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R E LaPorte

Publications and source records attributed to R E LaPorte.

At least 19 recordsLinked to original sources
PubMed2003

Estimating the lesbian population: a capture-recapture approach.

STUDY OBJECTIVE: Little is known about the number of women who identify as lesbian. Estimates from the US range from 1% to nearly 10%. Accurate estimates are critical in order to meet lesbian's healthcare needs and to address health problems that may be more prevalent among them. This study used capture-recapture methods to estimate the lesbian population of Allegheny County, Pennsylvania. DESIGN: Mailing lists from four sources were used to identify lesbians. The capture-recapture method and log-linear modelling were used to estimate the number of lesbians in the defined geographical area, and the percentage of the female population they comprised there was determined through census data. SETTING: Allegheny County, Pennsylvania, USA. RESULTS: A total of 2185 unique names were identified. The capture-recapture method estimated that the total lesbian population of Allegheny County was 7031 (95% CI 5850 to 8576). Therefore, based on the 1990 census figures, the county's adult lesbian population was estimated to be 1.87% (95% CI 1.56% to 2.28%) of the adult female population. CONCLUSIONS: An estimate of the lesbian population is fundamental for addressing lesbian's health needs and for developing appropriate research programmes. Capture-recapture methods have the potential to provide accurate and reliable estimates of this population in any location.

Adult↗
PubMed2003

Hazardous waste site frequency: use of the capture-recapture method.

This investigation used a two-source capture-recapture method (CRM) for determining ascertainment and undercounts of non-national priority listed hazardous waste sites in the states of Arizona, Maine and Pennsylvania. These findings suggest that ascertainment of hazardous waste sites vary greatly, with some more accurate (i.e., Maine) than others (i.e., Pennsylvania). These data suggest that nontraditional manufacturing states (e.g., Maine) have a higher ascertainment rate than traditional manufacturing states (e.g., Pennsylvania). These results indicate that resources for locating hazardous waste sites should be more heavily allotted to industrialized areas. We suggest that the CRM is a convenient, low cost and effective method for determining (1) the accuracy of previous estimates, and (2) the number of sites in a locale with 95% confidence intervals along with an estimate of the undercount. Findings suggest that estimates of hazardous waste sites should use the CRM to determine and improve accuracy.

Arizona↗
PubMed2002

Progression to insulin-requiring diabetes in seronegative prediabetic subjects: the role of two HLA-DQ high-risk haplotypes.

AIMS/HYPOTHESIS: Most Caucasians with Type I (insulin-dependent) diabetes mellitus develop an autoimmune form of diabetes known as Type IA diabetes, based on the presence of humoral responses to islet autoantigens. Alleles at the HLA locus account for the strongest susceptibility to this form of diabetes, which requires insulin therapy. Because a number of patients who develop insulin-requiring diabetes are islet autoantibody negative, the HLA class II haplotypes, DQA1*0501-DQB1*0201 and DQA1*0301-DQB1*0302, were evaluated to assess whether they are an independent risk factor for progression to insulin requirement in first-degree relatives of Type I diabetic patients. METHODS: Both HLA-DQ genotyping and islet cell autoantibody assessment (insulin, GAD65, IA-2 autoantibodies and cytoplasmic islet cell antibodies) were evaluated prospectively in 74 relatives of Type I diabetic patients who developed diabetes treated with insulin (prediabetics) and in 426 control subjects who did not develop insulin-requiring diabetes. Based on the presence of DQA1*0501-DQB1*0201 and/or DQA1*0301-DQB1*0302, the number of HLA-DQ high-risk haplotypes was assigned as 0, 1 or 2. RESULTS: A higher prevalence of 2 HLA-DQ high-risk haplotypes was present in seronegative prediabetic subjects as compared to non-diabetic autoantibody negative first-degree relatives (33.3 % vs 10.1 % respectively; p < 0.05). Moreover, in seronegative relatives who developed insulin-requiring diabetes, the presence of 2 HLA-DQ high-risk haplotypes conferred an increased cumulative risk of developing insulin requirement of 27 % at 12.5 years of follow-up, compared to a risk of 6 % for non-diabetic relatives who were antibody-negative and had 0 or 1 HLA-DQ high-risk haplotypes (Log rank p = 0.01). CONCLUSION/INTERPRETATION: These data provide evidence for a phenotype, which is associated with the absence of conventional islet autoantibodies at initial screening, while usually remaining seronegative, and the presence of 2 HLA-DQ high-risk haplotypes with progression to clinical Type I diabetes after a prolonged follow-up. Given the fact that in humans the highest risk-conferring locus associated and linked to the disease is the HLA cluster, and that HLA-DQ molecules play a key role in the development of autoimmune diabetes, our observations imply that as yet unidentified immunologic abnormalities could well exist in seronegative relatives at risk of developing clinical diabetes and carrying 2 HLA-DQ high-risk haplotypes.

Adolescent↗
PubMed2001

Towards an internet civil defence against bioterrorism.

Approaches towards the public-health prevention of bioterrorism are too little, and too late. New information-based approaches could yield better homeland protection. An internet civil defence is presented where millions of eyes could help to identify suspected cases of bioterrorism, with the internet used to report, confirm, and prevent outbreaks.

Bioterrorism↗
PubMed2001

Does the perception of downloading speed influence the evaluation of web-based lectures?

Medical schools put little emphasis upon education on public health, even though public health has played an important role in this century. One way to harness its benefit in order to improve global health in the 21st century is to globally share lectures on public health through the Internet. We have developed the Supercourse comprising of web-based learning modules on epidemiology in a standardized format with the size of each web page less than 10 kilobytes. A cross-sectional observational study was conducted to investigate the association of the perception of the access speed to Web-based lectures by teachers with their perception of lecture quality. There were 223 teachers who rated the lectures: 72% were from North America or Western Europe, 40% had taught epidemiology, and 14% reported that the speed of access was slow. Odds ratio of above-average rating among those who reported that the speed of access was fast relative to those who reported that the speed of access was slow was 4.25 (2.03-8.91; P = 0.001). The odds ratios were similar and significant after taking into account several other factors, including the variation of rating across lectures, region, and experiences in teaching epidemiology. The results indicate that the perception of the quality of Web-based lectures is related to the speed of access to a web page. The speed of access may be as important, if not more important, as the content itself. This suggests that, to share educational materials on the Web globally for teachers, one must consider not only the content, but also how people at local sites gain access to the Internet.

Cross-Sectional Studies↗
PubMed2001

Capture-recapture method to estimate lower extremity amputation rates in Rio de Janeiro, Brazil.

OBJECTIVE: To estimate rates of lower extremity amputations (LEAs) in persons with peripheral vascular disease, diabetes mellitus, trauma, neoplasm, osteomyelitis, or emphysematous gangrene. METHODS: Regional amputee registries were used to estimate the rate of lower extremity amputations with the capture-recapture (CR) technique. Data were extracted from three amputee registries in Rio de Janeiro: source 1, with 1,191 cases from 23 hospitals; source 2, with 157 cases from a limb-fitting center; and source 3, with 34 cases from a rehabilitation center. Amputee death certificates from source 1 identified 257 deaths from 1992 to 1994. Three CR models were evaluated using sources 2 and 3. In order to avoid an overestimation of the rate of LEAs, two models were applied for the data analysis: in one case, deceased patients listed in source 1 were excluded from the model, and in the other case, deceased patients were included as well. RESULTS: Excluding the 257 deaths, the estimated number of amputations in the municipality of Rio de Janeiro from 1992 to 1994 was 3,954, for a mean annual incidence rate of 13.9 per 100,000 inhabitants. Among persons with diabetes, the annual incidence rate of lower extremity amputations was substantially higher (180.6 per 100,000 persons per year), representing 13 times the risk of individuals without diabetes. The yearly rate of LEAs according to the routine surveillance system was estimated at 5.4 and 96.9 per 100,000 in the general population and in diabetics, respectively. If data from the three registries are added, 1,382 patients with LEAs were identified, with the reasons for the amputations distributed as follows: peripheral vascular disease = 804 (58.1%); diabetes mellitus = 379 (27.4%); trauma = 103 (7.4%); osteomyelitis = 44 (3.1%); gangrene = 36 (2.6%), and neoplasm = 16 (1.1%). CONCLUSIONS: These findings show a high incidence of LEAs in Brazil, when compared to countries such as Spain, that is attributable mainly to peripheral vascular disease and diabetes mellitus.

Amputation, Surgical↗
PubMed2001

Mortality trends in type 1 diabetes. The Allegheny County (Pennsylvania) Registry 1965-1999.

OBJECTIVES: To investigate long-term mortality and its temporal trends as of 1 January 1999 among the 1,075 patients with type 1 diabetes (onset age <18 years, diagnosed between 1965 and 1979) who comprise the Allegheny County population-based registry. RESEARCH DESIGN AND METHODS: Overall, sex- and race-specific mortality rates per person-year of follow-up were determined. Standardized mortality ratios were also calculated. Survival analyses and Cox proportional hazard model were also used. Temporal trends were examined by dividing the cohort into three groups by year of diagnosis (1965-1969, 1970-1974, and 1975-1979). RESULTS: Living status of 972 cases was ascertained as of January 1, 1999 (ascertainment rate 90.4%). The mean duration of diabetes was 25.2 +/- 5.8 (SD) years. Overall, 170 deaths were observed. The crude mortality rate was 627 per 100,000 person-years (95% CI 532-728) and standardized mortality ratio was 519 (440-602). Life-table analyses by the Kaplan-Meier method indicated cumulative survival rates of 98.0% at 10 years, 92.1% at 20 years, and 79.6% at 30 years duration of diabetes. There was a significant improvement in the survival rate between the cohort diagnosed during 1965-1969 and that diagnosed during 1975-1979 by the log-rank test (P = 0.03). Mortality was higher in African-Americans than in Caucasians, but there were no differences seen by sex. The improvement in recent years was seen in both ethnic groups and sexes. CONCLUSIONS: An improvement in long-term survival was observed in the more recently diagnosed cohort. This improvement is consistent with the introduction of HbA1 testing, home blood glucose monitoring, and improved blood pressure therapy in the 1980s.

Adult↗
PubMed2000

Disabilities due to injury in the military.

INTRODUCTION: Disability is a major health and economic issue in the Armed Forces associated with increased use of medical care, the loss of active duty time, and substantial compensation costs. METHODS: The role of injuries in physical disability from the early 1980s to 1994 was assessed by reviewing administrative data from the U.S. Army Physical Disability Agency, the Naval Disability Evaluation Board, and the Air Force Physical Disability Division. Information on the number of disability cases reviewed in 1994, the leading causes of disability, and the disposition of each case were examined most closely. Also, information from the Department of Defense on the cost of compensating disability cases was reviewed. RESULTS: Disability generally appears to be significant across the services, ranging from 10 to 30 events per 1000 personnel per year depending on the service. Evidence from the data reviewed indicates that 30% to 50% of disability cases may be due to injury. The leading conditions that bring about board reviews and lifetime compensation appear to be lower back and knee conditions, both commonly thought to be due to injuries. Total direct costs of compensation reached $1. 5 billion for fiscal year 1990. CONCLUSIONS: While current disability data systems are maintained for administrative and not research purposes, the information available may be valuable for injury surveillance and research and suggests that injury-related disability is a major health and economic burden for the Armed Forces.

Adult↗
PubMed2000

Mortality in patients with childhood-onset type 1 diabetes in Finland, Estonia, and Lithuania: follow-up of nationwide cohorts.

OBJECTIVE: To assess mortality of population-based cohorts of childhood-onset type 1 diabetic patients from the Eastern European countries of Estonia and Lithuania and compare this information with recent data from Finland. RESEARCH DESIGN AND METHODS: Estonian (n = 518) and Finnish (n = 5,156) type 1 diabetic cohorts were diagnosed between 1980 and 1994, and the Lithuanian (n = 698) cohort was diagnosed between 1983 and 1994. The mortality of these cohorts was determined in 1995. Life-table analysis, Cox survival analysis with covariates, and standardized mortality ratios (SMRs) were used. Causes of death were analyzed. RESULTS: Survival after 10 years duration of type 1 diabetes was similar in Estonia (94.3%) and Lithuania (94.0%), but much higher in Finland (99.1%). In the Cox survival analysis with covariates, the country of origin and age at diagnosis were found to be significant predictors of mortality. The SMR for the Estonian cohort was 4.35 (95% CI 2.25-7.61), the highest for the Lithuanian cohort was 7.55 (4.89-11.15), and the lowest for the Finnish cohort was 1.62 (1.10-2.28). The most common cause of death in Estonia and Lithuania was diabetic ketoacidosis (DKA), and in Finland, it was violent causes. No deaths from late complications of diabetes have been documented so far in any of the three countries. CONCLUSIONS: Our results demonstrate a high rate of short-term deaths due to DKA and inferior survival of childhood-onset type 1 diabetic patients in Estonia and Lithuania compared with Finland. In Finland, the survival of childhood-onset type 1 diabetic patients has improved and is only slightly inferior to that of the background population.

Adolescent↗
PubMed1999

[An Internet-based "distance" learning for health, environment and sustainable development "distance learning without a frontier"].

Quality of the environment is crucial for human health. Environmental hazards may lead to adverse health effects, while a sound environment can support of enable health. It has been clear that health and environment must be understood within the context of social and economic development, which was stressed especially in the Earth Summit held in Rio de Janeiro, Brazil, in 1992. Investing in improvement of people's health and their environment is a prerequisite for sustainable development. The telecommunication revolution enables distance learning without frontiers in a reansparent and interactive environment. Applying the Internet and other telecommunication into public health including environmental health holds the greatest promise for global health. A wide application and access would facilitate and expedite the reduction of inequity prevailing between the south and north in an unprecedented speed. This proposed course is thus designed to provide an overview on health and environment in sustainable development through the Internet.

Environmental Health↗
PubMed1998

How accurate is male recall of reproductive information?

The purpose of this study was to determine how well men recall reproductive information. By using a questionnaire, the authors surveyed men who had undergone orchiopexy for undescended testes and a group of matched control men, all of whom had had surgery at the Children's Hospital of Pittsburgh in Pittsburgh, Pennsylvania (n = 77), and their spouses. Subjects were a random subset of a larger (n = 1,212) male fertility study, which has been ongoing since 1992. In 1994, the spouses of men who participated in the study completed a short telephone survey that contained questions previously asked of their partners. Pearson correlations and kappa statistics were calculated to evaluate the accuracy of male recall of reproductive information. For the continuous measures, such as time to conception and frequency of intercourse, the correlations were high to moderate (r = 0.84 (p < 0.001) and r = 0.45 (p < 0.001), respectively). Agreement between the men and their spouses on the majority of bivariate (yes/no) questions, such as those concerning the use of birth control, as measured by the kappa statistic, was moderate to very good (K ranged from 0.14 to 0.69). Statistics were similar for formerly cryptorchid and control men. Male participants' responses to questions about their reproductive histories were accurate as compared with the responses given by their spouses. In this sample from a large cohort study, men appeared to recall reproductive information with acceptable accuracy.

Case-Control Studies↗