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Dubbeldeman EM, van der Kleij RMJJ, Brakema EA, Crone MR. Expert consensus on multilevel implementation hypotheses to promote the uptake of youth care guidelines: a Delphi study. Health Res Policy Syst 2024; 22:89. [PMID: 39095848 PMCID: PMC11295487 DOI: 10.1186/s12961-024-01167-x] [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: 01/10/2023] [Accepted: 06/23/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The implementation of youth care guidelines remains a complex process. Several evidence-based frameworks aid the identification and specification of implementation determinants and strategies. However, the influence of specific strategies on certain determinants remains unclear. Therefore, we need to clarify which active ingredients of strategies, known as behaviour change techniques (BCTs), elicit behaviour change and improve implementation outcomes. With this knowledge, we are able to formulate evidence-based implementation hypotheses. An implementation hypothesis details how determinants and in turn, implementation outcomes might be influenced by specific implementation strategies and their BCTs. We aimed to identify (1) determinants relevant to the implementation of youth care guidelines and (2) feasible and potentially effective implementation hypotheses. METHODS A four-round online modified Delphi study was conducted. In the first round, experts rated the implementation determinants based on their relevance. Next, experts formulated implementation hypotheses by connecting BCTs and implementation strategies to determinants and were asked to provide a rationale for their choices. In round three, the experts reconsidered and finalised their hypotheses based on an anonymous overview of all formulated hypotheses, including rationales. Finally, the experts rated the implementation hypotheses based on their potential effectiveness and feasibility. RESULTS Fourteen experts completed the first, second, and third rounds, with 11 completed the final round. Guideline promotion, mandatory education, presence of an implementation leader, poor management support, knowledge regarding guideline use, and a lack of communication skills were reported as most relevant determinants. In total, 46 hypotheses were formulated, ranging from 6 to 9 per determinant. For each determinant, we provide an overview of the implementation hypotheses that were most commonly deemed feasible and potentially effective. CONCLUSION This study offers valuable insights into youth care guideline implementation by systematically identifying relevant determinants and formulating hypotheses based on expert input. Determinants related to engagement and to knowledge and skills were found to be relevant to youth care guideline implementation. This study offers a set of hypotheses that could help organisations, policymakers, and professionals guide the implementation process of youth care guidelines to ultimately improve implementation outcomes. The effectiveness of these hypotheses in practice remains to be assessed.
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Affiliation(s)
- Eveline M Dubbeldeman
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands.
| | | | - Evelyn A Brakema
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
| | - Mathilde R Crone
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Health Promotion, Maastricht University, Maastricht, the Netherlands
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Hajji AL, Lucas KN. Anthropogenic stressors and the marine environment: From sources and impacts to solutions and mitigation. MARINE POLLUTION BULLETIN 2024; 205:116557. [PMID: 38875966 DOI: 10.1016/j.marpolbul.2024.116557] [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: 12/07/2023] [Revised: 05/30/2024] [Accepted: 06/02/2024] [Indexed: 06/16/2024]
Abstract
Human-released contaminants are often poorly understood wholistically in marine ecosystems. This review examines the sources, pathways, impacts on marine animals, and mitigation strategies of five pollutants (plastics, per- and polyfluoroalkyl substances, bisphenol compounds, ethynylestradiol, and petroleum hydrocarbons). Both abiotic and biotic mechanisms contribute to all five contaminants' movement. These pollutants cause short- and long-term effects on many biological processes genetically, molecularly, neurologically, physiologically, reproductively, and developmentally. We explore the extension of adverse outcome pathways to ecosystem effects by considering known inter-generational and trophic relations resulting in large-scale direct and indirect impacts. In doing so, we develop an understanding of their roles as environmental stressors in marine environments for targeted mitigation and future work. Ecosystems are interconnected and so international collaboration, standards, measures preceding mass production, and citizen involvement are required to protect and conserve marine life.
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Affiliation(s)
- Angelina L Hajji
- Biological Sciences, University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada.
| | - Kelsey N Lucas
- Biological Sciences, University of Calgary, 2500 University Dr NW, Calgary, AB T2N 1N4, Canada
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Bishal MM, Chowdory MRH, Das A, Kabir MA. COVIDHealth: A novel labeled dataset and machine learning-based web application for classifying COVID-19 discourses on Twitter. Heliyon 2024; 10:e34103. [PMID: 39100452 PMCID: PMC11295851 DOI: 10.1016/j.heliyon.2024.e34103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 06/27/2024] [Accepted: 07/03/2024] [Indexed: 08/06/2024] Open
Abstract
The COVID-19 pandemic has sparked widespread health-related discussions on social media platforms like Twitter (now named 'X'). However, the lack of labeled Twitter data poses significant challenges for theme-based classification and tweet aggregation. To address this gap, we developed a machine learning-based web application that automatically classifies COVID-19 discourses into five categories: health risks, prevention, symptoms, transmission, and treatment. We collected and labeled 6,667 COVID-19-related tweets using the Twitter API, and applied various feature extraction methods to extract relevant features. We then compared the performance of seven classical machine learning algorithms (Decision Tree, Random Forest, Stochastic Gradient Descent, Adaboost, K-Nearest Neighbor, Logistic Regression, and Linear SVC) and four deep learning techniques (LSTM, CNN, RNN, and BERT) for classification. Our results show that the CNN achieved the highest precision (90.41%), recall (90.4%), F1 score (90.4%), and accuracy (90.4%). The Linear SVC algorithm exhibited the highest precision (85.71%), recall (86.94%), and F1 score (86.13%) among classical machine learning approaches. Our study advances the field of health-related data analysis and classification, and offers a publicly accessible web-based tool for public health researchers and practitioners. This tool has the potential to support addressing public health challenges and enhancing awareness during pandemics. The dataset and application are accessible at https://github.com/Bishal16/COVID19-Health-Related-Data-Classification-Website.
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Affiliation(s)
- Mahathir Mohammad Bishal
- Department of Computer Science and Engineering, Chittagong University of Engineering and Technology, Chattogram, 4349, Bangladesh
| | - Md. Rakibul Hassan Chowdory
- Department of Computer Science and Engineering, Chittagong University of Engineering and Technology, Chattogram, 4349, Bangladesh
| | - Anik Das
- Department of Computer Science, St. Francis Xavier University, Antigonish, B2G 2W5, NS, Canada
| | - Muhammad Ashad Kabir
- School of Computing, Mathematics, and Engineering, Charles Sturt University, Bathurst, 2795, NSW, Australia
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Mohammad-Pour S, Barkhordari S, Tabatabaei SM, Hadian M. Economic impact of government health expenditure: An application of the computable general equilibrium model to the Iran. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2024; 13:140. [PMID: 38784277 PMCID: PMC11114564 DOI: 10.4103/jehp.jehp_199_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 05/25/2023] [Indexed: 05/25/2024]
Abstract
BACKGROUND Considering the increase in health expenses and the government's role in health financing, this study investigated the economic impact of increases in the share of the health sector in the government budget while taxes remain unchanged and government spending is fixed. MATERIAL AND METHODS The economic model used in this study was a macroeconomic Computable General Equilibrium (CGE) model. This model was calibrated using a 2011 Social Accounting Matrix (SAM) Of Iran. The CGE model was solved with non-linear programming using the General Algebraic Modeling System package, version 2.50. The effect of this simulation on the government budget deficit, the production of different sectors of the economy, and the employment rate was investigated. RESULTS Based on our fundings the elasticity of substitution in the agricultural and industrial sectors is higher than in the health and service sector. Also, the biggest decrease in production occurred in the industry, agriculture, and service sectors, respectively. With the doubling of the share of government spending in the health sector, the employment rate of this sector has increased by 40.9%, but the highest decrease in the ignition rate is related to the service sectors (-2.7%), agriculture (-0.23%), and industry (-0.14%). CONCLUSION Increasing the share of government spending in the health sector in comparison with other sectors of the economy, provided that government spending is maintained in general, leads to a decrease in production and economic welfare. It seems that the Iranian government should seek to increase the sources of health financing and the share of government expenditures in the health sector with other ways in order to improve the health level of the society and have a positive effect on other economic sectors.
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Affiliation(s)
- Saeed Mohammad-Pour
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Mohammad Hadian
- Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Amelia CZ, Gwan CH, Qi TS, Seng JTC. Prevalence of vitamin D insufficiency in early pregnancies- a Singapore study. PLoS One 2024; 19:e0300063. [PMID: 38603703 PMCID: PMC11008890 DOI: 10.1371/journal.pone.0300063] [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: 11/04/2023] [Accepted: 02/21/2024] [Indexed: 04/13/2024] Open
Abstract
Vitamin D plays an essential role in bone and mineral metabolism. There is increased interest in understanding prevalence of Vitamin D deficiency in pregnancy as many studies report association of low vitamin D levels with obstetric complications and neonatal sequelae. There is a paucity of studies in Singapore evaluating levels of vitamin D levels during the first trimester of pregnancies. We aim to study the prevalence of vitamin D insufficiency in this population. Our study assessed vitamin D levels in these women. Vitamin D (Plasma 25(OH)D concentration) levels in multiracial women during the first trimester were collected via venepuncture at their booking antenatal visit. They were stratified into sufficient ≥30ng/ml, insufficient ≥20ng/ml and <30ng/ml, moderately deficient ≥10ng/ml and <20ng/ml and severely deficient <10ng/ml. 93 women were included in this study. Only 2.2% of our study population had sufficient vitamin D levels. In women who had insufficient levels, the heavier the weight, the more likely to be vitamin D deficient. Interestingly, we also note that the older the patient, the less likely they are to be deficient. In women with periconceptual multivitamin supplementation, the average vitamin D level for those with supplementation was 2.10ng/ml higher than those without. Majority of patients were recruited from a single study member's patient pool who were mostly Chinese. Prevalence of Vitamin D deficiency in general obstetric patients with higher BMI and darker skinned patients may be even lower in Singapore. The high prevalence of Vitamin D insufficiency in our patients prove that it is a prominent problem in our population. We aim to implement screening of vitamin D levels as part of antenatal investigations in the first trimester and recommend supplementation as required. We also hope to evaluate the association of low vitamin D levels with obstetric or neonatal complications further understanding its implications.
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Affiliation(s)
- Chua Zu’Er Amelia
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Chan Hiu Gwan
- Obstetrics and Gynaecology Academic Clinical Programme (OBGYN ACP), SingHealth Services, Singapore, Singapore
- Department of Paediatrics, Endocrinology Service, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - Tan Shu Qi
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
| | - John Tee Chee Seng
- Department of Obstetrics and Gynaecology, KK Women’s and Children’s Hospital, Singapore, Singapore
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Abdullahi LH, Oketch S, Komen H, Mbithi I, Millington K, Mulupi S, Chakaya J, Zulu EM. Gendered gaps to tuberculosis prevention and care in Kenya: a political economy analysis study. BMJ Open 2024; 14:e077989. [PMID: 38569714 PMCID: PMC11146361 DOI: 10.1136/bmjopen-2023-077989] [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: 07/20/2023] [Accepted: 03/14/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Tuberculosis (TB) remains a public health concern in Kenya despite the massive global efforts towards ending TB. The impediments to TB prevention and care efforts include poor health systems, resource limitations and other sociopolitical contexts that inform policy and implementation. Notably, TB cases are much higher in men than women. Therefore, the political economy analysis (PEA) study provides in-depth contexts and understanding of the gender gaps to access and successful treatment for TB infection. DESIGN PEA adopts a qualitative, in-depth approach through key informant interviews (KII) and documentary analysis. SETTING AND PARTICIPANTS The KIIs were distributed among government entities, academia, non-state actors and community TB groups from Kenya. RESULTS The themes identified were mapped onto the applied PEA analysis framework domains. The contextual and institutional issues included gender concerns related to the disconnect between TB policies and gender inclusion aspects, such as low prioritisation for TB programmes, limited use of evidence to inform decisions and poor health system structures. The broad barriers influencing the social contexts for TB programmes were social stigma and cultural norms such as traditional interventions that negatively impact health-seeking behaviours. The themes around the economic situation were poverty and unemployment, food insecurity and malnutrition. The political context centred around the systemic and governance gaps in the health system from the national and devolved health functions. CONCLUSION Broad contextual factors identified from the PEA widen the disparity in targeted gender efforts toward men. Following the development of effective TB policies and strategies, it is essential to have well-planned gendered responsive interventions with a clear implementation plan and monitoring system to enhance access to TB prevention and care.
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Affiliation(s)
- Leila H Abdullahi
- Research Department, African Institute for Development Policy, Nairobi, Kenya
| | - Sandra Oketch
- African Institute for Development Policy (AFIDEP), Nairobi, Kenya
| | - Henry Komen
- African Institute for Development Policy (AFIDEP), Nairobi, Kenya
| | | | | | | | | | - Eliya M Zulu
- African Institute for Development Policy, Nairobi, Kenya
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El-Qushayri AE, Benmelouka AY. Sociodemographic predictors of beliefs about getting HIV infection by witchcraft or supernatural means: a population-based study of 15335 Senegalese women. Afr Health Sci 2024; 24:36-41. [PMID: 38962333 PMCID: PMC11217827 DOI: 10.4314/ahs.v24i1.6] [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: 07/05/2024] Open
Abstract
Aim To provide more insights about beliefs of witchcraft and supernatural means as causes of human immunodeficiency virus (HIV) among women in Senegal. Method We included eligible women from the demographic and health survey conducted in Senegal during the year 2017. Results We included 15335 women, of those 620 (4%) thought that they can get HIV through witchcraft or supernatural means. After the adjustment of all available covariates, old age, receiving primary or secondary education, higher wealth index, more frequency of listening to radio, watching television for less than once a week and reading newspaper or magazine for at least once a week were significantly associated with a reduction in the witchcraft and supernatural means beliefs (p < 0.05). Moreover, rural residence was associated with an increase in the wrong HIV beliefs (p < 0.05). Conclusion We demonstrated many predictors of the wrong beliefs about getting HIV infection by witchcraft or supernatural means in the Senegalese women. Policymakers should initiate health educational programs in parallel with increasing the socioeconomic status to limit the HIV transmission. In addition, continuous monitoring of the HIV knowledge in the endemic countries is crucial to decrease HIV burden.
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Londani M, Oladimeji O. Tobacco use and behaviour among South African adolescents and young adults: systematic review and meta-analysis. BMJ Open 2024; 14:e079657. [PMID: 38413155 PMCID: PMC10900320 DOI: 10.1136/bmjopen-2023-079657] [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: 09/08/2023] [Accepted: 01/26/2024] [Indexed: 02/29/2024] Open
Abstract
OBJECTIVE Tobacco use, particularly the initiation of smoking during adolescence and young adulthood, represents a significant public health concern in South Africa. This study aims to conduct a comprehensive review of published literature about tobacco use and behaviour among adolescents and young adults and to determine an aggregated prevalence estimate of tobacco use within this demographic. DESIGN Systematic review and meta-analysis. DATA SOURCES PubMed/MEDLINE, EMBASE, Cochrane Library, Scopus and Google Scholar were searched from 1 January 2000 through 31 October 2023. ELIGIBILITY CRITERIA Studies were eligible for inclusion if they were cross-sectional studies conducted in South Africa and measured the prevalence and determinants of tobacco use among adolescents and young adults aged 12-24 years. DATA EXTRACTION AND SYNTHESIS Two reviewers independently extracted information for each article and saved it into an Excel spreadsheet. Risk of bias analysis was conducted using the Risk of Bias Assessment Tool for non-randomised studies. The methodology quality of each selected study was evaluated using the Joanna Briggs Institute checklist. The heterogeneity of prevalence estimates was assessed using I2 statistic (random-effects DerSimonian-Laid approach). RESULTS Out of 73 articles identified, 12 articles were included in the analysis. The pooled prevalence of current tobacco use among South African adolescents and young adults was estimated to be 22%. The pooled prevalence of tobacco use among school dropouts, university students and secondary school learners was 51%, 20% and 16%, respectively. Stratifying using gender, boys (26%) were two times more likely to use tobacco than girls (13%). CONCLUSION The elevated occurrence of tobacco usage among South African adolescents and young adults is a relevant public health concern. There is a need for more population-based prevalence studies at a national level to estimate the burden of tobacco use in South Africa. PROSPERO REGISTRATION NUMBER CRD42023428369.
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Affiliation(s)
- Mukhethwa Londani
- Directorate of Research and Innovation, Tshwane University of Technology, Pretoria, South Africa
| | - Olanrewaju Oladimeji
- Department of Epidemiology and Biostatistics, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Maniraj P, Jegadeesan P, Ananthakrishnan S. Sleep hygiene a neglected paediatric identity - A cross-sectional study. J Family Med Prim Care 2023; 12:3075-3078. [PMID: 38361902 PMCID: PMC10866257 DOI: 10.4103/jfmpc.jfmpc_2160_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 05/05/2023] [Accepted: 05/25/2023] [Indexed: 02/17/2024] Open
Abstract
Background Sleep is the physiological need of any human being; its role in paediatric mental and physical development is irreplaceable. However, in recent days, the rising trend of childhood obesity makes it essential to assess the sleep hygiene of the children to know if there is any adjacent association. Objectives 1. To estimate the prevalence of poor sleep quality using Sleep Hygiene Index Scoring. 2. To determine the association of sleep quality with academic performance and body mass index among the school children. Materials and Methods The present cross-sectional study was conducted among 322 children aged between 7 and 12 years attending paediatric OPD of a private tertiary care hospital, Puducherry. Using Sleep Hygeine Index scoring with the cut off 16, prevalence of poor sleep quality was assessed and its association with BMI and academic performance was determined. Frequency, proportion, and Chi-square test were used for analysis; P value < 0.05 was considered statistically significant. Results The mean age of the participants was 8.8 ± 2 years, and most of them were boys. Around 53% of the children had poor quality of sleep, and there was a positive association between poor sleep quality with obesity (P value: 0.0003) and unfavourable academic performance (P value: 0.00001). Conclusion Sleep hygiene importance should be taught to the parents and periodical assessment helps in predicting the neglected reason for obesity and poor academic performance, which could be managed easily with small lifestyle changes.
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Affiliation(s)
- Pradeep Maniraj
- Department of Paediatrics, Mahatma Gandhi Medical College and Research Institute, SBV University, Puducherry, India
| | - Podhini Jegadeesan
- Department of Paediatrics, Mahatma Gandhi Medical College and Research Institute, SBV University, Puducherry, India
| | - Shanthi Ananthakrishnan
- Department of Paediatrics, Mahatma Gandhi Medical College and Research Institute, SBV University, Puducherry, India
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Jobe M, Mactaggart I, Hydara A, Kim MJ, Bell S, Badjie O, Bittaye M, Perel P, Prentice AM, Burton MJ. Evaluating the hypertension care cascade in middle-aged and older adults in The Gambia: findings from a nationwide survey. EClinicalMedicine 2023; 64:102226. [PMID: 37767194 PMCID: PMC10520336 DOI: 10.1016/j.eclinm.2023.102226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/31/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
Background Hypertension is a major public health problem in sub-Saharan Africa with poor treatment coverage and high case-fatality rates. This requires assessment of healthcare performance to identify areas where intervention is most needed. To identify areas where health resources should be most efficiently targeted, we assessed the hypertension care cascade i.e., loss and retention across the various stages of care, in Gambian adults aged 35 years and above. Methods This study was embedded within the nationally representative 2019 Gambia National Eye Health Survey of adults ≥35 years. We constructed a hypertension care cascade with four categories: prevalence of hypertension (defined as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg, and/or current use of medication prescribed for hypertension); those aware of their diagnosis; those treated; and those with a controlled blood pressure (defined as blood pressure <140/90 mmHg). Analyses were age- and sex-standardised to the population structure of The Gambia. Logistic regression was used to assess the socio-demographic factors associated with prevalence, awareness, treatment and control of hypertension. Findings Of 9171 participants with data for blood pressure, the prevalence of hypertension was 47.0%. Among people with hypertension, the prevalence of awareness was 54.7%, the prevalence of hypertension treatment was 32.5%, and prevalence of control was 10.0% with little difference between urban and rural residence. The cascade of care performance was better in women. However, there was no difference in achieving blood pressure control between men and women who were receiving treatment. Female sex, older age and higher body mass index were associated with higher hypertension awareness whilst having an occupation compared to being unemployed was associated with higher odds of being treated. Patients in the underweight category had higher odds of achieving blood pressure control. Interpretation There is a high prevalence of hypertension and low performance of the health care system that impact on the hypertension care cascade among middle-aged and older adults in The Gambia. Addressing the full cascade will be paramount especially in reducing the mounting prevalence and improving diagnosis of patients with hypertension, where the greatest dividends will be gained. Funding The Queen Elizabeth Diamond Jubilee Trust, Wellcome Trust.
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Affiliation(s)
- Modou Jobe
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Islay Mactaggart
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, UK
| | - Abba Hydara
- Sheikh Zayed Regional Eye Care Centre, Kanifing, The Gambia
| | - Min J. Kim
- International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Suzannah Bell
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Omar Badjie
- Directorate of Health Promotion & Education, Ministry of Health, The Gambia
| | - Mustapha Bittaye
- Directorate of Health Services, Ministry of Health, The Gambia
- Department of Obstetrics and Gynaecology, Edward Francis Small Teaching Hospital, Banjul, The Gambia
| | - Pablo Perel
- Department of Non-communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, UK
| | - Andrew M. Prentice
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Matthew J. Burton
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, UK
- National Institute for Health Research Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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Akinlotan M, Khodakarami N, Primm K, Bolin J, Ferdinand AO. Travel for medical or dental care by race/ethnicity and rurality in the U.S.: Findings from the 2001, 2009 and 2017 National Household Travel Surveys. Prev Med Rep 2023; 35:102297. [PMID: 37559948 PMCID: PMC10407956 DOI: 10.1016/j.pmedr.2023.102297] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 06/12/2023] [Accepted: 06/21/2023] [Indexed: 08/11/2023] Open
Abstract
The travel burden for medical or dental care is a well-documented barrier to healthcare access, particularly in rural areas. There is limited research providing national estimates of the travel trends for medical/dental care, particularly among racial/ethnic groups, and among rural and urban populations. We analyzed data from the 2001, 2009, and 2017 National Household Travel Surveys. Main outcomes were the average travel distance (in miles), average travel time (in minutes), and travel burden, characterized as the percentage of trips lasting ≥ 30 miles or minutes for medical/dental care. We used ordinary least squares and multivariable logistic regressions to examine trends in the travel time/distance and travel burden, controlling for socio-demographic and travel dynamics. Among rural residents, the average travel distance for medical/dental care increased by 17.8% between 2001 and 2017, while no increase was observed among urban residents. Thirty-six percent of trips among rural residents lasted ≥ 30 minutes in 2001 but increased to 47.4% in 2017. Logistic regression estimates show that though Blacks experienced higher odds of a travel time burden compared to Whites, the burden lessened over time. In 2017, urban Blacks (OR = 0.41, 95% C.I. = 0.26,0.66), and rural Blacks (OR = 0.16, 95% C.I. = 0.05,0.55) were less likely to spend ≥ 30 minutes traveling for medical/dental care compared to Whites, using the year 2001 as the baseline. The travel distance and time for medical/dental care have increased in rural areas. However, the travel burden among rural and urban Black residents has decreased. Continuing to alleviate excess burdens of transportation may be beneficial.
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Affiliation(s)
| | - Nima Khodakarami
- Department of Health Policy & Administration, Penn State Beaver, USA
| | - Kristin Primm
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, USA
| | - Jane Bolin
- Southwest Rural Health Research Center, Texas A&M School of Public Health, USA
- Texas A&M College of Nursing, USA
- Department of Health Policy & Management, Texas A&M School of Public Health, USA
| | - Alva O. Ferdinand
- Southwest Rural Health Research Center, Texas A&M School of Public Health, USA
- Department of Health Policy & Management, Texas A&M School of Public Health, USA
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Tan JK, Zhang X, Cheng D, Leong IYO, Wong CS, Tey J, Loh SC, Soh EF, Lim WY. Using the Johns Hopkins ACG Case-Mix System for population segmentation in a hospital-based adult patient population in Singapore. BMJ Open 2023; 13:e062786. [PMID: 36997258 PMCID: PMC10069494 DOI: 10.1136/bmjopen-2022-062786] [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: 03/31/2023] Open
Abstract
OBJECTIVE Population health management involves risk characterisation and patient segmentation. Almost all population segmentation tools require comprehensive health information spanning the full care continuum. We assessed the utility of applying the ACG System as a population risk segmentation tool using only hospital data. DESIGN Retrospective cohort study. SETTING Tertiary hospital in central Singapore. PARTICIPANTS 100 000 randomly selected adult patients from 1 January to 31 December 2017. INTERVENTION Hospital encounters, diagnoses codes and medications prescribed to the participants were used as input data to the ACG System. PRIMARY AND SECONDARY OUTCOME MEASURES Hospital costs, admission episodes and mortality of these patients in the subsequent year (2018) were used to assess the utility of ACG System outputs such as resource utilisation bands (RUBs) in stratifying patients and identifying high hospital care users. RESULTS Patients placed in higher RUBs had higher prospective (2018) healthcare costs, and were more likely to have healthcare costs in the top five percentile, to have three or more hospital admissions, and to die in the subsequent year. A combination of RUBs and ACG System generated rank probability of high healthcare costs, age and gender that had good discriminatory ability for all three outcomes, with area under the receiver-operator characteristic curve (AUC) values of 0.827, 0.889 and 0.876, respectively. Application of machine learning methods improved AUCs marginally by about 0.02 in predicting the top five percentile of healthcare costs and death in the subsequent year. CONCLUSION A population stratification and risk prediction tool can be used to appropriately segment populations in a hospital patient population even with incomplete clinical data.
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Affiliation(s)
- Joshua Kuan Tan
- Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Xiaojin Zhang
- Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
| | - Dawn Cheng
- Population Health Office, Tan Tock Seng Hospital, Singapore
| | | | | | - Jeannie Tey
- Planning and Development, Tan Tock Seng Hospital, Singapore
| | - Shu Ching Loh
- Division of Central Health, Tan Tock Seng Hospital, Singapore
| | | | - Wei Yen Lim
- Office of Clinical Epidemiology, Analytics, and Knowledge (OCEAN), Tan Tock Seng Hospital, Singapore
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Chamberlain S, Savage RD, Bronskill SE, Griffith LE, Rochon P, Batara J, Gruneir A. Retrospective cross-sectional study examining the association between loneliness and unmet healthcare needs among middle-aged and older adults using the Canadian Longitudinal Study of Aging (CLSA). BMJ Open 2023; 13:e068769. [PMID: 36918248 PMCID: PMC10016309 DOI: 10.1136/bmjopen-2022-068769] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/28/2023] [Indexed: 03/15/2023] Open
Abstract
OBJECTIVES Our primary objective was to estimate the association between loneliness and unmet healthcare needs and if the association changes when adjusted for demographic and health factors. Our secondary objective was to examine the associations by gender (men, women, gender diverse). DESIGN, SETTING, PARTICIPANTS Retrospective cross-sectional data from 44 423 community-dwelling Canadian Longitudinal Study on Aging participants aged 45 years and older were used. PRIMARY OUTCOME MEASURE Unmet healthcare needs are measured by asking respondents to indicate (yes, no) if there was a time when they needed healthcare in the last 12 months but did not receive it. RESULTS In our sample of 44 423 respondents, 8.5% (n=3755) reported having an unmet healthcare need in the previous 12 months. Lonely respondents had a higher percentage of unmet healthcare needs (14.4%, n=1474) compared with those who were not lonely (6.7%, n=2281). Gender diverse had the highest percentage reporting being lonely and having an unmet healthcare need (27.3%, n=3), followed by women (15.4%, n=887) and men (13.1%, n=583). In our logistic regression, lonely respondents had higher odds of having an unmet healthcare need in the previous 12 months than did not lonely (adjusted odd ratios (aOR) 1.80, 95% CI 1.64 to 1.97), adjusted for other covariates. In the gender-stratified analysis, loneliness was associated with a slightly greater likelihood of unmet healthcare needs in men (aOR 1.90, 95% CI 1.64 to 2.19) than in women (aOR 1.73, 95% CI 1.53 to 1.95). In the gender diverse, loneliness was also associated with increased likelihood of having an unmet healthcare need (aOR 1.38, 95% CI 0.23 to 8.29). CONCLUSIONS Loneliness was related to unmet healthcare needs in the previous 12 months, which may suggest that those without robust social connections experience challenges accessing health services. Gender-related differences in loneliness and unmet needs must be further examined in larger samples.
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Affiliation(s)
| | - Rachel D Savage
- Women's College Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Susan E Bronskill
- ICES, Toronto, Ontario, Canada
- University of Toronto Institute of Health Policy Management and Evaluation, Toronto, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Paula Rochon
- Women's College Research Institute, Toronto, Ontario, Canada
- Division of Geriatric Medicine, University of Toronto Department of Medicine, Toronto, Ontario, Canada
| | - Jesse Batara
- Department of Family Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
| | - Andrea Gruneir
- Women's College Research Institute, Toronto, Ontario, Canada
- Department of Family Medicine, University of Alberta Faculty of Medicine & Dentistry, Edmonton, Alberta, Canada
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Diniz NPMC, da Silva JFC, Sampaio ATL, Torres GDV, Schveitzer MC, Nobre TTX. Offer of integrative and complementary health practices for the elderly in health services: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2023; 102:e32856. [PMID: 36800612 PMCID: PMC9936020 DOI: 10.1097/md.0000000000032856] [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: 12/30/2022] [Accepted: 01/17/2023] [Indexed: 02/19/2023] Open
Abstract
INTRODUCTION Integrative and complementary health practices (ICHP) question the hegemony of the biomedical, technical and hospital paradigm, as they are an important axis in the process of redefining the health care model. Understanding how ICHP are offered to the elderly population can help to improve the production of changes in care and in the daily life of health services. OBJECTIVE To identify and summarize the scientific evidence on the provision of ICHP for the elderly in health services. METHODS This is a research protocol for a scoping review following the recommendations of the Extension for Scoping Reviews method proposed by the Joanna Briggs Institute. Studies will be collected in the following databases, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, Scielo, Online System for Searching and Analyzing Medical Literature (MEDLINE), Embase, Virtual Library in Health and gray literature. Two independent reviewers will perform screening, data extraction, and risk of bias assessment using the Joanna Briggs Institute Critical Assessment Checklist. For the quality of evidence, the Grading of Recommendations, Assessment, Development and Evaluation analysis will be used. RESULTS This review will provide information on the provision of ICHP for the elderly population in health services. CONCLUSIONS This scoping review will provide evidence to help health professionals, managers and users to recognize more effective therapeutic inventions for promoting, preventing and protecting comprehensive health at different levels of care.
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Affiliation(s)
| | | | - Ana Tânia Lopes Sampaio
- Department of Collective Health, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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15
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Denic-Roberts H, Engel LS, Buchanich JM, Miller RG, Talbott EO, Thomas DL, Cook GA, Costacou T, Rusiecki JA. Risk of longer-term neurological conditions in the Deepwater Horizon Oil Spill Coast Guard Cohort Study - Five years of follow-up. Environ Health 2023; 22:12. [PMID: 36694171 PMCID: PMC9875433 DOI: 10.1186/s12940-022-00941-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/14/2022] [Indexed: 05/23/2023]
Abstract
BACKGROUND Long-term neurological health risks associated with oil spill cleanup exposures are largely unknown. We aimed to investigate risks of longer-term neurological conditions among U.S. Coast Guard (USCG) responders to the 2010 Deepwater Horizon (DWH) oil spill. METHODS We used data from active duty members of the DWH Oil Spill Coast Guard Cohort Study (N=45224). Self-reported oil spill exposures were ascertained from post-deployment surveys. Incident neurological outcomes were classified using International Classification of Diseases, 9th Revision, codes from military health encounter records up to 5.5 years post-DWH. We used Cox Proportional Hazards regression to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI) for various incident neurological diagnoses (2010-2015). Oil spill responder (n=5964) vs. non-responder (n= 39260) comparisons were adjusted for age, sex, and race, while within-responder comparisons were additionally adjusted for smoking. RESULTS Compared to those not responding to the spill, spill responders had reduced risks for headache (aHR=0.84, 95% CI: 0.74-0.96), syncope and collapse (aHR=0.74, 95% CI: 0.56-0.97), and disturbance of skin sensation (aHR=0.81, 95% CI: 0.68-0.96). Responders reporting ever (n=1068) vs. never (n=2424) crude oil inhalation exposure were at increased risk for several individual and grouped outcomes related to headaches and migraines (aHR range: 1.39-1.83). Crude oil inhalation exposure was also associated with elevated risks for an inflammatory nerve condition, mononeuritis of upper limb and mononeuritis multiplex (aHR=1.71, 95% CI: 1.04-2.83), and tinnitus (aHR=1.91, 95% CI: 1.23-2.96), a condition defined by ringing in one or both ears. Risk estimates for those neurological conditions were higher in magnitude among responders reporting exposure to both crude oil and oil dispersants than among those reporting crude oil only. CONCLUSION In this large study of active duty USCG responders to the DWH disaster, self-reported spill cleanup exposures were associated with elevated risks for longer-term neurological conditions.
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Affiliation(s)
- Hristina Denic-Roberts
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room E-2009, Bethesda, MD, 20814, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jeanine M Buchanich
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rachel G Miller
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Evelyn O Talbott
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dana L Thomas
- United States Coast Guard Headquarters, Directorate of Health, Safety, and Work Life, Washington, D.C., USA
| | - Glen A Cook
- Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Tina Costacou
- Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jennifer A Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Room E-2009, Bethesda, MD, 20814, USA.
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Wu S, Litvinjenko S, Magwood O, Wei X. Defining tuberculosis vulnerability based on an adapted social determinants of health framework: a narrative review. Glob Public Health 2023; 18:2221729. [PMID: 37302100 DOI: 10.1080/17441692.2023.2221729] [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: 01/16/2023] [Accepted: 05/31/2023] [Indexed: 06/13/2023]
Abstract
The World Health Organization's new End TB Strategy emphasises socioeconomic interventions to reduce access barriers to TB care and address the social determinants of TB. To facilitate developing interventions that align with this strategy, we examined how TB vulnerability and vulnerable populations were defined in literature, with the aim to propose a definition and operational criteria for TB vulnerable populations through social determinants of health and equity perspectives. We searched for documents providing explicit definition of TB vulnerability or list of TB vulnerable populations. Guided by the Commission on the Social Determinants of Health framework, we synthesised the definitions, compiled vulnerable populations, developed a conceptual framework of TB vulnerability, and derived definition and criteria for TB vulnerable populations. We defined TB vulnerable populations as those whose context leads to disadvantaged socioeconomic positions that expose them to systematically higher risks of TB, but having limited access to TB care, thus leading to TB infection or progression to TB disease. We propose that TB vulnerable populations can be determined in three dimensions: disadvantaged socioeconomic position, higher risks of TB infection or progression to disease, and poor access to TB care. Examining TB vulnerability facilitates identification and support of vulnerable populations.
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Affiliation(s)
- Shishi Wu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Global Implementation Science Lab, University of Toronto, Toronto, Canada
| | - Stefan Litvinjenko
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Global Implementation Science Lab, University of Toronto, Toronto, Canada
| | - Olivia Magwood
- Bruyère Research Institute, Ottawa, Canada
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Xiaolin Wei
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Global Implementation Science Lab, University of Toronto, Toronto, Canada
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Davey VJ, Akhtar FZ, Cypel Y, Culpepper WJ, Ishii EK, Morley SW, Schneiderman AI. U.S. Blue Water Navy Veterans of the Vietnam War: Comparisons from the Vietnam Era Health Retrospective Observational Study (VE-HEROeS). JOURNAL OF MILITARY AND VETERANS' HEALTH 2023; 31:56-73. [PMID: 38567295 PMCID: PMC10986165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background US Vietnam War Blue Water Navy veterans (BWN) conducted military operations on Vietnam's offshore waters and likely experienced various war-related exposures. The overall health of the BWN has never been systematically studied. Purpose Describe and compare BWN's health with other servicemembers and non-veterans of the Vietnam era. Materials and methods Survey of 45 067 randomly selected US Vietnam War theatre and non-theatre veterans and 6885 non-veterans. Results For 22 646 male respondents, self-reported health was contrasted by veteran status defined as BWN (n=985), theatre veterans (n=6717), non-theatre veterans (n=10 698) and non-veterans (n=4246). Exposure was service in the Vietnam War theatre. Collected were demographics, military service characteristics, lifestyle factors and health conditions. Adjusted odds ratios (aOR) were calculated using multivariable logistic regression. Controlling for cigarette smoking and other covariates, respiratory cancer risk was highest in BWN vs other veterans (theatre: aOR 1.65; 95% CI 1.09, 2.50; non-theatre: aOR 1.77; 1.13, 2.77) and to non-veterans (aOR 1.78; 1.15, 2.74). Other findings showed BWN's health risks between theatre and non-theatre veterans. Conclusion There was a higher risk for respiratory cancers in BWN. Other risks were less than theatre veterans but greater than non-theatre or non-veterans, indicating a potential role of military exposures in BWN's health.
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Affiliation(s)
- V J Davey
- US Department of Veterans Affairs - Office of Research & Development, Washington DC, District of Columbia, United States
| | - F Z Akhtar
- US Department of Veterans Affairs - Epidemiology Program, Health Outcomes Military Exposures, Office of Patient Care Services, Washington, District of Columbia, United State
| | - Y Cypel
- US Department of Veterans Affairs - Epidemiology Program, Health Outcomes Military Exposures, Office of Patient Care Services, Washington, District of Columbia, United State
| | - W J Culpepper
- US Department of Veterans Affairs - Epidemiology Program, Health Outcomes Military Exposures, Office of Patient Care Services, Washington, District of Columbia, United State
| | - E K Ishii
- US Department of Veterans Affairs - Population Health, Office of Patient Care Services, Washington, District of Columbia, United States
| | - S W Morley
- US Department of Veterans Affairs - Center of Excellence for Suicide Prevention, Canandaigua, New York, United States
| | - A I Schneiderman
- US Department of Veterans Affairs - Epidemiology Program, Health Outcomes Military Exposures, Office of Patient Care Services, Washington, District of Columbia, United State
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Mobley TM, Shaw C, Hayes-Larson E, Fong J, Gilsanz P, Gee GC, Brookmeyer R, Whitmer RA, Casey JA, Rose Mayeda E. Neighborhood disadvantage and dementia incidence in a cohort of Asian American and non-Latino White older adults in Northern California. Alzheimers Dement 2023; 19:296-306. [PMID: 35388625 PMCID: PMC9535033 DOI: 10.1002/alz.12660] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/09/2022] [Accepted: 02/22/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Some evidence suggests that neighborhood socioeconomic disadvantage is associated with dementia-related outcomes. However, prior research is predominantly among non-Latino Whites. METHODS We evaluated the association between neighborhood disadvantage (Area Deprivation Index [ADI]) and dementia incidence in Asian American (n = 18,103) and non-Latino White (n = 149,385) members of a Northern California integrated health care delivery system aged 60 to 89 at baseline. Race/ethnicity-specific Cox proportional hazards models adjusted for individual-level age, sex, socioeconomic measures, and block group population density estimated hazard ratios (HRs) for dementia. RESULTS Among non-Latino Whites, ADI was associated with dementia incidence (most vs. least disadvantaged ADI quintile HR = 1.09, 95% confidence interval [CI] = 1.02-1.15). Among Asian Americans, associations were close to null (e.g., most vs. least disadvantaged ADI quintile HR = 1.01, 95% CI = 0.85-1.21). DISCUSSION ADI was associated with dementia incidence among non-Latino Whites but not Asian Americans. Understanding the potentially different mechanisms driving dementia incidence in these groups could inform dementia prevention efforts.
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Affiliation(s)
- Taylor M. Mobley
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California
| | - Crystal Shaw
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California
- Department of Biostatistics, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California
| | - Eleanor Hayes-Larson
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California
| | - Joseph Fong
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California
| | - Paola Gilsanz
- Kaiser Permanente Division of Research, Oakland, CA
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Gilbert C. Gee
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Ron Brookmeyer
- Department of Biostatistics, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California
| | - Rachel A. Whitmer
- Kaiser Permanente Division of Research, Oakland, CA
- Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA, USA
- Alzheimer’s Disease Center, University of California Davis Health, Sacramento, CA, USA
| | - Joan A. Casey
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, University of California, Los Angeles Fielding School of Public Health, Los Angeles, California
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
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Withanage NN, Botfield JR, Srinivasan S, Black KI, Mazza D. Effectiveness of preconception interventions in primary care: a systematic review. Br J Gen Pract 2022; 72:e865-e872. [PMID: 36376068 PMCID: PMC9678374 DOI: 10.3399/bjgp.2022.0040] [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: 01/20/2022] [Accepted: 08/11/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Primary care-based preconception care (PCC) has the potential to improve pregnancy outcomes, but the effectiveness is unclear. AIM To evaluate the effectiveness of primary care-based PCC delivered to reproductive-aged females and/or males to improve health knowledge, reduce preconception risk factors, and improve pregnancy outcomes. DESIGN AND SETTING A systematic review of primary care-based PCC. METHOD Ovid MEDLINE, Cochrane CENTRAL, Embase, Web of Science, Scopus, and CINAHL were searched for randomised controlled trials (RCTs) published between July 1999 and May 2021. Two reviewers independently evaluated article eligibility and quality. RESULTS Twenty-eight articles reporting on 22 RCTs were included. All but one focused on females. Interventions included brief education (single session) (n = 8), intensive education (multiple sessions) (n = 9), supplementary medication (n = 7), and dietary modification (n = 4). Brief education improved health knowledge in females (n = 3) and males (n = 1), reduced alcohol/tobacco consumption (n = 2), and increased folate intake (n = 3). Intensive education reduced spontaneous pregnancy loss (n = 1), alcohol-exposed pregnancies (n = 2), and increased physical activity (n = 2). Supplementary medication increased folate intake (n = 4) and dietary modification reduced pre-eclampsia (n = 1) and increased birth weight (n = 1). Only eight articles reported on pregnancy outcomes, with a range of interventions used; of these, four reported improvements in pregnancy outcomes. Most RCTs were of low quality (n = 12). CONCLUSION Primary care-based PCC including brief and intensive education, supplementary medication, and dietary modification are effective in improving health knowledge and reducing preconception risk factors in females, although there is limited evidence for males. Further research is required to determine whether primary care-based PCC can improve pregnancy outcomes.
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Affiliation(s)
- Nishadi N Withanage
- GAICD, (Graduate of the Australian Institute of Company Directors), head, Department of General Practice, Monash University, Australia
| | - Jessica R Botfield
- GAICD, (Graduate of the Australian Institute of Company Directors), head, Department of General Practice, Monash University, Australia
| | | | | | - Danielle Mazza
- GAICD, (Graduate of the Australian Institute of Company Directors), head, Department of General Practice, Monash University, Australia
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Senevirathna K, Hettiarachchi K, Warnakulasuriya S, Jayasinghe R. TikTok - Potential Impact on the Use of Smokeless Tobacco and Betel Quid by Young People. Asian Pac J Cancer Prev 2022; 23:3665-3671. [PMID: 36444578 PMCID: PMC9930953 DOI: 10.31557/apjcp.2022.23.11.3665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION TikTok has gained increasing popularity over the past year. The social media may affect awareness and perceptions of betel quid (BQ) and smokeless tobacco (SLT) by utilizing content generated by TikTok users. The purpose of this study is to examine how BQ and SLT are portrayed on TikTok. METHODS The 28 most viewed hashtag-based keywords were used to identify popular BQ and SLT-related videos on TikTok (n=513) from June 2018 to September 2021. Two researchers independently coded the number of likes, shares, views, user category and themes. RESULTS A final sample of 513 videos containing BQ and SLT that met the study criteria were included. Collectively, these videos were viewed over 725 million times, with a median 'view' count of 17,300 (range 152-155,000,000) and a median 'likes' count of 831 (range 4-2,400,000) and a median 'share' count of 21 (range 0-48,400). Majority of the videos showed BQ and SLT use positively i.e promoting the product (390/513; 76%) and these had more than 686 million times views. Neutral depictions of BQ and SLT use were viewed 15 million times (72/513; 14%) and negative portrayals of BQ and SLT have been viewed 193 million times (105/808; 13%). The video themes included 'life style' (349/513; 68.0%), 'marketing' (62/513; 12.09%), 'comedy' (44/513; 8.6%), 'warning' (25/513; 4.87%), 'awareness' (12/513; 2.3%), 'sports and other' (12/513; 2.3%) and social events or culture (9/513; 1.75%). CONCLUSION Our results demonstrated that video clips related to BQ and SLT on TikTok, a fast-growing, popular video-sharing platform among teens, which is available with no age restrictions has been viewed multiple times. Majority (76%) promoted these two products, that could be detrimental to oral health. Therefore, the age restrictions especially for the videos containing BQ and SLT is mandatory in order to reduce the potential exposure of adolescents/young adults.
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Affiliation(s)
- Kalpani Senevirathna
- Centre for Research in Oral Cancer, Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
| | - Kalani Hettiarachchi
- Centre for Research in Oral Cancer, Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.,Department of Oral Medicine and Periodontology, Faculty of Dental sciences, University of Peradeniya, Sri Lanka.,For Correspondence:
| | | | - Ruwan Jayasinghe
- Centre for Research in Oral Cancer, Department of Oral Pathology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.,Department of Oral Medicine and Periodontology, Faculty of Dental sciences, University of Peradeniya, Sri Lanka.
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Sriram K, Lin GX, Jefferson AM, McKinney W, Jackson MC, Cumpston JL, Cumpston JB, Leonard HD, Kashon ML, Fedan JS. Biological effects of inhaled crude oil vapor V. Altered biogenic amine neurotransmitters and neural protein expression. Toxicol Appl Pharmacol 2022; 449:116137. [PMID: 35750205 PMCID: PMC9936428 DOI: 10.1016/j.taap.2022.116137] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/06/2022] [Accepted: 06/17/2022] [Indexed: 12/19/2022]
Abstract
Workers in the oil and gas industry are at risk for exposure to a number of physical and chemical hazards at the workplace. Chemical hazard risks include inhalation of crude oil or its volatile components. While several studies have investigated the neurotoxic effects of volatile hydrocarbons, in general, there is a paucity of studies assessing the neurotoxicity of crude oil vapor (COV). Consequent to the 2010 Deepwater Horizon (DWH) oil spill, there is growing concern about the short- and long-term health effects of exposure to COV. NIOSH surveys suggested that the DWH oil spill cleanup workers experienced neurological symptoms, including depression and mood disorders, but the health effects apart from oil dispersants were difficult to discern. To investigate the potential neurological risks of COV, male Sprague-Dawley rats were exposed by whole-body inhalation to COV (300 ppm; Macondo surrogate crude oil) following an acute (6 h/d × 1 d) or sub-chronic (6 h/d × 4 d/wk. × 4 wks) exposure regimen. At 1, 28 or 90 d post-exposure, norepinephrine (NE), epinephrine (EPI), dopamine (DA) and serotonin (5-HT) were evaluated as neurotransmitter imbalances are associated with psychosocial-, motor- and cognitive- disorders. Sub-chronic COV exposure caused significant reductions in NE, EPI and DA in the dopaminergic brain regions, striatum (STR) and midbrain (MB), and a large increase in 5-HT in the STR. Further, sub-chronic exposure to COV caused upregulation of synaptic and Parkinson's disease-related proteins in the STR and MB. Whether such effects will lead to neurodegenerative outcomes remain to be investigated.
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Affiliation(s)
- Krishnan Sriram
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America.
| | - Gary X Lin
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
| | - Amy M Jefferson
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
| | - Walter McKinney
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
| | - Mark C Jackson
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
| | - Jared L Cumpston
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
| | - James B Cumpston
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
| | - Howard D Leonard
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
| | - Michael L Kashon
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
| | - Jeffrey S Fedan
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Morgantown, WV 26505, United States of America
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Abera W, Gintamo B, Shitemaw T, Mekuria ZN, Gizaw Z. Prevalence of intestinal parasites and associated factors among food handlers in food establishments in the Lideta subcity of Addis Ababa, Ethiopia: an institution-based, cross-sectional study. BMJ Open 2022; 12:e061688. [PMID: 35858725 PMCID: PMC9305799 DOI: 10.1136/bmjopen-2022-061688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study was conducted to assess the prevalence of intestinal parasites and the associated factors among food handlers in the Lideta subcity of Addis Ababa, Ethiopia. DESIGN An institution-based, cross-sectional study design was used. Stool samples were collected from food handlers and examined using direct wet mount and formalin-ether concentration techniques. Personal and establishment-related information was collected using a pretested questionnaire, with a structured observation. Multivariable binary logistic regression was used to identify factors associated with the prevalence of intestinal parasites on the basis of adjusted OR (AOR) and 95% CI and p values <0.05. SETTING Food establishments in the Lideta subcity of Addis Ababa, Ethiopia. PARTICIPANTS 411 food handlers participated in the study. OUTCOME MEASURES The primary outcome was the prevalence of intestinal parasites, defined as the presence of one or more intestinal parasitic species in stool samples. RESULTS One or more intestinal parasites were detected in 171 (41.6%; 95% CI 36.6% to 46.4%) stool samples. The most common intestinal parasites were Entamoeba histolytica/dispar (12.7%), Giardia duodenalis (11.2%) and Ascaris lumbricoides (8.3%). The presence of intestinal parasites among food handlers was associated with low monthly income (AOR: 2.83, 95% CI 1.50 to 8.84), untrimmed fingernails (AOR: 4.36, 95% CI 1.98 to 11.90), no food safety training (AOR: 2.51, 95% CI 1.20 to 5.58), low level of education (AOR: 3.13, 95% CI 1.34 to 7.44), poor handwashing practice (AOR: 2.16, 95% CI 1.03 to 4.22) and lack of medical check-up (AOR: 2.31, 95% CI 1.18 to 6.95). CONCLUSION The prevalence of intestinal parasites among food handlers in food establishments in the Lideta subcity of Addis Ababa was high. The presence of intestinal parasites was linked to socioeconomic conditions, poor hand hygiene conditions and absence of food safety training. It is crucially important to promote handwashing practices and provide food hygiene and safety training in these settings.
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Affiliation(s)
- Woinishet Abera
- Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia
| | - Binyam Gintamo
- Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia
- Department of Public Health, Addis Ababa Medical and Business College, Addis Ababa, Ethiopia
| | - Tewoderos Shitemaw
- Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia
- Anesthesia Department, Menelik II Health and Medical Science College, Kotebe Metropolitan University, Addis Ababa, Ethiopia
| | - Zelalem Negash Mekuria
- Department of Public Health, Yanet Health College, Addis Ababa, Ethiopia
- Department of Public Health, Addis Ababa Medical and Business College, Addis Ababa, Ethiopia
| | - Zemichael Gizaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chen H, Wang LJ, Xin F, Liang G, Chen Y. Associations between sleep duration, sleep quality, and weight status in Chinese children and adolescents. BMC Public Health 2022; 22:1136. [PMID: 35668374 PMCID: PMC9172025 DOI: 10.1186/s12889-022-13534-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 05/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background and objective
The high prevalence of obesity is a serious problem, and sleep is considered to be a factor for obesity. This study aimed to examine the relationship between sleep duration, sleep quality, and weight status among children and adolescents in China and to explore whether the relationship between sleep duration and weight status is independent of sleep quality. Sex and age differences were also explored. Methods A cross-sectional research was conducted among 2019 children and adolescents (1029 boys and 990 girls) aged 8–16 years in Shanghai. An open-question was used to obtain data on sleep duration, which was categorized into the following four groups based on the age-specific National Sleep Foundation Sleep Duration Recommendations: 1) very short, 2) short, 3) recommended, and 4) long. The Pittsburgh Sleep Quality Index was used to assess sleep quality. Weight and height were measured for all participants. The variable weight status was estimated with the Chinese children and adolescent age- and sex-specific body mass index (BMI) and was categorized into overweight/obesity and normal weight. Results Short sleep duration (7–8 and 6–7 h for 6–13 and 14–16 years old, respectively) significantly increased odds of overweight/obesity (OR = 1.32, 95% CI: 1.06–1.64) compared with that of the recommended sleep duration (9–11 and 8–10 h for 6–13 and 14–16 years old, respectively). The relationship between the two variables existed independent of sleep quality. No significant relationship was found between sleep quality and overweight/obesity of children and adolescents. Sleep quality (OR = 1.07, 95% CI: 1.01–1.14) and short sleep duration (OR = 1.51, 95% CI: 1.06–2.13) increased the risk for overweight/obesity among girls, whereas no significant relationships between sleep duration, sleep quality, and overweight/obesity were found among boys. Short sleep duration increased the risk of overweight/obesity in children aged 8–13 years (OR = 1.34, 95% CI: 1.05–1.71), independent of sleep quality, but no significant relationships between these two variables existed for adolescents aged 14–16 years. Conclusions Overall, short sleep duration increased the risks of overweight/obesity in children and adolescents in China, independent of sleep quality. This relationship is significant for girls and children aged 8–13 years instead of boys and adolescents aged 14–16 years. Interventions to extend the sleep duration of children and adolescents, especially girls and children aged 8–13 years in China, are necessary to improve their weight status. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13534-w.
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Affiliation(s)
- Huan Chen
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China
| | - Li-Juan Wang
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China.
| | - Fei Xin
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China
| | - Guo Liang
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China
| | - Yuan Chen
- School of Physical Education and Sport Training, Shanghai University of Sport, Yangpu District, Changhai Road No 399, Shanghai, 200438, China
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Kwansa AL, Akparibo R, Cecil JE, Infield Solar G, Caton SJ. Risk Factors for Overweight and Obesity within the Home Environment of Preschool Children in Sub-Saharan Africa: A Systematic Review. Nutrients 2022; 14:nu14091706. [PMID: 35565675 PMCID: PMC9100775 DOI: 10.3390/nu14091706] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 04/01/2022] [Accepted: 04/08/2022] [Indexed: 02/04/2023] Open
Abstract
Sub-Saharan Africa (SSA) is experiencing an increasing prevalence of young children being overweight and obese. Many feeding and physical activity-related behaviours are established at home during preschool years, yet the precise factors that contribute to preschool overweight and obesity have not been fully elucidated. This review aims to identify factors in the home environment associated with overweight and or obesity in preschool children in SSA. Ovid MEDLINE, EMBASE, CINAHL, Scopus, Web of Science, Africa Journals Online (AJOL) and the African Index Medicus databases were systematically searched for qualitative and quantitative studies published between 2000 and 2021. Eleven studies (ten quantitative, one qualitative) met the inclusion criteria. Overall, the results highlight the paucity of studies exploring factors in the home environment associated with overweight and obesity in preschool children in Sub-Saharan Africa. The home food environment and maternal BMI appear to be important factors associated with overweight and obesity in preschool children; however, the information for all other factors explored remains unclear due to the lack of evidence. For successful obesity prevention and treatment interventions to be developed, more research in this area is required to understand how different aspects of the home environment contribute to overweight and obesity in preschool Sub-Saharan African children.
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Affiliation(s)
- Albert L. Kwansa
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Robert Akparibo
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
| | - Joanne E. Cecil
- School of Medicine, Population and Behavioural Sciences, University of St Andrews, St Andrews KY16 9TF, UK;
| | | | - Samantha J. Caton
- Public Health Section, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield S1 4DA, UK; (A.L.K.); (R.A.)
- Correspondence:
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Bellis MA, Hughes K, Ford K, Madden HCE, Glendinning F, Wood S. Associations between adverse childhood experiences, attitudes towards COVID-19 restrictions and vaccine hesitancy: a cross-sectional study. BMJ Open 2022; 12:e053915. [PMID: 35105582 PMCID: PMC8829847 DOI: 10.1136/bmjopen-2021-053915] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES Adverse childhood experiences (ACEs) can affect life-course health and well-being, including risk-taking behaviour and trust. This study explored associations between ACEs and trust in health information on COVID-19, attitudes towards and compliance with COVID-19 restrictions and vaccine hesitancy. DESIGN National cross-sectional telephone survey using a sample of landline and mobile numbers stratified by Health Board, deprivation quintile and age group. SETTING Households in Wales during national COVID-19 restrictions (December 2020 to March 2021). PARTICIPANTS 2285 Welsh residents aged ≥18 years. MEASURES Nine ACEs; low trust in National Health Service (NHS) COVID-19 information; supporting removal of social distancing and mandatory face coverings; breaking COVID-19 restrictions; and vaccine hesitancy (rejection or uncertainty of vaccination). RESULTS Increasing ACE counts were independently related to low trust in NHS COVID-19 information, feeling unfairly restricted by government and ending mandatory face coverings. High ACE counts (4+ vs 0 ACEs) were also associated with supporting removal of social distancing. Breaking COVID-19 restrictions increased with ACE count with likelihood doubling from no ACEs to 4+ ACEs. Vaccine hesitancy was threefold higher with 4+ ACEs (vs 0 ACEs) and higher in younger age groups. Thus, modelled estimates of vaccine hesitancy ranged from 3.42% with no ACEs, aged ≥70 years, to 38.06% with 4+ ACEs, aged 18-29 years. CONCLUSIONS ACEs are common across populations of many countries. Understanding how they impact trust in health advice and uptake of medical interventions could play a critical role in the continuing response to COVID-19 and controlling future pandemics. Individuals with ACEs suffer greater health risks throughout life and may also be excluded from interventions that reduce infection risks. While pandemic responses should consider how best to reach those suffering from ACEs, longer term, better compliance with public health advice is another reason to invest in safe and secure childhoods for all children.
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Affiliation(s)
- Mark A Bellis
- College of Human Sciences, Bangor University, Bangor, UK
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Karen Hughes
- College of Human Sciences, Bangor University, Bangor, UK
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
| | - Kat Ford
- College of Human Sciences, Bangor University, Bangor, UK
| | - Hannah C E Madden
- College of Human Sciences, Bangor University, Bangor, UK
- School of Social Sciences, Liverpool Hope University, Liverpool, UK
| | | | - Sara Wood
- World Health Organization Collaborating Centre on Investment for Health and Well-being, Public Health Wales, Wrexham, UK
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Slawsky ED, Hajat A, Rhew IC, Russette H, Semmens EO, Kaufman JD, Leary CS, Fitzpatrick AL. Neighborhood greenspace exposure as a protective factor in dementia risk among U.S. adults 75 years or older: a cohort study. Environ Health 2022; 21:14. [PMID: 35033073 PMCID: PMC8760791 DOI: 10.1186/s12940-022-00830-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/06/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Research suggests that greenspace may confer neurocognitive benefits. This study examines whether residential greenspace is associated with risk of dementia among older adults. METHODS Greenspace exposure was computed for 3047 participants aged 75 years and older enrolled in the Gingko Evaluation of Memory Study (GEMS) across four U.S. sites that prospectively evaluated dementia and its subtypes, Alzheimer's disease (AD), vascular dementia (VaD), and mixed pathologies, using neuropsychiatric evaluations between 2000 and 2008. After geocoding participant residences at baseline, three greenspace metrics-Normalized Difference Vegetative Index, percent park overlap within a 2-km radius, and linear distance to nearest park-were combined to create a composite residential greenspace measure categorized into tertiles. Cox proportional hazards models estimated the associations between baseline greenspace and risk of incident all-cause dementia, AD, and Mixed/VaD. RESULTS Compared to low residential greenspace, high residential greenspace was associated with a reduced risk of dementia (HR = 0.76 95% CI: 0.59,0.98) in models adjusted for multiple covariates. After additional adjustment for behavioral characteristics, Apolipoprotein E ɛ4 status, and other covariates, the association was slightly attenuated (HR = 0.82; 95% CI:0.63,1.06). Those exposed to medium levels of greenspace also had 28% lower risk (HR = 0.72; CI: 0.55, 0.95) of dementia compared to those with low greenspace in adjusted models. Subtype associations between high residential greenspace and AD were not statistically significant. Greenspace was not found to be significantly associated with mixed/vascular pathologies. CONCLUSIONS This study showed evidence for an association between residential greenspace and all-cause dementia among older adults. Future research with larger sample size, precise characterization of different dementia subtypes, and assessment of residential greenspace earlier in life may help clarify the role between exposure to greenspace and dementia risk.
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Hosseininejad M, Moslemi S, Mohammadi S. The Effect of Physical Exposures and Job Stress on Sleep Quality and Mental Health in a Group of Pink-Collar Workers in Iran. Indian J Occup Environ Med 2022; 26:62-69. [PMID: 35991198 PMCID: PMC9384875 DOI: 10.4103/ijoem.ijoem_405_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/30/2021] [Accepted: 11/05/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Pink-collar workers are a group of workers in the service industries. Teachers are classified as a group of pink-collar workers, who are under a high level of stress. This study aimed to investigate the effect of physical exposures and job stress on mental health and sleep quality of technical and vocational teachers. MATERIALS AND METHODS This cross-sectional study was conducted on 622 teachers. The Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) were employed to evaluate sleep status; the Osipow Questionnaire was used to assess job stress; the musculoskeletal intervention center - Norrtalje questionnaire (MUSIC) was used to measure physical exposures; and the 12-Item General Health Questionnaire was used to assess mental health. RESULTS The mean scores of general health, job stress, and work hardness were 10.97 ± 6.29, 153.40 ± 22.63, and 15.61 ± 2.77, respectively; the mean score of ESS and PSQI were 6.22 ± 3.61 and 5.44 ± 2.97, respectively. The mental health status of the participants was significantly worse with more exposure to various types of job stressors and physical exposures. There was a significant relationship between sleep quality and general health score. CONCLUSION The mental health status was considerably better in women, smokers, and people who exercised, have less work experience, do not do shift work, work fewer hours per week, and have good sleep quality. Physical exposures and various occupational stressors can reduce mental health. There was a significant relationship between job stress and decreased sleep quality but sleep quality was not significantly associated with age, BMI, work experience, and working hours per week.
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Affiliation(s)
- Mahin Hosseininejad
- Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Mahin Hosseininejad, Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran. E-mail:
| | - Shahrbanoo Moslemi
- Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Saber Mohammadi
- Occupational Medicine Department, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Denic-Roberts H, Rowley N, Haigney MC, Christenbury K, Barrett J, Thomas DL, Engel LS, Rusiecki JA. Acute and longer-term cardiovascular conditions in the Deepwater Horizon Oil Spill Coast Guard Cohort. ENVIRONMENT INTERNATIONAL 2022; 158:106937. [PMID: 34688052 PMCID: PMC8688193 DOI: 10.1016/j.envint.2021.106937] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 08/25/2021] [Accepted: 10/11/2021] [Indexed: 05/31/2023]
Abstract
INTRODUCTION In 2010, the U.S. Coast Guard (USCG) led a clean-up response to the Deepwater Horizon (DWH) oil spill. Human studies evaluating acute and longer-term cardiovascular conditions associated with oil spill-related exposures are sparse. Thus, we aimed to investigate prevalent and incident cardiovascular symptoms/conditions in the DHW Oil Spill Coast Guard Cohort. METHODS Self-reported oil spill exposures and cardiovascular symptoms were ascertained from post-deployment surveys (n = 4,885). For all active-duty cohort members (n = 45,193), prospective cardiovascular outcomes were classified via International Classification of Diseases, 9th Edition from military health encounter records up to 5.5 years post-DWH. We used log-binomial regression to calculate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) in the cross-sectional analyses and Cox Proportional Hazards regression to calculate adjusted hazard ratios (aHR) and 95% CIs for incident cardiovascular diagnoses during 2010-2015 and stratifying by earlier (2010-2012) and later (2013-2015) time periods. RESULTS Prevalence of chest pain was associated with increasing levels of crude oil exposure via inhalation (aPRhigh vs. none = 2.00, 95% CI = 1.16-3.42, p-trend = 0.03) and direct skin contact (aPRhigh vs. none = 2.72, 95% CI = 1.30-5.16, p-trend = 0.03). Similar associations were observed for sudden heartbeat changes and for being in the vicinity of burning oil exposure. In prospective analyses, responders (vs. non-responders) had an elevated risk for mitral valve disorders during 2013-2015 (aHR = 2.12, 95% CI = 1.15-3.90). Responders reporting ever (vs. never) crude oil inhalation exposure were at increased risk for essential hypertension, particularly benign essential hypertension during 2010-2012 (aHR = 2.00, 95% CI = 1.08-3.69). Responders with crude oil inhalation exposure also had an elevated risk for palpitations during 2013-2015 (aHR = 2.54, 95% CI = 1.36-4.74). Cardiovascular symptoms/conditions aPR and aHR estimates were generally stronger among responders reporting exposure to both crude oil and oil dispersants than among those reporting neither. CONCLUSIONS In this large study of the DWH oil spill USCG responders, self-reported spill clean-up exposures were associated with acute and longer-term cardiovascular symptoms/conditions.
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Affiliation(s)
- Hristina Denic-Roberts
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Oak Ridge Institute for Science and Education, MD, USA
| | - Nicole Rowley
- Department of Laboratory Animal Resources, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Mark C Haigney
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Kate Christenbury
- Social & Scientific Systems, Inc., A DLH Holdings Corp Company ("DLH"), Durham, NC, USA
| | - John Barrett
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Dana L Thomas
- United States Coast Guard Headquarters, Directorate of Health, Safety, and Work Life, Washington, D.C., USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer A Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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Social Support Associated with Condom Use Behavior Among Female Sex Workers in Iran. Int J Behav Med 2022; 29:321-333. [PMID: 34476736 PMCID: PMC8412856 DOI: 10.1007/s12529-021-10017-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Despite the widespread knowledge about social support and health, there is little information about the association between social support and HIV risk behaviors such as condom use among female sex workers (FSWs) in Iran. This study aimed to determine the association between social support and frequency of condom use among FSWs in Tehran, Iran. METHODS Using mixed sampling methods, we recruited 170 FSWs in Tehran in 2017. We measured self-reported social support by face-to-face interviews using a standardized questionnaire. Linear regression was used to assess the association between socio-demographic characteristics (age, education level, marital status, and place of living), transactional sex characteristics (age at first transactional sex and frequency of transactional sex in the last month), HIV knowledge, social support network characteristics (social network size, duration of tie, intimacy, social support), and condom use behavior. RESULTS Of the total of 1193 persons in FSW's social networks, 615 (51%) were sexual partners, 529 (44%) were peer sex workers, and 36 (5%) were family members. The participants perceived moderate social support from sexual partners, low from peer sex workers, and very low from family members. Adjusted for individual and other network characteristics, peer sex worker social support (b = 0.28, 95%CI 0.06, 0.50), and family support (b = 1.12, 95%CI 0.028, 2.23) were significantly associated with condom use. CONCLUSION Family and peer sex worker social support are associated with condom use, but less strongly than HIV knowledge or place of living. However, very few FSWs are socially connected with families. Interventions to promote condom use among this vulnerable population should also consider social and familial support.
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Rusiecki JA, Denic-Roberts H, Thomas DL, Collen J, Barrett J, Christenbury K, Engel LS. Incidence of chronic respiratory conditions among oil spill responders: Five years of follow-up in the Deepwater Horizon Oil Spill Coast Guard Cohort study. ENVIRONMENTAL RESEARCH 2022; 203:111824. [PMID: 34364859 PMCID: PMC8616774 DOI: 10.1016/j.envres.2021.111824] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/30/2021] [Accepted: 07/30/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND Over ten years after the Deepwater Horizon (DWH) oil spill, our understanding of long term respiratory health risks associated with oil spill response exposures is limited. We conducted a prospective analysis in a cohort of U.S. Coast Guard personnel with universal military healthcare. METHODS For all active duty cohort members (N = 45,193) in the DWH Oil Spill Coast Guard Cohort Study we obtained medical encounter data from October 01, 2007 to September 30, 2015 (i.e., ~2.5 years pre-spill; ~5.5 years post-spill). We used Cox Proportional Hazards regressions to calculate adjusted hazard ratios (aHR), comparing risks for incident respiratory conditions/symptoms (2010-2015) for: responders vs. non-responders; responders reporting crude oil exposure, any inhalation of crude oil vapors, and being in the vicinity of burning crude oil versus responders without those exposures. We also evaluated self-reported crude oil and oil dispersant exposures, combined. Within-responder comparisons were adjusted for age, sex, and smoking. RESULTS While elevated aHRs for responder/non-responder comparisons were generally weak, within-responder comparisons showed stronger risks with exposure to crude oil. Notably, for responders reporting exposure to crude oil via inhalation, there were elevated risks for allsinusitis (aHR = 1.48; 95%CI, 1.06-2.06), unspecified chronic sinusitis (aHR = 1.55; 95%CI, 1.08-2.22), chronic obstructive pulmonary disease (COPD) and other allied conditions (aHR = 1.43; 95%CI, 1.00-2.06), and dyspnea and respiratory abnormalities (aHR = 1.29; 95%CI, 1.00-1.67); there was a suggestion of elevated risk for diseases classified as asthma and reactive airway diseases (aHR = 1.18; 95%CI, 0.98-1.41), including the specific condition, asthma (aHR = 1.35; 95%CI, 0.80-2.27), the symptom, shortness of breath (aHR = 1.50; 95%CI, 0.89-2.54), and the overall classification of chronic respiratory conditions (aHR = 1.18; 95%CI, 0.98-1.43). Exposure to both crude oil and dispersant was positively associated with elevated risk for shortness of breath (HR = 2.24; 95%CI, 1.09-4.64). CONCLUSIONS Among active duty Coast Guard personnel, oil spill clean-up exposures were associated with moderately increased risk for longer term respiratory conditions.
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Affiliation(s)
- Jennifer A Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Hristina Denic-Roberts
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Oak Ridge Institute for Science and Education, MD, USA
| | - Dana L Thomas
- United States Coast Guard Headquarters, Directorate of Health, Safety, and Work Life, Washington, D.C., USA
| | - Jacob Collen
- Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - John Barrett
- Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Kate Christenbury
- Social & Scientific Systems, a DLH Corporation Holding Company, Durham, NC, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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Berthelsen H, Owen M, Westerlund H. Does workplace social capital predict care quality through job satisfaction and stress at the clinic? A prospective study. BMC Public Health 2021; 21:1320. [PMID: 34225680 PMCID: PMC8259017 DOI: 10.1186/s12889-021-11320-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Welfare societies like Sweden face challenges in balancing the budget while meeting the demand for good quality healthcare. The aim of this study was to analyse whether care quality, operationalized as survival of dental fillings, is predicted by workplace social capital and if this effect is direct or indirect (through stress and/or job satisfaction among staff at the clinic), controlling for patient demographics. Methods The prospective design includes A) work environment data from surveys of 75 general public dental clinics (aggregated data based on 872 individual ratings), and B) register-based survival of 9381dental fillings performed during a 3-month period around the time of the survey, and C) patient demographics (age, gender, income level and birth place). Using a multi-level discrete-time proportional hazard model, we tested whether clinic-level social capital, stress, and job satisfaction could predict tooth-level filling failure, controlling for patient demographics. One direct and two indirect pathways, moderated by filling tooth, location, and filling type, were tested. Results High workplace social capital reduced the risk of early failure of fillings in molar teeth, mediated by group-perceived job satisfaction (indirect path: OR = 0.93, p < .05, direct path from job satisfaction: OR = 0.89, p < .05). Contrary to expectations, we found no support for a direct effect from social capital on care quality or for the indirect pathway via stress at the clinic level. Conclusions Workplace social capital boosted the quality of dental fillings through increased levels of job satisfaction. In addition, staff at clinics with higher social capital reported less stress and higher levels of job satisfaction. These results indicate that promotion of social capital may improve both occupational health and care quality.
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Affiliation(s)
- Hanne Berthelsen
- Centre for Work Life and Evaluation Studies (CTA) & Faculty of Odontology, Malmö University, Malmö, Sweden.
| | - Mikaela Owen
- Centre for Workplace Excellence, University of South Australia, Adelaide, SA, Australia
| | - Hugo Westerlund
- Department of Psychology, The Stress Research Institute, Stockholm University, Stockholm, Sweden
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Rodgers J, Cuevas AG, Williams DR, Kawachi I, Subramanian SV. The relative contributions of behavioral, biological, and psychological risk factors in the association between psychosocial stress and all-cause mortality among middle- and older-aged adults in the USA. GeroScience 2021; 43:655-672. [PMID: 33511488 PMCID: PMC8110664 DOI: 10.1007/s11357-020-00319-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022] Open
Abstract
Evidence of an association between psychosocial stress and mortality continues to accumulate. However, despite repeated calls in the literature for further examination into the physiological and behavioral pathways though which stress affects health and mortality, research on this topic remains limited. This study addresses this gap by employing a counterfactual-based mediation analysis of eight behavioral, biological, and psychological pathways often hypothesized to play a role in the association between stress and health. First, we calculated the survival rate of all-cause mortality associated with cumulative psychosocial stress (high vs. low/moderate) using random effects accelerated failure time models among a sample of 7108 adults from the Midlife in the United States panel study. Then, we conducted a multiple mediator mediation analysis utilizing a counterfactual regression framework to determine the relative contributions of each mediator and all mediators combined in the association between stress and mortality. Exposure to high psychosocial stress was associated with a 0.76 times reduced survival rate over the follow-up period 1995-2015, while adjusting for age, sex, race, income, education, baseline health, and study design effects. The mediators accounted for 49% of this association. In particular, smoking, sedentary behavior, obesity/BMI, and cardiovascular disease displayed significant indirect effects and accounted for the largest reductions in the total effect of stress on mortality, with natural indirect effects of 14%, 12%, 11%, and 4%, respectively. In conclusion, traditional behavioral and biological risk factors play a significant role in the association between psychosocial stress and mortality among middle and older adults in the US context. While eliminating stress and the socioeconomic disparities that so often deliver people into high-stress scenarios should be the ultimate goal, public health interventions addressing smoking cessation, physical activity promotion, and cardiovascular disease treatment may pay dividends for preventing premature mortality in the near-term.
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Affiliation(s)
- Justin Rodgers
- Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA, 02138, USA
| | - Adolfo G Cuevas
- Department of Community Health, Tufts University, Boston, MA, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Ichiro Kawachi
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S V Subramanian
- Harvard Center for Population and Development Studies, 9 Bow Street, Cambridge, MA, 02138, USA. .,Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Zhang J, Xu L, Sun L, Li J, Qin W. Gender difference in the association of frailty and health care utilization among Chinese older adults: results from a population-based study. Aging Clin Exp Res 2020; 32:1985-1991. [PMID: 31745830 DOI: 10.1007/s40520-019-01410-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 11/02/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Frailty is a public health concern in the ageing population. Little is known about the role of gender in the relationship between frailty and health care utilization in older adults. AIMS The study aims to examine gender differences in the association between different frailty status and health care utilization among Chinese older people. METHODS A total of 7070 older adults (60+) from Shandong Province, China, were enrolled in this study. Frailty was assessed by frailty index constructed using 45 health deficits. Multivariate logistic regression models were employed separately for men and women to examine the impact of frailty on self-care, outpatient, and inpatient utilization. RESULTS Overall, the prevalence of frailty was 7.9% in older adults, with 7.1% and 8.3% in men and women, respectively. 49.4% respondents reported they had self-care in the previous 2 weeks, and women were more likely to have self-care than men. Being pre-frail and frail was significantly associated with utilization of all types of health care among older men and women, and the relationship was stronger in the frail groups than that in the pre-frail groups except for self-care. Respective odds ratios for outpatient utilization were higher in men than that in women. CONCLUSIONS Frailty is a frequent condition in Chinese older adults. The association between frailty and health care utilization (except outpatient) tended to be stronger in women than men. The gender differences should be considered when designing the preventing or delaying the installation of frailty and geriatric care plans.
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Affiliation(s)
- Jiao Zhang
- School of Public Health, Shandong University, Jinan, 250012, China
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China
| | - Lingzhong Xu
- School of Public Health, Shandong University, Jinan, 250012, China.
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China.
| | - Long Sun
- School of Public Health, Shandong University, Jinan, 250012, China
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Jiajia Li
- School of Public Health, Shandong University, Jinan, 250012, China
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China
| | - Wenzhe Qin
- School of Public Health, Shandong University, Jinan, 250012, China
- NHC, Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
- Shandong University Center for Health Economics Experiment and Public Policy Research, Jinan, 250012, China
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Amor-Carro Ó, White KM, Fraga-Iriso R, Mariñas-Pardo LA, Núñez-Naveira L, Lema-Costa B, Villarnovo M, Verea-Hernando H, Ramos-Barbón D. Airway Hyperresponsiveness, Inflammation, and Pulmonary Emphysema in Rodent Models Designed to Mimic Exposure to Fuel Oil-Derived Volatile Organic Compounds Encountered during an Experimental Oil Spill. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:27003. [PMID: 32074461 PMCID: PMC7064321 DOI: 10.1289/ehp4178] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Fuel oil-derived volatile organic compounds (VOCs) inhalation is associated with accidental marine spills. After the Prestige petroleum tanker sank off northern Spain in 2002 and the Deepwater Horizon oil rig catastrophe in 2009, subjects involved in environmental decontamination showed signs of ongoing or residual lung disease up to 5 y after the exposure. OBJECTIVES We aimed at investigating mechanisms driving persistent respiratory disease by developing an animal model of inhalational exposure to fuel oil-derived VOCs. METHODS Female Wistar and Brown Norway (BN) rats and C57BL mice were exposed to VOCs produced from fuel oil mimicking the Prestige spill. Exposed animals inhaled the VOCs 2 h daily, 5 d per week, for 3 wk. Airway responsiveness to methacholine (MCh) was assessed, and bronchoalveolar lavage (BAL) and lung tissues were analyzed after the exposure and following a 2-wk washout. RESULTS Consistent with data from human studies, both strains of rats that inhaled fuel oil-derived VOCs developed airway hyperresponsiveness that persisted after the washout period, in the absence of detectable inflammation in any lung compartment. Histopathology and quantitative morphology revealed the development of peripherally distributed pulmonary emphysema, which persisted after the washout period, associated with increased alveolar septal cell apoptosis, microvascular endothelial damage of the lung parenchyma, and inhibited expression of vascular endothelial growth factor (VEGF). DISCUSSION In this rat model, fuel oil VOCs inhalation elicited alveolar septal cell apoptosis, likely due to DNA damage. In turn, the development of a peculiar pulmonary emphysema pattern altered lung mechanics and caused persistent noninflammatory airway hyperresponsiveness. Such findings suggest to us that humans might also respond to VOCs through physiopathological pathways different from those chiefly involved in typical cigarette smoke-driven emphysema in chronic obstructive pulmonary disease (COPD). If so, this study could form the basis for a novel disease mechanism for lasting respiratory disease following inhalational exposure to catastrophic fuel oil spills. https://doi.org/10.1289/EHP4178.
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Affiliation(s)
- Óscar Amor-Carro
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
- Respiratory Department, Hospital de la Santa Creu i Sant Pau and the Biomedical Research Institute (IIb Sant Pau), Barcelona, Spain
| | - Kathryn M. White
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Rebeca Fraga-Iriso
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
- Respiratory Department, Hospital de la Santa Creu i Sant Pau and the Biomedical Research Institute (IIb Sant Pau), Barcelona, Spain
| | - Luis A. Mariñas-Pardo
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Laura Núñez-Naveira
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Beatriz Lema-Costa
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Marta Villarnovo
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - Héctor Verea-Hernando
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
| | - David Ramos-Barbón
- Respiratory Research Unit, Complexo Hospitalario Universitario and the Instituto de Investigación Biomédica de A Coruña, A Coruña, Spain
- Respiratory Department, Hospital de la Santa Creu i Sant Pau and the Biomedical Research Institute (IIb Sant Pau), Barcelona, Spain
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Khadka P, Thapaliya J, Basnet RB, Ghimire GR, Amatya J, Rijal BP. Diagnosis of tuberculosis from smear-negative presumptive TB cases using Xpert MTB/Rif assay: a cross-sectional study from Nepal. BMC Infect Dis 2019; 19:1090. [PMID: 31888522 PMCID: PMC6937953 DOI: 10.1186/s12879-019-4728-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 12/23/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In most developing countries, smear-negative pulmonary TB (SNPT) often gets missed from the diagnosis of consideration, though it accounts 30-65% of total PTB cases, due to deficient or inaccessible molecular diagnostic modalities. METHODS The cross-sectional study enrolled 360 patients with clinical-radiological suspicion of SNPT in Tribhuvan University Teaching Hospital (TUTH). The patient selection was done as per the algorithm of Nepal's National Tuberculosis Program (NTP) for Xpert MTB/RIF testing. Participants' demographic and clinical information were collected using a pre-tested questionnaire. The specimens were collected, processed directly for Xpert MTB/RIF test according to the manufacturer's protocol. The same samples were stained using the Ziehl-Neelsen technique then observed microscopically. Both findings were interpreted; rifampicin-resistant, if obtained, on Xpert testing was confirmed with a Line Probe Assay. RESULT Of 360 smear-negative sputum samples analyzed, 85(23.61%) found positive while 3(0.8%) of them were rifampicin resistance. The infection was higher in males, i.e. 60(25.3%) compared to female 25(20.3%). The age group, > 45(nearly 33%) with median age 42 ± 21.5, were prone to the infection. During the study period, 4.6% (515/11048) sputum samples were reported as smear-positive in TUTH. Consequently, with Xpert MTB/RIF assay, the additional case 16.5% (n = 85/515) from smear-negative presumptive TB cases were detected. Among the most occurring clinical presentations, cough and chest pain were positively associated with SNPT. While upper lobe infiltrates (36.4%) and pleural effusion (40.4%) were the most peculiar radiological impression noted in PTB patient. 94 multi-drug resistant(MDR) suspected cases were enrolled; of total suspects, 29(30.8%) samples were rifampicin sensitive, 1(1.06%) indeterminate, 3(3.19%) rifampicin-resistant while remaining of them were negative. 2(2.2%) MDR cases were recovered from the patient with a previous history of ATT, of total 89 previously treated cases enrolled However, a single rifampicin-resistant from the new suspects. CONCLUSION With an application of the assay, the additional cases, missed with smear microscopy, could be sought and exact incidence of the diseases could be revealed.
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Affiliation(s)
- Priyatam Khadka
- Medical Microbiology, Tri-Chandra Multiple Campus, Kathmandu, Nepal. .,Tribhuvan University Teaching Hospital, Kathmandu, Nepal.
| | - Januka Thapaliya
- Medical Microbiology, Tri-Chandra Multiple Campus, Kathmandu, Nepal
| | | | | | - Jyoti Amatya
- Medical Microbiology, Tri-Chandra Multiple Campus, Kathmandu, Nepal
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Krishnamurthy J, Engel LS, Wang L, Schwartz EG, Christenbury K, Kondrup B, Barrett J, Rusiecki JA. Neurological symptoms associated with oil spill response exposures: Results from the Deepwater Horizon Oil Spill Coast Guard Cohort Study. ENVIRONMENT INTERNATIONAL 2019; 131:104963. [PMID: 31382236 PMCID: PMC6786260 DOI: 10.1016/j.envint.2019.104963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 06/21/2019] [Accepted: 06/24/2019] [Indexed: 05/23/2023]
Abstract
INTRODUCTION The Deepwater Horizon (DWH) oil spill was the largest marine oil spill in U.S. history, involving the response of tens of thousands clean-up workers. Over 8500 United States Coast Guard personnel were deployed in response to the spill. Little is understood about the acute neurological effects of oil spill clean-up-related exposures. Given the large number of people involved in large oil spill clean-ups, study of these effects is warranted. METHODS We utilized exposure, health, and lifestyle data from a post-deployment survey administered to Coast Guard responders to the DWH oil spill. Crude oil exposure was assessed via self-reported inhalation and skin contact metrics, categorized by frequency of self-reported exposure to crude oil during deployment (never, rarely, sometimes, most/all of the time). Combined exposure to crude oil and oil dispersant was also evaluated. Adjusted log binomial regressions were used to calculate prevalence ratios (PRs) and 95% confidence intervals (CI), investigating the associations between oil spill exposures and neurological symptoms during deployment. Stratified analyses investigated potential effect modification by sex, exhaust fume exposure, personal protective equipment (PPE) use, and deployment duration and timing. RESULTS Increasing frequency of crude oil exposure via inhalation was associated with increased likelihood of headaches (PRmost/all vs. never = 1.80), lightheadedness (PRmost/all vs. never = 3.36), difficulty concentrating (PRmost/all vs. never = 1.72), numbness/tingling sensation (PRmost/all vs. never = 3.32), blurred vision (PRmost/all vs. never = 2.87), and memory loss/confusion (PRmost/all vs. never = 2.03), with significant tests for trend. Similar results were found for crude oil exposure via skin contact. Exposure to both oil and oil dispersants yielded associations that were appreciably greater in magnitude than for oil alone for all neurological symptoms. Sensitivity analyses excluding responders in the highest environmental heat categories and responders with relevant pre-existing conditions indicated robustness of these results. Stratified analyses indicated possible effect modification by sex, PPE use, and heat exposure. CONCLUSIONS This study provides evidence of a cross sectional association between crude oil exposures and acute neurological symptoms in a sample of U.S. Coast Guard responders. Additionally, it suggests that exposure to both crude oil and oil dispersant may result in stronger associations and that heat may interact synergistically with oil exposures resulting in more acute neurological symptoms. Future investigations are needed to confirm these findings.
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Affiliation(s)
- Jayasree Krishnamurthy
- Department of Pediatrics, Uniformed Services University, Bethesda, MD, United States of America
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States of America
| | - Li Wang
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, United States of America
| | - Erica G Schwartz
- United States Coast Guard, Directorate of Health, Safety, and Work Life, Washington, DC, United States of America
| | | | - Benjamin Kondrup
- United States Naval Academy, Annapolis, MD, United States of America
| | - John Barrett
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, United States of America
| | - Jennifer A Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, United States of America.
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Beck B, Teague W, Cameron P, Gabbe BJ. Causes and characteristics of injury in paediatric major trauma and trends over time. Arch Dis Child 2019; 104:256-261. [PMID: 30279158 DOI: 10.1136/archdischild-2018-315565] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 08/31/2018] [Accepted: 09/03/2018] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To investigate causes, characteristics and temporal trends of paediatric major trauma. DESIGN A retrospective review of paediatric major trauma (<16 years of age) was conducted using data from the population-based Victorian State Trauma Registry from 2006 to 2016. Temporal trends in population-based incidence rates were evaluated using Poisson regression. SETTING Victoria, Australia. RESULTS Of the 1511 paediatric major trauma patients, most were male (68%), had sustained blunt trauma (87%) and had injuries resulting from unintentional events (91%). Motor vehicle collisions (15%), struck by/collisions with an object or person (14%) and low falls (13%) were the leading mechanisms of injury. Compared with those aged 1-15 years, a greater proportion of non-accidental injury events were observed in infants (<1 year) (32%). For all patients, isolated head injury (29%), other/multitrauma (27%) and head and other injuries (24%) were the most prevalent injury groups. The incidence of paediatric major trauma did not change over the study period (incidence rate ratio (IRR)=0.97; 95% CI 0.92 to 1.02; p=0.27), which was consistent in all age groups. There was a 3% per year decline in the incidence of transport events (IRR=0.97; 95% CI 0.94 to 0.99; p=0.005), but no change in the incidence of falls of any type (IRR=1.01; 95% CI 0.97 to 1.04; p=0.70) or other events (IRR=1.00; 95% CI 0.97 to 1.02; p=0.79). The overall in-hospital mortality rate was 7.2%. CONCLUSIONS This study demonstrated no change in the incidence of paediatric major trauma over an 11-year period. Given the potential lifelong impacts of serious injury in children, additional investment and coordination of injury prevention activities are required.
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Affiliation(s)
- Ben Beck
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Warwick Teague
- Trauma Service, The Royal Children's Hospital, Melbourne, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.,Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Peter Cameron
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Belinda J Gabbe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Farr Institute, Swansea University Medical School, Swansea University, Swansea, UK
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Corum M, Basoglu C, Yakal S, Sahinkaya T, Aksoy C. Effects of whole body vibration training on isokinetic muscular performance, pain, function, and quality of life in female patients with patellofemoral pain: a randomized controlled trial. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2018; 18:473-484. [PMID: 30511951 PMCID: PMC6313045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To investigate the effects of whole body vibration (WBV) training on isokinetic muscular performance, pain, function, and quality of life in patients with patellofemoral pain (PFP). METHODS Forty women with PFP were included in this study and assigned to either a WBV group that received WBV training plus home exercise or a control group that performed home exercise only. A supervised WBV training was performed in 24 sessions on a synchronous vertical vibration platform three times a week for eight weeks. The home exercise program in the control group was identical to that in the WBV group. Isokinetic measurements were performed at baseline and post-treatment. In addition, patients were assessed after 6 months using a visual analog scale (VAS), Kujala Patellofemoral Score (KPS), and Short Form-36 (SF-36). RESULTS Total work of knee extensors and VAS improved significantly post-treatment in the WBV group compared to the control group (P=0.041, P=0.003, respectively). However, there was no significant difference between groups at the 6-month follow-up (P>0.05). CONCLUSIONS The present findings recommended that eight weeks of WBV training plus home exercise can more effectively reduce pain and improve the endurance of the knee extensors than that of home exercise of patient with PFP.
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Affiliation(s)
- Mustafa Corum
- Physical Medicine and Rehabilitation Clinic, Kahta State Hospital, Kahta, Adıyaman, Turkey,Corresponding author: Mustafa Corum, Physical Medicine and Rehabilitation Clinic, Kahta State Hospital, Yavuz Selim Mah. Kahta, 02400 Adıyaman, Turkey E-mail:
| | - Ceyhun Basoglu
- Physical Medicine and Rehabilitation Clinic, Istanbul Kanuni Sultan Suleyman Training and Research Hospital, Kucukcekmece, Istanbul, Turkey
| | - Sertac Yakal
- Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
| | - Turker Sahinkaya
- Department of Sports Medicine, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
| | - Cihan Aksoy
- Department of Physical Medicine and Rehabilitation, Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul, Turkey
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Middleton N, Andreou P, Karanikola M, Kouta C, Kolokotroni O, Papastavrou E. Investigation into the metric properties of the workplace social capital questionnaire and its association with self-rated health and psychological distress amongst Greek-Cypriot registered nurses: cross-sectional descriptive study. BMC Public Health 2018; 18:1061. [PMID: 30139337 PMCID: PMC6108116 DOI: 10.1186/s12889-018-5959-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 08/13/2018] [Indexed: 11/29/2022] Open
Abstract
Background Social capital can been described as an individual or a collective attribute, with structural and cognitive components, and a bonding, bridging and linking typology. While extensively studied in the community, studies in occupational settings are sparse by comparison. Furthermore, there is no uniformity in its measurement. This study investigated the construct validity of a Workplace Social Capital questionnaire (WSC), originally developed in the Finnish Public Sector occupational cohort, in a different socio-cultural setting (Cyprus), language (Greek) and occupational group (Registered Nurses). It also explored its criterion concurrent validity according to observed association with self-rated health and psychological distress. Methods Participants were 10% of all registered nurses (N = 362) who responded to the 8-item WSC scale during a nationwide educational programme. A unidimensional model was compared with the postulated two-factor (structural vs cognitive) and three-factor model (bonding, bridging, linking) in Confirmatory Factor Analyses. The association with self-rated health (0–100 Visual Analogue Scale) and mental distress (GHQ-12 ≥ 4) was assessed in linear and logistic regression models. Results A bonding (Cronbach’s a = 0.76), bridging (a = 0.78) and linking (a = 0.89) structure explained 77.6% of the variance and was a better fit as indicated by goodness of fit indices. Elevated odds of mental distress and poorer self-rated health were observed among participants with the lowest levels of perceived workplace social capital. In adjusted models, associations appeared stronger with bonding social capital (adjOR of mental distress = 2.71 95% CI = 1.08, 6.79) while those with the highest scores rated their health higher by 8.0 points on average (95% CI = 2.1, 13.8). Low linking social capital was also associated with poorer health but no consistent associations were observed with bridging. Conclusion While associations appeared stronger with bonding and linking, this may reflect a weakness of the measure to fully capture bridging social capital. Even though, this aspect might need strengthening, the WSC showed good metric properties in a different setting, language and occupational group. Cross-national and cognitive validation studies are needed.
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Affiliation(s)
- Nicos Middleton
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15 Vragadinou Str, 3041, Limassol, Cyprus.
| | - Panayiota Andreou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15 Vragadinou Str, 3041, Limassol, Cyprus
| | - Maria Karanikola
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15 Vragadinou Str, 3041, Limassol, Cyprus
| | - Christiana Kouta
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15 Vragadinou Str, 3041, Limassol, Cyprus
| | - Ourania Kolokotroni
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15 Vragadinou Str, 3041, Limassol, Cyprus.,St George University of London Medical School at the University of Nicosia, Nicosia, Cyprus
| | - Evridiki Papastavrou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, 15 Vragadinou Str, 3041, Limassol, Cyprus
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Capturing complexity in clinician case-mix: classification system development using GP and physician associate data. BJGP Open 2018; 2:bjgpopen18X101277. [PMID: 30564699 PMCID: PMC6181080 DOI: 10.3399/bjgpopen18x101277] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 08/14/2017] [Indexed: 01/10/2023] Open
Abstract
Background There are limited case-mix classification systems for primary care settings which are applicable when considering the optimal clinical skill mix to provide services. Aim To develop a case-mix classification system (CMCS) and test its impact on analyses of patient outcomes by clinician type, using example data from physician associates' (PAs) and GPs' consultations with same-day appointment patients. Design & setting Secondary analysis of controlled observational data from six general practices employing PAs and six matched practices not employing PAs in England. Method Routinely-collected patient consultation records (PA n = 932, GP n = 1154) were used to design the CMCS (combining problem codes, disease register data, and free text); to describe the case-mix; and to assess impact of statistical adjustment for the CMCS on comparison of outcomes of consultations with PAs and with GPs. Results A CMCS was developed by extending a system that only classified 18.6% (213/1147) of the presenting problems in this study's data. The CMCS differentiated the presenting patient's level of need or complexity as: acute, chronic, minor problem or symptom, prevention, or process of care, applied hierarchically. Combination of patient and consultation-level measures resulted in a higher classification of acuity and complexity for 639 (30.6%) of patient cases in this sample than if using consultation level alone. The CMCS was a key adjustment in modelling the study's main outcome measure, that is rate of repeat consultation. Conclusion This CMCS assisted in classifying the differences in case-mix between professions, thereby allowing fairer assessment of the potential for role substitution and task shifting in primary care, but it requires further validation.
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Alexander M, Engel LS, Olaiya N, Wang L, Barrett J, Weems L, Schwartz EG, Rusiecki JA. The deepwater horizon oil spill coast guard cohort study: A cross-sectional study of acute respiratory health symptoms. ENVIRONMENTAL RESEARCH 2018; 162:196-202. [PMID: 29331799 PMCID: PMC5811337 DOI: 10.1016/j.envres.2017.11.044] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 11/22/2017] [Accepted: 11/27/2017] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Over 8500 United States Coast Guard (USCG) personnel were deployed in response to the Deepwater Horizon (DWH) oil spill; however, human respiratory effects as a result of spill-related exposures are relatively unknown. METHODS USCG personnel who responded to the DWH oil spill were queried via survey on exposures to crude oil and oil dispersant, and acute respiratory symptoms experienced during deployment. Adjusted log binomial regressions were used to calculate prevalence ratios (PRs) and 95% confidence intervals (CI), investigating the associations between oil spill exposures and respiratory symptoms. RESULTS 4855 USCG personnel completed the survey. More than half (54.6%) and almost one-fourth (22.0%) of responders were exposed to crude oil and oil dispersants, respectively. Coughing was the most prevalent symptom (19.4%), followed by shortness of breath (5.5%), and wheezing (3.6%). Adjusted analyses showed an exposure-response relationship between increasing deployment duration and likelihood of coughing, shortness of breath, and wheezing in the pre-capping period. A similar pattern was observed in the post-capping period for coughing and wheezing. Adjusted analyses revealed increased PRs for coughing (PR=1.92), shortness of breath (PR=2.60), and wheezing (PR=2.68) for any oil exposure. Increasing frequency of inhalation of oil was associated with increased likelihood of all three respiratory symptoms. A similar pattern was observed for contact with oil dispersants for coughing and shortness of breath. The combination of both oil and oil dispersants presented associations that were much greater in magnitude than oil alone for coughing (PR=2.72), shortness of breath (PR=4.65), and wheezing (PR=5.06). CONCLUSIONS Results from the present study suggested strong relationships between oil and oil dispersant exposures and acute respiratory symptoms among disaster responders. Future prospective studies will be needed to confirm these findings.
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Affiliation(s)
- Melannie Alexander
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, United States
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States
| | - Nathan Olaiya
- United States Naval Academy, Annapolis, MD, United States
| | - Li Wang
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, United States
| | - John Barrett
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, United States
| | - Laura Weems
- United States Army Corps of Engineers, Safety and Occupational Health Office, Little Rock, AR, United States
| | - Erica G Schwartz
- United States Coast Guard, Directorate of Health, Safety, and Work Life, Washington, DC, United States
| | - Jennifer A Rusiecki
- Department of Preventive Medicine and Biostatistics, Uniformed Services University, Bethesda, MD, United States
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Lei Y, Zhang K, Xiao X, Tang C, Li X, Wang H. Sexual Roles, Risk Sexual Behaviours, and HIV Prevalence among Men who Have Sex with Men Seeking HIV Testing in Changsha, China. Curr HIV Res 2018; 16:174-181. [PMID: 29992887 PMCID: PMC6182933 DOI: 10.2174/1570162x16666180711101643] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 05/11/2018] [Accepted: 07/02/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND HIV infection is prevalent among men who have sex with men (MSM), and sexual roles may be important factors related to it. This study aims to describe the sexual roles, risky sexual behaviors and HIV prevalence among MSM, and to determine associated factors for HIV prevalence. METHODS A convenient sampling method was used to recruit participants in a non-government organization in Changsha, China. The participants were asked to complete a 38-item self-administered questionnaire regarding demographic characteristics and risky sexual behaviours before collecting blood samples for HIV testing. Chi-square tests and logistic regression analysis were conducted with the Statistical Package for the Social Sciences Version 18.0 and other indexes were statistically described. RESULTS A total of 601 MSMs who came to a local non-government organization for voluntary counseling and testing completed a pencil-and-paper survey and were tested for HIV. The overall HIV prevalence of this sample was 13.3%, and that of the bottoms (16.3%) was similar to the versatiles (15.9%) but higher than the tops (6.1%). Bivariate analyses showed that there were significant differences in age, marital status, monthly income, sexual orientation, age at first sex, sex of the first sex partner, sex with a woman in the last 6 months, oral sex with a man in the last 6 months and role of oral sex among 3 subgroups of MSM (p < 0.05). Multivariate analyses indicated that MSMs who played the role of either the bottoms or the versatiles were more likely to be HIV positive than the tops. While MSMs who used condoms in anal sex in the last 6 months, had sex with a woman in the last 6 months or had oral sex with a man in the last 6 months were less likely to be HIV positive. CONCLUSION Different sexual roles are associated with high-risk sexual behaviors among MSMs and their HIV infection status. Further research should target preventive interventions, and improve the effectiveness of the intervention according to the characteristics of the subgroups to reduce the HIV transmission among Chinese MSM.
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Affiliation(s)
| | | | | | | | | | - Honghong Wang
- Address correspondence to this author at Xiangya School of Nursing of Central South University, 172 Tong Zi Po Road, Changsha 410013, Hunan, China; Tel: 86-731-82650270; Fax: 86-731-82650266; E-mail:
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Hussain A, Zaheer S, Shafique K. Individual, social and environmental determinants of smokeless tobacco and betel quid use amongst adolescents of Karachi: a school-based cross-sectional survey. BMC Public Health 2017; 17:913. [PMID: 29183302 PMCID: PMC5706393 DOI: 10.1186/s12889-017-4916-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 11/15/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND With 600 million people using betel quid (BQ) globally, and smokeless tobacco (SLT) use being more wide-spread; the duo is an uphill public health concern in South Asian countries. SLT and/or BQ use increases the risk for morbidity and mortality from oral cancer. Because SLT and/or BQ use is initiated during adolescence, it renders this group more vulnerable; and particular attention is needed to curb SLT and/or BQ use to reduce related disease burden. We aimed to observe the differential individual, social and environmental features amongst SLT and/or BQ users to determine the key influencers of its use in adolescents. METHODS This study was a cross-sectional survey of 2140 adolescents from secondary schools of Karachi, Pakistan. The main outcome measure was SLT and/or BQ use based on their consumption in the past 30 days. Univariate and multivariate regression binary logistic analyses were employed while reporting results in both crude form and adjusted odds ratio (after adjusting for all remaining individual, social and environmental level variables) with 95% confidence level. A p-value of < .05 was considered significant for all analyses. RESULTS The overall prevalence of SLT and/or BQ use was 42.6% (n = 912) of the total sample. The SLT and/or BQ consumer group had more males than females. A significant proportion of user (n = 558, 61.2%) was found in co-education schools. Students whose peers (OR = 6.79, 95% CI 4.67-9.87, p-value <0.001) and/or either of the parents (OR = 2.16, 95% CI 1.73-2.65, p-value <0.001) used SLT and/or BQ, alongside, adolescents who had not attended knowledge based sessions in schools regarding harmful effects of SLT and/or BQ were more likely to consume it. It's availability with outside school hawkers increased the odds of its use by 6 times, as indicated by both univariate and multivariate models after adjusting for the remaining variables. CONCLUSION In conclusion, students studying in co-education, parents and peers use, lack of knowledge based sessions on harmful health effects of SLT and/or BQ, and easy availability of the product from hawkers outside school all contribute towards enhanced risk of SLT and/or BQ use in adolescents.
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Affiliation(s)
- Azmina Hussain
- Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, OJHA Campus, Suparco Road, Gulzar-e-Hijri, Scheme, Karachi, 33 Pakistan
| | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, OJHA Campus, SUPARCO road, Gulzar e Hijri, Karachi, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, OJHA Campus, SUPARCO road, Gulzar e Hijri, Karachi, Pakistan
- Institute of Health and Wellbeing, Public Health, University of Glasgow, 1-Lilybank Gardens, G12 8RZ, Glasgow, UK
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Rusiecki J, Alexander M, Schwartz EG, Wang L, Weems L, Barrett J, Christenbury K, Johndrow D, Funk RH, Engel LS. The Deepwater Horizon Oil Spill Coast Guard Cohort study. Occup Environ Med 2017; 75:165-175. [PMID: 28899964 DOI: 10.1136/oemed-2017-104343] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Revised: 06/08/2017] [Accepted: 06/22/2017] [Indexed: 01/29/2023]
Abstract
OBJECTIVES Long-term studies of oil spill responders are urgently needed as oil spills continue to occur. To this end, we established the prospective Deepwater Horizon (DWH) Oil Spill Coast Guard Cohort study. METHODS DWH oil spill responders (n=8696) and non-responders (n=44 823) who were members of the US Coast Guard (20 April-17 December 2010) were included. This cohort uses both prospective, objective health data from military medical encounters and cross-sectional survey data. Here, we describe the cohort, present adjusted prevalence ratios (PRs) estimating cross-sectional associations between crude oil exposure (none, low/medium, high) and acute physical symptoms, and present adjusted relative risks (RRs) based on longitudinal medical encounter data (2010-2012) for responders/non-responders and responders exposed/not exposed to crude oil. RESULTS Responders and non-responders in this large cohort (n=53 519) have similar characteristics. Crude oil exposure was reported by >50% of responders. We found statistically significant associations for crude oil exposure with coughing (PRhigh=1.78), shortness of breath (PRhigh=2.30), wheezing (PRhigh=2.32), headaches (PRhigh=1.46), light-headedness/dizziness (PRhigh=1.96), skin rash/itching (PRhigh=1.87), diarrhoea (PRhigh=1.76), stomach pain (PRhigh=1.67), nausea/vomiting (PRhigh=1.48) and painful/burning urination (PRhigh=2.89) during deployment. Longitudinal analyses revealed that responders had elevated RRs for dermal conditions (RR=1.09), as did oil-exposed responders for chronic respiratory conditions (RR=1.32), asthma (RR=1.83) and dermal conditions (RR=1.21). CONCLUSIONS We found positive associations between crude oil exposure and various acute physical symptoms among responders, as well as longer term health effects. This cohort is well positioned to evaluate both short-term and long-term effects of oil spill exposures using both self-reported and clinical health data.
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Affiliation(s)
- Jennifer Rusiecki
- Department of Preventive Medicine and Biostatistics, F Edward Hebert School of Medicine, Uniformed Services University, Bethesda, USA
| | - Melannie Alexander
- Department of Preventive Medicine and Biostatistics, F Edward Hebert School of Medicine, Uniformed Services University, Bethesda, USA
| | - Erica G Schwartz
- Coast Guard, Directorate of Health, Safety and Work Life, Washington, USA
| | - Li Wang
- Department of Preventive Medicine and Biostatistics, F Edward Hebert School of Medicine, Uniformed Services University, Bethesda, USA
| | - Laura Weems
- United States Army Corps of Engineers, Safety and Occupational Health Office, Little Rock, USA
| | - John Barrett
- Department of Preventive Medicine and Biostatistics, F Edward Hebert School of Medicine, Uniformed Services University, Bethesda, USA
| | | | - David Johndrow
- Social & Scientific Systems, Durham, USA.,RTI International, Research Triangle Park, Durham, USA
| | - Renée H Funk
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Atlanta, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
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Puljević C, de Andrade D, Carroll M, Spittal MJ, Kinner SA. Use of prescribed smoking cessation pharmacotherapy following release from prison: a prospective data linkage study. Tob Control 2017; 27:474-478. [PMID: 28848000 DOI: 10.1136/tobaccocontrol-2017-053743] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 11/03/2022]
Abstract
BACKGROUND A significant proportion of people who cycle through prisons express a desire to quit smoking, yet smoking rates in this population are two to four times higher than in the general community. Smoking cessation pharmacotherapy (SCP) is an important component of evidence-based cessation support, yet no studies have examined use of this pharmacotherapy after release from prison. METHODS We linked data from a survey of 971 smokers who were within 8 weeks of release from prison in Queensland, Australia, with federal Pharmaceutical Benefits Scheme (PBS) records for the 2 years after release, to identify subsidised use of SCP (varenicline, bupropion and nicotine patches). We used Cox proportional hazards regression to identify independent predictors of SCP use. FINDINGS According to PBS data, 86 participants (8.9%) accessed SCP in the 2 years following release from prison. Participants who were aged 25 years or older (HR 2.51, 95% CI 1.19 to 5.31), employed before prison (HR 1.93, 95% CI 1.14 to 3.28), highly nicotine dependent at baseline (HR 2.21, 95% CI 1.23 to 3.97) and using non-psychotropic medications in prison (HR 2.29, 95% CI 1.24 to 4.22) were more likely to use subsidised SCP during follow-up. CONCLUSION Despite a very high rate of tobacco use among people cycling through prisons and the very low cost of (subsidised) SCP in Australia, few ex-prisoners obtain pharmaceutical assistance with quitting smoking. Policy attention needs to focus on supporting former prisoners to access SCP, to reduce the high rate of tobacco-related morbidity and mortality in this profoundly marginalised population.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Centre for Youth Substance Abuse Research, School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Megan Carroll
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Matthew J Spittal
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Sydney, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Australia.,Mater Research Institute-UQ, University of Queensland, Queensland, Australia
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Harville EW, Shankar A, Zilversmit L, Buekens P. Self-Reported Oil Spill Exposure and Pregnancy Complications: The GROWH Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070692. [PMID: 28654004 PMCID: PMC5551130 DOI: 10.3390/ijerph14070692] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 06/15/2017] [Accepted: 06/22/2017] [Indexed: 12/30/2022]
Abstract
Adverse infant outcomes often rise in the aftermath of disaster, but few studies have assessed the effects of disaster on maternal health. 1091 southern Louisiana women were interviewed about their pregnancy history, including pregnancy complications. Associations between oil spill exposures and gestational diabetes, hypertensive disorders, and nausea/vomiting were assessed for all reported pregnancies. 631 women had a pregnancy both before and after the oil spill. Generalized estimating equations (logistic regression) with adjustment for confounders were used. To assess possible unmeasured confounding, instead of considering oil spill exposure as a time-varying exposure, women were defined as oil spill-exposed or not. If oil spill-exposed women were equally prone to complications in pregnancies that occurred prior to the oil spill as after it, it was considered that any associations were likely due to selection or reporting issues. Women who reported oil spill exposure, particularly loss of use of the coast, were more likely to report gestational diabetes; however, the level of association was similar for pregnancies before and after the spill (p for interaction >0.10 and odds ratios (ORs) for pregnancies prior to the spill > than those after the spill). No associations were found between oil spill exposure and hypertensive disorders. This analysis does not suggest an increased risk of pregnancy complications associated with exposure to the oil spill; however, future studies should assess exposure and outcomes prospectively and clinically instead of relying on self-report.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, 1440 Canal St. Ste. 2000 #8318, New Orleans, LA 70112-2715, USA.
| | - Arti Shankar
- Department of Global Biostatistics and Data Science, Tulane School of Public Health and Tropical Medicine, New Orleans, LA 70112-2715, USA.
| | - Leah Zilversmit
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, 1440 Canal St. Ste. 2000 #8318, New Orleans, LA 70112-2715, USA.
| | - Pierre Buekens
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, 1440 Canal St. Ste. 2000 #8318, New Orleans, LA 70112-2715, USA.
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Heo GE, Kang KY, Song M, Lee JH. Analyzing the field of bioinformatics with the multi-faceted topic modeling technique. BMC Bioinformatics 2017; 18:251. [PMID: 28617229 PMCID: PMC5471940 DOI: 10.1186/s12859-017-1640-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Bioinformatics is an interdisciplinary field at the intersection of molecular biology and computing technology. To characterize the field as convergent domain, researchers have used bibliometrics, augmented with text-mining techniques for content analysis. In previous studies, Latent Dirichlet Allocation (LDA) was the most representative topic modeling technique for identifying topic structure of subject areas. However, as opposed to revealing the topic structure in relation to metadata such as authors, publication date, and journals, LDA only displays the simple topic structure. METHODS In this paper, we adopt the Tang et al.'s Author-Conference-Topic (ACT) model to study the field of bioinformatics from the perspective of keyphrases, authors, and journals. The ACT model is capable of incorporating the paper, author, and conference into the topic distribution simultaneously. To obtain more meaningful results, we use journals and keyphrases instead of conferences and bag-of-words.. For analysis, we use PubMed to collected forty-six bioinformatics journals from the MEDLINE database. We conducted time series topic analysis over four periods from 1996 to 2015 to further examine the interdisciplinary nature of bioinformatics. RESULTS We analyze the ACT Model results in each period. Additionally, for further integrated analysis, we conduct a time series analysis among the top-ranked keyphrases, journals, and authors according to their frequency. We also examine the patterns in the top journals by simultaneously identifying the topical probability in each period, as well as the top authors and keyphrases. The results indicate that in recent years diversified topics have become more prevalent and convergent topics have become more clearly represented. CONCLUSION The results of our analysis implies that overtime the field of bioinformatics becomes more interdisciplinary where there is a steady increase in peripheral fields such as conceptual, mathematical, and system biology. These results are confirmed by integrated analysis of topic distribution as well as top ranked keyphrases, authors, and journals.
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Affiliation(s)
- Go Eun Heo
- Department of Library and Information Science, Yonsei University, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Keun Young Kang
- Department of Library and Information Science, Yonsei University, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Min Song
- Department of Library and Information Science, Yonsei University, 50 Yonsei-ro Seodaemun-gu, Seoul, 03722 Republic of Korea
| | - Jeong-Hoon Lee
- Department of Creative IT Engineering, POSTECH, 77 Cheongam-ro Nam-gu, Pohang, Gyeongbuk 37673 Republic of Korea
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Primary care knowledge and beliefs about physical activity and health: a survey of primary healthcare team members. BJGP Open 2017; 1:bjgpopen17X100809. [PMID: 30564660 PMCID: PMC6169952 DOI: 10.3399/bjgpopen17x100809] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Physical activity has numerous health benefits and the primary healthcare team are ideally suited to promote activity. The Royal College of General Practitioners (RCGP) has announced physical activity to be a clinical priority in the next few years. However little attention is given to this in medical training, with unclear levels of knowledge and confidence. Aim To explore the primary healthcare team knowledge of the benefits of physical activity in preventing and treating ill health. Design & setting Questionnaire-based study, from six East Midlands sites in the UK. Method Self-completed anonymised questionnaire. Results Three hundred and two results were obtained in total, from 166 GPs, 65 GP registrars, and 71 practice nurses. There was a mean age of 44.8 years (range 22–71), with 62% female responders. Fifty-five per cent of responders underestimated UK recommended activity guidance. Responders considered activity promotion as part of their professional role, but this was discussed about one-third as often as other health promotion behaviours, such as weight or smoking. Barriers reported were lack of time (91.2%) and resources (36.8%). Conclusion This study has shown reasonable knowledge of recommended levels of activity and accrued health, but most underestimated UK guidance, suggest inadequate levels of activity for optimal health may be being recommended. Confidence in this area is lower in GP registrars than GPs which may mirror other health problems. There was a poor recognition of simple tools to assess the level of physical activity, and low levels of onward signposting or recommendations. If physical activity is to be a clinical priority area of the RCGP, then further opportunities for professional development may be required.
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Development of a multiplex loop-mediated isothermal amplification method for the simultaneous detection of Salmonella spp. and Vibrio parahaemolyticus. Sci Rep 2017; 7:45601. [PMID: 28349967 PMCID: PMC5368564 DOI: 10.1038/srep45601] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 02/28/2017] [Indexed: 11/21/2022] Open
Abstract
Rapid detection of food-borne pathogens is important in the food industry, to monitor and prevent the spread of these pathogens through contaminated food products. We therefore established a multiplex real-time loop-mediated isothermal amplification (LAMP) assay to simultaneously detect and distinguish Salmonella spp. and Vibrio parahaemolyticus DNA in a single reaction. Two target sequences, one specific for Salmonella and the other specific for Vibrio parahaemolyticus, were amplified by specific LAMP primers in the same reaction tube. After amplification at 65 °C for 60 min, the amplified products were subjected to melting curve analysis and thus could be distinguished based on the different melting temperatures (Tm values) of the two specifically amplified products. The specificity of the multiplex LAMP assay was evaluated using 19 known bacterial strains, including one V. parahaemolyticus and seven Salmonella spp. strains. The multiplex LAMP showed 100% inclusivity and exclusivity, and a detection limit similar to that of multiplex PCR. In addition, we observed and corrected preferential amplification induced by what we call LAMP selection in the multiplex LAMP reaction. In conclusion, our assay was rapid, specific, and quantitative, making it a useful tool for the food industry.
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Häusser JA, Mojzisch A. The physical activity-mediated Demand–Control (pamDC) model: Linking work characteristics, leisure time physical activity, and well-being. WORK AND STRESS 2017. [DOI: 10.1080/02678373.2017.1303759] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
| | - Andreas Mojzisch
- Institute of Psychology, University of Hildesheim, Hildesheim, Germany
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