Faculty Bibliography

BACKGROUND: Almost half of adult men in Vietnam are current cigarette smokers. Recent surveys also suggest a high prevalence of water pipe use, particularly in rural areas. Yet services to treat tobacco dependence are not readily available. The purpose of this study was to characterize current tobacco use treatment patterns among Vietnamese health care providers and factors influencing adherence to recommended guidelines for tobacco use screening and cessation interventions for water pipe, cigarette and dual users. METHODS: We conducted cross sectional surveys of 929 male current tobacco users immediately after they completed a primary care visit at one of 18 community health centers. RESULTS: Thirty-four percent of smokers used cigarettes only, 24% water pipe only, and 42% were dual users. Overall 12% of patients reported that a provider asked them if they used tobacco products during the visit. Providers were significantly more likely to screen cigarette smokers compared with water pipe or dual users (16%, 9% and 11% respectively). Similarly, 9% of current cigarette smokers received advice to quit compared to 6% of water pipe and 5% of dual users. No patients reported that their health care provider offered them assistance to quit (e.g., self-help materials, referral). CONCLUSION: Despite ratifying the Framework Convention on Tobacco Control, Vietnam has not made progress in implementing policies and systems to ensure smokers are receiving evidence-based treatment. High rates of water pipe and dual use indicate a need for health care provider training and policy changes to facilitate treatment for both cigarette and water pipe use.

Background/UNASSIGNED:In the United States (US), there are 19 million new sexually transmitted disease (STD) infections each year. Untreated STDs can lead to serious long-term adverse health consequences, especially for young women. Centers for Disease Control and Prevention estimates that undiagnosed and untreated STDs cause at least 24,000 women in the US each year to become infertile. This clearly is a public health issue of great concern for young women. Materials and Methods/UNASSIGNED:The current cross-sectional study included a community sample consisting of 343 female participants (50% African Americans, 50% Puerto Ricans) at their mean age of 39 years. Regression analyses were conducted to examine the associations of time-varying factors within-person (e.g., substance use) and fixed effects factors between-persons (e.g., race/ethnicity) with the number of male sexual partners. Results/UNASSIGNED:<0.01) were significantly related to having a higher number of male sex partners in the past year. Conclusions/UNASSIGNED:From a public health perspective, treatment and prevention programs for sexual risk behavior focused on substance use as well as socio-cultural factors (i.e., marital status, race/ethnicity) may be more effective than programs focused only on substance use.

BACKGROUND: In older adults (aged 70-74 years), African-Americans have 4-fold higher risk of developing hypertension-attributed end-stage renal disease (ESRD) than European-Americans. A hypothesized mechanism linking hypertension and progressive chronic kidney disease (CKD) is the innate immune response and inflammation. Persons with CKD are also more susceptible to infection. Gene expression in peripheral blood can provide a view of the innate immune activation profile. We aimed to identify differentially expressed genes, microRNAs, and pathways in peripheral blood between cases with CKD and high blood pressure under hypertension treatment versus controls without CKD and with controlled blood pressure in African Americans. METHODS: Case and control pairs (N = 15x2) were selected from those without diabetes and were matched for age, sex, body mass index, APOL1 risk allele count, and hypertension medication use. High blood pressure under hypertension treatment was defined as hypertension medication use and systolic blood pressure (SBP) >/= 145 mmHg. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73m2. Cases were selected from those with CKD and high blood pressure under hypertension treatment, and controls were selected from those without CKD (eGFR: 75-120 mL/min/1.73m2 and urine albumin-to-creatinine ratio < 30mg/g) and with blood pressure controlled by hypertension medication use (SBP < 135 mmHg and D(diastolic)BP < 90 mm Hg). We perform RNA sequencing of mRNA and microRNA and conducted differential expression and co-expression network analysis. RESULTS: Of 347 miRNAs included in the analysis, 14 were significantly associated with case status (Benjamini-Hochberg adjusted p-value [BH p] < 0.05). Of these, ten were downregulated in cases: three of each belong to the miR-17 and miR-15 families. In co-expression network analysis of miRNA, one module, which included 13 of the 14 significant miRNAs, had significant association with case status. Of the 14,488 genes and 41,739 transcripts included in the analysis, none had significant association with case status. Gene co-expression network analyses did not yield any significant associations for mRNA. CONCLUSION: We have identified 14 differentially expressed miRNAs in the peripheral blood of CKD cases with high blood pressure under hypertension treatment as compared to appropriate controls. Most of the significant miRNAs were downregulated and have critical roles in immune cell functions. Future studies are needed to replicate our findings and determine whether the downregulation of these miRNAs in immune cells may influence CKD progression or complications.

A decline in response rates in traditional household surveys, combined with increased internet coverage and decreased research budgets, has resulted in increased attractiveness of web survey research designs based on purposive and voluntary opt-in sampling strategies. In the study of hidden or stigmatised behaviours, such as cannabis use, web survey methods are increasingly common. However, opt-in web surveys are often heavily criticised due to their lack of sampling frame and unknown representativeness. In this article, we outline the current state of the debate about the relevance of pursuing representativeness, the state of probability sampling methods, and the utility of non-probability, web survey methods especially for accessing hidden or minority populations. Our article has two aims: (1) to present a comprehensive description of the methodology we use at Global Drug Survey (GDS), an annual cross-sectional web survey and (2) to compare the age and sex distributions of cannabis users who voluntarily completed (a) a household survey or (b) a large web-based purposive survey (GDS), across three countries: Australia, the United States, and Switzerland. We find that within each set of country comparisons, the demographic distributions among recent cannabis users are broadly similar, demonstrating that the age and sex distributions of those who volunteer to be surveyed are not vastly different between these non-probability and probability methods. We conclude that opt-in web surveys of hard-to-reach populations are an efficient way of gaining in-depth understanding of stigmatised behaviours and are appropriate, as long as they are not used to estimate drug use prevalence of the general population.

A growing literature has demonstrated that early math skills are associated with later outcomes for children. This research has generated interest in improving children's early math competencies as a pathway to improved outcomes for children in elementary school. The Making Pre-K Count study was designed to test the effects of an early math intervention for preschoolers. Its design was unique in that, in addition to causally testing the effects of early math skills, it also allowed for the examination of a number of additional questions about scale-up, the influence of contextual factors and the counterfactual environment, the mechanism of long-term fade-out, and the role of measurement in early childhood intervention findings. This chapter outlines some of the design considerations and decisions put in place to create a rigorous test of the causal effects of early math skills that is also able to answer these questions in early childhood mathematics and intervention. The study serves as a potential model for how to advance science in the fields of preschool intervention and early mathematics.