A system for the management of sandy shorelines under climate change: United States Virgin Islands (USVI).

A methodological framework is presented for the assessment of beach vulnerability to climate variability and change on small touristic islands. Based on the development of a coastal vulnerability index (CVI) fueled by open-source Earth Observations and social media information, it includes both physical and socio-economic characteristics of the shoreline. In a pilot study in the U.S. Virgin Islands (USVIs), most beaches were found to be vulnerable to erosion. The CVI was utilized to rank the most likely vulnerable beaches, which were then studied using historic geomorphologic data; these beaches were confirmed to be predominantly eroding. Significant erosion is projected as sea levels rise; for example, by 2050 under the RCP8.5 scenario, more than 50% of the 30 most vulnerable USVI beaches will erode by 50-100% of their current maximum width. The framework is designed to be used in vulnerable coastal settings that have limited financial and human resources.

Emotional Eating Predicts Weight Regain Among Black Women in the SisterTalk Intervention.

OBJECTIVE: This study aimed to assess effects of emotional eating and stress on weight change among Black women in a culturally tailored weight-control program. METHODS: SisterTalk, a cable-TV-delivered weight-control randomized trial, included 331 Black women (aged 18-75 years; BMI ≥ 25 kg/m2) in Boston, Massachusetts. BMI and waist circumference (WC) were assessed at baseline and 3, 8, and 12 months post randomization. Frequency of "eating when depressed or sad" (EWD) and "eating to manage stress" (ETMS) (i.e., "emotional eating") and perceived stress were also assessed. Lagged analyses of data for intervention participants (n = 258) assessed associations of BMI and WC outcomes at each follow-up visit with EWD and ETMS frequency and stress measured at the most recent prior visit. RESULTS: At 3 months (immediately post intervention), BMI decreased for women in all EWD and ETMS categories but increased at later follow-up for women reporting EWD and ETMS always/often. In addition, 8-month EWD and ETMS predicted 12-month BMI change (both P < 0.05). Higher perceived stress was associated with higher EWD and ETMS; however, stress was not associated with lagged BMI or WC at any time. CONCLUSIONS: Addressing emotional eating and related triggers may improve weight maintenance in interventions with Black women.

A method for regional estimation of climate change exposure of coastal infrastructure: Case of USVI and the influence of digital elevation models on assessments.

OBJECTIVE: This study tests the impacts of Digital Elevation Model (DEM) data on an exposure assessment methodology developed to quantify flooding of coastal infrastructure from storms and sea level rise on a regional scale. The approach is piloted on the United States Virgin Islands (USVI) for a one-hundred-year storm event in 2050 under the IPCC's 8.5 emission scenario (RCP 8,5). METHOD: Flooding of individual infrastructure was tested against three different digital elevation models using a GIS-based coastal infrastructure database created specifically for the project using aerial images. Inundation for extreme sea levels is based on dynamic simulations using Lisflood-ACC (LFP). RESULTS: The model indicates transport and utility infrastructure in the USVI are considerably exposed to sea level rise and modeled storm impacts from climate change. Prediction of flood extent was improved with a neural network processed SRTM, versus publicly available SRTM (~30 m) seamless C-band DEM but both SRTM based models underestimate flooding compared to LIDAR DEM. The modeled scenario, although conservative, showed significant flood exposure to a large number of access roads to facilities, 113/176 transportation related buildings, and 29/66 electric utility and water treatment buildings including six electric power transformers and six waste water treatment clarifiers. CONCLUSION: The method bridges a gap between large-scale non-specific flood assessments and single-facility detailed assessments and can be used to efficiently quantify and prioritize parcels and large structures in need of further assessment for regions that lack detailed data to assess climate exposure to sea level rise and flooding caused by waves. The method should prove particularly useful for assessment of Small Island Developing State regions that lack LIDAR data, such as the Caribbean.

Motivational interviewing with personalized feedback to reduce alcohol use in HIV-infected men who have sex with men: A randomized controlled trial.

OBJECTIVE: This randomized controlled trial tested the efficacy of motivational interviewing (MI) to reduce alcohol use among heavy drinking men who have sex with men (MSM) who are engaged in HIV care but not currently receiving addictions treatment. METHOD: One hundred eighty MSM living with HIV-recruited regardless of interest in changing drinking-were randomly assigned to MI or an assessment-only treatment as usual (TAU) control. MI comprised one in-person session followed by two brief phone calls and in-person booster sessions at 3 and 6 months. The Timeline Follow-Back Interview assessed past 30-day alcohol use and sexual behavior at 3, 6, and 12 months postbaseline, and serum samples and medical records assessed viral load, CD4 cell count, and liver function. RESULTS: At 6 and 12 months, MI compared to TAU resulted in significantly fewer drinks per week (6 months: b = -8.72, 95% confidence interval (CI) [-12.69, -4.76]; 12 months: b = -5.98, 95% CI [-9.77, -2.19]) and lower number of heavy drinking days (6 months: incidence rate ratio = 0.55, 95% CI [0.38, 0.79]; 12 months: incidence rate ratio = 0.50, 95% CI [0.33, 0.78]). Effects on viral load, CD4 cell count, and liver function were nonsignificant. Among those reporting condomless sex with nonsteady partners at baseline, MI resulted in significantly lower rates of this behavior at 3 and 12 months compared to TAU. CONCLUSIONS: In MSM living with HIV, MI shows substantial promise for reducing heavy drinking and for reducing condomless sex among those at risk. (PsycINFO Database Record

Improved HIV-1 Viral Load Monitoring Capacity Using Pooled Testing With Marker-Assisted Deconvolution.

OBJECTIVE: Improve pooled viral load (VL) testing to increase HIV treatment monitoring capacity, particularly relevant for resource-limited settings. DESIGN: We developed marker-assisted mini-pooling with algorithm (mMPA), a new VL pooling deconvolution strategy that uses information from low-cost, routinely collected clinical markers to determine an efficient order of sequential individual VL testing and dictates when the sequential testing can be stopped. METHODS: We simulated the use of pooled testing to ascertain virological failure status on 918 participants from 3 studies conducted at the Academic Model Providing Access to Healthcare in Eldoret, Kenya, and estimated the number of assays needed when using mMPA and other pooling methods. We also evaluated the impact of practical factors, such as specific markers used, prevalence of virological failure, pool size, VL measurement error, and assay detection cutoffs on mMPA, other pooling methods, and single testing. RESULTS: Using CD4 count as a marker to assist deconvolution, mMPA significantly reduces the number of VL assays by 52% [confidence interval (CI): 48% to 57%], 40% (CI: 38% to 42%), and 19% (CI: 15% to 22%) compared with individual testing, simple mini-pooling, and mini-pooling with algorithm, respectively. mMPA has higher sensitivity and negative/positive predictive values than mini-pooling with algorithm, and comparable high specificity. Further improvement is achieved with additional clinical markers, such as age and time on therapy, with or without CD4 values. mMPA performance depends on prevalence of virological failure and pool size but is insensitive to VL measurement error and VL assay detection cutoffs. CONCLUSIONS: mMPA can substantially increase the capacity of VL monitoring.

Anthropometric measures, physical activity, and risk of glioma and meningioma in a large prospective cohort study.

Body fatness has been associated with increased risk of a number of hormone-dependent cancers. Recent studies suggest that body mass index (BMI) may be related to meningiomas, which are more common in women than men, and for which estrogens are believed to play a role. Using data from a large European propective cohort, 203 incident cases of meningioma and 340 cases of glioma were included in the analysis for measures of body fat, height, and physical activity among 380,775 participants. All analyses were conducted using Cox proportional hazards model and controlling for age, sex, country, and education. A 71% increase in risk of meningioma was observed among men and women in the top quartile of waist circumference (HR = 1.71, 95% CI = 1.08-2.73, P(trend) = 0.01). A positive association was also observed for BMI and meningioma (HR = 1.48, 95% CI = 0.98-2.23, for BMI ≥30 compared with a BMI of 20-24.9, P(trend) = 0.05). An association with height and meningioma was also suggestive (HR = 1.24, 95% 0.96-1.51, for each 10 cm increase). In contrast, no associations were observed for height and different measures of body fat and risk of glioma. Physical activity was not related to either type of brain tumors. Results from this study support an increase in risk of meningioma with higher body fatness among both men and women. No association was observed between anthropometric measures and risk of glioma.

Case control study of the geographic variability of exposure to disinfectant byproducts and risk for rectal cancer.

BACKGROUND: Levels of byproducts that result from the disinfection of drinking water vary within a water distribution system. This prompted us to question whether the risk for rectal cancer also varies, depending upon one's long term geographic location within the system. Such a geographic distribution in rectal cancer risk would follow naturally from an association between level of byproduct and rectal cancer risk. We assess the effects of estimated geographic variability in exposure to some of the components of the trihalomethane group of disinfectant byproducts (DBPs) on the odds ratios and probabilities for rectal cancer in white males in a case control study of 128 cases and 253 controls, conducted in Monroe County, Western New York State, U.S.A. The study was designed around health data initially collected at the University at Buffalo (Department of Social and Preventative Medicine) as part of the Upstate New York Diet Study, and trihalomethane (THM) data collected from a separate independent study of THMs conducted by Monroe County Department of Health. Case participants were chosen from hospital pathology records. The controls are disease-free white males between 35-90 years old, living in Monroe County, and chosen from control groups for studies from cancer of five other (unrelated) sites. Using a combination of case control methodology and spatial analysis, the spatial patterns of THMs and individual measures of tap water consumption provide estimates of the effects of ingestion of specific amounts of some DBPs on rectal cancer risk. Trihalomethane (THM) data were used to spatially interpolate levels at the taps of cases and controls, and odds ratios were estimated using logistic regression to assess the effects of estimated THM exposure dose on cancer risk, adjusting for alcohol, dietary beta carotene intake, tap water intake, and total caloric intake. RESULTS: Trihalomethane levels varied spatially within the county; although risk for rectal cancer did not increase with total level of trihalomethanes, increasing levels of the component bromoform (measured in ug/day) did correspond with an increase in odds ratios (OR = 1.85; 95% CI = 1.25 - 2.74) for rectal cancer. The highest quartiles of estimated consumption of bromoform (1.69-15.43 ug/day) led to increased risk for rectal cancer (OR = 2.32; 95% CI = 1.22-4.39). Two other THMs were marginally associated with an increase in risk - chlorodibromomethane (OR = 1.78, 95% CI = 1.00-3.19) and bromodichloromethane (OR = 1.15; 95% CI = 1.00-1.32). CONCLUSION: Levels of THMs in the water distribution system exhibited spatial variation that was partially due to variation in water age. We also observed a geographic pattern of increased risk of rectal cancer in areas with the highest levels of bromoform in the county.

Case-control study of the effects of trihalomethanes on urinary bladder cancer risk.

In this research, the authors examined the relation between the estimated concentrations in drinking water of disinfectant byproduct (DBP) trihalomethanes (THMs) and the risk for urinary bladder cancer in a case-control study of 567 white men aged 35 to 90 years, in western New York State. They used logistic regression to estimate odds ratios (ORS) and to assess the effects of THM consumption on cancer risk. Higher levels of consumption of THMs led to increased risk for cancer of the urinary bladder (total 551, a composite measure of THMs based upon method 551 developed by the US Environmental Protection Agency: OR = 2.34; 95% confidence interval [CI] = 1.01-3.66). Results were most significant for bromoform (OR = 3.05; 95% CI = 1.51-5.69), and risk was highest (OR = 5.85; 95% CI = 1.93-17.46) for those who consumed the greatest amount of water at points within the distribution system with the oldest postdisinfected tap water.