allard dembe - Academia.edu (original) (raw)

Papers by allard dembe

Journal of Occupational & Environmental Medicine, 2016

Objectives: This study aims at evaluating the chronic disease risk related to prolonged work in l... more Objectives: This study aims at evaluating the chronic disease risk related to prolonged work in long-hour schedules for eight major chronic diseases: heart disease, non-skin cancer, arthritis, diabetes, chronic lung disease, asthma, chronic depression, and hypertension. Methods: The study used data from the National Longitudinal Survey of Youth, 1979 covering 32 years of job history (1978 to 2009) for 7492 respondents. Logistic regression analyses were performed to test the relationship between average weekly work hours, and the reported prevalence of those conditions for each individual. Results: Regularly working long hours over 32 years was significantly associated with elevated risks of heart disease, non-skin cancer, arthritis, and diabetes. The observed risk was much larger among women than among men. Conclusions: Working long-hour schedules over many years increases the risk for some specific chronic diseases, especially for women.

Occupational and Environmental Medicine, 2005

To analyse the impact of overtime and extended working hours on the risk of occupational injuries... more To analyse the impact of overtime and extended working hours on the risk of occupational injuries and illnesses among a nationally representative sample of working adults from the United States. Methods: Responses from 10 793 Americans participating in the National Longitudinal Survey of Youth (NLSY) were used to evaluate workers' job histories, work schedules, and occurrence of occupational injury and illness between 1987 and 2000. A total of 110 236 job records were analysed, encompassing 89 729 person-years of accumulated working time. Aggregated incidence rates in each of five exposure categories were calculated for each NLSY survey period. Multivariate analytical techniques were used to estimate the relative risk of long working hours per day, extended hours per week, long commute times, and overtime schedules on reporting a work related injury or illness, after adjusting for age, gender, occupation, industry, and region. Results: After adjusting for those factors, working in jobs with overtime schedules was associated with a 61% higher injury hazard rate compared to jobs without overtime. Working at least 12 hours per day was associated with a 37% increased hazard rate and working at least 60 hours per week was associated with a 23% increased hazard rate. A strong dose-response effect was observed, with the injury rate (per 100 accumulated worker-years in a particular schedule) increasing in correspondence to the number of hours per day (or per week) in the workers' customary schedule. Conclusions: Results suggest that job schedules with long working hours are not more risky merely because they are concentrated in inherently hazardous industries or occupations, or because people working long hours spend more total time ''at risk'' for a work injury. Strategies to prevent work injuries should consider changes in scheduling practices, job redesign, and health protection programmes for people working in jobs involving overtime and extended hours.

The RAND Corporation is a nonprofit research organization providing objective analysis and effect... more The RAND Corporation is a nonprofit research organization providing objective analysis and effective solutions that address the challenges facing the public and private sectors around the world. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors. R ® is a registered trademark.

Objectives. Research suggests that inmate populations are at a significant risk for STD infection... more Objectives. Research suggests that inmate populations are at a significant risk for STD infection while incarcerated and when inmates are released, that risk extends to the community beyond. This study presents the results of a pilot study examining the process of identifying HIV and other STDs among inmates prior to release from a state prison and documents the self-reported prevalence of STD-related risk behaviors during incarceration. Methods. Approximately 4-6 weeks prior to scheduled release, inmates took part in a mandatory blood test and optional genital swab and physical exam to test for STDs. Rates of pre-release identification of STDs were compared with identification rates at intake into the prison and among those tested for cause during their prison term. At the time of pre-release testing, a behavioral risk and STD knowledge survey was also administered. Results. Pre-release testing identified 50 new cases of STDs among the 916 inmates scheduled for release during the p...

Journal of occupational and environmental medicine / American College of Occupational and Environmental Medicine, 2014

This study examines the effect of taking a health risk assessment (HRA) on health care costs, uti... more This study examines the effect of taking a health risk assessment (HRA) on health care costs, utilization, and member health risks over a 3-year period. This retrospective cohort study examined changes utilization, costs, and health risks among a random sample of 500 employees completing an HRA compared with a matched group of 500 employees who did not complete an HRA. The HRA group accessed services more frequently and at a lower overall cost, was more likely to utilize primary care and preventive services after the HRA, and improved on seven out of eight health risk measures. This study demonstrates that significant and sustained improvement in health risks and lower health care costs may be achievable with efforts such as an HRA that seeks to engage employees in health improvement efforts.

Journal of Urban Health, 2011

This study presents the results of a pilot study of mandatory pre-release testing for sexually tr... more This study presents the results of a pilot study of mandatory pre-release testing for sexually transmitted disease (STD) and a behavioral risk survey for male inmates at an Ohio prison. Approximately 4-6 weeks prior to scheduled release, inmates took part in a mandatory blood test and optional genital swab and physical examination to test for STDs. At the time of testing, a voluntary behavioral and knowledge survey was administered to inmates. Pre-release testing identified 53 new cases of STDs among the 916 inmates (5.5%) scheduled for release during the pilot study period. Trichomoniasis and hepatitis C were the most common infections identified through pre-release testing. Nearly all inmates participated in the required blood test. Participation rates for the other testing methods averaged less than 45%. Inmates reported engaging in various risky behaviors during incarceration such as having sex (12.1%), tattooing (36.5%), and drug use (19.5%). Pre-release testing identified several new cases of STDs not identified through existing intake and for-cause testing procedures. Substantial useful information about the prevalence of STD risk behaviors can be obtained through a pre-release survey.

BMC Health Services Research, 2011

Background: This study aims to identify the statistical software applications most commonly emplo... more Background: This study aims to identify the statistical software applications most commonly employed for data analysis in health services research (HSR) studies in the U.S. The study also examines the extent to which information describing the specific analytical software utilized is provided in published articles reporting on HSR studies. Methods: Data were extracted from a sample of 1,139 articles (including 877 original research articles) published between 2007 and 2009 in three U.S. HSR journals, that were considered to be representative of the field based upon a set of selection criteria. Descriptive analyses were conducted to categorize patterns in statistical software usage in those articles. The data were stratified by calendar year to detect trends in software use over time. Results: Only 61.0% of original research articles in prominent U.S. HSR journals identified the particular type of statistical software application used for data analysis. Stata and SAS were overwhelmingly the most commonly used software applications employed (in 46.0% and 42.6% of articles respectively). However, SAS use grew considerably during the study period compared to other applications. Stratification of the data revealed that the type of statistical software used varied considerably by whether authors were from the U.S. or from other countries. Conclusions: The findings highlight a need for HSR investigators to identify more consistently the specific analytical software used in their studies. Knowing that information can be important, because different software packages might produce varying results, owing to differences in the software's underlying estimation methods.

American Journal of Industrial Medicine, 2011

Many authorities are concerned about the rising use and the potential overuse of opioid pain medi... more Many authorities are concerned about the rising use and the potential overuse of opioid pain medications. A study of opioid prevalence and dosage in Ohio&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s workers&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; compensation (WC) system was conducted, with comparisons made to opioid use in other WC and non-WC settings. Systematic literature reviews of WC and non-WC opioid use and dosage nationally were conducted. Two years of Ohio WC data (2008-2009) were analyzed to determine average daily morphine equivalent dose (MED), opioid costs, pharmacies used per claimant, and extent of long-duration cases. Nearly one-fifth (19.2%) of Ohio WC claims involved opioid use, compared to 31.8% in other WC systems and 17.9% in non-WC settings. Mean MED was 57.5 mg, compared to 47.8 mg in other WC systems, and 41.8 mg among non-WC populations. Nearly 10% of WC claims involved relatively high MED exceeding 120 mg/day. Policy makers need to develop strategies for addressing high opioid use in WC systems.

Scandinavian Journal of Work, Environment & Health, 2006

Objectives This study assessed the extent to which working various types of nonstandard shift sch... more Objectives This study assessed the extent to which working various types of nonstandard shift schedules (eg, night and evening shifts) is associated with the risk of occupational injuries or illnesses. Methods Multivariate analyses were conducted using data from 13 years (1987 to 2000) of the National Longitudinal Survey of Youth (NLSY) encompassing 110 236 job records and over 82 000 person-years of work experience. Cox proportional hazard regression techniques were used to derive hazard ratios comparing the relative risk of suffering a work-related injury among people working night, evening, rotating, split, and irregular shifts to the risks for those working conventional day shifts, after adjustment for age, gender, occupation, industry, and region. Incidence rates were normalized using a common denominator of 100 personyears of "at-risk time" to obtain valid comparisons. Results All of the nonstandard shift schedules, except split shifts, were found to have a higher risk for occupational injuries and illnesses than conventional day shifts. After control for the selected covariates, the calculated hazard ratios were 1.43 for evening shifts [95% confidence interval (95% CI) 1.26-1.62], 1.36 for rotating shifts (95% CI 1.17-1.58), 1.30 for night shifts (95% CI 1.12-1.52), 1.15 for irregular shifts (1.03-1.30), and 1.06 for split shifts (0.71-1.58). Conclusions These findings suggest that nonstandard shifts are not more risky merely because of the concentration of hazardous jobs in those types of schedules or because of underlying differences in the characteristics of employees working nonstandard shifts. The results point to the need to extend targeted injury prevention programs not only to people working night shifts, but also to those who work evenings.

Evaluation & the Health Professions, 2013

Increasing emphasis is being placed on measuring return on research investment and determining th... more Increasing emphasis is being placed on measuring return on research investment and determining the true impacts of biomedical research for medical practice and population health. This article describes initial progress on development of a new standardized tool for identifying and measuring impacts across research sites. The Translational Research Impact Scale (TRIS) is intended to provide a systematic approach to assessing impact levels using a set of 72 impact indicators organized into three broad research impact domains and nine subdomains. A validation process was conducted with input from a panel of 31 experts in translational research, who met to define and standardize the measurement of research impacts using the TRIS. Testing was performed to estimate the reliability of the experts’ ratings. The reliability was found to be high (ranging from .75 to .94) in all of the domains and most of the subdomains. A weighting process was performed assigning item weights to the individual...