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Avdoshina V, Yumoto F, Mocchetti I, Letendre SL, Tractenberg RE. Race-Dependent Association of Single-Nucleotide Polymorphisms in TrkB Receptor in People Living with HIV and Depression. Neurotox Res 2021; 39:1721-1731. [PMID: 34613587 PMCID: PMC10880801 DOI: 10.1007/s12640-021-00406-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 08/16/2021] [Accepted: 08/27/2021] [Indexed: 10/20/2022]
Abstract
Human immunodeficiency virus (HIV)-associated cognitive disorders (HAND) is characterized by impaired motor and intellectual functions, as well as mood disorders. Brain-derived neurotrophic factor and its receptor TrkB (or NTRK2) mediate the efficacy of antidepressant drugs. Genomic studies of BDNF/TrkB have implicated common single-nucleotide polymorphisms in the pathology of depression. In the current study, we investigated whether single-nucleotide polymorphisms (SNPs) (rs1212171, rs1439050, rs1187352, rs1778933, rs1443445, rs3780645, rs2378672, and rs11140800) in the NTRK2 has a functional impact on depression in HIV-positive subjects. We have utilized the Central Nervous System (CNS) HIV Antiretroviral Therapy Effects Research (CHARTER) cohort. Our methods explored the univariate associations of these SNPs with clinical (current and lifetime) diagnosis of depression via chi-square. The distribution of alleles was significantly different for African-Americans and Caucasians (non-Hispanic) for several SNPs, so our regression analyses included both "statistical controls" for race group and models for each group separately. Finally, we applied a method of simultaneous analysis of associations, estimating the mutually shared information across a system of variables, separately by race group. Our results indicate that there is no significant association between clinical diagnosis of major depression and these SNPs for either race group in any analysis. However, we identified that the SNP associations varied by race group and sex.
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Affiliation(s)
- Valeria Avdoshina
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA.
| | - Futoshi Yumoto
- Collaborative for Research on Outcomes and Metrics, Silver Spring, MD, USA
- Resonate, Inc., Reston, VA, USA
| | - Italo Mocchetti
- Department of Neuroscience, Georgetown University Medical Center, Washington, DC, USA
| | - Scott L Letendre
- Department of Medicine, University of California, San Diego, CA, USA
| | - Rochelle E Tractenberg
- Collaborative for Research on Outcomes and Metrics, Silver Spring, MD, USA
- Department of Neurology; Biostatistics, Bioinformatics & Biomathematics; and Rehabilitation Medicine, Georgetown University Medical Center, Washington, DC, USA
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2
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Crissman HP, Czuhajewski C, Moniz MH, Plegue M, Chang T. Youth Perspectives regarding the Regulating of Bathroom Use by Transgender Individuals. JOURNAL OF HOMOSEXUALITY 2020; 67:2034-2049. [PMID: 31161930 DOI: 10.1080/00918369.2019.1618646] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Regulations regarding bathroom use by transgender people affect youth across the United States. This study examines youth opinions on bathroom use regulations. Data were obtained from MyVoice, a weekly text messaging survey of youth aged 14-24 years. Youth were recruited nationally at community events and online; Southeast Michigan was overrepresented. Mixed methods analysis was performed using grounded theory methodology. The majority of respondents (n = 683) were white (71.4%) and had education beyond high school (56.5%). Most (79%) stated that bathroom use by transgender people should not be restricted, rationalizing: 1) bathroom use is private and should be a personal decision; 2) choosing bathrooms is a matter of equality, freedom, and human rights; 3) transgender people are not sexual perpetrators; and 4) forcing transgender people to use particular bathrooms puts them at risk. Contrary to the current policy in many schools, respondents do not support restrictions on bathroom use by transgender people.
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Affiliation(s)
- Halley P Crissman
- Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan, USA
| | | | - Michelle H Moniz
- Department of Obstetrics and Gynecology, University of Michigan , Ann Arbor, Michigan, USA
- Program on Women's Healthcare Effectiveness Research, University of Michigan , Ann Arbor, Michigan, USA
- Institute for Healthcare Policy & Innovation, University of Michigan , Ann Arbor, Michigan, USA
| | - Missy Plegue
- Department of Family Medicine, University of Michigan , Ann Arbor, Michigan, USA
| | - Tammy Chang
- Department of Family Medicine, University of Michigan , Ann Arbor, Michigan, USA
- Institute for Healthcare Policy & Innovation, University of Michigan , Ann Arbor, Michigan, USA
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3
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Lightner JS, Heinrich KM, Sanderson MR. A Population-Based Study of Coupling and Physical Activity by Sexual Orientation for Men. JOURNAL OF HOMOSEXUALITY 2020; 67:1533-1541. [PMID: 31020924 DOI: 10.1080/00918369.2019.1601435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Research has suggested that men in relationships are more physically active than men who are single. This study provides a weighted analysis of physical activity by coupling status for men of different sexual orientations. Aggregated data from the United States 2013-2014 National Health Interview Survey were used to conduct multivariate logistic regression analyses. Compared to straight men (n = 29,926), gay men (n = 623) were less likely to be in a relationship (AOR 0.32, CI: 0.25-0.41). Coupled gay men did more physical activity than coupled straight men and were 1.62 (CI: 1.05-2.50) times more likely to be active, 1.67 (CI: 1.10-2.51) times more likely to be high active, 1.89 (CI: 1.24-2.89) times more likely to engage in muscle-strengthening activities, and 2.00 (CI: 1.28-3.11) times more likely to meet aerobic and muscle-strengthening recommendations. Coupling facilitates physical activity for men. However, more research is needed to help explore underlying mechanisms for differences by sexuality.
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Affiliation(s)
- Joseph S Lightner
- School of Nursing and Health Studies, University of Missouri-Kansas City , Kansas City, Missouri, USA
- Missouri Health Department , Kansas City, Missouri, USA
| | - Katie M Heinrich
- Department of Kinesiology, Kansas State University , Manhattan, Kansas, USA
| | - Matthew R Sanderson
- Department of Sociology, Anthropology, and Social Work, Kansas State University , Manhattan, Kansas, USA
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4
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Hayashi K, Gonzales TK, Kapoor A, Ziegler TE, Meethal SV, Atwood CS. Development of Classification Models for the Prediction of Alzheimer's Disease Utilizing Circulating Sex Hormone Ratios. J Alzheimers Dis 2020; 76:1029-1046. [PMID: 32623397 DOI: 10.3233/jad-200418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND While sex hormones are essential for normal cognitive health, those individuals with greater endocrine dyscrasia around menopause and with andropause are more likely to develop cognitive loss and Alzheimer's disease (AD). OBJECTIVE To assess whether circulating sex hormones may provide an etiologically significant, surrogate biomarker, for cognitive decline. METHODS Plasma (n = 152) and serum (n = 107) samples from age- and gender-matched AD and control subjects from the Wisconsin Alzheimer's Disease Research Center (ADRC) were analyzed for 11 steroids and follicle-stimulating hormone. Logistic regression (LR), correlation analyses, and recursive partitioning (RP) were used to examine the interactions of hormones and hormone ratios and their association with AD. Models generated were then tested on an additional 43 ADRC samples. RESULTS The wide variation and substantial overlap in the concentrations of all circulating sex steroids across control and AD groups precluded their use for predicting AD. Classification tree analyses (RP) revealed interactions among single hormones and hormone ratios that associated with AD status, the most predictive including only the hormone ratios identified by LR. The strongest associations were observed between cortisol, cortisone, and androstenedione with AD, with contributions from progesterone and 17β-estradiol. Utilizing this model, we correctly predicted 81% of AD test cases and 64% of control test cases. CONCLUSION We have developed a diagnostic model for AD, the Wisconsin Hormone Algorithm Test for Cognition (WHAT-Cog), that utilizes classification tree analyses of hormone ratios. Further refinement of this technology could provide a quick and cheap diagnostic method for screening those with AD.
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Affiliation(s)
- Kentaro Hayashi
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Tina K Gonzales
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research, Education and Clinical Center, Veterans Administration Hospital, Madison, WI, USA
| | - Amita Kapoor
- Assay Services Unit and Institute for Clinical and Translational Research Core Laboratory, National Primate Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Toni E Ziegler
- Assay Services Unit and Institute for Clinical and Translational Research Core Laboratory, National Primate Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Sivan Vadakkadath Meethal
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Craig S Atwood
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.,Geriatric Research, Education and Clinical Center, Veterans Administration Hospital, Madison, WI, USA.,School of Exercise, Biomedical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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5
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Machine learning classification of ADHD and HC by multimodal serotonergic data. Transl Psychiatry 2020; 10:104. [PMID: 32265436 PMCID: PMC7138849 DOI: 10.1038/s41398-020-0781-2] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 02/20/2020] [Accepted: 02/28/2020] [Indexed: 12/15/2022] Open
Abstract
Serotonin neurotransmission may impact the etiology and pathology of attention-deficit and hyperactivity disorder (ADHD), partly mediated through single nucleotide polymorphisms (SNPs). We propose a multivariate, genetic and positron emission tomography (PET) imaging classification model for ADHD and healthy controls (HC). Sixteen patients with ADHD and 22 HC were scanned by PET to measure serotonin transporter (SERT') binding potential with [11C]DASB. All subjects were genotyped for thirty SNPs within the HTR1A, HTR1B, HTR2A and TPH2 genes. Cortical and subcortical regions of interest (ROI) were defined and random forest (RF) machine learning was used for feature selection and classification in a five-fold cross-validation model with ten repeats. Variable selection highlighted the ROI posterior cingulate gyrus, cuneus, precuneus, pre-, para- and postcentral gyri as well as the SNPs HTR2A rs1328684 and rs6311 and HTR1B rs130058 as most discriminative between ADHD and HC status. The mean accuracy for the validation sets across repeats was 0.82 (±0.09) with balanced sensitivity and specificity of 0.75 and 0.86, respectively. With a prediction accuracy above 0.8, the findings underlying the proposed model advocate the relevance of the SERT as well as the HTR1B and HTR2A genes in ADHD and hint towards disease-specific effects. Regarding the high rates of comorbidities and difficult differential diagnosis especially for ADHD, a reliable computer-aided diagnostic tool for disorders anchored in the serotonergic system will support clinical decisions.
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Kaonga NN, Morgan J. Common themes and emerging trends for the use of technology to support mental health and psychosocial well-being in limited resource settings: A review of the literature. Psychiatry Res 2019; 281:112594. [PMID: 31605874 DOI: 10.1016/j.psychres.2019.112594] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Revised: 09/29/2019] [Accepted: 09/29/2019] [Indexed: 12/19/2022]
Abstract
There are significant disparities in access to mental health care. With the burgeoning of technologies for health, digital tools have been leveraged within mental health and psychosocial support programming (eMental health). A review of the literature was conducted to understand and identify how eMental health has been used in resource-limited settings in general. PubMed, Ovid Medline and Web of Science were searched. Six-hundred and thirty full-text articles were identified and assessed for eligibility; of those, 67 articles met the inclusion criteria and were analyzed. The most common mental health use cases were for depression (n = 25) and general mental health and well-being (n = 21). Roughly one-third used a website or Internet-enabled intervention (n = 23) and nearly one-third used an SMS intervention (n = 22). Technology was applied to enhance service delivery (n = 32), behavior change communication (n = 26) and data collection (n = 8), and specifically dealt with adherence (n = 7), ecological momentary assessments (n = 7), well-being promotion (n = 5), education (n = 8), telemedicine (n = 28), machine learning (n = 5) and games (n = 2). Emerging trends identified wearables, predictive analytics, robots and virtual reality as promising areas. eMental health interventions that leverage low-tech tools can introduce, strengthen and expand mental health and psychosocial support services and can be a starting point for future, advanced tools.
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Affiliation(s)
- Nadi Nina Kaonga
- HealthEnabled, Cape Town, South Africa; Tufts University School of Medicine, Boston, MA, United States; Maine Medical Center, Portland, ME, United States.
| | - Jonathan Morgan
- Regional Psychosocial Support Initiative (REPSSI), Cape Town, South Africa.
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Sharifian N, Zahodne LB. The Enduring Effects of Mother-Child Interactions on Episodic Memory in Adulthood. JOURNAL OF MARRIAGE AND THE FAMILY 2019; 81:936-952. [PMID: 31937977 PMCID: PMC6959214 DOI: 10.1111/jomf.12569] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To examine the enduring effects of retrospective reports of early life mother-child interactions on psychosocial and cognitive functioning later in life. BACKGROUND Mother-child interactions have been linked to cognitive outcomes in childhood, however, little work has examined whether early life mother-child interactions have far-reaching effects on episodic memory in adulthood. Early life mother-child interactions may also influence cognitive functioning in adulthood indirectly through the development of academic competence (education attainment), social competence (marital satisfaction, social support, contact frequency), and/or depressive symptoms. METHODS Using longitudinal data from the Wisconsin Longitudinal Study sibling respondents (1993-2011; baseline: 29-79 years), we examined how retrospective positive mother-child interactions (PMCI) and negative mother-child interactions (NMCI) were independently associated with episodic memory. Structural equation modeling was used to model direct and indirect pathways from PMCI and NMCI to episodic memory and latent change in episodic memory. RESULTS More PMCI retrospectively reported at T1 were associated with higher T2 memory and less memory decline from T2 to T3 via higher education. Additionally, more PMCI were associated with higher T2 memory through greater marital satisfaction. Independent of these indirect effects, more PMCI and NMCI were each associated with higher T2 memory, but not memory change. CONCLUSION Mother-child interactions appeared to have an enduring effect on episodic memory in adulthood. These findings highlight the importance of taking a more integrative and lifespan perspective to assess how early life experiences affect socioemotional and cognitive development.
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Affiliation(s)
- Neika Sharifian
- Department of Psychology, University of Michigan, Ann Arbor MI
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Hmiel L, Collins C, Brown P, Cherney E, Farmer C. "We have this awesome organization where it was built by women for women like us": Supporting African American women through their pregnancies and beyond. SOCIAL WORK IN HEALTH CARE 2019; 58:579-595. [PMID: 30933655 DOI: 10.1080/00981389.2019.1597007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 02/20/2019] [Accepted: 03/15/2019] [Indexed: 06/09/2023]
Abstract
Infant mortality is a problem that disproportionately affects infants of African American women, particularly residents in underserved neighborhoods. Chronic stress due to racism has been identified as an important factor in infant mortality. This study examined a novel community-based perinatal support professional (PSP) program, Birthing Beautiful Communities (BBC), in Cleveland, Ohio. BBC provides services for pregnant African American women in underserved neighborhoods with the goal of decreasing infant mortality and low birthweight rates by addressing chronic stress. Focus groups and one individual interview were conducted with the program's 14 PSPs, and 25 clients were interviewed individually. Interviews were analyzed inductively using qualitative thematic analysis to identify pervasive themes. Coders identified major themes of stress, resilience, community, cultural matching, advocacy, self-care, transformation, and self-actualization. BBC PSPs and clients alike reported the program is transforming the lives of clients by helping them address stressors. Findings suggest the community-based PSP model is an important but underused intervention in addressing infant mortality.
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Affiliation(s)
- Laura Hmiel
- a Department of Medicine , Case Western Reserve University , Cleveland , OH , USA
| | - Cyleste Collins
- b Department of Social Work , Cleveland State University , Cleveland , OH , USA
| | | | - Emily Cherney
- b Department of Social Work , Cleveland State University , Cleveland , OH , USA
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9
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Boskey ER, Taghinia AH, Ganor O. Self-assessment of clinical competence with LGBT patients at a pediatric hospital. SOCIAL WORK IN HEALTH CARE 2019; 58:547-556. [PMID: 30908176 DOI: 10.1080/00981389.2019.1588189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 01/24/2019] [Accepted: 02/24/2019] [Indexed: 06/09/2023]
Abstract
Hospital social workers were asked to complete the LGBT-DOCSS, a validated self-assessment of clinical competence, attitudes, and knowledge about working with lesbian, gay, bisexual (LGB), and transgender patients. As a group, they held positive attitudes about LGBT patients (Mean 6.9/7, SD .22) but were less confident about their knowledge (Mean 5.9/7, SD 0.96) and clinical preparedness (Mean 5.0/7, SD 1.24). In addition, providers felt significantly less competent about working with transgender than LGB patients. Factors that affected domains of self-assessed competence including experience working with LGB or transgender patients and the year training was completed.
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Affiliation(s)
- Elizabeth R Boskey
- a Center for Gender Surgery , Boston Children's Hospital , Boston , MA , USA
| | - Amir H Taghinia
- a Center for Gender Surgery , Boston Children's Hospital , Boston , MA , USA
| | - Oren Ganor
- a Center for Gender Surgery , Boston Children's Hospital , Boston , MA , USA
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10
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Quandt SA, Groeschel-Johnson A, Kinzer HT, Jensen A, Miles K, O'Hara HM, Chen H, Arcury TA. Migrant Farmworker Nutritional Strategies: Implications for Diabetes Management. J Agromedicine 2019; 23:347-354. [PMID: 30230432 DOI: 10.1080/1059924x.2018.1501453] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Diabetes is a chronic disease prevalent in Hispanic/Latino adults, including migrant farmworkers in the US. Its management requires that individuals follow dietary guidelines, which may be difficult for migrant farmworkers due to work and environmental constraints. This analysis is designed to explore potential barriers to and supports for migrant farmworkers' practice of effective dietary self-management. METHODS Interviews were conducted with 200 Latino migrant farmworkers in North Carolina, including workers with and without diabetes, recruited at housing sites throughout the 2017 agricultural season. The survey instrument included questions designed to elucidate how workers obtain food, prepare and consume food, and maintain food security. RESULTS Most purchased food is obtained once per week at large grocery stores, with most farmworkers depending on others for transportation. Less than 1 in 5 supplement with garden produce and food from food pantries, farmers markets, and hunting and fishing. About half of lunches and a quarter of dinners are purchased from vendors or other commercial sources. More than 2 in 5 workers report they have to compromise on or lack control of meal content. About 1 in 5 report issues with food security. CONCLUSIONS The food-related practices of farmworkers would require change to accommodate effective dietary self-management of diabetes. Greater use of sources of fresh produce and other nutrient-dense foods, coupled with greater control over meal content and cooking techniques would be needed. While some accommodations could be encouraged through education, others would require policy change in housing or access to community resources.
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Affiliation(s)
- Sara A Quandt
- a Department of Epidemiology and Prevention, Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA.,b Center for Worker Health , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Augusta Groeschel-Johnson
- a Department of Epidemiology and Prevention, Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA.,c Anthropology Department , Lawrence University , Appleton , Wisconsin , USA
| | - Hannah T Kinzer
- a Department of Epidemiology and Prevention, Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA.,c Anthropology Department , Lawrence University , Appleton , Wisconsin , USA
| | - Anna Jensen
- d North Carolina Farmworkers Project , Benson , NC , USA
| | - Kenya Miles
- e Department of Family and Community Medicine , Meharry Medical College , Nashville , TN , USA
| | - Heather M O'Hara
- e Department of Family and Community Medicine , Meharry Medical College , Nashville , TN , USA
| | - Haiying Chen
- f Department of Biostatistical Science, Division of Public Health Sciences , Wake Forest School of Medicine , Winston-Salem , NC , USA
| | - Thomas A Arcury
- b Center for Worker Health , Wake Forest School of Medicine , Winston-Salem , NC , USA.,g Department of Family and Community Medicine , Wake Forest School of Medicine , Winston-Salem , NC , USA
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Sanders E, Antin T, Hunt G, Young M. Is Smoking Queer? Implications of California Tobacco Denormalization Strategies for Queer Current and Former Smokers. DEVIANT BEHAVIOR 2019; 41:497-511. [PMID: 33311820 PMCID: PMC7731982 DOI: 10.1080/01639625.2019.1572095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 08/09/2018] [Indexed: 06/12/2023]
Abstract
This article is concerned with normative conceptions of health structuring tobacco control strategies designed to "denormalize" tobacco use. Analysis of 201 interviews with non-heterosexual and/or non-cisgender adults in California revealed that participants implicated tobacco use in exacerbating health inequities and perpetuating harmful narratives of queer suffering, but also regarded smoking as a critical tool for self-care and symbol of resistance. Participant narratives suggest that using stigma in health promotion efforts which reinforce normative conceptions of health may be harmful to queer people whose social identities exist within ongoing legacies of pathology, health stigma, and deviance from hegemonic structural norms.
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Affiliation(s)
- Emile Sanders
- Critical Public Health Research Group Prevention Research Center Oakland, CA
- Center for Critical Public Health Institute for Scientific Analysis Alameda, CA
| | - Tamar Antin
- Critical Public Health Research Group Prevention Research Center Oakland, CA
- Center for Critical Public Health Institute for Scientific Analysis Alameda, CA
| | - Geoffrey Hunt
- Center for Critical Public Health Institute for Scientific Analysis Alameda, CA
- Centre for Alcohol and Drug Research Aarhus University Aarhus, Denmark
| | - Malisa Young
- Critical Public Health Research Group Prevention Research Center Oakland, CA
- Center for Critical Public Health Institute for Scientific Analysis Alameda, CA
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12
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Gentile K. “Dying for a Baby” and Other “Confusions of Tongues”: A Discussion of “Childless”. PSYCHOANALYTIC DIALOGUES 2019. [DOI: 10.1080/10481885.2018.1560866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Kautzky A, Seiger R, Hahn A, Fischer P, Krampla W, Kasper S, Kovacs GG, Lanzenberger R. Prediction of Autopsy Verified Neuropathological Change of Alzheimer's Disease Using Machine Learning and MRI. Front Aging Neurosci 2018; 10:406. [PMID: 30618713 PMCID: PMC6295575 DOI: 10.3389/fnagi.2018.00406] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/26/2018] [Indexed: 12/29/2022] Open
Abstract
Background: Alzheimer’s disease (AD) is the most common form of dementia. While neuropathological changes pathognomonic for AD have been defined, early detection of AD prior to cognitive impairment in the clinical setting is still lacking. Pioneer studies applying machine learning to magnetic-resonance imaging (MRI) data to predict mild cognitive impairment (MCI) or AD have yielded high accuracies, however, an algorithm predicting neuropathological change is still lacking. The objective of this study was to compute a prediction model supporting a more distinct diagnostic criterium for AD compared to clinical presentation, allowing identification of hallmark changes even before symptoms occur. Methods: Autopsy verified neuropathological changes attributed to AD, as described by a combined score for Aβ-peptides, neurofibrillary tangles and neuritic plaques issued by the National Institute on Aging – Alzheimer’s Association (NIAA), the ABC score for AD, were predicted from structural MRI data with RandomForest (RF). MRI scans were performed at least 2 years prior to death. All subjects derive from the prospective Vienna Trans-Danube Aging (VITA) study that targeted all 1750 inhabitants of the age of 75 in the starting year of 2000 in two districts of Vienna and included irregular follow-ups until death, irrespective of clinical symptoms or diagnoses. For 68 subjects MRI as well as neuropathological data were available and 49 subjects (mean age at death: 82.8 ± 2.9, 29 female) with sufficient MRI data quality were enrolled for further statistical analysis using nested cross-validation (CV). The decoding data of the inner loop was used for variable selection and parameter optimization with a fivefold CV design, the new data of the outer loop was used for model validation with optimal settings in a fivefold CV design. The whole procedure was performed ten times and average accuracies with standard deviations were reported. Results: The most informative ROIs included caudal and rostral anterior cingulate gyrus, entorhinal, fusiform and insular cortex and the subcortical ROIs anterior corpus callosum and the left vessel, a ROI comprising lacunar alterations in inferior putamen and pallidum. The resulting prediction models achieved an average accuracy for a three leveled NIAA AD score of 0.62 within the decoding sets and of 0.61 for validation sets. Higher accuracies of 0.77 for both sets, respectively, were achieved when predicting presence or absence of neuropathological change. Conclusion: Computer-aided prediction of neuropathological change according to the categorical NIAA score in AD, that currently can only be assessed post-mortem, may facilitate a more distinct and definite categorization of AD dementia. Reliable detection of neuropathological hallmarks of AD would enable risk stratification at an earlier level than prediction of MCI or clinical AD symptoms and advance precision medicine in neuropsychiatry.
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Affiliation(s)
- Alexander Kautzky
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Rene Seiger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Andreas Hahn
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Peter Fischer
- Department of Psychiatry, Danube Hospital, Medical Research Society Vienna D.C., Vienna, Austria
| | | | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Gabor G Kovacs
- Institute of Neurology, Medical University of Vienna, Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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14
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Fernández-Rouco N, Carcedo RJ, Yeadon-Lee T. Transgender Identities, Pressures, and Social Policy: A Study Carried Out in Spain. JOURNAL OF HOMOSEXUALITY 2018; 67:620-638. [PMID: 30507295 DOI: 10.1080/00918369.2018.1550330] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This article draws on a qualitative research project concerning the relationship between trans people's mental health and wellbeing, pressures, social policy, and heteronormative gender norms in Spain. Drawing on interviews carried out with trans people from all regions and generations, we use an ecological framework to illustrate how a socially entrenched heteronormativity pressures trans people to comply with gender norms that impact negatively their mental health and wellbeing. The article argues that the legal changes in Spain are not enough in themselves to bring about social change, but, rather, Spanish social policy makers also need to challenge gender categorization and work toward transforming public discourses on gender issues if trans people are to gain full social recognition and equal social rights.
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Affiliation(s)
| | - Rodrigo J Carcedo
- Department of Developmental and Educational Psychology, University of Salamanca, Salamanca, Spain
| | - Tray Yeadon-Lee
- Department of Behavioral & Social Sciences, University of Huddersfield, Huddersfield, UK
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Villani J, Schully SD, Meyer P, Myles RL, Lee JA, Murray DM, Vargas AJ. A Machine Learning Approach to Identify NIH-Funded Applied Prevention Research. Am J Prev Med 2018; 55:926-931. [PMID: 30458951 PMCID: PMC6251715 DOI: 10.1016/j.amepre.2018.07.024] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 05/20/2018] [Accepted: 07/20/2018] [Indexed: 02/07/2023]
Abstract
INTRODUCTION To fulfill its mission, the NIH Office of Disease Prevention systematically monitors NIH investments in applied prevention research. Specifically, the Office focuses on research in humans involving primary and secondary prevention, and prevention-related methods. Currently, the NIH uses the Research, Condition, and Disease Categorization system to report agency funding in prevention research. However, this system defines prevention research broadly to include primary and secondary prevention, studies on prevention methods, and basic and preclinical studies for prevention. A new methodology was needed to quantify NIH funding in applied prevention research. METHODS A novel machine learning approach was developed and evaluated for its ability to characterize NIH-funded applied prevention research during fiscal years 2012-2015. The sensitivity, specificity, positive predictive value, accuracy, and F1 score of the machine learning method; the Research, Condition, and Disease Categorization system; and a combined approach were estimated. Analyses were completed during June-August 2017. RESULTS Because the machine learning method was trained to recognize applied prevention research, it more accurately identified applied prevention grants (F1 = 72.7%) than the Research, Condition, and Disease Categorization system (F1 = 54.4%) and a combined approach (F1 = 63.5%) with p<0.001. CONCLUSIONS This analysis demonstrated the use of machine learning as an efficient method to classify NIH-funded research grants in disease prevention.
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Affiliation(s)
| | | | - Payam Meyer
- Office of Portfolio Analysis, NIH, Bethesda, Maryland
| | | | - Jocelyn A Lee
- Office of Disease Prevention, NIH, Rockville, Maryland
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Pan I, Nolan LB, Brown RR, Khan R, van der Boor P, Harris DG, Ghani R. Machine Learning for Social Services: A Study of Prenatal Case Management in Illinois. Am J Public Health 2017; 107:938-944. [PMID: 28426306 PMCID: PMC5425855 DOI: 10.2105/ajph.2017.303711] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate the positive predictive value of machine learning algorithms for early assessment of adverse birth risk among pregnant women as a means of improving the allocation of social services. METHODS We used administrative data for 6457 women collected by the Illinois Department of Human Services from July 2014 to May 2015 to develop a machine learning model for adverse birth prediction and improve upon the existing paper-based risk assessment. We compared different models and determined the strongest predictors of adverse birth outcomes using positive predictive value as the metric for selection. RESULTS Machine learning algorithms performed similarly, outperforming the current paper-based risk assessment by up to 36%; a refined paper-based assessment outperformed the current assessment by up to 22%. We estimate that these improvements will allow 100 to 170 additional high-risk pregnant women screened for program eligibility each year to receive services that would have otherwise been unobtainable. CONCLUSIONS Our analysis exhibits the potential for machine learning to move government agencies toward a more data-informed approach to evaluating risk and providing social services. Overall, such efforts will improve the efficiency of allocating resource-intensive interventions.
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Affiliation(s)
- Ian Pan
- Ian Pan is with the Department of Biostatistics, School of Public Health, Brown University, Providence, RI. Laura B. Nolan is with the Population Research Center, School of Social Work, Columbia University, New York, NY. Rashida R. Brown is with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Romana Khan is with the Kellogg School of Management, Northwestern University, Evanston, IL. Paul van der Boor and Rayid Ghani are with the Center for Data Science and Public Policy, University of Chicago, Chicago, IL. Daniel G. Harris is with the Department of Human Services, Illinois State Government, Chicago
| | - Laura B Nolan
- Ian Pan is with the Department of Biostatistics, School of Public Health, Brown University, Providence, RI. Laura B. Nolan is with the Population Research Center, School of Social Work, Columbia University, New York, NY. Rashida R. Brown is with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Romana Khan is with the Kellogg School of Management, Northwestern University, Evanston, IL. Paul van der Boor and Rayid Ghani are with the Center for Data Science and Public Policy, University of Chicago, Chicago, IL. Daniel G. Harris is with the Department of Human Services, Illinois State Government, Chicago
| | - Rashida R Brown
- Ian Pan is with the Department of Biostatistics, School of Public Health, Brown University, Providence, RI. Laura B. Nolan is with the Population Research Center, School of Social Work, Columbia University, New York, NY. Rashida R. Brown is with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Romana Khan is with the Kellogg School of Management, Northwestern University, Evanston, IL. Paul van der Boor and Rayid Ghani are with the Center for Data Science and Public Policy, University of Chicago, Chicago, IL. Daniel G. Harris is with the Department of Human Services, Illinois State Government, Chicago
| | - Romana Khan
- Ian Pan is with the Department of Biostatistics, School of Public Health, Brown University, Providence, RI. Laura B. Nolan is with the Population Research Center, School of Social Work, Columbia University, New York, NY. Rashida R. Brown is with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Romana Khan is with the Kellogg School of Management, Northwestern University, Evanston, IL. Paul van der Boor and Rayid Ghani are with the Center for Data Science and Public Policy, University of Chicago, Chicago, IL. Daniel G. Harris is with the Department of Human Services, Illinois State Government, Chicago
| | - Paul van der Boor
- Ian Pan is with the Department of Biostatistics, School of Public Health, Brown University, Providence, RI. Laura B. Nolan is with the Population Research Center, School of Social Work, Columbia University, New York, NY. Rashida R. Brown is with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Romana Khan is with the Kellogg School of Management, Northwestern University, Evanston, IL. Paul van der Boor and Rayid Ghani are with the Center for Data Science and Public Policy, University of Chicago, Chicago, IL. Daniel G. Harris is with the Department of Human Services, Illinois State Government, Chicago
| | - Daniel G Harris
- Ian Pan is with the Department of Biostatistics, School of Public Health, Brown University, Providence, RI. Laura B. Nolan is with the Population Research Center, School of Social Work, Columbia University, New York, NY. Rashida R. Brown is with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Romana Khan is with the Kellogg School of Management, Northwestern University, Evanston, IL. Paul van der Boor and Rayid Ghani are with the Center for Data Science and Public Policy, University of Chicago, Chicago, IL. Daniel G. Harris is with the Department of Human Services, Illinois State Government, Chicago
| | - Rayid Ghani
- Ian Pan is with the Department of Biostatistics, School of Public Health, Brown University, Providence, RI. Laura B. Nolan is with the Population Research Center, School of Social Work, Columbia University, New York, NY. Rashida R. Brown is with the Division of Epidemiology, School of Public Health, University of California, Berkeley. Romana Khan is with the Kellogg School of Management, Northwestern University, Evanston, IL. Paul van der Boor and Rayid Ghani are with the Center for Data Science and Public Policy, University of Chicago, Chicago, IL. Daniel G. Harris is with the Department of Human Services, Illinois State Government, Chicago
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From genomes to societies: a holistic view of determinants of human health. Curr Opin Biotechnol 2014; 28:134-42. [PMID: 24686286 DOI: 10.1016/j.copbio.2014.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Revised: 02/22/2014] [Accepted: 03/05/2014] [Indexed: 12/22/2022]
Abstract
Both biological and social sciences have identified contributing factors to human health. However, health outcomes are unlikely to equal a simple sum of these identified factors. This article makes an attempt to put together the information, methods, and technologies that relate to health outcomes from biological, behavioral, and social disciplines. Much of this information was obtained by controlling for the variations of the factors in 'other' disciplines. For example, genetic factors were controlled for in identifying the behavioral determinants of health. Looking forward, better understandings of health outcomes may require exploiting the interactions of health determinants that were identified from different disciplines. We propose the concept of 'systems health' studies, which take health outcomes as the outputs of a system, where the inputs and their interactions from multiple disciplines are considered.
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