Home About us Contact
|
Home About us Contact | ||
|
|
||
Poisson Regression Analyses (poisson + regression_analysis)
Selected AbstractsDo California Counties With Lower Socioeconomic Levels Have Less Access to Emergency Department Care?ACADEMIC EMERGENCY MEDICINE, Issue 5 2010Deepa Ravikumar Abstract Objectives:, The study objective was to examine the relationship between number of emergency departments (EDs) per capita in California counties and measures of socioeconomic status, to determine whether individuals living in areas with lower socioeconomic levels have decreased access to emergency care. Methods:, The authors linked 2005 data from the American Hospital Association (AHA) Annual Survey of Hospitals with the Area Resource Files from the United States Department of Health and Human Services and performed Poisson regression analyses of the association between EDs per capita in individual California counties using the Federal Information Processing Standard (FIPS) county codes and three measures of socioeconomic status: median household income, percentage uninsured, and years of education for individuals over 25 years of age. Multivariate analyses using Poisson regression were also performed to determine if any of these measures of socioeconomic status were independently associated with access to EDs. Results:, Median household income is inversely related to the number of EDs per capita (rate ratio = 0.83; 95% confidence interval [CI] = 0.71 to 0.96). Controlling for income in the multivariate analysis demonstrates that there are more EDs per 100,000 population in FIPS codes with more insured residents when compared with areas having less insured residents with the same levels of household income. Similarly, FIPS codes whose residents have more education have more EDs per 100,000 compared with areas with the same income level whose residents have less education. Conclusions:, Counties whose residents are poorer have more EDs per 100,000 residents than those with higher median household incomes. However, for the same income level, counties with more insured and more highly educated residents have a greater number of EDs per capita than those with less insured and less educated residents. These findings warrant in-depth studies on disparities in access to care as they relate to socioeconomic status. ACADEMIC EMERGENCY MEDICINE 2010; 17:508,513 © 2010 by the Society for Academic Emergency Medicine [source] Allergic rhinitis and the common cold , high cost to societyALLERGY, Issue 6 2010J. Hellgren To cite this article: Hellgren J, Cervin A, Nordling S, Bergman A, Cardell LO. Allergic rhinitis and the common cold , high cost to society. Allergy 2010; 65: 776,783. Abstract Background:, The common cold and allergic rhinitis constitute a global health problem that affects social life, sleep, school and work performance and is likely to impose a substantial economic burden on society because of absence from work and reduced working capacity. This study assesses the loss of productivity as a result of both allergic rhinitis and the common cold in the Swedish working population. Methods:, Four thousand questionnaires were sent to a randomized adult population, aged 18,65 years, in Sweden, stratified by gender and area of residence (metropolitan area vs rest of the country). The human capital approach was used to assign monetary value to lost productivity in terms of absenteeism (absence from work), presenteeism (reduced working capacity while at work) and caregiver absenteeism (absence from work to take care of a sick child). Results:, Thousand two hundred and thirteen individuals responded, response rate 32%. The mean productivity loss was estimated at 5.1 days or , 653 per worker and year, yielding a total productivity loss in Sweden of , 2.7 billion a year. Of the total costs, absenteeism (44%) was the dominant factor, followed by presenteeism (37%) and caregiver absenteeism (19%). Poisson regression analyses revealed that women, people in the 18,29 year age group, and respondents with ,doctor-diagnosed asthma' reported more lost days than the rest of the group. Conclusion:, In Sweden, the cost of rhinitis is , 2.7 billion a year in terms of lost productivity. A reduction in lost productivity of 1 day per individual and year would potentially save , 528 million. [source] Ergonomic and socioeconomic risk factors for hospital workers' compensation injury claimsAMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 7 2009Jon Boyer ScD Abstract Background Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers' compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions. Methods A single community hospital provided workforce demographics and WC claim records for 2003,2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the O*NET online database. Occupational exposures and SES categories were assigned to workers through their O*NET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES. Results The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims. Conclusions Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings. Am. J. Ind. Med. 52:551,562, 2009. © 2009 Wiley-Liss, Inc. [source] Cancer mortality among European asphalt workers: An international epidemiological study.AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 1 2003Abstract Background Inhalation of bitumen fumes is potentially carcinogenic to humans. Methods We conducted a study of 29,820 male workers exposed to bitumen in road paving, asphalt mixing and roofing, 32,245 ground and building construction workers unexposed to bitumen, and 17,757 workers not classifiable as bitumen workers, from Denmark, Finland, France, Germany, Israel, the Netherlands, Norway, and Sweden, with mortality follow-up during 1953,2000. We calculated standardized mortality ratios (SMRs) and 95% confidence intervals (CIs) based on national mortality rates. Poisson regression analyses compared mortality of bitumen workers to that of building or ground construction workers. Results The overall mortality was below expectation in the total cohort (SMR 0.92, 95% CI 0.90,0.94) and in each group of workers. The SMR of lung cancer was higher among bitumen workers (1.17, 95% CI 1.04,1.30) than among workers in ground and building construction (SMR 1.01, 95% CI 0.89,1.15). In the internal comparison, the relative risk (RR) of lung cancer mortality among bitumen workers was 1.09 (95% CI 0.89,1.34). The results of cancer of the head and neck were similar to those of lung cancer, based on a smaller number of deaths. There was no suggestion of an association between employment in bitumen jobs and other cancers. Conclusions European workers employed in road paving, asphalt mixing and other jobs entailing exposure to bitumen fume might have experienced a small increase in lung cancer mortality risk, compared to workers in ground and building construction. However, exposure assessment was limited and confounding from exposure to carcinogens in other industries, tobacco smoking, and other lifestyle factors cannot be ruled out. Am. J. Ind. Med. 43:18,27, 2003. © 2003 Wiley-Liss, Inc. [source] Determinants and sequelae associated with utilization of acetaminophen versus traditional nonsteroidal antiinflammatory drugs in an elderly populationARTHRITIS & RHEUMATISM, Issue 11 2002Elham Rahme Objective Acetaminophen is recommended as initial therapy for patients with arthritis, particularly those at increased risk of nonsteroidal antiinflammatory drug (NSAID),induced gastrointestinal (GI) side effects. However, higher doses of acetaminophen inhibit prostaglandin synthesis and have been associated with GI events. This study was undertaken to compare the observed and adjusted rates of GI events (hospitalizations, ulcers, dyspepsia, GI prophylaxis) occurring with higher versus lower doses of acetaminophen. Methods This was a retrospective cohort study of subjects ages ,65 years who received a prescription for acetaminophen or NSAID between 1994 and 1996. Pharmaceutical and medical records were reviewed for 1 year of historical data prior to the index prescription of acetaminophen or non-aspirin NSAID. Risk factors for GI events were identified based on the historical data. To further control for bias, patients were categorized by propensity score (the likelihood of receiving acetaminophen, given defined risk factor values). Records were then reviewed for the duration of the index prescription or 30 days, whichever was less, to generate data on the occurrence of GI events. Determinants of acetaminophen utilization were identified using logistic regression, and rates of GI events for each therapy were examined using Poisson regression analyses, controlling for duration of exposure, individual risk factors, and propensity scores. Results The study included 26,978 patients in the NSAID cohort and 21,207 in the acetaminophen cohort. Determinants of acetaminophen utilization compared with NSAIDs (odds ratio [95% confidence interval]) included recent hospitalization (8.6 [7.7,9.5]), concomitant anticoagulation therapy (3.2 [2.7,3.8]), age >85 years (2.3 [2.1,2.4]), and history of prior GI events, especially those requiring hospitalization (14.6 [11.7,18.7]). Unadjusted rates of GI hospitalization, ulcer, and dyspepsia were higher for patients in the acetaminophen cohort than for those in the NSAID cohort. The occurrence of GI events in acetaminophen-treated patients was dose dependent, with rate ratios (compared with high-dose NSAIDs and adjusted for risk susceptibility) ranging from 0.6 (95% confidence interval 0.5,0.7) for ,650 mg/day to 1.0 (0.9,1.1) for >3,250 mg/day. Conclusion In this cohort, acetaminophen utilization is more common in patients at higher risk of GI events. After adjustment for risk susceptibility, patients receiving higher doses of acetaminophen have higher rates of GI events compared with those receiving lower doses. [source] An epidemiological study of risk factors associated with the recurrence of equine grass sickness (dysautonomia) on previously affected premisesEQUINE VETERINARY JOURNAL, Issue 2 2004J. R. Newton Summary Reasons for performing study: The reasons why equine grass sickness (EGS) recurs on premises are unknown and, consequently, practical methods for reducing the risk of recurrence are not available. Objectives: To identify risk factors associated with recurrence of EGS on premises and to gain possible insights into the pathogenesis of the disease. Methods: Data on disease history and risk factors were collected by postal questionnaire from premises with EGS cases between 1st January 1997 and 31st December 2001. Data on variation in rates of recurrence of EGS for different risk factors were analysed using Poisson regression analysis. Results: Of 509 premises contacted, 305 (60%) returned useable questionnaires and 100 of these (33%) were classified as ,recurrent' premises. An overall median incidence rate for EGS of 2.1 EGS incidents/100 horses/premises/year was recorded. There was an increased rate of recurrence with higher numbers of horses, presence of younger animals, stud farms and livery/riding establishments, loam and sand soils, rearing of domestic birds and mechanical droppings removal. The rate of recurrence decreased with chalk soil, cograzing ruminants, grass cutting on pastures and removal of droppings by hand. Several statistically significant interactions were identified. Conclusions: Many of the findings are consistent with the theory that EGS is a toxico-infectious form of botulism. Several of the significant factors identified may directly or indirectly relate to soil disturbance and consequent soil contamination of grass, thereby increasing the rate of exposure of grazing horses to Clostridium botulinum, which resides in soil. Potential relevance: Identification of potentially modifiable risk factors may, ideally following validation in appropriately designed, controlled and randomised intervention studies, lead to practical measures to reduce the incidence of EGS on previously affected premises. [source] Survival probability of zirconia-based fixed dental prostheses up to 5 yr: a systematic review of the literatureEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 5 2010Jaana-Sophia Schley Schley J-S, Heussen N, Reich S, Fischer J, Haselhuhn K, Wolfart S. Survival probability of zirconia-based fixed dental prostheses up to 5 yr: a systematic review of the literature. Eur J Oral Sci 2010; 118: 443,450. © 2010 Eur J Oral Sci The purpose of this systematic review was to calculate the 5-yr survival rates of all-ceramic zirconia-based fixed dental prostheses (FDPs) and to analyze technical and biological complications. An electronic literature search of MEDLINE (PubMed) was conducted independently by three reviewers to identify clinical studies from 1999 to 2009 and was completed by a manual search. Keywords and inclusion and exclusion criteria were well-defined. The search revealed 399 titles and led to the final analysis of 18 full-text articles. Nine studies met the inclusion criteria. Extracted data were statistically calculated into 5-yr survival rates and 5-yr complication-free rates by using Poisson regression analysis. In total, 310, 3- to 4-unit FDPs and 20 FDPs with more than 4 units were included. The estimated 5-yr survival rate for all FDPs was 94.29% (95% CI: 58.98,99.32); 19 FDPs were lost as a result of catastrophic failures. The 5-yr complication-free rate regarding technical complications was 76.41% (95% CI: 42.42,91.60) with chipping being the most frequent complication. Regarding biological complications, the 5-yr complication-free rate was 91.72% (95% CI: 59.19,98.53). The survival rates of zirconia-based short-unit FDPs are promising. However, an important improvement of the veneering systems is required, and for FDPs with more units in function, further randomized, controlled clinical trials are necessary. [source] Testicular cancer: Marked birth cohort effects on incidence and a decline in mortality in southern Netherlands since 1970INTERNATIONAL JOURNAL OF CANCER, Issue 3 2008Rob Verhoeven Abstract The aim of our study was to interpret the changing incidence, and to describe the mortality of patients with testicular cancer in the south of the Netherlands between 1970 and 2004. On the basis of data from the Eindhoven Cancer Registry and Statistics Netherlands, 5-year moving average standardised incidence and mortality rates were calculated. An age-period-cohort (APC) Poisson regression analysis was performed to disentangle time and birth cohort effects on incidence. The incidence rate remained stable for all ages at about 3 per 100,000 person-years until 1989 but increased annually thereafter by 4% to 6 in 2004. This increase can almost completely be attributed to an increase in localised tumours. The largest increase was found for seminoma testicular cancer (TC) patients aged 35,39 and non-seminoma TC patients aged 20,24 years. Relatively more localised and tumours with lymph node metastases were detected in the later periods. APC analysis showed the best fit with an age-cohort model. An increase in incidence of TC was found for birth cohorts since 1950. The mortality rate dropped from 1.0 per 100,000 person-years in 1970 to 0.3 in 2005, with a steep annual decline of 12% in the period 1979,1986. In conclusion, the increase in incidence of TC was strongly correlated with birth cohorts since 1945. The increase in incidence is possibly caused by in utero or early life exposure to a yet unknown risk factor. There was a steep decline in mortality in the period 1979,1986. © 2007 Wiley-Liss, Inc. [source] A systematic review of the survival and complication rates of implant supported fixed dental prostheses with cantilever extensions after an observation period of at least 5 yearsCLINICAL ORAL IMPLANTS RESEARCH, Issue 5 2009Marco Aglietta Abstract Objective: The aim of this systematic review was to assess the survival rates of short-span implant-supported cantilever fixed dental prostheses (ICFDPs) and the incidence of technical and biological complications after an observation period of at least 5 years. Material and methods: An electronic MEDLINE search supplemented by manual searching was conducted to identify prospective or retrospective cohort studies reporting data of at least 5 years on ICFDPs. Five- and 10-year estimates for failure and complication rates were calculated using standard or random-effect Poisson regression analysis. Results: The five studies eligible for the meta-analysis yielded an estimated 5- and 10-year ICFDP cumulative survival rate of 94.3% [95 percent confidence interval (95% CI): 84.1,98%] and 88.9% (95% CI: 70.8,96.1%), respectively. Five-year estimates for peri-implantitis were 5.4% (95% CI: 2,14.2%) and 9.4% (95% CI: 3.3,25.4%) at implant and prosthesis levels, respectively. Veneer fracture (5-year estimate: 10.3%; 95% CI: 3.9,26.6%) and screw loosening (5-year estimate: 8.2%; 95% CI: 3.9,17%) represented the most common complications, followed by loss of retention (5-year estimate: 5.7%; 95% CI: 1.9,16.5%) and abutment/screw fracture (5-year estimate: 2.1%; 95% CI: 0.9,5.1%). Implant fracture was rare (5-year estimate: 1.3%; 95% CI: 0.2,8.3%); no framework fracture was reported. Radiographic bone level changes did not yield statistically significant differences either at the prosthesis or at the implant levels when comparing ICFDPs with short-span implant-supported end-abutment fixed dental prostheses. Conclusions: ICFDPs represent a valid treatment modality; no detrimental effects can be expected on bone levels due to the presence of a cantilever extension per se. [source] Discriminant validity of the International Caries Detection and Assessment System (ICDAS) and comparability with World Health Organization criteria in a cross-sectional studyCOMMUNITY DENTISTRY AND ORAL EPIDEMIOLOGY, Issue 5 2010Fausto Medeiros Mendes Mendes FM, Braga MM, Oliveira LB, Antunes JLF, Ardenghi TM, Bönecker M. Discriminant validity of the International Caries Detection and Assessment System (ICDAS) and comparability with World Health Organization criteria in a cross-sectional study. Community Dent Oral Epidemiol 2010; 38: 398,407. © 2010 John Wiley & Sons A/S Abstract,,, Objectives:, The aim of this cross-sectional study in preschool children was to assess the ability of International Caries Detection and Assessment System (ICDAS) in discriminating socioeconomic factors associated with the presence of caries lesions at both noncavitated and cavitated thresholds and to compare with the standard World Health Organization (WHO) criteria. Methods:, The study was carried out in Amparo, Brazil, during the National Day of Children's Vaccination including 252 children aged 36,59 months. The same child was independently examined by two calibrated examiners, one using the ICDAS and the other using WHO criteria. Socioeconomic information was also recorded. Associations between socioeconomic factors and presence of caries assessed as binary (caries prevalence) and count outcome (actual dmfs values) obtained by WHO criteria and by ICDAS at noncavitated and cavitated thresholds were evaluated by Poisson regression analysis with robust variance. Results:, Some covariates were significantly associated with the presence of caries evaluated by the WHO criteria and by ICDAS (using score 3 as cut-off point). When noncavitated scores of ICDAS were used to calculate the presence of caries, the discriminant power decreased. When dmfs values were used as outcome, no differences in the associations were observed between two systems or using noncavitated caries lesions. Conclusion:, Cavitated scores of ICDAS present similar discriminant validity compared with WHO criteria when presence of caries is used as outcome; however, when actual dmfs values are used, no differences are observed in using noncavitated or cavitated caries lesions. [source] | ||||||||||