Medicine and Health Sciences Commons^™

Primary Care-Based Educational Interventions To Decrease Risk Factors For Metabolic Syndrome For Adults With Major Psychotic And/Or Affective Disorders: A Systematic Review, Cynthia Nover, Sarah S. Jackson

Epidemiology Faculty Publications

Background

Individuals with major psychotic and/or affective disorders are at increased risk for developing metabolic syndrome due to lifestyle- and treatment-related factors. Numerous pharmacological and non-pharmacological interventions have been tested in inpatient and outpatient mental health settings to decrease these risk factors. This review focuses on primary care-based non-pharmacological (educational or behavioral) interventions to decrease metabolic syndrome risk factors in adults with major psychotic and/or affective disorders.

Methods

The authors conducted database searches of PsychINFO, MEDLINE and the Cochrane Database of Systematic Reviews, as well as manual searches and gray literature searches to identify included studies.

Results

The authors were …

Men At Risk; A Qualitative Study On Hiv Risk, Gender Identity And Violence Among Men Who Have Sex With Men Who Report High Risk Behavior In Kampala, Uganda., Rachel King, Joseph Barker, Sylvia Nakayiwa, David Katuntu, George Lubwama, Danstan Bagenda, Tim Lane, Alex Opio, Wolfgang Hladik

Journal Articles: Epidemiology

In Uganda, men who have sex with men (MSM) are at high risk for HIV. Between May 2008 and February 2009 in Kampala, Uganda, we used respondent driven sampling (RDS) to recruit 295 MSM≥18 years who reported having had sex with another man in the preceding three months. The parent study conducted HIV and STI testing and collected demographic and HIV-related behavioral data through audio computer-assisted self-administered interviews. We conducted a nested qualitative sub-study with 16 men purposively sampled from among the survey participants based on responses to behavioral variables indicating higher risk for HIV infection. Sub-study participants were interviewed …

Chinese Social Media Reaction To The Mers-Cov And Avian Influenza A (H7n9) Outbreaks, Isaac Chun-Hai Fung, King-Wa Fu, Yuchen Ying, Braydon Schaible, Yi Hao, Chung-Hong Chan, Zion Tsz-Ho Tse

Epidemiology Faculty Publications

Background: As internet and social media use have skyrocketed, epidemiologists have begun to use online data such as Google query data and Twitter trends to track the activity levels of influenza and other infectious diseases. In China, Weibo is an extremely popular microblogging site that is equivalent to Twitter. Capitalizing on the wealth of public opinion data contained in posts on Weibo, this study used Weibo as a measure of the Chinese people’s reactions to two different outbreaks: the 2012 Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak, and the 2013 outbreak of human infection of avian influenza A(H7N9) in China. …

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Patient and Provider Perspectives

Targeting Inflammation Using Salsalate In Patients With Type 2 Diabetes: Effects On Flow-Mediated Dilation (Tinsal-Fmd)., Allison B Goldfine, J Stewart Buck, Cyrus Desouza, Vivian Fonseca, Yii-Der Ida Chen, Steven E Shoelson, Kathleen A. Jablonski, Mark A Creager, The Tinsal-Fmd Team

GW Biostatistics Center

OBJECTIVE: To test whether inhibiting inflammation with salsalate improves endothelial function in patients with type 2 diabetes (T2D).

RESEARCH DESIGN AND METHODS: We conducted an ancillary study to the National Institutes of Health-sponsored, multicenter, randomized, double-masked, placebo-controlled trial evaluating the safety and efficacy of salsalate in targeting inflammation to improve glycemia in patients with T2D. Flow-mediated, endothelium-dependent dilation (FMD) and endothelium-independent, nitroglycerin-mediated dilation (NMD) of the brachial artery were assessed at baseline and 3 and 6 months following randomization to either salsalate 3.5 g/day or placebo. The primary end point was change in FMD at 6 months.

RESULTS: A total …

Multiple Hypotheses Testing Procedures In Clinical Trials And Genomic Studies, Qing Pan

Epidemiology Faculty Publications

We review and compare multiple hypothesis testing procedures used in clinical trials and those in genomic studies. Clinical trials often employ global tests, which draw an overall conclusion for all the hypotheses, such as SUM test, Two-Step test, Approximate Likelihood Ratio test (ALRT), Intersection-Union Test (IUT), and MAX test. The SUM and Two-Step tests are most powerful under homogeneous treatment effects, while the ALRT and MAX test are robust in cases with non-homogeneous treatment effects. Furthermore, the ALRT is robust to unequal sample sizes in testing different hypotheses. In genomic studies, stepwise procedures are used to draw marker-specific conclusions and …

An Argument And Plan For Promoting The Teaching And Learning Of Neglected Tropical Diseases, Kevin M. Bonney

Publications and Research

Neglected tropical diseases constitute a significant public health burden, affecting over one billion people globally, yet this group of diseases is underrepresented in the appropriation of both monetary and intellectual capital for developing improved therapies and public health campaigns. The topic of neglected tropical diseases has been similarly marginalized in the biology classrooms of our nation’s high schools and colleges, despite offering an opportunity to teach and learn about a diverse area of microbiology with far-reaching public health, social, and economic implications. Discussed herein is an argument for increasing the representation of neglected tropical diseases in microbiology education as a …

Comparing Papanicolau Smear, Visual Inspection With Acetic Acid And Human Papillomavirus Cervical Cancer Screening Methods Among Hiv-Positive Women By Immune Status And Antiretroviral Therapy, Michael Chung, K. P. Mckenzie, H. D. Vuyst, B. A. Richardson, Farzana Rana, R. Pamnani, J. W. Njoroge, E. Nyongesa-Malava, S. R. Sakr, G. C. John-Stewart, N. R. Mugo

Internal Medicine, East Africa

Background: A rigorous comparison of cervical cancer screening methods utilizing data on immune status, antiretroviral therapy (ART) and colposcopy-directed biopsy has not been performed among HIV-positive women.

Methods: Between June and November 2009, 500 HIV-positive women were enrolled at an HIV treatment clinic in Nairobi, Kenya, and underwent Papanicolau (Pap) smear, visual inspection with acetic acid (VIA), human papillomavirus (HPV) and colposcopydirected biopsy (gold standard). Positive Pap smear (ASCUS, LSIL, HSIL), VIA, HPV and their combinations were compared with CIN2/3+. Sensitivity, specificity and AUC (sensitivity and 1-specificity) were compared using pairwise tests and multivariate logistic regression models that included age, …

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Social Contacts and Depression

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Preventive Interventions

Diet And Toenail Arsenic Concentrations In A New Hampshire Population With Arsenic-Containing Water, Kathryn L. Cottingham, Roxanne Karimi, Joann F. Gruber, M Scot Zens, Vicki Sayarath, Carol L. Folt, Tracy Punshon, J. Steven Morris, Margaret R. Karagas

Dartmouth Scholarship

Background: Limited data exist on the contribution of dietary sources of arsenic to an individual's total exposure, particularly in populations with exposure via drinking water. Here, the association between diet and toenail arsenic concentrations (a long-term biomarker of exposure) was evaluated for individuals with measured household tap water arsenic. Foods known to be high in arsenic, including rice and seafood, were of particular interest.

Methods: Associations between toenail arsenic and consumption of 120 individual diet items were quantified using general linear models that also accounted for household tap water arsenic and potentially confounding factors (e.g., age, caloric intake, sex, smoking) …

Genetic Markers, Birth Characteristics, And Childhood Leukemia Risk, Amy Kennedy

FIU Electronic Theses and Dissertations

The cause for childhood acute lymphoblastic leukemia (ALL) remains unknown, but male gender is a risk factor, and among ethnicities, Hispanics have the highest risk. In this dissertation, we explored correlations among genetic polymorphisms, birth characteristics, and the risk of childhood ALL in a multi-ethnic sample in 161 cases and 231 controls recruited contemporaneously (2007-2012) in Houston, TX. We first examined three lymphoma risk markers, since lymphoma and ALL both stem from lymphoid cells. Of these, rs2395185 showed a risk association in non-Hispanic White males (OR=2.8, P=0.02; P_interaction=0.03 for gender), but not in Hispanics. We verified previously …

Local Tobacco Control: Application Of The Essential Public Health Services Model In A County Health Department’S Efforts To Put It Out Rockland, Lisa D. Lieberman, Una Diffley, Sandy King, Shelley Chanler, Maryanne Ferrera, Oscar Alleyne, Joan Facelle

Department of Public Health Scholarship and Creative Works

In 2000, Rockland County, a small suburban county north of New York City, dedicated $1 million of its Master Settlement Agreement funds to a comprehensive tobacco control program, Put It Out Rockland. Developed and implemented by the county health department, this program used an essential public health services model and an ongoing financial investment, within the context of strong statewide tobacco control efforts, to lower adult smoking rates to 9.7% and to reduce both smoking among youths and exposure to secondhand smoke over the ensuing decade. By combining state funds and local dollars for a total of $6.75 cost per …

Molecular Detection Of Culture-Confirmed Bacterial Bloodstream Infections With Limited Enrichment Time, Miranda S. Moore, Chase D. Mccann, Jeanne Jordan

Epidemiology Faculty Publications

Conventional blood culturing using automated instrumentation with phenotypic identification requires a significant amount of time to generate results. This study investigated the speed and accuracy of results generated using PCR and pyrosequencing compared to the time required to obtain Gram stain results and final culture identification for cases of culture-confirmed bloodstream infections. Research and physician-ordered blood cultures were drawn concurrently. Aliquots of the incubating research blood culture fluid were removed hourly between 5 and 8 h, at 24 h, and again at 5 days. DNA was extracted from these 6 time point aliquots and analyzed by PCR and pyrosequencing for …

Short- And Long-Term Associations Between Widowhood And Mortality In The United States: Longitudinal Analyses, J. Robin Moon, M. Maria Glamour, Anusha M. Vable, Sze Yan Liu, S.V. Subramanian

Department of Public Health Scholarship and Creative Works

Background

Past research shows that spousal death results in elevated mortality risk for the surviving spouse. However, most prior studies have inadequately controlled for socioeconomic status (SES), and it is unclear whether this ‘widowhood effect’ persists over time.

Methods

Health and Retirement Study participants aged 50+ years and married in 1998 (n = 12 316) were followed through 2008 for widowhood status and mortality (2912 deaths). Discrete-time survival analysis was used to compare mortality for the widowed versus the married.

Results

Odds of mortality during the first 3 months post-widowhood were significantly higher than in the continuously married (odds ratio …

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Georgia Southern Examines Abdominal Adiposity and Caregiver Recall

Social Capital, Hiv Risk Behavior And Substance Use Among Recent Latino Immigrants In South Florida, Elena Cyrus

FIU Electronic Theses and Dissertations

Social capital, or social cohesion or group connectedness, can influence both HIV risk behavior and substance use. Because recent immigrants undergo a change in environment, one of the consequences can be a change in social capital. There may be an association among changes in social capital, and HIV risk behavior and substance use post immigration. The dissertation focused on the interface of these three variables among recent Latino immigrants (RLIs) in South Florida.

The first manuscript is a systematic review of social capital and HIV risk behavior, and served as a partial background for the second and third manuscripts. Twelve …

Asthma And Risk Of Non-Respiratory Tract Infection: A Population-Based Case-Control Study, Duk Won Bang, Hyeon J Yang, Eell Ryoo, Majdi N. Al-Hasan, Brian Lahr, Larry M. Baddour, Barbara P. Yawn, Young J. Juhn

Internal Medicine Faculty Publications

OBJECTIVES: Asthmatics have increased risks of airway-related infections. Little is known about whether this is true for non-airway-related serious infections such as Escherichia coli bloodstream infection (BSI). We assessed whether asthma is associated with a risk of developing community-acquired E coli BSI.

DESIGN: The study was designed as a population-based retrospective case-control study.

SETTING: This population-based study was conducted in Olmsted County, Minnesota.

PARTICIPANTS: The study included 259 all eligible community-acquired E coli BSI cases in Olmsted County, MN between 1998 and 2007 and 259 birthday-matched, gender-matched and residency-matched controls.

PRIMARY AND SECONDARY OUTCOME MEASURES: Only community-acquired E coli BSI …

Structural Approaches To Health Promotion: What Do We Need To Know About Policy And Environmental Change?, Lisa D. Lieberman, Shelley D. Golden, Jo Anne L. Earp

Department of Public Health Scholarship and Creative Works

Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is …

Bibliographic Review Of Research Publications On Access To And Use Of Medicines In Low-Income And Middle-Income Countries In The Eastern Mediterranean Region: Identifying The Research Gaps., Arash Rashidian, Nader Jahanmehr, Samer Jabbour, Shehla Zaidi, Fatemeh Soleymani, Maryam Bigdeli

Community Health Sciences

BJECTIVES:

We assessed the situation of academic publications on access to and use of medicines (ATM) in low-income and middle-income countries (LMICs) of the Eastern Mediterranean Region (EMR). We aimed to inform priority setting for research on ATM in the region.

DESIGN:

Bibliographic review of published studies.

SETTING:

LMICs in EMR.

INCLUSION CRITERIA:

Publications on ATM issues originating from or focusing on EMR LMICs covering the period 2000-2011. Publications involving multinational studies were included if at least one eligible country had been included in the study.

INFORMATION SOURCES AND DATA EXTRACTION:

We conducted comprehensive searches of the PubMed, Social Science …

Structural Approaches To Health Promotion: What Do We Need To Know About Policy And Environmental Change?, Lisa D. Lieberman, Shelley D. Golden, Jo Anne L. Earp

Department of Public Health Scholarship and Creative Works

Although the public health literature has increasingly called on practitioners to implement changes to social, environmental, and political structures as a means of improving population health, recent research suggests that articles evaluating organization, community, or policy changes are more limited than those focused on programs with individuals or their social networks. Even when these approaches appear promising, we do not fully understand whether they will benefit all population groups or can be successful in the absence of accompanying individually oriented programs. The role of this broad category of approaches, including both policy and environmental changes, in decreasing health disparities is …

Comparison Of Hpv Dna Testing In Cervical Exfoliated Cells And Tissue Biopsies Among Hiv-Positive Women In Kenya, Hugo De Vuyst, Michael Chung, Lacopo Baussano, Nelly R. Mugo, Vanessa Tenet, Folkert J. Van Kemenade, Farzana S. Rana, Samah R. Sakr, Chris J.L.M. Meijer, Peter J.F. Snijders, Silvia Franceschi

Pathology, East Africa

HIV-positive women are infected with human papillomavirus (HPV) (especially with multiple types), and develop cervical intraepithelial neoplasia (CIN) and cervical cancer more frequently than HIV-negative women. We compared HPV DNA prevalence obtained using a GP5+/6+ PCR assay in cervical exfoliated cells to that in biopsies among 468 HIV-positive women from Nairobi, Kenya. HPV prevalence was higher in cells than biopsies and the difference was greatest in 94 women with a combination normal cytology/normal biopsy (prevalence ratio, PR = 3.7; 95% confidence interval, CI: 2.4-5.7). PR diminished with the increase in lesion severity (PR in 58 women with high-grade squamous intraepithelial …

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Perceptions or Reality of Body Weight

Mapping Disease At An Approximated Individual Level Using Aggregate Data: A Case Study Of Mapping New Hampshire Birth Defects, Xun Shi, Stephanie Miller, Kevin Mwenda, Akikazu Onda

Dartmouth Scholarship

Limited by data availability, most disease maps in the literature are for relatively large and subjectively-defined areal units, which are subject to problems associated with polygon maps. High resolution maps based on objective spatial units are needed to more precisely detect associations between disease and environmental factors. Method: We propose to use a Restricted and Controlled Monte Carlo (RCMC) process to disaggregate polygon-level location data to achieve mapping aggregate data at an approximated individual level. RCMC assigns a random point location to a polygon-level location, in which the randomization is restricted by the polygon and controlled by the background (e.g., …

Associations Of Smoking Status And Serious Psychological Distress With Chronic Obstructive Pulmonary Disease, Ke-Sheng Wang, Liang Wang, Shimin Zheng, Long-Yang Wu

ETSU Faculty Works

Background: Chronic obstructive pulmonary disease (COPD) has been a major public health problem due to its high prevalence, morbidity, and mortality. Smoking is a major risk factor for COPD, while serious psychological distress (SPD) is prevalent among COPD patients. However, no study focusing on the effect of SPD on COPD has been so far conducted, while few studies have focused on the associations of SPD and behavioral factors with COPD by smoking status.

Objectives: This study aimed to examine the associations of SPD and behavioral factors (such as smoking and physical activity) with COPD.

Materials and Methods: Weighted logistic regression …

Sessile Serrated Adenomas In The Proximal Colon Are Likely To Be Flat, Large And Occur In Smokers, Tarun Rustagi, Priya Rangasamy, Matthew Myers, Melinda Sanders, Haleh Vaziri, George Y. Wu, John W. Birk, Petr Protiva, Joseph C. Anderson

Dartmouth Scholarship

Aim: To examine the epidemiology and the morphology of the proximal sessile serrated adenomas (SSAs).

Methods: We conducted a retrospective study to identify patients with SSAs using a university-based hospital pathology database query from January 2007 to April 2011. Data collected included: age, gender, ethnicity, body mass index, diabetes, smoking, family history of colorectal cancer, aspirin, and statin use. We collected data on morphology of SSAs including site (proximal or distal), size, and endoscopic appearance (flat or protuberant). We also compared proximal SSAs to proximal tubular adenomas detected during same time period.

Epidemiology News, Georgia Southern University

Epidemiology News (2012-2018)

• Perceived Barriers

Plasma S-Adenosylmethionine, Dnmt Polymorphisms, And Peripheral Blood Line-1 Methylation Among Healthy Chinese Adults In Singapore, Maki Inoue-Choi, Heather H. Nelson, Kim Robien, Erland Arning, Teodoro Bottiglieri, Woon-Puay Koh, Jian-Min Yuan

Epidemiology Faculty Publications

Background

Global hypomethylation of repetitive DNA sequences is believed to occur early in tumorigenesis. There is a great interest in identifying factors that contribute to global DNA hypomethylation and associated cancer risk. We tested the hypothesis that plasma S-adenosylmethionine (SAM) level alone or in combination with genetic variation in DNA methyltransferases (DNMT1, DNMT3A andDNMT3B) was associated with global DNA methylation extent at long interspersed nucleotide element-1 (LINE-1) sequences.

Methods

Plasma SAM level and LINE-1 DNA methylation index were measured using stored blood samples collected from 440 healthy Singaporean Chinese adults during 1994-1999. Genetic polymorphisms of …

Correlates Of Hiv Acquisition In A Cohort Of Black Men Who Have Sex With Men In The United States: Hiv Prevention Trials Network (Hptn) 061, Beryl A. Koblin, Kenneth H. Mayer, Susan H. Eshleman, Lei Wang, Sharon B. Mannheimer, Carlos Del Rio, Steve Shoptaw, Manya Magnus, Susan Buchbinder, Leo Wilton, Ting-Yuan Liu, Vanessa Cummings, Estelle Piwowar-Manning, Sheldon D. Fields, Sam Griffith, Vanessa Elharrar, Darrell Wheeler

Epidemiology Faculty Publications

Background

Black men who have sex with men (MSM) in the United States (US) are affected by HIV at disproportionate rates compared to MSM of other race/ethnicities. Current HIV incidence estimates in this group are needed to appropriately target prevention efforts.

Methods

From July 2009 to October 2010, Black MSM reporting unprotected anal intercourse with a man in the past six months were enrolled and followed for one year in six US cities for a feasibility study of a multi-component intervention to reduce HIV infection. HIV incidence based on HIV seroconversion was calculated as number of events/100 person-years. Multivariate proportional …

Attributing Effects To Interactions, Tyler J. Vanderweele, Eric J. Tchetgen Tchetgen

Harvard University Biostatistics Working Paper Series

A framework is presented which allows an investigator to estimate the portion of the effect of one exposure that is attributable to an interaction with a second exposure. We show that when the two exposures are independent, the total effect of one exposure can be decomposed into a conditional effect of that exposure and a component due to interaction. The decomposition applies on difference or ratio scales. We discuss how the components can be estimated using standard regression models, and how these components can be used to evaluate the proportion of the total effect of the primary exposure attributable to …