Publications by authors named "Pamela Imm"

While the Department of Defense (DoD) has given increased attention and priority to preventing sexual assault and sexual harassment (SA/SH), it remains a problem. To build its prevention capacity, DoD piloted Getting To Outcomes (GTO) from 2019 to 2022 at 10 military installations. GTO is an evidence-based planning and implementation support that has been used in many civilian contexts but has only recently been adapted for military SA/SH.

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Context: Child Protective Services (CPS) reports and health records (hospital inpatient and emergency department visits) are the primary data sources to measure child maltreatment; yet, they are not linked at the state or national level. Linking provides novel insight into the demographic characteristics of the populations served by one or both agencies, thus informing opportunities for prevention and intervention.

Objective: This study compares children identified as maltreated in health records (based on International Classification of Diseases, Tenth Revision, Clinical Modification [ ICD-10-CM ] codes indicating suspected or confirmed child maltreatment) and/or CPS reports.

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Introduction: Alcohol-related mortality is increasing nationally, but state-specific trends still need to be explored. This paper reviews the patterning of alcohol-related deaths among Wisconsin residents in the 2 decades prior to the COVID-19 pandemic.

Methods: Data are from death certificates for state residents from 2000 through 2019.

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Background: This study explores the impact of using different criteria to identify nonfatal hospitalisations with self-harm injuries using 2017-2018 Wisconsin discharge data.

Methods: Using International Classification of Diseases, 10th Revision, Clinical Modification codes, we classified records by three mutually exclusive selection criteria: subset A--principal diagnosis of injury, and any code for self-harm, initial encounter only; subset B--non-injury principal diagnosis, and any code for self-harm, initial encounter only; subset C--any principal diagnosis, and any code for self-harm, subsequent and sequelae encounters only. These categories were used to conduct two separate logistic regression models.

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This study assessed potential under-ascertainment of autism spectrum disorder due to missing administrative information for Hispanic and non-Hispanic Black children within the Autism and Developmental Disabilities Monitoring Network. We analyzed data from two Network sites (Colorado and Wisconsin) for surveillance years 2012 and 2014 to determine whether children excluded from autism spectrum disorder prevalence estimates due to missing residency and other information differed from those included by race and ethnicity. We used multiple approaches to impute missing information to evaluate impacts on racial and ethnic disparities in autism spectrum disorder prevalence.

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Problem/condition: Autism spectrum disorder (ASD).

Period Covered: 2014.

Description Of System: The Autism and Developmental Disabilities Monitoring (ADDM) Network is an active surveillance system that provides estimates of the prevalence of autism spectrum disorder (ASD) among children aged 8 years whose parents or guardians reside within 11 ADDM sites in the United States (Arizona, Arkansas, Colorado, Georgia, Maryland, Minnesota, Missouri, New Jersey, North Carolina, Tennessee, and Wisconsin).

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Objectives: To describe the association between indicators of socioeconomic status (SES) and the prevalence of autism spectrum disorder (ASD) in the United States during the period 2002 to 2010, when overall ASD prevalence among children more than doubled, and to determine whether SES disparities account for ongoing racial and ethnic disparities in ASD prevalence.

Methods: We computed ASD prevalence and 95% confidence intervals (CIs) from population-based surveillance, census, and survey data. We defined SES categories by using area-level education, income, and poverty indicators.

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Fish are an important source of nutrients which may reduce risk of adverse health outcomes such as cardiovascular disease; however, fish may also contain significant amounts of environmental pollutants such as mercury, polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs), and perfluorinated compounds (PFCs, also called perfluoroalkyl compounds), which confer increased risk for adverse health effects. The Wisconsin Departments of Health Services and Natural Resources developed a survey instrument, along with a strategy to collect human biological samples to assess the risks and benefits associated with long-term fish consumption among older male anglers in Wisconsin. The target population was men aged 50 years and older, who fish Wisconsin waters and live in the state of Wisconsin.

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Fish is an important source of nutrients including omega-3 fatty acids, which may reduce risk of adverse health outcomes such as cardiovascular disease; however, fish may also contain significant amounts of environmental pollutants. The Wisconsin Departments of Health Services and Natural Resources developed a survey instrument, along with a strategy to collect human biological samples to assess the risks and benefits associated with long-term fish consumption among older male anglers in Wisconsin. The target population was men aged 50 years and older, who fish Wisconsin waters and live in the state of Wisconsin.

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Conditional means regression, including ordinary least squares (OLS), provides an incomplete picture of exposure-response relationships particularly if the primary interest resides in the tail ends of the distribution of the outcome. Quantile regression (QR) offers an alternative methodological approach in which the influence of independent covariates on the outcome can be specified at any location along the distribution of the outcome. We implemented QR to examine heterogeneity in the influence of early childhood lead exposure on reading and math standardized fourth grade tests.

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Purpose: This study investigated the association between moderate lead poisoning in early childhood with performance on a comprehensive set of end-of-grade examinations at the elementary school level in two urban school districts.

Methods: Children born between 1996 and 2000 who resided in Milwaukee or Racine, WI, with a record of a blood lead test before the age of 3 years were considered for the analysis. Children were defined as exposed (blood lead level ≥10 and <20 μg/dL) or not exposed (BLL < 5 μg/dL).

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School suspensions are associated with negative student outcomes. Environmental lead exposure increases hyperactivity and sensory defensiveness, two traits likely to increase classroom misbehavior and subsequent discipline. Childhood Blood Lead Level (BLL) test results categorized urban fourth graders as exposed (2687; lifetime max BLL 10-20 µg/dL) or unexposed (1076; no lifetime BLL ≥5 µg/dL).

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Objectives: The provision of fish consumption advice issued by the Wisconsin Department of Health Services (DHS) and Department of Natural Resources (DNR) has evolved over the past 40 years. In 2010, DHS received a US Environmental Protection Agency Great Lakes Restoration Initiative (GLRI) grant to evaluate existing advisory approaches, identify gaps, and adapt current communication approaches.

Methods: Previous research conducted by DHS found that older, male anglers eat more sport fish and have higher body burdens of persistent contaminants found in fish than other groups.

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Alcohol merchants (N=331) completed a cross-sectional survey assessing their attitudes and beliefs about underage drinking, its likely consequences, requirements for responsible beverage service (RBS) training, and performance of RBS practices and checking IDs. Merchants requiring more rigorous RBS training (i.e.

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Underage drinking is a significant problem facing US communities. Several environmental alcohol prevention (EAP) strategies (laws, regulations, responsible beverage service training and practices) successfully address underage drinking. Communities, however, face challenges carrying out these EAP strategies effectively.

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Purpose: To investigate and quantify the impact of moderate lead exposure on students' ability to score at the "proficient" level on end-of-grade standardized tests.

Methods: We compared the scores of 3757 fourth grade students from Milwaukee, Wisconsin, on the Wisconsin Knowledge and Concepts Exam (WKCE). The sample consisted of children with a blood lead test before age 3 years that was either unquantifiable at the time of testing (<5 μg/dL) or in the range of moderate exposure (10-19 μg/dL).

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Perfluoroalkyl chemicals (PFCs) have been used as surfactants and stain repellants in a variety of consumer products for more than 50years and there is growing concern regarding their persistence and toxicity. Human exposure to these chemicals is essentially universal in North America and researchers have linked them to a variety of health problems ranging from higher rates of cancer, to developmental and reproductive problems, and higher cholesterol levels. Major exposure pathways are food and water ingestion, dust ingestion via hand to mouth transfer.

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Human exposure to PCBs is nearly universal in North America. While most exposure can be linked to consumption of contaminated fish, detection of PCBs in non-fish eating populations suggests that other routes of exposure including inhalation of PCB-laden particles or volatile congeners, ingestion of contaminated soil or dust, or dermal absorption following direct contact are also important. In an effort to assess the role of the residential environment as a source of exposure, vacuum dust was collected from the homes of 26 Wisconsin residents whose serum PCB levels had been measured approximately 2 years earlier.

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Article Synopsis
  • Environmental strategies like limiting alcohol sales to minors can help reduce underage drinking, but they need teamwork between public and private organizations.
  • A study in South Carolina looked at 336 alcohol outlets to see how off-premises (like liquor stores) and on-premises (like bars) are alike and different in selling alcohol.
  • It found that off-premises outlets take more steps to stop selling alcohol to minors compared to on-premises venues, suggesting different strategies might be needed for each type of outlet.
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Cross-sectional surveys of human blood and breast milk show increasing concentrations of polybrominated diphenyl ethers (PBDEs) that parallel the expanded use in consumer products, but longitudinal studies are lacking. We compared levels of major BDE congeners in archived 1994-1995 blood samples collected from a cohort of frequent and infrequent Great Lakes fish consumers with levels in the blood collected from the same individuals in 2001-2003 and 2004-2005. In mixed linear regression models controlling for multiple measurements per individual and covariates, statistically significant increases were seen from 1994-1995 to 2001-2003 for ∑PBDEs and BDE-47, 99, and 153 and from 1994-1995 to 2004-2005 for ∑PBDEs and BDE-99, 100, and 153, but ∑PBDEs and BDE congeners did not change significantly between 2001-2003 and 2004-2005.

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Communities face challenges implementing evidence-based prevention programs. To help, policymakers are exploring how to build community-level capacity for prevention for thousands of organizations or communities across the United States. This article reports on a formative evaluation within 2 states' prevention systems of an Internet system designed to build capacity on a large scale, interactive Getting To Outcomes(R) (iGTO).

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Background: Human exposure to polybrominated diphenyl ethers (PBDEs) is virtually universal in the United States. Although the uses of these chemicals as flame retardants in fabrics, foams, and plastics are well defined, human exposure pathways are not well understood.

Objectives: This study was designed to assess current PBDE body burdens and identify residential sources of exposure among 29 men and 15 women in 38 households.

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Commercial and sport-caught fish provide a healthy source of dietary protein, omega-3 fatty acids, and other micronutrients. Regular fish consumption has been associated with decreased risk of heart disease and health professionals encourage adults to include fish in their weekly diets. However, fish harvested from contaminated waters can contain higher levels of persistent, bioaccumulative chemicals such as methylmercury, PCBs, dieldrin, and DDT.

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Background: Studies have demonstrated ubiquitous human exposure to persistent organic pollutants (POPs) such as p,p'-diphenyldichloroethene (DDE) and polychlorinated biphenyls (PCBs). Although there is considerable evidence that POP exposures are associated with prevalent diabetes, these studies do not establish causality because the cross-sectional study design does not allow for assessment of temporality of the exposure-disease association. Prospective studies, however, have been lacking.

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