Robert Laforge - Academia.edu (original) (raw)

Papers by Robert Laforge

Drug and Alcohol Dependence, Nov 1, 1990

This study examines the relationship of alcohol consumption and self-reported lifetime prevalence... more This study examines the relationship of alcohol consumption and self-reported lifetime prevalence of hypertension among 19,284 non-institutionalized civilians in the United States. Cross-sectional data from the 1983 National Health Interview Survey, a national probability sample, were examined for each sex separately. Women who report hypertension consumed significantly less alcohol than women who did not report hypertension. Self-reported hypertensive men consumed equal or greater amounts of alcohol than self-reported normotensive men. Alcohol consumption was significantly associated with greater risk of hypertension among men, but not among women. After controlling for other risk factors significant effects for hypertension were found among males who on average consumed more than one drink/day. Beer consumption and spirits consumption above three drinks/day were significant predictors of male hypertension after adjustment for the confounding effects of other alcoholic beverage consumption and other risk factors. This study suggests that alcohol consumption by men who know that they are hypertensive is an important public health concern, with policy implications for targeting prevention efforts.

PubMed, 1996

This article explores the supposition that the efficacy and impact of public health interventions... more This article explores the supposition that the efficacy and impact of public health interventions targeting behavioral and lifestyle factors can be improved by developing interventions that combine scientific advances in behavior change theory with advances in information technology. It is noted that programs of the public health revolution which began during the late 19th century have been based on biomedical theories to guide health promotion efforts for the purpose of increased public health impact. However, developments in behavior change research suggest that it is possible to incorporate behavior change theory into traditional large-scale public health intervention programs. It has been indicated that there is a need to align the field of health promotion and disease prevention with the science of behavior change for the development of theory-based intervention strategies for lifestyle change. The combination of advances in behavioral science and progress in information technologies provides a unique opportunity to enhance the efficacy, reach, and impact of the health promotion programs of the second public health revolution.

Clinical Trials, Jan 26, 2011

Human Nutrition & Metabolism

Journal of American College Health

Behavior, Health, and Aging, 1993

Prevalence rates for alcohol consumption, alcohol problems and stressful life events (SLEs) are p... more Prevalence rates for alcohol consumption, alcohol problems and stressful life events (SLEs) are presented for community hospital inpatients aged 60 to 75 who reported to have drunk alcoholic beverages within the past year. Overall in our initial sample 63% of the elderly that were interviewed reported that they drank alcoholic beverages within the past year. Among a sample of the alcohol drinkers, 26% had scores on the Short Michigan Alcoholism Screening Test \u27suggestive of alcoholism\u27 and 18% had scores \u27positive for alcoholism.\u27 Elderly males typically drank alcoholic beverages more frequently and in greater quantity than did females. More than one-quarter of those elderly male patients who drink scored \u27positive for alcoholism.\u27 The relationship between drinking and SLEs was examined. On average, hospitalized elderly experienced 3.5 stressful life events during the three years prior to admission. Neither alcohol consumption nor alcohol problems were associated with the total number of stressful life events. However, in terms of activities of daily living, among females dependence in bathing or dressing was associated with increased drinking frequency during the past year

University Microfilms International eBooks, 1987

Journal of Dual Diagnosis, 2019

Purpose: The aim of the study was to assess the risk of hepatotoxicity with fluoroquinolone use (... more Purpose: The aim of the study was to assess the risk of hepatotoxicity with fluoroquinolone use (ciprofloxacin, levofloxacin and moxifloxacin) among patients admitted to Veterans Affairs facilities nationally Methods: Matched case control design (time of admission) was utilized among a national cohort of patients admitted to all Veterans Affair facilities between January 1st, 2002 and December 31st, 2008. Conditional logistic regression was used to compute odds ratios and their 95% confidence interval (CI). Multivariate models were built to adjust and control for the potential clinical conditions or covariates that might influence hepatotoxicity risk. A stepwise backward elimination method (non-computer generated) was used to build the final model Results: A total 7,842 patients in case group and 45,512 patients in control group were entered in the final analysis. The mean age of the cases was 58 years and the majority of the patients were males (96%) and were white (59%), followed ...

Circulation: Cardiovascular Quality and Outcomes

Introduction: Dabigatran and Rivaroxaban have shown better or similar efficacy to lower stroke ri... more Introduction: Dabigatran and Rivaroxaban have shown better or similar efficacy to lower stroke risk compared to warfarin in clinical trials. Evidence suggests adherence to cardiac drugs tend to reduce outcomes and cost. Our study is the first to examine the impact of atleast 6 to 12 month adherence to NOACs on ischemic stroke, major bleeding, Deep Vein Thrombosis and Pulmonary Embolism (DVTPE) risk in a propensity score based matched sample. Methods: A retrospective cohort study utilized de-identified data from Optum® Clinformatics™ Data Mart database (OptumInsight, Eden Prairie, MN) (Jan 1, 2010 and Dec 31, 2012). Adult patients with ≥ 1 diagnosis of atrial fibrillation or flutter (ICD9 427.31/32), >1 prescription of NOACs, 6 months pre-index continuous enrollment and CHA2DS2VASC score >1 were included. Adherence was calculated using Proportion of Days Covered (PDC ≥80%) for atleast 6 and 12 months of NOAC use and cohorts (adherent vs. non adherent) were matched on propensity...

Current Medical Research and Opinion

Abstract Objectives: Our study examined the impact of adherence to novel oral anticoagulants [NOA... more Abstract Objectives: Our study examined the impact of adherence to novel oral anticoagulants [NOACs - dabigatran and rivaroxaban] on ischemic-stroke (IS), major-bleeding (MB), deep-vein-thrombosis and pulmonary-embolism (DVTPE) risk in a large, nationwide, propensity-matched sample. Methods: A retrospective cohort study utilized data from a US commercial managed-care database (2010–2012). Adult patients with ≥1 diagnosis of atrial fibrillation/flutter (ICD-9 427.31/32), >1 prescription of NOACs and CHA2DS2-VASc score ≥1 were included. Patients were categorized as adherent versus nonadherent (using proportion of days covered [PDC ≥80%]) based on their NOAC use up to 6 months and those continued its use up to 12 months. The patients were matched using propensity score (based on inverse probability treatment weighting) and the risk of IS, MB, DVTPE outcomes was evaluated for the matched cohorts’ post-adherence (exposure) assessment using multivariable Cox regression. Results: A total of 3,629 and 1,946 patients with at least 6 and 12 months of NOAC use were included. Based on a PDC threshold of ≥80%, adherence rates at 6 and 12 month usage were 77% and 76%, respectively. Patients with lowest adherence were from the South, had low stroke risk and EPO/HMO insurance. Using Cox models with matched cohorts, nonadherence within the first 6 months’ use was significantly associated with higher risk of IS and DVTPE (IS: hazard ratio [HR] = 1.82, p = .002; DVTPE: HR = 2.12, p = .010) and the risk increased with nonadherence for the prolonged period of 12 months’ use (IS: HR = 2.08, p = .022; DVTPE: HR = 5.39, p = .003). The risk of MB was not different (p > .05) between adherent and nonadherent groups for both 6 month and 12 month cohorts. Conclusion: Adherence to NOACs for both 6 months and prolonged use (up to 12 months) was associated with a reduction in IS and DVTPE risk, but did not substantially increase risk of MB. Further studies on newer, individual NOACs and older populations are warranted.

General and comparative endocrinology, May 15, 2017

Steroid hormone analysis in blow (respiratory vapor) may provide a minimally invasive way to asse... more Steroid hormone analysis in blow (respiratory vapor) may provide a minimally invasive way to assess the reproductive status of wild cetaceans. Biological validation of the method is needed to allow for the interpretation of hormone measurements in blow samples. Utilizing samples collected from trained belugas (Delphinapterus leucas, n=20), enzyme immunoassays for testosterone and progesterone were validated for use with beluga blow samples. Testosterone concentrations in 40 matched blood and blow samples collected from 4 male belugas demonstrated a positive correlation (R(2)=0.52, p<0.0001). Progesterone concentrations in 64 matching blood and blow samples from 11 females were also positively correlated (R(2)=0.60, p<0.0001). Testosterone concentrations (mean±SD) in blow samples collected from adult males (119.3±14.2pg/ml) were higher (p<0.01) than that of a juvenile male (<8years) (59.4±6.5pg/ml) or female belugas (54.1±25.7pg/ml). Among adult males, testosterone concen...