Searched for: Department/Unit:Population Health
Education and counseling in the methadone treatment setting improves knowledge of viral hepatitis
Larios, Sandra E; Masson, Carmen L; Shopshire, Michael S; Hettema, Jennifer; Jordan, Ashly E; McKnight, Courtney; Young, Christopher; Khalili, Mandana; Seewald, Randy M; Min, Albert; Hengl, Nicholas; Sorensen, James L; Des Jarlais, Don C; Perlman, David C
The aim of this study was to evaluate the effectiveness of an educational method of providing viral hepatitis education for methadone maintenance patients. Four hundred forty participants were randomly assigned to either a control or a motivationally-enhanced viral hepatitis education and counseling intervention. Viral hepatitis A (HAV), B (HBV), and C (HCV) knowledge tests were administered at baseline, following each of two education sessions (post-education), and at a 3-month follow-up assessment. Results indicated a significant increase in knowledge of HAV, HBV, and HCV over time. No differences were found in knowledge between the intervention groups in knowledge acquisition regarding any of the hepatitis viruses suggesting that a motivational interviewing style may not augment hepatitis knowledge beyond standard counseling. A two-session viral hepatitis education intervention effectively promotes hepatitis knowledge and can be integrated in methadone treatment settings.
PMCID:4019752
PMID: 24462241
ISSN: 0740-5472
CID: 820502
Parent health literacy and "obesogenic" feeding and physical activity-related infant care behaviors
Yin, H Shonna; Sanders, Lee M; Rothman, Russell L; Shustak, Rachel; Eden, Svetlana K; Shintani, Ayumi; Cerra, Maria E; Cruzatte, Evelyn F; Perrin, Eliana M
OBJECTIVE: To examine the relationship between parent health literacy and "obesogenic" infant care behaviors. STUDY DESIGN: Cross-sectional analysis of baseline data from a cluster randomized controlled trial of a primary care-based early childhood obesity prevention program (Greenlight). English- and Spanish-speaking parents of 2-month-old children were enrolled (n = 844). The primary predictor variable was parent health literacy (Short Test of Functional Health Literacy in Adults; adequate >/=23; low <23). Primary outcome variables involving self-reported obesogenic behaviors were: (1) feeding content (more formula than breast milk, sweet drinks, early solid food introduction), and feeding style-related behaviors (pressuring to finish, laissez-faire bottle propping/television [TV] watching while feeding, nonresponsiveness in letting child decide amount to eat); and (2) physical activity (tummy time, TV). Multivariate logistic regression analyses (binary, proportional odds models) performed adjusting for child sex, out-of-home care, Women, Infants, and Children program status, parent age, race/ethnicity, language, number of adults/children in home, income, and site. RESULTS: Eleven percent of parents were categorized as having low health literacy. Low health literacy significantly increased the odds of a parent reporting that they feed more formula than breast milk, (aOR = 2.0 [95% CI: 1.2-3.5]), immediately feed when their child cries (aOR = 1.8 [1.1-2.8]), bottle prop (aOR = 1.8 [1.002-3.1]), any infant TV watching (aOR = 1.8 [1.1-3.0]), and inadequate tummy time (<30 min/d), (aOR = 3.0 [1.5-5.8]). CONCLUSIONS: Low parent health literacy is associated with certain obesogenic infant care behaviors. These behaviors may be modifiable targets for low health literacy-focused interventions to help reduce childhood obesity.
PMCID:3943839
PMID: 24370343
ISSN: 0022-3476
CID: 820452
"To measure is to know. If you cannot measure it, you cannot improve it": statistical modeling cannot compensate for unmeasured bias [Editorial]
Stattin, Par; Loeb, Stacy
PMID: 23830142
ISSN: 0302-2838
CID: 820332
Examination of how neighborhood definition influences measurements of youths' access to tobacco retailers: a methodological note on spatial misclassification
Duncan, Dustin T; Kawachi, Ichiro; Subramanian, S V; Aldstadt, Jared; Melly, Steven J; Williams, David R
Measurements of neighborhood exposures likely vary depending on the definition of "neighborhood" selected. This study examined the extent to which neighborhood definition influences findings regarding spatial accessibility to tobacco retailers among youth. We defined spatial accessibility to tobacco retailers (i.e., tobacco retail density, closest tobacco retailer, and average distance to the closest 5 tobacco retailers) on the basis of circular and network buffers of 400 m and 800 m, census block groups, and census tracts by using residential addresses from the 2008 Boston Youth Survey Geospatial Dataset (n = 1,292). Friedman tests (to compare overall differences in neighborhood definitions) were applied. There were differences in measurements of youths' access to tobacco retailers according to the selected neighborhood definitions, and these were marked for the 2 spatial proximity measures (both P < 0.01 for all differences). For example, the median average distance to the closest 5 tobacco retailers was 381.50 m when using specific home addresses, 414.00 m when using census block groups, and 482.50 m when using census tracts, illustrating how neighborhood definition influences the measurement of spatial accessibility to tobacco retailers. These analyses suggest that, whenever possible, egocentric neighborhood definitions should be used. The use of larger administrative neighborhood definitions can bias exposure estimates for proximity measures.
PMCID:3895093
PMID: 24148710
ISSN: 0002-9262
CID: 816522
Further limiting bisphenol a in food uses could provide health and economic benefits
Trasande, Leonardo
There is mounting evidence that bisphenol A (BPA), a chemical used in the production of polycarbonate plastics and the linings of aluminum cans, may have adverse health consequences. The Food and Drug Administration has banned BPA from baby bottles and sippy cups but has deferred further action on other food uses-that is, uses in metal-based food and beverage containers. This article quantifies the potential social costs of childhood obesity and adult coronary heart disease attributable to BPA exposure in the United States in 2008 and models the potential health and economic benefits associated with replacing BPA in all food uses. BPA exposure was estimated to be associated with 12,404 cases of childhood obesity and 33,863 cases of newly incident coronary heart disease, with estimated social costs of $2.98 billion in 2008. Removing BPA from food uses might prevent 6,236 cases of childhood obesity and 22,350 cases of newly incident coronary heart disease per year, with potential annual economic benefits of $1.74 billion (sensitivity analysis: $889 million-$13.8 billion per year). Although more data are needed, these potentially large health and economic benefits could outweigh the costs of using a safer substitute for BPA.
PMID: 24452104
ISSN: 0278-2715
CID: 819002
Facilitating Alzheimer disease research recruitment
Grill, Joshua D; Galvin, James E
Alzheimer disease (AD) research faces challenges to successful enrollment, especially to clinical trials and biomarker studies. Failure to recruit the planned number of participants in a timely manner threatens the internal validity and success of clinical research, raising concerns about external validity and generalizability of results, and possibly leading to disparities in disease treatment. Methods to improve recruitment exist, but require varying levels of staff effort and financial resources, and evidence of effectiveness is often lacking or inconsistent. In this review, we summarize some of the available methods to improve AD research recruitment, the available literature to support or refute these strategies, and some of the experiences at the authors' AD Research Centers. We discuss the use of community-based participatory research principles and participant registries as a means to enhance research enrollment and increase diversity of research samples.
PMCID:3945167
PMID: 24322484
ISSN: 0893-0341
CID: 811002
HIV Infection and Microbial Diversity in Saliva
Li, Yihong; Saxena, Deepak; Chen, Zhou; Liu, Gaoxia; Abrams, Willam R; Phelan, Joan A; Norman, Robert G; Fisch, Gene S; Corby, Patricia M; Dewhirst, Floyd; Paster, Bruce J; Kokaras, Alexis S; Malamud, Daniel
Limited information is available about the effect of human immunodeficiency virus (HIV) and subsequent antiretroviral treatment on host-microbe interaction. This study aimed to determine the salivary microbial composition in 10 HIV-seropositive subjects, before and 6 months after highly active antiretroviral therapy (HAART), compared with that of 10 HIV-seronegative subjects. Both a conventional culture and two culture-independent analyses were used and consistently demonstrated differences in microbial composition among the three sets of samples. HIV+ subjects had higher levels of total cultivable microbes, including oral streptococci, lactobacilli, S. mutans, and Candida, in saliva as compared to HIV- subjects. The total cultivable microbial level was significantly correlated with CD4+ T cell counts. Denaturing gradient gel electrophoresis (DGGE), which compared the overall microbial profiles, showed distinct fingerprinting profiles for each group. Human oral microbe identification microarray (HOMIM), which compared the 16S rRNA genes, showed a clear separation among the three sample groups. Veillonella, Synergistetes, and Streptococcus, were present in all 30 saliva samples. Only minor changes or no changes were observed in the prevalence of Neisseria, Haemophilus, Gemella, Leptotrichia, Solobacterium, Parvimonas and RothiaI. Severn genera were detected only in HIV- samples, including Capnocytophaga, Slackia, Porphyromonas, Kingella, Peptostreptococcaceae, Lactobacillus, and Atopobium. The prevalence of Fusobacterium, Campylobacter, Prevotella, Capnocytophaga, Selenomonas, Actinomyces, and Atopobium was increased after therapy with HAART. In contrast, the prevalence of Aggregatibacter was significantly decreased after HAART. Findings of this study suggest that HIV infection and therapy with HAART could have a significant effect on salivary microbial colonization and composition.
PMCID:3993673
PMID: 24523469
ISSN: 0095-1137
CID: 807452
Developmental trajectories of marijuana use from adolescence to adulthood: Relationship with using weapons including guns
Brook, Judith S; Lee, Jung Yeon; Finch, Stephen J; Brook, David W
This is the first study to assess the associations between the trajectories of marijuana use and other predictors of violent behavior with the use of guns or other weapons as well as stealing without the use of weapons among inner-city African Americans and Puerto Ricans (N = 838). Logistic regression analyses examined whether the longitudinal trajectories of marijuana use compared with the trajectory of no/low marijuana use predicted violent behavior. A higher Bayesian posterior probability (BPP) for the increasing marijuana use trajectory group (AOR = 3.37, P < .001), the moderate use of marijuana trajectory group (AOR = 1.98, P < .01), and the quitter trajectory group (AOR = 1.70, P < .05) was associated with an increased likelihood of engaging in violence (i.e., shooting or hitting someone with a weapon) compared with the BPP of the no use of marijuana trajectory group. Our results address a number of important public health and clinical issues. Public health funds might be spent on prevention programs focused on decreasing the use of marijuana, increasing educational retention, and decreasing contact with deviant associates. Understanding the psychosocial conditions related to the use of weapons is critical for individuals involved in the criminal justice system, physicians, and other health care providers in managing individuals who engage in violent behavior. Aggr. Behav. 9999:XX-XX, 2013. (c) 2013 Wiley Periodicals, Inc.
PMCID:3980025
PMID: 24338741
ISSN: 0096-140x
CID: 801702
Adolescent self-control predicts joint trajectories of marijuana use and depressive mood into young adulthood among urban African Americans and Puerto Ricans
Pahl, Kerstin; Brook, Judith S; Lee, Jung Yeon
Previous studies have identified an association between depressive mood and marijuana use. We examined adolescent self-control as a predictor of membership in joint developmental trajectories of depressive mood and marijuana use from adolescence to young adulthood. Urban African Americans and Puerto Ricans (N = 838) were sampled when participants were on average 14, 19, 24, and 29 years old. Using growth mixture modeling, four joint trajectory groups of depressive mood and marijuana use were established: low marijuana use/low depressive mood, low marijuana use/intermediate depressive mood, high marijuana use/low depressive mood, and high marijuana use/high depressive mood. Weighted logistic regression analysis showed that self-control at age 14 distinguished the high marijuana use/high depressive mood group and the low marijuana use/low depressive mood group from each of the other groups. Findings show that the co-occurrence of high levels of marijuana use and depressive mood from adolescence into young adulthood is predicted by low levels of self-control in adolescence. On the other hand, high selfcontrol is associated with low marijuana use and low levels of depression over time. Thus, while deficits in self-control in adolescence constitute a significant risk for maladjustment over time, high self-control exerts a protective factor with regard to marijuana use and depressive mood into young adulthood.
PMCID:3766430
PMID: 23670644
ISSN: 0160-7715
CID: 801712
Slowing of number naming speed by King-Devick Test in Parkinson's disease
Lin, Tanya P; Adler, Charles H; Hentz, Joseph G; Balcer, Laura J; Galetta, Steven L; Devick, Steve
BACKGROUND: The King-Devick (KD) test measures the speed of rapid number naming, and is postulated to require fast eye movements, attention, language, and possibly other aspects of cognitive functions. While used in multiple sports concussion studies, it has not been applied to the field of movement disorders. METHODS: Forty-five Parkinson's disease (PD), 23 essential tremor (ET), and 65 control subjects were studied. Subjects performed two trials of reading out loud single-digit numbers separated by varying spacing on three test cards that were of different formats. The sum time of the faster trial was designated the KD score and compared across the three groups. RESULTS: PD patients had higher (worse) KD scores, with longer reading times compared to ET and control subjects (66 s vs. 49 s vs. 52 s, p < 0.001, adjusting for age and gender). No significant difference was found between ET and control (Delta = -3 s, 95% CI: -10 to 4). CONCLUSIONS: This is the first study of the King-Devick Test in Parkinson's disease. PD patients were found to have a slower rapid number naming speed compared to controls. This test may be a simple and rapid bedside tool for quantifying correlates of visual and cognitive function in Parkinson's disease.
PMCID:3946616
PMID: 24269283
ISSN: 1353-8020
CID: 799912