Sam Posner

Centers for Disease Control and Prevention | CDC · National Center for Immunization and Respiratory Diseases

Introduction: Rapid growth of the older adult population requires greater epidemiologic characterization of dementia. We developed national prevalence estimates of diagnosed dementia and subtypes in the highest risk U.S. Population: Methods: We analyzed Centers for Medicare & Medicaid administrative enrollment and claims data for 100% of Medic...

We explored how changes in insurance coverage contributed to recent nationwide decreases in newborn circumcision. Hospital discharge data from the 2000-2010 Nationwide Inpatient Sample were analyzed to assess trends in circumcision incidence among male newborn birth hospitalizations covered by private insurance or Medicaid. We examined the impact o...

The 2 articles by Urban and colleagues published this week in Preventing Chronic Disease report 15-year trends in sodium, trans fat, and saturated fat, 3 food components associated with increased risk for cardiovascular disease and obesity, in frequently ordered meal items (French fries, cheeseburgers, grilled chicken sandwiches, and regular cola)...

This is an invited commentary for a special issue on CPPW. In this invited commentary, we review definition frameworks for community health and examine factors having core relevance to shaping the meaning of this term and growing field. We conclude by suggesting a potential framework for conceptualizing and advancing this field of public health pra...

Mixed-method designs are increasingly used in sexually transmitted infection (STI) and HIV prevention research. The authors designed a mixedmethod approach and applied it to estimate and evaluate a predictor of continued female condom use (6+ uses, among those who used it at least once) in a 6-month prospective cohort study. The analysis included 4...

The concluding section of the course will describe tips on how to submit your paper to a journal. It will go over submission requirements, conflicts of interest disclosure, how to write a cover letter, what to expect after submission, how to revise a paper, and reasons why articles are rejected.

This part of the course will focus on the following topics: What an editor looks for in a submission; tips on writing a scientific paper; and how to get started. Under the first topic of this section, Dr. Petersen will cover study design, presentation, and fatal flaws. For tips on writing a scientific paper, Dr. Petersen will go over accuracy, brev...

This section of the course will provide information on how to write a Results section. Dr. Posner will cover the goals and purposes the section, how to prepare tables and figures, tips on clarity for this section, and how to avoid common mistakes for this part. The second half of this time period will be devoted to working with the class members on...

This section of the course will go over how to write an abstract and title. It will go over the importance, structure and goals of an abstract. There will be an exercise on matching the abstract structure with the journal. Dr. Posner will then go over how to title a manuscript, giving good and bad examples of titles.

Individuals with multiple (>2) chronic conditions (MCC) present many challenges to the health care system, such as effective coordination of care and cost containment. To assist health policy makers and to fill research gaps on MCC, we describe state-level variation of MCC among Medicare beneficiaries, with a focus on those with six or more conditi...

Public health and clinical strategies for meeting the emerging challenges of multiple chronic conditions must address the high prevalence of lifestyle-related causes. Our objective was to assess prevalence and trends in the chronic conditions that are leading causes of disease and death among adults in the United States that are amenable to prevent...

Current trends in US population growth, age distribution, and disease dynamics foretell rises in the prevalence of chronic diseases and other chronic conditions. These trends include the rapidly growing population of older adults, the increasing life expectancy associated with advances in public health and clinical medicine, the persistently high p...

We received 45 submissions this year, which was more than 4 times the number of submissions as last year, the contest’s first. The strong response this year reaffirms the primary goal of the contest: to recognize outstanding student research and give students an opportunity to publish their work. The contest also represents PCD’s commitment to prom...

STUDY QUESTION What characteristics are associated with a Day 5 embryo transfer? SUMMARY ANSWER The use of the Day 5 embryo transfer has increased over time, with clinicians allowing women with typically ‘poorer’ prognostic characteristics to undergo a Day 5 embryo transfer. The mean number of embryos per Day 5 transfer decreased from 2001 to 2009...

To compare frequencies of complications among HIV-infected and-uninfected women undergoing common gynecological surgical procedures in inpatient settings. We used 1994-2007 data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project, a nationally representative sample of inpatient hospitalizations. Our analysis included...

Never before has the global population included as many older adults as it does today. Over the past century in the United States alone, the proportion of persons aged 65 years or older increased more than threefold, from 4.1% to 12.9%. This issue of the Journal devoted to “Healthy Aging” opens a dialogue for examining innovative roles for public h...

This study investigated changes in cesarean delivery rate and cesarean indications in 3 county-level hospitals in rural China. Hospital delivery records in 1997 and 2003 were used to examine the reasons behind the changes. In Chengde County Hospital, the cesarean delivery rate increased from 28% in 1997 to 54% in 2003. The rate increased from 43% i...

To describe reproductive health-related visits to Maryland emergency departments (EDs) among women aged 15-44 years from 1999 to 2005. We obtained data from the Healthcare Cost and Utilization Project State Emergency Department Database and State Inpatient Database. ICD-9-CM diagnosis codes were used to classify reproductive health-related visits....

For many decades, early access to prenatal care has been considered the gold standard for improving birth outcomes. In Contra Costa County, a diverse urban and suburban county of over one million people in the San Francisco Bay Area, the Family Maternal and Child Health Programs of Contra Costa Health Services (CCHS) have seen high rates of early e...

To describe poisoning hospitalisations among reproductive-aged women from 1998 to 2006. 1998-2006 data from the Nationwide Inpatient Sample of the Healthcare Cost and Utilisation Project were used to identify hospitalisations for poisonings among US women aged 15-44 years. Differences in hospitalisation characteristics were compared by intent using...

We describe hospitalization trends of invasive pneumococcal disease (IPD) among HIV-infected adolescents and adults since the introduction of highly active antiretroviral therapy (HAART) and the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States, using the nation-wide inpatient sample. We estimated national trends of IPD hospitaliz...

Researchers have begun looking at joint responsibility for contraceptive decision making as a mechanism to increase effective contraceptive use. This analysis identifies correlates of partner involvement in contraceptive decision making. Participants were first-time users of either oral contraceptives or Depo-Provera recruited from 10 family planni...

We describe hospitalization trends of invasive pneumococcal disease (IPD) among human immunodeficiency virus-infected individuals <25 years of age since the introduction of highly active antiretroviral therapy (HAART) and the 7-valent pneumococcal conjugate vaccine (PCV7) in the United States, using the Nationwide Inpatient Sample. We estimated nat...

To examine trends in the prevalence of diabetes among delivery hospitalizations in the U.S. and to describe the characteristics of these hospitalizations. Hospital discharge data from 1994 through 2004 were obtained from the Nationwide Inpatient Sample. Diagnosis codes were selected for gestational diabetes mellitus (GDM), type 1 diabetes, type 2 d...

We sought to examine rates of birth trauma in 2 groupings (all International Classification of Diseases, Ninth Revision codes for birth trauma, and as defined by the Agency for Healthcare Research and Quality Patient Safety Indicator [PSI]) among infants born by vaginal and cesarean delivery. Data on singleton infants were obtained from the 2004-20...

OBJECTIVE:: To examine trends in the rates of severe obstetric complications and the potential contribution of changes in delivery mode and maternal characteristics to these trends. METHODS:: We performed a cross-sectional study of severe obstetric complications identified from the 1998-2005 Nationwide Inpatient Sample of the Healthcare Cost and Ut...

To compare maternal and fetal outcomes among women with and without diagnosed depression at the time of delivery. Hospital discharge data from the 1998-2005 Nationwide Inpatient Sample (NIS) were used to examine delivery-related hospitalizations for select maternal and fetal outcomes by depression diagnosis. The rate of depression per 1000 deliveri...

Psychiatric illnesses commonly co-occur with HIV infection and such illnesses have been linked to women's poorer medication adherence and suicide. Using hospital discharge data from the 1994-2004 Nationwide Inpatient Sample, we conducted this study to describe hospitalizations with psychiatric diagnoses from 1994 through 2004 and evaluate the assoc...

The prevalence of diabetes in the United States is rising. As HIV-infected people live longer, they become more susceptible to chronic diseases such as diabetes. Additionally, some antiretroviral agents have been linked to impaired glucose tolerance and increased diabetes risk. To estimate the burden and trends of diabetes among hospitalized HIV-in...

To examine trends in the rates of severe obstetric complications and the potential contribution of changes in delivery mode and maternal characteristics to these trends. We performed a cross-sectional study of severe obstetric complications identified from the 1998-2005 Nationwide Inpatient Sample of the Healthcare Cost and Utilization Project. Log...

Studies designed to evaluate HIV and STD prevention interventions often involve random assignment of groups such as neighborhoods or communities to study conditions (e.g., to intervention or control). Investigators who design group-randomized trials (GRTs) must take the expected intraclass correlation coefficient (ICC) into account in sample size e...

The purpose of this study was to describe trends in the prevalence of eating disorders among delivery hospitalizations in the United States from 1994 to 2004 and to compare hospital, demographic, and obstetrical outcomes among women with and without eating disorders. Hospital discharge data for 1994 to 2004 from the Nationwide Inpatient Sample (NIS...

To frame the discussion of the nation's health within the context of maternal and child health. We used national data or estimates to assess the burden of 46 determinants. During 2002-2004, U.S. women of reproductive age experienced significant challenges from macrosocial determinants, to health care access, and to their individual health preservat...

Improving preconception health is recognized as being crucial to improving reproductive health outcomes for women and infants. At the same time, there is increasing pressure on public health and clinical medicine programs to have evidence that documents positive health impact for continued support for program implementation and policy change. In th...

To evaluate effects of a 6-month social marketing campaign on awareness of, attitudes toward and use of female as well as male condoms for 15-25 year-old-women. Using a time-space sampling methodology, we conducted a cross-sectional survey of 3407 women at pre-campaign in 12 western U.S. neighborhoods on female and male condom awareness, attitudes,...

To examine trends in pregnancy hospitalizations with a diagnosis of amphetamine or cocaine abuse and the prevalence of associated medical complications. Data were obtained from the Nationwide Inpatient Sample. Hospitalization ratios per 100 deliveries for amphetamine or cocaine abuse from 1998 to 2004 were tested for linear trends. Amphetamine-abus...

In 2006, CDC published recommendations to improve health and health care for women before pregnancy and between pregnancies (CDC. Recommendations to improve preconception health and health care--United States: a report of the CDC/ATSDR Preconception Care Work Group and the Select Panel on Preconception Care. MMWR 2006;55[No. RR-6]). The Pregnancy R...

Background: Although hysterectomy is one of the most common surgical procedures in women, few studies have examined hysterectomy in HIV-infected women. The objective of the current study was to compare hospitalization characteristics and indications for hysterectomy in HIV-infected women and HIV-uninfected women. Methods: We utilized data from the...

Objective To examine trends in pregnancy hospitalizations with a diagnosis of illicit stimulant (cocaine or amphetamine) abuse and the prevalence of associated medical conditions. Methods Data were obtained from the Nationwide Inpatient Sample. Hospitalization ratios per 100 deliveries for illicit stimulant abuse from 1998 to 2004 were tested for...

Preterm birth (PTB), <37 weeks gestation, occurs in 12.1% of live births annually and is associated with significant morbidity and mortality in the United States. Racial/ethnic subgroups are disproportionately affected by PTB. Michigan is home to one of the largest Arab-American communities in the country; however, little is known about PTB in this...

The accuracy of maternal morbidity estimates from hospital discharge data may be influenced by incomplete identification of deliveries. In maternal/infant health studies, obstetric deliveries are often identified only by the maternal outcome of delivery code (International Classification of Diseases code = V27). We developed an enhanced delivery id...

The objective of this study was to describe trends in hospital use by HIV-infected children and adolescents in the United States in the 10 years from 1994 (before highly active antiretroviral therapy) to 2003 (widespread use of highly active antiretroviral therapy). Data from the Nationwide Inpatient Sample database were used. The most frequent dia...

Pregnant women and infants have unique health concerns in the aftermath of a natural disaster such as Hurricane Katrina. Although exact numbers are lacking, we estimate that approximately 56,000 pregnant women and 75,000 infants were directly affected by the hurricane. Disruptions in the supply of clean water for drinking and bathing, inadequate ac...

The purpose of this study was to describe hospital use patterns of children with sickle cell disease (SCD) and human immunodeficiency virus type-1 (HIV) infection in the United States. Hospital discharges of children with 1 or both of the 2 conditions (SCD and HIV infection) were analyzed using nationally weighted data from the 1994 to 2003 Nationw...

We conducted a 6-month acceptability study of diaphragms as a potential HIV/STI prevention method among Zimbabwean women. We examined partner involvement in diaphragm use, and importance of discreet use (use without partner awareness). Of the 181 women who completed the study, 45% said discreet use was "very or extremely important" and in multivari...

Highly active antiretroviral therapy (HAART) has improved the outlook of HIV-infected patients, but it has several side effects, particularly when it is used during pregnancy. Prior to the advent of HAART, HIV-infected women were at increased risk for adverse pregnancy outcomes. This report describes hospital use among pregnant HIV-infected women i...

To describe trends in hospitalizations with a diagnosis of substance abuse among reproductive-age women from 1998-2003. Data were obtained from the Healthcare Cost and Utilization Project Nationwide Inpatient Sample. Hospitalizations with a diagnosis of substance abuse were categorized into subgroups by age, primary expected payer, substance-specif...

To estimate the number of injury-related hospitalizations of pregnant women in the United States and to identify injury mechanisms associated with hospitalizations that end in delivery. Using data on injury hospitalizations of pregnant women from the 2002 Healthcare Cost and Utilization Project Nationwide Inpatient Sample, we compared the mechanism...

This study assessed the contraceptive outcomes of the Partners Against Risk-Taking: A Networking, Evaluation and Research Study (PARTNERS). The PARTNERS project developed and evaluated a 3-session intervention to help young women and their male partners reduce their risk for unintended pregnancies, and HIV and other STDs. Participating couples were...

Most studies of peripartum hysterectomy are conducted in single institutions, limiting the ability to provide national incidence estimates and examine risk factors. The objective of this study was to provide a national estimate of the incidence of peripartum hysterectomy and to examine factors associated with the procedure. We used data for 1998-20...

Women in sex work stand to benefit if the contraceptive diaphragm alone or combined with a microbicide proves to be an effective barrier method against HIV and sexually transmissible infection (STI). Currently, contraceptive diaphragm users are advised to leave the diaphragm in situ without concomitant use of other intravaginal substances for at le...

Women in later stages of pregnancy are at increased risk for serious influenza-related morbidity; thus, universal influenza vaccination of pregnant women is recommended. However, vaccine uptake in the United States has been suboptimal. We previously described the burden of severe influenza-related morbidity during pregnancy in the United States by...

The literature on whether HIV infection and its complex antiretroviral treatments confer a higher risk for adverse pregnancy outcomes is controversial. We compared rates of hospitalization for select morbidities among HIV-infected and uninfected pregnant women in the USA. Using data from the 1994-2003 Nationwide Inpatient Sample, we used descriptiv...

To examine the proportion of women who received information on genetic screening among those who had prenatal care and to determine whether the proportion varied by maternal characteristics. We used self-reported data from the Pregnancy Risk Assessment Monitoring System (PRAMS), a population-based survey of recent mothers, for birth years 2000-2002...

Information regarding the type and scope of preconception care programs in the United States is scant. We evaluated State Title V measurement and indicator data and abstracts presented at the National Summit on Preconception Care (June 2005) in order to identify existing programs and innovative strategies for preconception health promotion. We used...

The Centers for Disease Control and Prevention (CDC) and 35 partner organizations have engaged in developing an agenda for Preconception Health. A summit was held in June 2005 to discuss the current state of knowledge regarding preconception care and convene a select panel to develop recommendations and action steps for improving the health of wome...

The purpose of this research was to describe hospital use patterns of HIV-infected children in the United States. We analyzed a nationwide, stratified probability sample of 2.5 million hospital discharges of children and adolescents during the year 2000, weighted to 7.3 million discharges nationally. We excluded discharges after hospitalizations re...

To examine hospitalizations with respiratory illness among pregnant women in the United States during periods of influenza activity. Data were obtained from the Healthcare Cost and Utilization Project National Inpatient Sample (NIS), the largest publicly available all-payer hospital discharge database. Hospitalizations for respiratory illness and p...

This report provides recommendations to improve both preconception health and care. The goal of these recommendations is to improve the health of women and couples, before conception of a first or subsequent pregnancy. Since the early 1990s, guidelines have recommended preconception care, and reviews of previous studies have assessed the evidence f...

Hormonal contraceptive users may be at increased risk for HIV and other STDs. An understanding of their decisions and abilities to use condoms is needed to focus intervention programs aimed at improving their protective behaviors. Between 1999 and 2001, 426 new users of depot medroxyprogesterone acetate (DMPA) and oral contraceptives were recruited...

Problems with measuring socioeconomic status (SES)-frequently included in clinical and public health studies as a control variable and less frequently as the variable(s) of main interest-could affect research findings and conclusions, with implications for practice and policy. We critically examine standard SES measurement approaches, illustrating...

In Zimbabwe, adult HIV prevalence is over 25% and acceptable prevention methods are urgently needed. Sixty-eight Zimbabwean women who had completed a barrier-methods study and 34 of their male partners participated in focus group discussions and in-depth interviews to qualitatively explore acceptability of male condoms, female condoms and diaphragm...

The objective of this analysis was to assess the effect of introducing the diaphragm on condom use patterns. Participants included one hundred eighty-nine women attending family planning clinics in Harare, Zimbabwe who reported less than 100% condom use. The proportion of acts where at least one method was used significantly increased over using fo...

National estimates listing. List of countries for which national MMRs were identified through the systematic review, and for each country, the ratio, period of time to which the estimate refers and the study design.

CONTEXT: Hormonal contraceptive users may be at increased risk for HIV and other STDs. An understanding of their decisions and abilities to use condoms is needed to focus intervention programs aimed at improving their protective behaviors.METHODS: Between 1999 and 2001, 426 new users of depot medroxyprogesterone acetate (DMPA) and oral contraceptiv...

EDITORIAL

Background: To describe national hospital utilization patterns associated with HIV infection in children in the United States. Methods: We analyzed a nationwide and stratified probability sample of 1.3 million hospital discharges from the year 2000 KID database of children and adolescents aged 1 month to 18 years, weighted to 2.5 million discharges...

Despite the worldwide commitment to improving maternal health, measuring, monitoring and comparing maternal mortality estimates remain a challenge. Due to lack of data, international agencies have to rely on mathematical models to assess its global burden. In order to assist in mapping the burden of reproductive ill-health, we conducted a systemati...

This study evaluated Amsel's criteria, the FemExam card and pH plus amine methods for the diagnosis of bacterial vaginosis (BV) in a resource-poor setting. Two hundred Azerbaijani women participated in a study about reproductive health that included a gynaecological examination and an interviewer-administered survey. Using the WHO syndromic diagnos...

Women who are the most vulnerable to sexually transmitted diseases/HIV are often unable to consistently use condoms. One potential alternative method currently under investigation is the diaphragm. The goals of this study were to assess diaphragm uptake and use over time in Zimbabwe and to identify factors associated with self-reported consistent d...

Despite the availability of condoms and theoretically based interventions to promote their use, sexually active women aged 15 to 25 years continue to put themselves at risk for sexually transmitted diseases and unintended pregnancy. One hundred ninety-eight inner city women were interviewed about knowledge and attitudes about condoms. Using the Tra...

Background: Prenatal screening for chromosomalabnormalities is routinely offered to allpregnant women who present for care by their20th gestational week. Not all women,however, choose to undergo one of these tests,and choice of which test(s) to undergo alsovary. The reasons for variation in screeningtest behavior have not been fully explored.Method...

Despite availability for a decade and documented acceptability among some groups of women for the method, female condom use is still rare. We surveyed 198 young women (15-25 years old) living in the inner city of Denver about their knowledge of, attitudes toward, and practices regarding female and male condoms. Most (75%) women had ever considered...

The United Nations High Commissioner on Refugees (UNHCR) and United Nations Children's Fund (UNICEF) policy encourages foster care during refugee emergencies. We examined evidence to support this policy using data from the 1994 Rwandan refugee crisis. The association of weight gain and acute illness with family status (foster children vs children l...