Pilot of a Community Health Worker Video Intervention for Immigrant Day Laborers at Occupational Health Risk.

Significance: Immigrant day laborers suffer from disproportionate occupational health risks from hazardous reconstruction jobs after natural disasters. Methods: We conducted a randomized controlled trial of a short-video educational intervention to improve safety knowledge and intent to engage in safety preventive behaviors among 98 Hispanic day laborers (49 randomized to video and 49 control). The short video featured a male promotor and a female promotora who narrated 3 stories of day laborers who were injured while doing construction work in post-Katrina New Orleans. The main outcome measures were changes in scores for day laborer-reported safety knowledge and safety behaviors derived from interviewer-delivered baseline and post-intervention surveys. Results: Video participants reported improvement in overall average safety knowledge score (mean score of 11.3 out of a max score of 12 or 94% when standardized to 0-100% scale), as compared to the control group (mean score of 8.6 or 72%) who were not offered the video (p < 0.00001). The intervention was highly successful in workers stating that they learned and were willing to change their safety preventive behaviors to reduce their occupational risk. The average safety behavior score was higher among those watching the video (17.2 out of a max of 22 or 78.1% when standardized on a scale 0-100%) as compared to control (14.5 or 65.9%) (p = 0.0024). Conclusion: A short video intervention can improve knowledge and intent to engage in preventive behaviors among Hispanic workers for which there is a dearth of construction safety preventive research.

Spatial fine-mapping for gene-by-environment effects identifies risk hot spots for schizophrenia.

Spatial mapping is a promising strategy to investigate the mechanisms underlying the incidence of psychosis. We analyzed a case-cohort study (n = 24,028), drawn from the 1.47 million Danish persons born between 1981 and 2005, using a novel framework for decomposing the geospatial risk for schizophrenia based on locale of upbringing and polygenic scores. Upbringing in a high environmental risk locale increases the risk for schizophrenia by 122%. Individuals living in a high gene-by-environmental risk locale have a 78% increased risk compared to those who have the same genetic liability but live in a low-risk locale. Effects of specific locales vary substantially within the most densely populated city of Denmark, with hazard ratios ranging from 0.26 to 9.26 for environment and from 0.20 to 5.95 for gene-by-environment. These findings indicate the critical synergism of gene and environment on the etiology of schizophrenia and demonstrate the potential of incorporating geolocation in genetic studies.

Latino immigrant day laborer perceptions of occupational safety and health information preferences.

BACKGROUND: We address immigrant day laborers' experiences with occupational safety in the construction industry in New Orleans, and opinions about content and method of communication for educational interventions to reduce occupational risks. METHODS: In 2011, we conducted seven focus groups with 48 Spanish-speaking day laborers (8 women, 40 men, 35 years on average). Focus group results are based on thematic analysis. RESULTS: Most employers did not provide safety equipment, threatened to dismiss workers who asked for it, and did not provide health insurance. Attitudes toward accepting unsafe work conditions varied. Women faced lower pay and hiring difficulties than men. Day laborers preferred audio format over written, and content about consequences from and equipment for different jobs/exposures. CONCLUSIONS: Day laborers have common occupational experiences, but differences existed by gender, literacy and sense of control over safety. Day laborer information preferences and use of media needs further studying. Am. J. Ind. Med. 59:476-485, 2016. © 2016 Wiley Periodicals, Inc.

Urologic diseases in America Project: analytical methods and principal findings.

PURPOSE: The burden of urological diseases on the American public is immense in human and financial terms but it has been under studied. We undertook a project, Urologic Diseases in America, to quantify the burden of urological diseases on the American public. MATERIALS AND METHODS: We identified public and private data sources that contain population based data on resource utilization by patients with benign and malignant urological conditions. Sources included the Centers for Medicare and Medicaid Services, National Center for Health Statistics, Medical Expenditure Panel Survey, National Health and Nutrition Examination Survey, Department of Veterans Affairs, National Association of Children's Hospitals and Related Institutions, and private data sets maintained by MarketScan Health and Productivity Management (MarketScan, Chichester, United Kingdom), Ingenix (Ingenix, Salt Lake City, Utah) and Center for Health Care Policy and Evaluation. Using diagnosis and procedure codes we described trends in the utilization of urological services. RESULTS: In 2000 urinary tract infections accounted for more than 6.8 million office visits and 1.3 million emergency room visits, and 245,000 hospitalizations in women with an annual cost of more than 2.4 billion dollars. Urinary tract infections accounted for more than 1.4 million office visits, 424,000 emergency room visits and 121,000 hospitalizations in men with an annual cost of more than 1 billion dollars. Benign prostatic hyperplasia was the primary diagnosis in more than 4.4 million office visits, 117,000 emergency room visits and 105,000 hospitalizations, accounting for 1.1 billion dollars in expenditures that year. Urolithiasis was the primary diagnosis for almost 2 million office visits, more than 600,000 emergency room visits, and more than 177,000 hospitalizations, totaling more than 2 billion dollars in annual expenditures. Urinary incontinence in women was the primary cause for more than 1.1 million office visits in 2000 and 452 million dollars in aggregate primary cause for more than 1.1 million office visits in 2000 and 452 million dollars in aggregate annual expenditures. Other manuscripts in this series present further detail for specific urologic conditions. CONCLUSIONS: Recent trends in epidemiology, practice patterns, resource utilization and costs for urological diseases have broad implications for quality of health care, access to care and the equitable allocation of scarce resources for clinical care and research.