Peter Flom - Academia.edu (original) (raw)
Papers by Peter Flom
The belief that gifted children are more likely to have personality problems than "normal" indivi... more The belief that gifted children are more likely to have personality problems than "normal" individuals is not supported by 'research, but the image of the disturbed gifted child persists. This paper reviews research from a lifespan developmental perspective to examine why this image persists. The paper critically examines the research of L.
The American journal of emergency medicine, Jan 16, 2018
We compare the analgesic efficacy and safety of subdissociative intravenous-dose ketamine (SDK) v... more We compare the analgesic efficacy and safety of subdissociative intravenous-dose ketamine (SDK) versus morphine in geriatric Emergency Department (ED) patients. This was a prospective, randomized, double-blind trial evaluating ED patients aged 65 and older experiencing moderate to severe acute abdominal, flank, musculoskeletal, or malignant pain. Patients were randomized to receive SDK at 0.3 mg/kg or morphine at 0.1 mg/kg by short intravenous infusion over 15 min. Evaluations occurred at 15, 30, 60, 90, and 120 min. Primary outcome was reduction in pain at 30 min. Secondary outcomes included overall rates of adverse effects and incidence of rescue analgesia. Thirty patients per group were enrolled in the study. The primary change in mean pain scores was not significantly different in the ketamine and morphine groups: 9.0 versus 8.4 at baseline (mean difference 0.6; 95% CI -0.30 to 1.43) and 4.2 versus 4.4 at 30 min (mean difference -0.2; 95% CI -1.93 to1.46). Patients in the SDK gr...
The Journal of Infectious Diseases, 2005
AIDS, 2001
In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespre... more In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespread injection of drugs and HIV, 14% reported unprotected anal sex with men in the past year. Independent significant predictors were illegal drug use, having a main partner who takes the lead in deciding what to do during sex, and less self-deception. Having ever had anal sex was associated with having ever been infected with hepatitis B.
This paper examines the relationship between boundary-crossing sexual partnerships (i.e., those b... more This paper examines the relationship between boundary-crossing sexual partnerships (i.e., those between partners who are 5 or more years older, of a different race or ethnicity, or live in a different neighborhood or borough) and use of crack or injected drugs among young adults in Bushwick, Brooklyn. Women who smoked crack or injected drugs were more likely to have a sexual partner who was older, of a different race/ethnicity, or from a different borough than were women who did not use these drugs; men who used these drugs were more likely to have older sex partners than men who did not. Young people who use these drugs are known to be at higher risk of having HIV and a number of other sexually-transmittable infections such as hepatitis B, genital herpes, and syphilis. The results of this paper imply this risk may be even higher for people who cross these these boundaries. In addition, if these young people become infected, they may be particularly likely to serve as a gateway for spreading infection to other social groups.
Sexually Transmitted Diseases, 2001
Sex risks and drug use are related. This relation in youth is described. To determine how stigmat... more Sex risks and drug use are related. This relation in youth is described. To determine how stigmatized drug use is related to sexual risk behaviors and network characteristics among youth. In-person interviews were conducted with both a probability household sample (n = 363) and a targeted, street-recruited sample of cocaine, heroin, crack, or injected drug users (n - 165) comprising 18- to 24-year-olds in an inner city neighborhood. Drug use in the preceding 12 months was scaled hierarchically, lowest to highest social stigma, as none, marijuana, noninjected cocaine, noninjected heroin, crack, and injected drugs. Users of the more stigmatized drugs had more sex partners. They were more likely to report a history of concurrent sex partners, sex with someone who also had engaged in sex with a network member, commercial sex work, and unprotected sex. Findings showed crack use and drug injection to be associated more strongly with increased sex risk among women than among men. Young users of the more stigmatized drugs are at much greater network and behavior risk for sexually transmitted diseases. Drug use prevention, harm reduction interventions, or both may lower this risk.
The Journal of Infectious Diseases, 2005
International Journal of Drug Policy, 2003
Objective: To assess the extent of drug dealing and of non-hostile views towards drug dealing amo... more Objective: To assess the extent of drug dealing and of non-hostile views towards drug dealing among young adults and their peers in an impoverished minority community with considerable drug dealing and use. Methods: A population-representative sample of three hundred and sixty-three 18–24 year olds was interviewed in the Bushwick section of Brooklyn, NY. Questions asked about drug dealing, attitudes to dealing, and friends’ norms toward drug dealing. Results: 16% of men and 4.5% of women dealt drugs in the year prior to the interview. Among the other subjects, 30% of men and 13% of women view dealers in a non-hostile way; 22% of men and 8% of women report close friends have encouraged them to deal drugs; and 30% of men and 50% of women report that all of their close friends would object if they were to deal drugs. Among young women, potentially-traumatic events while growing up, such as sexual or physical abuse and undergoing racial discrimination are associated with less hostile attitudes and friends’ norms towards dealing; as is, for men, undergoing racial discrimination while growing up. Conclusions: In spite of policies based on imprisoning and stigmatising drug dealers and drug users, both drug dealing and non-hostile views towards it remain fairly prevalent among young adults in this community.
AIDS, 2001
In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespre... more In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespread injection of drugs and HIV, 14% reported unprotected anal sex with men in the past year. Independent significant predictors were illegal drug use, having a main partner who takes the lead in deciding what to do during sex, and less self-deception. Having ever had anal sex was associated with having ever been infected with hepatitis B.
Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2005
This article estimates HIV prevalence rates among injection drug users (IDUs) in 95 large US metr... more This article estimates HIV prevalence rates among injection drug users (IDUs) in 95 large US metropolitan areas to facilitate social and policy analyses of HIV epidemics. HIV prevalence rates among IDUs in these metropolitan areas were calculated by taking the mean of two estimates: (1
International Journal of Drug Policy, 2003
Objective: To assess the extent of drug dealing and of non-hostile views towards drug dealing amo... more Objective: To assess the extent of drug dealing and of non-hostile views towards drug dealing among young adults and their peers in an impoverished minority community with considerable drug dealing and use. Methods: A population-representative sample of three hundred and sixty-three 18–24 year olds was interviewed in the Bushwick section of Brooklyn, NY. Questions asked about drug dealing, attitudes to dealing, and friends’ norms toward drug dealing. Results: 16% of men and 4.5% of women dealt drugs in the year prior to the interview. Among the other subjects, 30% of men and 13% of women view dealers in a non-hostile way; 22% of men and 8% of women report close friends have encouraged them to deal drugs; and 30% of men and 50% of women report that all of their close friends would object if they were to deal drugs. Among young women, potentially-traumatic events while growing up, such as sexual or physical abuse and undergoing racial discrimination are associated with less hostile attitudes and friends’ norms towards dealing; as is, for men, undergoing racial discrimination while growing up. Conclusions: In spite of policies based on imprisoning and stigmatising drug dealers and drug users, both drug dealing and non-hostile views towards it remain fairly prevalent among young adults in this community.
Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2004
This article estimates the population prevalence of current injection drug users (IDUs) in 96 lar... more This article estimates the population prevalence of current injection drug users (IDUs) in 96 large US metropolitan areas to facilitate structural analyses of its predictors and sequelae and assesses the extent to which drug abuse treatment and human immunodeficiency virus (HIV) counseling and testing are made available to drug injectors in each metropolitan area. We estimated the total number of current IDUs in the United States and then allocated the large metropolitan area total among large metropolitan areas using four different multiplier methods. Mean values were used as best estimates, and their validity and limitations were assessed. Prevalence of drug injectors per 10,000 population varied from 19 to 173 (median 60; interquartile range 42-87). Proportions of drug injectors in treatment varied from 1.0% to 39.3% (median 8.6%); and the ratio of HIV counseling and testing events to the estimated number of IDUs varied from 0.013 to 0.285 (median 0.082). Despite limitations in the accuracy of these estimates, they can be used for structural analyses of the correlates and predictors of the population density of drug injectors in metropolitan areas and for assessing the extent of service delivery to drug injectors. Although service provision levels varied considerably, few if any metropolitan areas seemed to be providing adequate levels of services.
Geography and Drug Addiction, 2008
Epidemics, behaviors, and programs to change behaviors and ameliorate epidemics are shaped by the... more Epidemics, behaviors, and programs to change behaviors and ameliorate epidemics are shaped by the characteristics of geographically and socially defined communities. This chapter presents the rationale, methods, and selected findings from a study of injection ...
Sexually Transmitted Diseases, 2001
Sex risks and drug use are related. This relation in youth is described. To determine how stigmat... more Sex risks and drug use are related. This relation in youth is described. To determine how stigmatized drug use is related to sexual risk behaviors and network characteristics among youth. In-person interviews were conducted with both a probability household sample (n = 363) and a targeted, street-recruited sample of cocaine, heroin, crack, or injected drug users (n - 165) comprising 18- to 24-year-olds in an inner city neighborhood. Drug use in the preceding 12 months was scaled hierarchically, lowest to highest social stigma, as none, marijuana, noninjected cocaine, noninjected heroin, crack, and injected drugs. Users of the more stigmatized drugs had more sex partners. They were more likely to report a history of concurrent sex partners, sex with someone who also had engaged in sex with a network member, commercial sex work, and unprotected sex. Findings showed crack use and drug injection to be associated more strongly with increased sex risk among women than among men. Young users of the more stigmatized drugs are at much greater network and behavior risk for sexually transmitted diseases. Drug use prevention, harm reduction interventions, or both may lower this risk.
Objectives. To demonstrate the ineffectiveness of some commonly used collinearity diagnostics, an... more Objectives. To demonstrate the ineffectiveness of some commonly used collinearity diagnostics, and present a more effective method which was developed by David Belsley. ^ Methods. Collinearity is a problem in multiple regression when there is a relationship among the independent variables. When collinearity exists, parameter estimates may be incorrect, and their standard errors may be inflated. Some commonly used methods for diagnosing collinearity (e.g. the correlation matrix) are shown to inadequate. A Monte Carlo study of two widely recommended collinearity diagnostics (variance inflation factors and condition indexes) when three conditions were varied. These conditions were the number of IVs (3, 5 or 7), the presence (or absence) of interaction, and degree of collinearity (weak, moderate, or strong) are varied. This 3 x 2 x 3 factorial ANOVA design yielded 18 models, each of which was replicated 1000 times. Each replication was tested for collinearity using 2 diagnostics. ^ Resu...
This paper is written for academics and researchers who don't use LAT E X and wonder why anyo... more This paper is written for academics and researchers who don't use LAT E X and wonder why anyone does. People who do use LATEX (probably all of the readers of the article in this journal) may wish to share the article with their colleagues.
The BrainScope is a hand-held, non-invasive instrument for assessing brain function Use requires ... more The BrainScope is a hand-held, non-invasive instrument for assessing brain function Use requires training, but much less than for using a traditional EEG machine Can be used in emergency rooms, in sports arenas, and on battlefields Peter L. Flom
The scatter plot is a basic tool for presenting information on two continuous variables. While th... more The scatter plot is a basic tool for presenting information on two continuous variables. While the basic plot is good in many situations, enhancements can increase its utility. I also go over tools to deal with the problem of overplotting.
Ordinary least square regression is one of the most widely used statistical methods. However, it ... more Ordinary least square regression is one of the most widely used statistical methods. However, it is a parametric model and relies on assumptions that are often not met. Alternative methods of regression for continuous dependent variables relax these assumptions in various ways. This paper will explore PROCS such as QUANTREG, ADAPTIVEREG and TRANSREG for these data.
Logistic regression may be useful when we are trying to model a categorical dependent variable (D... more Logistic regression may be useful when we are trying to model a categorical dependent variable (DV) as a function of one or more independent variables. This paper reviews the case when the DV has more than two levels, either ordered or not, gives and explains SAS R code for these methods, and illustrates them with examples.
The belief that gifted children are more likely to have personality problems than "normal" indivi... more The belief that gifted children are more likely to have personality problems than "normal" individuals is not supported by 'research, but the image of the disturbed gifted child persists. This paper reviews research from a lifespan developmental perspective to examine why this image persists. The paper critically examines the research of L.
The American journal of emergency medicine, Jan 16, 2018
We compare the analgesic efficacy and safety of subdissociative intravenous-dose ketamine (SDK) v... more We compare the analgesic efficacy and safety of subdissociative intravenous-dose ketamine (SDK) versus morphine in geriatric Emergency Department (ED) patients. This was a prospective, randomized, double-blind trial evaluating ED patients aged 65 and older experiencing moderate to severe acute abdominal, flank, musculoskeletal, or malignant pain. Patients were randomized to receive SDK at 0.3 mg/kg or morphine at 0.1 mg/kg by short intravenous infusion over 15 min. Evaluations occurred at 15, 30, 60, 90, and 120 min. Primary outcome was reduction in pain at 30 min. Secondary outcomes included overall rates of adverse effects and incidence of rescue analgesia. Thirty patients per group were enrolled in the study. The primary change in mean pain scores was not significantly different in the ketamine and morphine groups: 9.0 versus 8.4 at baseline (mean difference 0.6; 95% CI -0.30 to 1.43) and 4.2 versus 4.4 at 30 min (mean difference -0.2; 95% CI -1.93 to1.46). Patients in the SDK gr...
The Journal of Infectious Diseases, 2005
AIDS, 2001
In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespre... more In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespread injection of drugs and HIV, 14% reported unprotected anal sex with men in the past year. Independent significant predictors were illegal drug use, having a main partner who takes the lead in deciding what to do during sex, and less self-deception. Having ever had anal sex was associated with having ever been infected with hepatitis B.
This paper examines the relationship between boundary-crossing sexual partnerships (i.e., those b... more This paper examines the relationship between boundary-crossing sexual partnerships (i.e., those between partners who are 5 or more years older, of a different race or ethnicity, or live in a different neighborhood or borough) and use of crack or injected drugs among young adults in Bushwick, Brooklyn. Women who smoked crack or injected drugs were more likely to have a sexual partner who was older, of a different race/ethnicity, or from a different borough than were women who did not use these drugs; men who used these drugs were more likely to have older sex partners than men who did not. Young people who use these drugs are known to be at higher risk of having HIV and a number of other sexually-transmittable infections such as hepatitis B, genital herpes, and syphilis. The results of this paper imply this risk may be even higher for people who cross these these boundaries. In addition, if these young people become infected, they may be particularly likely to serve as a gateway for spreading infection to other social groups.
Sexually Transmitted Diseases, 2001
Sex risks and drug use are related. This relation in youth is described. To determine how stigmat... more Sex risks and drug use are related. This relation in youth is described. To determine how stigmatized drug use is related to sexual risk behaviors and network characteristics among youth. In-person interviews were conducted with both a probability household sample (n = 363) and a targeted, street-recruited sample of cocaine, heroin, crack, or injected drug users (n - 165) comprising 18- to 24-year-olds in an inner city neighborhood. Drug use in the preceding 12 months was scaled hierarchically, lowest to highest social stigma, as none, marijuana, noninjected cocaine, noninjected heroin, crack, and injected drugs. Users of the more stigmatized drugs had more sex partners. They were more likely to report a history of concurrent sex partners, sex with someone who also had engaged in sex with a network member, commercial sex work, and unprotected sex. Findings showed crack use and drug injection to be associated more strongly with increased sex risk among women than among men. Young users of the more stigmatized drugs are at much greater network and behavior risk for sexually transmitted diseases. Drug use prevention, harm reduction interventions, or both may lower this risk.
The Journal of Infectious Diseases, 2005
International Journal of Drug Policy, 2003
Objective: To assess the extent of drug dealing and of non-hostile views towards drug dealing amo... more Objective: To assess the extent of drug dealing and of non-hostile views towards drug dealing among young adults and their peers in an impoverished minority community with considerable drug dealing and use. Methods: A population-representative sample of three hundred and sixty-three 18–24 year olds was interviewed in the Bushwick section of Brooklyn, NY. Questions asked about drug dealing, attitudes to dealing, and friends’ norms toward drug dealing. Results: 16% of men and 4.5% of women dealt drugs in the year prior to the interview. Among the other subjects, 30% of men and 13% of women view dealers in a non-hostile way; 22% of men and 8% of women report close friends have encouraged them to deal drugs; and 30% of men and 50% of women report that all of their close friends would object if they were to deal drugs. Among young women, potentially-traumatic events while growing up, such as sexual or physical abuse and undergoing racial discrimination are associated with less hostile attitudes and friends’ norms towards dealing; as is, for men, undergoing racial discrimination while growing up. Conclusions: In spite of policies based on imprisoning and stigmatising drug dealers and drug users, both drug dealing and non-hostile views towards it remain fairly prevalent among young adults in this community.
AIDS, 2001
In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespre... more In a population-representative sample of 202 18-24-year-old women in a neighborhood with widespread injection of drugs and HIV, 14% reported unprotected anal sex with men in the past year. Independent significant predictors were illegal drug use, having a main partner who takes the lead in deciding what to do during sex, and less self-deception. Having ever had anal sex was associated with having ever been infected with hepatitis B.
Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2005
This article estimates HIV prevalence rates among injection drug users (IDUs) in 95 large US metr... more This article estimates HIV prevalence rates among injection drug users (IDUs) in 95 large US metropolitan areas to facilitate social and policy analyses of HIV epidemics. HIV prevalence rates among IDUs in these metropolitan areas were calculated by taking the mean of two estimates: (1
International Journal of Drug Policy, 2003
Objective: To assess the extent of drug dealing and of non-hostile views towards drug dealing amo... more Objective: To assess the extent of drug dealing and of non-hostile views towards drug dealing among young adults and their peers in an impoverished minority community with considerable drug dealing and use. Methods: A population-representative sample of three hundred and sixty-three 18–24 year olds was interviewed in the Bushwick section of Brooklyn, NY. Questions asked about drug dealing, attitudes to dealing, and friends’ norms toward drug dealing. Results: 16% of men and 4.5% of women dealt drugs in the year prior to the interview. Among the other subjects, 30% of men and 13% of women view dealers in a non-hostile way; 22% of men and 8% of women report close friends have encouraged them to deal drugs; and 30% of men and 50% of women report that all of their close friends would object if they were to deal drugs. Among young women, potentially-traumatic events while growing up, such as sexual or physical abuse and undergoing racial discrimination are associated with less hostile attitudes and friends’ norms towards dealing; as is, for men, undergoing racial discrimination while growing up. Conclusions: In spite of policies based on imprisoning and stigmatising drug dealers and drug users, both drug dealing and non-hostile views towards it remain fairly prevalent among young adults in this community.
Journal of Urban Health: Bulletin of the New York Academy of Medicine, 2004
This article estimates the population prevalence of current injection drug users (IDUs) in 96 lar... more This article estimates the population prevalence of current injection drug users (IDUs) in 96 large US metropolitan areas to facilitate structural analyses of its predictors and sequelae and assesses the extent to which drug abuse treatment and human immunodeficiency virus (HIV) counseling and testing are made available to drug injectors in each metropolitan area. We estimated the total number of current IDUs in the United States and then allocated the large metropolitan area total among large metropolitan areas using four different multiplier methods. Mean values were used as best estimates, and their validity and limitations were assessed. Prevalence of drug injectors per 10,000 population varied from 19 to 173 (median 60; interquartile range 42-87). Proportions of drug injectors in treatment varied from 1.0% to 39.3% (median 8.6%); and the ratio of HIV counseling and testing events to the estimated number of IDUs varied from 0.013 to 0.285 (median 0.082). Despite limitations in the accuracy of these estimates, they can be used for structural analyses of the correlates and predictors of the population density of drug injectors in metropolitan areas and for assessing the extent of service delivery to drug injectors. Although service provision levels varied considerably, few if any metropolitan areas seemed to be providing adequate levels of services.
Geography and Drug Addiction, 2008
Epidemics, behaviors, and programs to change behaviors and ameliorate epidemics are shaped by the... more Epidemics, behaviors, and programs to change behaviors and ameliorate epidemics are shaped by the characteristics of geographically and socially defined communities. This chapter presents the rationale, methods, and selected findings from a study of injection ...
Sexually Transmitted Diseases, 2001
Sex risks and drug use are related. This relation in youth is described. To determine how stigmat... more Sex risks and drug use are related. This relation in youth is described. To determine how stigmatized drug use is related to sexual risk behaviors and network characteristics among youth. In-person interviews were conducted with both a probability household sample (n = 363) and a targeted, street-recruited sample of cocaine, heroin, crack, or injected drug users (n - 165) comprising 18- to 24-year-olds in an inner city neighborhood. Drug use in the preceding 12 months was scaled hierarchically, lowest to highest social stigma, as none, marijuana, noninjected cocaine, noninjected heroin, crack, and injected drugs. Users of the more stigmatized drugs had more sex partners. They were more likely to report a history of concurrent sex partners, sex with someone who also had engaged in sex with a network member, commercial sex work, and unprotected sex. Findings showed crack use and drug injection to be associated more strongly with increased sex risk among women than among men. Young users of the more stigmatized drugs are at much greater network and behavior risk for sexually transmitted diseases. Drug use prevention, harm reduction interventions, or both may lower this risk.
Objectives. To demonstrate the ineffectiveness of some commonly used collinearity diagnostics, an... more Objectives. To demonstrate the ineffectiveness of some commonly used collinearity diagnostics, and present a more effective method which was developed by David Belsley. ^ Methods. Collinearity is a problem in multiple regression when there is a relationship among the independent variables. When collinearity exists, parameter estimates may be incorrect, and their standard errors may be inflated. Some commonly used methods for diagnosing collinearity (e.g. the correlation matrix) are shown to inadequate. A Monte Carlo study of two widely recommended collinearity diagnostics (variance inflation factors and condition indexes) when three conditions were varied. These conditions were the number of IVs (3, 5 or 7), the presence (or absence) of interaction, and degree of collinearity (weak, moderate, or strong) are varied. This 3 x 2 x 3 factorial ANOVA design yielded 18 models, each of which was replicated 1000 times. Each replication was tested for collinearity using 2 diagnostics. ^ Resu...
This paper is written for academics and researchers who don't use LAT E X and wonder why anyo... more This paper is written for academics and researchers who don't use LAT E X and wonder why anyone does. People who do use LATEX (probably all of the readers of the article in this journal) may wish to share the article with their colleagues.
The BrainScope is a hand-held, non-invasive instrument for assessing brain function Use requires ... more The BrainScope is a hand-held, non-invasive instrument for assessing brain function Use requires training, but much less than for using a traditional EEG machine Can be used in emergency rooms, in sports arenas, and on battlefields Peter L. Flom
The scatter plot is a basic tool for presenting information on two continuous variables. While th... more The scatter plot is a basic tool for presenting information on two continuous variables. While the basic plot is good in many situations, enhancements can increase its utility. I also go over tools to deal with the problem of overplotting.
Ordinary least square regression is one of the most widely used statistical methods. However, it ... more Ordinary least square regression is one of the most widely used statistical methods. However, it is a parametric model and relies on assumptions that are often not met. Alternative methods of regression for continuous dependent variables relax these assumptions in various ways. This paper will explore PROCS such as QUANTREG, ADAPTIVEREG and TRANSREG for these data.
Logistic regression may be useful when we are trying to model a categorical dependent variable (D... more Logistic regression may be useful when we are trying to model a categorical dependent variable (DV) as a function of one or more independent variables. This paper reviews the case when the DV has more than two levels, either ordered or not, gives and explains SAS R code for these methods, and illustrates them with examples.
In ordinary least squares (OLS) regression, we model the conditional mean of the response or depe... more In ordinary least squares (OLS) regression, we model the conditional mean of the response or dependent variable as a function
of one or more independent variables and we make assumptions about the distribution of the errors. But, just as the mean
is not a full description of a distribution, so modeling the mean is not a full description of a relationship between dependent
and independent variables; it may not even be an adequate one. I show how PROC QUANTREG can be used to perform
quantile regression, which models the conditional quantiles, rather than the mean. I also show how both QUANTREG and
ROBUSTREG can be used when the assumptions of OLS regression are violated.