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  • ISSN: 2378-9328
    Semiparametric Spatial Autoregressive Model: A Two-Step Bayesian Approach
    Authors: Jiaqing Chen, Renfu Wang and Yangxin Huang
    Abstract: Spatial data arise frequently in econometric studies and it is a common practice to analyze such data with spatial autoregressive (SAR) models. This paper proposes a two-step Bayesian approach for inference in the semiparametric spatial autoregressive (SPSAR) model, including the cases for mixed data.
    Role of the Neighbourhood Deprivation in the Adverse Effect of Air Pollution on Congenital Abnormalities
    Authors: Maxime Jeanjean, Kihal Wahida, Cindy Padilla, Esther Kai-Chieh Chen and Severine Deguen
    Abstract: Congenital abnormalities (CAs) remain a major cause of stillbirth and neonatal mortality. The literature has shown that congenital malformations are suggested to have multifactorial determinants, including environmental exposures and socioeconomic patterns.
    Latest Articles
    Short Communication
    Katharina Kovacs Burns, Melita Avdagovska, Lana Bistritz, Karin Olson, and Leah Gramlich
    With more emphasis on healthy living, risk prevention and health promotion, people will seek advice from their healthcare providers (HCPs) who need to have the knowledge, skills and confidence to discuss these areas and provide advice. However, studies indicate that HCPs are not adequately prepared to provide advice on nutrition, physical activity, wellness (NPAW) and risk prevention. This communication report walks through a 10-year journey of the development of a WellnessRx education initiative focusing on building the knowledge, skills and attitudes of HCPs in NPAW and risk prevention. WellnessRx consists of five learning modules, piloted and evaluated with over 1,500 health science students and nurses. The evaluation findings from all pilots and other sources have guided the development of the WellnessRx modules over the 10 years. Participants indicated the importance of NPAW for personal and professional uses, and demonstrated improved KSAs as a result of completing the modules. In addition to successes, challenges were also noted to be addressed including the online format and technology, time to complete the modules including exercises and reading resources. Based on this decade of experiences, a call-to-action is needed concerning NPAW being an essential part of education and training competencies for HCP students and practitioners. NPAW education does not stop when HCP students graduate and enter the practice setting. Hence, the need for innovative education interventions like what WellnessRx offers. The journey for WellnessRx therefore continues with opportunities, partnerships and business ventures involving the universities and health systems.
    Trina Aguirre*, Ann Koehler, Susan Wilhelm, Eli Rodriguez, and Ashley Kamphaus
    We conducted this pilot study (n=50 mother/child dyads) to evaluate the feasibility of collecting biometric measures on 2-5 year old Mexican-American children. Measures included body composition using bioelectrical impedance analysis (BIA), body mass index (BMI), anthropometrics (triceps skin fold, waist circumference), lipid profiles, glucose levels, and blood pressure. We successfully performed the biometric measures in both a large scale event (40 mother-child dyads, single time point, at a neighborhood community center) and individualized appointments (10 mother-child dyads, 4 time points, at university facilities). In the large-scale setting, all measures were completed on 90% of the children. In the individualized setting (multiple time points), children became more comfortable with the research setting and measurement procedures over time, which helped when performing the measurement procedures. Measurement procedures were generally well received except those involving finger sticks (e.g. lipid profiles, glucose levels). Therefore, researchers should evaluate the need for such data and minimize the number of finger sticks required. Accommodating other family members was also important in this population. These findings will better enable us to objectively measure the impact of our obesity intervention during the fully powered study.
    Research Article
    Dawood HS*, Arthur RW, Meg MC, Deanna Ryder, Shawna MG, Arturo Rebollon Guardado, Nashrin KJ, David NO, and Jenelle RW
    Purpose: To determine differences in comorbidity-adjusted stroke hospitalization charges by patient race/ethnicity, age, and income prior to the implementation of the Patient Protection and Affordable Care Act and to outline health policy provisions which may reduce future hospitalization charges among black stroke patients.
    Materials and methods: The data source was the Healthcare Cost and Utilization Project (HCUP) 2008 Nationwide Inpatient Sample (NIS), a 20% stratified sample of all discharges from 705 hospitals from the 34 States which reported to HCUP data including race. Stroke inpatients aged 45 to 84 with a principal diagnosis for cerebral infarction (ICD-9 codes 362.3, 433.01, 434.01) and acute, but ill-defined, cerebrovascular disease (ICD-9 code 436), excluding secondary diagnoses of traumatic brain injury (codes 800-804, 850-854), were included in the study. Patients were stratified into two age groups: 45-64 and 65-84. Total charges were adjusted using HCUP cost-to-charge ratios. Data for 41,291 patients were analyzed.
    Results: Black patients were more likely to have a secondary diagnosis of diabetes, hypertension, and longer hospital stay. Adjusted charges and the number of secondary diagnoses were significantly higher for older black patients. Younger black patients with stroke-only diagnosis had significantly higher overall adjusted charges and higher charges at lower income levels than younger white patients of similar age. Older black patients with hypertension and diabetes had significantly higher adjusted charges in all diagnosis categories and lower income levels.
    Conclusions: Prevention programs and better management of diabetes and hypertension may reduce hospitalization charges among older African Americans and white/black disparities in charges.
    Kafayat Aminu* and Ayodele Samuel Jegede
    The symptoms of Ebola virus disease EVD are similar to those of common ailments in the Nigeria (such as malaria, cholera and diarrhoea) for which people consult traditional healers. The study investigated level of knowledge about EVD among traditional healers in Ibadan. The research design was descriptive cross-sectional and qualitative data collection approach was adopted to gather information from respondents. The level of awareness about EVD outbreak in Nigeria was high but the healers understanding of various aspects of EVD was inadequate. The limited knowledge about EVD revealed need for continuous education of the healers even after outbreak given their popularity in the State and country at large.
    Review Article
    Rauniyar M, Shrestha J, Raj L. Bhatta, Shrestha A*, and Acharya K
    Background: Infectious diseases are a common cause of hospital admission in developing countries.Communicable diseases are the main reasons for admission to the medical ward of developing countries. However, there is a rise in the prevalence of the non- communicable diseases in the developing countries.
    Primary objective: To see the trend of disease pattern admitted in the Internal Medicine ward of BPKIHS in the last 5yrs. To know the common causes of hospital admissions in Internal Medicine ward.
    Secondary objective: To analyse the rise and fall of diseases in certain year. To classify the diseases as communicable and non-communicable disease and to know about the changing pattern of disease.
    Methods: A retrospective observational study was performed to estimate the disease burden in the Internal medicine ward of BPKIHS in last 5 years. Data were obtained from the account section of BPKIHS and included patients admitted to the medicine ward from January 2008 to December 2012. Data entry was done in Microsoft excel, and data were analyzed using SPSS. Results were presented in both descriptive and tabular form.
    Results: The main system involved was respiratory (in 2008-21.6%, in 2009-21.4%, in 2010-19.3%, in 2011 -18.2%). COPD and Diabetes were among the top 10 diseases admitted in medicine ward. (COPD=in 2008-7.3%, in 2009-6%, in 2010-6%, in 2011-5.8%, in 2012-4.6%) (Diabetes in 2008-6.1%, in 2009-5.9%, in 2010-5.3%, in 2011-4.7%, in 2012-3%) The cases of poisoning have been increasing every year, with the maximum cases of it in the year 2012 i.e. 21% and initially in 2008 it was 10%. The most common diseases, according to our study were COPD, Diabetes, Nephritic syndrome, Poisoning, Pneumonia, angina, Tuberculosis.
    Conclusion: The Main cause of morbidity was organophosphorus poisoning and the main system responsible was Respiratory followed by CVS, Poisoning. The cases for respiratory system have been declining since 2008. Poisoning cases have increased since 2008. Endocrine disorders have been to be decreasing since 2008.
    Research Article
    Sule Yilmaz*, Memduha Tas, and Zulfiye Gul Ercan
    This study investigated whether the needs of preschoolers with speech and language problems are being met in Turkey. The study was conducted in the Speech and Language Unit of Trakya Universitys Early Childhood Education and Research Center based on data gathered retrospectively from case files. Factors thought to be important for the future course of the childrens condition (i.e., referral age for speechlanguage evaluation, attendance in the planned program, presence of additional risk factors, receptive language problems, and whether the families were given any information about the problem by their childrens doctors and teachers) were explored. It was found that needs related to speechlanguage intervention were not met in a great proportion of the children because about 80% of the families did not bring their children to therapy or follow-up. Attendance was significantly higher among children attending school compared with those not enrolled in school. Only 18% of the families had been previously informed of their childrens problems, and none of the families had been given any advice on how to behave toward their childrens problems or what to do to develop their speechlanguage skills. Barriers to childrens receipt of required interventions should be identified, and any additional supports needed to increase attendance should be provided.
    Short Communication
    Jidong Huang, Pamela Redmon, Zongshuan Duan*, Yixin Duan, Yuan Jiang, and Michael Eriksen
    Background: While exposure to secondhand smoke (SHS) is alarmingly high in China, little is known about variance of SHS exposure across Chinese cities. This study is designed to systematically assess SHS exposure and perceived health risks of tobacco use in five Chinese cities.
    Methods: The TQS was a subset of key questions from the Global Adult Tobacco Survey (GATS). Target population was noninstitutionalized adult residents age 15 and above in urban areas. Multistage cluster sampling was applied to select 2,500 individuals from each city.
    Results: Across all five cities, bars, restaurants, workplaces, and homes had the highest rates of SHS exposure. While SHS exposure in public transportation was low, it was high in schools, universities, government buildings and healthcare facilities. Importantly, significant variations exist in SHS exposure across cities. Regarding perceived health risks of SHS exposure, the vast majority of survey respondents believed SHS exposure can cause lung cancer in adults and lung diseases in children. In contrast, the percent of those who believed SHS exposure can cause heart disease in adults was low. In all five cities, smokers were less likely to believe the harms of SHS than nonsmokers.
    Conclusion: Significant variations exist in SHS exposure and perceived health risks of SHS in Chinese cities, which may be attributed to tobacco control efforts and implementation of city-wide smoke-free policies. Targeted media and education campaigns that aim to increase the level of knowledge of the negative health consequences of SHS exposure are urgently needed in Chinese cities.
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