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Zareba G, Harrington D, Scrimale T, Lesperance A, Watson GE, van Wijngaarden E, Shamlaye CF, Nicholas T, Myers GJ, Thurston SW. Relationship of mercury and selenium in ocean fish frequently consumed in the Seychelles: A comparison to levels in ocean fish consumed in the US. Neurotoxicology 2023; 99:34-42. [PMID: 37678724 PMCID: PMC10873038 DOI: 10.1016/j.neuro.2023.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 08/29/2023] [Accepted: 09/03/2023] [Indexed: 09/09/2023]
Abstract
We characterized mercury and selenium in the fish consumed in the Seychelles Islands to determine if their levels are similar to fish consumed in the US. A secondary aim was to examine whether fish weight and species predict mercury and selenium in fish consumed in the Seychelles. We measured total mercury (THg) and selenium (Se) content of 10 samples from each of the 19 most frequently consumed fish species in Seychelles and for each calculated the Se:Hg molar ratios and the Selenium Health Benefit Value Index (HBV Se). Linear regression models examined associations with weight and species. Average MeHg levels in fish ranged from less than 0.01 ppm (streamlined spinefoot) to 0.7 ppm (bludger trevally) with an overall mean of 0.21 ± 0.23 ppm. Average Se levels ranged from 0.34 ppm (blue-barred parrot fish) to 0.93 ppm (blue-lined large-eye bream) with a mean of 0.54 ± 0.23 ppm. All fish species had a mean Se:Hg molar ratio > 1 and positive mean HBV Se index values. Weight was strongly predictive of MeHg and Se:Hg molar ratio, both across and within most species, but was less predictive of Se and HBV Se. Our study demonstrated that fish consumed in Seychelles have mercury and selenium content similar to that of fish consumed in the US. Fish in both countries have favorable positive values for Se:Hg molar ratios and HBV Se indexes. Because mercury and selenium concentrations in fish are similar to those in the US but fish consumption is substantially higher in Seychelles, the Seychellois make an ideal population in which to determine if there are adverse effects of prenatal, postnatal, and lifetime low dose MeHg exposure from fish consumption.
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Affiliation(s)
- Grazyna Zareba
- Department of Environmental Medicine, University of Rochester, 601 Elmwood Avenue, Box EHSC, Rochester, NY 14642, USA
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester, 601 Elmwood Avenue, Box 630, Rochester, NY 14642, USA
| | - Tom Scrimale
- Department of Environmental Medicine, University of Rochester, 601 Elmwood Avenue, Box EHSC, Rochester, NY 14642, USA
| | - Aubrey Lesperance
- Seychelles Fishing Authority (SFA), Fishing Port, Victoria P.O. Box 449, Mahé, Seychelles
| | - Gene E Watson
- Department of Environmental Medicine, University of Rochester, 601 Elmwood Avenue, Box EHSC, Rochester, NY 14642, USA; Eastman Institute for Oral Health, and Department of Pharmacology and Physiology, University of Rochester, 601 Elmwood Avenue, Box 705, Rochester, NY 14642, USA
| | - Edwin van Wijngaarden
- Department of Environmental Medicine, University of Rochester, 601 Elmwood Avenue, Box EHSC, Rochester, NY 14642, USA; Department of Public Health Sciences; University of Rochester Medical Center, Rochester, NY, USA
| | - Conrad F Shamlaye
- Republic of Seychelles Ministry of Health and Social Services, Victoria, Mahé, Seychelles
| | - Tyler Nicholas
- Department of Environmental Medicine, University of Rochester, 601 Elmwood Avenue, Box EHSC, Rochester, NY 14642, USA
| | - Gary J Myers
- Department of Environmental Medicine, University of Rochester, 601 Elmwood Avenue, Box EHSC, Rochester, NY 14642, USA; Department of Public Health Sciences; University of Rochester Medical Center, Rochester, NY, USA; Department of Pediatrics, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA; Department of Neurology, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
| | - Sally W Thurston
- Department of Environmental Medicine, University of Rochester, 601 Elmwood Avenue, Box EHSC, Rochester, NY 14642, USA; Department of Biostatistics and Computational Biology, University of Rochester, 601 Elmwood Avenue, Box 630, Rochester, NY 14642, USA.
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Cerulli C, Missell-Gray R, Harrington D, Thurston SW, Quinlan K, Jones KR, Cross WF. A Randomized Control Trial to Test Dissemination of an Online Suicide Prevention Training For Intimate Partner Violence Hotline Workers. J Fam Violence 2023:1-14. [PMID: 37358978 PMCID: PMC10039335 DOI: 10.1007/s10896-023-00533-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/16/2023] [Indexed: 06/28/2023]
Abstract
Purpose Suicide risk is higher among violence-involved individuals. Intimate Partner Violence hotline workers are a critical source of support and can potentially be suicide prevention champions. Our primary goal was to examine the effectiveness of disseminating a free, online IPV-Suicide Prevention curriculum, via a randomized control trial, to hotline workers in ten states with the highest suicide and IPV homicide rates. Method We divided the country into five regions and, based on criterion, chose two states in each region to randomize into the two arms of the study. We examined training participation and engagement between the two approaches: (1) 'dissemination as usual' (control) using a National Domestic Violence Hotline email and a postcard to state/county IPV directors, versus (2) 'enhanced dissemination' (intervention) using a four-point touch method (postcard, phone call, email, and letter) to 'drive' participation. Results Participation increased in the intervention arm as approaches became more personal (i.e., email and phone calls vs. letters). Results indicate that traditional dissemination strategies such as email announcements and invitations are not as effective as varied and multiple touchpoints for IPV hotline staff. Conclusion Successful dissemination strategies to promote digital training should consider the value added by personalized connection. Future research is needed to understand how to offer effective and efficient web-based training to those providing IPV and child abuse services.
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Affiliation(s)
- Catherine Cerulli
- University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642 USA
- Susan B. Anthony Center, University of Rochester, Rochester, NY USA
| | - Rachel Missell-Gray
- University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642 USA
| | - Donald Harrington
- University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642 USA
| | - Sally W. Thurston
- University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642 USA
| | | | | | - Wendi F. Cross
- University of Rochester Medical Center, 300 Crittenden Blvd., Rochester, NY 14642 USA
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Hufham J, Aversano J, Doleshal M, Harrington D. PP01.02 Molecular Recurrence Risk Profiles in Patients with Early-Stage NSCLC: Current Standard of Care Compared to a Prognostic and Predictive 14-gene Expression Assay. J Thorac Oncol 2023. [DOI: 10.1016/j.jtho.2022.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Orlando MS, Love T, Harrington D, Dziorny AC, Shamlaye CF, Watson GE, van Wijngaarden E, Davidson PW, Myers GJ. The association of auditory function measures with low-level methylmercury from oceanic fish consumption and mercury vapor from amalgam: The Seychelles Child Development Study Nutrition 1 Cohort. Neurotoxicology 2023; 95:46-55. [PMID: 36621469 PMCID: PMC9998349 DOI: 10.1016/j.neuro.2022.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 12/21/2022] [Accepted: 12/29/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Some authors have reported that low-level exposure to methylmercury (MeHg) adversely impacts measures of auditory function. These reports, however, are not consistent in their findings. Consequently, we examined auditory function in a population exposed to low-level methylmercury (MeHg) exposure from fish consumption and to mercury vapor (Hg0) from dental amalgams. We analyzed their associations with the participants hearing acuity, absolute and interwave ABR latencies, and otoacoustic emissions (distortion product/DPOAE and click evoked/CEOAE). DESIGN We administered an audiometry test battery to 246 participants from the Seychelles Child Development Study (SCDS) Nutrition Cohort 1 (NC1) at 9 years of age. The test battery included standard pure-tone audiometry, tympanometry, Auditory Brainstem Responses (ABR) and Distortion Product and Click Evoked Otoacoustic Emissions (DPOAE and CEOAE) testing. We measured prenatal MeHg exposure in maternal hair and postnatal MeHg in children's hair. We approximated prenatal Hg0 exposure using maternal amalgam surface area and postnatal Hg0 using children amalgam surface area. Complete exposure records and audiometric data were available on 210 participants and in them we analyzed the association of MeHg and Hg0 exposures with auditory outcomes using covariate-adjusted linear regression models adjusted for sex and tympanometric pressure. RESULTS Hg exposures were similar for both sexes. Seven of the 210 evaluable participants examined had either a mild (5) or moderate (2) hearing loss. Four had a mild monaural hearing loss and 3 had either a mild (1) or moderate (2) bilateral hearing loss. No participant had greater than a moderate hearing loss in either ear. Hg exposures were higher in participants with either a mild or moderate hearing loss, but these differences were not statistically significant. Among the 210 with complete data, neither prenatal nor postnatal MeHg nor Hg0 exposure was statistically significantly associated with any of the ABR endpoints (p > 0.05 for all 72 associations). Neither prenatal nor postnatal Hg0 exposure was associated with any of the OAE endpoints (p > 0.05). MeHg exposure was statistically associated with 6 of the 56 DPOAE endpoints (p-values between 0.0001 and 0.023), but none of the 40 CEOAE endpoints. Two of the associations occurred with prenatal MeHg exposures and 1 of those would suggest a beneficial effect. Four of the other associations occurred with postnatal MeHg exposures with only 2 found in left ears of both males and females and the other 2 in the left and right ear of females at only one frequency. CONCLUSION Overall, these data do not present a clear and consistent pattern to suggest that the auditory system is negatively affected by low-level methylmercury exposure due to dietary consumption of oceanic fish or mercury vapor exposure from dental amalgams.
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Affiliation(s)
- Mark S Orlando
- Department of Otolaryngology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA.
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Adam C Dziorny
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Biomedical Engineering, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA
| | | | - Gene E Watson
- Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Pharmacology and Physiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Edwin van Wijngaarden
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Eastman Institute for Oral Health, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Community Health and Prevention, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Philip W Davidson
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA
| | - Gary J Myers
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA; Department of Neurology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY 14642, USA
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Thurston SW, Harrington D, Mruzek DW, Shamlaye C, Myers GJ, van Wijngaarden E. Development of a long-term time-weighted exposure metric that accounts for missing data in the Seychelles Child Development Study. Neurotoxicology 2022; 92:49-60. [PMID: 35868427 PMCID: PMC9749919 DOI: 10.1016/j.neuro.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 07/09/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
In many studies of the health effects of toxicants, exposure is measured once even though exposure may be continuous. However, some studies collect repeated measurements on participants over an extended time with the goal of determining a long-term metric that captures the average or cumulative exposure. This can be challenging, especially when exposure is measured at irregular intervals and has some missing values. Here we describe a method for determining a measure of long-term exposure using data on postnatal mercury (Hg) from the Seychelles Child Development Study (SCDS) Main Cohort as a model. In this cohort (n = 779), we incorporate postnatal Hg values that were measured on most study participants at seven ages, three between 6 months and 5.5 years ("childhood"), and an additional four between 17 and 24 years ("early adulthood"). We develop time-weighted measures of average exposure during the childhood and the early adulthood periods and compare the strengths and weaknesses of our metric to two standard measures: overall average and cumulative exposure. We account for missing values through an imputation method that uses information about age- and sex-specific Hg means and the participant's Hg values at similar ages to estimate subject-specific missing Hg values. We compare our method to the implicit imputation assumed by these two standard methods, and to Fully Conditional Specification (FCS), an alternative method of imputing missing data. To determine the accuracy of our imputation method we use data from participants with no missing Hg values in the relevant time window. The imputed values from our proposed method are substantially closer to the observed values on average than the average or cumulative exposure, while also performing slightly better than FCS. In conclusion, time-weighted long-term exposure appears to offer advantages over cumulative exposure in longitudinal studies with repeated measures where the follow-up period for a toxicant is similar for all participants. Additionally, our method to impute missing values maximizes the number of participants for whom the overall exposure metric can be calculated and should provide a more accurate long-term exposure metric than standard methods when exposure has missing values. Our method is applicable to any study of long-term toxicant effects when longitudinal exposure measurements are available but have missing values.
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Affiliation(s)
- Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Box 630, Rochester, NY 14642, United States; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States.
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Box 630, Rochester, NY 14642, United States
| | - Daniel W Mruzek
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, United States
| | | | - Gary J Myers
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States; Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, United States; Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Edwin van Wijngaarden
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
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Thurston SW, Myers G, Mruzek D, Harrington D, Adams H, Shamlaye C, van Wijngaarden E. Associations between time-weighted postnatal methylmercury exposure from fish consumption and neurodevelopmental outcomes through 24 years of age in the Seychelles Child Development Study Main Cohort. Neurotoxicology 2022; 91:234-244. [PMID: 35643326 PMCID: PMC9749799 DOI: 10.1016/j.neuro.2022.05.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/20/2022] [Accepted: 05/20/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE Methylmercury (MeHg) is a known neurodevelopmental toxicant in sufficient dosage and is universally found in fish. Current fish advisories for children are based on epidemiology studies examining prenatal exposure with a premise that MeHg exposure resulting from children eating fish could also be neurotoxic and have long-term consequences. However, the evidence that this assumption is true is limited. We investigated postnatal MeHg exposure from regular fish consumption using time weighted Hg measurements to determine if there are neurotoxic consequences. METHODS We examined 85 neurodevelopmental outcomes measured from ages 9-24 years in the Seychelles Child Development Study Main Cohort (n = 312-550) and examined their association with time-weighted measures of postnatal MeHg exposure in childhood and early adulthood. Postnatal MeHg exposure measured in the first cm of participants' hair samples collected at seven evaluations were used to create two time-weighted (TW) average MeHg exposure metrics, one for childhood (TW-C) and the other for early adulthood (TW-A). TW-C was based on Hg measures at three ages between 6 months and 5.5 years, and TW-A was based on Hg measured at up to four ages between 17 and 24 years. We examined the association between each of these exposure metrics and the neurodevelopmental outcomes using linear regression with adjustment for covariates known to influence neurodevelopmental outcomes. RESULTS There were 14 statistically significant associations between a postnatal metric and an endpoint. Six were associated with the TW-C and eight with the TW-A. Thirteen were adverse. Only the TW-C association at 9 years with the Bender Gestalt error score showed improvement. TW-C was adversely associated at 9 years with the Continuous Performance Task risk score, at 22 years with the Boston Naming Test (BNT) total and no cues scores, and at 24 years with the Test of Variables of Attention (TOVA) auditory response time variability and visual response time mean on the logarithmic scale. TW-A was adversely associated at 17 years with the Wisconsin Card Sorting Test % total errors, the Woodcock-Johnson passage comprehension, and the CANTAB rapid visual information processing false alarms, and at 22 years with the BNT total and no cue scores, the CANTAB rapid visual information processing false alarms and the intra-extra dimensional shift total errors and trials. CONCLUSION These findings suggest that postnatal MeHg exposure may be adversely associated with neurodevelopmental outcomes in early adulthood. However, the associations are statistical and of unknown, if any, clinical significance. The results need confirmation in other cohorts.
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Affiliation(s)
- Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Box 630, Rochester, NY 14642, United States; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States.
| | - Gary Myers
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States; Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, United States; Department of Neurology, University of Rochester Medical Center, Rochester, NY, United States
| | - Daniel Mruzek
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, United States
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Box 630, Rochester, NY 14642, United States
| | - Heather Adams
- Department of Pediatrics, University of Rochester Medical Center, Rochester, NY, United States
| | | | - Edwin van Wijngaarden
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, United States; Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, United States
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Gould MS, Pisani A, Gallo C, Ertefaie A, Harrington D, Kelberman C, Green S. Crisis text-line interventions: Evaluation of texters' perceptions of effectiveness. Suicide Life Threat Behav 2022; 52:583-595. [PMID: 35599358 PMCID: PMC9322288 DOI: 10.1111/sltb.12873] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Accepted: 04/27/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Crisis Text Line (CTL), the largest provider of text-based crisis intervention services in the U.S., has answered nearly 7 million conversations since its inception in 2013. The study's objective was to assess texter's perceptions of the effectiveness of CTL crisis interventions. METHOD Survey data completed by 85,877 texters linked to volunteer crisis counselor (CC) reports from October 12, 2017, to October 11, 2018 were analyzed. The relationship of several effectiveness measures with texters' demographic and psychosocial characteristics, frequency of CTL usage, and texters' perceptions of engagement with their CCs was examined using a series of logistic regression analyses. RESULTS By the end of the text-based conversation, nearly 90% of suicidal texters reported that the conversation was helpful, and nearly half reported being less suicidal. CONCLUSIONS Our study offers evidence for CTL's perceived effectiveness. These findings are of critical importance in light of the launch of a nationwide three-digit number (988) for suicide prevention and mental health crisis supports in the U.S., which will include texting.
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Affiliation(s)
- Madelyn S. Gould
- Department of PsychiatryColumbia UniversityNew YorkNew YorkUSA,Department of EpidemiologyColumbia UniversityNew YorkNew YorkUSA
| | - Anthony Pisani
- Departments of Psychiatry and PediatricsCenter for the Study and Prevention of SuicideUniversity of Rochester MedicalRochesterNew YorkUSA
| | - Carlos Gallo
- Department of Psychiatry and Behavioral ScienceNorthwestern UniversityChicagoIllinoisUSA
| | - Ashkan Ertefaie
- Department of Biostatistics and Computational BiologyUniversity of RochesterRochesterNew YorkUSA
| | - Donald Harrington
- Department of Biostatistics and Computational BiologyUniversity of RochesterRochesterNew YorkUSA
| | - Caroline Kelberman
- Departments of Psychiatry and PediatricsCenter for the Study and Prevention of SuicideUniversity of Rochester MedicalRochesterNew YorkUSA
| | - Shannon Green
- Data and Research Team, Crisis Text LineNew YorkNew YorkUSA
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Pisani AR, Gould MS, Gallo C, Ertefaie A, Kelberman C, Harrington D, Weller D, Green S. Individuals who text crisis text line: Key characteristics and opportunities for suicide prevention. Suicide Life Threat Behav 2022; 52:567-582. [PMID: 35615898 PMCID: PMC9324113 DOI: 10.1111/sltb.12872] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 04/27/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Text-based crisis services are increasingly prominent, with inclusion in the national 988 crisis number launching in 2022. Yet little is known about who uses them. This study seeks to understand the population served by Crisis Text Line (CTL), the largest crisis text service in the United States. METHODS Secondary data analysis was conducted on de-identified Crisis Counselor reports, texter post-conversation survey responses, and anonymized text conversation data from 85,877 texters who contacted CTL during a 12-month period. We examined Crisis Counselor's ratings of suicide ideation severity, texters' reports of race, gender, sexual orientation, recent mental health symptoms, and additional sources of help, and logs of frequency of contact. RESULTS 76% of texters were under 25. 79% were female. 48% identified as other than heterosexual/straight. 64% had only one conversation. 79% were above the clinical cutoff for depression and 80% for anxiety, while 23% had thoughts of suicide. 23% received help from a doctor or therapist, and 28% received help only from CTL. CONCLUSIONS CTL reaches a highly distressed, young, mostly female population, including typically underserved minorities and a substantial percentage of individuals who do not receive help elsewhere. These findings support the decision to include texting in the forthcoming national 988 implementation.
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Affiliation(s)
- Anthony R. Pisani
- Department of Psychiatry, Center for the Study and Prevention of SuicideUniversity of RochesterRochesterNew YorkUSA
| | - Madelyn S. Gould
- Department of PsychiatryColumbia UniversityNew YorkNew YorkUSA,Department of EpidemiologyColumbia UniversityNew YorkNew YorkUSA
| | - Carlos Gallo
- Department of Psychiatry and Behavioral ScienceNorthwestern UniversityChicagoIllinoisUSA
| | - Ashkan Ertefaie
- Department of Biostatics and Computational BiologyUniversity of RochesterRochesterNew YorkUSA
| | - Caroline Kelberman
- Department of Psychiatry, Center for the Study and Prevention of SuicideUniversity of RochesterRochesterNew YorkUSA
| | - Donald Harrington
- Department of Biostatics and Computational BiologyUniversity of RochesterRochesterNew YorkUSA
| | - Daniel Weller
- Department of Biostatics and Computational BiologyUniversity of RochesterRochesterNew YorkUSA
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Martin S, Searl T, Ohlander S, Harrington D, Stupp S, McVary K, Podlasek C. Sonic hedgehog signaling in corpora cavernosal cells from prostatectomy, diabetic, hypertension and Peyronie's patients with erectile dysfunction. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.03.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Martin S, Searl T, Ohlander S, Harrington D, Stupp S, McVary K, Podlasek C. Sonic Hedgehog Signaling in Corpora Cavernosal Cells from Prostatectomy, Diabetic, Hypertension and Peyronie's Patients with Erectile Dysfunction. J Sex Med 2022. [DOI: 10.1016/j.jsxm.2022.01.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Rhee H, Love T, Wicks MN, Tumiel-Berhalter L, Sloand E, Harrington D, Walters L. Long-term Effectiveness of a Peer-Led Asthma Self-management Program on Asthma Outcomes in Adolescents Living in Urban Areas: A Randomized Clinical Trial. JAMA Netw Open 2021; 4:e2137492. [PMID: 34874404 PMCID: PMC8652603 DOI: 10.1001/jamanetworkopen.2021.37492] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
IMPORTANCE Long-term effectiveness of a peer-led asthma self-management program in improving asthma outcomes in adolescents living in urban areas has not been established. OBJECTIVE To determine the long-term effects of a peer-led program on asthma control, quality of life, and asthma management among predominantly racial and ethnic minority adolescents living in urban areas. DESIGN, SETTING, AND PARTICIPANTS A parallel-group, randomized clinical trial was conducted in 2015 to 2019 in 3 metropolitan cities in the US: Buffalo, New York; Baltimore, Maryland; and Memphis, Tennessee. Adolescents aged 12 to 17 years old with persistent asthma were recruited mainly through clinical practices and schools. Participants were followed-up for 15 months after the intervention. Double-blinding was achieved for baseline. Data analysis was performed from June 2019 to June 2020. INTERVENTIONS The intervention group received a peer-led asthma self-management program; the control group received the identical program led by adult health care professionals. Peer leaders made follow-up contacts every other month for 12 months. MAIN OUTCOMES AND MEASURES The primary outcome was quality of life measured by the Pediatric Asthma Quality of Life Questionnaire, which consists of 3 subscales that measure symptoms (10 items), activity limitations (5 items), and emotional functioning (8 items) in the past 2 weeks. Each item was measured on a 7-point scale, with higher mean scores indicating better quality of life. Secondary measures included the Asthma Control Questionnaire and an asthma self-management index capturing steps to prevent and manage symptoms, self-efficacy, and lung function. RESULTS Of 395 eligible adolescents, 35 refused, 38 did not show or were lost to contact, and 2 withdrew before randomization; 320 adolescents participated (mean [SD] age, 14.3 [1.71] years), including 168 boys (52.5%), 251 Black or African American adolescents (78.4%), and 232 adolescents (72.5%) with public health insurance. Of 320 enrolled, 303 were included in the longitudinal analysis. Response rates were 80% or higher at all time points. The peer-led group had greater improvement in outcomes than the adult-led group, with adjusted mean differences (AMDs) between baseline and 15 months of 0.75 vs 0.37 for quality of life (between-group AMD, 0.38; 95% CI, 0.07 to 0.63) and -0.59 vs -0.31 for asthma control (between-group AMD, -0.28; 95% CI, -0.51 to -0.01). Outcomes were not affected by bimonthly contact doses. CONCLUSIONS AND RELEVANCE In this randomized clinical trial, a peer-led asthma self-management education was more effective than an adult-led program in improving asthma outcomes, with the improvements sustained for up to 15 months. These findings suggest that a peer-led asthma self-management program should be considered in addressing the disproportionate asthma burden in racial and ethnic minority adolescents living in urban communities. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02293499.
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Affiliation(s)
- Hyekyun Rhee
- School of Nursing, University of Rochester, Rochester, New York
- Now with School of Nursing, University of Texas at Austin, Austin
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Mona N. Wicks
- College of Nursing, University of Tennessee Health Science Center, Memphis
| | - Laurene Tumiel-Berhalter
- Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo
| | - Elizabeth Sloand
- School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Leanne Walters
- Department of Social Work, Roberts Wesleyan College, Rochester, New York
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Watson GE, Myers GJ, Thurston SW, Harrington D, Shamlaye CF, Strain JJ, Davidson PW, van Wijngaarden E. Neurodevelopmental outcomes in young children exposed to dental amalgam. Ann Epidemiol 2021. [DOI: 10.1016/j.annepidem.2021.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Bamuya C, Correia JC, Brady EM, Beran D, Harrington D, Damasceno A, Crampin AM, Magaia A, Levitt N, Davies MJ, Hadjiconstantinou M. Use of the socio-ecological model to explore factors that influence the implementation of a diabetes structured education programme (EXTEND project) inLilongwe, Malawi and Maputo, Mozambique: a qualitative study. BMC Public Health 2021; 21:1355. [PMID: 34238258 PMCID: PMC8268266 DOI: 10.1186/s12889-021-11338-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diabetes Self-Management Education and Support (DSMES) programmes are vital for type 2 diabetes mellitus (T2DM) management. However, they are limited in Sub-Saharan Africa (SSA). To address this gap, a DSMES, namedEXTEND was developed in Lilongwe (Malawi) and Maputo (Mozambique). This qualitative study aimed to explore factors that influence the implementation of DSMES in these settings. METHODS The Socio-ecological model was applied to explore factors influencing the implementation of DSMES in SSA. Data was analysed using the Framework method and constant comparative techniques. Sixty-six people participated in the study: people with T2DM who participated in the EXTEND programme; healthcare professionals (HCPs), EXTEND educators, EXTEND trainers, and stakeholders. RESULTS Our findings indicate that there is a need to develop an integrated and dedicated diabetes services in SSA healthcare systems, incorporating culturally adapted DSMES and tailored diabetes training to all professions involved in diabetes management. Traditional media and the involvement of community leaders were proposed as important elements to help engage and promote DSMES programmes in local communities. During the design and implementation of DSMES, it is important to consider individual and societal barriers to self-care. CONCLUSION Findings from this study suggest that multi-faceted factors play a significant role to the implementation of DSMES programmes in LICs. In the future, EXTEND could be incorporated in the development of diabetes training and dedicated diabetes services in SSA healthcare systems, acting as an educational tool for both people with T2DM and HCPs. This project was supported by the Medical Research Council GCRF NCDs Foundation Awards 2016 Development Pathway Funding.
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Affiliation(s)
- C Bamuya
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - J C Correia
- Unit of Patient Education, Division of Endocrinology, Diabetology, Nutrition and Patient Education, WHO Collaborating Center, Department of Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - E M Brady
- University Hospitals of Leicester NHS Trust, Leicester Diabetes Centre, Leicester, UK
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
| | - D Beran
- Division of Tropical and Humanitarian Medicine, Faculty of Medicine, University of Geneva and Geneva University Hospitals, Geneva, Switzerland
| | - D Harrington
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
- Psychological Sciences and Health, University of Strathclyde, Glasgow, Scotland
| | - A Damasceno
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - A M Crampin
- Malawi Epidemiology and Intervention Research Unit, Lilongwe, Malawi
| | - Ana Magaia
- Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| | - Naomi Levitt
- The University of Cape Town, Cape Town, South Africa
| | - M J Davies
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK
| | - M Hadjiconstantinou
- Diabetes Research Centre, College of Life Sciences, University of Leicester, Leicester, UK.
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Rhee H, Love T, Harrington D, Walters L, Mammen J, Sloand E. Long-term effects of a peer-led asthma self-management program on asthma outcomes in adolescent peer leaders. Patient Educ Couns 2021; 104:1415-1422. [PMID: 33339656 PMCID: PMC8164959 DOI: 10.1016/j.pec.2020.11.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 11/27/2020] [Accepted: 11/29/2020] [Indexed: 05/09/2023]
Abstract
OBJECTIVE To examine the long-term effects of a peer-led asthma self-management program on urban adolescent peer leaders with asthma. METHODS This longitudinal study includes 51 adolescents (16-20 years) enrolled in an asthma self-management program implemented at a one-day camp as peer leaders. Study outcomes, including quality of life, asthma control, asthma knowledge, and attitudes toward asthma were collected for 15 months post-intervention. Mixed-effects models were conducted to estimate time effects, and effect sizes were calculated for each model. RESULTS Of 51 enrolled, 41 completed the training, of which 35 successfully participated in the camp program. A total of 17 peer leaders withdrew between enrollment and 15-months follow-up. Quality of life, asthma control, and knowledge significantly improved after peer leader training and remained elevated for 15 months, while significant improvement in attitudes emerged immediately after camp, in which they served as leaders, and sustained for 15 months. CONCLUSION This study demonstrates the long-term positive effects of a peer-led program on a wide range of asthma outcomes in urban adolescent peer leaders. PRACTICE IMPLICATIONS A peer-led approach to asthma education providing peer leaders with intense training and leadership experience can be effective and sustainable in improving asthma outcomes among urban adolescents.
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Affiliation(s)
- Hyekyun Rhee
- University of Rochester School of Nursing, 601 Elmwood Ave, Box SON, Rochester, NY, 14642, USA.
| | - Tanzy Love
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, 601 Elmwood Ave, Box 630, Rochester, NY, 14642, USA.
| | - Donald Harrington
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, 601 Elmwood Ave, Box 630, Rochester, NY, 14642, USA.
| | - Leanne Walters
- University of Rochester School of Nursing, 601 Elmwood Ave, Box SON, Rochester, NY, 14642, USA.
| | - Jennifer Mammen
- University of Rhode Island College of Nursing, 350 Eddy St., Providence, RI, 02905, USA.
| | - Elizabeth Sloand
- Johns Hopkins University School of Nursing, 525 N. Wolfe Street, Baltimore, MD, 21205, USA.
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Hoeger KM, Harrington D, Thurston S, Bush NR, Sathyanarayana S, Nguyen RHN, Collett BR, Day DB, Swan SH, Barrett ES. Mother’s PCOS Diagnosis Is Not Associated With Behavioral Symptoms in Offspring at 4-5 years. J Endocr Soc 2021. [PMCID: PMC8089845 DOI: 10.1210/jendso/bvab048.1509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Variation in prenatal sex steroid concentrations has been linked to child behavioral problems, with higher maternal total and free testosterone associated with child internalizing and externalizing symptoms. Polycystic Ovary Syndrome (PCOS) is a hyperandrogenic disorder that results in elevated testosterone levels during pregnancy among affected women. Population-based analyses suggest a higher risk of depression and anxiety diagnosis in children of women with PCOS. Animal models of prenatal hyperandrogenism further support an association with increased anxiety in offspring. Within the context of a multi-center U.S. pregnancy cohort, we examined early childhood behavioral and social responsiveness in children born to mothers with and without PCOS. Methods: Pregnant women were recruited in their first trimester for The Infant Development and Environment Study (TIDES). PCOS status was determined by maternal reports of PCOS diagnosis or history of hirsutism/oligomenorrhea. Women who reported neither a history of PCOS or symptoms of hirsutism or oligomenorrhea served as a comparison group. When participating children were age 4, mothers completed the Behavioral Assessment System for Children, 2nd Edition (BASC-2), a measure of child behavior problems, and the Social Responsiveness Scale, 2nd Edition (SRS-2), a measure of social impairment consistent with autistic traits. We fit linear regression models considering three outcomes: (1) BASC-2 externalizing composite score (e.g., hyperactivity, aggression); (2) BASC internalizing composite score (e.g., anxiety, depression, somatization); and (3) SRS-2 total score, adjusting for covariates, maternal age, child age, race, study center, income, education, alcohol and tobacco use, child sex, maternal depression. For all outcomes, higher scores indicate more problematic behaviors. Results: A total of 360 mother/child pairs completed the 4-year assessment and were included in this analysis. This included 81 mothers with PCOS (37 male, 44 female) and 279 comparison mothers (132 male, 147 female). Mean maternal age at delivery was 30.7 years (±4.7) for PCOS cases and 31.9 years (±5.4) for comparison mothers. Interaction terms indicated no effect modification by child sex. In analyses combining both sexes, maternal PCOS was not associated with externalizing behaviors (β=1.81; 95% CI: ‐2.37, 6.0; p=0.40), internalizing behaviors (β=2.20; 95% CI: ‐2.14, 6.53; p=0.32), or social impairment (β=-0.34; 95% CI: ‐3.34, 2.65; p=0.82). Conclusions: In this prospective evaluation, we observed no association between maternal PCOS and neurobehavioral symptoms in children at age 4. Given that prior literature using population databases suggested increased behavioral symptoms in school-aged and older children of PCOS mothers, these symptoms may become more apparent with development and continued assessment is warranted.
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Affiliation(s)
| | | | | | - Nicole R Bush
- University of California San Francisco, San Francisco, CA, USA
| | | | - Ruby H N Nguyen
- University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Brent R Collett
- Seattle Children’s Research Institute, University of Washington, Seattle, WA, USA
| | - Drew B Day
- Seattle Children’s Research Institute, Seattle, WA, USA
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Riordan S, Doleshal M, Orck J, Harrington D. P07.05 Characterization of Clinicopathologic Features and Molecular Recurrence Risk Profiles in Patients with Early-Stage NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Martin S, Searl T, Ohlander S, Harrington D, Stupp S, McVary K, Podlasek C. 084 Sonic Hedgehog Signaling in Corporal Cavernosal Cells from Prostatectomy, Diabetic, Hypertension and Peyronie's Patients with ED. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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18
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Elhassan MMO, Ali AM, Kehlet AB, Ali OHA, Harrington D. The Response of Broiler Chicks to Dietary Supplementation with a Probiotic, Acidifiers Blend, and Their Combination. Braz J Poult Sci 2021. [DOI: 10.1590/1806-9061-2021-1511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - AM Ali
- King Faisal University, Saudi Arabia
| | | | - OHA Ali
- University of Khartoum, Sudan
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McSorley EM, van Wijngaarden E, Yeates AJ, Spence T, Mulhern MS, Harrington D, Thurston SW, Love T, Jusko TA, Allsopp PJ, Conway MC, Davidson PW, Myers GJ, Watson GE, Shamlaye CF, Strain JJ. Methylmercury and long chain polyunsaturated fatty acids are associated with immune dysregulation in young adults from the Seychelles child development study. Environ Res 2020; 183:109072. [PMID: 32007747 PMCID: PMC7213642 DOI: 10.1016/j.envres.2019.109072] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/20/2019] [Accepted: 12/20/2019] [Indexed: 05/07/2023]
Abstract
BACKGROUND Exposure to the environmental toxicant mercury (Hg) has been associated with immune dysregulation, including autoimmune disease, but few human studies have examined methylmercury (MeHg) exposure from fish consumption. OBJECTIVES We examined associations between MeHg exposure and biological markers of autoimmunity and inflammation while adjusting for long chain polyunsaturated fatty acids (LCPUFA). METHOD At age 19 years, hair total Hg (Y19Hg), LCPUFA status, a panel of 13 antinuclear antibodies (ANA), total serum immunoglobulins (Ig) IgG, IgA, and IgM and serum markers of inflammation (IL-1, IL-2, IL-6, IL-10, C-reactive protein (CRP), IFN-γ, TNF-α) were measured in the Seychelles Child Development Study (SCDS) Main Cohort (n = 497). Multivariable regression models investigated the association between Y19Hg and biomarkers, adjusting for prenatal total hair Hg (MatHg) and other relevant covariates, and with and without adjustment for LCPUFA. RESULTS With each 1 ppm increase in Y19Hg (mean 10.23 (SD 6.02) ppm) we observed a 4% increased odds in a positive Combined ANA following adjustment for the n6:n3 LCPUFA ratio (β = 0.036, 95%; CI: 0.001, 0.073). IgM was negatively associated with Y19Hg (β = -0.016, 95%CI: 0.016, -0.002) in models adjusted for n-3, n-6 LCPUFA and when separately adjusted for the n-6:n-3 LCPUFA ratio. No associations were observed with MatHg. Total n-3 LCPUFA status was associated with reduced odds of a positive anti-ribonuclear protein (RNP) A. The n-3 LCPUFA were negatively associated with IL-6, IL-10, CRP, IFN-γ, TNF-α and positively with TNF-α:IL-10. There were positive associations between the n-6:n-3 ratio and IL-6, IL-10, CRP, IFN-γ, TNF-α and a negative association with TNF-α:IL-10. DISCUSSION The Y19Hg exposure was associated with higher ANA and lower IgM albeit only following adjustment for the n-3 LCPUFA or the n-6:n-3 LCPUFA ratio. The clinical significance of these findings is unclear, but warrant follow up at an older age to determine any relationship to the onset of autoimmune disease.
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Affiliation(s)
- Emeir M McSorley
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom.
| | | | - Alison J Yeates
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Toni Spence
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Maria S Mulhern
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Donald Harrington
- The School of Medicine and Dentistry, University of Rochester, NY, United States
| | - Sally W Thurston
- The School of Medicine and Dentistry, University of Rochester, NY, United States
| | - Tanzy Love
- The School of Medicine and Dentistry, University of Rochester, NY, United States
| | - Todd A Jusko
- The School of Medicine and Dentistry, University of Rochester, NY, United States
| | - Philip J Allsopp
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Marie C Conway
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Philip W Davidson
- The School of Medicine and Dentistry, University of Rochester, NY, United States
| | - Gary J Myers
- The School of Medicine and Dentistry, University of Rochester, NY, United States
| | - Gene E Watson
- The School of Medicine and Dentistry, University of Rochester, NY, United States
| | | | - J J Strain
- The Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, United Kingdom
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20
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O'Donoghue JL, Watson GE, Brewer R, Zareba G, Eto K, Takahashi H, Marumoto M, Love T, Harrington D, Myers GJ. Neuropathology associated with exposure to different concentrations and species of mercury: A review of autopsy cases and the literature. Neurotoxicology 2020; 78:88-98. [PMID: 32092311 DOI: 10.1016/j.neuro.2020.02.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 02/16/2020] [Accepted: 02/21/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Human exposure to mercury (Hg) is widespread and both organic and inorganic Hg are routinely found in the human brain. Millions of people are exposed to methyl Hg (MeHg) due to the consumption of fish and to inorganic Hg from dental amalgams, small scale gold mining operations, use of Hg containing products, or their occupations. Neuropathology information associated with exposures to different species of Hg is primarily based on case reports of single individuals or collections of case studies involving a single species of Hg at toxic exposure levels such as occurred in Japan and Iraq. METHODS/RESULTS This study brings together information on the neuropathological findings and deposition of Hg in the central nervous system of people exposed to different species of Hg at varying concentrations. The low dose exposures were lifetime exposures while the high dose exposures were generally acute or short term by different exposure routes with survival lasting various lengths of time. Total and inorganic Hg deposits were identified in formalin-fixed, paraffin embedded tissues from both low and high exposure Hg cases. Low concentration exposures were studied in adult brains from Rochester, New York (n = 4) and the Republic of Seychelles (n = 17). Rochester specimens had mean total Hg concentrations of 16-18 ppb in the calcarine, rolandic, and cerebellar cortices. Inorganic Hg averaged between 5-6 ppb or 30-37% for the cerebral and cerebellar cortices of the Rochester subjects. Total Hg was approximately 10-fold higher in specimens from Seychelles, where consumption of ocean fish is high and consequently results in exposure to MeHg. The predominant Hg species was MeHg in both the Rochester and Seychelles brain specimens. Histologically, cerebral and cerebellar cortices from Rochester and Seychelles specimens were indistinguishable. High concentration exposures were studied in brains from four adults who were autopsied at variable time periods after exposure to organic Hg (methyl or dimethyl) or inorganic Hg (inhaled vapor or intravenous injection of metallic Hg). In contrast to the Seychellois adults, these individuals had acute or subacute exposures to lethal or significantly higher concentrations. The pattern of Hg deposition differed between subjects with high organic Hg exposure and high inorganic Hg exposure. In the organic Hg cases, glia (astrocytes and microglia) and endothelial cells accumulated more Hg than neurons and there were minimal Hg deposits in cerebellar granule and Purkinje cells, anterior horn motor neurons, and neocortical pyramidal neurons. In the inorganic Hg cases, Hg was seen predominantly in neurons, vascular walls, brainstem, and cerebellar and cerebral deep gray nuclei. The presence of inorganic Hg in neural and neural supporting cells in the four high exposure Hg cases was not closely correlated with cellular pathology; particularly in the inorganic Hg cases. CONCLUSIONS Different Hg species are associated with differing neuropathological patterns. No neuropathological abnormalities were present in the brains of either Rochester or Seychelles residents despite substantial differences in dietary MeHg exposure. Increasing concentrations of inorganic Hg were present in the brain of relatively low exposure subjects with increasing age.
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Affiliation(s)
- John L O'Donoghue
- Department of Environmental Medicine, University of Rochester Medical Center, School of Medicine and Dentistry, Box EHSC, 601 Elmwood Ave, Rochester, NY 14642, United States.
| | - Gene E Watson
- Department of Environmental Medicine, University of Rochester Medical Center, School of Medicine and Dentistry, Box EHSC, 601 Elmwood Ave, Rochester, NY 14642, United States; Eastman Institute for Oral Health and Department of Pharmacology and Physiology, University of Rochester Medical Center, School of Medicine and Dentistry, Box 683, 601 Elmwood Ave, Rochester, NY, 14642, United States
| | - Rubell Brewer
- Victoria Hospital and the Ministry of Health, Seychelles
| | - Grazyna Zareba
- Department of Environmental Medicine, University of Rochester Medical Center, School of Medicine and Dentistry, Box EHSC, 601 Elmwood Ave, Rochester, NY 14642, United States
| | - Komyo Eto
- Formerly Director General, National Institute for Minamata Disease, Ministry of the Environment, 4058-18, Hama, Minamata City, Kumamoto Prefecture, 867-0008, Japan
| | - Hitoshi Takahashi
- Department of Pathology, Brain Research Institute, Niigata University, 1-757 Asahimachi, Chuo-ku, Niigata, 951-8585, Japan
| | - Masumi Marumoto
- Toxicologic Pathology Section, Department of Basic Medical Sciences, National Institute for Minamata Disease, Ministry of the Environment, 4058-18, Hama, Minamata City, Kumamoto Prefecture, 867-0008, Japan
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, School of Medicine and Dentistry, Box 630, 601 Elmwood Ave, Rochester, NY, 14642, United States
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, School of Medicine and Dentistry, Box 630, 601 Elmwood Ave, Rochester, NY, 14642, United States
| | - Gary J Myers
- Department of Environmental Medicine, University of Rochester Medical Center, School of Medicine and Dentistry, Box EHSC, 601 Elmwood Ave, Rochester, NY 14642, United States; Department of Neurology, Child Neurology, University of Rochester Medical Center, School of Medicine and Dentistry, Box 631, 601 Elmwood Avenue, Rochester, NY 14642, United States; Department of Pediatrics, University of Rochester Medical Center, School of Medicine and Dentistry, Box 631, 601 Elmwood Ave, Rochester, NY, 14642, United States
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Orlando MS, Dziorny AC, Love T, Harrington D, Shamlaye CF, Watson G, van Wijngaarden E, Zareba G, Davidson PW, Mulhern MS, McSorley EM, Yeates AJ, Strain JJ, Myers GJ. Association of Audiometric Measures with plasma long chain polyunsaturated fatty acids in a high-fish eating population: The Seychelles Child Development Study. Neurotoxicology 2020; 77:137-144. [PMID: 31982419 DOI: 10.1016/j.neuro.2020.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 01/15/2020] [Accepted: 01/16/2020] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To determine if auditory function is associated with current long chain polyunsaturated fatty acids (LCPUFA) concentrations in a cohort of young adults who consume oceanic fish with naturally acquired methylmercury (MeHg). We measured participants plasma LCPUFA concentrations (total n-3, total n-6 and the n-6:n-3 ratio) and looked for an association with Auditory Brain Response (ABR) latencies and Otoacoustic Emissions (OAE) amplitudes. DESIGN Auditory function of 534 participants from the Seychelles Child Development Study (SCDS) main cohort was examined at 19 years of age. Tests included standard pure-tone audiometry, tympanometry, ABR and both Click-Evoked OAE (CEOAE) and Distortion-Product OAE (DPOAE). Associations of LCPUFA status, measured at the time of examination, and auditory outcomes were examined using covariate-adjusted linear regression models. All models were adjusted for sex, prenatal and current MeHg exposure and hearing status. RESULTS LCPUFA concentrations were similar for both sexes and when comparing participants with normal hearing (90.4 %) to those who had a sensorineural hearing loss in one or both ears (9.6 %). When looking at a subset of only hearing impaired participants, LCPUFA concentrations were similar in those participants who had a mild sensorineural hearing loss as compared with participants that had a moderate sensorineural hearing loss. LCPUFA concentrations were not correlated with current hair MeHg. LCPUFA concentrations were statistically significantly associated with only 6 of 174 ABR and OAE endpoints examined. Four of the 6 significant associations were present in only one sex. In female participants as n-6 concentrations increased, the ABR wave I absolute latency increased for a 60 dBnHL 19 click/sec stimulus. For male participants the interwave I-III latencies for a 60 dBnHL 69 clicks/sec stimulus increased as the n-6:n-3 LCPUFA ratio increased and the interwave I-V interval decreased for a 60 dBnHL 39 clicks/sec stimulus as the n-6 concentration increased. For both sexes interwave latencies were prolonged for the III-V interwave interval for an 80 dBnHL 39 clicks/sec as n-3 LCPUFA concentration increased. As the n-3 LCPUFA concentrations increased, the amplitude of the 6000 Hz DPOAE in the right ear increased for both sexes. As the n-6:n-3 ratio increased, the amplitude of the 1500 Hz DPOAE in the left ear decreased for females. The amplitude of the CEOAE was not associated with n-3, n-6 LCPUFA concentrations or the n-6:n-3 ratio. CONCLUSION There was no evidence to suggest LCPUFA status was associated with hearing acuity, ABR latencies or OAE amplitudes, even though our participants tended to have higher LCPUFA concentrations as compared to individuals consuming a more western diet. No association was observed between LCPUFA status and a participants hearing status (normal hearing or hearing loss). Although we found a few associations between current plasma LCPUFA status and ABR and OAE auditory endpoints examined, no clear pattern exists. Some of these associations would be considered detrimental resulting in prolonged ABR latencies or smaller OAE amplitudes, while others would be considered beneficial resulting in shortened ABR latencies or larger OAE amplitudes.
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Affiliation(s)
- Mark S Orlando
- Department of Otolaryngology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA.
| | - Adam C Dziorny
- Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | | | - Gene Watson
- Department of Dentistry, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Pharmacology and Physiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Edwin van Wijngaarden
- Department of Dentistry, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Grazyna Zareba
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Philip W Davidson
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Psychiatry, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
| | - Maria S Mulhern
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Cromore Road, Coleraine, BT52 1SA, Co. Londonderry, UK
| | - Emeir M McSorley
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Cromore Road, Coleraine, BT52 1SA, Co. Londonderry, UK
| | - Alison J Yeates
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Cromore Road, Coleraine, BT52 1SA, Co. Londonderry, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), Ulster University, Cromore Road, Coleraine, BT52 1SA, Co. Londonderry, UK
| | - Gary J Myers
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Pediatrics, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA; Department of Neurology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Ave, Rochester, NY, 14642, USA
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Rhee H, Love T, Harrington D, Walters L. Comparing Three Measures of Self-Efficacy of Asthma Self-Management in Adolescents. Acad Pediatr 2020; 20:983-990. [PMID: 32194214 PMCID: PMC7483287 DOI: 10.1016/j.acap.2020.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 03/06/2020] [Accepted: 03/08/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE This study examines the relationships between 3 measures of asthma-related self-efficacy and compares them by their relationships to quality of life, medication adherence, asthma control, asthma knowledge, and attitudes in adolescents. METHODS Participants included 371 urban adolescents (age 12-20 years) with asthma. Three self-efficacy measures included the Asthma Outcome Expectation-self-efficacy subscale (AOE-SE), Asthma Management Index-self-efficacy subscale (AMI-SE), and the Asthma Self-Efficacy scale (ASE). RESULTS The sample included 50% male, predominantly African American (78.4%) participants. All 3 measures of self-efficacy were positively correlated with each other (r = 0.46-0.54, P < .001). After controlling for gender, age, race, and health insurance type, all 3 self-efficacy measures predicted the symptom domain of quality of life, adherence, asthma control, and knowledge. Activity limitation was predicted by AMI-SE (B = 0.19, P = .008) and ASE (B = 0.38, P < .001) but not by AOE-SE, while emotional function associated only with ASE (B = 0.37, P < 0.001). Attitudes were positively associated with AOE-SE and ASE (B = 1.83 and 2.87, respectively, P < 0.001 for both), but not with AMI-SE. CONCLUSIONS Medication adherence and symptom control in adolescents were predicted by self-efficacy measured by the 3 measures, while these measures differed in their performance in predicting psychosocial outcomes. ASE appears the measure of choice in measuring adolescents' self-efficacy given its association with all outcome measures of the study. Further research is needed to investigate the generalized use of the self-efficacy measures in populations with varying demographic or asthma characteristics.
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Affiliation(s)
- Hyekyun Rhee
- University of Rochester School of Nursing (H Rhee and L Walters), Rochester, NY.
| | - Tanzy Love
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, 601 Elmwood Ave, Box 630, Rochester, NY14642, USA
| | - Donald Harrington
- University of Rochester Medical Center, Department of Biostatistics and Computational Biology, 601 Elmwood Ave, Box 630, Rochester, NY14642, USA
| | - Leanne Walters
- University of Rochester School of Nursing, 601 Elmwood Ave, Box SON, Rochester, NY 14642, USA
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Kalmanek E, Choe S, Harrington D, Stupp S, McVary K, Podlasek C. 172 Caspase Signalling in ED Patients and Animal Models. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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24
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Choe S, Kalmanek E, Harrington D, Stupp S, McVary K, Podlasek C. 174 Optimization of Sonic Hedgehog Delivery to the Penis from Self-assembling Nanofiber Hydrogels to Preserve Penile Morphology after Cavernous Nerve Injury. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2019.11.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rhee H, Love T, Groth SW, Grape A, Tumiel-Berhalter L, Harrington D. Associations between overweight and obesity and asthma outcomes in urban adolescents. J Asthma 2019; 57:1053-1062. [PMID: 31204534 DOI: 10.1080/02770903.2019.1633663] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Objective: To examine the prevalence of overweight and obesity in urban adolescents with asthma and to investigate the relationships between anthropometric measures and asthma outcomes including quality of life, asthma control and lung function.Methods: Adolescents with an asthma diagnosis, 12-20 years-old, were recruited from three urban communities in the United States. Spirometry and anthropometric data including height, weight and waist circumferences were collected along with questionnaire data measuring quality of life, asthma control, and medication adherence. Body mass index (BMI) and waist-height ratio (WHtR) were computed.Results: The sample (N = 294) included 48% female and 80% African American. About 50% of the sample were either overweight or obese, and 41% had central obesity. No significant gender interactions with either BMI or WHtR on asthma outcomes were found. Neither BMI nor WHtR predicted quality of life, asthma control or medication adherence, while females had poorer quality of life and asthma control regardless of weight status (p < 0.001). Higher BMI or WHtR predicted higher spirometry values. Regardless of weight status, females had greater percent predicted spirometry values, while raw values (L) were significantly greater in males.Conclusions: High BMI is a common comorbidity among poor, primarily African American, urban adolescents with asthma. The negative impact of being overweight or obese on quality of life or asthma control is yet to be manifested in adolescents. The findings underscore adolescence as an ideal period to safely intervene to reduce excessive body weight, which can prevent the potentially harmful effects of obesity on future asthma outcomes.
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Affiliation(s)
- Hyekyun Rhee
- School of Nursing, University of Rochester, Rochester, NY, USA
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Susan W Groth
- School of Nursing, University of Rochester, Rochester, NY, USA
| | - Annette Grape
- School of Social Work, The College at Brockport, Brockport, NY, USA
| | - Laurene Tumiel-Berhalter
- Department of Family Medicine, School of Medicine, State University of New York at Buffalo, Buffalo, NY, USA
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
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Dobbs R, Kalmanek E, Harrington D, Stupp S, McVary K, Podlasek C. 069 Sonic Hedgehog Regulation of Neurite Formation in Aged Pelvic Plexus. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Kalmanek E, Harrington D, Stupp S, McVary K, Podlasek C. 073 Bone Morphogenetic Protein 4 is Increased in Erectile Dysfunction Patients. J Sex Med 2019. [DOI: 10.1016/j.jsxm.2019.01.084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vidula H, Kutyifa V, Johnson BA, Strawderman RL, Harrington D, Polonsky B, Papernov A, Alexis JD. Readmission Patterns During Long-Term Follow-Up After Left Ventricular Assist Device Implantation. Am J Cardiol 2018; 122:1021-1027. [PMID: 30064855 DOI: 10.1016/j.amjcard.2018.05.037] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 05/21/2018] [Accepted: 05/21/2018] [Indexed: 01/06/2023]
Abstract
As more patients are supported for longer periods by a left ventricular assist device (LVAD), hospital readmission is becoming a growing problem. However, data about temporal changes in readmission rates and causes for patients with prolonged LVAD support are limited. We aimed to evaluate rates, causes, and predictors of any and long-term readmission after LVAD placement at our institution. We followed 177 HeartMate II LVAD patients for a mean of 1.90 ± 1.33 years post initial discharge after implantation. A marginal rate model was used to evaluate readmission rates, accounting for mortality. During the first year, the readmission rate was 1.79 (95% confidence interval 1.51 to 2.10) readmissions per year. The readmission rate was 1.54 (95% confidence interval 1.07 to 1.93) 2 to 3 years after initial discharge. There was a further decrease in readmission rate in the 3- to 4-year interval. The most common causes of readmission during the first year and even after 3 to 4 years of LVAD support were bleeding (excluding intracranial bleeding) and infection. Female gender was associated with an increased risk of readmission in multivariable analyses, while blood urea nitrogen was predictive of long-term readmissions. In conclusion, readmission after LVAD implantation is common, but readmission rates decrease during long-term follow-up. Bleeding and infection remain leading causes of readmission during longer follow-up and strategies to decrease these complications may reduce readmission rates. Female patients and patients with renal dysfunction have increased risk of readmission and further studies are needed to improve outcomes in these groups.
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Rhee H, Love T, Harrington D, Grape A. Common allergies in urban adolescents and their relationships with asthma control and healthcare utilization. Allergy Asthma Clin Immunol 2018; 14:33. [PMID: 30186335 PMCID: PMC6120086 DOI: 10.1186/s13223-018-0260-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Accepted: 04/28/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Urban adolescents suffer a disproportionate burden of asthma morbidity, often in association with allergies. Literature is limited on comparing various types of allergies regarding prevalence and associations with asthma morbidity in urban dwelling adolescents. The purpose of this study was to examine the prevalence of common allergies reported by urban adolescents and to assess their relationships to healthcare utilization and asthma control. METHODS Study participants included 313 urban adolescents (12-20 years of age) with persistent asthma who were recruited from three states in the United States. Self-report data were collected on nine indoor and outdoor allergies, healthcare utilization, and asthma exacerbation. Logistic regressions and zero-inflated Poisson regressions were conducted to examine the relationships between allergies and asthma morbidity. RESULTS The mean age of participants was 14.58 (± 1.97) and 52% were female, and 79% were black. Seventy-three percent (n = 229) reported one or more allergies. Dust mite and grass allergies were most common, each reported by 50%. The prevalence of pest allergies (cockroach and mouse) was 27.5% and 19%, respectively. Those with pest allergies were more likely to report ED visits (cockroach- Odds Ratio (OR) = 2.16, 95% CI 1.18-3.94, p = .01; mouse- OR = 2.13, 95% CI 1.09-4.07, p = .02), specialist visits (cockroach-OR = 2.69, 95% CI 1.60-4.54, p < .001; mouse- OR = 2.06, 95% CI 1.15-3.68, p = .01) and asthma exacerbation (cockroach-OR = 2.17, 95% CI 1.26-3.74, p < .001; mouse- OR = 2.30, 95% CI 1.26-4.18, p = .01). Cockroach allergies were associated with 2.2 times as many nights in the hospital (95% CI 1.053-3.398, p = 0.036) and 2.2 times as many specialist visits (95% CI 1.489-3.110, p < 0.001), and mouse allergy was associated with 1.6 times as many ED visits (95% CI 1.092-2.257, p = 0.015) compared to those without pest allergies. CONCLUSIONS Concomitant occurrence of allergies is ubiquitous among urban adolescents with asthma. Only pest allergies, of those examined, appear to have implications for poorly controlled asthma, exacerbation and acute healthcare utilization. To reduce asthma burden in urban adolescents, identification and management of high-risk adolescents with pest allergen sensitization and exposure are warranted.
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Affiliation(s)
- Hyekyun Rhee
- University of Rochester School of Nursing, 601 Elmwood Ave. Box SON, Rochester, NY 14642 USA
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 601 Elmwood Ave., Box 630, Rochester, NY 14642 USA
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, 601 Elmwood Ave., Box 630, Rochester, NY 14642 USA
| | - Annette Grape
- University of Rochester School of Nursing, 601 Elmwood Ave. Box SON, Rochester, NY 14642 USA
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Rhee H, Love T, Harrington D. Blood Neutrophil Count is Associated with Body Mass Index in Adolescents with Asthma. JSM Allergy Asthma 2018; 3:1019. [PMID: 30542672 PMCID: PMC6287916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Sputum neutrophils are associated with severe asthma, poor pulmonary function and high body mass index (BMI) in adult patients. However, little is known about the relationships between blood neutrophils, BMI and asthma severity in pediatric patients. This brief report is to assess the predictive value of blood neutrophils for asthma severity, BMI and pulmonary function in adolescents with asthma. METHODS The study included 166 adolescents with physician diagnosed asthma for at least 1 year. Participants were recruited from three metropolitan cities in the U.S. BMI-for-age percentile (BMI %) was determined by standardized charts and absolute neutrophil counts (cells/μL) were obtained from the complete blood count. Asthma severity was measured based on the national guidelines. Spirometry was performed to obtain percent predicted values for Forced Expiratory Volume in 1 second (FEV1), Forced Vital Capacity (FVC), and FEV1/FVC ratio as markers for pulmonary function. RESULTS The average age of participants was 14.79 years (± 1.86) and 54% were female. The majority (84%) were black. Fifty-five percent of the sample were either overweight (21%) or obese (34%). Blood neutrophil count was significantly correlated with BMI% (r=0.25, p=.001), but not with symptom severity (r=0.087, p=.268), FEV1 (r=-0.00, p=.937), or FVC (r=-0.010, p=.897).After controlling for sex, age, and age at asthma diagnosis, blood neutrophil count was a significant predictor for overweightness or obesity (OR=1.38, 95% CI 1.11, 1.75, p=0.01). CONCLUSIONS Elevated blood neutrophils are associated with higher BMI, but not lung function or symptom severity in our adolescent sample with asthma. This study suggests blood neutrophils may be a potential inflammatory biomarker for overweightness and obesity in adolescents with asthma, but not for asthma morbidity.
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Affiliation(s)
- Hyekyun Rhee
- School of Nursing, University of Rochester Medical Center, USA
| | - Tanzy Love
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, USA
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, USA
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Woolley A, Singh S, Mallidi H, Givertz M, Goldberg H, Mehra M, Coakley L, Kusztos A, Chen K, Fanikos J, Marty F, Harrington D, Camp P, Baden L. Transplanting Thoracic Organs from Hepatitis C Positive Donors to Hepatitis C Uninfected Recipients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Rhee H, Wicks MN, Dolgoff JS, Love TM, Harrington D. Cognitive factors predict medication adherence and asthma control in urban adolescents with asthma. Patient Prefer Adherence 2018; 12:929-937. [PMID: 29872278 PMCID: PMC5973469 DOI: 10.2147/ppa.s162925] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Adolescents with asthma often report poor medication adherence and asthma control. Cognitive factors embedded in the social cognitive theory including self-efficacy, outcome expectations, and barrier perceptions may explain poor asthma outcomes in this population. This study was performed to examine the extent to which these cognitive factors are intercorrelated and explain medication adherence and asthma control in urban adolescents. PATIENTS AND METHODS A total of 373 urban adolescents (12-20 years) with asthma completed questionnaires measuring asthma-related self-efficacy, outcome expectations, barrier perceptions, medication adherence, and asthma control. Multiple linear regression was conducted to examine the extent to which the three cognitive factors predicted medication adherence and asthma control after controlling for covariates including age, sex, household income, and age at diagnosis. RESULTS Participants' ages were on average 14.68 (±1.94) years; 50% were female, and most (78.6%) were African American. Higher self-efficacy associated with lower barrier perceptions and higher outcome expectations (r=0.50, p<0.001; r=-0.26, p<0.001, respectively). Self-efficacy predicted better asthma control (B=-0.098, p=0.004) and adherence (B=0.426, p=0.011), whereas barrier perceptions predicted poorer asthma control (B=0.13, p<0.001) and adherence (B=-0.568, p<0.001). Self-efficacy independently predicted fewer missed doses (B=-0.621, p=0.006), and barrier perception independently predicted asthma control (B=0.12, p<0.001) and adherence (B=-0.519, p<0.001). CONCLUSION Improving medication adherence and asthma control among adolescents may require a multifaceted approach. Interventions focused on increasing self-efficacy and addressing barriers, actual or potential, to medication adherence could ameliorate asthma disparities in urban adolescents.
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Affiliation(s)
- Hyekyun Rhee
- University of Rochester School of Nursing, Rochester, NY, USA
- Correspondence: Hyekyun Rhee, University of Rochester School of Nursing, 601 Elmwood Avenue, Box SON, Rochester, NY 14642, USA, Tel +1 585 276 3775, Fax +1 585 273 1270, Email
| | - Mona N Wicks
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Jennifer S Dolgoff
- College of Nursing, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Tanzy M Love
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA
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Rhee H, Love TM, Harrington D, Grape A. Comorbidity of atopy in urban adolescents with asthma. Ann Allergy Asthma Immunol 2017; 119:466-467. [PMID: 29150074 DOI: 10.1016/j.anai.2017.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 08/14/2017] [Accepted: 08/23/2017] [Indexed: 11/20/2022]
Affiliation(s)
- Hyekyun Rhee
- University of Rochester School of Nursing, Rochester, New York.
| | - Tanzy M Love
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, New York
| | - Annette Grape
- University of Rochester School of Nursing, Rochester, New York
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Lamberti JS, Weisman RL, Cerulli C, Williams GC, Jacobowitz DB, Mueser KT, Marks PD, Strawderman RL, Harrington D, Lamberti TA, Caine ED. A Randomized Controlled Trial of the Rochester Forensic Assertive Community Treatment Model. Psychiatr Serv 2017; 68:1016-1024. [PMID: 28566028 PMCID: PMC7369621 DOI: 10.1176/appi.ps.201600329] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Forensic assertive community treatment (FACT) is an adaptation of the assertive community treatment model and is designed to serve justice-involved adults with serious mental illness. This study compared the effectiveness of a standardized FACT model and enhanced treatment as usual in reducing jail and hospital use and in promoting engagement in outpatient mental health services. METHODS Seventy adults with psychotic disorders who were arrested for misdemeanor crimes and who were eligible for conditional discharge were recruited from the Monroe County, New York, court system. Participants were randomly assigned to receive either FACT (N=35) or enhanced treatment as usual (N=35) for one year. Criminal justice and mental health service utilization outcomes were measured by using state and county databases. RESULTS Forty-nine participants (70%) completed the full one-year intervention period. Nineteen (27%) were removed early by judicial order, one was removed by county health authorities, and one died of a medical illness. Intent-to-treat analysis for all 70 participants showed that those receiving the FACT intervention had fewer mean±SD convictions (.4±.7 versus .9±1.3, p=.023), fewer mean days in jail (21.5±25.9 versus 43.5±59.2, p=.025), fewer mean days in the hospital (4.4±15.1 versus 23.8±64.2, p=.025), and more mean days in outpatient mental health treatment (305.5±92.1 versus 169.4±139.6, p<.001) compared with participants who received treatment as usual. CONCLUSIONS The Rochester FACT model was associated with fewer convictions for new crimes, less time in jail and hospitals, and more time in outpatient treatment among justice-involved adults with psychotic disorders compared with treatment as usual.
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Affiliation(s)
- J Steven Lamberti
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Robert L Weisman
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Catherine Cerulli
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Geoffrey C Williams
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - David B Jacobowitz
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Kim T Mueser
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Patricia D Marks
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Robert L Strawderman
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Donald Harrington
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Tara A Lamberti
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
| | - Eric D Caine
- Dr. Lamberti, Dr. Weisman, Dr. Cerulli, Mr. Jacobowitz, and Dr. Caine are with the Department of Psychiatry, Dr. Williams is with the Department of Medicine and the Department of Clinical and Social Sciences in Psychology, Dr. Strawderman and Mr. Harrington are with the Department of Biostatistics and Computational Biology, and Ms. Lamberti is with the School of Nursing, all at the University of Rochester Medical Center, Rochester, New York. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Judge Marks (ret.) is with the Monroe County Courts, Rochester, New York
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Blackwell V, Holdaway L, Hogan J, Gilbert J, Sinha S, Vrakas G, Reddy S, Friend P, Mackillop L, Harrington D, Greenwood C, Vaidya A, Allan PJ. Multidisciplinary care ensures successful pregnancy following intestinal transplantation: a case report. BJOG 2016; 124:825-828. [PMID: 27885776 DOI: 10.1111/1471-0528.14420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2016] [Indexed: 11/29/2022]
Affiliation(s)
- V Blackwell
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - L Holdaway
- Oxford Transplant Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - J Hogan
- Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - J Gilbert
- Oxford Transplant Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - S Sinha
- Oxford Transplant Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - G Vrakas
- Oxford Transplant Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - S Reddy
- Oxford Transplant Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - P Friend
- Oxford Transplant Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - L Mackillop
- Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - D Harrington
- Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - C Greenwood
- Department of Obstetrics and Gynaecology, Women's Centre, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - A Vaidya
- Oxford Transplant Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
| | - P J Allan
- Translational Gastroenterology Unit, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, UK.,Oxford Transplant Centre, Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, UK
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van Wijngaarden E, Thurston SW, Myers GJ, Harrington D, Cory-Slechta DA, Strain JJ, Watson GE, Zareba G, Love T, Henderson J, Shamlaye CF, Davidson PW. Methyl mercury exposure and neurodevelopmental outcomes in the Seychelles Child Development Study Main cohort at age 22 and 24years. Neurotoxicol Teratol 2016; 59:35-42. [PMID: 27989696 DOI: 10.1016/j.ntt.2016.10.011] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 09/29/2016] [Accepted: 10/26/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND All fish contain methyl mercury (MeHg), a known neurotoxicant at adequate dosage. There is still substantial scientific uncertainty about the consequences, if any, of mothers consuming fish with naturally-acquired levels of MeHg contamination. In 1989-1990, we recruited the Main Cohort of the Seychelles Child Development Study to assess the potential developmental effects of prenatal MeHg exposure. We report here on associations with neurodevelopmental outcomes obtained at 22 and 24years of age. METHODS Neurodevelopmental tests at 22years included the Boston Naming Test, Cambridge Neuropsychological Test Automated Battery (CANTAB), and the Profile of Mood States. At 24years, we administered the Stroop Word-Color Test, the Barkley Adult ADHD Rating Scale, the Test of Variables of Attention, and the Finger Tapping test. We also administered a healthy behaviors survey at both ages. Primary analyses examined covariate-adjusted associations in multiple linear regression models with prenatal MeHg exposure. In secondary analyses we also examined associations with recent postnatal MeHg exposure. RESULTS We did not observe adverse associations between prenatal MeHg exposure and any of the measured endpoints. Some measures of attention, executive function, and delayed recall showed improved performance with increasing exposure. Secondary analysis did not show consistent patterns of association with postnatal exposure. CONCLUSIONS Our cohort has been examined at ten different ages over 24years of follow-up. Findings suggest that prenatal and recent postnatal MeHg exposure from ocean fish consumption is not adversely associated with neurobehavioral development at levels that are about ten times higher than typical U.S. exposures.
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Affiliation(s)
- Edwin van Wijngaarden
- University of Rochester School of Medicine and Dentistry, Rochester, NY, United States.
| | - Sally W Thurston
- University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Gary J Myers
- University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Donald Harrington
- University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | | | - J J Strain
- Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Gene E Watson
- University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Grazyna Zareba
- University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | - Tanzy Love
- University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
| | | | | | - Philip W Davidson
- University of Rochester School of Medicine and Dentistry, Rochester, NY, United States
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Vidula H, Kutyifa V, Johnson B, Harrington D, Papernov A, Alexis J. Readmission During Long-Term Follow-Up After Left Ventricular Assist Device Implantation. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Harrington D, Sims M, Kehlet A. Effect of Bacillus subtilis supplementation in low energy diets on broiler performance. J APPL POULTRY RES 2016. [DOI: 10.3382/japr/pfv057] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Orlando MS, Dziorny AC, Harrington D, Love T, Shamlaye CF, Watson GE, van Wijngaarden E, Davidson PW, Myers GJ. Associations between prenatal and recent postnatal methylmercury exposure and auditory function at age 19 years in the Seychelles Child Development Study. Neurotoxicol Teratol 2015; 46:68-76. [PMID: 25462959 DOI: 10.1016/j.ntt.2014.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 10/10/2014] [Accepted: 10/14/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of this study was to determine if prenatal or recent postnatal methylmercury (MeHg) exposure from consuming ocean fish and seafood is associated with auditory deficits in young adults. Some investigators have reported adverse associations while others have found no associations. Ocean fish is an important nutrient source for billions of people around the world. Consequently, determining if there is an adverse association with objective auditory measures is important in assessing whether a risk is present or not. DESIGN The peripheral and central auditory function of 534 subjects in the Seychelles Child Development Study (SCDS) Main Cohort was examined at age of 19 years. The auditory test battery included standard pure-tone audiometry, tympanometry, auditory brainstem response (ABR) latencies, and both click-evoked and distortion product otoacoustic emissions (OAE). Associations with MeHg were evaluated with multiple linear regression models, adjusting for sex, recent postnatal MeHg exposure, and hearing loss. RESULTS Bilateral hearing loss (defined as a mean pure-tone threshold of greater than 25 dB) was present in 1.1%of the subjects and was not associated with prenatal or recent postnatal MeHg exposure. As expected, absolute and interwave ABR latencies were shorter for women as compared to men, as the stimulus presentation rate decreased from 69.9 to 19.9 clicks/s and as the stimulus intensity increased from 60 to 80 dBnHL. Similarly, larger OAE amplitudes were elicited in women as compared to men and in the right ears as compared to the left. There was no association of prenatal MeHg exposure with hearing loss, ABR absolute and interwave latencies or OAE amplitudes. As recent postnatal MeHg increased, some associations were found with a few ABR absolute and interwave latencies and a few OAE amplitudes. However, the direction of these associations was inconsistent. As recent postnatal MeHg levels increased the wave I absolute latencies were shorter at 80 dBnHL for all three click rates, but the interwave I–V latency was longer for males for the 80 dBnHL 19 clicks/s and for the III–V interwave latencies for males and females for the dBnHL 69 clicks/s. Similarly, smaller OAE amplitudes were found at 1500, 2000, and 4000 Hz for males while larger OAE amplitudes were found for females at 1500 and 2000 Hz as the recent postnatal MeHg levels increased. CONCLUSIONS No consistent associations were present in this study between prenatal MeHg exposure from consumption of oceanic fish and seafood during pregnancy and auditory functions at 19 years of age. Given the level of prenatal exposure to MeHg, the number of audiologic measures tested, and the presence of the expected sex, click rate, and level dependent findings, it seems unlikely that an association was present and not detected. As recent postnatal MeHg exposure increased, a few associations with ABR latencies and OAE amplitudes were found. The direction of these associations was inconsistent as some showed improved performance as MeHg exposure levels increased while others showed poorer performance. The presence of the inconsistent postnatal MeHg exposure findings are intriguing and deserve further clarification.
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Affiliation(s)
- Mark S Orlando
- Department of Otolaryngology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Rochester, NY 14642,USA.
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Ribeiro V, Albino L, Rostagno H, Barreto S, Hannas M, Harrington D, de Araujo F, Ferreira H, Ferreira M. Corrigendum to “Effects of the dietary supplementation of Bacillus subtilis levels on performance, egg quality and excreta moisture of layers” [Anim. Feed Sci. Technol. 195 (2014) 142–146]. Anim Feed Sci Technol 2015. [DOI: 10.1016/j.anifeedsci.2015.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Liu W, Patel S, Harrington D, Stoker J, Ding X, Shen J, Wong W, Halyard M, Schild S, Ezzell G, Bues M. Correlation Study of Volumetric Modulated Arc Therapy Plan Robustness With Local Failure for Head and Neck Cancer. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Harrington D, Schild S, Wong W, Vora S, Liu W. SU-E-T-642: PTV Is the Voxel-Wise Worst-Case of CTV in Prostate Photon Therapy. Med Phys 2015. [DOI: 10.1118/1.4925005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Liu W, Patel S, Shen J, Harrington D, Stoker J, Ding X, Hu Y, Wong W, Halyard M, Schild S, Ezzell G, Bues M. SU-E-T-618: Plan Robustness Study of Volumetric-Modulated Arc Therapy Vs. Intensity-Modulated Radiation Therapy for Head and Neck Cancer. Med Phys 2015. [DOI: 10.1118/1.4924981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Harrington D, Clouser E. SU-D-BRB-03: Planning Margin Implications for Multiple-Target, Single-Isocenter VMAT SRS Based On Image Guidance Tolerances. Med Phys 2015. [DOI: 10.1118/1.4923876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Strain JJ, Yeates AJ, van Wijngaarden E, Thurston SW, Mulhern MS, McSorley EM, Watson GE, Love TM, Smith TH, Yost K, Harrington D, Shamlaye CF, Henderson J, Myers GJ, Davidson PW. Prenatal exposure to methyl mercury from fish consumption and polyunsaturated fatty acids: associations with child development at 20 mo of age in an observational study in the Republic of Seychelles. Am J Clin Nutr 2015; 101:530-7. [PMID: 25733638 PMCID: PMC4340059 DOI: 10.3945/ajcn.114.100503] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Fish is a rich source of n-3 polyunsaturated fatty acids (PUFAs) but also contains the neurotoxicant methyl mercury (MeHg). PUFAs may modify the relation between prenatal MeHg exposure and child development either directly by enhancing neurodevelopment or indirectly through the inflammatory milieu. OBJECTIVE The objective was to investigate the associations of prenatal MeHg exposure and maternal PUFA status with child development at 20 mo of age. DESIGN The Seychelles Child Development Study Nutrition Cohort 2 is an observational study in the Republic of Seychelles, a high-fish-eating population. Mothers were enrolled during pregnancy and their children evaluated at 20 mo of age by using the Bayley Scales of Infant Development II (BSID-II), the MacArthur Bates Communicative Development Inventories (CDI), and the Infant Behavior Questionnaire-Revised. There were 1265 mother-child pairs with complete data. RESULTS Prenatal MeHg exposure had no direct associations with neurodevelopmental outcomes. Significant interactions were found between MeHg and PUFAs on the Psychomotor Developmental Index (PDI) of the BSID-II. Increasing MeHg was associated with lower PDI but only in children of mothers with higher n-6/n-3. Among mothers with higher n-3 PUFAs, increasing MeHg was associated with improved PDI. Higher maternal docosahexaenoic acid (DHA) was associated with improved CDI total gestures (language development) but was significantly adversely associated with the Mental Development Index (MDI), both with and without MeHg adjustment. Higher n-6:n-3 ratios were associated with poorer scores on all 3 CDI outcomes. CONCLUSIONS We found no overall adverse association between prenatal MeHg exposure and neurodevelopmental outcomes. However, maternal PUFA status as a putative marker of the inflammatory milieu appeared to modify the associations of prenatal MeHg exposure with the PDI. Increasing DHA status was positively associated with language development yet negatively associated with the MDI. These findings may indicate the existence of an optimal DHA balance with respect to arachidonic acid for different aspects of neurodevelopment.
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Affiliation(s)
- J J Strain
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Alison J Yeates
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Edwin van Wijngaarden
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Sally W Thurston
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Maria S Mulhern
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Emeir M McSorley
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Gene E Watson
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Tanzy M Love
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Tristram H Smith
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Kelley Yost
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Donald Harrington
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Conrad F Shamlaye
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Juliette Henderson
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Gary J Myers
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
| | - Philip W Davidson
- From the Northern Ireland Centre for Food and Health (NICHE), School of Biomedical Sciences, University of Ulster (JJS, AJY, MSM, and EMM); the School of Medicine and Dentistry, University of Rochester, Rochester, NY (EvW, SWT, GEW, TML, THS, KY, DH, GJM, and PWD); and the Child Development Centre, Ministry of Health, Mahé, Republic of Seychelles (CFS and JH)
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Jafarzadeh F, Oo A, Kuduvalli M, Harrington D, Bashir M, Field M, Desmond M. 253 * INTRAOPERATIVE MOTOR EVOKED POTENTIAL CHANGES, PROCEDURE ALTERATIONS AND NEUROLOGICAL OUTCOME IN THORACIC AND THORACO-ABDOMINAL AORTIC ANEURYSM REPAIR. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fok M, Bashir M, Hammoud I, Harrington D, Kuduvalli M, Field M, Oo A. An apical left ventricular aneurysm rupture presenting as left breast mass 11 years after surgical repair. Ann R Coll Surg Engl 2014; 96:e6-7. [PMID: 25245713 DOI: 10.1308/003588414x13946184900561] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Left ventricular (LV) pseudoaneurysm is a rare entity and, consequently, there is limited knowledge of the condition's natural history. The most frequent mode of presentation for LV pseudoaneurysm is heart failure with chest pain. However, the variable presentation of this condition requires a high index of suspicion for diagnosis. We report the case of a 75-year-old woman who had suffered an acute myocardial infarction 23 years previously, which resulted in a calcified LV apical aneurysm. Three weeks prior to being referred to our hospital, she was noted by her general practitioner to have a left-sided breast mass although mammography was negative. One week later, she attended the accident and emergency department; she was haemodynamically unstable but was resuscitated successfully. Contrast enhanced computed tomography showed a large haematoma located in the left chest wall communicating with the left ventricle. She underwent emergency cardiac surgical repair. On arrival at the intensive care unit following surgery, her haemodynamic status was unstable, and she deteriorated rapidly and died. With this report, we aim to raise the level of awareness for an apical LV pulsatile mass that could anatomically expand and present as a breast mass or tumour. An early diagnosis and timely surgical intervention is essential in order to achieve better outcomes and avoid detrimental complications.
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Affiliation(s)
- M Fok
- Thoracic Aortic Aneurysm Service, Liverpool Heart and Chest Hospital, Liverpool, UK
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Paulsen J, Long J, Ross C, Harrington D, Erwin C, Williams J, Westervelt H, Johnson H, Aylward E, Zhang Y, Bockholt J, Barker R. J01 Improving Prediction Of Huntington Disease Onset With Clinical And Imaging Measures: A 10-year Preopective Study Of Converters. Journal of Neurology, Neurosurgery & Psychiatry 2014. [DOI: 10.1136/jnnp-2014-309032.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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van Wijngaarden E, Harrington D, Kobrosly R, Thurston SW, O'Hara T, McSorley EM, Myers GJ, Watson GE, Shamlaye CF, Strain JJ, Davidson PW. Prenatal exposure to methylmercury and LCPUFA in relation to birth weight. Ann Epidemiol 2014; 24:273-8. [PMID: 24525104 DOI: 10.1016/j.annepidem.2014.01.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 12/24/2013] [Accepted: 01/02/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Epidemiologic studies have been inconclusive regarding the impact of coexposure to long chain polyunsaturated fatty acids (LCPUFA) and methylmercury (MeHg) from fish consumption during pregnancy on measures of fetal development. OBJECTIVES We evaluated the association between birth weight and prenatal maternal LCPUFA status and MeHg exposure in the Republic of Seychelles. METHODS We measured LCPUFA in maternal whole blood collected at 28 weeks of gestation and following delivery and MeHg in maternal hair obtained at delivery. There were 230 births with complete data on birth weight and covariates. Multiple linear regression models controlled for infant sex, gestational age, maternal age, smoking during pregnancy, intrapartum weight gain, prepregnancy body mass index, maternal socioeconomic status, parity, gestational diabetes, and alcohol use during pregnancy. RESULTS The average birth weight was 3252 g (range 1654-4450) and the average gestational age was 39 weeks (range 34-41). Prenatal MeHg exposure and maternal LCPUFA status were not associated with birth weight. Infant sex and length of gestation were the only predictors, with male sex and increased gestational age consistently associated with greater birth weight. CONCLUSIONS These findings do not support a relationship between prenatal exposure to LCPUFA and/or MeHg from fish consumption and birth weight.
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Affiliation(s)
- Edwin van Wijngaarden
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, NY; Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, NY.
| | - Donald Harrington
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, NY
| | - Roni Kobrosly
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, NY
| | - Sally W Thurston
- Department of Biostatistics and Computational Biology, University of Rochester School of Medicine and Dentistry, NY
| | - Todd O'Hara
- Department of Veterinary Medicine, College of Natural Sciences and Mathematics, University of Alaska Fairbanks, AK
| | - Emeir M McSorley
- Northern Ireland Centre for Food and Health, School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland
| | - Gary J Myers
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, NY; Department of Neurology, University of Rochester School of Medicine and Dentistry, NY; Department of Pediatrics, University of Rochester School of Medicine and Dentistry, NY
| | - Gene E Watson
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, NY; Department of Neurology, University of Rochester School of Medicine and Dentistry, NY; Eastman Department of Dentistry, University of Rochester School of Medicine and Dentistry, NY
| | | | - J J Strain
- Northern Ireland Centre for Food and Health, School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland
| | - Philip W Davidson
- Department of Environmental Medicine, University of Rochester School of Medicine and Dentistry, NY; Department of Pediatrics, University of Rochester School of Medicine and Dentistry, NY
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