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Public Health Genetics: Surveying Preparedness for the Next Generation of Public Health Professionals. Genes (Basel) 2023; 14:genes14020317. [PMID: 36833244 PMCID: PMC9956260 DOI: 10.3390/genes14020317] [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: 12/15/2022] [Revised: 01/14/2023] [Accepted: 01/17/2023] [Indexed: 01/28/2023] Open
Abstract
Since the Human Genome Project's completion in 2003, the need for increased population genetic literacy has grown exponentially. To address this need, public health professionals must be educated appropriately to serve the public best. This study examines the current state of public health genetics education within existing master of public health (MPH) programs. A total of 171 MPH Council on Education for Public Health Accreditation (CEPH)-accredited programs across the nation were identified via a preliminary internet search. The American Public Health Association (APHA) Genomics Forum Policy Committee created 14 survey questions to assess the current status of incorporating genetics/genomics education within MPH programs. Using the Qualtrics survey system through the University of Pittsburgh, a link to the anonymous survey was sent to each director's email address obtained from their program's website. There were 41 survey responses, with 37 finished to completion, for a response rate of 21.6% (37/171). A total of 75.7% (28/37) of respondents reported having courses containing genetics/genomics information in their programs' coursework. Only 12.6% reported such coursework to be required for program completion. Commonly listed barriers to incorporating genetics/genomics include limited faculty knowledge and lack of space in existing courses and programs. Survey results revealed the incongruous and limited incorporation of genetics/genomics within the context of graduate-level public health education. While most recorded programs report offering public health genetics coursework, the extent and requirement of such instruction are not considered necessary for program completion, thereby potentially limiting the genetic literacy of the current pool of public health professionals.
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Pettey CM, McSweeney JC, Stewart KE, Price ET, Cleves MA, Heo S, Souder E. Perceptions of family history and genetic testing and feasibility of pedigree development among African Americans with hypertension. Eur J Cardiovasc Nurs 2014; 14:8-15. [PMID: 25322748 DOI: 10.1177/1474515114556198] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Pedigree development, family history, and genetic testing are thought to be useful in improving outcomes of chronic illnesses such as hypertension (HTN). However, the clinical utility of pedigree development is still unknown. Further, little is known about the perceptions of African Americans (AAs) of family history and genetic testing. AIMS This study examined the feasibility of developing pedigrees for AAs with HTN and explored perceptions of family history and genetic research among AAs with HTN. METHODS The US Surgeon General's My Family Health Portrait was administered, and 30-60 min in-person individual interviews were conducted. Descriptive statistics were used to analyze pedigree data. Interview transcripts were analyzed with content analysis and constant comparison. RESULTS Twenty-nine AAs with HTN were recruited from one free clinic (15 women, 14 men; mean age 49 years, standard deviation (SD) 9.6). Twenty-six (90%) reported their family history in sufficient detail to develop a pedigree. Perceptions of family history included knowledge of HTN in the family, culturally influenced family teaching about HTN, and response to family history of HTN. Most participants agreed to future genetic testing and DNA collection because they wanted to help others; some said they needed more information and others expressed a concern for privacy. CONCLUSION The majority of AAs in this sample possessed extensive knowledge of HTN within their family and were able to develop a three-generation pedigree with assistance. The majority were willing to participate in future genetic research.
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Affiliation(s)
| | - Jean C McSweeney
- College of Nursing, University of Arkansas for Medical Sciences, USA
| | - Katharine E Stewart
- General Administration, University of North Carolina and Department of Public Health Sciences, University of North Carolina - Charlotte, USA
| | - Elvin T Price
- College of Pharmacy, University of Arkansas for Medical Sciences, USA
| | - Mario A Cleves
- College of Medicine, University of Arkansas for Medical Sciences, USA
| | - Seongkum Heo
- College of Nursing, University of Arkansas for Medical Sciences, USA
| | - Elaine Souder
- College of Nursing, University of Arkansas for Medical Sciences, USA
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Patel CJ, Sivadas A, Tabassum R, Preeprem T, Zhao J, Arafat D, Chen R, Morgan AA, Martin GS, Brigham KL, Butte AJ, Gibson G. Whole genome sequencing in support of wellness and health maintenance. Genome Med 2013; 5:58. [PMID: 23806097 PMCID: PMC3967117 DOI: 10.1186/gm462] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 05/23/2013] [Accepted: 06/27/2013] [Indexed: 12/19/2022] Open
Abstract
Background Whole genome sequencing is poised to revolutionize personalized medicine, providing the capacity to classify individuals into risk categories for a wide range of diseases. Here we begin to explore how whole genome sequencing (WGS) might be incorporated alongside traditional clinical evaluation as a part of preventive medicine. The present study illustrates novel approaches for integrating genotypic and clinical information for assessment of generalized health risks and to assist individuals in the promotion of wellness and maintenance of good health. Methods Whole genome sequences and longitudinal clinical profiles are described for eight middle-aged Caucasian participants (four men and four women) from the Center for Health Discovery and Well Being (CHDWB) at Emory University in Atlanta. We report multivariate genotypic risk assessments derived from common variants reported by genome-wide association studies (GWAS), as well as clinical measures in the domains of immune, metabolic, cardiovascular, musculoskeletal, respiratory, and mental health. Results Polygenic risk is assessed for each participant for over 100 diseases and reported relative to baseline population prevalence. Two approaches for combining clinical and genetic profiles for the purposes of health assessment are then presented. First we propose conditioning individual disease risk assessments on observed clinical status for type 2 diabetes, coronary artery disease, hypertriglyceridemia and hypertension, and obesity. An approximate 2:1 ratio of concordance between genetic prediction and observed sub-clinical disease is observed. Subsequently, we show how more holistic combination of genetic, clinical and family history data can be achieved by visualizing risk in eight sub-classes of disease. Having identified where their profiles are broadly concordant or discordant, an individual can focus on individual clinical results or genotypes as they develop personalized health action plans in consultation with a health partner or coach. Conclusion The CHDWB will facilitate longitudinal evaluation of wellness-focused medical care based on comprehensive self-knowledge of medical risks.
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Affiliation(s)
- Chirag J Patel
- Division of Systems Medicine, Department of Pediatrics, Stanford University School of Medicine, 251 Campus Drive, Palo Alto, CA 94304, USA ; Lucille Packard Children's Hospital, 725 Welch Rd, Palo Alto, CA 94304, USA
| | - Ambily Sivadas
- School of Biology, Georgia Institute of Technology, 310 Ferst Drive, Atlanta GA 30332, USA
| | - Rubina Tabassum
- School of Biology, Georgia Institute of Technology, 310 Ferst Drive, Atlanta GA 30332, USA
| | - Thanawadee Preeprem
- School of Biology, Georgia Institute of Technology, 310 Ferst Drive, Atlanta GA 30332, USA
| | - Jing Zhao
- School of Biology, Georgia Institute of Technology, 310 Ferst Drive, Atlanta GA 30332, USA
| | - Dalia Arafat
- School of Biology, Georgia Institute of Technology, 310 Ferst Drive, Atlanta GA 30332, USA
| | - Rong Chen
- Division of Systems Medicine, Department of Pediatrics, Stanford University School of Medicine, 251 Campus Drive, Palo Alto, CA 94304, USA ; Lucille Packard Children's Hospital, 725 Welch Rd, Palo Alto, CA 94304, USA ; Personalis, Inc., 1350 Willow Rd Suite 202, Menlo Park, CA 94025, USA
| | - Alexander A Morgan
- Division of Systems Medicine, Department of Pediatrics, Stanford University School of Medicine, 251 Campus Drive, Palo Alto, CA 94304, USA ; Lucille Packard Children's Hospital, 725 Welch Rd, Palo Alto, CA 94304, USA
| | - Gregory S Martin
- Center for Health Discovery and Well Being, and School of Medicine, Emory University Midtown Hospital, 550 Peachtree St, Atlanta GA 30308, USA
| | - Kenneth L Brigham
- Center for Health Discovery and Well Being, and School of Medicine, Emory University Midtown Hospital, 550 Peachtree St, Atlanta GA 30308, USA
| | - Atul J Butte
- Division of Systems Medicine, Department of Pediatrics, Stanford University School of Medicine, 251 Campus Drive, Palo Alto, CA 94304, USA ; Lucille Packard Children's Hospital, 725 Welch Rd, Palo Alto, CA 94304, USA
| | - Greg Gibson
- School of Biology, Georgia Institute of Technology, 310 Ferst Drive, Atlanta GA 30332, USA ; Center for Health Discovery and Well Being, and School of Medicine, Emory University Midtown Hospital, 550 Peachtree St, Atlanta GA 30308, USA
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Patel CJ, Chen R, Butte AJ. Data-driven integration of epidemiological and toxicological data to select candidate interacting genes and environmental factors in association with disease. Bioinformatics 2013; 28:i121-6. [PMID: 22689751 PMCID: PMC3371861 DOI: 10.1093/bioinformatics/bts229] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Motivation: Complex diseases, such as Type 2 Diabetes Mellitus (T2D), result from the interplay of both environmental and genetic factors. However, most studies investigate either the genetics or the environment and there are a few that study their possible interaction in context of disease. One key challenge in documenting interactions between genes and environment includes choosing which of each to test jointly. Here, we attempt to address this challenge through a data-driven integration of epidemiological and toxicological studies. Specifically, we derive lists of candidate interacting genetic and environmental factors by integrating findings from genome-wide and environment-wide association studies. Next, we search for evidence of toxicological relationships between these genetic and environmental factors that may have an etiological role in the disease. We illustrate our method by selecting candidate interacting factors for T2D. Contact:abutte@stanford.edu
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Affiliation(s)
- Chirag J Patel
- Division of Systems Medicine, Department of Pediatrics, Stanford University School of Medicine, Stanford, CA 94305, USA
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El Rhazi K, Nejjari C, Romaguera D, Feart C, Obtel M, Zidouh A, Bekkali R, Gateau PB. Adherence to a Mediterranean diet in Morocco and its correlates: cross-sectional analysis of a sample of the adult Moroccan population. BMC Public Health 2012; 12:345. [PMID: 22578133 PMCID: PMC3438093 DOI: 10.1186/1471-2458-12-345] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2012] [Accepted: 05/02/2012] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Dietary habits in Morocco are changing and the causes are not well understood. This study aimed to analyse socio-demographic factors associated with adherence to the Mediterranean diet (MeDi) in a national random sample of the adult Moroccan population. METHODS The data collected in this cross-sectional survey included socio-demographic factors and a food frequency questionnaire. MeDi adherence was assessed in 2214 individuals with complete dietary data. MeDi adherence was measured according to a simplified MeDi score based on the weekly frequency of intake of eight food groups (vegetables, legumes, fruits, cereal or potatoes, fish, red meat, dairy products and olive oil) with the use of the sex specific medians of the sample as cut-offs. A value of 0 or 1 was assigned to consumption of each component according to its presumed detrimental or beneficial effect on health. Logistic regression was used to estimate the association between MeDi adherence (low score 1-4 vs. high 5-8) and other factors. RESULTS Mean age of the sample was 41.4 (standard deviation 15.3) years, 45.4% were men and 29.9% had a low MeDi adherence. Married subjects (adjusted odds ratio ORa=0.68, 95% CI 0.55-0.84) were less likely to have a low MeDi adherence compared to single, divorced or widowed persons. Persons from rural areas (ORa=1.46, 95% CI: 1.02-2.08), were more often low MeDi adherents compared to those from urban areas. Obese persons (ORa=1.56, 95% CI: 1.16-2.11) were more prone to low MeDi adherence than normal weight individuals. CONCLUSION MeDi is far from being a universal pattern in the Moroccan population. Intervention strategies should be implemented in target groups to maintain the traditional MeDi pattern considered as the original diet in Morocco.
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Affiliation(s)
- Karima El Rhazi
- Department of epidemiology and Public Health, Faculty of Medicine, Fez, 30000, Morocco
| | - Chakib Nejjari
- Department of epidemiology and Public Health, Faculty of Medicine, Fez, 30000, Morocco
| | - Dora Romaguera
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, W2 1PG, UK
| | - Catherine Feart
- Inserm, U897, Bordeaux, F-33076, France
- Université Bordeaux Segalen, Bordeaux, F-33076, France
| | - Majdouline Obtel
- Department of epidemiology and Public Health, Faculty of Medicine, Fez, 30000, Morocco
| | - Ahmed Zidouh
- Association Lalla Salma de Lutte Contre le cancer, Rabat, 10000, Morocco
| | - Rachid Bekkali
- Association Lalla Salma de Lutte Contre le cancer, Rabat, 10000, Morocco
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Abstract
Evolution has long provided a foundation for population genetics, but some major advances in evolutionary biology from the twentieth century that provide foundations for evolutionary medicine are only now being applied in molecular medicine. They include the need for both proximate and evolutionary explanations, kin selection, evolutionary models for cooperation, competition between alleles, co-evolution, and new strategies for tracing phylogenies and identifying signals of selection. Recent advances in genomics are transforming evolutionary biology in ways that create even more opportunities for progress at its interfaces with genetics, medicine, and public health. This article reviews 15 evolutionary principles and their applications in molecular medicine in hopes that readers will use them and related principles to speed the development of evolutionary molecular medicine.
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Tercyak KP, Hensley Alford S, Emmons KM, Lipkus IM, Wilfond BS, McBride CM. Parents' attitudes toward pediatric genetic testing for common disease risk. Pediatrics 2011; 127:e1288-95. [PMID: 21502235 PMCID: PMC3081191 DOI: 10.1542/peds.2010-0938] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/20/2011] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE To describe parents' attitudes toward pediatric genetic testing for common, adult-onset health conditions and to identify factors underlying these attitudes. PARTICIPANTS AND METHODS Parents (n = 219) enrolled in a large, group-practice health plan were offered a "multiplex" genetic test for susceptibility to 8 common, adult-onset health conditions and completed an online survey assessing attitudes and beliefs about the risks and benefits of the test for their child, their willingness to consider having their child tested, and other psychosocial variables. RESULTS Parents viewed the benefits of pediatric testing to outweigh its risks (positive decisional balance) and were moderately interested in pediatric testing. Variables associated with positive decisional balance included greater interest in knowing about gene-health associations in their child, anticipation of less difficulty understanding their child's genetic health risks, and more positive emotional reactions to learning about their child's decreased health risks (adjusted R(2) = 0.33, P < .0001). Similarly, variables associated with greater parental willingness to test were being a mother (versus being a father), greater perceived risk of diseases in their child, greater interest in knowing about gene-health relationships in their child, anticipating less difficulty learning about their child's genetic health risks, anticipating more positive emotional reactions to learning about their child's decreased health risks, and positive decisional balance (adjusted R(2) = 0.57, P < .0001). CONCLUSIONS As genetic susceptibility testing for common, adult-onset health conditions proliferates, pediatricians should anticipate parents' interest in testing children and be prepared to facilitate informed decision making about such testing.
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Affiliation(s)
- Kenneth P Tercyak
- Division of Health Outcomes and Health Behaviors, Department of Oncology, Georgetown University Medical Center, 3300 Whitehaven St, NW, Suite 4100, Washington, DC 20007, USA.
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McManus A, Merga M, Newton W. Omega-3 fatty acids. What consumers need to know. Appetite 2011; 57:80-3. [PMID: 21497627 DOI: 10.1016/j.appet.2011.03.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 02/03/2011] [Accepted: 03/28/2011] [Indexed: 12/24/2022]
Abstract
The general public is increasingly aware of the health benefits associated with consumption of omega-3 fatty acids. While evidence of health benefits continues to mount, the underlying science is complex. Omega-3 fatty acids vary in their physiological efficacy. Consumers are typically unaware of differences in the efficacy of different omega-3 fatty acids and this lack of knowledge can result in consumers being misled within the marketplace. There is a need for consumers to be educated about the distinctions between omega-3 fatty acids. In the interim consumers remain at risk of purchasing premium fortified products and supplements that will not correspond to their desired health outcomes. This paper summarises the current understanding of fatty acid physiological metabolism and interaction for the purpose of highlighting this complex and multifaceted concern.
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Affiliation(s)
- Alexandra McManus
- Curtin Health Innovation Research Institute, GPO Box U1987, Perth, WA 6845, Australia.
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Lionis C, Anyfantakis D, Symvoulakis EK, Shea S, Panagiotakos D, Castanas E. Bio-psychosocial determinants of cardiovascular disease in a rural population on Crete, Greece: formulating a hypothesis and designing the SPILI-III study. BMC Res Notes 2010; 3:258. [PMID: 20937097 PMCID: PMC2992030 DOI: 10.1186/1756-0500-3-258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2010] [Accepted: 10/11/2010] [Indexed: 11/10/2022] Open
Abstract
Background In 1988, the SPILI project was established in order to evaluate the cardiovascular disease (CVD) risk profile of the inhabitants of Spili, in rural Crete, Greece. The first reports from this project revealed that against the unfavourable risk factors' profile observed, only a few men with a previous myocardial infarction were encountered. A follow-up study (SPILI II) was performed twelve years after the initial examination, and the unfavourable cardiovascular risk profile was re-confirmed. Presentation of the Hypothesis This paper presents a hypothesis formulated on the basis of previous research to investigate if dynamic psycho-social determinants, including social coherence of the local community, religiosity and spirituality, are protective against the development of coronary heart disease in a well-defined population. Testing the Hypothesis A follow-up examination of this Cretan cohort is currently being performed to assess the link between psychosocial factors and CVD. Psychosocial factors including sense of control, religiosity and spirituality are assessed in together with conventional CVD risk factors. Smoking and alcohol consumption, as well as dietary habits and activity levels are recorded. Oxidative stress and inflammatory markers, as well as ultrasound measurement of carotid intima media thickness, a preclinical marker of atherosclerosis, will also be measured. Implications of the hypothesis tested The issue of the cardio-protective effect of psycho-social factors would be revisited based on the results of this Cretan cohort; nevertheless, further research is needed across different sub-populations in order to establish a definite relationship. A comprehensive approach based on the aspects of bio-social life may result in more accurate CVD risk management.
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Affiliation(s)
- Christos Lionis
- Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete, Greece.
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