166 research outputs found
Diabetes Res Clin Pract
No full textAimsWe hypothesized that height-corrected abdominal size (supine sagittal abdominal diameter/height ratio [SADHtR] or waist circumference/height ratio [WHtR]) would associate more strongly than body mass index (BMI, weight/height2) with levels of fasting insulin, triglycerides, and three derived biomarkers of insulin resistance.MethodsAnthropometry, including SAD by caliper, was collected on 4398 adults in the 2011\u20132014 National Health and Nutrition Examination Survey. For comparison purposes, each adiposity indicator was scaled to its population-based, sex-specific, interquartile range (IQR). For each biomarker we created four outcome groups based on equalsized populations with ascending values. Multivariable polytomous logistic regression modeled the relationships between the adiposity indicators and each biomarker.ResultsHighest-group insulin was associated with a one-IQR increment of BMI (RR 4.3 [95% CI 3.9\u20134.9]), but more strongly with a one-IQR increment of SADHtR (RR 5.7 [5.0\u20136.6]). For highest-group HOMA-IR the RR for BMI (4.2 [3.7\u20134.6]) was less than that of SADHtR (6.0 [5.1\u20137.0]). Similarly, RRs for BMI were smaller than those for SADHtR applying to highest-group triglycerides (RR 1.6 vs 2.1), triglycerides/HDL-cholesterol (RR 1.9 vs 2.4) and TyG index (RR 1.7 vs 2.2) (all p < .001). The RRs for WHtR were consistently between those for SADHtR and BMI. The top 25% of insulin resistance among US adults was estimated to lie above adiposity thresholds of 0.140 for SADHtR, 0.606 for WHtR, or 29.6 kg/m2 for BMI.ConclusionsRelative abdominal size rather than relative weight may better define adiposity associated with homeostatic insulin resistance. These population-based, cross-sectional findings could improve anthropometric prediction of cardiometabolic risk.CC999999/Intramural CDC HHS/United State
Human Capital, Capital Structure, and Employee Pay: An Empirical Analysis a Replicated Confirmation
No full textThis paper replicates the paper named Human capital, capital structure, and employee pay: An empirical analysis written by Thomas J. Chemmanur, Yingmei Cheng, and Tianming Zhang in 2013. In this paper, I examine the effect of market leverage on labor expenses to prove the predictions of Titman (1984) and Berk, Stanton, and Zechner (2010). Through the OLS regression analysis, I find that market leverage has a significantly positive effect on total, cash, equity-based compensation of chief executive officers (CEOs). So an increase market leverage will always lead to an incremental labor cost, and in fact labor costs will limit the use of debt to some extent
Treating the patient not just the disease? : Delving deeper into the possible link between affective disorders and coronary heart disease through statistical analysis of a random sample of Maltese people
No full textBackground: Ischemic heart disease is the leading cause of death in Males in Malta and globally. Affective disorders are the commonest psychological problem. This cross-sectional study utilizes a multiple regression model utilizing binary logistic to delve deeper into the link between affective disorders and coronary heart disease and also the link between coronary heart disease and anxiety and depression separately.
Methods: The study was performed in the small Mediterranean island of Malta through the European health interview survey (EHIS), at a national level involving 5500 participants. The response rate attained in the actual field work was 72%. Statistical analysis involved performing chi-squared tests on all contributing variables and retaining those variables that were significant to both diseases. These were then placed in a multiple regression model using forward stepwise binary logistic to retain only the most significant variables.
Results: Age, gender, BMI, diabetes prevalence, depression prevalence, anxiety prevalence, hypertension prevalence, affective disorders( having either anxiety or depression), smoking status, frequency of alcohol intake, and educational level all had a significance of <0.05, some; than less than 0.01. On fitting a multiple regression model, Anxiety (p=0.033), age (p=<0.001), gender (p=<0.001), hypertension (p=0.016) retained their significance in the model. Diabetes could not be analyzed due to power issues.
Conclusion: BMI was not retained in the model having been replaced by associated conditions such as hypertension, together with age and gender as strongly associated risk factors. Anxiety nevertheless retained its independent association with coronary heart disease, in spite of the presence of the other stronger predictors described above.peer-reviewe
Modeling the determinants of foreign language teachers' intentions to use technology for student-centered learning : an extension of the theory of planned behavior
No full textPrior studies have highlighted the relative rarity of student-centered technology use among teachers, and concluded this was due - at least in part - to teachers' constructivist-oriented pedagogical beliefs (CPB) and their technological pedagogical content knowledge (TPACK). Nevertheless, few studies have included these concepts in models aimed at predicting teachers' intensions to use technology for student-centered learning; nor have many examinations of such teacher' intentions been conducted using the well-established theory of planned behavior (TPB). The present study helps fill this gap by testing how well the TPB predicts teachers' intentions to use technology for student-centered learning using 621 in-service college-level English as foreign Language (EFL) teachers, and also compares the original TPB's predictive validity, data fit, and variance explained against those of a modified TPB model that incorporates both CPB and TPACK. The participants, all of whom were from southern China, completed a survey that measured their attitudes towards student-centered technology use (ATTU), subjective norms about student-centered technology use (SN), and perceived behavioral control about student-centered technology use (PBC), along with their CPB, TPACK and intentions to use technology for student-centered learning. Structural equation modeling was employed to examine the validity of the TPB and the modified TPB, and the relationships among the factors in the models. The results indicate 1) that both models are effective at predicting Chinese EFL teachers' intentions to use technology for student-centered learning; 2) that two factors in the TPB (ATTU, PBC), together with TPACK, were significantly correlated with the participants' intentions to use technology for student-centered learning, whereas SN and CPB had no such significant correlation with it; and 3) that the modified TPB model significantly outperformed the TPB model in terms of predictive validity, data fit, and variance explained. As well as contributing to our understanding of the TPB and teachers' intentions to use technology for student-centered learning, this study provides valuable guidance for policy-makers in the spheres of teacher education and technology use.Thesis (Ph. D.)--Michigan State University. Educational Psychology and Educational Technology, 2019Includes bibliographical references (pages 94-106
Popul Health Metr
No full textBackgroundMonitoring national mortality among persons with a disease is important to guide and evaluate progress in disease control and prevention. However, a method to estimate nationally representative annual mortality among persons with and without diabetes in the United States does not currently exist. The aim of this study is to demonstrate use of weighted discrete Poisson regression on national survey mortality follow-up data to estimate annual mortality rates among adults with diabetes.MethodsTo estimate mortality among US adults with diabetes, we applied a weighted discrete time-to-event Poisson regression approach with post-stratification adjustment to national survey data. Adult participants aged 18 or older with and without diabetes in the National Health Interview Survey 1997\ue2\u20ac\u201c2004 were followed up through 2006 for mortality status. We estimated mortality among all US adults, and by self-reported diabetes status at baseline. The time-varying covariates used were age and calendar year. Mortality among all US adults was validated using direct estimates from the National Vital Statistics System (NVSS).ResultsUsing our approach, annual all-cause mortality among all US adults ranged from 8.8 deaths per 1,000 person-years (95% confidence interval [CI]: 8.0, 9.6) in year 2000 to 7.9 (95% CI: 7.6, 8.3) in year 2006. By comparison, the NVSS estimates ranged from 8.6 to 7.9 (correlation\ue2\u20ac\u2030=\ue2\u20ac\u20300.94). All-cause mortality among persons with diabetes decreased from 35.7 (95% CI: 28.4, 42.9) in 2000 to 31.8 (95% CI: 28.5, 35.1) in 2006. After adjusting for age, sex, and race/ethnicity, persons with diabetes had 2.1 (95% CI: 2.01, 2.26) times the risk of death of those without diabetes.ConclusionPeriod-specific national mortality can be estimated for people with and without a chronic condition using national surveys with mortality follow-up and a discrete time-to-event Poisson regression approach with post-stratification adjustment.2016-12-15T00:00:00Z27978825PMC516002
PLoS One
No full textIntroductionDiabetes imposes large health and financial burdens on Medicare beneficiaries. Type 2 diabetes can be prevented or delayed through lifestyle modification programs. In 2018, Medicare began to offer the Medicare Diabetes Prevention Program (MDPP), a lifestyle intervention, to eligible beneficiaries nationwide. The number of MDPP-eligible beneficiaries is not known, but this information is essential in efforts to expand the program and increase enrollment. This study aimed to estimate the number and spatial variation of MDPP-eligible Part B beneficiaries at the county level and by urban\u2013rural classification.MethodsData from 2011\u20132016 National Health and Nutrition Examination Surveys and a survey-weighted logistic regression model were used to estimate proportions of prediabetes in the United States by sex, age, and race/ethnicity based on the MDPP eligibility criteria. The results from the predictive model were applied to 2015 Medicare Part B beneficiaries to estimate the number of MDPP-eligible beneficiaries. The National Center for Health Statistics\u2019 Urban\u2013Rural Classification Scheme for Counties from 2013 were used to define urban and rural categories.ResultsAn estimated 5.2 million (95% CI = 3.5\u20137.0 million) Part B beneficiaries were eligible for the MDPP. By state, estimates ranged from 13,000 (95% CI = 8,500\u201318,000) in Alaska to 469,000 (95% CI = 296,000\u2013641,000) in California. There were 2,149 counties with 641,000 eligible beneficiaries and 11 with >25,000. Consistent with demographic patterns, urban counties had more eligible beneficiaries than rural counties.ConclusionsThese estimates could be used to plan locations for new MDPPs and reach eligible Part B beneficiaries for enrollment
Preventing Chronic Disease (PCD)
No full textIntroductionMonitoring menthol cigarette use allows for identification of potential health disparities. We examined sociodemographic and temporal differences in menthol cigarette use among US adults who smoke.MethodsWe analyzed data from the 1999\u20132018 National Health and Nutrition Examination Survey for adults aged 20 years or older who smoke (N\u2006=\u200611,431) using binary logistic regression.ResultsAmong US adults who smoke, 28.8% used menthol cigarettes. After adjusting for age, sex, race and ethnicity, education, income-to-poverty ratio, and health status, the prevalence of menthol use among adults who smoke increased on average by 3.8% (95% CI, 2.7%\u20134.9%) annually. Non-Hispanic Black adults had the highest average prevalence of menthol cigarette use, 73.0% (95% CI, 70.9%\u201375.2%), and Mexican American adults had higher average annual increase in menthol cigarette use, 7.1% (95% CI, 4.0%\u201310.3%). Adults with fair or poor health status had a 4.3% annual increase in menthol cigarette use (95% CI, 2.5%\u20136.1%). The adjusted prevalence ratios of menthol cigarette use were 1.61 (95% CI, 1.39\u20131.83) for adults aged 20\u201329 years compared with those aged 65 years or older, 1.41 (95% CI, 1.32\u20131.49) for female adults compared with male adults, and 1.17 (95% CI, 1.07\u20131.27) for high school graduates or higher compared with those with no high school diploma.ConclusionNon-Hispanic Black adults who smoke had the highest prevalence of menthol cigarette use among all racial and ethnic groups; the prevalence of menthol cigarette use among adults who smoke increased especially among Mexican American adults, younger adults, and adults who reported fair to poor health status
Vaccine
No full textBackground:Diabetes is associated with higher risk of hospitalization, morbidity, and mortality from influenza. We assessed influenza vaccination coverage among adults aged 6518 years with diabetes during the 2007\u201308 through 2017\u201318 influenza seasons and identified factors independently associated with vaccination during the 2017\u201318 season.Methods:We analyzed data from the 2007\u20132018 National Health Interview Surveys, using Kaplan-Meier survival analysis to estimate season-specific influenza vaccination coverage. Multivariable logistic regression was conducted to examine whether diabetes was independently associated with self-reported influenza vaccination in the past 12 months and identify factors independently associated with vaccination among adults with diabetes using the 2017\u201318 data.Results:During the 2007\u201308 through 2017\u201318 influenza seasons, influenza vaccination coverage among adults aged 6518 years with diabetes ranged from 62.6% to 64.8%. In the 2017\u201318 influenza season, coverage was significantly higher among adults with diabetes (64.8%) compared with those without diabetes (43.9%). Having diabetes was independently associated with an increased prevalence of vaccination after controlling for other factors. Among adults with diabetes, living at or above poverty level, having more physician contacts, having usual place for health care, and being unemployed were independently associated with increased prevalence of vaccination; being 18\u201364 years and non-Hispanic black were independently associated with decreased prevalence of vaccination.Conclusions:Despite specific recommendations for influenza vaccination among people with diabetes, more than one-third of adults with diabetes are unvaccinated. Targeted efforts are needed to increase influenza vaccination coverage among adults with diabetes.CC999999/ImCDC/Intramural CDC HHSUnited States
BMC Health Serv Res
No full textBackgroundIncreases in population and life expectancy of Americans may result in shortages of endocrinologists by 2020. This study aims to assess variations in geographic accessibility to endocrinologists in the US, by age group at state and county levels, and by urban/rural status, and distance.MethodsWe used the 2012 National Provider Identifier Registry to obtain office locations of all adult and pediatric endocrinologists in the US. The population with geographic access to an endocrinologist within a series of 6 distance radii, centered on endocrinologist practice locations, was estimated using the US Census 2010 block-level population. We assumed that persons living within the same circular buffer zone of an endocrinologist location have the same geographic accessibility to that endocrinologist. The geographic accessibility (the percentage of the population with geographic access to at least one endocrinologist) and the population-to-endocrinologist ratio for each geographic area were estimated.ResultsBy using 20 miles as the distance radius, geographic accessibility to at least one pediatric/adult endocrinologist for age groups 0\ue2\u20ac\u201c17, 18\ue2\u20ac\u201c64, and \ue2\u2030\ua565\uc2\ua0years was 64.1\uc2\ua0%, 85.4\uc2\ua0%, and 82.1\uc2\ua0%. The overall population-to-endocrinologist ratio within 20 miles was 39,492:1 for children, 29,887:1 for adults aged 18\ue2\u20ac\u201c64 years, and 6,194:1 for adults aged \ue2\u2030\ua565\uc2\ua0years. These ratios varied considerably by state, county, urban/rural status, and distance.ConclusionsThis study demonstrates that there are geographic variations of accessibility to endocrinologists in the US. The areas with poorer geographic accessibility warrant further study of the effect of these variations on disease prevention, detection, and management of endocrine diseases in the US population. Our findings of geographic access to endocrinologists also may provide valuable information for medical education and health resources allocation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1185-5) contains supplementary material, which is available to authorized users.2015-12-07T00:00:00Z26644021PMC467257
Deep characteristics analysis on travel time of emergency traffic
No full textOwing to the rapid development of emergency rescue transportation in cities and the frequent emergencies, demand for emergency rescue is increasing drastically. How to select an emergency rescue route quickly and shorten the rescue travel time under the condition of limited urban road resources is of great significance. Based on the characteristics analysis of emergency rescue, this paper classifies priority levels of different emergency traffic, moreover, the travel times are also analysed with three scenarios: 1) emergency rescue vehicles encountering no queues; 2) encountered queues but lanes available; 3) encountered queues with no available lanes. Related case study shows that model in this paper can effectively shorten travel time of emergency traffic in the route and improve its efficiency.Accepted Author ManuscriptTransport and Plannin
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