1,720,961 research outputs found
Health disparities in severe maternal morbidity: selection bias, intersectionality, and hypertensive disorders of pregnancy
No full text2026Severe maternal morbidity (SMM), defined as unexpected outcomes of labor and delivery, affects more than 50,000 birthing individuals annually in the United States, and is characterized by persistent health disparities across various social factors, such as race/ethnicity and socioeconomic status. These patterns have continued over time despite evidence that many SMM events are preventable. Therefore, a deeper understanding of both social and clinical drivers, along with careful consideration of potential sources of systematic error, is critical to inform effective interventions. Using data from the Pregnancy to Early Life Longitudinal Data System, which links live birth and fetal death certificates to hospital delivery discharge records in Massachusetts, we analyzed deliveries from 1998 to 2021 to address key methodological, social, and clinical gaps in research on health disparities in SMM. In the first study, we estimated the effect of SMM, compared with no SMM at the first hospital delivery, on the risk of SMM at the second hospital delivery and applied inverse probability of continuation weighting to quantify the magnitude and direction of bias introduced by selective attrition. A history of SMM was associated with an excess of more than 500 SMM events per 10,000 in-hospital deliveries at the second delivery, underscoring the importance of tailored care in future pregnancies. We also found that Black birthing people were disproportionately affected, with rate differences (RD) exceeding 800 per 10,000 in-hospital deliveries. Selection bias was minimal and generally resulted in a slight downward bias of <1%. In the second study, guided by intersectionality, we used interaction analyses to examine the association between occupying one or more marginalized identities compared with only privileged social identities and the risk of SMM. Multiply marginalized groups (i.e., racially and ethnically minoritized individuals with socioeconomic disadvantage), as well as Black individuals with socioeconomic advantage, experienced excess SMM events (RD 27–150 per 10,000 in-hospital deliveries) compared with White birthing people with socioeconomic advantage. These findings highlight the importance of addressing multiple intersecting social positions in efforts to reduce disparities in SMM. In the third study, we used mediation analysis to estimate the proportion of the Black–White racial disparity in SMM that would be eliminated through the prevention of hypertensive disorders of pregnancy (HDP). HDP accounted for 38.5% of the Black–White racial disparity in SMM, indicating that prevention of HDP may represent a potential pathway for reducing part of the racial disparities in SMM. Together, these three studies advance our understanding of various methodological, social, and clinical factors underlying health disparities in SMM.2029-01-31T00:00:00
Transgenerational risk for low birth weight and preterm birth: The role of biology and neighborhood factors in racial disparities
Get PDFThe purpose of this dissertation research is to ascertain the impact of biological factors as well as social and economic environmental factors on the risk of low birth weight (LBW) and preterm birth (PTB) among infants of non-Hispanic (NH) white and NH black mothers, under the hypothesis that intergenerational factors could be explanatory variables in the perpetuated trend in racial/ethnic disparities in birth outcomes. Three separate research studies were performed. The first is a systematic review and meta-analysis of studies reporting the association between LBW/PTB and neighborhood disadvantage, where the results demonstrate that there is a statistically significant higher odds of LBW and PTB among mothers resident in the most disadvantaged neighborhoods relative to those in the least disadvantaged neighborhoods. This relationship was found only when race-stratified, rather than race-adjusted, models were performed. The second and third studies use a transgenerational dataset of births in Allegheny County, Pennsylvania with birth records of infants born in the years 2009-2011 to mothers who were also born in the County in the years 1979-1998. The second study focuses on the role of mothers’ birth weight (MBW) along with social and economic contextual factors on infant risk of LBW; while the third study focuses on the role of mothers’ gestational age (MGA) coupled with social and economic contextual factors on infant risk of PTB. This research makes significant unique contributions to this field of public health research by examining both biological and neighborhood context factors as predictors of PTB and LBW in multivariate and multilevel models. Even more important is the novel examination of the subcategories of birth weight and gestational age, which led to results suggesting differing roles of biology and neighborhood context among these subcategories. LBW and PTB are of public health significance because they increase an infant’s risk of death in the first year of life, developmental disabilities, and chronic diseases in adulthood. The healthcare costs related to treatment of a prematurely born infant costs the United States billions of dollars a year and can be associated with billions more decades later when chronic diseases develop in adulthood
Sex-specific Associations of Maternal Birthweight with Offspring Birthweight in the Omega Study: The role of pre-pregnancy body mass index
Get PDFThesis (Master's)--University of Washington, 2016-12Background: Birth weight is an indicator of fetal growth and development, important determinants of life course health. Maternal birthweight (BW) is one of the strongest predictors of offspring BW, perpetuating generational cycles of poor health and risk for adverse birth outcomes. However, potential non-linear relationships or modifying or mediating factors of maternal and offspring BW associations have not been fully described. Objective: We examined (1) the overall maternal-offspring BW association, (2) offspring sex-specific differences in the association, as well as (3) the role of pre-pregnancy body mass index (BMI) as modifier or mediator of the association. Methods: The study was conducted among N = 3745 participants of the Omega pregnancy cohort study in Washington State (1996-2008). The exposure variable was maternal BW, modeled as a continuous variable, a linear spline with knots at 2500 grams and 4000 grams (macrosomia), and a binary variable indicating low birthweight (LBW) status (< 2500 grams vs. ≥ 2500 grams). Outcomes were offspring BW and LBW status. Linear and logistic regression models, adjusted for potential confounders, were used to estimate differences in mean offspring BW and odds of LBW, respectively, and corresponding 95% confidence intervals. Effect modification (by offspring sex or pre-pregnancy BMI) was assessed using stratified analyses and interaction terms. Mediation of associations by pre-pregnancy BMI was examined using the potential outcomes framework of causal analysis. Results: The average offspring BW in the study population was 3450.8 grams. Overall, 4.2% of the offspring had LBW. An increase in maternal BW was positively associated with offspring BW among mothers with normal BW (β =22.05 grams offspring BW per 100 grams maternal BW, 95% CI: 17.32, 26.79) or macrosomia (β =23.86 grams offspring BW per 100 grams maternal BW, 95%CI: 7.26, 40.46). LBW mothers had a two-fold higher risk of having LBW infants (OR = 1.96, 95% CI: 1.24, 3.09). Across the distribution of maternal BW we observed a non-linear slope for males (likelihood ratio test (LRT) p-value for improvement in fit by linear spline vs continuous model < 0.001) and a linear slope for females (LRT p-value = 0.9231). The relationship between maternal and offspring BW, as represented by the linear spline, differed by offspring sex (p-value for interaction = 0.0149). Mothers who were LBW and had male offspring had a statistically insignificant 1.2-fold (95% CI: 0.55, 2.72) higher risk of having a LBW infant while mothers who were LBW and had female offspring had a 2.67-fold (95% CI: 1.51, 4.75) higher risk of having a LBW infant (p-value for interaction = 0.120). In sex-specific analyses, maternal-offspring BW associations were similar among women of normal pre-pregnancy BMI or overweight/obese pre-pregnancy BMI groups. Maternal pre-pregnancy BMI mediated 2.57% (95% CI: 2.16%, 3.21%) of the associations between maternal and offspring BW, overall. However this mediation was not evident in offspring sex-specific models. Conclusion: We found that the association between maternal and offspring BW may differ by offspring sex, with a non-linear relationship among males, but not females. Pre-pregnancy BMI did not appear to modify maternal-offspring BW associations and it mediated only a small proportion of the associations. Our findings, if supported by other replication studies in diverse populations, provide a new paradigm to understand factors involved in transgenerational BW transmission and guide future investigations of potential mechanisms accounting for maternal-offspring BW associations
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
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
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
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