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Cepeda-Benito A, Doogan NJ, Redner R, Roberts ME, Kurti AN, Villanti AC, Lopez AA, Quisenberry AJ, Stanton CA, Gaalema DE, Keith DR, Parker MA, Higgins ST. Trend differences in men and women in rural and urban U.S. settings. Prev Med 2018; 117:69-75. [PMID: 29627511 PMCID: PMC6173654 DOI: 10.1016/j.ypmed.2018.04.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 02/21/2018] [Accepted: 04/02/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Smoking prevalence is declining at a slower rate in rural than urban settings in the United States (U.S.), and known predictors of smoking do not readily account for this trend difference. Given that socioeconomic and psychosocial determinants of health disparities accumulate in rural settings and that life-course disadvantages are often greater in women than men, we examined whether smoking trends are different for rural and urban men and women. METHOD We used yearly cross-sectional data (n = 303,311) from the U.S. National Survey on Drug Use and Health (NSDUH) from 2007 through 2014 to compare cigarette smoking trends in men and women across rural and urban areas. Current smoking status was modelled using logistic regression controlling for confounding risk factors. RESULTS Regression derived graphs predicting unadjusted prevalence estimates and 95% confidence bands revealed that whereas the smoking trends of rural men, urban men, and urban women significantly declined from 2007 to 2014, the trend for rural women was flat. Controlling for demographic, socioeconomic and psychosocial predictors of smoking did not explain rural women's significantly different trend from those of the other three groups. CONCLUSION Rural women lag behind rural men, urban men and urban women in decreasing smoking, a health disparity finding that supports the need for tobacco control and regulatory policies and interventions that are more effective in reducing smoking among rural women.
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Affiliation(s)
- A Cepeda-Benito
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States.
| | - N J Doogan
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, United States
| | - R Redner
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Rehabilitation Institute, Southern Illinois University, United States
| | - M E Roberts
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, United States
| | - A N Kurti
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - A C Villanti
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - A A Lopez
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States
| | - A J Quisenberry
- Center of Excellence in Regulatory Tobacco Science, College of Public Health, The Ohio State University, United States
| | - C A Stanton
- Westat, Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Department of Oncology, Georgetown University Medical Center, United States; Department of Oncology, Georgetown University Medical Center / Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, United States
| | - D E Gaalema
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - D R Keith
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - M A Parker
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
| | - S T Higgins
- University of Vermont Center of Tobacco Regulatory Science, University of Vermont, United States; Department of Psychological Science, University of Vermont, United States; Department of Psychiatry, University of Vermont, United States
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Doogan NJ, Roberts ME, Wewers ME, Stanton CA, Keith DR, Gaalema DE, Kurti AN, Redner R, Cepeda-Benito A, Bunn JY, Lopez AA, Higgins ST. A growing geographic disparity: Rural and urban cigarette smoking trends in the United States. Prev Med 2017; 104:79-85. [PMID: 28315761 PMCID: PMC5600673 DOI: 10.1016/j.ypmed.2017.03.011] [Citation(s) in RCA: 146] [Impact Index Per Article: 20.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/01/2017] [Accepted: 03/12/2017] [Indexed: 11/17/2022]
Abstract
Rural areas of the United States have a higher smoking prevalence than urban areas. However, no recent studies have rigorously examined potential changes in this disparity over time or whether the disparity can be explained by demographic or psychosocial characteristics associated with smoking. The present study used yearly cross sectional data from the National Survey on Drug Use and Health from 2007 through 2014 to examine cigarette smoking trends in rural versus urban areas of the United States. The analytic sample included 303,311 respondents. Two regression models were built to examine (a) unadjusted rural and urban trends in prevalence of current smoking and (b) whether differences remained after adjusting for demographic and psychosocial characteristics. Results of the unadjusted model showed disparate and diverging cigarette use trends during the 8-year time period. The adjusted model also showed diverging trends, initially with no or small differences that became more pronounced across the 8-year period. We conclude that differences reported in earlier studies may be explained by differences in rural versus urban demographic and psychosocial risk factors, while more recent and growing disparities appear to be related to other factors. These emergent differences may be attributable to policy-level tobacco control and regulatory factors that disproportionately benefit urban areas such as enforcement of regulations around the sale and marketing of tobacco products and treatment availability. Strong federal policies and targeted or tailored interventions may be important to expanding tobacco control and regulatory benefits to vulnerable populations including rural Americans.
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Affiliation(s)
- N J Doogan
- Center of Excellence in Tobacco Regulatory Science, The Ohio State University, College of Public Health, 1841 Neil Ave., Columbus, OH 43210, USA.
| | - M E Roberts
- Center of Excellence in Tobacco Regulatory Science, The Ohio State University, College of Public Health, 1841 Neil Ave., Columbus, OH 43210, USA
| | - M E Wewers
- Center of Excellence in Tobacco Regulatory Science, The Ohio State University, College of Public Health, 1841 Neil Ave., Columbus, OH 43210, USA
| | - C A Stanton
- Center for Evaluation and Coordination of Training and Research (CECTR) in Tobacco Regulatory Science, Westat, 1600 Research Boulevard, Rockville, MD 20850, USA; Department of Oncology/Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, Research Building, Suite E501, 3970 Reservoir Road, N.W., Washington D.C. 20057, USA
| | - D R Keith
- Department of Psychiatry, University of Vermont, 1 South Prospect Street, MS 446AR6, Burlington, VT 05401, USA
| | - D E Gaalema
- Vermont Center on Tobacco Regulatory Science, University of Vermont, Given Building, 89 Beaumont Ave., Burlington, VT 05405-0068, USA
| | - A N Kurti
- Vermont Center on Tobacco Regulatory Science, University of Vermont, Given Building, 89 Beaumont Ave., Burlington, VT 05405-0068, USA
| | - R Redner
- Rehabilitation Institute, Southern Illinois University Carbondale, Rehn Hall, Mail Code 4609, Carbondale, IL 62901, USA
| | - A Cepeda-Benito
- Vermont Center on Tobacco Regulatory Science, University of Vermont, Given Building, 89 Beaumont Ave., Burlington, VT 05405-0068, USA; Department of Psychological Science, University of Vermont, John Dewey Hall, Rm 248, 2 Colchester Avenue, Burlington, VT 05405-0134, USA
| | - J Y Bunn
- Vermont Center on Tobacco Regulatory Science, University of Vermont, Given Building, 89 Beaumont Ave., Burlington, VT 05405-0068, USA
| | - A A Lopez
- Department of Psychiatry, University of Vermont, 1 South Prospect Street, MS 446AR6, Burlington, VT 05401, USA
| | - S T Higgins
- Vermont Center on Tobacco Regulatory Science, University of Vermont, Given Building, 89 Beaumont Ave., Burlington, VT 05405-0068, USA
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Mendoza ES, Lopez AA, Valdez VAU, Cunanan EC, Matawaran BJ, Kho SA, Sero-Gomez MH. Predictors of incomplete response to therapy among Filipino patients with papillary thyroid cancer in a tertiary hospital. J Endocrinol Invest 2016; 39:55-62. [PMID: 26036600 DOI: 10.1007/s40618-015-0319-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Accepted: 05/21/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Although survival rate in papillary thyroid cancer (PTC) is high, the risk of persistence and recurrence together with the dramatic rise in its incidence cannot be overemphasized. Filipinos are considered to be at greater risk for negative outcomes. A paradigm shift in the management of PTC introduces re-stratification based on response to therapy which was reported to have better correlation with long-term outcome. The study aimed to identify predictors of incomplete response after thyroidectomy and radioiodine therapy among patients with PTC. The results of the study may have important implications in our understanding of the disease process allowing more aggressive treatment and monitoring of certain subgroups of patients. METHODOLOGY Retrospective review of 225 patients with PTC (59% ATA low risk, 30 % ATA intermediate risk and 11% ATA high risk) who underwent thyroidectomy and radioiodine therapy was performed. Thirteen variables were considered (age, gender, histopathological variant, stage, extent of disease, MACIS score, AMES score, primary tumour size, lymph node, lymphovascular invasion, bilaterality, multifocality and preoperative TSH level). Logistic regression analysis using Backward Wald algorithm was used to identify independent predictors of incomplete response to therapy after 24 months. RESULTS Of the 225 patients, 69 (31%) had incomplete response. Biochemical and structural (predominantly thyroid bed, lung and bone) incomplete response was observed in 6 and 63 patients, respectively. Incomplete response was documented in 8, 54 and 92% of low-, intermediate- and high-risk patients based on ATA recommendation. Incomplete response was significantly dependent on gender, lymph node involvement and location, extent of malignancy and multifocality taking into account the size of concurrent tumours (p < 0.05). The model was found to have high sensitivity (71%) and specificity (96%). CONCLUSION A significant fraction of PTC patients experienced incomplete response to therapy. Our data suggest that male gender, lateral or mediastinal lymph node involvement, class III extent of disease by De Groot and multifocality with concurrent tumour or tumours more than 1 cm are major predictors of incomplete response. Not all predictors of recurrence and mortality are consistent predictors of treatment response which may be equally important in a disease with low mortality but significant morbidity like PTC.
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Affiliation(s)
- E S Mendoza
- Section of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
| | - A A Lopez
- Section of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
| | - V A U Valdez
- Section of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
| | - E C Cunanan
- Section of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
| | - B J Matawaran
- Section of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
| | - S A Kho
- Section of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
| | - M H Sero-Gomez
- Section of Endocrinology Diabetes and Metabolism, Department of Medicine, University of Santo Tomas Hospital, Manila, Philippines.
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Avila M, Dyment DA, Sagen JV, St-Onge J, Moog U, Chung BHY, Mo S, Mansour S, Albanese A, Garcia S, Martin DO, Lopez AA, Claudi T, König R, White SM, Sawyer SL, Bernstein JA, Slattery L, Jobling RK, Yoon G, Curry CJ, Merrer ML, Luyer BL, Héron D, Mathieu-Dramard M, Bitoun P, Odent S, Amiel J, Kuentz P, Thevenon J, Laville M, Reznik Y, Fagour C, Nunes ML, Delesalle D, Manouvrier S, Lascols O, Huet F, Binquet C, Faivre L, Rivière JB, Vigouroux C, Njølstad PR, Innes AM, Thauvin-Robinet C. Clinical reappraisal of SHORT syndrome with PIK3R1 mutations: toward recommendation for molecular testing and management. Clin Genet 2015; 89:501-506. [PMID: 26497935 DOI: 10.1111/cge.12688] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/10/2015] [Accepted: 10/16/2015] [Indexed: 12/01/2022]
Abstract
SHORT syndrome has historically been defined by its acronym: short stature (S), hyperextensibility of joints and/or inguinal hernia (H), ocular depression (O), Rieger abnormality (R) and teething delay (T). More recently several research groups have identified PIK3R1 mutations as responsible for SHORT syndrome. Knowledge of the molecular etiology of SHORT syndrome has permitted a reassessment of the clinical phenotype. The detailed phenotypes of 32 individuals with SHORT syndrome and PIK3R1 mutation, including eight newly ascertained individuals, were studied to fully define the syndrome and the indications for PIK3R1 testing. The major features described in the SHORT acronym were not universally seen and only half (52%) had four or more of the classic features. The commonly observed clinical features of SHORT syndrome seen in the cohort included intrauterine growth restriction (IUGR) <10th percentile, postnatal growth restriction, lipoatrophy and the characteristic facial gestalt. Anterior chamber defects and insulin resistance or diabetes were also observed but were not as prevalent. The less specific, or minor features of SHORT syndrome include teething delay, thin wrinkled skin, speech delay, sensorineural deafness, hyperextensibility of joints and inguinal hernia. Given the high risk of diabetes mellitus, regular monitoring of glucose metabolism is warranted. An echocardiogram, ophthalmological and hearing assessments are also recommended.
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Affiliation(s)
- M Avila
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Service de Pédiatrie 1, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - D A Dyment
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - J V Sagen
- Hormone Laboratory, Haukeland University Hospital, Bergen, Norway.,KJ Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - J St-Onge
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,CHU Dijon, Laboratoire de Génétique Moléculaire, Dijon, France
| | - U Moog
- Institute of Human Genetics, University of Heidelberg, Heidelberg, Germany
| | - B H Y Chung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - S Mo
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong - Shenzhen Hospital, Shenzhen, China
| | - S Mansour
- SW Thames Regional Genetics Service, St. George's Hospital Medical School, London, SW17 0RE, UK
| | - A Albanese
- Paediatric Endocrine Unit, St George's Hospital, London, UK
| | - S Garcia
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain.,Instituto de Salud Carlos III, Unit 753, Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - D O Martin
- Department of Ophthalmology, Hospital Central de la Cruz Roja San Jose y Santa Adela, Madrid, Spain
| | - A A Lopez
- Puerta de Hierro, University Hospital, Madrid, Spain
| | - T Claudi
- Department of Medicine, Bodø, Norway
| | - R König
- Department of Human Genetics, University of Frankfurt, Frankfurt, Germany
| | - S M White
- Victorian Clinical genetics Services, Murdoch Childrens Research institute, Parkville, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - S L Sawyer
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada
| | - J A Bernstein
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - L Slattery
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Stanford, CA, USA
| | - R K Jobling
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - G Yoon
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - C J Curry
- Genetic Medicine/, University of California, San Francisco, CA, USA
| | - M L Merrer
- Département de Génétique, Hôpital Necker Enfants Malades, Paris, France
| | - B L Luyer
- Service de Pédiatrie, CH Le Havre, Le Havre, France
| | - D Héron
- Département de Génétique et Centre de Référence "Déficiences intellectuelles de causes rares", Paris, France
| | | | - P Bitoun
- Service de Pédiatrie, Bondy, France
| | - S Odent
- Service de Génétique clinique, Rennes, France.,UMR CNRS 6290 IGDR, Universitė Rennes, Rennes, France
| | - J Amiel
- Département de Génétique, Hôpital Necker Enfants Malades, Paris, France
| | - P Kuentz
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France
| | - J Thevenon
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
| | - M Laville
- Département d'Endocrinologie, Diabétologie et Nutrition, Hospices Civils de Lyon, Centre Hospitalier Lyon-Sud, Pierre-Bénite, France.,Institut National de la Santé et de la Recherche Médicale Unité 1060, Centre Européen pour la nutrition et la Santé, Centre de Recherche en Nutrition Humaine Rhône-Alpes, Université Claude Bernard Lyon, Pierre-Bénite, France
| | - Y Reznik
- Service d'Endocrinologie, Centre Hospitalier Universitaire Côte-de-Nacre, Caen, France
| | - C Fagour
- Département d'Endocrinologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - M-L Nunes
- Département d'Endocrinologie, Hôpital Haut-Lévêque, Centre Hospitalier Universitaire de Bordeaux, Pessac, France
| | - D Delesalle
- Service de pédiatrie, CH de Valencienne, Valencienne, France
| | - S Manouvrier
- Centre de Référence CLAD NdF - Service de génétique clinique Guy Fontaine, CHRU de Lille - Hôpital Jeanne de Flandre, Lille, France
| | - O Lascols
- INSERM, UMR_S938, Centre de Recherche Saint-Antoine, Paris, France.,UPMC Univ Paris 06, Paris, France.,ICAN, Institute of Cardiometabolism And Nutrition, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France.,AP-HP, Hôpital Saint-Antoine, Laboratoire Commun de Biologie et Génétique Moléculaires, Paris, France
| | - F Huet
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Service de Pédiatrie 1, Centre Hospitalier Universitaire Dijon, Dijon, France
| | - C Binquet
- Centre d'Investigation Clinique-Epidémiologique Clinique/essais cliniques du CHU de Dijon, Dijon, France
| | - L Faivre
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
| | - J-B Rivière
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,CHU Dijon, Laboratoire de Génétique Moléculaire, Dijon, France
| | - C Vigouroux
- INSERM, UMR_S938, Centre de Recherche Saint-Antoine, Paris, France.,UPMC Univ Paris 06, Paris, France.,ICAN, Institute of Cardiometabolism And Nutrition, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France.,AP-HP, Hôpital Saint-Antoine, Laboratoire Commun de Biologie et Génétique Moléculaires, Paris, France
| | - P R Njølstad
- Department of Pediatrics, Haukeland, University Hospital, Bergen, Norway
| | - A M Innes
- Department of Medical Genetics, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute for Child and Maternal Health, University of Calgary, Calgary, Canada
| | - C Thauvin-Robinet
- EA4271 "Génétique des Anomalies du Développement" (GAD), Université de Bourgogne, Dijon, France.,Centre de Génétique et Centre de Référence Anomalies du Développement et Syndromes Malformatifs de l'interrégion Est, FHU-TRANSLAD, Dijon, France
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