Onyebuchi Arah

Onyebuchi Arah
University of California, Los Angeles | UCLA · Department of Epidemiology; Department of Statistics

44.48
 · 
MD, MSc, DSc, MPH, PhD
About
272
Research items
23,856
Reads
4,858
Citations
Introduction
Editor, International Journal of Epidemiology Editorial Board Member, Scientific Reports Associate Editor (Epidemiology), Frontiers in Public Health Section Editor, BMC Health Services Research Editorial Board Member, Pan African Medical Journal Editorial Board Member, Emerging Themes in Epidemiology
Research Experience
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Following
Projects
Projects (8)
Archived project
To review, develop, and investigate conceptual frameworks and measurement tools in health and healthcare.
Project
Investigates the clinical epidemiology of non-communicable diseases and their risk factors. Pays particular attention to perinatal and pediatric exposures and outcomes, and obesity, diabetes, cardiovascular and general health outcomes
Research
Research items (272)
Article
Introduction: Little is known about what interventions worked or did not work in slowing the obesity epidemic. The long-term comparative effectiveness of environmental and behavioral public health interventions for obesity and type 2 diabetes prevention over an individual's life course is relatively unexplored. The potential impact and long-term c...
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Uncontrolled confounding due to unmeasured confounders biases causal inference in health science studies using observational and imperfect experimental designs. The adoption of methods for analysis of bias due to uncontrolled confounding has been slow, despite the increasing availability of such methods. Bias analysis for such uncontrolled confound...
Article
Uncontrolled confounders are an important source of bias in epidemiologic studies. The authors review and derive a set of parallel simple formulas for bias factors in the risk difference, risk ratio, and odds ratio from studies with an unmeasured polytomous confounder and a dichotomous exposure and outcome. The authors show how the bias formulas ar...
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Recent work has considerably advanced the definition, identification and estimation of controlled direct, and natural direct and indirect effects in causal mediation analysis. Despite the various estimation methods and statistical routines being developed, a unified approach for effect estimation under different effect decomposition scenarios is st...
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Background: Average treatment effects on the treated (ATT) and the untreated (ATU) are useful when there is interest in: the evaluation of the effects of treatments or interventions on those who received them, the presence of treatment heterogeneity, or the projection of potential outcomes in a target (sub-) population. In this paper we illustrate...
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Identifying the mechanisms behind socioeconomic inequalities in adiposity among youth is vital for efforts aimed at combating these inequalities. The study explored whether a broad range of behavioral and familial factors mediated the associations between parental education and indicators of adiposity among adolescents. Baseline data from a school-...
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Background: In many countries, an increased prevalence of obesity in pregnancy has coincided with a declining pubertal age. We aimed to explore the potential effect of maternal pre-pregnancy overweight and obesity on timing of puberty in sons and daughters. Methods: Between 2012 and 2018, 15 819 of 22 439 invited children from the Danish Nationa...
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Background: Socioeconomic disparities in infant mortality have persisted for decades in high-income countries and may have become stronger in some populations. Therefore, new understandings of the mechanisms that underlie socioeconomic differences in infant deaths are essential for creating and implementing health initiatives to reduce these death...
Article
Purpose Residential mobility is considered as a potential source of confounding in studies assessing environmental exposures, including in studies of electromagnetic field (EMF) exposures and childhood leukemia. Methods We present a hybrid simulation study where we simulate a synthetic dataset based on an existing study and use it to assess the se...
Article
Background Effort‐reward imbalance (ERI) was hypothesized to be associated with ambulatory blood pressure (ABP) and pulse pressure (PP) among female hotel room cleaners. Methods ERI, ABP, and PP were assessed among 419 cleaners from five hotels during 18 waking hours. Adjusted linear regression models were used to assess associations of ERI with A...
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This study assessed factors associated with the perceived dose of intervention received and with the participant satisfaction in a school-based obesity prevention intervention. It also explored the variance in the dose of intervention received that was at the school level. Process evaluation data from a school-based intervention study conducted in...
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There is growing evidence that prenatal participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) reduces the risk of adverse birth outcomes. With recent changes in health care, rising health care costs, and increasing rates of prematurity in the U.S., there is urgency to estimate the potential cost savings a...
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STUDY QUESTION: Does parental fertility, measured by time to pregnancy (TTP), or use of medically assisted reproduction (MAR) affect pubertal development in the offspring? SUMMARY ANSWER: Neither TTP nor type of MAR treatment had clinically relevant implications for mean age at achieving individual pubertal milestones or overall timing of puberty...
Chapter
Introduction: In contrast to body postures during the entire day or during leisure, associations of work postures with acute myocardial infarction (AMI) have not been examined while adjusting for socioeconomic status, leisure time physical activity, fitness, and other CVD risk factors.
Article
Cancer patients are at lower risk of developing Parkinson’s disease (PD) compared with the general population. One explanation is the negative association between smoking and PD, but PD risk is also lower for cancers not related to smoking. Another explanation is survival bias where death from cancer may act as a competing risk. We conducted a larg...
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An optimal learning climate is crucial for the quality of residency training and may also improve residents’ well-being and empathy. We investigated the associations of learning climate with residents’ work-related well-being. A multicenter questionnaire study was performed among 271 surgery and gynaecology residents in 21 training programs from Se...
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Background High levels of work engagement protect against burnout. This can be supported through the work environment and by faculty themselves when they try to improve their work environment. As a result, they can become more engaged and better performers. We studied the relationship between adaptations by physicians to improve their teaching work...
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Background Chronic inflammation and immune activation are reported to play a key role in the etiology of non-Hodgkin lymphoma (NHL). We conducted a meta-analysis on the associations between prediagnosis circulating levels of immune stimulatory markers, interleukin 6 (IL-6), IL-10, tumor necrosis factor α (TNF-α), CXCL13, soluble CD23 (sCD23), sCD27...
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Purpose: To examine the association between residency learning climate and inpatient care experience. Method: The authors analyzed 1,201 evaluations of the residency learning climate (using the Dutch Residency Educational Climate Test questionnaire) and 6,689 evaluations of inpatient care experience (using the Consumer Quality Index Inpatient Ho...
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Introduction: For continuous professional development, it is imperative that physicians regularly receive performance feedback from their peers. Research shows that professionals are more proactive in learning and knowledge sharing with peers in teams with more psychological safety. Psychological safety has however not been studied in relation to...
Article
Purpose: Improving residents' patient safety behavior should be a priority in graduate medical education to ensure the safety of current and future patients. Supportive learning and patient safety climates may foster this behavior. This study examined the extent to which residents' self-reported patient safety behavior can be explained by the lear...
Article
Aims: Studies of environmental exposures and childhood leukemia studies do not usually account for residential mobility. Yet, in addition to being a potential risk factor, mobility can induce selection bias, confounding, or measurement error in such studies. Using data collected for California Powerline Study (CAPS), we attempt to disentangle the...
Article
Objective: This study assessed the change in body mass index (BMI) distribution among 18- or 19-year-olds over 24 years. It also investigated parallel changes in the distribution of birth weight and in the association between birth weight and later risk of overweight and/or obesity. Parental educational variations in the trends and associations we...
Article
PurposeThe Public Mental Health Care (PMHC) system is a network of public services and care- and support institutions financed from public funds. Performance indicators based on the registration of police contacts could be a reliable and useful source of information for the stakeholders of the PMHC system to monitor performance. This study aimed to...
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BACKGROUND: Postgraduate medical education prepares residents for delivery of high quality patient care during training as well as for later practice, which makes high quality residency training programs crucial to safeguard patient care. Healthy learning climates contribute to high quality postgraduate medical education. In several countries, mode...
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Introduction: The improvement of clinical departments’ learning climate is central to achieving high-quality residency training and patient care. However, improving the learning climate can be challenging given its complexity as a multi-dimensional construct. Distinct representations of the dimensions might create different learning climate groups...
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Background: Existing evidence suggests that the prevalence of overweight and obesity among prisoners in different settings is high. Evaluating weight change during incarceration would allow for the investigation of whether the prison environment indeed contributes to unfavourable weight changes. Objectives: This study aimed to do a systematic re...
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Background: This study explores the effects of occupational (OPA) and leisure time physical activity (LTPA) on mortality relative to cardiorespiratory fitness and pre-existing coronary heart disease (CHD). Methods: Associations between OPA, measured as energy expenditure (kcal/day) and relative aerobic workload (%VO2 max), LTPA, and 22-year mort...
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Purpose: To investigate the association between learning climate and adverse perinatal and maternal outcomes in obstetrics-gynecology departments. Method: The authors analyzed 23,629 births and 103 learning climate evaluations from 16 nontertiary obstetrics-gynecology departments in the Netherlands in 2013. Multilevel logistic regressions were u...
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Background A study reported an increased risk of asthma in children whose mothers were exposed to magnetic field (MF) levels above 0.2 μT during pregnancy. We re-examined this association using data from mothers and children in the Danish National Birth Cohort (DNBC). Methods This study included 92,676 singleton-born children and their mothers f...
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Purpose: Physician work engagement is associated with better work performance and fewer medical errors; however, whether work-engaged physicians perform better from the patient perspective is unknown. Although availability of job resources (autonomy, colleague support, participation in decision making, opportunities for learning) bolster work enga...
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Background: Youth with a low socioeconomic position in developed countries are at a disproportionately higher risk of being overweight or obese than their counterparts. Tackling these inequalities requires that the mechanisms behind them are well understood. Objectives: The aim of this review was to summarize existing evidence regarding the fact...
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Hospitalization is a major source of morbidity among patients with ESRD undergoing maintenance hemodialysis and is a significant contributor to health care costs. To identify subgroups at the highest risk of hospitalization, we analyzed by sex, age, and race, adjusting for demographic and clinical characteristics, the hospitalization rates, and 30-...
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Aim: Although birth asphyxia is a major risk factor for neonatal and childhood morbidity and mortality, it has not been investigated much in relation to attention deficit hyperactivity disorder (ADHD). We examined if birth asphyxia measured by the pH of the blood in the umbilical artery cord was associated with childhood ADHD. Method: A populati...
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Background The macro environment we live in projects what we can achieve and how we behave, and in turn, shapes our health in complex ways. Policymaking will benefit from insights into the mechanisms underlying how national socioeconomic context affects health. This study examined the impact of human development on individual health and the possibl...
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Background: Evaluation of patients' health care experiences is central to measuring patient-centred care. However, different instruments tend to be used at the hospital or departmental level but rarely both, leading to a lack of standardization of patient experience measures. Objective: To validate the Consumer Quality Index (CQI) Inpatient Hosp...
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Introduction: Multisource feedback (MSF) instruments are used to and must feasibly provide reliable and valid data on physicians' performance from multiple perspectives. The "INviting Co-workers to Evaluate Physicians Tool" (INCEPT) is a multisource feedback instrument used to evaluate physicians' professional performance as perceived by peers, re...
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Background Partial nephrectomy is considered the preferred care for localized kidney tumors and may yield better patient and kidney survival and similar oncological outcomes compared with radical nephrectomy. We sought to reexamine these hypotheses in a large nationally representative cohort of US veterans who underwent radical or partial nephrecto...
Chapter
The World Health Organization is the global authority on health issues. Since its inception in 1948, it has made large strides in advancing its goal of the highest attainable level of health for all people. Through the years, the organization has faced many setbacks, but it has also marked numerous achievements. The global forces that necessitated...
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Purpose: Cancer and birth defects cluster in families more often than expected by chance, but the reasons are neither well known nor well studied. Methods: From singletons born alive in Denmark between 1 January 1977 and 31 December 2007, we identified children who had no congenital malformations but had a full or half sibling with a congenital...
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Background: Given the increasing international recognition of clinical teaching as a competency and regulation of residency training, evaluation of anesthesiology faculty teaching is needed. The System for Evaluating Teaching Qualities (SETQ) Smart questionnaires were developed for assessing teaching performance of faculty in residency training pr...
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Extended-hours hemodialysis offers substantially longer treatment time compared to conventional hemodialysis schedules and is associated with improved fluid and electrolyte control and favorable cardiac remodeling. However, whether extended-hours hemodialysis improves survival remains unclear. Therefore, we determined the association between extend...
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Background: Acetaminophen (paracetamol) is the most commonly used pain and fever medication during pregnancy, and recently has been linked to hyperactivity and behavioral problems in children. We examine whether prenatal use of acetaminophen affects children's Intelligence Quotient (IQ). Methods: We studied 1,491 mothers and children enrolled in...
Article
Objectives: This study aimed to disentangle the interplay between occupational physical activity (OPA) and leisure-time physical activity (LTPA) in affecting cardiovascular health by examining: (i) interactions between OPA and LTPA and their combined effect on 20-year incidence of acute myocardial infarction (AMI) and (ii) the effect of OPA on AMI...
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Background: It is difficult to evaluate the effectiveness of interventions aimed at reducing early childhood obesity using randomized trials. Objective To illustrate how observational data can be analysed using causal inference methods to estimate the potential impact of behavioural 'interventions' on early childhood adiposity. Methods We used lon...
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Background We previously reported associations between cellphone exposure and emotional and behavioural difficulties in children in the Danish National Birth Cohort using cross-sectional data. To overcome the limitations of cross-sectional analysis, we re-examined these associations with prospectively collected data. Methods Based on maternal repor...
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Purpose: Clinician-supervisors often work simultaneously as doctors and teachers. Supervisors who are more engaged for their teacher work are evaluated as better supervisors. Work engagement is affected by the work environment, yet the role of supervisors' personality traits is unclear. This study examined (i) the impact of supervisors' personalit...
Article
Objectives: It remains unclear whether different types of shift work impose similar risks for cardiovascular events in middle-aged workers, especially those with pre-existing ischaemic heart disease (IHD). This study investigated the relations between different shift types and incident acute myocardial infarction (AMI) among men with and without p...
Article
Numerous studies have reported a protective association between asthma and acute lymphoblastic leukemia (ALL), but the causal structure of this association remains unclear. We present a hybrid simulation to examine the compatibility of this association with uncontrolled confounding by infection or another unmeasured factor. We generated a synthetic...
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Background: A department's learning climate is known to contribute to the quality of postgraduate medical education and, as such, to the quality of patient care provided by residents. However, it is unclear how the learning climate is perceived over time. Objectives: This study investigated whether the learning climate perceptions of residents c...
Article
Background and objectives: In individuals undergoing in-center hemodialysis (HD), use of central venous catheters (CVCs) is associated with worse clinical outcomes compared with use of arteriovenous access. However, it is unclear whether a similar difference in risk by vascular access type is present in patients undergoing home HD. Design, settin...
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It has been previously reported that a higher erythropoiesis stimulating agent (ESA) dose in hemodialysis patients is associated with adverse outcomes including mortality; however the causal relationship between ESA and mortality is still hotly debated. We hypothesize ESA dose indeed exhibits a direct linear relationship with mortality in models of...
Data
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Detailed information on cause of death was obtained from the US Renal Data System (USRDS) “CDeath” codes, which are derived from the ESRD Death Notification Form (CMS-2746) provided by ESRD networks to the USRDS. Cause of death was categorized as cardiovascular, infectious, or others by clinician decision according to these “CDeath” codes.
Article
Home dialysis, which comprises peritoneal dialysis (PD) or home hemodialysis (home HD), offers patients with ESRD greater flexibility and independence. Although ESRD disproportionately affects racial/ethnic minorities, data on disparities in use and outcomes with home dialysis are sparse. We analyzed data of patients who initiated maintenance dialy...
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Background: Although obesity continues to rise and remains a great public health concern in the U.S., a number of important levers such as self-perception of weight and calorie postings at point-of-purchase in restaurants are still not well-characterized in the literature, especially for low-income and minority groups in Los Angeles County (LAC)....
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Antibiotic computerised decision support systems (CDSSs) are shown to improve antibiotic prescribing, but evidence of beneficial patient outcomes is limited. We conducted a prospective cohort study in a 1500-bed tertiary-care hospital in Singapore, to evaluate the effectiveness of the hospital’s antibiotic CDSS on patients’ clinical outcomes, and t...
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Background: Given the amount of time and resources invested in implementing quality programs in hospitals, few studies have investigated their clinical impact and what strategies could be recommended to enhance its effectiveness. Objective: To assess variations in clinical practice and explore associations with hospital- and department-level qua...
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Background: Residents' well-being is essential for both the individual physician and the quality of patient care they deliver. Therefore, it is important to maintain or possibly enhance residents' well-being. We investigated (i) the influence of mind fitness training (MFT) on quality of care-related well-being characteristics: work engagement, emp...
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Background: To examine the association between hospital and clinician obstetric volume and postpartum infection risk in the pre- and postdischarge periods. Methods: We used data from the 2011 New York State Inpatient and Emergency Department Databases to fit generalized estimating equation models to examine the effect of hospital and clinician o...
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This study aimed to investigate the associations of quality management systems with teamwork and safety climate, and to describe and compare differences in perceptions of teamwork climate and safety climate among clinical leaders and frontline clinicians. We used a multi-method, cross-sectional approach to collect survey data of quality managemen...
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Antibiotic computerized decision support systems (CDSSs) were developed to guide antibiotic decisions, yet prescriptions of CDSS-recommended antibiotics have remained low. Our aim was to identify predictors of patients' receipt of empiric antibiotic therapies recommended by a CDSS when the prescribing physician had an initial preference for using b...
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This study investigated whether the relationship between body mass index (BMI) and poor self-rated health differed by sex in low-income countries and middle-income countries. We analyzed data from the World Health Survey (2002-2004) on 160,099 participants from 49 low-income and middle-income countries by using random-intercept multilevel logistic...
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The researchers' assumptions invariably influence research outcomes. This is true for both qualitative and quantitative studies. Assumptions or choices regarding underlying theories, causal relations, study setting and population, sampling strategies, participant non-response, data collection, data analysis, and researchers' perceptions and interpr...