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Wang D, Su N, Wang R, Zhang L, Qi Z, Liu Z, Yang J, Leng J, Xiang Y. Serous surface papillary borderline ovarian tumors: correlation of sonographic features with clinic pathological findings. Ultrasound Obstet Gynecol 2024; 63:691-698. [PMID: 37592848 DOI: 10.1002/uog.27454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/23/2023] [Accepted: 08/04/2023] [Indexed: 08/19/2023]
Abstract
Serous surface papillary borderline ovarian tumor (SSPBOT) is a distinct subtype of serous borderline ovarian tumor characterized by solid tissue deposition confined to the ovarian surface. Because SSPBOT is rare, there are few published reports on the ultrasonographic features of this condition. In this retrospective study, we investigated 12 cases of SSPBOT. Ultrasound imaging of SSPBOT showed grossly normal ovaries that were encased partially or wholly by tumor deposits that were confined to the surface, with clear demarcation between normal ovarian tissue and surrounding tumors. Color Doppler imaging demonstrated the 'fireworks sign' in all cases of SSPBOT, corresponding to an intratumoral vascular bundle originating from the ovarian vessels and supplying hierarchical branching blood flow to the surrounding tumor. No patient with ovarian high-grade serous carcinoma showed these morphological and Doppler features. In our series, the fireworks sign appeared to be a characteristic feature of SSPBOT that could facilitate correct identification of this tumor. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- D Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - N Su
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - R Wang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - L Zhang
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Z Qi
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - Z Liu
- Department of Ultrasound, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China
| | - J Yang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - J Leng
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
| | - Y Xiang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, People's Republic of China
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Lui F, Finik J, Wu M, Leng J, Gany F. The Association of Untreated Mental Health Problems with Alcohol and Tobacco use Among New York City Taxi Drivers. J Community Health 2023; 48:1015-1025. [PMID: 37322364 PMCID: PMC10658444 DOI: 10.1007/s10900-023-01246-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Accepted: 06/01/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Mental disorders and substance use disorders are highly comorbid. The "self-medication hypothesis" posits that individuals may use substances such as tobacco and alcohol to cope with symptoms associated with untreated mental health problems. The present study examined the association between having a currently untreated mental health condition and tobacco and alcohol use among male taxi drivers in NYC, a population at risk for poor mental and physical health outcomes. METHODS The sample included 1105 male, ethnoracially diverse, primarily foreign-born NYC taxi drivers participating in a health fair program. This secondary cross-sectional analysis utilized logistic regression modeling to examine whether endorsement of a currently untreated mental health problem (i.e., depression, anxiety, or posttraumatic stress disorder) was associated with alcohol and/or tobacco use, controlling for potential confounders. RESULTS 8.5% of drivers reported having mental health problems; among these, only 0.5% reported receiving treatment. Untreated mental health problems were associated with an increased risk of current tobacco/alcohol use after controlling for age, educational attainment, nativity, and pain history: drivers with untreated mental health problems had 1.9x the odds of reporting current tobacco use [95% CI: 1.10-3.19] and 1.6x the odds of reporting current alcohol use [95% CI: 1.01-2.46] than those without untreated mental health problems. CONCLUSIONS Few drivers with mental health problems receive treatment. In line with the self-medication hypothesis, drivers with untreated mental health problems demonstrated significantly increased risk of tobacco and alcohol use. Efforts to encourage timely screening and treatment of mental health problems among taxi drivers are warranted.
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Affiliation(s)
- Florence Lui
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Jackie Finik
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Lui F, Zhang Q, Bao G, Narang B, Chen RY, Niu Y, Leng J, Breitbart W. Refinement of a Meaning-Centered Counseling Program for Chinese Patients with Advanced Cancer: Integrating Cultural Adaptation and Implementation Science Approaches. Res Sq 2023:rs.3.rs-3576089. [PMID: 38045381 PMCID: PMC10690327 DOI: 10.21203/rs.3.rs-3576089/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Background: This mixed methods study identified needed refinements to a telehealth-delivered cultural and linguistic adaptation of Meaning-Centered Psychotherapy for Chinese patients with advanced cancer (MCP-Ch) to enhance acceptability, comprehensibility, and implementation of the intervention in usual care settings, guided by the Ecological Validity Model (EVM) and the Practical, Robust Implementation and Sustainability Model (PRISM). Methods: 15 purposively sampled mental health professionals who work with Chinese cancer patients completed surveys providing Likert-scale ratings on acceptability and comprehensibility of MCP-Ch content (guided by the EVM) and pre-implementation factors (guided by PRISM), followed by semi-structured interviews. Survey data were descriptively summarized and linked to qualitative interview data. Three analysts independently coded the transcripts according to EVM and PRISM domains; discrepancies were resolved through discussion and consensus. Results: Quantitative findings showed high appropriateness and relevance of MCP-Ch across five EVM domains of Language, Metaphors/Stories, Goals, Content, and Concepts. Qualitative analysis yielded 23 inductive codes under the seven EVM domains: (1) Language (3 subcodes), (2) Persons (2 subcodes), (3) Metaphors/Stories (2 subcodes), (4) Methods (8 subcodes), (5) Content (2 subcodes), (6) Goals (4 subcodes), and (7) Concepts (2 subcodes). Themes based on PRISM included (1) Intervention characteristics (organizational perspective, 7 subcodes; and patient perspective, 6 subcodes) (2) External environment (2 subcodes), (3) Implementation and sustainability infrastructure (4 subcodes), and (4) Recipients (organizational characteristics, 5 subcodes; and patient characteristics, 4 subcodes). Conclusion: Recommendations for next steps include increasing the MCP-Ch protocol's flexibility and adaptability to allow interventionists to flexibly tailor MCP-Ch material to meet patients' individual needs, simplifying content to improve comprehension and acceptability, providing additional training to Chinese-serving providers to increase adoption and sustainability, and considering interpreter-assisted delivery to increase access. Findings yielded important information to maximize cultural relevance as well as the implementation and sustainability potential of MCP-Ch in real-world settings.
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Leng J, Lui F, Narang B, Cabral J, Finik J, Wu M, Tonda J, Gany F. An Innovative Approach to Promote Weight Loss Among Mexican Immigrants: A Pilot Study. J Immigr Minor Health 2023:10.1007/s10903-023-01562-6. [PMID: 37934337 DOI: 10.1007/s10903-023-01562-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 11/08/2023]
Abstract
Mexican Americans are among the highest risk groups for obesity and its associated health consequences, including diabetes, heart disease, and cancer. 154 overweight/obese Mexican Americans recruited from the Mexican Consulate in New York City were enrolled in COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), a 12-week Spanish-language lifestyle intervention that included a dietary counseling session, weight-loss resources, and thrice-weekly text messages. Participants' weight (primary outcome); dietary intake, physical activity, and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention. Of the 109 who completed follow-up, 28% lost ≥ 5% of their baseline body weight. Post-intervention, participants consumed more fruit and less soda, sweet pastries, fried foods and red meat; increased physical activity; and evidenced greater nutrition knowledge. A community-based lifestyle intervention with automated components such as text messaging may be a scalable, cost-effective approach to address overweight/obesity among underserved populations.
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Affiliation(s)
- Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Ave, New York, NY, 10016, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
| | - Florence Lui
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Ave, New York, NY, 10016, USA
| | - Jacqueline Cabral
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Ave, New York, NY, 10016, USA
| | - Jacqueline Finik
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Ave, New York, NY, 10016, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Ave, New York, NY, 10016, USA
| | - Josana Tonda
- Ventanillas de Salud Program at the Consulate General of Mexico, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 633 3rd Ave, New York, NY, 10016, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
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Lee B, Leng J, Kerbel R. Using a Clinical Triggers System to Improve Early Recognition of Clinical Changes. CLIN NURSE SPEC 2023; 37:228-236. [PMID: 37595197 DOI: 10.1097/nur.0000000000000769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/20/2023]
Abstract
PURPOSE A medical-surgical telemetry unit implemented a clinical triggers system for early recognition of clinical deterioration and bedside management between nurses and providers. The goal was to decrease cardiopulmonary arrest events. DESCRIPTION OF THE PROJECT A clinical triggers system was developed to help nurses to identify clinical markers early and advocate for prompt bedside assessment and interventions. When clinical triggers were identified, the nurse notified the provider, who performed a bedside assessment within 15 minutes. If the provider did not respond promptly, the rapid response team was activated. OUTCOMES Before intervention, the unit experienced 14 cardiopulmonary arrest events (rate of 1.37 per 1000 patient days). Incidences decreased annually to 5, 4, and 3 events (rates of 0.49, 0.39, and 0.3 per 1000 patient days) during the 3-year implementation period. CONCLUSIONS The clinical triggers system was successful in achieving the project objective of decreasing unit cardiopulmonary arrest events through early recognition and response to patient deterioration during the implementation period. The clinical nurse specialist helped nurses to use the clinical triggers system to detect and respond to clinical changes. Nurses were empowered to address concerns and promote patient safety.
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Affiliation(s)
- Betty Lee
- Author Affiliations: Clinical Nurse Specialist (Ms Lee) and Clinical Nurse (Ms Leng), UCLA Health; and Associate Professor of Medicine (Dr Kerbel), David Geffen School of Medicine, UCLA, Santa Monica, California
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Lui F, Lewicka M, Bao GC, Moyer A, Boyce L, Leng J. A systematic review and meta-analysis of psychosocial interventions for immigrant and limited English proficient cancer patients. Psychooncology 2023; 32:516-557. [PMID: 36792931 PMCID: PMC10410571 DOI: 10.1002/pon.6110] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/02/2023] [Accepted: 02/05/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Immigrants, particularly those who are less acculturated and limited English proficient (LEP), often lack access to culturally and linguistically appropriate psychosocial care in cancer survivorship. We sought to determine what psychosocial interventions are available for immigrant and/or LEP cancer patients and to assess treatment and patient factors that may correlate with better psychosocial outcomes for this population. METHODS We conducted a systematic review and meta-analysis of studies published through August 2022 of interventions conducted with immigrant and/or LEP cancer patients aimed at improving psychosocial outcomes (i.e., quality of life, depression, cancer-related distress, and anxiety). Using Covidence, a software program for systematic review management, four independent raters screened 16,123 records with a systematic process for reconciling disagreement, yielding 48 articles (45 studies) for systematic review and 21 studies for meta-analysis. RESULTS Most studies were conducted with Spanish-speaking patients with breast cancer. Study participants (N = 5400) were primarily middle-aged (mean = 53 years old), female (90.0%), and Hispanic (67.0%). The weighted average effect size (g) across studies was 0.14 (95% CI 0.03-0.26) for quality of life (18 studies), 0.04 (95% CI -0.08 to 0.17) for depression (8 studies), 0.14 (95% CI -0.03 to 0.31) for cancer-related distress (6 studies), and 0.03 (95% CI -0.11 to 0.16) for anxiety (5 studies). CONCLUSION The interventions under review had small but beneficial effects on psychosocial outcomes for immigrant and LEP cancer patients. Notably, effect sizes were smaller than those found in previous meta-analyses of psychosocial interventions conducted in majority U.S.-born, non-Hispanic White, English-speaking cancer patient samples. More research is needed to identify key components and adaptations of interventions that benefit immigrant and LEP cancer patients to strengthen their effects for this growing yet underserved population.
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Affiliation(s)
- Florence Lui
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center; Department of Psychiatry, Weill Cornell Medical College
| | - Malwina Lewicka
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - George C. Bao
- Department of Medicine, Weill Cornell Medical College
| | - Anne Moyer
- Department of Psychology, Stony Brook University
| | - Lindsay Boyce
- Medical Library, Memorial Sloan Kettering Cancer Center
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center; Department of Healthcare Policy and Research, Weill Cornell Medical College
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Gany FM, Meraji NN, Narang B, Wu M, Leng J. Food insecurity among New York City taxi and for-hire vehicle drivers. Work 2023; 74:1585-1594. [PMID: 36530123 PMCID: PMC10191220 DOI: 10.3233/wor-211471] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND New York City's (NYC's) taxi/for-hire vehicle (FHV) drivers have occupational and demographic characteristics associated with food insecurity (low income, comorbidities, minority race/ethnicity). OBJECTIVE To analyze food insecurity rates in a sample of NYC drivers and to identify associated factors. METHODS At health fairs, we recruited a cross-sectional sample of licensed taxi/FHV drivers willing to receive study text messages. Most lacked a primary care provider. Food insecurity prevalence and associations with health and economic indicators were analyzed. RESULTS Of 503 participants who completed a 2-item food security screener, 39.2% were food insecure. Significantly fewer food insecure than food secure drivers reported a doctor visit within the past year (48% vs 25%; P < .001). Food insecure drivers had greater weekly traffic ticket expenditure ($34 vs $24; P = .02) and were more likely to report insufficient household income (61% vs 39%; P < .001) and history of depression (14% vs 7%; P = .02), to have elevated (>200) measured total cholesterol (50% vs 37%; P = .02), and to have Perceived Stress Scale scores indicating greater stress than food secure drivers (14 vs 11; P = .002). In a binary logistic regression analysis, drivers who reported that their total household income was enough to meet their basic needs had significantly lower odds of being food insecure (0.695 odds ratio; P = .016). CONCLUSION Food insecurity was high in this group of taxi/FHV drivers. Food insecurity interventions are needed and could be occupationally based, with worksite screening and resource navigation. Policies should address improving wages and healthcare access.
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Affiliation(s)
- Francesca M Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA
| | - Nujbat Nasim Meraji
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA
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Leng J, Lui F, Narang B, Puebla L, Finik J, Wu M, Tonda J, Gany F. A Pilot Group-Based Lifestyle Intervention to Promote Weight Loss Among Mexican Immigrants. J Community Health 2022; 47:885-893. [PMID: 35902442 PMCID: PMC10105641 DOI: 10.1007/s10900-022-01124-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Subscribe] [Scholar Register] [Accepted: 07/14/2022] [Indexed: 12/26/2022]
Abstract
Mexican Americans are at increased risk for obesity upon immigration to the U.S., increasing their risk for diabetes, cardiovascular disease, and cancer. Our pilot individual lifestyle intervention culturally tailored for Mexican Americans, COMIDA (Consumo de Opciones Más Ideales De Alimentos) (Eating More Ideal Food Options), showed promising results. This paper presents outcomes from the group-based version of COMIDA. 129 overweight/obese Mexican Americans were enrolled in 'Group COMIDA'. Participants' weight (primary outcome), dietary intake and nutrition knowledge (secondary outcomes) were assessed pre- and post-intervention. Seventeen percent of participants experienced 5% weight loss at follow-up. Post-intervention, participants consumed more fruit and vegetables and fewer sweets and fried foods. A group-based, culturally adapted lifestyle intervention may be a more cost-effective approach than individual interventions to improve dietary behavior among underserved populations, though additional modifications may be considered to increase the intervention's effectiveness in promoting significant weight loss.
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Affiliation(s)
- Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
- Immigrant Health and Cancer Disparities Service, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA.
| | - Florence Lui
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Leslie Puebla
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Jacqueline Finik
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Josana Tonda
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Francesca Gany
- Department of Psychiatry and Behavioral Sciences, Department of Medicine, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
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Gany F, Melnic I, Wu M, Li Y, Finik J, Ramirez J, Blinder V, Kemeny M, Guevara E, Hwang C, Leng J. Food to Overcome Outcomes Disparities: A Randomized Controlled Trial of Food Insecurity Interventions to Improve Cancer Outcomes. J Clin Oncol 2022; 40:3603-3612. [PMID: 35709430 PMCID: PMC9622577 DOI: 10.1200/jco.21.02400] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/08/2022] [Accepted: 05/05/2022] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Food insecurity is prevalent among low-income immigrant and minority patients with cancer. To our knowledge, this randomized controlled trial is the first to prospectively examine the impact on cancer outcomes of food insecurity interventions, with the goal of informing evidence-based interventions to address food insecurity in patients with cancer. METHODS A three-arm randomized controlled trial was conducted among food-insecure (18-item US Department of Agriculture Household Food Security Survey Module score ≥ 3) patients with cancer (N = 117) at four New York City safety net cancer clinics. Arms included a hospital cancer clinic-based food pantry (arm 1), food voucher plus pantry (arm 2), and home grocery delivery plus pantry (arm 3). Treatment completion (primary outcome) and full appointment attendance were assessed at 6 months. Food security status, depression symptoms (Patient Health Questionnaire-9), and quality-of-life scores (Functional Assessment of Cancer Therapy-General) were assessed at baseline and at 6 months. RESULTS Voucher plus pantry had the highest treatment completion rate (94.6%), followed by grocery delivery plus pantry (82.5%) and pantry (77.5%; P = .046). Food security scores improved significantly in all arms, and Patient Health Questionnaire-9 and Functional Assessment of Cancer Therapy-General scores improved significantly in the pantry and delivery plus pantry arms. CONCLUSION Our findings in this preliminary study suggest that voucher plus pantry was the most effective intervention at improving treatment completion, and it met our a priori criterion for a promising intervention (≥ 90%). All interventions demonstrated the potential to improve food security among medically underserved, food-insecure patients with cancer at risk of impaired nutrition status, reduced quality of life, and poorer survival. All patients with cancer should be screened for food insecurity, with evidence-based food insecurity interventions made available.
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Affiliation(s)
- Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Public Health, Weill Cornell Medical College, New York, NY
| | - Irina Melnic
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Yuelin Li
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jackie Finik
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Julia Ramirez
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Victoria Blinder
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Public Health, Weill Cornell Medical College, New York, NY
| | | | | | | | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
- Department of Public Health, Weill Cornell Medical College, New York, NY
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Lui F, Finik J, Leng J, Gany F. Social determinants and health-related quality of life in a sample of diverse, low socioeconomic status cancer patients. Psychooncology 2022; 31:1922-1932. [PMID: 35953894 PMCID: PMC10108711 DOI: 10.1002/pon.6006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/13/2022] [Accepted: 07/18/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES In the United States, medically underserved populations, such as ethnoracially underrepresented groups, the limited English proficient (LEP), and the unemployed, may be vulnerable to poor functioning in cancer survivorship. The present study examined whether race/ethnicity, LEP status, and unemployment status were associated with poor health-related quality of life (HRQL) in four domains (physical, social, emotional, and functional well-being (FWB)) in a diverse, low socioeconomic status (SES) sample of cancer patients. METHODS The sample included 1592 ethnoracially diverse, low SES, primarily foreign-born adult oncology patients participating in an enhanced patient navigation program in 11 New York City hospital-based cancer clinics. This secondary cross-sectional analysis of program intake data examined bivariate associations between sociodemographic and clinical factors and poor HRQL (Functional Assessment of Cancer Therapy-General scores ≤70). Factors found to be related to poor HRQL (at p < 0.05) were entered into logistic regressions with overall HRQL and the four HRQL subscales as outcomes. The Benjamini-Hochberg Procedure controlled for potentially inflated type-I error rate due to multiple comparisons. RESULTS All three predictor variables (race/ethnicity, LEP status, and unemployment status) were significantly associated with increased odds of reporting poor FWB. Specifically, non-Hispanic White and Hispanic cancer patients had 2.7 and 1.5 times the odds of reporting poor FWB than non-Hispanic Black patients. The unemployed had 1.4 times the odds of reporting poor FWB than their employed or retired counterparts. Limited EP patients had 1.4 times the odds of reporting poor FWB than EP participants. Non-Hispanic Black patients evidenced significantly lower odds of reporting poor HRQL across all subscale domains compared with other ethnoracial groups. CONCLUSIONS LEP and unemployed individuals were more likely to report poor FWB, which may indicate that the most marginalized cancer patients face significant barriers to adequate functioning. Interventions that promote functional abilities (i.e., activities of daily living, self-care, and work retention) and policies and programs that reduce systemic inequality and address social determinants of health may aid in improving HRQL for these underserved groups in survivorship. Non-Hispanic Black cancer patients were less likely than other groups to report poor physical, social, emotional, and FWB. Identifying protective factors in this group may aid in efforts to improve HRQL for all patients.
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Affiliation(s)
- Florence Lui
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jackie Finik
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center; Department of Healthcare Policy and Research, Weill Cornell Medical College
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center; Department of Healthcare Policy and Research, Weill Cornell Medical College
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Leng J, Lei SF, Lei L, Cortez J, Capua J, Lui F, Gany F. Primary Care Providers' Knowledge, Attitudes, Beliefs, and Practice Related to Lung Cancer Screening in Five High-Risk Communities in New York City. J Cancer Educ 2022; 37:631-640. [PMID: 32844367 PMCID: PMC7904966 DOI: 10.1007/s13187-020-01857-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Racial/ethnic minorities face stark inequalities in lung cancer incidence, treatment, survival, and mortality compared with US born non-Hispanic Whites. Lung cancer screening (LCS) with low-dose computed tomography (LDCT) is effective at reducing lung cancer mortality in high-risk current and former smokers and is recommended by the US Preventive Services Task Force (USPSTF). This study sought to assess primary care providers' (PCPs') knowledge, attitudes, beliefs, and practice related to LCS and the recent USPSTF guidelines in five high-risk immigrant communities in New York City. We surveyed 83 eligible PCPs between December 2016 and January 2018 through surveys sent by mail, email, and fax, administered by phone or in person. The survey included questions about providers' clinical practice, knowledge, attitudes, and beliefs related to LCS and the USPSTF guidelines. Information about patient demographics, PCPs' training background, and practice type were also collected. Sixty-seven percent of respondents reported that they did not have established guidelines for LCS at their practice, and 52% expressed that "vague" screening criteria influenced their referral processes for LCS. Barriers to LCS with LDCT included concerns that LDCT is not covered by insurance, patients' fears of screening results, and patients' concerns regarding radiation exposure. Targeted educational interventions for both PCPs and patients may increase access to recommended LCS, especially for populations at disproportionate risk for lung cancer.
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Affiliation(s)
- Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
| | - Shu Fang Lei
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lei Lei
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jeralyn Cortez
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - John Capua
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Florence Lui
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Clinical Psychology, The City College of New York, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
- Department of Healthcare Policy and Research, Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Leng J, Li R, Lui F, Gany F. Healthcare Professionals' Perspectives on Adapting a Community Health Worker Model to Facilitate Lung Cancer Screening for Chinese For-Hire Vehicle Drivers. J Cancer Educ 2022; 37:311-318. [PMID: 32583351 PMCID: PMC7759596 DOI: 10.1007/s13187-020-01813-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Chinese immigrant for-hire vehicle (FHV) drivers who smoke or smoked are at high risk for lung cancer due to the combined impact of tobacco use and air pollution exposure yet underutilize lung cancer screening (LCS). Community Health Worker (CHW) programs have been effective at improving cancer screening rates. This study describes a community needs assessment to inform the adaptation of an existing CHW intervention to facilitate LCS among Chinese FHV drivers. Interviews were conducted until saturation with 13 Chinese-serving health professionals to determine the community's needs, priorities, and preferences. Transcripts were qualitatively analyzed using Atlas.ti. Seven frequently occurring themes were identified: knowledge of guidelines/access to LCS, acceptability of CHW program, CHW role in screening process, qualities of an ideal CHW, barriers to LCS, challenges to implementing a CHW program, and adaptations to CHW program. The adapted CHW intervention should include culturally tailored health education to increase LCS knowledge for patients and providers.
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Affiliation(s)
- Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, 10017, USA.
| | - Randall Li
- Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Florence Lui
- City College & The Graduate Center, City University of New York, New York, NY, USA
| | - Francesca Gany
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, 10017, USA
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13
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Leng J, Lui F, Narang B, Puebla L, González J, Lynch K, Gany F. Developing a Culturally Responsive Lifestyle Intervention for Overweight/Obese U.S. Mexicans. J Community Health 2022; 47:28-38. [PMID: 34291359 PMCID: PMC8881907 DOI: 10.1007/s10900-021-01016-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Hispanics are the largest minority group in the United States, constituting 18 % of the population. Mexicans are the largest Hispanic subgroup and are at disproportionate risk for overweight/obesity. Lifestyle interventions targeting dietary change and physical activity have resulted in significant weight loss in several large randomized clinical trials in the general population, but few studies have tailored interventions to Mexican Americans. We conducted a community needs assessment from 2018 to 2020 in accordance with Domenech-Rodriguez and Wieling's Cultural Adaptation Process (CAP) model to inform the development of SANOS (SAlud y Nutrición para todOS) (Health and Nutrition for All), a culturally-tailored, community-based diet and lifestyle education and counseling program that addresses overweight/obesity among U.S. Mexicans. METHODS Five Spanish-language focus groups were conducted until thematic saturation with 31 overweight/obese Mexicans in New York City about their knowledge, priorities, and preferences regarding diet, exercise, and evidence-based strategies for behavioral change. A grounded theory approach was used to analyze the data. RESULTS Five themes were identified: (1) A strong desire for tangible information related to diet and health, (2) Family as a primary motivator for behavior change, (3) Desire for group-based motivation and accountability to sustain intervention participation, (4) Belief in short-term goal setting to prevent loss of motivation, and (5) Time and workplace-related barriers to intervention adoption. CONCLUSIONS Ecological factors such as the effect of acculturation on diet, family members' role in behavior change, and socioenvironmental barriers to healthy dietary practices and physical activity should be considered when adapting evidence-based treatments for Mexican Americans.
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Affiliation(s)
- Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
| | - Florence Lui
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Bharat Narang
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Leslie Puebla
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Javier González
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Kathleen Lynch
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Francesca Gany
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Leng J, Lui F, Gany F. Chinese Livery Drivers' Perspectives on Adapting a Community Health Worker Intervention to Facilitate Lung Cancer Screening. J Health Care Poor Underserved 2022; 33:332-348. [PMID: 35153223 PMCID: PMC9126037 DOI: 10.1353/hpu.2022.0024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chinese immigrant livery drivers with a smoking history are at high risk for lung cancer. A culturally adapted community health worker (CHW) program may be an effective approach to increase lung cancer screening (LCS) uptake in this underserved group. Five focus groups were conducted with 39 Chinese immigrant male livery drivers with a smoking history in New York City to assess their needs, priorities, and preferences regarding the proposed intervention. Transcripts were qualitatively analyzed using Atlas. ti. Focus group participants were uncertain about whether smoking was associated with cancer, unfamiliar with LCS, and reported numerous barriers to LCS uptake. Most believed a CHW program to facilitate LCS would be acceptable and feasible, if tailored to meet their needs. Our results have implications for improving access to early detection of lung cancer and preventive care (e.g., culturally appropriate smoking cessation and health education programs) for Chinese livery drivers.
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Gany F, Melnic I, Ramirez J, Wu M, Li Y, Paolantonio L, Roberts-Eversley N, Blinder V, Leng J. The association between housing and food insecurity among medically underserved cancer patients. Support Care Cancer 2021; 29:7765-7774. [PMID: 34169329 PMCID: PMC8225310 DOI: 10.1007/s00520-021-06254-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess the prevalence of socioeconomic needs and associations between housing characteristics and food insecurity among low-income cancer patients, among whom housing and food insecurity are particularly prevalent. METHODS Low-income cancer patients in active treatment (N = 1618) were enrolled in a comprehensive patient navigation program. Food insecurity was assessed using the 18-item US Department of Agriculture US Household Food Security Survey Module. Participants self-reported their need for assistance with housing issues/type of assistance needed, perception of overcrowding, satisfaction with living situation, and household density via a cross-sectional survey. Descriptive analyses, cross-tabulations and tests of proportions, and binary logistic regression were used in data analyses. RESULTS Seventy percent of patients were food insecure. Housing characteristics associated with food insecurity were homelessness or living in sheltered/supportive housing (83.3% food insecure), renting (71.9%), and homeownership (58.1%; p < .001); living situation satisfaction (not satisfied, 79.4%; somewhat satisfied, 25.6%; very satisfied, 66%; p < .001); need of housing assistance (79.2%; p < .001), and feeling crowded in their living unit (77.6%; p < .05). Associations of living unit type with food insecurity were significant in the binary logistic regression model (renters 1.68 OR, homeless/sheltered housing 2.80 OR vs homeowners). CONCLUSION The vulnerability to food insecurity of patients in this low-income sample was underlined by the high rates found, and clear associations with housing characteristics of homelessness, housing assistance needs, and feeling overcrowded were identified. These results could help shape priorities around screening patients for nutrition and housing needs and developing interventions to address them.
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Affiliation(s)
- Francesca Gany
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA.
- Department of Medicine, Department of Public Health, Weill Cornell Medical College, New York, NY, USA.
| | - Irina Melnic
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Julia Ramirez
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Minlun Wu
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Luke Paolantonio
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Nicole Roberts-Eversley
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Victoria Blinder
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Department of Public Health, Weill Cornell Medical College, New York, NY, USA
| | - Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Department of Public Health, Weill Cornell Medical College, New York, NY, USA
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Mujawar I, Leng J, Roberts-Eversley N, Narang B, Kim SY, Gany F. Sleep behavior of New York City taxi drivers compared to the general US population. J Transp Health 2021; 22:101237. [PMID: 35783554 PMCID: PMC9249005 DOI: 10.1016/j.jth.2021.101237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Introduction Taxi drivers are a low income population with long work hours, a high-stress sedentary occupation, and varied work shifts, augmenting their risk for sleep disorders. We evaluated sleep quality among New York City (NYC) taxi drivers, a predominantly immigrant/minority population, for associations with sleep outcomes and examined intervention development and policy implications. Methods A cross-sectional survey was conducted at driver-frequented locations with 211 consenting NYC taxi drivers and included the 12-item Medical Outcomes Study Sleep Scale and the Perceived Stress Scale-10. For five domains (sleep disturbance, snoring, shortness of breath, sleep adequacy, and somnolence) and Sleep Problems Index-II, self-reported scores were calculated and normed against a nationally representative 2009 US sample to obtain standardized t-test scores. Scores <47 were lower than US averages, indicating worse sleep quality. Results were explored in multivariable linear and logistic regression models. Results Almost one-half (47%) of drivers had scores indicating sleep quality below US averages for snoring, 36% for shortness of breath/obstruction, and 19% for somnolence. There were significant associations of perceived stress with Sleep Problems Index II (p<0.001), sleep disturbance (p<0.001), somnolence (p<0.001), and sleep adequacy (p<0.05). Stress was predictive of sleep adequacy (p<0.05, bivariate; p<0.05, multivariate) and shortness of breath/obstruction (p<0.01, bivariate; p<0.001, multivariate). Nightshift drivers had significantly worse sleep disturbance scores than dayshift drivers (p<0.05). Taxi drivers were more likely to get an inadequate amount of daily sleep (<7 hours) than the average US male (48.5% vs. 38.3%). Conclusions Sleep hygiene and stress management interventions could benefit the health of this population and improve driver and public safety. The associations of taxi driver sleep quality and stress indicate an opportunity for targeted intervention. Further research into sleep as an important determinant of taxi driver health is needed, especially in the burgeoning for-hire vehicle (Uber, Lyft, etc) sector.
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Affiliation(s)
- Imran Mujawar
- Immigrant Health and Cancer Disparities, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
| | - Nicole Roberts-Eversley
- Immigrant Health and Cancer Disparities, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Soo Young Kim
- Immigrant Health and Cancer Disparities, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Gany FM, Leng J. The Experience of Cancer as an Immigrant. Psychooncology 2021. [DOI: 10.1093/med/9780190097653.003.0078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Immigrants, refugees, and asylum seekers make up approximately 13.6% of the U.S. population (44.4 million people). They have experienced diverse healthcare systems in their sending countries, with varied cancer care options and attitudes toward cancer (e.g., stigmatization). Immigration status and other socioeconomic factors have a deterministic influence on immigrants’ cancer experience, impacting access to treatment and psychosocial resources, and compel the development of linguistically and culturally responsive interventions. Several interventions and programs have been developed to address the socioeconomic and psychosocial factors contributing to cancer health disparities among immigrants. Healthcare access must be greatly improved, and culturally and linguistically responsive evidence-based interventions must be broadly implemented to improve the immigrant experience of cancer.
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Gany F, Mirpuri S, Kim SY, Narang B, Ramirez J, Roberts-Eversley N, Ocampo A, Aragones A, Leng J. Predictors of Health Insurance, Life Insurance, and Retirement Savings Among NYC's Immigrant Taxi and For-Hire Vehicle Drivers. J Community Health 2020; 45:1098-1110. [PMID: 32803621 PMCID: PMC7429200 DOI: 10.1007/s10900-020-00903-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Taxi and for-hire vehicle (FHV) drivers are a predominantly immigrant population facing a range of occupational stressors, including lack of workplace benefits and increasing financial strain from tumultuous industry changes and now COVID-19's devastating impact. Bilingual research staff surveyed 422 New York City taxi/FHV drivers using a stratified sampling approach in driver-frequented locations to examine drivers' health and financial planning behaviors for the first time. Drivers lacked health insurance at double the NYC rate (20% vs. 10%). Life insurance and retirement savings rates were lower than U.S. averages (20% vs. 60%, 25% vs. 58%, respectively). Vehicle ownership was a significant predictor of health insurance, life insurance, and retirement savings. Compared to South Asian drivers, Sub-Saharan African drivers were significantly less likely to have health insurance and North African, and Middle Eastern drivers were significantly less likely to have retirement savings. Although most drivers indicated the importance of insurance and benefits, < 50% understood how to use them. Drivers felt primary care coverage to be most important followed by other health-related coverage, retirement benefits, and life insurance. Results reveal compelling addressable gaps in insurance and benefits coverage and the need to implement accessible financial literacy with navigation and advising services and programs.
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Affiliation(s)
- Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA.
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA.
| | - Sheena Mirpuri
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Soo Young Kim
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Bharat Narang
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Julia Ramirez
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Nicole Roberts-Eversley
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Alex Ocampo
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
| | - Abraham Aragones
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd FL, New York, NY, 100065, USA
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA
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Leng J, Lei L, Lei SF, Zhu Z, Ocampo A, Gany F. Use of Traditional Chinese Herbal Medicine Concurrently with Conventional Cancer Treatment Among Chinese Cancer Patients. J Immigr Minor Health 2020; 22:1240-1247. [PMID: 32418000 PMCID: PMC8279391 DOI: 10.1007/s10903-020-01017-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In the U.S. and Canada, Traditional Chinese Medicine (TCM) use has become increasingly common; Chinese immigrants have particularly high rates of TCM use. In this study, we used a cross sectional survey study design to assess the specific types of Traditional Chinese Herbal Medicine (TCHM) used, the concurrent use of TCHM and conventional cancer treatment, and communication with providers about TCHM use, among Chinese immigrant cancer patients in New York City (NYC). We surveyed 114 patients from several community and clinical settings in NYC. The mean age was 63, 59% were female, and 83% originated from mainland China. Breast (18%) and lung (21%) cancer were the most common cancer diagnoses, and 60% were receiving conventional cancer treatment at the time of the survey. 75% reported ever using TCHM since their most recent primary cancer diagnosis. 68% of those who used herbs reported concurrent use of TCHM with conventional cancer treatment. Only 13% of those who used herbs reported sharing TCHM use with a provider, and only 19% reported that a provider had ever discussed TCHM use with them. Our findings demonstrated an alarmingly high rate of concurrent use of TCHM and conventional cancer treatment and low rate of communication with providers about TCHM use. A wide variety of herbs were used, including those with potentially negative interactions with conventional treatment. This study highlights the urgent need for the development of interventions to assist providers and patients in improving communication around this important topic.
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Affiliation(s)
- Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
| | - Lei Lei
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Shu Fang Lei
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Zhiying Zhu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Alex Ocampo
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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Selove R, Neil-Sztramko S, Leng J, Walker PD, Salloum RG, Ginossar T, Heckman C, Scheuermann TS, Combs T, Qualls-Hampton R, Armstrong R, Ellis S. Use of implementation science in tobacco control intervention studies in the USA between 2000 and 2020: a scoping review protocol. BMJ Open 2020; 10:e038617. [PMID: 33177136 PMCID: PMC7661380 DOI: 10.1136/bmjopen-2020-038617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 08/24/2020] [Accepted: 09/29/2020] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Despite continuing efforts to reduce tobacco use in the USA, decline in smoking rates have stalled and smoking remains a major contributor to preventable death. Implementation science could potentially improve uptake and impact of evidence-based tobacco control interventions; however, no previous studies have systematically examined how implementation science has been used in this field. Our scoping review will describe the use of implementation science in tobacco control in the USA, identify relevant gaps in research and suggest future directions for implementation science application to tobacco control. METHODS AND ANALYSIS Our team, including a medical research librarian, will conduct a scoping review guided primarily by Arksey and O'Malley's methodology. We will search English language peer-reviewed literature published from 2000 to 31 December 2020 for terms synonymous with 'tobacco use', 'prevention', 'cessation' and 'implementation science'. The databases included in this search are MEDLINE (PubMed), Embase (Ovid), CINAHL (EBSCOhost), PsycINFO (ProQuest), ERIC (ProQuest) and the Cochrane Library (Wiley). We will include cohort and quasi-experimental studies, single-group experiments and randomised trials that report qualitative and/or quantitative data related to applying implementation science to the planning and/or delivery of interventions to prevent or decrease the use of tobacco products. Studies must target potential or active tobacco users, intervention providers such as educators or healthcare professionals, or US policy-makers. A minimum of two reviewers will independently examine each title and abstract for relevance, and each eligible full text for inclusion and analysis. Use of implementation science, demonstrated by explicit reference to implementation frameworks, strategies or outcomes, will be extracted from included studies and summarised. ETHICS AND DISSEMINATION This study is exempt from ethics board approval. We will document the equity-orientation of included studies with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Equity Extension checklist. Results will be submitted for conferences and peer-reviewed journals. TRIAL REGISTRATION NUMBER Open Science Framework Registry (6YRK8).
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Affiliation(s)
- Rebecca Selove
- Center for Prevention Research, Tennessee State University, Nashville, Tennessee, USA
| | | | - Jennifer Leng
- Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Philip D Walker
- Eskind Biomedical Library, Vanderbilt University, Nashville, Tennessee, USA
| | - Ramzi George Salloum
- Health Outcomes & Biomedical Informatics, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Tamar Ginossar
- Communications & Journalism, University of New Mexico, Albuquerque, New Mexico, USA
| | - Carolyn Heckman
- Division of Medicine, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | | | - Todd Combs
- Center for Public Health Systems Science, Washington University in Saint Louis, Saint Louis, Missouri, USA
| | | | - Rebecca Armstrong
- Australian Institute of Family Studies, Melbourne, Victoria, Australia
| | - Shellie Ellis
- Population Health, University of Kansas School of Medicine, Lawrence, Kansas, USA
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21
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Daniels SP, Leng J, Swann JR, Proudman CJ. Bugs and drugs: a systems biology approach to characterising the effect of moxidectin on the horse's faecal microbiome. Anim Microbiome 2020; 2:38. [PMID: 33499996 PMCID: PMC7807906 DOI: 10.1186/s42523-020-00056-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 10/02/2020] [Indexed: 02/08/2023] Open
Abstract
Background Anthelmintic treatment is a risk factor for intestinal disease in the horse, known as colic. However the mechanisms involved in the onset of disease post anthelmintic treatment are unknown. The interaction between anthelmintic drugs and the gut microbiota may be associated with this observed increase in risk of colic. Little is known about the interaction between gut microbiota and anthelmintics and how treatment may alter microbiome function. The objectives of this study were: To characterise (1) faecal microbiota, (2) feed fermentation kinetics in vitro and (3) metabolic profiles following moxidectin administration to horses with very low (0 epg) adult strongyle burdens. Hypothesis: Moxidectin will not alter (1) faecal microbiota, (2) feed fermentation in vitro, or, (3) host metabolome. Results Moxidectin increased the relative abundance of Deferribacter spp. and Spirochaetes spp. observed after 160 h in moxidectin treated horses. Reduced in vitro fibre fermentation was observed 16 h following moxidectin administration in vivo (P = 0.001), along with lower pH in the in vitro fermentations from the moxidectin treated group. Metabolic profiles from urine samples did not differ between the treatment groups. However metabolic profiles from in vitro fermentations differed between moxidectin and control groups 16 h after treatment (R2 = 0.69, Q2Y = 0.48), and within the moxidectin group between 16 h and 160 h post moxidectin treatment (R2 = 0.79, Q2Y = 0.77). Metabolic profiles from in vitro fermentations and fermentation kinetics both indicated altered carbohydrate metabolism following in vivo treatment with moxidectin. Conclusions These data suggest that in horses with low parasite burdens moxidectin had a small but measurable effect on both the community structure and the function of the gut microbiome.
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Affiliation(s)
- S P Daniels
- School of Equine Management and Science, Royal Agricultural University, Cirencester, Gloucestershire, GL9 6JS, UK. .,School of Veterinary Medicine, University of Surrey, Guildford, Surrey, GU2 7TE, UK.
| | - J Leng
- School of Veterinary Medicine, University of Surrey, Guildford, Surrey, GU2 7TE, UK
| | - J R Swann
- Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, London, SW7 2AZ, UK
| | - C J Proudman
- School of Veterinary Medicine, University of Surrey, Guildford, Surrey, GU2 7TE, UK
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22
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Leng J, Costas-Muniz R, Pelto D, Flores J, Ramirez J, Lui F, Tonda J, Gany F. A Case Study in Academic-Community Partnerships: A Community-Based Nutrition Education Program for Mexican Immigrants. J Community Health 2020; 46:660-666. [PMID: 33025364 DOI: 10.1007/s10900-020-00933-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/28/2020] [Indexed: 11/28/2022]
Abstract
Hispanics are the largest U.S. immigrant group and Mexican Americans are the largest U.S. Hispanic population. Hispanics, particularly Mexican Americans, are among the highest risk groups for obesity, placing them at increased risk for cardiovascular disease and certain types of cancer. Obesity lifestyle interventions incorporating Motivational Interviewing techniques and specific adaptations for the population of interest can have a significant impact on reducing health risks. This paper presents a community-engaged, culturally-sensitive nutrition and dietary counseling intervention conducted between 2016 and 2018 at the Consulate General of Mexico in New York City and reports preliminary findings regarding participant satisfaction and self-reported changes in eating and exercise habits. In addition, it describes the community and academic partners' roles and processes in program development, discusses strengths and challenges posed by a multi-sector partnership and describes adaptations made using the Behavioral Model for Vulnerable Populations to increase the program's sustainability and potential for scalability.
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Affiliation(s)
- Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA. .,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
| | - Rosario Costas-Muniz
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Debra Pelto
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Jessica Flores
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Julia Ramirez
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA
| | - Florence Lui
- City College & the Graduate Center, City University of New York, New York, NY, USA
| | - Josana Tonda
- Ventanillas de Salud Program at the Consulate General of Mexico, New York, NY, USA
| | - Francesca Gany
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center, 485 Lexington Ave., 2nd Floor, New York, NY, 10017, USA.,Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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23
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Fu JD, Yao JJ, Wang H, Cui WG, Leng J, Ding LY, Fan KY. Effects of EGCG on proliferation and apoptosis of gastric cancer SGC7901 cells via down-regulation of HIF-1α and VEGF under a hypoxic state. Eur Rev Med Pharmacol Sci 2020; 23:155-161. [PMID: 30657557 DOI: 10.26355/eurrev_201901_16759] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To investigate the effects of epigallocatechin-3-gallate (EGCG) on proliferation and apoptosis of human gastric cancer SGC7901 cells under a hypoxic state. MATERIALS AND METHODS Human gastric cancer SGC7901 cells were sub-cultured, and the cobalt chloride (CoCl2) hypoxia model was established. The blank control group (normoxia group), hypoxia control group (hypoxia group) and hypoxia + different concentrations of EGCG subgroups (20, 40, 60, 80, 100 μg/mL EGCG) were set up. Cell viability was detected via methyl thiazolyl tetrazolium (MTT) assay, apoptosis was detected via flow cytometry, and expressions of hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) were detected via reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting. RESULTS Relatively low concentrations of EGCG (20-80 μg/mL) presented no significant inhibiting effect on SGC7901 cell growth within a short time (24 h) (p>0.05). The increasing concentration of EGCG inhibited cell proliferation under a hypoxia state (p<0.05). EGCG induced apoptosis in a dose-dependent manner under hypoxia (p<0.05). EGCG could significantly impede expressions of HIF-1α and VEGF proteins (p<0.05), and down-regulate the level of VEGF mRNA (p<0.05), but it showed no significant effect on the HIF-1α mRNA expression (p>0.05). CONCLUSIONS EGCG inhibited cell proliferation under hypoxia via the downregulation of HIF-1α and its downstream target gene VEGF levels, providing a theoretical basis for the early diagnosis and treatment of gastric cancer in clinic.
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Affiliation(s)
- J-D Fu
- Department of Digestive Disease, People's Hospital of Rizhao, Affiliated Clinical Hospital of Jining Medical Univerity, Jining Medical University, Rizhao, Shandong, China.
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24
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Costas-Muñiz R, Roberts N, Narang B, Mehmood R, Acharya S, Aragones A, Leng J, Gany F. Colorectal Cancer Screening and Access to Healthcare in New York City Taxi Drivers. J Immigr Minor Health 2020; 22:526-533. [PMID: 31263989 PMCID: PMC6938571 DOI: 10.1007/s10903-019-00911-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
This study examined differences in colorectal cancer screening across sociodemographic, migration, occupational, and health-related factors in a sample of male taxi drivers. Male drivers eligible for colorectal cancer screening (CRCS) (≥ 50 years old) were recruited in 55 community-based health fairs conducted during November 2015 to February 2017 in 16 taxi garages or community locations located in Queens, Brooklyn, Manhattan and Bronx. Participants completed a survey that included sociodemographic, migration, occupational, health-related, and cancer screening practices. For this study 33 questions were analyzed. The sample consisted of 137 male drivers, 27% of them had undergone CRCS. Occupation-related factors, including night shifts and driving high numbers of weekly hours, were associated with lower CRCS rates; having a family history of cancer, health insurance, a regular source of primary care, and a routine check-up in the last year, were associated with higher CRCS rates. The findings suggest that drivers with health insurance and better access to primary care are more likely to be up-to-date with CRCS. The results provide important information that can inform occupation-based public health interventions.
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Affiliation(s)
- Rosario Costas-Muñiz
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Immigrant Health & Cancer Disparities Service, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA.
| | - Nicole Roberts
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Immigrant Health & Cancer Disparities Service, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Bharat Narang
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Immigrant Health & Cancer Disparities Service, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Rehan Mehmood
- South Asian Council for Social Services, 143-06, 45 Avenue, Flushing, NY, 11355, USA
| | - Sudha Acharya
- South Asian Council for Social Services, 143-06, 45 Avenue, Flushing, NY, 11355, USA
| | - Abraham Aragones
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Immigrant Health & Cancer Disparities Service, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Jennifer Leng
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Immigrant Health & Cancer Disparities Service, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
| | - Francesca Gany
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, Immigrant Health & Cancer Disparities Service, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
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25
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Gany F, Melnic I, Ramirez J, Wu M, Li Y, Paolantonio L, Smith J, Pan S, Roberts-Eversley N, Blinde V, Leng J. Food Insecurity among Cancer Patients Enrolled in the Supplemental Nutrition Assistance Program (SNAP). Nutr Cancer 2020; 73:206-214. [PMID: 32268803 PMCID: PMC8988088 DOI: 10.1080/01635581.2020.1743867] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/14/2019] [Accepted: 11/15/2019] [Indexed: 10/24/2022]
Abstract
Purpose: Food insecurity, which leads to adverse health outcomes, has even more severe implications for cancer patients. Yet medically underserved cancer patients are more likely to be food insecure than the general population.Methods: This study is a cross-sectional analysis of intake data from patients who participated in the Integrated Cancer Care Access Network (ICCAN). ICCAN is a specialized program that addresses socioeconomic barriers to cancer care among underserved cancer patients in NYC. This study utilized ICCAN data from 2011 to 2017. The USDA food insecurity score, self-reported SNAP receipt, and SNAP eligibility based on household income were compared between SNAP and non-SNAP recipients.Results: 681 patients were assessed for food insecurity. Sixty-nine percent of participants lived in food insecure households. Despite SNAP assistance, most SNAP recipients (68%) were food insecure; 69% of respondents who did not receive SNAP were also food insecure.Conclusions: Underserved cancer patients who receive SNAP are still food insecure, hence at more significant risk for its associated negative outcomes. Supplemental programs for patients with chronic diseases are needed in clinics with large low income populations. SNAP benefits should account for the additional financial burden posed by treatment costs and exceptional circumstances faced by cancer patients.
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Affiliation(s)
- Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, Department of Public Health, 1275 York Avenue, New York, NY, USA
| | - Irina Melnic
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Julia Ramirez
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Minlun Wu
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yuelin Li
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Luke Paolantonio
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Julia Smith
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sabrina Pan
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Nicole Roberts-Eversley
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Victoria Blinde
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, Department of Public Health, 1275 York Avenue, New York, NY, USA
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, Department of Public Health, 1275 York Avenue, New York, NY, USA
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Leng J, Li W, Wang L, Zhang S, Liu H, Li W, Wang S, Shao P, Pan L, Wang S, Liu E. Higher thyroid-stimulating hormone levels in the first trimester are associated with gestational diabetes in a Chinese population. Diabet Med 2019; 36:1679-1685. [PMID: 31407386 DOI: 10.1111/dme.14106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/10/2019] [Indexed: 01/11/2023]
Abstract
AIM To evaluate the relationship between maternal thyroid-stimulating hormone levels during the first trimester and gestational diabetes risk. METHODS In Tianjin, China, 7258 women underwent a thyroid-stimulating hormone screening test within 12 gestational weeks and then had a glucose challenge test at 24-28 weeks of gestational age. The women with a glucose challenge test ≥7.8 mmol/l underwent a 75 g oral glucose tolerance test. Gestational diabetes was diagnosed following International Association of Diabetes and Pregnancy Study Group criteria. Restricted cubic spline analysis was performed to explore full-range risk associations of thyroid-stimulating hormone levels with gestational diabetes. Logistic regression was performed to obtain odds ratios and 95% confidence intervals. RESULTS In all, 594 women (8.2%) had gestational diabetes. Among women with thyroid-stimulating hormone ≤3.2 mIU/l, a positive association between thyroid-stimulating hormone levels and gestational diabetes risk was found (adjusted OR: 1.13, 95% CI: 1.00-1.27). There was no relationship between thyroid-stimulating hormone levels and gestational diabetes risk in univariable and multivariable analyses among women with thyroid-stimulating hormone >3.2 mIU/l. In subgroup analyses, among women with thyroid-stimulating hormone ≤3.2 mIU/l and BMI ≥25 kg/m2 , the adjusted odds ratio for thyroid-stimulating hormone levels with gestational diabetes was enhanced to 1.25 (95% CI: 1.02-1.53). CONCLUSIONS In pregnant Chinese women, thyroid-stimulating hormone levels even within normal range in the first trimester were positively related to gestational diabetes risk, especially for pre-pregnancy overweight/obese women.
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Affiliation(s)
- J Leng
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - W Li
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - L Wang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - S Zhang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - H Liu
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - W Li
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - S Wang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - P Shao
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - L Pan
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - S Wang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - E Liu
- Tianjin Women and Children's Health Centre, Tianjin, China
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Davies MR, Kalsi G, Armour C, Jones IR, McIntosh AM, Smith DJ, Walters JTR, Bradley JR, Kingston N, Ashford S, Beange I, Brailean A, Cleare AJ, Coleman JRI, Curtis CJ, Curzons SCB, Davis KAS, Dowey LRC, Gault VA, Goldsmith KA, Bennett MH, Hirose Y, Hotopf M, Hübel C, Kanz C, Leng J, Lyall DM, Mason BD, McAtarsney-Kovacs M, Monssen D, Moulton A, Ovington N, Palaiologou E, Pariante CM, Parikh S, Peel AJ, Price RK, Rimes KA, Rogers HC, Sambrook J, Skelton M, Spaul A, Suarez ELA, Sykes BL, Thomas KG, Young AH, Vassos E, Veale D, White KM, Wingrove J, Eley TC, Breen G. The Genetic Links to Anxiety and Depression (GLAD) Study: Online recruitment into the largest recontactable study of depression and anxiety. Behav Res Ther 2019; 123:103503. [PMID: 31715324 PMCID: PMC6891252 DOI: 10.1016/j.brat.2019.103503] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 09/04/2019] [Accepted: 10/23/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND Anxiety and depression are common, debilitating and costly. These disorders are influenced by multiple risk factors, from genes to psychological vulnerabilities and environmental stressors, but research is hampered by a lack of sufficiently large comprehensive studies. We are recruiting 40,000 individuals with lifetime depression or anxiety and broad assessment of risks to facilitate future research. METHODS The Genetic Links to Anxiety and Depression (GLAD) Study (www.gladstudy.org.uk) recruits individuals with depression or anxiety into the NIHR Mental Health BioResource. Participants invited to join the study (via media campaigns) provide demographic, environmental and genetic data, and consent for medical record linkage and recontact. RESULTS Online recruitment was effective; 42,531 participants consented and 27,776 completed the questionnaire by end of July 2019. Participants' questionnaire data identified very high rates of recurrent depression, severe anxiety, and comorbidity. Participants reported high rates of treatment receipt. The age profile of the sample is biased toward young adults, with higher recruitment of females and the more educated, especially at younger ages. DISCUSSION This paper describes the study methodology and descriptive data for GLAD, which represents a large, recontactable resource that will enable future research into risks, outcomes, and treatment for anxiety and depression.
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Affiliation(s)
- Molly R Davies
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Gursharan Kalsi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Chérie Armour
- School of Psychology, Queens University Belfast (QUB), Belfast, Northern Ireland, UK
| | - Ian R Jones
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - Andrew M McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinurgh, UK
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - James T R Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - John R Bradley
- NIHR BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK
| | - Nathalie Kingston
- NIHR BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK; Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Sofie Ashford
- NIHR BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK; Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Ioana Beange
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinurgh, UK
| | - Anamaria Brailean
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
| | - Anthony J Cleare
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, UK
| | - Jonathan R I Coleman
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Charles J Curtis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Susannah C B Curzons
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Katrina A S Davis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, UK
| | - Le Roy C Dowey
- School of Biomedical Sciences, Ulster University, Coleraine Campus, Northern Ireland, UK; GreenLight Pharmaceuticals Limited, Unit 2, Block E, Nutgrove Office Park, Dublin 14, Ireland
| | - Victor A Gault
- School of Biomedical Sciences, Ulster University, Coleraine Campus, Northern Ireland, UK
| | - Kimberley A Goldsmith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Megan Hammond Bennett
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Yoriko Hirose
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinurgh, UK
| | - Matthew Hotopf
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, UK
| | - Christopher Hübel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Carola Kanz
- NIHR BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK; Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Jennifer Leng
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Donald M Lyall
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Bethany D Mason
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Monika McAtarsney-Kovacs
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Dina Monssen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Alexei Moulton
- NIHR BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK; Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Nigel Ovington
- NIHR BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK; Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Elisavet Palaiologou
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Carmine M Pariante
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, UK
| | - Shivani Parikh
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Alicia J Peel
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Ruth K Price
- School of Biomedical Sciences, Ulster University, Coleraine Campus, Northern Ireland, UK
| | - Katharine A Rimes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
| | - Henry C Rogers
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Jennifer Sambrook
- NIHR BioResource, Cambridge University Hospitals NHS Foundation, Cambridge Biomedical Campus, Cambridge, UK; Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Megan Skelton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Anna Spaul
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Eddy L A Suarez
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Bronte L Sykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Keith G Thomas
- School of Biomedical Sciences, Ulster University, Coleraine Campus, Northern Ireland, UK
| | - Allan H Young
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, UK
| | - Evangelos Vassos
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK
| | - David Veale
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK; South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, UK
| | - Katie M White
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Janet Wingrove
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, UK
| | - Thalia C Eley
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK
| | - Gerome Breen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, Denmark Hill, Camberwell, London, UK; UK National Institute for Health Research (NIHR) Biomedical Research Centre, South London and Maudsley Hospital, London, UK.
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Leng J, Lui F, Huang X, Breitbart W, Gany F. Patient perspectives on adapting meaning-centered psychotherapy in advanced cancer for the Chinese immigrant population. Support Care Cancer 2019; 27:3431-3438. [PMID: 30661201 PMCID: PMC6642030 DOI: 10.1007/s00520-019-4638-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 01/07/2019] [Indexed: 11/25/2022]
Abstract
The Chinese immigrant community faces multiple obstacles to effective cancer support and psychosocial care post diagnosis. Meaning-centered psychotherapy (MCP) is an empirically based treatment (EBT) that has been found to significantly reduce psychological distress while increasing spiritual well-being and a sense of meaning and purpose in life in patients with advanced cancer. However, it has not yet been adapted for Chinese immigrants who have unique linguistic and cultural needs. This study presents a community needs assessment to inform the cultural adaptation of MCP for Chinese patients with advanced cancer using Bernal et al.'s ecological validity model and the cultural adaptation process model of Domenech-Rodriquez and Weiling. Interviews were conducted until saturation with 12 Chinese immigrants with advanced cancer to determine the community's needs and preferences regarding the MCP intervention. Transcripts were translated and analyzed using Atlas.ti and six frequently occurring themes were identified: Coping; End of Life; Family; Culture, Religion, and Language; Immigration; and Specific Adaptations to MCP. Sociocultural values, beliefs, and practices such as filial piety and the use of Traditional Chinese Medicine (TCM) should be considered when adapting EBTs for Chinese immigrant cancer patients.
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Affiliation(s)
- Jennifer Leng
- Immigrant Health and Cancer Disparities Center, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
| | - Florence Lui
- Immigrant Health and Cancer Disparities Center, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Clinical Psychology, The City College of New York, New York, NY, USA
| | - Xiaoxiao Huang
- Immigrant Health and Cancer Disparities Center, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Center, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA
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29
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Kandula N, Ahmed M, Dodani S, Gupta L, Hore P, Kanaya A, Khowaja A, Mathur A, Mehta D, Misra R, Paracha M, Bharmal N, Aghhi M, Leng J, Gany F. Cardiovascular Disease & Cancer Risk Among South Asians: Impact of Sociocultural Influences on Lifestyle and Behavior. J Immigr Minor Health 2019; 21:15-25. [PMID: 28493115 PMCID: PMC7646689 DOI: 10.1007/s10903-017-0578-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
A comprehensive literature review revealed cultural beliefs, societal obligations, and gender roles within the South Asian community to be indirect contributors to the health of South Asian immigrants (SAIs). Health professionals need to increase their work with SAI communities to change less beneficial cultural elements such as misconceptions about health and exercise, and lack of communication when using alternative medicines. Community engaged efforts and continuing medical education are both needed to improve the health of the South Asian immigrant population in a culturally appropriate manner.
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Affiliation(s)
- Namratha Kandula
- Department of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Munerah Ahmed
- Bureau of Environmental Surveillance and Policy, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Sunita Dodani
- Division of Cardiology, Department of Medicine & Center for Health Equity and Quality Research, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Leena Gupta
- Life Sciences Research and Surveys, Gerson Lehrman Group, New York, NY, USA
| | - Paromita Hore
- Bureau of Environmental Disease and Injury Prevention, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Alka Kanaya
- Division of General Internal Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | - Ashish Mathur
- South Asian Heart Center, El Camino Hospital, Mountain View, CA, USA
| | - Darshan Mehta
- Benson-Henry Institute for Mind Body Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Ranjita Misra
- Department of Health and Kinesiology, College of Education and Human Development, Center for the Study of Health Disparities, Texas A&M University, College Station, TX, USA
| | - Muhammad Paracha
- Asian Human Services Family Health Center, Inc., Chicago, IL, USA
| | - Nazleen Bharmal
- Division of General Internal Medicine and Health Services Research, Department of Medicine, University of California, Los Angeles, CA, USA
| | | | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
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Abstract
The US South Asian population has grown tremendously, and is now over 2.5 million. South Asians often face tremendous cultural, socioeconomic, linguistic and structural obstacles to good health, and face staggering cardiovascular disease (CVD) and cancer risk. Coupled with this is a paucity of detailed data on the population's unique CVD and cancer risk profiles, etiologic mechanisms, and effective interventions to address South Asian health disparities. This data gap compelled an initiative to develop more targeted research and evidence-based practice and policy approaches. The South Asian Health Initiative (SAHI), a community based participatory research partnership between the Immigrant Health and Cancer Disparities Center at Memorial Sloan Kettering Cancer and the South Asian Council for Social Services (SACSS), and the Palo Alto Medical Foundation Research Institute thus partnered to effect the first national South Asian translational research endeavor, South Asian Health: From Research to Practice and Policy, summarized in this paper.
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Affiliation(s)
- Francesca Gany
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
| | | | - Lakshmi Prasad
- Ohio Perinatal Quality Collaborative, Cincinnati, OH, USA
| | - Sudha Acharya
- South Asian Council for Social Services, Flushing, NY, USA
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
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Leng J, Peruluswami P, Bari S, Gaur S, Radparvar F, Parvez F, Chen Y, Flores C, Gany F. South Asian Health: Inflammation, Infection, Exposure, and the Human Microbiome. J Immigr Minor Health 2019; 21:26-36. [PMID: 28952002 PMCID: PMC5871532 DOI: 10.1007/s10903-017-0652-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
This paper presents the results of the literature review conducted for the working group topic on inflammation, infection, exposure, and the human microbiome. Infection and chronic inflammation can elevate risk for cardiovascular disease and cancer. Environmental exposures common among South Asian (SA) subgroups, such as arsenic exposure among Bangladeshis and particulate matter air pollution among taxi drivers, also pose risks. This review explores the effects of exposure to arsenic and particulate matter, as well as other infections common among SAs, including human papillomavirus (HPV) and hepatitis B/C infection. Emerging research on the human microbiome, and the effect of microbiome changes on obesity and diabetes risk among SAs are also explored.
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Affiliation(s)
- Jennifer Leng
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, 1300 York Avenue, New York, NY, USA
| | - Ponni Peruluswami
- Department of Medicine, Icahn School of Medicine at the Mount Sinai Medical Center, 1468 Madison Avenue, New York, NY, USA
| | - Sehrish Bari
- The Earth Institute, Columbia University, 2910 Broadway, New York, NY, USA
| | - Sunanda Gaur
- Robert Wood Johnson Medical School, South Asian Total Health Initiative, Rutgers School of Public Health, Rutgers, The State University of New Jersey, 1 Robert Wood Johnson Place, New Brunswick, NJ, USA
| | - Farshid Radparvar
- Cardiology Department, Queens Hospital Center, 82-68 164th Street, Jamaica, New York, NY, USA
| | - Faruque Parvez
- Department of Environmental Health Sciences, Columbia University, 722 W 168th Street, New York, NY, USA
| | - Yu Chen
- Department of Population Health, Department of Environmental Medicine, New York University School of Medicine, 550 1st Avenue, New York, NY, USA
| | - Cristina Flores
- The Warren Alpert Medical School, The Brown Human Rights Asylum Clinic (BHRAC), Brown University, 222 Richmond Street, Providence, RI, USA
| | - Francesca Gany
- Department of Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, 1300 York Avenue, New York, NY, USA.
- Department of Medicine, Weill Cornell Medical College, 1300 York Avenue, New York, NY, USA.
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Doherty LS, Bari S, Gany F, Leng J, Duch T, Reveille D, Morris JS, Hernandez M, Nadas A, Costa M, Zelikoff JT. Community health perceptions and human environmental exposure to chromium contamination in a small New Jersey City. ACTA ACUST UNITED AC 2019; 2. [PMID: 34113778 DOI: 10.15761/pmch.1000122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Following a 1983 chromic acid (hexavalent chromium [CrVI]) spill from a Garfield, NJ electroplating plant, CrVI-contaminated water was found in a local firehouse basement in 1993. An ATSDR public health advisory was issued for the plant site in 2010, and from 2008-2015, fourteen residential properties have required remediation to address CrVI-contaminated dust in the basements. As part of the Community Outreach and Engagement Core of the NYU NIEHS Center, seventytwo Garfield residents aged 18-65 years, participated in a community survey with the goal of identifying concerns related to environmental and community health. Thirty-two percent responded that they 'didn't know' if they were exposed to chemicals or pollutants where they live. This finding suggests a limited awareness of environmental chemical exposures, chromium contamination and/or potential exposure to CrVI. Furthermore, toenail clippings were collected from forty-seven Garfield residents and analyzed for total chromium levels to assess potential long-term exposure. On average, residents living on/inside the contaminated plume area had higher total chromium levels in their toenail clippings than residents living outside the plume area. However, chromium levels for all participants were within the range of historical normal. This study highlights the value of partnerships between environmentally-impacted community's and academic scientists working together to identify potential contaminant exposures and address public health concerns through research and environmental health education.
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Affiliation(s)
- Lyons Sp Doherty
- Department of Environmental Medicine, New York University School of Medicine, USA
| | | | - F Gany
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Center, USA
| | - J Leng
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Center, USA
| | - T Duch
- City of Garfield, NJ, USA
| | | | - J S Morris
- Research Reactor Center, University of Missouri, USA
| | | | - A Nadas
- Department of Environmental Medicine, New York University School of Medicine, USA
| | - M Costa
- Department of Environmental Medicine, New York University School of Medicine, USA
| | - J T Zelikoff
- Department of Environmental Medicine, New York University School of Medicine, USA
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Palaniappan L, Garg A, Enas E, Lewis H, Bari S, Gulati M, Flores C, Mathur A, Molina C, Narula J, Rahman S, Leng J, Gany F. South Asian Cardiovascular Disease & Cancer Risk: Genetics & Pathophysiology. J Community Health 2018; 43:1100-1114. [PMID: 29948525 PMCID: PMC6777562 DOI: 10.1007/s10900-018-0527-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
South Asians (SAs) are at heightened risk for cardiovascular disease as compared to other ethnic groups, facing premature and more severe coronary artery disease, and decreased insulin sensitivity. This disease burden can only be partially explained by conventional risk factors, suggesting the need for a specific cardiovascular risk profile for SAs. Current research, as explored through a comprehensive literature review, suggests the existence of population specific genetic risk factors such as lipoprotein(a), as well as population specific gene modulating factors. This review catalogues the available research on cardiovascular disease and genetics, anthropometry, and pathophysiology, and cancer genetics among SAs, with a geographical focus on the U.S. A tailored risk profile will hinge upon population customized classification and treatment guidelines, informed by continued research.
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Affiliation(s)
| | - Arun Garg
- Laboratory Medicine and Pathology, Fraser Health Authority, New Westminster, BC, Canada
| | - Enas Enas
- Coronary Artery Disease among Asian Indians (CADI) Research Foundation, Lisle, IL, USA
| | - Henrietta Lewis
- Rollins School of Public Health, Global Epidemiology, Emory University, Atlanta, GA, USA
| | | | - Martha Gulati
- Division of Cardiology, University of Arizona College of Medicine, Phoenix, AZ, USA
| | - Cristina Flores
- The Warren Alpert Medical School, The Brown Human Rights Asylum Clinic (BHRAC), Brown University, Providence, RI, USA
| | - Ashish Mathur
- South Asian Heart Center, El Camino Hospital, Mountain View, CA, USA
| | - Cesar Molina
- South Asian Heart Center, El Camino Hospital, Mountain View, CA, USA
| | | | - Shahid Rahman
- I-Say, Bangladeshi American Youth Association, Teach & Travel, New York, NY, USA
| | - Jennifer Leng
- Immigrant Health and Cancer Disparities Center, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA
| | - Francesca Gany
- Immigrant Health and Cancer Disparities Center, Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
- Department of Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA.
- Department of Medicine, Weill Cornell Medical College, New York, NY, USA.
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Burningham Z, Richter Lagha R, Leng J, Peters C, Huynh T, Patel S, Sauer BC, Josea Kramer B. CREATION OF A SUITE OF QUALITY IMPROVEMENT DASHBOARDS FOR THE GERIATRIC SCHOLARS PROGRAM. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Z Burningham
- VA Salt Lake City Healthcare System, Salt lake City, Utah, United States
| | | | - J Leng
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - C Peters
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - T Huynh
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - S Patel
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA; VA Salt Lake City Healthcare System IDEAS 2.0, Salt Lake City, UT, USA
| | - B C Sauer
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA: VA Salt Lake City Healthcare System IDEAS 2.0, Salt Lake City, UT, USA
| | - B Josea Kramer
- VA Greater Los Angeles Healthcare System GRECC, Sepulveda CA USA
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35
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Richter Lagha R, Burningham Z, Sauer BC, Leng J, Peters C, Huynh T, Patel S, Josea Kramer B. USABILITY TESTING THE GERIATRIC SCHOLARS QUALITY IMPROVEMENT DASHBOARDS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- R Richter Lagha
- Geriatric Workforce Enhancement Program at UCLA, Torrance, California, United States
| | - Z Burningham
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - B C Sauer
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - J Leng
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - C Peters
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT USA
| | - T Huynh
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - S Patel
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT USA; VA Salt Lake City Healthcare System IDEAS 2.0, Salt Lake City, UT, USA
| | - B Josea Kramer
- VA Greater Los Angeles Healthcare System GRECC, Sepulveda CA USA
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36
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Leng J, Ibraheem A, Olopade O, Ntekim A. Infrastructural Challenges to Radiation Therapy in a Nigerian Teaching Hospital. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Patel S, Sauer BC, Burningham Z, Chen W, Leng J, Huynh T, Richter Lagha R, Josea Kramer B. IMPACT OF THE GERIATRIC SCHOLARS PROGRAM ON PRESCRIBING PRACTICES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.3032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- S Patel
- VA Salt Lake City Healthcare System, Salt Lake City, Utah, United States
| | - B C Sauer
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - Z Burningham
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - W Chen
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - J Leng
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | - T Huynh
- Division of Epidemiology, Department of Internal Medicine, School of Medicine, Salt Lake City, UT, USA
| | | | - B Josea Kramer
- VA Greater Los Angeles Healthcare System GRECC, Los Angeles, CA USA
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Leng J, Liu CW, Hartwell H, Yu R, Lai Y, Lu K, Leibold E, Swenberg J. Evaluation of Inhaled Low Dose Formaldehyde Induced DNA Damage by Liquid Chromatography-Tandem Mass Spectrometry. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.06.765] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Jones BE, South BR, Shao Y, Lu CC, Leng J, Sauer BC, Gundlapalli AV, Samore MH, Zeng Q. Development and Validation of a Natural Language Processing Tool to Identify Patients Treated for Pneumonia across VA Emergency Departments. Appl Clin Inform 2018; 9:122-128. [PMID: 29466818 DOI: 10.1055/s-0038-1626725] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND Identifying pneumonia using diagnosis codes alone may be insufficient for research on clinical decision making. Natural language processing (NLP) may enable the inclusion of cases missed by diagnosis codes. OBJECTIVES This article (1) develops a NLP tool that identifies the clinical assertion of pneumonia from physician emergency department (ED) notes, and (2) compares classification methods using diagnosis codes versus NLP against a gold standard of manual chart review to identify patients initially treated for pneumonia. METHODS Among a national population of ED visits occurring between 2006 and 2012 across the Veterans Affairs health system, we extracted 811 physician documents containing search terms for pneumonia for training, and 100 random documents for validation. Two reviewers annotated span- and document-level classifications of the clinical assertion of pneumonia. An NLP tool using a support vector machine was trained on the enriched documents. We extracted diagnosis codes assigned in the ED and upon hospital discharge and calculated performance characteristics for diagnosis codes, NLP, and NLP plus diagnosis codes against manual review in training and validation sets. RESULTS Among the training documents, 51% contained clinical assertions of pneumonia; in the validation set, 9% were classified with pneumonia, of which 100% contained pneumonia search terms. After enriching with search terms, the NLP system alone demonstrated a recall/sensitivity of 0.72 (training) and 0.55 (validation), and a precision/positive predictive value (PPV) of 0.89 (training) and 0.71 (validation). ED-assigned diagnostic codes demonstrated lower recall/sensitivity (0.48 and 0.44) but higher precision/PPV (0.95 in training, 1.0 in validation); the NLP system identified more "possible-treated" cases than diagnostic coding. An approach combining NLP and ED-assigned diagnostic coding classification achieved the best performance (sensitivity 0.89 and PPV 0.80). CONCLUSION System-wide application of NLP to clinical text can increase capture of initial diagnostic hypotheses, an important inclusion when studying diagnosis and clinical decision-making under uncertainty.
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Qin HL, Leng J, Zhang W, Kantchev EAB. DFT modelling of a diphosphane - N-heterocyclic carbene-Rh(i) pincer complex rearrangement: a computational evaluation of the electronic effects in C-P bond activation. Dalton Trans 2018; 47:2662-2669. [PMID: 29410986 DOI: 10.1039/c7dt04759b] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
DFT calculations confirmed that the rearrangement of a PCP-Rh-H pincer to a CCP-Rh-phosphane pincer occured by C-P oxidative addition (ΔG‡ = 29.5 kcal mol-1, rate-determining step), followed by P-H reductive elimination (ΔG‡ = 4.8 kcal mol-1). The oxidative addition proceeded via a 3-centered transition state and is accelerated by electron-withdrawing substituents p- to the reacting C-P bond, resulting in a reaction constant (ρ) of 2.12 for ΔG‡ and 2.76 for ΔH‡ in a Hammett-type linear free energy relationship. AIM wavefunction analyses indicated a decrease in the negative charge on the carbon bonded to Rh with a concomitant increase in the positive charge on the latter. The electronic density at the Rh-P bond critical point and the atomic charge on Rh correlate well with the Hammett constants (σ) of the p-substituents. The replacement of the Rh-bound hydride with other anions (CH3, Ph, t-Bu, OH, F, Cl, and CN) results in a decrease in the OA barrier only for CH3, which is in accordance with the experimental results. The reductive elimination occurs via a 3-centered (Rh, H, P) transition state, which adopts a conformation wherein the steric clash between the i-Pr groups is minimized, followed by recomplexation of Rh and the newly formed (i-Pr)2PH by a conformational twist around the Rh-P axis.
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Affiliation(s)
- H-L Qin
- State Key Laboratory of Silicate Materials for Architectures and School of Chemistry, Chemical Engineering, and Life Science, Wuhan University of Technology, 122 Luoshi Road, Wuhan 430070, Hubei, People's Republic of China.
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Zhang S, Wang L, Leng J, Liu H, Li W, Zhang T, Li N, Li W, Tian H, Baccarelli AA, Hou L, Hu G. Hypertensive disorders of pregnancy in women with gestational diabetes mellitus on overweight status of their children. J Hum Hypertens 2017; 31:731-736. [PMID: 28300070 PMCID: PMC5600626 DOI: 10.1038/jhh.2017.17] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 12/20/2016] [Accepted: 01/17/2017] [Indexed: 12/16/2022]
Abstract
Hypertensive disorders of pregnancy (HDP) as a group of medical complications in pregnancy are believed to be associated with an increased risk of poor fetal growth, but the influence on offspring’s body composition is not clear. The aim of the present study was to evaluate the association between maternal hypertensive disorders of pregnancy and overweight status in the offspring of mothers with gestational diabetes mellitus (GDM). A cross-sectional study among 1263 GDM mother-child pairs was performed in Tianjin, China. General linear models and logistic regression models were used to assess the associations of maternal hypertension in pregnancy with anthropometry and overweight status in the offspring from birth to 1–5 years old. Offspring of GDM mothers who were diagnosed with hypertensive disorders during pregnancy had higher mean values of Z scores for birth weight for gestational age and birth weight for length, and higher mean values of Z scores for weight for age, weight for length/height, and body mass index for age at 1–5 years old than those of GDM mothers with normal blood pressure during pregnancy. Maternal hypertensive disorders of pregnancy were associated with increased risks of large for gestational age (OR 1.74, 95%CI 1.08–2.79) and macrosomia (OR 2.02, 95%CI 1.23–3.31) at birth and childhood overweight/obesity at 1–5 years old age (OR 1.88, 95%CI 1.16–3.04). For offspring of mothers with GDM, maternal hypertension during pregnancy was a risk factor for macrosomia at birth and childhood overweight and obesity, and controlling the maternal hypertension may be more important for preventing large for gestational age babies and childhood obesity.
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Affiliation(s)
- S Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - L Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - J Leng
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - H Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - W Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - T Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China.,Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - N Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - W Li
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - H Tian
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - A A Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - L Hou
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - G Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Gany F, Bari S, Prasad L, Leng J, Lee T, Thurston GD, Gordon T, Acharya S, Zelikoff JT. Perception and reality of particulate matter exposure in New York City taxi drivers. J Expo Sci Environ Epidemiol 2017; 27:221-226. [PMID: 27168392 PMCID: PMC5547750 DOI: 10.1038/jes.2016.23] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 03/22/2016] [Indexed: 05/05/2023]
Abstract
Exposure to fine particulate matter (PM2.5) and black carbon (BC) have been linked to negative health risks, but exposure among professional taxi drivers is understudied. This pilot study measured drivers' knowledge, attitudes, and beliefs (KAB) about air pollution compared with direct measures of exposures. Roadside and in-vehicle levels of PM2.5 and BC were continuously measured over a single shift on each subject, and exposures compared with central site monitoring. One hundred drivers completed an air pollution KAB questionnaire, and seven taxicabs participated in preliminary in-cab air sampling. Taxicab PM2.5 and BC concentrations were elevated compared with nearby central monitoring. Average PM2.5 concentrations per 15-min interval were 4-49 μg/m3. BC levels were also elevated; reaching>10 μg/m3. Fifty-six of the 100 drivers surveyed believed they were more exposed than non-drivers; 81 believed air pollution causes health problems. Air pollution exposures recorded suggest that driver exposures would likely exceed EPA recommendations if experienced for 24 h. Surveys indicated that driver awareness of this was limited. Future studies should focus on reducing exposures and increasing awareness among taxi drivers.
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Affiliation(s)
- Francesca Gany
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine; Weill Cornell Medical College, Department of Public Health; 300 E. 66 St., New York, NY 10065
| | - Sehrish Bari
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences; 300 East 66 St., New York, NY 10065
| | - Lakshmi Prasad
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences; 300 East 66 St., New York, NY 10065
| | - Jennifer Leng
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences, Department of Medicine; Weill Cornell Medical College, Department of Public Health; 300 E. 66 St., New York, NY 10065
| | - Trevor Lee
- Memorial Sloan-Kettering Cancer Center, Immigrant Health and Cancer Disparities Service, Department of Psychiatry and Behavioral Sciences; 300 East 66 St., New York, NY 10065
| | - George D Thurston
- New York University School of Medicine, Department of Environmental Medicine. 57 Old Forge Road, Tuxedo, NY 10987
| | - Terry Gordon
- New York University School of Medicine, Department of Environmental Medicine. 57 Old Forge Road, Tuxedo, NY 10987
| | - Sudha Acharya
- South Asian Council for Social Services, 143-06 45th Avenue, Flushing, NY 11355
| | - Judith T Zelikoff
- New York University School of Medicine, Department of Environmental Medicine. 57 Old Forge Road, Tuxedo, NY 10987
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Wang H, Leng J, Li W, Wang L, Zhang C, Li W, Liu H, Zhang S, Chan J, Hu G, Yu Z, Yang X. Sleep duration and quality, and risk of gestational diabetes mellitus in pregnant Chinese women. Diabet Med 2017; 34:44-50. [PMID: 27154471 DOI: 10.1111/dme.13155] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/03/2016] [Indexed: 01/05/2023]
Abstract
AIMS To examine the association between sleep disturbances during pregnancy and risk of gestational diabetes mellitus. METHODS From 2010 to 2012, 12 506 women in Tianjin, China, were screened using a 50-g 1-h glucose challenge test at 24-28 weeks' gestation. Those with glucose challenge test values of ≥ 7.8 mmol/l were invited to further undergo a 75-g 2-h oral glucose tolerance test. Gestational diabetes was determined according to the International Association of Diabetes and Pregnancy Study Group's definition. Self-reported sleep duration and sleep quality during pregnancy was documented using a modified questionnaire. Logistic regression was used to obtain odds ratios and 95% CIs. RESULTS A total of 919 women (7.3%) had gestational diabetes. Sleep duration was found to have an approximate J-shaped association with gestational diabetes risk after adjusting for covariates. Compared with a sleep duration of 7-9 h/day (43% of 12 506 women), the adjusted odds ratios for sleep duration of ≥ 9 h/day (55%) and < 7 h/day (2%) for gestational diabetes were 1.21 (95% CI 1.03-1.42) and 1.36 (95% CI 0.87-2.14), respectively. Compared with good sleep quality (37.9% of 12 506 women), the adjusted odds ratios of moderate (59.9%) and poor sleep quality (2.2%) for gestational diabetes were 1.19 (95% CI 1.01-1.41) and 1.61 (95% CI 1.04-2.50), respectively. CONCLUSION In pregnant Chinese women, poor sleep quality, and shorter and longer duration of sleep during pregnancy were independently associated with an increased risk of gestational diabetes.
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Affiliation(s)
- H Wang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - J Leng
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - W Li
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - L Wang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - C Zhang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - W Li
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - H Liu
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - S Zhang
- Tianjin Women and Children's Health Centre, Tianjin, China
| | - J Chan
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity and Li Ka Shing Institute of Health Science, Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong SAR, China
| | - G Hu
- Chronic Disease Epidemiology Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - Z Yu
- Population Cancer Research Program and Department of Pediatrics, Dalhousie University, Halifax, Canada
| | - X Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
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Song C, Li J, Leng J, Ma RC, Yang X. Lifestyle intervention can reduce the risk of gestational diabetes: a meta-analysis of randomized controlled trials. Obes Rev 2016; 17:960-9. [PMID: 27417680 DOI: 10.1111/obr.12442] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [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: 02/17/2016] [Revised: 05/05/2016] [Accepted: 05/23/2016] [Indexed: 12/16/2022]
Abstract
This study aimed to examine the effect of lifestyle intervention on the risk of gestational diabetes mellitus (GDM). We searched PubMed, Springer and other databases to retrieve articles published in English and Chinese up to 30 September 2015. The inclusion criteria were randomized controlled trials evaluating the effects of lifestyle intervention on risk of GDM. Exclusion criteria were studies with prepregnancy diabetes mellitus or interventions with nutrient supplements. Random-effect and fixed-effect model analyses were used to obtain pooled relative risks and 95% confidence intervals (CIs) of diet and physical activity on the risk of GDM. Subgroup analyses were performed to check the consistency of effect sizes across groups where appropriate. We identified 29 randomized controlled trials with 11,487 pregnant women, addressing the effect of lifestyle intervention on the risk of GDM. In the pooled analysis, either diet or physical activity resulted in an 18% (95%CI 5-30%) reduction in the risk of GDM (P = 0.0091). Subgroup analysis showed that such intervention was effective among women with intervention before the 15th gestational week (relative risk: 0.80, 95%CI 0.66-0.97), but not among women receiving the intervention afterwards. We conclude that lifestyle modification during pregnancy, especially before the 15th gestational week, can reduce the risk of GDM. © 2016 World Obesity.
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Affiliation(s)
- C Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Center for Disease Control and Prevention of Tianjin Economic-Technological Development Area, TEDA, Tianjin, China
| | - J Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - J Leng
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Women and Children's Health Centre, Tianjin, China
| | - R C Ma
- Department of Medicine and Therapeutics, Prince of Wales Hospital, and the Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, China
| | - X Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China. ,
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Cannon G, Mehortra S, South B, Leng J, Lu CC, Sauer B. THU0612 Development and Validation of An Accurate and Precise Natural Language Processing System To Capture Rheumatoid Arthritis Disease Activity Measures: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.1890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Li W, Liu H, Qiao Y, Lv F, Zhang S, Wang L, Leng J, Liu H, Qi L, Tuomilehto J, Hu G. Metabolic syndrome of weight change from pre-pregnancy to 1-5 years post-partum among Chinese women with prior gestational diabetes. Diabet Med 2015; 32:1492-9. [PMID: 25962467 PMCID: PMC4615340 DOI: 10.1111/dme.12790] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/07/2015] [Indexed: 01/23/2023]
Abstract
AIMS Few studies have evaluated the effect of weight change from pre-pregnancy to post-partum with the risk of cardiometabolic diseases among women with a history of gestational diabetes mellitus. The aim of this study was to evaluate the association between weight change from pre-pregnancy to 1-5 years post-partum with metabolic syndrome among Chinese women with prior gestational diabetes mellitus. METHODS We performed a retrospective cohort study in 1263 women with gestational diabetes mellitus at 1-5 years post-partum. Participants were divided into four groups based on their weight change from pre-pregnancy to 1-5 years post-partum: loss of ≥ 3 kg, ± 3 kg, gain of 3-7 kg and gain of ≥7 kg. RESULTS The prevalence of metabolic syndrome was 12.1%, 16.2%, 26.0% and 44.3% among women with weight loss ≥ 3 kg, stable weight ( ± 3 kg), weight gain 3-7 kg and weight gain ≥ 7 kg from pre-pregnancy to post-partum, respectively. The positive association between weight change and metabolic syndrome was observed among women with pre-pregnancy normal weight (BMI < 24 kg/m(2)), overweight (BMI 24-27.9 kg/m(2)) and obesity (BMI ≥ 28 kg/m(2)). The prevalence of metabolic syndrome was almost similar among pre-pregnancy normal weight women with weight gain ≥ 7 kg, pre-pregnancy overweight women with stable weight ( ± 3 kg) and pre-pregnancy obese women with weight loss ≥ 3 kg from pre-pregnancy to post-partum (P = 0.62). CONCLUSIONS Women with gestational diabetes mellitus who had large weight gain from pre-pregnancy to post-partum were more likely to develop metabolic syndrome. Women who are pre-pregnancy overweight/obesity and also diagnosed as gestational diabetes mellitus during pregnancy need more weight control after delivery.
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Affiliation(s)
- W Li
- Tianjin Women's and Children's Health Center, Tianjin, China
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
| | - H Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - Y Qiao
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - F Lv
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - S Zhang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - L Wang
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - J Leng
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - H Liu
- Tianjin Women's and Children's Health Center, Tianjin, China
| | - L Qi
- Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - J Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - G Hu
- Pennington Biomedical Research Center, Baton Rouge, LA, USA
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Leng J, Proudman C, Blow F, Darby A, Swann J. Understanding Intestinal Microbiota in Equine Grass Sickness: Next Generation Sequencing of Faecal Bacterial DNA. Equine Vet J 2015. [DOI: 10.1111/evj.12486_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- J. Leng
- School of Veterinary Medicine; Faculty of Health and Medical Sciences; University of Surrey; Guildford Surrey GU2 7TE UK
| | - C. Proudman
- School of Veterinary Medicine; Faculty of Health and Medical Sciences; University of Surrey; Guildford Surrey GU2 7TE UK
| | - F. Blow
- School of Biological Sciences; University of Liverpool; Crown Street Liverpool L69 7ZB UK
| | - A. Darby
- School of Biological Sciences; University of Liverpool; Crown Street Liverpool L69 7ZB UK
| | - J. Swann
- Department of Food and Nutritional Sciences; University of Reading; Whiteknights Reading RG6 6AP UK
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Gany F, Leng J, Ramirez J, Phillips S, Aragones A, Roberts N, Mujawar MI, Costas-Muñiz R. Health-Related Quality of Life of Food-Insecure Ethnic Minority Patients With Cancer. J Oncol Pract 2015; 11:396-402. [PMID: 26286100 DOI: 10.1200/jop.2015.003962] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The association between food insecurity and health-related quality of life (QOL) of racial/ethnic minority patients with cancer has not been examined. The purpose of this study is to determine the relationship between food insecurity and health-related QOL reported by racial/ethnic minority patients with cancer. METHODS A consecutive sample of 1,390 underserved ethnic minority patients receiving cancer care in 10 cancer clinics and hospitals in New York City participated in this study. Health-related QOL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G) and food security was assessed by the US Department of Agriculture Core Food Security Module. RESULTS Of the 1,390 patients, 581 (41.8%) were classified as food secure, 571 (41.1%) with low food security, and 238 (17.1%) with very low food security. Health-related QOL decreased with each lower food security level. Patient self-reported physical, functional, social, and emotional well-being subscale scores decrease significantly with increasing food insecurity. After controlling for demographic and medical-related factors, the decreases in QOL, physical, functional, social and emotional well-being scores with increasing food insecurity remained significant. CONCLUSION Food insecurity was associated with lower QOL in this sample of underserved racial/ethnic minority patients with cancer. Underserved ethnic minority patients diagnosed with cancer are a vulnerable patient population, at significant risk for inadequate food access and the related lower QOL.
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Affiliation(s)
| | - Jennifer Leng
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Julia Ramirez
- Memorial Sloan Kettering Cancer Center, New York, NY
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Cannon G, Teng C, Tang D, Leng J, Harrison D, Sauer B. FRI0113 Persistence and Adherence with Triple Therapy and Tumor Necrosis Factor Inhibitor-Methotrexate Combination Therapy in us Veterans with Rheumatoid Arthritis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.1199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Costas-Muniz R, Leng J, Aragones A, Ramirez J, Roberts N, Mujawar MI, Gany F. Association of socioeconomic and practical unmet needs with self-reported nonadherence to cancer treatment appointments in low-income Latino and Black cancer patients. Ethn Health 2015; 21:118-128. [PMID: 25989483 PMCID: PMC4653085 DOI: 10.1080/13557858.2015.1034658] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Treatment adherence, with minimal numbers of missed appointments, is an important determinant of survival among cancer patients. This study aims to determine if unmet financial, logistic, and supportive care needs predict self-reported adherence to cancer treatment appointments of chemotherapy and/or radiation among low-income ethnic minority patients. DESIGN The sample included 1098 underserved Latino and Black patients recruited from cancer clinics in New York City through the Cancer Portal Project. Participants completed a survey which included sociodemographic, health-related questions and a needs assessment, in their preferred language. Patients' adherence to chemotherapy and/or radiation treatment appointments was assessed using a self-report. RESULTS A sample of 1098 patients (581 Latino and 517 Black cancer patients) was recruited. Forty-two Latino cancer patients (7.4%) and 78 Black cancer patients (15.5%) reported missing treatment appointments. Patients, who experienced four or more unmet needs (odds ratios [OR] = 2.02-3.36), and those with unmet housing needs (OR = 3.10-3.31), were more likely to report missing cancer treatment appointments, regardless of their ethnicity/race. Black patients with unmet supportive care (OR = 2.27) and health insurance needs (OR = 3.80) were more likely to miss appointments. Amongst Latinos, legal health-related issues (OR = 2.51) was a significant predictor of missed appointments. CONCLUSIONS Among ethnic minority cancer patients, unmet socioeconomic and supportive care needs, housing needs in particular, predicted patient-reported missed radiation, and/or chemotherapy appointments. Future research should focus on exploring the impact of practical and supportive unmet needs on adherence and development of interventions aiming to improve cancer treatment adherence.
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Affiliation(s)
- Rosario Costas-Muniz
- Memorial Sloan Kettering Cancer Center Immigrant Health & Cancer Disparities Service Department of Psychiatry & Behavioral Sciences 300 E 66th St. 15th Fl, New York, NY 10065
| | - Jennifer Leng
- Memorial Sloan Kettering Cancer Center Immigrant Health & Cancer Disparities Service Department of Psychiatry & Behavioral Sciences 300 E 66th St. 15th Fl, New York, NY 10065
| | - Abraham Aragones
- Memorial Sloan Kettering Cancer Center Immigrant Health & Cancer Disparities Service Department of Psychiatry & Behavioral Sciences 300 E 66th St. 15th Fl, New York, NY 10065
| | - Julia Ramirez
- Memorial Sloan Kettering Cancer Center Immigrant Health & Cancer Disparities Service Department of Psychiatry & Behavioral Sciences 300 E 66th St. 15th Fl, New York, NY 10065
| | - Nicole Roberts
- Memorial Sloan Kettering Cancer Center Immigrant Health & Cancer Disparities Service Department of Psychiatry & Behavioral Sciences 300 E 66th St. 15th Fl, New York, NY 10065
| | - Mohammed Imran Mujawar
- Memorial Sloan Kettering Cancer Center Immigrant Health & Cancer Disparities Service Department of Psychiatry & Behavioral Sciences 300 E 66th St. 15th Fl, New York, NY 10065
| | - Francesca Gany
- Memorial Sloan Kettering Cancer Center Immigrant Health & Cancer Disparities Service Department of Psychiatry & Behavioral Sciences 300 E 66th St. 15th Fl, New York, NY 10065
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