Alcohol-Related Emergency Department Visits Associated With Collegiate Football Games

Abstract

Objective: In 2003, after several post–college football game riots, multiple strategies including strict enforcement of open container laws were instituted by the authors’ city and university. The authors compared alcohol-related visits to the on-campus emergency department (ED) associated with home football games in 2002 and 2006, hypothesizing that alcohol-related visits should decline. Participants: ED patients during home game weekends. Methods: Retrospective cohort study comparing the 2002 and 2006 home games—similar seasons wherein the team went undefeated. Logistic regression assessed the impact of environmental and patient characteristics on the likelihood of an ED visit being alcohol related. Results: In total 2,220 visits in 2002 and 2,146 visits in 2006 were reviewed. Alcohol-related visits increased from 2002 (7.9%) to 2006 (9.5%, p = .06). Despite community interventions, the odds of an ED visit being alcohol related increased (odds ratio [OR] 1.3, 95% confidence interval [CI₉₅] 1.06–1.64). Conclusions: Community measures did not reduce alcohol-related visits to the ED.     

Make Time for Physical Activity or You May Spend More Time Sick!

This work estimates the association between various types of physical activities and physical health, mental health and health service utilization. Specifically, we consider participation in housework, manual, walking, sports/exercise and total physical activities to a moderate level. We view this as an important contribution given that governments usually recommend a total level of activity that their citizens should achieve to be healthy, rather than a particular activity per se. Our results suggest that participation in any of these activities predicts a lower probability of poor health roughly to the same level. For mental health, our estimates highlight that those who participate in (and do more of) any activity have better mental health when compared to those who do not. The associations are higher for women. The associations are also higher for manual activities and sports/exercise when compared to other activities. The analysis also reveals some lower utilization of in-patient, out-patient visits and GP services among individuals who are moderately physically active.     

A multi-index model for quantile regression with ordinal data

In this paper, we propose a quantile approach to the multi-index semiparametric model for an ordinal response variable. Permitting non-parametric transformation of the response, the proposed method achieves a root-n rate of convergence and has attractive robustness properties. Further, the proposed model allows additional indices to model the remaining correlations between covariates and the residuals from the single-index, considerably reducing the error variance and thus leading to more efficient prediction intervals (PIs). The utility of the model is demonstrated by estimating PIs for functional status of the elderly based on data from the second longitudinal study of aging. It is shown that the proposed multi-index model provides significantly narrower PIs than competing models. Our approach can be applied to other areas in which the distribution of future observations must be predicted from ordinal response data.     

Multivariate thin plate spline estimates for the posterior probabilities in the classification problem

A nonparametric estimate for the posterior probabilities in the classification problem using multivariate thin plate splines is proposed. This method presents a nonpararnetric alternative to logistic discrimination as well as to survival curve estimation. The degree of smoothness of the estimate is determined from the data using generalized crossvalidation.     

Out-of-Sample Forecast Performance as a Test for Nonlinearity in Time Series

This article uses a local-information, near-neighbor forecasting methodology as a prediction test for evidence of a noisy, chaotic data-generating process underlying the Divisia monetary-aggregate series. Using a nonparametric method known to perform well with low-dimensional chaotic processes infected by noise, accompanied by a robust test of forecast performance evaluation, we compare out-of-sample forecasting accuracy from the local-information method to forecasting accuracy from the best fitting global linear model. Our results fail to substantiate previous claims for determinism in the Divisia monetary-aggregate series because the degree of forecast improvement obtained by the local-information method is not consistent with the hypothesis of a low-dimensional attractor underlying the Divisia data.     

The Relationship Between Urinary Tract Infections and the Collegiate Academic Calendar

Abstract

College students believe that they are more likely to be ill during examination periods than at other times in the academic year. We in the health service hypothesized that urinary tract infections are not affected by the demands of the academic calendar.

During a 4-year study, the university health service obtained urine culture data prospectively from 456 patients who had a total of 508 episodes of urinary tract infections. Each year, the number of urinary tract infections decreased during both midterm and final examination periods, but rebounded to higher-than-average levels in the second week following the midterm examination period, as well as during the second week of the second (spring) semester, immediately after the mid-winter recess. Mean duration of symptoms was 34 hours (range, from 12 to 60).

Urinary tract infections were less common during examination periods, when students were preoccupied with academic responsibilities, but such infections increased in frequency in the period immediately after examinations, when sexual intimacy was resumed or when sexual intercourse with a new partner began. Urinary tract infections in college women, the study indicated, are primarily related to sexual intercourse, and susceptibility is only indirectly affected by the demands of the academic calendar.     

Rapid Ethnographic Assessment of HIV/AIDS among Garífuna Communities in Honduras: Informing HIV Surveillance among Garífuna Women

ABSTRACT

Garífuna, an Afro-Caribbean ethnic group in Honduras, have among the highest HIV prevalence rates in Central America; 15- to 49-year-old Garífuna have HIV rates comparable to heterosexual transmission rates in regions of sub-Saharan Africa. The heightened rates in this age range pose a significant risk of vertical transmission from woman to child at birth. In 2006, a Behavioral Surveillance Survey plus Biomarkers (BSS+) reexamined seroprevalence of HIV, sexually transmitted infections, and HIV-related risk behaviors among Garífuna to inform HIV prevention activities and monitor trends in HIV transmission over time. To inform the BSS+ survey protocol, we conducted a rapid ethnographic assessment (REA) in Garífuna communities to specifically examine acceptability among Garífuna to be surveyed, suggest ways to minimize HIV-testing related stigma, and determine female gender-specific concerns among BSS+ respondents. Data were collected in 2 weeks in November, 2004, using a semi-structured interview guide for key informant interviews and focus groups. Seventeen key informant interviews and three focus groups were conducted; participant observation and 11 site visits were also conducted. Major findings included high Garífuna acceptability to participate in the BSS+ with key member involvement and incentives. Maintaining confidentiality at HIV testing sites is required to minimize Garífuna women's risk of intimate partner violence. Recommendations to BSS+ partners from this REA informed the BSS+ study protocol and was expected to increase participation and validity and decrease potential risks associated with women's survey participation.