The purpose of this study was to identify subgroups of adolescents based on their past 12 months use of tobacco, alcohol, marijuana, illicit drugs, and nonmedical use and excessive medical use of ...prescription medications. A cross-sectional Web-based survey of adolescents from two middle and high school districts in Southeastern Michigan was conducted. The sample included 2,744 middle school (7th and 8th grade) and high school (9th through 12th grade) students. Participants had a mean age of 14.8 years (SD = 1.9 years); 50.4% were female, 64.1% were Caucasian, and 30.6% were African American. Participants completed measures of the past 12 months of substance use, parental monitoring, parental substance use, and internalizing and externalizing problems. Exploratory latent class analysis (LCA) indicated four classes. The largest class was composed of participants with low probabilities of using any substances (low/no use class), and the smallest class was composed of participants with relatively high probabilities of using all substances (multiple substances class). A third class included participants with high probabilities of using tobacco, alcohol, and marijuana (TAM). The fourth class consisted of participants with relatively high probabilities of alcohol use, nonmedical prescription drug use, and excessive medical use of prescription drugs (ANM). Female gender predicted membership in the ANM and multiple substance classes, and parental monitoring, parental substance use problems, internalizing, and externalizing problems uniquely predicted membership in all three high-risk risk classes. Results indicated three high-risk subgroups of adolescents, each characterized by a different pattern of substance use. Two risk groups are characterized by relatively high probabilities of nonmedical use and excessive medical use of prescription medications. PUBLICATION ABSTRACT
Abstract
The methyl-coenzyme M reductase (MCR) complex is a key enzyme in archaeal methane generation and has recently been proposed to also be involved in the oxidation of short-chain hydrocarbons ...including methane, butane, and potentially propane. The number of archaeal clades encoding the MCR continues to grow, suggesting that this complex was inherited from an ancient ancestor, or has undergone extensive horizontal gene transfer. Expanding the representation of MCR-encoding lineages through metagenomic approaches will help resolve the evolutionary history of this complex. Here, a near-complete Archaeoglobi metagenome-assembled genome (MAG; Ca. Polytropus marinifundus gen. nov. sp. nov.) was recovered from the deep subseafloor along the Juan de Fuca Ridge flank that encodes two divergent McrABG operons similar to those found in Ca. Bathyarchaeota and Ca. Syntrophoarchaeum MAGs. Ca. P. marinifundus is basal to members of the class Archaeoglobi, and encodes the genes for β-oxidation, potentially allowing an alkanotrophic metabolism similar to that proposed for Ca. Syntrophoarchaeum. Ca. P. marinifundus also encodes a respiratory electron transport chain that can potentially utilize nitrate, iron, and sulfur compounds as electron acceptors. Phylogenetic analysis suggests that the Ca. P. marinifundus MCR operons were horizontally transferred, changing our understanding of the evolution and distribution of this complex in the Archaea.
ABSTRACT Objectives While the most obvious impact of a burn is a visible scar, there are hidden impacts. The main contributors to adverse health outcomes after burns are the metabolic, inflammatory, ...immune and endocrine changes that occur in response to the initial injury. These responses have been shown to persist for at least three years after paediatric severe burns, with adverse effects to the circulatory and musculoskeletal systems. Recent evidence demonstrates that minor burns and severe burns can trigger these systemic responses. Currently, minimal data on the long-term effects of burns are available, and the data that do exist are primarily related to paediatric severe burns. We have used population-based record linkage to support a research program to shed light on the spectrum of long-term morbidity, expressed in terms of hospital admissions, experienced by burn patients to guide burn clinicians in the management of their patients. We report here our current findings of post-burn mortality and morbidity. Approach A population-based longitudinal study using linked hospital morbidity and death data from Western Australia was undertaken of all persons hospitalised for a first burn injury (n=30,997) in 1980–2012 and a frequency matched non-injury comparison cohort, randomly selected from Western Australia’s birth registrations and electoral roll (n = 127,000). Crude admission rates and cumulative length of stay for disease-specific admissions were calculated. Negative binomial and Cox proportional hazards regression modelling were used to generate incidence rate ratios (IRR) and hazard ratios (HR), respectively, adjusting for sociodemographic and health factors. Results For both paediatric and adult burn patients we identified increased long-term all-cause mortality (IRR, 95%CI: <15 years: 1.6, 1.3-2.0; 15-44 years: 1.8, 1.7-2.0; ≥ 45 years: 1.4, 1.3-1.5). Increased post-burn discharge health service use for cardiovascular diseases (IRR, 95%CI: <15 years: 1.3, 1.1-1.6; 15-44 years: 1.6, 1.4-1.7; ≥ 45 years: 1.5, 1.4-1.6) and musculoskeletal conditions (IRR, 95%CI: <20 years: 1.9, 1.7-2.1; ≥ 20 years: 2.0, 1.9-2.1) were also found. Analyses found significantly elevated admission rates for minor and severe burns. Adjusted HRs identified time periods after discharge where burn patients experienced significantly elevated disease-specific incident admissions (results not provided). Conclusions Both minor and severe burns were associated with increased long-term cardiovascular and musculoskeletal morbidity and mortality. These results identify treatment needs for burn patients for a prolonged time after discharge. Further research that links primary care and pharmaceutical data is required to facilitate identification of at-risk patients and appropriate treatment pathways to reduce post-burn morbidity.
ABSTRACT Objectives The grouping of record-pairs to determine which administrative records belong to the same individual is an important process in record linkage. A variety of grouping methods are ...used but the relative benefits of each are unknown. We evaluate a number of grouping methods against the traditional merge based clustering approach using large scale administrative data. Approach The research aimed to both describe current grouping techniques used for record linkage, and to evaluate the most appropriate grouping method for specific circumstances. A range of grouping strategies were applied to three datasets with known truth sets. Conditions were simulated to appropriately investigate one-to-one, many-to-one and ongoing linkage scenarios. Results Results suggest alternate grouping methods will yield large benefits in linkage quality, especially when the quality of the underlying repository is high. Stepwise grouping methods were clearly superior for one-to-one linkage. There appeared little difference in linkage quality between many-to-one grouping approaches. The most appropriate techniques for ongoing linkage depended on the quality of the population spine and the underlying dataset. Conclusions These results demonstrate the large effect that the choice of grouping strategy can have on overall linkage quality. Ongoing linkages to high quality population spines provide large improvements in linkage quality compared to merge based linkages. Procuring or developing such a population spine will provide high linkage quality at far lower cost than current methods for improving linkage quality. By improving linkage quality at low cost, this resource can be further utilised by health researchers.
ABSTRACT Objectives Record linkage is a powerful technique which transforms discrete episode data into longitudinal person-based records. These records enable the construction and analysis of complex ...pathways of health and disease progression, and service use. Achieving high linkage quality is essential for ensuring the quality and integrity of research based on linked data. The methods used to assess linkage quality will depend on the volume and characteristics of the datasets involved, the processes used for linkage and the additional information available for quality assessment. This paper proposes and evaluates two methods to routinely assess linkage quality. Approach Linkage units currently use a range of methods to measure, monitor and improve linkage quality; however, no common approach or standards exist. There is an urgent need to develop “best practices” in evaluating, reporting and benchmarking linkage quality. In assessing linkage quality, of primary interest is in knowing the number of true matches and non-matches identified as links and non-links. Any misclassification of matches within these groups introduces linkage errors. We present efforts to develop sharable methods to measure linkage quality in Australia. This includes a sampling-based method to estimate both precision (accuracy) and recall (sensitivity) following record linkage and a benchmarking method - a transparent and transportable methodology to benchmark the quality of linkages across different operational environments. Results The sampling-based method achieved estimates of linkage quality that were very close to actual linkage quality metrics. This method presents as a feasible means of accurately estimating matching quality and refining linkages in population level linkage studies. The benchmarking method provides a systematic approach to estimating linkage quality with a set of open and shareable datasets and a set of well-defined, established performance metrics. The method provides an opportunity to benchmark the linkage quality of different record linkage operations. Both methods have the potential to assess the inter-rater reliability of clerical reviews. Conclusions Both methods produce reliable estimates of linkage quality enabling the exchange of information within and between linkage communities. It is important that researchers can assess risk in studies using record linkage techniques. Understanding the impact of linkage quality on research outputs highlights a need for standard methods to routinely measure linkage quality. These two methods provide a good start to the quality process, but it is important to identify standards and good practices in all parts of the linkage process (pre-processing, standardising activities, linkage, grouping and extracting).
ABSTRACT Objectives While record linkage has become a strategic research priority within Australia and internationally, legal and administrative issues prevent data linkage in some situations due to ...privacy concerns. Even current best practices in record linkage carry some privacy risk as they require the release of personally identifying information to trusted third parties. Application of record linkage systems that do not require the release of personal information can overcome legal and privacy issues surrounding data integration. Current conceptual and experimental privacy-preserving record linkage (PPRL) models show promise in addressing data integration challenges but do not yet address all of the requirements for real-world operations. This paper aims to identify and address some of the challenges of operationalising PPRL frameworks. Approach Traditional linkage processes involve comparing personally identifying information (name, address, date of birth) on pairs of records to determine whether the records belong to the same person. Designing appropriate linkage strategies is an important part of the process. These are typically based on the analysis of data attributes (metadata) such as data completeness, consistency, constancy and field discriminating power. Under a PPRL model, however, these factors cannot be discerned from the encrypted data, so an alternative approach is required. This paper explores methods for data profiling, blocking, weight/threshold estimation and error detection within a PPRL framework. Results Probabilistic record linkage typically involves the estimation of weights and thresholds to optimise the linkage and ensure highly accurate results. The paper outlines the metadata requirements and automated methods necessary to collect data without compromising privacy. We present work undertaken to develop parameter estimation methods which can help optimise a linkage strategy without the release of personally identifiable information. These are required in all parts of the privacy preserving record linkage process (pre-processing, standardising activities, linkage, grouping and extracting). Conclusions PPRL techniques that operate on encrypted data have the potential for large-scale record linkage, performing both accurately and efficiently under experimental conditions. Our research has advanced the current state of PPRL with a framework for secure record linkage that can be implemented to improve and expand linkage service delivery while protecting an individual’s privacy. However, more research is required to supplement this technique with additional elements to ensure the end-to-end method is practical and can be incorporated into real-world models.
Although humor has been linked to resilience among many populations, little is known regarding the role of humor in the coping of individuals with severe mental illness (SMI). In this study, a series ...of interviews focused on humor was completed by 15 individuals with SMI, with narratives analyzed using grounded theory methods.The marginalized and stigmatized social position occupied by persons with SMI was found to affect both the use and meanings of humor. Humor was described as being the subject of clinical scrutiny. Humor was also emphasized as a means of subverting power differentials revolving around the identity of SMI with, for many, the primary goal being the development of “real” and genuine connections with service providers.
The simplified public health approach to cART management has been a key ingredient in the success of access programmes.9 Unfortunately, the guidelines for secondline therapy are far from simple: they ...are complicated in terms of deciding when treatment has failed, whether the failure requires initiation of a new cART regimen, and how the regimen should be constructed.4,8 The reason for this complexity is simple: we do not know the best strategy for management of first-line ART failure, in any country as regards income.10 Incredibly, the research that could have already answered this question has not been done. ... the question is: how do we provide access to simple and tolerable second-line cART that will reliably rescue those in whom first-line therapy has failed and can be prescribed according to a simplified approach?
The present study examined the impact of using a Web survey vs. a more traditional mail survey on the reporting of secondary consequences associated with substance use by undergraduate students.
...During the spring of 2001, a survey questionnaire was administered to a randomly selected sample of 7000 undergraduate students attending a large Midwestern research university in the United States. Sampled students were randomly assigned to a Web survey mode (
n
=
3500) or a mail survey mode (
n
=
3500).
The majority of respondents experienced a secondary consequence of substance use in the past 12 months. Bivariate and multivariate results showed minimal differences between Web and mail survey modes in the reporting of secondary consequences associated with substance use.
The present study provides evidence that Web surveys can be used as an effective mode for collecting data regarding secondary consequences among undergraduate college students. The present study suggests secondary consequences associated with substance use are highly prevalent among undergraduate students.
The prevalence and correlates of illicit methylphenidate use were examined within a nationally representative U.S. sample of 8th, 10th, and 12th graders. The annual prevalence of illicit ...methylphenidate use was 4%. Race, grade level, geographical region, grade point average, and substance use were all significantly associated with illicit methylphenidate use.
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