Québec (ELDEQ). Les IMC ont été calculés à partir de données fournies par les mères des enfants et recueillis chaque année sur une durée de 8 ans. Des données propres à l’enfant sa mère, ainsi que socioéconomiques, ont étés recueillies. Une régression logistique multinomiale a été utilisée pour distinguer les enfants avec un IMC élevé des autres enfants, selon les facteurs de risques précoces. Les programmes PROC TRAJ (extension de SAS), SPSS (version 16), et SAS (version 9.1.3) ont été utilisés pour ces analyses. Résultats: Trois trajectoires d’IMC ont étés identifiées : IMC « bas-stable » (54,5%), IMC « modéré » (41,0%) et IMC « élevé et en hausse » (4,5%). Le groupe « élevé et en hausse » incluait des enfants pour qui l’IMC à 8 ans dépassait la valeur limite pour l’obésité. Les analyses de régression logistique ont révélé que deux facteurs de risques maternels étaient significativement associés avec la trajectoire “en hausse” par rapport aux deux autres groupes : le tabac durant la grossesse et le surpoids maternel. Conclusions: Des risques d’obésité infantile peuvent êtres identifiés dès la grossesse. Des études d’intervention sont requises pour identifier la possibilité de réduire le risque d’obésité chez l’enfant en ciblant le tabac et le surpoids maternelle durant la grossesse. Mots clés: Indice de masse corporelle (IMC), obésité infantile, trajectoires développementales de groupe, facteurs de risque précoce, étude populationnelle, tabac pendant la grossesse, obésité maternelle.

Follow-up of three large community-based programs to reduce anaemia among children 24-59 months in Ghana, Malawi and Tanzania

L'anémie de l'enfant reste un problème d'importance pour la santé mondiale, malgré les décennies de recherche visant à comprendre son étiologie et à développer des interventions efficaces pour réduire sa prévalence et ses conséquences. Bien que les facteurs de risque individuels de l'anémie soient connus, y compris les facteurs liés à la malnutrition et à la morbidité, l'interaction entre lesdits facteurs est moins documentée dans des contextes où les enfants sont fréquemment exposés à plusieurs facteurs en même temps. Cette étude vise à documenter les efforts de lutte contre l'anémie du programme MICAH qui a été mis en oeuvre au Ghana, au Malawi et en Tanzanie. Ensuite, en utilisant les données relatives à la fois au processus et à l'évaluation colligées au cours du programme, elle vise à mieux comprendre les facteurs de risque d'anémie chez les jeunes enfants dans ces contextes et à comprendre comment les relations entre ces facteurs peuvent avoir changé au fil du temps lors de l'intervention. Spécifiquement, cette étude vérifie s‘il y a des preuves d'une réduction de la vulnérabilité des enfants aux facteurs de risque associés à l'anémie dans chaque contexte. Un examen de la documentation a été réalisé afin de caractériser le contexte du programme et des interventions, leur l'intensité et étendue. Les données transversales sur la nutrition et l'état de santé des enfants âgés de 24 à 59 mois (N = 2405) obtenues en 2000 et 2004 à partir des enquêtes d'évaluation du programme MICAH au Ghana, au Malawi et en Tanzanie, ont été utilisées pour décrire la prévalence de l'anémie. Les modèles polynomiaux de régression logistique et linéaire ont été utilisés pour estimer les risques d'anémie légère et d'anémie modérée / sévère et les niveaux d‘hémoglobine associés à des groupes de variables. Les estimations du risque attribuable à une population (RAP) ont aussi été calculées. Une anémie (Hb <110 g/L) a touché au moins 60% des enfants dans les trois pays; l'anémie modérée / sévère (<100 g/L) constituait la majorité des cas. Une forte diminution de l'anémie a été observée entre 2000 et 2004 au Ghana, mais seulement une légère baisse au Malawi et en Tanzanie. Le risque d'anémie modérée / sévère était associé au retard de croissance chez les enfants du Ghana (OR 2,68, IC 95% 1,70-4,23) et du Malawi (OR 1,71; 1,29-2,27) mais pas de la Tanzanie (OR 1,29; 0,87- 1,92). Le paludisme et les maladies récentes étaient associées à une hémoglobine plus basse. Une atténuation de cette association en 2004 a été observée seulement au Malawi pour le paludisme et au Ghana pour les maladies récentes. Le risque d'anémie modérée / sévère était 44% moindre chez les enfants âgés de 48 à 59 mois comparativement aux enfants de 24 à 35 mois dans les trois pays et cela n'a pas changé entre 2000 et 2004. Les RAP estimés ont montré qu‘environ un cinquième des cas d‘anémie modérée à sévère était attribuable au retard de croissance au Ghana et Malawi, mais pas en Tanzanie. Des RAP moindres et dépendants des contextes ont été trouvés pour le paludisme et les maladies récentes. Dans ces zones d‘intervention intégrées de santé et de nutrition la relation de certains facteurs de risque à l'anémie se modifia avec le temps. Le retard de croissance est resté toutefois un facteur de risque indépendant et non mitigé de l'anémie. Une réduction efficace des causes de la malnutrition chronique est nécessaire afin de réduire la vulnérabilité des enfants et de garantir un impact maximum des programmes de lutte contre l'anémie. Une mitigation de l'impact du paludisme peut par contre être visée dans les régions endémiques.