Medicine and Health Sciences Commons^™

Conflict Translates Environmental And Social Risk Into Business Costs, Daniel M. Franks, Rachel Davis, Anthony J. Bebbington, Saleem H. Ali, Deanna Kemp, Martin Scurrah

Faculty Publications

Sustainability science has grown as a field of inquiry, but has said little about the role of large-scale private sector actors in socio-ecological systems change. However, the shaping of global trends and transitions depends greatly on the private sector and its development impact. Market-based and command-and-control policy instruments have, along with corporate citizenship, been the predominant means for bringing sustainable development priorities into private sector decision-making. This research identifies conflict as a further means through which environmental and social risks are translated into business costs and decision making. Through in-depth interviews with finance, legal, and sustainability professionals in the extractive …

Primary Care And Youth Mental Health In Ireland: Qualitative Study In Deprived Urban Areas, Dorothy Leahy, Elisabeth Schaffalitzky, Claire Armstrong, Gerard Bury, Paula Cussen-Murphy, Rachel Davis, Barbara Dooley, Blanaid Gavin, Rory Keane, Eamon Keenan, Linda Latham, David Meagher, Pat Mcgorry, Fiona Mcnicholas, Ray O'Connor, Ellen O'Dea, Veronica O'Keane, Tom P. O'Toole, Edel Reilly, Patrick Ryan, Lena Sanci, Bobby P. Smyth, Walter Cullen

Faculty Publications

BACKGROUND: Mental disorders account for six of the 20 leading causes of disability worldwide with a very high prevalence of psychiatric morbidity in youth aged 15-24 years. However, healthcare professionals are faced with many challenges in the identification and treatment of mental and substance use disorders in young people (e.g. young people's unwillingness to seek help from healthcare professionals, lack of training, limited resources etc.) The challenge of youth mental health for primary care is especially evident in urban deprived areas, where rates of and risk factors for mental health problems are especially common. There is an emerging consensus that …

Patients’ Attitudes Towards Patient Involvement In Safety Interventions: Results Of Two Exploratory Studies, Rachel Davis, Nick Sevdalis, Anna Pinto, Ara Darzi, Charles A. Vincent

Faculty Publications

BACKGROUND: In recent years, patient-focused interventions have been introduced aimed at increasing patient involvement in safety-related behaviours. However, patients' attitudes towards these interventions and comfort in participating in the recommended behaviours remain largely unexplored. OBJECTIVE: To evaluate patients' attitudes towards a video and leaflet aimed at encouraging patient involvement in safety-related behaviours. DESIGN: Two exploratory studies employing a within-subjects mixed-methods design. SETTING: Six hospital wards on an inner-city London teaching hospital. PARTICIPANTS: Medical and surgical inpatients: 80 patients in study 1 (mean age 55; 69% men) and 80 patients in study 2 (mean age 52; 60% men). INTERVENTION: Patients watched …

Creating A Gold Medal Olympic And Paralympics Health Care Team: A Satisfaction Survey Of The Mobile Medical Unit/Polyclinic Team Training For The Vancouver 2010 Winter Games, D Ross Brown, Behrouz Heidary, Nathaniel Bell, Leanne Appleton, Richard K. Simons, David C. Evans, S Morad Hameed, Jack Taunton, Kosar Khwaja, Michael O'Connor, Naisan Garraway, Peter Hennecke, Donna Kuipers, Tracey Taulu, Lori Quinn

Faculty Publications

BACKGROUND:

The mobile medical unit/polyclinic (MMU/PC) was an essential part of the medical services to support ill or injured Olympic or Paralympics family during the 2010 Olympic and Paralympics winter games. The objective of this study was to survey the satisfaction of the clinical staff that completed the training programs prior to deployment to the MMU.

METHODS:

Medical personnel who participated in at least one of the four training programs, including (1) week-end sessions; (2) web-based modules; (3) just-in-time training; and (4) daily simulation exercises were invited to participate in a web-based survey and comment on their level of satisfaction …

Confronting Myths About Household Food Insecurity And Excess Weight, Edward A. Frongillo Jr.

Faculty Publications

No abstract provided.

A Two-Stage Cluster Sampling Method Using Gridded Population Data, A Gis, And Google Earth(Tm) Imagery In A Population-Based Mortality Survey In Iraq, Lp Galway, Nathaniel Bell, Al Shatari Sae, Amy Hagopian, Gilbert Burnham, Abraham Flaxman, Wiliam M. Weiss, Julie Rajaratnam, Tim K. Takaro

Faculty Publications

BACKGROUND:

Mortality estimates can measure and monitor the impacts of conflict on a population, guide humanitarian efforts, and help to better understand the public health impacts of conflict. Vital statistics registration and surveillance systems are rarely functional in conflict settings, posing a challenge of estimating mortality using retrospective population-based surveys.

RESULTS:

We present a two-stage cluster sampling method for application in population-based mortality surveys. The sampling method utilizes gridded population data and a geographic information system (GIS) to select clusters in the first sampling stage and Google Earth TM imagery and sampling grids to select households in the second sampling …

Role Of Raltegravir In Hiv-1 Management, Kristina E. Rokas, P Brandon Bookstaver, Caitlin L. Shamroe, S Scott Sutton, Vanessa E. Millisor, Jacquelyn E. Bryant, Sharon B. Weissman

Faculty Publications

OBJECTIVE: To review the literature concerning the role of raltegravir in the treatment of HIV-1 in antiretroviral (ARV)-experienced and ARV-naïve patients. DATA SOURCES: A PubMed search was conducted for published data through March 2012 using the search terms raltegravir, MK-0518, and integrase strand transfer inhibitor. An additional search of International Pharmaceutical Abstracts for unpublished data, including data from the Infectious Diseases Society of America, the Conference on Retroviruses and Opportunistic Infections, the International AIDS Society, and the Interscience Conference on Antimicrobial Agents and Chemotherapy, was conducted using similar search terms. STUDY SELECTION AND DATA EXTRACTION: In vitro and in vivo …

Reactive Oxygen Species And Mitochondrial Sensitivity To Oxidative Stress Determine Induction Of Cancer Cell Death By P21, Ionica Masgras, Samantha Carrera, Petra J. De Verdier, Paul Brennan, Aneela Majid, Wan Makhtar, Eugene Tulchinsky, George D. Jones, Igor Roninson, Salvador Macip

Faculty Publications

p21(Waf1/Cip1/Sdi1) is a cyclin-dependent kinase inhibitor that mediates cell cycle arrest. Prolonged p21 up-regulation induces a senescent phenotype in normal and cancer cells, accompanied by an increase in intracellular reactive oxygen species (ROS). However, it has been shown recently that p21 expression can also lead to cell death in certain models. The mechanisms involved in this process are not fully understood. Here, we describe an induction of apoptosis by p21 in sarcoma cell lines that is p53-independent and can be ameliorated with antioxidants. Similar levels of p21 and ROS caused senescence in the absence of significant death in other cancer …

Evaluation Of Lay Support In Pregnant Women With Social Risk (Elsips): A Randomised Controlled Trial, Sara Kenyon, Kate Jolly, Karla Hemming, Lucy Annang Ingram Phd, Nicola Gale, Sophie-Anna Dann, Jacky Chambers, Christine Macarthur

Faculty Publications

BACKGROUND: Maternal, neonatal and child health outcomes are worse in families from black and ethnic minority groups and disadvantaged backgrounds. There is little evidence on whether lay support improves maternal and infant outcomes among women with complex social needs within a disadvantaged multi-ethnic population in the United Kingdom (UK). METHOD/DESIGN: The aim of this study is to evaluate a lay Pregnancy Outreach Worker (POW) service for nulliparous women identified as having social risk within a maternity service that is systematically assessing social risks alongside the usual obstetric and medical risks. The study design is a randomised controlled trial (RCT) in …

Systematic Review Of Peer Support For Breastfeeding Continuation: Metaregression Analysis Of The Effect Of Setting, Intensity, And Timing, Kate Jolly, Lucy Annang Ingram Phd, Khalid S. Khan, Jonathan J. Deeks, Nick Freemantle, Christine Macarthur

Faculty Publications

OBJECTIVE: To examine the effect of setting, intensity, and timing of peer support on breast feeding. DESIGN: Systematic review and metaregression analysis of randomised controlled trials. DATA SOURCES: Cochrane Library, Medline, CINAHL, the National Research Register, and British Nursing Index were searched from inception or from 1980 to 2011. Review methods Study selection, data abstraction, and quality assessment were carried out independently and in duplicate. Risk ratios and 95% confidence intervals were calculated for individual studies and pooled. Effects were estimated for studies grouped according to setting (high income countries, low or middle income countries, and the United Kingdom), intensity …

Tp53 Codon 72 Polymorphism Affects Accumulation Of Mtdna Damage In Human Cells, Serena Altilia, Aurelia Santoro, Davide Malagoli, Catia Lanzarini, Josué Adolfo Ballesteros Álvarez, Gianluca Galazzo, Donald Carl Porter, Paolina Crocco, Giuseppina Rose, Giuseppe Passarino, Igor Roninson, Claudio Franceschi, Stefano Salvioli

Faculty Publications

Human TP53 gene is characterised by a polymorphism at codon 72 leading to an Arginine-to-Proline (R/P) substitution. The two resulting p53 isoforms have a different subcellular localisation after stress (more nuclear or more mitochondrial for the P or R isoform, respectively). p53P72 variant is more efficient than p53R72 in inducing the expression of genes involved in nuclear DNA repair. Since p53 is involved also in mitochondrial DNA (mtDNA) maintenance, we wondered whether these p53 isoforms are associated with different accumulation of mtDNA damage. We observed that cells bearing p53R72 accumulate lower amount of mtDNA damage upon rotenone stress with respect …

Effects Of Prenatal Food And Micronutrient Supplementation On Child Growth From Birth To 54 Months Of Age: A Randomized Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Eva-Charlotte Ekström, Kajsa Åsling-Monemi, Dewan Shamsul Alam, Edward A. Frongillo Jr., Md Yunus, Shams Arifeen, Lars-Åke Persson

Faculty Publications

Background: There is a lack of information on the optimal timing of food supplementation to malnourished pregnant women and possible combined effects of food and multiple micronutrient supplementations (MMS) on their offspring's growth. We evaluated the effects of prenatal food and micronutrient interventions on postnatal child growth. The hypothesis was that prenatal MMS and early invitation to food supplementation would increase physical growth in the offspring during 0-54 months and a combination of these interventions would further improve these outcomes.

Methods: In the large, randomized MINIMat trial (Maternal and Infant Nutrition Interventions in Matlab), Bangladesh, 4436 pregnant women were enrolled …

Relationship Between Vancomycin Trough Concentrations And Nephrotoxicity: A Prospective Multicenter Trial, John A. Bosso, Jean Nappi, Celeste Rudisill, Marlea Wellein, P Brandon Bookstaver, Jenna Swindler, Patrick D. Mauldin

Faculty Publications

Several single-center studies have suggested that higher doses of vancomycin, aimed at producing trough concentrations of >15 mg/liter, are associated with increased risk of nephrotoxicity. We prospectively assessed the relative incidence of nephrotoxicity in relation to trough concentration in patients with documented methicillin-resistant Staphylococcus aureus (MRSA) infections at seven hospitals throughout South Carolina. Adult patients receiving vancomycin for at least 72 h with at least one vancomycin trough concentration determined under steady-state conditions were prospectively studied. The relationship between vancomycin trough concentrations of >15 mg/ml and the occurrence of nephrotoxicity was assessed using univariate and multivariate analyses, controlling for age, …

Food Insecurity And Sexual Risk In An Hiv Endemic Community In Uganda, Cari L. Miller, David R. Bangsberg, David M. Tuller, Jude Senkungu, Annet Kawuma, Edward A. Frongillo Jr., Sheri D. Weiser

Faculty Publications

Food insecurity has been linked to high-risk sexual behavior in sub-Saharan Africa, but there are limited data on these links among people living with HIV/AIDS, and on the mechanisms for how food insecurity predisposes individuals to risky sexual practices. We undertook a series of in-depth open-ended interviews with 41 individuals living with HIV/AIDS to understand the impact of food insecurity on sexual-risk behaviors. Participants were recruited from the Immune Suppression Clinic at the Mbarara University of Science and Technology in Mbarara, Uganda. Interviews were recorded, transcribed verbatim, translated, and coded following the strategy of grounded theory. Four major themes emerged …

Gis And Injury Prevention And Control: History, Challenges, And Opportunities, Nathaniel Bell, Nadine Schuurman

Faculty Publications

Intentional and unintentional injury is the leading cause of death and potential years of life lost in the first four decades of life in industrialized countries around the world. Despite surgical innovations and improved access to emergency care, research has shown that certain populations remain particularly vulnerable to the risks and consequences of injury. Recent evidence has shown that the analytical, data linkage, and mapping tools of geographic information systems (GIS) technology provide can further address these determinants and identify populations in need. This paper traces the history of injury prevention and discusses current and future challenges in furthering our …

Food Insecurity Among Homeless And Marginally Housed Individuals Living With Hiv/Aids In San Francisco, Sheri D. Weiser, David R. Bangsberg, Susan Kegeles, Kathleen Ragland, Margot B. Kushel, Edward A. Frongillo Jr.

Faculty Publications

Food insecurity is a risk factor for both HIV transmission and worse HIV clinical outcomes. We examined the prevalence of and factors associated with food insecurity among homeless and marginally housed HIV-infected individuals in San Francisco recruited from the Research on Access to Care in the Homeless Cohort. We used multiple logistic regression to determine socio-demographic and behavioral factors associated with food insecurity, which was measured using the Household Food Insecurity Access Scale. Among 250 participants, over half (53.6%) were food insecure. Higher odds of food insecurity was associated with being white, low CD4 counts, recent crack use, lack of …

Identification Of Single Nucleotide Polymorphisms In The P21 (Cdkn1a) Gene And Correlations With Longevity In The Italian Population, Silvia Gravina, Francesco Lescai, Gregory Hurteau, Graham J. Brock, Anna Saramaki, Stefano Salvioli, Claudio Franceschi, Igor Roninson

Faculty Publications

Longevity in humans is determined by multiple environmental and genetic factors. We have investigated possible associations between longevity and Single Nucleotide Polymorphisms (SNPs) in the p21 (CDKN1A) gene, a stress-inducible senescence-associated cell cycle inhibitor, expression of which upregulates genes implicated in several age-related diseases. By sequencing the promoter and exons of p21 in genomic DNA of ten individuals over 90 years old, we have identified 30 SNPs, many of which had not been previously characterized. A cluster of minor alleles within the -4547/-3489 bp region did not alter the basal activity or p53 responsiveness of the p21 promoter. We then …

Antenatal Peer Support Workers And Initiation Of Breast Feeding: Cluster Randomised Controlled Trial, Christine Macarthur, Kate Jolly, Lucy Annang Ingram Phd, Nick Freemantle, Cindy-Lee Dennis, Ros Hamburger, Julia Brown, Jackie Chambers, Khalid Khan

Faculty Publications

OBJECTIVE: To assess the effectiveness of an antenatal service using community based breastfeeding peer support workers on initiation of breast feeding. DESIGN: Cluster randomised controlled trial. SETTING: Community antenatal clinics in one primary care trust in a multiethnic, deprived population. PARTICIPANTS: 66 antenatal clinics with 2511 pregnant women: 33 clinics including 1140 women were randomised to receive the peer support worker service and 33 clinics including 1371 women were randomised to receive standard care. INTERVENTION: An antenatal peer support worker service planned to comprise a minimum of two contacts with women to provide advice, information, and support from approximately 24 …

Repression Of The Sumo-Specific Protease Senp1 Induces P53-Dependent Premature Senescence In Normal Human Fibroblasts, Kristin E. Yates, Gregory A. Korbel, Michael Shtutman, Igor Roninson, Daniel Dimaio

Faculty Publications

The proliferative lifespan of normal somatic human cells in culture terminates in a permanent growth-arrested state known as replicative senescence. In this study, we show that RNA interference-mediated repression of the genes encoding the small ubiquitin-related modifier (SUMO)-specific proteases, Senp1, Senp2, and Senp7, induced low passage primary human fibroblasts to senesce rapidly. Following Senp1 repression, we observed a global increase in sumoylated proteins and in the number and size of nuclear SUMO-containing promyelocytic leukemia (PML) bodies. SUMO/PML bodies also increased during replicative senescence. p53 transcriptional activity was enhanced towards known p53 target genes following repression of Senp1, and inhibition of …

Patient Involvement In Patient Safety: What Factors Influence Patient Participation And Engagement?, Rachel Davis, Rosamond Jacklin, Nick Sevdalis, Charles A. Vincent

Faculty Publications

BACKGROUND: Patients can play an important role in improving patient safety by becoming actively involved in their health care. However, there is a paucity of empirical data on the extent to which patients take on such a role. In order to encourage patient participation in patient safety we first need to assess the full range of factors that may be implicated in such involvement. OBJECTIVE: To delineate factors that could affect the participation of the patient in quality and safety issues in their health care. METHOD: Literature review of patient involvement in health care, drawing from direct evidence (specifically from …

Using Gis-Based Methods Of Multicriteria Analysis To Construct Socio-Economic Deprivation Indices, Nathaniel Bell, Nadine Schuurman, Michael V. Hayes

Faculty Publications

BACKGROUND: Over the past several decades researchers have produced substantial evidence of a social gradient in a variety of health outcomes, rising from systematic differences in income, education, employment conditions, and family dynamics within the population. Social gradients in health are measured using deprivation indices, which are typically constructed from aggregated socio-economic data taken from the national census--a technique which dates back at least until the early 1970's. The primary method of index construction over the last decade has been a Principal Component Analysis. Seldom are the indices constructed from survey-based data sources due to the inherent difficulty in validating …