1
|
Mellqvist UH, Cai Q, Hester LL, Grövdal M, Börsum J, Rahman I, Ammann EM, Hansson M. Epidemiology and clinical outcomes of light-chain amyloidosis in Sweden: A nationwide population-based study. Eur J Haematol 2023; 111:697-705. [PMID: 37533343 DOI: 10.1111/ejh.14063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 08/04/2023]
Abstract
OBJECTIVES This study evaluated data from six Swedish national registries to fill current evidence gaps on the epidemiology, clinical burden, and overall survival (OS) associated with light-chain (AL) amyloidosis. METHODS Patients newly diagnosed with AL amyloidosis were identified using six linked Swedish nationwide population-based registers. For each case, individuals from the general population were selected and matched with a maximum ratio of 1:5 based on age, sex, calendar year, and county. RESULTS 846 patients newly diagnosed with AL amyloidosis and 4227 demographically matched individuals were identified. From 2011 to 2019, annual AL amyloidosis incidence increased from 10.5 to 15.1 cases per million. At baseline, patients with AL amyloidosis had a significantly higher disease burden including higher rates of cardiac and renal failure relative to the comparison group. Among patients with AL amyloidosis, 21.5% had incident heart failure and 17.1% had incident renal failure after initial diagnosis. Median OS for patients with AL amyloidosis was 56 months versus not reached in the matched general population comparison group. CONCLUSION The incidence of newly diagnosed AL amyloidosis in Sweden increased over time with AL amyloidosis being associated with a higher risk of cardiac/renal failure and all-cause mortality compared with the general population.
Collapse
Affiliation(s)
- Ulf-Henrik Mellqvist
- Section of Hematology and Coagulation, Department of Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Qian Cai
- Janssen Global Services, Titusville, New Jersey, USA
| | - Laura L Hester
- Janssen Research & Development, Horsham, Pennsylvania, USA
| | | | | | | | | | - Markus Hansson
- Department of Hematology, Sahlgrenska Academy, Göteborg University and Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Hematology, Skåne University Hospital, Lund, Sweden
| |
Collapse
|
2
|
Wang Y, Hester LL, Lofland J, Rose S, Karyekar CS, Kern DM, Blacketer M, Davis K, Shields-Tuttle K. Update on prevalence of diagnosed systemic lupus erythematosus (SLE) by major health insurance types in the US in 2016. BMC Res Notes 2022; 15:5. [PMID: 35000586 PMCID: PMC8744244 DOI: 10.1186/s13104-021-05877-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/06/2021] [Indexed: 11/10/2022] Open
Abstract
Objective To provide current estimates of the number of patients with prevalent systemic lupus erythematosus (SLE) by major health insurance types in the US and to describe patient characteristics. Four large US health insurance claims databases were analyzed to represent different types of insurance coverage, including private insurance, Medicaid, and Medicare Supplemental. Results Overall unadjusted SLE prevalence per 100,000 persons in the US ranged from 150.1 (private insurance) to 252.9 (Medicare Supplemental insurance). Extrapolating to the US civilian population in 2016, we estimated roughly 345,000 to 404,000 prevalent SLE patients with private/Medicare insurance and 99,000 prevalent SLE patients with Medicaid insurance. Comorbidities, including renal failure/dialysis were commonly observed across multiple organ systems in SLE patients (8.4–21.1%). We estimated a larger number of prevalent SLE cases in the US civilian population than previous reports and observed extensive disease burden based on a 1-year cross-sectional analysis. Supplementary Information The online version contains supplementary material available at 10.1186/s13104-021-05877-1.
Collapse
Affiliation(s)
- Yiting Wang
- Janssen Research & Development, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA
| | - Laura L Hester
- Janssen Research & Development, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA.
| | | | - Shawn Rose
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | - David M Kern
- Janssen Research & Development, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA
| | - Margaret Blacketer
- Janssen Research & Development, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA
| | - Kourtney Davis
- Janssen Research & Development, LLC, 1125 Trenton-Harbourton Road, Titusville, NJ, 08560, USA
| | | |
Collapse
|
3
|
Hester LL, Gifkins DM, M Bellew K, Vermeulen J, Schecter JM, Strony J, Dishy V, Weiss BM. Diagnostic delay and characterization of the clinical prodrome in AL amyloidosis among 1523 US adults diagnosed between 2001 and 2019. Eur J Haematol 2021; 107:428-435. [PMID: 34137077 DOI: 10.1111/ejh.13679] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/12/2021] [Accepted: 06/15/2021] [Indexed: 12/19/2022]
Abstract
Light-chain (AL) amyloidosis is a multisystem disorder with a high early mortality and diagnostic delays of >1 year from symptom onset. This retrospective observational study sought to characterize the clinical prodrome and diagnostic delay to inform early detection. We identified 1523 adults with newly diagnosed AL amyloidosis in the Optum de-identified Clinformatics® Datamart US healthcare claims database as those with ≥2 new diagnosis codes for AL or other amyloidosis in 90 days with ≥1 multiple myeloma treatment within 730 days, excluding patients with prior hereditary or secondary amyloidosis and Familial Mediterranean Fever. We considered 34 signs/symptoms using diagnosis codes in all observable time on or before AL amyloidosis diagnosis. Sign/symptom prevalence was compared to that of 1:4 matched population controls. The overlap and sequence of signs/symptoms and the median time from first sign/symptom to AL amyloidosis diagnosis were explored. Healthcare utilization was summarized. The most common individual AL amyloidosis signs/symptoms were malaise/fatigue (61%) and dyspnea (59%). Cardiac signs/symptoms were observed in 77% of patients, followed by renal (62%) and neurologic (59%) signs/symptoms. Multisystem involvement (≥3 systems) was present in 54%. Monoclonal gammopathy was detected in 29% before diagnosis. Median time from symptom onset to AL amyloidosis diagnosis was 2.7 years. Healthcare utilization was high between first AL amyloidosis signs/symptoms and diagnosis, with 50% visiting ≥5 physician types. AL amyloidosis patients have a lengthy and complex clinical prodrome. Novel approaches to early diagnosis are needed to improve outcomes.
Collapse
Affiliation(s)
- Laura L Hester
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | | | - Kevin M Bellew
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | | | - John Strony
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | - Victor Dishy
- Janssen Research & Development, LLC, Raritan, NJ, USA
| | | |
Collapse
|
4
|
Mayer SE, Tan HJ, Peacock Hinton S, Sanoff HK, Stürmer T, Hester LL, Faurot KR, Jonsson Funk M, Lund JL. Comparison of Medicare Claims-based Proxy Measures of Poor Function and Associations With Treatment Receipt and Mortality in Older Colon Cancer Patients. Med Care 2019; 57:286-294. [PMID: 30789540 PMCID: PMC6417959 DOI: 10.1097/mlr.0000000000001073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Multiple claims-based proxy measures of poor function have been developed to address confounding in observational studies of drug effects in older adults. We evaluated agreement between these measures and their associations with treatment receipt and mortality in a cohort of older colon cancer patients. METHODS Medicare beneficiaries age 66+ diagnosed with stage II-III colon cancer were identified in the Surveillance, Epidemiology, and End Results-Medicare database (2004-2011). Poor function was operationalized by: (1) summing the total poor function indicators for each model; and (2) estimating predicted probabilities of poor function at diagnosis. Agreement was evaluated using Fleiss' κ and Spearman's correlation. Associations between proxy measures and: (1) laparoscopic versus open surgery; (2) chemotherapy versus none; (3) 5-fluorouracil (5FU)+oxaliplatin (FOLFOX) versus 5FU monotherapy; and (4) 1-year mortality were estimated using log-binomial regression, controlling for age, sex, stage, and comorbidity. Survival estimates were stratified by functional group, age, and comorbidity. RESULTS Among 29,687 eligible colon cancer patients, 67% were 75+ years and 45% had stage III disease. Concordance across the poor function indicator counts was moderate (κ: 0.64) and correlation of predicted probability measures varied (ρ: 0.21-0.74). Worse function was associated with lower chemotherapy and FOLFOX receipt, and higher 1-year mortality. Within age and comorbidity strata, poor function remained associated with mortality. CONCLUSIONS While agreement varied across the claims-based proxy measures, each demonstrated anticipated associations with treatment receipt and mortality independent of comorbidity. Claims-based comparative effectiveness studies in older populations should consider applying one of these models to improve confounding control.
Collapse
Affiliation(s)
- Sophie E Mayer
- Department of Epidemiology, Gillings School of Global Public Health
| | | | | | - Hanna K Sanoff
- Division of Hematology/Oncology, School of Medicine & Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Til Stürmer
- Department of Epidemiology, Gillings School of Global Public Health
| | | | - Keturah R Faurot
- Department of Physical Medicine and Rehabilitation, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Jennifer L Lund
- Department of Epidemiology, Gillings School of Global Public Health
| |
Collapse
|
5
|
Hester LL, Park SI, Wood WA, Stürmer T, Brookhart MA, Lund JL. Cause-specific mortality among Medicare beneficiaries with newly diagnosed non-Hodgkin lymphoma subtypes. Cancer 2018; 125:1101-1112. [PMID: 30548238 DOI: 10.1002/cncr.31821] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Revised: 07/27/2018] [Accepted: 08/31/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND As the US population ages and non-Hodgkin lymphoma (NHL)-specific mortality declines, deaths from causes other than NHL will become increasingly important in treatment decision making for older patients with NHL. The objective of the current study was to describe how the 5-year cumulative incidence of NHL-specific and other-cause mortality varies by subtype, age, comorbidity level, and time since diagnosis in older patients. METHODS Using the Surveillance, Epidemiology, and End Results cancer registry data linked to Medicare claims, patients aged ≥66 years were identified at the time of diagnosis with a first, primary NHL diagnosis from 2004 through 2013. Death certificate data and Fine-Gray competing risks models were used to estimate the 5-year cumulative incidence of NHL-specific and other-cause mortality by NHL subtype, age, and comorbidity level. Estimates were displayed over time using stacked cumulative incidence curves. RESULTS Among 30,666 patients with NHL, 32% died of NHL and 13% died of other causes within 5 years of diagnosis. The cumulative incidence of other-cause mortality increased with age and comorbidity level for all subtypes. Among patients with aggressive NHL subtypes, NHL-specific mortality exceeded other-cause mortality across all age groups, comorbidity levels, and number of years after diagnosis. For patients with indolent NHL subtypes, other-cause mortality was similar to or exceeded NHL-specific mortality, especially among older patients with severe comorbidity or with the indolent marginal zone, lymphoplasmacytic, and mycosis fungoides subtypes. CONCLUSIONS The findings of the current study suggest that mortality from causes other than NHL are important for patients of an older age, with a higher comorbidity level, and with indolent disease. Evidence from the current study can guide the development of tools for estimating individual prognosis that inform treatment discussions in patients with NHL.
Collapse
Affiliation(s)
- Laura L Hester
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Janssen Research & Development, LLC, Titusville, New Jersey
| | - Steven I Park
- Department of Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Division of Hematology and Oncology, Levine Cancer Institute, Charlotte, North Carolina
| | - William A Wood
- Leukemia, Lymphoma, and Myeloma Program, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Til Stürmer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - M Alan Brookhart
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Jennifer L Lund
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| |
Collapse
|
6
|
Hester LL, Poole C, Suarez EA, Der JS, Anderson OG, Almon KG, Shirke AV, Brookhart MA. Reply to: comparative effectiveness medicines research cannot assess efficacy. J Clin Epidemiol 2017; 92:130-132. [PMID: 28916489 DOI: 10.1016/j.jclinepi.2017.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/06/2017] [Indexed: 10/18/2022]
Affiliation(s)
- Laura L Hester
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 1-609-703-6927, USA.
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 1-609-703-6927, USA
| | - Elizabeth A Suarez
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 1-609-703-6927, USA
| | - Jane S Der
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 1-609-703-6927, USA
| | - Olivia G Anderson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 1-609-703-6927, USA
| | - Kathryn G Almon
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 1-609-703-6927, USA
| | - Avanti V Shirke
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 1-609-703-6927, USA
| | - M Alan Brookhart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 1-609-703-6927, USA
| |
Collapse
|
7
|
Hester LL, Poole C, Suarez EA, Der JS, Anderson OG, Almon KG, Shirke AV, Brookhart MA. Publication of comparative effectiveness research has not increased in high-impact medical journals, 2004-2013. J Clin Epidemiol 2017; 84:185-187. [PMID: 28188899 DOI: 10.1016/j.jclinepi.2017.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 12/17/2016] [Accepted: 01/19/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To explore the impact of increasing interest and investment in patient-centered research, this study sought to describe patterns of comparative effectiveness research (CER) and patient-reported outcomes (PROs) in pharmacologic intervention studies published in widely read medical journals from 2004-2013. DESIGN AND SETTING We identified 2335 articles published in five widely read medical journals from 2004-2013 with ≥1 intervention meeting the US Food and Drug Administration's definitions for a drug, biologic, or vaccine. Six trained reviewers extracted characteristics from a 20% random sample of articles (468 studies). We calculated the proportion of studies with CER and PROs. Trends were summarized using locally-weighted means and 95% confidence intervals. RESULTS Of the 468 sampled studies, 30% used CER designs and 33% assessed PROs. The proportion of studies using CER designs did not meaningfully increase over the study period. However, we observed an increase in the use of PROs. CONCLUSIONS Among pharmacological intervention studies published in widely read medical journals from 2004-2013, we identified no increase in CER. Randomized, placebo-controlled trials continue to be the dominant study design for assessing pharmacologic interventions. Increasing trends in PRO use may indicate greater acceptance of these outcomes as evidence for clinical benefit.
Collapse
Affiliation(s)
- Laura L Hester
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA.
| | - Charles Poole
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA
| | - Elizabeth A Suarez
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA
| | - Jane S Der
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA
| | - Olivia G Anderson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA
| | - Kathryn G Almon
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA
| | - Avanti V Shirke
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA
| | - M Alan Brookhart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, 135 Dauer Drive, 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC 27599, USA
| |
Collapse
|
8
|
Abstract
Risk is an important parameter to describe the occurrence of health outcomes over time. However, many outcomes of interest in healthcare settings, such as disease incidence, treatment initiation, and cause-specific mortality, may be precluded from occurring by other events, often referred to as competing events. Here, we review straightforward approaches to estimate risk in the presence of competing events. We illustrate the application of these methods using timely examples in pharmacoepidemiologic research and compare results to those obtained using analytic simplifications commonly used to handle competing events. These examples demonstrate how the analytic methods used to account for competing events affect the interpretation of results from pharmacoepidemiologic studies.
Collapse
Affiliation(s)
- Jessie K Edwards
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Laura L Hester
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Mugdha Gokhale
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Epidemiology, Real World Evidence, GlaxoSmithKline, Collegeville, PA, USA
| | - Catherine R Lesko
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA
| |
Collapse
|
9
|
Nuss HJ, Hester LL, Perry MA, Stewart-Briley C, Reagon VM, Collins P. Applying the Social Ecological Model to Creating Asthma-Friendly Schools in Louisiana. J Sch Health 2016; 86:225-32. [PMID: 26830509 PMCID: PMC4754781 DOI: 10.1111/josh.12369] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 06/23/2015] [Accepted: 05/20/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND In 2010, the Louisiana Asthma Management and Prevention Program (LAMP) implemented the Asthma-Friendly Schools Initiative in high-risk Louisiana populations. The social ecological model (SEM) was used as a framework for an asthma program implemented in 70 state K-12 public schools over 2 years. METHODS Activities included a needs assessment, identification of students with asthma, individualized asthma action plans (AAP), staff trainings, environmental quality improvement, and school system policy changes to address the asthma burden. RESULTS There were 522 new or existing asthma cases recognized. Asthma knowledge/awareness was measurably improved among school personnel. School indoor air quality was improved across all locations. School-level policies were adopted that improved AAP collection, compliance to bus-idling restrictions, and asthma medication self-carry. CONCLUSIONS The SEM framework can be used for school-based programs to address successfully and improve asthma-related issues from the individual through policy levels.
Collapse
Affiliation(s)
- Henry J Nuss
- Louisiana State University Health Sciences Center, School of Public Health, 2020 Gravier St., Ste. 216, New Orleans, LA 70112.
| | - Laura L Hester
- ORISE/CDC Research Program, Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F60, Atlanta, GA 30341.
| | - Mark A Perry
- University of Phoenix, College of Health Sciences and Nursing, Baton Rouge, LA.
| | - Collette Stewart-Briley
- Section of Environmental Epidemiology and Toxicology, Office of Public Health, Department of Health and Hospitals, 628 N, 4th Street, Baton Rouge, LA 70812-4489.
| | - Valamar M Reagon
- Jiann-Ping Hsu College of Public Health, Georgia Southern University, 501 Forest Drive, Statesboro, GA 30458.
| | - Pamela Collins
- Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F60, Atlanta, GA 30341.
| |
Collapse
|
10
|
Hester LL, Wilce MA, Gill SA, Disler SL, Collins P, Crawford G. Roles of the state asthma program in implementing multicomponent, school-based asthma interventions. J Sch Health 2013; 83:833-841. [PMID: 24261517 PMCID: PMC4555870 DOI: 10.1111/josh.12101] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 08/18/2013] [Indexed: 06/02/2023]
Abstract
BACKGROUND Asthma is a leading chronic childhood disease in the United States and a major contributor to school absenteeism. Evidence suggests that multicomponent, school-based asthma interventions are a strategic way to address asthma among school-aged children. The Centers for Disease Control and Prevention (CDC) encourages the 36 health departments (34 states, District of Columbia, and Puerto Rico) in the National Asthma Control Program (NACP) to implement multicomponent, school-based asthma interventions on a larger scale. METHODS To gain a better understanding of replicable best practices for state-coordinated asthma interventions in schools, an NACP evaluation team conducted evaluability assessments of promising interventions run by state asthma programs in Louisiana, Indiana, and Utah. RESULTS The team found that state asthma programs play a critical role in implementing school-based asthma interventions due to their ability to (1) use statewide surveillance data to identify asthma trends and address disparities; (2) facilitate connections between schools, school systems, and school-related community stakeholders; (3) form state-level connections; (4) translate policies into action; (5) provide resources and public health practice information to schools and school systems; (6) monitor and evaluate implementation. CONCLUSIONS This article presents evaluability assessment findings and illustrates state roles using examples from the 3 participating state asthma programs.
Collapse
Affiliation(s)
- Laura L Hester
- Environmental Health Scientist, , ORISE/CDC Research Program, Air Pollution and Respiratory Health Branch, National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, Mailstop F60, Atlanta, GA 30341
| | | | | | | | | | | |
Collapse
|
11
|
Hester LL. Charles E. Flowers, Jr., MD. Ala J Med Sci 1986; 23:284-5. [PMID: 3530008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
|
12
|
Miller JM, Smith IK, Lancaster CJ, Hester LL. Comparison of a faculty-developed final examination with the National Board miniexamination in an obstetric-gynecologic clerkship. J Reprod Med 1984; 29:65-6. [PMID: 6708023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
13
|
Miller JM, Smith IK, Sosnowski JR, Hester LL. Evaluation of student performance in an obstetrics and gynecology clerkship. J Reprod Med 1982; 27:443-6. [PMID: 7131433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
14
|
Abstract
Aneurysms rarely presenta as a complication of hysterectomy. A case is reported of a left common iliac artery aneurysm causing readmission 2 weeks after total abdominal hysterectomy. The aneurysm remained undiagnosed prior to percutaneous rupture and subsequent laparotomy. The aneurysm was ligated and resected. No graft or arterial repair was attempted because of the infection that was present. Twenty-three days after hysterectomy, the patient underwent above-the-knee amputation. A review of the literatureis undertaken and possible etiolgic mechanisms discussed.
Collapse
|
15
|
|
16
|
Roberts DB, Hester LL. Progressive synergistic bacterial gangrene arising from abscesses of the vulva and Bartholin's gland duct. Am J Obstet Gynecol 1972; 114:285-91. [PMID: 4629235 DOI: 10.1016/0002-9378(72)90605-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
17
|
|
18
|
Hester LL. Delivery of gynecologic and obstetric health care. J S C Med Assoc 1971; 67:1-4. [PMID: 5276436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
19
|
Hester LL, Kellett WW, Spicer SS, Williamson HO, Pratt-Thomas HR. Effects of the intrauterine contraceptive device on endometrial enzyme and carbohydrate histochemistry. Am J Obstet Gynecol 1970; 106:1144-54. [PMID: 4314520 DOI: 10.1016/0002-9378(70)90508-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
20
|
House TE, Williams BL, Meares GM, Hester LL. Pregnancy complicated by urinary tract infections. Obstet Gynecol 1969; 34:670-4. [PMID: 5348671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
21
|
Kellett WW, Hester LL, Spicer SS, Williamson HO. Effects of a sequential oral contraceptive on endocervical corbohydrate histochemistry. Obstet Gynecol 1969; 34:536-44. [PMID: 4186233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
22
|
|
23
|
Hester LL, Kellett WW, Spicer SS, Williamson HO, Pratt-Thomas HR. Effects of a sequential oral contraceptive on endometrial enzyme and carbohydrate histochemistry. Am J Obstet Gynecol 1968; 102:771-83. [PMID: 4176774 DOI: 10.1016/0002-9378(68)90503-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|
24
|
House TE, Hester LL. Radical vulvectomy for carcinoma of the vulva. Obstet Gynecol 1968; 31:739-45. [PMID: 5646411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
|
25
|
Horger EO, Williamson HO, Hester LL. The treatment of uterine adenocarcinoma with medroxyprogesterone acetate. J S C Med Assoc 1966; 62:217-23. [PMID: 5227728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|