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Steck MR, Arheart KL, Xue RD, Aryaprema VS, Peper ST, Qualls WA. Insights and Challenges for the Development of Mosquito Control Action Thresholds Using Historical Mosquito Surveillance and Climate Datasets. J Am Mosq Control Assoc 2024; 40:50-70. [PMID: 38353588 DOI: 10.2987/23-7121] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Strategies to advance action threshold development can benefit both civilian and military vector control operations. The Anastasia Mosquito Control District (AMCD) has curated an extensive record database of surveillance programs and operational control activities in St. Johns County, Florida, since 2004. A thorough exploratory data analysis was performed on historical mosquito surveillance and county-wide climate data to identify climate predictors that could be used in constructing proactive threshold models for initiating control of Aedes, Culex, and Anopheles vector mosquitoes. Species counts pulled from Centers for Disease Control and Prevention (CDC) light trap (2004-2019) and BG trap (2014-2019) collection records and climate parameters of temperature (minimum, maximum, average), rainfall, and relative humidity were used in two iterations of generalized linear models. Climate readings were incorporated into models 1) in the form of continuous measurements, or 2) for categorization into number of "hot," "wet," or "humid" days by exceedance of selected biological index threshold values. Models were validated with tests of residual error, comparison of model effects, and predictive capability on testing data from the two recent surveillance seasons 2020 and 2021. Two iterations of negative binomial regression models were constructed for 6 species groups: container Aedes (Ae. aegypti, Ae. albopictus), standing water Culex (Cx. nigripalpus, Cx. quinquefasciatus), floodwater Aedes (Ae. atlanticus, Ae. infirmatus), salt-marsh Aedes (Ae. taeniorhyncus, Ae. sollicitans), swamp water Anopheles (An. crucians), and a combined Total Mosquitoes group. Final significant climate predictors varied substantially between species groups. Validation of models with testing data displayed limited predictive abilities of both model iterations. The most significant climate predictors for floodwater Aedes, the dominant and operationally influential species group in the county, were either total precipitation or frequency of precipitation events (number of "wet" days) at two to four weeks before trap collection week. Challenges hindering the construction of threshold models were discussed. Insights gained from these models provide initial feedback for streamlining the AMCD mosquito control program and analytical recommendations for future modelling efforts of interested mosquito control programs, in addition to generalized guidance for deployed armed forces personnel with needs of mosquito control but lacking active surveillance programs.
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Schmidtke KA, Aujla N, Marshall T, Hussain A, Hodgkinson GP, Arheart KL, Birnbach DJ, Kudrna L, Vlaev I. A Crossover Randomized Controlled Trial of Priming Interventions to Increase Hand Hygiene at Ward Entrances. Front Public Health 2022; 9:781359. [PMID: 35111716 PMCID: PMC8801705 DOI: 10.3389/fpubh.2021.781359] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
BackgroundResearch conducted in the United States suggests that two primes (citrus smells and pictures of a person's eyes) can increase hand gel dispenser use on the day they are introduced in hospital. The current study, conducted at a hospital in the United Kingdom, evaluated the effectiveness of these primes, both in isolation and in combination, at the entry way to four separate wards, over a longer duration than the previous work.MethodsA crossover randomized controlled trial was conducted. Four wards were allocated for 6 weeks of observation to each of four conditions, including “control,” “olfactory,” “visual,” or “both” (i.e., “olfactory” and “visual” combined). It was hypothesized that hand hygiene compliance would be greater in all priming conditions relative to the control condition. The primary outcome was whether people used the gel dispenser when they entered the wards. After the trial, a follow up survey of staff at the same hospital assessed the barriers to, and facilitators of, hand hygiene compliance. The trial data were analyzed using regression techniques and the survey data were analyzed using descriptive statistics.ResultsThe total number of individuals observed in the trial was 9,811 (female = 61%), with similar numbers across conditions, including “control” N = 2,582, “olfactory” N = 2,700, “visual” N = 2,488, and “both” N = 2,141. None of the priming conditions consistently increased hand hygiene. The lowest percentage compliance was observed in the “both” condition (7.8%), and the highest was observed in the “visual” condition (12.7%). The survey was completed by 97 staff (female = 81%). “Environmental resources” and “social influences” were the greatest barriers to staff cleaning their hands.ConclusionsTaken together, the current findings suggest that the olfactory and visual priming interventions investigated do not influence hand hygiene consistently. To increase the likelihood of such interventions succeeding, future research should focus on prospectively determined mechanisms of action.
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Affiliation(s)
| | - Navneet Aujla
- Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Tom Marshall
- Primary Care Clinical Sciences Institute of Applied Health Research College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Abid Hussain
- Public Health England, Public Health Laboratory, Birmingham Heartlands Hospital, Birmingham, United Kingdom
| | - Gerard P. Hodgkinson
- Manchester Institute of Innovation Research, Alliance Manchester Business School, The University of Manchester, Manchester, United Kingdom
| | - Kristopher L. Arheart
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States
| | - David J. Birnbach
- Department of Anesthesiology, University of Miami Leonard M. Miller School of Medicine, Miami, FL, United States
| | - Laura Kudrna
- Institute of Applied Health, University of Birmingham, Birmingham, United Kingdom
- *Correspondence: Laura Kudrna
| | - Ivo Vlaev
- Behavioral Science Group, Warwick Business School, The University of Warwick, Coventry, United Kingdom
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Birnbach DJ, Rosen LF, Fitzpatrick M, Shekhter I, Arheart KL. Preparing Anesthesiology Residents for Operating Room Communication Challenges: A New Approach for Conflict Resolution Training. Anesth Analg 2021; 133:1617-1623. [PMID: 33929385 DOI: 10.1213/ane.0000000000005561] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The hierarchical culture in high-stake areas such as operating rooms (ORs) may create volatile communication challenges. This unfunded exploratory study sought to establish whether a conflict resolution course was effective in preparing anesthesiology residents to handle and deescalate disagreements that may arise in the clinical environment, especially when challenging a surgeon. METHODS Thirty-seven anesthesiology residents were assessed for ability to deescalate conflict. Nineteen had completed a conflict resolution course, and 18 had not. The 2-hour course used 10 videotaped vignettes that showed attending anesthesiologists, patients, and surgeons challenging residents in a potentially confrontational situation. Guided review of the videos and discussions was focused on how the resident could optimally engage in conflict resolution. To determine efficacy of the conflict resolution course, we used simulation-based testing. The setting was a simulated OR with loud music playing (75-80 dB) under the control of the surgeon. The music was used as a tool to create a potential, realistic confrontation with the surgeon to test conflict resolution skills. The initial evaluation of the resident was whether they ignored the music, asked for the surgeon to turn it off, or attempted to turn it off themselves. The second evaluation was whether the resident attempted to deescalate (eg, calmly negotiate for the music to be turned off or down) when the surgeon was scripted to adamantly refuse. Two trained observers evaluated residents' responses to the surgeon's refusal. RESULTS Of the residents who experienced the confrontational situation and had not yet taken the conflict resolution course, 1 of 5 (20.0%; 95% CI, 0.5-71.6) were judged to have deescalated the situation. In comparison, of those who had taken the course, 14 of 15 (93.3%; 95% CI, 68.1-99.8) were judged to have deescalated the situation (P = .002). Only 2 of 19 (10.5%; 95% CI, 1.3-33.1) of those who completed the course ignored the music on entering the OR versus 10 of 18 (55.6%; 95% CI, 30.8-78.5) who did not complete the course (P = .004). CONCLUSIONS This study suggests that a conflict resolution course may improve the ability of anesthesiology residents to defuse clinical conflicts. It also demonstrated the effectiveness of a novel, simulation-based assessment of communication skills used to defuse OR confrontation.
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Affiliation(s)
- David J Birnbach
- From the Department of Anesthesiology, University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, Miami, Florida
| | - Lisa F Rosen
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, Miami, Florida
| | - Maureen Fitzpatrick
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, Miami, Florida
| | | | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
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Bartlett SL, Lamberski N, Arheart KL, Cray C. Protein Electrophoresis and Haptoglobin Values for Captive Bongo ( Tragelaphus eurycerus). Front Vet Sci 2021; 8:646500. [PMID: 33996975 PMCID: PMC8113405 DOI: 10.3389/fvets.2021.646500] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/22/2021] [Indexed: 01/01/2023] Open
Abstract
Serum samples collected from 37 clinically normal bongo (Tragelaphus eurycerus) and 13 abnormal bongo were tested using assays for acute-phase proteins (APPs) and by protein electrophoresis. Abnormal bongo samples (n = 27) had significantly higher levels of fibrinogen (FIB) (p < 0.001) and trending but not significantly increased haptoglobin (HP) (p = 0.07) vs. samples from normal bongo (n = 37). There were no significant differences in values for total white blood cell counts or for any of the fractions determined by protein electrophoresis. Clinically normal female bongo (n = 19) had significantly lower levels of FIB than normal males (n = 18) (p = 0.014), and this observation was also made with samples from the clinically abnormal group (p = 0.004). Many weak to moderate significant correlations were observed with increasing age, including increased globulins, FIB, and HP and decreased albumin-to-globulin (A/G) ratio and albumin. In clinical cases reviewed in this study, mild HP changes categorized this reactant as a minor APP, which contrasts with the major APP classification of HP in the related species of the cow. The preliminary data indicate that the quantitation of these APPs may offer value in assessing inflammation in this species, but additional studies are needed.
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Affiliation(s)
- Susan L Bartlett
- Wildlife Conservation Society, Zoological Health Program, Bronx, NY, United States
| | | | - Kristopher L Arheart
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Carolyn Cray
- Division of Comparative Pathology, University of Miami Miller School of Medicine, Miami, FL, United States
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Fernandez CA, Choi KW, Marshall BDL, Vicente B, Saldivia S, Kohn R, Koenen KC, Arheart KL, Buka SL. Assessing the relationship between psychosocial stressors and psychiatric resilience among Chilean disaster survivors. Br J Psychiatry 2020; 217:630-637. [PMID: 32522300 PMCID: PMC8268117 DOI: 10.1192/bjp.2020.88] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Indexed: 11/23/2022]
Abstract
BACKGROUND According to the stress inoculation hypothesis, successfully navigating life stressors may improve one's ability to cope with subsequent stressors, thereby increasing psychiatric resilience. AIMS Among individuals with no baseline history of post-traumatic stress disorder (PTSD) and/or major depressive disorder (MDD), to determine whether a history of a stressful life event protected participants against the development of PTSD and/or MDD after a natural disaster. METHOD Analyses utilised data from a multiwave, prospective cohort study of adult Chilean primary care attendees (years 2003-2011; n = 1160). At baseline, participants completed the Composite International Diagnostic Interview (CIDI), a comprehensive psychiatric diagnostic instrument, and the List of Threatening Experiences, a 12-item questionnaire that measures major stressful life events. During the study (2010), the sixth most powerful earthquake on record struck Chile. One year later (2011), the CIDI was re-administered to assess post-disaster PTSD and/or MDD. RESULTS Marginal structural logistic regressions indicated that for every one-unit increase in the number of pre-disaster stressors, the odds of developing post-disaster PTSD or MDD increased (OR = 1.21, 95% CI 1.08-1.37, and OR = 1.16, 95% CI 1.06-1.27 respectively). When categorising pre-disaster stressors, individuals with four or more stressors (compared with no stressors) had higher odds of developing post-disaster PTSD (OR = 2.77, 95% CI 1.52-5.04), and a dose-response relationship between pre-disaster stressors and post-disaster MDD was found. CONCLUSIONS In contrast to the stress inoculation hypothesis, results indicated that experiencing multiple stressors increased the vulnerability to developing PTSD and/or MDD after a natural disaster. Increased knowledge regarding the individual variations of these disorders is essential to inform targeted mental health interventions after a natural disaster, especially in under-studied populations.
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Affiliation(s)
- Cristina A. Fernandez
- Department of Epidemiology, Harvard T. H. School of Public Health, Boston, MA, USA,Department of Epi demiology, Brown School of Public Health, Providence, RI USA
| | - Karmel W. Choi
- Department of Epidemiology, Harvard T. H. School of Public Health, Boston, MA, USA
| | - Brandon DL Marshall
- Department of Epi demiology, Brown School of Public Health, Providence, RI USA
| | - Benjamin Vicente
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile
| | - Sandra Saldivia
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile
| | - Robert Kohn
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence RI, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T. H. School of Public Health, Boston, MA, USA
| | - Kristopher L. Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Stephen L. Buka
- Department of Epi demiology, Brown School of Public Health, Providence, RI USA
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Asfar T, Arheart KL, McClure LA, Ruano-Herreria EC, Dietz NA, Ward KD, Caban-Martinez AJ, Samano Martin Del Campo D, Lee DJ. Implementing a Novel Workplace Smoking Cessation Intervention Targeting Hispanic/Latino Construction Workers: A Pilot Cluster Randomized Trial. Health Educ Behav 2020; 48:795-804. [PMID: 33063570 DOI: 10.1177/1090198120960395] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND U.S. Hispanic/Latino construction workers constitute a large and historically underserved group in terms of smoking cessation services. Using formative research, we developed a worksite smoking cessation intervention tailored to the life/work circumstances of these workers. AIMS This study aims to examine the feasibility, acceptability, and potential efficacy of the developed intervention "Enhanced Care" (EC; one group behavioral counseling session provided around the food truck + fax referral to tobacco quitline [QL] + 8-week nicotine replacement treatment [NRT]) compared with "Standard Care" (SC; fax referral to tobacco QL + 8-week NRT) in a pilot, two-arm, cluster randomized controlled trial. METHOD In collaboration with construction site safety managers, a sample of 17 construction sites (EC: nine sites/65 smokers; SC: eight sites/69 smokers) was enrolled. Participants received two follow-ups at 3 and 6 months after enrollment. Feasibility outcomes were enrollment rate, adherence to treatment, and 6-month retention rates. The primary efficacy outcome was 6 months prolonged abstinence verified by expired carbon monoxide <10 ppm. RESULTS Enrollment rate was high (85.9%). Six-month follow-up rates were acceptable (EC = 76.9%, SC = 66.6%). Adherence to treatment was better in the EC group (received worksite intervention: EC = 93.8%, SC = 88.4%; contacted by QL: EC = 49.2%, SC = 40.6%). Abstinence rates were 27.7% for the EC and 20.3% for the SC (p = .315). DISCUSSION The developed intervention was feasible and acceptable, and it substantially improved abstinence among Hispanic/Latino workers. The involvement of safety managers was essential to the implementation of the intervention. Training safety managers to deliver the intervention has great potential to implement a sustainable smoking cessation service in the construction sector.
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Affiliation(s)
- Taghrid Asfar
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Laura A McClure
- University of Miami Miller School of Medicine, Miami, FL, USA
| | | | | | - Kenneth D Ward
- School of Public Health, The University of Memphis, Memphis, TN, USA
| | | | | | - David J Lee
- University of Miami Miller School of Medicine, Miami, FL, USA
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Alfahel W, Gopinath A, Arheart KL, Gensler T, Lerman J. The Effects of a Shoulder Roll During Laryngoscopy in Infants: A Randomized, Single-Blinded, Crossover Study. Anesth Analg 2020; 131:1210-1216. [PMID: 32925342 DOI: 10.1213/ane.0000000000004802] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND The use of a shoulder roll to view the glottic opening during direct laryngoscopy in infants has been recommended but is not evidence based. METHODS Twenty infants with normal airways, <6 months of age undergoing elective surgery under general anesthesia were randomized to undergo direct laryngoscopy first with a 2-inch vertical shoulder roll and then without, or vice versa. The primary outcome was the difference in the vertical distance between the angle of the laryngoscopist's eye and the operating room table in the 2 positions. Also, the views of the glottic opening in both positions were recorded for each infant and analyzed by a blinded investigator using the percent of glottic opening (POGO). RESULTS Twenty infants completed the study without complications. The vertical distance did not differ significantly whether the shoulder roll was placed first or second, and there was no evidence of a differential carryover effect in the crossover design (P = .268). The main effect of the shoulder roll on the mean (95% confidence interval [CI]) vertical distances without 47.8 cm (43.5-52.1) and with the shoulder roll 37.2 cm (33.3-41) yielded a mean (95% CI) vertical difference of 10.6 cm (9.3-11.79; P = .0001). The median (interquartile range [IQR]) POGO scores without 100 [86.2, 100] and with the shoulder roll 97.5 [80, 100] did not differ (median difference [95% CI]: 0 [-20 to 0]; P = .39). CONCLUSIONS A 2-inch shoulder roll lowers the line of sight of the glottic opening compared with no shoulder roll, without affecting the view of the glottic opening during laryngoscopy in infants.
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Affiliation(s)
- Waseem Alfahel
- From the Department of Anesthesia, John R. Oishei Children's Hospital, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Anupama Gopinath
- From the Department of Anesthesia, John R. Oishei Children's Hospital, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Kristopher L Arheart
- Division of Biostatistics, Department of Public Health Sciences, University of Miami School of Medicine, Miami, Florida
| | - Tara Gensler
- From the Department of Anesthesia, John R. Oishei Children's Hospital, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Jerrold Lerman
- From the Department of Anesthesia, John R. Oishei Children's Hospital, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York
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McDonough IM, McDougall GJ, LaRocca M, Dalmida SG, Arheart KL. Refining the metamemory in adulthood questionnaire: a 20-item version of change and capacity designed for research and clinical settings. Aging Ment Health 2020; 24:1054-1063. [PMID: 30957531 PMCID: PMC6779492 DOI: 10.1080/13607863.2019.1594160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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] [Indexed: 10/27/2022]
Abstract
Objective: Subjective memory concerns (SMCs) might be an early indicator of future cognitive decline and conversion to dementia. However, a rich history of mixed findings, moderating factors, and heterogenous methods preclude the usefulness of SMCs in both research and clinical settings. The present study aimed to review some of the factors that might cause mixed results and propose a revised version the Metamemory in Adulthood (MIA) Questionnaire that can be easily implemented to more consistently derive estimates of SMCs.Method: We used factor analysis and regression to investigate the utility of a revised 20-item version of the MIA Change and Capacity subscales.Results: Based on two samples of older adults (N = 382 and N = 221), the revised scale showed strong internal reliability and a two-factor structure. Regression analyses supported the incremental validity of the MIA-Revised Change scale in predicting performance on the Rivermead Behavioural Memory Test.Conclusions: By establishing a revised version of a well-known and previously validated questionnaire to assess SMCs, research and clinics can better implement a psychometrically sound measure quickly and easily. Moreover, the revised Change and Capacity subscales provide sufficient divergence to be sensitive to different facets of SMCs in a community dwelling older adult sample.
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Affiliation(s)
- Ian M. McDonough
- Department of Psychology, The University of Alabama, Tuscaloosa, Alabama, USA,Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa, Alabama, USA
| | | | - Michael LaRocca
- VA Palo Alto Health Care System, War Related Illness & Injury Study Center, Palo Alto, California, USA
| | - Safiya G. Dalmida
- College of Nursing, The University of Alabama, Tuscaloosa, Alabama, USA
| | - Kristopher L. Arheart
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida, USA
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Weerakoon SM, Keeton JM, Vidot DC, Arheart KL, Messiah SE. Relationship between risky behaviors and non-prescription opioid use among Asian American youth. J Ethn Subst Abuse 2020; 21:377-386. [PMID: 32497460 DOI: 10.1080/15332640.2020.1772931] [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] [Indexed: 10/24/2022]
Abstract
Asian Americans (AA) are a highly understudied population and are often considered the "model minority" for health. However, there is a dearth of research on risky behaviors associated with opioid use in AA teens. Data among AA youth aged 12 to 16 was collected from the 2017 Youth Risk Behavior Surveillance System. Multivariate logistic regression models were run to determine associations between opioid use and risky behaviors, controlling for age and sex. Findings showed that opioid use is significantly associated with weapon carrying, risky sexual behavior, and body image. These conclusions inform public health practice on substance abuse treatment in AA teens.
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Affiliation(s)
- Sitara M Weerakoon
- University of Texas Health Science Center (UTHealth), Dallas, Texas.,UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas
| | - Juang M Keeton
- UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas
| | - Denise C Vidot
- University of Miami School of Nursing, Coral Gables, Florida.,University of Miami Miller School of Medicine, Miami, Florida
| | | | - Sarah E Messiah
- University of Texas Health Science Center (UTHealth), Dallas, Texas.,UTHealth School of Public Health and Children's Health System of Texas, Dallas, Texas
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Silberstein J, Gwynn L, Mathew MS, Arheart KL, Messiah SE. Evidence to Support Universal Blood Pressure Screening in School-Based Clinical Settings. J Sch Health 2020; 90:474-481. [PMID: 32236966 DOI: 10.1111/josh.12893] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 05/28/2019] [Accepted: 07/04/2019] [Indexed: 06/11/2023]
Abstract
BACKGROUND Most pediatric elevated blood pressure (BP) remains undiagnosed. The American Academy of Pediatrics states "there is limited evidence to support school-based measurement of children's BP." We explored the utility school-based BP screening. METHODS A cross-sectional sample of 4096 students ages 6 to 17 from Title 1 Miami-Dade Public Schools (50% female, 71% non-Hispanic black, 26% Hispanic) had their systolic/diastolic BP (SBP/DBP) and body mass index (BMI) collected over the 2016 to 2017 or 2017 to 2018 school years. Relative risks (RRs) ratios were calculated to estimate normal/elevated SBP/DBP by BMI percentile, ethnicity, and sex. RESULTS Overall, 26.4% had at least one elevated BP measurement, of which 59% were not obese. RR for obese status was significant for all categories of elevated BP (RRs > 1.88, p < .0001). Being either female (RR = 1.34, p = .009) or Hispanic (RR = 1.31, p = .014) was significantly associated with elevated DBP. BMI accounted for <10% of the variation in BP (SBP: F(1, 4095) = 367.6, adjusted R2 = .08, p < .0001; DBP: F(1, 4095) = 93.3, adjusted R2 = .02, p < .0001). CONCLUSION These findings support providing BP screenings in school settings. Low-income and minority students often have limited access to health care, higher obesity rates, and unhealthy behaviors. Our findings support universal school-based BP screening regardless of weight status, particularly among ethnically diverse populations.
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Affiliation(s)
- Juliet Silberstein
- University of Miami Miller School of Medicine, 1601 NW 12th Ave. #403, Miami, FL 33136., USA
| | - Lisa Gwynn
- Clinical Pediatrics and Public Health Sciences, University of Miami Miller School of Medicine, 1601 NW 12th Ave., Miami, FL 33136., USA
| | - M Sunil Mathew
- Department of Pediatrics, University of Miami Miller School of Medicine, 1601 NW 12th Ave., Miami, FL 33136., USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1601 NW 12th Ave., Miami, FL 33136., USA
| | - Sarah E Messiah
- Department of Pediatrics and Department Public Health Sciences, University of Miami Miller School of Medicine, 1601 NW 12th Ave., Miaxsmi, FL 33136., USA
- University of Texas Health, School of Public Health, Dallas Campus, Dallas, TX, USA
- Center for Pediatric Population Health, UT Health School of Public Health and Children's Health System of Texas, Dallas, TX, USA
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Pallikkuth S, Bolivar H, Fletcher MA, Babic DZ, De Armas LR, Gupta S, Termini JM, Arheart KL, Stevenson M, Tung FY, Fischl MA, Pahwa S, Stone GW. A therapeutic HIV-1 vaccine reduces markers of systemic immune activation and latent infection in patients under highly active antiretroviral therapy. Vaccine 2020; 38:4336-4345. [PMID: 32387010 DOI: 10.1016/j.vaccine.2020.04.015] [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] [Received: 10/21/2019] [Revised: 03/10/2020] [Accepted: 04/06/2020] [Indexed: 10/24/2022]
Abstract
HIV infection is characterized by chronic immune activation and the establishment of a pool of latently infected cells. Antiretroviral therapy (ART) can suppress viral load to undetectable levels in peripheral blood by standard measure, however immune activation/chronic inflammation and latent infection persist and affect quality of life. We have now shown that a novel therapeutic HIV vaccine consisting of replication-defective HIV (HIVAX), given in the context of viral suppression under ART, can reduce both immune activation/chronic inflammation and latent infection. Immune activation, as measured by percent of CD8 + HLA-DR + CD38 + T cells, approached levels of healthy controls at week 16 following vaccination. Reduced immune activation was accompanied by a reduction in pro-inflammatory cytokines and peripheral α4β7 + plasmacytoid DC (a marker of mucosal immune activation). Levels of both HIV-1 DNA and 2-LTR circles were reduced at week 16 following vaccination, suggesting HIVAX can impact HIV-1 latency and reduce viral replication. Surprisingly, reduced immune activation/chronic inflammation was accompanied by an increase in the percent of memory CD4 + T cells expressing markers PD-1 and TIM-3. In addition, evaluation of HIV-1 Gag-specific CD4 + T cells for expression of 96 T cell related genes pre- and post-therapy revealed increased expression of a number of genes involved in the regulation of immune activation, T cell activation, and antiviral responses. Overall this study provides evidence that vaccination with HIVAX in subjects under long term antiviral suppression can reduce immune activation/chronic inflammation and latent infection (Clinicaltrials.gov, identifier NCT01428596).
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Affiliation(s)
- Suresh Pallikkuth
- Department of Microbiology and Immunology and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hector Bolivar
- Department of Medicine, Division of Infectious Diseases and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mary A Fletcher
- Department of Medicine, Division of Infectious Diseases and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Dunja Z Babic
- Department of Medicine, Division of Infectious Diseases and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lesley R De Armas
- Department of Microbiology and Immunology and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sachin Gupta
- Department of Microbiology and Immunology and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - James M Termini
- Department of Microbiology and Immunology and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences and the Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mario Stevenson
- Department of Medicine, Division of Infectious Diseases and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Margaret A Fischl
- Department of Medicine, Division of Infectious Diseases and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Savita Pahwa
- Department of Microbiology and Immunology and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Geoffrey W Stone
- Department of Microbiology and Immunology and Miami Center for AIDS Research, University of Miami Miller School of Medicine, Miami, FL, USA
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Traore MM, Junnila A, Traore SF, Doumbia S, Revay EE, Kravchenko VD, Schlein Y, Arheart KL, Gergely P, Xue RD, Hausmann A, Beck R, Prozorov A, Diarra RA, Kone AS, Majambere S, Bradley J, Vontas J, Beier JC, Müller GC. Large-scale field trial of attractive toxic sugar baits (ATSB) for the control of malaria vector mosquitoes in Mali, West Africa. Malar J 2020; 19:72. [PMID: 32059671 PMCID: PMC7023716 DOI: 10.1186/s12936-020-3132-0] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [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] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 01/22/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The aim of this field trial was to evaluate the efficacy of attractive toxic sugar baits (ATSB) in Mali, where sustained malaria transmission occurs despite the use of long-lasting insecticidal nets (LLINs). ATSB bait stations were deployed in seven of 14 similar study villages, where LLINs were already in widespread use. The combined use of ATSB and LLINs was tested to see if it would substantially reduce parasite transmission by Anopheles gambiae sensu lato beyond use of LLINs alone. METHODS A 2-day field experiment was conducted to determine the number of mosquitoes feeding on natural sugar versus those feeding on bait stations containing attractive sugar bait without toxin (ASB)-but with food dye. This was done each month in seven random villages from April to December 2016. In the following year, in seven treatment villages from May to December 2017, two ATSB bait stations containing the insecticide dinotefuran were placed on the outer walls of each building. Vector population density was evaluated monthly by CDC UV light traps, malaise traps, pyrethrum spray (PSCs) and human landing catches (HLCs). Female samples of the catch were tested for age by examination of the ovarioles in dissected ovaries and identification of Plasmodium falciparum sporozoite infection by ELISA. Entomological inoculation rates (EIR) were calculated, and reductions between treated and untreated villages were determined. RESULTS In the 2-day experiment with ASB each month, there was a lower number of male and female mosquitoes feeding on the natural sugar sources than on the ASB. ATSB deployment reduced CDC-UV trap female catches in September, when catches were highest, were by 57.4% compared to catches in control sites. Similarly, malaise trap catches showed a 44.3% reduction of females in August and PSC catches of females were reduced by 48.7% in September. Reductions of females in HLCs were lower by 19.8% indoors and 26.3% outdoors in September. The high reduction seen in the rainy season was similar for males and reductions in population density for both males and females were > 70% during the dry season. Reductions of females with ≥ 3 gonotrophic cycles were recorded every month amounting to 97.1% in October and 100.0% in December. Reductions in monthly EIRs ranged from 77.76 to 100.00% indoors and 84.95% to 100.00% outdoors. The number of sporozoite infected females from traps was reduced by 97.83% at treated villages compared to controls. CONCLUSIONS Attractive toxic sugar baits used against Anopheles mosquitoes in Mali drastically reduced the density of mosquitoes, the number of older females, the number of sporozoite infected females and the EIR demonstrating how ATSB significantly reduces malaria parasite transmission.
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Affiliation(s)
- Mohamad M Traore
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali
| | - Amy Junnila
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali
| | - Sekou F Traore
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali
| | - Seydou Doumbia
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali
| | - Edita E Revay
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali
| | | | - Yosef Schlein
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, 91120, Jerusalem, Israel
| | - Kristopher L Arheart
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
| | | | - Rui-De Xue
- Anastasia Mosquito Control District, 120 EOC, St. Augustine, FL, 32092, USA
| | - Axel Hausmann
- SNSB-Zoologische Staatssammlung, 81247, Munich, Germany
| | - Robert Beck
- SNSB-Zoologische Staatssammlung, 81247, Munich, Germany
| | - Alex Prozorov
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali
| | - Rabiatou A Diarra
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali
| | - Aboubakr S Kone
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali
| | - Silas Majambere
- Pan-African Mosquito Control Association, P.O. Box 54840-00200, Nairobi, Kenya
| | - John Bradley
- MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - John Vontas
- Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology-Hellas, 70013, Heraklion, Greece
- Pesticide Science Laboratory, Department of Crop Science, Agricultural University of Athens, 11855, Athens, Greece
| | - John C Beier
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
| | - Günter C Müller
- Malaria Research and Training Centre, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, BP 1805, Bamako, Mali.
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13
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Asfar T, Koru-Sengul T, Ruano-Herreria EC, Sierra D, Lee DJ, Arheart KL. Secondhand Smoke Exposure Among High-Risk Patients in the United States (NHANES 2001-2012): Implications for Clinical Practice. Nicotine Tob Res 2020; 21:551-556. [PMID: 29584874 DOI: 10.1093/ntr/nty060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/22/2018] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Patients with cancer, cardiovascular disease (CVD), and respiratory disease are susceptible to health consequences related to secondhand smoke (SHS) exposure. This study examined the prevalence, time trends, and correlates of SHS exposure among these patients compared with individuals without these diseases (control). METHODS Data were obtained from the 2001-2012 National Health and Nutrition Examination Survey. All adults (≥20 years old) who were nonsmokers and exposed to SHS (serum cotinine level 0.015-10 ng/mL), had cancer (n = 1,440), CVD (congestive heart failure, coronary heart disease, angina, heart attack, or stroke; n = 1,754), respiratory disease (asthma, chronic bronchitis, emphysema; n = 1,444), or none of these diseases (control; n = 11,615) were included in the analysis. Weighted prevalence, weighted second-degree polynomial linear regression of prevalence on year for trend analysis, and multivariable logistic regression analyses were performed with adjustments to the complex survey design. RESULTS SHS exposure was the highest among patients with respiratory disease (72.1%), followed by patients with CVD (70.6%), controls (70.4%), and patients with cancer (65.4%). From 2001 to 2012, exposure decreased the most among CVD patients (19.6%), followed by controls (16.0%), cancer patients (14.7%), and respiratory patients (10.0%). Exposed individuals in all groups were more likely to be younger, Black, and less educated. Exposed patients with respiratory disease were more likely to be former smokers (p < .05 for all). CONCLUSIONS SHS exposure among these patients is high and comparable to the general population. Strengthening smoke-free policies in all settings is critical. More efforts are needed to address SHS exposure more effectively in clinical care settings. IMPLICATIONS Despite the negative health effect of SHS exposure among patients with cancer, CVD, and respiratory disease, modest progress has been made in reducing their exposure. Continued efforts to strengthen smoke-free policies in workplaces, public place, and multiunit housing is critical. In addition, exposure to SHS among these patients seems to be overlooked in clinical care settings. More efforts are needed to address this problem more effectively in health care settings and investigate specific interventions directed at increasing patients' awareness about the risk of exposure to SHS and helping them to reducing their exposure.
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Affiliation(s)
- Tahgrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | | | - Danielle Sierra
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.,Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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Birnbach DJ, McKenty NT, Rosen LF, Arheart KL, Everett-Thomas R, Lindsey SF. Does Adherence to World Health Organization Hand Hygiene Protocols in the Operating Room Have the Potential to Produce Irritant Contact Dermatitis in Anesthesia Providers? Anesth Analg 2019; 129:e182-e184. [PMID: 31743176 DOI: 10.1213/ane.0000000000004112] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/05/2022]
Abstract
Anesthesia providers have the burden of constant hand hygiene during task dense periods. The requirement for hand hygiene often demands frequent application of alcohol-based hand rub. To assess whether frequent alcohol-based hand rub use leads to skin changes or irritant contact dermatitis, volunteers cleaned their hands with alcohol-based hand rub every 15 minutes for 8 hours for 5 sequential days. They were examined by a dermatologist before and after and asked about subjective skin changes. Results suggest an increase in irritant contact dermatitis scores and subjective complaints.
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Affiliation(s)
- David J Birnbach
- From the Department of Anesthesiology, University of Miami Miller School of Medicine
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | - Nathan T McKenty
- From the Department of Anesthesiology, University of Miami Miller School of Medicine
| | - Lisa F Rosen
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine
| | | | - Scott F Lindsey
- Department of Dermatology, University of Miami Miller School of Medicine
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Birnbach DJ, Thiesen TC, McKenty NT, Rosen LF, Arheart KL, Fitzpatrick M, Everett-Thomas R. Targeted Use of Alcohol-Based Hand Rub on Gloves During Task Dense Periods: One Step Closer to Pathogen Containment by Anesthesia Providers in the Operating Room. Anesth Analg 2019; 129:1557-1560. [PMID: 31743175 DOI: 10.1213/ane.0000000000004107] [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] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Anesthesia providers' hand hygiene practices in the operating room may contribute to the transmission of bacteria. There is a debate, however, over the best approaches for pathogen containment during task dense periods (induction and extubation) of anesthesia care. A novel approach to reducing pathogen spread during these task dense periods is the use of alcohol-based hand rub on gloves when it may be difficult to either change gloves or clean hands. METHODS To evaluate the impact of alcohol-based hand rub on gloves, we estimated perforation rates of 50 gloves that were worn as pairs by volunteers for 2 hours at a time applying alcohol-based hand rub every 15 minutes (total of 8 alcohol-based hand rub applications per pair of gloves). We also identified perforation rates of 50 new, unused gloves. To evaluate the ability to perform routine anesthesia functions, volunteers were asked to pick up a coin from a table top and document whether the gloves felt normal or sticky at each 15-minute period. RESULTS Fifty new gloves (not exposed to alcohol-based hand rub) were tested for integrity using the Food and Drug Administration-approved process, and one was found to have a microperforation. Of the 50 gloves that had been applied with alcohol-based hand rub 8 times, no microperforations were identified. All volunteers demonstrated tactile competence by picking up a coin from a table top after 8 alcohol-based hand rub applications; in addition, as the number of alcohol-based hand rub applications progressed, the volunteers reported increased stickiness. CONCLUSIONS This study suggests that the use of alcohol-based hand rub on commonly used nitrile examination gloves does not compromise glove integrity or hamper the ability to safely perform routine anesthesia functions.
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Affiliation(s)
- David J Birnbach
- From the Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Taylor C Thiesen
- From the Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Nathan T McKenty
- From the Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Lisa F Rosen
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Maureen Fitzpatrick
- University of Miami-Jackson Memorial Hospital Center for Patient Safety, Miami, Florida
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Waibel JS, Rudnick A, Arheart KL, Nagrani N, Gonzalez A, Gianatasio C. Re-pigmentation of Hypopigmentation: Fractional Lasers vs Laser-Assisted Delivery of Bimatoprost vs Epidermal Melanocyte Harvesting System. J Drugs Dermatol 2019; 18:1090-1096. [PMID: 31738492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Background: Hypopigmentation is a common cutaneous manifestation that frequently poses a therapeutic challenge for dermatologists. Current treatments have varying efficacies and rarely provide patients with long-term results. However, new treatments are emerging, and head-to-head studies comparing these treatments are warranted. Methods & Materials: In this prospective, Institutional Review Board (IRB)-approved, double-blinded study, 40 subjects with moderate to severe hypopigmentation were randomized into 1 of 4 treatment arms; non-ablative fractional laser, ablative fractional laser, ablative fractional laser with laser-assisted delivered bimatoprost, and an epidermal harvesting system. Results: All patients in this study showed improvement regardless of the treatment modality. The average improvement score was calculated on a 0 to 4 scale, and Group 3 (fractional ablative laser and bimatoprost) was found to have a significantly higher average improvement than all other treatments, with 76% of the patients exhibiting at least a grade 3 (over 50%) improvement over the treatment course. Group 1 (non-ablative fractional) also had a significantly higher average score compared with group 2 (fractional ablative laser). Conclusion: New and emerging therapies have shown promise in helping re-pigmentation of cutaneous hypopigmentation. In this head-to-head trial, it was shown that laser-assisted delivery of bimatoprost had a greater statistically significant improvement compared with 3 possible treatment modalities for stimulation of pigment in medical and cosmetic hypopigmentation. J Drugs Dermatol. 2019;18(11):1090-1096.
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Asfar T, McClure LA, Arheart KL, Ruano-Herreria EC, Gilford CG, Moore K, Dietz NA, Ward KD, Lee DJ, Caban-Martinez AJ. Integrating Worksite Smoking Cessation Services Into the Construction Sector: Opportunities and Challenges. Health Educ Behav 2019; 46:1024-1034. [PMID: 31426671 DOI: 10.1177/1090198119866900] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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: 11/16/2022]
Abstract
Background. Smoking prevalence among Hispanic/Latino construction workers in the United States is very high (31%). Aims. To investigate tobacco use profiles in these minority workers and explore their management's views about implementing sustainable worksite smoking cessation services. Methods. Analysis of baseline data from a smoking cessation trial among Hispanic/Latino construction workers (n = 134; adult men ≥18 years), and semistructured, 45-minute interviews with 24 key personnel at six construction companies in south Florida were conducted. Interviews were recorded, transcribed, and analyzed thematically. Results. Overall, 43.3% of workers were Cuban, and 81.3% had low acculturation level. Nicotine dependence levels were "high" in 61.8% of workers. Half of the workers had a successful quit attempt but only 9.9% received advice from a physician to quit smoking, 16.7% used medication to quit, and 79.2% did not receive assistance. Participants in the interviews stated that nothing was provided to help smokers quit smoking and considered distributing self-help materials with free medications as the most appropriate service. Challenges to integrating the service were time restriction and cost. Recommendations for implementing the service were local/state government mandate. Discussion. Tailoring tobacco treatment to Hispanic/Latino construction workers' job circumstances and culture is essential to support their cessation efforts. Integrating worksite tobacco treatment services into other available health promotion programs (e.g., safety) and enforcing smoke-free legislation in the construction sector can facilitate its adoption. Conclusion. Involving key stakeholders and mandating the service by the State and local government are necessary to integrate sustainable worksite smoking cessation services in the construction sector.
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Affiliation(s)
| | | | | | | | | | | | - Noella A Dietz
- University of Miami, Miami, FL, USA.,Broward Health Systems, Fort Lauderdale, FL, USA
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18
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Messiah SE, D'Agostino EM, Patel HH, Hansen E, Mathew MS, Arheart KL. Changes in cardiovascular health and physical fitness in ethnic youth with intellectual disabilities participating in a park-based afterschool programme for two years. J Appl Res Intellect Disabil 2019; 32:1478-1489. [PMID: 31219677 DOI: 10.1111/jar.12642] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 03/09/2019] [Accepted: 06/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Youth with intellectual disabilities are more likely to be an unhealthy weight and less physically active than youth without intellectual disability. OBJECTIVE The effects of Fit2Play, a park-based afterschool programme on cardiovascular/fitness health outcomes among youth with intellectual disability, were prospectively assessed. METHODS Youth ages 6 to 22 with intellectual disability who participated in Fit2Play for either one or two school years between 2010 and 2016 (N = 297, mean age 14.1 years, 70% Hispanic, 20% non-Hispanic black, 72% male) were examined via a fitness battery at the beginning/end of the school year(s). Effects of length of Fit2Play participation on body mass index (BMI) %ile, skinfold thicknesses, systolic/diastolic blood pressure (SBP/DBP) %iles, fitness tests, and health and wellness knowledge) were evaluated via two-level repeated measures analysis adjusted for child gender, age, ethnicity and area-level poverty. RESULTS Adjusted models showed that up to two years of Fit2Play participation was significantly associated with improved BMI %ile, skinfold thicknesses, SPB/DBP %iles and PACER scores (p < 0.05 for all). One and two years of programme participation was associated with a 6% [95% CI: 0.92, 0.96] and 10% [95% CI: 0.87, 0.93] reduction in SBP%ile, respectively (p < 0.001), and a 36% [95% CI: 1.28, 1.45] and 57% [95% CI: 1.44, 1.70] increase in PACER score laps, respectively, compared to baseline. CONCLUSIONS Results here suggest that park-based, structured afterschool programmes with a focus on health and wellness can be a rich resource for this nation by offering both exclusive and immersion programmes for children with intellectual disability to foster cardiovascular health in all youth.
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Affiliation(s)
- Sarah E Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida.,Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Emily M D'Agostino
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida
| | - Hersila H Patel
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida
| | - Eric Hansen
- Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida
| | - Matthew Sunil Mathew
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
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19
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Sissoko F, Junnila A, Traore MM, Traore SF, Doumbia S, Dembele SM, Schlein Y, Traore AS, Gergely P, Xue RD, Arheart KL, Revay EE, Kravchenko VD, Beier JC, Müller GC. Frequent sugar feeding behavior by Aedes aegypti in Bamako, Mali makes them ideal candidates for control with attractive toxic sugar baits (ATSB). PLoS One 2019; 14:e0214170. [PMID: 31206547 PMCID: PMC6576782 DOI: 10.1371/journal.pone.0214170] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 04/18/2019] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Current tools and strategies are not sufficient to reliably address threats and outbreaks of arboviruses including Zika, dengue, chikungunya, and yellow fever. Hence there is a growing public health challenge to identify the best new control tools to use against the vector Aedes aegypti. In this study, we investigated Ae. aegypti sugar feeding strategies in Bamako, Mali, to determine if this species can be controlled effectively using attractive toxic sugar baits (ATSB). METHODOLOGY We determined the relative attraction of Ae. aegypti males and females to a variety of sugar sources including flowers, fruits, seedpods, and honeydew in the laboratory and using plant-baited traps in the field. Next, we observed the rhythm of blood feeding versus sugar feeding activity of Ae. aegypti in vegetation and in open areas. Finally, we studied the effectiveness of spraying vegetation with ATSB on Ae. aegypti in sugar rich (lush vegetation) and in sugar poor (sparse vegetation) urban environments. PRINCIPAL FINDINGS Male and female laboratory sugar feeding rates within 24 h, on 8 of 16 plants offered were over 80%. The survival rates of mosquitoes on several plant sources were nearly as long as that of controls maintained on sucrose solution. In the field, females were highly attracted to 11 of 20 sugar sources, and 8 of these were attractive to males. Peak periods of host attraction for blood-feeding and sugar feeding in open areas were nearly identical and occurred shortly after sunrise and around sunset. In shaded areas, the first sugar-seeking peak occurred between 11:30 and 12:30 while the second was from 16:30 to 17:30. In a 50-day field trial, ATSB significantly reduced mean numbers of landing / biting female Ae. aegypti in the two types of vegetation. At sugar poor sites, the mean pre-treatment catch of 20.51 females on day 14 was reduced 70-fold to 0.29 on day 50. At sugar rich sites, the mean pre-treatment catch of 32.46 females on day 14 was reduced 10-fold to a mean of 3.20 females on day 50. CONCLUSIONS This is the first study to show how the vector Ae. aegypti depends on environmental resources of sugar for feeding and survival. The demonstration that Ae. aegypti populations rapidly collapsed after ATSB treatment, in both sugar rich and sugar poor environments, is strong evidence that Ae. aegypti is sugar-feeding frequently. Indeed, this study clearly demonstrates that Ae. aegypti mosquitoes depend on natural sugar resources, and a promising new method for vector control, ATSB, can be highly effective in the fight against Aedes-transmitted diseases.
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Affiliation(s)
- Fatoumata Sissoko
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
| | - Amy Junnila
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Mohamad M. Traore
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
| | - Sekou F. Traore
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
| | - Seydou Doumbia
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
| | - Seydou Mamadou Dembele
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
| | - Yosef Schlein
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Amadou Sekou Traore
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
| | | | - Rui-De Xue
- Anastasia Mosquito Control District, St. Augustine, FL, United States of America
| | - Kristopher L. Arheart
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Edita E. Revay
- Department of Anatomy and Cell Biology, Bruce Rappaport Faculty of Medicine, Technion, Haifa, Israel
| | | | - John C. Beier
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Gunter C. Müller
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Sciences, Techniques and Technology of Bamako, Bamako, Mali
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, Jerusalem, Israel
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21
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Gerkowicz SA, Fiorentino DG, Kovacs AP, Arheart KL, Verma U. Uterine structural abnormality and intrauterine device malposition: analysis of ultrasonographic and demographic variables of 517 patients. Am J Obstet Gynecol 2019; 220:183.e1-183.e8. [PMID: 30419198 DOI: 10.1016/j.ajog.2018.11.122] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Revised: 10/26/2018] [Accepted: 11/01/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND Intrauterine devices are currently one of the leading forms of reversible contraception in the world. However, in approximately 10-25% of women, intrauterine devices can become malpositioned, leading to consequences including pain, bleeding, as well as possible decreased contraceptive efficacy. OBJECTIVE We sought to determine whether certain reproductive and uterine characteristics are associated with an increased risk of intrauterine device malposition. We hypothesized that anatomical characteristics such as the presence of any uterine anomalies, particularly congenital anomalies and fibroids that may lead to cavitary distortion, would be associated with a higher incidence of intrauterine device malposition. MATERIALS AND METHODS We conducted a retrospective case-control study in an academic medical center. All patients presenting for scheduled ultrasound appointments for gynecologic indication between June 2004 and February 2016 were included (1,253 ultrasound reports identified). Of these, 236 demonstrated malpositioned intrauterine devices. With a control group of 281 patients with normal intrauterine device location, a total of 517 patients were included in the study. Transabdominal and transvaginal ultrasounds were performed followed by 3-dimensional rendering (as per our institution's protocol for patients with intrauterine devices) using Voluson 730 and Voluson E8 ultrasound machines. Demographic and reproductive characteristics, indication for ultrasound, intrauterine device, and uterine characteristics were all extrapolated from the electronic medical record. χ2 Tests were performed for categorical variables. Generalized linear models for Poisson distributed variables, and multiple logistic regression were used to ascertain significant independent predictors of IUD malposition. Ninety-five percent confidence intervals and effect sizes were calculated, and P < .05 was considered statistically significant. RESULTS In this study, we found a cumulative IUD malposition rate of 19%. In patients with malpositioned intrauterine devices, there was increased incidence of retroflexed uterine positions (7.6% vs 1.8%, P = .001), and all uterine anomalies (this includes septate and bicornuate uteri and fibroids, 31.9% vs 23.5%, P = .02) compared with controls. The anterior midline uterine position was more commonly noted in controls (28.5% vs 11%, P < .001). A higher total number of fibroids was noted in the malpositioned group (3.7 vs 1.8, P = .01); however, fibroid size was not statistically significant. In particular, there was an increased incidence of submucosal fibroids in women with malpositioned intrauterine devices (P = .01). Multivariable logistic regression revealed that anterior midline position (odds ratio [OR], 0.33; 95% confidence interval [CI], 0.20-0.57) and absence of uterine anomalies (OR, 0.59; 95% CI, 0.38-0.93) were factors associated with a lower risk of IUD malposition; whereas vaginal bleeding (OR, 2.25; 95% CI, 1.38-3.67), pain (OR, 2.85; 95% CI, 1.84-4.44), or missing IUD strings at time of presentation (OR, 3.58; 95% CI, 1.88-6.82) were associated with an increased risk of malposition. CONCLUSION Retroflexed uterine positions and all uterine malformations are associated with higher incidence of malpositioned intrauterine devices. Presence of increased number of fibroids and specifically submucosal fibroids showed a positive association with intrauterine device malposition, as did symptoms of bleeding, pain, and missing IUD strings at time of presentation. These findings pertain to women presenting for gynecologic ultrasound evaluation and may not be generalizable to all women with IUDs.
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Affiliation(s)
- Sabrina A Gerkowicz
- Department of Obstetrics and Gynecology, Jackson Memorial Hospital/University of Miami, Miami, FL.
| | - Desiree G Fiorentino
- Department of Obstetrics and Gynecology, Jackson Memorial Hospital/University of Miami, Miami, FL
| | | | - Kristopher L Arheart
- University of Miami Department of Public Health Sciences, Division of Biostatistics, Miami, FL
| | - Usha Verma
- Department of Obstetrics and Gynecology, Jackson Memorial Hospital/University of Miami, Miami, FL
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Hecht EM, Arheart KL, Lee DJ, Hennekens CH, Hlaing WM. Interrelationships of Cadmium, Smoking, and Angina in the National Health and Nutrition Examination Survey, a Cross-Sectional Study. Cardiology 2019; 141:177-182. [PMID: 30699411 DOI: 10.1159/000496016] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 12/03/2018] [Indexed: 11/19/2022]
Abstract
The interrelationships between cadmium biomarker levels, smoking, and myocardial infarction and stroke have been established. In this cross-sectional analysis, we explored the interrelationships of blood cadmium levels, smoking, and angina. We analyzed the National Health and Nutrition Examination Survey (NHANES, 2003-2014) accounting for the multi-staged complex sampling design. Participants 40-79 years of age with blood cadmium levels but without a history of myocardial infarction and/or stroke were included (n = 14,832). We examined blood cadmium levels (3 tertile groups) in relation to 3 (diagnosed, undiagnosed, and composite diagnosed and/or undiagnosed) angina outcomes. Multivariable logistic regression models adjusted for age, diabetes, smoking status, and household income were used to estimate odds ratios (ORs) and their corresponding 95% confidence intervals (CIs). Of 14,832 participants, 741 (4.2%) had positive composite angina. The crude and adjusted ORs comparing those in the lowest tertile (referent group) of blood cadmium to those in the highest tertile for the composite outcome were 1.82 (95% CI 1.42-2.34) and 1.45 (95% CI 1.12-1.88), respectively. These cross-sectional data from a nationally representative sample contribute to the hypothesis that there are interrelationships between smoking, cadmium, and angina.
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Affiliation(s)
- Eric M Hecht
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA,
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Charles H Hennekens
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA.,Department of Preventive Medicine, Nova Southeastern University, Fort Lauderdale, Florida, USA.,Department of Family Medicine and Community Health, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - WayWay M Hlaing
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
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Abstract
BACKGROUND To address the low levels of hand hygiene compliance (HHC) at our academic medical centre, we developed an annual patient safety course required for all incoming third-year medical students. Based on previous observations of medical students, it was determined that hand hygiene (HH) would be a central component of the course. METHODS Over a 1-year period (2015/16), we observed third- and fourth-year medical students who had participated in the annual patient safety course entering three intensive care units (ICUs) at two teaching hospitals. A total of 150 medical students failed to perform HH on entry and were subsequently asked why they did not comply. RESULTS Of the 150 medical students observed entering an ICU without performing HH, 74.7% were male and 25.3% were female. Males cited inadequate time (21.4%), lack of role models (10.7%) and provided incorrect information regarding HH requirements (58.9%). Females cited concerns about dry or cracked skin (34.2%) and forgetting (23.7%). DISCUSSION Our study demonstrates that even when medical students receive intensive HH education, compliance remains low. Of note, males and females offered different reasons for why they failed to perform HH. To address the suboptimal HHC, we developed an annual patient safety course required for all third-year medical students immediately prior to beginning clinical rotations. In this study, we sought to understand why medical students' HH remains suboptimal even after an intensive course.
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Affiliation(s)
- David J Birnbach
- UM-JMH Center for Patient Safety, Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Lisa F Rosen
- UM-JMH Center for Patient Safety, Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maureen Fitzpatrick
- UM-JMH Center for Patient Safety, Department of Anesthesiology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences Division of Biostatistics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Ruth Everett-Thomas
- University of Miami School of Nursing and Health Studies, Miami, Florida, USA
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Sharma TS, Somarriba G, Arheart KL, Neri D, Mathew MS, Graham PL, Scott GB, Miller TL. Longitudinal Changes in Body Composition by Dual-energy Radiograph Absorptiometry Among Perinatally HIV-infected and HIV-uninfected Youth: Increased Risk of Adiposity Among HIV-infected Female Youth. Pediatr Infect Dis J 2018; 37:1002-1007. [PMID: 29474262 PMCID: PMC6105572 DOI: 10.1097/inf.0000000000001963] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Combination antiretroviral therapy has allowed youth with perinatal HIV infection (PHIV+) to live into adulthood, but many youth may experience metabolic and body composition changes that predispose to greater cardiovascular disease (CVD) risk. This longitudinal study evaluated changes in body composition measured by dual-energy radiograph absorptiometry (DXA) in a cohort of PHIV+ youth compared with HIV- controls over a 7-year period. METHODS PHIV+ youth and HIV- controls were prospectively enrolled in a single-site study to assess nutrition and CVD risk. Anthropometrics and DXA scans were longitudinally obtained to assess percent body fat and regional fat distribution. Using general linear models, we analyzed differences in body composition and anthropometric measures by sex between PHIV+ youth and controls over time. RESULTS Two hundred thirty-five participants (156 PHIV+ and 79 HIV- controls) with at least 1 DXA performed since study enrollment were included for analysis. During the study period, 471 DXAs were obtained in the PHIV+ group and 95 in HIV- controls. PHIV+ females demonstrated greater increase in weight and body mass index over time compared with HIV- females, and significant increases in total percent body fat [estimate = 1.212 (95% confidence interval: 0.837-1.587) percent per year; P < 0.001) and percent trunk fat [1.3818 (95% confidence interval: 0.922-1.84); P < 0.001] compared with HIV- females and PHIV+ males. CONCLUSIONS PHIV+ females demonstrate an unfavorable change in fat redistribution and percent body fat over time that exceeds the pattern seen in PHIV+ males or HIV- females. Providers should have heightened awareness of body composition changes of PHIV+ females that may eventually lead to increased CVD risk.
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Affiliation(s)
- Tanvi S Sharma
- From the Division of Infectious Diseases, Department of Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Gabriel Somarriba
- Department of Clinical Education, University of St. Augustine for Health Sciences, St. Augustine, Florida
| | - Kristopher L Arheart
- Division of Biostatistics, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Daniela Neri
- Discipline of Nutrition, Department of Pediatrics, Paulista School of Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - M Sunil Mathew
- Division of Pediatric Clinical Research, Department of Pediatrics
| | | | - Gwendolyn B Scott
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Miller School of Medicine, University of Miami, Miami, Florida
| | - Tracie L Miller
- Division of Pediatric Clinical Research, Department of Pediatrics
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Guerra Sanchez CH, Lorica CD, Arheart KL, Perez MM, Tekin A, Gonzalez IA. Virologic response with 2 different cidofovir dosing regimens for preemptive treatment of adenovirus DNAemia in pediatric solid organ transplant recipients. Pediatr Transplant 2018; 22:e13231. [PMID: 29862610 DOI: 10.1111/petr.13231] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/05/2018] [Indexed: 01/28/2023]
Abstract
ADV is frequently seen in our pediatric SOT population. It presents in a variety of clinical presentation and can cause severe disease. In this population, there are very few studies to determine the safety of CDV as a potential therapeutic agent. We present the findings of our retrospective study evaluating the efficacy and safety of CDV as 2 separate dosing regimens. Regimen A uses the standard 5 mg/kg once a week (Regimen A), and the second uses the 1 mg/kg 3 times per week (Regimen B). Overall, the dosing regimen did not differ in nephrotoxicity, but Regimen B had a higher, although non-significant, rate of viral load clearance. This suggests that more frequent dosing at lower levels may be more efficacious without any significant side effects in our SOT population.
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Affiliation(s)
- Carlos H Guerra Sanchez
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Miller School of Medicine-Jackson Health System, University of Miami, Miami, FL, USA
| | - Cherish D Lorica
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Miller School of Medicine-Jackson Health System, University of Miami, Miami, FL, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, Division of Biostatistics, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Michelle M Perez
- Pediatric Pharmacy Services, Holtz Children's Hospital, Jackson Health System, Miami, FL, USA
| | - Akin Tekin
- Division of Liver and Gastrointestinal Transplantation, Department of Surgery, Miller School of Medicine, University of Miami, Miami, FL, USA
- Miami Transplant Institute, Jackson Health System, Miami, FL, USA
| | - Ivan A Gonzalez
- Division of Pediatric Infectious Diseases and Immunology, Department of Pediatrics, Miller School of Medicine-Jackson Health System, University of Miami, Miami, FL, USA
- Miami Transplant Institute, Jackson Health System, Miami, FL, USA
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Messiah SE, D'Agostino EM, Patel HH, Hansen E, Mathew MS, Arheart KL. Sex differences in fitness outcomes among minority youth after participation in a park-based after-school program. Ann Epidemiol 2018; 28:432-439. [PMID: 29703522 DOI: 10.1016/j.annepidem.2018.03.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 03/05/2018] [Accepted: 03/30/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE This study aimed to describe sex differences in fitness outcomes after participation in Fit2Play, a park-based after-school health and wellness program. METHODS Youth who participated in Fit2Play for either 1, 2, or 3 school years between 2010 and 2016 (n = 2129, mean age 9.1 years, 52% Hispanic, 48% non-Hispanic black, 54% male) were tested via a comprehensive fitness battery at the beginning/end of the school year(s). Effects of length of Fit2Play participation on fitness outcomes were assessed via three-level repeated measures analysis stratified by sex and adjusted for child sociodemographics, weight category, area poverty, and year. RESULTS Significant improvements for boys and girls were found in the Progressive Aerobic Cardiovascular Endurance Run (P < .01 for girls, P < .001 for boys), 400 meter run tests (P < .001 for girls, P < .01 for boys), and push-ups (P < .01 for both), with dose-response trends for girls after up to 3 years of Fit2Play participation. From baseline to 1, 2, and 3 years of participation, girls demonstrated 8%, 14%, and 23% mean improvement in 400 meter run times versus 9%, 9%, and 17% for boys, respectively (P < .001 for all). Dose-response improvements were also found in girls for PACER scores and sit-ups. CONCLUSIONS After-school physical activity programs can improve fitness in all youth, and particularly girls with increased years of participation. Further research should examine sex differences in the effects of park-/community-based programs to reduce sex disparities in fitness, particularly in light of the current youth obesity epidemic.
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Affiliation(s)
- Sarah E Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL.
| | | | | | - Eric Hansen
- Department of Parks, Recreation and Open Spaces, Miami, FL
| | - M Sunil Mathew
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
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Fernandez CA, Vicente B, Marshall BD, Koenen KC, Arheart KL, Kohn R, Saldivia S, Buka SL. Longitudinal course of disaster-related PTSD among a prospective sample of adult Chilean natural disaster survivors. Int J Epidemiol 2018; 46:440-452. [PMID: 27283159 DOI: 10.1093/ije/dyw094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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] [Accepted: 03/31/2016] [Indexed: 11/14/2022] Open
Abstract
Background With an increasing number of individuals surviving natural disasters, it is crucial to understand who is most at risk for developing post-traumatic stress disorder (PTSD). The objective of this study was to prospectively examine the role that pre-existing psychopathology plays in developing PTSD after a disaster. Methods This study uses data from a prospective 5-wave longitudinal cohort (years 2003-11) of Chilean adults from 10 health centres ( N = 1708). At baseline, participants completed the Composite International Diagnostic Interview (CIDI), a comprehensive psychiatric diagnostic instrument. In 2010, the sixth most powerful earthquake on record struck Chile. One year later, a modified version of the PTSD module of the CIDI was administered. Marginal structural logistic regressions with inverse probability censoring weights were constructed to identify pre-disaster psychiatric predictors of post-disaster PTSD. Results The majority of participants were female (75.9%) and had a high-school/college education (66.9%). After controlling for pre-disaster PTSD, pre-existing dysthymia [odds ratio (OR) = 2.21; 95% confidence interval (CI) = 1.39-3.52], brief psychotic disorder (OR = 2.67; 95% CI = 1.21-5.90), anxiety disorders (not including PTSD; OR = 1.49; 95% CI = 1.27-1.76), panic disorder (OR = 2.46; 95% CI = 1.37-4.42), agoraphobia (OR = 2.23; 95% CI = 1.22-4.10), social phobia (OR = 1.86; 95% CI = 1.06-3.29), specific phobia (OR = 2.07; 95% CI = 1.50-2.86) and hypochondriasis (OR = 2.10; 95% CI = 1.05-4.18) were predictors of post-disaster PTSD. After controlling for pre-disaster anxiety disorders, dysthymia, and non-affective psychotic disorders, individuals with pre-disaster PTSD (vs those without pre-disaster PTSD) had higher odds of developing post-disaster PTSD (OR = 2.53; 95% CI = 1.37-4.65). Conclusions This is the first Chilean study to demonstrate prospectively that pre-disaster psychiatric disorders, independent of a prior history of other psychiatric disorders, increase the vulnerability to develop PTSD following a major natural disaster.
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Affiliation(s)
- Cristina A Fernandez
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Benjamin Vicente
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile
| | - Brandon Dl Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Karestan C Koenen
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Kohn
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Sandra Saldivia
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile
| | - Stephen L Buka
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
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Asfar T, Caban-Martinez AJ, McClure LA, Ruano-Herreria EC, Sierra D, Gilford Clark G, Samano D, Dietz NA, Ward KD, Arheart KL, Lee DJ. A cluster randomized pilot trial of a tailored worksite smoking cessation intervention targeting Hispanic/Latino construction workers: Intervention development and research design. Contemp Clin Trials 2018; 67:47-55. [PMID: 29454141 PMCID: PMC6377564 DOI: 10.1016/j.cct.2018.02.007] [Citation(s) in RCA: 7] [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: 10/12/2017] [Revised: 02/12/2018] [Accepted: 02/13/2018] [Indexed: 11/18/2022]
Abstract
Construction workers have the highest smoking rate among all occupations (39%). Hispanic/Latino workers constitute a large and increasing group in the US construction industry (over 2.6 million; 23% of all workers). These minority workers have lower cessation rates compared to other groups due to their limited access to cessation services, and lack of smoking cessation interventions adapted to their culture and work/life circumstances. Formative research was conducted to create an intervention targeting Hispanic/Latino construction workers. This paper describes the intervention development and the design, methods, and data analysis plans for an ongoing cluster pilot two-arm randomized controlled trial comparing an Enhanced Care worksite cessation program to Standard Care. Fourteen construction sites will be randomized to either Enhanced Care or Standard Care and 126 participants (63/arm) will be recruited. In both arms, recruitment and intervention delivery occur around "food trucks" that regularly visit the construction sites. Participants at Enhanced Care sites will receive the developed intervention consisting of a single face-to-face group counseling session, 2 phone calls, and a fax referral to Florida tobacco quitline (QL). Participants at Standard Care sites will receive a fax referral to the QL. Both groups will receive eight weeks of nicotine replacement treatment and two follow-up assessments at three and six months. Feasibility outcomes are estimated recruitment yield, barriers to delivering the intervention onsite, and rates of adherence/compliance to the intervention, follow-ups, and QL enrollment. Efficacy outcomes are point-prevalence and prolonged abstinence rates at six month follow-up confirmed by saliva cotinine <15 ng/ml.
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Affiliation(s)
- Taghrid Asfar
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States.
| | - Alberto J Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States
| | - Laura A McClure
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States
| | - Estefania C Ruano-Herreria
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States
| | - Danielle Sierra
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States
| | - G Gilford Clark
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States
| | - Daniel Samano
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States
| | - Noella A Dietz
- Broward Health Systems, 1600 S Andrews Avenue, Fort Lauderdale, FL 33316, United States
| | - Kenneth D Ward
- School of Public Health, The University of Memphis, 201 Robison Hall, Memphis, TN 38152-3480, United States
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, 1120 NW 14(th) St, 9(th) Floor, Miami, FL 33136, United States
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Asfar T, Arheart KL, Caban-Martinez AJ, Sierra D, Ruano-Herreria EC, McClure LA, Ward KD, Lee DJ. National estimates and correlates of cigarette smoking among Hispanic/Latino construction workers in the US. Tob Induc Dis 2018. [DOI: 10.18332/tid/84546] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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de Armas LR, Pallikkuth S, George V, Rinaldi S, Pahwa R, Arheart KL, Pahwa S. Reevaluation of immune activation in the era of cART and an aging HIV-infected population. JCI Insight 2017; 2:e95726. [PMID: 29046481 PMCID: PMC5846952 DOI: 10.1172/jci.insight.95726] [Citation(s) in RCA: 30] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 09/20/2017] [Indexed: 09/16/2023] Open
Abstract
Biological aging is associated with immune activation (IA) and declining immunity due to systemic inflammation. It is widely accepted that HIV infection causes persistent IA and premature immune senescence despite effective antiretroviral therapy and virologic suppression; however, the effects of combined HIV infection and aging are not well defined. Here, we assessed the relationship between markers of IA and inflammation during biological aging in HIV-infected and -uninfected populations. Antibody response to seasonal influenza vaccination was implemented as a measure of immune competence and relationships between IA, inflammation, and antibody responses were explored using statistical modeling appropriate for integrating high-dimensional data sets. Our results show that markers of IA, such as coexpression of HLA antigen D related (HLA-DR) and CD38 on CD4+ T cells, exhibit strong associations with HIV infection but not with biological age. Certain variables that showed a strong relationship with aging, such as declining naive and CD38+ CD4 and CD8+ T cells, did so regardless of HIV infection. Interestingly, the variable of biological age was not identified in a predictive model as significantly impacting vaccine responses in either group, while distinct IA and inflammatory variables were closely associated with vaccine response in HIV-infected and -uninfected populations. These findings shed light on the most relevant and persistent immune defects during virological suppression with antiretroviral therapy.
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Affiliation(s)
| | | | | | | | | | - Kristopher L. Arheart
- Department of Epidemiology and Public Health, Division of Biostatistics, University of Miami Miller School of Medicine, Miami, Florida, USA
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de Silva PS, Yang X, Korzenik JR, Goldman RH, Arheart KL, Caban-Martinez AJ. Association of urinary phenolic compounds, inflammatory bowel disease and chronic diarrheal symptoms: Evidence from the National Health and Nutrition Examination Survey. Environ Pollut 2017; 229:621-626. [PMID: 28689150 DOI: 10.1016/j.envpol.2017.06.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 05/03/2017] [Accepted: 06/09/2017] [Indexed: 06/07/2023]
Abstract
Endocrine disruptors such as phenolic compounds and parabens may be involved in chronic non-infective disease. While products incorporating these compounds are extensively utilized in consumer and personal products, little is known about their effect on bowel health. Inflammatory bowel disease (IBD) - consisting of the diseases ulcerative colitis and Crohn's disease - and irritable bowel syndrome are common chronic non-infectious diarrheal diseases. Despite limited knowledge on the etiology of IBD, these diseases have increased prevalence in industrialized countries and cause significant impairment to quality of life. In the present study we examine relationships between urinary environmental phenolic compounds, chronic diarrhea and inflammatory bowel disease. Data was obtained from the 2005-2010 US National Health and Nutrition Examination Survey (NHANES) including demographics, lifestyle factors, self-reported health conditions, inflammatory markers and urinary phenolic chemical concentrations. Only participants with complete environmental phenols & parabens component were included in our analysis. Chronic diarrheal symptoms were determined by using the 2009-2010 NHANES questionnaire which included questions pertaining to bowel health. We utilized chronic bowel leakage symptoms as a surrogate marker for chronic diarrhea. The presence of IBD was also analyzed from 2009 to 2010 NHANES data, as a sub-analysis for arthropathy directly querying the presence or absence of IBD. Among the subset of 5218 American adults aged 20-80 years in the NHANES study period who completed environmental phenols & parabens component, 25.5% reported chronic diarrheal symptoms. Abnormal markers of inflammation were present in 2200 (42.2%) of respondents. For IBD, 19 individuals with arthropathy confirmed a diagnosis of ulcerative colitis, and 1 person confirmed a Crohn's diagnosis. After adjustment for demographics, inflammatory and subsample weighing; lower paraben levels were associated with chronic bowel leakage (diarrheal) symptoms. Higher 4-tert-octylphenol levels was significantly associated with ulcerative colitis. Further study of underlying mechanisms should be considered.
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Affiliation(s)
- Punyanganie S de Silva
- Division of Gastroenterology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
| | - Xuan Yang
- Division of Environment and Public Health of the Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL 33136, United States
| | - Joshua R Korzenik
- Division of Gastroenterology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, United States
| | - Rose H Goldman
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States
| | - Kristopher L Arheart
- Division of Biostatistics of the Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL 33136, United States
| | - Alberto J Caban-Martinez
- Division of Environment and Public Health of the Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL 33136, United States; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, United States; Division of Biostatistics of the Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL 33136, United States; Department of Orthopedic Surgery, Brigham & Women's Hospital, Harvard Medical School, Boston, MA 02115, United States
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McClure LA, Tannenbaum SL, Zheng DD, Joslin CE, Perera MJ, Gellman MD, Arheart KL, Lam BL, Lee DJ. Eye Health Knowledge and Eye Health Information Exposure Among Hispanic/Latino Individuals: Results From the Hispanic Community Health Study/Study of Latinos. JAMA Ophthalmol 2017; 135:878-882. [PMID: 28662239 DOI: 10.1001/jamaophthalmol.2017.1998] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Importance Routine eye care is important to maintaining eye health and preventing visual impairment. However, poor knowledge of ocular risk factors and disease as well as minimal exposure to eye health information may compromise adherence to eye care recommendations. Studies have shown that Hispanic/Latino people have poor eye care utilization, but little is known about their knowledge of eye health and exposure to eye health information. Objective To examine factors associated with more eye health knowledge and greater exposure to eye health information among Hispanic/Latino people. Design, Setting, and Participants This was a cross-sectional ocular study of 1235 participants living in the Miami, Florida, site of the Hispanic Community Health Study/Study of Latinos, a multisite epidemiologic study of disease prevalence and development among Hispanic/Latino people. Data were collected from October 1, 2011, through September 30, 2013, and data analyses were conducted between May 28, 2014, and March 18, 2015. Descriptive and multivariable regression analyses were performed for 3 ocular health care outcomes. Regression models were built sequentially, with variables conceptually grouped according to Andersen's Behavioral Model of Health Services Use and Behavioral Model for Vulnerable Populations. Main Outcomes and Measures Ability to identify 8 factors on a general eye health knowledge scale and number of eye health information sources seen or heard about in the past 12 months. Results Of the 1235 participants, 748 (73.4%) self-identified as being of Cuban descent and 407 (19.2%) self-identified as being from Central or South America, 478 (46.7%) were women and 757 (53.3%) were men, and the mean (SD) age was 53.6 (8.1) years. Participants with at least a high school degree or general educational development certificate had greater eye health knowledge (incidence rate ratio [IRR], 1.08; 95% CI, 1.01-1.15 and IRR, 1.11; 95% CI, 1.04-1.17, respectively) as did those with a higher mental health score on the Short Form 12-Item, version 2, Health Survey (IRR, 1.03; 95% CI, 1.01-1.04). Those with educational attainment beyond a high school degree or a general educational development certificate (IRR, 1.29; 95% CI, 1.07-1.54), those who were 60 years or older (IRR, 1.32; 95% CI, 1.06-1.63), and those with a household income in US dollars of $20 001 to $40 000 (IRR, 1.23; 95% CI, 1.05-1.44) or greater than $40 000 (IRR, 1.25; 95% CI, 0.98-1.59) were more likely to be exposed to at least 5 sources of eye health information in the past 12 months. Conclusions and Relevance Among Hispanic/Latino people, age, educational level, income, and mental health may be important correlates of eye disease knowledge and eye health information exposure. These findings might be used to support the development of targeted interventions designed to improve eye health in this population.
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Affiliation(s)
- Laura A McClure
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Stacey L Tannenbaum
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - D Diane Zheng
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Charlotte E Joslin
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago
| | - Marisa J Perera
- Department of Psychology, University of Miami, Coral Gables, Florida
| | - Marc D Gellman
- Department of Psychology, University of Miami, Coral Gables, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Byron L Lam
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
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Messiah SE, D’Agostino EM, Hansen E, Mathew MS, Okeke D, Nardi M, Kardys J, Arheart KL. Longitudinal Impact of a Park-Based Afterschool Healthy Weight Program on Modifiable Cardiovascular Disease Risk Factors in Youth. J Community Health 2017; 43:103-116. [DOI: 10.1007/s10900-017-0393-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Muller GC, Junnila A, Traore MM, Traore SF, Doumbia S, Sissoko F, Dembele SM, Schlein Y, Arheart KL, Revay EE, Kravchenko VD, Witt A, Beier JC. The invasive shrub Prosopis juliflora enhances the malaria parasite transmission capacity of Anopheles mosquitoes: a habitat manipulation experiment. Malar J 2017; 16:237. [PMID: 28676093 PMCID: PMC5497341 DOI: 10.1186/s12936-017-1878-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [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: 03/09/2017] [Accepted: 05/26/2017] [Indexed: 11/10/2022] Open
Abstract
Background A neglected aspect of alien invasive plant species is their influence on mosquito vector ecology and malaria transmission. Invasive plants that are highly attractive to Anopheles mosquitoes provide them with sugar that is critical to their survival. The effect on Anopheles mosquito populations was examined through a habitat manipulation experiment that removed the flowering branches of highly attractive Prosopis juliflora from selected villages in Mali, West Africa. Methods Nine villages in the Bandiagara district of Mali were selected, six with flowering Prosopis juliflora, and three without. CDC-UV light traps were used to monitor their Anopheles spp. vector populations, and recorded their species composition, population size, age structure, and sugar feeding status. After 8 days, all of the flowering branches were removed from three villages and trap catches were analysed again. Results Villages where flowering branches of the invasive shrub Prosopis juliflora were removed experienced a threefold drop in the older more dangerous Anopheles females. Population density dropped by 69.4% and the species composition shifted from being a mix of three species of the Anopheles gambiae complex to one dominated by Anopheles coluzzii. The proportion of sugar fed females dropped from 73 to 15% and males from 77 to 10%. Conclusions This study demonstrates how an invasive plant shrub promotes the malaria parasite transmission capacity of African malaria vector mosquitoes. Proper management of invasive plants could potentially reduce mosquito populations and malaria transmission.
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Affiliation(s)
- Gunter C Muller
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, Jerusalem, Israel. .,Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, Bamako, BP 1805, Mali.
| | - Amy Junnila
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Mohamad M Traore
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, Bamako, BP 1805, Mali
| | - Sekou F Traore
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, Bamako, BP 1805, Mali
| | - Seydou Doumbia
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, Bamako, BP 1805, Mali
| | - Fatoumata Sissoko
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, Bamako, BP 1805, Mali
| | - Seydou M Dembele
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, Bamako, BP 1805, Mali
| | - Yosef Schlein
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Kristopher L Arheart
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Edita E Revay
- Department of Anatomy and Cell Biology, Bruce Rappaport Faculty of Medicine, Technion, 34995, Haifa, Israel
| | | | - Arne Witt
- CABI Africa, Box 633-00621, Nairobi, Kenya
| | - John C Beier
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
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Zhu L, Müller GC, Marshall JM, Arheart KL, Qualls WA, Hlaing WM, Schlein Y, Traore SF, Doumbia S, Beier JC. Is outdoor vector control needed for malaria elimination? An individual-based modelling study. Malar J 2017; 16:266. [PMID: 28673298 PMCID: PMC5496196 DOI: 10.1186/s12936-017-1920-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [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: 04/29/2017] [Accepted: 06/27/2017] [Indexed: 11/17/2022] Open
Abstract
Background Residual malaria transmission has been reported in many areas even with adequate indoor vector control coverage, such as long-lasting insecticidal nets (LLINs). The increased insecticide resistance in Anopheles mosquitoes has resulted in reduced efficacy of the widely used indoor tools and has been linked with an increase in outdoor malaria transmission. There are considerations of incorporating outdoor interventions into integrated vector management (IVM) to achieve malaria elimination; however, more information on the combination of tools for effective control is needed to determine their utilization. Methods A spatial individual-based model was modified to simulate the environment and malaria transmission activities in a hypothetical, isolated African village setting. LLINs and outdoor attractive toxic sugar bait (ATSB) stations were used as examples of indoor and outdoor interventions, respectively. Different interventions and lengths of efficacy periods were tested. Simulations continued for 420 days, and each simulation scenario was repeated 50 times. Mosquito populations, entomologic inoculation rates (EIRs), probabilities of local mosquito extinction, and proportion of time when the annual EIR was reduced below one were compared between different intervention types and efficacy periods. Results In the village setting with clustered houses, the combinational intervention of 50% LLINs plus outdoor ATSBs significantly reduced mosquito population and EIR in short term, increased the probability of local mosquito extinction, and increased the time when annual EIR is less than one per person compared to 50% LLINs alone; outdoor ATSBs alone significantly reduced mosquito population in short term, increased the probability of mosquito extinction, and increased the time when annual EIR is less than one compared to 50% LLINs alone, but there was no significant difference in EIR in short term between 50% LLINs and outdoor ATSBs. In the village setting with dispersed houses, the combinational intervention of 50% LLINs plus outdoor ATSBs significantly reduced mosquito population in short term, increased the probability of mosquito extinction, and increased the time when annual EIR is less than one per person compared to 50% LLINs alone; outdoor ATSBs alone significantly reduced mosquito population in short term, but there were no significant difference in the probability of mosquito extinction and the time when annual EIR is less than one between 50% LLIN and outdoor ATSBs; and there was no significant difference in EIR between all three interventions. A minimum of 2 months of efficacy period is needed to bring out the best possible effect of the vector control tools, and to achieve long-term mosquito reduction, a minimum of 3 months of efficacy period is needed. Conclusions The results highlight the value of incorporating outdoor vector control into IVM as a supplement to traditional indoor practices for malaria elimination in Africa, especially in village settings of clustered houses where LLINs alone is far from sufficient.
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Affiliation(s)
- Lin Zhu
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA.
| | - Günter C Müller
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, Jerusalem, Israel.,Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, BP 1805, Bamako, Mali
| | - John M Marshall
- Divisions of Biostatistics and Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Whitney A Qualls
- Zoonosis Control Branch, Texas Department of State Health Services, Austin, TX, USA
| | - WayWay M Hlaing
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Yosef Schlein
- Department of Microbiology and Molecular Genetics, IMRIC, Kuvin Centre for the Study of Infectious and Tropical Diseases, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Sekou F Traore
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, BP 1805, Bamako, Mali
| | - Seydou Doumbia
- Malaria Research and Training Center, Faculty of Medicine, Pharmacy and Odonto-Stomatology, University of Bamako, BP 1805, Bamako, Mali
| | - John C Beier
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL, USA
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Huntley SR, Lee DJ, LeBlanc WG, Arheart KL, McClure LA, Fleming LE, Caban-Martinez AJ. Acute joint pain in the emerging green collar workforce: Evidence from the linked National Health Interview Survey and Occupational Information Network (O*NET). Am J Ind Med 2017; 60:518-528. [PMID: 28514025 DOI: 10.1002/ajim.22710] [Citation(s) in RCA: 2] [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: 02/21/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Green jobs are a rapidly emerging category of very heterogeneous occupations that typically involve engagement with new technologies and changing job demands predisposing them to physical stressors that may contribute to the development of joint pain. METHODS We estimated and compared the prevalence of self-reported acute (past 30 days) joint pain between green and non-green collar workers using pooled 2004-2012 National Health Interview Survey (NHIS) data linked to the Occupational Information Network Database (O*NET). RESULTS Green collar workers have a higher prevalence of acute joint pain as compared to non-green collar workers. Green collar workers with pain in the upper extremity joints were significantly greater than in the non-green collar workforce, for example, right shoulder [23.2% vs 21.1%], right elbow [13.7% vs 12.0%], left shoulder [20.1% vs 18.2%], and left elbow [12.0% vs 10.7%]. CONCLUSIONS Acute joint pain reported by the emerging green collar workforce can assist in identifying at risk worker subgroups for musculoskeletal pain interventions.
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Affiliation(s)
- Samuel R Huntley
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida.,Department of Orthopaedics and Rehabilitation, Miami Center for Orthopaedic Research and Education (CORE), Miller School of Medicine, University of Miami, Miami, Florida
| | - David J Lee
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - William G LeBlanc
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Laura A McClure
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
| | - Lora E Fleming
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida.,European Centre for Environment and Human Health, Knowledge Spa, Royal Cornwall Hospital, University of Exeter Medical School, Truro, Cornwall, United Kingdom
| | - Alberto J Caban-Martinez
- Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida
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Birnbach DJ, Rosen LF, Fitzpatrick M, Paige JT, Arheart KL. Introductions During Time-outs: Do Surgical Team Members Know One Another's Names? Jt Comm J Qual Patient Saf 2017; 43:284-288. [PMID: 28528622 DOI: 10.1016/j.jcjq.2017.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Introductions are the first item of the time-out in the World Health Organization Surgical Safety Checklist (SSC). It has yet to be established that surgical teams use colleagues' names or consider the use of names important. A study was conducted to determine if using the SSC has a measurable impact on name retention and to assess if operating room (OR) personnel believe it is important to know the names of their colleagues or for their colleagues to know theirs. METHODS All OR personnel were individually interviewed at the end of 25 surgical cases in which the SSC was used. They were asked (1) to name each OR participant, and (2) if they believed it is important to know the names of their team members and (3) for their team members to know their name. RESULTS Of the 150 OR personnel interviewed, 147 (98%) named the surgery attending correctly. The surgery attending named only 44% of other OR staff (p <0.001). Only 62% of the OR staff correctly named the anesthesiology attending. The anesthesiology resident was the least well known but was able to name 82% of the others. The anesthesiology attending named his or her resident 100% of the time; the surgery attending correctly named his or her resident only 68% of the time (p = 0.002). CONCLUSION This study suggests that OR personnel may consider introductions to be another bureaucratic hurdle instead of the safety check they were designed to be. It appears that this first step of the time-out is often being performed perfunctorily.
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Willen EJ, Cuadra A, Arheart KL, Post MJD, Govind V. Young adults perinatally infected with HIV perform more poorly on measures of executive functioning and motor speed than ethnically matched healthy controls. AIDS Care 2017; 29:387-393. [PMID: 27690617 DOI: 10.1080/09540121.2016.1234677] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 10/20/2022]
Abstract
Perinatal HIV is associated with significant neurocognitive morbidities, but few studies have examined cognitive impact of early HIV infection on patients surviving to adulthood. The purpose of this study was to evaluate neurocognitive outcomes among a cohort of perinatally infected young adults. Individuals between the ages of 18 and 24 with perinatal infection were recruited for this cross-sectional study along with similarly aged healthy controls. Participants completed an MRI and brief neuropsychological assessment battery. Multivariate analysis of covariance controlling for age, gender, race/ethnicity, and education was completed to detect differences between the HIV+ and control groups. Multivariable linear regression was performed to assess HIV-associated factors potentially impacting neuropsychological findings among the HIV+ group. Twenty-nine HIV+ young adults and 13 healthy controls were included in the study. After adjusting for age and sociodemographic variables, the HIV+ group scored lower on attention/working memory (Digit Span (p = .008) and Letter-Number Sequencing (p = .038)), set-shifting (DKEFS Trail Making Test Condition 4 (p = .026) and motor speed (DKEFS Trail Making Test Condition 5 (p = .003)). For the HIV+ group, nadir CD4 was associated with better Letter-Number Sequencing score (p = .029) and use of highly active antiretroviral therapy was associated with better performance on Category Fluency (p = .040). After controlling for sociodemographic variables, executive dysfunction persists among young adults with perinatal HIV infection in comparison to controls. Future studies to further elucidate the impact of executive dysfunction on independent living and functional outcomes are indicated.
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Affiliation(s)
- Elizabeth J Willen
- a Department of Pediatrics, Mailman Center for Child Development , University of Miami, Miller School of Medicine , Miami , FL , USA
- b Department of Pediatrics , University of Missouri , Kansas City , MO , USA
- c Children's Mercy , Kansas City , MO , USA
| | - Anai Cuadra
- a Department of Pediatrics, Mailman Center for Child Development , University of Miami, Miller School of Medicine , Miami , FL , USA
| | - Kristopher L Arheart
- d Department of Public Health Sciences , University of Miami School of Medicine , Miami , FL , USA
| | - M J D Post
- e Department of Radiology , University of Miami School of Medicine , Miami , FL , USA
| | - Varan Govind
- e Department of Radiology , University of Miami School of Medicine , Miami , FL , USA
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Messiah SE, Vidot D, Hansen E, Kardys J, Sunil Matthew M, Nardi M, Arheart KL. Impact of a park-based afterschool program replicated over five years on modifiable cardiovascular disease risk factors. Prev Med 2017; 95:66-73. [PMID: 27956224 DOI: 10.1016/j.ypmed.2016.12.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/02/2016] [Accepted: 12/07/2016] [Indexed: 11/26/2022]
Abstract
Major challenges to the current childhood obesity epidemic include availability of prevention and/or treatment programs that are affordable and acc5essible. We evaluated the change in several modifiable, obesity-related cardiovascular disease risk factors after participation in Fit2Play™, a structured afterschool program housed in a large urban county parks system. Children ages 6-14 who participated in Fit2Play™ in one of 34 parks for one school year during a five-year period (2010-2015) had height, weight, 4-site skinfold thicknesses, systolic/diastolic blood pressure (SBP/DBP), fitness tests, and a health/wellness behavior/knowledge test collected at the beginning and end of the school year. Comparison of pre/post outcome measures were assessed via general linear mixed models for normal weight, overweight, and obese participants and both aggregate and cohort/year-specific results were generated. Aggregate (N=1546, 51% Hispanic, 44% NHB) results showed after one year of participation (U.S. Department of Health and Human Services, 2016) both the obese and overweight groups significantly decreased their mean body mass index (BMI) percentile (98th to 95th percentile, p<0.001; 91st percentile to 89th percentile, p<0.001, respectively); (Ogden et al. 2015) the normal weight group maintained a healthy BMI percentile (54.6th); (Ogden et al., 2014) mean SBP and DBP significantly decreased (3.6 percentile and 6 percentile points, respectively, p<0.001 for both). Mean number of sit-ups, push-ups, 400meter run time, and nutrition knowledge scores improved in all participants (p<0.001 for all). These findings suggest that parks-based afterschool health/wellness programs can be a low-cost, high value tool in both preventing and treating the current childhood obesity epidemic and among high-risk groups in particular.
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Affiliation(s)
- Sarah E Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
| | - Denise Vidot
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eric Hansen
- Miami Dade County Department of Parks, Recreation and Open Spaces, Miami, FL, USA
| | - Jack Kardys
- Miami Dade County Department of Parks, Recreation and Open Spaces, Miami, FL, USA
| | - M Sunil Matthew
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Maria Nardi
- Miami Dade County Department of Parks, Recreation and Open Spaces, Miami, FL, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Kachan D, Olano H, Tannenbaum SL, Annane DW, Mehta A, Arheart KL, Fleming LE, Yang X, McClure LA, Lee DJ. Prevalence of Mindfulness Practices in the US Workforce: National Health Interview Survey. Prev Chronic Dis 2017; 14:E01. [PMID: 28055821 PMCID: PMC5217767 DOI: 10.5888/pcd14.160034] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Mindfulness-based practices can improve workers' health and reduce employers' costs by ameliorating the negative effect of stress on workers' health. We examined the prevalence of engagement in 4 mindfulness-based practices in the US workforce. METHODS We used 2002, 2007, and 2012 National Health Interview Survey (NHIS) data for adults (aged ≥18 y, n = 85,004) to examine 12-month engagement in meditation, yoga, tai chi, and qigong among different groups of workers. RESULTS Reported yoga practice prevalence nearly doubled from 6.0% in 2002 to 11.0% in 2012 (P < .001); meditation rates increased from 8.0% in 2002 to 9.9% in 2007 (P < .001). In multivariable models, mindfulness practice was significantly lower among farm workers (odds ratio [OR] = 0.42; 95% confidence interval [CI], 0.21-0.83]) and blue-collar workers (OR = 0.63; 95% CI, 0.54-0.74) than among white-collar workers. CONCLUSION Worker groups with low rates of engagement in mindfulness practices could most benefit from workplace mindfulness interventions. Improving institutional factors limiting access to mindfulness-based wellness programs and addressing existing beliefs about mindfulness practices among underrepresented worker groups could help eliminate barriers to these programs.
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Affiliation(s)
- Diana Kachan
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida
| | - Henry Olano
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida
| | - Stacey L Tannenbaum
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
| | - Debra W Annane
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
| | - Ashwin Mehta
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, United Kingdom
| | - Xuan Yang
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, 1120 NW 14th St, Room 1027, Miami, FL 33136. E-mail:
| | - Laura A McClure
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
| | - David J Lee
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida
- Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
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Messiah SE, Asfour L, Arheart KL, Selem SM, Uhlhorn SB, Natale R. Relationship between parent demographic characteristics, perinatal and early childhood behaviors, and body mass index among preschool-age children. J Immigr Minor Health 2016; 17:414-21. [PMID: 25062613 DOI: 10.1007/s10903-014-0079-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/30/2022]
Abstract
Approximately 25% of US 2-to-5-year olds are overweight and ethnic minority groups are disproportionately affected. We explored the relationship between parent demographic characteristics, various perinatal/early childhood (EC) factors, and child body mass index (BMI) to determine possible contributors to these disparities. A preschool-based randomized controlled (N = 28 centers) obesity prevention intervention was conducted among multiethnic 2-to-5 year olds. Baseline assessment of demographic characteristics, various perinatal/EC factors, and child BMI were analyzed via generalized linear mixed models and logistic regression analysis. Foreign-born parents were almost 2.5 times as likely to have an obese child versus children of US-born parents (OR 2.43, 95% CI 1.53-3.87). Families who spoke Spanish only or a combination of Creole/English at home were over twice as likely to have an obese preschool child versus families who spoke English only at home. Parent place of birth and language spoken at home plays a significant role in early childhood obesity. Future early childhood healthy weight initiatives should incorporate strategies that take into account these particular parent characteristics.
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Affiliation(s)
- Sarah E Messiah
- Division of Pediatric Clinical Research, Department of Pediatrics, University of Miami Miller School of Medicine, Batchelor Children's Research Institute Room 541, 1580 NW 10th Avenue (D820), Miami, FL, 33101, USA,
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Qualls WA, Naranjo DP, Subía MA, Ramon G, Cevallos V, Grijalva I, Gómez E, Arheart KL, Fuller DO, Beier JC. Movement of Aedes aegypti following a sugar meal and its implication in the development of control strategies in Durán, Ecuador. J Vector Ecol 2016; 41:224-231. [PMID: 27860016 DOI: 10.1111/jvec.12217] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 03/16/2016] [Accepted: 06/20/2016] [Indexed: 05/15/2023]
Abstract
We evaluated how the presence of sugar sources impacted the distribution of Aedes aegypti in different habitats in Durán, Ecuador. Land cover and normalized difference vegetation index maps were used to guide a random point sampling routine to select study grids (30 m × 30 m) in low vegetation (LV) and high vegetation (HV). Five individual plants, at one home in the LV and HV grid, were treated with a different colored, non-attractive, 60% sucrose solution to determine mosquito feeding and movement. Sugar alone is not attractive to mosquitoes, so spraying vegetation with a dyed sugar solution can be used for visual determination of sugar feeding. Outdoor collections using BG sentinel traps and indoor collections using aspirators were conducted at the treatment home and with collection points at 20, 40, and 60 m surrounding the treatment home for three consecutive days. A total of 3,245 mosquitoes in two genera, Aedes and Culex, was collected. The proportion of stained Ae. aegypti females was 56.8% (510/898) and 0% for males. For Culex, 63.9% (248/388) females and 36.1% (140/388) males were collected stained. Aedes aegypti and Culex spp. were found up to 60 m stained in both LV and HV grids. Significantly more stained females Ae. aegypti were found inside homes compared to females and males of Culex spp. in both habitats. This study identifies that outdoor sugar feeding is a common behavior of Ae. aegypti and can be targeted as a control strategy in urban habitats in Latin America.
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Affiliation(s)
- Whitney A Qualls
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL, U.S.A. 33136
- PROMETEO, Secretaría de Educación Superior, Ciencia, Tecnología e Innovación, Quito, Ecuador
| | - Diana P Naranjo
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL, U.S.A. 33136
| | | | - Giovanni Ramon
- Instituto Nacional de Investigación en Salud Pública, Quito, Ecuador
| | - Varsovia Cevallos
- Instituto Nacional de Investigación en Salud Pública, Quito, Ecuador
| | - Isabel Grijalva
- Universidad Católica de Santiago de Guayaquil, Facultad de Ciencias Médicas, Guayas, Ecuador
| | - Eduardo Gómez
- Universidad Católica de Santiago de Guayaquil, Facultad de Ciencias Médicas, Guayas, Ecuador
- Ministerio de Salud Pública del Ecuador
| | - Kristopher L Arheart
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL, U.S.A. 33136
| | - Douglas O Fuller
- Department of Geography, University of Miami, Coral Gables, FL 33136, U.S.A
| | - John C Beier
- University of Miami Miller School of Medicine, Department of Public Health Sciences, Miami, FL, U.S.A. 33136
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Messiah SE, Vidot DC, Baeker Bispo J, Arheart KL, Khorgami Z, De La Cruz-Muñoz N. Ethnic and Gender Differences in the Prevalence of Nonalcoholic Steatohepatitis Among Bariatric Surgery Patients. Bariatr Surg Pract Patient Care 2016. [DOI: 10.1089/bari.2016.0018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Affiliation(s)
- Sarah E. Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida
- Division of Epidemiology and Population Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Denise C. Vidot
- Division of Epidemiology and Population Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Jordan Baeker Bispo
- Division of Epidemiology and Population Health, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Kristopher L. Arheart
- Division of Biostatistics, Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Zhamak Khorgami
- Division of Laparoendoscopic and Bariatric Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
| | - Nestor De La Cruz-Muñoz
- Division of Laparoendoscopic and Bariatric Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida
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Qualls WA, Scott-Fiorenzano J, Müller GC, Arheart KL, Beier JC, Xue RD. Evaluation and Adaptation of Attractive Toxic Sugar Baits For Culex tarsalis and Culex quinquefasciatus Control In The Coachella Valley, Southern California. J Am Mosq Control Assoc 2016; 32:292-299. [PMID: 28206859 DOI: 10.2987/16-6589.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The project goal was to determine how a new vector control strategy that targets the sugar-feeding behavior of mosquitoes, attractive toxic sugar baits (ATSBs), can be used to more effectively control West Nile virus (WNV) vectors in the Coachella Valley, California. Three laboratory studies were conducted to determine the utility of this method for control against Culex quinquefasciatus and Culex tarsalis : 1) efficacy evaluations of 2 formulations of ATSB, microencapsulated garlic oil, and a combination of microencapsulated garlic oil and 1% boric acid; 2) choice assays to determine the attractiveness of ATSB with the microencapsulated garlic oil against attractive sugar baits (ASB; the attractant alone; without toxin) and a 10% sucrose solution; and 3) vegetation efficacy tests on 3 common plant species in the Coachella Valley, Atriplex lentiformis, Tamarix ramosissima , and Pluchea sericea. At 48 h the average mortality for Cx. quinquefasciatus was 91% after exposure to ATSB with microencapsulated garlic oil and 99% on ATSB garlic + 1% boric acid solution. Culex tarsalis averaged 86% and 91% mortality following the ATSB microencapsulated garlic oil solution and the ATSB garlic + 1% boric acid solution, respectively. Choice assays indicated that the there were differences in preferences between the solutions and between species. Both Cx. quinquefasciatus and Cx. tarsalis were found to prefer the ASB and ATSB solutions to the 10% sucrose solution. However, when comparing the ASB to ATSB, Cx. quinquefasciatus significantly preferred the ASB solution (t = 3.6, df = 25, P = 0.0008). There were no significant differences in the preference of Cx. tarsalis to feed on the ASB or ATSB solutions as indicated in the choice assays (t = 1.9, df = 25, P = 0.07). Assays indicated that applications of ATSB to the 3 common plants in the Coachella Valley resulted in high mortality in both Cx. quinquefasciatus and Cx. tarsalis. There were significant differences in the treatments compared to the control (F = 40.15, df1,2 = 4,72, P < 0.001) but no significant differences among the different plants and ATSB treatments (F = 1.06, df1,2 = 4,72, P = 0.38). Laboratory findings suggest that ATSB is effective for use against WNV vectors in California. Further evaluations are needed in the field to determine how the environment may impact ATSB applications to influence mosquito mortality and nontarget organisms in arid environments in the United States.
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Bou Nemer L, Weitzman VN, Arheart KL, Barrionuevo MJ, Christie DR, Mouhayar Y, Hoffman DI, Maxson WS, Ory SJ. In Vitro Fertilization Versus Mild Stimulation Intrauterine Insemination in Women Aged 40 and Older. Reprod Sci 2016; 24:609-612. [DOI: 10.1177/1933719116667215] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Laurice Bou Nemer
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
| | - Vanessa N. Weitzman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
- IVF Florida Reproductive Associates, Margate, FL, USA
| | - Kristopher L. Arheart
- Division of Biostatistics, Department of Public Health Sciences, University of Miami, Miami, FL, USA
| | - Marcelo J. Barrionuevo
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
- IVF Florida Reproductive Associates, Margate, FL, USA
| | - Daniel R. Christie
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
- IVF Florida Reproductive Associates, Margate, FL, USA
| | - Youssef Mouhayar
- Department of Obstetrics and Gynecology, University of Miami, Miami, FL, USA
| | - David I. Hoffman
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
- IVF Florida Reproductive Associates, Margate, FL, USA
| | - Wayne S. Maxson
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
- IVF Florida Reproductive Associates, Margate, FL, USA
| | - Steven J. Ory
- Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, UT Southwestern Medical Center, Dallas, TX, USA
- IVF Florida Reproductive Associates, Margate, FL, USA
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Natale RA, Messiah SE, Asfour LS, Uhlhorn SB, Englebert NE, Arheart KL. Obesity Prevention Program in Childcare Centers: Two-Year Follow-Up. Am J Health Promot 2016; 31:502-510. [PMID: 27630110 DOI: 10.1177/0890117116661156] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [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: 11/17/2022]
Abstract
PURPOSE To assess the impact of an early childhood obesity prevention intervention "Healthy Caregivers-Healthy Children" (HC2) on dietary patterns and body mass index percentile (PBMI) over 2 school years. DESIGN Randomized controlled trial. SETTING Childcare centers. PARTICIPANTS Low-income families. INTERVENTION Intervention centers (N = 12) received HC2 which consisted of (1) menu modifications, (2) a healthy eating and physical activity curriculum for children, and (3) a parent curriculum for healthy meal preparation, reinforced through a role-modeling curriculum. Control centers (N = 16) received an injury prevention/safety intervention. MEASURES Child PBMI and parent report of child's consumption of fruits/vegetables and unhealthy food. ANALYSIS Confirmatory factor analysis verified the psychometric properties of factor scores for children's consumption of fruits/vegetables and unhealthy food. Growth curve analysis assessed the impact of HC2 on change in consumption of fruits/vegetables and unhealthy food and PBMI over 2 school years. RESULTS Children in the intervention group (n = 754) had a negative slope (β = -1.95, standard error [SE] = 0.97, P = .04), indicating less increase in PBMI versus control children (n = 457). Stratified analyses showed that obese children in the intervention arm had a significantly higher increase in fruit/vegetable consumption versus control group obese children (β = 0.24, SE = 0.08, P = .003). CONCLUSION The HC2 intervention resulted in the maintenance of healthy PBMI over 2 preschool years among low-income multiethnic children. These findings support efforts to implement healthy weight programs in the childcare setting.
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Affiliation(s)
- Ruby A Natale
- 1 Division of Clinical Psychology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sarah E Messiah
- 2 Department of Pediatrics, Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, FL, USA.,3 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Lila S Asfour
- 3 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susan B Uhlhorn
- 1 Division of Clinical Psychology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nicole E Englebert
- 1 Division of Clinical Psychology, Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kristopher L Arheart
- 2 Department of Pediatrics, Mailman Center for Child Development, University of Miami Miller School of Medicine, Miami, FL, USA.,3 Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
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Vidot DC, Stoutenberg M, Gellman M, Arheart KL, Teng Y, Daviglus ML, González HM, Talavera G, Isasi CR, Heiss G, Schneiderman N. Alcohol Consumption and Metabolic Syndrome Among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos. Metab Syndr Relat Disord 2016; 14:354-62. [PMID: 27304318 PMCID: PMC5011615 DOI: 10.1089/met.2015.0171] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The association between alcohol consumption and metabolic syndrome (MetS) among Hispanic/Latino populations has not been studied in great detail. Our study examined the relationship between alcohol consumption and MetS among U.S. Hispanics/Latinos and explored whether this relationship varied by age, body mass index, gender, and Hispanic/Latino backgrounds. METHODS The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multisite, prospective, population-based, cohort study of Hispanics/Latinos, ages 18-74 years from four U.S. communities. Participants were categorized into never, former, occasional, low, moderate, and high alcohol consumption categories. A cross-sectional analysis of 15,905 participants with complete data was conducted. Survey design appropriate chi-squared and logistic regression models were run to detect significant associations between alcohol consumption categories and cases of MetS. RESULTS Almost half (47.4%) of the sample was classified as occasional, low, moderate, or heavy drinkers. Low and moderate alcohol consumers had lower odds of MetS than never drinkers. Low and heavy drinkers had higher odds of presenting with elevated central obesity, while occasional, low, moderate, and heavy drinkers had higher odds of having low high-density lipoprotein cholesterol levels compared to never drinkers. Low and moderate wine drinkers had lower odds of MetS compared to never drinkers. There were no significant findings among beer or liquor drinkers, or with binge drinking after model adjustments. CONCLUSIONS Our findings suggest that low and moderate alcohol consumption may lower the odds of MetS in a sample of Hispanic/Latino adults, but that the relationship of alcohol consumption varies with the individual components of MetS.
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Affiliation(s)
- Denise C. Vidot
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Coral Gables, Florida
| | - Mark Stoutenberg
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Marc Gellman
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Coral Gables, Florida
| | - Kristopher L. Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Yanping Teng
- Department of Biostatistics, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois
| | - Hector M. González
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan
| | - Gregory Talavera
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Neil Schneiderman
- Department of Psychology and Behavioral Medicine Research Center, University of Miami, Coral Gables, Florida
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Tannenbaum SL, McClure LA, Zheng DD, Lam BL, Arheart KL, Joslin CE, Talavera GA, Lee DJ. Ocular screening adherence across Hispanic/Latino heritage groups with diabetes: results from the Ocular SOL ancillary to the Miami site of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). BMJ Open Diabetes Res Care 2016; 4:e000236. [PMID: 27547415 PMCID: PMC4985913 DOI: 10.1136/bmjdrc-2016-000236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 06/09/2016] [Accepted: 07/14/2016] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE The objective of this study was to examine the prevalence and correlates of ocular screening adherence among select Hispanics/Latinos living with diabetes. RESEARCH DESIGN AND METHODS Data were obtained through an ancillary study of the Hispanic Community Health Study/Study of Latinos (Miami site). Participants included Hispanics/Latinos aged 40+ years who underwent a baseline examination/risk factor assessment (2008-2011) and then completed a survey on vision health/knowledge (conducted October 2011-September 2013; sample n=1235; diabetic subsample=264). The dependent variable was having a dilated eye examination within the past 12 months. Covariate candidate selection for entry into sequential multivariable logistic regression models was guided by Anderson's Behavioral Model of Health Services Use and the Behavioral Model for Vulnerable Populations. RESULTS Participants aged 65+ were more likely to have dilated eye examinations (OR 2.62, 95% CI 1.22 to 5.60) compared with those aged 40-54 years. Participants less likely to have dilated examinations had a high school degree or general educational development (GED) (OR 0.30, 95% CI 0.10 to 0.96, compared to no degree) and those currently uninsured or never insured ((OR 0.34, 95% CI 0.14 to 0.83) and (OR 0.19, 95% CI 0.07 to 0.51)) compared to those currently insured. Participants who heard or saw something about eye health from two or more sources (eg, media outlets, doctor's office, relatives/friends) compared to those who reported no sources in the past 12 months were more likely to have a dilated eye examination (OR 2.82, 95% CI 1.26 to 6.28). CONCLUSIONS Lack of health insurance is strongly associated with low screening uptake in Hispanics/Latinos living with diabetes. Health promotion strategies stressing the importance of annual dilated eye examinations and increasing sources of information on eye health are other potential strategies to increase screening uptake in Hispanics/Latinos.
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Affiliation(s)
- Stacey L Tannenbaum
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Laura A McClure
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - D Diane Zheng
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Byron L Lam
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Charlotte E Joslin
- Department of Ophthalmology and Visual Sciences, Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Gregory A Talavera
- Division of Behavioral Sciences, Graduate School of Public Health, San Diego State University, San Diego, California, USA
| | - David J Lee
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
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Hecht EM, Arheart KL, Lee DJ, Hennekens CH, Hlaing WM. Interrelation of Cadmium, Smoking, and Cardiovascular Disease (from the National Health and Nutrition Examination Survey). Am J Cardiol 2016; 118:204-9. [PMID: 27316775 DOI: 10.1016/j.amjcard.2016.04.038] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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] [Received: 12/09/2015] [Revised: 04/27/2016] [Accepted: 04/27/2016] [Indexed: 11/30/2022]
Abstract
Cadmium biomarker levels are associated with both cigarette smoking and cardiovascular disease. In this cross-sectional survey, we explore whether the association between cadmium and cardiovascular disease differs between cigarette smoking states. A cross-sectional analysis using the National Health and Nutrition Examination Survey in 2003 to 2012 was performed accounting for the nationally representative complex sampling design. All participants 45 to 79 years old with blood and urinary cadmium levels were included (n = 12,511). We explored the inter-relationships of blood and urine cadmium levels with cigarette smoking and a composite cardiovascular outcome that included self-reported myocardial infarction or stroke or both. We used multivariable logistic regressing models to further adjust for age, income, gender, hypercholesterolemia, body mass index, diabetes, smoking intensity, and time period of smoking cessation. Of the 12,511 participants, 1,330 (8.5%) had previous myocardial infarction or stroke or both. The crude prevalence ratio (PR) comparing those in the lowest tertile of blood cadmium with those in the highest tertile for the composite outcome was 1.73 (95% confidence interval [CI] 1.49 to 2.01). After adjustment for age, gender, income, self-reported diabetes, self-reported hypercholesterolemia, body mass index, and smoking status, the PR was 1.54 (95% CI 1.30 to 1.84). The adjusted PRs for each smoking subgroup were 1.54 (95% CI 1.09 to 2.18) for never-smokers, 1.57 (95% CI 1.11 to 2.23) for current smokers, and 1.31 (95% CI 0.96 to 1.78) for former smokers. These descriptive data from a nationally representative sample suggest that cadmium is related to cardiovascular outcomes even after adjustment for smoking status.
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Affiliation(s)
- Eric M Hecht
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida.
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Charles H Hennekens
- Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida; Department of Preventive Medicine, Nova Southeastern University, Fort Lauderdale, Florida; Department of Family Medicine and Community Health, University of Miami Miller School of Medicine, Miami, Florida
| | - WayWay M Hlaing
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida
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Birnbach DJ, Rosen LF, Fitzpatrick M, Everett-Thomas R, Arheart KL. A ubiquitous but ineffective intervention: Signs do not increase hand hygiene compliance. J Infect Public Health 2016; 10:295-298. [PMID: 27422141 DOI: 10.1016/j.jiph.2016.05.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 04/21/2016] [Accepted: 05/11/2016] [Indexed: 11/28/2022] Open
Abstract
Proper hand hygiene is critical for preventing healthcare-associated infection, but provider compliance remains suboptimal. While signs are commonly used to remind physicians and nurses to perform hand hygiene, the content of these signs is rarely based on specific, validated health behavior theories. This observational study assessed the efficacy of a hand hygiene sign disseminated by the Centers for Disease Control and Prevention in an intensive care unit compared to an optimized evidence-based sign designed by a team of patient safety experts. The optimized sign was developed by four patient safety experts to include known evidence-based components and was subsequently validated by surveying ten physicians and ten nurses using a 10 point Likert scale. Eighty-two physicians and 98 nurses (102 females; 78 males) were observed for hand hygiene (HH) compliance, and the total HH compliance rate was 16%. HH compliance was not significantly different among the signs (Baseline 10% vs. CDC 18% vs. OIS 20%; p=0.280). The findings of this study suggest that even when the content and design of a hand hygiene reminder sign incorporates evidence-based constructs, healthcare providers comply only a fraction of the time.
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Affiliation(s)
- David J Birnbach
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety (R-370A), 1611 NW 12th Avenue, Institute 4th Floor, Miami, FL 33136, USA.
| | - Lisa F Rosen
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, USA.
| | - Maureen Fitzpatrick
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, USA.
| | - Ruth Everett-Thomas
- University of Miami Miller School of Medicine, UM-JMH Center for Patient Safety, USA.
| | - Kristopher L Arheart
- University of Miami Miller School of Medicine, Clinical Research Building, Department of Public Health Science, Miami, FL 33136, USA.
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