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1.
Pediatr Infect Dis J ; 37(12): 1286-1289, 2018 12.
Article in English | MEDLINE | ID: mdl-29570589

ABSTRACT

BACKGROUND: The recent occurrence of congenital syphilis in Columbus, OH, raised concern for an increase in syphilis among women and infants. The objectives were to examine the rates of syphilis among men, women and infants in Ohio from 2003 to 2016 and compare these rates to the rest of the United States. METHODS: This retrospective study evaluated cases of syphilis among men, women and infants from 2003 to 2016 using data from the Ohio Department of Health and the Centers for Disease Control and Prevention. RESULTS: In Ohio from 2003 to 2016, the number of all syphilis cases among women significantly increased from 153 (2.6/100,000) to 294 (5.2/100,000), respectively (b = 0.26; P = 0.001; 95% confidence interval [CI]: 0.137-0.382). From 2003 to 2016, congenital syphilis in Ohio also increased significantly from 3 (2/100,000) to 13 cases (9.3/100,000), respectively (b = 1.05; P ≤ 0.001; 95% CI: 0.687-1.408). The increase in congenital syphilis mirrored the increase in all cases of syphilis in women but not with the rates of primary and secondary syphilis. Among men, cases of primary and secondary syphilis increased significantly in Ohio and the rest of the United States, from 156 (2.8/100,000) and 5956 (4.2/100,000) in 2003 to 622 (10.5/100,000) and 24,724 (15.6/100,000) in 2016, respectively (Ohio: b = 0.55; P < 0.001; 95% CI: 0.426-0.679; United States: b = 0.77; P < 0.001; 95% CI: 0.629-0.916). CONCLUSIONS: The association of congenital syphilis with all syphilis cases in women highlights the importance of reporting all cases and not just primary and secondary syphilis. The increase in congenital syphilis reinforces the recommendation for repeat maternal screening during pregnancy.


Subject(s)
Syphilis, Congenital/epidemiology , Female , Humans , Infant, Newborn , Male , Ohio/epidemiology , Prevalence , Retrospective Studies , United States
2.
Cancer Epidemiol Biomarkers Prev ; 26(4): 578-586, 2017 04.
Article in English | MEDLINE | ID: mdl-28270500

ABSTRACT

Background: Physical activity (PA) protects against cancer and enhances cancer survivorship. Given high inactivity rates nationwide, population-level physical activity facilitators are needed. Several authoritative bodies have recognized that zoning and planning helps create activity-friendly environments. This study examined the association between activity-friendly zoning, inactivity, and cancer in 478 of the most populous U.S. counties.Methods: County geocodes linked county-level data: cancer incidence and smoking (State Cancer Profiles), inactivity (Behavioral Risk Factor Surveillance System), 11 zoning measures (compiled by the study team), and covariates (from the American Community Survey and NAVTEQ). For each zoning measure, single mediation regression models and Sobel tests examined whether activity-friendly zoning was associated with reduced cancer incidence, and whether inactivity mediated those associations. All models were clustered on state with robust SEs and significance at the P < 0.05 level.Results: Zoning for crosswalks, bike-pedestrian connectivity, and bike-pedestrian trails/paths were associated with reduced cancer incidence (ß between -0.71 and -1.27, P < 0.05), about 1 case per 100,000 for each 10 percentage-point increase in county population exposure to zoning. Except for crosswalks, each association was mediated by inactivity. However, county smoking attenuated these results, with only crosswalks remaining significant. Results were similar for males (with zoning for bike-pedestrian connectivity, street connectivity, and bike-pedestrian trails/paths), but not females, alone.Conclusions: Zoning can help to create activity-friendly environments that support decreased inactivity, and possibly reduced cancer incidence.Impact: Given low physical activity levels nationwide, cross-sectoral collaborations with urban planning can inform cancer prevention and public health efforts to decrease inactivity and cancer. Cancer Epidemiol Biomarkers Prev; 26(4); 578-86. ©2017 AACRSee all the articles in this CEBP Focus section, "Geospatial Approaches to Cancer Control and Population Sciences."


Subject(s)
Environment Design , Exercise , Neoplasms/epidemiology , Sedentary Behavior , Behavioral Risk Factor Surveillance System , City Planning , Cross-Sectional Studies , Female , Humans , Incidence , Male , Neoplasms/prevention & control , Smoking/epidemiology , United States/epidemiology
3.
Prev Med ; 95 Suppl: S126-S133, 2017 02.
Article in English | MEDLINE | ID: mdl-27713102

ABSTRACT

Active travel to work can provide additional minutes of daily physical activity. While the literature points to the relationship between zoning, equity and socioeconomic status, and physical activity, no study has quantitatively explored these connections. This study examined whether zoning may help to moderate any income and poverty inequities in active travel and taking public transit to work. Research was conducted between May 2012 and June 2015. Zoning data were compiled for 3914 jurisdictions covering 45.45% of the U.S. population located in 471 of the most populous U.S. counties and 2 consolidated cities located in 48 states and the District of Columbia. (Sensitivity analyses also captured unincorporated areas which, with the municipalities, collectively covered ~72% of the U.S. POPULATION: ) Zoning codes were obtained and evaluated to assess the pedestrian-orientation of the zoning codes. Public transit use, active travel to work, median household income, and poverty data were obtained for all study jurisdictions from the 2010-2014 American Community Survey estimates. Associations were examined through multivariate regression models, controlling for community sociodemographics, clustered on county, with robust standard errors. We found that certain pedestrian-oriented zoning provisions (e.g., crosswalks, bike-pedestrian connectivity, street connectivity, bike lanes, bike parking, and more zoning provisions) were associated with reduced income and/or poverty disparities in rates of public transit use and active travel to work. Findings from this study can help to inform cross-sectoral collaborations between the public health, planning, and transportation fields regarding zoning for pedestrian-orientation and active travel.


Subject(s)
City Planning/methods , Pedestrians/psychology , Poverty , Socioeconomic Factors , Transportation/statistics & numerical data , Adult , Bicycling/statistics & numerical data , Ethnicity , Exercise , Humans , United States , Walking/statistics & numerical data
4.
Environ Behav ; 48(1): 111-130, 2016 Jan.
Article in English | MEDLINE | ID: mdl-27587898

ABSTRACT

Although zoning is recognized for its role in facilitating healthy communities, no study has examined whether active living-oriented zoning codes are associated with adult leisure time physical activity (PA). This study sought to fill this gap and hypothesized that adult leisure time PA would be greater in communities with more progressive zoning code reforms and more active living-oriented zoning. Zoning codes for 1,617 county and municipal jurisdictions located in 30 states (covering ~40% of the U.S. population) were evaluated for code reform zoning and 11 active living markers. County-aggregated zoning measures were created for linking with five adult PA behaviors obtained from the 2011 Behavioral Risk Factor Surveillance System controlling for individual and county sociodemographics. Zoning elements most associated with adult PA included requirements for mixed use, active and passive recreation, bike parking/street furniture, and bike-pedestrian trails/paths. This study provides new insights as to the role that zoning can play in facilitating adult PA.

5.
Eur J Pediatr ; 175(10): 1371-8, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27624626

ABSTRACT

UNLABELLED: This study prospectively assessed whether positive screening surveys for autism spectrum disorders (ASDs) in children with functional defecation disorders (FDDs) accurately identify ASD. Parents of children (4-12 years) who met Rome III criteria for functional constipation (FC), FC with fecal incontinence (FI) and functional nonretentive FI (FNRFI) completed two ASD screening surveys. Children with positive screens were referred for psychological evaluation, and a year later, follow-up surveys were conducted. Of the 97 study participants, 30.9 % were diagnosed with FC, 62.9 % with FC with FI, and 6.2 % with FNRFI. ASD surveys were positive for 27 children (27.8 %). New DSM diagnoses were made in 10 out of the 15 children that completed further evaluation. Two (2.1 %) met criteria for ASD, and 12 (12.4 %) met criteria for other behavioral disorders. Average SRS and SCQ-L scores were higher in subjects with FC with FI as compared to FC alone and in those who reported no improvement versus those who reported improvement 1 year later. CONCLUSION: While positive ASD screening surveys did not correctly identify ASD in the majority, it did help to identify other unrecognized behavioral disorders in children with FDD. High screening scores were more common in children with FC with FI and in children with poorer responses to current medical treatments. WHAT IS KNOWN: •A prior study found that 29 % of children with FDD scored positive on ASD screening questionnaires. •Whether positive screens correctly identify ASD in children with FDD is unknown. What is New: •This study shows that positive ASD screens do not correctly identify ASD in children with FDD. However, the use of ASD screening questionnaires can identify previously unrecognized and untreated behavioral/developmental disorders in children with FDD. •High screening scores are more common in children with FC with FI and in children with poorer responses to current medical treatments.


Subject(s)
Autism Spectrum Disorder/diagnosis , Constipation/diagnosis , Defecation , Fecal Incontinence/psychology , Mental Disorders/diagnosis , Autism Spectrum Disorder/psychology , Child , Child, Preschool , Constipation/psychology , Female , Follow-Up Studies , Humans , Male , Mental Disorders/psychology , Parents , Prospective Studies , Surveys and Questionnaires
6.
Front Public Health ; 4: 71, 2016.
Article in English | MEDLINE | ID: mdl-27148517

ABSTRACT

BACKGROUND: Communities across the United States have been reforming their zoning codes to create pedestrian-friendly neighborhoods with increased street connectivity, mixed use and higher density, open space, transportation infrastructure, and a traditional neighborhood structure. Zoning code reforms include new urbanist zoning such as the SmartCode, form-based codes, transects, transportation and pedestrian-oriented developments, and traditional neighborhood developments. PURPOSE: To examine the relationship of zoning code reforms and more active living--oriented zoning provisions with adult active travel to work via walking, biking, or by using public transit. METHODS: Zoning codes effective as of 2010 were compiled for 3,914 municipal-level jurisdictions located in 471 counties and 2 consolidated cities in 48 states and the District of Columbia, and that collectively covered 72.9% of the U.S. population. Zoning codes were evaluated for the presence of code reform zoning and nine pedestrian-oriented zoning provisions (1 = yes): sidewalks, crosswalks, bike-pedestrian connectivity, street connectivity, bike lanes, bike parking, bike-pedestrian trails/paths, mixed-use development, and other walkability/pedestrian orientation. A zoning scale reflected the number of provisions addressed (out of 10). Five continuous outcome measures were constructed using 2010-2014 American Community Survey municipal-level 5-year estimates to assess the percentage of workers: walking, biking, walking or biking, or taking public transit to work OR engaged in any active travel to work. Regression models controlled for municipal-level socioeconomic characteristics and a GIS-constructed walkability scale and were clustered on county with robust standard errors. RESULTS: Adjusted models indicated that several pedestrian-oriented zoning provisions were statistically associated (p < 0.05 or lower) with increased rates of walking, biking, or engaging in any active travel (walking, biking, or any active travel) to work: code reform zoning, bike parking (street furniture), bike lanes, bike-pedestrian trails/paths, other walkability, mixed-use zoning, and a higher score on the zoning scale. Public transit use was associated with code reform zoning and a number of zoning measures in Southern jurisdictions but not in non-Southern jurisdictions. CONCLUSION: As jurisdictions revisit their zoning and land use policies, they may want to evaluate the pedestrian-orientation of their zoning codes so that they can plan for pedestrian improvements that will help to encourage active travel to work.

7.
Contemp Clin Trials ; 45(Pt A): 34-40, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26188163

ABSTRACT

More than 20years have passed since the NIH 1993 Act was initiated, and while progress has been made toward better representation of minorities and women in clinical research studies, as this review will show, there is still tremendous room for improvement. The purpose of this review was to identify the current state of literature on recruitment and retention strategies in clinical studies of low-income and minority populations. We identified 165 studies published in English between 2004 and 2014. Data extracted included information on the study type (descriptive or analytical), study design, study focus (recruitment, retention, both recruitment and retention), health outcome, specific minority group, special population or age group, if specific recruitment/retention techniques were tested, and key research findings. Particular attention was given to articles that statistically analyzed the effectiveness of recruitment and retention strategies on enrollment/retention rates. Effective recruitment and retention strategies for low-income and minority groups, differential effectiveness across groups, and implications for future research are discussed.


Subject(s)
Biomedical Research/methods , Ethnicity , Minority Groups , Patient Selection , Poverty , Aging , Clinical Trials as Topic , Community Participation , Cultural Competency , Health Status , Humans , Language , Research Design , Trust , Women's Health
8.
Transp Res D Transp Environ ; 33: 17-25, 2014 Dec 01.
Article in English | MEDLINE | ID: mdl-25506255

ABSTRACT

The objective of this study is to develop a measure of traffic calming with nationally available GIS data from NAVTEQ and to validate the traffic calming index with the percentage of children reported by school administrators as walking or biking to school, using data from a nationally representative sample of elementary schools in 2006-2010. Specific models, with and without correlated errors, examined associations of objective GIS measures of the built environment, nationally available from NAVTEQ, with the latent construct of traffic calming. The best fit model for the latent traffic calming construct was determined to be a five factor model including objective measures of intersection density, count of medians/dividers, count of low mobility streets, count of roundabouts, and count of on-street parking availability, with no correlated errors among items. This construct also proved to be a good fit for the full measurement model when the outcome measure of percentage of students walking or biking to school was added to the model. The traffic calming measure was strongly, significantly, and positively correlated with the percentage of students reported as walking or biking to school. Applicability of results to public health and transportation policies and practices are discussed.

9.
J Immigr Minor Health ; 15(3): 540-52, 2013 Jun.
Article in English | MEDLINE | ID: mdl-23224773

ABSTRACT

Post-immigration adaptation is characterized by chronic and acute acculturative stressors. Salivary cortisol is a commonly used hormonal marker of stress, but few studies have investigated its use as an indicator of acculturative stress and adjustment in immigrants. The purpose of this study was to examine relationships among predictors of adjustment (environmental and language mastery), self-reported stress outcomes (depressive symptoms, perceived stress, alienation), and salivary cortisol response in immigrants from the former Soviet Union. The sample included 137 married men and women aged 42-80 who lived in the U.S. for 1-13 years. Results indicated that while men and women had similar values for cortisol response, relationships among adjustment measures, stress outcomes, and cortisol differed by gender. Among men, environmental mastery significantly reduced depressive symptoms, perceived stress, and cortisol response. Among women, environmental mastery also reduced depressive symptoms, perceived stress, and alienation, but language mastery increased cortisol response and decreased alienation.


Subject(s)
Acculturation , Emigrants and Immigrants , Hydrocortisone/analysis , Saliva/chemistry , Sex Factors , Stress, Psychological/diagnosis , Stress, Psychological/ethnology , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , USSR/ethnology , United States
10.
J Youth Adolesc ; 41(1): 53-66, 2012 Jan.
Article in English | MEDLINE | ID: mdl-21706260

ABSTRACT

Neighborhood disadvantage in early adolescence may help explain racial and ethnic disparities in obesity during the transition to adulthood; however the processes may work differently for males and females and for minority groups compared to Whites. The present study examines the relationship between neighborhood disadvantage and young adult obesity and the extent to which it contributes to racial/ethnic disparities among males and females. Data are from waves I and III of The National Longitudinal Study of Adolescent Health (Add Health), a nationally representative sample of adolescents administered between 1994 and 2002. The final sample of 5,759 adolescents was 54% female, 63% White, 21% African American, 16% Hispanic, and 14 years of age, on average, at wave I. Using hierarchical logit models and controlling for prior obesity status, findings indicate that, for females, adolescent neighborhood disadvantage partially explains racial/ethnic disparities in young adult obesity. Further, neighborhood disadvantage increases the odds of becoming obese for adolescent females in a curvilinear form, and this relationship significantly varies between Whites and Hispanics. Neighborhood disadvantage does not increase the risk of obesity for males, regardless of race/ethnicity. Implications for obesity prevention are discussed.


Subject(s)
Health Status Disparities , Obesity/ethnology , Residence Characteristics , Adolescent , Adolescent Development , Black or African American , Female , Health Surveys , Hispanic or Latino , Humans , Longitudinal Studies , Male , Models, Statistical , Nonlinear Dynamics , Obesity/economics , Self Report , Sex Factors , Socioeconomic Factors , United States , White People , Young Adult
11.
Contemp Clin Trials ; 32(3): 353-62, 2011 May.
Article in English | MEDLINE | ID: mdl-21276876

ABSTRACT

BACKGROUND: Conducting longitudinal research studies with low-income and/or minority participants present a unique set of challenges and opportunities. PURPOSE: To outline the specific strategies employed to successfully recruit and retain participants in a longitudinal study of nutritional anticipatory guidance during early childhood, conducted with a low-income, ethnically diverse, urban population of mothers. METHODS: We describe recruitment and retention efforts made by the research team for the 'MOMS' Study (Making Our Mealtimes Special). The 'multilayered' approach for recruitment and retention included commitment of research leadership, piloting procedures, frequent team reporting, emphasis on participant convenience, incentives, frequent contact with participants, expanded budget, clinical staff buy-in, a dedicated phone line, and the use of research project branding and logos. RESULTS: Barriers to enrollment were not encountered in this project, despite recruiting from a low-income population with a large proportion of African-American families. Process evaluation with clinic staff demonstrated the perception of the MOMS staff was very positive. Participant retention rate was 75% and 64% at 6 months and 12 months post-recruitment, respectively. We attribute retention success largely to a coordinated effort between the research team and the infrastructure support at the clinical sites, as well as project branding and a dedicated phone line. CONCLUSIONS: Successful participant recruitment and retention approaches need to be specific and consistent with clinical staff buy in throughout the project.


Subject(s)
Health Promotion/methods , Obesity/prevention & control , Patient Selection , Randomized Controlled Trials as Topic/methods , Research Personnel/organization & administration , Adolescent , Adult , Attitude of Health Personnel , Child , Child, Preschool , Communication , Diet , Ethnicity , Female , Health Education/methods , Humans , Infant , Longitudinal Studies/methods , Marketing of Health Services , Mothers/education , Ohio , Patient Dropouts , Poverty , Research Personnel/education , Research Personnel/psychology , Researcher-Subject Relations , Urban Population , Young Adult
12.
Am J Cardiol ; 102(12): 1728-30, 2008 Dec 15.
Article in English | MEDLINE | ID: mdl-19064032

ABSTRACT

There has been a tremendous focus on gynecologic health with the increasing number of women with congenital heart disease (CHD). Conversely, experience in providing sexual health screening to men with CHD is lacking. The purpose of this study was to identify sexual health issues in men with CHD. An anonymous survey was distributed to men in our adult CHD clinic. Age, type of CHD, medications, detailed sexual history including cardiovascular symptoms with intercourse, erectile dysfunction (ED), and willingness to discuss ED with a physician was obtained. A logistic regression analysis was performed to analyze the relation between medications, CHD complexity, and ED; 86 men completed the survey with a mean age of 34 +/- 10 years. The prevalence of ED was 38%. Men were treated with cardiac medications including beta blockers (BB; 24%), angiotensin-converting enzyme (ACE) inhibitors (8%), calcium-channel blockers (6%), and combination BB and ACE inhibitor therapy (16%). Men on BB were 3.13 times more likely to report ED (p = 0.045). Complexity of CHD did not increase the likelihood of ED symptoms (p >0.10). Although most men attributed symptoms to their underlying CHD, most were willing to discuss issues of ED with their cardiologist. In conclusion, ED is prevalent in young men with CHD. Although an emotional component may contribute, certain medications may exacerbate symptoms.


Subject(s)
Adrenergic beta-Antagonists/adverse effects , Angiotensin-Converting Enzyme Inhibitors/adverse effects , Erectile Dysfunction/etiology , Heart Defects, Congenital/complications , Adult , Drug Therapy, Combination , Erectile Dysfunction/epidemiology , Heart Defects, Congenital/drug therapy , Humans , Logistic Models , Male , Prevalence , Young Adult
13.
Life Sci ; 83(23-24): 786-94, 2008 Dec 05.
Article in English | MEDLINE | ID: mdl-18955067

ABSTRACT

AIMS: Fibrosis and myocyte hypertrophy are classical remodeling parameters in heart failure (HF); however, an intriguing possibility is that myocytes undergo intracellular remodeling which decrease compliance, contributing to diastolic dysfunction. The most obvious candidates are cytoskeletal proteins. The cytoskeletal protein desmin reinforces the sarcomeres, enabling force generation. As a contributor to sarcomere performance, desmin may represent a better appraisal of dysfunction than fibrosis or myocyte hypertrophy. MAIN METHODS: HF was induced in sheep via coronary microembolization. Echocardiography was performed at baseline, 4-, and 12-months in HF. Desmin, fibrosis, and myocyte hypertrophy from infarcted LV posterior and noninfarcted LV anterior walls were measured using Western blot, immunohistochemistry, and digital image analysis. Multivariate regression analysis was performed, providing structure/function mechanisms. *p<0.05. KEY FINDINGS: EF decreased from 55% to 24%*. LV end-diastolic area (LVEDA) increased 123%* at month-12. Fibrosis increased only in posterior LV whereas myocyte hypertrophy increased in both LV posterior and LV anterior regions but only at month-12. Desmin content progressively increased 121% at month-4 and 182%* at month-12 in both LV posterior and anterior walls. Multivariate linear regression (beta coefficient standardization) demonstrated that desmin was a much better predictor of EF (beta=-0.38*) and LVEDA (beta=0.58*) than fibrosis or myocyte hypertrophy. SIGNIFICANCE: Desmin, fibrosis, and myocyte hypertrophy are temporally and spatially heterogeneous in HF. Desmin content more accurately correlated with remodeling than fibrosis or myocyte hypertrophy, suggesting that intra-myocyte responses, likely related to mechanical stretch, are better predictors of LV function and may represent novel targets for therapeutic intervention.


Subject(s)
Cytoskeleton/metabolism , Desmin/biosynthesis , Desmin/chemistry , Heart Failure , Myocytes, Cardiac/pathology , Ventricular Remodeling , Animals , Biomarkers/chemistry , Biomarkers/metabolism , Blotting, Western , Cell Size , Disease Models, Animal , Electrophoresis, Polyacrylamide Gel , Fibrosis , Heart Failure/diagnosis , Heart Failure/metabolism , Heart Failure/pathology , Heart Failure/physiopathology , Heart Function Tests , Immunohistochemistry , Protein Conformation , Sheep , Ventricular Dysfunction, Left/physiopathology
14.
J Food Prot ; 67(10): 2165-70, 2004 Oct.
Article in English | MEDLINE | ID: mdl-15508625

ABSTRACT

In December 2002, the Ohio Department of Health was notified of two children with Salmonella infection. Both had a history of drinking raw milk from a combination dairy-restaurant-petting zoo (dairy). The dairy was the only establishment in Ohio licensed to sell raw milk and reported 1.35 million visitors annually. We investigated to determine the extent of the outbreak and identify illness risk factors. A case patient was any person with pulsed-field gel electrophoresis-matched Salmonella enterica serotype Typhimurium from 30 November 2002 to 18 February 2003. Sixty-two met the confirmed case definition. Forty dairy case patient patrons were included in a case-control study; 56 controls were their well meal companions. Consumption of raw milk was found to be associated with illness (odds ratio, 45.1; 95% confidence interval, 8.8 to 311.9). The dairy discontinued selling raw milk. Because 27 other states still allow the sale of raw milk, awareness of the hazards of its consumption should be raised and relevant regulations carefully reviewed.


Subject(s)
Disease Outbreaks , Food Handling/methods , Milk/microbiology , Salmonella Food Poisoning/epidemiology , Salmonella typhimurium/pathogenicity , Adolescent , Adult , Aged , Animals , Case-Control Studies , Cattle , Child , Child, Preschool , Consumer Product Safety , Female , Food Microbiology , Humans , Illinois/epidemiology , Infant , Male , Middle Aged , Ohio/epidemiology , Tennessee/epidemiology
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