Alcohol Use Disorder (AUD) in New Jersey (NJ): Disparity in Treatment.

Alcohol use disorder (AUD) continues to be a threat to public health due to the associated morbidity, mortality, and social and economic impacts. AUD accounts for greater than 85,000 deaths annually in the United States and greater than 1500 deaths annually in New Jersey (NJ). Despite these associated burdens, the treatment of AUD remains unequal among the population, and it is important to identify the factors influencing the disparity in defined population groups such as NJ to drive the appropriate intervention. Data were retrieved from the 2018 Treatment Episode Data Set-Discharges (TEDS-D) of the United States Substance Abuse and Mental Health Services Administration (SAMHSA). Logistic regression analysis was used to predict the odds of receiving treatment based on socioeconomic factors and the type of treatment received. Compared to Asian or Pacific Islanders in NJ, the American Indian [odds ratio, OR=2.12, 95% confidence interval, CI: 1.95-2.31] has the greatest odds of receiving treatment for AUD, followed by the Black or African American [OR=1.70, 95% CI: 1.65-1.75], the Alaska Native [OR=1.67, 95% CI: 1.42-1.96], and then the White [OR=1.31, 95% CI: 1.12-1.52]. Those who are retired or on disability [OR=0.88, 95% CI: 0.82-0.94] have lower odds of receiving treatment than those on salary or wages. Those with AUD in NJ have a lower odd of receiving detoxification treatment in a 24-h hospital inpatient setting [OR=0.88, 95% CI 0.82-0.95] and a higher odd of receiving detoxification treatment in a 24-h service, free-standing residential setting when compared to the treatment received in a rehabilitation/hospital (other than detoxification) setting. This study shows that disparity exists in relation to the type of treatment received and the setting of treatment for AUD in NJ in addition to disparity based on the sociodemographic factors.

Validation of a multi-ancestry polygenic risk score and age-specific risks of prostate cancer: A meta-analysis within diverse populations.

Background: We recently developed a multi-ancestry polygenic risk score (PRS) that effectively stratifies prostate cancer risk across populations. In this study, we validated the performance of the PRS in the multi-ancestry Million Veteran Program and additional independent studies. Methods: Within each ancestry population, the association of PRS with prostate cancer risk was evaluated separately in each case-control study and then combined in a fixed-effects inverse-variance-weighted meta-analysis. We further assessed the effect modification by age and estimated the age-specific absolute risk of prostate cancer for each ancestry population. Results: The PRS was evaluated in 31,925 cases and 490,507 controls, including men from European (22,049 cases, 414,249 controls), African (8794 cases, 55,657 controls), and Hispanic (1082 cases, 20,601 controls) populations. Comparing men in the top decile (90-100% of the PRS) to the average 40-60% PRS category, the prostate cancer odds ratio (OR) was 3.8-fold in European ancestry men (95% CI = 3.62-3.96), 2.8-fold in African ancestry men (95% CI = 2.59-3.03), and 3.2-fold in Hispanic men (95% CI = 2.64-3.92). The PRS did not discriminate risk of aggressive versus nonaggressive prostate cancer. However, the OR diminished with advancing age (European ancestry men in the top decile: ≤55 years, OR = 7.11; 55-60 years, OR = 4.26; >70 years, OR = 2.79). Men in the top PRS decile reached 5% absolute prostate cancer risk ~10 years younger than men in the 40-60% PRS category. Conclusions: Our findings validate the multi-ancestry PRS as an effective prostate cancer risk stratification tool across populations. A clinical study of PRS is warranted to determine whether the PRS could be used for risk-stratified screening and early detection. Funding: This work was supported by the National Cancer Institute at the National Institutes of Health (grant numbers U19 CA214253 to C.A.H., U01 CA257328 to C.A.H., U19 CA148537 to C.A.H., R01 CA165862 to C.A.H., K99 CA246063 to B.F.D, and T32CA229110 to F.C), the Prostate Cancer Foundation (grants 21YOUN11 to B.F.D. and 20CHAS03 to C.A.H.), the Achievement Rewards for College Scientists Foundation Los Angeles Founder Chapter to B.F.D, and the Million Veteran Program-MVP017. This research has been conducted using the UK Biobank Resource under application number 42195. This research is based on data from the Million Veteran Program, Office of Research and Development, and the Veterans Health Administration. This publication does not represent the views of the Department of Veteran Affairs or the United States Government.

Effective Project Management of a Pan-African Cancer Research Network: Men of African Descent and Carcinoma of the Prostate (MADCaP).

PURPOSE: Health research in low- and middle-income countries can generate novel scientific knowledge and improve clinical care, fostering population health improvements to prevent premature death. Project management is a critical part of the success of this research, applying knowledge, skills, tools, and techniques to accomplish required goals. Here, we describe the development and implementation of tools to support a multifaceted study of prostate cancer in Africa, focusing on building strategic and operational capacity. METHODS: Applying a learning organizational framework, we developed and implemented a project management toolkit (PMT) that includes a management process flowchart, a cyclical center-specific schedule of activities, periodic reporting and communication, and center-specific monitoring and evaluation metrics. RESULTS: The PMT was successfully deployed during year one of the project with effective component implementation occurring through periodic cycles of dissemination and feedback to local center project managers. A specific evaluation was conducted 1 year after study initiation to obtain enrollment data, evaluate individual quality control management plans, and undertake risk log assessments and follow-up. Pilot data obtained identified areas in which centers required mentoring, strengthening, and capacity development. Strategies were implemented to improve project goals and operational capacity through local problem solving, conducting quality control checks and following compliancy with study aims. Moving forward, centers will perform quarterly evaluations and initiate strengthening measures as required. CONCLUSION: The PMT has fostered the development of both strategic and operational capacity across project centers. Investment in project management resources is essential to ensuring high-quality, impactful health research in low- and middle-income countries.

Prevalence of bovine brucellosis in slaughtered cattle and barriers to better protection of abattoir workers in Ibadan, South-Western Nigeria.

INTRODUCTION: Brucellosis is a neglected zoonosis of public health importance. This study was conducted to determine the prevalence and risk factors of brucellosis among slaughtered cattle as well as challenges to the protection of abattoir workers in Nigeria. METHODS: A slaughterhouse study was conducted in a major abattoir in Ibadan from March to August, 2013. To diagnose brucellosis, serum samples from 1,241 slaughtered cattle were tested using Rose-Bengal test (RBT) and competitive enzyme-linked immunosorbent assay (cELISA); again, 57 milk samples were tested with milk ring test (MRT) and indirect ELISA (iELISA). Furthermore, a survey on the usage of personal protective equipment (PPE) and challenges to its use by abattoir workers was done. Data were analysed using Stata 12. RESULTS: Seroprevalence by RBT was 7.8%; 77.3% (75/97) of these were corroborated by cELISA. Prevalence in milk samples by MRT and indirect ELISA were 33.3% and 3.5%, respectively. Sex (OR: 2.5; 95%CI:1.3-4.5) was the factor significantly associated with Brucella seropositivity. None of the abattoir workers used standard protective overalls; while, 99.6% of the meat handlers and 84.1% of the butchers worked barefoot. Most of the workers (75.7%) wore no protective gloves. The respondents agreed that provision of free PPE and sanctions against non-users would encourage its use. CONCLUSION: Our findings indicate moderate prevalence (7.8%) of bovine brucellosis with sex of cattle being a risk factor. A notable barrier to better protection of abattoir workers against brucellosis is perceived inconvenience arising from use of gloves. Therefore, preventive and control measures against brucellosis must include education and use of PPE among abattoir workers.

A Survey of Texas Health Educators' Family Health History-based Practice.

OBJECTIVES: To examine Texas health educators' practice of providing family health history (FHH)-based services, alongside factors shaping their practice. METHODS: A theoretical model of factors influencing health educators' FHH-based practice was developed and tested through structural equation modeling. (Master) Certified Health Education Specialists (N = 228; 40.93%) in Texas completed a baseline survey immediately before online or workshop FHH training. RESULTS: Participants incorporated FHH into their practice at low rates (on average=37.10%). Our model fit the data adequately based on the overall model chi-square test and model-fit-indices (ie, χ(2) [df = 21]=27.20; p = .16; RMSEA=0.04; SRMR=0.05; CFI=0.97). Intention, self-efficacy, attitudes, and knowledge were associated with practice. CONCLUSIONS: Training health educators to incorporate FHH into their practice is needed. Our theoretical model suggests intervention points for future training.