Public Health Commons^™

Burnout: Absence Of Binding Diagnostic Criteria Hampers Prevalence Estimates, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Comments on an article by Jef Adriaenssens et al. (see record 2015-00662-015). In a recent review paper, Adriaenssens et al. concluded that about 26% of emergency nurses (EN) suffer from burnout and described their results as alarming. While commentators applaud Adriaenssens et al. efforts to provide a clearer picture of ill-health in EN, they thought that these authors' conclusions were weakened by a fundamental fact, namely, the absence of consensual, clinically valid diagnostic criteria for burnout. Trying to determine the prevalence of a condition that has no binding diagnostic criteria is problematic. Indeed, depending on how researchers decide to …

Bayesian Nonparametric Cross-Study Validation Of Prediction Methods, Lorenzo Trippa, Levi Waldron, Curtis Huttenhower, Giovanni Parmigiani

Publications and Research

We consider comparisons of statistical learning algorithms using multiple data sets, via leave-one-in cross-study validation: each of the algorithms is trained on one data set; the resulting model is then validated on each remaining data set. This poses two statistical challenges that need to be addressed simultaneously. The first is the assessment of study heterogeneity, with the aim of identifying a subset of studies within which algorithm comparisons can be reliably carried out. The second is the comparison of algorithms using the ensemble of data sets. We address both problems by integrating clustering and model comparison. We formulate a Bayesian …

Patchy Progress On Obesity Prevention: Emerging Exemplars, Entrenched Barriers, And New Thinking, Christina A. Roberto, Boyd Swinburn, Corinna Hawkes, Terry T-K Huang, Sergio Costa, Marice Ashe, Lindsey Zwicker, John H. Cawley, Kelly D. Brownell

Publications and Research

Although there have been positive pockets of change, no country has yet turned around its obesity epidemic. Preventing an increase in obesity prevalence will require urgent actions from government as well as a broader spectrum of stakeholders than previously emphasized. In this paper, we review a number of regulatory and non-regulatory actions taken around the world to address obesity and discuss some of the reasons for the patchy progress. In addition, we preview the papers in this Lancet series, which each identify priority actions on key obesity issues and challenge some of the entrenched dichotomies that present obesity and its …

Exploring Social Networking Technologies As Tools For Hiv Prevention For Men Who Have Sex With Men, Jorge Ramallo, Thomas Kidder, Tashuna Albritton, Gary Blick, John Pachankis, Valen Grandeleski, Trace Kershaw

Publications and Research

Social networking technologies are influential among men who have sex with men (MSM) and may be an important strategy for HIV prevention. We conducted focus groups with HIV positive and negative participants. Almost all participants used social networking sites to meet new friends and sexual partners. The main obstacle to effective HIV prevention campaigns in social networking platforms was stigmatization based on homosexuality as well as HIV status. Persistent stigma associated with HIV status and disclosure was cited as a top reason for avoiding HIV-related conversations while meeting new partners using social technologies. Further, social networking sites have different social …

Promoting Colorectal Cancer Screening Among Haitian Americans, Steven S. Coughlin, Erica I. Lubetkin, Jennifer L. Hay, Renald Raphael, Selina A. Smith

Publications and Research

Background

Few studies have examined colorectal cancer screening among Haitian Americans, although striking disparities in colorectal cancer screening and mortality are well-documented among U.S. Blacks. Race, socioeconomic status, and place of birth are factors associated with colorectal cancer incidence and mortality patterns.

Methods

In this article, we summarize published studies on colorectal cancer screening among Haitian Americans, identified through bibliographic searches in PubMed and CINAHL through August 2015, and offer recommendations for further research.

Results

Only one qualitative study and three quantitative surveys have examined colorectal cancer screening among Haitian Americans. A qualitative study found important differences in perceptions of …

Rationale, Design, And Method Of The Diabetes & Women’S Health Study – A Study Of Long-Term Health Implications Of Glucose Intolerance In Pregnancy And Their Determinants, Cuilin Zhang, Frank B. Hu, Sjurdur F. Olsen, Allan Vaag, Robert Gore-Langton, Jorge E. Chavarro, Wei Bao, Edwina Yeung, Katherine Bowers, Louise Groth Grunnet, Seth Sherman, Michele Kiely, Marin Strøm, Susanne Hansen, Aiyi Liu, James Mills, Ruzong Fan

Publications and Research

Women who develop gestational diabetes mellitus or impaired glucose tolerance during pregnancy are at substantially increased risk for type 2 diabetes and comorbidities after pregnancy. Little is known about the role of genetic factors and their interactions with environmental factors in determining the transition from gestational diabetes mellitus to overt type 2 diabetes mellitus. These critical data gaps served as the impetus for this Diabetes & Women’s Health study with the overall goal of investigating genetic factors and their interactions with risk factors amenable to clinical or public health interventions in relation to the transition of gestational diabetes mellitus to …

Explaining Racial/Ethnic Disparities In Use Of High-Volume Hospitals: Decision-Making Complexity And Local Hospital Environments, Karl Kronebusch, Bradford H. Gray, Mark Schlesinger

Publications and Research

Racial/ethnic minorities are less likely to use higher-quality hospitals than whites. We propose that a higher level of informationrelated complexity in their local hospital environments compounds the effects of discrimination and more limited access to services, contributing to racial/ethnic disparities in hospital use. While minorities live closer than whites to high-volume hospitals, minorities also face greater choice complexity and live in neighborhoods with lower levels of medical experience. Our empirical results reveal that it is generally the overall context associated with proximity, choice complexity, and local experience, rather than differential sensitivity to these factors, that provides a partial explanation of …

Effects Of Extreme Climate Events On Tea (Camellia Sinensis) Functional Quality Validate Indigenous Farmer Knowledge And Sensory Preferences In Tropical China, Selena Ahmed, John Richard Stepp, Colin M. Orians, Timothy S. Griffin, Corene Matyas, Albert Robbat, Sean Cash, Dayuan Xue, Chunlin Long, Uchenna Unachukwu, Sarabeth Buckley, Edward J. Kennelly

Publications and Research

Climate change is impacting agro-ecosystems, crops, and farmer livelihoods in communities worldwide. While it is well understood that more frequent and intense climate events in many areas are resulting in a decline in crop yields, the impact on crop quality is less acknowledged, yet it is critical for food systems that benefit both farmers and consumers through high-quality products. This study examines tea (Camellia sinensis; Theaceae), the world’s most widely consumed beverage after water, as a study system to measure effects of seasonal precipitation variability on crop functional quality and associated farmer knowledge, preferences, and livelihoods. Sampling was conducted in …

Low Risk Of Attrition Among Adults On Antiretroviral Therapy In The Rwandan National Program: A Retrospective Cohort Analysis Of 6, 12, And 18 Month Outcomes, Harriet Nuwagaba-Biribonwoha, Aleksandra Jakubowski, Veronicah Mudisha, Paulin Basinga, Anita Asiimwe, Denis Nash, Batya Elul

Publications and Research

Background
We report levels and determinants of attrition in Rwanda, one of the few African countries with universal ART access.

Methods
We analyzed data abstracted from health facility records of a nationally representative sample of adults [≥18 years] who initiated ART 6, 12, and 18 months prior to data collection; and collected facility characteristics with a health facility assessment questionnaire. Weighted proportions and rates of attrition [loss to follow-up or death] were calculated, and patient- and health facility-level factors associated with attrition examined using Cox proportional hazard models.

Results
1678 adults initiated ART 6, 12 and 18 months prior to …

Lineage-Specific Interface Proteins Match Up The Cell Cycle And Differentiation In Embryo Stem Cells, Angela Re, Christopher T. Workman, Levi Waldron, Alessandro Quattrone, Søren Brunak

Publications and Research

The shortage of molecular information on cell cycle changes along embryonic stem cell (ESC) differentiation prompts an in silico approach, which may provide a novel way to identify candidate genes or mechanisms acting in coordinating the two programs. We analyzed germ layer specific gene expression changes during the cell cycle and ESC differentiation by combining four human cell cycle transcriptome profiles with thirteen in vitro human ESC differentiation studies. To detect cross-talk mechanisms we then integrated the transcriptome data that displayed differential regulation with protein interaction data. A new class of non-transcriptionally regulated genes was identified, encoding proteins which interact …

Obesity Indicators And C - Reactive Protein In African And Haitian Americans With And Without Type 2 Diabetes, Fatma G. Huffman, Joan A. Vaccaro, T. M. Rowe, Gustavo G. Zarini, Shiryn D. Sukhram, Lemia H. Shaban, Susan Himburg

Publications and Research

Purpose: High sensitivity C-reactive protein (CRP) is a risk factor for cardiovascular disease based on finding in primarily non-Hispanic White populations. Obesity, another risk factor for cardiovascular disease, is higher in Blacks as compared to non-Hispanic Whites. The objective of this study was to assess the relationship between CRP, a marker of systemic inflammation, and obesity indicators by ethnicity, diabetes status and gender for two Black ethnicities.

Methods: Anthropometrics and venous blood were collected for African and Haitian Americans with and without type 2 diabetes in a cross-sectional study. A total of 434 participants; 190 African Americans, 244 Haitian Americans, …

Increasing Maternal Or Post-Weaning Folic Acid Alters Gene Expression And Moderately Changes Behavior In The Offspring, Subit Barua, Kathryn K. Chadman, Salomon Kuizon, Diego Buenaventura, Nathan W. Stapley, Felicia Ruocco, Umme Begum, Sara R. Guariglia, W. Ted Brown, Mohamad Junaid

Publications and Research

Background: Studies have indicated that altered maternal micronutrients and vitamins influence the development of newborns and altered nutrient exposure throughout the lifetime may have potential health effects and increased susceptibility to chronic diseases. In recent years, folic acid (FA) exposure has significantly increased as a result of mandatory FA fortification and supplementation during pregnancy. Since FA modulates DNA methylation and affects gene expression, we investigated whether the amount of FA ingested during gestation alters gene expression in the newborn cerebral hemisphere, and if the increased exposure to FA during gestation and throughout the lifetime alters behavior in C57BL/6J mice.

Methods …

Physical Activity And Sedentary Behaviors Associated With Risk Of Progression From Gestational Diabetes Mellitus To Type 2 Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Deirdre K. Tobias, Katherine Bowers, Jorge Chavarro, Allan Vaag, Louise Groth Grunnet, Marin Strom, James Mills, Aiyi Liu, Michele Kiely, Cuilin Zhang

Publications and Research

Importance: Women with a history of gestational diabetes mellitus (GDM) are at substantially increased risk of type 2 diabetes mellitus (T2DM). The identification of important modifiable factors could help prevent T2DM in this high-risk population.

Objective: To examine the role of physical activity and television watching and other sedentary behaviors, and changes in these behaviors in the progression from GDM to T2DM.

Design, Setting, and Participants: Prospective cohort study of 4554 women from the Nurses' Health Study II who had a history of GDM, as part of the ongoing Diabetes & Women's Health Study. These women were followed up from …

Male Clients' Behaviours With And Perspectives About Their Last Male Escort Encounter: Comparing Repeat Versus First-Time Hires, Margaret M. Wolff, Christian Grov, Michael D. Smith, Juline Koken, Jeffrey T. Parsons

Publications and Research

Research on men who have sex with men suggests that condomless anal intercourse occurs more frequently in established sexual relationships. While comparable data regarding male-for-male escorting is unavailable, research implies that many clients seek emotional as well as physical connections with the men they hire. In 2012, 495 male clients, recruited via daddysreviews.com completed an online survey about their last hiring experience. Most participants were from the USA (85.7%), the UK and Canada (3.2% each). In total, 75% of encounters involved an escort hired for the first time; 25% were with a previously hired escort ('repeat encounter'). The client's age, …

Association Between Symptomatic Vulvovaginal Candidiasis And Hiv Rna Levels In Plasma And Genital Secretions Among Women On Haart, Teke Apalata, William H. Carr, Benjamin Longo-Mbenza, Willem A. Sturm, P. Moodley

Publications and Research

Background. Genital tract (GT) inflammation plays a major role in HIV transmission. We aimed to determine the association between symptomatic vulvovaginal candidiasis (VVC) and HIV RNA levels in plasma and GTs of HIV-infected women on highly active antiretroviral therapy (HAART).

Method. Women with VVC on HAART were recruited from a primary healthcare clinic in KwaZulu-Natal Province, South Africa, between June 2011 and December 2011. VVC was diagnosed clinically, supported by Gram staining and culture of genital secretions. HIV RNA load was determined by reverse transcription polymerase chain reaction. CD4+ counts were obtained from patients’ medical records.

Results. Plasma HIV RNA …

Extreme Heat Awareness And Protective Behaviors In New York City, Kathryn Lane, Katherine Wheeler, Kizzy Charles-Guzman, Munerah Ahmed, Micheline Blum, Katherine Gregory, Nathan Graber, Nancy Clark, Thomas Matte

Publications and Research

Heat waves can be lethal and routinely prompt public warnings about the dangers of heat. With climate change, extreme heat events will become more frequent and intense. However, little is known about public awareness of heat warnings or behaviors during hot weather. Awareness of heat warnings, prevention behaviors, and air conditioning (AC) prevalence and use in New York City were assessed using quantitative and qualitative methods. A random sample telephone survey was conducted in September 2011 among 719 adults and follow-up focus groups were held in winter 2012 among seniors and potential senior caregivers. During summer 2011, 79 % of …

From Punishment To Treatment: A Providers’ Perspective On The Implementation Of 2009 Rockefeller Drug Law Reforms In New York, Robert Riggs, Jim Parsons, Qing Wei, Ernest Drucker

Publications and Research

Background: In 2009, New York reformed its “Rockefeller Drug Laws”, terminating mandatory imprisonment for many drug charges and expanding the availability of treatment alternatives to incarceration. The reforms occurred in an environment characterized by high incarceration rates, racial/ethnic disparities in drug convictions and incarceration rates, and expanded use of alternatives to incarceration. Early administrative data show a large impact on the criminal justice system. Few studies have considered the reforms from the providers’ perspective and none have sought to understand how providers are experiencing the reforms in their everyday practice.

Methods: To provide a providers’ perspective, we use a qualitative, …

Prepregnancy Low-Carbohydrate Dietary Pattern And Risk Of Gestational Diabetes Mellitus: A Prospective Cohort Study, Wei Bao, Katherine Bowers, Deirdre K. Tobias, Sjurdur F. Olsen, Jorge Chavarro, Allan Vaag, Michele Kiely, Cuilin Zhang

Publications and Research

Background: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.

Objective: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.

Design: We included 21,411 singleton pregnancies in the Nurses’ Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal …

Skin Cancer Prevention Coverage In Popular Us Women’S Health And Fitness Magazines: An Analysis Of Advertisements And Articles, Corey Hannah Basch, Danna Ethan, Grace Clarke Hillyer, Alyssa Berdnik

Publications and Research

The desire to be tan is a phenomenon that public health researchers have investigated, as exposure to UV radiation increases the chances of developing skin cancer. Media messages in women’s magazines have been shown to contribute to this problem. Much less is known about the prevalence of skin cancer prevention messages in these magazines. This study's aim was to identify the number and type of articles and advertised products devoted to skin health (sun protection and skin cancer prevention in particular) within five popular U.S. greater than women’s health and fitness magazines. We analyzed articles and advertisements over seven months …

Hepatitis C Virus Infection Among Hiv-Positive Men Who Have Sex With Men: Protocol For A Systematic Review And Meta-Analysis, Holly Hagan, Joshua Neurer, Ashly E. Jordan, Don C. Des Jarlais, Jennifer Wu, Kirk Dombrowski, Bilal Khan, Ronald Scott Braithwaite, Jason Kessler

Publications and Research

Background: Outbreaks of hepatitis C virus (HCV) infection have been reported in HIV-positive men who have sex with men (MSM) in North America, Europe and Asia. Transmission is believed to be the result of exposure to blood during sexual contact. In those infected with HIV, acute HCV infection is more likely to become chronic, treatment for both HIV and HCV is more complicated and HCV disease progression may be accelerated. There is a need for systematic reviews and meta-analyses to synthesize the epidemiology, prevention and methods to control HCV infection in this population.

Methods/design: Eligible studies will include quantitative empirical …

Epidemiology Of Undiagnosed Trichomoniasis In A Probability Sample Of Urban Young Adults, Susan M. Rogers, Charles F. Turner, Marcia Hobbs, William C. Miller, Sylvia Tan, Anthony M. Roman, Elizabeth Eggleston, Maria A. Villarroel, Laxminarayana Ganapathi, James R. Chromy, Emily Erbelding

Publications and Research

T. vaginalis infection (trichomoniasis) is the most common curable sexually transmitted infection (STI) in the U.S. It is associated with increased HIV risk and adverse pregnancy outcomes. Trichomoniasis surveillance data do not exist for either national or local populations. The Monitoring STIs Survey Program (MSSP) collected survey data and specimens which were tested using nucleic acid amplification tests to monitor trichomoniasis and other STIs in 2006–09 among a probability sample of young adults (N = 2,936) in Baltimore, Maryland — an urban area with high rates of reported STIs. The estimated prevalence of trichomoniasis was 7.5% (95% CI 6.3, 9.1) …

Chagas Disease In The 21st Century: A Public Health Success Or An Emerging Threat?, Kevin M. Bonney

Publications and Research

Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, is a major public health burden in Latin America and a potentially serious emerging threat to a number of countries throughout the world. Although public health programs have significantly reduced the prevalence of Chagas disease in Latin America in recent decades, the number of infections in the United States and non-endemic countries in Europe and the Western Pacific Region continues to rise. Moreover, there is still no vaccine or highly effective cure available for the approximately 10 million people currently infected with T. cruzi, a third of which will develop potentially …

Gender-Based Screening For Chlamydial Infection And Divergent Infection Trends In Men And Women, Susan M. Rogers, Charles F. Turner, William C. Miller, Emily Erbelding, Elizabeth Eggleston, Sylvia Tan, Anthony Roman, Marcia Hobbs, James Chromy, Ravikiran Muvva, Laxminarayana Ganapathi

Publications and Research

Objectives: To assess the potential impact of chlamydial screening policy that recommends routine screening of women but not men.

Methods: Population surveys of probability samples of Baltimore adults aged 18 to 35 years in 1997–1998 and 2006–2009 collected biospecimens to estimate trends in undiagnosed chlamydial infection. Survey estimates are compared to surveillance data on diagnosed chlamydial infections reported to the Health Department.

Results: Prevalence of undiagnosed chlamydial infection among men increased from 1.6% to 4.0%, but it declined from 4.3% to 3.1% among women (p = 0.028 for test of interaction). The annual (average) number of diagnosed infections was substantially …

Lethal But Legal: Corporations, Consumption, And Protecting Public Health (Preface), Nicholas Freudenberg

Publications and Research

Decisions made by the food, tobacco, alcohol, pharmaceutical, gun, and automobile industries have a greater impact on today's health than the decisions of scientists and policymakers. As the collective influence of corporations has grown, governments around the world have stepped back from their responsibility to protect public health by privatizing key services, weakening regulations, and cutting funding for consumer and environmental protection. Today's corporations are increasingly free to make decisions that benefit their bottom line at the expense of public health.

Lethal but Legal examines how corporations have impacted -- and plagued -- public health over the last century, first …

A Feasibility Study Of Motivational Interviewing For Health Risk Behaviors Among Thai Youth Living With Hiv, Chokechai Rongkavilit, Sylvie Naar-King, Juline Koken, Torsak Bunupuradah, Xinguang Chen, Pichai Saengcharnchai, Apirudee Panthong, Jeffrey T. Parsons

Publications and Research

Thailand is among the few less-developed countries with successful HIV prevention among segments of the population (National AIDS Prevention and Alleviation Committee, 2010). However, the success of HIV prevention among Thai adolescents and young adults has been questionable. The highest percentage of Thai persons with AIDS remain in the age group of 25–34 years, indicating that the time of greatest HIV acquisition has occurred in adolescence and young adulthood (Thai Working Group on HIV/AIDS, 2010). Most Thai youth living with HIV (TYLH) acquire HIV through sexual contact (National AIDS Prevention and Alleviation Committee, 2010). In a study of TYLH, only …

Male Clients Of Male Escorts: Satisfaction, Sexual Behavior, And Demographic Characteristics, Christian Grov, Margaret Wolff, Michael D. Smith, Juline A. Koken, Jeffrey T. Parsons

Publications and Research

Few studies have examined male clients who pay for sex with male escorts. In 2012, clients (n = 495) completed an online survey about their most recent hire. Most clients were White/Caucasian (87.7%), HIV negative (89.5%), employed full time (71.1%), single (58.6%), with a mean age of 54. Three-quarters of clients were gay identified, 18% bisexual, and 4% heterosexual. The median rate paid to escorts was $250 per hour with a modal appointment time of 1 to 2 hours (41.6%). Oral sex was common (80% gave, 69% received), 30% reported anal insertive sex, and 34% reported anal receptive sex. In …

Case Study: Sick On A South American Sugarcane Plantation, Kevin M. Bonney

Publications and Research

A case study is presented that was designed to be used in high school and college level courses to familiarize students with chagas disease, its transmission, and effects in Central and South America. Noted objectives of the lesson include evaluating disease symptoms, examining socioeconomic factors related to the epidemiology, and creating visual aids with public health information. Questions are provided for discussing the a case of chagas disease at a Brazilian sugarcane plantation.

Community-Based Settings And Sampling Strategies: Implications For Reducing Racial Health Disparities Among Black Men, New York City, 2010–2013, Helen Cole, Antoinette Schoenthaler, Scott Braithwaite, Joseph Ladapo, Sherry Mentor, Jennifer Uyei, Chau Trinh-Shevrin

Publications and Research

Introduction Rates of screening colonoscopies, an effective method of preventing colorectal cancer, have increased in New York City over the past decade, and racial disparities in screening have declined. However, vulnerable subsets of the population may not be reached by traditional surveillance and intervention efforts to improve colorectal cancer screening rates.

Methods We compared rates of screening colonoscopies among black men aged 50 or older from a citywide random-digit–dial sample and a location-based sample focused on hard-to-reach populations to evaluate the representativeness of the random-digit–dial sample. The location-based sample (N = 5,568) was recruited from 2010 through 2013 from community-based …

Perception Of Childhood Obesity And Support For Prevention Policies Among Latinos And Whites, Douglas M. Puricelli Purin, Leah Frerichs, Sergio Costa, Amelie G. Ramirez, Terry T.-K. Huang

Publications and Research

A cross-sectional survey was administered to Latino and White residents of Omaha, NE, to assess perception of the childhood obesity problem, attribution of responsibility, and support for obesity-related policies. The sample included 40.8% () Latinos and 59.2% () Whites. Among Latinos, 25% did not see childhood obesity as a problem, compared to 6% of Whites (). This difference persisted after adjusting for age, gender, and education level (odds ratio (OR) 2.10, 95% confidence interval (CI) 1.07–4.14). Latinos were more likely to agree that government was responsible for addressing childhood obesity compared to Whites (OR 2.81, 95% CI 1.82–4.35). Higher support …

Influences Of Maternal Stress During Pregnancy On The Epi/Genome: Comparison Of Placenta And Umbilical Cord Blood, Jia Chen, Qian Li, Alexender Rialdi, Elana Mystal, Jenny Ly, Jackie Finik, Taira Davey, Luca Lambertini, Yoko Nomura

Publications and Research

Background: Maternal stress during pregnancy is one of the major adverse environmental factors in utero that is capable of influencing health outcomes of the offspring throughout life. Both genetic and epigenetic processes are susceptible to environmental insults in utero and are potential biomarkers of the experienced environment including maternal stress.

Methods: We profiled expression level of six genes in hypothalamic pituitary adrenal (HPA) axis functioning (HSD11B2, SLC6A4, NR3C1, NR3C2, CRHR1 and CRHR2), two imprinted genes (IGF2 and H19) and one neurodevelopmental gene (EGR1), from 49 pairs of placenta and umbilical cord blood (UCB) samples from a birth cohort. We also …