Comparative effectiveness of hysterectomy versus myomectomy on one-year health-related quality of life in women with uterine fibroids.

Objective: To compare long-term health-related quality of life (HRQOL) 1 year after hysterectomy or myomectomy for treatment of uterine fibroids (UFs) and to determine whether route of procedure, race, or age affected improvements in HRQOL.

Design: Prospective cohort study.

Setting: Eight clinical sites throughout the United States.

The Comparing Options for Management: PAtient-centered REsults for Uterine Fibroids (COMPARE-UF) registry: rationale and design.

Background: Uterine fibroids are common in premenopausal women, yet comparative effectiveness research on uterine fibroid treatments is rare.

Objective: The purpose of this study was to design and establish a uterine fibroid registry based in the United States to provide comparative effectiveness data regarding uterine fibroid treatment.

Study Design: We report here the design and initial recruitment for the Comparing Options for Management: Patient-centered REsults for Uterine Fibroids (COMPARE-UF) registry (Clinicaltrials.

Interpathologist Diagnostic Agreement for Non-Small Cell Lung Carcinomas Using Current and Recent Classifications.

Context.—: Measurement of interpathologist diagnostic agreement (IPDA) should allow pathologists to improve current diagnostic criteria and disease classifications.

Objectives.

Contraceptive Care of Obese Women.

Importance: In the United States, 27% of reproductive-aged women are overweight, and 35% are obese. Until recently, contraceptive research excluded women greater than 130% of their ideal body weight. Gaps in data limit evidence-based decision making for effective contraceptive counseling and management in this rapidly growing population.

Temporomandibular joint positional change accompanies post-surgical mandibular relapse-A long-term retrospective study among patients who underwent mandibular advancement.

Objective: This study evaluated the relationship between follow-up temporomandibular joint positional change and mandibular stability among patients who had orthognathic and orthodontic treatment for a skeletal Class II malocclusion.

Methods: Thirty-seven patients who underwent 2-jaw surgery (Le Fort I osteotomy, bilateral sagittal split ramus osteotomy and genioplasty with rigid internal fixation) were included with an average follow-up length of 8.10 ± 2.

A Patient Reported Approach to Identify Medical Errors and Improve Patient Safety in the Emergency Department.

Objective: Medical errors in the emergency department (ED) occur frequently. Yet, common adverse event detection methods, such as voluntary reporting, miss 90% of adverse events. Our objective was to demonstrate the use of patient-reported data in the ED to assess patient safety, including medical errors.

Does the quality of safetalk motivational interviewing counseling predict sexual behavior outcomes among people living with HIV?

Objective: Although past research has demonstrated a link between the quality of motivational interviewing (MI) counseling and client behavior change, this relationship has not been examined in the context of sexual risk behavior among people living with HIV/AIDS. We studied MI quality and unprotected anal/vaginal intercourse (UAVI) in the context of SafeTalk, an evidence-based secondary HIV prevention intervention.

Methods: We used a structured instrument (the MISC 2.

The prevalence and validity of high, biologically implausible values of weight, height, and BMI among 8.8 million children.

Objective: This study assessed the prevalence and consistency of high values of weight, height, and BMI considered to be biologically implausible (BIV) using cut points proposed by WHO among 8.8 million low-income children (13.7 million observations).

Multivariable analysis to determine if HIV-1 Tat dicysteine motif is associated with neurodevelopmental delay in HIV-infected children in Malawi.

Background: HIV-1 Tat protein is implicated in HIV-neuropathogenesis. Tat C31S polymorphism (Tat(CS)) has been associated with milder neuropathology in vitro and in animal models but this has not been addressed in a cohort of HIV-infected adults or children.

Methods: HIV viral load (VL) in plasma and cerebrospinal fluid (CSF) were determined and plasma HIV tat gene was sequenced.

Low frequency of cigarette smoking and the risk of head and neck cancer in the INHANCE consortium pooled analysis.

Background: Cigarette smoking is a major risk factor for head and neck cancer (HNC). To our knowledge, low cigarette smoking (<10 cigarettes per day) has not been extensively investigated in fine categories or among never alcohol drinkers.

Methods: We conducted a pooled analysis of individual participant data from 23 independent case-control studies including 19 660 HNC cases and 25 566 controls.

Barriers to antiretroviral adherence in HIV-positive patients receiving free medication in Kayunga, Uganda.

Global and local efforts have been devoted to increase the supply of antiretroviral therapy (ART) in sub-Saharan Africa. Recent qualitative studies suggest that even with free ART, patients may fail to adhere to medication because of socioeconomic barriers such as transportation costs to clinics. The aim of this study was to measure adherence in a population of patients receiving free ART and to examine barriers to adherence.

Differential pulmonary and cardiac effects of pulmonary exposure to a panel of particulate matter-associated metals.

Biological mechanisms underlying the association between particulate matter (PM) exposure and increased cardiovascular health effects are under investigation. Water-soluble metals reaching systemic circulation following pulmonary exposure are likely exerting a direct effect. However, it is unclear whether specific PM-associated metals may be driving this.

Neurobehavioral effects of ambient air pollution on cognitive performance in US adults.

Background: In vivo animal experiments demonstrate neurotoxicity of exposures to particulate matter (PM) and ozone, but only one small epidemiological study had linked ambient air pollution with central nervous system (CNS) functions in children.

Objectives: To examine the neurobehavioral effects associated with long-term exposure to ambient PM and ozone in adults.

Methods: We conducted a secondary analysis of the Neurobehavioral Evaluation System-2 (NES2) data (including a simple reaction time test [SRTT] measuring motor response speed to a visual stimulus; a symbol-digit substitution test [SDST] for coding ability; and a serial-digit learning test [SDLT] for attention and short-term memory) from 1764 adult participants (aged 37.

Systemic translocation of (70)zinc: kinetics following intratracheal instillation in rats.

Mechanisms of particulate matter (PM)-induced cardiotoxicity are not fully understood. Direct translocation of PM-associated metals, including zinc, may mediate this effect. We hypothesized that following a single intratracheal instillation (IT), zinc directly translocates outside of the lungs, reaching the heart.

(Errors in statistical tests)3.

In 2004, Garcia-Berthou and Alcaraz published "Incongruence between test statistics and P values in medical papers," a critique of statistical errors that received a tremendous amount of attention. One of their observations was that the final reported digit of p-values in articles published in the journal Nature departed substantially from the uniform distribution that they suggested should be expected. In 2006, Jeng critiqued that critique, observing that the statistical analysis of those terminal digits had been based on comparing the actual distribution to a uniform continuous distribution, when digits obviously are discretely distributed.

Subchronic inhalation of zinc sulfate induces cardiac changes in healthy rats.

Zinc is a common metal in most ambient particulate matter (PM), and has been proposed to be a causative component in PM-induced adverse cardiovascular health effects. Zinc is also an essential metal and has the potential to induce many physiological and nonphysiological changes. Most toxicological studies employ high levels of zinc.

The MD-MPH program at the University of North Carolina at Chapel Hill.

In 1997, the Schools of Medicine and Public Health at the University of North Carolina at Chapel Hill (UNC) developed a formal MD-MPH program, called the Health Care and Prevention (HC&P) Program, located in the Public Health Leadership Program in the UNC School of Public Health. Since then, and especially since 2003, the number of UNC medical students taking a year out of their medical studies to pursue an MPH has increased dramatically. At present, more than 20% of UNC medical students enter an MPH program at some point between entering medical school and leaving for residency.

Effectiveness of employee internet-based weight management program.

Objective: To evaluate an employee Internet-based weight management program.

Methods: Changes in eating habits, stage of change, body weight, and weight categories were compared between enrollment and 6 months after enrollment. Weights and weight categories were compared among a subset of participants and non-participants at 12 months.

Epidemiologic analysis of racial/ethnic disparities: some fundamental issues and a cautionary example.

Racial/ethnic health disparities are a primary focus of epidemiologic research, encompassing both sociological hypotheses about differential treatment as well as biomedical hypotheses about distinctive etiologic processes that might underlie observed disparities. These two main currents in disparities research are often pitted against one another as opposing paradigms. Despite contentious debate about the balance between these hypotheses in the etiology of existing disparities, one consideration that has been largely ignored is that there are important distinctions in the statistical justifications for these two types of inferences.

Creating thought diversity: the antidote to group think.

The Management Moment is a regular column within the Journal of Public Health Management and Practice. Edward L. Baker, MD, MPH, MSc, serves as the Management Moment Editor.

Risk compensation and vaccination: can getting vaccinated cause people to engage in risky behaviors?

Background: Some believe that vaccinating young women against human papillomavirus (HPV) will increase their risky behavior. In more formal terms, vaccination lowers risk perception, and people compensate for their lower perceived risk by reducing other preventive behaviors.

Purpose: We test several predictions from the risk compensation hypothesis in the context of vaccination behavior.