600 Research Boulevard

Rockville, MD, United States

600 Research Boulevard

Rockville, MD, United States
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Kissin W.B.,600 Research Boulevard | Tang Z.,600 Research Boulevard | Claus R.E.,600 Research Boulevard | Orwin R.G.,600 Research Boulevard
Journal of Substance Abuse Treatment | Year: 2014

The present study links an empirically-developed quantitative measure of gender-sensitive (GS) substance abuse treatment to arrest outcomes among 5109 substance abusing women in mixed-gender short-term residential programs in Washington State. Frailty models of survival analysis and three-level hierarchical linear models were conducted to test the beneficial effects of GS treatment on decreasing criminal justice involvement. Propensity scores were used to control for the pre-existing differences among women due to the quasi-experimental nature of the study. Men's arrest outcomes were used to control for confounding at the program level. Results show that women in more GS treatment programs had a lower risk of drug-related arrests, and women in more GS treatment programs who also completed treatment had a significant reduction in overall arrests from 2. years before- to 2. years after treatment, above and beyond the reduction in arrests due to treatment alone. Implications and directions for future research are discussed. © 2014 Elsevier Inc.

Tourangeau R.,600 Research Boulevard | Conrad F.G.,University of Maryland University College | Conrad F.G.,University of Michigan | Couper M.P.,University of Maryland University College | And 2 more authors.
Public Opinion Quarterly | Year: 2014

We conducted a preliminary study and two follow-up studies investigating how providing examples affected responses to survey questions about food consumption. The results of the first follow-up study indicated that, when the examples were frequently consumed food items, respondents reported higher consumption than when they were infrequently consumed items. In addition, atypical examples had greater impact on the answers than did typical examples, probably because respondents are likely to think of the typical instances anyway. Our second follow-up study compared answers to open-ended food consumption questions with answers to closed-ended food consumption questions; respondents tended to leave food items out of the open responses (as compared to the closed responses), but this tendency was reduced for the items they received as examples with the open-ended questions. Examples seem to improve the accuracy of the answers when they remind respondents to include items they might otherwise have left out, because they either had forgotten them or were unsure whether to include them. Overall, these results suggest that respondents base their food-consumption judgments on a limited set of category members. The examples affect which and how many category members they consider. © The Author 2014.

PubMed | Urologic, Inc. 8757 Georgia Avenue and 600 Research Boulevard
Type: | Journal: SSM - population health | Year: 2016

Higher mortality in Blacks than Whites has been consistently reported in the US, but previous investigations have not accounted for poverty at the individual level. The health of its population is an important part of the capital of a nation. We examined the association between individual level poverty and disability and racial mortality differences in a 5% Medicare beneficiary random sample from 2004 to 2010. Cox regression models examined associations of race with all-cause mortality, adjusted for demographics, comorbidities, disability, neighborhood income, and Medicare Buy-in status (a proxy for individual level poverty) in 1,190,510 Black and White beneficiaries between 65 and 99 years old as of January 1, 2014, who had full and primary Medicare Part A and B coverage in 2004, and lived in one of the 50 states or Washington DC. Overall, black beneficiaries had higher sex-and-age adjusted mortality than Whites (hazard ratio [HR] 1.18). Controlling for health-related measures and disability reduced the HR for Black beneficiaries to 1.03. Adding Buy-in as an individual level covariate lowered the HR for Black beneficiaries to 0.92. Neither of the residential measures added to the predictive model. We conclude that poorer health status, excess disability, and most importantly, greater poverty among Black beneficiaries accounts for racial mortality differences in the aged US Medicare population. Poverty fosters social and health inequalities, including mortality disparities, notwithstanding national health insurance for the US elderly. Controlling for individual level poverty, in contrast to the common use of area level poverty in previous analyses, accounts for the White survival advantage in Medicare beneficiaries, and should be a covariate in analyses of administrative databases.

Winokur M.,Colorado State University | Ellis R.,600 Research Boulevard | Drury I.,045 S. Lowell Boulevard | Rogers J.,600 Research Boulevard
Child Abuse and Neglect | Year: 2015

Over the past 20 years, jurisdictions across the United States have implemented differential response (DR), which provides child protective services with the flexibility to tailor their response to reports of child abuse or neglect based on the level of risk. Given the widespread adoption of DR, there has been an increasing demand from policymakers, practitioners, and community stakeholders to build the evidence base for this innovative child welfare approach. This study was designed to answer the big questions regarding the effect of differential response on child welfare outcomes and costs using a randomized controlled trial in five Colorado counties. Specifically, the study examined the safety outcomes and costs of families who were randomly assigned to either a family assessment response (FAR) or an investigation response (IR). According to the regression results, there were no differences between the tracks on measures of system re-involvement. However, survival analysis findings indicate that FAR families were 18% less likely, over time, to have a high risk assessment after their initial accepted referral than were IR families. The cost study revealed no differences between the tracks on initial costs for caseworker contacts, services, and out-of-home placements. However, the results suggest that follow-up costs for IR cases were significantly higher (p<. 0.001) than for FAR cases. The authors discuss policy and practice implications for jurisdictions considering DR. © 2014 Elsevier Ltd.

Sugarbaker P.H.,Washington Hospital Center | Chang D.,600 Research Boulevard | Stuart O.A.,Washington Hospital Center
Gastroenterology Research and Practice | Year: 2012

Cytoreductive surgery combined with hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment option for selected patients with pseudomyxoma peritonei (PMP) and diffuse malignant peritoneal mesothelioma (DMPM). Tumor infiltration of the hemidiaphragm requiring partial resection occurs as a result of large volume and/or invasive disease at this anatomic site. Transmission of disease from abdomen to chest is a great danger in this group of patients. From a prospective database, patients who had diaphragm resection and then hyperthermic thoracoabdominal chemotherapy (HITAC) as a component of a cytoreductive surgical procedure were identified. Data from control patients receiving HIPEC or hyperthermic intrathoracic chemotherapy (HITOC) were analyzed for comparison. The morbidity, mortality, survival, and recurrence rate within the thoracic space were presented. Thirty patients had partial resection of a hemidiaphragm as part of a cytoreductive surgical procedure that utilized HITAC. The pharmacologic benefit of intracavitary chemotherapy administration was documented with an area under the curve ratio of intracavitary concentration times time to plasma concentration times time of 27 ± 10 for mitomycin C and 75 ± 26 for doxorubicin. Comparing percent chemotherapy absorbed for a ninety-minute treatment showed the largest for HIPEC, then for HITAC, and lowest for HITOC. The incidence of grade 3 and 4 adverse events was 43%. There was no mortality. Adjustments in the chemotherapy dose are not necessary with HITAC. The morbidity was high, the survival was acceptable, and intrathoracic recurrence was low. Copyright © 2012 Paul H. Sugarbaker et al.

Zador P.L.,600 Research Boulevard | Ahlin E.M.,600 Research Boulevard | Rauch W.J.,600 Research Boulevard | Howard J.M.,600 Research Boulevard | Duncan G.D.,600 Research Boulevard
Accident Analysis and Prevention | Year: 2011

This randomized controlled trial of 2168 DWI multiple offenders assigned to a state-wide ignition interlock program in Maryland compared non-compliance with interlock requirements among drivers who were closely monitored (by Westat staff) and drivers who received standard monitoring (by the Motor Vehicle Administration). Compliance comparisons relied on datalogger data from MVA's interlock providers plus driver records that contained demographic information, prior alcohol-related traffic violations, their dispositions, and interlock duration. Measures for quantifying non-compliance included rates per 1000 engine starts for initial breath test failures at varying BAC levels and time periods, retest failures, retest refusals, interlock disconnects, startup violations, and summation measures. Regression analysis estimated the effects of closer monitoring on non-compliance, using linear mixed models that included random driver effects and fixed effects for study-group assignment, prior alcohol-related traffic violations, and months of continuous datalogger data with a quadratic function that assessed changes and rates of change in interlock non-compliance over time. All the separate non-compliance rates and summary measures derived from them were lower for closer monitored than control drivers for continuous data series of at least 6, 12, or 24 months. The differences for initial test failures and the two summary measures were statistically significant. Most measures of non-compliance decreased significantly as continuous time on the interlock increased. Parallel trends in each study group indicated that drivers learned to improve their compliance over time. Thus, this study convincingly demonstrates that closer monitoring substantially enhanced compliance with requirements of the ignition interlock and that regardless of group assignment, compliance increased over time. © 2011 Elsevier Ltd.

Burke-Garcia A.,600 Research Boulevard | Scally G.,University of the West of England
Journal of public health (Oxford, England) | Year: 2014

BACKGROUND: Digital media usage is expanding enormously and is starting to be used as a public health intervention and communication tool. It has an ability to increase the reach of public health research and communication, as well as drive measurable behaviour change. But there is an absence of both deep and wide understanding of the opportunities within digital media, i.e. most people think only of Facebook and Twitter when they think of social media; smart, strategic planning for its widespread use is not common practice and rigorous evaluative studies of its effectiveness are few and far between.METHODS: This paper analyses the published literature on this topic and identifies the top 10 directions that use of digital media is likely to take in the medium term.RESULTS: The analysis strongly supports the position that digital media needs to be taken seriously as a vehicle for public health activity in its own right and not merely as an adjunct to other campaigns.CONCLUSIONS: Digital media will continue to develop and move from being an add-on to existing activity to being the major vehicle for significant elements of research, data collection and advocacy. It is important that public health leaders fully understand and engage in its development and use. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. for permissions, please e-mail: journals.permissions@oup.com.

Tourangeau R.,600 Research Boulevard | Couper M.P.,University of Michigan | Conrad F.G.,University of Michigan
Public Opinion Quarterly | Year: 2013

This paper presents results from six experiments that examine the effect of the position of an item on the screen on the evaluative ratings it receives. The experiments are based on the idea that respondents expect "good" things-those they view positively-to be higher up on the screen than "bad" things. The experiments use items on different topics (Congress and HMOs, a variety of foods, and six physician specialties) and different methods for varying their vertical position on the screen. A meta-analysis of all six experiments demonstrates a small but reliable effect of the item's screen position on mean ratings of the item; the ratings are significantly more positive when the item appears in a higher position on the screen than when it appears farther down. These results are consistent with the hypothesis that respondents follow the "Up means good" heuristic, using the vertical position of the item as a cue in evaluating it. Respondents seem to rely on heuristics both in interpreting response scales and in forming judgments. © 2013 The Author.

Tang Z.,600 Research Boulevard | Claus R.E.,600 Research Boulevard | Orwin R.G.,600 Research Boulevard | Kissin W.B.,600 Research Boulevard | Arieira C.,600 Research Boulevard
Drug and Alcohol Dependence | Year: 2012

Background: Gender-sensitive (GS) substance abuse treatment services have emerged in response to the multidimensional profile of problems that women display upon admission to substance abuse treatment. The present study examines the extent to which treatment programs vary in GS programming for women in real-world mixed-gender treatment settings, where most women are treated. Methods: Data were collected through site visits using semi-structured interviews with program directors, clinical directors, and counselors in 13 mixed-gender treatment programs from Washington State. Rasch modeling techniques were used to analyze the data. Results: Naturally occurring variation was revealed within and across the treatment programs, and demonstrated that reliable measures of three GS domains (Grella, 2008) can be constructed despite a small number of programs. Conclusions: This is the first study to quantify GS treatment for substance abusing women. The identified treatment services and practices and the way they clustered together to form scales have practical implications for researchers, service providers, clinicians, and policy makers. The scales can be used to study treatment outcomes and to evaluate the effectiveness, cost-effectiveness, and cost-benefit of GS programming for women. © 2011 Elsevier Ireland Ltd.

PubMed | U.S. Environmental Protection Agency, University of Alberta, University of North Carolina at Chapel Hill and 600 Research Boulevard
Type: Journal Article | Journal: Environmental health : a global access science source | Year: 2016

Because some adverse health effects associated with chronic arsenic exposure may be mediated by methylated arsenicals, interindividual variation in capacity to convert inorganic arsenic into mono- and di-methylated metabolites may be an important determinant of risk associated with exposure to this metalloid. Hence, identifying biological and behavioral factors that modify an individuals capacity to methylate inorganic arsenic could provide insights into critical dose-response relations underlying adverse health effects.A total of 904 older adults (45years old) in Churchill County, Nevada, who chronically used home tap water supplies containing up to 1850g of arsenic per liter provided urine and toenail samples for determination of total and speciated arsenic levels. Effects of biological factors (gender, age, body mass index) and behavioral factors (smoking, recent fish or shellfish consumption) on patterns of arsenicals in urine were evaluated with bivariate analyses and multivariate regression models.Relative contributions of inorganic, mono-, and di-methylated arsenic to total speciated arsenic in urine were unchanged over the range of concentrations of arsenic in home tap water supplies used by study participants. Gender predicted both absolute and relative amounts of arsenicals in urine. Age predicted levels of inorganic arsenic in urine and body mass index predicted relative levels of mono- and di-methylated arsenic in urine. Smoking predicted both absolute and relative levels of arsenicals in urine. Multivariate regression models were developed for both absolute and relative levels of arsenicals in urine. Concentration of arsenic in home tap water and estimated water consumption were strongly predictive of levels of arsenicals in urine as were smoking, body mass index, and gender. Relative contributions of arsenicals to urinary arsenic were not consistently predicted by concentrations of arsenic in drinking water supplies but were more consistently predicted by gender, body mass index, age, and smoking.These findings suggest that analyses of dose-response relations in arsenic-exposed populations should account for biological and behavioral factors that modify levels of inorganic and methylated arsenicals in urine. Evidence of significant effects of these factors on arsenic metabolism may also support mode of action studies in appropriate experimental models.

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