Annals of epidemiology
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Annals of epidemiology · Oct 2008
Time-dependent confounding in the study of the effects of regular physical activity in chronic obstructive pulmonary disease: an application of the marginal structural model.
Results from longitudinal studies about the association between physical activity and chronic obstructive pulmonary disease (COPD) may have been biased because they did not properly adjust for time-dependent confounders. Marginal structural models (MSMs) have been proposed to address this type of confounding. We sought to assess the presence of time-dependent confounding in the association between physical activity and COPD development and course by comparing risk estimates between standard statistical methods and MSMs. ⋯ These results support the previously reported associations between physical activity and reduced risk of COPD development, hospitalizations, and mortality, thereby suggesting they were not due to time-dependent confounding.
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Annals of epidemiology · Sep 2008
Racial/ethnic, socioeconomic, and behavioral determinants of childhood and adolescent obesity in the United States: analyzing independent and joint associations.
This study examines independent and joint associations between several socioeconomic, demographic, and behavioral characteristics and obesity prevalence among 46,707 children aged 10-17 years in the United States. ⋯ Race/ethnicity, SES, and behavioral factors are independently related to childhood and adolescent obesity. Joint effects by gender, race/ethnicity, and SES indicate the potential for considerable reduction in the existing disparities in childhood obesity in the United States.
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A prevalence survey was performed to estimate the magnitude and predictors for needlestick injury (NSI) in nurses of Fars province hospitals. ⋯ The prevalence of NSI in Iranian nurses is high, with the majority of injured staff having sustained up to 4 NSIs in a 12-month period. Nearly all NSIs were high-risk injuries involving a hollow-bore needle. Providing nursing staff with safety-engineered devices, including retractable syringes when hollow-bore needles are to be used, will be an important step toward reducing our NSI epidemic.
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Annals of epidemiology · Sep 2007
Regional differences in African Americans' high risk for stroke: the remarkable burden of stroke for Southern African Americans.
The stroke mortality rate for African Americans aged 45 to 64 years is 3 to 4 times higher than for whites of the same age, with a decreasing black-to-white mortality ratio with increasing age. There is also a "STROKE BELT" with higher stroke mortality in the southeastern United States. This study assesses if there are also geographic variations in the magnitude of the excess stroke mortality for African Americans. ⋯ The increase in stroke mortality rates for African Americans in southern states is even larger than expected. That southern states that are not part of the "STROKE BELT" (Virginia and Florida) also have an elevated black-to-white mortality ratio suggests the mechanism of higher risk for African Americans may be independent of the causes contributing to "STROKE BELT."
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Annals of epidemiology · Jul 2007
Comparative StudyRisk-adjusted mortality rates of elderly veterans with hip fractures.
The goal of this research was to estimate 12-month survival rates for a large sample of elderly veterans after hip fracture with a risk-adjusted model and to compare the results of men to those of women. ⋯ One in 3 elderly male veterans who sustain a hip fracture dies within 1 year. Our work represents the first large study of hip fractures with a predominantly male sample and confirms that men have a higher mortality risk than women, as reported by previous researchers who used smaller samples that were mostly female. Fracture patients with metastatic cancer, renal failure, lymphoma, weight loss, and liver disease have higher mortality risks. The adverse outcomes associated with hip fracture argue for clinical intervention strategies, such as gait and balance testing, and osteoporosis diagnosis that may prevent fractures in both genders.