Pedestrian Traffic Fatalities by State: 2015 Preliminary Data

The number of pedestrian fatalities in the United States increased 19 percent from 2009 to 2014, a period in which total traffic deaths decreased by about 4 percent. In fact, pedestrians now account for the largest proportion of traffic fatalities recorded in the past 25 years. Earlier studies by the Governors Highway Safety Association (GHSA), based on preliminary data reported by State Highway Safety Offices (SHSOs), were the first to predict recent increases in pedestrian fatalities.The present study, based on preliminary data from all states and the District of Columbia (DC) for the first six months of 2015, found an increase of 6 percent in the reported number of fatalities compared with the first six months of 2014. After adjusting for anticipated underreporting in the preliminary state data, GHSA estimates there has been a 10 percent increase in the number of pedestrians killed in 2015 compared with 2014. In addition, pedestrian deaths as a percent of total motor vehicle crash deaths have increased steadily from 11 percent in 2005-2007 to 15 percent in 2014. It has been 25 years (1990) since pedestrians accounted for 15 percent of total traffic fatalities. Preliminary data indicate that pedestrians will represent about 15 percent of total fatalities again in 2015

Empiricism and Theorizing in Epidemiology and Social Network Analysis

The connection between theory and data is an iterative one. In principle, each is informed by the other: data provide the basis for theory that in turn generates the need for new information. This circularity is reflected in the notion of abduction, a concept that focuses on the space between induction (generating theory from data) and deduction (testing theory with data). Einstein, in the 1920s, placed scientific creativity in that space. In the field of social network analysis, some remarkable theory has been developed, accompanied by sophisticated tools to develop, extend, and test the theory. At the same time, important empirical data have been generated that provide insight into transmission dynamics. Unfortunately, the connection between them is often tenuous and the iterative loop is frayed. This circumstance may arise both from data deficiencies and from the ease with which data can be created by simulation. But for whatever reason, theory and empirical data often occupy different orbits. Fortunately, the relationship, while frayed, is not broken, to which several recent analyses merging theory and extant data will attest. Their further rapprochement in the field of social network analysis could provide the field with a more creative approach to experimentation and inference

A Look at the Change in the Seasonality of Influenza between Three Distinct Regions of Uganda: Central, Northwest, and Western

Influenza is suspected to be endemic in tropical climates, with peaks during and/or following cold or rainy seasons. To date, only one study has been conducted examining the epidemiology and seasonality of influenza in Uganda. The focus of this analysis is to determine whether a change in the seasonality of influenza can been seen between three distinct regions of Uganda: Central, Northwest, and Western. Secondary data analysis was conducted on surveillance data collected by the Uganda Virus Research Institute (UVRI) between April 2007 to September 2010 from 10 surveillance sites. Surveillance sites were grouped for this analysis into three regions: Central, Northwest, and Western. A total of 3,944 samples were collected and tested for any strain of influenza. The prevalence of influenza over the 4 years of surveillance was 10.1%. The majority of cases came from the Central region (81.7%) and the highest prevalence of influenza-positive samples were collected in the Central region (88.7 cases/1,000 persons). A clear difference in influenza activity was observed during the 2009 H1N1 pandemic. Uganda reported its first case of H1N1 in July 2009 (Relief Web). The Central region experienced its initial flux of influenza activity in July and August 2009 (Figure 1). However, the Northwest region did not experience a flux in activity until October 2009 (Figure 2). Influenza activity in the Central and Northwest regions appear to coincide with colder temperatures and both rainy seasons. The Northwest region was the only region to experience a peak corresponding with warmer weather. Results showed a slight change in the seasonality of influenza between the Central and Northwest regions of Uganda from surveillance data collected between April 2007 and September 2010

Disassortative Age-Mixing Does Not Explain Differences in HIV Prevalence between Young White and Black MSM: Findings from Four Studies

Objective Age disassortativity is one hypothesis for HIV disparities between Black and White MSM. We examined differences in age mixing by race and the effect of partner age difference on the association between race and HIV status. Design We used data from four studies of MSM. Participants reported information about recent sexual partners, including age, race, and sexual behavior. Two studies were online with a US sample and two focused on MSM in Atlanta. Methods We computed concordance correlation coefficients (CCCs) by race across strata of partner type, participant HIV status, condom use, and number of partners. We used Wilcoxon ranksum tests to compare Black and White MSM on partner age differences across five age groups. Finally, we used logistic regression models using race, age, and partner age difference to determine the odds ratio of HIV-positive serostatus. Results Of 48 CCC comparisons, Black MSM were more age-disassortative than White MSM in only two. Furthermore, of 20 comparisons of median partner age, Black and White MSM differed in two age groups. One indicated larger age gaps among the Black MSM (18-19). Prevalent HIV infection was associated with race and age. Including partner age difference in the model resulted in a 2% change in the relative odds of infection among Black MSM. Conclusions Partner age disassortativity and partner age differences do not differ by race. Partner age difference offers little predictive value in understanding prevalent HIV infection among Black and White MSM, including diagnosis of HIV-positive status among self-reported HIVnegative individuals

Characterization of Men with Hemophilia B and Factors Associated with Treatment Practices, Participating in the Community Counts Registry from 2014 to 2018.

Hemophilia B is an inherited, X-linked, bleeding disorder caused by a mutation of the clotting factor 9 (FIX) gene. The mutation reduces the amount of FIX protein and results in spontaneous and trauma-related bleeding episodes. In 1994, approximately 2,800 men with hemophilia B (MWHB) were treated at hemophilia treatment centers (HTCs) in the United States (US). To date, studies examining health outcomes for MWHB in the US have not been compared across disease severities. Treatment of MWHB has become more complex with changes in prophylaxis practices in the US and the introduction of novel treatment products. Observational studies that describe health outcomes among MWHB and current treatment practices are important to inform future clinical practices. These cross-sectional analyses used data from MWHB enrolled in the Community Counts surveillance Registry (Registry) from 2014 to 2018. The first paper compared the sample of MWHB in the Registry to the population of MWHB who received treatment in HTCs and described the demographic, clinical factors, and health outcomes across disease severities. From 2014-2018, the population of MWHB who received care in HTCs included 4,816 MWHB, of which 2091 participated in the Registry. The second paper examined demographic, clinical factors, and health outcomes associated with treatment regimen, prophylaxis versus episodic; and used a marginal model. The final model included ethnicity, health insurance, history of a joint bleed, and interactions between severity by chronic pain as well as age by history of central venous access device utilization. The third paper examined demographic, clinical factors, and health outcomes associated with treatment product type utilization, standard half-life products versus extended half-life products, among MWHB on continuous prophylaxis; and used a marginal model. The final model included disease severity, enrollment year, HTC region, and percent of missed treatment dose. The second and third paper demonstrated that patient-level treatment outcomes were clustered by the HTCs where they received care. Future studies should examine the treatment dosage and frequency of administration of treatment products for MWHB on prophylaxis and replicate these studies for hemophilia A to determine if the factors associated with treatment are similar for all men with hemophilia

Kearns-sayre syndrome with reduced plasma and cerebrospinal fluid folate

A young woman with Kearns-Sayre syndrome and progressive central nervous system deterioration over 15 years had decreased plasma and cerebrospinal fluid folate levels while receiving phenytoin for a seizure disorder. A muscle biopsy showed a “ragged red fiber” myopathy with reduced muscle carnitine and mitochondrial enzymes. Computed tomographic brain scans showed cerebral white matter hypodensities and bilateral calcification of the basal ganglia. The mechanism for the folate deficiency and altered ratio of plasma to cerebrospinal fluid folate is unknown, but the deficiency may be responsive to replacement therapy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/50301/1/410130620_ftp.pd

Urban Health Indicators and Indices- Current Status,

Though numbers alone may be insufficient to capture the nuances of population health, they provide a common language of appraisal and furnish clear evidence of disparities and inequalities. Over the past 30 years, facilitated by high speed computing and electronics, considerable investment has been made in the collection and analysis of urban health indicators, environmental indicators, and methods for their amalgamation. Much of this work has been characterized by a perceived need for a standard set of indicators. We used publication databases (e.g. Medline) and web searches to identify compilations of health indicators and health metrics. We found 14 long-term large-area compilations of health indicators and determinants and seven compilations of environmental health indicators, comprising hundreds of metrics. Despite the plethora of indicators, these compilations have striking similarities in the domains from which the indicators are drawn—an unappreciated concordance among the major collections. Research with these databases and other sources has produced a small number of composite indices, and a number of methods for the amalgamation of indicators and the demonstration of disparities. These indices have been primarily used for large-area (nation, region, state) comparisons, with both developing and developed countries, often for purposes of ranking. Small area indices have been less explored, in part perhaps because of the vagaries of data availability, and because idiosyncratic local conditions require flexible approaches as opposed to a fixed format. One result has been advances in the ability to compare large areas, but with a concomitant deficiency in tools for public health workers to assess the status of local health and health disparities. Large area assessments are important, but the need for small area action requires a greater focus on local information and analysis, emphasizing method over prespecified content