Association of childhood blood lead levels with firearm violence perpetration and victimization in Milwaukee.

Childhood lead exposure impairs future decision-making and may influence criminal behavior, but its role in future firearm violence is unclear. Using public health, education, and criminal justice datasets linked at the individual level, we studied a population-based cohort of all persons born between June 1, 1986 and December 31, 2003 with a valid blood lead test before age 6 years and stable Milwaukee residency (n = 89,129). We estimated associations with firearm violence perpetration (n = 553) and victimization (n = 983) using logistic regression, adjusting for temporal trends, child sex, race, and neighborhood socioeconomic status.

Facilitating Factors and Barriers to Weight Management in Women: Physician Perspectives.

Purpose: The complexity of addressing overweight and obesity in women has been an ongoing public health and health care challenge. While the mechanism for addressing overweight and obesity in women remains unclear, it has been speculated that disparities in overweight and obesity by race and gender contribute to the complexity. The purpose of the present study was to examine perceptions of primary care physicians when discussing weight management with their patients.

Weight Loss Associated With Employee Income in an Incentivized Employee Wellness Program.

Objective: We examined the relationship between the type of incentivized wellness program and employee weight loss and the effects of participant income.

Methods: We retrospectively examined employees who participated in one of six weight loss wellness programs, which were categorized for the present analysis: reweigh/body mass index, Coaching, and Weight Watchers/Meal Replacement. Those who participated were eligible for a $350/year insurance premium discount.

Discovering Outliers of Potential Drug Toxicities Using a Large-scale Data-driven Approach.

We systematically compared the adverse effects of cancer drugs to detect event outliers across different clinical trials using a data-driven approach. Because many cancer drugs are toxic to patients, better understanding of adverse events of cancer drugs is critical for developing therapies that could minimize the toxic effects. However, due to the large variabilities of adverse events across different cancer drugs, methods to efficiently compare adverse effects across different cancer drugs are lacking.

Population Analysis of Adverse Events in Different Age Groups Using Big Clinical Trials Data.

Background: Understanding adverse event patterns in clinical studies across populations is important for patient safety and protection in clinical trials as well as for developing appropriate drug therapies, procedures, and treatment plans.

Objectives: The objective of our study was to conduct a data-driven population-based analysis to estimate the incidence, diversity, and association patterns of adverse events by age of the clinical trials patients and participants.

Methods: Two aspects of adverse event patterns were measured: (1) the adverse event incidence rate in each of the patient age groups and (2) the diversity of adverse events defined as distinct types of adverse events categorized by organ system.

Physician Use of Electronic Health Records in Obesity Management.

Objective: To assess Wisconsin physician knowledge, attitudes, and practices in obesity management.

Methods: The Wisconsin Medical Society distributed an e-mail survey to 12,372 members with questions on obesity causes, barriers to documentation, and training in obesity management.

Results: A total of 590 surveys (4.

Trends and Progress in Reducing Teen Birth Rates and the Persisting Challenge of Eliminating Racial/Ethnic Disparities.

Purpose: We examined progress made by the Milwaukee community toward achieving the Milwaukee Teen Pregnancy Prevention Initiative's aggressive 2008 goal of reducing the teen birth rate to 30 live births/1000 females aged 15-17 years by 2015. We further examined differential teen birth rates in disparate racial and ethnic groups.

Method: We analyzed teen birth count data from the Wisconsin Interactive Statistics on Health system and demographic data from the US Census Bureau.

Obese Employee Participation Patterns in a Wellness Program.

The purpose of this research was to retrospectively examine whether demographic differences exist between those who participated in an employee wellness program and those who did not, and to identify the selection of employees' choice in weight management activities. A nonequivalent, 2-group retrospective design was used. This study involved employees at a large, not-for-profit integrated health system.

Healthcare costs around the time of smoking cessation.

Background: The Affordable Care Act mandates that new insurance plans cover smoking-cessation therapy without cost-sharing. Previous cost difference estimates, which show a spike around the time of cessation, suggest premiums might rise as a result of covering these services.

Purpose: The goal of the study was to test (1) whether individuals in an RCT of pharmacotherapy and counseling for smoking cessation differed in their healthcare costs around the cessation period, and (2) whether the healthcare costs of those in the trial who successfully quit were different from a matched sample of smokers in the community.

Impact of treatment with intramuscular, injectable, extended-release naltrexone on counseling and support group participation in patients with alcohol dependence.

Objectives: : The impact of intramuscular, injectable, extended-release naltrexone (XR-NTX; Vivitrol) on counseling and support group participation was examined in a post hoc analysis of a 24-week, randomized, double-blind study in 624 alcohol-dependent adults, most of whom were nonabstinent at baseline.

Methods: : Patients were offered 6 monthly injections of XR-NTX 380 mg, XR-NTX 190 mg, or placebo (n = 205, 210, and 209, respectively) and 12 sessions of manualized brief counseling. Voluntary participation in extramural counseling (eg, couples or family therapy) and self-help support groups (eg, Alcoholics Anonymous) was permitted and assessed.

Sociodemographic correlates of energy drink consumption with and without alcohol: results of a community survey.

Objective: We examined the sociodemographic correlates of energy drink use and the differences between those who use them with and without alcohol in a representative community sample.

Methods: A random-digit-dial landline telephone survey of adults in the Milwaukee, Wisconsin area responded to questions about energy drink and alcohol plus energy drink use.

Results: Almost one-third of respondents consumed at least one energy drink in their lifetime, while slightly over 25% used energy drinks in the past year and 6% were past-year alcohol plus energy drink users.

Aberrant fetal growth and early, late, and postneonatal mortality: an analysis of Milwaukee births, 1996-2007.

Objective: The objective of the study was to ascertain the association between fetal growth (small- [SGA], appropriate- [AGA], and large-for-gestational-age [LGA]) and early, late, and postneonatal mortality.

Study Design: Birth certificate data for nonanomalous singletons, delivered from 1996 to 2007, were obtained for Milwaukee residents. Multivariate logistic regression analyses, adjusted for 19 covariates, determined the association between fetal growth and mortality.

Influence of socioeconomic factors and race on birth outcomes in urban Milwaukee.

Purpose: A national study found that infants born in low socioeconomic areas had the worst infant mortality rates (IMRs) and the highest racial disparity. Racial disparities in birth outcomes are also evident in the city of Milwaukee, with African American infants at 3 times greater the risk than white infants. This study was conducted to examine the influence of socioeconomic status (SES) and race on birth outcomes in the city of Milwaukee.

The effect of alcohol treatment on social costs of alcohol dependence: results from the COMBINE study.

Background: The COMBINE (combined pharmacotherapies and behavioral intervention) clinical trial recently evaluated the efficacy of pharmacotherapies, behavioral therapies, and their combinations for the treatment of alcohol dependence. Previously, the cost and cost-effectiveness of COMBINE have been studied. Policy makers, patients, and nonalcohol-dependent individuals may be concerned not only with alcohol treatment costs but also with the effect of alcohol interventions on broader social costs and outcomes.

The Wisconsin Network for Health Research (WiNHR): a statewide, collaborative, multi-disciplinary, research group.

In response to the goals of the Wisconsin Partnership Program and the National Institutes of Health (NIH) Initiatives to Improve Healthcare, the Wisconsin Network for Health Research (WiNHR) was formed. As a collaborative, multi-disciplinary statewide research network, WiNHR encourages and fosters the discovery and application of scientific knowledge for researchers and practitioners throughout Wisconsin. The 4 founding institutions--Aurora Health Care/Center for Urban Population Health (CUPH), Gundersen Lutheran Medical Foundation, Marshfield Clinic Research Foundation, and the University of Wisconsin-Madison--representing geographically diverse areas of the state, are optimistic and committed to WiNHR's success.

Setting a goal to reduce teen births in Milwaukee by 2015.

Introduction: Although teen birth rates have declined significantly since 1991, teen pregnancy remains a significant public health problem in Milwaukee, Wis. Using historical teen birth data trends, this study sets a birth rate reduction goal by the year 2015 for Milwaukee teenagers between the ages of 15 and 17.

Methods: Birth counts and birth rates for teenagers between the ages of 15 and 17 were obtained from the Wisconsin Interactive Statistics on Health (WISH).

Active consent in urban elementary schools: an examination of demographic differences in consent rates.

The consent process is an integral piece of research and evaluation studies, especially when conducted within a school setting. The challenge of reaching parents of students to obtain consent is an issue with which those conducting school-based studies grapple. The literature suggests that the success of the consent process can affect the representativeness of the sample.

Second births to teenage mothers: risk factors for low birth weight and preterm birth.

Context: Teenagers are more likely than older women to have a low-birth-weight infant or a preterm birth, and the risks may be particularly high when they have a second birth. Identifying predictors of these outcomes in second teenage births is essential for developing preventive strategies.

Methods: Birth certificate data for 1993-2002 were linked to identify second births to Milwaukee teenagers.

Alcohol treatment effects on secondary nondrinking outcomes and quality of life: the COMBINE study.

Objective: To evaluate the full range of alcohol treatment effectiveness, it is important to assess secondary nondrinking outcome dimensions in addition to primary alcohol consumption outcomes.

Method: We used a large sample (n=1,226) of alcohol-dependent participants entering the National Institute on Alcohol Abuse and Alcoholism-sponsored COMBINE (Combining Medications and Behavioral Interventions) Study, a multisite clinical trial of pharmacological (naltrexone [ReVia] and acamprosate [Campral]) and behavioral interventions, to examine the effects of specific treatment combinations on nondrinking functional outcomes. We assessed the outcomes at baseline and at the end of 16 weeks of alcohol treatment and again at the 26-week and/or 52-week postrandomization follow-ups.

Cost and cost-effectiveness of the COMBINE study in alcohol-dependent patients.

Context: The COMBINE (Combined Pharmacotherapies and Behavioral Intervention) clinical trial recently evaluated the efficacy of medications, behavioral therapies, and their combinations for the outpatient treatment of alcohol dependence. The costs and cost-effectiveness of these combinations are unknown and of interest to clinicians and policy makers.

Objective: To evaluate the costs and cost-effectiveness of the COMBINE Study interventions after 16 weeks of treatment.

The Milwaukee Homicide Review Commission: an interagency collaborative process to reduce homicide.

The Milwaukee Hoimicide Review Commission (MHRC) is a multi-level, multi-disciplinary, and multiagency homicide review process aimed at reducing the occurrence of homicides in Milwaukee. Based on the public health approach to violence reduction, the MHRC has 3 goals: (1) to gain a better understanding of homicide through strategic problem analysis, (2) to develop innovative, effective responses, and (3) to focus limited enforcement and intervention activities on identifiable risks. The MHIRC creates an environment for many disciplines and agencies to share information and work collectively on violence prevention strategies.

Health disparities in Milwaukee by socioeconomic status.

Background: In 2006, the city of Milwaukee ranked worse than any Wisconsin county for health outcomes and worse than all but 1 county for health determinants.

Methods: To further examine disparities in health, Milwaukee city ZIP codes were stratified into 3 groups (lower, middle, and upper) by socioeconomic status (SES). Health determinants (15 measures) and health outcomes (2 measures) were compared across these ZIP code groups, and to the rest of Wisconsin.

Social networks and their influence on drinking behaviors: differences related to cognitive impairment in clients receiving alcoholism treatment.

Objective: Mechanisms of behavioral change that support positive addiction treatment outcomes in individuals with co-occurring alcohol-use disorders and cognitive impairment remain largely unknown. This article combines person- and variable-centered approaches to examine the interrelated influence of cognitive impairment and social support on stability of and changes in drinking behaviors of Project MATCH (Matching Alcoholism Treatments to Client Heterogeneity) outpatients and aftercare clients (N = 1,726) during the first year after their entry into treatment.

Method: Latent class analysis identified homogeneous groups of clients based on the nature and extent of social support for abstinence or drinking at treatment entry.

Measuring economic outcomes of alcohol treatment using the Economic Form 90.

Objective: This article assesses the ability of the economic outcome measures in the Economic Form 90 to detect differences across levels of alcohol dependence as measured by the Alcohol Dependence Scale.

Method: We used baseline data from the Combining Medications and Behavioral Interventions (COMBINE) Study, a large, multisite clinical trial, to assess the extent to which the economic items on the Economic Form 90 instrument can detect differences across levels of alcohol dependence.

Results: After adjusting for differences in demographic characteristics, the Economic Form 90 can detect significant differences across a range of dependence severity levels for the economic outcomes of inpatient medical care, emergency-department medical care, behavioral health care, being on parole or probation, and missed workdays, conditional on being employed.