Public Health Commons^™

Intimate Partner Violence During Pregnancy: Victim Or Perpetrator? Does It Make A Difference?, Yuliya Shneyderman, Michele Kiely

Publications and Research

Objectives: To differentiate between forms of intimate partner violence (IPV)(victim only, perpetrator only, or participating in reciprocal violence) and examine risk profiles and pregnancy outcomes.

Design: Prospective

Setting: Washington, DC, July 2001 to October 2003

Sample: 1044 high-risk African-American pregnant women who participated in a randomized controlled trial to address IPV, depression, smoking, and environmental tobacco smoke exposure.

Methods: Multivariable linear and logistic regression

Main outcome measures: Low and very low birth weight, preterm and very preterm birth

Results: 5% of women were victims only, 12% were perpetrators only, 27% participated in reciprocal violence, and 55% reported no IPV. …

Sequential Screening For Psychosocial And Behavioural Risk During Pregnancy In A Population Of Urban African Americans, Michele Kiely, Marie G. Gantz, M. Nabil El-Khorazaty, Ayman El-Mohandes

Publications and Research

Objective: Screening for psychosocial and behavioral risks, such as depression, intimate partner violence and smoking, during pregnancy is considered state-of-the-art in prenatal care (PNC). This prospective longitudinal analysis examines the added benefit of repeated screening over a one-time screen in identifying such risks during pregnancy.

Design: Data were collected as part of a randomized controlled trial to address intimate partner violence (IPV), depression, smoking and environmental tobacco smoke exposure (ETSE) in African-Americans women.

Setting: PNC sites in the District of Columbia serving mainly minority women

Population: 1044 African-American pregnant women in the District of Columbia

Methods: Mothers were classified by …

Situational Awareness: Reframing Within Fire Service Culture, Martha Dow, Len Garis, Larry Thomas

Publications and Research

There is increasing attention being paid to better understanding and consequently decreasing the incidence of on-the-job injuries and deaths within the fire service across North America. Heightening situational awareness is being explored as the most critical factor in maintaining the safety of participants in high risk, low frequency events. Situational awareness is generally defined as “understanding the current environment and being able to accurately anticipate future problems to enable effective action”. Situational awareness is cited as a critical factor in most research exploring safety in fire suppression activities and in many cases the “No. 1 factor identified by firefighters filing …

Assessing The Burden Of Crime And The Criminal Sanction: A Public Health Perspective On Critical Issues In Criminal Justice, Jeremy Travis

Publications and Research

No abstract provided.

Consumers' Perceptions Of Patient-Accessible Electronic Medical Records, Christina Zarcadoolas, Wendy L. Vaughon, Sara J. Czaja, Joslyn Levy, Maxine L. Rockoff

Publications and Research

Background: Electronic health information (eHealth) tools for patients, including patient-accessible electronic medical records (patient portals), are proliferating in health care delivery systems nationally. However, there has been very limited study of the perceived utility and functionality of portals, as well as limited assessment of these systems by vulnerable (low education level, racial/ethnic minority) consumers.

Objective: The objective of the study was to identify vulnerable consumers’ response to patient portals, their perceived utility and value, as well as their reactions to specific portal functions.

Methods: This qualitative study used 4 focus groups with 28 low education level, English-speaking consumers in June …

The 2012 Economic Burden Of Intimate Partner Violence (Ipv) In Ecuador: Setting The Agenda For Future Research And Violence Prevention Policies, Maria-Isabel Roldos, Phaedra Corso

Publications and Research

Introduction: Intimate partner violence (IPV) is a widespread social structural problem that affects a great proportion of Ecuadorian women. IPV is a sexually, psychologically, or physically coercive act against an adult or adolescent woman by a current or former intimate partner. Not-for-profit groups in Ecuador report that 70% of women experience 1 of the forms of IPV sometime during their lifetime, but population-based surveys suggest that 41% of Ecuadorian women are exposed to emotional violence, 31% physical violence, and 12% sexual violence by their spouse or partner over their lifetime. Despite the high prevalence, the response of the Ecuadorian government …

The Association Between A Medical History Of Depression And Gestational Diabetes In A Large Multi-Ethnic Cohort In The United States, Katherine Bowers, S. Katherine Laughon, Sungduk Kim, Sunni L. Mumford, Jennifer Brite, Michele Kiely, Cuilin Zhang

Publications and Research

Background: Both major depression and gestational diabetes mellitus (GDM) are prevalent among women of reproductive age. Our objective was to determine whether a medical history of depression is related to subsequent development of GDM.

Methods: The Consortium on Safe Labor was a US retrospective cohort study of 228 562 births between 2002 and 2008. Exclusion criteria for the present analysis included multiple gestation pregnancies (n = 5059), pre-existing diabetes (n = 12 771), deliveries(n = 395), site GDM prevalence (

Results: The final analytic population included 121 260 women contributing 128 295 pregnancies, of which 5606 were affected by GDM. …

A Randomized Clinical Trial Of Trans-Dermal Nicotine Replacement In Pregnant African-American Smokers, Ayman El-Mohandes, Richard Windsor, Sylvia Tan, David C. Perry, Marie G. Gantz, Michele Kiely

Publications and Research

We compared acceptability, adherence and efficacy of trans-dermal nicotine patches and cognitive behavioral therapy (Group 1) to cognitive behavioral therapy alone (Group 2) in minority pregnant smokers. This is a randomized controlled trial. 52 women were recruited during pregnancy with a mean gestational age 18.5 ± 5.0 weeks and followed through delivery. Randomization was by site and initial cotinine levels. Interventionists and interviewers were blinded to group assignment. Two different nicotine replacement therapy dosing regiments were administered according to the baseline salivary cotinine level. A process evaluation model summarized patient adherence. The main outcome measure was self-report of cessation since …

The Impact Of Medicare Prescription Drug Coverage On The Use Of Antidementia Drugs, Nicole R. Fowler, Yi-Fan Chen, Christiana A. Thurton, Aiju Men, Eric G. Rodriguez, Julie M. Donohue

Publications and Research

Background Cholinesterase inhibitors and memantine are prescribed to slow the progression dementia. Although the efficacy of these drugs has been demonstrated, their effectiveness, from the perspective of patients and caregivers, has been questioned. Little is known about whether the demand for cholinesterase inhibitors and memantine are sensitive to out-of-pocket cost. Using the 2006 implementation of Medicare Part D as a natural experiment, this study examines the impact of changes in drug coverage on use of cholinesterase inhibitors and memantine by comparing use before and after Medicare Part D implementation among older adults who did and did not experience a change …

Network Firewall Dynamics And The Subsaturation Stabilization Of Hiv, Bilal Khan, Kirk Dombrowski, Mohamed Saad, Katherine Mclean, Samuel Friedman

Publications and Research

In 2001, Friedman et al. conjectured the existence of a “firewall effect” in which individuals who are infected with HIV, but remain in a state of low infectiousness, serve to prevent the virus from spreading. To evaluate this historical conjecture, we develop a new graph-theoreticmeasure that quantifies the extent towhich Friedman’s firewall hypothesis (FH) holds in a risk network.We compute this new measure across simulated trajectories of a stochastic discrete dynamical system that models a social network of 25,000 individuals engaging in risk acts over a period of 15 years. The model’s parameters are based on analyses of data collected …

Sexual Orientation And Functional Pain In U.S. Young Adults: The Mediating Role Of Childhood Abuse, Andrea L. Roberts, Margaret Rosario, Heather L. Corliss, David Wypij, Jennifer R. Lightdale, S. Bryn Austin

Publications and Research

Objective: Pain without known pathology, termed ‘‘functional pain,’’ causes much school absenteeism, medication usage, and medical visits. Yet which adolescents are at risk is not well understood. Functional pain has been linked to childhood abuse, and sexual orientation minority youth (gay, lesbian, bisexual, ‘‘mostly heterosexual,’’ and heterosexual with same-sex sexual contact) are more likely to be victims of childhood abuse than heterosexuals, thus may be at greater risk of functional pain.

Methods: We examined sexual orientation differences in past-year prevalence of functional headache, pelvic, and abdominal pain and multiple sites of pain in 9,864 young adults (mean age = …

Motivational Interviewing Targeting Risk Behaviors For Youth Living With Hiv In Thailand, Chokechai Rongkavilit, Sylvie Naar-King, Bo Wang, Apirudee Panthong, Torsak Bunupuradah, Jeffrey T. Parsons, Supalak Phonphithak, Juline A. Koken, Pichai Saengcharnchai, Praphan Phanuphak

Publications and Research

Healthy Choices, a four-session motivational interviewing-based intervention, reduces risk behaviors among US youth living with HIV (YLWH). We randomized 110 Thai YLWH (16–25 years) to receive either Healthy Choices or time-matched health education (Control) over 12 weeks. Risk behaviors were assessed at baseline, 1, and 6 months post-session. The pilot study was not powered for between-group differences; there were no statistical differences in sexual risks, alcohol use, and antiretroviral adherence between the two groups at any visit. In within-group analyses, Healthy Choices group demonstrated decreases in the proportion of HIV-negative partners (20 vs 8.2 %, P = 0.03) and HIV …

A Guide To Enterotypes Across The Human Body: Meta- Analysis Of Microbial Community Structures In Human Microbiome Datasets, Omry Koren, Dan Knights, Antonio Gonzalez, Levi Waldron, Nicola Segata, Rob Knight, Curtis Huttenhower, Ruth E. Ley

Publications and Research

Recent analyses of human-associated bacterial diversity have categorized individuals into ‘enterotypes’ or clusters based on the abundances of key bacterial genera in the gut microbiota. There is a lack of consensus, however, on the analytical basis for enterotypes and on the interpretation of these results. We tested how the following factors influenced the detection of enterotypes: clustering methodology, distance metrics, OTU-picking approaches, sequencing depth, data type (whole genome shotgun (WGS) vs.16S rRNA gene sequence data), and 16S rRNA region. We included 16S rRNA gene sequences from the Human Microbiome Project (HMP) and from 16 additional studies and WGS sequences from …

Changes In Natural Killer Cell Activation And Function During Primary Hiv-1 Infection, Vivek Naranbhai, Marcus Altfeld, Salim S. Abdool Karim, Thumbi Ndung’U, Quarraisha Abdool Karim, William H. Carr

Publications and Research

Background: Recent reports suggest that Natural Killer (NK) cells may modulate pathogenesis of primary HIV-1 infection. However, HIV dysregulates NK-cell responses. We dissected this bi-directional relationship to understand how HIV impacts NK-cell responses during primary HIV-1 infection.

Methodology/Principal Findings: Paired samples from 41 high-risk, initially HIV-uninfected CAPRISA004 participants were analysed prior to HIV acquisition, and during viraemic primary HIV-1 infection. At the time of sampling post-infection five women were seronegative, 11 women were serodiscordant, and 25 women were seropositive by HIV-1 rapid immunoassay. Flow cytometry was used to measure NK and T-cell activation, NK-cell receptor expression, cytotoxic and cytokine-secretory functions, …

Bridging The Gap Between Health And Justice, Lior Gideon

Publications and Research

No abstract provided.

Infant Mortality In American Indians And Alaska Natives 1995–1999 And 2000–2004, Patrik Johansson, Weston Williams, Ayman El-Mohandes

Publications and Research

Objectives. (1) To determine the infant mortality rate (IMR) in American Indians/ Alaska Natives (AI/AN) and Whites between 1995–1999 and 2000–2004. (2) To compare the leading causes of infant mortality in AI/AN and Whites. (3) To examine differences in neonatal vs. postneonatal causes of death in Whites and AI/AN.

Methods. Using the 1995–99 and 2000–04 Centers for Disease Control and Prevention’s National Center for Health Statistics national linked birth/infant death data, we examined neonatal and postneonatal IMR among AI/AN and Whites.

Results. AI/AN experienced significantly greater overall IMR in 1995–1999 and 2000–2004 than Whites. While the reduction in …

Strengths And Limitations Of Qualitative Approaches To Research In Occupational Health Psychology, Irvin Sam Schonfeld, Joseph J. Mazzola

Publications and Research

Like all research methods, qualitative methods have strengths and limitations. This chapter describes seven strengths and five limitations. With an understanding of their strengths and limitations and how to minimize and/or balance them, occupational health psychology (OHP) researchers can benefit from qualitative methods. It is important to understand that qualitative findings do not establish generalizable cause-effect relations. However, qualitative methods can help an OHP researcher develop a theory of causality and derive hypotheses related to the theory and, thus, motivate quantitatively organized research designed to test the hypotheses. The challenge for the OHP researcher is to be mindful of what …

Ambiguity, Ambivalence, And Apprehensions Of Taking Hiv-1 Pre-Exposure Prophylaxis Among Male Couples In San Francisco: A Mixed Methods Study, Parya Saberi, Kristine Elizabeth Gamarel, Torsten B. Neilands, Megan Comfort, Nicolas Sheon, Lynae A. Darbes, Mallory O. Johnson

Publications and Research

Objective: We conducted a mixed-methods study to examine serodiscordant and seroconcordant (HIV-positive/HIVpositive) male couples’ PrEP awareness, concerns regarding health care providers offering PrEP to the community, and correlates of PrEP uptake by the HIV-negative member of the couple.

Design: Qualitative sub-study included one-on-one interviews to gain a deeper understanding of participants’ awareness of and experiences with PrEP and concerns regarding health care providers offering PrEP to men who have sex with men (MSM). Quantitative analyses consisted of a cross-sectional study in which participants were asked about the likelihood of PrEP uptake by the HIV-negative member of the couple and level …

Sexual And Reproductive Health Care Access And Utilization By Mexican Immigrant Women In New York City – A Descriptive Study, Gabriela Betancourt

Center for Latin American, Caribbean, and Latino Studies

Introduction: This study examines reproductive health care access and utilization by Mexicans in New York City.

Methods: This report uses data collected by Planned Parenthood of New York City (PPNYC) as part of a larger sexual and reproductive health (SRH) needs assessment. We analyzed various demographic factors and barriers to describe SRH access and utilization of services among Mexican immigrant women residing in New York City (NYC). We purposely sampled 151 adult women seeking assistance from the Mexican Consulate of New York City and other community-based organizations (CBOs). Women choosing to participate were administered an anonymous survey. Data collected included …

Risk Factor Detection As A Metric Of Starhs Performance For Hiv Incidence Surveillance Among Female Sex Workers In Kigali, Rwanda, Sarah L. Braunstein, Janneke H. Van De Wijgert, Joseph Vyankandondera, Evelyn Kestelyn, Justin Ntirushwa, Denis Nash

Publications and Research

Background:
The epidemiologic utility of STARHS hinges not only on producing accurate estimates of HIV incidence, but also on identifying risk factors for recent HIV infection.

Methods:
As part of an HIV seroincidence study, 800 Rwandan female sex workers (FSW) were HIV tested, with those testing positive further tested by BED-CEIA (BED) and AxSYM Avidity Index (Ax-AI) assays. A sample of HIV-negative (N=397) FSW were followed prospectively for HIV seroconversion. We compared estimates of risk factors for: 1) prevalent HIV infection; 2) recently acquired HIV infection (RI) based on three different STARHS classifications (BED alone, Ax-AI alone, BED/Ax-AI combined); and …

Weaponizing Tear Gas: Bahrain’S Unprecedented Use Of Toxic Chemical Agents Against Civilians., Richard Sollom, Holly G. Atkinson

Publications and Research

The Bahraini government’s response to the early 2011 pro-democracy protests was brutal, systematic, and violent. In addition to birdshot and rubber bullets, government law enforcement attacked unarmed protestors with toxic chemical agents including tear gas. The government’s crackdown on the medical profession was especially harmful, as security forces arrested and detained doctors, raided health facilities, and obstructed patients from receiving necessary care. This report’s findings are based on field research that the authors conducted in Bahrain (April 2012) to investigate excessive use of force by law enforcement officials since June 2011—the end of Bahrain’s state of emergency. The medico-legal team …

Lung Cancer Screening For The Poor And Underserved: Should Routine Screening Be Performed?, Vaibhav Verma, Vladimir K. Gotlieb, Joshua Fogel, Alan S. Multz, Geeti Sharma

Publications and Research

Background: Lung cancer is a leading cause of death in United States. A recent study using low dose CT scans for screening long term smokers for lung cancer has, for the first time, demonstrated reduction in mortality, although it is not a standard of care in the community yet.

Methods: We analyzed lung cancer data for stages 0 through 4 for 1,412 individuals from, a public hospital, Nassau University Medical Center (NUMC) with patients of lower income, two private hospitals, North Shore University Hospital (NSUH) and Long Island Jewish Hospital (LIJ), with patients of higher income, with average household income …

Under The Gun: Ongoing Assaults On Bahrain’S Health System, Richard Sollom, Holly G. Atkinson

Publications and Research

In February 2011, the Government of Bahrain began targeting health professionals who treated protesters. In April 2012, PHR's Richard Sollom, Deputy Director, and Holly Atkinson, MD, FACP, past President of PHR's Board and volunteer expert, authored a report showing the devastation on Bahrain's health system that have resulted from the Government of Bahrain’s continued assault on doctors, patients, and the healthcare system.

The Association Between Marital Transitions, Body Mass Index, And Weight: A Review Of The Literature, Lauren Dinour, May May Leung, Gina Tripicchio, Sahar Khan, Ming-Chin Yeh

Publications and Research

Objective: To examine the association between different marital transitions and changes in body mass index (BMI) and body weight.

Methods: A systematic literature search was conducted for peer-reviewed articles published between January 1990 and December 2011. Longitudinal studies were included if they compared dependent variables, such as BMI or weight, before and after a change in marital status.

Results: Twenty articles were included: 4 articles described only transitions into marriage and/or cohabitation, 2 articles described only transitions out of marriage and/or cohabitation, and 14 articles described both. Overall, transitions into marriage were associated with weight gain, whereas transitions out of …

The Manufacture Of Lifestyle: The Role Of Corporations In Unhealthy Living, Nicholas Freudenberg

Publications and Research

Recently, researchers have debated two views on the connection between lifestyle and health. In the first, health-related lifestyles including tobacco and alcohol use, diet, and physical activity are seen as primary influences on health. In the second, social stratification is the dominant influence with lifestyles simply markers of social status. Neither approach leads to interventions that can reverse the world's most serious health problems. This article proposes that corporate practices are a dominant influence on the lifestyles that shape patterns of health and disease. Modifying business practices that promote unhealthy lifestyles is a promising strategy for improving population health. Corporations …

Persistent Disparities In Cholesterol Screening Among Immigrants To The United States, Jim P. Stimpson, Fernando A. Wilson, Rosenda Murillo, Jose A. Pagan

Publications and Research

Background: This study compared differences in cholesterol screening among immigrant populations and US born race/ethnic groups and whether improving access to health care reduced differences in screening.

Methods: Self-reported cholesterol screening for adults was calculated from multivariate logistic regression analysis of the 1988–2008 National Health and Nutrition Examination Surveys (N = 17,118). Immigrant populations were classified by place of birth and length of residency.

Results: After adjusting for individual characteristics and access to health care, the multivariate adjusted probability of cholesterol screening is significantly lower for persons originating from Mexico (70.9%) compared to persons born in the US (80.1%) or …

Understanding The Public Health Challenges In The Era Of Mass Incarceration. President Travis' Keynote Speech At The Fifth Annual Academic And Health Policy Conference On Correctional Health On March 22, 2012 In Atlanta, Ga., Jeremy Travis

Publications and Research

No abstract provided.

Culture Ontogeny: Lifespan Development Of Religion And The Ethics Of Spiritual Counselling, Glen Milstein, Amy Manierre

Publications and Research

The counsellor has an ethical obligation to treat the whole person. Humans are cultural beings and the foundation of most cultures is religion. Religion and culture are received from our early relation~ ships and modified through later relationships across the lifespan. The paper introduces the term "culture ontogeny" to emphasize that this is a biological process wherein abstract ideas of culture and religion become material in the developing neurophysiology of each brain. A framework and methods are offered to examine the changing roles of religion in clients' emotional self~ structure, inclusive of those who describe themselves as spiritual, not religious. …

The Murine Caecal Microrna Signature Depends On The Presence Of The Endogenous Microbiota, Natasha Singh, Elize A. Shirdel, Levi Waldron, Regan-Heng Zhang, Igor Jurisica, Elena M. Comelli

Publications and Research

The intestinal messenger RNA expression signature is affected by the presence and compo-sition of the endogenous microbiota, with effects on host physiology. The intestine is also characterized by a distinctive micronome. However, it is not known if microbes also impact intestinal gene expression epigenetically. We investigated if the murine caecal microRNA expression signature depends on the presence of the microbiota, and the potential implica-tions of this interaction on intestinal barrier function. Three hundred and thirty four mi-croRNAs were detectable in the caecum of germ-free and conventional male mice and 16 were differentially expressed, with samples from the two groups clustering …

Understanding The Association Of Biomedical, Psychosocial And Behavioral Risks With Adverse Pregnancy Outcomes, Michele Kiely, Ayman El-Mohandes, Marie G. Gantz, Dhuly Chowdhury, Jutta S. Thornberry, M. Nabil El-Khorazaty

Publications and Research

Objectives: This study investigates the relationship between diabetes, hypertension, preeclampsia, and Body Mass Index (BMI) -- the most common and interrelated medical conditions occurring during pregnancy; sociodemographic and behavioral risk factors; and adverse pregnancy outcomes in high-risk urban African American women in Washington, DC.

Methods: Data are from a randomized controlled trial conducted in 6 prenatal clinics. Women in their 1^st or 2^nd trimester were screened for behavioral risks (smoking, environmental tobacco smoke exposure, depression, and intimate partner violence) and demographic eligibility. 1,044 were eligible, interviewed and followed through their pregnancies. Classification and Regression Trees (CART) methodology was …