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1
Xiao, Tao. "Bayesian Threshold Regression for Current Status Data with Informative Censoring." The Ohio State University, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=osu1438272888.
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Chen, Lu. "The Sum of Standardized Residuals: Goodness of Fit Test for Binary Response Model." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu149270866727902.
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Myers, John Vincent. "An Exploratory Analysis of the DADA2 and uBiome Pipelines." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555603546669156.
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Li, Guilin 1973. "Re-analyses of Framingham data using time-dependent covariates." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=29907.
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I propose a new approach, based on time-dependent covariates, to assess the impact of within-subject changes in predictors on subsequent mortality, and apply it to reevaluate the impact of changes in serum cholesterol and smoking status on the coronary heart mortality in the Framingham Heart Study. Time-dependent covariates, representing updated risk factor value or its changes from either the baseline or the most recent measurement are included in two types of multivariable Cox regression analyses. The results reveal that in order to avoid confounding of the effects of changes in risk factor, the model should include a time-dependent variable identifying subjects who developed coronary disease during the follow-up. After adjusting for this variable, a within-subject decrease in cholesterol was associated with a significant reduction of corollary mortality, in contrast to the results of previous studies that did not prevent such confounding.
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Loo, Vivian G. (Vivian Grace). "The impact of aids on tuberculosis in Vancouver and Edmonton : a small area analysis." Thesis, McGill University, 1996. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23913.
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The purpose of the study was to use small area analysis to estimate the attributable risk percent of tuberculosis incidence associated with AIDS incidence among Canadian-born males aged 20 to 49.Information on all incident cases of tuberculosis and AIDS between 1980 and 1991 in Vancouver and Edmonton was obtained from provincial registries. The relationship in each census tract between tuberculosis incidence among Canadian-born males aged 20 to 49 and AIDS incidence was examined using small area analysis. Covariates included tuberculosis incidence among the foreign-born and socioeconomic variables from the 1986 Canada census.
In Vancouver, unemployment, tuberculosis incidence among the foreign-born, and AIDS incidence were significantly associated with tuberculosis incidence among the Canadian-born. In Edmonton, only unemployment was significantly associated with tuberculosis incidence among the Canadian-born. Small area analysis detected a measurable, although small impact of AIDS incidence on tuberculosis incidence among Canadian-born males aged 20 to 49 in Vancouver.
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Ducharme, Francine M. (Francine Monique). "Prédiction d'une rechute suite à un traitement pour une crise d'asthme chez l'enfant." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59278.
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We prospectively followed 314 children with an acute asthmatic attack who presented and were discharged from the emergency room of the Montreal Children's Hospital, to identify risk factors for relapse, i.e. a second ER visit for asthma within the next 10 days.Ninety-six of the 314 children relapsed, most within 24 hours. Using multiple logistic regression, a predictive model for relapse was developed on 211 patients. The best model contained two variables: (1) the number of ER visits for acute asthma in the previous year and (2) the intake of a short-acting theophylline preparation during the course of the ER treatment. When applied to the subsequent "validation set" sensitivity was 73%, specificity 50% and PPV 41%, thus indicating the robustness of the model. Based on the total sample, the probability of relapse was 31%. Patients with $ ge$4 ER visits for acute asthma in the past year (frequent visitors) had a probability of relapse of 45% vs 20% for nonfrequent visitors. The intake of short-acting theophylline during the ER visit reduced the probability of relapse from 50% to 34% among the frequent visitors, and from 30% to 11% among the nonfrequent visitors.
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Miller, Mark A. (Mark Allen). "A tuberculosis outbreak in a native community : HLA linkage analysis and evaluation of diagnostic tests." Thesis, McGill University, 1991. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59999.
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An outbreak of pulmonary tuberculosis in a Canadian Native Indian family was analyzed. Of 66 evaluated subjects, 52 (79%) became newly-infected, twenty-four (46%) of which developed disease.Chest radiography was the single best diagnostic test (sensitivity 92%; specificity 100%), after which neither demographic variables nor skin test reactivity detected additional disease in a multivariate discriminant analysis. Without radiography, tuberculin skin test reactivity and the subject's age together were significant but poor predictors of disease (model sensitivity 74% and specificity 64%). All diseased adults, but only 46% of children, produced culture-positive specimens (p = 0.006). Therefore, children with suspected disease should be treated, regardless of culture results.
No linkage was found between HLA type and disease occurrence in any model. Higher lod scores were obtained by reclassifying subjects' phenotypes, but linkage was excluded up to a recombination fraction of 0.20. Neither HLA class I loci nor a closely-linked recessive susceptibility locus is a major factor in tuberculosis disease development in this Canadian Indian family.
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Sampalis, John Sotirios. "Evaluation of pre-hospital trauma services in Montreal." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=74365.
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The objectives of this observational study were to describe and evaluate the impact of emergency services on trauma mortality in Montreal. Urgences-Sante provides pre-hospital care in the greater Montreal region. Physicians provide on-scene care including advanced life support (ALS). Basic life support (BLS) is provided by emergency medical technicians or physicians. The study was conducted over a one-year period from April 1, 1987 to March 31, 1988.The results of this study showed that the response and total pre-hospital times of Urgences-Sante were similar to those in other North American cities. Pre-hospital time exceeding 60 minutes was associated with increased mortality. A significant trend towards lesser mortality in hospitals with higher level trauma care was observed. The use of ALS by physicians was not associated with reduced mortality. However, ALS and the presence of a physician were significantly associated with increased pre-hospital time.
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Gravel, Jocelyn. "Evaluation of the use of the intention-to-treat-approach in randomized controlled trials. : do authors say what they do and do what they say?" Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82246.
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Background. The intention-to-treat (ITT) approach is an analytic approach for the analysis of randomized controlled trials (RCT) in which patients are analysed as randomized regardless of the treatment received.Objective. To evaluate the (1) proportion of articles describing a randomized trial in main medical journals in 2002 reporting the use of ITT, (2) proportion violating a major component of ITT, (3) distribution and management of missing data in the analysis of the studies reporting an ITT analysis.
Method. We conducted a cross-sectional literature review of RCTs reported in 10 medical journals in 2002. A single rater, using a standardized form, evaluated all articles. A second rater evaluated a 10% sample to assess reliability. The proportion of articles reporting the use of ITT was calculated. Among these, the proportion of articles that "analyzed patients as randomized" and the proportion and management of missing data was evaluated using standardized definitions.
Results. Of the 403 articles, 249 reported the use of ITT. Among these, available patients were analyzed as randomized in 192 articles (77+/-5%). However, more than 60% of the articles had missing data in their primary analysis. The main reason for missing data was loss to follow-up. Few articles reported a strategy for missing data.
Conclusion. This study emphasizes the fact that authors use the label "intention-to-treat" quite differently. Its most common use refers to the analysis of all AVAILABLE subjects as randomized.
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Mohamed, Nashila. "Association of the home environment and asthma in Kenyan school children : a case-control study." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=56629.
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Among participants in a community-based prevalence survey of asthma in Nairobi school children, a case-control study was conducted to investigate the association of home environment factors with asthma. The prevalence survey was conducted among children in Grade four (age 9-11 years) in five schools, selected to represent a wide range of socioeconomic status (SES). Asthma was defined as a history of wheeze, or doctor diagnosed asthma, or a decline of FEV1 of $ ge$10% at 5 or 10 minutes post exercise.Of the 409 children studied, 77 cases and 77 age and gender matched controls were identified, and visits made to their homes to carry out visual inspection and questionnaire administration. Assessment included: house construction material, cooking fuel, air pollution in or around the house, child's bedding material, presence of rugs, carpets, sofas, or pets; evidence of damp damage, and nutritional information including salt intake.
The following factors were significantly associated with asthma: damp damage in the child's sleeping area (odds ratio (OR): 4.38; 95% confidence interval (CI) $ {$2.11, 9.11$ }$), air pollution in the home (OR: 2.97; 95% CI $ {$1.40, 6.32$ }$), presence of rugs or carpets in child's bedroom (OR: 2.92; 95% CI $ {$1.35, 6.34$ }$).
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Hodge, William G. "Risk factors for cytomegalovirus retinitis in patients with the acquired immunodeficiency syndrome." Thesis, McGill University, 2002. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82894.
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Cytomegalovirus (CMV) retinitis is the most common and most devastating ocular opportunistic infection among patients with the acquired immunodeficiency syndrome (AIDS). The lifetime cumulative incidence of this infection in patients with AIDS ranges from 25% to 40%. With the advent of highly active antiretroviral treatment (HAART) in 1996, the incidence of CMV retinitis is declining in industrialized nations. However, at least 20% of patients do not respond to HAART. Furthermore, it is possible that more resistance to HAART may develop in the not too distant future, with an explosive increase in the incidence of CMV retinitis. In developing and mixed-economy countries, the incidence is actually increasing. No other ocular opportunistic infection among patients with AIDS has a lifetime cumulative incidence over 1--2%. Without treatment, blindness occurs in 100% of patients within 6 months. When treatment is undertaken; it is expensive, not always effective and exhausting for the patient.Among the clinical risk factors, flashing lights and floaters (OR 11.42, 95% confidence interval [CI] 3.43--38.01), retinal microinfarction (cotton-wool spots) (OR 2.90, 95% CI 1.01--8.29), number of previous opportunistic infections (OR I.81, 95% CI 1.24--2.64), nonocular CMV infections (OR 82.99, 95% CI 6.86--1004.58) and homosexual acquisition of human immunodeficiency virus (OR 2.83, 95% CI 1.13--7.12) were significant predictors of CMV retinitis. From the laboratory model, a high CMV viral load was a significant predictor of CMV retinitis (OR 33.03, 95% CI 2.32--469.39), as was a low hemoglobin concentration (OR 0.96, 95% CI 0.94--0.98). Among the HLA types, HLA-Bw4 (OR 11.68,95% CI 1.29--105.82) and HLA-DRBI15 (OR 9.34,95% CI 1.14--76.41) were significant predictors of CMV retinitis, whereas HLA-Cw7 was protective against CMV retinitis (OR 0.09, 95% CI 0.01--0.67). From the iatrogenic model, steroid use was predictive of CMV retinitis (OR 6.41, 95% CI 2.35--17.51).
Based on this study, the use of steroids systemically elevated the risk of CMV retinitis. Other clinical and laboratory variables were found to elevate the risk of (or protect against) this disease. These findings may be useful to clinicians and health policy experts in developing rational guidelines for screening, examination frequency and targeted prophylaxis for patients with AIDS.
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Duarte, Elisabeth Carmen. "Previous exposure-dependent factors related to protection against malaria in a Braziliam Amazon migrant population : an open cohort study." Thesis, McGill University, 1999. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=36579.
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Malaria remains an important public health problem in developing countries. Because of difficulties in control programmes, naturally acquired immunity (NAI) for many is the only factor that limits the number and severity of malaria episodes. To improve scientific knowledge about the determinants of NAI, this study describes the relationship between previous exposure-dependent factors and malaria occurrence in a Brazilian migrant population. Using an open-cohort design, all individuals living in two hypo-endemic rural communities of Peixoto de Azevedo (MT - Brazil) between September 1996 and April 1997 were enrolled. An interview, spleen measurement, blood samples for anti-RESA ELISA-based indices and malaria thick smears were undertaken at baseline. Incident malaria infections were identified through follow-up visits (4-months interval) and lab monitoring. Associations between previous exposure-dependent factors and time to malaria onset or malaria episode frequency were assessed using Cox's proportional hazards or linear regression models. The study population consisted of 521 individuals, mostly males (60.5%), mean age 26.3 (+/-18.0) years, born in hypo or non-endemic malaria areas (63.1%) and living in endemic areas for 11 years, on average. The majority had non-palpable spleens (65.4%) and had experienced malaria during their lifetime (93.0%) and during the last two years (76.1%). A total of 107 (20.5%) individuals were lost to follow-up. The malaria incidence rate was low [101 cases: 4.49 per 100 person-months], and vivax malaria was four times more frequent than falciparum malaria. The anti-RESA index was positively associated (p ≤ 0.003) with indicators of previous-exposure to malaria: age, malaria episodes during lifetime and months lived in mining environments. Higher malaria incidence rates were associated with lower anti-RESA indices [hazard ratio (HR) = 0.979, p = 0.004] and increased malaria episodes during the last two years (HR = 1.049; p < 0
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Arnold, Cody. "What's wrong with the concept of "very low birthweight"? : heterogeneity and confounding in epidemiologic studies of very small or immature neonates." Thesis, McGill University, 1989. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59301.
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We divided 640 consecutively live-born newborns into two overlapping groups: a traditional very low birthweight (BW) cohort (500-1500 g, mean BW 1055 g) and a gestational age (GA) cohort (23-30 weeks, mean BW 1070 g). We showed: (1) An illusory protective effect of intrauterine growth retardation (IUGR) for in-hospital mortality in the 500-1500 cohort: odds ratio (OR), 0.55. In the 23-30 cohort the crude OR was 1.19; adjusting for differences in GA between IUGR and non-IUGR infants resulted in an odds ratio of 3.15 (95% C.I., 1.57-6.32). (2) Confounding by growth status was demonstrated in a hypothetical observational study of method of delivery and in-hospital mortality. Although this confounding was present in both cohorts, it was larger in the 500-1500 cohort (1.9 vs. 1.1 weeks difference in GA between cesarean and vaginally delivered infants after adjusting for differences in BW). (3) Assessing and/or controlling for confounding by growth status is problematic in a cohort defined by BW criteria but straightforward when GA criteria are used.
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Svenson, James E. "Compliance with antimalarial chemoprophylaxis and malaria infection : a case-control study." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=69741.
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Objective. To determine if there is a difference in compliance with antimalarial chemoprophylaxis between travellers with and without malaria. Secondarily, to determine if clinical presentation can be used in predicting malaria infection.Design. Case-control study.
Subjects. 157 patients with malaria and recent travel to a malaria-endemic area and 157 matched controls.
Results. 152 (48%) of all patients had antimalarial chemoprophylaxis prescribed. Chemoprophylaxis use was correlated with region and purpose of travel. Cases were less likely to have been compliant (53%) than controls (76%) (OR = 0.35 (0.27,0.73)).
Fever pattern, symptom duration, temperature, splenomegaly, and platelet count were correlated with malaria infection. These criteria, either singly, or in combination, had low sensitivity.
Conclusions. Compliance with antimalarial chemoprophylaxis is protective against the subsequent development of malaria. Travel agents and health practitioners should provide travellers with adequate information about chemoprophylaxis.
Because no criterion could accurately predict the presence of malaria, testing for malaria should be done in all symptomatic patients with a history of travel to a malaria-endemic area.
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Carrière, Philippe. "Estimating the incidence of vertebral deformities in Canadian men and women." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81607.
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Background. Vertebral deformities are important sequelae of osteoporosis, but for feasibility and technical reasons their epidemiology has yet to be thoroughly described in Canada, especially in men.Objective. To estimate the incidence of osteoporotic vertebral deformities, from data collected by the Canadian Multicentre Osteoporosis Study (CaMos), a large cohort study of randomly selected Canadians radiographed at a five year interval.
Methods. Sex- and age-specific incidence was estimated in men and women aged 55 years and older. Bayesian methods were employed, including adjustment for nonresponse and attrition biases using multiple imputation. Different assumptions for the missing data mechanism were used in a sensitivity analysis.
Results. Weighted to the Canadian population, men aged 55+ have a crude incidence estimate of 17.7/1000 person-years (PY) (95% CrI: 13.5 - 22.1), whereas the corresponding estimate in women is 14.6/1000 PY (95% CrI: 12.2 - 17.1). Adjustment for bias due to attrition has only a slight effect on the estimates in women across all age groups and in men aged 65+ years, under the assumption that the missing data mechanism is ignorable. The rate estimates that are adjusted for both nonresponse and attrition biases variably diverge from the crude estimates both in magnitude and direction, depending on the assumptions made about the missing data mechanism.
Conclusions. A reasonable assumption for modeling the missing data mechanism is that the sex- and age-specific biases are at least as large, and in the same direction, as the differences between the respondent rates and the imputed rates for groups with missing deformity data. Therefore, in Canadians aged 55+ years, vertebral deformity rates that are adjusted for nonresponse and attrition biases are estimated as 14.4/1000 PY (95% CrI: 11.8 - 17.4) in women, and 23.8/1000 PY (95% CrI: 19.6 - 29.0) in men.
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Opatrny, Lucie. "A case-control study examining the association between travel and deep venous thrombosis /." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82303.
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Background. This thesis explores the link between travel and deep venous thrombosis (DVT). While it is biologically plausible that prolonged travel is an independent risk factor for venous thromboembolic disease (VTE), epidemiological data to date are conflicting.Aim. To determine whether there is a independent association between travel and DVT.
Methods. This was a multi-center case control study. Consecutive patients presenting to the vascular laboratory with clinically suspected DVT were eligible to participate. Cases were patients with confirmed DVT; controls were patients who had DVT ruled out. Travel history and clinical characteristics were determined though standardized interviewer-administered questionnaire. Genetic testing of Factor V Leiden and Prothrombin gene mutations were also performed. SAS was used to perform unconditional multivariate logistic regression analysis.
Results. There were 359 cases and 359 controls. The crude and adjusted odds ratios (OR) for travel and DVT were 1.15 (95%CI: 0.78, 1.69) and 1.51 (95%CI: 0.91, 2.50) respectively. Travel of >=12 hours' duration had a higher OR estimate (2.82, 95%CI: 0.52, 15.24) than shorter travel durations (OR = 1.32, 95%CI: 0.63, 2.76), although this did not reach statistical significance. Analyzing plane and car travel separately showed that plane travel of >=12 hours duration had a crude and adjusted OR of 8.22 (95%CI: 1.02, 66.05) and 7.10 (95% CI: 0.70, 72.35). No such association was found with long durations of car travel.
Interpretation. Plane travel appears to be a mild independent risk factor for DVT overall, although the adjusted OR does not achieve conventional levels of statistical significance. Plane travel durations of 12 hours or longer had the highest estimate of risk. This was not found to be true of car travel. These findings may have future implications regarding the use of thromboprophylaxis in travelers.
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Brassard, Paul. "Diabetes in the James Bay Cree communities of Québec, Canada." Thesis, McGill University, 1991. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=60545.
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Using chronic disease registers, a list of physician-diagnosed diabetics was drawn up for the 8 James Bay Cree communities (total population 8840). Medical records were then consulted to ascertain the clinical histories of the patients. The World Health Organization definition of diabetes was applied to diagnosed cases and those not meeting the biochemical criteria were eliminated. A total of 235 persons with diabetes were found, giving a total prevalence of 2.7%. Prevalence of type II was 5.2% in the 20 years and older age group. Prevalence varied from 1.9% in the northernmost village to 9.0% in the southernmost Cree community. The Cree diabetic population is characterized by high levels of obesity and low rates of macrovascular diseases. Duration of disease and poor glycemic control (as reflected by the type of medication needed) influences the presence of microangiopathies.
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Siegel, Erin Michelle. "Association of antioxidant nutrients and human papillomavirus persistence, clearance and viral load among women in the Ludwig-McGill Cohort Study." Diss., The University of Arizona, 2004. http://hdl.handle.net/10150/280535.
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Although an oncogenic human papillomavirus (HPV) infection has been established as the necessary cause of cervical cancer, most HPV infections are transient and rarely progress to significant cervical lesions. Current research has focused on identifying factors associated with viral persistence and clearance. Low nutritional status might influence a woman's risk of having a persistent HPV infection and progression of that infection to cervical dysplasia, or at higher levels increase the probability of clearing infections. The overall goal of this research was to determine the associations between serum carotenoid, tocopherol, and retinoic acid levels and cervical carcinogenesis among the Ludwig-McGill Cohort Study. A sub-cohort of 846 women, all of whom had HPV results available from four consecutive study visits in the first year of follow-up, had serum samples analyzed for circulating nutrients. We determined the variability of circulating retinoic acid levels over the four months in a sample of 502 women and identified lifestyle, demographic and nutritional factors that were associated with these levels. The relative abundance of retinoic acid isomers was similar for each visit and the within person-variability of total retinoic acid and individual isomers was low. Using multivariate logistic regression models that serum nutrient levels (retinol, β-carotene, and β-cryptoxanthin), age, race, oral contraceptive use, total number of pregnancies, and season of initial blood draw were significantly associated with endogenous retinoic acid isomer levels. Among the 407 HPV positive women, endogenous levels of all-trans retinoic acid were positively associated with an increased probability of clearing oncogenic and nononcogenic type-specific HPV infections. Furthermore, among the carotenoids and tocopherols examined, we found that higher circulating zeaxanthin concentrations were associated with increased probability of clearing type-specific oncogenic HPV infections. Inverse associations were found between serum tocopherol levels (α-, δ- and γ-tocopherol) and type-specific nononcogenic HPV persistence. Overall, the findings of this study suggest that women with the highest levels of serum all-trans retinoic acid, zeaxanthin, and tocopherol are at a decreased risk for a persistent, type-specific HPV infection of long duration. As both classes of nutrients are modifiable by diet, alterations in diet may be a safe approach to cervical cancer prevention.
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Chen, Li. "A comparison of methods in the presence of censored cost data under different censoring mechanisms." Thesis, University of Ottawa (Canada), 2005. http://hdl.handle.net/10393/26868.
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Several approaches have recently been proposed in order to derive an accurate estimate of mean costs given censoring. The aim of this study was to compare methods for estimating mean costs given censoring across different censoring mechanisms and censoring levels. 736 "complete" cases from the CHART study were used to form a "complete" set where the mean cost was known. This "complete" cohort was used to generate simulated data sets. The accuracy of methods was measured by comparing the difference between estimates and the "true" cost. The Uncensored cases method, Cox's PH model and the Weighted method CHU consistently gave better estimates of mean costs across different censoring mechanisms and censoring levels. Estimates of mean costs from all methods deteriorated as the censoring level increased. The Uncensored cases method, Cox's PH model and the Weighted method CHU may be appropriate methods for estimating mean costs given censoring in short-term studies.
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Terry, Paul, Margaret Knight, Reagan Bollig, R. Eric Heidel, Preston Miller, Megan Quinn, and Brian Daley. "Overreliance on Standardized Protocols: A Pilot Study of Surgical Residents and Fellows." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/6782.
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Beckstrand, Margaret. "The Distribution of Type 1 Diabetes Onset in the United States by Demographic Factors." Thesis, Walden University, 2015. http://pqdtopen.proquest.com/#viewpdf?dispub=3702522.
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Type 1 diabetes (T1D) is a chronic and lifelong condition, often diagnosed in childhood. Patients with T1D are at elevated risks of associated health complications, comorbidities, and mortality. Occurrence, clinical presentation, and complications related to T1D differ by age of onset, ethnicity, and gender. The last reported population-based estimates regarding the burden of T1D in children using the National Health and Nutrition Examination Survey (NHANES) were published in 2008, and these estimates were not well stratified by age of onset, ethnicity, and gender. The purpose of this study was to examine these demographics within the conceptual framework of the hygiene hypothesis using data from NHANES from 1999 to 2012. A cross-sectional study design was used to determine the average age of onset of T1D with respect to ethnicity and gender and to assess if age of onset is associated with ethnicity and gender. The average age of onset was 10.5 years for males and 11.8 years for females. The average age of onset was 13.0 years for Hispanics, 12.7 years for Non-Hispanic Blacks, and 10.6 years for Non-Hispanic Whites. Regression analysis indicated that there was no significant association between age of onset and gender (β = 1.1, p = 0.386) and between age of onset and ethnicity (β = 2.1, p = 0.070 for Hispanic White; β = 1.9, p = 0.101 for Non-Hispanic Black) having considered the Non-Hispanic White as the reference population. The result of this study may contribute to positive social change by providing better insight on demographic determinants of the risk of T1D, which is crucially important in the planning and implementation of prevention measures in highly susceptible populations.
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Owusu, Daniel, Ke Sheng Wang, Megan Quinn, Jocelyn Aibangbee, Rijo M. John, and Hadii M. Mamudu. "Health Care Provider Intervention and Utilization of Cessation Assistance in 12 Low- and Middle-Income Countries." Digital Commons @ East Tennessee State University, 2019. https://doi.org/10.1093/ntr/nty028.
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Background and Aim: There is a need to improve utilization of cessation assistance in low- and middle-income countries (LMICs), and tobacco cessation research has been identified as priority in LMICs. This study evaluates the relationship between health care provider intervention and cessation assistance utilization in LMICs.
Methods: Data from 13 967 participants (aged ≥15 years, 90.3% males) of the Global AdultsTobacco Survey conducted in 12 LMICs (74.3%-97.3% response rates) were analyzed with utilization of counseling/cessation clinic, WHO-recommended medications, and quitline as outcome variables. Health care provider intervention (“no intervention,” only “tobacco screening,” “quit advice”) was the exposure variable. Weighted multiple logistic regression models were used to examine the relationship between each outcome variable and the exposure variable, adjusting for other covariates. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) are reported.
Results: Approximately 52%, 8%, and 40% of participants received no intervention, only tobacco screening, and advice to quit, respectively. Overall, 0.4%, 1.9%, 3.0%, and 4.5% used quitline, WHO-recommended medications, counseling/cessation clinic, and any cessation assistance, respectively. Compared with no intervention, quit advice was associated with increased utilization of quitline (OR = 2.24, 95% CI = 1.2 to 4.4), WHO-recommended medications (OR = 1.67, 95% CI = 1.2 to 2.3), counseling/cessation clinic (OR = 4.41, 95% CI = 3.2 to 6.1), and any assistance (any of the three types) (OR = 2.80, 95% CI = 2.2 to 3.6).
Conclusion: The findings of this study suggest that the incorporation of quit advice by health care providers in tobacco control programs and health care systems in LMICs could potentially improve utilization of cessation assistance to improve smoking cessation in LMICs.
Implications: This first study of association between health care provider intervention and the utilization of cessation assistance in LMICs reports that there was a missed opportunity to provide quit advice to about 60% of smokers who visited a health care provider in the past year. The odds of utilization of counseling/cessation clinic, WHO-recommended medications, and quitline were significantly increased in participants who were advised to quit smoking. The results suggest that effective integration and implementation of advice to quit in tobacco control programs and the national health care systems may increase the use of cessation assistance to quit smoking.
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Ladouceur, Martin. "Bayesian estimation of the prevalence of osteoarthritis in the Québec elderly population from an administrative database." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81351.
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Osteoarthritis (OA) is the most prevalent form of arthritis. It is a disabling condition that mostly affects the elderly with huge costs to society. Estimating the prevalence of OA is important for planning health services, for creating programs aimed to prevent OA disability and for assisting patients living with these disabilities. Several authors have attempted to estimate the prevalence of OA using data obtained from self-report questionnaires or administrative databases. Self-report questionnaires are prone to recall bias and estimates from administrative databases have relied solely on diagnostic codes, that can sometimes be inaccurate. If data from three presumed conditionally independent tests are used to estimate the prevalence, then the problem is identifiable, meaning that all parameters can be estimated without imposing constraints on the parameter space. When data from the three conditionally independent diagnostic tests were considered, the estimated prevalence of OA was 14.8% (95% CI: 14.5-15.1). A moderate degree of variation in this prevalence estimate was found across different models carrying different assumptions. The Bayesian latent class methodology used is advantageous in accounting for the different estimates that may arise from different sets of modelling assumptions. As the validity of the results rely on various assumptions, all of which are difficult to verify, final conclusions depend on which assumptions are thought most likely to be true, and the degree of robustness of estimates across different models.
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Cardinal, Héloise. "Determinants of patient and graft survival in the elderly recipients of a kidney graft." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81606.
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Elderly patients represent an increasing proportion of kidney transplant recipients. Yet factors that determine their post-transplantation outcomes remain poorly defined.The aim of this study was to identify pre- and post-transplant predictors of patient and graft survival in elderly recipients of kidney grafts.
We performed a population-based retrospective cohort study involving patients aged 60 years or older who received a first cadaveric kidney transplant. Potential outcome predictors were identified with survival analyses based on a Cox proportional hazard model.
Active smoking at transplantation, increased body mass index and time on dialysis before transplantation were significantly associated with an increased risk of post-transplant mortality and graft loss. Decreased graft function at one year was associated with a higher risk of mortality and graft loss beyond one year post-transplant.
In conclusion, our study has identified potential targets for interventions aimed at improving patient and graft survival in elderly patients.
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Ionescu-Ittu, Raluca. "Continuity of primary care and return visits to the emergency department for seniors in Quebec." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=82255.
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Background. Continuity of care as a principle of health care planning is losing ground in favor of new principles such as accessibility and plurality of provision, but the long-term effects of these changes on the utilization of expensive health services such as hospitalizations and emergency department utilization are still unknown.Objective. To investigate among individuals aged 66 years or older who have had an index visit to an emergency department (ED) whether there is an association between the continuity with a primary care provider and the likelihood of having an ED return visit 14 days after the index ED visit.
Conclusions. Among Quebec seniors, relational continuity of care measured by UPC may not be an important protective factor against returning to the ED after an index visit. The main study limitations to be considered in the interpretation of these results relate to the use of administrative data, and include potential misclassification of ED visits and return visits, inability to distinguish planned from unplanned return visits, and residual confounding due to covariates that were either not measured or measured at the ecological level (e.g., socioeconomic status).
Research and policy implications. Further research, using different data sources and measures, is needed to investigate the association between continuity of care and ED utilization among seniors in Quebec. (Abstract shortened by UMI.)
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Liyanage, Nilani. "Misclassification bias in epidemiologic studies." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=23406.
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Misclassification of disease and/or exposure is a common and potentially serious problem in epidemiologic studies. The impact of misclassification may be profound and may invalidate results. Despite the fact that there have been a number of articles published on the significance of misclassification bias, many epidemiologic studies are carried out with little attention paid to this issue either in the design or the analysis. The goal of this thesis is to provide clarifications on issues surrounding misclassification of exposure in case-control studies. Specifically, the conditions under which misclassification is likely to occur, the potential impact on effect measures and how misclassification can be prevented through design and corrected for in the analysis are discussed in detail.
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Bjerre, Lise M. (Lise Marie). "Analysis of etiologic studies : understanding the Mantel-Haenszel estimator of odds ratio." Thesis, McGill University, 1995. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=22849.
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The present work is an endeavour to gain an understanding of the Mantel-Haenszel (MH) estimator beyond that which can be garnered from textbook consultation. To this end, I explore two aspects of the estimator which cannot be fully understood from the textbooks: the rationale for its weights, and its performance. The first one has to do with the basis for the particular choice of the estimator's weights, and the second one with the estimator's distributional properties and their assessment.The approach to each of the topics is, first, to identify and understand what is presented in the original literature; and second, critically to examine the findings in light of established principles of data analysis, to shed new light on the issues that turn out to be ill-understood.
Rather striking new understandings arise. Theoretical justification for the "weights" of the cross-products cannot be found in the literature. The textbook conceptualization of the MH estimator as a weighted average of stratum-specific estimates of odds ratio (unconditional) is supported by the original literature, yet untenable.
A new and tenable conceptualization of the estimator is proposed. Unrecognized in the literature, the stratum-specific cross-products involve a random aspect of the data, and the structure of the estimator is hence unjustifiable in this respect. A first order improvement is proposed and illustrated using examples.
Theoretical evaluation of the estimator's performance is limited by the literature's focus on one of the asymptotic situations. Results of empirical evaluations of the estimator are in accord with textbook claims, but are still too limited. (Abstract shortened by UMI.)
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Coffin, Donna. "Factors associated with non-participation in a study of medication compliance in the elderly." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ55043.pdf.
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Damicis, Adrienne. "A Spatial Risk Map of Malaria in Four African Countries." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1555615180322027.
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Sullivan, Shannon M. "Development and evaluation through structural equation modeling of a model of healthy behaviours in older adults." Thesis, University of Ottawa (Canada), 2006. http://hdl.handle.net/10393/27421.
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Unhealthy behaviours contribute significantly to chronic disease. Longitudinal studies report improvements in the health of older adults after positive changes in health behaviours.
A conceptual model of healthy behaviours in older adults was developed based on prospective evidence. Structural equation modeling was used to test specific hypotheses in a sample of 980 family practice patients over 65 years who attended a cardiovascular health awareness session.
A model was specified that included variables reflecting health status, health-related quality of life, physician counseling and patient knowledge (p=0.02, CFI=0.97, RMSEA=0.039). Health-related quality is the most important pathway to healthy lifestyle behaviours (beta=0.41). Physician counseling is the most important pathway to healthy self-care behaviours (beta=0.64).
This preliminary model provides evidence of the importance of health-related quality of life and physician counseling for influencing healthy behaviours among older adults.
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Strasser, Sheryl M., Megan Smith, Scott Weaver, Shimin Zheng, and Yan Cao. "Screening for Elder Mistreatment among Older Adults Seeking Legal Assistance Services." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/60.
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Introduction: The aging population is a rapidly growing demographic in the United States. Isolation, limited autonomy, and declining physical and mental health render many older adults vulnerable to elder mistreatment (EM). The purpose of this study was to assess the prevalence and correlates of EM among a sample of older adults using legal assistance services in Atlanta, Georgia.
Methods: Researchers administered surveys to consenting older adults (aged 60þ) in 5 metro Atlanta community centers that hosted legal assistance information sessions as part of the Elderly Legal Assistance Program. The surveys screened for risk factors and prevalence of EM risk using valid and reliable measures and included additional questions regarding demographics characteristics and healthcare use behaviors.
Results: Surveys were completed by 112 participants. Findings reveal that 32 (28.6%) respondents met the criteria for elder abuse / neglect risk; 17 (15.2%) respondents met criteria for depression; and 105 (93.7%) had visited a healthcare provider during the past 6 months.
Conclusion: The rates of EM risk in this sample were higher than those previously reported in research. Findings support continued examination of unique risks that may be present among older adults who may be possibly facing legal issues. Additionally, the reported frequency of healthcare visits among participants reveals a promising opportunity to examine development of a more widespread EM screening approach to be conducted in non-emergency settings. Interdisciplinary collaboration is required to inform screening approaches that account for complexities that EM cases present. [West J Emerg Med. 2013;14(4):309–315.]
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Alamian, Arsham. "Multiple Behavioral Risk Factors for Chronic Diseases and Public Health Implications." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/1382.
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Leclerc, Pascale C. "Representativeness and behaviors of volunteers in a study of pregnancy." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=60424.
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The principal objective of this study was to examine use of alcohol, cigarettes and medication by women who were or were trying to become pregnant using two available data sets: one from l'Etude sur la Grossesse de Montreal (EGM) and the other from l'Enquete Sante Quebec (ESQ). A second objective was to assess the representativeness of volunteers in a study of reproduction.We studied the relationship between "time trying to conceive" and consumption of alcohol, cigarettes and medications and we compared the prevalence of these behaviors among pregnant and non-pregnant women.
To assess the representativeness of volunteers, we compared the consumption of alcohol and cigarettes of the whole groups of ESQ and EGM women, and of the subgroups of pregnant women.
In summary, there were variations in some of the studied behaviors with "time trying to conceive" and pregnancy status. Also, volunteers were similar to the general population for cigarette smoking, but not alcohol consumption.
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Rajabi, Zeyad. "BIAS : bioinformatics integrated application software and discovering relationships between transcription factors." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81427.
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In the first part of this thesis, we present a new development platform especially tailored to Bioinformatics research and software development called Bias (Bioinformatics Integrated Application Software) designed to provide the tools necessary for carrying out integrative Bioinformatics research. Bias follows an object-relational strategy for providing persistent objects, allows third-party tools to be easily incorporated within the system, and it supports standards and data-exchange protocols common to Bioinformatics. The second part of this thesis is on the design and implementation of modules and libraries within Bias related to transcription factors. We present a module in Bias that focuses on discovering competitive relationships between mouse and yeast transcription factors. By competitive relationships we mean the competitive binding of two transcription factors for a given binding site. We also present a method that divides a transcription factor's set of binding sites into two or more different sets when constructing PSSMs.
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Semenciw, Robert. "Evaluation of trend measures of census division mortality, Canada 1974-1986." Thesis, McGill University, 1990. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=59637.
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The methodologic issues involved in evaluating trends in mortality by Census Division (CD) are explored. The three trend measures investigated included Poisson regression, ordinary least squares (OLS), and a measure based on Raveh's measure of monotone association for time series.Assumptions required for the parametric methods of Poisson regression and OLS were not satisfied. The non-parametric method based on the ranking of the measure of monotone association did not require such assumptions. Significant spatial correlation in the measure of monotone association was observed for all-cause mortality.
Using deaths among persons 35-69 years for 3 causes, comparisons were carried out by cross-tabulations, Pearson rank correlation coefficients, and an investigation of discrepancies. Minor discrepancies resulted from differences in trends of age-specific death rates and from CDs with small populations. Rather than distinguishing further between the three trend measures, guidelines should be developed for minimum populations at risk required for mapping as well as methods for combining regions.
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Delfino, Ralph J. (Ralph John). "The relationship of urgent hospital admissions for respiratory illnesses to air pollution levels in Montreal." Thesis, McGill University, 1993. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=41570.
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The relationship between the number of daily hospital admissions for respiratory illnesses and ambient air pollution in Montreal, Canada, was investigated for cold and warm periods between 1983 and 1988. The comprehensive hospital discharge database of the Quebec Ministry of Health and Social Services was used to derive daily counts of hospital admissions for respiratory illnesses, and for certain non-respiratory illnesses not expected to be related to air pollution levels. The reliability of this database was assessed by reviewing 1,270 hospital discharges.Routinely monitored independent variables, derived from various government databases, included temperature, relative humidity, ozone, nitrogen dioxide, sulfur dioxide, coefficient of haze, and measures of particulate pollution, several of which were recorded only every sixth day. To permit a daily time series analysis, levels for the missing 5 days were modelled using meteorologic and other pollutant variables.
To control for confounding by season, the dependent and independent time series were detrended using a weighted 19-day moving average linear filter. To control for confounding by day-of-week cycles, the dependent series were pre-filtered with day-of-week indicator variables.
For the July to August periods, statistically significant relationships were shown for all respiratory admissions to 8-hour maximal average ozone levels 4 days prior to the admission day, relationships which were however confounded by temperature of the same lag day. After controlling for temperature, admissions for asthma, and for respiratory illnesses other than asthma, were significantly associated with particulate levels 2 to 4 days prior to the admission day for the warm but not the cold periods. Stronger associations were found using a filter which did not remove month-to-month temporal trends. A significant correlation of non respiratory admissions to particulate levels on the day of admission was confounded by temperature and relative humidity.
These results suggest that particulate air pollution, possibly acidic, during photochemically active periods is related to respiratory morbidity in Montreal. The effects shown, at levels mostly below current ambient air quality standards in North America, are relevant to public health, since hospital admissions are likely to reflect more frequent episodes of less serious illness.
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Schaffer, Andrea. "Insulin-like growth factor-I, insulin-like growth factor binding protein-3 and the risk of cervical squamous intraepithelial lesions." Thesis, McGill University, 2004. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=81435.
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Insulin-like growth factors (IGFs) and their binding proteins (IGFBPs) have been associated with an increased risk of several cancers. This case-control study investigated the relationship between IGF-I and IGFBP-3 plasma levels and the risk of squamous intraepithelial lesions (SILs) of the cervix, as well as the risk of HPV infection in women. 366 cases and 366 controls were recruited from five Montreal area hospitals. There was a significantly decreased risk of LSIL for the highest quartile of IGFBP-3 relative to the lowest quartile (Odds Ratio (OR)=0.25, 95% confidence interval (CI) 0.08-0.77), adjusted for age, HPV status and IGF-I. Also, there was a significantly increased risk of being positive for HPV, specifically high-risk types, for the highest quartiles of IGFBP-3 relative to the lowest quartile in controls (OR=4.53, 95% CI 1.33-15.40), adjusted for age and IGF-I. IGF-I was not significantly associated with SILs or HPV infection.
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Musana, Kenneth Apollo. "The molecular epidemiology of tuberculosis in Montreal and British Columbia." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp03/MQ64413.pdf.
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Fosser, Cecilia. "Statistical analysis of a stochastic automata model for the spread of disease among mobile individuals." Diss., The University of Arizona, 2000. http://hdl.handle.net/10150/284283.
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We present techniques that allow for the statistical identification of the infection front and for the microscopic control of macroscopic statistics in a simple stochastic lattice automata model for the spread of an infectious disease through a mobile host population. The individual based model consists of susceptible and infected individuals that are free to move about a regular lattice. These individuals interact with each other when located at the same node of the lattice, and susceptible individuals become infected with a probability of infection that is dependent on the number of infected individuals present. By using statistics from the healthy population alone, we present a method by which the spread of an infection in the model can be located spatially, even in a low-density population. A parameter which governs the local mobility rules of the model is shown to be functionally related to the non-dimensional statistical values of skewness and flatness for various macroscopic quantities. We show formal convergence to reaction-diffusion equations from the lattice Boltzmann equations of the model via a Hilbert expansion. The validity of both the lattice Boltzmann equations and the reaction-diffusion equations is shown in a low-density population regime.
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Risendal, Betsy Corsino 1962. "Cancer screening among urban American Indian women." Diss., The University of Arizona, 1998. http://hdl.handle.net/10150/288796.
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Existing information about cancer among American Indians, although limited, suggests that incidence and mortality rates are increasing. Cancer is now the second leading cause of death among American Indian women. American Indians also have the poorest cancer survival of any group in the US. Improving the early detection of cancer is key to reducing mortality and improving survival. This study assessed screening rates and behaviors for breast and cervical cancer, two of the main causes of cancer death in American Indian women. The health beliefs and practices of urban American Indian women, a group which comprises half of this special population, were the focus of this cross-sectional random household survey. Our results are similar to the results of other studies which indicate that breast and cervical cancer screening rates in American Indian women are below both national estimates and goals set forth by the Public Health Service for the Year 2000. The prevalence of recent mammogram among urban southwestern American Indian women surveyed (35.7%) was less than half that of the US population, and only 49.5% indicated they had received a Pap smear in the last year in accordance with current guidelines for this high-risk population. Rate of physician referral for several cancer risk reduction programs also did not meet recommended levels. Improving health care access and knowledge and awareness of cancer screening are other potential ways of increasing screening participation, and more research is needed to promote the link between lifestyle habits and long-term health promotion in urban southwestern American Indian women.
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Zhong, Lijie 1962. "A population-based, case-control study of lung cancer and indoor air pollution among nonsmoking women living in Shanghai, China /." Thesis, McGill University, 1998. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=35494.
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This dissertation describes the design and results of an epidemiological study that was conducted to estimate associations between the incidence of lung cancer and indoor air pollution from environmental tobacco smoke and from Chinese-style cooking. The study was designed as a population-based, case-control study of incident, primary lung cancer. It was carried out between 1992 and 1994 among nonsmoking women living in Shanghai, People's Republic of China, and data for 504 case subjects and 601 control subjects were collected and analyzed.Exposure to tobacco smoke from the husbands of subjects was not found to be associated with all types of lung cancer combined, although increased risks were observed for nonadenocarcinomas of the lung. Exposure to environmental tobacco smoke at work conferred excess risks in all histological subtypes. In addition, risks increased with increasing numbers of hours of daily exposure to environmental tobacco smoke in the workplace and with increasing numbers of smoking coworkers, but risk did not increase with increasing numbers of years that subjects were exposed to the tobacco smoke from coworkers.
Increased risks of lung cancer were found for a variety of indices representing exposure to indoor air pollutants from Chinese-style cooking, including not having a separate kitchen, heating cooking oils to high temperatures (about 280°C), and most often cooking with rapeseed oil. Similar patterns of risk were found across the different histological subtypes.
Lung cancer risks were also associated with a higher frequency of eye irritation, greater extent of smokiness in the kitchen during cooking, with a more than daily use of stir-frying, and with a more than weekly use of deep-frying and frying. The risks of lung cancer were lower if a fume extractor was used and decreased with increasing ventilation, as measured by increasing area of the windows in the apartment.
In conclusion, long-term occupational exposure to environmental tobacco smoke increases the risk of lung cancer among women who were lifetime nonsmokers. Exposure to indoor air pollution from Chinese-style cooking, especially cooking unrefined rapeseed oil at high temperatures in woks, also increases the risk of lung cancer.
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Duarte, Elisabeth Carmen. "Randomized controlled trial of artesunate plus tetracycline versus standard treatment (quinine plus tetracycline) for uncomplicated plasmodium falciparum malaria in Brazil." Thesis, McGill University, 1994. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=55491.
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A triple blind randomized controlled trial was undertaken in a Brazilian Amazon region (Cuiaba-MT), to compare the effectiveness and side effects of oral artesunate (7 days, total dose = 0.75 g) plus tetracycline (7 days, total dose = 10.5 g) (AT) and oral quinine (3 days, total dose = 6 g) plus tetracycline (7 days, total dose = 10.5 g) (QT). Eligible patients had uncomplicated P. falciparum malaria; age $ geq$ 14 years; no previous malaria treatment related to the present attack; and, if women, indication of absence of pregnancy. Clinical exam and blood tests were performed at baseline (day 0) and thereafter at days 2, 4, 7, 14 and 28. Effectiveness was assessed by cure rates (WHO criteria) and parasite clearance at day 2.176 patients were randomized, 88 to each group. 96.6% of the AT group and 93.2% of the QT group completed the 7-day treatment. 81.8% of the AT group and 78.4% of the QT group completed follow-up visits to day 28. Groups had similar clinical characteristics at baseline. The incidence of side effects was much higher in the QT group (82%) than in the AT group (50%) (p $<$ 0.0001). Cure rates were similar: 80% in the AT and 77% in the QT group (p = 0.68). Parasitemia (by day 2) cleared faster in the AT group than in the QT group (98.5% versus 47.6%, respectively) (p $<$ 0.0001).
These results indicate that AT is effective in the treatment of uncomplicated falciparum malaria and may provide a useful alternative to other treatment regimens.
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Assimes, Themistocles. "Hypertension and the risk of cancer : a population study." Thesis, McGill University, 2001. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=31184.
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Several epidemiological studies have evaluated whether an association exists between hypertension and cancer with inconclusive results because of several design biases.Using the Saskatchewan Health Databases, a cohort of subjects with incident treated hypertension between 1980 and 1987 was assembled and followed until 1996 to identify all incident cancer hospitalizations. Age and sex-standardized incidence ratios for all cause and for site-specific cancers were estimated using provincial cancer rates.
A small increased risk of all-cause cancer was found mainly among females (RR: 1.12, 95 percent CI 1.06--1.17). Site-specific analyses revealed increased risks for uterine, breast, bladder, kidney, and several less common cancers. Re-analyses to control for reverse causality and detection bias did not alter the findings.
While this study suggests a weak association between hypertension and cancer, the inability to control for information bias and for certain confounders does not allow for a definitive conclusion on causality.
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Levy, Adrian R. 1962. "Projecting the lifetime risk of breast and thyroid cancer from exposure to diagnostic ionizing radiation for adolescent idiopathic scoliosis." Thesis, McGill University, 1992. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61333.
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The purpose of this study was to determine the cumulative doses of x-ray radiation to the thyroid gland and female breast from spinal radiographs for Adolescent idiopathic scoliosis (AIS) and to estimate the number of cancers at these sites attributable to x-rays.Subjects for this study were patients referred from 1960 to 1979 for AIS to Hopital Ste-Justine, Montreal.
About 85 percent of 2,181 subjects were first referred for scoliosis between the ages of eleven and seventeen and the average time under observation was about three years. The mean number of radiographs was about twelve. The mean cumulative dose to the thyroid gland and to the female breast was about three cGy. Seven excess breast cancer and thyroid cancer cases were projected to occur over the lifetime of the women; among these, two excess deaths from cancers were projected. Approximately one in every 250 women in this cohort would be expected to develop breast or thyroid cancer over their lifetime, and one in every 900 women would be expected to develop a fatal cancer. (Abstract shortened by UMI.)
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Dow, Darcie. "Analysis and review of analytic approaches to dealing with post-randomized ineligible patients resulting from a change in post-randomization disease-state ascertainment." Thesis, University of Ottawa (Canada), 2006. http://hdl.handle.net/10393/27351.
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In a series of three parts, this thesis explores the available approaches to analyze post-randomized ineligible patients. Part one: a comprehensive systematic review yielding 18 unique articles from the Medline and the Cochrane Methodology Register databases. Part two: the methods found from the review were applied to a dataset where 23% of the patients in the experimental treatment group were found to be post-randomized ineligible patients. The results of this exercise revealed that little can be done when these patients exist and the best approach to dealing with them is to carefully choose an approach and accurately report how these patients were analyzed. Part three: Influenza was explored to further illustrate the importance of accurate reporting and the broader impact of this analytic issue. In sum, no firm conclusion could be reached on one "best" approach to take for randomized ineligible patients, however prevention and accurate reporting were surrogate recommendations.
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Carswell, Kendra. "Psychosocial predictors of smoking and alcohol use in Canadian pediatric cancer survivors: Structural equation modeling." Thesis, University of Ottawa (Canada), 2007. http://hdl.handle.net/10393/27452.
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Survivors of pediatric cancer should avoid smoking and heavy alcohol use due to health risks associated with intensive cancer treatments they received. Data were analyzed from a multi-centre, population-based study of pediatric cancer survivors in Canada (n=1231) and a frequency matched control group (n=1372). Logistic regression analyses showed that survivors were significantly less likely to be smokers and alcohol drinkers than the controls. Still, a substantial proportion of survivors were smokers (23%), binge drinkers (25%), alcohol drinkers (69%) and concurrent users (20%). Low education, poor life satisfaction, and high stress were the most consistent predictors of substance use. Results from the structural equation modeling analysis to describe pathways to concurrent smoking and alcohol use showed significant pathways from education and chronic stress to concurrent use in the cancer survivors. This study identifies potential risk factors for smoking and alcohol use in cancer survivors and suggests a need for preventive education.
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Barbee, Jessica R., Aleigha Spaulding, Christian Nwabueze, Sreenivas P. Veeranki, and Shimin Zheng. "National and Tennessee Trends in BMI Percentile, Obesity, and Overweight Rates Among Youth Using YRBSS Data 1999-2017." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/asrf/2019/schedule/3.
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Adolescents in the United States continue to exhibit epidemic proportions of obesity and overweight, contributing to significant morbidity and mortality rates. Obesity and overweight are also found to be associated with other unhealthy behaviors in adolescents, such as physical inactivity and smoking. The Center for Disease Control and Prevention (CDC) reports the annual rates of adolescent obesity in the U.S.; however, comparative trends for the past two decades and comparisons of rates between general U.S. and Tennessee, a tobacco-producing state in the stroke belt, are not available. To compare trends in rates of BMI percentile, overweight, and obesity among adolescents, grades 9th through 12th, between the U.S. and Tennessee during 2003-2017 and identify critical factors associated with them. Both national and Tennessee BMI trends show different patterns from 1999 to 2017; further analysis of covariate factors will provide more information on this difference in trends. We expect to find little variation between the United States and Tennessee when comparing the age of high school obesity rates. However, previous trends in racial and ethnic disparities for BMI percentiles, obesity, and overweight suggest there will be differences among these variables. Preventable chronic diseases should not affect children. The outcomes of childhood obesity are too severe to ignore. Understanding the risk factors, risk behaviors, and prevalence of adolescent obesity is the first step in addressing this public health crisis.
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Raynault, Marie-France. "Les principales pathologies des sans-abri /." Thesis, McGill University, 1991. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=60005.
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Objectif. Comparer l'experience d'hospitalisation des sans-abri avec celle d'une population residente de bas niveau socio-economique. Methode. Une recherche de dossiers a ete effectuee a l'hopital Saint-Luc a partir du recensement des 7993 sans-abri qui avaient utilise les refuges montrealais durant la periode allant du 1er mars 1988 au 22 fevrier 1989. Les donnees de la feuille sommaire des 245 hospitalisations qui avaient eu lieu durant la meme periode ont ete comparees a celles extraites du registre MedEcho pour les residents du territoire du Departement de Sante Communautaire Sant-Luc ayant ete hospitalises a l'hopital Saint-Luc. En outre, les dossiers des sans-abri ont ete revises pour verifier la presence d'anemies, de tuberculose et de seropositivite au VIH ou au virus de l'hepatite B. Conclusion. Les san-abri presentent une augmentation marquee du risque relatif en ce qui concerne les pathologies mentales qui sont aussi les pathologies les plus frequentes. On n'a pas note d'augmentation des durees de sejour lorsque les itinerants etaient hospitalises.
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Hendrickson, Blake Edward. "Personality traits of alcohol and other drug users in Cape Town, South Africa." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/16568.
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Includes bibliographical referencesThe Substance Use Risk Profile Scale (SURPS) is a relatively new questionnaire that assesses individual personality risk for substance-related problems. Preliminary findings have indicated that the SURPS is a useful measure for identifying characteristics predisposing some individuals to alcohol and other drug (AOD) use. High levels of hopelessness, anxiety sensitivity, sensation seeking, and impulsivity are each associated with specific patterns of substance use caused by underlying motivational susceptibilities. Furthermore, incorporating these traits into tailored prevention and treatment efforts have shown value in other countries. The present study enrolled a community sample in Cape Town, South Africa and asked respondents about their demographics, history of AOD use, personality as measured by the SURPS, and other mental health indicators. This information was used to identify personality risks in the local population and validate the utility of the SURPS for the first time in Sub-Saharan Africa. Results found that sensation seekers had a significantly higher risk for alcohol, tobacco, cannabis, cocaine, and hallucinogen use compared to other personality groups and controls. As expected, respondents demonstrating anxiety sensitivity also showed high-risk use of alcohol, but less high-risk illicit drug use . Finally, the hopelessness group exhibited a higher risk for opioid use but overall, hopelessness and impulsivity had little impact on concurrent substance use, which contrasts with other literature. Unlike findings from mostly European and North American samples that indicate generalizability, this study did not find structural or concurrent validity for the SURPS. This provides evidence against it being adopted as a culturally appropriate assessment tool in a diverse South African population.
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Nwosu, Ann. "Sensitivity Analyses of the Effect of Atomoxetine and Behavioral Therapy in a Randomized Control Trial." The Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu1492475391440277.
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