Biomedical subjects

Beth A Reboussin

Publications and source records attributed to Beth A Reboussin.

4 recordsLinked to original sources

PubMed2003

Postmenopausal hormone therapy and change in mammographic density.

BACKGROUND: Mammographic density is an independent risk factor for breast cancer. Postmenopausal hormone use is associated with an increase in mammographic density, but the magnitude of the density increase is unknown. METHODS: Baseline and 12-month mammograms were obtained for 571 (65%) of the 875 women, aged 45-64 years, who were enrolled in the Postmenopausal Estrogen/Progestin Interventions Trial and randomly assigned to receive placebo, daily conjugated equine estrogens at 0.625 mg/day (CEE), daily CEE and medroxyprogesterone acetate (MPA) at 10 mg/day on days 1-12 (CEE+MPA-cyclic), daily CEE and MPA at 2.5 mg/day (CEE+MPA-continuous), or daily CEE and micronized progesterone (MP) at 200 mg/day on days 1-12 (CEE+MP). We analyzed digitized mammograms to determine the percentage of the left breast that was composed of dense tissue (i.e., mammographic percent density). Linear regression analysis was used to examine the effects of treatments on the change in mammographic percent density between baseline and 12 months, before and after adjustment for possible confounders. All statistical tests were two-sided. RESULTS: The adjusted absolute mean changes in mammographic percent density over 12 months were 4.76% (95% confidence interval [CI] = 3.29% to 6.23%), 4.58% (95% CI = 3.19% to 5.97%), and 3.08% (95% CI = 1.65% to 4.51%) for women in the CEE+MPA-cyclic, CEE+MPA-continuous, and CEE-MP groups, respectively. Each of those absolute mean changes was statistically significantly different from the adjusted absolute mean change in mammographic percent density for women in the placebo group, which was -0.07% (95% CI = -1.50% to 1.38%). CONCLUSION: Greater mammographic density was associated with the use of estrogen/progestin combination therapy, regardless of how the progestin was given, but not with the use of estrogen only.

Breast↗

PubMed2003

Rates and predictors of aftercare services among formerly hospitalized adolescents: a prospective naturalistic study.

OBJECTIVE: To examine rates and predictors of aftercare use, lengths of service use, and predictors of the duration of aftercare service use among 180 adolescents monitored for up to 8.1 years after discharge from an inpatient psychiatry unit. METHOD: Drawing upon the Anderson-Newman model of service use, severity of illness, enabling, and predisposing factors assessed during the hospitalization were examined as potential predictors of service use. Information about outpatient mental health specialty services after hospitalization was assessed repeatedly and verified with treatment records. RESULTS: Seventy-three percent of adolescents received aftercare within the first month after discharge, and 92% eventually received outpatient services. Fifty-seven percent of adolescents remained in treatment 6 months after initiation of services. Psychiatric comorbidity, prior service use, and presence of a biological parent or grandparent in the home were related to initial service use. Psychiatric comorbidity and history of repeated suicide attempts were related to longer duration, and older age and minority group status were related to shorter duration of aftercare service use. CONCLUSIONS: Most adolescents receive aftercare services, but there are certain groups that are relatively less likely to access or remain in services. Interventions to decrease the barriers to care in such groups may be beneficial.

Adolescent↗

PubMed2003

Rates and predictors of rehospitalization among formerly hospitalized adolescents.

OBJECTIVE: The authors examined rates and predictors of rehospitalization among 180 adolescents followed up for up to 10.3 years after discharge from an inpatient psychiatric unit. METHODS: In this prospective, naturalistic study, demographic variables, including gender, race, and age, and psychiatric variables, including diagnoses, prehospitalization suicide attempts, and previous hospitalizations, were examined as potential predictors of rehospitalization. Information about rehospitalizations was repeatedly assessed and verified with treatment records. RESULTS: During the follow-up period, 79 adolescents (44 percent) had one or more rehospitalizations. By six months after discharge, 19 percent of the adolescents had been rehospitalized. The mean time to first rehospitalization was estimated to be 5.7 years. Univariate analyses revealed significant differences between adolescents who were rehospitalized and those who were not in terms of age, presence of an affective disorder, and presence of a comorbid psychiatric disorder. In the multivariate predictor model, age and the presence of an affective disorder were the only significant predictors of rehospitalization. CONCLUSIONS: Clinicians should examine risk of rehospitalization before discharge, especially for younger patients and those with depression. Future research must focus on methods of intervention for this high-risk group.

Adolescent↗

PubMed2002

Mixed effects logistic regression models for multiple longitudinal binary functional limitation responses with informative drop-out and confounding by baseline outcomes.

In the context of analyzing multiple functional limitation responses collected longitudinally from the Longitudinal Study of Aging (LSOA), we investigate the heterogeneity of these outcomes with respect to their associations with previous functional status and other risk factors in the presence of informative drop-out and confounding by baseline outcomes. We accommodate the longitudinal nature of the multiple outcomes with a unique extension of the nested random effects logistic model with an autoregressive structure to include drop-out and baseline outcome components with shared random effects. Estimation of fixed effects and variance components is by maximum likelihood with numerical integration. This shared parameter selection model assumes that drop-out is conditionally independent of the multiple functional limitation outcomes given the underlying random effect representing an individual's trajectory of functional status across time. Whereas it is not possible to fully assess the adequacy of this assumption, we assess the robustness of this approach by varying the assumptions underlying the proposed model such as the random effects structure, the drop-out component, and omission of baseline functional outcomes as dependent variables in the model. Heterogeneity among the associations between each functional limitation outcome and a set of risk factors for functional limitation, such as previous functional limitation and physical activity, exists for the LSOA data of interest. Less heterogeneity is observed among the estimates of time-level random effects variance components that are allowed to vary across functional outcomes and time. We also note that. under an autoregressive structure, bias results from omitting the baseline outcome component linked to the follow-up outcome component by subject-level random effects.

Aged↗