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Villalobos A, Alaimo K, Erickson C, Harrall K, Glueck D, Buchenau H, Buchenau M, Coringrato E, Decker E, Fahnestock L, Hamman R, Hebert J, Hurley T, Leiferman J, Li K, Quist P, Litt J. CAPS on the move: Crafting an approach to recruitment for a randomized controlled trial of community gardening. Contemp Clin Trials Commun 2019; 16:100482. [PMID: 31799473 PMCID: PMC6883325 DOI: 10.1016/j.conctc.2019.100482] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 07/17/2019] [Revised: 10/18/2019] [Accepted: 10/24/2019] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To describe and evaluate recruitment approaches for a randomized controlled trial (RCT) of community gardening in Denver, Colorado. (ClinicalTrials.gov: NCT03089177). METHODS We used community and staff feedback to adapt our recruitment approach from year 1 to year 2 of a multi-year RCT to address health behaviors related to cancer prevention. In year 2, we added a full-time recruitment coordinator, designed and implemented a tracking spreadsheet, and engaged advisory committee members, local garden leaders, and health partners in planning and outreach. Screening and consent rates, staff time and costs for years 1 and 2 are compared. RESULTS In year 1, recruitment methods yielded 136 initial contacts, 106 screenings and 64 consented participants. In year 2, enhanced staffing and outreach yielded 257 initial contacts, 193 screenings, and 123 consented participants. Personal referrals, health fairs, NextDoor, and fliers yielded the highest percentage of consented participants. School and community meetings yielded the lowest yield for potential participants. Spanish-speaking participants were mostly recruited by direct methods. Compared to year 1 recruitment, which required 707 h of staff time and cost $14,446, year 2 recruitment required 1224 h of staff time and cost $22,992. Average cost for retained participants was $226 (year 1) and $186 (year 2). DISCUSSION Those planning pragmatic clinical trials with recruitment in multi-ethnic communities can use the results from this study to understand the efficacy of techniques, and to budget costs for recruitment. While our culturally-tailored recruitment methods cost more, they provided more effective and efficient ways to reach recruitment goals.
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Affiliation(s)
| | - K. Alaimo
- Michigan State University, East Lansing, MI, USA
| | - C. Erickson
- University of Colorado Boulder, Boulder, CO, USA
| | - K.K. Harrall
- Colorado School of Public Health, Denver, CO, USA
| | - D.H. Glueck
- University of Colorado School of Medicine, Denver, CO, USA
| | - H. Buchenau
- University of Colorado Boulder, Boulder, CO, USA
| | | | | | - E. Decker
- University of Colorado Boulder, Boulder, CO, USA
| | | | - R.F. Hamman
- Colorado School of Public Health, Denver, CO, USA
- LEAD Center, Colorado School of Public Health, Denver, CO, USA
| | - J.R. Hebert
- University of South Carolina, Charleston, SC, USA
| | - T.G. Hurley
- University of South Carolina, Charleston, SC, USA
| | | | - K. Li
- Colorado State University, Fort Collins, CO, USA
| | - P. Quist
- University of Colorado Boulder, Boulder, CO, USA
| | - J.S. Litt
- University of Colorado Boulder, Boulder, CO, USA
- Colorado School of Public Health, Denver, CO, USA
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Hamman R, Thompson PN, Smuts MP, Tshuma T, Holm DE. Oocyte quality and viability in Nguni and Hereford cows exposed to different levels of dietary protein. Trop Anim Health Prod 2019; 51:1187-1194. [DOI: 10.1007/s11250-019-01806-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 01/07/2019] [Indexed: 10/27/2022]
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Luderer U, Li T, Fine J, Hamman R, Stanford J, Baker D. Transitions in pregnancy planning in women recruited for a large prospective cohort study. Hum Reprod 2017; 32:1325-1333. [PMID: 28398523 PMCID: PMC5437361 DOI: 10.1093/humrep/dex065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 02/10/2017] [Accepted: 03/21/2017] [Indexed: 11/13/2022] Open
Abstract
STUDY QUESTION Do the rates at which women transition among different intensities of pregnancy planning vary with age, marital status and race/ethnicity? SUMMARY ANSWER Rates of transition from low or moderate pregnancy probability groups (PPGs) to higher PPGs vary by age, marital status and race/ethnicity. WHAT IS KNOWN ALREADY The design of prospective studies of the effects of pre- and peri-conception exposures on fecundity, pregnancy and children's health is challenging because at any specific time only a small percentage of reproductive age women is attempting to conceive. To our knowledge, there has been no population-based, prospective study that repeatedly assessed pregnancy planning, which included women who were not already planning pregnancy at enrollment and whose ages spanned the female reproductive age range. STUDY DESIGN, SIZE, DURATION A longitudinal study was carried out that repeatedly assessed pregnancy probability in 12 916 women for up to 21 months from January 2009 to September 2010. PARTICIPANTS/MATERIALS, SETTING, METHOD We analyzed data from the National Children's Study Vanguard Study, a pilot study for a large-scale epidemiological birth cohort study of children and their parents. During the Vanguard Study, investigators followed population-based samples of reproductive age women in each of seven geographically dispersed and diverse study locations over time to identify when they sought to become pregnant, providing a unique opportunity to prospectively assess changes in pregnancy planning in a large sample of US women. At study entry and each follow-up contact, which occurred at 1, 3 or 6 month intervals depending on PPG, a questionnaire was used to assess behavior dimensions of pregnancy planning to assign women to low, moderate, high non-tryer and high tryer PPGs. MAIN RESULTS AND THE ROLE OF CHANCE Crude rates of pregnancy increased with higher assigned PPG, validating the utility of the instrument. The initial PPG and probabilities of transitioning from low or moderate PPG to higher PPG or pregnancy varied with age, marital status and race/ethnicity. Women aged 25 to <35 years had shorter times to transition to higher PPGs or to pregnant compared with women <25 years. Women who were not currently married had longer times to transition from any initial PPG to pregnant, high tryer or high non-tryer status than currently married women. Non-Hispanic Black (NHB) and Hispanic women had shorter time to transition from low or moderate to high non-tryer than non-Hispanic White (NHW) women. NHB women also had shorter time to transition from low to high tryer than NHW women. High tryers are more likely to be aged 25 to <30 years, to be married, and to be Hispanic, NHB or other race/ethnicity than women in the low PPG. LIMITATIONS, REASONS FOR CAUTION Loss to follow-up varied by age, marital status and race/ethnicity. Although weights were not developed for the Vanguard study, the self-weighting design minimizes the bias of unweighted analysis. Nonetheless, the SEs for some estimates may be under-estimated. WIDER IMPLICATIONS OF THE FINDINGS Our results show that demographic characteristics are strong predictors of women's behaviors toward pregnancy. The results further show that frequent follow-up assessments of pregnancy planning behavior in large numbers of women are required to recruit an unbiased sample of preconception women. These findings will be useful to investigators designing prospective studies of fecundability, pregnancy outcomes and children's health. STUDY FUNDING/COMPETING INTERESTS National Institutes of Health (contracts N01-HD53414, N01-HD63416, N01-HD53410, N01-HD53415, N01-HD53396, N01-HD53413 and N01-HD-53411; grant R21 ES016846) and by the University of California Irvine Center for Occupational and Environmental Health. No competing interests. TRIAL REGISTRATION NUMBER None.
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Affiliation(s)
- U. Luderer
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California Irvine, Irvine, CA 92617, USA
| | - T. Li
- Westat, Rockville, MD 20850, USA
| | - J.P. Fine
- Department of Biostatistics, University of North Carolina Gillings School of Public Health, Chapel Hill, NC 27599, USA
| | - R.F. Hamman
- Department of Epidemiology, Colorado School of Public Health, Aurora, CO 80045, USA
| | - J.B. Stanford
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT 84108, USA
| | - D. Baker
- Division of Occupational and Environmental Medicine, Department of Medicine, University of California Irvine, Irvine, CA 92617, USA
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Fowkes FGR, Murray GD, Butcher I, Heald CL, Lee RJ, Chambless LE, Folsom AR, Hirsch AT, Dramaix M, deBacker G, Wautrecht JC, Kornitzer M, Newman AB, Cushman M, Sutton-Tyrrell K, Fowkes FGR, Lee AJ, Price JF, d'Agostino RB, Murabito JM, Norman PE, Jamrozik K, Curb JD, Masaki KH, Rodríguez BL, Dekker JM, Bouter LM, Heine RJ, Nijpels G, Stehouwer CDA, Ferrucci L, McDermott MM, Stoffers HE, Hooi JD, Knottnerus JA, Ogren M, Hedblad B, Witteman JC, Breteler MMB, Hunink MGM, Hofman A, Criqui MH, Langer RD, Fronek A, Hiatt WR, Hamman R, Resnick HE, Guralnik J, McDermott MM. Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA 2008; 300:197-208. [PMID: 18612117 PMCID: PMC2932628 DOI: 10.1001/jama.300.2.197] [Citation(s) in RCA: 1350] [Impact Index Per Article: 84.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Prediction models to identify healthy individuals at high risk of cardiovascular disease have limited accuracy. A low ankle brachial index (ABI) is an indicator of atherosclerosis and has the potential to improve prediction. OBJECTIVE To determine if the ABI provides information on the risk of cardiovascular events and mortality independently of the Framingham risk score (FRS) and can improve risk prediction. DATA SOURCES Relevant studies were identified. A search of MEDLINE (1950 to February 2008) and EMBASE (1980 to February 2008) was conducted using common text words for the term ankle brachial index combined with text words and Medical Subject Headings to capture prospective cohort designs. Review of reference lists and conference proceedings, and correspondence with experts was conducted to identify additional published and unpublished studies. STUDY SELECTION Studies were included if participants were derived from a general population, ABI was measured at baseline, and individuals were followed up to detect total and cardiovascular mortality. DATA EXTRACTION Prespecified data on individuals in each selected study were extracted into a combined data set and an individual participant data meta-analysis was conducted on individuals who had no previous history of coronary heart disease. RESULTS Sixteen population cohort studies fulfilling the inclusion criteria were included. During 480,325 person-years of follow-up of 24,955 men and 23,339 women, the risk of death by ABI had a reverse J-shaped distribution with a normal (low risk) ABI of 1.11 to 1.40. The 10-year cardiovascular mortality in men with a low ABI (< or = 0.90) was 18.7% (95% confidence interval [CI], 13.3%-24.1%) and with normal ABI (1.11-1.40) was 4.4% (95% CI, 3.2%-5.7%) (hazard ratio [HR], 4.2; 95% CI, 3.3-5.4). Corresponding mortalities in women were 12.6% (95% CI, 6.2%-19.0%) and 4.1% (95% CI, 2.2%-6.1%) (HR, 3.5; 95% CI, 2.4-5.1). The HRs remained elevated after adjusting for FRS (2.9 [95% CI, 2.3-3.7] for men vs 3.0 [95% CI, 2.0-4.4] for women). A low ABI (< or = 0.90) was associated with approximately twice the 10-year total mortality, cardiovascular mortality, and major coronary event rate compared with the overall rate in each FRS category. Inclusion of the ABI in cardiovascular risk stratification using the FRS would result in reclassification of the risk category and modification of treatment recommendations in approximately 19% of men and 36% of women. CONCLUSION Measurement of the ABI may improve the accuracy of cardiovascular risk prediction beyond the FRS.
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Vehik K, Dabelea D, Chase M, Mayer-Davis B, Hamman R. 208-S: Maternal Recall of Birth Weights of Youth with and without Diabetes: Validation by State Birth Certificate Records. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s52c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Vehik
- University of Colorado at Denver Health Sciences Center, Denver, CO
| | - D Dabelea
- University of Colorado at Denver Health Sciences Center, Denver, CO
| | - M Chase
- University of Colorado at Denver Health Sciences Center, Denver, CO
| | - B Mayer-Davis
- University of Colorado at Denver Health Sciences Center, Denver, CO
| | - R Hamman
- University of Colorado at Denver Health Sciences Center, Denver, CO
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Xu J, Setser DW, Hamman R. Radiative Lifetimes, Electronic Quenching Rate Constants, and Spin-Orbit Relaxation Rate Constants of the PF(A3.PI.) and PF(d1.PI.) States. ACTA ACUST UNITED AC 2002. [DOI: 10.1021/j100010a031] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Torkko KC, Gershman K, Crane LA, Hamman R, Barón A. Testing for Chlamydia and sexual history taking in adolescent females: results from a statewide survey of Colorado primary care providers. Pediatrics 2000; 106:E32. [PMID: 10969116 DOI: 10.1542/peds.106.3.e32] [Citation(s) in RCA: 64] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Little is known about the practice patterns of primary care providers as they relate to assessing risk of and screening for chlamydial infections, an important cause of preventable reproductive morbidity in young women in the United States. The present cross-sectional study was undertaken to assess levels of chlamydia testing, sexual history taking, and prevention practices by Colorado primary care physicians, nurse practitioners, and physician assistants who provide gynecologic care to adolescent females (13-19 years old). METHODS Between July 1998 and October 1998, an anonymous, self-administered questionnaire was mailed to a 25% random sample (n = 1265) of Colorado physicians (family practitioners, internal medicine specialists, obstetrician-gynecologists, and pediatricians), nurse practitioners, and physician assistants. Practitioners were identified through professional organization membership, state-licensing bodies, and listings in the yellow pages. RESULTS After estimating the eligibility rate among non-respondents, the adjusted response rate was 71.5%. Only 53.8% of providers reported regularly testing sexually active female adolescents for chlamydia; 71.8% of providers regularly took a sexual history. Female providers reported significantly higher levels of regularly taking a sexual history (87. 2% vs 60.6% of males), feeling comfortable discussing sex (94.4% vs 77.8%), discussing sexually transmitted disease (STD) prevention (81. 5% vs 71.3%), and testing for chlamydia (64.4% vs 38.6%). Among provider types, obstetrician-gynecologists, nurse practitioners, and pediatricians were most likely to report regularly taking a sexual history (90.1%, 88.6%, and 76.0%, respectively). Internal medicine specialists were the least likely to report taking a sexual history (43.9%). Pediatricians and nurse practitioners were the most likely to report testing sexually active adolescent females for chlamydia (74.1% and 70.1%, respectively), whereas physician assistants and internal medicine specialists were the least likely (46.0% and 38.5%, respectively). In multivariate analysis, variables independently associated with regularly taking a sexual history included female provider gender (odds ratio [OR]: 5.5; 95% confidence interval [CI]: 2.9-10.9), obstetrics/gynecology specialty (OR: 4.0; 95% CI: 1.7-10. 3; referent group: family practitioners), and provider comfort level in discussing sex (OR: 4.9; 95% CI: 2.3-11.1). Variables independently associated with regularly testing adolescent females for chlamydia included female provider gender (OR: 2.8; 95% CI: 1. 6-4.8), regularly discussing STD prevention (OR: 2.1; 95% CI: 1.1-4. 1), and regularly discussing limiting the number of patients' sex partners (OR: 2.4; 95% CI: 1.4-4.1). CONCLUSIONS Only a little over one half of providers (54%) reported regularly performing chlamydia tests on adolescent females who are sexually active by history. Because this falls well short of the recommendations of the Centers for Disease Control and Prevention to test all sexually active female adolescents, efforts are needed to improve STD clinical practices of Colorado physician and nonphysician providers of primary care for adolescent females. Particular efforts are needed to close the provider gender gap.
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Affiliation(s)
- K C Torkko
- Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, CO 80220, USA.
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Abstract
A pathfinder pilot survey was conducted in rural Chiriqui Province, Panama, using standard WHO methodology, in order to estimate dental caries prevalence and treatment need. Examinations for caries and treatment need were performed by six trained, experienced examiners. From a convenience sample of 2,597 subjects, a stratified cluster sample was constructed using index ages 12 and 15 years and age groups 35-44 and 65-74 years. The results showed a mean Decayed, Missing and Filled Teeth index (DMFT) of 4.08 for 12 year olds, 6.40 for 15 year olds, 13.20 for the 35-44 age group, and 18.88 for the 65-74 age group (P < 0.001). No statistically significant differences by gender were found. These findings rank rural Panama with Mexico and Haiti when compared to the results of other Central American community studies. The percentage of caries free 12 year olds was 6.8 per cent. Of the total sample, 74.7 per cent of individuals would require one or multiple surface restorations and 47.9 per cent would require at least one extraction. Restorative need was greatest in the 15 year olds. The severity of dental caries in this sample was moderately severe and the treatment need extraordinarily high.
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Affiliation(s)
- J Astroth
- Department of Applied Dentistry, University of Colorado School of Dentistry, Denver 80262, USA
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Merriwether DA, Huston S, Iyengar S, Hamman R, Norris JM, Shetterly SM, Kamboh MI, Ferrell RE. Mitochondrial versus nuclear admixture estimates demonstrate a past history of directional mating. Am J Phys Anthropol 1997; 102:153-9. [PMID: 9066897 DOI: 10.1002/(sici)1096-8644(199702)102:2<153::aid-ajpa1>3.0.co;2-#] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Six blood group antigens (ABO, RH, MNS, KK, KP, FY) and five plasma proteins (HP, GC, APOA4, FXIIIB, C1R) were typed in 790 individuals, and 12 mtDNA RFLP and deletion polymorphisms were typed in 657 individuals from the San Luis Valley, Colorado. The 790 nuclear typings were conducted on 399 Anglos and 391 Hispanics, while the 657 mitochondrial haplotypes were generated from 207 Anglos and 450 Hispanics. Chakraborty's ADMIX2 FORTRAN program was used to estimate the average Amerindian admixture using all nuclear loci simultaneously. Since there is no recombination in mtDNA, the sum of the frequencies of the Amerindian/Asian-specific mitochondrial haplotypes represents the level of Amerindian admixture. The nuclear estimates of Amerindian admixture were 33.15 +/- 2.41% for the Hispanics and 9.72 +/- 1.90% for the Anglos, while the strictly maternally inherited mtDNA estimates of Amerindian admixture were 85.11% for the Hispanics and 0.97% for the Anglos. This dramatic difference in estimated levels of admixture between the biparentally derived nuclear estimates and the uniparentally derived mtDNA estimates is indicative of past directional matings between Hispanic males and Amerindian females.
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Affiliation(s)
- D A Merriwether
- Department of Anthropology, University of Michigan, Ann Arbor 48109, USA
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Haffner SM, Howard G, Mayer E, Bergman RN, Savage PJ, Rewers M, Mykkänen L, Karter AJ, Hamman R, Saad MF. Insulin sensitivity and acute insulin response in African-Americans, non-Hispanic whites, and Hispanics with NIDDM: the Insulin Resistance Atherosclerosis Study. Diabetes 1997; 46:63-9. [PMID: 8971083 DOI: 10.2337/diab.46.1.63] [Citation(s) in RCA: 108] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
NIDDM is usually characterized by beta-cell failure and decreased insulin sensitivity. It has been reported that a high proportion of African-American NIDDM subjects are insulin sensitive. To examine this issue, we determined insulin sensitivity (S(I)) in 479 NIDDM subjects by minimal model analyses of frequently sampled intravenous glucose tolerance (FSIGT) from the Insulin Resistance Atherosclerosis Study (IRAS), a large multicenter study of insulin sensitivity and cardiovascular risk in African-Americans, Hispanics, and non-Hispanic whites. The African-Americans and non-Hispanic whites were sampled in Los Angeles and Oakland, California. The non-Hispanic whites and Hispanics were sampled in San Antonio, Texas, and San Luis Valley, Colorado. We defined the proportion of insulin-sensitive (S(I)) subjects as > or =1.61 min-1 x microU-1 x ml-1, which is above the median for nondiabetic subjects of all ethnic groups in the IRAS. Using this definition, the proportion of insulin-sensitive diabetic subjects was very low in all ethnic groups (non-Hispanic whites [14.3%] vs. African-Americans [6.5%], P = 0.039 in Los Angeles and Oakland; non-Hispanic whites [6.8%] vs. Hispanics [4.9%], P = 0.737 in San Luis Valley and San Antonio). These results were also similar in newly diagnosed mildly hyperglycemic diabetic subjects. In addition, these results were not affected by the adjustment for differences in obesity, body fat distribution, and severity of hyperglycemia. Even in nonobese subjects (with BMI <30 kg/m2), the proportion of insulin-sensitive subjects (S(I) > or =1.61 min-1 x microU-1 x ml-1) was low (3.6-9.7%). The acute insulin response (AIR) was significantly higher in African-Americans than in non-Hispanic whites; there were no ethnic differences in AIR between Hispanics and non-Hispanic whites. There were no significant ethnic differences for non-insulin-mediated glucose disposal (S(G)). We conclude that the number of insulin-sensitive NIDDM subjects is low and similar among non-Hispanic whites, Hispanics, and African-Americans in the U.S.
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Affiliation(s)
- S M Haffner
- Department of Medicine, University of Texas Health Science Center, San Antonio 78284-7873, USA
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Howard G, O'Leary DH, Zaccaro D, Haffner S, Rewers M, Hamman R, Selby JV, Saad MF, Savage P, Bergman R. Insulin sensitivity and atherosclerosis. The Insulin Resistance Atherosclerosis Study (IRAS) Investigators. Circulation 1996; 93:1809-17. [PMID: 8635260 DOI: 10.1161/01.cir.93.10.1809] [Citation(s) in RCA: 451] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Reduced insulin sensitivity has been proposed as an important risk factor in the development of atherosclerosis. However, insulin sensitivity is related to many other cardiovascular risk factors, including plasma insulin levels, and it is unclear whether an independent role of insulin sensitivity exists. Large epidemiological studies that measure insulin sensitivity directly have not been conducted. METHODS AND RESULTS The Insulin Resistance Atherosclerosis Study (IRAS) evaluated insulin sensitivity (SI) by the frequently sampled intravenous glucose tolerance test with analysis by the minimal model of Bergman. IRAS measured intimal-medial thickness (IMT) of the carotid artery as an index of atherosclerosis by use of noninvasive B-mode ultrasonography. These measures, as well as factors that may potentially confound or mediate the relationship between insulin sensitivity and atherosclerosis, were available in relation to 398 black, 457 Hispanic, and 542 non-Hispanic white IRAS participants. There was a significant negative association between SI and the IMT of the carotid artery both in Hispanics and in non-Hispanic whites. This effect was reduced but not totally explained by adjustment for traditional cardiovascular disease risk factors, glucose tolerance, measures of adiposity, and fasting insulin levels. There was no association between SI and the IMT of the carotid artery in blacks. The association between SI and the IMT was stronger for the internal carotid artery than for the common carotid artery in all ethnic groups. CONCLUSIONS Higher levels of insulin sensitivity are associated with less atherosclerosis in Hispanics and non-Hispanic whites but not in blacks. This effect is partially mediated by traditional cardiovascular risk factors.
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Affiliation(s)
- G Howard
- Department of Public Health Sciences, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC 27157-1063, USA
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Hamman R, Longridge NS, Mekjavic I, Dickinson J. Effect of age and training schedules on balance improvement exercises using visual biofeedback. J Otolaryngol 1995; 24:221-9. [PMID: 8551534] [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] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
There has been a growing popularity and success rate of balance rehabilitation programs, and this success is paralleled by the growth of technology, making available instruments that provide objective, quantitative, and immediate results. The Balance Master is such a commercially available instrument, consisting of a dual-force platform connected to a micro-computer that provides visual feedback of the centre of gravity (COG) in relation to the theoretical limits of stability. Spontaneous body sway can be measured in a static central position, or in peripheral positions around the limits of stability (peripheral sway area). The trajectory between targets can also be analyzed in terms of time (transition time) and accuracy (path error) of transition, which gives a quantitative measure of dynamic movement of the COG. This study examined the practice effect that occurs while using this instrument over repeated sessions for two schedules of training (daily and weekly) and over two age groups (20-35 years, and 60-75 years). Each group completed a series of postural exercises, with an assessment of static and dynamic postural variables before and after training, and at approximately 3 and 6 weeks post-training. Spontaneous body sway was measured with eyes open, eyes closed, and with visual feedback of the COG. No significant changes were observed in these variables as measured over the four standard assessment occasions. Peripheral sway area and path error decreased significantly for both the daily and weekly training groups from pre- to post-training, and these skills were retained over both retention tests, whereas the tendency toward decreasing transition time was not significant.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- R Hamman
- Department of Kinesiology, Simon Fraser University
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Abstract
BACKGROUND Human papillomavirus infection is a sexually transmitted disease associated with cervical dysplasia and carcinoma. GOAL OF THIS STUDY To determine prevalence rates of cervical human papillomavirus infection compared with other sexually transmitted diseases and risk factors associated with human papillomavirus infection among adolescent women, we evaluated 634 patients attending three urban adolescent clinics. STUDY DESIGN Patient evaluation included Pap smears; screening for chlamydia, gonorrhea, and trichomoniasis; and testing of cervical swab samples for human papillomavirus DNA. RESULTS Cervical human papillomavirus was the most common STD in our population (15.6%), followed by infection with Chlamydia trachomatis (11.0%), Neisseria gonorrhoeae (7.1%), and Trichomonas vaginalis (5.4%). The most prevalent human papillomavirus types were 16/18 (7.3%), followed by 31/33/35 (4.7%) and 6/11 (3.5%). When genital warts on exam, low-grade squamous intraepithelial lesions on cytology, or cervical human papillomavirus DNA were considered as indicators of genital human papillomavirus infection, 24% of patients had any manifestation of infection, including 15% with clinically apparent infection (genital warts), 36% with cytologically apparent infection without warts, and 49% with subclinical infection only (cervical human papillomavirus DNA without low-grade squamous intraepithelial lesions or warts). Factors associated with detection of cervical human papillomavirus DNA by multivariate analysis included number of lifetime sexual partners and genital warts on exam. CONCLUSION Cervical human papillomavirus infection was the most prevalent sexually transmitted disease among an ethnically diverse group of urban adolescent females, with a large proportion of infections neither clinically nor cytologically apparent. The strong association with lifetime sexual partners substantiates that cervical human papillomavirus is acquired predominantly by sexual contact and often soon after the onset of sexual activity.
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Affiliation(s)
- J H Jamison
- Department of Public Health, Denver Department of Health & Hospitals, Colorado, USA
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LaPorte RE, Tajima N, Akerblom HK, Berlin N, Brosseau J, Christy M, Drash AL, Fishbein H, Green A, Hamman R. Geographic differences in the risk of insulin-dependent diabetes mellitus: the importance of registries. Diabetes Care 1985; 8 Suppl 1:101-7. [PMID: 4053948 DOI: 10.2337/diacare.8.1.s101] [Citation(s) in RCA: 152] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
There are marked geographic differences in the incidence of insulin-dependent diabetes mellitus (IDDM); for example, children in countries such as Finland are over 35 times more likely to develop IDDM than children in Japan. An understanding of the reasons for the geographic differences is likely to be important for understanding and, hopefully, preventing IDDM. There are problems, however, because of the lack of registries with adequate standardization. The major needs for the future studies include (1) to clarify the definition of IDDM for epidemiologic study, (2) to establish a standardized approach for IDDM registries, (3) to use registries to evaluate viral, immunologic, and genetic differences in order to explain differential risks across populations, and (4) to encourage the development of new population-based registries worldwide.
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Garvey W, Olefsky J, Griffin J, Hamman R, Kolterman O. Diabetes, Vol. 34 (3), 1985 The effect of insulin treatment on in sulin secretion and insulin action in Type II diabetes mellitus. Diabetes Educ 1985. [DOI: 10.1177/014572178501100221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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