1,720,969 research outputs found
Impact of protocol changes in Michigan newborn screening for congenital hypothyroidism on screening performance metrics
Get PDFObjective: This study was conducted to evaluate changes in newborn screening for congenital hypothyroidism operations in Michigan. Study Design & Participants: This population-based retrospective cohort analysis includes Michigan resident infants born and screened in Michigan from 1/1/1994 to 6/30/2010. Newborn screening laboratory and follow-up data managed by the Michigan Department of Community Health are used in this study. Methods: The primary exposure is the method of dried blood spot testing: 1) thyroxine (T4) with backup thyrotropin (TSH) testing, 2) tandem T4 and TSH testing; 3) primary TSH testing without serial testing; and 4) primary TSH testing plus serial testing for births weighing <1,800g. Outcomes of interest include screening performance metrics: detection rate, positive predictive value, false positive rate, sensitivity, and specificity. The proportion of cases later determined to have transient disease is also investigated among those detected since 10/1/2003 that were followed-up after age three years and underwent diagnostic re-evaluation. Logistic regression analysis is used to investigate: a) whether the detection and false positive rates changed significantly as dried blood spot testing methods changed, and b) to investigate predictors of transient CH among cases followed-up and re-evaluated after age three years. Results: T4 testing is as likely to detect CH as is primary TSH testing without serial testing. Primary TSH testing yields fewer false positive determinations. Primary TSH testing yields fewer false positive determinations. The addition of serial testing among infants born weighing < 1,800g to the primary TSH testing protocol significantly increased the detection rate; in this period, 14% of detected cases were identified by retest and three of five cases weighing <1,800g were detected by retest. Primary TSH screening is more susceptible to false negative screening determinations and is incapable of detecting the 1-3 cases of central hypothyroidism expected annually in Michigan. Tandem T4 and TSH testing increased the detection rate by 80% and 20% relative to primary T4 backup TSH and primary TSH plus serial testing approaches respectively; however, this approach increased the number of false positives by eight fold relative to primary TSH plus serial testing. At three year follow-up, one of four cases was no longer receiving thyroid hormone medication. One of five cases re-evaluated had stopped treatment without medical supervision. Discussion: Our results indicate that newborn screening programs should consider tandem T4 and TSH testing or primary TSH plus serial testing for infants at risk of later rising TSH for detecting congenital hypothyroidism; however, a benchmark balance between sensitivity and specificity is necessary to determine the optimal testing strategy. Further efforts are necessary to standardize the process of diagnosis and terminologies used to characterize cases across newborn screening programs to make comparisons between and within programs over time more meaningful; guidelines for newborn screening, pediatricians, and pediatric endocrinologists are necessary to support this effort. Our findings also indicate that long term follow-up should be conducted for all CH cases, not only those eligible for a trial off thyroid hormone supplements, to ensure treatment compliance in hopes of avoiding potential brain damage among cases. As diagnostics and the nomenclature of congenital hypothyroidism are standardized across newborn screening programs, cost-benefit analyses are necessary to support recommended program operations.Thesis (Ph. D.)--Michigan State University. EPIDEMIOLOGY, 2011Includes bibliographical reference
J Womens Health (Larchmt)
Get PDFIntroductionPopulation-level data on infertility and impaired fecundity are sparse. We explored the use of self-reported information provided by reproductive-aged women participating in the Centers for Disease Control and Prevention\u2019s Behavioral Risk Factor Surveillance System (BRFSS).Materials and MethodsThree out of 12 questions on reproductive history, family planning, and infertility that seven states included in the 2013 BRFSS were used for this study. In addition to descriptive statistics, we used multinomial logistic regression to identify factors associated with ever experiencing infertility only, difficulty staying pregnant only, and neither infertility nor difficulty staying pregnant. We also explored the association between healthcare coverage and type of treatment received among women ever experiencing infertility only or difficulty staying pregnant only.ResultsCompared with women reporting having never experienced either infertility or difficulty staying pregnant, women who reported ever experiencing difficulty staying pregnant only were significantly more likely to report a history of depressive disorders and smoking (adjusted odds ratio [aOR] = 1.69, 95% confidence interval [CI] = 1.07\u20132.68 and aOR = 1.98, 95% CI = 1.22\u20133.20, respectively). Women who ever experienced infertility only were also more likely to report a history of depressive disorders (aOR = 2.02, 95% CI = 1.14\u20133.59), but less likely to report healthcare coverage (aOR = 0.26, 95% CI = 0.14\u20130.46). Only 18.9% (95% CI = 11.4\u201329.9) of women who ever experienced difficulty staying pregnant only reported seeking infertility treatment compared with 49.6% (95% CI = 34.9\u201364.4) of women who ever experienced infertility only.ConclusionsOngoing public health surveillance systems of state-specific self-reported data, such as BRFSS, provide the opportunity to explore preventable risk factors and treatment use related to infertility and impaired fecundity.CC999999/ImCDC/Intramural CDC HHS/United State
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Am J Prev Med
Get PDFBackgroundNeonatal withdrawal syndrome, which is associated most frequently with opioid use in pregnancy, is an emerging public health concern, with recent studies documenting an increase in the rate of U.S. infants diagnosed.PurposeThis study examined neonatal withdrawal syndrome diagnosis among Michigan infants from 2000 to 2009 and hospital length of stay (LOS) between infants with and without the syndrome for a subset of years (2006\u20132009).MethodsMichigan live birth records from 2000 to 2009 were linked with hospital discharge data to identify infants with neonatal withdrawal syndrome. Linked data were restricted to infants born between 2006 and 2009 to examine the difference in hospital LOS between infants with and without the syndrome. Multivariable regression models were constructed to examine the adjusted impact of syndrome diagnosis on infant LOS and fit using negative binomial distribution. Data were analyzed from July 2011 to February 2012.ResultsFrom 2000 to 2009, the overall birth rate of infants with neonatal withdrawal syndrome increased from 41.2 to 289.0 per 100,000 live births (p<0.0001). Among infants born from 2006 to 2009, the average hospital LOS for those with the syndrome was between 1.36 (95% CI=1.24, 1.49) and 5.75 (95% CI=5.41, 6.10) times longer than for infants without it.ConclusionsDiagnosis of neonatal withdrawal syndrome increased significantly in Michigan with infants who had the syndrome requiring a significantly longer LOS compared to those without it.CC999999/ImCDC/Intramural CDC HHSUnited States/U38 HM000414/HM/NCHM CDC HHSUnited States/5U38HM000414/HM/NCHM CDC HHSUnited States
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
J Public Health Manag Pract
Get PDFContext:Syndromic surveillance consists of the systematic collection and use of near real-time data about health-related events for situational awareness and public health action. As syndromic surveillance programs continue to adopt new technologies and expand, it is valuable to evaluate these syndromic surveillance systems and practices to ensure that they meet public health needs.Objective:This assessment\u2019s aim is to provide recent information about syndromic surveillance systems and practice characteristics among a group of state and local health departments.Design/Setting:Information was obtained between November 2017 and June 2018 through a telephone survey using an Office of Management and Budget\u2013approved standardized data collection tool. Participants were syndromic surveillance staff from each of 31 state and local health departments participating in the National Syndromic Surveillance Program funded by the Centers for Disease Control and Prevention. Questions included jurisdictional experience, data sources and analysis systems used, syndromic system data processing characteristics, data quality verification procedures, and surveillance activities conducted with syndromic data.Measures:Practice-specific information such as types of systems and data sources used for syndromic surveillance, data quality monitoring, and uses of data for public health situational awareness (eg, investigating occurrences of or trends in diseases).Results:The survey analysis revealed a wide range of experiences with syndromic surveillance. Participants reported the receipt of data daily or more frequently. Emergency department data were the primary data source; however, other data sources are being integrated into these systems. All health departments routinely monitored data quality. Syndromes of highest priority across the respondents for health events monitoring were influenza-like illness and drug-related syndromes. However, a wide variety of syndromes were reported as priorities across the health departments.Conclusion:Overall, syndromic surveillance was relevantly integrated into the public health surveillance infrastructure. The near real-time nature of the data and its flexibility to monitor different types of health-related issues make it especially useful for public health practitioners. Despite these advances, syndromic surveillance capacity, locally and nationally, must continue to evolve and progress should be monitored to ensure that syndromic surveillance systems and data are optimally able to meet jurisdictional needs.CC999999/ImCDC/Intramural CDC HHSUnited States
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