ORCID Profile
0000-0003-3941-0907
Current Organisations
University of Queensland
,
Centers for Disease Control and Prevention
,
Bond University
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Publisher: Springer Science and Business Media LLC
Date: 18-03-2020
DOI: 10.1186/S12942-020-00203-7
Abstract: Ecologic health studies often rely on outcomes from health service utilization data that are limited by relatively coarse spatial resolutions and missing geographic information, particularly neighborhood level identifiers. When fine-scale geographic data are missing, the ramifications and strategies for addressing them are not well researched or developed. This study illustrates a novel spatio-temporal framework that combines a geographic identifier assignment (i.e., geographic imputation) algorithm with predictive Bayesian variable selection to identify neighborhood factors associated with disparities in emergency department (ED) visits for asthma. ED visit records with missing fine-scale spatial identifiers (~ 20%) were geocoded using information from known, coarser, misaligned spatial units using an innovative geographic identifier assignment algorithm. We then employed systematic variable selection in a spatio-temporal Bayesian hierarchical model (BHM) predictive framework within the NIMBLE package in R. Our novel methodology is illustrated in an ecologic case study aimed at identifying neighborhood-level predictors of asthma ED visits in South Carolina, United States, from 1999 to 2015. The health outcome was annual ED visit counts in small areas (i.e., census tracts) with primary diagnoses of asthma (ICD9 codes 493.XX) among children ages 5 to 19 years. We maintained 96% of ED visit records for this analysis. When the algorithm used areal proportions as probabilities for assignment, which addressed differential missingness of census tract identifiers in rural areas, variable selection consistently identified significant neighborhood-level predictors of asthma ED visit risk including pharmacy proximity, average household size, and carbon monoxide interactions. Contrasted with common solutions of removing geographically incomplete records or scaling up analyses, our methodology identified critical differences in parameters estimated, predictors selected, and inferences. We posit that the differences were attributable to improved data resolution, resulting in greater power and less bias. Importantly, without this methodology, we would have inaccurately identified predictors of risk for asthma ED visits, particularly in rural areas. Our approach innovatively addressed several issues in ecologic health studies, including missing small-area geographic information, multiple correlated neighborhood covariates, and multiscale unmeasured confounding factors. Our methodology could be widely applied to other small-area studies, useful to a range of researchers throughout the world.
Publisher: Springer Science and Business Media LLC
Date: 12-2015
DOI: 10.1186/S13054-015-0764-5
Abstract: Corticosteroids are used empirically in influenza A (H1N1) treatment despite lack of clear evidence for effective treatment. This study aims to assess the efficacy of corticosteroids treatment for H1N1 infection. Systematic review and meta-analysis were used to estimate the efficacy of corticosteroids for the prevention of mortality in H1N1 infection. Databases searched included MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Clinical Trials and so on, and bibliographies of retrieved articles, from April 2009 to October 2014. We included both cohort studies and case-control studies reported in English or Chinese that compared treatment effects between corticosteroids and non-corticosteroids therapy in inpatients with H1N1 virus infection. Cohort studies employed mortality as outcome, and case-control studies employed deaths as cases and survivors as controls both were assessed in this meta-analysis. In total twenty-three eligible studies were included. Both cohort studies (nine studies, n = 1,405) and case-control studies (14 studies, n = 4,700) showed a similar trend toward increased mortality (cohort studies relative risk was 1.85 with 95% confidence interval (CI) 1.46 to 2.33 case-control studies odds ratio was 4.22 with 95% CI 3.10 to 5.76). The results from both subgroup analyses and sensitive analyses were consistent with each other, showing that steroid treatment is associated with mortality. However, considering the fact that corticosteroids were tend to be used in sickest case-patients and heterogeneity was observed between studies, we cannot make a solid conclusion. Available evidence did not support the use of corticosteroids as standard care for patients with severe influenza. We conclude that further research is required.
Publisher: University of New South Wales Law Journal
Date: 05-2017
DOI: 10.53637/PHWQ1298
Publisher: MDPI AG
Date: 31-12-2020
Abstract: Asthma in children poses a significant clinical and public health burden. We examined the association between reported neighborhood traffic (a proxy for traffic-related air pollution) and asthma among 855 multi-racial children aged 4–8 years old who participated in the Environmental Influences on Child Health Outcomes (ECHO) cohort. We hypothesized that high neighborhood traffic density would be associated with the prevalence of asthma. Asthma/asthma-like symptoms (defined as current and/or past physician diagnosed asthma, past wheezing, or nighttime cough or wheezing in the past 12 months) was assessed by parental report. The relationship between neighborhood traffic and asthma/asthma-like symptoms was assessed using logistic regression. The prevalence of asthma/asthma-like symptoms among study participants was 23%, and 15% had high neighborhood traffic. Children with significant neighborhood traffic had a higher odds of having asthma/asthma-like symptoms than children without neighborhood traffic [adjusted OR = 2.01 (95% CI: 1.12, 3.62)] after controlling for child’s race-ethnicity, age, sex, maternal education, family history of asthma, play equipment in the home environment, public parks, obesity and prescribed asthma medication. Further characterization of neighborhood traffic is needed since many children live near high traffic zones and significant racial/ethnic disparities exist.
Publisher: Wiley
Date: 28-09-2020
Abstract: Should a defendant to an action in trespass be entitled to a reduction in compensatory damages on the basis of provocation by the claimant? Judges and academic commentators are ided on the issue, although the weight of authority is that, in Australia, New Zealand and the UK, no such reduction is permissible. This article demonstrates that the reasons conventionally offered in support of the current position are unpersuasive, and that a strong moral argument supports the reduction of damages in many commonplace scenarios. However, the article also shows that the continued rejection of provocation might be justified on the grounds that no principled basis exists upon which to preclude its operation in normatively problematic contexts, such as domestic violence and unwanted sexual advances. It is suggested that the best solution would be for the common law to recognise a partial defence of provocation, subject only to certain principled limitations, leaving it to parliament to ‘carve out’ appropriate policy exceptions.
Publisher: Elsevier BV
Date: 11-2020
Publisher: Oxford University Press (OUP)
Date: 10-2018
DOI: 10.1093/EEP/DVY028
Publisher: Springer Science and Business Media LLC
Date: 17-08-2017
Publisher: Springer Science and Business Media LLC
Date: 06-07-2017
DOI: 10.1007/S10661-017-6063-7
Abstract: Neighborhood level air pollution represents a long-standing issue for many communities that, until recently, has been difficult to address due to the cost of equipment and lack of related expertise. Changes in available technology and subsequent increases in community-based participatory research (CBPR) have drastically improved the ability to address this issue. However, much still needs to be learned as these types of studies are expected to increase in the future. To assist, we review the literature in an effort to improve understanding of the motivations, approaches, and outcomes of air monitoring studies that incorporate CBPR and citizen science (CS) principles. We found that the primary motivations for conducting community-based air monitoring were concerns for air pollution health risks, residing near potential pollution sources, urban sprawl, living in "unmonitored" areas, and a general quest for improved air quality knowledge. Studies were mainly conducted using community led partnerships. Fixed site monitoring was primarily used, while mobile, personal, school-based, and occupational s ling approaches were less frequent. Low-cost sensors can enable thorough neighborhood level characterization however, keeping the community involved at every step, understanding the limitations and benefits of this type of monitoring, recognizing potential areas of debate, and addressing study challenges are vital for achieving harmony between expected and observed study outcomes. Future directions include assessing currently unregulated pollutants, establishing long-term neighborhood monitoring sites, performing saturation studies, evaluating interventions, and creating CS databases.
Publisher: Oxford University Press (OUP)
Date: 2018
DOI: 10.1093/OJLS/GQY007
Location: United States of America
Location: United States of America
Location: United States of America
Location: United States of America
Location: United States of America
No related grants have been discovered for Erik Svendsen.