Medicine and Health Sciences Commons^™

Better Engaging Communities: Moving Beyond Cardinal Rules, Anna G. Hoover

Anna G. Hoover

“Cardinal rules” and best practice approaches have guided governmental risk communication efforts at chronic risk sites for more than two decades, playing an important role in how those most affected by contamination make sense of risk. In addition to providing information, however, communication approaches themselves can affect community perceptions indirectly, through stakeholder interpretations of the processes by which risk information is shared. It is increasingly necessary to evaluate not only whether risk communication approaches have been effective for increasing knowledge but if, in fact, the ways in which information is shared has had unintended consequences that change how stakeholders perceive …

Research Translation: Informing Evidence-Based Policies, Anna G. Hoover

Anna G. Hoover

This presentation describes the need for evidence-based policy, outlines strategies for researchers and communities to inform various policy stages, and provides a case study example of research generated specifically to inform policy implementation.

Connecting Disciplines To Inform And Develop The Emerging Field Of Environmental Health Literacy, Anna G. Hoover

Anna G. Hoover

No abstract provided.

Copd Surveillance-United States, 1999-2011, Earl S. Ford, Janet B. Croft, David M. Mannino, Anne G. Wheaton, Xingyou Zhang, Wayne H. Giles

David M. Mannino

This report updates surveillance results for COPD in the United States. For 1999 to 2011, data from national data systems for adults aged ≥ 25 years were analyzed. In 2011, 6.5% of adults (approximately 13.7 million) reported having been diagnosed with COPD. From 1999 to 2011, the overall age-adjusted prevalence of having been diagnosed with COPD declined (P = .019). In 2010, there were 10.3 million (494.8 per 10,000) physician office visits, 1.5 million (72.0 per 10,000) ED visits, and 699,000 (32.2 per 10,000) hospital discharges for COPD. From 1999 to 2010, no significant overall trends were noted for physician …

Using Risk And Participatory Communication To Support Community-Based Decisions: The Paducah Gaseous Diffusion Plant Future Vision Project, Anna G. Hoover

Anna G. Hoover

No abstract provided.

Cph601 Chapter 2 Toxicology, David M. Mannino

David M. Mannino

No abstract provided.

Syllabus - Cph601-401 Environmental Health, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 5 Air, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 7 Food And Agriculture, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 8 Human Settlement And Urbanization, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 10 Industrial Pollution And Chemical Safety, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 9 Health And Energy Use, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 1 Introduction, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 3 Risk Assessment, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 6 Water, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 12 Action!, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 11 Transboundary Health/Global Health, David M. Mannino

David M. Mannino

No abstract provided.

Cph601 Chapter 4 Risk Management, David M. Mannino

David M. Mannino

No abstract provided.

Elevated Cardiovascular Risk Among Adults With Obstructive And Restrictive Airway Functioning In The United States: A Cross-Sectional Study Of The National Health And Nutrition Examination Survey From 2007 - 2010, Earl S. Ford, Ann G. Wheaton, David M. Mannino, Latitia Presley-Cantrell, Chaoyang Li, Janet B. Croft

David M. Mannino

Background

Reasons for the excess risk for cardiovascular disease among people with chronic obstructive pulmonary disease remain unclear. Our objective was to examine the cardiovascular risk profile for adults with obstructive and restrictive impairments of lung functioning in a representative sample of adults from the United States.

Methods

We used data from adults aged 20–79 years who participated in the National Health and Nutrition Examination Survey from 2007 to 2010 and had a pulmonary function test. The severity of obstructive impairment was defined by adapting the Global Initiative for Chronic Obstructive Lung Disease criteria.

Results

Among 7249 participants, 80.9% had …

Occupational Chronic Obstructive Pulmonary Disease: An Update, Enrique Diaz-Guzman, David M. Mannino, Shambhu Aryal

David M. Mannino

Chronic obstructive pulmonary disease represents a major cause of morbidity and mortality in industrialized and nonindustrialized countries. Although tobacco use remains the main factor associated with development of the disease, occupational risk factors represent an important and preventable cause. The most common occupationally related factors include exposure to organic dusts, metallic fumes, and a variety of other mineral gases and/or vapors. This article summarizes the literature on the subject and provides an update of the most recent advances in the field.

Epidemiology Of Comorbidities In Chronic Obstructive Pulmonary Disease: Clusters, Phenotypes And Outcomes, Shambhu Aryal, Enrique Diaz-Guzman, David M. Mannino

David M. Mannino

COPD is a complex multisystem disease often accompanied by multiple co-morbidities that contribute to symptoms, exacerbations, hospital admissions and mortality. Individual comorbidities can be grouped into clusters of common human pathology: inflammation/immune response (e.g., ischemic heart disease, metabolic syndrome), thrombosis/hemorrhage (e.g., cerebrovascular diseases, pulmonary embolism), fibrosis/cell proliferation (e.g., lung cancer and other malignancies) and apoptosis/necrosis (e.g., osteoporosis, skeletal muscle dysfunction). While the prevalence of the co-morbidities has been described in a number of observational studies, there is considerable variability in results; moreover characterization of cluster of co-morbidities with the most clinical significance in terms of morbidity and mortality is still …

Sensemaking In The Shadow Of A Superfund Site: Defining Atsdr Roles And Goals In An Agency-Saturated Community, Anna G. Hoover, Lindell Ormsbee, Stephanie W. Jenkins, Ashley M. Bush

Anna G. Hoover

By working directly in Superfund communities, the Agency for Toxic Substances and Disease Registry is embedded within a complex tapestry of federal and state agencies, local government entities, and other organizations that community stakeholders encounter regularly. The diversity of statutory obligations and expertise among these organizations, particularly as they relate to stakeholders’ health concerns, presents challenges for creating shared understanding between agencies and the communities they serve. Thus, addressing key elements of individual sensemaking during engagement activities is essential for those who work in communities.

Because sensemaking helps individuals determine the seriousness of a situation, decide how to react to …

Investigation Of The Correlates And Effectiveness Of A Prison-Based Wellness Program, Monica L. Clouse, David M. Mannino, Philip R. Curd

David M. Mannino

In 2006, a comprehensive wellness intervention, titled Wellness Works, was implemented in an incarcerated male population at a 200-bed facility in LaGrange, Kentucky. The purpose of this study was to determine health risk factors and benefits of program participation by analyzing data from a pre-/post-participation health risk assessment (HRA). In total, 448 inmates completed the pre- HRA and 177 (40%) completed the post- HRA. Among program completers, two of the six measured domains (smoking and depression) showed significant improvement at the post- HRA while the other domains (exercise, nutrition, stress, and dental hygiene) did not show significant changes. Overall, this …

Blood Fibrinogen As A Biomarker Of Chronic Obstructive Pulmonary Disease, Annelyse Duvoix, Jenny Dickens, Imran Haq, David M. Mannino, Bruce Miller, Ruth Tal-Singer, David A. Lomas

David M. Mannino

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a multicomponent condition that is characterised by airflow obstruction that is not fully reversible and is a major global cause of morbidity and mortality. The most widely used marker of disease severity and progression is FEV(1). However, FEV(1) correlates poorly with both symptoms and other measures of disease progression and thus there is an urgent need for other biological markers to better characterise individuals with COPD. Fibrinogen is an acute phase plasma protein that has emerged as a promising biomarker in COPD. Here we review the current clinical evidence linking fibrinogen with COPD …

Worldwide Patterns Of Bronchodilator Responsiveness: Results From The Burden Of Obstructive Lung Disease Study, Wan C. Tan, William M. Vollmer, Berned Lamprecht, David M. Mannino, Anamika Jithoo, Ewa Nizankowska-Mogilnicka, Filip Mejza, Thorarinn Gislason, Peter Burney, A Sonia Buist

David M. Mannino

Rationale: Criteria for a clinically significant bronchodilator response (BDR) are mainly based on studies in patients with obstructive lung diseases. Little is known about the BDR in healthy general populations, and even less about the worldwide patterns.

Methods: 10 360 adults aged 40 years and older from 14 countries in North America, Europe, Africa and Asia participated in the Burden of Obstructive Lung Disease study. Spirometry was used before and after an inhaled bronchodilator to determine the distribution of the BDR in population-based samples of healthy non-smokers and individuals with airflow obstruction.

Results: In 3922 healthy never smokers, the weighted …

Fibrinogen, Copd And Mortality In A Nationally Representative U.S. Cohort, David M. Mannino, Deepa Valvi, Hana Mullerova, Ruth Tal-Singer

David M. Mannino

BACKGROUND:

Fibrinogen is a marker of systemic inflammation and may represent an important biomarker for the progression of chronic obstructive pulmonary disease (COPD).

METHODS:

We used baseline data from the Third National Health and Nutrition Examination Survey (NHANES III) and follow-up mortality data to determine the relation between fibrinogen levels and COPD and to examine how fibrinogen levels at baseline affected long-term outcomes. Elevated fibrinogen was defined as the upper 10% of the fibrinogen level distribution.

RESULTS:

Our study sample included 8,507 subjects, including 245 with Stage 3 or 4 COPD and 826 with Stage 2 COPD. Then, 3,290 of …

Fibrinogen, Chronic Obstructive Pulmonary Disease (Copd) And Outcomes In Two United States Cohorts, Deepa Valvi, David M. Mannino, Hana Mullerova, Ruth Tal-Singer

David M. Mannino

Background

Fibrinogen is a marker of systemic inflammation and may be important in the pathogenesis and progression of chronic obstructive pulmonary disease (COPD).

Methods

We used baseline data from Atherosclerosis Risk in Communities and Cardiovascular Health Studies to determine the relation between fibrinogen levels and COPD and to examine how fibrinogen levels at baseline affected outcomes of death, development of COPD, lung function decline, and COPD-hospitalizations.

Results

Our study sample included 20,192 subjects, of whom 2995 died during the follow-up period. The mean fibrinogen level was 307.6 mg/dL and 10% of the sample had levels >393.0 mg/dL. Subjects with Stage …

Syllabus - Cph 911 Epidemiology Seminar I, David M. Mannino

David M. Mannino

No abstract provided.

Pre- And Post-Bronchodilator Lung Function As Predictors Of Mortality In The Lung Health Study, David M. Mannino, Enrique Diaz-Guzman, Sonia Buist

David M. Mannino

Background

Chronic obstructive pulmonary disease (COPD) is supposed to be classified on the basis of post-bronchodilator lung function. Most longitudinal studies of COPD, though, do not have post-bronchodilator lung function available. We used pre-and post bronchodilator lung function data from the Lung Health Study to determine whether these measures differ in their ability to predict mortality.

Methods

We limited our analysis to subjects who were of black or white race, on whom we had complete data, and who participated at either the 1 year or the 5 year follow-up visit. We classified subjects based on their baseline lung function, according …

Race-Ethnicity As An Effect Modifier Of The Association Between Hbalc And Mortality In U.S. Adults Without Diagnosed Diabetes, Katharina G. Kehl, Hannes M. Findeisen, David W. Fardo, Dennis Bruemmer, David M. Mannino, Wayne T. Sanderson

David M. Mannino

Objective

HbAlc is increasingly appreciated as a risk factor for all-cause and cardiovascular disease (CVD) mortality in the non-diabetic population. In this study, we investigated the association between HbAlc and mortality with a particular focus on the impact of race–ethnicity.

Design

Cohort study.

Methods

We analyzed the association between HbAlc and all-cause and CVD mortality in 12 698 non-diabetic adults 20 years or older from the Third National Health and Nutrition Examination Survey using separate models for people of different race–ethnicity.

Results

In our stratified analyses, higher non-diabetic HbAlc levels were associated with all-cause and CVD mortality in non-Hispanic whites …