National Aggregate Data Research Articles

Trend analysis of tuberculosis case notifications with scale-up of antiretroviral therapy and roll-out of isoniazid preventive therapy in Zimbabwe, 2000–2018

ObjectivesAntiretroviral therapy (ART) and isoniazid preventive therapy (IPT) are known to have a tuberculosis (TB) protective effect at the individual level among people living with HIV (PLHIV). In Zimbabwe where...

Community Assessment of Colorectal Cancer Screening Compliance in Northwest Louisiana.

In the United States, colorectal cancer (CRC) screening rates have steadily increased. The state of Louisiana has persistent lower screening rates compared to the United States and other states, and with African Americans experiencing the highest CRC incidence rates. Aggregate national and state data can be problematic in isolating key health issues and data in rural areas. Study Purpose: At the Louisiana parish-level, which is comparable to county municipalities in other U.S. states, the research study examined endoscopy CRC screening among African American Medicare beneficiaries. Using cluster sampling, survey-based data from two neighboring parishes in northwest Louisiana were collected. The survey instrument was adapted from the Medicare Current Beneficiary Survey. The key study variables were CRC screening compliance, residence location, self-reported CRC knowledge, and physician recommendation. The findings showed significant differences in CRC screening compliance between the two parishes. Participants with CRC knowledge score of at least 3 out of 5 were more likely to be compliant with CRC screening. The findings demonstrated the importance of isolating geo-specific data, especially in rural areas, to plan effective health education or intervention strategies.

Evolving Consumption Patterns in the U.S. Alcohol Market: Disaggregated Spatial Analysis

AbstractGlobal consumption patterns for alcoholic beverages are evolving, with some convergence in per capita consumption among nations as traditionally beer-drinking nations increase their consumption of wine and, conversely, wine-consuming nations shift towards beer. This article explores regional patterns of alcoholic beverage consumption within the United States. One purpose is to see if similar patterns of spatial convergence in consumption patterns can be observed within countries as have been documented in international comparisons. A more fundamental purpose is to explore the converse question and seek to better understand the persistent differences in alcoholic beverage consumption among groups. These issues are addressed using annual U.S. national and state-level data over four decades and, for the more recent period, supermarket scanner data at finer scales of geopolitical aggregation. Socioeconomic and other demographic variables appear to play significant roles in accounting for the spatial differences in consumption patterns, although the details vary across different models and data sets. The analysis of demand using less-aggregative data for a shorter time period reveals some shortcomings in the corresponding analysis based on state-level data over a longer time period, but with poorly measured prices. These findings might extrapolate to studies making international comparisons using national aggregate data. (JEL Classifications: D12, L66)

State of Pharmacology Education in Medical Schools Across the USA; A Ten‐Year Review

On the Centennial anniversary of the Flexner report the Medical School Graduation Questionnaire, published by the American Association of Medical Colleges (AAMC), introduced a question asking recent medical graduates to agree or disagree if basic science was integrated into required clinical experiences. This question was later revised to ask the more recent medical graduates to agree or disagree if the required clinical experiences integrated basic science content. An analysis of published national aggregate data of graduates from both allopathic and osteopathic medical schools during the past 8 years indicated that the basic sciences in the medical schools have continued to be well integrated with clinical training. More importantly, the satisfaction score analysis for the past ten years (2008–2018) indicated that the pharmacology being taught had prepared graduates for clinical clerkships and electives. Similar to the satisfaction scores from other disciplines such as physiology, microbiology or pathology, pharmacology continued to show stability where at least 60 % of the medical students rated the pharmacology as “Good or Excellent” for past 10 years. During the past five years from 2013–2018, the satisfaction score appears to have reached a plateau after it rapidly increased between 2008 and 2010. With some medical schools facing budget cuts, less available faculty strictly devoted to teaching pharmacology as a discipline, and/or curricular changes that encourage more integration between basic sciences the existing risk is that pharmacology may be taught by non-pharmacology faculty. It is important to encourage more training in academia of educators devoted to teaching pharmacology so that the satisfaction score continues to be stable and/or continues to improve across medical schools in the nation. Support or Funding Information Institutional Support Figure illustrates the median stable at 2 for all years, that means at least 50% of the students rated Good or Excellent every year. The average line indicates a great improvement from 2008–2010. For the last 5 years from 2013–2018, the progress appears to have reached a plateau. This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Mature students’ socio-economic backgrounds and their choices of Access to Higher Education courses

ABSTRACTThis article discusses the educational, social and economic backgrounds of Access to Higher Education (AHE) students and how these factors influence students’ choice of courses and colleges in which to pursue their desire to enter higher education (HE) despite the risks involved and the initial lack of confidence of many of them in their capabilities as learners. The discussion is based on three main sources: studies about mature students’ views of their experiences as learners, national aggregate data about AHE students in England and Wales and the findings from a study of approximately 700 AHE students about their experiences on AHE courses that was carried out in a region of England in seven further education (FE) colleges. The study used a social constructivist perspective and linked case study design to collect and compare trustworthy qualitative and quantitative data. What emerges is that mature students need supportive learning environments that are easily accessible and build their confidence and competence as independent but collaborative learners who can achieve their aspirations as well as meet their needs as adults as spouses, breadwinners and childcarers. This has implications for how further and higher education institutions attract, teach and sustain mature students.

03:09 PM Abstract No. 142 Market shifts in transcatheter dialysis conduit procedures in the Medicare population: a 15-year national and state-level analysis

To evaluate trends in transcatheter hemodialysis conduit procedures in the Medicare population over a recent 15-year interval. Aggregate national claims data were extracted from CMS PSPS Master Files from 2001-2015 for hemodialysis conduit angiography and thrombectomy procedures. Utilization was stratified by billing specialty and site of service. Additionally, individual claims data from 2004-2015 CMS 5% Research Identifiable Files were used to assess state-level utilization. Utilization was normalized per 100,000 Medicare fee-for-service beneficiaries. From 2001-2015, hemodialysis conduit angiography utilization rates increased from 385 to 1,045 per 100,000 beneficiaries [compound annual growth rate (CAGR) +7.4%)], and thrombectomy rates increased from 114 to 168 (CAGR +2.8%). The CAGR for angiography was, by specialty, +1.5% for radiologists, +18.4% for surgeons, and +24.0% for nephrologists, and by site, +29.1% for office and +0.8% for hospital settings. Radiologists’ overall market share of angiography decreased from 81.5% in 37.0%. By combination of specialty and site of service, angiography utilization growth was greatest for nephrologists in the office (from 5 to 265) and surgeons in the office (0 to 128). The greatest decline was for radiologists in the hospital (299 to 205). At the state level, there was marked heterogeneity in dialysis angiography utilization in 2015 [0 (Wyoming) to 1,1,73 (Georgia)], temporal change in angiography utilization from 2004-2015 [CAGR -100.0% (Wyoming) to +19.9% (Nevada)], and radiologists’ 2015 market share [4.8% (Washington DC) to 100.0% (North Dakota)]. Nonetheless, radiologists’ market share decreased in 49 states, and in some states dramatically (e.g., in Nevada, from 100.0% in 2004 to 6.7% in 2015). Transcatheter dialysis conduit angiography utilization has grown substantially, and more so than thrombectomy. This growth has been accompanied by a drastic market shift from radiologists in the hospital to nephrologists and surgeons in the office. Despite wide geographic heterogeneity across the U.S., decreasing radiologist market share has been observed in nearly every state.

The Economic and Social Roots of Populist Rebellion: Support for Donald Trump in 2016

This paper critically analyzes voting patterns in the 2016 U.S. presidential election. Using survey data from the American National Election Survey and aggregate data on Congressional districts, it assesses the roles that economic and social factors played in Donald J. Trump’s “Populist” candidacy. It shows the hollowness of claims that economic issues played little or no role in the campaign and that social factors such as race or gender suffice to explain the outcome. While agreeing that racial resentment and sexism were important influences, the paper shows how various economic considerations helped Trump win the Republican primary and then led significant blocs of voters to shift from supporting Democrats or abstaining in 2012 to vote for him. It also presents striking evidence of the importance of political money and Senators’ “reverse coattails” in the dramatic final result.

Clinical Laboratory Personnel Workforce Survey in Montana

<h3>ABSTRACT</h3> <h3>INTRODUCTION:</h3> The medical laboratory professional workforce shortage in the United States has been documented through several national survey reports that also describe the use of temporary staffing to fill vacancies. The primary study objectives were to determine the extent of the workforce shortage in Montana and describe the usage of temporary staffing to fill vacancies. <h3>STUDY OBJECTIVES:</h3> The study objectives were as follows: (1) identify Montana Clinical Laboratory Improvement Amendments laboratories by geographical area classification, (2) identify usage of temporary medical laboratory professionals based on laboratory type, (3) determine wage differences between full-time/part-time permanent employees versus temporary medical laboratory professionals, (4) determine the usage rates of temporary medical laboratory professionals, (5) identify the cause(s) for usage of temporary staffing, and (6) determine the length of time to fill vacancies. <h3>METHOD:</h3> An electronic survey composed of multiple-choice, dichotomous, short-answer, and open-ended questions was developed to collect qualitative and quantitative data and was distributed via email. <h3>RESULTS:</h3> The survey was sent to 83 facilities, with a 54% (<i>n</i> = 45) response rate. Of respondents, 49% (<i>n</i> = 22) reported employing temporary staffing, and 51% (<i>n</i> = 23) do not employ temporary staffing. The reasons for hiring temporary staffing included being unable to fill the position (62%), medical leave (13%), vacation (10%), and other reasons, such as deployment, maternity leave, being short-staffed, and administrative projects (15%). Of the 22 facilities employing temporary staffing, 45% (<i>n</i> = 10) have a temporary staffing budget line item. <h3>CONCLUSION:</h3> The survey results indicated there is a medical laboratory professional shortage in Montana, and compared with the national rate, the usage of temporary staffing is higher, and vacancies take longer to fill by up to 2 years. The usage of temporary staffing is more than twice as high compared with national survey rates. The state-specific data obtained from this study provided vital information to the Montana clinical laboratory community and could serve as an impetus to work collaboratively to explore solutions to the shortage based on state-specific needs. The survey design can also serve as an example for other states to conduct similar studies to gather state-specific information versus national survey aggregate data.

Trends in adolescent first births in five countries in Latin America and the Caribbean: disaggregated data from demographic and health surveys

BackgroundAdolescents in the Latin American and Caribbean region continue to experience poor reproductive health outcomes, including high rates of first birth before the age of 20 years. Aggregate national level data fails to identify groups where progress is particularly poor. This paper explores how trends in adolescent births have changed over time in five countries (Bolivia, Colombia, Dominican Republic, Haiti, and Peru) using data disaggregated by adolescent age group, wealth and urban / rural residence.MethodsThe study draws on Demographic and Health Survey data from five countries where three surveys are available since 1990, with the most recent after 2006. It examines trends in adolescent births by wealth status and urban/rural residence.ResultsThere has been little progress in reducing adolescent first births over the last two decades in these countries. Adolescent first births continue to be more common among the poorest and rural residents, and births among the youngest age-group (< 16 years) are particularly concentrated among these populations.ConclusionAdolescent first births continue to be a major issue in these five countries, including amongst the youngest group (< 16 years), although the contexts in which it is occurring are changing over time. Efforts are needed to expand sexual education and services for adolescents and young people, as well as introduce and enforce legislation to provide effective protection from abuse or exploitation. Greater disaggregation of adolescent fertility data is needed if we are to measure progress towards the attainment of the Sustainable Development Goals to “leave no-one behind”.

Synthetic building stocks as a way to assess the energy demand and greenhouse gas emissions of national building stocks

In Europe, the final energy demand and greenhouse gas (GHG) emissions of residential and commercial building stocks account for approximately 40% of energy and emissions. A building stock model (BSM) is a method of assessing the energy demand and GHG emissions of building stocks and developing pathways for energy and GHG emission reduction. The most common approach to building stock modeling is to construct archetypes that are taken to representing large segments of the stock. This paper introduces a new method of building stock modeling based on the generation of synthetic building stocks. By drawing on relevant research, the developed methodology uses aggregate national data and combines it with various data sources to generate a disaggregated synthetic building stock. The methodology is implemented and validated for the residential building stock of Switzerland. The results demonstrate that the energy demand and GHG emissions can vary greatly across the stock. These and other indicators vary significantly within common building stock segments that consider only few attributes such as building type and construction period. Furthermore, the results indicate a separation of the stock in terms of GHG emissions between old fossil fuel-heated buildings and new and refurbished buildings that are heated by renewable energy. Generating a disaggregated synthetic building stock allows for a discrete representation of various building states. This enables a more realistic representation of past building stock alterations, such as refurbishment, compared with commonly used archetypes, and not relying on more extensive data sources and being able to accommodate a wide variation of data types. The developed methodology can be extended in numerous manners and lays groundwork for future studies.

إمکانیات التکامل الزراعی العربی فی مجال إنتاج الحبوب

The requirement of economic integration in the agricultural area between Arab states, the current demands and strategy, especially in the conditions of globalization, given the food gap on the level of the Arab world as a whole, and on the level of each individual State, which increases the importance of identifying the aspects of this problem is the difficulty that the individual State to make use of all its resources as a result of the imbalance in the distribution of the resources. Thus, this study aimed at monitoring the most important aspects of Arab agricultural integration from the estimate of a function of grain production in the Arab countries of using mathematical model Kobe Douglas Production function, drawing on national aggregate data, in the form of (series data panel sectional data) instead of time-series data, taking advantage of a model (Hayami and Ruttan model), to assess and analyze the reasons for the disparity and in agricultural productivity in the Arab States. Through relying on secondary data available domestic and international issued by official authorities of the relationship with the subject of our study, the statistics, reports and studies organizations and regional, Arab and international levels. Consequently, the above account has been possible increases in the productivity of hectares of grain, in the case of if the integrated among Arab countries in the field of grain production, assuming that the possibility of the movement of production and exchange of experience and knowledge between the Arab countries.

Suicide mortality and marital status for specific ages, genders, and education levels in South Korea: Using a virtually individualized dataset from national aggregate data

BackgroundPrevious studies in Eastern as well as Western countries have shown a relationship between marital status and suicide mortality. However, to date, no Korean study has calculated national suicide rates by marital status for specific genders, ages, and education levels. This study investigated whether the relationship between marital status and suicide differs by age, gender, and educational attainment, and analyzed the effect of marital status on suicide risk after controlling for these socio-demographic variables. MethodsUsing national mortality data from 2015, and aggregated census data from 2010 in South Korea, we created a virtually individualized dataset with multiple weighting algorithms, including individual socio-demographic characteristics and suicide rates across the entire population. ResultsThe findings show that the following groups faced the highest relative suicide risks: 1) divorced men of all ages and men aged more than 75 years, particularly divorced men aged more than 75; and 2) never-married men aged 55–64 years, and never-married women of lower education status. LimitationsWe did not account for important variables such as mental health, substance abuse, employment insecurity, social integration, perceived loneness, and family income which we were unable to access. ConclusionsThis current research extends prior theoretical and methodological work on suicide, aiding efforts to reduce suicide mortality in South Korea.

Efficiency of Sustainability Management in Bulgarian Agriculture

This article applies a holistic framework for assessing efficiency of environmental and sustainability management in Bulgarian agriculture. Initially the multiprinciple, multictiteria and mulriindicator framework for assessing environmental and sustainability management in agriculture is outlined. After that environmental sustainability of Bulgarian agriculture at national and farms levels is evaluated. Finally, factors for improving environmental and sustainability management in agricultural farms in the country are identified. Our assessment at national and farm level have found out that there are significant discrepancies in efficiency levels based on aggregate national data and assessment (perception) of farm managers. Therefore, in management practices all kind of data have to be used in order to be able to take efficient decision at different managerial levels. Having in mind the importance of holistic assessments of efficiency of environmental and sustainability management in agriculture, and the enormous benefits for the farm management and agrarian policies, such studies are to be expended and their precision and representation increased.

National scale-up of tuberculosis-human immunodeficiency virus collaborative activities in Myanmar from 2005 to 2016 and tuberculosis treatment outcomes for patients with human immunodeficiency virus-positive tuberculosis in the Mandalay Region in 2015.

HIV-associated TB is a serious public health problem in Myanmar. Study objectives were to describe national scale-up of collaborative activities to reduce the double burden of TB and HIV from 2005 to 2016 and to describe TB treatment outcomes of individuals registered with HIV-associated TB in 2015 in the Mandalay Region. Secondary analysis of national aggregate data and, for treatment outcomes, a cohort study of patients with HIV-associated TB in the Mandalay Region. The number of townships implementing collaborative activities increased from 7 to 330 by 2016. The number of registered TB patients increased from 1577 to 139 625 in 2016, with the number of individuals tested for HIV increasing from 432 to 114 180 (82%) in 2016: 10 971 (10%) were diagnosed as HIV positive. Uptake of co-trimoxazole preventive therapy (CPT) and antiretroviral therapy (ART) nationally in 2016 was 77% and 52%, respectively. In the Mandalay Region, treatment success was 77% and mortality was 18% in 815 HIV-associated TB patients. Risk factors for unfavourable outcomes and death were older age (≥45 years) and not taking CPT and/or ART. Myanmar is making good progress with reducing the HIV burden in TB patients, but better implementation is needed to reach 100% HIV testing and 100% CPT and ART uptake in TB-HIV co-infected patients.

HIGH PREVALENCE OF VASCULAR AND METABOLIC RISK FACTORS AMONG DOWN SYNDROME PATIENTS WITH ALZHEIMER’S DISEASE: A SURVEY REPORT OF THE NATIONAL DOWN SYNDROME REGISTRY (DS-CONNECT)

Down syndrome (DS) patients have approximately five times greater risk of developing Alzheimer's disease (AD) compared to the general population, partially due to the presence of the amyloid precursor protein gene on chromosome 21. By age 40, nearly all individuals with DS have significant levels of the characteristic beta-amyloid plaques, yet not all of these individuals demonstrate cognitive decline. Given the high prevalence of AD within the DS population, it may prove that studying shared incidences of the two diseases will reveal specific risk factors for AD. We performed a preliminary study to investigate the prevalence of lifestyle-related health factors, such as type 2 diabetes, hypothyroidism, and lipid profile surveillance, among the DS population and their potential associations with AD. The survey analysis was performed using the de-identified national Down Syndrome Registry and aggregate data within the NIH database DS-Connect, the first web-based, voluntary DS registry and data resource. We identified 13 individuals with DS and AD. All individuals had filled out surveys, which included the diagnoses of disease variables and data on lifestyle risk factors. We identified 13 individuals with DS aged ≥ 30 who were concurrently diagnosed with AD. The mean age was approximately 45.8 years. The prevalences of hypothyroidism (58.3% vs. 48.5%) and thyroid dysfunction (76.9% vs. 55.7%) were higher in this population compared to DS patients without AD. DS patients with diabetes also saw a greater incidence of AD compared to DS patients without diabetes (33.3% vs. 14.8%). Additionally, DS patients who monitored their cholesterol on a yearly basis saw a decreased prevalence of AD (9.0% vs. 14.8%). Preliminary data from the Down Syndrome Registry shows that individuals with DS and AD have a higher prevalence of metabolic risk factors. Since these risk factors are modifiable, and their aggressive management and reversal have shown to reduce the pathophysiological markers of AD in non-DS populations, future studies are needed to investigate the association between metabolic and vascular risk factors and AD among the DS population, and explore mechanisms of prevention of cognitive impairment by management of these factors.

The Incidence of the Corporate Income Tax on Wages: Evidence from Canadian Provinces

The Incidence of the Corporate Income Tax on Wages: Evidence from Canadian Provinces

Rising Herbicide Use and Its Driving Forces in China

China is one of the developing countries that has experienced rapid growth in herbicide use in the past two decades. However, little information is available on what drive this growing use of herbicides. This study aims for a better understanding of the trend and major factors that affect herbicide use in China. Based on national aggregate data and primary household survey data, this study shows that besides falling herbicide prices, rising wages have been a major driver of this rapid growth since the mid-2000s. Analyses based on household data show that off-farm rural labor employment away from home province contributes to the increasing use of herbicides in wheat and maize production. In addition, irrigation and farmers’ education have significant impacts on herbicide use. With increasing wages and off-farm rural labor employment, we expect herbicide use in China to continue rising.

Using Data and Statistics to Explain Investment Effectiveness on Flood Protection

Losses and damages caused by natural disasters have negatively impacted poverty alleviation and human development and undermine the achievement of the Millennium Development Goals (MDGs). However, disaster issues were not included in MDG targets set up in 2000. A new development agenda, Sustainable Development Goals (SDGs), was approved in the UN General Assembly in September 2015. In the SDGs, disaster issues are included in many targets such as target 11.5. To appropriately set targets and prepare monitoring measures for disaster-related issues, quantitatively measurable indicators of impacts of disaster risk reduction on economic growth and poverty alleviation should be prepared. In addition, to promote disaster prevention measures, we need to convince policy makers that such measures are highly essential for a country’s development and are cost-effective. Although the cost-effectiveness of single disaster prevention projects has been studied, aggregate effectiveness of these projects at a national level has not been presented. This study proposes a simple method to explain the cost-effectiveness of flood protection investment in Japan post World War II by using national aggregate data.

Automating indicator data reporting from health facility EMR to a national aggregate data system in Kenya: An Interoperability field-test using OpenMRS and DHIS2.

Introduction:Developing countries are increasingly strengthening national health information systems (HIS) for evidence-based decision-making. However, the inability to report indicator data automatically from electronic medical record systems (EMR) hinders this process. Data are often printed and manually re-entered into aggregate reporting systems. This affects data completeness, accuracy, reporting timeliness, and burdens staff who support routine indicator reporting from patient-level data. Method: After conducting a feasibility test to exchange indicator data from Open Medical Records System (OpenMRS) to District Health Information System version 2 (DHIS2), we conducted a field test at a health facility in Kenya. We configured a field-test DHIS2 instance, similar to the Kenya Ministry of Health (MOH) DHIS2, to receive HIV care and treatment indicator data and the KenyaEMR, a customized version of OpenMRS, to generate and transmit the data from a health facility. After training facility staff how to send data using DHIS2 reporting module, we compared completeness, accuracy and timeliness of automated indicator reporting with facility monthly reports manually entered into MOH DHIS2. Results: All 45 data values in the automated reporting process were 100% complete and accurate while in manual entry process, data completeness ranged from 66.7% to 100% and accuracy ranged from 33.3% to 95.6% for seven months (July 2013-January 2014). Manual tally and entry process required at least one person to perform each of the five reporting activities, generating data from EMR and manual entry required at least one person to perform each of the three reporting activities, while automated reporting process had one activity performed by one person. Manual tally and entry observed in October 2013 took 375 minutes. Average time to generate data and manually enter into DHIS2 was over half an hour (M=32.35 mins, SD=0.29) compared to less than a minute for automated submission (M=0.19 mins, SD=0.15). Discussion and Conclusion: The results indicate that indicator data sent electronically from OpenMRS-based EMR at a health facility to DHIS2 improves data completeness, eliminates transcription errors and delays in reporting, and reduces the reporting burden on human resources. This increases availability of quality indicator data using available resources to facilitate monitoring service delivery and measuring progress towards set goals.

ANALISIS SPASIAL TERHADAP PERUBAHAN STATUS GIZI ANAK BALITA DI INDONESIA (RISKESDAS 2007 2010)

Transitions nutritional status is a reflection of the general transition, such as demographics, food, education and health. Demographic Transition reciprocally affects the transition in nutrition/health. This analysis was aimed to identify the distribution of the area and the differentiating factor of the double burden malnutrition on the children under five. Analysis was performed using aggregated National Data from Susenas 2007-2010 and Riskesdas 2007-2010. Unit analysis is the province. Spatial analysis was done with overlay method. The Analysis showed that high levels of potentially affected areas with double burden malnutrition were all of province in Kalimantan, Sulawesi and Maluku. Additionally was DKI province, Central Java, North Sumatra, South Sumatra, Riau Islands, Bangka Belitung and Lampung. Those situation is need to be concerned especially with demographic bonus phenomena. Demographic Bonus becomes a problem, if it is not accompanied by an increment in education, skills, health. When assuming other factor remain, it is predicted that in the event of the demographic bonus, there will be also a double burden malnutrition problems. Distribution of areas that experience with double burden malnutrition, clustered in regions outside Java, it shows social disparities still exist among Indonesian, community. Susceptible areas of double burden malnutrition was spread outside Java. Namely, Kalimantan, Sulawesi, Maluku. Sumatra, Riau Islands, Bangka Belitung.