Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Population Health
Total Results:
12279
Bias, Bravery and Burnout: The Journey of Women in Medicine
ORIGINAL:0011833
ISSN: n/a
CID: 2518042
American journal of respiratory & critical care medicine. 2017:195(6):718-724.DOI: 10.1164/rccm.201604-0687PP
Environment, Global Climate Change, and Cardiopulmonary Health
There is widespread agreement among scientists that climate change, primarily due to greenhouse gas (GHG) production from human activities, is causing significant global health impacts.The focus of this Pulmonary Perspective is to highlight emerging evidence for cardio-respiratory health impacts related to climate change, and to suggest possible strategies for individual and collective responses to this threat. Adaptation and mitigation strategies, along with co-benefits of these actions, are also discussed. The association between heat stress and cardiopulmonary mortality is well established. Hot and drier climates are associated with increased land degradation and desertification, impacting food production and particulate matter air pollution worldwide. Warmer temperatures also increase levels of ozone and combustion particles, and extend the growing season of allergenic plants and fungi. Extreme weather (e.g. hurricanes, cyclones and floods) cause acute injuries and associated mortality and morbidity, but also longer term impacts of increased gastro-intestinal illness, degraded housing, and increased levels of indoor microbial growth that can contribute to pulmonary disease. While these impacts are daunting, coping with climate change also offers opportunities for public health. Reductions in GHG emissions reduce other air pollutants. Climate-driven adaptation in our food and water distribution systems could lead to more equitable distribution of these eco-necessities. Improved urban design and transportation could improve physical activity levels and make today's urban environments more hospitable. The positive outcomes of California's multi-pronged climate change mitigation policies provide one example in which such strategies have limited GHG emissions, and shifted energy use to more sustainable sources.
PMCID:5363965
PMID: 27654004
ISSN: 1535-4970
CID: 2254852
An eHealth Intervention to Increase Physical Activity and Healthy Eating in Older Adult Cancer Survivors: Summative Evaluation Results
BACKGROUND: A healthy lifestyle is associated with improved quality of life among cancer survivors, yet adherence to health behavior recommendations is low. OBJECTIVE: This pilot trial developed and tested the feasibility of a tailored eHealth program to increase fruit and vegetable consumption and physical activity among older, long-term cancer survivors. METHODS: American Cancer Society (ACS) guidelines for cancer survivors were translated into an interactive, tailored health behavior program on the basis of Social Cognitive Theory. Patients (N=86) with a history of breast (n=83) or prostate cancer (n=3) and less than 5 years from active treatment were randomized 1:1 to receive either provider advice, brief counseling, and the eHealth program (intervention) or advice and counseling alone (control). Primary outcomes were self-reported fruit and vegetable intake and physical activity. RESULTS: About half (52.7%, 86/163) of the eligible patients consented to participate. The most common refusal reasons were lack of perceived time for the study (32/163) and lack of interest in changing health behaviors (29/163). Furthermore, 72% (23/32) of the intervention group reported using the program and most would recommend it to others (56%, 14/25). Qualitative results indicated that the intervention was highly acceptable for survivors. For behavioral outcomes, the intervention group reported increased fruit and vegetable consumption. Self-reported physical activity declined in both groups. CONCLUSIONS: The brief intervention showed promising results for increasing fruit and vegetable intake. Results and participant feedback suggest that providing the intervention in a mobile format with greater frequency of contact and more indepth information would strengthen treatment effects.
PMCID:5392211
PMID: 28410171
ISSN: 2369-1999
CID: 2528432
INTRODUCTION TO PROGRESSIVE MUSCLE RELAXATION THERAPY FOR MIGRAINE IN THE EMERGENCY DEPARTMENT: A PILOT FEASIBILITY STUDY [Meeting Abstract]
ISI:000398947201121
ISSN: 1532-4796
CID: 2559862
Ideal cardiovascular health is associated with self-rated health status. The Polish Norwegian Study (PONS)
BACKGROUND:The concept of ideal cardiovascular health emphasizes a more integrative definition of health to include protective biological factors and behaviors but it has not been investigated in relation to individuals' perspectives on their own health. METHODS:We used cross-sectional data of 10,687 participants, age 45-64years, free of cardiovascular diseases. Ideal cardiovascular health was defined according to the American Heart Association criteria (7 metrics assessed at 3 levels: ideal, intermediate, and poor). A single-item of self-rated health (SRH) was recorded on a scale from 1 to 10. We adjusted for age, sex, education, place of residence, alcohol intake, chronic diseases and depression score in general linear and Poisson regression models. RESULTS:The study participants met an average of two ideal cardiovascular factors and rated their health around a mean (SD) of 6.8 (1.4). The mean number of ideal metrics met and the total cardiovascular health score displayed a graded association with increasing SRH ratings. Examining prevalence ratios, compared to participants with a lower SRH, those with a SRH≥7 were more likely to be physically active (PR 1.79, 95% CI 1.30-2.45), more likely to have an optimal BMI (PR 1.24, 95% CI 1.16-1.33) and more likely to have their blood pressure controlled (PR 1.24, 95% CI 1.12-1.38). CONCLUSIONS:The prevalence of ideal cardiovascular behaviors and factors is low in the community. The association between ideal cardiovascular health and self-rated health suggests potential opportunity to motivate and deliver health promotion interventions.
PMID: 28043659
ISSN: 1874-1754
CID: 3240142
Changing Patterns in Rates and Means of Suicide in California, 2005 to 2013
OBJECTIVES/OBJECTIVE:To describe recent trends in suicide throughout California and to compare rates and methods of suicide ("means") across demographic groups. METHODS:Data from statewide mortality records were used to estimate age-adjusted rates of suicide from 2005 to 2013, overall and by means, age, gender, race/ethnicity, urbanicity, and county. RESULTS:The suicide rate increased 12.6% between 2005 and 2013, from 11.2 to 12.6 per 100 000 population, but this overall trend masks substantial heterogeneity across subgroups. In particular, rapid increases were observed for individuals of multiple races/ethnicities. Means of suicide changed, trending away from firearms toward suffocation and drug poisoning. CONCLUSIONS:High-risk groups and means of suicide are changing rapidly in California, so appropriate public health programming should prioritize population-based strategies.
PMCID:5296704
PMID: 28177819
ISSN: 1541-0048
CID: 5031272
Child Conduct Problems across Home and School Contexts: A Person-Centered Approach
To examine patterns of conduct problems across the home and school context, we used latent class analysis to analyze primary caregivers' and teachers' ratings on the conduct problems subscale of the Strengths and Difficulties Questionnaire (R. Goodman, 1997) in the Family Life Project (N = 1,292), a prospective study of child development in rural and small town contexts. We found a similar four-class solution at five and seven years of age. In decreasing prevalence, the following classes were identified: (1) low symptoms reported by both informants (low cross-context); (2) high parent-reported symptoms, low teacher-reported symptoms (home context); (3) low parent-reported symptoms, moderate teacher-reported symptoms (school context); and (4) high symptoms reported by both informants (high cross-context). Classes exhibited stability from age five to age seven: children were more likely to remain in the same class than to transition to a different class, and longitudinal stability was especially high for children in the low cross-context class at age 5. A number of child and family characteristics measured in early childhood (executive function, verbal ability, poverty-related risk, sensitive parenting, and parental depressive symptoms) were associated with class membership at age five and age seven, but were generally not associated with longitudinal transitions between classes.
PMCID:5926240
PMID: 29720784
ISSN: 0882-2689
CID: 3061052
SOS2 and ACP1 Loci Identified through Large-Scale Exome Chip Analysis Regulate Kidney Development and Function
Genome-wide association studies have identified >50 common variants associated with kidney function, but these variants do not fully explain the variation in eGFR. We performed a two-stage meta-analysis of associations between genotypes from the Illumina exome array and eGFR on the basis of serum creatinine (eGFRcrea) among participants of European ancestry from the CKDGen Consortium (n
PMCID:5328154
PMID: 27920155
ISSN: 1533-3450
CID: 5584352
Efficient estimation for accelerated failure time model under case-cohort and nested case-control sampling
Case-cohort (Prentice, 1986) and nested case-control (Thomas, 1977) designs have been widely used as a cost-effective alternative to the full-cohort design. In this article, we propose an efficient likelihood-based estimation method for the accelerated failure time model under case-cohort and nested case-control designs. An EM algorithm is developed to maximize the likelihood function and a kernel smoothing technique is adopted to facilitate the estimation in the M-step of the EM algorithm. We show that the proposed estimators for the regression coefficients are consistent and asymptotically normal. The asymptotic variance of the estimators can be consistently estimated using an EM-aided numerical differentiation method. Simulation studies are conducted to evaluate the finite-sample performance of the estimators and an application to a Wilms tumor data set is also given to illustrate the methodology.
PMCID:5288392
PMID: 27479331
ISSN: 1541-0420
CID: 2199422
The primary care provider (PCP)-cancer specialist relationship: A systematic review and mixed-methods meta-synthesis
Although they are critical to models of coordinated care, the relationship and communication between primary care providers (PCPs) and cancer specialists throughout the cancer continuum are poorly understood. By using predefined search terms, the authors conducted a systematic review of the literature in 3 databases to examine the relationship and communication between PCPs and cancer specialists. Among 301 articles identified, 35 met all inclusion criteria and were reviewed in-depth. Findings from qualitative, quantitative, and disaggregated mixed-methods studies were integrated using meta-synthesis. Six themes were identified and incorporated into a preliminary conceptual model of the PCP-cancer specialist relationship: 1) poor and delayed communication between PCPs and cancer specialists, 2) cancer specialists' endorsement of a specialist-based model of care, 3) PCPs' belief that they play an important role in the cancer continuum, 4) PCPs' willingness to participate in the cancer continuum, 5) cancer specialists' and PCPs' uncertainty regarding the PCP's oncology knowledge/experience, and 6) discrepancies between PCPs and cancer specialists regarding roles. These data indicate a pervasive need for improved communication, delineation, and coordination of responsibilities between PCPs and cancer specialists. Future interventions aimed at these deficiencies may improve patient and physician satisfaction and cancer care coordination. CA Cancer J Clin 2017;67:156-169. (c) 2016 American Cancer Society.
PMCID:5342924
PMID: 27727446
ISSN: 1542-4863
CID: 2586922
