1
|
Haley CO, Singleton CR, King LE, Dyer L, Theall KP, Wallace M. Association of Food Desert Residency and Preterm Birth in the United States. Int J Environ Res Public Health 2024; 21:412. [PMID: 38673324 PMCID: PMC11049944 DOI: 10.3390/ijerph21040412] [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] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/15/2024] [Accepted: 03/18/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION Food deserts are a major public health concern. Inadequate access to healthy food has been associated with poor nutrition and the development of dietary related chronic conditions. OBJECTIVE To determine the association between geographic access to nutritious food and preterm birth and whether gestational hypertension mediates this relationship. METHODS Food access data was retrieved from the U.S. Department of Agriculture Food Access Research Atlas (2019) and used to quantify the percentage of Census tracts within each county that were food deserts: low-income tracts with limited access to grocery stores, supermarkets, or other sources of healthy, nutritious foods. These data were merged with US birth records from 2018 to 2019 by using the maternal county of residence (n = 7,533,319). We fit crude and adjusted logistic regression models with generalized estimating equations to determine the association between living in a food desert and the odds of preterm birth. We conducted a secondary within-group analysis by stratifying the fully adjusted model by race for non-Hispanic White and non-Hispanic Black birthing people. RESULTS In the fully adjusted model, we found a dose-response relationship. As the prevalence of tract-level food deserts within counties increased, so did the likelihood of preterm birth (mid-range: odds ratio (OR) = 1.04, 95% confidence interval (C.I.) 1.01-1.07; high: OR = 1.07, 95% C.I. 1.03-1.11). Similar results were seen in the White-Black stratified models. However, a disparity remained as Black birthing people had the highest odds for preterm birth. Lastly, gestational hypertension appears to mediate the relationship between nutritious food access and preterm birth (natural indirect effect (NIE) = 1.01, 95% CI = 1.00, 1.01). CONCLUSION It is salient, particularly for Black birthing people who experience high rates of adverse birth outcomes, that the role of food desert residency be explored within maternal and child health disparities.
Collapse
Affiliation(s)
- Chanell O. Haley
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
- Mary Amelia Center for Women’s Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Chelsea R. Singleton
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
| | - Lily E. King
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
| | - Lauren Dyer
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
| | - Katherine P. Theall
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
- Mary Amelia Center for Women’s Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| | - Maeve Wallace
- Department of Behavioral, Social and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA; (C.R.S.); (L.E.K.); (L.D.); (K.P.T.); (M.W.)
- Mary Amelia Center for Women’s Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA
| |
Collapse
|
2
|
Haley CO, King LE, Dyer L, Evans MG, Theall KP, Wallace M. Maternity Care Deserts in Louisiana and Breastfeeding Initiation. Womens Health Issues 2024:S1049-3867(23)00211-6. [PMID: 38216366 DOI: 10.1016/j.whi.2023.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 11/10/2023] [Accepted: 11/21/2023] [Indexed: 01/14/2024]
Abstract
BACKGROUND Breastfeeding provides physical, psychological, and immunological benefits to both the mother and infant, but breastfeeding rates are suboptimal. The purpose of this study was to examine whether residing in a maternity care desert (a county with no hospital offering obstetric care and no OB/GYN or certified nurse midwife providers) was associated with lower breastfeeding rates among birthing people in Louisiana from 2019 to 2020. METHODS Data provided by the March of Dimes were used to classify Louisiana parishes by level of access to maternity care. Using data on all live births provided by the Louisiana Office of Vital Records (n = 112,151), we fit adjusted modified Poisson regression models with generalized estimating equations and exploratory geospatial analysis to examine the association between place of residence and breastfeeding initiation and racial disparities in initiation. We conducted a secondary within-group analysis by fitting the fully adjusted model stratified by race/ethnicity for non-Hispanic white and non-Hispanic Black birthing people. RESULTS We found that residing in a parish with limited (odds ratio [OR] = 0.87; 95% confidence interval [CI] [0.77, 0.99]) to no access (OR = 0.88; 95% CI [0.80, 0.97]) was significantly associated with lower breastfeeding initiation rates. The within-group analysis determined that both non-Hispanic Black and non-Hispanic white birthing people residing in a parish with limited or no maternity care access had lower breastfeeding initiation rates. CONCLUSION Reducing rural and racial inequities in breastfeeding may require structural changes and investments in infrastructure to deliver pregnancy care.
Collapse
Affiliation(s)
- Chanell O Haley
- Department of Behavioral, Social, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Mary Amelia Center for Women's Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
| | - Lily E King
- Department of Behavioral, Social, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Lauren Dyer
- Department of Behavioral, Social, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Mary Amelia Center for Women's Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Melissa G Evans
- Department of Behavioral, Social, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Mary Amelia Center for Women's Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Katherine P Theall
- Department of Behavioral, Social, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Mary Amelia Center for Women's Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Maeve Wallace
- Department of Behavioral, Social, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Mary Amelia Center for Women's Health Equity Research, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| |
Collapse
|
3
|
Potts KS, Gustat J, Wallace M, Ley S, Qi L, Bazzano LA. Diet quality in young adulthood and sleep at midlife: a prospective analysis in the Bogalusa Heart Study. Res Sq 2023:rs.3.rs-3788358. [PMID: 38234725 PMCID: PMC10793508 DOI: 10.21203/rs.3.rs-3788358/v1] [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] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Background Diet and sleep are both established risk factors for cardiometabolic diseases. Prior evidence suggests a potential link between these behaviors, though evidence for how they associate with each is scarce. This study aimed to determine the association between diet quality in young adulthood and multiple sleep outcomes at midlife in the Bogalusa Heart Study (BHS). Methods This prospective study included 593 BHS subjects with dietary assessment at the 2001-2002 visit and sleep questionnaire responses from the 2013-2016 visit, after an average of 12.7 years (baseline mean age: 36 years, 36% male, 70%/30% White and Black persons). A culturally tailored, validated food frequency questionnaire assessed usual diet. Diet quality was measured with the Alternate Healthy Eating Index (AHEI) 2010, the Healthy Eating Index (HEI) 2015, and the alternate Mediterranean (aMed) dietary score. Robust Poisson regression with log-link function estimated risk ratios (RR) for insomnia symptoms, high sleep apnea score, and having a healthy sleep pattern by quintile and per standard deviation (SD) increase in dietary patterns. Models adjusted for potential confounders including multi-level socioeconomic factors, depression, and body mass index. Trends across quintiles and effect modification by sex, race, and education were tested. Results Higher diet quality in young adulthood, measured by both AHEI and HEI, was associated with lower risk of having insomnia symptoms at midlife. In the adjusted model, each SD-increase in AHEI (7.8 points; 7% of score range) conferred 15% lower risk of insomnia symptoms at follow-up (RR [95% confidence interval CI]: 0.85 [0.77, 0.93]), those in Q5 of AHEI had 0.54 times the risk as those in Q1 (95% CI: 0.39, 0.75), and there was a significant decreasing risk trend across quintiles (trend p = 0.001). There were no significant associations between young adult diet quality and having a high sleep apnea risk or a healthy sleep pattern at follow-up. Conclusions A healthy diet was associated with a lower risk of future insomnia symptoms. If replicated, these findings could have implications for chronic disease prevention strategies incorporating the lifestyle behaviors of sleep and diet.
Collapse
Affiliation(s)
- Kaitlin S Potts
- Tulane University School of Public Health and Tropical Medicine
| | - Jeanette Gustat
- Tulane University School of Public Health and Tropical Medicine
| | - Maeve Wallace
- Tulane University School of Public Health and Tropical Medicine
| | - Sylvia Ley
- Tulane University School of Public Health and Tropical Medicine
| | - Lu Qi
- Tulane University School of Public Health and Tropical Medicine
| | - Lydia A Bazzano
- Tulane University School of Public Health and Tropical Medicine
| |
Collapse
|
4
|
Jahn JL, Wallace M, Theall KP, Hardeman RR. Neighborhood Proactive Policing and Racial Inequities in Preterm Birth in New Orleans, 2018‒2019. Am J Public Health 2023; 113:S21-S28. [PMID: 36696607 PMCID: PMC9877384 DOI: 10.2105/ajph.2022.307079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 01/26/2023]
Abstract
Objectives. To measure neighborhood exposure to proactive policing as a manifestation of structural racism and its association with preterm birth. Methods. We linked all birth records in New Orleans, Louisiana (n = 9102), with annual census tract rates of proactive police stops using data from the New Orleans Police Department (2018-2019). We fit multilevel Poisson models predicting preterm birth across quintiles of stop rates, controlling for several individual- and tract-level covariates. Results. Nearly 20% of Black versus 8% of White birthing people lived in neighborhoods with the highest rates of proactive police stops. Fully adjusted models among Black birthing people suggest the prevalence of preterm birth in the neighborhoods with the highest proactive policing rates was 1.41 times that of neighborhoods with the lowest rates (95% confidence interval = 1.04, 1.93), but associations among White birthing people were not statistically significant. Conclusions. Taken together with previous research, high rates of proactive policing likely contribute to Black‒White inequities in reproductive health. Public Health Implications. Proactive policing is widely implemented to deter violence, but alternative strategies without police should be considered to prevent potential adverse health consequences. (Am J Public Health. 2023;113(S1):S21-S28. https://doi.org/10.2105/AJPH.2022.307079).
Collapse
Affiliation(s)
- Jaquelyn L Jahn
- Jaquelyn L. Jahn is with The Ubuntu Center on Racism, Global Movements, and Population Health Equity at Drexel University Dornsife School of Public Health, Philadelphia, PA. Maeve Wallace and Katherine P. Theall are with the Department of Social, Behavioral, and Population Science and the Mary Amelia Center for Women's Health Equity Research at the Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Rachel R. Hardeman is with the Division of Health Policy and Management, the Center for Antiracism Research for Health Equity at the University of Minnesota School of Public Health, as well as the Minnesota Population Center, Minneapolis
| | - Maeve Wallace
- Jaquelyn L. Jahn is with The Ubuntu Center on Racism, Global Movements, and Population Health Equity at Drexel University Dornsife School of Public Health, Philadelphia, PA. Maeve Wallace and Katherine P. Theall are with the Department of Social, Behavioral, and Population Science and the Mary Amelia Center for Women's Health Equity Research at the Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Rachel R. Hardeman is with the Division of Health Policy and Management, the Center for Antiracism Research for Health Equity at the University of Minnesota School of Public Health, as well as the Minnesota Population Center, Minneapolis
| | - Katherine P Theall
- Jaquelyn L. Jahn is with The Ubuntu Center on Racism, Global Movements, and Population Health Equity at Drexel University Dornsife School of Public Health, Philadelphia, PA. Maeve Wallace and Katherine P. Theall are with the Department of Social, Behavioral, and Population Science and the Mary Amelia Center for Women's Health Equity Research at the Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Rachel R. Hardeman is with the Division of Health Policy and Management, the Center for Antiracism Research for Health Equity at the University of Minnesota School of Public Health, as well as the Minnesota Population Center, Minneapolis
| | - Rachel R Hardeman
- Jaquelyn L. Jahn is with The Ubuntu Center on Racism, Global Movements, and Population Health Equity at Drexel University Dornsife School of Public Health, Philadelphia, PA. Maeve Wallace and Katherine P. Theall are with the Department of Social, Behavioral, and Population Science and the Mary Amelia Center for Women's Health Equity Research at the Tulane University School of Public Health and Tropical Medicine, New Orleans, LA. Rachel R. Hardeman is with the Division of Health Policy and Management, the Center for Antiracism Research for Health Equity at the University of Minnesota School of Public Health, as well as the Minnesota Population Center, Minneapolis
| |
Collapse
|
5
|
Dyer L, Bell C, Perez S, Crear-Perry J, Theall K, Wallace M. US county-level prevalence and spatial distribution of optimal birth outcomes 2018-2019. Sci Rep 2022; 12:16535. [PMID: 36192415 PMCID: PMC9529881 DOI: 10.1038/s41598-022-20517-9] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 09/14/2022] [Indexed: 11/09/2022] Open
Abstract
A shift in focus towards healthy reproductive outcomes may reveal opportunities for novel interventions and strategies to promote optimal health. Using variables from the National Center for Health Statistics restricted use natality files, we calculated Empirical Bayes smoothed (EBS) rates of optimal birth for the all live births-both overall and by maternal race/ethnicity-by applying the smoothing tool in GeoDa version 1.18.0.10 We defined counties achieving greater racial birth equity as those where the overall EBS optimal birth rate was greater than the national 75th percentile and the absolute difference between maternal racial/ethnic categories was smaller than the national 25th percentile difference. During the study period, 49.80% of overall births could be classified as an optimal birth according to the study definition. Of the 3140 US counties, only 282 (8.98%) appeared to advance White-Black equity in optimal births, and 205 (6.53%) appeared to advance White-Hispanic equity in optimal births. In the effort improve maternal health, we should focus not only on the absence of negative outcomes, but also the occurrence of positive outcomes. Our analytic results suggest that optimal births can be measured and that geographic inequities by race occur.
Collapse
Affiliation(s)
- Lauren Dyer
- Mary Amelia Women's Center, Department of Social, Behavioral and Population Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA.
| | - Caryn Bell
- Mary Amelia Women's Center, Department of Social, Behavioral and Population Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA
| | - Susan Perez
- National Birth Equity Collaborative, 4747 Earhart Blvd, New Orleans, LA, USA.,Department of Public Health, California State University, Sacramento, 6000 J Street, Sacramento, CA, 95819, USA
| | - Joia Crear-Perry
- National Birth Equity Collaborative, 4747 Earhart Blvd, New Orleans, LA, USA
| | - Katherine Theall
- Mary Amelia Women's Center, Department of Social, Behavioral and Population Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA
| | - Maeve Wallace
- Mary Amelia Women's Center, Department of Social, Behavioral and Population Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA
| |
Collapse
|
6
|
Dyer L, Vilda D, Harville E, Theall K, Wallace M. Income Inequality and Pregnancy-Associated Homicide in the US: A Longitudinal, State-Level Analysis. Violence Against Women 2022:10778012221120446. [PMID: 36017550 DOI: 10.1177/10778012221120446] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Pregnancy-associated homicide remains an understudied yet critical issue. Using restricted use mortality files provided by the National Center for Health Statistics and the National Violent Death Reporting System, annual state-level pregnancy-associated homicide ratios were estimated as the count of deaths divided by the number of live births. The exposure, the state Gini index, was categorized into tertiles to compare states by levels of income inequality. In the final adjusted longitudinal linear model, those who experienced the greatest amount of income inequality had a significant 1.28 per 100,000 homicide rate when compared to the lowest income inequality tertile.
Collapse
Affiliation(s)
- Lauren Dyer
- Mary Amelia Women's Center, Department of Social, Behavioral and Population Sciences, 25812Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Dovile Vilda
- Mary Amelia Women's Center, Department of Social, Behavioral and Population Sciences, 25812Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Emily Harville
- Department of Epidemiology, 25812Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Katherine Theall
- Mary Amelia Women's Center, Department of Social, Behavioral and Population Sciences, 25812Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - Maeve Wallace
- Mary Amelia Women's Center, Department of Social, Behavioral and Population Sciences, 25812Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| |
Collapse
|
7
|
Goldin Evans M, Wallace M, Theall KP, Mahoney AM, Richardson L, Daniel CM. State-Level Recommendations to Reduce Inequities in Sexually Transmitted Infections. Womens Health Issues 2022; 32:427-430. [PMID: 35961852 DOI: 10.1016/j.whi.2022.07.002] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 07/05/2022] [Accepted: 07/15/2022] [Indexed: 10/15/2022]
Affiliation(s)
- Melissa Goldin Evans
- Mary Amelia Center for Women's Health Equity Research, Department of Social, Behavioral, and Population Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana.
| | - Maeve Wallace
- Mary Amelia Center for Women's Health Equity Research, Department of Social, Behavioral, and Population Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | - Katherine P Theall
- Mary Amelia Center for Women's Health Equity Research, Department of Social, Behavioral, and Population Science, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana
| | | | - Lisa Richardson
- Institute of Women and Ethnic Studies, New Orleans, Louisiana
| | - Clare M Daniel
- Newcomb Institute, Tulane University, New Orleans, Louisiana
| |
Collapse
|
8
|
Salanitri FP, Bellitto G, Palazzo S, Irmakci I, Wallace M, Bolan C, Engels M, Hoogenboom S, Aldinucci M, Bagci U, Giordano D, Spampinato C. Neural Transformers for Intraductal Papillary Mucosal Neoplasms (IPMN) Classification in MRI images. Annu Int Conf IEEE Eng Med Biol Soc 2022; 2022:475-479. [PMID: 36085787 PMCID: PMC9921314 DOI: 10.1109/embc48229.2022.9871547] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Early detection of precancerous cysts or neoplasms, i.e., Intraductal Papillary Mucosal Neoplasms (IPMN), in pancreas is a challenging and complex task, and it may lead to a more favourable outcome. Once detected, grading IPMNs accurately is also necessary, since low-risk IPMNs can be under surveillance program, while high-risk IPMNs have to be surgically resected before they turn into cancer. Current standards (Fukuoka and others) for IPMN classification show significant intra- and inter-operator variability, beside being error-prone, making a proper diagnosis unreliable. The established progress in artificial intelligence, through the deep learning paradigm, may provide a key tool for an effective support to medical decision for pancreatic cancer. In this work, we follow this trend, by proposing a novel AI-based IPMN classifier that leverages the recent success of transformer networks in generalizing across a wide variety of tasks, including vision ones. We specifically show that our transformer-based model exploits pre-training better than standard convolutional neural networks, thus supporting the sought architectural universalism of transformers in vision, including the medical image domain and it allows for a better interpretation of the obtained results.
Collapse
|
9
|
Dyer L, Chambers BD, Crear-Perry J, Theall KP, Wallace M. The Index of Concentration at the Extremes (ICE) and Pregnancy-Associated Mortality in Louisiana, 2016-2017. Matern Child Health J 2022; 26:814-822. [PMID: 34148221 PMCID: PMC8684557 DOI: 10.1007/s10995-021-03189-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [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] [Accepted: 06/09/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Social and contextual factors underlying the continually disproportionate and burdensome risk of adverse health outcomes experienced by Black women in the US are underexplored in the literature. The aim of this study was to use an index based on area-level population distributions of race and income to predict risk of death during pregnancy and up to 1 year postpartum among women in Louisiana. METHODS Using vital records data provided by the Louisiana Department of Health 2016-2017 (n = 125,537), a modified Poisson model was fit with generalized estimating equations to examine the risk of pregnancy-associated death associated with census tract-level values of the Index of Concentration at the Extremes (ICE)-grouped by tertile-while adjusting for both individual and tract-level confounders. RESULTS Analyses resulted in an estimated 1.73 (95% CI 1.02-2.93) times increased risk for pregnancy-associated death for those in areas which were characterized by concentrated deprivation (high proportions of Black and low-income residents) relative to those in areas of concentrated privilege (high proportions of white and high-income residents), independent of other factors. CONCLUSIONS FOR PRACTICE In addition to continuing to consider the deeply entrenched racism and economic inequality that shape the experience of pregnancy-associated death, we must also consider their synergistic effect on access to resources, maternal population health, and health inequities.
Collapse
Affiliation(s)
- Lauren Dyer
- Department of Social, Behavioral, and Population Sciences, Mary Amelia Women's Center, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA.
| | - Brittany D Chambers
- School of Medicine, Epidemiology and Biostatistics, University of San Francisco, 550 16th St., San Francisco, CA, 94158, USA
| | - Joia Crear-Perry
- National Birth Equity Collaborative, 4747 Earhart Blvd, New Orleans, LA, USA
| | - Katherine P Theall
- Department of Social, Behavioral, and Population Sciences, Mary Amelia Women's Center, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA
| | - Maeve Wallace
- Department of Social, Behavioral, and Population Sciences, Mary Amelia Women's Center, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA
| |
Collapse
|
10
|
Mullen AJ, O’Connor DL, Hanley AJ, Piedimonte G, Wallace M, Ley SH. Associations of Metabolic and Obstetric Risk Parameters with Timing of Lactogenesis II. Nutrients 2022; 14:nu14040876. [PMID: 35215526 PMCID: PMC8879345 DOI: 10.3390/nu14040876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 01/21/2022] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/02/2022] Open
Abstract
Lactogenesis II is the onset of copious milk production following parturition. Delayed onset of lactogenesis II (DLII) often contributes to poorer lactation performance, which may adversely affect maternal and child health. The present study aims to identify the metabolic and obstetric risk factors for DLII in a secondary analysis of a prospective cohort study following pregnant women through postpartum. We defined the onset of lactogenesis II as delayed if it occurred ≥72 h postpartum. Multiple logistic regression analyses were conducted to evaluate the associations of metabolic and obstetric variables with DLII. Median onset of lactogenesis II was 72.4 h (IQR 60.4–91.6) postpartum, and 55.4% (98 of 177) of women experienced DLII. Time to first breast contact ≥ 2 h postpartum compared to ≤1 h postpartum was associated with DLII (OR 2.71 95% CI 1.12–6.53) with adjustment for age, race, pregravid BMI, primiparity, and mode of delivery, while metabolic variables were not significantly associated with DLII. In this comprehensive examination of potential metabolic and obstetric parameters, earlier timing of putting the infant to the breast remained significantly associated with earlier onset of milk coming in after consideration of the other potential risk factors. Obstetrical practices, including putting the baby to the breast later, may have an important impact on the timing of lactation, and interventions are needed to address this concern.
Collapse
Affiliation(s)
- Amber J. Mullen
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, M.B. 8318, New Orleans, LA 70112, USA;
| | - Deborah L. O’Connor
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.L.O.); (A.J.H.)
- Translational Medicine Program, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Anthony J. Hanley
- Department of Nutritional Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada; (D.L.O.); (A.J.H.)
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Division of Endocrinology, University of Toronto, Toronto, ON M5S 3H2, Canada
- Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada
| | - Giovanni Piedimonte
- Departments of Pediatrics, Biochemistry and Molecular Biology, Tulane University School of Medicine, New Orleans, LA 70112, USA;
| | - Maeve Wallace
- Department of Social, Behavioral, and Population Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA;
| | - Sylvia H. Ley
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, M.B. 8318, New Orleans, LA 70112, USA;
- Correspondence: ; Tel.: +1-504-988-2433; Fax: +1-504-988-1568
| |
Collapse
|
11
|
Walsh DP, Fahey AG, Lonergan P, Wallace M. Economics of timed artificial insemination with unsorted or sexed semen in a high-producing, pasture-based dairy production system. J Dairy Sci 2022; 105:3192-3208. [PMID: 35181145 DOI: 10.3168/jds.2021-21070] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 01/01/2022] [Indexed: 11/19/2022]
Abstract
This study used a stochastic simulation model to estimate the potential economic benefit of using timed artificial insemination (TAI) in combination with conventional unsorted (TCONV) and sexed (TSEX) semen in heifers only (TCONV-H, TSEX-H) and in both heifers and lactating cows (TCONV-HC, TSEX-HC) in a high-producing, pasture-based production system. The scenarios were compared with a conventional reproductive policy (CONV) in which heifers and cows were inseminated with conventional unsorted semen after estrus detection. Sensitivity analysis was also used to estimate the effect of hormone costs from TAI use on the profitability of each program relative to CONV. The mean annual (± standard deviation) profit advantage (ΔPROF) over CONV for TCONV-H, TCONV-HC, TSEX-H, and TSEX-HC scenarios were €3.90/cow ± 4.65, €34.11/cow ± 25.69, €13.96/cow ± 6.83, and €41.52/cow ± 42.86, respectively. Combined application of both technologies was shown to return a greater annual ΔPROF on average compared with that achievable from TAI alone. However, the risk of not returning a positive annual ΔPROF varied across the scenarios with higher risk in TCONV-H and TSEX-HC. Specifically, TCONV-H and TSEX-HC had a 24 and 18% chance, respectively, of not returning a positive annual ΔPROF. Sensitivity analysis showed that when hormone costs increased by €10/cow TCONV-H and TSEX-HC had a 38 and 23% chance, respectively, of not returning a positive annual ΔPROF. The range in ΔPROF for TCONV policies was most sensitive to the TAI pregnancy rate and TSEX policies were most sensitive to the relative fertility achieved with sexed compared with unsorted semen. This study has shown TAI and sexed semen are complementary technologies that can increase genetic gain and profitability in a pasture-based, dairy production system.
Collapse
Affiliation(s)
- D P Walsh
- School of Agriculture and Food Science, University College Dublin, D04 V1W8, Dublin, Ireland
| | - A G Fahey
- School of Agriculture and Food Science, University College Dublin, D04 V1W8, Dublin, Ireland.
| | - P Lonergan
- School of Agriculture and Food Science, University College Dublin, D04 V1W8, Dublin, Ireland
| | - M Wallace
- School of Agriculture and Food Science, University College Dublin, D04 V1W8, Dublin, Ireland
| |
Collapse
|
12
|
Wallace M, Gillispie-Bell V, Cruz K, Davis K, Vilda D. Homicide During Pregnancy and the Postpartum Period in the United States, 2018-2019. Obstet Gynecol 2021; 138:762-769. [PMID: 34619735 PMCID: PMC9134264 DOI: 10.1097/aog.0000000000004567] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/12/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To estimate the national pregnancy-associated homicide mortality ratio, characterize pregnancy-associated homicide victims, and compare the risk of homicide in the perinatal period (pregnancy and up to 1 year postpartum) with risk among nonpregnant, nonpostpartum females aged 10-44 years. METHODS Data from the National Center for Health Statistics 2018 and 2019 mortality files were used to identify all female decedents aged 10-44 in the United States. These data were used to estimate 2-year pregnancy-associated homicide mortality ratios (deaths/100,000 live births) for comparison with homicide mortality among nonpregnant, nonpostpartum females (deaths/100,000 population) and to mortality ratios for direct maternal causes of death. We compared characteristics and estimated homicide mortality rate ratios and 95% CIs between pregnant or postpartum and nonpregnant, nonpostpartum victims for the total population and with stratification by race and ethnicity and age. RESULTS There were 3.62 homicides per 100,000 live births among females who were pregnant or within 1 year postpartum, 16% higher than homicide prevalence among nonpregnant and nonpostpartum females of reproductive age (3.12 deaths/100,000 population, P<.05). Homicide during pregnancy or within 42 days of the end of pregnancy exceeded all the leading causes of maternal mortality by more than twofold. Pregnancy was associated with a significantly elevated homicide risk in the Black population and among girls and younger women (age 10-24 years) across racial and ethnic subgroups. CONCLUSION Homicide is a leading cause of death during pregnancy and the postpartum period in the United States. Pregnancy and the postpartum period are times of elevated risk for homicide among all females of reproductive age.
Collapse
Affiliation(s)
- Maeve Wallace
- Mary Amelia Center for Women's Health Equity Research, Department of Social, Behavioral, and Population Science, Tulane University School of Public Health and Tropical Medicine, the Department of Obstetrics and Gynecology, Ochsner Baptist Medical Center, and the National Birth Equity Collaborative, New Orleans, Louisiana
| | | | | | | | | |
Collapse
|
13
|
Yee LM, McGee P, Bailit JL, Wapner RJ, Varner MW, Thorp JM, Caritis SN, Prasad M, Tita AT, Saade GR, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Mallett G, Grobman W, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Leveno K, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Rouse D, Andrews W, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, Zhao Y, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Differences in obstetrical care and outcomes associated with the proportion of the obstetrician's shift completed. Am J Obstet Gynecol 2021; 225:430.e1-430.e11. [PMID: 33812810 DOI: 10.1016/j.ajog.2021.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/14/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Understanding and improving obstetrical quality and safety is an important goal of professional societies, and many interventions such as checklists, safety bundles, educational interventions, or other culture changes have been implemented to improve the quality of care provided to obstetrical patients. Although many factors contribute to delivery decisions, a reduced workload has addressed how provider issues such as fatigue or behaviors surrounding impending shift changes may influence the delivery mode and outcomes. OBJECTIVE The objective was to assess whether intrapartum obstetrical interventions and adverse outcomes differ based on the temporal proximity of the delivery to the attending's shift change. STUDY DESIGN This was a secondary analysis from a multicenter obstetrical cohort in which all patients with cephalic, singleton gestations who attempted vaginal birth were eligible for inclusion. The primary exposure used to quantify the relationship between the proximity of the provider to their shift change and a delivery intervention was the ratio of time from the most recent attending shift change to vaginal delivery or decision for cesarean delivery to the total length of the shift. Ratios were used to represent the proportion of time completed in the shift by normalizing for varying shift lengths. A sensitivity analysis restricted to patients who were delivered by physicians working 12-hour shifts was performed. Outcomes chosen included cesarean delivery, episiotomy, third- or fourth-degree perineal laceration, 5-minute Apgar score of <4, and neonatal intensive care unit admission. Chi-squared tests were used to evaluate outcomes based on the proportion of the attending's shift completed. Adjusted and unadjusted logistic models fitting a cubic spline (when indicated) were used to determine whether the frequency of outcomes throughout the shift occurred in a statistically significant, nonlinear pattern RESULTS: Of the 82,851 patients eligible for inclusion, 47,262 (57%) had ratio data available and constituted the analyzable sample. Deliveries were evenly distributed throughout shifts, with 50.6% taking place in the first half of shifts. There were no statistically significant differences in the frequency of cesarean delivery, episiotomy, third- or fourth-degree perineal lacerations, or 5-minute Apgar scores of <4 based on the proportion of the shift completed. The findings were unchanged when evaluated with a cubic spline in unadjusted and adjusted logistic models. Sensitivity analyses performed on the 22.2% of patients who were delivered by a physician completing a 12-hour shift showed similar findings. There was a small increase in the frequency of neonatal intensive care unit admissions with a greater proportion of the shift completed (adjusted P=.009), but the findings did not persist in the sensitivity analysis. CONCLUSION Clinically significant differences in obstetrical interventions and outcomes do not seem to exist based on the temporal proximity to the attending physician's shift change. Future work should attempt to directly study unit culture and provider fatigue to further investigate opportunities to improve obstetrical quality of care, and additional studies are needed to corroborate these findings in community settings.
Collapse
|
14
|
Crear-Perry J, Correa-de-Araujo R, Lewis Johnson T, McLemore MR, Neilson E, Wallace M. Social and Structural Determinants of Health Inequities in Maternal Health. J Womens Health (Larchmt) 2021; 30:230-235. [PMID: 33181043 PMCID: PMC8020519 DOI: 10.1089/jwh.2020.8882] [Citation(s) in RCA: 336] [Impact Index Per Article: 112.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Since the World Health Organization launched its commission on the social determinants of health (SDOH) over a decade ago, a large body of research has proven that social determinants-defined as the conditions in which people are born, grow, live, work, and age-are significant drivers of disease risk and susceptibility within clinical care and public health systems. Unfortunately, the term has lost meaning within systems of care because of misuse and lack of context. As many disparate health outcomes remain, including higher risk of maternal mortality among Black women, a deeper understanding of the SDOH-and what forces underlie their distribution-is needed. In this article, we will expand our review of social determinants of maternal health to include the terms "structural determinants of health" and "root causes of inequities" as we assess the literature on this topic. We hypothesize that the addition of structural determinants and root causes will identify racism as a cause of inequities in maternal health outcomes, as many of the social and political structures and policies in the United States were born out of racism, classism, and gender oppression. We will conclude with proposed practice and policy solutions to end inequities in maternal health outcomes.
Collapse
Affiliation(s)
- Joia Crear-Perry
- National Birth Equity Collaborative, Washington, District of Columbia, USA
| | - Rosaly Correa-de-Araujo
- Division of Geriatrics and Clinical Gerontology, National Institute on Aging, National Institutes of Health, Bethesda, Maryland, USA
| | - Tamara Lewis Johnson
- Office of Disparities Research and Workforce Diversity, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Monica R. McLemore
- Family Health Care Nursing Department, University of California San Francisco, San Francisco, California, USA
- Advancing New Standards in Reproductive Health, University of California San Francisco, San Francisco, California, USA
| | - Elizabeth Neilson
- Office of Disease Prevention, Office of the Director, National Institutes of Health, Bethesda, Maryland, USA
| | - Maeve Wallace
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| |
Collapse
|
15
|
Vilda D, Hardeman R, Dyer L, Theall KP, Wallace M. Structural racism, racial inequities and urban-rural differences in infant mortality in the US. J Epidemiol Community Health 2021; 75:788-793. [PMID: 33504545 PMCID: PMC8273079 DOI: 10.1136/jech-2020-214260] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 07/15/2020] [Accepted: 01/06/2021] [Indexed: 11/13/2022]
Abstract
Background While evidence shows considerable geographic variations in county-level racial inequities in infant mortality, the role of structural racism across urban–rural lines remains unexplored. The objective of this study was to examine the associations between county-level structural racism (racial inequity in educational attainment, median household income and jail incarceration) and infant mortality and heterogeneity between urban and rural areas. Methods Using linked live birth/infant death data provided by the National Center for Health Statistics, we calculated overall and race-specific 2013–2017 5-year infant mortality rates (IMRs) per 1000 live births in every county. Racially stratified and area-stratified negative binomial regression models estimated IMR ratios and 95% CIs associated with structural racism indicators, adjusting for county-level confounders. Adjusted linear regression models estimated associations between structural racism indicators and the absolute and relative racial inequity in IMR. Results In urban counties, structural racism indicators were associated with 7%–8% higher black IMR, and an overall structural racism score was associated with 9% greater black IMR; however, these findings became insignificant when adjusting for the region. In white population, structural racism indicators and the overall structural racism score were associated with a 6% decrease in urban white IMR. Both absolute and relative racial inequity in IMR were exacerbated in urban counties with greater levels of structural racism. Conclusions Our findings highlight the complex relationship between structural racism and population health across urban–rural lines and suggest its contribution to the maintenance of health inequities in urban settings.
Collapse
Affiliation(s)
- Dovile Vilda
- Mary Amelia Center for Women's Health Equity Research, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Rachel Hardeman
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Lauren Dyer
- Mary Amelia Center for Women's Health Equity Research, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Katherine P Theall
- Mary Amelia Center for Women's Health Equity Research, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Maeve Wallace
- Mary Amelia Center for Women's Health Equity Research, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| |
Collapse
|
16
|
Walsh DP, Fahey AG, Mulligan FJ, Wallace M. Effects of herd fertility on the economics of sexed semen in a high-producing, pasture-based dairy production system. J Dairy Sci 2021; 104:3181-3196. [PMID: 33455796 DOI: 10.3168/jds.2020-18676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 10/13/2020] [Indexed: 12/22/2022]
Abstract
This study used a stochastic simulation model to estimate the potential economic benefit of using sexed semen in heifers only and in heifers and lactating cows in a high-producing, pasture-based system under 3 fertility scenarios. Three breeding strategies were modeled: (1) only heifers inseminated with sexed semen and cows inseminated with conventional unsexed semen (SSH); (2) both heifers and cows inseminated with sexed semen (SSHC); and (3) a reference scenario in which all females were inseminated with conventional, unsexed semen (CONV). Each scenario was evaluated under 3 herd fertility states: high (HF), medium (MF), and low (LF), which, under the reference scenario, corresponded to herd replacement rates of 21, 25, and 31%, respectively. The model estimated the economic profit, including the net present value of the genetic gain from selection intensity. The economic return from adoption of sexed semen strategies declined, with reduced levels of baseline herd fertility turning negative in the LF state. The mean (±SD) sexed semen advantage (SSA) per cow for HF-SSH, MF-SSH, and LF-SSH scenarios were €30.61 ± 8.98, €27.45 ± 7.19, and €14.69 ± 11.06, respectively. However, the SSA per cow for HF-SSHC, MF-SSHC, and LF-SSHC scenarios were €49.14 ± 15.43, €18.46 ± 30.08, and -€19.30 ± 57.11. The range in economic profit for SSA for SSH was most sensitive to calf prices in HF-SSH and the pregnancy rate of sexed semen as a percentage of conventional unsorted semen in MF-SSH and LF-SSH. The range in economic profit for SSA for SSHC scenarios was most sensitive to the pregnancy rate of sexed semen as a percentage of conventional unsorted semen in HF-SSHC, MF-SSHC, and LF-SSHC. This study highlights the effect of baseline herd fertility state on the financial advantage of adopting sexed semen in a pasture-based dairy production system.
Collapse
Affiliation(s)
- D P Walsh
- School of Agriculture and Food Science, University College Dublin, Dublin D04 V1W8, Ireland
| | - A G Fahey
- School of Agriculture and Food Science, University College Dublin, Dublin D04 V1W8, Ireland.
| | - F J Mulligan
- School of Veterinary Medicine, University College Dublin, Dublin D04 V1W8, Ireland
| | - M Wallace
- School of Agriculture and Food Science, University College Dublin, Dublin D04 V1W8, Ireland
| |
Collapse
|
17
|
Gill K, Johnson L, Dietrich J, Myer L, Marcus R, Wallace M, Pidwell T, Mendel E, Fynn L, Jones K, Wiesner L, Slack C, Strode A, Spiegel H, Hosek S, Rooney J, Gray G, Bekker LG. Acceptability, safety, and patterns of use of oral tenofovir disoproxil fumarate and emtricitabine for HIV pre-exposure prophylaxis in South African adolescents: an open-label single-arm phase 2 trial. Lancet Child Adolesc Health 2020; 4:875-883. [PMID: 33222803 PMCID: PMC9832157 DOI: 10.1016/s2352-4642(20)30248-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 06/22/2020] [Accepted: 07/14/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND HIV incidence among adolescents in southern Africa remains unacceptably high. Pre-exposure prophylaxis (PrEP) is an effective HIV prevention intervention but there are few data on its implementation among adolescents. We aimed to investigate the safety, feasibility, and acceptability of PrEP with oral tenofovir disoproxil fumarate and emtricitabine as part of a comprehensive HIV prevention package in an adolescent population in South Africa. METHODS This open-label single-arm phase 2 study (PlusPills) was done in two research clinics in Cape Town and Johannesburg, South Africa. Adolescents aged 15-19 years were recruited into the study through recruitment events and outreach in the community. Potential participants were eligible for enrolment if they reported being sexually active. Exclusion criteria were a positive test for HIV or pregnancy at enrolment, breastfeeding, or any relevant co-morbidities. Participants were given oral tenofovir disoproxil fumarate and emtricitabine for PrEP to take daily for the first 12 weeks and were then given the choice to opt in or out of PrEP use at three monthly intervals during scheduled clinic visits. Participants were invited to monthly visits for adherence counselling and HIV testing during the study period. The primary outcomes were acceptability, use, and safety of PrEP. Acceptability was measured by the proportion of participants who reported willingness to take up PrEP and remain on PrEP at each study timepoint. Use was defined as the number of participants who continued to use PrEP after the initial 12-week period until the end of the study (week 48). Safety was measured by grade 2, 3, and 4 laboratory and clinical adverse events using the Division of AIDS table for grading the severity of adult and paediatric adverse events, version 1.0. Dried blood spot samples were collected at each study time-point to measure tenofovir diphosphate concentrations. This trial is registered with ClinicalTrials.gov, NCT02213328. FINDINGS Between April 28, 2015, and Nov 11, 2016, 244 participants were screened, and 148 participants were enrolled (median age was 18 years; 99 participants [67%] were female) and initiated PrEP. PrEP was stopped by 26 of the 148 (18%) participants at 12 weeks. Cumulative PrEP opt-out, from the total cohort, was 41% (60 of 148 participants) at week 24 and 43% (63 of 148 participants) at week 36. PrEP was well tolerated with only minor adverse events (grade 2) thought to be related to study drug, which included headache (n=4, 3%), gastrointestinal upset (n=8, 5%), and skin rash (n=2, 1%). Two participants (1%) experienced grade 3 weight loss, which was deemed related to the study drug and resolved fully when PrEP was discontinued. Tenofovir diphosphate concentrations were detectable (>16 fmol/punch) in dried blood spot samples in 108 (92%) of 118 participants who reported PrEP use at week 12, in 74 (74%) of 100 participants at week 24, and in 22 (59%) of 37 participants by the study end at week 48. INTERPRETATION In this cohort of self-selected South African adolescents at risk of HIV acquisition, PrEP appears safe and tolerable in those who continued use. PrEP use decreased throughout the course of the study as the number of planned study visits declined. Adolescents in southern Africa needs access to PrEP with tailored adherence support and possibly the option for more frequent and flexible visit schedules. FUNDING National Institute of Allergy and Infectious Diseases of the US National Institutes of Health.
Collapse
Affiliation(s)
- K Gill
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - L Johnson
- Centre for Infectious Diseases Epidemiology and Research, University of Cape Town, South Africa
| | - J Dietrich
- Perinatal HIV Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - L Myer
- Health Systems Research Unit, South African Medical Research Council, Western Cape, South Africa
| | - R Marcus
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - M Wallace
- Cancer Association of South Africa (CANSA)
| | - T Pidwell
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - E Mendel
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - L Fynn
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| | - K Jones
- Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
| | - L Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, South Africa
| | - C Slack
- HIV AIDS Vaccines Ethics Group, University of KwaZulu- Natal, South Africa
| | - A Strode
- School of Socio Legal Studies, School of Law, Pietermaritzburg, University of KwaZulu-Natal, Private Bag X01, Scottsville
| | - H Spiegel
- Kelly Government Solutions, Contractor to National Institute of Allergy and Infectious Diseases, National Institutes of Health, Department of Health and Human Services, Rockville, USA
| | - S Hosek
- Stroger Hospital of Cook County, Chicago, USA
| | - J Rooney
- Gilead Sciences, 333 Lakeside Drive, Building 300, Foster City, USA
| | - G Gray
- Office of the President, South African Medical Research Council, Western Cape, South Africa
| | - LG Bekker
- Desmond Tutu HIV Centre, University of Cape town, Observatory, Cape Town, South Africa
| |
Collapse
|
18
|
Ha T, Kemp B, Wallace M. Hybrid team based learning-personalised education for teaching epidemiology in public health degrees. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa165.312] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
University education in Australia and internationally involves teaching diverse students: in terms of age, life experience, previous degrees completed, and level of English competency. In Australia the Bachelors of Public Health (BPH) at The University of Wollongong, epidemiology is a core subject. It aims to equip students with the knowledge and skills needed to design, critique and interpret studies that investigate why different populations experience different health outcomes. A student-centred learning strategy; Hybrid Team Based Learning and Personalised Education teaching strategy (HTBL-PE) was created to maximise academic success. Each phase has a distinct purpose based on learning theories (e.g. TBL, Bloom's taxonomy and Vygotsky). HTBL-PE aims to systematically build students abilities; strengthen self-confidence and belief, by teaching the way students learn and harnessing the capabilities of the team to strengthen the individual.
Objectives
HTBL-PE was evaluated in spring 2019 in the BPH, where their experiences at the beginning and end of semester were measured.
Results
In total 73 out of 84 enrolled students provided data at both time-points (87%). At the end of the semester, the vast majority of students indicated their interest in epidemiology had increased (93%), critical thinking had improved (92%), and confidence as independent learners had increased (86%). Outcomes did not differ significantly by gender or across learning styles. More than two thirds of students had already applied learnings from this subject in other settings (67%). Students' final mark for this subject was significantly higher than their Weighted Average Mark (WAM) prior to the semester (+17.4, p < 0.001). Average scores for the subject were > 84/100 with a < 0.5% failure rate.
Conclusions
HTBL-PE has positive learning outcomes; low failure rates, increased confidence in learning and themselves, increased interest in epidemiology and high overall scores in the subject.
Key messages
An effective new innovative teaching strategy resulted in a subject average score > 84/100 and <0.5% failure rate. The vast majority of students reported increased confidence as independent lifelong learners, critical thinking, confidence in epidemiology (knowledge, skills, and attitudes) and themselves.
Collapse
Affiliation(s)
- T Ha
- School of Health and Society, The University of Wollongong, Wollongong, Australia
| | - B Kemp
- School of Health and Society, The University of Wollongong, Wollongong, Australia
| | - M Wallace
- Learning Teaching and Curriculum, The University of Wollongong, Wollongong, Australia
| |
Collapse
|
19
|
|
20
|
Wallace M, Felker-Kantor E, Madkour A, Ferguson T, Welsh D, Molina P, Theall KP. Adverse Childhood Experiences, Smoking and Alcohol Use, and Allostatic Load Among People Living with HIV. AIDS Behav 2020; 24:1653-1662. [PMID: 31559525 DOI: 10.1007/s10461-019-02684-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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] [Indexed: 02/05/2023]
Abstract
Allostatic load is an indicator of multisystem physiologic dysregulation that may arise from prolonged or accumulated exposure to stress, including adverse childhood experiences (ACEs) and chronic stressors persisting into adulthood. People living with HIV (PLWH) may be particularly vulnerable given their high burdens of adversity across the life course. Using data from a cohort of middle aged PLWH, we examined associations between ACEs and two measures of allostatic load. In order to determine whether the negative impact of ACEs on allostatic load operates through increasing the adoption of adverse coping behaviors, we tested for mediation by smoking and alcohol use. PLWH who had experienced 4 or more ACEs had on average higher allostatic load in adulthood compared to those who experienced fewer. Neither smoking nor alcohol use mediated this relationship, however, suggesting alternative mechanisms may be at play.
Collapse
Affiliation(s)
- Maeve Wallace
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA.
| | - Erica Felker-Kantor
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
| | - Aubrey Madkour
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
| | - Tekeda Ferguson
- Department of Epidemiology, Louisiana State University School of Public Health, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - David Welsh
- Section of Pulmonary/Critical Care, Louisiana State University School of Medicine, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - Patricia Molina
- Department of Physiology, Louisiana State University School of Medicine, 2020 Gravier St., 5th floor, New Orleans, LA, 70112, USA
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., suite 2200, New Orleans, LA, 70112, USA
| |
Collapse
|
21
|
Alcantara C, Wallace M, Sotres-Alvarez D, Vetter C, Phillips AJ, Shafazand S, Johnson DA, Wallace D, Gallo LC, Ramos AR, Penedo F, Wohlgemuth WK, Zee PC, Redline S, Patel SR. 1097 Sleep Disturbances, Sleep Burden, And Depressive Symptoms In US Hispanics/Latinos: Results From The HCHS/SOL Sueño Study. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.1092] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
While sleep disturbances and depression often co-occur, these associations are understudied among Hispanics/Latinos. We examined the associations of sleep disturbances and sleep burden with depressive symptoms among Hispanic/Latino adults in the United States.
Methods
We used cross-sectional data from the Hispanic Community Health Study/Study of Latinos Sueño Ancillary study (2010-2013). The study enrolled 2072 adults (ages 18-64; 51.5% females) who completed one-week wrist-actigraphy and sleep questionnaires. Sleep burden was operationalized as the total count of sleep disturbances across six domains (duration, efficiency, midpoint, variability, insomnia, sleepiness). Depressive symptoms were assessed using the Center for Epidemiological Studies Depression scale (CESD-10). We used weighted survey linear regressions to evaluate the association of sleep disturbances and sleep burden with elevated depressive symptoms (CESD≥10) in individual models adjusted for age, gender, site, heritage, nativity, education, income, and employment. Sensitivity analyses further adjusted for behavioral health risk factors and apnea-hypopnea index.
Results
An estimated 28.3% had elevated depressive symptoms, 8.0% had short sleep duration (<6 hours of sleep), 10.9% had long sleep duration (>9 hours), 45.2% exhibited a later sleep midpoint (≥4:00AM), 38.4% had high sleep timing variability (upper third tertile for between day sleep midpoint), 15.3% had insomnia (ISI≥10), 17.3% had excessive daytime sleepiness (ESS ≥10), 21.5% had poor sleep efficiency (<85%), and 77.4% had a total sleep burden count of ≥0. Insomnia (ß=0.49,95%CI:.43,.56), later sleep timing (ß=0.10,95%CI:.04,.16), excessive daytime sleepiness (ß=0.19,95%CI:.11,.27), poor sleep efficiency (ß=0.09,95%CI:.02,.17), high variability (ß=0.07, 95%CI:.01,.12), and sleep burden (ß=0.11,95%CI:.09,.13), were each positively associated with elevated depressive symptoms in individual adjusted models and sensitivity analyses. Extreme sleep durations were not associated with elevated depressive symptoms.
Conclusion
Multiple inter-related sleep disturbances, particularly those pertaining to sleep quality and timing, are associated with depression and may be targets for future interventions aimed at improving mood among Hispanics/Latinos.
Support
HL127307, HL098927, HL125748
Collapse
Affiliation(s)
| | - M Wallace
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - C Vetter
- University of Colorado--Boulder, Boulder, CO
| | | | | | | | | | - L C Gallo
- San Diego State University, San Diego, CA
| | | | | | | | - P C Zee
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - S R Patel
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| |
Collapse
|
22
|
Chung J, Goodman MO, Huang T, Wallace M, Bertisch S, Johnson D, Redline S. 0363 Racial/Ethnic Differences in Actigraphy, Questionnaire, and Polysomnography-Measured Indicators of Sleep Health and Sleep Quality: The Multi-Ethnic Study of Atherosclerosis. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.360] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Introduction
Paradigm shifts in sleep research suggest the importance of considering multi-dimensional sleep health, compared to single metrics, to promote physical and mental well-being and to understand racial/ethnic disparities in sleep.
Methods
We used data from the Multi-Ethnic Study of Atherosclerosis (MESA; n = 1,740) to create a Sleep Health Score (SHS), including questionnaire (quality, sleepiness); 7-day actigraphy (total sleep time, sleep continuity [sleep maintenance efficiency], timing consistency [midpoint variability], fragmentation, wake after sleep onset, sleep onset latency); and in-home polysomnography (%N3 sleep, %REM sleep, AHI). Sleep parameters were dichotomized based on prior literature or by healthiest quartile(s), with positive values denoting healthier sleep (e.g. Epworth scores < 10). All 11 dichotomized parameters were summed to calculate the SHS (mean=4.9, sd=1.58). We used modified Poisson and linear regression for individual sleep outcomes and the SHS, respectively, adjusting for age and sex.
Results
The sample was older (mean age=68.28, sd=9.08) and 54% female. SHSs were associated with Black race (β=-0.60 [-0.78, -0.42]) and Hispanic ethnicity (β=-0.40 [-0.59, -0.21]), but not Chinese ethnicity (β=-0.16 [-0.41, 0.08]). Compared to Whites (n=644), Blacks (n=485) showed lower adjusted probability of obtaining favorable levels of: sleep continuity, fragmentation, timing consistency, alertness/sleepiness, and sleep depth (%N3 sleep). Chinese respondents (n=202) had lower probability of obtaining favorable levels of: sleep continuity and timing consistency, but higher probability of quality. Hispanics (n=409) had lower probability of obtaining healthy levels of: sleep continuity, timing consistency, and fragmentation. Neither healthy total sleep time (middle quartiles) nor AHI (<30) differed by race/ethnicity.
Conclusion
Among MESA-Sleep participants, summary SHSs were lowest in Blacks, followed by Hispanics. Multiple dimensions of sleep - particularly related to continuity and timing consistency - were less favorable across race/ethnic minority groups. A summary SHS may help monitor sleep health across populations, while measurement of specific sleep components may help identify modifiable targets.
Support
Joon Chung is supported by a T-32 NIH training grant.
Collapse
Affiliation(s)
- J Chung
- Brigham and Women’s Hospital, Boston, MA
| | | | - T Huang
- Brigham and Women’s Hospital, Boston, MA
| | - M Wallace
- University of Pittsburgh, Pittsburgh, PA
| | - S Bertisch
- Brigham and Women’s Hospital, Boston, MA
| | | | - S Redline
- Brigham and Women’s Hospital, Boston, MA
| |
Collapse
|
23
|
Madkour AS, Felker-Kantor E, Wallace M, Ferguson T, Welsh DA, Molina PE, Theall KP. Latent Alcohol Use Typologies and Health Status Among a Cohort of Adults Living with HIV. Alcohol Alcohol 2020; 54:584-592. [PMID: 31580404 DOI: 10.1093/alcalc/agz071] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 07/15/2019] [Accepted: 08/02/2019] [Indexed: 11/13/2022] Open
Abstract
AIMS To characterize latent typologies of alcohol use among persons living with human immunodeficiency virus (HIV) (PLWH) and test their relationship with physical and mental health status. METHODS Baseline data from 365 adult in-care PLWH enrolled in the New Orleans Alcohol Use in HIV study were analyzed. Indicators of current and former heavy drinking, intoxication, withdrawal and dependence symptoms, alcohol-related problems and past contact with alcohol use treatment were drawn from validated scales. Physical and mental health measures included SF-36 subscales, medication non-adherence and anxiety, depressive and post-traumatic stress disorder symptoms. Latent class analysis was conducted to characterize alcohol drinking typologies. Logistic and ordinary least-squares regression were employed to test associations between alcohol use and health status. RESULTS Four latent classes were identified: heavy drinkers (36%), former heavy drinkers (14%), heavy drinkers with problems (12%) and low-risk drinkers/abstainers (38%). Controlling for background characteristics, low-risk drinkers/abstainers showed significantly better health compared to heavy drinkers with problems across most domains. Although current and former heavy drinkers without alcohol-related problems were similar to heavy drinkers with problems in most health domains, they presented worse mental health and energy compared to low-risk drinkers/abstainers. CONCLUSIONS Heavy drinkers with alcohol-related problems evidenced the worst health status among PLWH, and should be considered for mental and physical health interventions. However, interventions to improve physical and mental health of PLWH should consider history of heavy alcohol use, as current alcohol use status alone may be insufficient for identifying groups at increased risk.
Collapse
Affiliation(s)
- Aubrey Spriggs Madkour
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, USA
| | - Erica Felker-Kantor
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, USA
| | - Maeve Wallace
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, USA
| | - Tekeda Ferguson
- Department of Epidemiology, School of Public Health, Louisiana State University, 2020 Gravier Street, 3rd Floor, New Orleans, LA 70112, USA.,Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University, 1901 Perdido Street, 7th Floor, New Orleans, LA 70112, USA
| | - David A Welsh
- Section of Pulmonary/Critical Care, School of Medicine, Louisiana State University, 1901 Perdido Street, 3rd Floor, New Orleans, LA 70112, USA.,Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University, 1901 Perdido Street, 7th Floor, New Orleans, LA 70112, USA
| | - Patricia E Molina
- Department of Physiology Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University, 1901 Perdido Street, 7th Floor, New Orleans, LA 70112, USA.,Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University, 1901 Perdido Street, 7th Floor, New Orleans, LA 70112, USA
| | - Katherine P Theall
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, 1440 Canal Street, Suite 2200, New Orleans, LA 70112, USA.,Comprehensive Alcohol Research Center, School of Medicine, Louisiana State University, 1901 Perdido Street, 7th Floor, New Orleans, LA 70112, USA
| |
Collapse
|
24
|
Readnour RS, Coleman MR, Leadbetter MG, Armstrong F, Campbell H, Cleveland C, Dixon S, Massom L, Nandihalli U, Pritts K, Smallidge R, Steed M, Wallace M. Liquid Chromatographic Determination of Tilmicosin in Swine Feed at 200–400 mg/kg Level: Interlaboratory Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.6.1156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
An analytical method for the determination of tilmicosin at 200–400 mg/kg, the intended use concentration range, was evaluated in an interlaboratory study involving 5 laboratories, including the sponsor. The interlaboratory study evaluated the intra- and interlaboratory precision and accuracy of a tilmicosin feed method. The method procedure involved extracting tilmicosin from feed by adding 200 mL extractant to 20 g feed and shaking for 1 h. The extract is filtered and analyzed by gradient liquid chromatography which separates tilmicosin from feed matrix in 30 min. Each laboratory assayed 5 replicates of fortified feed at concentrations of 0,100, 200, 400, and 600 mg/kg. The mean recovery among fortified samples ranged from 81.4 to 98.8%, with a percent coefficient of variation (%CV) ranging from 0.3 to 4.0%. For all blank control feed samples no significant interferences were observed. In addition, each laboratory assayed 5 replicates of medicated feed samples prepared at 2 levels (200 and 400 mg/kg) with either a horizontal or vertical mixer. Along with the medicated feed samples were included 5 replicates of a blank control feed. The identities of the medicated and blank control feed samples were blinded to the analysts. The results for the medicated feed samples ranged from 95.8 to 106% of label claim, with a %CV ranging from 2.1 to 6.7%.
Collapse
Affiliation(s)
- Robin S Readnour
- Elanco Animal Health, A Division of Eli Lilly and Co., 2001 W. Main St, Greenfield, IN 46140
| | - Mark R Coleman
- Elanco Animal Health, A Division of Eli Lilly and Co., 2001 W. Main St, Greenfield, IN 46140
| | - Mary G Leadbetter
- U.S. Food and Drug Administration, Center for Veterinary Medicine, New Animal Drug Evaluation, Division of Chemistry, Chemotherapeutics Branch, HFV-143, 7500 Standish Place, Rockville, MD 20855
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Schreier CJ, Greene RJ, Bhandari S, Britton N, Greene B, Grimm D, Hannah K, Hwang Y, Jeffress D, Kegley M, Mawhinney T, McGill B, Oehrl L, Schulze C, Smallidge R, Vincent D, Wallace M, Willis D. Determination of Ethoxyquin in Feeds by Liquid Chromatography: Collaborative Study. J AOAC Int 2020. [DOI: 10.1093/jaoac/80.4.725] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Ethoxyquin is a chemical antioxidant used in feeds, ingredients, fats, and oils. A liquid chromatographic (LC) method for determination of ethoxyquin was developed. The method involves acetonitrile extraction of the sample and isocratic Cis reversed-phase chromatography with ammonium acetate buffer-acetonitrile as mobile phase and fluorescence detection. A collaborative study of the determination of ethoxyquin in various meals and extruded pet foods was conducted by The lams Company Research Laboratory. Eleven laboratories analyzed 16 samples (including 2 blind duplicates) consisting of 7 meat meals and 9 extruded pet foods. Sample means ranged from 0.25 to 289 ppm. Repeatability standard deviations ranged from 0.08 to 3.2 ppm, and repeatability relative standard deviations ranged from 4.5 to 32%. Reproducibility standard deviations ranged from 0.12 to 13 ppm, and reproducibility relative standard deviations ranged from 4.5 to 55%. The LC method for determination of ethoxyquin in feeds has been adopted first action by AOAC INTERNATIONAL.
Collapse
|
26
|
Jelinek JS, Wu A, Wallace M, Kumar D, Henshaw RM, Murphey MJ, Van Horn A, Aboulafia AJ. Imaging of spindle cell lipoma. Clin Radiol 2020; 75:396.e15-396.e21. [PMID: 31932047 DOI: 10.1016/j.crad.2019.11.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 11/26/2019] [Indexed: 11/28/2022]
Abstract
AIM To review the evaluation, diagnosis, and treatment of spindle cell lipoma (SCL) with emphasis on the location of these tumours and the spectrum of magnetic resonance imaging (MRI) and computed tomography (CT) appearances. MATERIALS AND METHODS The MRI and CT findings of 27 histopathologically proven SCLs were evaluated retrospectively. Imaging features evaluated included margins, percentage visible fat, MRI signal characteristics, oedema, and contrast enhancement patterns. RESULTS Patient ages ranged from 18 to 80 years with an average age of 56.5 years. Men were affected twice as frequently as women (M=18, F=9). SCLs ranged in size from 2 to 10 cm, with an average greatest dimension of 5.5 cm. Five lesions (19%) contained no visible fat on CT or MRI, and the leading differential diagnosis of high-grade soft-tissue sarcoma diagnosis was suggested by referring surgeons. Five lesions (19%) had <50% fatty areas, nine lesions (52%) demonstrated >50% but <90% fat at MRI or CT. Only three of 25 lesions (12%) had an appearance of a typical lipoma on unenhanced MRI sequences. All SCLs that were imaged with contrast medium (n = 18) demonstrated some degree of enhancement, with eight (44%) showing marked enhancement, four (22%) showing moderate, and six (33%) minimal enhancement. CONCLUSION SCLs have considerably variable imaging appearances and may have minimal or no visible fat at MRI or CT. Imaging features may make it difficult to distinguish this benign tumour from a potentially higher-grade malignant tumour.
Collapse
Affiliation(s)
- J S Jelinek
- Department of Radiology, MedStar Washington Hospital Center, 110 Irving Street, NW, Washington DC, 20010, USA.
| | - A Wu
- Department of Internal Medicine, MedStar Franklin Square Medical Center, 9000 Franklin Square Drive, Baltimore, MD, 21237, USA
| | - M Wallace
- Department of Orthopedic Oncology, MedStar Franklin Square Medical Center, 9000 Franklin Square Drive, Baltimore, MD, 21237, USA
| | - D Kumar
- Department of Radiology, MedStar Washington Hospital Center, 110 Irving Street, NW, Washington DC, 20010, USA
| | - R M Henshaw
- Department of Orthopedic Oncology, MedStar Franklin Square Medical Center, 9000 Franklin Square Drive, Baltimore, MD, 21237, USA
| | - M J Murphey
- American Institute for Radiologic Pathology, 1100 Wayne Avenue, Silver Spring, MD, 20910, USA
| | - A Van Horn
- Department of Orthopedic Oncology, MedStar Franklin Square Medical Center, 9000 Franklin Square Drive, Baltimore, MD, 21237, USA
| | - A J Aboulafia
- Department of Orthopedic Oncology, MedStar Franklin Square Medical Center, 9000 Franklin Square Drive, Baltimore, MD, 21237, USA
| |
Collapse
|
27
|
Dyer L, Hardeman R, Vilda D, Theall K, Wallace M. Mass incarceration and public health: the association between black jail incarceration and adverse birth outcomes among black women in Louisiana. BMC Pregnancy Childbirth 2019; 19:525. [PMID: 31881857 PMCID: PMC6935062 DOI: 10.1186/s12884-019-2690-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 12/19/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND A growing body of evidence is beginning to highlight how mass incarceration shapes inequalities in population health. Non-Hispanic blacks are disproportionately affected by incarceration and criminal law enforcement, an enduring legacy of a racially-biased criminal justice system with broad health implications for black families and communities. Louisiana has consistently maintained one of the highest rates of black incarceration in the nation. Concurrently, large racial disparities in population health persist. METHODS We conducted a cross-sectional analysis of all births among non-Hispanic black women in Louisiana in 2014 to identify associations between parish-level (county equivalent) prevalence of jail incarceration within the black population and adverse birth outcomes (N = 23,954). We fit a log-Poisson model with generalized estimating equations to approximate the relative risk of preterm birth and low birth weight associated with an interquartile range increase in incarceration, controlling for confounders. In sensitivity analyses, we additionally adjusted for the parish-level index crime prevalence and analyzed regression models wherein white incarceration was used to predict the risk of adverse birth outcomes in order to quantify the degree to which mass incarceration may harm health above and beyond living in a high crime area. RESULTS There was a significant 3% higher risk of preterm birth among black women associated with an interquartile range increase in the parish-level incarceration prevalence of black individuals, independent of other factors. Adjusting for the prevalence of index crimes did not substantively change the results of the models. CONCLUSION Due to the positive significant associations between the prevalence of black individuals incarcerated in Louisiana jails and estimated risk of preterm birth, mass incarceration may be an underlying cause of the persistent inequities in reproductive health outcomes experienced by black women in Louisiana. Not only are there economic and social impacts stemming from mass incarceration, but there may also be implications for population health and health inequities, including the persistence of racial disparities in preterm birth and low birth weight.
Collapse
Affiliation(s)
- Lauren Dyer
- Mary Amelia Douglas-Whited Community Women’s Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112 USA
| | - Rachel Hardeman
- Division of Health Policy and Management, University of Minnesota School of Public Health, 420 Delaware St SE, Minneapolis, MN 55455 USA
| | - Dovile Vilda
- Mary Amelia Douglas-Whited Community Women’s Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112 USA
| | - Katherine Theall
- Mary Amelia Douglas-Whited Community Women’s Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112 USA
| | - Maeve Wallace
- Mary Amelia Douglas-Whited Community Women’s Health Education Center, Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA 70112 USA
| |
Collapse
|
28
|
Theall KP, Wallace M, Felker-Kantor E, Madkour AS, Brashear M, Ferguson T, Welsh D, Molina P. Neighborhood Alcohol Environment: Differential Effects on Hazardous Drinking and Mental Health by Sex in Persons Living with HIV (PLWH). AIDS Behav 2019; 23:3237-3246. [PMID: 31401740 DOI: 10.1007/s10461-019-02632-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Indexed: 12/14/2022]
Abstract
Despite greater mental health co-morbidities and heavier alcohol use among PLWH, few studies have examined the role of the neighborhood alcohol environment on either alcohol consumption or mental health. Utilizing cross-sectional data from a cohort study in a southern U.S. metropolitan area, we examine the association between neighborhood alcohol environments on hazardous drinking and mental health among 358 in-care PLWH (84% African American, 31% female). Multilevel models were utilized to quantify associations between neighborhood alcohol exposure on hazardous drinking and effect modification by sex. Neighborhood alcohol density was associated with hazardous drinking among men but not women. Women living in alcohol dense neighborhoods were nearly two-fold likely to report depression compared to those in less dense neighborhoods, with no association between neighborhood alcohol density and depression among men. Neighborhood alcohol environments may be an important contextual factor to consider in reducing heavy alcohol consumption and improving mental health among PLWH.
Collapse
Affiliation(s)
- K P Theall
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA.
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA.
| | - M Wallace
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
| | - E Felker-Kantor
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - A S Madkour
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
| | - M Brashear
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
| | - T Ferguson
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
- Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA
| | - D Welsh
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
| | - P Molina
- Louisiana State University Health Sciences Center Comprehensive Alcohol and HIV Research Center (CARC), New Orleans, LA, USA
| |
Collapse
|
29
|
Visser J, Knight K, Philips L, Visser W, Wallace M, Nel DG, Blaauw R. Determinants of serum 25-hydroxyvitamin D levels in healthy young adults living in the Western Cape, South Africa. S Afr Fam Pract (2004) 2019. [DOI: 10.4102/safp.v61i4.4951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Background: Vitamin D deficiency is fast emerging as a global pandemic. In South Africa few studies have been conducted to determine the vitamin D status of the healthy population.Methods: This prospective study with an analytical component investigated vitamin D status of healthy undergraduate students at two time points (winter and summer) at Stellenbosch University. Serum 25(OH)D was determined, anthropometric measurements taken and dietary vitamin D intake estimated (food-frequency questionnaire). Skin tone was determined (Fitzpatrick skin type classification), and a skin reflectometry device used to measure dermal melanin content.Results: Results of 242 students indicated a mean serum 25(OH)D of 63.80 ± 41.35 ng/ml and a high prevalence of vitamin D sufficiency (88%). Significantly more females experienced suboptimal vitamin D levels than males (18 vs. 5%; p 0.01). Participants with lighter skin tones had higher levels of 25(OH)D than those with darker skin tones (chi-square = 24.02; p = 0.02). The majority (60.74%) had a normal BMI, although there was no significant relationship between BMI and serum 25 (OH)D (Spearman’s r=–0.11; p = 0.09). Total mean dietary vitamin D intake was 7.99 ± 13.81 mcg, with 87.2% having inadequate intake ( 15 mcg). The relationship between total vitamin D intake and serum 25(OH)D was found to be significant in winter (p 0.001) and summer (p = 0.01). Serum vitamin D levels were significantly higher in the winter phase (p 0.001).Conclusions: A low prevalence of vitamin D deficiency was found amongst healthy young adults, despite low dietary vitamin D intakes. Significant relationships were found between serum 25(OH)D and gender, skin tone and vitamin D intake. Further studies need to be conducted, especially in high-risk groups, before results are applied to the greater South African public.
Collapse
|
30
|
Vitzthum L, Riviere P, Sheridan P, Nalawade V, Deka R, Xu R, Mell L, Wallace M, Murphy J. Predicting Persistent Opioid Use, Abuse and Toxicity Among Cancer Survivors. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.524] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
31
|
Vilda D, Wallace M, Dyer L, Harville E, Theall K. Income inequality and racial disparities in pregnancy-related mortality in the US. SSM Popul Health 2019; 9:100477. [PMID: 31517017 PMCID: PMC6734101 DOI: 10.1016/j.ssmph.2019.100477] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/24/2019] [Accepted: 08/25/2019] [Indexed: 12/24/2022] Open
Abstract
In this ecological study, we examined the associations between state-level income inequality and pregnancy-related mortality among non-Hispanic (NH) black and NH white populations across the US. We estimated total population and race-specific 5-year pregnancy-related mortality ratios in each state based on national death and live birth records from 2011 to 2015. We obtained data on Gini coefficients for income inequality and population-level characteristics from the US Census American Community Survey. Poisson regression with robust standard errors estimated pregnancy-related mortality rate ratios (RR) and 95% confidence intervals (CI) associated with a one unit increase in income inequality overall and separately within black and white populations. Adjusted linear regression models estimated the associations between income inequality and magnitude of the absolute and relative racial inequity in pregnancy-related mortality within states. Across all states, increasing contemporaneous income inequality was associated with a 15% and 5-year lagged inequality with 14% increase in pregnancy-related mortality among black women (aRR = 1.15, 95% CI = 1.05; 1.25 and aRR = 1.14, 95% CI = 1.04; 1.24, respectively) after controlling for states' racial compositions and socio-economic conditions. In addition, both lagged and contemporaneous income inequality were associated with larger absolute and relative racial inequities in pregnancy-related mortality. These findings highlight the role of contextual factors in contributing to pregnancy-related mortality among black women and the persistent racial inequity in maternal death in the US.
Collapse
Affiliation(s)
- Dovile Vilda
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA.,Tulane Mary Amelia Douglas-Whited Community Women's Health Education Center, 143 S. Liberty Street, New Orleans, LA, 70112, USA
| | - Maeve Wallace
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA.,Tulane Mary Amelia Douglas-Whited Community Women's Health Education Center, 143 S. Liberty Street, New Orleans, LA, 70112, USA
| | - Lauren Dyer
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA.,Tulane Mary Amelia Douglas-Whited Community Women's Health Education Center, 143 S. Liberty Street, New Orleans, LA, 70112, USA
| | - Emily Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA
| | - Katherine Theall
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., New Orleans, LA, 70112, USA.,Tulane Mary Amelia Douglas-Whited Community Women's Health Education Center, 143 S. Liberty Street, New Orleans, LA, 70112, USA
| |
Collapse
|
32
|
Visser J, Knight K, Philips L, Visser W, Wallace M, Nel DG, Blaauw R. Determinants of serum 25-hydroxyvitamin D levels in healthy young adults living in the Western Cape, South Africa. S Afr Fam Pract (2004) 2019. [DOI: 10.1080/20786190.2019.1621047] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- J Visser
- Division of Human Nutrition, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - K Knight
- Division of Human Nutrition, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - L Philips
- Division of Human Nutrition, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| | - W Visser
- Division of Dermatology, Stellenbosch University, Cape Town, South Africa
| | - M Wallace
- Cancer Association of South Africa (CANSA), Cape Town, South Africa
| | - DG Nel
- Centre for Statistical Consultation, Stellenbosch University, Stellenbosch, South Africa
| | - R Blaauw
- Division of Human Nutrition, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
33
|
Harville EW, Jacobs M, Shu T, Breckner D, Wallace M. Comparison of reproductive history gathered by interview and by vital records linkage after 40 years of follow-up: Bogalusa Babies. BMC Med Res Methodol 2019; 19:114. [PMID: 31164081 PMCID: PMC6549375 DOI: 10.1186/s12874-019-0758-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 05/21/2019] [Indexed: 11/17/2022] Open
Abstract
Background To examine the consistency and likely degree of bias in a study of cardiovascular health, linked with reproductive data over 40 years. Methods Linkage of vital statistics data of births to female Bogalusa Heart Study participants was compared to interviewing of female participants. The characteristics of participants, the agreement, and demographic, study-related, and medical predictors of discrepancy were analyzed, using kappa statistics, mean and median differences, and logistic regression. Results Overall, 3944 (66.7%) of participants were located by one or both sources. The strongest predictor of either linkage or interview was recent and/or frequent participation in the parent study. Agreement between the two sources was generally good (kappa > 0.9 for birthweight and 0.8 for gestational age). Black race, older age, and time since pregnancy were associated with greater discrepancy in reporting of outcomes, but cardiovascular risk factors generally were not. Conclusions Combining information from multiple sources to increase sample size and outcome ascertainment may be valid, which will increase population health sciences’ ability to leverage the many existing, large-scale sources to answer previously unexplored questions, even those that the data were not initially collected to answer. Electronic supplementary material The online version of this article (10.1186/s12874-019-0758-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Epidemiology #8318, 1440 Canal ST STE 2000, New Orleans, LA, 70112, USA.
| | - Marni Jacobs
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Epidemiology #8318, 1440 Canal ST STE 2000, New Orleans, LA, 70112, USA.,Division of Biostatistics and Study Methodology, Children's National Health System, Washington, DC, 20010, USA
| | - Tian Shu
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Epidemiology #8318, 1440 Canal ST STE 2000, New Orleans, LA, 70112, USA
| | - Dorothy Breckner
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Epidemiology #8318, 1440 Canal ST STE 2000, New Orleans, LA, 70112, USA
| | - Maeve Wallace
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, Epidemiology #8318, 1440 Canal ST STE 2000, New Orleans, LA, 70112, USA.,Department of Global Community Health and Behavior, Tulane School of Public Health and Tropical Medicine, New Orleans, LA, USA
| |
Collapse
|
34
|
|
35
|
Smith MS, Cash B, Konda V, Trindade AJ, Gordon S, DeMeester S, Joshi V, Diehl D, Ganguly E, Mashimo H, Singh S, Jobe B, McKinley M, Wallace M, Komatsu Y, Thakkar S, Schnoll-Sussman F, Sharaiha R, Kahaleh M, Tarnasky P, Wolfsen H, Hawes R, Lipham J, Khara H, Pleskow D, Navaneethan U, Kedia P, Hasan M, Sethi A, Samarasena J, Siddiqui UD, Gress F, Rodriguez R, Lee C, Gonda T, Waxman I, Hyder S, Poneros J, Sharzehi K, Di Palma JA, Sejpal DV, Oh D, Hagen J, Rothstein R, Sawhney M, Berzin T, Malik Z, Chang K. Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry. Dis Esophagus 2019; 32:5481776. [PMID: 31037293 PMCID: PMC6853704 DOI: 10.1093/dote/doz029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 02/08/2019] [Indexed: 12/11/2022]
Abstract
Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291.
Collapse
Affiliation(s)
- M S Smith
- Mount Sinai West & Mount Sinai St. Luke's Hospitals, New York, New York,Address correspondence to: Michael S. Smith, M.D., M.B.A., Chief of Gastroenterology and Hepatology, Mount Sinai West & Mount Sinai St. Luke's Hospitals, Ambulatory Care Center, Floor 13, 440 W. 114th Street, New York, NY 10025, USA.
| | - B Cash
- University of Texas Health Science Center at Houston, Houston, Texas
| | - V Konda
- Baylor University Medical Center, Dallas, Texas
| | - A J Trindade
- Zucker School of Medicine at Hofstra/Northwell, Northwell Health System Manhasset, New York
| | - S Gordon
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - V Joshi
- University Medical Center at LSU, New Orleans, Louisiana
| | - D Diehl
- Geisinger Medical Center, Danville, Pennsylvania
| | - E Ganguly
- University of Vermont Medical Center, Burlington, Vermont
| | - H Mashimo
- VA Boston Health Care System, Boston, Massachusetts
| | - S Singh
- VA Boston Health Care System, Boston, Massachusetts
| | - B Jobe
- Allegheny Health Network, Pittsburgh, Pennsylvania
| | - M McKinley
- Zucker School of Medicine at Hofstra/Northwell, Northwell Health System Manhasset, New York,ProHEALTHcare Associates, Lake Success, New York, New York
| | | | - Y Komatsu
- Allegheny Health Network, Pittsburgh, Pennsylvania
| | - S Thakkar
- Allegheny Health Network, Pittsburgh, Pennsylvania
| | | | - R Sharaiha
- Weill Cornell Medicine, New York, New York
| | - M Kahaleh
- Robert Wood Johnson University Hospital, New Brunswick, New Jersey
| | | | | | - R Hawes
- Florida Hospital, Orlando, Florida
| | - J Lipham
- University of Southern California, Keck School of Medicine, Los Angeles, California
| | - H Khara
- Geisinger Medical Center, Danville, Pennsylvania
| | - D Pleskow
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | - P Kedia
- Methodist Health System, Dallas, Texas
| | - M Hasan
- Florida Hospital, Orlando, Florida
| | - A Sethi
- Columbia University Medical Center, New York, New York
| | | | | | - F Gress
- Columbia University Medical Center, New York, New York
| | - R Rodriguez
- University of South Alabama, Mobile, Alabama
| | - C Lee
- Zucker School of Medicine at Hofstra/Northwell, Northwell Health System Manhasset, New York
| | - T Gonda
- Columbia University Medical Center, New York, New York
| | - I Waxman
- Chicago Medicine, Chicago, Illinois
| | - S Hyder
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - J Poneros
- Columbia University Medical Center, New York, New York
| | - K Sharzehi
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - J A Di Palma
- University of Texas Health Science Center at Houston, Houston, Texas
| | - D V Sejpal
- Zucker School of Medicine at Hofstra/Northwell, Northwell Health System Manhasset, New York
| | - D Oh
- University of Southern California, Keck School of Medicine, Los Angeles, California
| | - J Hagen
- University of Southern California, Keck School of Medicine, Los Angeles, California
| | - R Rothstein
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - M Sawhney
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - T Berzin
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Z Malik
- Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania
| | - K Chang
- UC Irvine Medical Center, Irvine, California
| |
Collapse
|
36
|
Puschendorf R, Wallace M, Chavarría MM, Crawford AJ, Wynne F, Knight M, Janzen DH, Hallwachs W, Palmer C, Price SJ. Cryptic diversity and ranavirus infection of a critically endangered Neotropical frog before and after population collapse. Anim Conserv 2019. [DOI: 10.1111/acv.12498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- R. Puschendorf
- School of Biological and Marine Sciences University of Plymouth Devon UK
| | - M. Wallace
- Department of Zoology University of Oxford Oxford UK
| | - M. M. Chavarría
- Programa de Investigación Área de Conservación Guanacaste Liberia Costa Rica
| | - A. J. Crawford
- Departamento de Ciencias Biológicas Universidad de los Andes Bogotá Colombia
| | - F. Wynne
- School of Biological and Marine Sciences University of Plymouth Devon UK
| | - M. Knight
- School of Biological and Marine Sciences University of Plymouth Devon UK
| | - D. H. Janzen
- Department of Biology University of Pennsylvania Philadelphia PA USA
| | - W. Hallwachs
- Department of Biology University of Pennsylvania Philadelphia PA USA
| | - C.V. Palmer
- School of Biological and Marine Sciences University of Plymouth Devon UK
| | - S. J. Price
- UCL Genetics Institute London UK
- Institute of Zoology, ZSL London UK
| |
Collapse
|
37
|
Moeller-Bertram T, Schilling J, Hughes C, Wallace M, Sexton M, Backonja M. (360) Can CBD Reduce the Use of Pain Medication? Lessons from a Survey in a Pain Clinic Environment. The Journal of Pain 2019. [DOI: 10.1016/j.jpain.2019.02.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
38
|
Scovil CY, Delparte JJ, Walia S, Flett HM, Guy SD, Wallace M, Burns AS, Wolfe DL, Wolfe D, Kras-Dupuis A, Walia S, Guy S, Askes H, Casalino A, Fraser C, Paiva M, Miles S, Gagliardi J, Orenczuk S, Sommerdyk J, Genereaux M, Jarvis D, Wesenger J, Bloetjes L, Flett H, Burns A, Scovil C, Delparte J, Leber D, McMillan L, Domingo T, Wallace M, Stoesz B, Aguillon G, Koning C, Mumme L, Cwiklewich M, Bayless K, Crouse L, Crocker J, Erickson G, Mark M, Charbonneau R, Lloyd A, Van Doesburg C, Knox J, Wright P, Mouneimne M, Parmar R, Isaacs T, Reader J, Oga C, Birchall N, McKenzie N, Nicol S, Joly C, Laramée M, Robidoux I, Casimir M, Côté S, Lubin C, Lemay J, Beaulieu J, Truchon C, Noreau L, Lemay V, Vachon J, Bélanger D, Proteau F, O'Connell C, Savoie J, McCullum S, Brown J, Duda M, Bassett-Spiers K, Riopelle R, Hsieh J, Reinhart-McMillan W, Joshi P, Noonan V, Humphreys S, Hamilton L, MacIsaac G. Implementation of Pressure Injury Prevention Best Practices Across 6 Canadian Rehabilitation Sites: Results From the Spinal Cord Injury Knowledge Mobilization Network. Arch Phys Med Rehabil 2019; 100:327-335. [DOI: 10.1016/j.apmr.2018.07.444] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 07/11/2018] [Accepted: 07/20/2018] [Indexed: 12/19/2022]
|
39
|
Affiliation(s)
- C Musil
- Case Western Reserve University, Cleveland, Ohio, United States
| | | | - S E Givens
- Case Western Reserve University, Cleveland, OH, USA
| | - C Henrich
- Case Western Reserve University, Cleveland, OH, USA
| | - M Wallace
- Case Western Reserve University, Cleveland, OH, USA
| | - A Jeanblanc
- Case Western Reserve University, Cleveland, OH, USA
| | - C J Burant
- Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
40
|
Jeanblanc A, Wallace M, Musil C, Givens S. NOVEL APPROACHES FOR USING FACEBOOK AS A RECRUITMENT TOOL FOR GRANDMOTHER CAREGIVERS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.580] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Jeanblanc
- Case Western Reserve University - Frances Payne Bolton School of Nursing
| | - M Wallace
- Case Western Reserve University - Frances Payne Bolton School of Nursing
| | - C Musil
- Case Western Reserve University
| | - S Givens
- Case Western Reserve University - Frances Payne Bolton School of Nursing
| |
Collapse
|
41
|
Buysse DJ, Blackwell T, Ancoli-Israel S, Ensrud KE, Wallace M, Cawthon PM, Spira AP, Stone KL. MULTI-DIMENSIONAL SUBJECTIVE SLEEP HEALTH AND AGE-RELATED OUTCOMES. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2211] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- D J Buysse
- University of Pittsburgh, Pittsburgh, PA, USA
| | - T Blackwell
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | | | - K E Ensrud
- University of Minnesota, Minneapolis, MN, USA.edu
| | - M Wallace
- University of Pittsburgh, Pittsburgh, PA, USA
| | - P M Cawthon
- California Pacific Medical Center Research Institute, San Francisco, CA, USA
| | - A P Spira
- Johns Hopkins University, Baltimore, MD, USA
| | - K L Stone
- California Pacific Medical Center Research Institute, San Francisco, California, United States
| |
Collapse
|
42
|
Wallace M, Bos A, Noble C. Cancer-Related Stigma in South Africa: Exploring Beliefs and Experiences Among Cancer Patients and the General Public. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.53700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Stigma refers to a distinctive, discrediting characteristic, rendering its bearer tainted or inferior by others. Definitions of stigma acknowledge the recognition of difference; and devaluation. Evidence, largely from high-income countries suggests that cancer is a stigmatized disease. Cancer-related stigma is not well-documented in South Africa, and little is known about how it impacts health-seeking behavior, treatment adherence, quality of life and psychosocial well-being in cancer patients. Limited research has explored perceptions and cultural representations of cancer but an in-depth focus on this is lacking. This context-specific information is essential for relevant, effective intervention. Aim: This study aims to increase understanding of cancer-related stigma in South Africa and the role of cultural beliefs in contributing to this. Findings will be used to inform a larger study and ultimately, interventions to address cancer-related stigma in communities in which the Cancer Association of South Africa (CANSA) is working. Methods: This qualitative study was conducted in two provinces of South Africa, KwaZulu Natal and the Western Cape and included participants from a range of cultural and racial groups. Cancer patients over 18 years were recruited through CANSA's Service Delivery teams to participate in focus groups or one to one in depth interviews. Six focus groups and 40 in depth interviews were conducted with cancer patients. Data collection focused on understanding patient experiences of cancer stigma; cognitive, emotional and behavioral responses to this; and inputs on interventions to address this. Six focus groups were also conducted with noncancer patients recruited from local communities to explore cultural perceptions of cancer and reasons for stigmatization. Audio recordings were transcribed and translated; coded using NVivo 11; and analyzed by the authors using thematic analysis. Results: Results indicated very poor knowledge of cancer both in patients and nonpatients. Overwhelmingly, findings highlight the perception of cancer as a “death sentence”, influencing patients' experiences and responses of others in numerous ways. The influence of cultural beliefs was relevant, exacerbating stigma in some cases. The location of the cancer also played a role in determining level of stigmatization. Certain body parts (associated with masculine and feminine roles) as well as more visible cancers/side-effects were more stigmatised. Conclusion: Results indicate that stigmatization is a significant factor for cancer patients in South Africa, increasing social isolation and negatively impacting quality of life. The implications of the findings for intervention development will be discussed. Education is needed but requires a different focus for different cultural groups.
Collapse
Affiliation(s)
- M. Wallace
- Cancer Association of South Africa, Cape Town, South Africa
| | - A. Bos
- Cancer Association of South Africa, Cape Town, South Africa
| | - C. Noble
- Cancer Association of South Africa, Cape Town, South Africa
| |
Collapse
|
43
|
Affiliation(s)
- K. Y. Low
- Depatrment of Medicine University of Cambridge Cambridge UK
| | - M. Wallace
- Department of Dermatology Cambridge University Hospitals NHS Trust Cambridge UK
| |
Collapse
|
44
|
Wennerstrom A, Haywood C, Wallace M, Sugarman M, Walker A, Bonner T, Sutton Y, Keller BL, Lewis M, Springgate B, Theall K. Creating Safe Spaces: A Community Health Worker-Academic Partnered Approach to Addressing Intimate Partner Violence. Ethn Dis 2018; 28:317-324. [PMID: 30202184 DOI: 10.18865/ed.28.s2.317] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [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: 11/18/2022] Open
Abstract
Intimate partner violence (IPV) is a persistent public health problem in the United States, with an estimated one in three women experiencing rape, physical violence, and/or stalking by an intimate partner within her lifetime. Non-Hispanic Black women disproportionately experience IPV, but there has been limited success in implementing culturally appropriate prevention programs and services for members of this population. Community health workers (CHWs) are trusted members of under-resourced communities who provide reliable health information and improve the cultural appropriateness of service delivery and may be a vital resource for developing new IPV interventions. Guided by the principles of community partnered participatory research, we developed the CHW-led Safe Spaces project, which aimed to establish a strong academic-community partnership to focus on issues related to experiences of IPV and the prevention of IPV in New Orleans. In this article, we describe the development of our partnership including the formation of an advisory board, creation of a broad-based stakeholder coalition, offering a community partnered participatory research training, conducting IPV education and outreach, and establishing a research agenda. Our processes are replicable and lessons learned may be relevant to other groups seeking to address IPV by leveraging the strengths of community-academic collaborations and CHWs.
Collapse
Affiliation(s)
| | | | - Maeve Wallace
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | | | - Ashlee Walker
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | | | - Yana Sutton
- Kali Red's Initiative: Take Back Your Life Foundation, New Orleans, LA
| | | | - Marva Lewis
- Tulane University School of Social Work, New Orleans, LA
| | | | - Katherine Theall
- Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| |
Collapse
|
45
|
Tita AT, Jablonski KA, Bailit JL, Grobman WA, Wapner RJ, Reddy UM, Varner MW, Thorp JM, Leveno KJ, Caritis SN, Iams JD, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, Wallace M, Northen A, Grant J, Colquitt C, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Shubert P, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Zhao Y, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Spong C, Tolivaisa S, VanDorsten J. Neonatal outcomes of elective early-term births after demonstrated fetal lung maturity. Am J Obstet Gynecol 2018; 219:296.e1-296.e8. [PMID: 29800541 DOI: 10.1016/j.ajog.2018.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 11/09/2016] [Accepted: 05/14/2018] [Indexed: 10/16/2022]
Abstract
BACKGROUND Studies of early-term birth after demonstrated fetal lung maturity show that respiratory and other outcomes are worse with early-term birth (370-386 weeks) even after demonstrated fetal lung maturity when compared with full-term birth (390-406 weeks). However, these studies included medically indicated births and are therefore potentially limited by confounding by the indication for delivery. Thus, the increase in adverse outcomes might be due to the indication for early-term birth rather than the early-term birth itself. OBJECTIVE We examined the prevalence and risks of adverse neonatal outcomes associated with early-term birth after confirmed fetal lung maturity as compared with full-term birth in the absence of indications for early delivery. STUDY DESIGN This is a secondary analysis of an observational study of births to 115,502 women in 25 hospitals in the United States from 2008 through 2011. Singleton nonanomalous births at 37-40 weeks with no identifiable indication for delivery were included; early-term births after positive fetal lung maturity testing were compared with full-term births. The primary outcome was a composite of death, ventilator for ≥2 days, continuous positive airway pressure, proven sepsis, pneumonia or meningitis, treated hypoglycemia, hyperbilirubinemia (phototherapy), and 5-minute Apgar <7. Logistic regression and propensity score matching (both 1:1 and 1:2) were used. RESULTS In all, 48,137 births met inclusion criteria; the prevalence of fetal lung maturity testing in the absence of medical or obstetric indications for early delivery was 0.52% (n = 249). There were 180 (0.37%) early-term births after confirmed pulmonary maturity and 47,957 full-term births. Women in the former group were more likely to be non-Hispanic white, smoke, have received antenatal steroids, have induction, and have a cesarean. Risks of the composite (16.1% vs 5.4%; adjusted odds ratio, 3.2; 95% confidence interval, 2.1-4.8 from logistic regression) were more frequent with elective early-term birth. Propensity scores matching confirmed the increased primary composite in elective early-term births: adjusted odds ratios, 4.3 (95% confidence interval, 1.8-10.5) for 1:1 and 3.5 (95% confidence interval, 1.8-6.5) for 1:2 matching. Among components of the primary outcome, CPAP use and hyperbilirubinemia requiring phototherapy were significantly increased. Transient tachypnea of the newborn, neonatal intensive care unit admission, and prolonged neonatal intensive care unit stay (>2 days) were also increased with early-term birth. CONCLUSION Even with confirmed pulmonary maturity, early-term birth in the absence of medical or obstetric indications is associated with worse neonatal respiratory and hepatic outcomes compared with full-term birth, suggesting relative immaturity of these organ systems in early-term births.
Collapse
|
46
|
Hanrahan L, McHugh N, Hennessy T, Moran B, Kearney R, Wallace M, Shalloo L. Factors associated with profitability in pasture-based systems of milk production. J Dairy Sci 2018. [DOI: 10.3168/jds.2017-13223] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
47
|
Theall KP, Felker-Kantor E, Wallace M, Zhang X, Morrison CN, Wiebe DJ. Considering high alcohol and violence neighborhood context using daily diaries and GPS: A pilot study among people living with HIV. Drug Alcohol Depend 2018; 187:236-241. [PMID: 29684891 PMCID: PMC5959796 DOI: 10.1016/j.drugalcdep.2018.03.005] [Citation(s) in RCA: 8] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 03/06/2018] [Accepted: 03/06/2018] [Indexed: 02/07/2023]
Abstract
Our understanding of how community-level context impacts care of persons living with HIV (PLWH), including antiretroviral therapy (ART) adherence and retention in care, is limited. The objective of this study was to characterize the activity spaces of PLWH from an urban area in Southeastern U.S., where the epidemic is among the nation's highest, and to examine how such activity spaces are associated with daily mood and health behaviors. In this small, pilot study, 11 participants were tracked with a global positioning system (GPS)-enabled application on their smartphones for 2 weeks. Activity spaces were created by connecting GPS points sequentially and adding buffers. Contextual exposure data (e.g., alcohol outlets) were connected to activity spaces. Participants also completed daily diary entry through texts 3 times per day regarding outcomes of substance use behaviors, mood, and medication adherence. This yielded a total of 18,007 GPS polyline records that we aggregated into 258 person-days that captured discrete occasions of exposure to contextual factors and subjects' behaviors and moods. On average, the participants spent 19% of their time awake during the 2-week periods in their residential census tract. Exposure to social and built environment factors such as alcohol outlets was greater when participants were outside versus inside their residential census tract. Exposures on daily routes were also significantly associated with ART adherence, alcohol consumption, and mood. Findings suggest substantial differences between activity spaces and residential contexts. Activity spaces are relevant for PLWH and may impact HIV care and behavioral outcomes such as ART adherence and substance use.
Collapse
Affiliation(s)
- Katherine P Theall
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA; Louisiana State University Health Sciences Center Comprehensive Alcohol Research Center (CARC), 1901 Perdido Street, New Orleans, LA, 70112, USA.
| | - Erica Felker-Kantor
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA
| | - Maeve Wallace
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA; Louisiana State University Health Sciences Center Comprehensive Alcohol Research Center (CARC), 1901 Perdido Street, New Orleans, LA, 70112, USA
| | - Xiao Zhang
- Tulane University School of Public Health and Tropical Medicine, 1440 Canal St., Mailstop 8319, New Orleans, LA, 70112, USA
| | - Christopher N Morrison
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA
| | - Douglas J Wiebe
- University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Blvd., Philadelphia, PA, 19104, USA
| |
Collapse
|
48
|
Williams AD, Wallace M, Nobles C, Mendola P. Racial residential segregation and racial disparities in stillbirth in the United States. Health Place 2018; 51:208-216. [PMID: 29715639 DOI: 10.1016/j.healthplace.2018.04.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [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: 02/14/2018] [Revised: 04/18/2018] [Accepted: 04/23/2018] [Indexed: 12/19/2022]
Abstract
We examined whether current and/or persistent racial residential segregation is associated with black-white stillbirth disparities among 49,969 black and 71,785 white births from the Consortium on Safe Labor (2002-2008). Black-white segregation was measured using the dissimilarity index and the isolation index, categorized into population-based tertiles. Using hierarchical logistic models, we found low and decreasing levels of segregation were associated with decreased odds of stillbirth, with blacks benefitting more than whites. Decreasing segregation may prevent approximately 900 stillbirths annually among U.S. blacks. Reducing structural racism, segregation in particular, could help reduce black-white stillbirth disparities.
Collapse
Affiliation(s)
- Andrew D Williams
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge, Bethesda, MD 20892, USA
| | - Maeve Wallace
- Department of Global Community Health and Behavioral Sciences, Tulane University School of Public Health and Tropical Medicine, 1440 Canal Street, Suite 2210, New Orleans, LA 70117, USA
| | - Carrie Nobles
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge, Bethesda, MD 20892, USA
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge, Bethesda, MD 20892, USA.
| |
Collapse
|
49
|
Wallace M, Stone K, Redline S, Hall M, Buysse D. 0735 Which Self-Reported Sleep Health Characteristics Predict Mortality in Older Adults? Sleep 2018. [DOI: 10.1093/sleep/zsy061.734] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M Wallace
- University of Pittsburgh, Pittsburgh, PA
| | - K Stone
- California Pacific Medical Center, San Francisco, CA
| | | | - M Hall
- University of Pittsburgh, Pittsburgh, PA
| | - D Buysse
- University of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
50
|
Cottle DJ, Wallace M, Lonergan P, Fahey AG. Bioeconomics of sexed semen utilization in a high-producing Holstein-Friesian dairy herd. J Dairy Sci 2018; 101:4498-4512. [PMID: 29454687 DOI: 10.3168/jds.2017-13172] [Citation(s) in RCA: 12] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 12/18/2017] [Indexed: 11/19/2022]
Abstract
A bioeconomic, stochastic spreadsheet model, that included calculation of the net present value of the additional value of all future descendants resulting from increased selection intensity, was developed to study the profitability of using sexed semen in a high input-high output dairy herd. Three management strategies were modeled: (1) only heifers inseminated with sex-sorted semen and cows inseminated with unsorted semen; (2) both heifers and cows inseminated with sex-sorted semen; and (3) a reference scenario, in which all breeding females were inseminated with unsorted semen. A Monte Carlo simulation (@risk software, Palisade Corp., Ithaca, NY) was run to study the sensitivity of net profit and sexed semen advantage to key input parameters. Most input parameters were given truncated normal distributions, whereas the maximum numbers of inseminations in heifers and cows were given discrete distribution functions. The calculated intensity of selection accounted for the different numbers of dairy females born for each of the 100,000 iterations. Using sexed semen (X-sorted, female) was shown to be profitable, with insemination of both heifers and cows being most profitable. The returns on assets were higher when only heifers were inseminated with sexed semen (8.54% ± 2.94; ±SD) or all females were inseminated with sexed semen (8.85% ± 2.93) than when all females were inseminated with unsexed semen (8.38% ± 2.95). The range in net profit was most sensitive to the assumed distributions of milk protein price (€/kg), milk fat price (€/kg), cow pregnancy rate, fertilizer price (€/t), and concentrate price (€/t) when unsorted semen was used. When only heifers or both heifers and cows were inseminated with sex-sorted semen, the range in net profit was most sensitive to the same distributions, with fertilizer price and cow pregnancy rate in reverse order of sensitivity. However, the range in sex-sorted semen advantage (in net profit) when only heifers were inseminated with sex-sorted semen was most sensitive to the assumed distributions of cow pregnancy rate, sex-sorted semen pregnancy rate as a percent of unsorted semen rates, standard deviation of index, additional cost of sex-sorted semen (€/dose), dairy bull calf price (€/head), and dairy heifer calf price (€/head). When both heifers and cows were inseminated, the order of importance of the last 2 inputs was reversed. This study highlights the relatively high effect of pregnancy rate and the genetic value of dairy bulls in determining the level of financial advantage from using sex-sorted semen in a dairy herd.
Collapse
Affiliation(s)
- D J Cottle
- School of Environmental and Rural Science, University of New England, Armidale, NSW, 2351, Australia; School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - M Wallace
- School of Natural and Environmental Sciences, Newcastle University, Newcastle upon Tyne, NE1 7RU, United Kingdom.
| | - P Lonergan
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| | - A G Fahey
- School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, D04 V1W8, Ireland
| |
Collapse
|