The Emergence of Spatial Clustering in Medical Vaccine Exemptions Following California Senate Bill 277, 2015–2018

2020 ◽  
Vol 110 (7) ◽  
pp. 1084-1091 ◽  
Author(s):  
Ashley Gromis ◽  
Ka-Yuet Liu
Keyword(s):  
Disease Transmission ◽  
Negative Binomial ◽  
Spatial Clustering ◽  
Local Level ◽  
Spatial Association ◽  
Positive Association ◽  
Negative Binomial Regression ◽  
Scan Statistics ◽  
Senate Bill ◽  
Before And After

Objectives. To understand how the elimination of nonmedical vaccine exemptions through California Senate Bill 277 (SB277) may have resulted in increased spatial clustering of medical exemptions. Methods. We used spatial scan statistics and negative binomial regression models to examine spatial clustering in medical vaccine exemptions in California kindergartens from 2015 to 2018. Results. Spatial clustering of medical exemptions across schools emerged following SB277. Clusters were located in similar geographic areas to previous clusters of nonmedical vaccine exemptions, suggesting a spatial association between high nonmedical exemption prevalence and increasing rates of medical exemptions. Regression results confirmed this positive association at the local level. The sociodemographic characteristics of the neighborhoods in which schools were located explained some, but not all, of the positive spatial associations between exemptions before and after SB277. Conclusions. Elimination of nonmedical vaccine exemptions via SB277 may have prompted some parents to instead seek medical exemptions to required school vaccines. The spatial association of these 2 types of exemptions has implications for maintaining pockets of low vaccine compliance and increased disease transmission.

scholarly journals Analysis of Pneumonia Occurrence in Relation to Climate Change in Tanga, Tanzania

2021 ◽  
Vol 18 (9) ◽  
pp. 4731
Author(s):  
Samweli Faraja Miyayo ◽  
Patrick Opiyo Owili ◽  
Miriam Adoyo Muga ◽  
Tang-Huang Lin
Keyword(s):  
Climate Change ◽  
Negative Binomial ◽  
Health Management ◽  
Severe Pneumonia ◽  
Positive Association ◽  
Negative Binomial Regression ◽  
Health Management Information System ◽  
Cold Temperatures ◽  
Climate Indicators ◽  
And Control

In 2018, 70% of global fatalities due to pneumonia occurred in about fifteen countries, with Tanzania being among the top eight countries contributing to these deaths. Environmental and individual factors contributing to these deaths may be multifaceted, but they have not yet been explored in Tanzania. Therefore, in this study, we explore the association between climate change and the occurrence of pneumonia in the Tanga Region, Tanzania. A time series study design was employed using meteorological and health data of the Tanga Region collected from January 2016 to December 2018 from the Tanzania Meteorological Authority and Health Management Information System, respectively. The generalized negative binomial regression technique was used to explore the associations between climate indicators (i.e., precipitation, humidity, and temperature) and the occurrence of pneumonia. There were trend differences in climate indicators and the occurrence of pneumonia between the Tanga and Handeni districts. We found a positive association between humidity and increased rates of non-severe pneumonia (incidence rate ratio (IRR) = 1.01; 95% CI: 1.01–1.02; p ≤ 0.05) and severe pneumonia (IRR = 1.02; 95% CI: 1.01–1.03; p ≤ 0.05). There was also a significant association between cold temperatures and the rate of severe pneumonia in Tanga (IRR = 1.21; 95% CI: 1.11–1.33; p ≤ 0.001). Other factors that were associated with pneumonia included age and district of residence. We found a positive relationship between humidity, temperature, and incidence of pneumonia in the Tanga Region. Policies focusing on prevention and control, as well as promotion strategies relating to climate change-related health effects should be developed and implemented.

scholarly journals Injury-related falls from bicycles, skateboards, roller skates, and non-motorized scooters in the United States: 2005 - 2014

2017 ◽  
Vol 4 (1) ◽  
pp. 16
Author(s):  
William Milczarski ◽  
Peter Tuckel ◽  
Richard Maisel
Keyword(s):  
Public Health ◽  
New York ◽  
Negative Binomial ◽  
Local Level ◽  
Specific Treatment ◽  
Negative Binomial Regression ◽  
The United States ◽  
Treatment Modalities ◽  
Public Health Officials ◽  
National Databases

Purpose: To provide an updated and comparative analysis of injury-related falls from bicycles, skateboards, roller skates and non-motorized scooters.Methods: The study uses two national databases – the Nationwide Emergency Department Sample and the Nationwide Inpatient Sample  – and subnational databases for New York, California, and Maryland.  Univariate and multivariate analyses (negative binomial regression) are performed to identify effects of age, gender, racial-ethnic background, and region on the incidence of injury-related falls from each of the four devices.Results: The rate of injuries due to falls from bicycles far surpasses the rates due to falls from the other devices.  When a measure of “exposure” is taken into consideration, however, the rate of injuries from skateboards outstrips the rates from bicycles or roller skates.  The profile of patients who are injured from falls from each of the four devices is distinctive.  Asian-Americans are greatly underrepresented among those who suffer a fall-related injury from any of the four devices.  The incidence of injuries attributable to falls varies considerably by geographic region.Conclusions: Public health officials need to be mindful that while certain activities such as scootering might be gaining in popularity, the number of injuries sustained from bicycles still dwarfs the number attributable to falls from skateboards, roller skates, and scooters combined.  Thus special attention needs to be paid to both prevent falls from bicycles and specific treatment modalities.  It is important for public health officials to gather injury data at the local level to allocate prevention and treatment resources more efficiently.

scholarly journals Effects of seasonality and land use on the abundance and distribution of mosquitoes on St. Kitts, West Indies

2020 ◽  
Author(s):  
Matthew J. Valentine ◽  
Brenda Ciraola ◽  
Gregory R. Jacobs ◽  
Charlie Arnot ◽  
Patrick J. Kelly ◽  
...  
Keyword(s):  
Land Cover ◽  
Disease Transmission ◽  
Negative Binomial ◽  
Mosquito Control ◽  
Mosquito Species ◽  
Negative Binomial Regression ◽  
Common Species ◽  
Negative Binomial Regression Model ◽  
Local Data ◽  
Land Covers

AbstractBackgroundHigh quality mosquito surveys that collect fine resolution local data on mosquito species’ abundances provide baseline data to help us understand potential host-pathogen-mosquito relationships, accurately predict disease transmission, and target mosquito control efforts in areas at risk of mosquito borne diseases.MethodsAs part of an investigation into arboviral sylvatic cycles on the Caribbean island of St. Kitts, we carried out an island wide mosquito survey from November 2017 to March 2019. Using Biogents Sentinel 2 and miniature CDC light traps that were set monthly and run for 48 hour intervals, we collected mosquitoes from a total of 30 sites distributed across the five common land covers on the island (agricultural, mangrove, rainforest, scrub, and urban). We developed a mixed effects negative binomial regression model to predict the effects of land cover, seasonality, and precipitation on observed counts of the most abundant mosquito species we found.ResultsWe captured 10 of the 14 mosquito species reported on the island, the four most abundant being Aedes taeniorhynchus, Culex quinquefasciatus, Aedes aegpyti, and Deinocerites magnus. Sampling in the mangroves yielded the most mosquitoes, with Ae. taeniorhynchus, Cx. quinquefasciatus, and De. magnus predominating. Aedes aegypti was recovered primarily from urban and agricultural habitats, but also at lower frequency in other land covers. Psorophora pygmaea and Toxorhynchites guadeloupensis were only captured in scrub habitat. Capture rates in rainforests were low. Our models indicated the relative abundance of the four most common species varied seasonally and with land cover. They also suggested that the extent to which monthly average precipitation influenced counts varied according to species.ConclusionsThis study demonstrates there is high seasonality in mosquito abundances and that land cover influenced the distribution and abundance of mosquito species on St. Kitts. Further, human-adapted mosquito species (e.g. Ae. aegypti and Cx. quinquefasciatus) that are known vectors for many human relevant pathogens are the most wide-spread (across land covers) and the least responsive to seasonal variation in precipitation.

scholarly journals The association between self-harm and area-level characteristics in Northern Ireland: an ecological study

2019 ◽  
Vol 29 (5) ◽  
pp. 948-953 ◽  
Author(s):  
Eve Griffin ◽  
Brendan Bonner ◽  
Christina B Dillon ◽  
Denise O’Hagan ◽  
Paul Corcoran
Keyword(s):  
Northern Ireland ◽  
Population Density ◽  
Suicidal Behaviour ◽  
Urban Areas ◽  
Negative Binomial ◽  
Positive Association ◽  
Negative Binomial Regression ◽  
Binomial Regression ◽  
Self Harm ◽  
Deprived Areas

Abstract Background Factors contributing to suicidal behaviour are complex and multi-faceted. This study took an ecological approach to examine the association between area-level factors and rates of self-harm in Northern Ireland. Methods Data on self-harm presentations to emergency departments (EDs) were obtained from the Northern Ireland Self-harm Registry. The study included residents of Northern Ireland aged 16–64 years. Deprivation was measured using the Northern Ireland Multiple Deprivation Measure 2017. Population density and social fragmentation were calculated using measures from the 2011 census. Associations between area-level factors and self-harm rates were explored using negative binomial regression. Results Between 2013 and 2015, 14 477 individuals aged 16–64 years presented to EDs in Northern Ireland following self-harm. The rate of self-harm was 472 per 100 000 and was higher for male residents (478 vs. 467). Self-harm rates were highest in urban areas—680 per 100 000 in Belfast City and 751 per 100 000 in Derry City. Rates of self-harm in Northern Ireland were more than four times higher in the most deprived areas. A positive association with rates of self-harm held for the deprivation domains of employment, crime, education, health and income. There was a moderate association with population density. Some gender differences emerged, with associations with male rates of self-harm more pronounced. Conclusion These findings indicate that self-harm rates are highest for those residing in highly deprived areas, where unemployment, crime and low level of education are challenges. Community interventions tailored to meet the needs of specific areas may be effective in reducing suicidal behaviour.

Effect of Median Design on Rural Freeway Safety

2008 ◽  
Vol 2060 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Andrew P. Tarko ◽  
Natalie M. Villwock ◽  
Nicolas Blond
Keyword(s):  
Opposite Direction ◽  
Negative Binomial ◽  
Prediction Models ◽  
Negative Binomial Regression ◽  
Well Being ◽  
Crash Severity ◽  
Before And After ◽  
Single Vehicle ◽  
Median Width ◽  
The Impact

Although median barriers are an absolute means of preventing drivers from crossing road medians and colliding with vehicles moving in the opposite direction, they may cause additional crashes. This perhaps complex safety effect of median barriers has not been investigated well. Being able to predict the safety impact of most types of median barriers on rural freeways is becoming more desirable because some state departments of transportation plan to expand many of their four-lane rural freeways to six lanes to accommodate increases in traffic volume. Realistic crash prediction models sensitive to the median design would provide the needed guidance useful in designing adequate median treatments on widened freeways. The impact of median designs on crash frequency was investigated in this study through negative binomial regression and before-and-after studies based on data collected in eight participating states. The impact on crash severity was investigated with a logit model. The separate effects of changes in median geometry were quantified for single-vehicle, multiple-vehicle same direction, and multiple-vehicle opposite direction crashes. The results were significantly different and indicated that reducing the median width without adding barriers (the remaining median width is still reasonably wide) increases the severity of crashes, particularly opposite direction crashes. Further, reducing the median and installing concrete barriers eliminates opposite direction crashes but doubles the frequency of single-vehicle crashes and tends to lessen the frequency of same direction crashes. The crash severity also tends to increase.

scholarly journals Trends in Infant Mortality and Stillbirth Rates in Scotland by Socio-Economic Position, 2000-2018: A Longitudinal Ecological Study

2021 ◽  
Author(s):  
Alice Harpur ◽  
Jon Minton ◽  
Julie Ramsay ◽  
Gerry McCartney ◽  
Lynda Fenton ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Early Years ◽  
Live Births ◽  
Before And After ◽  
Break Points ◽  
Economic Position ◽  
Economic Inequalities

Abstract Background:As Scotland strives to become a country where children flourish in their early years, it is faced with the challenge of socio-economic health inequalities, which are at risk of worsening amidst austerity policies. The aim of this study was to explore trends in infant mortality rates (IMR) and stillbirth rates by socio-economic position (SEP) in Scotland, between 2000-2018, inclusive.Methods:Data for live births, infant deaths, and stillbirths between 2000-2018 were obtained from National Records of Scotland. Annual IMR and stillbirth rates were calculated and visualised for all of Scotland and when stratified by SEP. Negative binomial regression models were used to estimate the association between SEP and infant mortality and stillbirth events, and to assess for break points in trends over time. The slope (SII) and relative (RII) index of inequality compared absolute and relative socio-economic inequalities in IMR and stillbirth rates before and after 2010.Results:IMR fell from 5.7 to 3.2 deaths per 1000 live births between 2000-2018, with no change in trend identified. Stillbirth rates were relatively static between 2000-2008 but experienced accelerated reduction from 2009 onwards. When stratified by SEP, inequalities in IMR and stillbirth rates persisted throughout the study and were greatest amongst the sub-group of post-neonates. Although comparison of the SII and RII in IMR and stillbirths before and after 2010 suggested that inequalities remained stable, descriptive trends in mortality rates displayed a 3-year rise in the most deprived quintiles from 2015 onwards.Conclusion:Whilst Scotland has experienced downward trends in IMR and stillbirth rates between 2000-2018, the persistence of socio-economic inequalities and suggestion that mortality rates amongst the most deprived groups may be worsening warrants further action to improve maternal health and strengthen support for families with young children.

scholarly journals Trends in infant mortality and stillbirth rates in Scotland by socio-economic position, 2000–2018: a longitudinal ecological study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Alice Harpur ◽  
Jon Minton ◽  
Julie Ramsay ◽  
Gerry McCartney ◽  
Lynda Fenton ◽  
...  
Keyword(s):  
Infant Mortality ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Mortality Rates ◽  
Early Years ◽  
Live Births ◽  
Before And After ◽  
Break Points ◽  
Economic Position ◽  
Economic Inequalities

Abstract Background As Scotland strives to become a country where children flourish in their early years, it is faced with the challenge of socio-economic health inequalities, which are at risk of widening amidst austerity policies. The aim of this study was to explore trends in infant mortality rates (IMR) and stillbirth rates by socio-economic position (SEP) in Scotland, between 2000 and 2018, inclusive. Methods Data for live births, infant deaths, and stillbirths between 2000 and 2018 were obtained from National Records of Scotland. Annual IMR and stillbirth rates were calculated and visualised for all of Scotland and when stratified by SEP. Negative binomial regression models were used to estimate the association between SEP and infant mortality and stillbirth events, and to assess for break points in trends over time. The slope (SII) and relative (RII) index of inequality compared absolute and relative socio-economic inequalities in IMR and stillbirth rates before and after 2010. Results IMR fell from 5.7 to 3.2 deaths per 1000 live births between 2000 and 2018, with no change in trend identified. Stillbirth rates were relatively static between 2000 and 2008 but experienced accelerated reduction from 2009 onwards. When stratified by SEP, inequalities in IMR and stillbirth rates persisted throughout the study and were greatest amongst the sub-group of post-neonates. Although comparison of the SII and RII in IMR and stillbirths before and after 2010 suggested that inequalities remained stable, descriptive trends in mortality rates displayed a 3-year rise in the most deprived quintiles from 2016 onwards. Conclusion Whilst Scotland has experienced downward trends in IMR and stillbirth rates between 2000 and 2018, the persistence of socio-economic inequalities and suggestion that mortality rates amongst the most deprived groups may be worsening warrants further action to improve maternal health and strengthen support for families with young children.

The relationship between citations, downloads and alternative metrics in rheumatology publications: a bibliometric study

Rheumatology ◽  
2019 ◽  
Vol 59 (2) ◽  
pp. 277-280 ◽  
Author(s):  
Winnie M Y Chen ◽  
Marwan Bukhari ◽  
Francesca Cockshull ◽  
James Galloway
Keyword(s):  
Negative Binomial ◽  
Positive Association ◽  
Negative Binomial Regression ◽  
Significant Positive Association ◽  
H Index ◽  
Binomial Regression ◽  
Number Of Citations ◽  
The Impact ◽  
The Relationship ◽  
Alternative Metrics

Abstract Objective Scientific journals and authors are frequently judged on ‘impact’. Commonly used traditional metrics are the Impact Factor and H-index. However, both take several years to formulate and have many limitations. Recently, Altmetric—a metric that measures impact in a non-traditional way—has gained popularity. This project aims to describe the relationships between subject matter, citations, downloads and Altmetric within rheumatology. Methods Data from publications in Rheumatology were used. Articles published from 2010 to 2015 were reviewed. Data were analysed using Stata 14.2 (StataCorp, College Station, TX, USA). Correlation between citations, downloads and Altmetric were quantified using linear regression, comparing across disease topics. Relationship between downloads and months since publications were described using negative binomial regression, clustering on individual articles. Results A total of 1460 Basic Science and Clinical Science articles were identified, with the number of citations, downloads and Altmetric scores. There were no correlations between disease topic and downloads (R2 = 0.016, P = 0.03), citations (R2 = 0.011, P = 0.29) or Altmetric (R2 = 0.025, P = 0.02). A statistically significant positive association was seen between the number of citations and downloads (R2 = 0.29, P < 0.001). No correlations were seen between Altmetric and downloads (R2 = 0.028, P < 0.001) or citations (R2 = 0.004, P = 0.445). Conclusion Disease area did not correlate with any of the metrics compared. Correlations were apparent with clear links between downloads and citations. Altmetric identified different articles as high impact compared with citation or download metrics. In conclusion: tweeting about your research does not appear to influence citations.

scholarly journals Population mobility, demographic, and environmental characteristics of dengue fever epidemics in a major city in Southeastern Brazil, 2007-2015

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Igor Cavallini Johansen ◽  
Marcia Caldas de Castro ◽  
Luciana Correia Alves ◽  
Roberto Luiz do Carmo
Keyword(s):  
Negative Binomial ◽  
Local Level ◽  
Negative Binomial Regression ◽  
Environmental Data ◽  
Southeastern Brazil ◽  
Population Census ◽  
Population Mobility ◽  
Major City ◽  
Behavioral Correlates ◽  
Binomial Regression

Around 14% of world dengue virus (DENV) cases occur in the Americas, most of them in Brazil. While socioeconomic, environmental, and behavioral correlates have been analyzed thoroughly, the role played by population mobility on DENV epidemics, especially at the local level, remains scarce. This study assesses whether the daily pattern of population mobility is associated with DENV incidence in Campinas, a Brazilian major city with over 1.2 million inhabitants in São Paulo State. DENV notifications from 2007 to 2015 were geocoded at street level (n = 114,884) and combined with sociodemographic and environmental data from the 2010 population census. Population mobility was extracted from the Origin-Destination Survey (ODS), carried out in 2011, and daily precipitation was obtained from satellite imagery. Multivariate zero-inflated negative binomial regression models were applied. High population mobility presented a relevant positive effect on higher risk for DENV incidence. High income and residence in apartments were found to be protective characteristics against the disease, while unpaved streets, number of strategic points (such as scrapyards and tire repair shops), and precipitation were consistently risk factors.

scholarly journals Incidence and temporal trends of co-occurring personality disorder diagnoses in immune-mediated inflammatory diseases

2020 ◽  
Vol 29 ◽  
Author(s):  
C. Blaney ◽  
J. Sommer ◽  
R. El-Gabalawy ◽  
C. Bernstein ◽  
R. Walld ◽  
...  
Keyword(s):  
Negative Binomial ◽  
Inflammatory Diseases ◽  
Temporal Trends ◽  
Negative Binomial Regression ◽  
Case Definitions ◽  
Immune Mediated ◽  
Before And After ◽  
Shared Risk ◽  
Incident Cases ◽  
Over Time

Abstract Aims Although immune-mediated inflammatory diseases (IMID) are associated with multiple mental health conditions, there is a paucity of literature assessing personality disorders (PDs) in these populations. We aimed to estimate and compare the incidence of any PD in IMID and matched cohorts over time, and identify sociodemographic characteristics associated with the incidence of PD. Methods We used population-based administrative data from Manitoba, Canada to identify persons with incident inflammatory bowel disease (IBD), multiple sclerosis (MS) and rheumatoid arthritis (RA) using validated case definitions. Unaffected controls were matched 5:1 on sex, age and region of residence. PDs were identified using hospitalisation or physician claims. We used unadjusted and covariate-adjusted negative binomial regression to compare the incidence of PDs between the IMID and matched cohorts. Results We identified 19 572 incident cases of IMID (IBD n = 6,119, MS n = 3,514, RA n = 10 206) and 97 727 matches overall. After covariate adjustment, the IMID cohort had an increased incidence of PDs (incidence rate ratio [IRR] 1.72; 95%CI: 1.47–2.01) as compared to the matched cohort, which remained consistent over time. The incidence of PDs was similarly elevated in IBD (IRR 2.19; 95%CI: 1.69–2.84), MS (IRR 1.79; 95%CI: 1.29–2.50) and RA (IRR 1.61; 95%CI: 1.29–1.99). Lower socioeconomic status and urban residence were associated with an increased incidence of PDs, whereas mid to older adulthood (age 45–64) was associated with overall decreased incidence. In a restricted sample with 5 years of data before and after IMID diagnosis, the incidence of PDs was also elevated before IMID diagnosis among all IMID groups relative to matched controls. Conclusions IMID are associated with an increased incidence of PDs both before and after an IMID diagnosis. These results support the relevance of shared risk factors in the co-occurrence of PDs and IMID conditions.

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