Recent uci_pph_hsb_oapdeposits items

Structural disadvantage and HIV risk – comparing risk factors between trans women’s partnerships with cis men and trans women sexual partners

Tue, 23 Jun 2026 00:00:00 +0000

IntroductionLittle is known about differences in HIV risk for trans women by partner gender, particularly with respect to social determinants of health and partner-level factors that affect behavior. We examined differences in demographic, social determinants, and HIV-related risk behaviors for trans women with cisgender men and trans women sexual partners.Materials and methodsData are from a cross-sectional survey of trans women and their sexual partners conducted between April 2020 and January 2021. Interviews were held remotely via videoconference during shelter-in-place ordinances due to the Covid-19 pandemic. This analysis characterized associations between HIV risk and preventive behaviors comparing trans women with cisgender men partners to trans women with trans women partners.ResultsA total of 336 sexual partners were identified from 156 trans women. Trans women with cisgender men partners were significantly more likely to be from racial/ethnic minority populations and...

Changes in Type 2 Diabetes Medications Among Primary Care Patients After California's 2022 Medicaid Expansion.

Thu, 18 Jun 2026 00:00:00 +0000

OBJECTIVE: In May 2022, California expanded full-scope Medicaid (Medi-Cal) to low-income undocumented immigrants aged 50 years or older, which provided access to newer type 2 diabetes (T2D) medications. This study examined whether the expansion led to more prescriptions of newer therapies like glucagon-like peptide 1 receptor agonists and sodium-glucose cotransporter 2 inhibitors among older undocumented immigrants. RESEARCH DESIGN AND METHODS: We used patient records between January 2019 to June 2023 from two Federally Qualified Health Centers (FQHCs) in Los Angeles County. We compared prescriptions among 1) older undocumented immigrants newly eligible for Medi-Cal, 2) younger undocumented immigrants not eligible for Medi-Cal, and 3) documented patients (n = 20,420 encounters and 4,601 patients). We used generalized linear mixed models with patient-level random intercepts to examine whether the patient groups differed in their likelihood of being prescribed newer medications...

Wildfire and Smoke Risk Communication: A Systematic Literature Review from a Health Equity Focus

Wed, 17 Jun 2026 00:00:00 +0000

Effective wildfire smoke risk and evacuation communication is urgently needed to avert unnecessary deaths as wildfires increase in frequency and intensity. Human exposure to wildfires has doubled in the last two decades. Low-income, marginalized communities are the most disadvantaged in their ability to respond. A systematic literature review of wildfire and wildfire smoke risk communication research between 2014 and 2024 was conducted. Web of Science and Scopus databases were searched using the keywords "wildfire", "communication", "wildfire smoke", "risk", and "public health", resulting in 23 studies. The findings revealed marginalized communities were ill-prepared to respond to wildfires and take protective action against wildfire smoke. The findings were summarized across eight areas: the needs of marginalized communities to respond to wildfires, the role of trusted messengers to disseminate wildfire and smoke risk messaging, using diverse channels, timing and frequency considerations...

COVID-19 and HPV Vaccine Knowledge Attitudes, and Behaviour among Students at Historically Black Colleges and Universities

Wed, 17 Jun 2026 00:00:00 +0000

Objective: This study examined HPV and COVID-19 vaccination uptake, attitudes, risk perceptions, and exposure to vaccine misinformation among young adults enrolled at historically Black colleges and universities (HBCUs). Methods: Surveys and focus groups were conducted at three southeastern HBCUs. Quantitative data were analyzed using descriptive statistics, and Wilcoxon rank and ANOVA for group comparisons. Qualitative data were examined through content analysis. Results: Most participants identified as religious and female. A majority (86.2%) reported receiving at least one dose of the COVID-19 vaccine, with 56.3% reporting a COVID-19 booster. For HPV vaccination, only 56.3% reported having received at least one dose. Vaccinated students reported higher perceived risk, stronger social support, greater peer motivation, lower endorsement of misinformation, and more positive vaccine attitudes than unvaccinated peers. Unvaccinated participants reported low vaccine confidence and...

Correction: The social amplification and attenuation of COVID-19 risk perception shaping mask wearing behavior: A longitudinal twitter analysis

Wed, 17 Jun 2026 00:00:00 +0000

[This corrects the article DOI: 10.1371/journal.pone.0257428.].

Unraveling the Self: A Scoping Review of Moral Injury and Professional Nursing Identity

Wed, 13 May 2026 00:00:00 +0000

Moral injury increasingly describes the distress nurses experience when systemic constraints prevent them from practicing in alignment with their professional values. Moral injury has been theoretically presented as an injury to one’s identity. Professional identity in nursing is “a sense of oneself in relationship to others” which results in an individual “thinking, acting, and feeling like a nurse.” This scoping literature review explores contemporary understandings of nursing professional or moral identity and the association between moral injury and identity among nurses in the United States.

Peer influence decay and behavioral diffusion in adolescent networks: A simulation approach.

Fri, 8 May 2026 00:00:00 +0000

How far does peer influence spread through social networks before dissipating? This study investigates the diffusion of smoking behavior in adolescent friendship networks using longitudinal data from two schools (n = 3154 students) in the National Longitudinal Study of Adolescent to Adult Health. Using Stochastic Actor-Oriented Models, we simulate interventions targeting heavy smokers using various strategies (random, in-degree, eigenvector centrality) and coverage (10 to 100%). A new exponential decay model quantifies influence attenuation, revealing indirect peer influences, or spillover effects, up to three steps from targets. Targeting 10 to 30% of central individuals maximizes smoking reductions, but gains plateau beyond 40 to 50% owing to network saturation. In our analyses, the denser network exhibits broader diffusion and slower decay than the larger, sparser network. This decay metric optimizes intervention design across diverse network structures.

Food pantry organizational features, nutrition environments, and partnerships: a community-engaged study in Southern California

Sun, 29 Mar 2026 00:00:00 +0000

BackgroundCharitable food organizations are critical community hubs for promoting food security and nutrition. Few studies have examined whether food pantry organizational features (e.g., setting and size) are associated with the use of health promotion strategies.MethodsThis cross-sectional study used a validated survey instrument (Nutrition Environment Food Pantry Assessment Tool+, NEFPAT+) in partnership with a southern California regional food bank to examine pantry consumer nutrition environments, including client choice models, marketing, and partnership/referral practices. Eligible pantries were: food bank partners, open at least 1/week for public distribution, and in high-poverty cities. We collected surveys from 27 of 35 eligible sites in 2024. We used descriptive statistics to summarize NEFPAT+ objective outcomes and conducted exploratory analyses to assess differences for specific objective results. Mann‒Whitney U tests and Kruskal‒Wallis tests were used to compare...

Assessing Social Vulnerability and FDA Tobacco Retailer Compliance Inspections and Violations in Los Angeles County, CA (2021–2023)

Tue, 17 Feb 2026 00:00:00 +0000

INTRODUCTION: Tobacco control policies aim to limit access, reduce initiation, and mitigate tobacco-related harms, particularly among youth. However, the effectiveness of these policies relies on consistent enforcement to ensure widespread compliance and achieve their intended public health impacts. Socioeconomic vulnerability and neighborhood characteristics have been shown to influence retailer compliance, although existing studies often primarily focus on compliance violations instead of inspections. This study uses Los Angeles (LA) County, California to explore the associations between compliance inspections, violations, and neighborhood social vulnerability. METHODS: We identified inspection and violation data from the Food and Drug Administration (FDA) Tobacco Compliance Check Outcomes database for Los Angeles County, CA (January 1, 2021 to December 31, 2023) and linked these data to census tract level data from the 2022 Centers for Disease Control and Prevention Social...

Low-Income and Legally Vulnerable: Immigration-Impacted Latino Students’ Perceived Barriers to Accessing Essential Needs Resources at a Hispanic Serving Institution

Tue, 17 Feb 2026 00:00:00 +0000

Immigration-impacted college students, including undocumented students and U.S. citizens with undocumented parents, struggle with food and essential needs insecurity. Drawing on focus groups with 38 immigration-impacted undergraduates, we examine barriers to campus essential needs resource use and investigate the extent to which self or parental immigration status influences use. Findings reveal structural, psychological, and operational barriers and highlight how institutional trust, peer networks, and culturally responsive practices can facilitate more equitable access to resources.

Multi-level Factors Influencing College Campus Basic Needs Service Utilization: A Focus on Latino Immigration-Impacted Students in California

Tue, 17 Feb 2026 00:00:00 +0000

BackgroundImmigration-impacted college students face unique challenges that increase their risk of experiencing basic needs insecurity. This study examined multi-level factors influencing the use of campus basic needs centers among Latino immigration-impacted students attending the University of California (UC).MethodsWe analyzed three Latino undergraduate student populations: (1) undocumented immigrants, (2) U.S. citizens with undocumented immigrant parents, and (3) U.S. citizens with lawfully present parents. Survey data was collected by the UC Collaborative to Promote Immigrant and Student Equity (UC PromISE) from March-June 2020 at nine University of California campuses. Variables related to the Health Equity Framework were examined in relation to Basic Needs Center (BNC) use through descriptive and logistic regression analyses.ResultsAmong 1,875 students who identify as Latina/o/x (mean age 20.6 ± 2.4 years; 77% female; 93% first-generation college students), 59% experienced...

A systematic review investigating policy design and implementation of US state and local policy to restrict the sale of flavored tobacco products

Tue, 17 Feb 2026 00:00:00 +0000

INTRODUCTION: State and local jurisdictions in the United States (U.S.) are increasingly adopting flavored tobacco sales restrictions (FTSRs) to mitigate tobacco initiation and use. Policy implementation is highly understudied yet can impact policy effectiveness. This review examines existing literature on state and local FTSR policy design and implementation in the U.S. METHODS: We systematically searched for PubMed articles published by 12/31/2024 which were: original research articles in English focused on a U.S. state or local FTSR that reported at least one policy implementation outcome measure. We excluded articles that were systematic reviews or reported on federal or non-FTSR policy. Guided by policy and implementation science frameworks, we developed a data extraction template to report: policy design elements, study characteristics, and implementation measures (i.e., inputs, activities, outcomes). RESULTS: Of 1,595 articles identified, 30 were retained for review. Most...

Unseen Burdens: How ACEs and Citizenship Status Shape Health in Aging Latinx Populations

Wed, 11 Feb 2026 00:00:00 +0000

AbstractBackground and Objectives

Citizenship (or the lack thereof) and adverse childhood experiences (ACEs) are both independent predictors of poor self-rated health (SRH), but we know little about their cumulative effects among older Latinx adults. Using a life course perspective, we examine 1) the relationship between ACEs, citizenship status, and poor SRH and 2) whether race-ethnicity-citizenship status combinations modify the association between ACEs and SRH.

Research Design and Methods

Latinx and White adult respondents age 50+ were selected from the 2021 and 2022 California Health Interview Survey (n = 20,491). Generalized linear models (logit link, binomial family) estimated the relationship between ethnicity-citizenship status, ACEs, and SRH. We use an interaction between ethnicity-citizenship and ACEs to test for a moderating effect on SRH.

Results

High ACE exposure and noncitizen status were each significant predictors of poor SRH, adjusting for covariates....

Nutrition Environment Gaps and Distribution Challenges in Rural Food Pantries During the COVID-19 Pandemic: A Mixed-Methods Study

Fri, 2 Jan 2026 00:00:00 +0000

BACKGROUND: Food insecurity disproportionately affects low-income, racially marginalized, and rural communities. The COVID-19 pandemic led to higher demand for emergency food distribution, potentially impacting food pantry operations and services. Limited research exists assessing consumer nutrition environments of pantries in rural regions. OBJECTIVES: To assess the consumer nutrition environment of rural food pantries and report challenges and adaptations encountered during the pandemic. DESIGN: A mixed-methods, cross-sectional survey. PARTICIPANTS/SETTING: Nineteen food pantry representatives from California's San Joaquin Valley were surveyed between August 2020 and June 2021. Representatives were eligible if their pantry served the general population and was open at least once a week. Nine were church-based pantries, and 10 were from other settings. MAIN OUTCOME MEASURES: The Nutrition Environment Food Pantry Assessment Tool (NEFPAT) measured the nutrition food environment...

Structural Barriers Influencing Food Insecurity, Malnutrition, and Health Among Latinas During and After COVID-19: Considerations and Recommendations

Fri, 2 Jan 2026 00:00:00 +0000

Structural Barriers Influencing Food Insecurity, Malnutrition, and Health Among Latinas During and After COVID-19: Considerations and Recommendations

Assessing Dietary Consumption of Toxicant-Laden Foods and Beverages by Age and Ethnicity in California: Implications for Proposition 65

Wed, 5 Nov 2025 00:00:00 +0000

BACKGROUND: Investigating human exposure to toxic contaminants through dietary consumption is critical to identify disease risk factors and health guidelines. METHODS: In this study, we developed a cross-sectional online survey to collect information about dietary patterns and related food consumption habits among adults (age ≥ 18) and adolescents (ages 13-17) in Southern California, focusing on popular staple foods and/or those targeted most commonly under California's Proposition 65 law for lead and acrylamide exposure. RESULTS: Results identified root vegetables, rice, leafy greens, pasta/noodles, tea, juice, and seafood to be among the most heavily consumed foods by mass, while the daily intake of many foods such as stuffed grape leaves, tamarind/chili candy and herbs/spices varied by age and race/ethnicity, suggesting that many of Proposition 65's pollution allowances may be exacerbating issues of health inequity and environmental injustice. Moreover, findings from this study...

Values conflicts, burnout, and moral injury among U.S. nurses: A scoping review

Thu, 23 Oct 2025 00:00:00 +0000

Occupational burnout and moral injury are related, but distinct, processes with operational and relational drivers. This scoping literature review examines one key relational driver of burnout and moral injury: values conflicts between nurses and their organizational leadership. This review included a five-database search, which produced 346 citations for full-text review. Preliminary results have identified 11 relevant citations: 8 journal articles, 2 journal-published expert opinions, and 1 qualitative dissertation study. All references examined some aspect of leadership in relation to burnout and discussed values conflicts; only one investigated moral injury in relation to leadership structures and values conflicts. Six sources explicitly found that perceived differences in values between administrators and clinicians may contribute to burnout. One article discussed the betrayal of nurses' moral values by leadership in connection with moral injury. Implications suggest a potential...

Occupational moral injury in healthcare: A concept analysis

Thu, 23 Oct 2025 00:00:00 +0000

This project seeks to: (1) better understand the concept of occupational moral injury (MI) as it relates to moral distress (MD) and burnout (BO), and (2) improve the understanding of occupational MI in healthcare settings, such that healthcare systems may better develop strategies for MI assessment, prevention, and mitigation. Based on Walker and Avant's (2019) methodology, this concept analysis of occupational MI in healthcare describes the antecedents, defining attributes, and consequences of MI in relation to MD and to the oft associated phenomenon of BO. Our findings reveal a highly interconnected network of related concepts that can intensify each other and that are not mutually exclusive. MI, MD, and BO have shared antecedents and overlapping consequences that can render their delineation challenging. MI, MD, and BO in healthcare contexts all share the attribute of capturing experiences of clinician distress with varying sources, intensity, and chronicity. MI and MD introduce...

Abstract A104: How neighborhood social and sociocultural contexts are associated with mortality in Asian American breast cancer patients

Wed, 22 Oct 2025 00:00:00 +0000

Abstract: PURPOSE:: Asian American (AA) women with breast cancer on average have more favorable survival compared to other racial and ethnic groups in the US. Identifying how neighborhood factors are associated with mortality can inform interventions to optimize survival after breast cancer diagnosis. We examined associations between neighborhood socioeconomic status (nSES), living in ethnic enclaves, and presence of sociocultural institutions (SCIs) with survival in AA women with breast cancer. METHODS:: We analyzed data from a pooled cohort of studies with AA women with breast cancer in California including the Pathways Study, Multiethnic Cohort Study, Northern California Breast Cancer Family Registry, and Asian American Breast Cancer Study. Participant addresses at diagnosis were geocoded to determine their census tract of residence, then linked to...

Reflecting on the Backstage and Frontstage of Community-Based Participatory Research: Ethics and Collaboration in the CATALYST Study

Wed, 22 Oct 2025 00:00:00 +0000

Community-based participatory research (CBPR) is critical for promoting health equity through the incorporation of equitable decision-making and participatory processes into health equity research. Yet, research processes often fail to align with community realities. Drawing on Goffman’s frontstage–backstage framework, this paper examines how a community–academic partnership navigated and negotiated processes to support ethical inclusion of community researchers and participants in a CBPR qualitative study conducted in Orange County, California, focused on the roles of Community Health Workers (CHWs) during the COVID-19 pandemic. We share how backstage processes of trust-building and negotiation directly informed frontstage strategies to strengthen ethical research practices with community participants. We explore considerations for key components of qualitative research processes that have consequences for participatory research approaches: (a) partnership formation (b) inclusive...

LGBTQ+ persons, queer bioethics, and inclusivity in stem cell research and regenerative medicine

Mon, 13 Oct 2025 00:00:00 +0000

Despite the increasing visibility of the LGBTQ+ (Lesbian, Gay, Bisexual, Transgender, Queer, and other expansive genders or sexual orientations) community, LGBTQ+ persons continue to face significant barriers, discrimination, and stigmatization in the health care space. The unique challenges faced by LGBTQ+ persons in healthcare led bioethicists to develop queer bioethics. This approach to ethical reflection suggests that we should develop understanding of biomedical and biological topics related to LGBTQ+ persons and that we should examine topics not traditionally associated with LGBTQ+ persons through a queer lens. Here, we argue that queer bioethics provides valuable new perspectives for improving stem cell science. We examine specific issues that should be examined using a queer bioethical framework for the benefit of all persons and the overall advancement of stem cell science. We specifically address strategies for stem cell donation recruitment, creation of more comprehensive...

Policy stakeholders' perspectives and use of data, research evidence, and misinformation in three counties in California, USA during the COVID-19 pandemic, 2020–2022

Wed, 24 Sep 2025 00:00:00 +0000

Objective: This study investigates how local policy stakeholders viewed and used research evidence, data, and (mis)information in county policy discussions during the COVID-19 pandemic. Method: We employed document and exploratory content analysis methods to examine Board of Supervisor materials (N = 534 policy documents) from general and special/emergency meetings (March 2020 - December 2022). We purposefully selected three jurisdictions from California, USA with varying socio-demographic, political, and health care characteristics as case studies. Results: Many residents who commented during local policy discussions contested the: 1) validity of health data provided (i.e., mortality rates), and 2) efficacy of proposed preventive measures like mask wearing and vaccine receipt. While government officials and healthcare personnel referenced research evidence and data as justification for these measures, several stakeholders expressed skepticism about the information...

Challenging Reward Structures and Organizational Cultures that Propagate Stem Cell Hyperbole

Wed, 10 Sep 2025 00:00:00 +0000

How science is communicated shapes public understanding of science and informs decision-making by patients, research participants, policymakers, public funding agencies, private philanthropic organizations, and corporations. Responsible science communication is a collective responsibility of scientists. Accurate reporting is also a crucial feature of news media coverage of scientific research. Unfortunately, scientists, journalists, and other parties sometimes make hyperbolic claims that go beyond available evidence and exaggerate the significance of particular research findings. This phenomenon is evident in the rapidly evolving and highly competitive fields of stem cell biology and regenerative medicine, though hyperbolic representations have also been documented in such fields as artificial intelligence, genomics, precision medicine, and synthetic biology. Stem cell hyperbole is shaped and promoted by systemic factors. We highlight the continued significance of responsible...

A Cross-Sectional Study Examining Vaccine Uptake and Attitudes Among Parents Compared to Other Adults.

Sun, 31 Aug 2025 00:00:00 +0000

Encouraging vaccine uptake among U.S. residents is an increasingly important public health issue that was magnified during the COVID-19 pandemic. Vaccine hesitancy, an important correlate of vaccine uptake, has been studied extensively in parents with respect to parental attitudes and decision-making toward vaccinating their children. Less work has examined parent attitudes and behaviors regarding personal vaccine uptake and how COVID-19-related vaccine attitudes and behaviors may differ from other types of vaccine attitudes and behaviors (e.g., influenza vaccination). We surveyed a probability-based sample of 585 United States adults in November 2021. Parents (i.e., primary caregiver of at least one child aged 18 years or younger, living in the home) compared to other adults, demographics (age, sex, income, education, ethnicity, urbanicity), and political affiliation were examined as correlates of COVID-19 vaccine attitudes and COVID-19 and influenza vaccine uptake. Multivariate...

Practical Qualitative Data Analysis for Public Health Research: A Guide to a Team-Based Approach With Flexible Coding

Wed, 13 Aug 2025 00:00:00 +0000

Qualitative research is important to advance health equity as it offers nuanced insights into structural determinants of health inequities, amplifies the voices of communities directly affected by health inequities, and informs community-based interventions. The scale and frequency of public health crises have accelerated in recent years (e.g., pandemic, environmental disasters, climate change). The field of public health research and practice would benefit from timely and time-sensitive qualitative inquiries for which a practical approach to qualitative data analysis (QDA) is needed. One useful QDA approach stemming from sociology is flexible coding. We discuss our practical experience with a team-based approach using flexible coding for qualitative data analysis in public health, illustrating how this process can be applied to multiple research questions simultaneously or asynchronously. We share lessons from this case study, while acknowledging that flexible coding has broader...

Community Activation to TrAnsform Local sYSTems (CATALYST): A Qualitative Study Protocol

Wed, 13 Aug 2025 00:00:00 +0000

Community Health Workers, promotores, and navigators (henceforth, CHWs) emerged as critical members of the public health workforce addressing social, economic, and health inequities worsened by the COVID-19 pandemic. While there is increasing appreciation for and utilization of CHW models, and recognition of the importance of tailoring and innovating these models during the pandemic, few studies have examined the processes of change by which CHW models operated during the COVID-19 pandemic, and factors that facilitated or constrained CHW health equity efforts. This protocol paper describes and reflects on the research methodology used in our qualitative study focused on CHWs. The CATALYST study aims to examine the roles that CHWs served during the COVID-19 pandemic and facilitators and barriers related to CHW health equity strategies. This qualitative study incorporates the lived experiences of CHWs, low-income communities of color whom CHWs engaged, and institutional representatives...

Structural supports and challenges for community health worker models: Lessons from the COVID-19 response in Orange County, California

Wed, 13 Aug 2025 00:00:00 +0000

Public health relied on community health workers (CHWs) during the COVID-19 pandemic to connect with the most vulnerable communities, which saved lives and addressed inequities. Understanding the structural factors that supported and hindered the success of CHWs is essential for building a stronger public health infrastructure in the future. We analyzed semi-structured, in-depth interviews with 15 institutional representatives and policymakers who engaged in COVID-19 response involving CHWs in Orange County, California. Findings indicated that while participants realized during the COVID-19 pandemic how essential CHWs were in addressing health and social inequities, CHWs were often undervalued by systems that were not established to support them. Participants highlighted needs for government and healthcare systems to equally partner with CHWs, reimburse CHWs for their work, decrease administrative barriers, and fund CHW-hiring organizations sustainably. We discuss recommendations...

Psychological distress across 2 years of the COVID‐19 pandemic differs by age and by race/ethnicity

Tue, 15 Jul 2025 00:00:00 +0000

The COVID-19 pandemic profoundly impacted mental health, with psychological distress varying across age and racial/ethnic groups. This study examined trajectories of five distress measures-symptoms of posttraumatic stress (PTS), anxiety, depression, anger, and somatization-over the first 2 years of the pandemic, adjusting for prepandemic mental health. Participants in a nationally representative, probability-based U.S. sample (N = 4,298, age range: 18-97 years) completed four online surveys from March 2020 to June 2022. Multilevel models revealed that symptom levels and changes over time varied by age group across outcomes. Across time, PTS and anxiety symptoms declined for most age groups at different rates, F(6, 85,660) = 6.21, p < .001. Younger adults initially reported higher PTS symptom levels at Wave 1, Bs = 0.10-0.14, p < .001, but levels converged across age groups by Wave 4. Rates of anxiety symptoms were similar across age groups at Wave 4 except for...

Beyond the Surface: Mapping DDE's Metabolic Footprint on Adolescent Obesity.

Wed, 2 Jul 2025 00:00:00 +0000

BACKGROUND: Bariatric surgery is an intervention for severe obesity, leading to significant weight loss and metabolic improvements. However, the release of lipophilic chemicals accumulated in adipose tissue during weight loss presents a unique clinical challenge and research opportunity. Dichlorodiphenyldichloroethylene (DDE) is a persistent organic pollutant increasingly recognized as obesogen, while the biological mechanisms through which DDE influences body mass index (BMI) and waist circumference remain underexplored. OBJECTIVES: We aimed to identify metabolic signatures mediating the association between DDE exposure and weight loss by plasma and adipose tissue metabolomics. METHODS: We conducted a longitudinal study involving 60 adolescents with severe obesity undergoing bariatric surgery. We quantified p,p'-DDE concentrations in visceral adipose tissue collected during surgery and analyzed metabolic profiles from both adipose tissues collected at surgery and plasma...

Understanding climate change anxiety and anticipatory climate disaster stress: A survey of residents in a high-risk California county during wildfire season

Tue, 10 Jun 2025 00:00:00 +0000

BACKGROUND: With the increasing prevalence of climate-related disasters, psychological responses, including climate change anxiety and anticipatory climate disaster stress, have received heightened attention. OBJECTIVE: We investigate the correlates of climate change anxiety and anticipatory climate disaster stress, as well as the nature of these psychological responses. METHODS: At the start of the annual fire season (June to August 2023), we recruited a county-representative sample of n=813 residents of Lake County, in Northern California, to complete an anonymous online survey. Multiple regression analyses identified correlates of climate change anxiety and anticipatory climate disaster stress and explored how anxiety and stress were associated with disaster preparedness. FINDINGS: Climate change anxiety, assessed via its cognitive-emotional impairment (odds ratio (OR)_loss/injury=1.68; OR_media=2.37) and functional impairment (OR_loss/injury=1.68;...

“Each one of us did the best we could for the community, while also supporting each other”: community residents’ perspectives on community health worker (CHW) response during the COVID-19 pandemic - a community science worker-led qualitative study

Wed, 4 Jun 2025 00:00:00 +0000

BackgroundThe COVID-19 pandemic significantly disrupted the health and social wellbeing of the United States population, disproportionately affecting low-income, immigrant communities of color. In Orange County, California, community health workers (CHWs) were essential to addressing multilevel community needs among impacted communities. However, little is known about how communities and CHWs responded to meet their needs amid pressing challenges.MethodsCHWs completed a popular education qualitative methods program under a Community Science Worker (CSW) model to design and facilitate four semi-structured focus groups and three interviews with 32 residents in Orange County, California, to understand their pandemic experiences and interactions with CHWs. Sessions were recorded, transcribed, and analyzed using an adapted flexible coding approach to derive data-driven themes.ResultsResidents described how they supported one another, advocated for their communities, and fostered livelihood...

Racialization processes and depressive symptoms among pregnant Mexican‐origin immigrant women

Wed, 4 Jun 2025 00:00:00 +0000

This study examines how racialization processes (conceptualized as multilevel and dynamic processes) shape prenatal mental health by testing the association of discrimination and the John Henryism hypothesis on depressive symptoms for pregnant Mexican-origin immigrant women. We analyzed baseline data (n = 218) from a healthy lifestyle intervention for pregnant Latinas in Detroit, Michigan. Using separate multiple linear regression models, we examined the independent and joint associations of discrimination and John Henryism with depressive symptoms and effect modification by socioeconomic position. Discrimination was positively associated with depressive symptoms (β = 2.84; p < .001) when adjusting for covariates. This association did not vary by socioeconomic position. Women primarily attributed discrimination to language use, racial background, and nativity. We did not find support for the John Henryism hypothesis, meaning that the hypothesized association between John Henryism...

Increased vulnerability to psychological distress and suicidal ideation among transgender women with self-reported disabilities in San Francisco, California

Thu, 22 May 2025 00:00:00 +0000

OBJECTIVE: Research among transgender women has found health, but especially mental health, to be shaped by social inequities and multiple, intersectional, structural vulnerabilities. While some studies have shown that transgender adults are also more likely to have a disability than cisgender adults, few studies have explored this intersection. We assess possible associations between disability status and psychological stress and suicidal ideation among transgender women. METHODS: We analyzed data from the San Francisco site of the National HIV Behavioral Surveillance Transgender (NHBS-Trans) Study (2019-2020) to explore how disability status among transgender women influences mental health. Chi-squared and Fisher's exact tests to assess associations between disability status and psychological distress. Multivariable logistic regression models assessed the magnitude of these associations adjusted for potential confounders. RESULTS: 71.14 % of the sample (N = 201)...

Does Early Life Adversity Limit Delivery of High‐Quality Health Care Among Children?

Sat, 26 Apr 2025 00:00:00 +0000

BACKGROUND: Adverse childhood experiences (ACEs) have been associated with poor health and underuse of preventive health services. However, less is known about how ACEs are associated with quality of care that children receive, like care that involves shared decision-making. METHODS: Using data from the 2021-2022 National Survey of Children's Health (n = 47 179) the association between ACEs, both individual and cumulative and (1) needing medical decisions made in the past 12 months and (2) three different measures of always receiving care that involved shared decision-making. Logistic regression models were used to calculate odds of each outcome. Each of the 11 ACEs and the cumulative number of ACEs served as independent variables each in separate models. RESULTS: After accounting for confounders, the number of ACEs experienced, and most individual ACE items were associated with higher odds of needing medical decisions made, and lower odds of receiving health care that involved...

Health equity in the era of large language models.

Wed, 16 Apr 2025 00:00:00 +0000

This commentary presents a summary of 8 major regulations and guidelines that have direct implications for the equitable design, implementation, and maintenance of health care-focused large language models (LLMs) deployed in the US. We grouped key equity issues for LLMs into 3 domains: (1) linguistic and cultural bias, (2) accessibility and trust, and (3) oversight and quality control. Solutions shared by these regulations and guidelines are to (1) ensure diverse representation in training data and in teams that develop artificial intelligence (AI) tools, (2) develop techniques to evaluate AI-enabled health care tool performance against real-world data, (3) ensure that AI used in health care is free of discrimination and integrates equity principles, (4) take meaningful steps to ensure access for patients with limited English proficiency, (5) apply AI tools to make workplaces more efficient and reduce administrative burdens, (6) require human oversight of AI tools used in...

Building Bridges Toward Common Goals – A Call for Greater Collaboration Between Public Health and Integrative, Complementary and Traditional Health Providers

Fri, 11 Apr 2025 00:00:00 +0000

This commentary makes the case for greater collaboration between public health professionals and integrative, complementary and traditional health practitioners (ICTHP). Previous partnerships have been successful, and more such collaborative work is needed to help overcome division, enhance the health workforce, and move all involved toward shared goals. ICTHP providers may be uniquely able to work across ideological differences and engage individuals and communities who are less trusting of public health, including those who are vaccine hesitant. Diverse partnerships can be difficult to maintain, but the application of equitable processes may aid their success. In the face of highly complex public health challenges, partnerships with ICTHP are critical.

They Saw a Hearing: Democrats’ and Republicans’ Perceptions of and Responses to the Ford-Kavanaugh Hearings

Sat, 5 Apr 2025 00:00:00 +0000

In several highly publicized hearings, Dr. Christine Blasey Ford and Judge Brett Kavanaugh presented two opposing accounts of an alleged sexual assault. In the wake of these proceedings, partisans appeared similarly divided in how they regarded this political event. Using a U.S. national sample (N = 2,474) and a mixed-methods design, we investigated partisans' perceptions of, and responses to, the Ford-Kavanaugh hearings. Respondents reported their views of the hearings soon after they occurred. We used topic modeling to analyze these open-ended responses and found uniquely partisan topics emerged, including judicial impartiality and due process. Acute stress (AS) responses to the hearings were also related to partisan identities and perceptions; both Republicans (incidence rate ratio [IRR] = 0.81, 95% confidence interval [CI] = [0.78, 0.84]) and individuals who wrote more about Republican topics (IRR = 0.72, 95% CI = [0.56, 0.92]) reported lower AS than their Democratic...

Risk of sleep apnea associated with higher blood pressure among Chinese and Korean Americans

Thu, 3 Apr 2025 00:00:00 +0000

OBJECTIVE: This study examines associations between sleep apnea risk and hypertension in a sample of immigrant Chinese and Korean Americans. DESIGN: The dataset included Chinese and Korean patients ages 50-75 recruited from primary care physicians' offices from April 2018 to June 2020 in the Baltimore-Washington DC Metropolitan Area (n = 394). Hypertension risk was determined using a combination of blood pressure measurements, self-reported diagnosis of hypertension by a medical professional, and/or self-reported use of antihypertensive medications. Linear regression models examined the associations between sleep apnea risk and blood pressure (systolic blood pressure [SBP] and diastolic blood pressure [DBP]). Poisson regression models examined associations sleep apnea risk and hypertension. Models controlled for body mass index (BMI), demographic, and socioeconomic risk factors. We further examined models for potential effect modification by age, gender, Asian subgroup,...

Metabolic Signatures in Adipose Tissue Linking Lipophilic Persistent Organic Pollutant Mixtures to Blood Pressure Five Years After Bariatric Surgery Among Adolescents

Wed, 2 Apr 2025 00:00:00 +0000

Persistent organic pollutants (POPs) are lipophilic environmental contaminants accumulated in the adipose tissue. Weight loss interventions, such as bariatric surgery, can mobilize POPs from adipose tissue into the bloodstream. We hypothesized that this mobilization could contribute to increases in blood pressure among 57 adolescents with severe obesity undergoing bariatric surgery. POPs and metabolic features were measured from visceral adipose tissue collected during surgery using gas and liquid chromatography, coupled with high-resolution mass spectrometry. Blood pressure was assessed at baseline, 6 months, and 5 years post-surgery. We used quantile g-computation to estimate associations of POP mixtures with blood pressure changes. With one quartile increase in POP mixtures, systolic blood pressure (SBP) increased by 6.4% five years after bariatric surgery compared to baseline SBP [95% confidence interval (CI): 0.4%, 12.4%]. The meet-in-the-middle approach identified overlapping...

Exposure to per- and polyfluoroalkyl substances and alterations in plasma microRNA profiles in children

Fri, 21 Mar 2025 00:00:00 +0000

BACKGROUND: Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals that persist in the environment and can accumulate in humans, leading to adverse health effects. MicroRNAs (miRNAs) are emerging biomarkers that can advance the understanding of the mechanisms of PFAS effects on human health. However, little is known about the associations between PFAS exposures and miRNA alterations in humans. OBJECTIVE: To investigate associations between PFAS concentrations and miRNA levels in children. METHODS: Data from two distinct cohorts were utilized: 176 participants (average age 17.1 years; 75.6% female) from the Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) cohort in the United States, and 64 participants (average age 6.5 years, 39.1% female) from the Rhea study, a mother-child cohort in Greece. PFAS concentrations and miRNA levels were assessed in plasma samples from both studies. Associations between individual PFAS and plasma miRNA levels were examined...

Decision-Making Regarding Elective Child and Adolescent Vaccinations Among Native Hawaiian and Pacific Islander Parents in Orange County

Tue, 18 Mar 2025 00:00:00 +0000

Native Hawaiians and Pacific Islanders (NHPIs) in aggregate experience greater health burdens than non-Hispanic Whites, such as a higher incidence of cervical cancer and COVID-19. Given the importance of vaccinations in preventing and reducing the severity of diseases, such as the flu, cervical cancer, and COVID-19, the receipt of vaccines during childhood and adolescence is crucial. Therefore, this qualitative study aimed to explore the factors associated with NHPI parents' decisions regarding vaccinating their children with these elective vaccinations-that is, vaccinations not required for child care, preschool, or K-12 admissions in California but highly recommended. A total of 15 NHPI parents were recruited through a community-based organization. Semi-structured interviews explored parents' reasons for accepting or denying each vaccine for their child(ren). Results demonstrated variable acceptance of each vaccine, though consistent themes included protection and concerns over...

Telemedicine Implementation for Safety Net Populations: A Systematic Review

Tue, 18 Mar 2025 00:00:00 +0000

Background: Telemedicine systems were rapidly implemented in response to COVID-19. However, little is known about their effectiveness, acceptability, and sustainability for safety net populations. This study systematically reviewed primary care telemedicine implementation and effectiveness in safety net settings. Methods: We searched PubMed for peer-reviewed articles on telemedicine implementation from 2013 to 2021. The search was done between June and December 2021. Included articles focused on health care organizations that primarily serve low-income and/or rural populations in the United States. We screened 244 articles from an initial search of 343 articles and extracted and analyzed data from N = 45 articles. Results: Nine (20%) of 45 articles were randomized controlled trials. N = 22 reported findings for at least one marginalized group (i.e., racial/ethnic minority, 65 years+, limited English proficiency). Only n = 19...

Inhaled Aerosol Dosimetry: Models, Implications and Impact: Proceedings of the Conference

Tue, 25 Feb 2025 00:00:00 +0000

The fourth conference, “Inhaled Aerosol Dosimetry: Advances, Applications and Impacts on Risk Assessments and Therapeutics”, was also held at “The Arnold and Mabel Beckman Center of the National Academies of Sciences and Engineering”, Irvine, California, October 16-18, 2024. It attracted 66 attendees including graduate students from seven nations (USA, Germany, France, India, the Netherlands, Switzerland, and S. Korea) and 52 papers and posters were presented. There were two highlighted sessions, number 5 and 6 in the program, on in vitro aerosol exposures and exposure systems. Keynote/Overview papers were delivered by Dr. Annie Jarabek (U.S. EPA), Dr. Gunter Oberdorster (U of Rochester), Dr. Jesssica Murray (U.S. EPA), Dr. Roger McClellan (Toxicology and Risk Analysis), Dr. Ross Walenga (U.S. FDA), and Dr. Ron Wolff (RK Wolff Safety Consulting, Inc.). See abstracts AB 52, 03, 04, 34 & 39, 50, and 41 respectively for these presentations. There were three awards to students...

Improving Behavioral Healthcare Access Disparities by Training Providers in Disadvantaged Communities — Evidence of Strategy Effectiveness

Mon, 17 Feb 2025 00:00:00 +0000

BackgroundInadequate access to behavioral health services disproportionately impacts marginalized populations who live in disadvantaged areas. To reduce this gap, programs dedicated to optimizing behavioral health education and training must focus their efforts to enroll providers who practice in these disadvantaged areas.ObjectiveThe Train New Trainers (TNT) fellowship program aims to enhance behavioral health knowledge, skills, and attitudes of primary care providers (PCPs) who deliver care in disadvantaged communities. We evaluate the effectiveness of the TNT recruitment strategy and the use of scholarships for targeting and recruiting PCPs who practice in disadvantaged communities.DesignObservational study.ParticipantsTNT fellows from 2016 to 2023.Main MeasuresState/federal classifications of medically underserved counties were used to establish scholarship criteria. Area Deprivation Index (ADI) was utilized to provide criterion validity for the use of state/federal criteria...

Associations between perinatal risk and physical health in pre-adolescence in the Adolescent Brain Cognitive Development (ABCD) Study®: the unexpected relationship with sleep disruption

Mon, 17 Feb 2025 00:00:00 +0000

BackgroundTo investigate relationships among different physical health problems in a large, sociodemographically diverse sample of 9-to-10-year-old children and determine the extent to which perinatal health factors are associated with childhood physical health problems.MethodsA cross-sectional study was conducted utilizing the Adolescent Brain Cognitive Development℠ (ABCD) Study (n = 7613, ages 9-to-10-years-old) to determine the associations among multiple physical health factors (e.g., prenatal complications, current physical health problems). Logistic regression models controlling for age, sex, pubertal development, household income, caregiver education, race, and ethnicity evaluated relationships between perinatal factors and childhood physical health problems.ResultsThere were significant associations between perinatal and current physical health measures. Specifically, those who had experienced perinatal complications were more likely to have medical problems by 9-to-10...

Comparing imputation approaches for immigration status in ED visits: Implications for using electronic medical records

Mon, 17 Feb 2025 00:00:00 +0000

OBJECTIVE: This study aimed to compare imputation approaches to identify the likely undocumented patient population in electronic health record (EHRs). EHR are a promising source of information on undocumented immigrants' medical needs and care utilization, but there is no verified way to identify immigration status in the data. Different approaches to approximating immigration status in EHR introduce unique biases, which in turn has major implications on our understanding of undocumented immigrant patients. STUDY SETTING AND DESIGN: We used a dataset of all emergency department (ED) visits from 2016 to 2019 in the Los Angeles Department of Health Services (LADHS) merged across patient medical records, demographic data, and claims data. We included all ED visits from our patient groups of interest and limited to patients at or over the age of 18 years at the time of their ED visit and excluded empty encounter records (n = 1,106,086 ED encounters). DATA SOURCES AND ANALYTIC SAMPLE:...

Racial disparities in law enforcement/court-ordered psychiatric inpatient admissions after the 2008 recession: a test of the frustration–aggression–displacement hypothesis

Fri, 14 Feb 2025 00:00:00 +0000

BackgroundSocieties under duress may selectively increase the reporting of disordered persons from vulnerable communities to law enforcement. Mentally ill African American males reportedly are perceived as more threatening relative to females and other race/ethnicities. We examine whether law enforcement/court order-requested involuntary psychiatric hospitalizations increased among African American males shortly after ambient economic decline—a widely characterized population stressor.MethodsWe identified psychiatric inpatient admissions requested by law enforcement/court orders from 2006 to 2011 across four US states (Arizona, California, New York, North Carolina). Our analytic sample comprises 13.1 million psychiatric inpatient admissions across 95 counties over 72 months. We operationalized exposure to economic downturns as percent change in monthly employment in a metropolitan statistical area (MSA). We used zero inflated negative binomial and linear fixed effects regression...

Vanishing twins, selection in utero, and infant mortality in the United States

Sat, 1 Feb 2025 00:00:00 +0000

Background and Objectives: Research to identify fetal predictors of infant mortality among singletons born in the United States (US) concludes that poorly understood and unmeasured "confounders" produce a spurious association between fetal size and infant death. We argue that these confounders include Vanishing Twin Syndrome (VTS)-the clinical manifestation of selection against frail male twins in utero. We test our argument in 276 monthly conception cohorts conceived in the US from January 1995 through December 2017. Methodology: We use Box-Jenkins transfer function modeling to test the hypothesis that among infants born from 276 monthly conception cohorts conceived in the US from January 1995 through December 2017, the sex ratio of twins born in the 37th week of gestation will correlate inversely with infant mortality among singleton males born at the 40th week of gestation. Results: We find support for our hypothesis and infer that the contribution of survivors of VTS...

Emergency managers’ challenges with wildfires and related cascading hazards in California

Wed, 29 Jan 2025 00:00:00 +0000

This study investigates the complexities faced by emergency managers in wildfire-prone areas to uncover pressing issues and potential solutions. Four themes are discerned through three focus group discussions with emergency managers from nine counties across California. First, there is unequal access to resources for both risk assessment and response, with counties that have fewer resources facing significant challenges in effectively managing wildfire risks. Second, effective risk communication depends on the available resources and the unique characteristics of each community. Participants stress the need for improved communication tools to reach vulnerable groups (e.g., seniors, individuals with disabilities, non-English-speaking residents). Third, the complexity and confusion surrounding multi-level collaboration in wildfire management is a recurring theme. Participants note that unclear roles and responsibilities between state and federal agencies hinder response efforts,...

Addressing mental health aftershocks from the Turkey–Syria earthquake: a call to action

Wed, 29 Jan 2025 00:00:00 +0000

Addressing mental health aftershocks from the Turkey–Syria earthquake: a call to action

JAHA at Scientific Sessions 2023: Moving Toward Social Justice in Cardiovascular Health in the United States

Sat, 4 Jan 2025 00:00:00 +0000

Attention to social justice is essential to improving cardiovascular health outcomes. In the absence of social justice, equitable cardiovascular health is impossible. This viewpoint provides a brief synopsis of the 2023 Journal of the American Heart Association (JAHA)-sponsored session titled "Moving Towards Social Justice in Cardiovascular Health." We define social justice and summarize the burden of cardiovascular disease inequity in the United States. We also highlight strategies for achieving social justice, including addressing workforce diversity, integrating social determinants into cardiovascular research, designing cardiovascular interventions to close the equity gap, and improving inclusivity in cardiovascular disease trials.

Associations between language, telehealth, and clinical outcomes in patients with cancer during the COVID‐19 pandemic

Thu, 19 Dec 2024 00:00:00 +0000

BACKGROUND: The COVID-19 pandemic prompted a surge in telehealth utilization. However, language barriers have emerged as a potential obstacle to effective telemedicine engagement, impacting millions of limited English proficient (LEP) individuals. Understanding the role of language spoken in telehealth outcomes is critical, particularly in cancer care, in which consistent follow-up and communication are vital. The primary objective was to assess the impact of telehealth utilization and primary language spoken on clinical outcomes in cancer patients. METHODS: This study utilized a retrospective cohort design, encompassing cancer patients seen at the Chao Family Comprehensive Cancer Center between March 1, 2020, and December 31, 2022. The study incorporated both in-person and telehealth visits, examining the association between encounter type and clinical outcomes. RESULTS: The study included 7890 patients with more than one outpatient visit during the study period. There was decreased...

Casino-based cash transfers and fertility among the Eastern Band of Cherokee Indians in North Carolina: A time-series analysis

Thu, 5 Dec 2024 00:00:00 +0000

Fertility decline remains a key concern among high-income countries. Prior research indicates that income supplementation through unconditional cash transfers (UCT) may correspond with increased fertility. We examine whether a casino-based UCT, in the form of per capita (percap) payments to members of the Eastern Band of Cherokee Indians (EBCI) corresponds with an acute increase in fertility. We use North Carolina vital statistics datasets from 1990 to 2006 and apply time-series analysis methods to examine the relation between specific months of percap payments (exposure) and monthly number of conceptions that result in live births (outcome) among the EBCI. We control for autocorrelation and monthly counts of births (arrayed by conception cohorts) among white women (ineligible for UCT receipt) in the study region. Results indicate an increase in conceptions that result in live births at 1 and 3 months after percap receipt among EBCI women aged ≥20 years (exposure month lag 1 coefficient...

Prenatal Tobacco Exposure Associations With Physical Health and Neurodevelopment in the ABCD Cohort

Tue, 3 Dec 2024 00:00:00 +0000

OBJECTIVE: To investigate the strength and reproducibility of the teratogenic impact of prenatal tobacco exposure (PTE) on child physical health and neurodevelopmental outcomes, in the context of intersecting sociodemographic and other prenatal correlates, and test if early postnatal health mediates PTE associations with childhood outcomes. METHOD: Among 9-10-year-olds (N = 8,803) in the Adolescent Brain Cognitive Development Study, linear mixed-effect models tested PTE associations with birth and childhood outcomes of physical health, cognitive performance, and brain structure, controlling for confounding sociodemographic and prenatal health correlates. Mediation analysis tested the extent to which health at birth explained the associations between PTE and childhood outcomes. RESULTS: PTE was reported by 12% of mothers (8% [n = 738] pre-knowledge of pregnancy only, and 4% [n = 361] pre- and post-knowledge of pregnancy). PTE was highest for children with a...

Trends in anti‐diabetic medication use, severe hyperglycaemia and severe hypoglycaemia among American Indian and Alaska Native Peoples, 2009–2013

Tue, 3 Dec 2024 00:00:00 +0000

AIMS: Type 2 diabetes (T2D) and its complications disproportionally affect American Indian and Alaska Native (AI/AN) peoples. Prescribing decisions for anti-diabetic medications are complicated and require balancing medication benefits, costs and side effects. Little is known about trends in anti-diabetic medication use as well as acute diabetes complications among AI/AN adults. Here, we examined patterns and trends in anti-diabetic medication use and rates of hospital admissions or emergency department (ED) visits due to severe hypoglycaemia and hyperglycaemia among AI/AN adults with T2D. MATERIALS AND METHODS: We conducted a retrospective analysis of Indian Health Service (IHS) Improving Health Care Delivery Data Project. A total of 39 183 AI/AN adults aged ≥18 years with T2D who used IHS or Tribal health services during any of the fiscal years (FYs) 2009-2013 were included. Utilization rates of each class of anti-diabetic medications and rates of severe hypoglycaemia and severe...

Remote school instruction in Fall 2020 and psychiatric emergencies among adolescents in Los Angeles County

Mon, 2 Dec 2024 00:00:00 +0000

ObjectiveSchools play an essential role in providing mental health care for adolescents. School closures during COVID-19, as well as re-opening to remote-only instruction in Fall 2020, may indirectly affect the utilization of emergency psychiatric care. We examine COVID-19-related changes in emergency psychiatric care among youth during the school closure and after school reopening (with remote instruction).MethodsWe use Box-Jenkins interrupted time series methods to analyze psychiatric emergency department (ED) visits among patients 10–19 years at LAC + USC Medical Center (LAC + USC) between January 5th, 2018, and December 31st, 2020. We control for the 1st societal shutdown in LA County (i.e., the nine weeks from March 13 to May 14, 2020) when analyzing the potential “return to remote school” shock.ResultsYouth psychiatric ED visits fell by 15.3 per week during the Spring 2020 school closure (p < .05). The “return to remote school” coefficient (i.e., August 14th to September...

Longitudinal policy surveillance of state obesity legislation in California, 1999–2020

Thu, 21 Nov 2024 00:00:00 +0000

BackgroundObesity rates among children and adults continue to accelerate in the U.S., particularly among marginalized and low-income populations. Obesity prevention and reduction policies can significantly impact population health by improving environmental conditions and increasing access to health-promoting resources. Limited research has been conducted to examine state obesity policy change over time. The primary aim of this study is to examine legislative approaches used to prevent and reduce obesity in the state of California (U.S.).MethodsWe used quantitative policy surveillance methods to develop a state database of obesity-related legislation (bills, resolutions) introduced in California’s legislature between 1999 and 2020. Descriptive statistics were used to examine trends of introduced and enacted policy by legislative and policy characteristics. Chi-square tests were used to determine differences in characteristics between enacted and non-enacted legislation. Legislative...

Disparities in preterm birth following the July 1995 Chicago heat wave

Tue, 19 Nov 2024 00:00:00 +0000

PURPOSE: To evaluate if changes in preterm birth (PTB, <37 weeks of gestation) incidence differed between non-Hispanic (NH) Black and NH white births following the July 1995 Chicago heat wave-among the most severe U.S. heat waves since 1950. METHODS: We used an ecologic study design. We obtained birth data from January 1990-December 1996 from the National Vital Statistics File to calculate the mean monthly PTB incidence in Chicago's Cook County, Illinois. Births between July 1995 and February 1996 were potentially exposed to the heat wave in utero. We generated time series models for NH Black and NH white births, which incorporated synthetic controls of Cook County based on unexposed counties. We ran a secondary analysis considering socioeconomic status (SES). RESULTS: From 1990-1996, the mean monthly PTB incidence among NH Black births was 18.6% compared to 7.8% among NH white births. The mean monthly PTB incidence among NH Black births from August 1995-January 1996 was...

Workforce estimate to treat mental disorders in the Kingdom of Saudi Arabia

Mon, 11 Nov 2024 00:00:00 +0000

BackgroundMental, neurological, and substance abuse (MNS) disorders describe a range of conditions that affect the brain and cause distress or functional impairment. In the Middle East and North Africa (MENA), MNS disorders make up 10.88 percent of the burden of disease as measured in disability-adjusted life years. The Kingdom of Saudi Arabia (KSA) is one of the main providers of mental health services and one of the largest contributors to mental health research in the region. Within the past decade, mental health resources and services has increased.MethodsWe employ a needs-based workforce estimate as a planning exercise to arrive at the total number of psychiatrists, nurses, and psychosocial care providers needed to meet the epidemiological need of mental health conditions of the population of KSA. Estimates for a potential mental health workforce gap were calculated using five steps: Step 1—Quantify target population for priority mental health conditions. Step 2—Identify...

Differences in Smoking Behavior by Nativity, Race/Ethnicity, and Education among Women Diagnosed with Breast Cancer.

Mon, 11 Nov 2024 00:00:00 +0000

BACKGROUND: We evaluated smoking differences across nativity and race/ethnicity among women diagnosed with breast cancer. METHODS: In our Northern Californian pooled population of 5,653 [670 Asian, 690 Hispanic, and 4,300 non-Hispanic White (White)] women diagnosed with breast cancer, we evaluated smoking differences across nativity, race/ethnicity, and acculturation and effect modification of nativity by race/ethnicity and education. RESULTS: Foreign-born women currently smoked less than US-born women [odds ratio (OR) = 0.46, 95% confidence limit (CL): 0.29-0.72]. Hispanic (OR = 0.50; 95% CL: 0.32-0.78) women currently smoked less than White women. Among those who ever smoked (n = 2,557), foreign-born women smoked 5.23 fewer pack-years (PY) than US-born women (95% CL: -2.75 to -7.70). Furthermore, Asian (-4.60, 95% CL: -0.81 to -8.39) and Hispanic (-6.79, 95% CL: -4.14 to -9.43) women smoked fewer PY than White women. Associations were generally suggestive of greater smoking...

Trends in Substance Use Disorder–Related Emergency Department Visits in California: An Analysis of 46 Million Visits From 2006 to 2011

Sat, 9 Nov 2024 00:00:00 +0000

INTRODUCTION: To better understand the development of the growing opioid crisis in the early 21st century, the authors studied trends in substance use disorder among 46,132,211 emergency department (ED) visit discharges in California between 2006 and 2011. METHODS: Utilizing the California State Emergency Department Database, the authors identified substance use based on International Classification of Diseases, Ninth Revision codes. Tabular and multivariable analysis methods were applied. ED visits were considered clustered at the level of patient. RESULTS: The authors observed a notable increase in substance use prevalence from 7.32 ± 6.07 to 12.21 ± 9.35 per 1000 ED visits. Nonopioid substance use was more prevalent among individuals aged ≤ 50 years old. Opioid use disorder (OUD) was associated with a higher mortality rate in the ED. In 2011, OUD was significantly higher among American Indians visiting the ED. A multivariable analysis revealed that OUD was an independent predictor...

Intergenerational effects of a casino-funded family transfer program on educational outcomes in an American Indian community

Tue, 5 Nov 2024 00:00:00 +0000

Cash transfer policies have been widely discussed as mechanisms to curb intergenerational transmission of socioeconomic disadvantage. In this paper, we take advantage of a large casino-funded family transfer program introduced in a Southeastern American Indian Tribe to generate difference-in-difference estimates of the link between children’s cash transfer exposure and third grade math and reading test scores of their offspring. Here we show greater math (0.25 standard deviation [SD], p =.0148, 95% Confidence Interval [CI]: 0.05, 0.45) and reading (0.28 SD, p = .0066, 95% CI: 0.08, 0.49) scores among American Indian students whose mother was exposed ten years longer than other American Indian students to the cash transfer during her childhood (or relative to the non-American Indian student referent group). Exploratory analyses find that a mother’s decision to pursue higher education and delay fertility appears to explain some, but not all, of the relation between cash transfers...

HIV and hepatitis C virus infection and co-infection among trans women in San Francisco, 2020

Sat, 2 Nov 2024 00:00:00 +0000

BACKGROUND: Transgender women (hereafter "trans women") face social marginalization, stigma, and discrimination and experience a high burden of HIV. More recently, trans women have been identified as having a high risk for hepatitis C (HCV) infection. The interaction between these two diseases and the risks for HIV/HCV co-infection among trans women are understudied. OBJECTIVE: To characterize epidemiological, behavioral, and socio-structural interactions between HIV and HCV infections among trans women. METHODS: This cross-sectional study examined data from a community-based survey of trans women in San Francisco recruited through respondent-driven sampling (RDS) in 2019/2020. Face-to-face interviews collected data on demographics, medical history, drug injection practices, sexual behavior, and socio-structural factors (e.g., poverty, housing insecurity, incarceration, social support). HIV and HCV antibodies were detected using oral fluid rapid tests and prior diagnosis and treatment...

Social Determinants of Cardiovascular Health in Asian Americans: A Scientific Statement From the American Heart Association

Wed, 23 Oct 2024 00:00:00 +0000

To achieve cardiovascular health (CVH) equity in the United States, an understanding of the social and structural factors that contribute to differences and disparities in health is necessary. The Asian American population is the fastest-growing racial group in the United States but remains persistently underrepresented in health research. There is heterogeneity in how individual Asian American ethnic groups experience CVH and cardiovascular disease outcomes, with certain ethnic groups experiencing a higher burden of adverse social conditions, disproportionately high burden of suboptimal CVH, or excess adverse cardiovascular disease outcomes. In this scientific statement, upstream structural and social determinants that influence CVH in the Asian American population are highlighted, with particular emphasis on the role of social determinants of health across disaggregated Asian American ethnic groups. Key social determinants that operate in Asian American communities include socioeconomic...

HPV Vaccination Decision Among Catch-up Population Through a Digital Intervention: Empowering Young Adults to Their Own Health Decision-Making

Tue, 1 Oct 2024 00:00:00 +0000

Human papillomavirus (HPV) is the most common sexually transmitted infection on U.S. college campuses. Although HPV vaccination is recommended through age 26, current efforts to improve vaccination rates have predominantly focused on adolescents. Consequently, vaccine uptake remains suboptimal among young adults. This represents a significant missed opportunity, as young adults face the highest risk for new HPV infections. To contextualize the factors impacting decision-making process for this vulnerable population, this study reports key themes that emerged from in-depth interviews with participants (N = 30) who had completed an online intervention study for HPV vaccination among college students. Twelve (40%) of the interviewees vaccinated after exposure to the intervention. Findings centered around empowerment among young adults as the facilitator to get the HPV vaccine: key themes emerged were (1) convenience is critical and empowering; (2) adulthood identity, marked...

Proceedings from the 9th annual conference on the science of dissemination and implementation : Washington, DC, USA. 14-15 December 2016

Tue, 1 Oct 2024 00:00:00 +0000

Proceedings from the 9th annual conference on the science of dissemination and implementation : Washington, DC, USA. 14-15 December 2016

A multilevel intervention to promote HPV vaccination among young adults in Texas: protocol for a randomized controlled trial

Tue, 1 Oct 2024 00:00:00 +0000

BackgroundHuman papillomavirus (HPV) infections can cause cancers of the cervix, vagina, vulva, penis, anus, and oropharynx. The most recently approved HPV vaccine, Gardasil-9, protects against HPV infection and can prevent HPV-associated invasive cancers. However, Gardasil-9 is one of the most underused vaccines in the US today. Young adults are at risk for HPV infection, but many are not vaccinated. This study uses a randomized controlled trial (RCT) to test an innovative multilevel intervention to increase HPV vaccination rates among young adults. In this paper, we describe the research protocol.MethodsThe study uses a two by three factorial design. A total of 1200 young adults in Texas, age 18–26 years, who have not been previously fully vaccinated against HPV will be randomly assigned to one of six conditions to receive: (1) standard CDC information about HPV vaccination (control); (2) video narratives about HPV vaccination; (3) written narratives about HPV vaccination; or...

Vanishing twins, spared cohorts, and the birthweight of periviable infants born to Black and white women in the United States

Fri, 27 Sep 2024 00:00:00 +0000

Pregnancies ending before 26 weeks contribute 1% of births but 40% of infant deaths in the United States. The rate of these "periviable" births to non-Hispanic (NH) Black women exceeds four times that for NH whites. Small male periviable infants remain most likely to die. NH white periviable males weigh more than their NH Black counterparts. We argue that male infants born from twin gestations, in which one fetus died in utero (i.e., the vanishing twin syndrome), contribute to the disparity. We cannot directly test our argument because "vanishing" typically occurs before clinical recognition of pregnancy. We, however, describe and find associations that would emerge in vital statistics were our argument correct. Among male periviable singleton births from 288 monthly conception cohorts (January 1995 through December 2018), we found an average NH white advantage of 30 grams (759 grams versus 729 grams). Consistent with our argument, however, cohorts signaling relatively few survivors...

Anxious Activists? Examining Immigration Policy Threat, Political Engagement, and Anxiety among College Students with Different Self/Parental Immigration Statuses

Mon, 23 Sep 2024 00:00:00 +0000

Restrictive immigration policies harm the mental health of undocumented immigrants and their U.S. citizen family members. As a sociopolitical stressor, threat to family due to immigration policy can heighten anxiety, yet it is unclear whether political engagement helps immigrant-origin students to cope. We used a cross-sectional survey of college students from immigrant families (N = 2,511) to investigate whether anxiety symptomatology was associated with perceived threat to family and if political engagement moderated this relationship. We stratified analyses by self/parental immigration statuses-undocumented students, U.S. citizens with undocumented parents, and U.S. citizens with lawfully present parents-to examine family members' legal vulnerability. Family threat was significantly associated with anxiety; higher levels of political engagement reduced the strength of this relationship. However, this moderation effect was significant only for U.S. citizens with lawfully present...

Toilet construction under the Swachh Bharat Mission and infant mortality in India

Thu, 19 Sep 2024 00:00:00 +0000

Improvement of water and sanitation conditions may reduce infant mortality, particularly in countries like India where open defecation is highly prevalent. We conducted a quasi-experimental study to investigate the association between the Swachh Bharat Mission (SBM)—a national sanitation program initiated in 2014—and infant (IMR) and under five mortality rates (U5MR) in India. We analyzed data from thirty-five Indian states and 640 districts spanning 10 years (2011–2020), with IMR and U5MR per thousand live births as the outcomes. Our main exposure was the district-level annual percentage of households that received a constructed toilet under SBM. We mapped changes in IMR and U5MR and toilet access at the district level over time. We fit two-way fixed effects regression models controlling for sociodemographic, wealth, and healthcare-related confounders at the district-level to estimate the association between toilets constructed and child mortality. Toilet access and child...

The impact of prenatal alcohol and/or tobacco exposure on brain structure in a large sample of children from a South African birth cohort.

Fri, 6 Sep 2024 00:00:00 +0000

BACKGROUND: Neuroimaging studies have emphasized the impact of prenatal alcohol exposure (PAE) on brain development, traditionally in heavily exposed participants. However, less is known about how naturally occurring community patterns of PAE (including light to moderate exposure) affect brain development, particularly in consideration of commonly occurring concurrent impacts of prenatal tobacco exposure (PTE). METHODS: Three hundred thirty-two children (ages 8 to 12) living in South Africas Cape Flats townships underwent structural magnetic resonance imaging. During pregnancy, their mothers reported alcohol and tobacco use, which was used to evaluate PAE and PTE effects on their childrens brain structure. Analyses involved the main effects of PAE and PTE (and their interaction) and the effects of PAE and PTE quantity on cortical thickness, surface area, and volume. RESULTS: After false-discovery rate (FDR) correction, PAE was associated with thinner left parahippocampal cortices,...

Undocumented Latino Immigrants and the Latino Health Paradox

Mon, 5 Aug 2024 00:00:00 +0000

INTRODUCTION: Despite having worse healthcare access and other social disadvantages, immigrants have, on average, better health outcomes than U.S.-born individuals. For Latino immigrants, this is known as the Latino health paradox. It is unknown whether this phenomenon applies to undocumented immigrants. METHODS: This study used restricted California Health Interview Survey data from 2015 to 2020. Data were analyzed to test the relationships between citizenship/documentation status and physical and mental health among Latinos and U.S.-born Whites. Analyses were stratified by sex (male/female) and length of U.S. residence (<15 years/>= 15 years). RESULTS: Undocumented Latino immigrants had lower predicted probabilities of reporting any health condition, asthma, and serious psychological distress and had a higher probability of overweight/obesity than U.S.-born Whites. Despite having a higher probability of overweight/obesity, undocumented Latino immigrants did not have probabilities...

Increased AID results in mutations at the CRLF2 locus implicated in Latin American ALL health disparities

Fri, 2 Aug 2024 00:00:00 +0000

Activation-induced cytidine deaminase (AID) is a B cell-specific mutator required for antibody diversification. However, it is also implicated in the etiology of several B cell malignancies. Evaluating the AID-induced mutation load in patients at-risk for certain blood cancers is critical in assessing disease severity and treatment options. We have developed a digital PCR (dPCR) assay that allows us to quantify mutations resulting from AID modification or DNA double-strand break (DSB) formation and repair at sites known to be prone to DSBs. Implementation of this assay shows that increased AID levels in immature B cells increase genome instability at loci linked to chromosomal translocation formation. This includes the CRLF2 locus that is often involved in translocations associated with a subtype of acute lymphoblastic leukemia (ALL) that disproportionately affects Hispanics, particularly those with Latin American ancestry. Using dPCR, we characterize the CRLF2 locus in B cell-derived...

Lessons Learned from Immigrant Health Cohorts: A Review of the Evidence and Implications for Policy and Practice in Addressing Health Inequities among Asian Americans, Native Hawaiians, and Pacific Islanders

Wed, 31 Jul 2024 00:00:00 +0000

The health of Asian Americans, Native Hawaiians, and Pacific Islanders (AANHPI) is uniquely impacted by structural and social determinants of health (SSDH) shaped by immigration policies and colonization practices, patterns of settlement, and racism. These SSDH also create vast heterogeneity in disease risks across the AANHPI population, with some ethnic groups having high disease burden, often masked with aggregated data. Longitudinal cohort studies are an invaluable tool to identify risk factors of disease, and epidemiologic cohort studies among AANHPI populations have led to seminal discoveries of disease risk factors. This review summarizes the limited but growing literature, with a focus on SSDH factors, from seven longitudinal cohort studies with substantial AANHPI samples. We also discuss key information gaps and recommendations for the next generation of AANHPI cohorts, including oversampling AANHPI ethnic groups; measuring and innovating on measurements of SSDH; emphasizing...

2023 Inaugural Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium

Wed, 24 Jul 2024 00:00:00 +0000

Introduction: This article provides an overview of presentations and discussions from the inaugural Healthcare Delivery Science: Innovation and Partnerships for Health Equity Research (DESCIPHER) Symposium. Methods: The symposium brought together esteemed experts from various disciplines to explore models for translating evidence-based interventions into practice. Results: The symposium highlighted the importance of disruptive innovation in healthcare, the need for multi-stakeholder engagement, and the significance of family and community involvement in healthcare interventions. Conclusions: The article concluded with a call to action for advancing healthcare delivery science to achieve health equity.

Challenges to Engaging Women Veterans in Quality Improvement From Patient Care to Policy: Women's Health Managers' Perspectives

Wed, 17 Jul 2024 00:00:00 +0000

INTRODUCTION: Patients are uniquely positioned to identify issues and to provide innovative solutions to problems impacting their care. Yet, patient engagement in quality improvement (QI) and health care governance remains limited and underexplored. In the Veterans Health Administration, the work of women's health managers (WHMs) includes engaging women veterans, a numerical minority with unique health care needs, in QI. We aimed to understand the extent to which WHMs engage women veterans along a continuum, highlight challenges to engagement, and identify potential strategies to facilitate multilevel patient engagement. METHODS: Data were generated from a multisite evaluation to improve delivery of comprehensive women's health care in Veterans Health Administration primary care sites. We conducted 39 semistructured interviews with WHMs across 21 sites. Guided by Carman et al.'s patient engagement framework, we analyzed the interviews using rapid-qualitative and content analysis...

BEYOND STEREOTYPES AND CARICATURES

Wed, 17 Jul 2024 00:00:00 +0000

BEYOND STEREOTYPES AND CARICATURES

It matters what you see: Graphic media images of war and terror may amplify distress

Wed, 17 Jul 2024 00:00:00 +0000

Media exposure to graphic images of violence has proliferated in contemporary society, particularly with the advent of social media. Extensive exposure to media coverage immediately after the 9/11 attacks and the Boston Marathon bombings (BMB) was associated with more early traumatic stress symptoms; in fact, several hours of BMB-related daily media exposure was a stronger correlate of distress than being directly exposed to the bombings themselves. Researchers have replicated these findings across different traumatic events, extending this work to document that exposure to graphic images is independently and significantly associated with stress symptoms and poorer functioning. The media exposure-distress association also appears to be cyclical over time, with increased exposure predicting greater distress and greater distress predicting more media exposure following subsequent tragedies. The war in Israel and Gaza, which began on October 7, 2023, provides a current, real-time...

Managers' and Leaders’ Perceptions of Sexual and Gender-Based Public Harassment in the Veterans Health Administration

Wed, 17 Jul 2024 00:00:00 +0000

PURPOSE: Managers and leaders have a critical role to play in sexual and gender-based harassment prevention within organizations. Although the Veterans Health Administration has committed to eliminating harassment through national directives and training programs, it is unclear how aware local-level managers and leaders are about public harassment at their facilities and how they perceive sexual and gender-based harassment. We examined middle managers' and leaders' views about whether harassment is perceived as a problem locally, and what policies and procedures (if any) are in place to address public harassment. METHODS: We conducted 69 semistructured telephone interviews with middle managers and facility leaders before implementation of an evidence-based quality improvement project designed to improve delivery of comprehensive women's health care. Transcripts were coded using the constant comparative method and analyzed for overarching themes. RESULTS: Perceptions of the prevalence...

Structural racism, air pollution and the association with adverse birth outcomes in the United States: the value of examining intergenerational associations

Tue, 16 Jul 2024 00:00:00 +0000

Structurally racist policies and practices of the past are likely to be a driving factor in current day differences in exposure to air pollution and may contribute to observed racial and ethnic disparities in adverse birth outcomes in the United States (U.S.). Non-Hispanic Black women in the U.S. experience poorer health outcomes during pregnancy and throughout the life course compared to non-Hispanic White women. This disparity holds even among non-Hispanic Black women with higher socioeconomic status. Reasons for this finding remain unclear, but long-term environmental exposure, either historical exposure or both historical and ongoing exposure, may contribute. Structural racism likely contributes to differences in social and environmental exposures by race in the U.S. context, and these differences can affect health and wellbeing across multiple generations. In this paper, we briefly review current knowledge and recommendations on the study of race and structural racism in...

Association Between Repeated Exposure to Hurricanes and Mental Health in a Representative Sample of Florida Residents

Wed, 19 Jun 2024 00:00:00 +0000

Importance: During the past century, more than 100 catastrophic hurricanes have impacted the Florida coast; climate change will likely be associated with increases in the intensity of future storms. Despite these annual threats to residents, to our knowledge, no longitudinal studies of representative samples at risk of hurricane exposure have examined psychological outcomes associated with repeated exposure. Objective: To assess psychosocial and mental health outcomes and functional impairment associated with repeated hurricane exposure. Design, Setting, and Participants: In this survey study, a demographically representative sample of Florida residents was assessed in the 60 hours prior to Hurricane Irma (wave 1: September 8-11, 2017). A second survey was administered 1 month after Hurricane Irma (wave 2: October 12-29, 2017), and a third survey was administered after Hurricane Michael (wave 3: October 22 to November 6, 2018). Data were analyzed from July 19 to 23, 2021. Exposure:...

Contrasting Objective and Perceived Risk: Predicting COVID-19 Health Behaviors in a Nationally Representative U.S. Sample

Wed, 19 Jun 2024 00:00:00 +0000

BACKGROUND: Individuals confronting health threats may display an optimistic bias such that judgments of their risk for illness or death are unrealistically positive given their objective circumstances. PURPOSE: We explored optimistic bias for health risks using k-means clustering in the context of COVID-19. We identified risk profiles using subjective and objective indicators of severity and susceptibility risk for COVID-19. METHODS: Between 3/18/2020-4/18/2020, a national probability sample of 6,514 U.S. residents reported both their subjective risk perceptions (e.g., perceived likelihood of illness or death) and objective risk indices (e.g., age, weight, pre-existing conditions) of COVID-19-related susceptibility and severity, alongside other pandemic-related experiences. Six months later, a subsample (N = 5,661) completed a follow-up survey with questions about their frequency of engagement in recommended health protective behaviors (social distancing, mask wearing, risk behaviors,...

A sudden but prolonged collective trauma: The Ukrainian experience

Wed, 19 Jun 2024 00:00:00 +0000

A sudden but prolonged collective trauma: The Ukrainian experience

Chapter 4 Ethical Issues in Research with Human Subjects

Wed, 19 Jun 2024 00:00:00 +0000

Chapter 4 Ethical Issues in Research with Human Subjects

Responses to natural disasters

Wed, 19 Jun 2024 00:00:00 +0000

Responses to natural disasters

Economic downturns and male cesarean deliveries: a time-series test of the economic stress hypothesis

Mon, 17 Jun 2024 00:00:00 +0000

BackgroundIn light of the recent Great Recession, increasing attention has focused on the health consequences of economic downturns. The perinatal literature does not converge on whether ambient economic declines threaten the health of cohorts in gestation. We set out to test the economic stress hypothesis that the monthly count of cesarean deliveries (CD), which may gauge the level of fetal distress in a population, rises after the economy declines. We focus on male CD since the literature reports that male more than female fetuses appear sensitive to stressors in utero.MethodsWe tested our ecological hypothesis in California for 228 months from January 1989 to December 2007, the most recent data available to us at the time of our tests. We used as the independent variable the Bureau of Labor Statistics unadjusted total state employment series. Time-series methods controlled for patterns of male CD over time. We also adjusted for the monthly count of female CD, which controls...

State-Level Education Standards for Substance Use Prevention Programs in Schools: A Systematic Content Analysis

Mon, 17 Jun 2024 00:00:00 +0000

PURPOSE: Three fourths of public schools in the United States maintain instructional programs to discourage alcohol, tobacco, and other drug (ATOD) use. State-sanctioned instructional standards attempt to direct this ATOD preventive education. No existing research, however, systematically codes these standards across all grades and states. We performed such an analysis. METHODS: We retrieved ATOD standards information from all 50 states and the District of Columbia from multiple sources, including the National Association of State Boards of Education's State School Health Policy Web site. Three independent researchers classified and cross-validated ATOD standards (inter-rater agreement = 98%) based on recommended content domains and pedagogic delivery methods. RESULTS: We find substantial grade-level variation in standards. Elementary schools emphasize generic social skills and affective skills, whereas middle and high school standards focus on knowledge about biological and behavioral...

Biomarker-Based Calibration of Retrospective Exposure Predictions of Perfluorooctanoic Acid

Mon, 17 Jun 2024 00:00:00 +0000

Estimated historical exposures and serum concentrations of perfluorooctanoic acid (PFOA) have been extensively used in epidemiologic studies that examined associations between PFOA exposures and adverse health outcomes among residents in highly exposed areas in the Mid-Ohio Valley. Using measured serum PFOA levels in 2005-2006, we applied two calibration methods to these retrospective exposure predictions: (1) multiplicative calibration and (2) Bayesian pharmacokinetic calibration with larger adjustments to more recent exposure estimates and smaller adjustments to exposure estimates for years farther in the past. We conducted simulation studies of various hypothetical exposure scenarios and compared hypothetical true historical intake rates with estimates based on mis-specified baseline exposure and pharmacokinetic models to find the method with the least bias. The Bayesian method outperformed the multiplicative method if a change to bottled water consumption was not reported...

Depression, Suicidal Ideation, and Suicidal Attempt Presenting to the Emergency Department: Differences Between These Cohorts

Sun, 16 Jun 2024 00:00:00 +0000

INTRODUCTION: The World Health Organization estimates that one million people die by suicide every year. Few studies have looked at factors associated with disposition in patients with chief complaints of depression, suicidal ideation (SI) and suicidal attempts (SA) who present to the emergency department (ED). Our objective was to assess individual determinants associated with ED disposition of patients in depressed patients presenting to the ED. METHODS: We conducted a retrospective study using the National Hospital Ambulatory Medical Care Survey from 2006 to 2008. We used logistic regression to identify factors associated with discharge, in SI, SA and depression patients. Independent variables included socio-demographic information, vital signs, mode of arrival, insurance status, place of residence and concomitant psychiatric diagnosis. RESULTS: Of the 93,030 subjects, 2,314 met the inclusion criteria (1,362 depression, 353 SI and 599 SA). Patients who arrived by ambulance...

Travel patterns during pregnancy: comparison between Global Positioning System (GPS) tracking and questionnaire data

Sun, 16 Jun 2024 00:00:00 +0000

BackgroundMaternal exposures to traffic-related air pollution have been associated with adverse pregnancy outcomes. Exposures to traffic-related air pollutants are strongly influenced by time spent near traffic. However, little is known about women’s travel activities during pregnancy and whether questionnaire-based data can provide reliable information on travel patterns during pregnancy.ObjectivesExamine women’s in-vehicle travel behavior during pregnancy and examine the difference in travel data collected by questionnaire and global positioning system (GPS) and their potential for exposure error.MethodsWe measured work-related travel patterns in 56 pregnant women using a questionnaire and one-week GPS tracking three times during pregnancy (<20 weeks, 20–30 weeks, and >30 weeks of gestation). We compared self-reported activities with GPS-derived trip distance and duration, and examined potentially influential factors that may contribute to differences. We...

Proceedings from the 9th annual conference on the science of dissemination and implementation

Fri, 31 May 2024 00:00:00 +0000

Proceedings from the 9th annual conference on the science of dissemination and implementation

Latina/o/x undocumented college students’ perceived barriers and motivations for talking to a campus mental health professional: A focus on communication, culture, and structural barriers