Modelling Body Mass Index Distribution using Maximum Entropy Density

The objective of this paper is to model the distribution of Body Mass Index (BMI) for a given set of covariates. BMI is one of the leading indicators of health and has been studied by health professionals for many years. As such, there have been various approaches to model the distribution of BMI. Furthermore, there are numerous studies which investigate the association between an individual’s physical and socio-economic attributes (covariates) to their BMI levels. This paper proposes the use of Maximum Entropy Density (MED) to model the distribution of BMI using information from covariates. The paper shows how covariates can be incorporated into the MED framework. This framework is then applied to an Australian data set. The results show how different covariates affect different moments of the estimated BMI distribution

The Slippery Slope of MIS Academia: A Discussion of the Quest for Relevance in Our Discipline

The MIS discipline faces the need to periodically re-establish its relevance to both academics and practitioners. Evolving technology forces our discipline to change at a rate far exceeding that of other business disciplines. In the workplace, rapidly evolving IT management issues and technologies have led corporations to manage technical employees differently than other employees. In academia, however, MIS faculty are faced with the same expectations as other business faculty. The current model of MIS as an academic discipline has many issues that make staying current and relevant very difficult. The result is that MIS research and teaching lag practice. One might argue that as the field matures, we are falling further behind. This paper is the outcome of a panel discussion held during the 2006 Americas Conference on Information Systems in Acapulco, Mexico. The panel discussed the assertions that MIS is on a Slippery Slope that threatens our existence as a business discipline and that our current model encourages irrelevance, both in research and in teaching. Panel members were asked to share their views on five questions relative to the Slippery Slope from their unique perspectives

Association of urinary uromodulin with kidney function decline and mortality: the health ABC study .

BackgroundUrine uromodulin (uUMOD) is a protein secreted by the kidney tubule. Recent studies have suggested that higher uUMOD may be associated with improved kidney and mortality outcomes.MethodsUsing a case-cohort design, we evaluated the association between baseline uUMOD levels and ≥ 30% estimated glomerular filtration rate (eGFR) decline, incident chronic kidney disease (CKD), rapid kidney function decline, and mortality using standard and modified Cox proportional hazards regression.ResultsThe median value of uUMOD was 25.8 µg/mL, mean age of participants was 74 years, 48% were women, and 39% were black. Persons with higher uUMOD had lower prevalence of diabetes and coronary artery disease (CAD), and had lower systolic blood pressure. Persons with higher uUMOD also had higher eGFR, lower urinary albumin to creatinine ratio (ACR), and lower C-reactive protein (CRP). There was no association of uUMOD with > 30% eGFR decline. In comparison to those in the lowest quartile of uUMOD, those in the highest quartile had a significantly (53%) lower risk of incident CKD (CI 73%, 18%) and a 51% lower risk of rapid kidney function decline (CI 76%, 1%) after multivariable adjustment. Higher uUMOD was associated with lower risk of mortality in demographic adjusted models, but not after multivariable adjustment.ConclusionHigher levels of uUMOD are associated with lower risk of incident CKD and rapid kidney function decline. Additional studies are needed in the general population and in persons with advanced CKD to confirm these findings.


Full-Polarization Observations of OH Masers in Massive Star-Forming Regions: I. Data

We present full-polarization VLBA maps of the ground-state, main-line, 2 Pi 3/2, J = 3/2 OH masers in 18 Galactic massive star-forming regions. This is the first large polarization survey of interstellar hydroxyl masers at VLBI resolution. A total of 184 Zeeman pairs are identified, and the corresponding magnetic field strengths are indicated. We also present spectra of the NH3 emission or absorption in these star-forming regions. Analysis of these data will be presented in a companion paper.Comment: 111 pages, including 42 figures and 21 tables, to appear in ApJ

Explaining the variation in the management of lifestyle risk factors in primary health care: a multilevel cross sectional study

BackgroundDespite evidence for the effectiveness of interventions to modify lifestyle behaviours in the primary health care (PHC) setting, assessment and intervention for these behaviours remains low in routine practice. Little is known about the relative importance of various determinants of practice.This study aimed to examine the relative importance of provider characteristics and attitudes, patient characteristics and consultation factors in determining the rate of assessment and intervention for lifestyle risk factors in PHC.MethodsA prospective audit of assessment and intervention for lifestyle risk factors was undertaken by PHC nurses and allied health providers (n = 57) for all patients seen (n = 732) over a two week period. Providers completed a survey to assess key attitudes related to addressing lifestyle issues. Multi-level logistic regression analysis of patient audit records was undertaken. Associations between variables from both data sources were examined, together with the variance explained by patient and consultation (level 1) and provider (level 2) factors.ResultsThere was significant variance between providers in the assessment and intervention for lifestyle risk factors. The consultation type and reason for the visit were the most important in explaining the variation in assessment practices, however these factors along with patient and provider variables accounted for less than 20% of the variance. In contrast, multi-level models showed that provider factors were most important in explaining the variance in intervention practices, in particular, the location of the team in which providers worked (urban or rural) and provider perceptions of their effectiveness and accessibility of support services. After controlling for provider variables, patients\u27 socio-economic status, the reason for the visit and providers\u27 perceptions of the \u27appropriateness\u27 of addressing risk factors in the consultation were all significantly associated with providing optimal intervention. Together, measured patient consultation and provider variables accounted for most (80%) of the variation in intervention practices between providers.ConclusionThe findings highlight the importance of provider factors such as beliefs and attitudes, team location and work context in understanding variations in the provision of lifestyle intervention in PHC. Further studies of this type are required to identify variables that improve the proportion of variance explained in assessment practices

An exploration of how clinician attitudes and beliefs influence the implementation of lifestyle risk factor management in primary healthcare: a grounded theory study

BackgroundDespite the effectiveness of brief lifestyle intervention delivered in primary healthcare (PHC), implementation in routine practice remains suboptimal. Beliefs and attitudes have been shown to be associated with risk factor management practices, but little is known about the process by which clinicians\u27 perceptions shape implementation. This study aims to describe a theoretical model to understand how clinicians\u27 perceptions shape the implementation of lifestyle risk factor management in routine practice. The implications of the model for enhancing practices will also be discussed.MethodsThe study analysed data collected as part of a larger feasibility project of risk factor management in three community health teams in New South Wales (NSW), Australia. This included journal notes kept through the implementation of the project, and interviews with 48 participants comprising 23 clinicians (including community nurses, allied health practitioners and an Aboriginal health worker), five managers, and two project officers. Data were analysed using grounded theory principles of open, focused, and theoretical coding and constant comparative techniques to construct a model grounded in the data.ResultsThe model suggests that implementation reflects both clinician beliefs about whether they should (commitment) and can (capacity) address lifestyle issues. Commitment represents the priority placed on risk factor management and reflects beliefs about role responsibility congruence, client receptiveness, and the likely impact of intervening. Clinician beliefs about their capacity for risk factor management reflect their views about self-efficacy, role support, and the fit between risk factor management ways of working. The model suggests that clinicians formulate different expectations and intentions about how they will intervene based on these beliefs about commitment and capacity and their philosophical views about appropriate ways to intervene. These expectations then provide a cognitive framework guiding their risk factor management practices. Finally, clinicians\u27 appraisal of the overall benefits versus costs of addressing lifestyle issues acts to positively or negatively reinforce their commitment to implementing these practices.ConclusionThe model extends previous research by outlining a process by which clinicians\u27 perceptions shape implementation of lifestyle risk factor management in routine practice. This provides new insights to inform the development of effective strategies to improve such practices

Additional Ultracool White Dwarfs Found in the Sloan Digital Sky Survey

We identify seven new ultracool white dwarfs discovered in the Sloan Digital Sky Survey (SDSS). The SDSS photometry, spectra, and proper motions are presented, and additional BVRI data are given for these and other previously discovered ultracool white dwarfs. The observed colors span a remarkably wide range, qualitatively similar to colors predicted by models for very cool white dwarfs. One of the new stars (SDSS J1251+44) exhibits strong collision-induced absorption (CIA) in its spectra, while the spectra and colors of the other six are consistent with mild CIA. Another of the new discoveries (SDSS J2239+00A) is part of a binary system -- its companion is also a cool white dwarf, and other data indicate that the companion exhibits an infrared flux deficiency, making this the first binary system composed of two CIA white dwarfs. A third discovery (SDSS J0310-00) has weak Balmer emission lines. The proper motions of all seven stars are consistent with membership in the disk or thick disk.Comment: Accepted for Astrophysical Journal. 16 pages (includes 3 figures

Factors influencing participation in a vascular disease prevention lifestyle program among participants in a cluster randomized trial

BackgroundPrevious research suggests that lifestyle intervention for the prevention of diabetes and cardiovascular disease (CVD) are effective, however little is known about factors affecting participation in such programs. This study aims to explore factors influencing levels of participation in a lifestyle modification program conducted as part of a cluster randomized controlled trial of CVD prevention in primary care.MethodsThis concurrent mixed methods study used data from the intervention arm of a cluster RCT which recruited 30 practices through two rural and three urban primary care organizations. Practices were randomly allocated to intervention (n = 16) and control (n = 14) groups. In each practice up to 160 eligible patients aged between 40 and 64 years old, were invited to participate. Intervention practice staff were trained in lifestyle assessment and counseling and referred high risk patients to a lifestyle modification program (LMP) consisting of two individual and six group sessions over a nine month period. Data included a patient survey, clinical audit, practice survey on capacity for preventive care, referral and attendance records at the LMP and qualitative interviews with Intervention Officers facilitating the LMP. Multi-level logistic regression modelling was used to examine independent predictors of attendance at the LMP, supplemented with qualitative data from interviews with Intervention Officers facilitating the program.ResultsA total of 197 individuals were referred to the LMP (63% of those eligible). Over a third of patients (36.5%) referred to the LMP did not attend any sessions, with 59.4% attending at least half of the planned sessions. The only independent predictors of attendance at the program were employment status - not working (OR: 2.39 95% CI 1.15-4.94) and having high psychological distress (OR: 2.17 95% CI: 1.10-4.30). Qualitative data revealed that physical access to the program was a barrier, while GP/practice endorsement of the program and flexibility in program delivery facilitated attendance.ConclusionBarriers to attendance at a LMP for CVD prevention related mainly to external factors including work commitments and poor physical access to the programs rather than an individuals’ health risk profile or readiness to change. Improving physical access and offering flexibility in program delivery may enhance future attendance. Finally, associations between psychological distress and attendance rates warrant further investigation