A Field-Based Introduction to Urban Education at the Middle School

Middle school teachers developed objectives and suggested activities for a pilot early field experience to introduce freshman teacher candidates to urban education at the middle school level. This paper presents these objectives and activities plus data about the effects of their use by 15 teachers and 22 freshmen; an additional 30 freshmen placed in a traditional (tutoring) early field experience formed a comparison group. Project freshmen demonstrated higher sense of personal teaching efficacy and flexibility among people in a multicultural setting. In their journals, project freshmen reported more awareness of the urban environment; however, comparison group freshmen were more likely to report a sense of accomplishment. The project experience seems to have provided a “big picture” introduction to urban education, while the traditional experience gave students a taste of success at one small teaching task

Approaches to inverse-probability-of-treatment–weighted estimation with concurrent treatments

Objectives: In a setting with two concurrent treatments, inverse-probability-of-treatment weights can be used to estimate the joint treatment effects or the marginal effect of one treatment while taking the other to be a confounder. We explore these two approaches in a study of intravenous iron use in hemodialysis patients treated concurrently with epoetin alfa (EPO). Study Design and Setting: We linked US Renal Data System data with electronic health records (2004–2008) from a large dialysis provider. Using a retrospective cohort design with 776,203 records from 117,050 regular hemodialysis patients, we examined a composite outcome: mortality, myocardial infarction, or stroke. Results: With EPO as a joint treatment, inverse-probability-of-treatment weights were unstable, confidence intervals for treatment effects were wide, covariate balance was unsatisfactory, and the treatment and outcome models were sensitive to omission of the baseline EPO covariate. By handling EPO exposure as a confounder instead of a joint treatment, we derived stable weights and balanced treatment groups on measured covariates. Conclusions: In settings with concurrent treatments, if only one treatment is of interest, then including the other in the treatment model as a confounder may result in more stable treatment effect estimates. Otherwise, extreme weights may necessitate additional analysis steps

A Semiparametric Model Selection Criterion with Applications to the Marginal Structural Model

Estimators for the parameter of interest in semiparametric models often depend on a guessed model for the nuisance parameter. The choice of the model for the nuisance parameter can affect both the finite sample bias and efficiency of the resulting estimator of the parameter of interest. In this paper we propose a finite sample criterion based on cross validation that can be used to select a nuisance parameter model from a list of candidate models. We show that expected value of this criterion is minimized by the nuisance parameter model that yields the estimator of the parameter of interest with the smallest mean-squared error relative to the expected value of an initial consistent reference estimator. In a simulation study, we examine the performance of this criterion for selecting a model for a treatment mechanism in a marginal structural model (MSM) of point treatment data. For situations where all possible models cannot be evaluated, we outline a forward/backward model selection algorithm based on the cross validation criterion proposed in this paper and show how it can be used to select models for multiple nuisance parameters. We evaluate the performance of this algorithm in a simulation study of the one-step estimator of the parameter of interest in a MSM where models for both a treatment mechanism and a conditional expectation of the response need to be selected. Finally, we apply the forward model selection algorithm to a MSM analysis of the relationship between boiled water use and gastrointestinal illness in HIV positive men

Counterpoint: The Treatment Decision Design

The comparative new-user design is a principled approach to learning about the relative risks and benefits of starting different treatments in patients who have no history of use of the treatments being studied. Vandenbroucke and Pearce (Am J Epidemiol. 2015;182(10):826–833) discuss some problems inherent in incident exposure designs and argue that epidemiology may be harmed by a rigid requirement that follow-up can only begin at first exposure. In the present counterpoint article, a range of problems in pharmacoepidemiology that do not necessarily require that observation begin at first exposure are discussed. For example, among patients who are past or current users of a medication, we might want to know whether treatment should be augmented, switched, restarted, or discontinued. To answer these questions, a generalization of the new-user design, the treatment decision design, which identifies cohorts anchored at times when treatment decisions are being made, such as the evaluation of laboratory parameters, is discussed. The design aims to provide estimates that are directly relevant to physicians and patients, helping them to better understand the risks and benefits of the different treatment choices that they are considering

The Madison plasma dynamo experiment: a facility for studying laboratory plasma astrophysics

The Madison plasma dynamo experiment (MPDX) is a novel, versatile, basic plasma research device designed to investigate flow driven magnetohydrodynamic (MHD) instabilities and other high-$\beta$ phenomena with astrophysically relevant parameters. A 3 m diameter vacuum vessel is lined with 36 rings of alternately oriented 4000 G samarium cobalt magnets which create an axisymmetric multicusp that contains $\sim$14 m$^{3}$ of nearly magnetic field free plasma that is well confined and highly ionized $(>50\%)$. At present, 8 lanthanum hexaboride (LaB$_6$) cathodes and 10 molybdenum anodes are inserted into the vessel and biased up to 500 V, drawing 40 A each cathode, ionizing a low pressure Ar or He fill gas and heating it. Up to 100 kW of electron cyclotron heating (ECH) power is planned for additional electron heating. The LaB$_6$ cathodes are positioned in the magnetized edge to drive toroidal rotation through ${\bf J}\times{\bf B}$ torques that propagate into the unmagnetized core plasma. Dynamo studies on MPDX require a high magnetic Reynolds number $Rm > 1000$, and an adjustable fluid Reynolds number $10< Re <1000$, in the regime where the kinetic energy of the flow exceeds the magnetic energy ($M_A^2=($v$/$v$_A)^2 > 1$). Initial results from MPDX are presented along with a 0-dimensional power and particle balance model to predict the viscosity and resistivity to achieve dynamo action.Comment: 14 pages, 13 figure

Disease transmission models for public health decision making: analysis of epidemic and endemic conditions caused by waterborne pathogens.

Developing effective policy for environmental health issues requires integrating large collections of information that are diverse, highly variable, and uncertain. Despite these uncertainties in the science, decisions must be made. These decisions often have been based on risk assessment. We argue that two important features of risk assessment are to identify research needs and to provide information for decision making. One type of information that a model can provide is the sensitivity of making one decision over another on factors that drive public health risk. To achieve this goal, a risk assessment framework must be based on a description of the exposure and disease processes. Regarding exposure to waterborne pathogens, the appropriate framework is one that explicitly models the disease transmission pathways of pathogens. This approach provides a crucial link between science and policy. Two studies--a Giardia risk assessment case study and an analysis of the 1993 Milwaukee, Wisconsin, Cryptosporidium outbreak--illustrate the role that models can play in policy making

Patterns of Use of Human Papillomavirus and Other Adolescent Vaccines in the United States

AbstractPurposeThe purpose of the study was to describe the patterns of use of universally recommended adolescent vaccines in the United States.MethodsWe identified 11-year-olds using the MarketScan insurance claims database (2009–2014). Human papillomavirus (HPV), tetanus-diphtheria-acellular pertussis (Tdap), and meningococcal (MenACWY) vaccination claims were identified using diagnosis and procedure codes. Generalized linear models estimated vaccination incidence rates and correlates of adolescent vaccination and timely vaccination.ResultsAmong 1,691,223 adolescents, receipt of Tdap (52.1%) and MenACWY (45.8%) vaccinations exceeded receipt of HPV vaccination (18.4%). While both sexes had similar Tdap and MenACWY vaccination proportions, girls received HPV vaccination more frequently than boys (21.9% vs. 15.1%). Adolescents received HPV vaccination later (mean age: 11.8 years) than Tdap or MenACWY vaccination (mean age: 11.2 years for both). Half of vaccinated adolescents received Tdap and MenACWY vaccination only; however, coadministration with HPV vaccine increased with birth cohort. Western adolescents had the highest incidence rates of HPV vaccination, and Southern adolescents had the lowest. Rural adolescents were less likely than urban adolescents to receive each vaccination except in the Northeast, where they were more likely to receive HPV vaccination (incidence rate ratio: 1.09, 95% confidence interval: 1.2005–1.13). Timely HPV vaccination was associated with female sex, urbanicity, Western residence, and later birth cohort.ConclusionsHPV vaccination occurred later than Tdap or MenACWY vaccination and was less frequent in boys and rural adolescents. Girls, Western and urban residents, and younger birth cohorts were more likely to receive timely HPV vaccination. Vaccine coadministration increased over time and may encourage timely and complete vaccination coverage