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McDaniels-Davidson C, Davis A, Wing D, Macera C, Lindsay SP, Schousboe JT, Nichols JF, Kado DM. Kyphosis and incident falls among community-dwelling older adults. Osteoporos Int 2018; 29:163-169. [PMID: 29018904 DOI: 10.1007/s00198-017-4253-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 10/01/2017] [Indexed: 10/18/2022]
Abstract
UNLABELLED Hyperkyphosis commonly affects older persons and is associated with morbidity and mortality. Many have hypothesized that hyperkyphosis increases fall risk. Within this prospective study of older adults, kyphosis was significantly associated with incident falls over 1 year. Measures of hyperkyphosis could enhance falls risk assessments during primary care office visits. INTRODUCTION To determine the association between four measures of kyphosis and incident and injurious falls in older persons. METHODS Community-dwelling adults aged 65 and older (n = 72) residing in southern California were invited to participate in a prospective cohort study. Participants had kyphosis assessed four ways. Two standing measures included a flexicurve ruler placed against the back to derive a kyphotic index and the Debrunner kyphometer, a protractor used to measure the kyphotic angle in degrees. Two lying measures included the blocks method (number of 1.7 cm blocks needed to achieve a neutral head position while lying supine) and traditional Cobb angle calculation derived from DXA based lateral vertebral assessment. Baseline demographic, clinical, and other health information (including a timed up and go (TUG) test) were assessed at a clinic visit. Participants were followed monthly through email or postcard for 1 year, with falls outcomes confirmed through telephone interview. RESULTS Mean age was 77.8 (± 7.1) among the 52 women and 20 men. Over 12 months, 64% of participants experienced at least one incident fall and 35% experienced an injurious fall. Each standard deviation increase in kyphosis resulted in more than doubling the adjusted odds of an incident fall, even after adjusting for TUG. Odds of injurious falls were less consistent across measures; after adjusting for TUG, only the blocks method was associated with injurious falls. CONCLUSIONS Each kyphosis measure was independently associated with incident falls. Findings were inconsistent for injurious falls; the blocks measure suggested the strongest association. If these findings are replicated, the blocks measure could be incorporated into office visits as a quick and efficient tool to identify patients at increased fall risk.
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Affiliation(s)
- C McDaniels-Davidson
- San Diego State University/University of California, San Diego | Joint Doctoral Program in Public Health (Epidemiology), San Diego, CA, USA.
| | - A Davis
- San Diego State University/University of California, San Diego | Joint Doctoral Program in Public Health (Epidemiology), San Diego, CA, USA
| | - D Wing
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - C Macera
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - S P Lindsay
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - J T Schousboe
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
- Park Nicollet Osteoporosis Center and Institute for Research and Education, Minneapolis, MN, USA
| | - J F Nichols
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
| | - D M Kado
- Department of Family Medicine and Public Health, University of California, San Diego, CA, USA
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Radin JM, Shaffer RA, Lindsay SP, Araneta MRG, Raman R, Fowler JH. International chicken trade and increased risk for introducing or reintroducing highly pathogenic avian influenza A (H5N1) to uninfected countries. Infect Dis Model 2017; 2:412-418. [PMID: 30137719 PMCID: PMC6001958 DOI: 10.1016/j.idm.2017.09.001] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/18/2017] [Accepted: 09/20/2017] [Indexed: 11/17/2022] Open
Abstract
Every year billions of chickens are shipped thousands of miles around the globe in order to meet the ever increasing demands for this cheap and nutritious protein source. Unfortunately, transporting chickens internationally can also increase the chance for introducing zoonotic viruses, such as highly pathogenic avian influenza A (H5N1) to new countries. Our study used a retrospective analysis of poultry trading data from 2003 through 2011 to assess the risk of H5N1 poultry infection in an importing country. We found that the risk of infection in an importing country increased by a factor of 1.3 (95% CI: 1.1-1.5) for every 10-fold increase in live chickens imported from countries experiencing at least one H5N1 poultry case during that year. These results suggest that the risk in a particular country can be significantly reduced if imports from countries experiencing an outbreak are decreased during the year of infection or if biosecurity measures such as screening, vaccination, and infection control practices are increased. These findings show that limiting trade of live chickens or increasing infection control practices during contagious periods may be an important step in reducing the spread of H5N1 and other emerging avian influenza viruses.
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Affiliation(s)
- Jennifer M Radin
- Joint Doctoral Program in Public Health (Epidemiology), San Diego State University/University of California, San Diego, La Jolla, CA 92093, USA
| | - Richard A Shaffer
- Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA 92182, USA
| | - Suzanne P Lindsay
- Division of Epidemiology and Biostatistics, San Diego State University, San Diego, CA 92182, USA
| | - Maria Rosario G Araneta
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - Rema Raman
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093, USA
| | - James H Fowler
- Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093, USA.,Department of Political Sciences, University of California, San Diego, La Jolla, CA 92093, USA.,Division of Medical Genetics, University of California, San Diego, La Jolla, CA 92093, USA
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Bharti B, Lee SJ, Lindsay SP, Wingard DL, Jones KL, Lemus H, Chambers CD. Disease Severity and Pregnancy Outcomes in Women with Rheumatoid Arthritis: Results from the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project. J Rheumatol 2015; 42:1376-82. [PMID: 25877497 DOI: 10.3899/jrheum.140583] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the effect of rheumatoid arthritis (RA) disease severity on pregnancy outcomes in pregnant women with and without autoimmune diseases. METHODS A prospective cohort study was conducted using the Organization of Teratology Information Specialists Autoimmune Diseases in Pregnancy Project. Pregnant women with RA enrolled between 2005 and 2013 were selected if they (1) delivered a live-born singleton infant; and (2) completed 3 telephone-based measures of RA disease severity prior to 20 weeks' gestation, including the Health Assessment Questionnaire Disability Index (HAQ-DI), pain score, and patient's global scale. Associations between RA disease severity and preterm delivery, small for gestational age (SGA), or cesarean delivery were tested in unadjusted and multivariate analyses using modified Poisson regression models. RESULTS The sample consisted of 440 women with RA. Several unadjusted comparisons yielded significant associations. After adjustment for covariates, increasing disease severity was associated with risk for preterm delivery and SGA. For each unit increase in HAQ-DI (0-1), the adjusted relative risk (aRR) for preterm delivery increased by 58% (aRR 1.58, 95% CI 1.17-2.15). Among those with HAQ-DI > 0.5, the aRR for SGA was 1.81 (95% CI 1.01-3.33). CONCLUSION RA disease severity in early pregnancy, as measured in this study, was predictive of preterm delivery and SGA. These findings suggest that the risk of preterm delivery and SGA in women with RA might be lowered if RA is well controlled early in pregnancy.
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Affiliation(s)
- Balambal Bharti
- From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego.
| | - Susan J Lee
- From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego
| | - Suzanne P Lindsay
- From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego
| | - Deborah L Wingard
- From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego
| | - Kenneth L Jones
- From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego
| | - Hector Lemus
- From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego
| | - Christina D Chambers
- From the departments of Pediatrics, Medicine, and Family and Preventive Medicine, University of California San Diego; Graduate School of Public Health, San Diego State University; San Diego Veterans Affairs Medical Center, San Diego, California, USA.B. Bharti, MBBS, MPH, PhD, Doctoral Candidate University of California San Diego and San Diego State University Joint Doctoral Program, Department of Pediatrics and Department of Family and Preventive Medicine, University of California San Diego, and Graduate School of Public Health, San Diego State University; S.J. Lee, MD, Associate Professor, Department of Medicine, University of California San Diego, and San Diego Veterans Affairs Medical Center; S.P. Lindsay, PhD, Associate Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; D.L. Wingard, PhD, Professor and Associate Chief, Division of Epidemiology, Department of Family and Preventive Medicine University of California San Diego; K.L. Jones, MD, Professor and Chief, Division of Dysmorphology and Teratology, Department of Pediatrics, University of California San Diego; H. Lemus, PhD, Assistant Professor, Division of Epidemiology and Biostatistics, Graduate School of Public Health, San Diego State University; C.D. Chambers, PhD, MPH, Professor, Department of Pediatrics, and Family and Preventive Medicine Director, Center for Promotion of Maternal Health and Infant Development, University of California San Diego
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Radin JM, Hawksworth AW, Kammerer PE, Balansay M, Raman R, Lindsay SP, Brice GT. Epidemiology of pathogen-specific respiratory infections among three US populations. PLoS One 2014; 9:e114871. [PMID: 25549089 PMCID: PMC4280218 DOI: 10.1371/journal.pone.0114871] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Accepted: 11/14/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diagnostic tests for respiratory infections can be costly and time-consuming. Improved characterization of specific respiratory pathogens by identifying frequent signs, symptoms and demographic characteristics, along with improving our understanding of coinfection rates and seasonality, may improve treatment and prevention measures. METHODS Febrile respiratory illness (FRI) and severe acute respiratory infection (SARI) surveillance was conducted from October 2011 through March 2013 among three US populations: civilians near the US-Mexico border, Department of Defense (DoD) beneficiaries, and military recruits. Clinical and demographic questionnaire data and respiratory swabs were collected from participants, tested by PCR for nine different respiratory pathogens and summarized. Age stratified characteristics of civilians positive for influenza and recruits positive for rhinovirus were compared to other and no/unknown pathogen. Seasonality and coinfection rates were also described. RESULTS A total of 1444 patients met the FRI or SARI case definition and were enrolled in this study. Influenza signs and symptoms varied across age groups of civilians. Recruits with rhinovirus had higher percentages of pneumonia, cough, shortness of breath, congestion, cough, less fever and longer time to seeking care and were more likely to be male compared to those in the no/unknown pathogen group. Coinfections were found in 6% of all FRI/SARI cases tested and were most frequently seen among children and with rhinovirus infections. Clear seasonal trends were identified for influenza, rhinovirus, and respiratory syncytial virus. CONCLUSIONS The age-stratified clinical characteristics associated with influenza suggest that age-specific case definitions may improve influenza surveillance and identification. Improving identification of rhinoviruses, the most frequent respiratory infection among recruits, may be useful for separating out contagious individuals, especially when larger outbreaks occur. Overall, describing the epidemiology of pathogen specific respiratory diseases can help improve clinical diagnoses, establish baselines of infection, identify outbreaks, and help prioritize the development of new vaccines and treatments.
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Affiliation(s)
- Jennifer M. Radin
- Operational Infectious Diseases Department, Naval Health Research Center San Diego, San Diego, California, United States of America
- Joint Doctoral Program in Public Health (Epidemiology), San Diego State University/University of California San Diego, San Diego, California, United States of America
| | - Anthony W. Hawksworth
- Operational Infectious Diseases Department, Naval Health Research Center San Diego, San Diego, California, United States of America
| | - Peter E. Kammerer
- Operational Infectious Diseases Department, Naval Health Research Center San Diego, San Diego, California, United States of America
| | - Melinda Balansay
- Operational Infectious Diseases Department, Naval Health Research Center San Diego, San Diego, California, United States of America
| | - Rema Raman
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, California, United States of America
| | - Suzanne P. Lindsay
- Graduate School of Public Health, San Diego State University, San Diego, California, United States of America
| | - Gary T. Brice
- Operational Infectious Diseases Department, Naval Health Research Center San Diego, San Diego, California, United States of America
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Fink DS, Lindsay SP, Slymen DJ, Kral AH, Bluthenthal RN. Abscess and self-treatment among injection drug users at four California syringe exchanges and their surrounding communities. Subst Use Misuse 2013; 48:523-31. [PMID: 23581506 PMCID: PMC4334130 DOI: 10.3109/10826084.2013.787094] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [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: 02/05/2023]
Abstract
This study aimed to identify the prevalence and determinants of soft tissue infections and self-treatment among injection drug users (IDUs) in California. The study interviewed 864 IDUs in California using computer-assisted personal interview (CAPI) from 2003 to 2005. Multiple logistic regression analyses were performed to examine adjusted associations for recent abscess and abscess self-treatment. In these analyses, Latinos had higher odds than African Americans to self-treat, while IDUs reporting a usual place of health care had lower odds of self-treatment. Findings suggest an expansion of wound care facilities to mitigate the self-treatment of abscesses, with special consideration to Latinos.
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Affiliation(s)
- David S Fink
- Division of Epidemiology and Biostatistics, San Diego State University, San Diego, California, USA
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Beauchamp R, Lindsay SP, Hunter LP, Talavera G. Patriarchal Beliefs and Attitudes Toward Intimate Partner Violence Among Spanish-Speaking Adults. Hisp Hlth Care Int 2012. [DOI: 10.1891/1540-4153.10.3.137] [Citation(s) in RCA: 2] [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: 11/25/2022]
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Salgado H, Castañeda SF, Talavera GA, Lindsay SP. The role of social support and acculturative stress in health-related quality of life among day laborers in Northern San Diego. J Immigr Minor Health 2012; 14:379-85. [PMID: 22286606 PMCID: PMC4169889 DOI: 10.1007/s10903-011-9568-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
There is evidence to suggest that Latino day laborers experience higher levels of acculturative stress than Latinos in employment sectors in the US. Given the stress-buffering role that social support plays in minimizing the negative physical and mental health outcomes of stress, this study examined this relationship in a sample of 70 Latino Day laborers in the northern San Diego area(100% male, mean age = 27.7, SD = 9.1). Results from multivariate regression analyses showed that there was a significant interaction effect between social support and acculturative stress (P = 0.025) on physical health, indicating that higher levels of social support buffered the negative effects of acculturative stress on physical health.Acculturative stress and social support were not associated with mental health status. Overall, these findings suggest that fostering social support may be an essential strategy for promoting health among Latino male day laborers.
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Affiliation(s)
- Hugo Salgado
- Joint Doctoral Program in Public Health (Global Health), San Diego State/University of California, San Diego CA, Hardy Tower 119, 5500 Campanile Dr., San Diego, CA 92182-4162, USA
- Graduate School of Public Health, San Diego State University/ University of California, 9245 Sky Park Court, Suite 110, San Diego, CA 92123, USA
- Institute for Behavioral and Community Health (IBACH), 9245 Sky Park Court, Suite 221, San Diego, CA 92123-4311, USA
| | - Sheila F. Castañeda
- Institute for Behavioral and Community Health (IBACH), 9245 Sky Park Court, Suite 221, San Diego, CA 92123-4311, USA
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Gregory A. Talavera
- Institute for Behavioral and Community Health (IBACH), 9245 Sky Park Court, Suite 221, San Diego, CA 92123-4311, USA
- Graduate School of Public Health, San Diego State University, San Diego, CA, USA
| | - Suzanne P. Lindsay
- Institute for Public Health, Graduate School of Public Health, San Diego State University, 6505 Alvarado Road, Suite 115, San Diego, CA, USA
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Andaya AA, Arredondo EM, Alcaraz JE, Lindsay SP, Elder JP. The association between family meals, TV viewing during meals, and fruit, vegetables, soda, and chips intake among Latino children. J Nutr Educ Behav 2011; 43:308-315. [PMID: 20965787 PMCID: PMC3117953 DOI: 10.1016/j.jneb.2009.11.005] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2009] [Revised: 11/20/2009] [Accepted: 11/24/2009] [Indexed: 05/30/2023]
Abstract
OBJECTIVE Examine the relationship of family meals to children's consumption of fruit and vegetables as well as soda and chips. Additionally, to assess the relationship between viewing TV during family meals and children's diet. DESIGN Cross-sectional study that used a questionnaire completed by parents. SETTING Thirteen schools in San Diego, California. PARTICIPANTS Seven hundred ninety-four children and their parents. ANALYSIS Ordinal regression assessed associations between children's intake of fruit, vegetables, soda, and chips with family meal frequency and TV viewing during family meals. RESULTS Children who consumed breakfast, lunch, or dinner with their family at least 4 days per week ate fruit and vegetables 5 or more times a week 84%, 85%, and 80%, respectively. Of those children who ate breakfast, lunch, or dinner with their family at least 4 days per week, 40%, 44%, and 43% consumed soda and chips 5 or more times a week, respectively. Children who ate breakfast with their families at least 4 times a week were more likely to consume fruit and vegetables, and children whose TV was never or rarely on during family meals were less likely to consume soda and chips (P = .04 and P < .001, respectively). CONCLUSIONS Interventions geared at increasing the frequency of eating breakfast as a family and decreasing the amount of TV watched during family meals are needed, especially among acculturating Latino families.
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Affiliation(s)
- Abegail A Andaya
- San Diego State University, Graduate School of Public Health, CA, USA.
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Abstract
Hookah use is gaining popularity nationwide. We determined the correlates and trends for hookah use from the California Tobacco Survey. Between 2005 and 2008 hookah use increased more than 40%, and in 2008, 24.5% of young men reported ever using a hookah. Hookah use was more common among the young (18-24 years), the educated, the non-Hispanic Whites, and the cigarette smokers. Hookah use is increasing in California, especially among young adults, and in 2008 reached the highest prevalence ever reported for both genders.
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Affiliation(s)
- Joshua R Smith
- Joint Doctoral Program, University of California, San Diego, and San Diego State University, San Diego, CA, USA
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Chadwick DL, Castillo EM, Kuelbs C, Cox SA, Lindsay SP. Missed and missing cases of abusive injuries: the magnitude and the measurement of the problem. Child Abuse Negl 2010; 34:943-950. [PMID: 21047687 DOI: 10.1016/j.chiabu.2010.08.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2008] [Revised: 08/04/2010] [Accepted: 08/07/2010] [Indexed: 05/30/2023]
Abstract
OBJECTIVE The authors' objective is to describe the disparity between the case-fatality rates for inflicted versus unintentional injuries of children, and to emphasize its utility as a way of estimating the effectiveness of the ascertainment of inflicted injuries of children. METHOD Determination, comparison, and explanation of the case-fatality-rate disparity in four injury databases were derived from hospitalized injury cases. RESULTS The CFR disparity is 6-14-fold in the 4 injury databases. The CFR disparity varies strongly and inversely with the observed incidence of inflicted injuries in the databases. CONCLUSIONS A large disparity between the case fatality rates (CFRs) of inflicted and unintentional injuries exists in a number of injury databases. Inflicted injuries have much higher CFRs than unintentional injuries. The disparity can be accounted for by "missed" (incorrectly diagnosed) and "missing" (unseen) cases. PRACTICE IMPLICATIONS Present diagnostic criteria for physically abusive (inflicted) injuries are forensically-driven and too conservative for public health purposes. New public-health-oriented case definitions for "inflicted injury" are needed. Programs to reduce injury recidivism in young children should be a part of overall injury prevention.
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Affiliation(s)
- David L Chadwick
- The Chadwick Center for Children and Families, Rady Children's Hospital-San Diego, 4816 Rushville Lane, La Mesa, San Diego, CA, USA
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MacGregor AJ, Corson KS, Larson GE, Shaffer RA, Dougherty AL, Galarneau MR, Raman R, Baker DG, Lindsay SP, Golomb BA. Injury-specific predictors of posttraumatic stress disorder. Injury 2009; 40:1004-10. [PMID: 19524912 DOI: 10.1016/j.injury.2009.04.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2008] [Revised: 04/14/2009] [Accepted: 04/16/2009] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) is an important source of morbidity in military personnel, but its relationship with characteristics of battle injury has not been well defined. The aim of this study was to characterise the relationship between injury-related factors and PTSD among a population of battle injuries. PATIENTS AND METHODS A total of 831 American military personnel injured during combat between September 2004 and February 2005 composed the study population. Patients were followed through November 2006 for diagnosis of PTSD (ICD-9 309.81) or any mental health outcome (ICD-9 290-319). RESULTS During the follow-up period, 31.3% of patients received any type of mental health diagnosis and 17.0% received a PTSD diagnosis. Compared with minor injuries those with moderate (odds ratio [OR], 2.37; 95% confidence interval [CI], 1.61-3.48), serious (OR, 4.07; 95% CI, 2.55-6.50), and severe (OR, 5.22; 95% CI, 2.74-9.96) injuries were at greater risk of being diagnosed with any mental health outcome. Similar results were found for serious (OR, 3.03; 95% CI, 1.81-5.08) and severe (OR, 3.21; 95% CI, 1.62-6.33) injuries with PTSD diagnosis. Those with gunshot wounds were at greater risk of any mental health diagnosis, but not PTSD, in comparison with other mechanisms of injury (OR 2.07; 95% CI, 1.35, 3.19). Diastolic blood pressure measured postinjury was associated with any mental health outcome, and the effect was modified by injury severity. CONCLUSIONS Injury severity was a significant predictor of any mental health diagnosis and PTSD diagnosis. Gunshot wounds and diastolic blood pressure were significant predictors of any mental health diagnosis, but not PTSD. Further studies are needed to replicate these results and elucidate potential mechanisms for these associations.
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Affiliation(s)
- Andrew J MacGregor
- Department of Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, CA 92106, USA
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Reis JP, Macera CA, Araneta MR, Lindsay SP, Marshall SJ, Wingard DL. Comparison of overall obesity and body fat distribution in predicting risk of mortality. Obesity (Silver Spring) 2009; 17:1232-9. [PMID: 19197258 DOI: 10.1038/oby.2008.664] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [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] [Indexed: 11/09/2022]
Abstract
Results of studies comparing overall obesity and abdominal adiposity or body fat distribution with risk of mortality have varied considerably. We compared the relative importance and joint association of overall obesity and body fat distribution in predicting risk of mortality. Participants included 5,799 men and 6,429 women aged 30-102 years enrolled in the third National Health and Nutrition Examination Survey who completed a baseline health examination during 1988-1994. During a 12-year follow-up (102,172 person-years), 1,188 men and 925 women died. In multivariable-adjusted analyses, waist-to-thigh ratio (WTR) in both sexes (Ptrend<0.01 for both) and waist-to-hip ratio (WHR) in women (Ptrend 0.001) were positively associated with mortality in middle-aged adults (30-64 years), while BMI and waist circumference (WC) exhibited U- or J-shaped associations. Risk of mortality increased with a higher WHR and WTR among normal weight (BMI 18.5-24.9 kg/m2) and obese (BMI>or=30.0 kg/m2) adults. In older adults (65-102 years), a higher BMI in both sexes (Ptrend<0.05) and WC in men (Ptrend 0.001) were associated with increased survival, while remaining measures of body fat distribution exhibited either no association or an inverse relation with mortality. In conclusion, ratio measures of body fat distribution are strongly and positively associated with mortality and offer additional prognostic information beyond BMI and WC in middle-aged adults. A higher BMI in both sexes and WC in men were associated with increased survival in older adults, while a higher WHR or WTR either decreased or did not influence risk of death.
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Affiliation(s)
- Jared P Reis
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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Reis JP, Araneta MR, Wingard DL, Macera CA, Lindsay SP, Marshall SJ. Overall obesity and abdominal adiposity as predictors of mortality in u.s. White and black adults. Ann Epidemiol 2009; 19:134-42. [PMID: 19185808 DOI: 10.1016/j.annepidem.2008.10.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2008] [Revised: 10/02/2008] [Accepted: 10/21/2008] [Indexed: 11/17/2022]
Abstract
PURPOSE The association of overall obesity and abdominal adiposity in predicting risk of all-cause mortality in white and black adults was compared. METHODS This prospective study included a national sample of 3219 non-Hispanic white and 2,561 non-Hispanic black adults 30 to 64 years of age enrolled in the third National Health and Nutrition Examination Survey during 1988-1994. Multiple measures of adiposity were measured and calculated, including body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), and waist-to-thigh ratio (WTR). Vital status was ascertained with the National Death Index through 2000. RESULTS During 12 years of follow-up (51,133 person-years), 188 white and 222 black adults died. After adjustment for age, education, smoking, and existing disease, positive dose-response associations between WTR and mortality in both sexes and races, and WHR in white and black women were observed (p(trend) < 0.05 for all). These results were unchanged after additional adjustment for BMI. In contrast, BMI and waist circumference alone exhibited curvilinear-shaped associations with mortality. A higher WTR was associated with a higher risk of mortality among normal weight (BMI: 18.5-24.9 kg/m(2)) and obese (BMI: > or =30.0 kg/m(2)) white and black adults. CONCLUSIONS These results suggest ratio measures of abdominal adiposity, particularly WTR in both sexes and WHR in women, strongly and positively predict mortality, independent of BMI, among white and black adults. Furthermore, WTR offers additional prognostic information beyond that provided by BMI alone.
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Affiliation(s)
- Jared P Reis
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
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MacGregor AJ, Shaffer RA, Dougherty AL, Galarneau MR, Raman R, Baker DG, Lindsay SP, Golomb BA, Corson KS. Psychological Correlates of Battle and Nonbattle Injury Among Operation Iraqi Freedom Veterans. Mil Med 2009; 174:224-31. [DOI: 10.7205/milmed-d-03-9107] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Reis JP, Macera CA, Araneta MRG, Lindsay SP, Marshall SJ, ingard DL. A Comparison of Overall Obesity and Central Adiposity in Predicting the Risk for All-Cause Mortality among White and Black U.S. Adults. Med Sci Sports Exerc 2008. [DOI: 10.1249/01.mss.0000323056.70096.cd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Dunford JV, Castillo EM, Chan TC, Vilke GM, Jenson P, Lindsay SP. Impact of the San Diego Serial Inebriate Program on Use of Emergency Medical Resources. Ann Emerg Med 2006; 47:328-36. [PMID: 16546617 DOI: 10.1016/j.annemergmed.2005.11.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2005] [Revised: 11/04/2005] [Accepted: 11/08/2005] [Indexed: 10/25/2022]
Abstract
STUDY OBJECTIVE We determine the impact of a treatment strategy called the San Diego Serial Inebriate Program on the use of emergency medical services (EMS) and emergency department (ED) and inpatient services by individuals repeatedly arrested for public intoxication. METHODS This was a retrospective review of health care utilization records (EMS, ED, and inpatient) of 529 individuals from 2000 to 2003. Judges offered individuals a 6-month outpatient treatment program in lieu of custody (Serial Inebriate Program). Demographics and health care utilization are reported overall and by treatment acceptance. RESULTS From 2000 to 2003, 308 of 529 (58%) individuals were transported by EMS 2,335 times; 409 of 529 (77%) individuals amassed 3,318 ED visits, and 217 of 529 (41%) individuals required 652 admissions, resulting in 3,361 inpatient days. Health care charges totaled $17.7 million (EMS, $1.3 million; ED, $2.5 million; and inpatient, $13.9 million). Treatment was offered to 268 individuals, and 156 (58%) accepted. Use of EMS, ED, and inpatient services declined by 50% for clients who chose treatment, resulting in an estimated decrease in total monthly average charges of $5,662 (EMS), $12,006 (ED), and $55,684 (inpatient). There was no change in use of services for individuals who refused treatment. There was a significant increasing trend in acceptance among individuals with longer jail sentences (<0.001). Treatment acceptance was 20% among those with sentences of 0 to 30 days and reached 63% for those with sentences longer than 150 days. Operational costs and alternate care at clinics and nonparticipating hospitals were not analyzed. CONCLUSION This community-supported treatment strategy reduced the use of EMS, ED, and inpatient resources by individuals repeatedly intoxicated in public.
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Affiliation(s)
- James V Dunford
- Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, CA 92103, USA.
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Abstract
The processes and procedures used to promote interrater reliability in the abstraction of data from medical records are described. Several proactive strategies that serve the purpose of leading to standard interpretations of clinical data are discussed. These include (a) establishment of priorities for the sources of information; (b) creation of orders of value for the likeliness of validity of recorded data; (c) standardization of terminology; and (d) reaffirmation of decisions, based on an evolving body of evidence. Lessons learned from this project can assist nurse researchers to develop high-quality information retrieval methods, when multiple observers (or abstractors) are used during a medical record abstraction data collection process.
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Affiliation(s)
- Clara Eder
- Center for Health Professional Education and Training, San Diego State University, San Diego, CA 92120, USA.
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Abstract
To determine how current researchers address the use of race and ethnicity as variables in epidemiologic and public health studies, the authors conducted a comprehensive review of 1,198 articles published in the American Journal of Epidemiology and the American Journal of Public Health from 1996 to 1999. Seventy-seven percent (n = 919) of the articles referred to race or ethnicity. The number of variable categories ranged from 0 to 24, with an average of 3.14 per article. An enormous diversity of terms was used to describe the concepts of race and ethnicity as variables as well as to describe the categories used to assess these variables. Researchers frequently failed to differentiate between the concepts of race and ethnicity, to state the context in which these variables were used, to state the study methods used to assess these variables, and to discuss significant study results based on race or ethnicity. Continued professional commitment is needed to ensure the scientific integrity of race and ethnicity as variables. At a minimum, researchers should clearly state the context in which these valuable epidemiologic and public health study variables are being used, describe the method used to assess and categorize these variables, and discuss all significant findings.
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Affiliation(s)
- R Dawn Comstock
- Epidemic Intelligence Service, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Willis WO, Eder CH, Lindsay SP, Chavez G, Shelton ST. Lower rates of low birthweight and preterm births in the California Black Infant Health Program. J Natl Med Assoc 2004; 96:315-24. [PMID: 15040513 PMCID: PMC2594864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVES The objective of this study was to determine the impact of prenatal interventions in the California Black Infant Health (BIH) Program on low birthweight (LBW) and preterm births (PTB) outcomes. METHODS A prospective observational study design with a comparison group was used. BIH participants with a delivery recorded between July 1996 and September 1998 were included in the birthweight and PTB analyses. These outcomes for BIH participants who entered the BIH program prior to 32 weeks' gestation (n=1,553) were compared to those of all African-American women in the BIH Program targeted ZIP codes (n=11,633). RESULTS No statistically significant differences in LBW and PTB were found between the BIH population and the comparison group. However, a comparison of the BIH infant VLBW (<1,500 g) rate (1.9%) with the VLBW rate for the comparison group (3.0%) shows that the BIH rate is 63% of the comparison group rate. For very PTB (<32 weeks), the BIH rate (3.5%) is 81% of the comparison group rate (4.3%). BIH participants had higher risk profiles (pregnancy history, current pregnancy, and psychosocial; p=<0.01) than women in the comparison group. CONCLUSIONS The BIH Program retained high-risk women in the program to delivery and assisted them with maintenance of prenatal care. Even though the program participants were higher risk, their LBW and PTB outcomes were comparable to the geographic area overall. More importantly, there was a trend among women in the BIH Program toward better outcomes than the comparison group in both VLBW and VPTB.
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Affiliation(s)
- Winnie O Willis
- San Diego State University, Graduate School of Public Health, Black Infant Health Evaluation Project, San Diego, California 92120, USA.
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