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1.
BMC Pediatr ; 23(1): 43, 2023 01 25.
Article in English | MEDLINE | ID: mdl-36698086

ABSTRACT

BACKGROUND AND OBJECTIVES: Pulmonary hypertension (PH) is a rare, but serious disease among children. However, PH has been primarily evaluated among adults. Consequently, treatment therapies have not been fully evaluated among pediatric populations and are used in an 'off label' manner. The purpose of this study was to estimate the side effect profiles of the most commonly prescribed pediatric PH therapies and to understand the burdens placed upon families caring for children living with PH. METHODS: Participants were recruited online through the "Families of children with pulmonary hypertension" Facebook group and asked to complete a survey about PH treatments. RESULTS: A total of 139 parents of a child living with PH completed the survey. Almost all children used ≥ 1 medication to treat PH, with 52% using ≥ 3 medications. The highest average number of side effects was reported by users of Treprostinil, Selexipag and type-5 phosphodiesterase (PDE5) inhibitors. The most common side effects were skin flushing, headache, nasal congestion, joint/muscle pain, and nausea. In terms of accessing care, 81% travel ≥ 20 miles and 68% travel for ≥ 60 min to receive care. CONCLUSIONS: We found an array of treatment combinations employed to mitigate symptoms of PH in children, with a wide range of side effects. We also found a large, unseen economic, emotional, and time burden of caring for a child living with PH. Further research is warranted to understand the clinical implications of these side effects to move towards labeled usage of these therapies rather than post-hoc off-label usage.


Subject(s)
Caregiver Burden , Drug-Related Side Effects and Adverse Reactions , Hypertension, Pulmonary , Child , Humans , Hypertension, Pulmonary/drug therapy
2.
BMC Public Health ; 22(1): 2305, 2022 12 09.
Article in English | MEDLINE | ID: mdl-36494713

ABSTRACT

BACKGROUND: Pulmonary hypertension (PH) is a serious and life-threatening disease characterized by elevated mean arterial pressure and pulmonary vascular resistance. COVID-19 may exacerbate PH, as evidenced by higher mortality rates among those with PH. The objective of this study was to understand the unique burdens that the COVID-19 pandemic has placed upon families of children living with PH. METHODS: Participants were recruited online through the "Families of children with pulmonary hypertension" Facebook group and asked to complete a survey about their experiences during the COVID-19 pandemic. RESULTS: A total of 139 parents/caregivers of children living with PH completed the online survey. Almost all (85.6%) of parents/caregivers had received the COVID-19 vaccine, though only 59.7% reported a willingness to vaccinate their child with PH against COVID-19. Over 75% of parents/caregivers felt that they practiced preventative measures (e.g., wearing a facemask, social distancing, and avoiding gatherings) more than those in the community where they live. They also reported several hardships related to caring for their child with PH during the pandemic such as financial duress, loss of work, and affording treatment costs. CONCLUSIONS: These findings indicate that parents/caregivers of children at higher risk for COVID-19 complications may be more willing to act on clinical recommendations themselves as proxy for protecting those at high risk. The economic, emotional and social impacts of COVID-19 are significantly greater for high-risk individuals.


Subject(s)
COVID-19 , Hypertension, Pulmonary , Child , Humans , COVID-19 Vaccines , Pandemics/prevention & control , Caregivers , Parents , Vaccination
3.
J Synchrotron Radiat ; 27(Pt 2): 446-454, 2020 Mar 01.
Article in English | MEDLINE | ID: mdl-32153283

ABSTRACT

X-ray absorption spectroscopy (XAS) beamlines worldwide are steadily increasing their emphasis on full photon-in/photon-out spectroscopies, such as resonant inelastic X-ray scattering (RIXS), resonant X-ray emission spectroscopy (RXES) and high energy resolution fluorescence detection XAS (HERFD-XAS). In such cases, each beamline must match the choice of emission spectrometer to the scientific mission of its users. Previous work has recently reported a miniature tender X-ray spectrometer using a dispersive Rowland refocusing (DRR) geometry that functions with high energy resolution even with a large X-ray spot size on the sample [Holden et al. (2017). Rev. Sci. Instrum. 88, 073904]. This instrument has been used in the laboratory in multiple studies of non-resonant X-ray emission spectroscopy using a conventional X-ray tube, though only for preliminary measurements at a low-intensity microfocus synchrotron beamline. This paper reports an extensive study of the performance of a miniature DRR spectrometer at an unfocused wiggler beamline, where the incident monochromatic flux allows for resonant studies which are impossible in the laboratory. The results support the broader use of the present design and also suggest that the DRR method with an unfocused beam could have important applications for materials with low radiation damage thresholds and that would not survive analysis on focused beamlines.

4.
BMC Infect Dis ; 19(1): 339, 2019 Apr 24.
Article in English | MEDLINE | ID: mdl-31014275

ABSTRACT

BACKGROUND: Zika virus is associated with increased cases of both microcephaly and Guillain-Barré syndrome. Community knowledge, perceptions and practices to prevent infection with the Zika virus are not well understood, particularly among high risk populations living in resource-poor and Zika-endemic areas. Our objective was to assess knowledge of symptoms, health effects and prevention practices associated with Zika virus in rural communities on the northern coast of the Dominican Republic. METHODS: Study participants were contacted while attending community events such as free medical clinics and invited to be interviewed regarding their knowledge, attitudes, and perceptions of Zika virus using the World Health Organization's Zika survey tool. RESULTS: Of the 75 Dominicans that participated, 33% did not know who could become infected with Zika. In addition, only 40% of respondents were able to identify mosquitoes or sexual transmission as the primary routes of infection though 51% of respondents thought that Zika was an important issue in their community. CONCLUSIONS: This study found that general knowledge regarding the basic risks and transmission of Zika were not well understood among a sample of rural Dominicans. Our findings highlight disparities in knowledge and perception of risk from Zika in rural areas compared to previous studies conducted in the Dominican Republic. Education about the basic risks and transmission of Zika are critically needed in these remote populations to reduce Zika transmission.


Subject(s)
Health Knowledge, Attitudes, Practice , Rural Population/statistics & numerical data , Zika Virus Infection , Zika Virus , Dominican Republic , Humans , Zika Virus Infection/psychology , Zika Virus Infection/transmission
5.
BMC Public Health ; 19(1): 1217, 2019 Sep 03.
Article in English | MEDLINE | ID: mdl-31481059

ABSTRACT

BACKGROUND: The aim of this study was to investigate what factors predict knowledge about Zika transmission, symptomology, and treatment among U.S. travelers and, additionally, to evaluate how Zika knowledge influences the adoption of personal protective behaviors. METHODS: Data were collected as part of a cross-sectional survey study using a probability-based internet panel of U.S. travelers in June 2017. We ran logistic regression models of factors predicting Zika knowledge (high vs. low) and of knowledge predicting adoption of personal protective measures. RESULTS: We found that traveling to a Zika endemic country and travelers' gender were both significantly predictive of higher Zika knowledge (odds ratio (OR): 1.48, 95% confidence interval (CI): 1.14-1.93 and OR: 1.44, 95% CI: 1.08-1.92), adjusting for age, race, education, income, and trip purpose. Additionally, among travelers to Zika endemic countries, individuals with higher Zika knowledge had significantly higher odds of engaging in preventive behaviors compared to those with lower knowledge. However, few travelers knew about the sexual transmission of Zika and adopted sexual prevention measures. CONCLUSIONS: Our findings suggest that there are gaps in knowledge about the risks and transmission of Zika and travelers with low knowledge are less likely to engage in the appropriate prevention methods. Significantly, few U.S. travelers have knowledge of the sexual transmission of Zika and, accordingly, there is less overall engagement with prevention measures for this transmission mechanism than for vector-borne transmission.


Subject(s)
Health Knowledge, Attitudes, Practice , Zika Virus Infection/prevention & control , Adolescent , Adult , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Travel , United States , Young Adult
6.
J Community Health ; 44(2): 377-386, 2019 04.
Article in English | MEDLINE | ID: mdl-30478625

ABSTRACT

Individuals are often at increased risk of acquiring infectious disease while traveling. We sought to understand knowledge, attitudes and practices (KAP) regarding Zika virus among travelers from the United States. A total of 1043 study participants were recruited from a probability-based internet panel. Participants self-reported their knowledge of Zika infection and modes of transmission, and identified actions they had taken to prevent Zika infection and transmission including actions to prevent unintentional pregnancy since becoming aware of the Zika virus. Logistic regression was used to model the odds of taking preventive actions against Zika infection with adjustment for potential confounding factors. Knowledge of the sexual transmissibility of Zika virus significantly increased the odds of taking a preventive action against Zika infection, especially condom use or sexual abstention. Participants reported preferences for receiving information about Zika from private doctors and from the Internet. Discrepancies between where travelers seek information about Zika and how they would like to receive information regarding Zika were also found. These findings suggest that improving targeted messaging through online media may increase awareness of the sexual transmissibility of Zika as well as improve health communications with U.S. travelers. Travelers who are unaware of potential disease risks are less likely to adopt personal protective measures to protect themselves and reduce disease spread. Thus, future work should focus on improving communication and providing education to adopt effective prevention strategies while traveling.


Subject(s)
Health Knowledge, Attitudes, Practice , Sexually Transmitted Diseases, Viral , Travel , Zika Virus Infection , Zika Virus , Humans , Sexually Transmitted Diseases, Viral/prevention & control , Sexually Transmitted Diseases, Viral/transmission , Zika Virus Infection/prevention & control , Zika Virus Infection/transmission
7.
Subst Use Misuse ; 53(9): 1468-1481, 2018 07 29.
Article in English | MEDLINE | ID: mdl-29313738

ABSTRACT

BACKGROUND: Trends in abstaining from substance use and delinquency among adolescent's ages 12-17 in the United States was examined. METHODS: Data was derived from the National Survey on Drug Use and Health (NSDUH) involving non-Hispanic white, African American, and Hispanic respondents (n = 98,620) and spanning the years 2002-2014. Logistic regression was used to examine significance of trend year and correlates of low-risk and high-risk behavioral groups relative to abstaining. RESULTS: Overall, the prevalence of abstaining was 47.56% between 2002 and 2014. Prevalence increased significantly among all adolescents from 44.85% in 2002 to 53.58% in 2014. Relative to abstainers nonabstaining youth were more likely to be male, and report lower household income, poorer grades, depression, and lower levels of parental affirmation and control. CONCLUSIONS: Findings indicate that there is a corresponding increase in abstaining mirroring the recent decreases found in adolescent drug use found in national surveys.


Subject(s)
Juvenile Delinquency/trends , Substance-Related Disorders/epidemiology , Adolescent , Child , Female , Health Surveys , Humans , Male , Prevalence , United States , Violence/trends
8.
Stroke ; 48(5): 1191-1197, 2017 05.
Article in English | MEDLINE | ID: mdl-28386038

ABSTRACT

BACKGROUND AND PURPOSE: Short-term exposure to ambient fine particulate pollution (PM2.5) has been linked to increased stroke. Few studies, however, have examined the effects of long-term exposure. METHODS: A total of 45 625 participants were interviewed and included in this study, the participants came from the Study on Global Ageing and Adult Health, a prospective cohort in 6 low- and middle-income countries. Ambient PM2.5 levels were estimated for participants' communities using satellite data. A multilevel logistic regression model was used to examine the association between long-term PM2.5 exposure and stroke. Potential effect modification by physical activity and consumption of fruit and vegetables was assessed. RESULTS: The odds of stroke were 1.13 (95% confidence interval, 1.04-1.22) for each 10 µg/m3 increase in PM2.5. This effect remained after adjustment for confounding factors including age, sex, smoking, and indoor air pollution (adjusted odds ratio=1.12; 95% confidence interval, 1.04-1.21). Further stratified analyses suggested that participants with higher levels of physical activity had greater odds of stroke, whereas those with higher consumption of fruit and vegetables had lower odds of stroke. These effects remained robust in sensitivity analyses. We further estimated that 6.55% (95% confidence interval, 1.97%-12.01%) of the stroke cases could be attributable to ambient PM2.5 in the study population. CONCLUSIONS: This study suggests that ambient PM2.5 may increase the risk of stroke and may be responsible for the astounding stroke burden in low- and middle-income countries. In addition, greater physical activity may enhance, whereas greater consumption of fruit and vegetables may mitigate the effect.


Subject(s)
Air Pollution/statistics & numerical data , Environmental Exposure/statistics & numerical data , Exercise/physiology , Fruit , Particulate Matter/adverse effects , Stroke/epidemiology , Stroke/etiology , Vegetables , Adult , Aged , Aged, 80 and over , China/epidemiology , Diet , Female , Ghana/epidemiology , Humans , India/epidemiology , Male , Mexico/epidemiology , Middle Aged , Prospective Studies , Russia/epidemiology , South Africa/epidemiology
9.
Sex Transm Infect ; 93(1): 56-61, 2017 Feb.
Article in English | MEDLINE | ID: mdl-28100761

ABSTRACT

OBJECTIVE: To examine whether or not self-sampled cervical screening for human papillomavirus (HPV) DNA is acceptable and if women prefer self-sampling to clinician-based sampling. DESIGN: Systematic review and meta-analysis. DATA SOURCES: Thirty-seven primary studies obtained through a comprehensive search of six electronic bibliographic databases from 1986 to 2014 and other sources. Search keywords included HPV, screening, DNA testing, vaginal testing, self-collected specimen, self-collected sample, self-sampling, self-screening, preferences and acceptability. REVIEW METHODS: Studies eligible for analysis included those that had participants perform self-sampling, evaluated participant acceptance of or preference for self-sampled vaginal HPV DNA and reported data to calculate an effect size. There were no exclusion criteria for publication status or geographical location. Meta-analytic methods were used to quantitatively synthesise effect sizes across studies. RESULTS: The 37 studies included 18 516 female participants from 24 countries across five continents. Overall, there was a high level of acceptability of self-sampling among the participants. Participants reported preference for self-sampling over clinician sampling due to attractive characteristics such as ease and privacy. CONCLUSIONS: The overall acceptability of self-sampled cervical screening, coupled with economic and effective care, provides opportunities for expanding screening services. Importantly, this can provide a creative screening alternative for women who do not participate in traditional cytological screening, and may ultimately reduce health disparities and prevent cervical disease.


Subject(s)
Papillomaviridae/isolation & purification , Papillomavirus Infections/diagnosis , Patient Acceptance of Health Care/statistics & numerical data , Self-Examination , Uterine Cervical Neoplasms/prevention & control , Early Detection of Cancer/methods , Female , Humans , Papillomavirus Infections/prevention & control , Self-Examination/statistics & numerical data , Specimen Handling , Vaginal Smears
10.
Am J Public Health ; 107(5): 724-731, 2017 05.
Article in English | MEDLINE | ID: mdl-28323468

ABSTRACT

OBJECTIVES: To understand where transmission of Zika virus has the highest likelihood to occur in the contiguous United States with regard to its transmission both sexually and via Aedes aegypti mosquito bites. METHODS: We evaluated the 2 routes of transmission risk with predictors of sexually transmitted infections (percentage women of childbearing age, birthrate, gonorrhea and chlamydia rates, concentrated disadvantage) as a surrogate for unprotected sexual activity and the demographic distribution of the A. aegypti mosquito across 3108 counties in the contiguous United States. RESULTS: We found that 507 counties had the highest risk of virus exposure via mosquito vector or unprotected sexual activity; these were concentrated in southern states extending northward along the Atlantic coast and southern California, with the highest predicted risk in Mississippi counties. CONCLUSIONS: Identifying areas with higher transmission risk can inform prevention strategies and vector control, and assist in planning for diagnosis and treatment.


Subject(s)
Aedes/virology , Insect Vectors/virology , Sexually Transmitted Diseases, Viral/transmission , Zika Virus Infection/transmission , Adolescent , Adult , Animals , Female , Humans , Male , Pregnancy , Risk Factors , Sexually Transmitted Diseases, Viral/epidemiology , United States/epidemiology , Zika Virus Infection/epidemiology
11.
Am J Public Health ; 107(6): 977-982, 2017 06.
Article in English | MEDLINE | ID: mdl-28426317

ABSTRACT

OBJECTIVES: To examine trends in and correlates of fighting and violence among youths from the 3 largest racial/ethnic groups in the United States. METHODS: We derived race/ethnicity-specific prevalence estimates for fighting, group fighting, and attacks with intent to harm from the National Survey on Drug Use and Health, a population-based study of youths aged 12 to 17 years. RESULTS: The prevalence of youth fighting and violence decreased significantly in all racial/ethnic groups over the study period (2002-2014), dropping from a high of 33.6% in 2003 to a low of 23.7% in 2014, reflecting a 29% decrease in the relative proportion of young people involved in these behaviors. However, there was also a clear severity gradient in which year-by-year point estimates for fighting and violence were consistently highest among non-Hispanic African American youths, followed by Hispanic and then non-Hispanic White youths. CONCLUSIONS: Although fighting and violence are on the decline among young people in general and across racial/ethnic subgroups, there is a stable pattern of disparities in youth involvement in these behaviors.


Subject(s)
Adolescent Behavior , Aggression/psychology , Violence/ethnology , Violence/statistics & numerical data , Adolescent , Black or African American/statistics & numerical data , Hispanic or Latino/statistics & numerical data , Humans , Prevalence , Racial Groups , Socioeconomic Factors , Surveys and Questionnaires , United States , White People/statistics & numerical data
12.
Matern Child Health J ; 21(8): 1643-1654, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28092059

ABSTRACT

Objectives Children born large for gestational age (LGA) are at risk of numerous adverse outcomes. While the racial/ethnic disparity in LGA risk has been studied among women with Gestational Diabetes Mellitus (GDM), the independent effect of race on LGA risk by maternal prepregnancy BMI is still unclear among women without GDM. Therefore, the objective of this study was to assess the association between maternal race/ethnicity and LGA among women without GDM. Methods This was a population-based cohort study of 2,842,278 singleton births using 2012 U.S. Natality data. We conducted bivariate and multivariate logistic regression analyses to assess the association between race and LGA. Due to effect modification by maternal prepregnancy BMI, we stratified our analysis by four BMI subgroups. Results The prevalence of LGA was similar across the different racial/ethnic groups at about 9%, but non-Hispanic Asian Americans had slightly higher prevalence of 11%. After controlling for potential confounders, minority women had higher odds of birthing LGA babies compared to non-Hispanic white women. Non-Hispanic Asian Americans had the highest odds of LGA babies across all BMI categories: underweight (aOR = 2.67; 95% CI: 2.24, 3.05); normal weight (aOR = 2.53; 2.43, 2.62); overweight (aOR = 2.45; 2.32, 2.60) and obese (aOR = 2.05; 1.91, 2.20). Conclusions for practice Racial/ethnic disparities exist in LGA odds, particularly among women with underweight or normal prepregnancy BMI. Most minorities had higher LGA odds than non-Hispanic white women regardless of prepregnancy BMI category. These racial/ethnic disparities should inform public health policies and interventions to address this problem.


Subject(s)
Birth Weight , Body Mass Index , Ethnicity/statistics & numerical data , Fetal Macrosomia/ethnology , Pregnancy Complications/ethnology , Adult , Asian People , Black People , Cohort Studies , Female , Fetal Macrosomia/epidemiology , Gestational Age , Hispanic or Latino , Humans , Infant, Newborn , Obesity/epidemiology , Obesity/ethnology , Population Surveillance , Pregnancy , Pregnancy Complications/epidemiology , Prevalence , Retrospective Studies , Risk Factors , United States/epidemiology , White People
13.
Child Youth Serv Rev ; 81: 188-196, 2017 Oct.
Article in English | MEDLINE | ID: mdl-29269965

ABSTRACT

BACKGROUND: Truancy has long been regarded a common problem in urgent need of effective intervention. Knowledge about factors associated with truancy can guide the development and implementation of interventions. METHOD: This paper examined trends in truancy rates between 2002-2014 and correlates of truancy across racial/ethnic groups. Variables of interest included sociodemographic factors (e.g., age, gender, socio-economic background), behavioral factors (e.g., substance use, violence), and psychosocial factors (e.g., academic engagement, grades, parental control). Using data from a large sample of adolescents (n=209,393; 12-17 years) we estimated truancy prevalence rates and examined trends and correlates via regression analyses. RESULTS: Truancy rates remained constant between 2002 (10.8%) and 2014 (11.1%). Rates were highest among older youth, females, and Hispanic youth. For all racial/ethnic groups, truancy was significantly correlated with alcohol and marijuana use, fighting, the propensity to take risks, and lower academic engagement and school grades. Other factors were differentially associated with racial/ethnic groups. This divergence in risk patterns for different racial/ethnic groups points to some heterogeneity amongst truant youth. DISCUSSION: Despite truancy reduction efforts, truancy rates have remained stable. Efforts to prevent truancy and to intervene with truant youth may need to target risk factors more prevalent in specific racial/ethnic groups.

14.
Sex Transm Infect ; 92(3): 194-9, 2016 May.
Article in English | MEDLINE | ID: mdl-26567330

ABSTRACT

BACKGROUND: Identifying predictors that contribute to geographical disparities in sexually transmitted infections (STIs) is necessary. This study assesses the spatial relationship between condom availability to locations of STIs in order to better understand these geographical disparities. OBJECTIVES: We conducted a condom availability audit among potential condom-selling establishments. New gonorrhoea and chlamydia cases in 2011 (n=6034) and HIV infection cases from 2006 to 2011 (n=565) were collected by census tract in St Louis, Missouri. 829 potential condom-selling establishments participated in the condom availability audit in St Louis City; 242 of which sold condoms. RESULTS: A negative linear relationship exists between condom vendors and cases of gonorrhoea and chlamydia, after adjusting for concentrated disadvantage and free condom locations. Higher concentrated disadvantage, higher proportions of convenience vendors and free locations were associated with higher rates of HIV. CONCLUSIONS: This study was conducted to provide evidence that lack of condom availability is associated with STI rates, and likely is an integral component to influencing the subjective norms surrounding condom use and STI rates. Condom distribution interventions may be addressing availability needs and social norms, yet are more likely to be effective when placed in locations with the highest STI rates.


Subject(s)
Chlamydia Infections/epidemiology , Condoms/supply & distribution , Gonorrhea/epidemiology , HIV Infections/epidemiology , Healthcare Disparities/statistics & numerical data , Sexually Transmitted Diseases/epidemiology , Chlamydia Infections/prevention & control , Cross-Sectional Studies , Female , Gonorrhea/prevention & control , HIV Infections/prevention & control , Humans , Male , Missouri/epidemiology , Poisson Distribution , Sexually Transmitted Diseases/prevention & control , Spatial Regression
15.
Prev Med ; 88: 127-33, 2016 07.
Article in English | MEDLINE | ID: mdl-27063946

ABSTRACT

The objective of the present study was to examine trends and correlates of handgun carrying among adolescents ages 12-17 in the United States. Data was derived from the National Survey on Drug Use and Health (NSDUH) involving non-Hispanic White, African American, and Hispanic respondents ages 12-17 (n=197,313) and spanning the years 2002-2013. Logistic regression was used to examine significance of trend year and correlates of previous 12-month handgun carrying. The overall self-reported prevalence of handgun carrying was 3.4%. The prevalence of handgun carrying during 2004-2005 was significantly higher for African-Americans (4.39%) compared to non-Hispanic Whites (3.03%). However, by 2012-2013, non-Hispanic Whites (4.08%) completely diverged and reported carrying handguns significantly more than both African-American (2.96%) and Hispanic (2.82%) youth. Male gender and a number of externalizing behaviors were significant correlates of handgun carrying; however, we also found evidence of differential correlates with regard to such factors as drug selling, parental affirmation, and income by race/ethnicity. To our knowledge, this is the largest study of handgun carrying among youth in the United States. Findings indicate that although at historically low levels handgun carrying is on the rise but only among non-Hispanic Whites. Differential correlates among racial/ethnic groups suggest prevention programming and policies may need modifications depending on group and geographic locale targeted.


Subject(s)
Adolescent Behavior/ethnology , Ethnicity/statistics & numerical data , Firearms/statistics & numerical data , Adolescent , Child , Drug Trafficking/trends , Female , Humans , Male , Prevalence , Self Report , Sex Factors , Socioeconomic Factors , Surveys and Questionnaires , United States , Urban Population
16.
Environ Res ; 148: 79-85, 2016 07.
Article in English | MEDLINE | ID: mdl-27035924

ABSTRACT

CONTEXT: Childhood lead exposure has been associated with criminal behavior later in life. The current study aimed to analyze the association between elevated blood lead levels (n=59,645) and crime occurrence (n=90,433) across census tracts within St. Louis, Missouri. DESIGN: Longitudinal ecological study. SETTING: Saint Louis, Missouri. EXPOSURE MEASURE: Blood lead levels. MAIN OUTCOME MEASURE: Violent, Non-violent, and total crime at the census tract level. RESULTS: Spatial statistical models were used to account for the spatial autocorrelation of the data. Greater lead exposure at the census-tract level was associated with increased violent, non-violent, and total crime. In addition, we examined whether non-additive effects existed in the data by testing for an interaction between lead exposure and concentrated disadvantage. Some evidence of a negative interaction emerged, however, it failed to reach traditional levels of statistical significance (supplementary models, however, revealed a similar negative interaction that was significant). CONCLUSIONS: More precise measurements of lead exposure in the aggregate, produced additional evidence that lead is a potent predictor of criminal outcomes.


Subject(s)
Crime/statistics & numerical data , Environmental Pollutants/blood , Lead/blood , Child , Child, Preschool , Cities , Environmental Exposure , Humans , Infant , Infant, Newborn , Missouri
17.
Environ Res ; 143(Pt A): 131-7, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26479187

ABSTRACT

INTRODUCTION: The adverse health effects of lead exposure in children are well documented and include intellectual and behavioral maladies. Childhood lead exposure has also been linked to impulsive behaviors, which, in turn, are associated with a host of negative health outcomes including an increased risk for sexually transmitted infections (STI). The purpose of this study was to assess the association of lead exposure with STI rates across census tracts in St. Louis City, Missouri. METHODS: Incident cases of gonorrhea and chlamydia (GC) during 2011 were identified from the Missouri Department of Health and Senior Services and aggregated by census tract. We also geocoded the home address of 59,645 children >72 months in age who had blood lead level tests performed in St. Louis City from 1996 to 2007. Traditional regression and Bayesian spatial models were used to determine the relationship between GC and lead exposure while accounting for confounders (condom and alcohol availability, crime, and an index of concentrated disadvantage). RESULTS: Incident GC rates were found to cluster across census tracts (Moran's I=0.13, p=0.006). After accounting for confounders and their spatial dependence, a linear relationship existed between lead exposure and GC incidence across census tracts, with higher GC rates occurring in the northern part of St. Louis City CONCLUSIONS: At the census-tract level, higher lead exposure is associated with higher STI rates. Visualizing these patterns through maps may help deliver targeted interventions to reduce geographic disparities in GC rates.


Subject(s)
Chlamydia Infections/epidemiology , Environmental Pollutants/blood , Gonorrhea/epidemiology , Impulsive Behavior/drug effects , Lead/blood , Censuses , Child , Chlamydia Infections/blood , Chlamydia Infections/psychology , Chlamydia Infections/transmission , Crime/statistics & numerical data , Environmental Pollutants/adverse effects , Gonorrhea/blood , Gonorrhea/psychology , Gonorrhea/transmission , Humans , Incidence , Lead/adverse effects , Missouri/epidemiology , Socioeconomic Factors
18.
J Community Health ; 40(3): 379-86, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25257565

ABSTRACT

Submission of vaginal samples collected at home could remove barriers that women face in getting screened for cervical cancer. From December 2013 to January 2014, women aged 21-30 years were recruited online to participate in either (1) self-collected testing for human papillomavirus (HPV) infection and an online survey, or (2) an online survey regarding their perceptions of self-collected testing for HPV infection. Demographics, risk factors, testing perceptions, and satisfaction with self-collected testing were assessed with online questionnaires. Women who performed self-collection were sent a home sampling kit by US mail, which was returned via US mail for HPV testing. A total of 197 women were enrolled, with 130 completing the online survey and 67 participating in both the survey and self-collection. Of the 67 women who were sent kits, 62 (92.5%) were returned for testing. Sixty kits contained a sample sufficient for testing. The overall prevalence of HPV infection was 17.8%, however 6 women (9.7%) were infected with >1 type of HPV. Women who self-collected a sample reported more favorable attributes of self-collection compared to women who only participated in the online survey, including ease of sampling (87.1 vs. 18.9%), no pain during sampling (72.6 vs. 5.6%), and lack of embarrassment (67.7 vs. 12.9%). A high prevalence of HPV infection was demonstrated among women recruited via the internet. Online recruitment and at home screening methods have the potential to engage women in screening by offering an approach that might be more acceptable to women of different backgrounds.


Subject(s)
Internet , Mass Screening/methods , Papillomavirus Infections/diagnosis , Self Care/methods , Vaginal Smears/methods , Adult , Alphapapillomavirus , Consumer Behavior , Female , Humans , Postal Service , Risk Factors , Socioeconomic Factors , Specimen Handling , Surveys and Questionnaires
19.
J Med Internet Res ; 16(9): e198, 2014 Sep 01.
Article in English | MEDLINE | ID: mdl-25231937

ABSTRACT

BACKGROUND: Federally funded surveys of human papillomavirus (HPV) vaccine uptake are important for pinpointing geographically based health disparities. Although national and state level data are available, local (ie, county and postal code level) data are not due to small sample sizes, confidentiality concerns, and cost. Local level HPV vaccine uptake data may be feasible to obtain by targeting specific geographic areas through social media advertising and recruitment strategies, in combination with online surveys. OBJECTIVE: Our goal was to use Facebook-based recruitment and online surveys to estimate local variation in HPV vaccine uptake among young men and women in Minnesota. METHODS: From November 2012 to January 2013, men and women were recruited via a targeted Facebook advertisement campaign to complete an online survey about HPV vaccination practices. The Facebook advertisements were targeted to recruit men and women by location (25 mile radius of Minneapolis, Minnesota, United States), age (18-30 years), and language (English). RESULTS: Of the 2079 men and women who responded to the Facebook advertisements and visited the study website, 1003 (48.2%) enrolled in the study and completed the survey. The average advertising cost per completed survey was US $1.36. Among those who reported their postal code, 90.6% (881/972) of the participants lived within the previously defined geographic study area. Receipt of 1 dose or more of HPV vaccine was reported by 65.6% women (351/535), and 13.0% (45/347) of men. These results differ from previously reported Minnesota state level estimates (53.8% for young women and 20.8% for young men) and from national estimates (34.5% for women and 2.3% for men). CONCLUSIONS: This study shows that recruiting a representative sample of young men and women based on county and postal code location to complete a survey on HPV vaccination uptake via the Internet is a cost-effective and feasible strategy. This study also highlights the need for local estimates to assess the variation in HPV vaccine uptake, as these estimates differ considerably from those obtained using survey data that are aggregated to the state or federal level.


Subject(s)
Advertising , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Social Media , Vaccination/statistics & numerical data , Adolescent , Adult , Female , Health Promotion/organization & administration , Health Surveys , Humans , Internet , Male , Papillomavirus Infections/epidemiology , Social Networking , United States , Young Adult
20.
J Occup Environ Med ; 66(4): 310-315, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38234095

ABSTRACT

OBJECTIVE: The purpose of this study is to determine the relationship that emotional, psychological, and social well-being has with self-reported illness-related absenteeism. METHODS: This study examines the relationship between three dimensions of well-being (emotional, psychological, and social) and self-report illness-related absenteeism among 133 workers spanning multiple industries across 16 different companies. This secondary, cross-sectional data were analyzed using multiple linear regression. RESULTS: As hypothesized, emotional well-being and psychological well-being were found to be negatively associated with absenteeism, with emotional well-being being the stronger predictor. Contrary to our hypothesis, we found that social well-being was not associated with absenteeism among workers. CONCLUSIONS: Employee emotional well-being and psychological well-being are associated with self-reported illness-related absenteeism. Future work should explore causal relationships between these constructs.


Subject(s)
Absenteeism , COVID-19 , Humans , Cross-Sectional Studies , Self Report , Psychological Well-Being , Pandemics , COVID-19/epidemiology
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