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Andersen A, Milefchik E, Papworth E, Penaluna B, Dawes K, Moody J, Weeks G, Froehlich E, deBlois K, Long JD, Philibert R. ZSCAN25 methylation predicts seizures and severe alcohol withdrawal syndrome. Epigenetics 2024; 19:2298057. [PMID: 38166538 PMCID: PMC10766392 DOI: 10.1080/15592294.2023.2298057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 12/11/2023] [Indexed: 01/04/2024] Open
Abstract
Currently, clinicians use their judgement and indices such as the Prediction of Alcohol Withdrawal Syndrome Scale (PAWSS) to determine whether patients are admitted to hospitals for consideration of withdrawal syndrome (AWS). However, only a fraction of those admitted will experience severe AWS. Previously, we and others have shown that epigenetic indices, such as the Alcohol T-Score (ATS), can quantify recent alcohol consumption. However, whether these or other alcohol biomarkers, such as carbohydrate deficient transferrin (CDT), could identify those at risk for severe AWS is unknown. To determine this, we first conducted genome-wide DNA methylation analyses of subjects entering and exiting alcohol treatment to identify loci whose methylation quickly reverted as a function of abstinence. We then tested whether methylation at a rapidly reverting locus, cg07375256, or other existing metrics including PAWSS scores, CDT levels, or ATS, could predict outcome in 125 subjects admitted for consideration of AWS. We found that PAWSS did not significantly predict severe AWS nor seizures. However, methylation at cg07375256 (ZSCAN25) and CDT strongly predicted severe AWS with ATS (p < 0.007) and cg07375256 (p < 6 × 10-5) methylation also predicting AWS associated seizures. We conclude that epigenetic methods can predict those likely to experience severe AWS and that the use of these or similar Precision Epigenetic approaches could better guide AWS management.
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Affiliation(s)
- Allan Andersen
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Emily Milefchik
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Emma Papworth
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Brandan Penaluna
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Kelsey Dawes
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Behavioral Diagnostics LLC, Coralville, IA, USA
| | - Joanna Moody
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Gracie Weeks
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Ellyse Froehlich
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Kaitlyn deBlois
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Jeffrey D Long
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa, Iowa City, IA, USA
| | - Robert Philibert
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Behavioral Diagnostics LLC, Coralville, IA, USA
- Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
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Schiebinger L. Role of Gender in Health and Disease: Methods of Reporting and Interactions with Sex and Other Factors. J Bone Joint Surg Am 2024:00004623-990000000-01170. [PMID: 39102468 DOI: 10.2106/jbjs.24.00081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
ABSTRACT Sex and gender are distinct terms that must be used correctly. Data regarding sex and gender may be collected using a 2-step method that separates biological sex and self-reported gender identity. The PhenX Toolkit, funded by the National Institutes of Health (NIH), is one tool that provides investigators with recommended standard data-collection protocols. Another tool is the Diversity Minimal Item Set questionnaire. Importantly, sex and gender interact: for example, pain has both biological aspects (sex differences in electrical, ischemic, thermal, pressure, and muscle pain sensitivity) and cultural aspects (gender factors in how people report pain and how physicians understand and treat pain in patients). Gender norms, identity, and relations all impact patient care. Gender norms, for instance, may influence how a person experiences pain, gender identity may influence a person's willingness to report pain, and gender relations may influence a physician's gendered expectations in relation to a patient's gendered behaviors. Clinicians may perceive women's pain to be psychological; as a result, women may receive more nonspecific diagnoses, wait longer for treatment, and receive more antidepressants and fewer analgesics than men. Research on gender-diverse people and pain is just now emerging. Resources for methods of reporting include The Lancet, Nature, and the Sex and Gender Equity in Research (SAGER) Guidelines. We must consider all relevant factors intersecting with sex and gender, including age, disabilities, educational background, ethnicity, family configuration, geographic location, race, sexuality, social and economic status, sustainability, and more.
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Shao IY, Al-Shoaibi AAA, Testa A, Ganson KT, Baker FC, Nagata JM. The Association between Family Environment and Subsequent Risk of Cyberbullying Victimization in Adolescents. Acad Pediatr 2024; 24:957-962. [PMID: 38042404 PMCID: PMC11136877 DOI: 10.1016/j.acap.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 11/19/2023] [Accepted: 11/22/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Family environment and parental monitoring have long been recognized as two important factors associated with adolescents' psychological development. Studies have suggested a potential link between parenting style/parental engagement and the likelihood of bullying victimization among adolescents. Nonetheless, no studies to date have investigated the association between family environment and the subsequent risk of cyberbullying victimization among adolescents. In this study, we assessed the association between family environment (eg, parental monitoring and family conflict) and subsequent risk of cyberbullying victimization using data from the Adolescent Brain Cognitive Development (ABCD). METHODS We used multivariable logistic regressions to assess the association between parental monitoring and family conflict at year 1 and the subsequent risk of cyberbullying victimization at year 2 in 10,410 eligible ABCD study participants. RESULTS Adjusting for sociodemographic characteristics, study sampling weights and study site, higher levels of parental monitoring at year 1 were associated with a lower reported past 12-month (OR: 0.61, 95% CI: 0.50-0.75) history of cyberbullying victimization at year 2. Higher levels of family conflict at year 1 were associated with a higher risk of reported past 12-month history (OR: 1.10, 95% CI: 1.04-1.16) of cyberbullying victimization one year later. CONCLUSION Higher levels of parental monitoring and lower levels of family conflict are associated with a subsequent lower risk of cyberbullying victimization among adolescents. Cyberbullying victimization preventive programs should advocate for increased parental monitoring and minimize family conflict at home to reduce the risks of cyberbullying victimization among adolescents.
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Affiliation(s)
- Iris Y Shao
- Department of Pediatrics (IY Shao, AAA Al-shoaibi, and JM Nagata), University of California, San Francisco, Calif.
| | - Abubakr A A Al-Shoaibi
- Department of Pediatrics (IY Shao, AAA Al-shoaibi, and JM Nagata), University of California, San Francisco, Calif
| | - Alexander Testa
- Department of Management (A Testa), Policy and Community Health, University of Texas Health Science Center at Houston
| | - Kyle T Ganson
- Factor-Inwentash Faculty of Social Work (KT Ganson), University of Toronto, Toronto, Ontario, Canada
| | - Fiona C Baker
- Center for Health Sciences (FC Baker), SRI International, Menlo Park, Calif
| | - Jason M Nagata
- Department of Pediatrics (IY Shao, AAA Al-shoaibi, and JM Nagata), University of California, San Francisco, Calif
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Rader L, Reineberg AE, Petre B, Wager TD, Friedman NP. Familial effects account for association between chronic pain and past month smoking. Eur J Pain 2024; 28:1144-1155. [PMID: 38318651 PMCID: PMC11269048 DOI: 10.1002/ejp.2247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Smoking is associated with chronic pain, but it is not established whether smoking causes pain or if the link is due to familial effects. One proposed mechanism is that smoking strengthens maladaptive cortico-striatal connectivity, which contributes to pain chronification. We leveraged a twin design to assess direct effects of smoking on pain controlling for familial confounds, and whether cortico-striatal connectivity mediates this association. METHODS In a population-based sample of 692 twins (age = 28.83 years), we assessed past-month smoking frequency (n = 132 used in the past month), presence and severity of a current pain episode (n = 179 yes), and resting-state functional connectivity of the nucleus accumbens and medial prefrontal cortex (NAc-mPFC). RESULTS Smoking was significantly associated with pain, but the association was not significantly mediated by NAc-mPFC connectivity. In a co-twin control model, smoking predicted which families had more pain but could not distinguish pain between family members. Pain risk was 43% due to additive genetic (A) and 57% due to non-shared environmental (E) influences. Past-month smoking frequency was 71% genetic and 29% non-shared environmental. Smoking and pain significantly correlated phenotypically (r = 0.21, p = 0.001) and genetically (rg = 0.51, p < 0.001), but not environmentally (re = -0.18, p = 0.339). CONCLUSIONS Pain and smoking are associated; however, the association appears to reflect shared familial risk factors, such as genetic risk, rather than being causal in nature. The connectivity strength of the reward pathway was not related to concurrent pain and smoking in this sample. SIGNIFICANCE Smoking does not appear to directly cause chronic pain; rather, there may be shared biopsychosocial risk factors, including genetic influences, that explain their association. These findings can be integrated into future research to identify shared biological pathways of both chronic pain and smoking behaviours as a way to conceptualize pain chronification.
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Affiliation(s)
- L Rader
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - A E Reineberg
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
| | - B Petre
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - T D Wager
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - N P Friedman
- Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, Colorado, USA
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Evans-Polce RJ, Kcomt L, Veliz P, Boyd CJ, McCabe SE. Associations of sexual identity change and identity-attraction discordance with symptomatic alcohol and other drug use. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1389-1399. [PMID: 38095678 PMCID: PMC11176265 DOI: 10.1007/s00127-023-02600-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 11/20/2023] [Indexed: 06/15/2024]
Abstract
PURPOSE National studies examining alcohol and other drug use by sexual orientation have been primarily cross-sectional. Understanding changes in sexual orientation over time may further elucidate the mechanisms behind sexual orientation differences in alcohol and other drug use. This national longitudinal study examines changes in sexual orientation across four waves (2013-2019), and the associations with symptomatic alcohol and other drug use. METHODS Data from Waves 1 through 5 of the Population Assessment of Tobacco and Health (PATH) study were used to examine associations of sexual identity change/stability and sexual identity-attraction discordance/concordance from baseline to follow-up with symptomatic substance use at follow-up. We examined four outcomes: any symptomatic substance use, symptomatic alcohol use, symptomatic other drug use, and symptomatic alcohol + other drug use. Mixed effects logistic regression models were used and all analyses were weighted and stratified by sex. RESULTS In models adjusting for potential confounders, greater likelihood of symptomatic alcohol and other drug use outcomes was found among males and females experiencing a change from a heterosexual to sexual minority identity and among females with new or consistent sexual identity-attraction discordance. CONCLUSION These findings highlight important sex differences and suggest that the period of transitioning to a sexual minority identity is a particularly vulnerable period for symptomatic alcohol and other drug use. For females, incongruent sexual identity and attraction is also a risk factor. Interventions that assist individuals during this transitional period and during a time when identity and attraction are incongruent, may reduce symptomatic substance use during this period.
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Affiliation(s)
- Rebecca J Evans-Polce
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls St, Ann Arbor, MI, 48108, USA.
| | - Luisa Kcomt
- School of Social Work, Wayne State University, Detroit, MI, USA
| | - Philip Veliz
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls St, Ann Arbor, MI, 48108, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Carol J Boyd
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls St, Ann Arbor, MI, 48108, USA
- Institute for Research On Women and Gender, University of Michigan, Ann Arbor, MI, USA
- Addiction Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
| | - Sean Esteban McCabe
- Center for the Study of Drugs, Alcohol, Smoking and Health, Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, 400 N. Ingalls St, Ann Arbor, MI, 48108, USA
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Institute for Research On Women and Gender, University of Michigan, Ann Arbor, MI, USA
- Center for Sexuality and Health Disparities, School of Nursing, University of Michigan, Ann Arbor, MI, USA
- Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA
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Roche AI, Young A, Sabaque C, Kelpin SS, Sinicrope P, Pham C, Marsch LA, Campbell ANC, Venner K, Baker-DeKrey L, Wyatt T, WhiteHawk S, Nord T, Resnicow K, Young C, Brown A, Bart G, Patten C. Wiidookaage'win: Beta-test of a Facebook group intervention for Native women to support opioid use recovery. JOURNAL OF SUBSTANCE USE AND ADDICTION TREATMENT 2024; 163:209396. [PMID: 38759734 DOI: 10.1016/j.josat.2024.209396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/16/2024] [Accepted: 05/06/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION The ongoing opioid misuse epidemic has had a marked impact on American Indian/Alaska Native (AI/AN) communities. Culture- and gender-specific barriers to medically assisted recovery from opioid use disorder (OUD) have been identified, exacerbating its impact for AI/AN women. Wiidookaage'win is a community-based participatory research study that aims to develop a culturally tailored, moderated, private Facebook group intervention to support Minnesotan AI/AN women in medically assisted recovery from OUD. The current study assessed the preliminary feasibility and acceptability of the intervention in a beta-test to inform refinements before conducting a pilot randomized controlled trial (RCT). METHODS The intervention was beta-tested for 30 days. Moderators were trained prior to delivering the intervention. Study assessments were conducted at baseline and post-intervention. The post-intervention assessments included substance use (self-report and urine drug screen), treatment acceptability, mental health, and spirituality outcomes. We examined intervention engagement patterns using Facebook metrics and qualitatively explored common topics that emerged in participant posts and comments. RESULTS Ten AI/AN women taking medication for OUD (MOUD) were accrued (age range 25-62 years). Participants had been in opioid recovery a mean of 15.2 months (SD = 16.1; range = 3-60). The study participation rate (accrued/eligible) was 91 %. Nine participants completed the post-intervention survey assessment and eight completed a UDS. Acceptability was high based on the mean treatment satisfaction score (M = 4.8, SD = 0.2 out of a possible 5.0), Facebook group engagement, and positive qualitative feedback. All participants retained at post-intervention continued their MOUD treatment, and none had returned to opioid use. CONCLUSIONS The beta-test indicated that the Facebook platform and study procedures generally worked as intended and that the intervention was largely acceptable to study participants. The results of this study phase provided valuable insights to inform refinements prior to conducting a pilot RCT to further assess the feasibility, acceptability, and potential efficacy of the intervention.
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Affiliation(s)
- Anne I Roche
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Antonia Young
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Corinna Sabaque
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Sydney S Kelpin
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Pamela Sinicrope
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Cuong Pham
- Division of General Internal Medicine, University of Minnesota, 401 East River Parkway, Minneapolis, MN, 55455, USA.
| | - Lisa A Marsch
- Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, 46 Centerra Parkway, Lebanon, NH 03766, USA.
| | - Aimee N C Campbell
- Division on Substance Use Disorders, Department of Psychiatry, Columbia University Irving Medical Center and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY 10032, USA.
| | - Kamilla Venner
- Department of Psychology and Center on Alcohol, Substance Use and Addictions, University of New Mexico, 2650 Yale Boulevard Southeast, Albuquerque, NM 87106, USA.
| | - Laiel Baker-DeKrey
- Counseling and Recovery Services, Indian Health Board of Minneapolis, Inc., 1315 East 24(th) Street, Minneapolis, MN 55404, USA.
| | - Thomas Wyatt
- Department of Emergency Medicine, Hennepin Healthcare, 701 Park Avenue, Minneapolis, MN 55404, USA.
| | - Sharyl WhiteHawk
- American Indian Family Center, 579 Wells Street, St. Paul, MN, USA.
| | - Teresa Nord
- ICWA Law Center, American Indian Prison Project, 1730 Clifton Place Suite 104, Minneapolis, MN 55403, USA
| | - Kenneth Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Colleen Young
- Division of Health Education & Content Services, Mayo Clinic Connect, 200 First Street Southwest, Rochester, MN 55905, United States.
| | - Ashley Brown
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
| | - Gavin Bart
- Hennepin Healthcare, 730 South Eighth Street, Minneapolis, MN 55415, USA.
| | - Christi Patten
- Behavioral Health Research Program, Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA.
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Talley AE. The need for persistent and expansive efforts to advance diversity in alcohol research. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1469-1472. [PMID: 38890125 DOI: 10.1111/acer.15390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Revised: 05/21/2024] [Accepted: 05/29/2024] [Indexed: 06/20/2024]
Affiliation(s)
- Amelia E Talley
- Department of Psychological Sciences, Texas Tech University, Lubbock, Texas, USA
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Richardson BT, Jackson J, Marable G, Barker J, Gardiner H, Igarabuza L, Leasy M, Matthews E, Zisman-Ilani Y. The Role of Black Churches in Promoting Mental Health for Communities of Socioeconomically Disadvantaged Black Americans. Psychiatr Serv 2024; 75:740-747. [PMID: 38595118 DOI: 10.1176/appi.ps.20230263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Churches in socioeconomically disadvantaged neighborhoods serve as safe havens in many Black communities. Churches provide faith and charitable services but often have limited resources to address the mental health needs of their communities. This article reports on a collaborative effort, driven by members of a Black church, to understand mental health needs, coping strategies, and resilience factors in a community of socioeconomically disadvantaged Black Americans. METHODS A community-based participatory research effort was established among a church, a community mental health organization, clinicians, and researchers to interview and survey individuals residing near the church. RESULTS The sample consisted of 59 adults, most of whom were ages 46-65 years, men (N=34, 58%), and unemployed (N=46, 78%). Mean scores on the Patient Health Questionnaire-9 (9.2±7.7) and Generalized Anxiety Disorder-7 scale (9.4±6.7) were almost three times higher than those reported by studies of other Black populations in the United States. Five themes emerged: prolonged poverty and daily exposure to violence trigger emotional distress, mental health stigma affects help seeking, spirituality promotes mental relief and personal recovery, spirituality helps in coping with poverty and unsafe neighborhoods, and church-based programs are needed. CONCLUSIONS Uptake of traditional mental health services was low, and reliance on faith and resource distribution by the church was high. Church-led interventions are needed to promote mental health at the individual and community levels. Mental health stigma, and negative attitudes toward mental health promotion in the community, may be addressed by integrating traditional mental health services in church-based recreational and leisure activities.
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Affiliation(s)
- Briana T Richardson
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Jacqueline Jackson
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Grace Marable
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Jessica Barker
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Heather Gardiner
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Laura Igarabuza
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Menachem Leasy
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Elizabeth Matthews
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
| | - Yaara Zisman-Ilani
- Office of Community-Engaged Research and Practice (Richardson, Barker, Gardiner) and Department of Social and Behavioral Sciences (Gardiner, Zisman-Ilani), College of Public Health, and the Lewis Katz School of Medicine (Igarabuza, Leasy), Temple University, Philadelphia; Bethel Presbyterian Church, Philadelphia (Jackson, Marable); Graduate School of Social Service, Fordham University, New York City (Matthews); Division of Psychology and Language Sciences, University College London, London (Zisman-Ilani)
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Zamor RL, Liberman DB, Hall JE, Rees CA, Hartford EA, Chaudhari PP, Portillo EN, Johnson MD. Collecting Sociodemographic Data in Pediatric Emergency Research: A Working Group Consensus. Pediatrics 2024; 154:e2023065277. [PMID: 39044723 PMCID: PMC11291964 DOI: 10.1542/peds.2023-065277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 07/25/2024] Open
Abstract
Understanding and addressing health care disparities relies on collecting and reporting accurate data in clinical care and research. Data regarding a child's race, ethnicity, and language; sexual orientation and gender identity; and socioeconomic and geographic characteristics are important to ensure equity in research practices and reported outcomes. Disparities are known to exist across these sociodemographic categories. More consistent, accurate data collection could improve understanding of study results and inform approaches to resolve disparities in child health. However, published guidance on standardized collection of these data in children is limited, and given the evolving nature of sociocultural identities, requires frequent updates. The Pediatric Emergency Care Applied Research Network, a multi-institutional network dedicated to pediatric emergency research, developed a Health Disparities Working Group in 2021 to support and advance equitable pediatric emergency research. The working group, which includes clinicians involved in pediatric emergency medical care and researchers with expertise in pediatric disparities and the conduct of pediatric research, prioritized creating a guide for approaches to collecting race, ethnicity, and language; sexual orientation and gender identity; and socioeconomic and geographic data during the conduct of research in pediatric emergency care settings. Our aims with this guide are to summarize existing barriers to sociodemographic data collection in pediatric emergency research, highlight approaches to support the consistent and reproducible collection of these data, and provide rationale for suggested approaches. These approaches may help investigators collect data through a process that is inclusive, consistent across studies, and better informs efforts to reduce disparities in child health.
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Affiliation(s)
- Ronine L. Zamor
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
- Division of Emergency Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Danica B. Liberman
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, California
- Departments of Pediatrics
- Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jeanine E. Hall
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, California
- Departments of Pediatrics
| | - Chris A. Rees
- Division of Pediatric Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia
- Division of Emergency Medicine, Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Emily A. Hartford
- Division of Emergency Medicine, Department of Pediatrics, University of Washington, Seattle, Washington
| | - Pradip P. Chaudhari
- Division of Emergency and Transport Medicine, Children’s Hospital Los Angeles, Los Angeles, California
- Departments of Pediatrics
| | - Elyse N. Portillo
- Division of Pediatric Emergency medicine, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas
| | - Michael D. Johnson
- Division of Pediatric Emergency Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah
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Zamarripa K, Crusan A, Roozen K, Godoy-Henderson C, Evans A. Strengthening the Voices of Hispanic/ Latine Immigrants Managing Chronic Disease: A Mixed Methods Approach to Understanding Perspectives of Health. Healthcare (Basel) 2024; 12:1519. [PMID: 39120222 PMCID: PMC11311751 DOI: 10.3390/healthcare12151519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Revised: 07/22/2024] [Accepted: 07/28/2024] [Indexed: 08/10/2024] Open
Abstract
Individuals who migrate from their home country face a variety of challenges while adapting to the culture in the United States. Immigrant communities are at a significantly higher risk for poor health outcomes; therefore, assessing healthcare treatment for diverse and resilient immigrant populations, including Hispanic/Latine communities, is crucial to preserving their health, culture, and spirit. A paucity of literature exists surrounding perceptions of well-being in immigrant, Hispanic/Latine adults managing chronic diseases. Past studies have shown a discrepancy between providers' and patients' perceptions of healthcare options for overall well-being. We aim to share varying perspectives found within our work geared towards improving the quality of life for Hispanic/Latine immigrants managing chronic disease, especially type 2 diabetes mellitus and hypertension. The primary objective of this article is to strengthen the understanding of intersections between social, physical, financial, and spiritual health within an (im)migrant Hispanic/Latine community using semi-structured ethnographic interviews. These interviews have highlighted community resilience, demonstrating that individuals can adapt to major life transitions while maintaining balance across dimensions of health. This knowledge could be implemented by actively listening to patient concerns regarding their health dimensions to improve individualized and patient-centric care.
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Affiliation(s)
- Kathy Zamarripa
- Department of Biology, Aging & Longevity, School of Arts, Humanities, and Sciences, St. Catherine University, St. Paul, MN 55105, USA;
| | - Ambria Crusan
- Department of Nutrition and Dietetics, St. Catherine University, St. Paul, MN 55105, USA
| | - Kerrie Roozen
- Department of Nutrition and Dietetics, St. Catherine University, St. Paul, MN 55105, USA
| | - Clara Godoy-Henderson
- Department of Health Services Research, Policy and Administration, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Angela Evans
- Department of Nutrition and Dietetics, St. Catherine University, St. Paul, MN 55105, USA
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Lewis CT, Toman J, Sanchez VA, Corvin J, Arnold ML. Examining the Relationship Between Hearing Health Beliefs and Social Determinants of Health in Black Adults. Ear Hear 2024:00003446-990000000-00321. [PMID: 39106324 DOI: 10.1097/aud.0000000000001562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
OBJECTIVES Hearing loss is a highly prevalent condition; however, it is widely under-treated, and Black Americans have been found to have significantly lower rates of hearing aid utilization than other ethnic/racial groups. In this exploratory study, we aimed to identify hearing health beliefs among Black adults, guided by the Health Belief Model, with social determinants of health, and examine individual differences in these perspectives. DESIGN The Hearing Beliefs Questionnaire (HBQ) was administered online to measure constructs of the Health Belief Model among 200 Black adults aged 18 to 75 (M = 39.14, SD = 14.24). Approximately 13% reported hearing difficulty. In addition, 11 social determinants of health questions were included. Participants were recruited from a university otolaryngology clinic and local Black congregations, meeting inclusion criteria of being 18 or older and Black/African American. Mean scores and SDs for HBQ subscales were calculated. Analysis included analysis of variance and t tests to explore relationships with demographic variables and social determinants of health. Multiple regression analyses predicted HBQ subscale scores from sociodemographic variables. RESULTS Mean HBQ subscale scores ranged from 3.88 (SD = 2.28) for Perceived Barriers to 6.76 (SD = 1.93) for Perceived Benefits. Positive correlations were observed between Perceived Severity, Perceived Benefits, and Perceived Self-Efficacy scores and participant educational attainment. Lower economic stability was correlated with poorer scores in Perceived Self-Efficacy, Perceived Severity, and Perceived Benefits. Black adults' willingness to purchase a hearing aid was heavily influenced by their Perceived Benefit, Perceived Severity, and Perceived Self-Efficacy scores, with lower scores correlating with unwillingness to purchase devices. Higher frequency of racism/discrimination and financial hardship correlated with increased Perceived Barriers scores for accessing hearing healthcare. In addition, hearing health beliefs between participants with self-reported hearing difficulty and those without trouble only exhibited differences in the Perceived Susceptibility subscale, with those experiencing hearing difficulty having higher scores in this subscale; no other distinctions were identified. CONCLUSIONS The Health Belief Model, used with social determinants of health, revealed associations, and variations, in the hearing health beliefs held by Black adults. The present investigation reveals heterogeneity within this group and pinpoints individuals at higher risk for untreated hearing loss, stemming from their negative perceptions about hearing healthcare. These beliefs are influenced by demographics and social determinants of health, underscoring areas ripe for intervention.
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Affiliation(s)
- Charity T Lewis
- Auditory Rehabilitation & Clinical Trials Laboratory, University of South Florida, Tampa, Florida, USA
- School of Aging Studies, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida, USA
| | - Julia Toman
- Department of Otolaryngology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Victoria A Sanchez
- Auditory Rehabilitation & Clinical Trials Laboratory, University of South Florida, Tampa, Florida, USA
- Department of Otolaryngology, Morsani College of Medicine, University of South Florida, Tampa, Florida, USA
| | - Jaime Corvin
- Department of Global Health, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Michelle L Arnold
- Auditory Rehabilitation & Clinical Trials Laboratory, University of South Florida, Tampa, Florida, USA
- Department of Communication Sciences & Disorders, College of Behavioral & Community Sciences, University of South Florida, Tampa, Florida, USA
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12
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English NC, Smith BP, Jones BA, Oslock W, Hollis RH, Wood L, Rubyan M, Kennedy G, Kaushik M, Gibson QX, Swenson L, Chu DI. Novel Characterization of Socioecological Determinants of Health in Rural Alabama. J Surg Res 2024; 301:468-481. [PMID: 39033598 DOI: 10.1016/j.jss.2024.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/01/2024] [Accepted: 06/24/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION Socioecological determinants of health (SEDOHs) influence disparities in surgical outcomes. However, SEDOHs are challenging to measure, limiting our ability to address disparities. Using a validated survey (SEDOH-88), we assessed SEDOHs in three rural communities in Alabama. We hypothesized that SEDOHs would vary significantly across sites but measuring them would be acceptable and feasible. MATERIALS AND METHODS This was a retrospective review of a prospectively maintained database involving surgical patients who completed the SEDOH-88 and a secondary survey assessing it's acceptability or feasibility from August 2021 to July 2023. Included patients underwent endoscopic, minimally invasive, or open surgery at three rural hospitals: Demopolis (DM), Alexander City (AC), and Greenville (GV). RESULTS The 107 participants comprised 48 (44.9%) from DM, 27 (25.2%) from AC, and 32 (29.9%) from GV, respectively. The median age was 64 y, and 65.6% were female. When comparing DM to AC and GV by individual factors, DM had the largest Black population (78.7 versus 22.2 versus 48.3%, P < 0.001) and more often required help reading hospital materials (20.5 versus 3.7 versus 10.3%, P = 0.007). When comparing DM to AC and GV by structural and environmental factors, DM had more Medicaid enrollees (27.3 versus 3.7 versus 6.9%, P = 0.033) and lacked fresh produce (18.2 versus 25.9 versus 39.3%, P = 0.033) and internet access (63.6 versus 100.0 versus 86.2%, P < 0.001). The SEDOH-88 had an overall 90.9% positive acceptability and feasibility score. CONCLUSIONS SEDOHs varied significantly across rural communities regarding individual (race or health literacy), structural (insurance), and environmental-level factors (nutritious food or internet access). The high acceptability and feasibility of the SEDOH-88 shows it's potential utility in identifying targets for future disparity-reducing interventions.
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Affiliation(s)
- Nathan C English
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama; Department of General Surgery, University of Cape Town, Cape Town, South Africa
| | - Burkely P Smith
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Bayley A Jones
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Wendelyn Oslock
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama; Department of Quality, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama
| | - Robert H Hollis
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lauren Wood
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael Rubyan
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Gregory Kennedy
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Manu Kaushik
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Quince-Xhosa Gibson
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lacey Swenson
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama
| | - Daniel I Chu
- Division of Gastrointestinal Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
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Erinoso O, Watts T, Koning S, Lu M, Wagner K, Pearson J. Choice of smoking cessation products among people with substance use problems in the US: Findings from the Population Assessment of Tobacco and Health (PATH) study Wave 6. Addict Behav 2024; 158:108104. [PMID: 39042998 DOI: 10.1016/j.addbeh.2024.108104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 07/06/2024] [Accepted: 07/15/2024] [Indexed: 07/25/2024]
Abstract
OBJECTIVE The aim of this study was to compare past 12-month use of cigarette smoking cessation aids (e.g., Food and Drug Administration (FDA)-approved cessation products or e-cigarettes for smoking cessation) among people with substance use problems (PWSUPs) who currently smoke to people without substance use problems (SUPs) who currently smoke cigarettes in a nationally representative US sample. METHODS We used the Population Assessment of Tobacco and Health (PATH) Wave 6 Study [n = 30,516]. Our sample comprised adult (18+) established cigarette smokers (100+ lifetime-sticks with daily/non-daily use) [n = 5,895]. The independent variable was SUP status (no, moderate, and high). The dependent variables were past-year use of: nicotine replacement therapies (NRTs), cessation medications [i.e., varenicline or bupropion], or e-cigarettes [for cigarette cessation and reduction]. Weighted multivariable logistic regression models for each dependent variable examined the associations between SUP status and each cessation aid, adjusting for cigarette dependence, daily cigarette smoking, and demographic factors. RESULTS Among people who smoke, a higher proportion of respondents with high SUP severity used NRTs, cessation medications, and e-cigarettes for cigarette cessation, respectively (12.3%, 8.4%, 15.7%), compared to those with no/low SUP severity (9.8%, 6.0%, 8.9%). In the multivariable models, respondents with high SUPs had 63% (95% CI:1.16-2.29) higher odds of using e-cigarettes for cessation than those without SUPs. No significant differences were seen between high (vs. no/low SUPs) in the past-year use of NRTs and cessation medications. CONCLUSION Our findings indicate that cigarette smokers with high SUPs had higher odds of using e-cigarettes for cessation and reduction compared to smokers without SUPs.
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Affiliation(s)
- Olufemi Erinoso
- Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, United States.
| | - Theresa Watts
- Orvis School of Nursing, University of Nevada, Reno, United States
| | - Stephanie Koning
- Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Minggen Lu
- Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Karla Wagner
- Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
| | - Jennifer Pearson
- Department of Health Behavior, Policy, and Administration Sciences, School of Public Health, University of Nevada, Reno, United States
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14
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Schick MR, Sullivan TP, Alfano AR, Weiss NH. A psychometric evaluation of the PTSD Checklist for DSM-5 among women experiencing intimate partner violence. J Trauma Stress 2024. [PMID: 39031171 DOI: 10.1002/jts.23087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 06/18/2024] [Accepted: 06/18/2024] [Indexed: 07/22/2024]
Abstract
Recent national estimates suggest that 1 in 2 women will experience intimate partner violence (IPV) in their lifetime. Given the high prevalence of posttraumatic stress disorder (PTSD) among women experiencing IPV, it is necessary to consider whether PTSD assessments function adequately for this population. Thus, the present study aimed to evaluate the psychometric properties of the past-month version of the PTSD Checklist for DSM-5 (PCL-5), one of the most widely used self-report measures of PTSD symptoms, in a sample of community women experiencing IPV. Participants were 158 women who had experienced IPV in the past 6 months (Mage = 40.14 years, 39.9% White). The PCL-5 demonstrated good internal consistency, Cronbach's α = .97, and scores were significantly positively correlated with theoretically related constructs (i.e., PTSD symptom count on the SCID-5, IPV severity, substance use, depression, anxiety, and emotion dysregulation); however, it demonstrated poor 30-day stability, r = .38, ICC = .55. The ability of the PCL-5 to discriminate with respect to a PTSD diagnosis was acceptable, AUC = .74. A cutoff score of 21 maximized sensitivity (82.5%) and specificity (55.4%); this is lower than typical cutoffs (i.e., 31-33). Although the PCL-5 has generally demonstrated adequate psychometric properties, findings suggest that it does not function optimally for women experiencing IPV relative to its functioning for other trauma-exposed populations. The lower-than-typical cutoff suggests that the PCL-5 may underestimate PTSD prevalence among women experiencing IPV.
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Affiliation(s)
- Melissa R Schick
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Tami P Sullivan
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Alexis R Alfano
- Division of Prevention and Community Research, Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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15
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Jamal L, Zayhowski K, Berro T, Baker K. Queering genomics: How cisnormativity undermines genomic science. HGG ADVANCES 2024; 5:100297. [PMID: 38637989 PMCID: PMC11129102 DOI: 10.1016/j.xhgg.2024.100297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/11/2024] [Accepted: 04/11/2024] [Indexed: 04/20/2024] Open
Abstract
Over the past century, genetics and genomics ("genomics") have contributed significantly to our knowledge of human biology and disease. Genomics has also bolstered inaccurate and harmful arguments about "essential" differences between socially defined groups. These purported differences have reinforced class hierarchies and justified the mistreatment of groups such as Black people, Indigenous people, and other people of color and/or people with disabilities. With this history in mind, we explore how genomics is used to reinforce scientifically unsound understandings of the relationship between two fundamental aspects of the human experience: sex and gender. We argue that imprecise, inaccurate practices for collecting data and conducting genomic research have adversely influenced genomic science and can contribute to the stigmatization of people whose sex and/or gender challenge binary expectations. The results have been to preclude transgender and intersex people from accessing high-quality, evidence-based healthcare and to hinder their participation in scientifically sound research. In this perspective, we use the lens of queer theory to render this situation more visible. First, we highlight the theoretical contributions queer theory can make to genomic science. Second, we examine practices in research and clinical genomics that exclude and stigmatize transgender and intersex people. Third, we highlight the ways that many current genomic research practices generate false conclusions that are used to support unjust public policies. We conclude by recommending ways that clinicians and researchers can-and should-harness the scientific, social, and cultural power of genomics to advance knowledge and improve lives across the spectra of sex and gender.
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Affiliation(s)
- Leila Jamal
- Genetics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA; Bioethics Department, National Institutes of Health, Bethesda, MD, USA.
| | - Kimberly Zayhowski
- Department of Obstetrics and Gynecology, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA
| | - Tala Berro
- Department of Genetics, Kaiser Permanente Oakland Medical Center, Oakland, CA, USA
| | - Kellan Baker
- Whitman-Walker Institute, Washington, DC, USA; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Boyden JY, Umaretiya PJ, D'Souza L, Johnston EE. Disparities in Pediatric Palliative Care: Where Are We and Where Do We Go from Here? J Pediatr 2024; 275:114194. [PMID: 39004168 DOI: 10.1016/j.jpeds.2024.114194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/12/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024]
Affiliation(s)
- Jackelyn Y Boyden
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA; Division of General Pediatrics, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Puja J Umaretiya
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX
| | - Louise D'Souza
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA
| | - Emily E Johnston
- Institute for Cancer Outcomes and Survivorship, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL; Pediatric Hematology/Oncology, Department of Pediatrics, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL.
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17
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Jović M, Haeri MA, Whitehouse A, van den Berg SM. Harmonizing the CBCL and SDQ ADHD scores by using linear equating, kernel equating, item response theory and machine learning methods. Front Psychol 2024; 15:1345406. [PMID: 39049945 PMCID: PMC11267626 DOI: 10.3389/fpsyg.2024.1345406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 06/17/2024] [Indexed: 07/27/2024] Open
Abstract
Introduction A problem that applied researchers and practitioners often face is the fact that different institutions within research consortia use different scales to evaluate the same construct which makes comparison of the results and pooling challenging. In order to meaningfully pool and compare the scores, the scales should be harmonized. The aim of this paper is to use different test equating methods to harmonize the ADHD scores from Child Behavior Checklist (CBCL) and Strengths and Difficulties Questionnaire (SDQ) and to see which method leads to the result. Methods Sample consists of 1551 parent reports of children aged 10-11.5 years from Raine study on both CBCL and SDQ (common persons design). We used linear equating, kernel equating, Item Response Theory (IRT), and the following machine learning methods: regression (linear and ordinal), random forest (regression and classification) and Support Vector Machine (regression and classification). Efficacy of the methods is operationalized in terms of the root-mean-square error (RMSE) of differences between predicted and observed scores in cross-validation. Results and discussion Results showed that with single group design, it is the best to use the methods that use item level information and that treat the outcome as interval measurement level (regression approach).
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Affiliation(s)
- Miljan Jović
- Department of Learning, Data Analytics and Technology, University of Twente, Enschede, Netherlands
| | - Maryam Amir Haeri
- Department of Learning, Data Analytics and Technology, University of Twente, Enschede, Netherlands
| | - Andrew Whitehouse
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
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Motsinger-Reif AA, Reif DM, Akhtari FS, House JS, Campbell CR, Messier KP, Fargo DC, Bowen TA, Nadadur SS, Schmitt CP, Pettibone KG, Balshaw DM, Lawler CP, Newton SA, Collman GW, Miller AK, Merrick BA, Cui Y, Anchang B, Harmon QE, McAllister KA, Woychik R. Gene-environment interactions within a precision environmental health framework. CELL GENOMICS 2024; 4:100591. [PMID: 38925123 PMCID: PMC11293590 DOI: 10.1016/j.xgen.2024.100591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/26/2024] [Accepted: 06/02/2024] [Indexed: 06/28/2024]
Abstract
Understanding the complex interplay of genetic and environmental factors in disease etiology and the role of gene-environment interactions (GEIs) across human development stages is important. We review the state of GEI research, including challenges in measuring environmental factors and advantages of GEI analysis in understanding disease mechanisms. We discuss the evolution of GEI studies from candidate gene-environment studies to genome-wide interaction studies (GWISs) and the role of multi-omics in mediating GEI effects. We review advancements in GEI analysis methods and the importance of large-scale datasets. We also address the translation of GEI findings into precision environmental health (PEH), showcasing real-world applications in healthcare and disease prevention. Additionally, we highlight societal considerations in GEI research, including environmental justice, the return of results to participants, and data privacy. Overall, we underscore the significance of GEI for disease prediction and prevention and advocate for integrating the exposome into PEH omics studies.
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Affiliation(s)
- Alison A Motsinger-Reif
- Biostatistics and Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC, USA.
| | - David M Reif
- Predictive Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Farida S Akhtari
- Biostatistics and Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - John S House
- Biostatistics and Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - C Ryan Campbell
- Biostatistics and Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Kyle P Messier
- Biostatistics and Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC, USA; Predictive Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - David C Fargo
- Office of the Director, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Tiffany A Bowen
- Office of the Director, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Srikanth S Nadadur
- Exposure, Response, and Technology Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Charles P Schmitt
- Office of the Scientific Director, Office of Data Science, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Kristianna G Pettibone
- Program Analysis Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - David M Balshaw
- Office of the Director, National Institute of Environmental Health Sciences, Durham, NC, USA; Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Cindy P Lawler
- Genes, Environment, and Health Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Shelia A Newton
- Office of Scientific Coordination, Planning and Evaluation, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Gwen W Collman
- Office of the Director, National Institute of Environmental Health Sciences, Durham, NC, USA; Office of Scientific Coordination, Planning and Evaluation, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Aubrey K Miller
- Office of Scientific Coordination, Planning and Evaluation, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - B Alex Merrick
- Mechanistic Toxicology Branch, Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Yuxia Cui
- Exposure, Response, and Technology Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Benedict Anchang
- Biostatistics and Computational Biology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Quaker E Harmon
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Kimberly A McAllister
- Genes, Environment, and Health Branch, Division of Extramural Research and Training, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Rick Woychik
- Office of the Director, National Institute of Environmental Health Sciences, Durham, NC, USA
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Yang CH, Lee J, Wilcox S, Rudisill AC, Friedman DB, Hakun JG, Neils-Strunjas J, Wei J, Miller MC, Byers MD. Implementation and evaluation of a community-based mindful walking randomized controlled trial to sustain cognitive health in older African Americans at risk for dementia. BMC Geriatr 2024; 24:579. [PMID: 38965464 PMCID: PMC11225163 DOI: 10.1186/s12877-024-05090-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/17/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND With an increasing proportion of older adults and the associated risk of Alzheimer's Disease and Related Dementias (ADRD) around the globe, there is an urgent need to engage in ADRD risk reduction efforts. African American (AA) older adults in the U.S. are disproportionally impacted by ADRD compared to other races and ethnicities. Mindful walking integrates two potentially protective factors of ADRD by elevating mindfulness and physical activity (i.e., walking), resulting in a synergistic behavioral strategy that is feasible and safe for older adults. However, the efficacy of applying this intervention for cognitive health outcomes has not been evaluated using experimental designs. METHODS This paper documents the goal and protocol of a community-based, mindful walking randomized controlled trial to examine the short- and longer-term efficacy on cognitive and other health-related outcomes in ADRD at-risk AA older adults. The study outcomes include various brain health determinants, including cognitive function, quality of life, psychological well-being, physical activity, mindfulness, sleep, and overall health status. In addition, the estimated costs of program implementation are also collected throughout the study period. This study will recruit 114 older adults (ages 60+ years) with elevated ADRD risk from the Midlands region of South Carolina. Older adults are randomly assigned to participate in 24 sessions of outdoor mindful walking over three months or a delayed mindful walking group (n=57 in each group). Participants in both groups follow identical measurement protocols at baseline, after 12 weeks, after 18 weeks, and after 24 weeks from baseline. The outcome measures are administered in the lab and in everyday settings. Costs per participant are calculated using micro-costing methods. The eliciting participant costs for mindful walking engagement with expected results are reported using the payer and the societal perspectives. DISCUSSION This study will generate evidence regarding the efficacy of mindful walking on sustaining cognitive health in vulnerable older adults. The results can inform future large-scale effectiveness trials to support our study findings. If successful, this mindful walking program can be scaled up as a low-cost and viable lifestyle strategy to promote healthy cognitive aging in diverse older adult populations, including those at greatest risk. TRIAL REGISTRATION ClinicalTrials.gov number NCT06085196 (retrospectively registered on 10/08/2023).
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Affiliation(s)
- Chih-Hsiang Yang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Jongwon Lee
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Sara Wilcox
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - A Caroline Rudisill
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Daniela B Friedman
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jonathan G Hakun
- Department of Neurology, The Pennsylvania State University, College of Medicine, Hershey, PA, 17033, USA
- Department of Psychology, The Pennsylvania State University, University Park, PA, 16802, USA
- Department of Public Health Sciences, The Pennsylvania State University, College of Medicine, Hershey, PA, 17033, USA
| | - Jean Neils-Strunjas
- Department of Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jingkai Wei
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Margaret C Miller
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Megan D Byers
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Office for the Study of Aging, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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20
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Coates PM, Bailey RL, Blumberg JB, El-Sohemy A, Floyd ZE, Goldenberg JZ, Gould Shunney A, Holscher HD, Nkrumah-Elie Y, Rai D, Ritz BW, Weber WJ. The Evolution of Science and Regulation of Dietary Supplements: Past, Present, and Future. J Nutr 2024:S0022-3166(24)00356-0. [PMID: 38971530 DOI: 10.1016/j.tjnut.2024.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/19/2024] [Accepted: 06/26/2024] [Indexed: 07/08/2024] Open
Abstract
Dietary supplement use in the United States is widespread and increasing, especially among certain population groups, such as older Americans. The science surrounding dietary supplements has evolved substantially over the last few decades since their formal regulation in 1994. Much has been learned about the mechanisms of action of many dietary supplement ingredients, but the evidence on their health effects is still building. As is true of much nutrition research, there are many studies that point to health effects, but not all are at the level of scientific evidence (e.g., randomized controlled interventions), rigor, or quality needed for definitive statements of efficacy regarding clinical end points. New technologies and approaches are being applied to the science of dietary supplements, including nutrigenomics and microbiome analysis, data science, artificial intelligence (AI), and machine learning-all of which can elevate the science behind dietary supplements. Products can contain an array of bioactive compounds derived from foods as well as from medicinal plants, which creates enormous challenges in data collection and management. Clinical applications, particularly those aimed at providing personalized nutrition options for patients, have become more sophisticated as dietary supplements are incorporated increasingly into clinical practice and self-care. The goals of this article are to provide historical context for the regulation and science of dietary supplements, identify research resources, and suggest some future directions for science in this field.
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Affiliation(s)
- Paul M Coates
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, United States.
| | - Regan L Bailey
- Institute for Advancing Health Through Agriculture, Texas A&M University System, College Station, TX, United States
| | - Jeffrey B Blumberg
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Ahmed El-Sohemy
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Z Elizabeth Floyd
- McIlhenny Botanical Research Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, United States
| | - Joshua Z Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, United States
| | | | - Hannah D Holscher
- Department of Food Science and Human Nutrition, University of Illinois Urbana-Champaign, Urbana, IL, United States
| | | | - Deshanie Rai
- OmniActive Health Technologies, Morristown, NJ, United States
| | - Barry W Ritz
- Nestlé Health Science, Bridgewater, NJ, United States
| | - Wendy J Weber
- National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, MD, United States
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21
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Bottenhorn KL, Corbett JD, Ahmadi H, Herting MM. Spatiotemporal patterns in cortical development: Age, puberty, and individual variability from 9 to 13 years of age. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.06.29.601354. [PMID: 39005403 PMCID: PMC11244861 DOI: 10.1101/2024.06.29.601354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Humans and nonhuman primate studies suggest that timing and tempo of cortical development varies neuroanatomically along a sensorimotor-to-association (S-A) axis. Prior human studies have reported a principal S-A axis across various modalities, but largely rely on cross-sectional samples with wide age-ranges. Here, we investigate developmental changes and individual variability in cortical organization along the S-A axis between the ages of 9-13 years using a large, longitudinal sample (N = 2487-3747, 46-50% female) from the Adolescent Brain Cognitive Development Study (ABCD Study®). This work assesses multiple aspects of neurodevelopment indexed by changes in cortical thickness, cortical microarchitecture, and resting-state functional fluctuations. First, we evaluated S-A organization in age-related changes and, then, computed individual-level S-A alignment in brain changes and assessing differences therein due to age, sex, and puberty. Varying degrees of linear and quadratic age-related brain changes were identified along the S-A axis. Yet, these patterns of cortical development were overshadowed by considerable individual variability in S-A alignment. Even within individuals, there was little correspondence between S-A patterning across the different aspects of neurodevelopment investigated (i.e., cortical morphology, microarchitecture, function). Some of the individual variation in developmental patterning of cortical morphology and microarchitecture was explained by age, sex, and pubertal development. Altogether, this work contextualizes prior findings that regional age differences do progress along an S-A axis at a group level, while highlighting broad variation in developmental change between individuals and between aspects of cortical development, in part due to sex and puberty. Significance Statement Understanding normative patterns of adolescent brain change, and individual variability therein, is crucial for disentangling healthy and abnormal development. We used longitudinal human neuroimaging data to study several aspects of neurodevelopment during early adolescence and assessed their organization along a sensorimotor-to-association (S-A) axis across the cerebral cortex. Age differences in brain changes were linear and curvilinear along this S-A axis. However, individual-level sensorimotor-association alignment varied considerably, driven in part by differences in age, sex, and pubertal development.
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22
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Alvarado F, Allouch F, Laurent J, Chen J, Bundy JD, Gustat J, Crews DC, Mills KT, Ferdinand KC, He J. Neighborhood-level social determinants of health and cardioprotective behaviors among church members in New Orleans, Louisiana. Am J Med Sci 2024; 368:9-17. [PMID: 38556001 DOI: 10.1016/j.amjms.2024.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/13/2024] [Accepted: 03/27/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Favorable neighborhood-level social determinants of health (SDoH) are associated with lower cardiovascular disease risk. Less is known about their influence on cardioprotective behaviors. We evaluated the associations between neighborhood-level SDoH and cardioprotective behaviors among church members in Louisiana. METHODS Participants were surveyed between November 2021 to February 2022, and were asked about health behaviors, aspects of their neighborhood, and home address (to link to census tract and corresponding social deprivation index [SDI] data). Logistic regression models were used to assess the relation of neighborhood factors with the likelihood of engaging in cardioprotective behaviors: 1) a composite of healthy lifestyle behaviors [fruit and vegetable consumption, physical activity, and a tobacco/nicotine-free lifestyle], 2) medication adherence, and 3) receipt of routine medical care within the past year. RESULTS Participants (n = 302, mean age: 63 years, 77% female, 99% Black) were recruited from 12 churches in New Orleans. After adjusting for demographic and clinical factors, perceived neighborhood walkability or conduciveness to exercise (odds ratio [OR]=1.25; 95% CI: 1.03, 1.53), availability of fruits and vegetables (OR=1.23; 95% CI: 1.07, 1.42), and social cohesion (OR=1.55; 95% CI: 1.22, 1.97) were positively associated with the composite of healthy lifestyle behaviors. After multivariable adjustment, SDI was in the direction of association with all three cardioprotective behavior outcomes, but associations were not statistically significant. CONCLUSIONS In this predominantly Black, church-based population, neighborhood-level SDoH including the availability of fruits and vegetables, walkability or conduciveness to exercise, and social cohesion were associated with cardioprotective behaviors. Findings reiterate the need to address adverse neighborhood-level SDoH in the design and implementation of health interventions.
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Affiliation(s)
- Flor Alvarado
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
| | - Farah Allouch
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jodie Laurent
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jing Chen
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Joshua D Bundy
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Jeanette Gustat
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Deidra C Crews
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Katherine T Mills
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Keith C Ferdinand
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - Jiang He
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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23
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Kapera O, Chen B, Almandoz JP, Byrd-Williams C, Messiah SE. Prevalence of Weight Stigma in Medical Settings Among Reproductive-Aged Women in the All of Us Study. Obstet Gynecol 2024; 144:89-97. [PMID: 38781589 PMCID: PMC11216880 DOI: 10.1097/aog.0000000000005614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/18/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To analyze health care treatment experiences among a diverse cohort of reproductive-aged women from the All of Us study, focusing on variations due to body mass index (BMI). METHODS We conducted a cross-sectional study that used data from the All of Us Research Program. We analyzed weight bias among reproductive-aged women aged 18-44 years. Weight bias was assessed using a proxy 7-item survey that evaluated discrimination in health care experiences, including courtesy, respect, service quality, being treated as competent, displaying fear, being treated as inferior, and being listened to during health care visits. RESULTS Overall, 16,791 reproductive-aged women (mean [SD] age, 35.8 [6.3]) were included in the study. Of 11,592 patients with data available on BMI, 582 were Asian (5.0%), 1,984 (17.1%) were Hispanic or Latinx, 1,007 (8.7%) were non-Hispanic Black, and 7,370 (63.6%) were non-Hispanic White. Approximately 24.2% of participants (n=2,878) had obesity, and 11.1% of participants (n=1,292) had severe obesity. In general, participants in higher BMI categories had negative experiences in the health care setting. Women with severe obesity were 1.5 to 2 times more likely to report poor experiences with their health care clinicians compared with women with healthy weight. CONCLUSION Results show significant disparities in the health care experiences among reproductive-aged women. As participants' BMI category increased, so did their negative experiences in the health care setting. These findings underscore the urgent need for targeted interventions to address these inequities. Health care systems must prioritize strategies to ensure that all individuals, regardless of weight or BMI, receive equitable and respectful care.
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Affiliation(s)
- Olivia Kapera
- Center for Pediatric Population Health, UT Health School of Public Health, Dallas, TX, USA
- University of Texas Health Science Center, School of Public Health, Austin Campus, Austin, TX, USA
| | - Baojiang Chen
- Department of Biostatistics and Data Science, University of Texas Health Science Center at Houston, USA
| | - Jaime P. Almandoz
- University of Texas Southwestern Medical Center, Department of Internal Medicine, Division of Endocrinology, Dallas, TX, USA
| | - Courtney Byrd-Williams
- University of Texas Health Science Center, School of Public Health, Austin Campus, Austin, TX, USA
| | - Sarah E. Messiah
- Center for Pediatric Population Health, UT Health School of Public Health, Dallas, TX, USA
- University of Texas Health Science Center, School of Public Health, Dallas Campus, Dallas, TX, USA
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24
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Smith AK, Katrinli S, Cobb DO, Goff EG, Simmond M, Christensen GM, Prusisz T, Garth SN, Brashear M, Hüls A, Wolf EJ, Trapido EJ, Rung AL, Nugent NR, Peters ES. Epigenetic Age Acceleration and Disparities in Posttraumatic Stress in Women in Southeast Louisiana: NIMHD Social Epigenomics Program. JAMA Netw Open 2024; 7:e2421884. [PMID: 39073815 PMCID: PMC11287391 DOI: 10.1001/jamanetworkopen.2024.21884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 04/23/2024] [Indexed: 07/30/2024] Open
Abstract
Importance Disasters experienced by an entire community provide opportunities to understand individual differences in risk for adverse health outcomes over time. DNA methylation (DNAm) differences may help to distinguish individuals at increased risk following large-scale disasters. Objective To examine the association of epigenetic age acceleration with probable posttraumatic stress disorder (PTSD) and PTSD symptom severity in women. Design, Setting, and Participants This prospective cohort study examined data from participants in the Women and Their Children's Health cohort, who were characterized longitudinally following the Deepwater Horizon oil spill (DHOS) in 2010 and through numerous hurricanes in the Gulf Coast region of the US. Wave 1 occurred August 6, 2012, through June 26, 2014, and wave 2 occurred September 2, 2014, through May 27, 2016. Data were analyzed between August 18 and November 4, 2023. Address-based sampling was used to recruit women aged 18 to 80 years and residing in 1 of the 7 Louisiana parishes surrounding the DHOS-affected region. Recruitment consisted of 2-stage sampling that (1) undersampled the 2 more urban parishes to maximize probability of participant oil exposure and (2) proportionally recruited participants across census tracts in the 5 other parishes closest to the spill. Exposure Posttraumatic stress subsequent to the DHOS. Main Outcome and Measures Epigenetic age acceleration was measured by DNAm assayed from survey wave 1 blood samples. Posttraumatic stress disorder was assessed using the PTSD Checklist for DSM-5 at survey wave 2, and lifetime trauma exposure was assessed using the Life Events Checklist for DSM-5. General linear models were used to examine the association between wave 1 DNAm age and wave 2 probable PTSD diagnosis and symptom severity. Results A total of 864 women (mean [SD] age, 47.1 [12.0] years; 328 Black [38.0%], 19 American Indian [2.2%], 486 White [56.3%], and 30 of other racial groups, including uknown or unreported [3.5%]) were included. Black and American Indian participants had a higher age acceleration at wave 1 compared with White participants (β = 1.64 [95% CI, 1.02-2.45] and 2.34 [95% CI, 0.33-4.34], respectively), and they had higher PTSD symptom severity at wave 2 (β = 7.10 [95% CI, 4.62-9.58] and 13.08 [95% CI, 4.97-21.18], respectively). Epigenetic age acceleration at wave 1 was associated with PTSD symptom severity at wave 2 after adjusting for race, smoking, body mass index, and household income (β = 0.38; 95% CI, 0.11-0.65). Conclusions and Relevance In this cohort study, epigenetic age acceleration was higher in minoritized racial groups and associated with future PTSD diagnosis and severity. These findings support the need for psychoeducation about traumatic responses to increase the likelihood that treatment is sought before years of distress and entrenchment of symptoms and comorbidities occur.
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Affiliation(s)
- Alicia K. Smith
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, Georgia
- Department of Human Genetics, School of Medicine, Emory University, Atlanta, Georgia
| | - Seyma Katrinli
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Dawayland O. Cobb
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Evan G. Goff
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Michael Simmond
- Department of Gynecology and Obstetrics, School of Medicine, Emory University, Atlanta, Georgia
| | - Grace M. Christensen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Tyler Prusisz
- Epidemiology Program, Louisiana State University School of Public Health, New Orleans
| | - Sierra N. Garth
- Epidemiology Department, University of Nebraska Medical Center College of Public Health, Omaha
| | - Meghan Brashear
- Epidemiology Department, University of Nebraska Medical Center College of Public Health, Omaha
| | - Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Erika J. Wolf
- National Center for PTSD at VA Boston Healthcare System and Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts
| | - Edward J. Trapido
- Epidemiology Program, Louisiana State University School of Public Health, New Orleans
| | - Ariane L. Rung
- Epidemiology Department, University of Nebraska Medical Center College of Public Health, Omaha
| | - Nicole R. Nugent
- Department of Psychiatry and Human Behavior, Alpert Brown Medical School, Providence, Rhode Island
- Department of Pediatrics, Alpert Brown Medical School, Providence, Rhode Island
- Department of Emergency Medicine, Alpert Brown Medical School, Providence, Rhode Island
| | - Edward S. Peters
- Epidemiology Department, University of Nebraska Medical Center College of Public Health, Omaha
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Ba DM, Kayembe C, Littlejohn J, Van Scoy LJ, VanDyke E, Williams J, Katoch A, Shook NC, Zhang Y, Livelsberger C, McDonald AC, Muscat JE. Navigation-Based Telehealth Informed Decision-Making for Prostate Cancer Screening in Black Men. Curr Oncol 2024; 31:3698-3712. [PMID: 39057145 PMCID: PMC11275421 DOI: 10.3390/curroncol31070273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024] Open
Abstract
The rapid increase in telehealth has the potential to bring informed decision-making for prostate cancer screening (PCS) at the population level to high-risk individuals. We utilized a global technology platform of electronic health records data repositories (TriNetX) to determine its utility for Navigator-guided decision-making aid for PCS in Black men ages 45-79 years with no history of prostate cancer and PSA testing. Patients from Pennsylvania were invited to participate in a telehealth-delivered informed decision-making session for PCS. Focus groups, social learning theory, visual diagrams, and quantitative data on PCS risks and benefits were used to develop the content of the sessions, which included numerical discussions of risks vs. benefits in Black men. Participants completed several surveys, including baseline demographic and numeracy questionnaires, a one-on-one telehealth session with a trained Navigator, post-Navigation surveys, and an optional follow-up session with a urologist. Eighty-seven participants were consented and recruited. Although the mean numeracy score was only 1.9 out of 6, more than 90% rated as good or excellent that the sessions aided their PCS decision-making skills. This study indicates that Navigation by telehealth offers the ability to assist in informed decision-making for PCS at the population level.
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Affiliation(s)
- Djibril M. Ba
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Chrispin Kayembe
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Joe Littlejohn
- Department of Urology, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Lauren J. Van Scoy
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - Erika VanDyke
- Qualitative and Mixed Methods Core, Penn State College of Medicine, Hershey, PA 17033, USA;
| | - James Williams
- Pennsylvania Prostate Cancer Coalition, Harrisburg, PA 17120, USA;
| | - Avnish Katoch
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Neil C. Shook
- Center for Survey Research, Penn State Harrisburg, Harrisburg, PA 17057, USA;
| | - Yue Zhang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Craig Livelsberger
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Alicia C. McDonald
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
| | - Joshua E. Muscat
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA 17033, USA; (D.M.B.); (C.K.); (L.J.V.S.); (A.K.); (Y.Z.); (C.L.); (A.C.M.)
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26
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Meropol SB, Norris CJ, Frontera JA, Adeagbo A, Troxel AB. The National Institutes of Health COVID-19 Neuro Databank/Biobank: Creation and Evolution. Neuroepidemiology 2024:1-13. [PMID: 38934169 DOI: 10.1159/000539830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Diverse neurological conditions are reported associated with the SARS-CoV-2 virus; neurological symptoms are the most common conditions to persist after the resolution of acute infection, affecting 20% of patients 6 months after acute illness. The COVID-19 Neuro Databank (NeuroCOVID) was created to overcome the limitations of siloed small local cohorts to collect detailed, curated, and harmonized de-identified data from a large diverse cohort of adults with new or worsened neurological conditions associated with COVID-19 illness, as a scientific resource. METHODS A Steering Committee including US and international experts meets quarterly to provide guidance. Initial study sites were recruited to include a wide US geographic distribution; academic and non-academic sites; urban and non-urban locations; and patients of different ages, disease severity, and comorbidities seen by a variety of clinical specialists. The NeuroCOVID REDCap database was developed, incorporating input from professional guidelines, existing common data elements, and subject matter experts. A cohort of eligible adults is identified at each site; inclusion criteria are: a new or worsened neurological condition associated with a COVID-19 infection confirmed by testing. De-identified data are abstracted from patients' medical records, using standardized common data elements and five case report forms. The database was carefully enhanced in response to feedback from site investigators and evolving scientific interest in post-acute conditions and their timing. Additional US and international sites were added, focusing on diversity and populations not already described in published literature. By early 2024, NeuroCOVID included over 2,700 patient records, including data from 16 US and 5 international sites. Data are being shared with the scientific community in compliance with NIH requirements. The program has been invited to share case report forms with the National Library of Medicine as an ongoing resource for the scientific community. CONCLUSION The NeuroCOVID database is a unique and valuable source of comprehensive de-identified data on a wide variety of neurological conditions associated with COVID-19 illness, including a diverse patient population. Initiated early in the pandemic, data collection has been responsive to evolving scientific interests. NeuroCOVID will continue to contribute to scientific efforts to characterize and treat this challenging illness and its consequences.
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Affiliation(s)
- Sharon B Meropol
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Cecile J Norris
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA,
| | - Jennifer A Frontera
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Adenike Adeagbo
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Andrea B Troxel
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
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Takase M, Nakaya N, Nakamura T, Kogure M, Hatanaka R, Nakaya K, Chiba I, Kanno I, Nochioka K, Tsuchiya N, Hirata T, Narita A, Obara T, Ishikuro M, Uruno A, Kobayashi T, Kodama EN, Hamanaka Y, Orui M, Ogishima S, Nagaie S, Fuse N, Sugawara J, Kuriyama S, Matsuda K, Izumi Y, Kinoshita K, Tamiya G, Hozawa A, Yamamoto M. Genetic Risk, Healthy Lifestyle Adherence, and Risk of Developing Diabetes in the Japanese Population. J Atheroscler Thromb 2024:64906. [PMID: 38910120 DOI: 10.5551/jat.64906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2024] Open
Abstract
AIM This study examined the relationship between genetic risk, healthy lifestyle, and risk of developing diabetes. METHODS This prospective cohort study included 11,014 diabetes-free individuals ≥ 20 years old from the Tohoku Medical Megabank Community-based cohort study. Lifestyle scores, including the body mass index, smoking, physical activity, and gamma-glutamyl transferase (marker of alcohol consumption), were assigned, and participants were categorized into ideal, intermediate, and poor lifestyles. A polygenic risk score (PRS) was constructed based on the type 2 diabetes loci from the BioBank Japan study. A multiple logistic regression model was used to estimate the association between genetic risk, healthy lifestyle, and diabetes incidence and to calculate the area under the receiver operating characteristic curve (AUROC). RESULT Of the 11,014 adults included (67.8% women; mean age [standard deviation], 59.1 [11.3] years old), 297 (2.7%) developed diabetes during a mean 4.3 (0.8) years of follow-up. Genetic and lifestyle score is independently associated with the development of diabetes. Compared with the low genetic risk and ideal lifestyle groups, the odds ratio was 3.31 for the low genetic risk and poor lifestyle group. When the PRS was integrated into a model including the lifestyle and family history, the AUROC significantly improved to 0.719 (95% confidence interval [95% CI]: 0.692-0.747) compared to a model including only the lifestyle and family history (0.703 [95% CI, 0.674-0.732]). CONCLUSION Our findings indicate that adherence to a healthy lifestyle is important for preventing diabetes, regardless of genetic risk. In addition, genetic risk might provide information beyond lifestyle and family history to stratify individuals at high risk of developing diabetes.
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Affiliation(s)
| | - Naoki Nakaya
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University
- Kyoto Women's University
| | - Mana Kogure
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Rieko Hatanaka
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Kumi Nakaya
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Ippei Chiba
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Kotaro Nochioka
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- Tohoku University Hospital, Tohoku University
| | - Naho Tsuchiya
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University
- Human Care Research Team, Tokyo metropolitan Institute for Geriatrics and Gerontology
| | - Akira Narita
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Taku Obara
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University
| | - Tomoko Kobayashi
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- Tohoku University Hospital, Tohoku University
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University
- International Research Institute of Disaster Science, Tohoku University
| | | | - Masatsugu Orui
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Soichi Ogishima
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Satoshi Nagaie
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Nobuo Fuse
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- Tohoku University Hospital, Tohoku University
- Suzuki Memorial Hospital
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- International Research Institute of Disaster Science, Tohoku University
| | - Koichi Matsuda
- Laboratory of Clinical Genome Sequencing, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, the University of Tokyo
| | - Yoko Izumi
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Kengo Kinoshita
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Gen Tamiya
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- RIKEN Center for Advanced Intelligence Project
| | - Atsushi Hozawa
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Masayuki Yamamoto
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
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Klein EG, Shoben AB, Carpenter KM, Mullis K, Nemeth JM, Mayers E, Vickerman KA. A Randomized Clinical Trial of a Quitline Vaping Cessation Intervention: Baseline Characteristics of Young Adult Exclusive E-Cigarette Users Seeking Treatment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:809. [PMID: 38929055 PMCID: PMC11203730 DOI: 10.3390/ijerph21060809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/23/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Despite interest in quitting vaping among young adults (YAs), little is known about characteristics of e-cigarette (EC) users seeking treatment. In this study, YAs aged 18-24 living in the United States interested in vaping cessation treatment were recruited to complete an online survey regarding demographics and EC use. Primary eligibility criteria were EC use on at least 20 days per month (no other tobacco use), and interest in quitting in the next month. We report descriptive statistics for those who did and did not complete a mandatory coaching call (n = 981). In this sample, most EC users reported high nicotine dependence, a history of unsuccessful quit attempts (including 29.4% with previous NRT use), along with stress, anxiety, and depression. There were few meaningful differences in demographics, EC use behaviors, or behavioral health factors between those who engaged with a phone coaching call (fully enrolled in study; n = 508), and those who did not (n = 473). YAs demonstrated interest in vaping cessation support, but there were no clear characteristics for the half who did not complete a coaching call. Vaping cessation program designers should consider tailoring for the self-reported behavioral health concerns present in this population.
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Affiliation(s)
- Elizabeth G. Klein
- College of Public Health, Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA; (A.B.S.); (J.M.N.); (E.M.)
| | - Abigail B. Shoben
- College of Public Health, Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA; (A.B.S.); (J.M.N.); (E.M.)
| | - Kelly M. Carpenter
- RVO Health, 1101 Red Ventures Drive, Fort Mill, SC 29707, USA; (K.M.C.); (K.M.); (K.A.V.)
| | - Kristina Mullis
- RVO Health, 1101 Red Ventures Drive, Fort Mill, SC 29707, USA; (K.M.C.); (K.M.); (K.A.V.)
| | - Julianna M. Nemeth
- College of Public Health, Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA; (A.B.S.); (J.M.N.); (E.M.)
| | - Elizabeth Mayers
- College of Public Health, Ohio State University, 1841 Neil Avenue, Columbus, OH 43210, USA; (A.B.S.); (J.M.N.); (E.M.)
| | - Katrina A. Vickerman
- RVO Health, 1101 Red Ventures Drive, Fort Mill, SC 29707, USA; (K.M.C.); (K.M.); (K.A.V.)
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29
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McCurry KL, Toda-Thorne K, Taxali A, Angstadt M, Hardi FA, Heitzeg MM, Sripada C. Data-driven, generalizable prediction of adolescent sleep disturbances in the multisite Adolescent Brain Cognitive Development Study. Sleep 2024; 47:zsae048. [PMID: 38366843 PMCID: PMC11168765 DOI: 10.1093/sleep/zsae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/21/2024] [Indexed: 02/18/2024] Open
Abstract
STUDY OBJECTIVES Sleep disturbances are common in adolescence and associated with a host of negative outcomes. Here, we assess associations between multifaceted sleep disturbances and a broad set of psychological, cognitive, and demographic variables using a data-driven approach, canonical correlation analysis (CCA). METHODS Baseline data from 9093 participants from the Adolescent Brain Cognitive Development (ABCD) Study were examined using CCA, a multivariate statistical approach that identifies many-to-many associations between two sets of variables by finding combinations for each set of variables that maximize their correlation. We combined CCA with leave-one-site-out cross-validation across ABCD sites to examine the robustness of results and generalizability to new participants. The statistical significance of canonical correlations was determined by non-parametric permutation tests that accounted for twin, family, and site structure. To assess the stability of the associations identified at baseline, CCA was repeated using 2-year follow-up data from 4247 ABCD Study participants. RESULTS Two significant sets of associations were identified: (1) difficulty initiating and maintaining sleep and excessive daytime somnolence were strongly linked to nearly all domains of psychopathology (r2 = 0.36, p < .0001); (2) sleep breathing disorders were linked to BMI and African American/black race (r2 = 0.08, p < .0001). These associations generalized to unseen participants at all 22 ABCD sites and were replicated using 2-year follow-up data. CONCLUSIONS These findings underscore interwoven links between sleep disturbances in early adolescence and psychological, social, and demographic factors.
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Affiliation(s)
| | | | - Aman Taxali
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Felicia A Hardi
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Chandra Sripada
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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30
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Wang Z, Kwan ML, Haque R, Pratt R, Lee VS, Roh JM, Ergas IJ, Cannavale KL, Loo RK, Aaronson DS, Quesenberry CP, Ambrosone CB, Kushi LH, Tang L. Environmental and occupational exposures and prognosis in patients with non-muscle-invasive bladder cancer in the Be-Well Study. Am J Epidemiol 2024; 193:863-873. [PMID: 38055616 DOI: 10.1093/aje/kwad236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 11/16/2023] [Accepted: 12/01/2023] [Indexed: 12/08/2023] Open
Abstract
Bladder cancer is primarily diagnosed as non-muscle-invasive bladder cancer (NMIBC), with high recurrence and progression rates. Environmental and occupational exposures to carcinogens are well-known risk factors for developing bladder cancer, yet their effects on prognosis remain unknown. In the Be-Well Study, a population-based prospective cohort study of 1472 Kaiser Permanente patients newly diagnosed with NMIBC in California from 2015 to 2019, we examined history of environmental and occupational exposures in relation to tumor stage and grade at initial diagnosis by multivariable logistic regression, and subsequent recurrence and progression by Cox proportional hazards regression. Exposure to environmental and occupational carcinogens was significantly associated with increased risk of progression (hazard ratio (HR) = 1.79; 95% CI, 1.04-3.09), specifically with increased progression to muscle-invasive disease (HR = 2.28; 95% CI, 1.16-4.50). Exposures to asbestos and arsenic were associated with increased odds of advanced stage at diagnosis (asbestos: odds ratio (OR) = 1.43 [95% CI, 1.11-1.84]; arsenic: OR = 1.27 [95% CI, 1.01-1.63]), and formaldehyde exposure was associated with increased risk of recurrence (HR = 1.38; 95% CI, 1.12-1.69). Our findings suggest that considering a patient's history of these exposures may benefit current risk stratification systems in better tailoring clinical care and improving prognosis among patients with NMIBC.
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31
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Roy E, Van Rinsveld A, Nedelec P, Richie-Halford A, Rauschecker AM, Sugrue LP, Rokem A, McCandliss BD, Yeatman JD. Differences in educational opportunity predict white matter development. Dev Cogn Neurosci 2024; 67:101386. [PMID: 38676989 DOI: 10.1016/j.dcn.2024.101386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 02/05/2024] [Accepted: 04/15/2024] [Indexed: 04/29/2024] Open
Abstract
Coarse measures of socioeconomic status, such as parental income or parental education, have been linked to differences in white matter development. However, these measures do not provide insight into specific aspects of an individual's environment and how they relate to brain development. On the other hand, educational intervention studies have shown that changes in an individual's educational context can drive measurable changes in their white matter. These studies, however, rarely consider socioeconomic factors in their results. In the present study, we examined the unique relationship between educational opportunity and white matter development, when controlling other known socioeconomic factors. To explore this question, we leveraged the rich demographic and neuroimaging data available in the ABCD study, as well the unique data-crosswalk between ABCD and the Stanford Education Data Archive (SEDA). We find that educational opportunity is related to accelerated white matter development, even when accounting for other socioeconomic factors, and that this relationship is most pronounced in white matter tracts associated with academic skills. These results suggest that the school a child attends has a measurable relationship with brain development for years to come.
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Affiliation(s)
- Ethan Roy
- Graduate School of Education, Stanford University, Stanford, CA, USA.
| | | | - Pierre Nedelec
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Adam Richie-Halford
- Graduate School of Education, Stanford University, Stanford, CA, USA; Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, USA
| | - Andreas M Rauschecker
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Leo P Sugrue
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, USA
| | - Ariel Rokem
- Department of Psychology and eScience Institute, University of Washington, Seattle, WA, USA
| | | | - Jason D Yeatman
- Graduate School of Education, Stanford University, Stanford, CA, USA; Division of Developmental-Behavioral Pediatrics, Stanford University, Stanford, CA, USA
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32
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Bravo LG, Meza J, Schiff SJ, Ahmed C, Elliot T, La Charite J, Choi K. Parental Legal System Involvement, Positive Childhood Experiences, and Suicide Risk. Pediatrics 2024; 153:e2023062566. [PMID: 38779781 PMCID: PMC11153318 DOI: 10.1542/peds.2023-062566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 05/25/2024] Open
Abstract
OBJECTIVES To examine whether adverse parental legal system involvement (incarceration, arrest) was associated with suicide risk, accounting for other adverse childhood experiences, and whether there was a moderating relationship between positive childhood experiences (PCEs) and parental legal system involvement in suicide risk. METHODS This cross-sectional study used 2-year follow-up data from the Adolescent Brain Cognitive Development Study when children were age 11 to 12 years. Outcomes were lifetime suicidal ideation, attempts, and nonsuicidal self-injury (NSSI). Exposures were parent incarceration or arrest. We used generalized linear models to estimate the relative risk of suicide outcomes from adverse parent legal involvement and whether there was an interaction between parent legal system involvement and PCE count, controlling for adverse childhood experiences and demographic factors. RESULTS Among our sample (n = 10 532;), 687 children (6.5%) reported parent incarceration and 1265 (12.0%) reported parent arrest. Suicidal ideation was the most frequent risk outcome (n = 490; 4.7%). Children whose parents had been incarcerated had a relative risk of suicidal ideation of 1.74 (95% CI: 1.32-2.31). Children whose parents had been arrested had a relative risk of suicidal ideation of 1.89 (95% CI: 1.53-2.37) and a relative risk of suicide attempt of 2.69 (95% CI: 1.7-4.25). Parental incarceration/arrest were not associated with NSSI. PCEs were associated with reduced relative risk of suicidal ideation and NSSI, though there was no significant interaction between PCEs and adverse parent legal system involvement exposures. CONCLUSIONS Parental legal system involvement may negatively affect child mental health. Strengthening PCEs in childhood may mitigate suicide-related risks.
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Affiliation(s)
- Lilian G. Bravo
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California
| | - Jocelyn Meza
- Department of Psychiatry and Biobehavioral Sciences
| | | | - Charisse Ahmed
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California
| | - Thomas Elliot
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California
| | - Jaime La Charite
- National Clinician Scholars Program, Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Kristen Choi
- School of Nursing
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
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33
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Zhang A, Koroukian S, Owusu C, Moore SE, Momotaz H, Albert JM. Loneliness and Crowded Living Predicted Poor Health in a Sample of Cancer Patients During COVID-19 Pandemic. Clin Nurs Res 2024; 33:370-383. [PMID: 38773912 DOI: 10.1177/10547738241252889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/24/2024]
Abstract
We investigated the influence of social determinants of health (SDOH), healthcare services, and health behaviors on mental and physical health outcomes of cancer patients between the first winter and the following post-vaccine summer of the COVID-19 pandemic. A three-wave online survey of individuals diagnosed with incident cancer between January 2019 and January 2020 was conducted between November of 2020 and August of 2021 in northeast Ohio. Descriptive analysis and mixed-effect regression analyses were performed. A total of 322 newly diagnosed cancer patients, with 40 African Americans and 282 Whites (215 from metropolitan areas and 67 nonmetropolitan) responded to the survey questions. In Wave 3 ending in August 2021, the survey respondents reported significantly reduced depression (p = .019) on the Hamilton Depression Rating Scale and improved global health (p = .036) on PROMIS. With age, comorbidity, and other demographic and medical variables controlled in the analyses, the feeling of loneliness (p < .001) and crowded living space (p = .001, p = .015) were the two most prominent factors associated with depression, irritability, and poor global health at baseline, with the lowest p values and persistent effect. Self-efficacy of taking preventive measures was associated with reduced depression (p = .001) and improved global health (p = .029). Increasing access to medicine (p < .01) and satisfaction with telehealth appointments (p < .01) were significantly associated with better global health and reduced irritability. Respondents who had private health insurance reported better health than those that had Medicare coverage only (p < .05). This longitudinal, observational study demonstrated the impact of SDOH on health outcomes of cancer patients. Substandard living conditions resulting in loneliness and crowdedness, quality of medical care (e.g., quality telehealth and access to medicine), and personal behaviors (e.g., self-efficacy) were significantly associated with health outcomes in newly diagnosed cancer patients during the pandemic and should be given adequate consideration for the purpose of improving clinical care.
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Affiliation(s)
- Amy Zhang
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Siran Koroukian
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Cynthia Owusu
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Scott E Moore
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Hasina Momotaz
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Jeffrey M Albert
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
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34
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Takase M, Nakamura T, Nakaya N, Kogure M, Hatanaka R, Nakaya K, Chiba I, Kanno I, Nochioka K, Tsuchiya N, Hirata T, Obara T, Ishikuro M, Uruno A, Kobayashi T, Kodama EN, Hamanaka Y, Orui M, Ogishima S, Nagaie S, Fuse N, Sugawara J, Izumi Y, Kuriyama S, Hozawa A. Relationships of Fat Mass Index and Fat-Free Mass Index with Low-Density Lipoprotein Cholesterol Levels in the Tohoku Medical Megabank Community-Based Cohort Study. J Atheroscler Thromb 2024; 31:979-1003. [PMID: 38325860 DOI: 10.5551/jat.64535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2024] Open
Abstract
AIMS Although fat mass (FM) and fat-free mass (FFM) have an impact on lipid metabolism, the relationship between different body composition phenotypes and lipid profiles is still unclear. By dividing the FM and FFM by the square of the height, respectively, the fat mass index (FMI) and fat-free mass index (FFMI) can be used to determine the variations in body composition. This study aimed to investigate the relationship of combined FMI and FFMI with low-density lipoprotein cholesterol (LDL-C) levels. METHODS This cross-sectional study comprised 5,116 men and 13,630 women without cardiovascular disease and without treatment for hypertension, and diabetes. Following sex-specific quartile classification, FMI and FFMI were combined into 16 groups. Elevated LDL-C levels were defined as LDL-C ≥ 140 mg/dL and/or dyslipidemia treatment. Multivariable logistic regression models were used to examine the relationships between combined FMI and FFMI and elevated LDL-C levels. RESULTS Overall, elevated LDL-C levels were found in 1,538 (30.1%) men and 5,434 (39.9%) women. In all FFMI subgroups, a higher FMI was associated with elevated LDL-C levels. Conversely, FFMI was inversely associated with elevated LDL-C levels in most FMI subgroups. Furthermore, the groups with the highest FMI and lowest FFMI had higher odds ratios for elevated LDL-C levels than those with the lowest FMI and highest FFMI. CONCLUSIONS Regardless of FFMI, FMI was positively associated with elevated LDL-C levels. Conversely, in the majority of FMI subgroups, FFMI was inversely associated with elevated LDL-C levels.
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Affiliation(s)
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University
- Kyoto Women's University
| | - Naoki Nakaya
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Mana Kogure
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Rieko Hatanaka
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Kumi Nakaya
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Ippei Chiba
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Kotaro Nochioka
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- Tohoku University Hospital, Tohoku University
| | - Naho Tsuchiya
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University
- Institute for Clinical and Translational Science, Nara Medical University
| | - Taku Obara
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University
| | - Tomoko Kobayashi
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- Tohoku University Hospital, Tohoku University
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University
- International Research Institute of Disaster Science, Tohoku University
| | | | - Masatsugu Orui
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Soichi Ogishima
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Satoshi Nagaie
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Nobuo Fuse
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- Tohoku University Hospital, Tohoku University
- Suzuki Memorial Hospital
| | - Yoko Izumi
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
- International Research Institute of Disaster Science, Tohoku University
| | - Atsushi Hozawa
- Graduate School of Medicine, Tohoku University
- Tohoku Medical Megabank Organization, Tohoku University
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35
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Takase M, Nakaya N, Tanno K, Kogure M, Hatanaka R, Nakaya K, Chiba I, Kanno I, Nochioka K, Tsuchiya N, Nakamura T, Hirata T, Obara T, Ishikuro M, Kotozaki Y, Uruno A, Kobayashi T, Kodama EN, Hamanaka Y, Orui M, Ogishima S, Nagaie S, Ohmomo H, Fuse N, Sugawara J, Shimizu A, Izumi Y, Kuriyama S, Hozawa A. Relationship between traditional risk factors for hypertension and systolic blood pressure in the Tohoku Medical Megabank Community-based Cohort Study. Hypertens Res 2024; 47:1533-1545. [PMID: 38424250 PMCID: PMC11150157 DOI: 10.1038/s41440-024-01582-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 12/20/2023] [Accepted: 12/24/2023] [Indexed: 03/02/2024]
Abstract
Risk factors for hypertension have been emphasized in the Japanese Society of Hypertension Guidelines for the Management of Hypertension. However, large-scale studies on the association of smoking, potassium excretion, and gamma-glutamyl transferase level with BP in the Japanese population are limited. We conducted a cross-sectional study to examine the association between hypertension risk factors and systolic blood pressure in the Tohoku Medical Megabank Community-based Cohort Study (23,446 men and 38,921 women aged ≥20 years). A model adjusted for age, body mass index, smoking status, drinking status, estimated daily salt intake, potassium excretion, (or urinary sodium-to-potassium ratio), gamma-glutamyl transferase, physical activity, education level, status of damage to homes during the Great East Japan Earthquake, and residential areas was used. The average age and systolic blood pressure were 62.5 (10.3) years for men and 59.6 (11.3) years for women, 128.9 (16.7) mmHg for men and 124.7 (17.5) mmHg for women, respectively. Body mass index estimated daily salt intake, urinary sodium-to-potassium ratio and gamma-glutamyl transferase levels were positively associated with systolic blood pressure. Compared with never-drinkers, current drinkers who consumed 23-45 g/day and ≥46.0 g/day had significantly increased systolic blood pressure. Conversely, current smokers (1-10 cigarettes/day and 11-20 cigarettes/day) were inversely associated with systolic blood pressure compared to never-smokers. Overall, systolic blood pressure was associated with gamma-glutamyl transferase and hypertension risk factors, including body mass index, alcohol consumption, estimated daily salt intake, urinary sodium-to-potassium ratio, and potassium excretion. Our findings support the notion that lifestyle modifications should be attempted to prevent hypertension.
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Affiliation(s)
- Masato Takase
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Naoki Nakaya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kozo Tanno
- Iwate Medical Megabank Organization, Iwate Medical University, Kamaishi, Iwate, Japan
- School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Mana Kogure
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Rieko Hatanaka
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kumi Nakaya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Ippei Chiba
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Ikumi Kanno
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Kotaro Nochioka
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Naho Tsuchiya
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Kyoto Women's University, Kyoto, Japan
| | - Takumi Hirata
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Institute for Clinical and Translational Science, Nara Medical University, Shijo-cho, Kashihara, Nara, Japan
| | - Taku Obara
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Mami Ishikuro
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Yuka Kotozaki
- Iwate Medical Megabank Organization, Iwate Medical University, Kamaishi, Iwate, Japan
| | - Akira Uruno
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Tomoko Kobayashi
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Eiichi N Kodama
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- International Research Institute of Disaster Science, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Yohei Hamanaka
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Masatsugu Orui
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Soichi Ogishima
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Satoshi Nagaie
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Hideki Ohmomo
- Iwate Medical Megabank Organization, Iwate Medical University, Kamaishi, Iwate, Japan
- School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Nobuo Fuse
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Junichi Sugawara
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku University Hospital, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Suzuki Memorial Hospital, Satonomori, Iwanumashi, Miyagi, Japan
| | - Atsushi Shimizu
- Iwate Medical Megabank Organization, Iwate Medical University, Kamaishi, Iwate, Japan
- School of Medicine, Iwate Medical University, Morioka, Iwate, Japan
| | - Yoko Izumi
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Shinichi Kuriyama
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
- International Research Institute of Disaster Science, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan
| | - Atsushi Hozawa
- Graduate School of Medicine, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan.
- Tohoku Medical Megabank Organization, Tohoku University, Aoba-ku, Sendai, Miyagi, Japan.
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Worsley S, McMahon EL, Samuels LR, White MJ, Heerman WJ. The Associations between Neighborhood Characteristics and Childhood Overweight and Obesity in a National Dataset. Acad Pediatr 2024:S1876-2859(24)00165-7. [PMID: 38823500 DOI: 10.1016/j.acap.2024.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 05/14/2024] [Accepted: 05/25/2024] [Indexed: 06/03/2024]
Abstract
BACKGROUND National child obesity rates continue to climb. While neighborhood factors are known to influence childhood weight, more work is needed to further our understanding of these relationships and inform intervention and policy approaches reflective of complex real-world contexts. METHODS To evaluate the associations between neighborhood components and childhood overweight/obesity, we analyzed sequential, cross-sectional data from the National Survey of Children's Health collected annually between 2016 and 2021. To characterize the complexity of children's neighborhood environments, several interrelated neighborhood factors were examined: amenities, detractions, support, and safety. We used ordinal logistic regression models to evaluate the associations between these exposures of interest and childhood weight status, adjusting for potential confounders. RESULTS Our analytic sample contained 96,858 children representing a weighted population of 28,228,799 children ages 10-17 years. Child weight status was healthy in 66.5%, overweight in 16.8%, and obese in 17.2%. All four neighborhood factors were associated with child weight status. The odds of overweight or obesity generally increased with a decreasing number of amenities and increasing number of detractions, with the highest adjusted odds ratio seen with no amenities and all three possible detractions (1.71; 95% confidence interval [1.31, 2.11]). CONCLUSIONS Multiple factors within a child's neighborhood environment were associated with child weight status in this sample representative of the US population aged 10-17 years. This suggests the need for future research into how policies and programs can support multiple components of a healthy neighborhood environment simultaneously to reduce rates of childhood overweight/obesity.
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Affiliation(s)
- Sarah Worsley
- Department of Pediatrics (S Worsley, EL McMahon, and WJ Heerman), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tenn
| | - Ellen L McMahon
- Department of Pediatrics (S Worsley, EL McMahon, and WJ Heerman), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tenn.
| | - Lauren R Samuels
- Department of Biostatistics (LR Samuels), Vanderbilt University Medical Center, Nashville, Tenn
| | - Michelle J White
- Department of Pediatrics and Duke Center for Childhood Obesity Research (MJ White), Duke University Medical Center, Durham, NC
| | - William J Heerman
- Department of Pediatrics (S Worsley, EL McMahon, and WJ Heerman), Monroe Carell Jr. Children's Hospital, Vanderbilt University Medical Center, Nashville, Tenn
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Herrera-Luis E, Benke K, Volk H, Ladd-Acosta C, Wojcik GL. Gene-environment interactions in human health. Nat Rev Genet 2024:10.1038/s41576-024-00731-z. [PMID: 38806721 DOI: 10.1038/s41576-024-00731-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 05/30/2024]
Abstract
Gene-environment interactions (G × E), the interplay of genetic variation with environmental factors, have a pivotal impact on human complex traits and diseases. Statistically, G × E can be assessed by determining the deviation from expectation of predictive models based solely on the phenotypic effects of genetics or environmental exposures. Despite the unprecedented, widespread and diverse use of G × E analytical frameworks, heterogeneity in their application and reporting hinders their applicability in public health. In this Review, we discuss study design considerations as well as G × E analytical frameworks to assess polygenic liability dependent on the environment, to identify specific genetic variants exhibiting G × E, and to characterize environmental context for these dynamics. We conclude with recommendations to address the most common challenges and pitfalls in the conceptualization, methodology and reporting of G × E studies, as well as future directions.
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Affiliation(s)
- Esther Herrera-Luis
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kelly Benke
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Heather Volk
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Genevieve L Wojcik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Corbera S, Marín-Chollom AM. The Role of Anxiety and Prosocial Behaviors on Adherence Behaviors to Prevent COVID-19 in University Students in the United States: Cross-Sectional Study. JMIRX MED 2024; 5:e52970. [PMID: 38832671 PMCID: PMC11149054 DOI: 10.2196/52970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 03/25/2024] [Accepted: 03/25/2024] [Indexed: 06/05/2024]
Abstract
Background In situations of acute stress, individuals may engage in prosocial behaviors or risk-taking self-oriented behaviors. The COVID-19 pandemic created large stress-promoting conditions that impacted individuals' decisions to adhere to COVID-19 preventative behaviors. objectives The study aimed to examine the relationship between anxiety during the pandemic and adherence behaviors to prevent the spread of COVID-19, and the moderating influence of prosocial behaviors. We hypothesized that individuals with high anxiety during COVID-19 would adhere more to preventive COVID-19 behaviors than ones with low anxiety and that this relationship would be stronger in those individuals with higher prosocial behaviors. Methods A web-based survey was administered through the SONA web-based participant tool of the psychology department of a university in the Northeastern United States. A final sample of 54 undergraduate students completed web-based questionnaires during the second wave of the COVID-19 pandemic, from January to May 2021, which included demographic measures and surveys on prosocial behaviors, anxiety, and COVID-19 preventive behaviors. Moderation analyses were conducted using PROCESS in SPSS. Results Participants reported high levels of trait and state anxiety symptoms, most of them meeting or exceeding the cutoff criteria to be clinically meaningful (state anxiety: 47/54, 87%; trait anxiety: 38/44, 86%), and over 50% highly adhered to the COVID-19 preventive behaviors of wearing a face mask, using hand sanitizer, handwashing, coughing/sneezing into their elbow or a tissue, self-quarantining, maintaining social distance, avoiding social gatherings, and avoiding nonessential travel. No significant associations were observed between prosocial behavior, anxiety types, and adherence to COVID-19 preventive behaviors. However, when moderation analyses were conducted between anxiety types and adherence to COVID-19 preventive behaviors, results demonstrated a statistically significant interaction of public prosocial behavior with state anxiety (β=-.17, t53=-2.60; P=.01), predicting engagement in COVID-19 preventative behaviors. At high levels of anxiety, low levels of prosocial public behaviors were associated with higher engagement in COVID-19 preventative behaviors. In contrast, high levels of public prosocial behavior were associated with low engagement in COVID-19 preventative behaviors at higher levels of anxiety. Conclusions These results provide information that can aid in the creation of interventions that could increase adherence to COVID-19 preventative behaviors (Reviewed by the Plan P #PeerRef Community).
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Affiliation(s)
- Silvia Corbera
- Department of Psychological Science, Central Connecticut State University, New Britain, CT, United States
| | - Amanda M Marín-Chollom
- Department of Psychological Science, Central Connecticut State University, New Britain, CT, United States
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Capan M, Bigelow L, Kathuria Y, Paluch A, Chung J. Analysis of multi-level barriers to physical activity among nursing students using regularized regression. PLoS One 2024; 19:e0304214. [PMID: 38787846 PMCID: PMC11125535 DOI: 10.1371/journal.pone.0304214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Physical inactivity is a growing societal concern with significant impact on public health. Identifying barriers to engaging in physical activity (PA) is a critical step to recognize populations who disproportionately experience these barriers. Understanding barriers to PA holds significant importance within patient-facing healthcare professions like nursing. While determinants of PA have been widely studied, connecting individual and social factors to barriers to PA remains an understudied area among nurses. The objectives of this study are to categorize and model factors related to barriers to PA using the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework. The study population includes nursing students at the study institution (N = 163). Methods include a scoring system to quantify the barriers to PA, and regularized regression models that predict this score. Key findings identify intrinsic motivation, social and emotional support, education, and the use of health technologies for tracking and decision-making purposes as significant predictors. Results can help identify future nursing workforce populations at risk of experiencing barriers to PA. Encouraging the development and employment of health-informatics solutions for monitoring, data sharing, and communication is critical to prevent barriers to PA before they become a powerful hindrance to engaging in PA.
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Affiliation(s)
- Muge Capan
- Department of Mechanical and Industrial Engineering, College of Engineering, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Lily Bigelow
- Department of Mechanical and Industrial Engineering, College of Engineering, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Yukti Kathuria
- Department of Mechanical and Industrial Engineering, College of Engineering, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Amanda Paluch
- Department of Kinesiology and Institute for Applied Life Sciences, University of Massachusetts Amherst, Amherst, MA, United States of America
| | - Joohyun Chung
- College of Nursing, University of Massachusetts Amherst, Amherst, MA, United States of America
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Burnett-Bowie SAM, Wright NC, Yu EW, Langsetmo L, Yearwood GMH, Crandall CJ, Leslie WD, Cauley JA. The American Society for Bone and Mineral Research Task Force on clinical algorithms for fracture risk report. J Bone Miner Res 2024; 39:517-530. [PMID: 38590141 DOI: 10.1093/jbmr/zjae048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 02/23/2024] [Accepted: 03/13/2024] [Indexed: 04/10/2024]
Abstract
Using race and ethnicity in clinical algorithms potentially contributes to health inequities. The American Society for Bone and Mineral Research (ASBMR) Professional Practice Committee convened the ASBMR Task Force on Clinical Algorithms for Fracture Risk to determine the impact of race and ethnicity adjustment in the US Fracture Risk Assessment Tool (US-FRAX). The Task Force engaged the University of Minnesota Evidence-based Practice Core to conduct a systematic review investigating the performance of US-FRAX for predicting incident fractures over 10 years in Asian, Black, Hispanic, and White individuals. Six studies from the Women's Health Initiative (WHI) and Study of Osteoporotic Fractures (SOF) were eligible; cohorts only included women and were predominantly White (WHI > 80% and SOF > 99%), data were not consistently stratified by race and ethnicity, and when stratified there were far fewer fractures in Black and Hispanic women vs White women rendering area under the curve (AUC) estimates less stable. In the younger WHI cohort (n = 64 739), US-FRAX without bone mineral density (BMD) had limited discrimination for major osteoporotic fracture (MOF) (AUC 0.53 (Black), 0.57 (Hispanic), and 0.57 (White)); somewhat better discrimination for hip fracture in White women only (AUC 0.54 (Black), 0.53 (Hispanic), and 0.66 (White)). In a subset of the older WHI cohort (n = 23 918), US-FRAX without BMD overestimated MOF. The Task Force concluded that there is little justification for estimating fracture risk while incorporating race and ethnicity adjustments and recommends that fracture prediction models not include race or ethnicity adjustment but instead be population-based and reflective of US demographics, and inclusive of key clinical, behavioral, and social determinants (where applicable). Research cohorts should be representative vis-à-vis race, ethnicity, gender, and age. There should be standardized collection of race and ethnicity; collection of social determinants of health to investigate impact on fracture risk; and measurement of fracture rates and BMD in cohorts inclusive of those historically underrepresented in osteoporosis research.
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Affiliation(s)
- Sherri-Ann M Burnett-Bowie
- Endocrine Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Nicole C Wright
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35233, United States
| | - Elaine W Yu
- Endocrine Division, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Lisa Langsetmo
- Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care Center, Minneapolis, MN 55417, United States
- Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States
| | - Gabby M H Yearwood
- Department of Anthropology and Center for Civil Rights and Racial Justice, University of Pittsburgh, Pittsburgh, PA 15260, United States
| | - Carolyn J Crandall
- Division of General Internal Medicine and Health Services Research, Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, United States
| | - William D Leslie
- Departments of Internal Medicine and Radiology, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0T6, Canada
| | - Jane A Cauley
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, United States
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Afshar M, Graham Linck EJ, Spicer AB, Rotrosen J, Salisbury-Afshar EM, Sinha P, Semler MW, Churpek MM. Machine Learning-Driven Analysis of Individualized Treatment Effects Comparing Buprenorphine and Naltrexone in Opioid Use Disorder Relapse Prevention. J Addict Med 2024:01271255-990000000-00313. [PMID: 38776423 DOI: 10.1097/adm.0000000000001313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVE A trial comparing extended-release naltrexone and sublingual buprenorphine-naloxone demonstrated higher relapse rates in individuals randomized to extended-release naltrexone. The effectiveness of treatment might vary based on patient characteristics. We hypothesized that causal machine learning would identify individualized treatment effects for each medication. METHODS This is a secondary analysis of a multicenter randomized trial that compared the effectiveness of extended-release naltrexone versus buprenorphine-naloxone for preventing relapse of opioid misuse. Three machine learning models were derived using all trial participants with 50% randomly selected for training (n = 285) and the remaining 50% for validation. Individualized treatment effect was measured by the Qini value and c-for-benefit, with the absence of relapse denoting treatment success. Patients were grouped into quartiles by predicted individualized treatment effect to examine differences in characteristics and the observed treatment effects. RESULTS The best-performing model had a Qini value of 4.45 (95% confidence interval, 1.02-7.83) and a c-for-benefit of 0.63 (95% confidence interval, 0.53-0.68). The quartile most likely to benefit from buprenorphine-naloxone had a 35% absolute benefit from this treatment, and at study entry, they had a high median opioid withdrawal score (P < 0.001), used cocaine on more days over the prior 30 days than other quartiles (P < 0.001), and had highest proportions with alcohol and cocaine use disorder (P ≤ 0.02). Quartile 4 individuals were predicted to be most likely to benefit from extended-release naltrexone, with the greatest proportion having heroin drug preference (P = 0.02) and all experiencing homelessness (P < 0.001). CONCLUSIONS Causal machine learning identified differing individualized treatment effects between medications based on characteristics associated with preventing relapse.
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Affiliation(s)
- Majid Afshar
- From the University of Wisconsin School of Medicine and Public Health, Madison, WI (MA, EJGL, ABS, EMS-A, MMC); New York University Grossman School of Medicine, New York, NY (JR); Washington University School of Medicine, Saint Louis, MO (PS); and Vanderbilt University Medical Center, Nashville, TN (MWS)
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Saadi A, Choi KR, Khan T, Tang JT, Iverson GL. Examining the Association Between Adverse Childhood Experiences and Lifetime History of Head or Neck Injury and Concussion in Children From the United States. J Head Trauma Rehabil 2024; 39:E113-E121. [PMID: 37582185 DOI: 10.1097/htr.0000000000000883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2023]
Abstract
OBJECTIVE Our objective was to determine whether there is an association between adverse childhood experiences (ACEs) and lifetime history of early childhood mild head or neck injury and concussion in a nationally representative US cohort. SETTING AND DESIGN This is a cross-sectional study using data from the Adolescent Brain Cognitive Development (ABCD) Study (data release 3.0), a prospective investigation of child brain development and health. PARTICIPANTS There were 11 878 children aged 9 or 10 years at baseline, recruited from 21 school-based sites in the United States. After excluding children with missing questionnaires for the primary exposure variable and children with severe brain injuries involving more than 30-minute loss of consciousness, the final sample size was 11 230 children. MEASURES The primary exposure variable was ACEs. We measured eight ACEs: sexual abuse, physical abuse, emotional neglect, parent domestic violence, parent substance use disorder, parental mental illness, parent criminal involvement, and parent divorce. The primary outcomes were head or neck injury and concussion, measured using the Ohio State University Traumatic Brain Injury Screen-Identification Method Short Form. RESULTS The sample ( N = 11 230) was 52% boys with a mean age of 9.9 years (SD = 0.62 years). The racial and ethnic makeup was reflective of national demographics. Having a higher overall ACE count was associated with higher odds of head or neck injury, with greater odds with more ACEs reported. Children with 2 ACEs had 24% greater odds of head or neck injury (AOR = 1.24, 95% confidence interval [CI] = 1.06-1.45) and 64% greater odds of concussion (AOR = 1.64, 95% CI = 1.18-2.22), and children with 4 or more ACEs had 70% greater odds of head or neck injury (AOR = 1.7, 95% CI = 1.14, 2.49) and 140% greater odds of concussion (AOR = 2.4, 95% CI = 1.15-4.47). The individual ACE categories of sexual abuse, parent domestic violence, parental mental illness, and parent criminal involvement were significantly associated with increased risk of head or neck injury and parental mental illness with increased risk of concussion. CONCLUSIONS AND RELEVANCE ACEs are associated with early childhood mild head or neck injury and concussion and should be integrated in head injury prevention and intervention efforts.
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Affiliation(s)
- Altaf Saadi
- Department of Neurology, Harvard Medical School, Boston, Massachusetts (Dr Saadi); School of Nursing, University of California, Los Angeles (Dr Choi and Ms Tang); Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles (Dr Choi); Boston Medical Center and Boston Children's Hospital, Boston, Massachusetts (Dr Khan); Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts (Dr Iverson); and Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation, Boston, Massachusetts (Dr Iverson)
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Schiariti V, Shierk A, Stashinko EE, Sukal-Moulton T, Feldman RS, Aman C, Mendoza-Puccini MC, Brandenburg JE. Cerebral palsy pain instruments: Recommended tools for clinical research studies by the National Institute of Neurological Disorders and Stroke Cerebral Palsy Common Data Elements project. Dev Med Child Neurol 2024; 66:610-622. [PMID: 37650571 PMCID: PMC10902183 DOI: 10.1111/dmcn.15743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 07/18/2023] [Accepted: 07/27/2023] [Indexed: 09/01/2023]
Abstract
AIM This study describes the process of updating the cerebral palsy (CP) common data elements (CDEs), specifically identifying tools that capture the impact of chronic pain on children's functioning. METHOD Through a partnership between the American Academy for Cerebral Palsy and Developmental Medicine and the National Institute of Neurological Disorders and Stroke (NINDS), the CP CDEs were developed as data standards for clinical research in neuroscience. Chronic pain was underrepresented in the NINDS CP CDEs version 1.0. A multi-step methodology was applied by an interdisciplinary professional team. Following an adapted CP chronic pain tools' rating system, and a review of psychometric properties, clinical utility, and compliance with inclusion/exclusion criteria, a set of recommended pain tools was posted online for external public comment in May 2022. RESULTS Fifteen chronic pain tools met inclusion criteria, representing constructs across all components of the International Classification of Functioning, Disability and Health. INTERPRETATION This paper describes the first condition-specific pain CDEs for a pediatric population. The proposed set of chronic pain tools complement and enhance the applicability of the existing pediatric CP CDEs. The novel CP CDE pain tools harmonize the assessment of chronic pain, addressing not only intensity of chronic pain, but also the functional impact of experiencing it in everyday activities.
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Affiliation(s)
- Verónica Schiariti
- Division of Medical Sciences, University of Victoria, Victoria, BC, Canada
| | - Angela Shierk
- Texas Woman’s University, Scottish Rite for Children, Dallas, TX, USA
| | - Elaine E Stashinko
- Johns Hopkins School of Nursing and School of Medicine, Baltimore, MD, USA
| | - Theresa Sukal-Moulton
- Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | | | - M Carolina Mendoza-Puccini
- National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health, Bethesda, MD, USA
| | - Joline E Brandenburg
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
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Golder J, Jerge M, Sundstrom B, Dziobak M, Hart LB. Factors influencing CDC- recommended preventative behaviors through the COVID-19 pandemic in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-9. [PMID: 38683887 DOI: 10.1080/07448481.2024.2346340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
Objective: To understand how student perceptions of physical health and generalized concern about infection influenced engagement in COVID-19 preventive behaviors. Participants: 418 full-time undergraduate and graduate students attending a public university in South Carolina, USA. Methods: A self-administered survey was distributed during the 2020-2021 academic year. The health belief model, structural equation modeling, and regression methods were used to evaluate associations between students' perceived physical health and the use of CDC-recommended mitigation strategies. Results: Our findings suggest that an individual's perception of their own physical health impacted engagement in preventive behaviors by influencing concerns about disease severity (p = 0.01) and susceptibility (p = 0.03). However, perceived physical health was not associated with perceived benefits (p = 0.21), barriers (p = 0.57), or self-efficacy (p = 0.62) of mitigation strategies. Conclusions: Intrapersonal factors may play a strong role in the way a student undertakes disease control and prevention.
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Affiliation(s)
- J Golder
- Department of Health and Human Performance, College of Charleston, Charleston, SC, USA
- Honors College, College of Charleston, Charleston, SC, USA
| | - M Jerge
- Department of Health and Human Performance, College of Charleston, Charleston, SC, USA
- Honors College, College of Charleston, Charleston, SC, USA
| | - B Sundstrom
- Department of Communication, College of Charleston, Charleston, SC, USA
| | - M Dziobak
- Environmental and Sustainability Studies Graduate Program, College of Charleston, Charleston, SC, USA
- Department of Environmental Health Sciences, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - L B Hart
- Department of Health and Human Performance, College of Charleston, Charleston, SC, USA
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Avery J, Leak-Johnson T, Francis SC. Association between MCU Gene Polymorphisms with Obesity: Findings from the All of Us Research Program. Genes (Basel) 2024; 15:512. [PMID: 38674446 PMCID: PMC11050077 DOI: 10.3390/genes15040512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 04/09/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Obesity is a public health crisis, and its prevalence disproportionately affects African Americans in the United States. Dysregulation of organelle calcium homeostasis is associated with obesity. The mitochondrial calcium uniporter (MCU) complex is primarily responsible for mitochondrial calcium homeostasis. Obesity is a multifactorial disease in which genetic underpinnings such as single-nucleotide polymorphisms (SNPs) may contribute to disease progression. The objective of this study was to identify genetic variations of MCU with anthropometric measurements and obesity in the All of Us Research Program. METHODS We used an additive genetic model to assess the association between obesity traits (body mass index (BMI), waist and hip circumference) and selected MCU SNPs in 19,325 participants (3221 normal weight and 16,104 obese). Eleven common MCU SNPs with a minor allele frequency ≥ 5% were used for analysis. RESULTS We observed three MCU SNPs in self-reported Black/African American (B/AA) men, and six MCU SNPs in B/AA women associated with increased risk of obesity, whereas six MCU SNPs in White men, and nine MCU SNPs in White women were protective against obesity development. CONCLUSIONS This study found associations of MCU SNPs with obesity, providing evidence of a potential predictor of obesity susceptibility in B/AA adults.
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Affiliation(s)
- Jade Avery
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA 30310, USA;
| | - Tennille Leak-Johnson
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA 30310, USA;
- Institute of Translational Genomic Medicine, Morehouse School of Medicine, Atlanta, GA 30310, USA
| | - Sharon C. Francis
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA 30310, USA;
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA 30310, USA
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Goodkind JR, Van Horn ML, Hess JM, Lardier D, Vasquez Guzman CE, Ramirez J, Echeverri Herrera S, Blackwell M, Lemus A, Ruiz-Negron B, Choe R. Protocol of the study: Multilevel community-based mental health intervention to address structural inequities and adverse disparate consequences of COVID-19 pandemic on Latinx Immigrants and African refugees. PLoS One 2024; 19:e0298369. [PMID: 38626038 PMCID: PMC11020834 DOI: 10.1371/journal.pone.0298369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 04/18/2024] Open
Abstract
The NIMH-funded Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees study aims to advance the science of multilevel interventions to reduce the disparate, adverse mental health, behavioral, and socioeconomic consequences of the COVID-19 pandemic that are a result of complex interactions between underlying structural inequities and barriers to health care. The study tests three nested levels of intervention: 1) an efficacious 4-month advocacy and mutual learning model (Refugee and Immigrant Well-being Project, RIWP); 2) engagement with community-based organizations (CBOs); and 3) structural policy changes enacted in response to the pandemic. This community-based participatory research (CBPR) study builds on long-standing collaboration with five CBOs. By including 240 Latinx immigrants and 60 African refugees recruited from CBO partners who are randomly assigned to treatment-as-usual CBO involvement or the RIWP intervention and a comparison group comprised of a random sample of 300 Latinx immigrants, this mixed methods longitudinal waitlist control group design study with seven time points over 36 months tests the effectiveness of the RIWP intervention and engagement with CBOs to reduce psychological distress, daily stressors, and economic precarity and increase protective factors (social support, access to resources, English proficiency, cultural connectedness). The study also tests the ability of the RIWP intervention and engagement with CBOs to increase access to the direct benefits of structural interventions. This paper reports on the theoretical basis, design, qualitative and quantitative analysis plan, and power for the study.
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Affiliation(s)
- Jessica R. Goodkind
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
| | - M. Lee Van Horn
- Department of Individual, Family, and Community Education, University of New Mexico, Albuquerque, NM, United States of America
| | - Julia Meredith Hess
- Department of Pediatrics, University of New Mexico, Albuquerque, NM, United States of America
| | - David Lardier
- Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM, United States of America
| | - Cirila Estela Vasquez Guzman
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Janet Ramirez
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
| | | | - Meredith Blackwell
- Department of Psychology, University of New Mexico, Albuquerque, NM, United States of America
| | - Alejandra Lemus
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
| | - Bianca Ruiz-Negron
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
| | - Ryeora Choe
- Department of Sociology, University of New Mexico, Albuquerque, NM, United States of America
- United Voices for Newcomer Rights, Albuquerque, New Mexico, United States of America
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Kosyluk K, Baeder T, Greene KY, Tran JT, Bolton C, Loecher N, DiEva D, Galea JT. Mental Distress, Label Avoidance, and Use of a Mental Health Chatbot: Results From a US Survey. JMIR Form Res 2024; 8:e45959. [PMID: 38607665 PMCID: PMC11053397 DOI: 10.2196/45959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 01/19/2024] [Accepted: 02/13/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND For almost two decades, researchers and clinicians have argued that certain aspects of mental health treatment can be removed from clinicians' responsibilities and allocated to technology, preserving valuable clinician time and alleviating the burden on the behavioral health care system. The service delivery tasks that could arguably be allocated to technology without negatively impacting patient outcomes include screening, triage, and referral. OBJECTIVE We pilot-tested a chatbot for mental health screening and referral to understand the relationship between potential users' demographics and chatbot use; the completion rate of mental health screening when delivered by a chatbot; and the acceptability of a prototype chatbot designed for mental health screening and referral. This chatbot not only screened participants for psychological distress but also referred them to appropriate resources that matched their level of distress and preferences. The goal of this study was to determine whether a mental health screening and referral chatbot would be feasible and acceptable to users. METHODS We conducted an internet-based survey among a sample of US-based adults. Our survey collected demographic data along with a battery of measures assessing behavioral health and symptoms, stigma (label avoidance and perceived stigma), attitudes toward treatment-seeking, readiness for change, and technology readiness and acceptance. Participants were then offered to engage with our chatbot. Those who engaged with the chatbot completed a mental health screening, received a distress score based on this screening, were referred to resources appropriate for their current level of distress, and were asked to rate the acceptability of the chatbot. RESULTS We found that mental health screening using a chatbot was feasible, with 168 (75.7%) of our 222 participants completing mental health screening within the chatbot sessions. Various demographic characteristics were associated with a willingness to use the chatbot. The participants who used the chatbot found it to be acceptable. Logistic regression produced a significant model with perceived usefulness and symptoms as significant positive predictors of chatbot use for the overall sample, and label avoidance as the only significant predictor of chatbot use for those currently experiencing distress. CONCLUSIONS Label avoidance, the desire to avoid mental health services to avoid the stigmatized label of mental illness, is a significant negative predictor of care seeking. Therefore, our finding regarding label avoidance and chatbot use has significant public health implications in terms of facilitating access to mental health resources. Those who are high on label avoidance are not likely to seek care in a community mental health clinic, yet they are likely willing to engage with a mental health chatbot, participate in mental health screening, and receive mental health resources within the chatbot session. Chatbot technology may prove to be a way to engage those in care who have previously avoided treatment due to stigma.
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Affiliation(s)
- Kristin Kosyluk
- Department of Mental Health Law & Policy, University of South Florida, Tampa, FL, United States
| | - Tanner Baeder
- School of Social Work, University of South Florida, Tampa, FL, United States
| | - Karah Yeona Greene
- School of Social Work, University of South Florida, Tampa, FL, United States
| | - Jennifer T Tran
- Department of Mental Health Law & Policy, University of South Florida, Tampa, FL, United States
| | - Cassidy Bolton
- Department of Mental Health Law & Policy, University of South Florida, Tampa, FL, United States
| | - Nele Loecher
- Department of Mental Health Law & Policy, University of South Florida, Tampa, FL, United States
| | - Daniel DiEva
- School of Social Work, University of South Florida, Tampa, FL, United States
| | - Jerome T Galea
- School of Social Work, University of South Florida, Tampa, FL, United States
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Black N, Chung S, Tisdale C, Fialho LS, Aramrattana A, Assanangkornchai S, Blaszczynski A, Bowden-Jones H, van den Brink W, Brown A, Brown QL, Cottler LB, Elsasser M, Ferri M, Florence M, Gueorguieva R, Hampton R, Hudson S, Kelly PJ, Lintzeris N, Murphy L, Nadkarni A, Neale J, Rosen D, Rumpf HJ, Rush B, Segal G, Shorter GW, Torrens M, Wait C, Young K, Farrell M. An International, Multidisciplinary Consensus Set of Patient-Centered Outcome Measures for Substance-Related and Addictive Disorders. J Clin Med 2024; 13:2154. [PMID: 38610919 PMCID: PMC11012938 DOI: 10.3390/jcm13072154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 03/26/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024] Open
Abstract
Background: In 1990, the United States' Institute of Medicine promoted the principles of outcomes monitoring in the alcohol and other drugs treatment field to improve the evidence synthesis and quality of research. While various national outcome measures have been developed and employed, no global consensus on standard measurement has been agreed for addiction. It is thus timely to build an international consensus. Convened by the International Consortium for Health Outcomes Measurement (ICHOM), an international, multi-disciplinary working group reviewed the existing literature and reached consensus for a globally applicable minimum set of outcome measures for people who seek treatment for addiction. Methods: To this end, 26 addiction experts from 11 countries and 5 continents, including people with lived experience (n = 5; 19%), convened over 16 months (December 2018-March 2020) to develop recommendations for a minimum set of outcome measures. A structured, consensus-building, modified Delphi process was employed. Evidence-based proposals for the minimum set of measures were generated and discussed across eight videoconferences and in a subsequent structured online consultation. The resulting set was reviewed by 123 professionals and 34 people with lived experience internationally. Results: The final consensus-based recommendation includes alcohol, substance, and tobacco use disorders, as well as gambling and gaming disorders in people aged 12 years and older. Recommended outcome domains are frequency and quantity of addictive disorders, symptom burden, health-related quality of life, global functioning, psychosocial functioning, and overall physical and mental health and wellbeing. Standard case-mix (moderator) variables and measurement time points are also recommended. Conclusions: Use of consistent and meaningful outcome measurement facilitates carer-patient relations, shared decision-making, service improvement, benchmarking, and evidence synthesis for the evaluation of addiction treatment services and the dissemination of best practices. The consensus set of recommended outcomes is freely available for adoption in healthcare settings globally.
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Affiliation(s)
- Nicola Black
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
| | - Sophie Chung
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Calvert Tisdale
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
| | - Luz Sousa Fialho
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Apinun Aramrattana
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sawitri Assanangkornchai
- Department of Epidemiology, Faculty of Medicine, Prince of Songkla University, Songkhla 90110, Thailand
| | - Alex Blaszczynski
- School of Psychology, Brain and Mind Centre, Faculty of Science, University of Sydney, Sydney 2006, Australia;
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University College London, London NW1 2AE, UK
- Department of Psychiatry, Cambridge University, Cambridge CB2 1QW, UK
| | - Wim van den Brink
- Amsterdam University Medical Centers, Department of Psychiatry, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Adrian Brown
- Northwick Park Hospital, Central and North West London Trust, London HA1 3UJ, UK
| | - Qiana L. Brown
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA
| | - Linda B. Cottler
- Department of Epidemiology, College of Medicine & Public Health and Health Professions, University of Florida, Homestead, FL 33031, USA
| | | | - Marica Ferri
- Department of Psychology, Faculty of Community and Health, European Monitoring Centre for Drugs and Drug Addiction, 1249-289 Lisbon, Portugal;
| | - Maria Florence
- Department of Biostatistics, School of Public Health, University of the Western Cape, Cape Town 7535, South Africa;
| | - Ralitza Gueorguieva
- Department of Biostatistics, School of Public Health, Yale University, New Haven, CT 06511, USA
| | | | - Suzie Hudson
- Network of Alcohol and Other Drugs Agencies, Sydney 2751, Australia;
| | - Peter J. Kelly
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong 2522, Australia;
| | - Nicholas Lintzeris
- Discipline of Addiction Medicine, Faculty of Medicine and Health, University of Sydney, Sydney 2006, Australia;
| | | | - Abhijit Nadkarni
- Addictions and Related Research Group, Sangath, Bardez 403501, Goa, India
- Centre for Global Mental Health, Department of Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Joanne Neale
- Addictions Department, King’s College London, London SE1 9NH, UK
| | - Daniel Rosen
- School of Social Work, University of Pittsburgh, Pittsburgh, PA 15213, USA
| | - Hans-Jürgen Rumpf
- Translational Psychiatry Unit, Universität zu Lübeck, 23562 Lübeck, Germany
| | - Brian Rush
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
| | - Gabriel Segal
- Department of Philosophy, King’s College London, London SE1 9NH, UK;
| | - Gillian W. Shorter
- Drug and Alcohol Research Network, School of Psychology, Queen’s University Belfast, Belfast BT9 5AJ, UK
- Institute of Mental Health Sciences, Ulster University, Coleraine BT52 1SA, UK
| | - Marta Torrens
- Addiction Service, Hospital del Mar, 08003 Barcelona, Spain
| | | | - Katherine Young
- International Consortium for Health Outcomes Measurement, London W12 8EU, UK
| | - Michael Farrell
- National Drug and Alcohol Research Centre, UNSW, Sydney 2052, Australia
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49
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Zhang R, Schwandt M, Vines L, Volkow ND. Changes in rest-activity rhythms in adolescents as they age: associations with brain changes and behavior in the ABCD study. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.03.19.24303825. [PMID: 38562879 PMCID: PMC10984078 DOI: 10.1101/2024.03.19.24303825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background Adolescents with disrupted rest-activity rhythms (RAR) including shorter sleep duration, later sleep timing and low physical activity levels have higher risk for mental and behavioral problems. However, it remains unclear whether the same associations can be observed for within-subject changes in RAR. Methods Our longitudinal investigation on RAR used Fitbit data from the Adolescent Brain Cognitive Development (ABCD) Study at the 2-year (FL2: aged 10-13 years) and 4-year follow-up (FL4: aged 13-16 years). 963 youths had good-quality Fitbit data at both time points. In this study we examined changes in RAR from FL2 to FL4, their environmental and demographic contributors as well as brain and behavioral correlates. Results From FL2 to FL4, adolescents showed decreases in sleep duration and physical activity as well as delayed sleep timing (Cohen's d .44-.75). The contributions of environmental and demographic factors to RAR changes were greatest to sleep timing (explained 10% variance) and least to sleep duration (explained 1% variance). Delays in sleep timing had stronger correlations with behavioral problems including greater impulsivity and poor academic performance than reductions in sleep duration or physical activity. Additionally, the various brain measures differed in their sensitivity to RAR changes. Reductions in sleep duration were associated with decreased brain functional connectivity between subcortical regions and sensorimotor and cingulo-opercular networks and with enhanced functional connectivity between sensorimotor, visual and auditory networks. Delays in sleep timing were mainly associated with grey matter changes in subcortical regions. Conclusions The current findings corroborate the role of sleep and physical activity in adolescent's brain neurodevelopment and behavior problems. RAR might serve as biomarkers for monitoring behavioral problems in adolescents and to serve as potential therapeutic targets for mental disorders.
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Affiliation(s)
- Rui Zhang
- National Institute on Alcohol Abuse and Alcoholism, Laboratory of Neuroimaging, National Institutes of Health, Bethesda, MD 20892-1013, USA
| | - Melanie Schwandt
- National Institute on Alcohol Abuse and Alcoholism, Laboratory of Neuroimaging, National Institutes of Health, Bethesda, MD 20892-1013, USA
| | - Leah Vines
- National Institute on Alcohol Abuse and Alcoholism, Laboratory of Neuroimaging, National Institutes of Health, Bethesda, MD 20892-1013, USA
| | - Nora D. Volkow
- National Institute on Alcohol Abuse and Alcoholism, Laboratory of Neuroimaging, National Institutes of Health, Bethesda, MD 20892-1013, USA
- National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892-1013, USA
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50
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Maria Guzmán EM, LeDuc MK, Cha CB, Goger P, Ng MY, Huang X, Ribeiro JD, Fox KR. Accounting for diversity in the treatment of suicide and self-injury: A systematic review of the past 50 years of randomized controlled trials. Suicide Life Threat Behav 2024; 54:250-262. [PMID: 38193589 DOI: 10.1111/sltb.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 11/07/2023] [Accepted: 11/27/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE Patients receiving treatment for self-injurious thoughts and behaviors (SITBs) have diverse backgrounds, yet it remains unclear exactly who is represented in the current SITB treatment literature. METHODS We conducted a systematic review of the past 50 years of randomized controlled trials (RCTs) testing SITB treatments to evaluate sampling practices and reporting of sample characteristics, as well as inclusion of global populations across the included 525 papers. We also assessed changes over the past five decades in these three domains. RESULTS SITB RCTs frequently reported age and sex (98.6%-95.1%), less frequently reported race (83.4%-38.6%), socioeconomic status (48.1%-46.1%) and ethnicity (41.9%-8.1%), and rarely reported LGBTQ+ status (3.7%-1.6%). U.S.-based RCTs featured predominantly White, non-Hispanic, and non-LGBTQ+ samples. Most RCTs were conducted in high-income North American or European countries. Sample reporting practices, sample representativeness, and inclusion of global populations modestly and inconsistently improved over time. CONCLUSIONS There has not been substantial improvement in reporting practices, sample representativeness, or inclusion of global populations in SITB RCTs over the past 50 years. Acknowledging who is being studied and representing diverse populations in SITB treatment research is key to connecting research advances with those who may need it most.
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Affiliation(s)
- Eleonora M Maria Guzmán
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Michael K LeDuc
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Pauline Goger
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Mei Yi Ng
- Department of Psychology, Center for Children and Families, Florida International University, Miami, Florida, USA
| | - Xieyining Huang
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Jessica D Ribeiro
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Kathryn R Fox
- Department of Psychology, University of Denver, Denver, Colorado, USA
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