Public Health Commons^™

Burnout’S Prevalence Estimations: A House Of Cards?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Elmariah et al. (2016) found that 65% of the internal medicine residents who were assessed suffered from burnout. We have 3 concerns about the conclusion. First, the authors used a cutoff score on a burnout measure that is problematic because (a) it is devoid of theoretical or clinical grounding and (b) burnout items were formatted in an unorthodox manner, and (c) including residents who responded "neutral" to a symptom item among those identified as burned out. Second, the authors identified as burned out residents who worked on the night float rotation although the data suggest otherwise. Third information on symptom …

On The Dead End Of Current Research On Burnout's Prevalence, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Dimou et al. (2016) concluded that >50% of surgeons experience burnout. For three reasons, we think that such conclusions are unwarranted. First, there are no consensual or binding diagnostic criteria for burnout. Second, recent research (e.g., Bianchi, Schonfeld, & Laurent, 2015) suggests that burnout is actually a depressive syndrome. Finally, we note that researchers’ recommendations about stress-reducing organizational changes often remain incantatory because they insufficiently consider the economic issues and macrosocial power relationships that can hamper the recommendations’ implementation. Current practices in burnout research have led to an accumulation of results, the clinical meaning of which is obscure.

Burnout-Depression Overlap: A Study Of New Zealand Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Mayor, Eric Laurent

Publications and Research

We examined the overlap of burnout with depression in a sample of 184 New Zealand schoolteachers. Burnout and depressive symptoms were strongly correlated with each other (r = .73; disattenuated correlation: .82) and moderately correlated with dysfunctional attitudes, ruminative responses, and pessimistic attributions. All the participants with high frequencies of burnout symptoms were identified as clinically depressed. Suicidal ideation was reported by 36% of those participants. Three groups of teachers emerged from a two-step cluster analysis: “low burnout-depression,” “medium burnout-depression,” and “high burnout-depression.” The correlation between the affective-cognitive and somatic symptoms of depression was similar in strength to the burnout-depression …

Knowledge-Based Tweet Classification For Disease Sentiment Monitoring, Xiang Ji, Soon Ae Chun, James Geller

Publications and Research

Disease monitoring and tracking is of tremendous value, not only for containing the spread of contagious diseases but also for avoiding unnecessary public concerns and even panic. In this chapter, we present a near real-time sentiment analysis service of public health-related tweets. Traditionally, it is impossible for humans to effectively measure the degree of public health concerns due to limited resources and significant time delays. To solve this problem, we have developed a computational intelligence approach for Epidemic Sentiment Monitoring System (ESMOS) to automatically analyze the disease sentiments and gauge the Measure of Concern (MOC) expressed by Twitter users. More …

An Advertisement Analysis Of Alcohol Products In Popular Women’S Magazines, M Dottington Fullwood, Jennifer Mongiovi, Grace Hillyer, Corey H. Basch, Danna Ethan, Rodney Hammond

Publications and Research

No abstract provided.

Cellmapper: Rapid And Accurate Inference Of Gene Expression In Difficult-To-Isolate Cell Types, Bradlee D. Nelms, Levi Waldron, Luis A. Barrera, Andrew W. Weflen, Jeremy A. Goettel, Guoji Guo, Robert K. Montgomery, Marian R. Neutra, David T. Breault, Scott B. Snapper, Stuart H. Orkin, Martha L. Bulyk, Curtis Huttenhower, Wayne I. Lencer

Publications and Research

We present a sensitive approach to predict genes expressed selectively in specific cell types, by searching publicly available expression data for genes with a similar expression profile to known cell-specific markers. Our method, CellMapper, strongly outperforms previous computational algorithms to predict cell type-specific expression, especially for rare and difficult-to-isolate cell types. Furthermore, CellMapper makes accurate predictions for human brain cell types that have never been isolated, and can be rapidly applied to diverse cell types from many tissues. We demonstrate a clinically relevant application to prioritize candidate genes in disease susceptibility loci identified by GWAS.

The Physical Activity And Redesigned Community Spaces (Parcs) Study: Protocol Of A Natural Experiment To Investigate The Impact Of Citywide Park Redesign And Renovation, Terry T. K. Huang, Katarzyna E. Wyka, Emily Ferris, Jennifer Gardner, Kelly R. Evenson, Devanshi Tripathi, Gabriel Martinez Soto, Matthew S. Cato, Jon Moon, Julia Wagner, Joan M. Dorn, Diane J. Catellier, Lorna E. Thorpe

Publications and Research

Background: The built environment plays a critical role in promoting physical activity and health. The association between parks, as a key attribute of the built environment, and physical activity, however, remains inconclusive. This project leverages a natural experiment opportunity to assess the impact of the Community Parks Initiative (CPI), a citywide park redesign and renovation effort in New York City, on physical activity, park usage, psychosocial and mental health, and community wellbeing.

Methods: The project will use a longitudinal design with matched controls. Thirty intervention park neighborhoods are socio-demographically matched to 20 control park neighborhoods. The study will investigate whether …

Burnout In Firefighters: A Word On Methodology, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

At least three methodological problems affect the study by Katsavouni et al. (2016). First, there are currently no diagnostic criteria for burnout, neither in the DSM-5, nor in the ICD-10. Second, one extremely important variable was omitted from this study of firefighters, namely, depression. Third, the authors did not control for relevant nonoccupational factors such as stressors occurring outside of work.

Job Stress, Inflammation, And Atherosclerosis: A Reflection, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Stress in general has been associated with inflammation and atherosclerosis (Sapolsky, 2004; Slavich and Irwin, 2014). The accumulation of inadequately controlled studies has become a concern (Bianchi, 2016; Schonfeld & Bianchi, 2016). Stronger efforts should be made to take into account both empirically identified and theoretically likely confounders in this research field. Assessing the contribution of job-related factors to given outcomes without simultaneously considering the role of relevant non-job factors is unwarranted. Results from inadequately controlled studies can lead to our making ineffective, or even counter-productive, decisions in terms of public health policies.

The “Burnout” Construct: An Inhibitor Of Public Health Action?, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The prevention and treatment of the “burnout syndrome” within the critical care community is an important objective of the Moss et al. Burnout in the occupational area is based on the idea that burnout is especially common in individuals who care for critically ill patients. We think that the authors’ observations and recommendations are diminished by the fact that studies of burnout’s prevalence are methodologically problematic. The current definition and use of the burnout construct may in fact be detrimental to public health decision making.

Burnout And Depression In Psychiatric Residents, Irvin Sam Schonfeld, Eric Laurent, Pierre Vandel, Renzo Bianchi

Publications and Research

Kealy et al. (2016) found that 21% of psychiatric residents were suffering symptoms of burnout. A number of problems call that finding into question. First, the writers used a one-item measure to assess burnout. Second, mounting evidence suggests that burnout is a depressive syndrome. Third, unresolvable job stress is related to depression. Given burnout's overlap with depression and the diagnostic blur around burnout, research on the impact of job stress should connect with depression, which is nosologically well characterized and diagnosable using clinically validated instruments.

Burnout And Depression: Label-Related Stigma, Help-Seeking, And Syndrome Overlap, Renzo Bianchi, Jay Verkuilen, Romain Brisson, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

We investigated whether burnout and depression differed in terms of public stigma and help-seeking attitudes and behaviors. Secondarily, we examined the overlap of burnout and depressive symptoms. A total of 1046 French schoolteachers responded to an Internet survey in November–December 2015. The survey included measures of public stigma, help-seeking attitudes and behaviors, burnout and depressive symptoms, self-rated health, neuroticism, extraversion, history of anxiety or depressive disorder, social desirability, and socio-demographic variables. The burnout label appeared to be less stigmatizing than the depression label. In either case, however, fewer than 1% of the participants exhibited …

A Randomized Controlled Trial Of A Videoconferencing Smoking Cessation Intervention For Korean American Women: Preliminary Findings, Sun S. Kim, Somporn Sitthisongkram, Kunsook Bernstein, Hua Fang, Won S. Choi, Douglas Ziedonis

Publications and Research

Introduction: Korean women are reluctant to pursue in-person smoking cessation treatment due to stigma attached to women smokers and prefer treatment such as telephone and online smoking cessation programs that they can access secretively at home. However, there is some evidence that face-to-face interaction is the most helpful intervention component for them to quit smoking.

Methods: This study is a pilot clinical trial that examined the acceptability and feasibility of a videoconferencing smoking cessation intervention for Korean American women and compared its preliminary efficacy with a telephone-based intervention. Women of Korean ethnicity were recruited nationwide in the United States and …

When Free Is Not For Me: Confronting The Barriers To Use Of Free Quitline Telephone Counseling For Tobacco Dependence, Christine Sheffer, Sharon Brackman, Charnette Lercara, Naomi Cottoms, Mary Olson, Luana Panissidi, Jami Pittman, Helen Stayna

Publications and Research

Remarkable disparities in smoking rates in the United States contribute significantly to socioeconomic and minority health disparities. Access to treatment for tobacco use can help address these disparities, but quitlines, our most ubiquitous treatment resource, reach just 1%–2% of smokers. We used community-based participatory methods to develop a survey instrument to assess barriers to use of the quitline in the Arkansas Mississippi delta. Barriers were quitline specific and barriers to cessation more broadly. Over one-third (34.9%) of respondents (n = 799) did not have access to a telephone that they could use for the quitline. Respondents reported low levels of …

Pvt1 Exon 9: A Potential Biomarker Of Aggressive Prostate Cancer?, Adeodat Ilboudo, Jyoti Chouhan, Brian K. Mcneil, Joseph R. Osborne, Olorunseun O. Ogunwobi

Publications and Research

Prostate cancer (PCa) is the most commonly diagnosed cancer as well as the greatest source of cancer-related mortality in males of African ancestry (MoAA). Interestingly, this has been shown to be associated with single nucleotide polymorphisms around regions 2 and 3 of the 8q24 human chromosomal region. The non-protein coding gene locus Plasmacytoma Variant Translocation 1 (PVT1) is located at 8q24 and is overexpressed in PCa and, therefore, is also a candidate biomarker to explain the well-known disparity in this group. PVT1 has at least 12 exons that make separate transcripts which may have different functions, all of which are …

Willingness To Take Prep And Potential For Risk Compensation Among Highly Sexually Active Gay And Bisexual Men, Christian Grov, Thomas H.F. Whitfield, H. Jonathan Rendina, Ana Ventuneac, Jeffrey T. Parsons

Publications and Research

Once-daily Truvada (Emtricitabine/Tenofovir) as a method of pre-exposure prophylaxis (PrEP) is one of the most promising biomedical interventions to eliminate new HIV infections; however, uptake among gay, bisexual, and other men who have sex with men has been slow amidst growing concern in popular/social media that PrEP use will result in reduced condom use (i.e., risk compensation). We investigated demographic, behavioral, and psychosocial differences in willingness to use PrEP as well as the perceived impact of PrEP on participants’ condom use in a sample of 206 highly sexually active HIV-negative gay and bisexual men. Nearly half (46.1%) said they would …

Impact Of Executive Order 13211 On Environmental Regulation: An Empirical Study, Elizabeth Ann Glass Geltman

Publications and Research

A great deal has been written about the Energy Policy Act of 2005 exempting oil and gas operations using hydraulic fracturing from the purview of certain federal environmental laws. Far less attention has been paid to George W. Bush’s Executive Order 13211 (EO 13211), entitled “Actions Concerning Regulations that Significantly Affect Energy Supply, Distribution or Use.” The executive order requires federal agencies to evaluate the impact of federal regulations on “supply, distribution and use of energy.” This study examined the impact of EO 13211 on United States environmental and conservation regulations proposed and promulgated by federal agencies. The study found …

Could Androgens Be Relevant To Partly Explain Why Men Have Lower Life Expectancy Than Women?, C Mary Schooling

Publications and Research

No abstract provided.

Changes In Familiarity With And Willingness To Take Prep In A Longitudinal Study Of Highly Sexually Active Gay And Bisexual Men, Christian Grov, H. Jonathan Rendina, Thomas H.F. Whitfield, Ana Ventuneac, Jeffrey T. Parsons

Publications and Research

PURPOSE: For gay and bisexual men (GBM), research suggests that familiarity with Pre-Exposure Prophylaxis (PrEP) has been increasing since being approved by the U.S. FDA in 2012. However, it is less clear how willingness to start using PrEP has changed over time. Likewise, some have expressed concerns regarding the potential for risk compensation (i.e., reduced condom use) were one to start PrEP; however, again, it is unclear how these may have been changing over time.

METHODS: We conducted baseline and 12 month assessments with 158 highly sexually active HIV-negative GBM in NYC who were assessed between 2011 and 2014. …

Diabetes Training For Community Health Workers, Judith Aponte

Publications and Research

Background: A 2.5-month diabetes education training for community health workers (CHWs) was developed, implemented, and evaluated.

Methods: Training methods used included case studies, role-playing, and lectures. Exams were used throughout the training for its evaluation. Teaching was delivered by different ways: a one day American Diabetes Association (ADA) course; a five day Diabetes Self-Management Program (DSMP); Conversation Maps; and a series of seven National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) diabetes education booklets.

Results: Qualitative and quantitative evaluative methods were used during and after the training. The CHWs' diabetes knowledge was evaluated by a pre- and post-test …

'At-Risk' Places: Inequaties In The Distribution Of Environmental Stressors And Prescription Rates Of Mental Health Medications In Glasgow, Scotland, Juliana A. Maantay, Andrew Maroko

Publications and Research

Using geospatial analytical methods, this study examines the association between one aspect of the built environment, namely, the concentration of vacant and derelict land (VDL), and the prevalence of mental health disorders (using the proxy variable of mental health medication prescription rates) in Glasgow, Scotland. This study builds on our previous research, which demonstrated the spatial correspondence between the locations of VDL in Glasgow and several physical health outcomes. Numerous studies of other locales have found similar correspondence between different elements of the built environment and various health outcomes. This is the first study of its kind to look at …

Water And Sanitation Hygiene Knowledge, Attitude, And Practices Among Household Members Living In Rural Setting Of India, Anjana Kuberan, Awnish Kumar Singh, Jyoti Bala Kasav, Satish Prasad, Krishna Mohan Surapaneni, Vandana Upadhyay, Ashish Joshi

Publications and Research

Background: Rural population in developing countries face water, sanitation, and hygiene-related health issues. To objectively highlight these issues, we studied the knowledge, attitude, and practices-related to drinking water and sanitation facilities among the rural population of Chennai, India.

Materials and Methods: A cross-sectional study was designed involving individuals over 18 years of age living in Thandalam village, Chennai, India. Basic information about sociodemographic profile and existing drinking water and sanitation related knowledge, attitude, and practices was collected using a modified version of previously validated questionnaire and analyzed.

Results: Forty-five percent of the participants were not following any methods of water …

The Nutrition And Dietetics Workforce Needs Skills And Expertise In The New York Metropolitan Area, Ann Gaba, Apoorva Srivastava, Chioma Amadi, Ashish Joshi

Publications and Research

Background: There is an increased demand in the Nutrition and Dietetics field which has fostered credentialing to ensure competent graduates. The objective of this study is to conduct an exploratory analysis to identify nutrition/dietetics workforce needs, skills and expertise in the New York metropolitan area as exemplified in position announcements over a 4 year period.

Methods: We recorded position announcements for jobs in nutrition and dietetics from the New York State Registered Dietitian Yahoo group, and the Hunter College Nutrition and Food Sciences student and alumni listserv (NFS-L) over a 4 year period. Keywords were identified using job categories defined …

A Protocol For Developing An Evaluation Framework For An Academic And Private-Sector Partnership To Assess The Impact Of Major Food And Beverage Companies’ Investments In Community Health In The United States, Terry T-K Huang, Emily Ferris, Rachel Crossley, Michelle Guillermin, Sergio Costa, John Cawley

Publications and Research

Public health leaders increasingly recognize the importance of multi-sector partnerships and systems approaches to address obesity. Public-private partnerships (PPP), which are joint ventures between government agencies and private sector entities, may help facilitate this process, but need to be delivered through comprehensive, transparent frameworks to maximize potential benefits and minimize potential risks for all partners. The City University of New York (CUNY) School of Public Health and the Healthy Weight Commitment Foundation (HWCF) propose to engage in a unique academic-private-sector research partnership to evaluate the impact and effectiveness of the food and beverage industry’s investment in obesity and hunger prevention …

Rising Gasoline Prices Increase New Motorcycle Sales And Fatalities, He Zhu, Fernando A. Wilson, Jim P. Stimpson, Peter E. Hilsenrath

Publications and Research

Background: We examined whether sales of new motorcycles was a mechanism to explain the relationship between motorcycle fatalities and gasoline prices.

Methods: The data came from the Motorcycle Industry Council, Energy Information Administration and Fatality Analysis Reporting System for 1984–2009. Autoregressive integrated moving average (ARIMA) regressions estimated the effect of inflation-adjusted gasoline price on motorcycle sales and logistic regressions estimated odds ratios (ORs) between new and old motorcycle fatalities when gasoline prices increase.

Results: New motorcycle sales were positively correlated with gasoline prices (r = 0.78) and new motorcycle fatalities (r = 0.92). ARIMA analysis estimated that a US$1 increase …

Inconsistencies Exist In National Estimates Of Eye Care Services Utilization In The United States, Fernando A. Wilson, Jim P. Stimpson, Yang Wang

Publications and Research

Background. There are limited research and substantial uncertainty about the level of eye care utilization in the United States. Objectives. Our study estimated eye care utilization using, to our knowledge, every known nationally representative, publicly available database with information on office-based optometry or ophthalmology services.

Research Design. We analyzed the following national databases to estimate eye care utilization: the Medical Expenditure Panel Survey (MEPS), National Health Interview Survey (NHIS), Joint Canada/US Survey of Health (JCUSH), Behavioral Risk Factor Surveillance System (BRFSS), and the National Ambulatory Medical Care Survey (NAMCS). Subjects. US adults aged 18 and older. Measures. Self-reported utilization …

Comparative Analysis Of Dietary Guidelines In The Spanish-Speaking Caribbean, Melissa Fuster

Publications and Research

Objective: Dietary guidelines are important education and policy tools to address local nutrition concerns. The current paper presents a comparative analysis of nutrition messages from three Spanish-speaking Caribbean countries (Cuba, Puerto Rico and Dominican Republic) to explore how these dietary guidelines address common public health nutrition concerns, contextualized in different changing food environments and food culture similarities.

Design: Qualitative, comparative analysis of current dietary guideline documents and key recommendations.

Results: Key recommendations were categorized into sixteen themes (two dietbased, ten food-based and four ‘other’). Only the Cuban dietary guidelines included diet-based key recommendations. Of the ten food-based …

Aggregate And Event-Level Associations Of Substance Use And Sexual Behavior Among Gay And Bisexual Men: Comparing Retrospective And Prospective Data, H. Jonathan Rendina, Raymond L. Moody, Ana Ventuneac, Christian Grov, Jeffrey T. Parsons

Publications and Research

Background: Despite limited research, some evidence suggests that examining substance use at multiple levels may be of greater utility in predicting sexual behavior than utilizing one level of measurement, particularly when investigating different substances simultaneously. We aimed to examine aggregated and event-level associations between three forms of substance use—alcohol, marijuana, and club drugs—and two sexual behavior outcomes—sexual engagement and condomless anal sex (CAS).

Method: Analyses focused on both 6-week timeline follow-back (TLFB; retrospective) and 30-day daily diary (prospective) data among a demographically diverse sample of 371 highly sexually active HIV-positive and HIV-negative gay and bisexual men.

Results: …

Rationale, Design And Respondent Characteristics Of The 2013–2014 New York City Health And Nutrition Examination Survey (Nyc Hanes 2013–2014), Lorna E. Thorpe, Carolyn Greene, Amy Freeman, Elisabeth Snell, Jesica S. Rodriguez-Lopez, Martin Frankel, Amado Punsalang Jr., Claudia Chernov, Elizabeth Lurie, Mark Friedman, Ram Koppaka, Sharon E. Perlman

Publications and Research

Purpose. Capacity to monitor non-communicable diseases (NCDs) at state or local levels is limited. Emerging approaches include using biomeasures and electronic health record (EHR) data. In 2004, New York City (NYC) performed a population-based health study on adult residents using biomeasures (NYC Health and Nutrition Examination Study, or NYC HANES), modeled after NHANES. A second NYC HANES was launched in 2013 to examine change over time, evaluate municipal policies, and validate a proposed EHR-based surveillance system. We describe the rationale and methods of NYC HANES 2013–2014.

Methods. NYC HANES was a population-based, cross-sectional survey of NYC adults using three-stage cluster …

Familiarity With And Preferences For Oral And Long-Acting Injectable Hiv Pre-Exposure Prophylaxis (Prep) In A National Sample Of Gay And Bisexual Men In The U.S., Jeffrey T. Parsons, H. Jonathan Rendina, Thomas H.F. Whitfield, Christian Grov

Publications and Research

Objectives: We sought to determine preferences for oral versus long-acting injectable (LAI) PrEP among gay and bisexual men (GBM).

Methods: We surveyed a national U.S. sample of 1,071 GBM about forms of PrEP.

Results: Overall, 46.0% preferred LAI, 14.3% oral, 21.7% whichever was most effective, 10.1% had no preference, and 7.8% would not take PrEP. There were no differences in PrEP preferences by race/ethnicity, income, region of residence, or relationship status. Those unwilling to take PrEP were significantly older than those who preferred LAI PrEP and those who would take either. Those who preferred the most effective …