Public Health Commons^™

Evaluation Of Self-Report Adherence Measures And Their Associations With Detectable Viral Load Among People Living With Hiv (Plhiv) In China, Wendi Da, Xiaoming Li Ph.D., Shan Qiao Ph.D., Yuejiao Zhou, Zhiyong Shen

Faculty Publications

Objectives Self-report antiretroviral therapy (ART) adherence has been consistently associated with clinical outcomes. This study aims to compare the accuracy of self-report ART adherence measures with varying recall timeframes or item contents to predict virological response.

Methods Data from a cross-sectional study among 2146 participants on ART in Guangxi, China were used. Detectable viral load was defined as viral load > 50 copies/ml. Adherence was measured using the number of days on which all doses were taken in the past month (i.e., the “one-month days taken” measure), the number of days on which any dose was missed in the past month …

Large-Scale Social And Behavior Change Communication Interventions Have Sustained Impacts On Infant And Young Child Feeding Knowledge And Practices: Results Of A 2-Year Follow-Up Study In Bangladesh, Sunny S. Kim, Phuong Hong Nguyen, Lan Mai Tran, Tina Sanghvi, Zeba Mahmud, Mohammad Raisul Haque, Kaosar Afsana, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Background: Sustained improvements in infant and young child feeding (IYCF) require continued implementation of effective interventions. From 2010-2014, Alive & Thrive (A&T) provided intensive interpersonal counseling (IPC), community mobilization (CM), and mass media (MM) in Bangladesh, demonstrating impact on IYCF practices. Since 2014, implementation has been continued and scaled up by national partners with support from other donors and with modifications such as added focus on maternal nutrition and reduced program intensity. Objective: We assessed changes in intervention exposure and IYCF knowledge and practices in the intensive (IPC + CM + MM) compared with nonintensive areas (standard nutrition counseling + …

Attitudes Toward Evidence-Based Practice, Occupational Stress And Work-Related Social Support Among Health Care Providers In China: A Sem Analysis, Shan Qiao Ph.D., Xiaoming Li Ph.D., Yuejiao Zhou, Zhiyong Shen, Bonita Stanton

Faculty Publications

Individuals’ attitudes toward evidence-based practices (EBP) are critical in adopting, implementing and maintaining the EBP in clinical settings. Multiple empirical studies have examined how work context may shape perceptions and attitudes towards EBP. The current study aims to further explore how both work and family contexts, as assessed by three psychosocial indicators (i.e., occupational stress, work-related social support from coworkers, and work-related social support from family), may affect attitudes toward EBP among health care providers in HIV clinics in China. We analyzed cross-sectional survey data from 357 health care providers recruited from 40 HIV clinics across 16 cities/counties in Guangxi …

Dietary Inflammatory Index And Biomarkers Of Lipoprotein Metabolism, Inflammation And Glucose Homeostasis In Adults, Catherine Phillips, Nitin Shivappa, James R. Hébert, Ivan Perry

Faculty Publications

Accumulating evidence identifies diet and inflammation as potential mechanisms contributing to cardiometabolic risk. However, inconsistent reports regarding dietary inflammatory potential, biomarkers of cardiometabolic health and metabolic syndrome (MetS) risk exist. Our objective was to examine the relationships between a food frequency questionnaire (FFQ)-derived dietary inflammatory index (DII®), biomarkers of lipoprotein metabolism, inflammation and glucose homeostasis and MetS risk in a cross-sectional sample of 1992 adults. Energy-adjusted DII (E-DII) scores derived from an FFQ were calculated. Lipoprotein particle size and subclass concentrations were measured using nuclear magnetic resonance (NMR) spectroscopy. Serum acute-phase reactants, adipocytokines, pro-inflammatory cytokines and white blood cell (WBC) …

Engagement Of Husbands In A Maternal Nutrition Program Substantially Contributed To Greater Intake Of Micronutrient Supplements And Dietary Diversity During Pregnancy: Results Of A Cluster-Randomized Program Evaluation In Bangladesh, Phuong Hong Nguyen, Edward A. Frongillo Jr., Tina Sanghvi, Gargi Wable, Zeba Mahmud, Lan Mai Tran, Bachera Aktar, Kaosar Afsana, Silvia Alayon, Marie T. Ruel, Purnima Menon

Faculty Publications

Background:

Although husbands may provide support during pregnancy, limited evidence exists on how to promote husbands' engagement and what impact it has. Alive & Thrive integrated nutrition-focused interventions, targeting both wives and husbands, through an existing Maternal, Neonatal, and Child Health (MNCH) platform in Bangladesh.

Objectives:

We evaluated 1) the impact of a nutrition-focused MNCH program, compared with the standard MNCH program, on husbands' behavioral determinants (i.e., awareness, knowledge, self-efficacy) and support to wives to adopt optimal nutrition practices and 2) how much of the previously documented impact on women's supplement intake and dietary diversity was explained by husbands' behavioral …

Design, Development And Construct Validation Of The Children’S Dietary Inflammatory Index, Samira Khan, Micheal D. Wirth, Andrew Ortaglia, Christian R. Alvarado, Nitin Shivappa, Thomas Hurley, James R. Hébert

Faculty Publications

Objective: To design and validate a literature-derived, population-based Children’s Dietary Inflammatory Index (C-DII)TM. Design: The C-DII was developed based on a review of literature through 2010. Dietary data obtained from children in 16 different countries were used to create a reference database for computing C-DII scores based on consumption of macronutrients, vitamins, minerals, and whole foods. Construct validation was performed using quantile regression to assess the association between C-reactive protein (CRP) concentrations and C-DII scores. Data Sources: All data used for construct validation were obtained from children between six and 14 years of age (n = 3300) who participated in …

Smokers' Neurological Responses To Novel And Repeated Health Warning Labels (Hwls) From Cigarette Packages, Johann F. Fridriksson, Chris Rorden, Roger D. Newman-Norlund, Brett Froeliger, Jim Thrasher

Faculty Publications

Graphic health warning labels (HWLs) depicting bodily injury due to smoking are effective for producing changes in affect, cognition and smoking behavior in adult smokers. However, little is known about the effects of repeated presentation of graphic HWL’s on the aforementioned processes. The goal of this study was to examine neural and behavioral responses to graphic HWL’s and evaluate whether the repeated presentation of graphic HWL’s leads to repetition suppression (RS). Smokers (N = 16) performed an event-related HWL cue task while blood oxygen level dependent (BOLD) signal was collected during a functional magnetic resonance imaging (fMRI) experimental session. Consistent …

Aerosol Microdroplets Exhibit A Stable Ph Gradient, Haoran Wei, Eric P. Vejerano, Weinan Leng, Qishen Haung, Marjorie R. Willner, Linsey C. Marr, Peter J. Vikesland

Faculty Publications

Suspended aqueous aerosol droplets (<50 μm) are microreactors for many important atmospheric reactions. In droplets and other aquatic environments, pH is arguably the key parameter dictating chemical and biological processes. The nature of the droplet air/ water interface has the potential to significantly alter droplet pH relative to bulk water. Historically, it has been challenging to measure the pH of individual droplets because of their inaccessibility to conventional pH probes. In this study, we scanned droplets containing 4-mercaptobenzoic acid–functionalized gold nanoparticle pH nanoprobes by 2D and 3D laser confocal Raman microscopy. Using surface-enhanced Raman scattering, we acquired the pH distribution inside approximately 20-μm-diameter phosphate-buffered aerosol droplets and found that the pH in the core of a droplet is higher than that of bulk solution by up to 3.6 pH units. This finding suggests the accumulation of protons at the air/water interface and is consistent with recent thermodynamic model results. The existence of this pH shift was corroborated by the observation that a catalytic reaction that occurs only under basic conditions (i.e., dimerization of 4-aminothiophenol to produce dimercaptoazobenzene) occurs within the high pH core of a droplet, but not in bulk solution. Our nanoparticle probe enables pH quantification through the cross-section of an aerosol droplet, revealing a spatial gradient that has implications for acid-base–catalyzed atmospheric chemistry.

Validity Of The Food Insecurity Experience Scale For Use In Sub-Saharan Africa And Characteristics Of Food-Insecure Individuals, Edwina A. Wambogo, Hala Ghattas Ph.D., Kenneth L. Leonard, Nadine R. Sahyoun

Faculty Publications

Background

The Food Insecurity Experience Scale (FIES) is a UN FAO-Voices of the Hungry project (FAO-VoH) metric of food insecurity (FI). The FAO-VoH tested the psychometric properties of FIES with the use of global 2014 Gallup World Poll (GWP) data. However, similarities in its psychometric structure in sub-Saharan Africa (SSA) to allow aggregation of SSA results were untested.

Objectives

We aimed to 1) assess the validity of FIES for use in SSA, 2) determine the prevalence of FI by country, age group, and gender, and 3) examine the sociodemographic and economic characteristics of individuals with FI.

Methods

The Rasch modeling …

Socioeconomic Determinants Of Broadband Non-Adoption Among Consumer Households In South Carolina, Usa, Lori Dickes, Elizabeth L. Crouch, Thomas Walker

Faculty Publications

he policy environment around broadband technology in the United States is shifting again and there are concerns about the impact these proposed changes will have on the future of rural bro- adband deployment and access. Similar to the Obama administration’s discussion of net neutrality, reclas- sifying high-speed internet is again receiving growing media and policy attention at the federal and state level in the United States. Globally, it is argued that affordable high-speed internet access is imperative to rural and regional economic development success. The global digital divide and challenges of non-adoption impact both developing and developed nations. While many …

Infant And Young Child Feeding In Emergencies: Organisational Policies And Activities During The Refugee Crisis In Lebanon, Linda Shaker-Berbari, Hala Ghattas Ph.D., Andrew G. Symon, Annie S. Anderson

Faculty Publications

Appropriate infant and young child feeding (IYCF) is key to reducing mortality amongst children aged under 2. Facilitating adherence to recommended IYCF practices during emergencies includes having relevant policies to support breastfeeding and complementary feeding as well as regulating the distribution of breast milk substitutes. In the current crisis, more than 1.2 million Syrian refugees are in Lebanon and it is timely to examine organisational IYCF policies and programmes. One hundred and thirty-five non-governmental organisations providing humanitarian aid in Lebanon were invited to participate in an online survey about organisational policies and programmatic activities on IYCF. Responses were obtained from …

Prostate Cancer Information Available In Health-Care Provider Offices: An Analysis Of Content, Readability, And Cultural Sensitivity, Seul Ki Choi, Jessica S. Seel, Brooks Yelton Ma, Lmsw, Susan E. Steck Phd, Mph, Rd, Douglas P. Mccormick, Johnny Payne, Anthony Minter, Elizabeth K. Deutchki, James Hébert Scd, Daniela B. Friedman Ph.D.

Faculty Publications

Prostate cancer (PrCA) is the most common cancer affecting men in the United States, and African American men have the highest incidence among men in the United States. Little is known about the PrCA-related educational materials being provided to patients in health-care settings. Content, readability, and cultural sensitivity of materials available in providers’ practices in South Carolina were examined. A total of 44 educational materials about PrCA and associated sexual dysfunction was collected from 16 general and specialty practices. The content of the materials was coded, and cultural sensitivity was assessed using the Cultural Sensitivity Assessment Tool. Flesch Reading Ease, …

Disclosure Of Homosexual Behaviors To Healthcare Providers And Uptake Of Hiv Testing For Men Who Have Sex With Men: A Systematic Review., Shan Qiao Ph.D., Guangyu Zhou, Xiaoming Li

Faculty Publications

To promote HIV-testing and offer optimal care for men who have sex with men (MSM), health-care providers (HCPs) must first be aware of their patients’ sexual behaviors. Otherwise, HCPs may overlook MSM’s risks for HIV infection and their special health-care needs. For MSM, reporting their same-sex behaviors to HCPs (disclosure to HCPs) may promote their linkage to HIV prevention and treatment cascade and improve their health outcomes. No literature review has been conducted to examine the relationship between disclosure to HCPs and uptake of HIV-testing among MSM. The current study reviewed and synthesized findings from 29 empirical studies published in …

Best Practices For Developing And Validating Scales For Health, Social, And Behavioral Research: A Primer, Godfred O. Boateng, Torsten B. Neilands, Edward A. Frongillo Jr., Hugo R. Melgar-Quiñonez, Sera L. Young

Faculty Publications

Scale development and validation are critical to much of the work in the health, social, and behavioral sciences. However, the constellation of techniques required for scale development and evaluation can be onerous, jargon-filled, unfamiliar, and resource-intensive. Further, it is often not a part of graduate training. Therefore, our goal was to concisely review the process of scale development in as straightforward a manner as possible, both to facilitate the development of new, valid, and reliable scales, and to help improve existing ones. To do this, we have created a primer for best practices for scale development in measuring complex phenomena. …

Cohort Profile: The Maternal And Infant Nutrition Interventions In Matlab (Minimat) Cohort In Bangladesh, Shams El Arifeen, Eva-Charlotte Ekström, Edward A. Frongillo Jr., Jena Hamadani, Ashraful I. Khan, Ruchira T. Naved, Anisur Rahman, Rubhana Raqib, Kathleen M. Rasmussen, Katarina Ekholm Selling, Yukiko Wagatsuma, Lars Åke Persson

Faculty Publications

No abstract provided.

The Importance Of Interdisciplinarity: Redefining The Health Belief Model, Ross F. Lordo

Senior Theses

Throughout academia, there lacks an existence of a commonly utilized multicomponent and interdisciplinary approach in understanding our outside world. This thesis provides an analysis of the current state of interdisciplinarity and the need to develop interdisciplinary theory. Through this effort, the researcher utilizes the health belief model as a framework that is severely limited in applicable scope due to its constructs. Contrastingly, systems theory and game theory are validated as examples of theories with an interdisciplinary nature. Through the coding of the literature pertaining to the qualitative characteristics of the health belief model, game theory and systems theory, guidelines in …

When Helping Helps: Exploring Health Benefits Of Cancer Survivors Participating In For-Cause Physical Activity Events, Renée M. Umstattd Meyer, Andrew R. Meyer, Cindy Wu, John Bernhart Ph.D., Mph, Ches

Faculty Publications

Background

Over 15.5 million Americans live with cancer and 5-year survival rates have risen to 69%. Evidence supports important health benefits of regular physical activity for cancer survivors, including increased strength and quality of life, and reduced fatigue, recurrence, and mortality. However, physical activity participation among cancer survivors remains low. Cancer organizations provide various resources and support for cancer survivors, including emotional, instrumental, informational, and appraisal support. Many cancer organizations, like the LIVESTRONG Foundation, support the cancer community by sponsoring and hosting for-cause physical activity events, providing opportunities for anyone (including cancer survivors) to “help”/support those living with cancer. The …

Dietary Diversity Predicts The Adequacy Of Micronutrient Intake In Pregnant Adolescent Girls And Women In Bangladesh, But Use Of The 5-Group Cutoff Poorly Identifies Individuals With Inadequate Intake, Phuong Hong Nguyen, Lieven Huybregts, Tina G. Sanghvi, Lan Mai Tran, Edward A. Frongillo Jr., Purnima Menon, Marie T. Ruel

Faculty Publications

Background: The Minimum Dietary Diversity for Women (MDD-W) indicator based on a 10-food group women dietary diversity score (WDDS-10) has been validated to assess dietary quality in nonpregnant women. Little is known about its applicability in pregnant women, and specifically pregnant adolescent girls with higher nutrient requirements. Objectives: This study aimed to 1) compare the adequacy of micronutrient intakes between pregnant adolescent girls and women, 2) examine the performance of WDDS-10 in predicting the mean probability of adequacy (MPA) of 11 micronutrients, and 3) assess how well the MDD-W cutoff of 5 groups performed in pregnant adolescent girls and women. …

Which Type Of Tobacco Product Warning Imagery Is More Effective And Sustainable Over Time?, Dien Anshari, Hua-Hei Yong, Ron Borland, Kamala Swayampakala, Jim Thrasher

Faculty Publications

Objective This study examined smokers’ responses to pictorial health warnings (PHWs) with different types of imagery under natural exposure conditions.

Methods Adult smokers from online panels in Canada (n=2357), Australia (n=1671) and Mexico (n=2537) were surveyed every 4 months from 2012 to 2013. Participants were shown PHWs on packs in their respective countries and asked about: (1) noticing PHWs; (2) negative affects towards PHWs; (3) believability of PHWs; (4) PHW-stimulated discussions; and (5) quit motivation due to PHWs. Country-specific generalised estimating equation models regressed these outcomes on time (ie, survey wave), PHW imagery type (ie, symbolic representations of risk, suffering …

Importance Of Coverage And Quality For Impact Of Nutrition Interventions Delivered Through An Existing Health Programme In Bangladesh, Phuong Hong Nguyen, Edward A. Frongillo Jr., Tina Sanghvi, Sunny S. Kim, Silvia Alayon, Lan Mai Tran, Zeba Mahmud, Bachera Aktar, Purnima Menon

Faculty Publications

Understanding implementation of interventions is critical to illuminate if, how, and why the interventions achieve impact. Alive & Thrive integrated a nutrition intervention into an existing maternal, neonatal, and child health (MNCH) programme in Bangladesh, documenting improvements in women's micronutrient supplement intake and dietary diversity. Here, we examined how well the nutrition intervention was implemented and which elements of implementation explained intervention impact. Survey data were collected in 2015 and 2016 from frontline health workers (FLW) and households in areas randomized to nutrition‐focused MNCH (intensified interpersonal counselling, community mobilization, distribution of free micronutrient supplements, and weight‐gain monitoring) or standard MNCH …

Impressions Of Participants In A Chemical Mass Casualty Exercise, Ethan J. Start, Joan M. Culley, Abbas Tavakoli

Senior Theses

A mass casualty exercise was performed to investigate triage and decontamination of patients exposed to an irritant gas. Nursing students participated in two groups: emergency department triage (ED) and decontamination (DECON). While participants felt overall that the experience was valuable, DECON participants had a greater interest in emergency response and were more likely to volunteer again.

Reducing High-Users’ Visits To The Emergency Department By A Primary Care Intervention For The Uninsured: A Retrospective Study, Meng-Han Tsai, Sudha Xirasagar Mbbs., Ph.D., Scott Carroll, Charles S. Bryan, Pamela J. Gallagher, Kim Davis, Edward C. Jauch

Faculty Publications

Reducing avoidable emergency department (ED) visits is an important health system goal. This is a retrospective cohort study of the impact of a primary care intervention including an in-hospital, free, adult clinic for poor uninsured patients on ED visit rates and emergency severity at a nonprofit hospital. We studied adult ED visits during August 16, 2009-August 15, 2011 (preintervention) and August 16, 2011-August 15, 2014 (postintervention). We compared pre- versus postmean annual visit rates and discharge emergency severity index (ESI; triage and resource use–based, calculated Agency for Healthcare Research and Quality categories) among high-users (≥3 ED visits in 12 months) …

Dietary Inflammatory Index And Type 2 Diabetes Mellitus In Adults: The Diabetes Mellitus Survey Of Mexico City, Edgar Denova-Gutiérrez, Paloma Muñoz-Aguirre, Nitin Shivappa, James R. Hébert, Lizbeth Tolentino-Mayo, Carolina Batis, Simón Barquera

Faculty Publications

Diet and inflammation are both associated with type 2 diabetes mellitus (T2DM). In the present study, we aimed to assess the relation between the dietary inflammatory index (DII) and the presence of T2DM in Mexican adults participating in the Diabetes Mellitus Survey administered in Mexico City (DMS-MC). The study involved 1174 subjects (48.5% men) between 20–69 years of age. A validated semi-quantitative food frequency questionnaire was employed to evaluate dietary intake and to compute DII. The DII is based on scientific evidence about the association between dietary compounds and six established inflammatory biomarkers. Multivariate logistic regression models were used to …

Antenatal Care Satisfaction In A Developing Country: A Cross-Sectional Study From Nigeria, Dumbiri J. Onyeajam, Sudha Xirasagar Mbbs., Ph.D., Mahmud M. Khan, James W. Hardin, Oluwole Odutolu

Faculty Publications

Background

Utilization of Antenatal Care (ANC) is very low in Nigeria. Self-reported patient satisfaction may be useful to identify provider- and facility-specific factors that can be improved to increase ANC satisfaction and utilization.

Methods

Exit interview data collected from ANC users and facility assessment survey data from 534 systematically selected facilities in four northern Nigerian states were used. Associations between patient satisfaction (satisfied, not-satisfied) and patient ratings of the provider’s interactions, care processes, out-of-pocket costs, and quality of facility infrastructure were studied.

Results

Of 1336 mothers, 90% were satisfied with ANC. Patient satisfaction was positively associated with responsive service (prompt, …

Antenatal Care Satisfaction In A Developing Country: A Study From Nigeria, Dumbiri J. Onyeajam, Sudha Xirasagar, Mahmud M. Khan, James W. Hardin, Oluwole Odutolu

Faculty Publications

Background: Utilization of Antenatal Care (ANC) is very low in Nigeria. Self-reported patient satisfaction may be useful to identify provider- and facility-specific factors that can be improved to increase ANC satisfaction and utilization.

Methods: Exit interview data collected from ANC users and facility assessment survey data from 534 systematically selected facilities in four northern Nigerian states were used. Associations between patient satisfaction (satisfied, not-satisfied) and patient ratings of the provider’s interactions, care processes, out-of-pocket costs, and quality of facility infrastructure were studied.

Results: Of 1336 mothers, 90% were satisfied with ANC. Patient satisfaction was positively associated with responsive service (prompt, …

Integrating Nutrition Into Health Systems At Community Level:Impact Evaluation Of The Community‐Based Maternal Andneonatal Health And Nutrition Projects In Ethiopia, Kenya, And Senegal, Jacqueline K. Kung'u, Richard Pendame, Mame Bineta Ndiaye, Mulusew Gerbaba, Sophie Ochola, Adama Faye, Sulochana Basnet, Edward A. Frongillo Jr., Sara Wuehler, Luz Maria De‐Regil

Faculty Publications

Maternal undernutrition and mortality remain high in several African countries. Key nutrition andhealth interventions improve maternal and birth outcomes. Evidence is scarce on how tostrengthen health systems to ensure pregnant women and newborns are reached with theseinterventions. We conducted three quasi‐experimental nonrandomized Community BasedMaternal and Neonatal Health and Nutrition projects in regions of Ethiopia, Senegal, and Kenyato demonstrate how proven nutrition interventions could be integrated into health programs toimprove knowledge and practices during pregnancy, birth, and postpartum. We evaluated impacton knowledge and practices related to maternal and neonatal care using logistic regression andrepeated‐measures models with districts as a fixed variable …

Factors Associated With Quit Attempts And Smoking Cessation In Brazil: Findings From The International Tobacco Control Brazil Survey, Leticia Casado, Jim Thrasher, Cristina Perez, Luiz Claudio Thuler, Geoffrey T. Fong

Faculty Publications

Background:
In Brazil, the treatment of tobacco dependence is available at no cost. This study aimed to identify factors associated with attempting to quit and of successful smoking cessation in a population-based sample of Brazilian smokers.

Methods:
Data came from the first two waves of the International Tobacco Control (ITC) Brazil Survey, conducted in 2009 and 2012/2013 in three cities: Rio de Janeiro, São Paulo, and Porto Alegre. Prospective cohort data were collected from 488 adults (≥18 years) who smoked at Wave 1 who were resurveyed at Wave 2. Crude and adjusted relative risks (RR) for two outcomes (making a …

Physico-Chemical Characteristics Of Evaporating Respiratory Fluid Droplets, Eric P. Vejerano, Linsey C. Marr

Faculty Publications

The detailed physico-chemical characteristics of respiratory droplets in ambient air, where they are subject to evaporation, are poorly understood. Changes in the concentration and phase of major components in a droplet—salt (NaCl), protein (mucin) and surfactant (dipalmitoylphosphatidylcholine)—may affect the viability of any pathogens contained within it and thus may affect the efficiency of transmission of infectious disease by droplets and aerosols. The objective of this study is to investigate the effect of relative humidity (RH) on the physico-chemical characteristics of evaporating droplets of model respiratory fluids. We labelled these components in model respiratory fluids and observed evaporating droplets suspended on …

Sociocultural And Health System Factors Associated With Mortality Among Febrile Inpatients In Tanzania: A Prospective Social Biopsy Cohort Study, Michael E. Snavely, Michael J. Maze, Charles Muiruri, Lilian Ngowi, Flora Mboya, Julia Beamesderfer, Glory F. Makupa, Anthon G. Mwingwa, Bingileki F. Lwezaula, Blandina T. Mmbaga, Venance P. Maro, John A. Crump, Jan Ostermann, Matthew P. Rubach

Faculty Publications

Introduction Communicable diseases are the leading causes of death in Tanzania despite the existence of effective treatment tools. We aimed to assess the sociocultural and health system factors associated with mortality from febrile illness in northern Tanzania.

Methods We interviewed febrile inpatients to determine prevalence of barriers in seeking or receiving care and grouped these barriers using the Three Delays model (delays at home, in transport and at healthcare facilities). We assessed 6-week mortality and, after matching on age, gender and severity of illness, measured the association between delays and mortality using conditional logistic regression.

Results We enrolled 475 children, …

Dietary Inflammatory Index And Cardiovascular Risk And Mortality—A Meta-Analysis, Nitin Shivappa, Justyna Godos, James R. Hébert, Michael Wirth, Gabriele Piuri, Attilio Speciani, Giuseppe Grosso

Faculty Publications

Diet and chronic inflammation have been suggested to be risk factors in the development of cardiovascular disease (CVD) and related mortality. The possible link between the inflammatory potential of diet measured through the Dietary Inflammatory Index (DII^®) and CVD has been investigated in several populations across the world. The aim of this study was to conduct a meta-analysis on studies exploring this association. Data from 14 studies were eligible, of which two were case-control, eleven were cohort, and one was cross-sectional. Results from the random-effects meta-analysis showed a positive association between increasing DII, indicating a pro-inflammatory diet, and …