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Lara ST, Rein LE, Simanek AM, Totoraitis MF, Rausch DJ, Weston BW, Ahn KW, Meurer JR, Beyer KMM. Asthma as a Risk Factor for Hospitalization in Children and Youth With COVID-19: A Retrospective Cohort Study. Pediatr Infect Dis J 2024; 43:437-443. [PMID: 38241639 DOI: 10.1097/inf.0000000000004248] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2024]
Abstract
BACKGROUND Studies examining the association between asthma and hospitalization among children and youth with coronavirus disease 2019 (COVID-19) have yielded mixed results. Both asthma and COVID-19 hospitalization are characterized by racial, ethnic and socioeconomic disparities which also pattern geographically, yet no studies to date have adjusted for neighborhood context in the assessment of this association. METHODS Mixed effects logistic regression was used to estimate the association between asthma and hospitalization due to COVID-19 in a sample of 28,997 children and youth diagnosed with COVID-19 in Milwaukee County, Wisconsin, from March 1, 2020, to May 31, 2022. Models adjusted for individual-level sociodemographic factors (age, gender, race, ethnicity and city/suburb residence) and season of diagnosis were examined as moderators. Random intercepts by census tract accounted for geographic variation in neighborhood factors and census tract-level measures of education, health and environment, and social and economic factors were assessed via childhood opportunity indices. RESULTS Asthma history was statistically significantly associated with hospitalization due to COVID-19 among children and youth. Hospitalization rates varied statistically significantly by census tract, and results were unchanged after accounting for childhood opportunity indices and census tract. Season of diagnosis was not found to moderate the effect of asthma history on COVID-19 hospitalization. CONCLUSION Our study suggests that asthma history is a risk factor for hospitalization in the context of COVID-19 infection among children and youth, warranting observation and follow-up of children with asthma as well as continued measures to prevent COVID-19 in this population.
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Affiliation(s)
- Shana T Lara
- From the Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI
- Milwaukee County COVID-19 Epidemiology Intel Team, Milwaukee, WI
| | - Lisa E Rein
- From the Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI
- Milwaukee County COVID-19 Epidemiology Intel Team, Milwaukee, WI
| | - Amanda M Simanek
- Milwaukee County COVID-19 Epidemiology Intel Team, Milwaukee, WI
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
- Michael Reese Foundation Center for Health Equity Research, Rosalind Franklin University, Chicago, IL
| | - Michael F Totoraitis
- Milwaukee County COVID-19 Epidemiology Intel Team, Milwaukee, WI
- City of Milwaukee Health Department, Milwaukee, WI
| | - Darren J Rausch
- Milwaukee County COVID-19 Epidemiology Intel Team, Milwaukee, WI
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI
- Greenfield Health Department, Milwaukee, WI
| | - Benjamin W Weston
- From the Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI
- Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - Kwang Woo Ahn
- From the Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI
- Milwaukee County COVID-19 Epidemiology Intel Team, Milwaukee, WI
| | - John R Meurer
- From the Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI
| | - Kirsten M M Beyer
- From the Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI
- Milwaukee County COVID-19 Epidemiology Intel Team, Milwaukee, WI
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Simanek AM, Xiong M, Woo JMP, Zheng C, Zhang YS, Meier HCS, Aiello AE. Association between prenatal socioeconomic disadvantage, adverse birth outcomes, and inflammatory response at birth. Psychoneuroendocrinology 2023; 153:106090. [PMID: 37146471 PMCID: PMC10807729 DOI: 10.1016/j.psyneuen.2023.106090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 05/07/2023]
Abstract
Prenatal socioeconomic disadvantage is associated with inflammation in mid- to late-life, yet whether a pro-inflammatory phenotype is present at birth and the role of adverse birth outcomes in this pathway remains unclear. We utilized data on prenatal socioeconomic disadvantage at the individual- (i.e., mother's and father's education level, insurance type, marital status, and Women, Infants, and Children benefit receipt) and census-tract level as well as preterm (< 37 weeks gestation) and small-for-gestational-age (SGA) (i.e., < 10th percentile of sex-specific birth weight for gestational age) birth status, and assessed inflammatory markers (i.e., C-reactive protein, serum amyloid p, haptoglobin, and α-2 macroglobulin) in archived neonatal bloodspots from a Michigan population-based cohort of 1000 neonates. Continuous latent variables measuring individual- and combined individual- and neighborhood-level prenatal socioeconomic disadvantage were constructed and latent profile analysis was used to create a categorical inflammatory response variable (high versus low) based on continuous inflammatory marker levels. Structural equation models were used to estimate the total and direct effect of prenatal socioeconomic disadvantage on the inflammatory response at birth as well as indirect effect via preterm or SGA birth (among term neonates only), adjusting for mother's age, race/ethnicity, body mass index, smoking status, comorbidities, and antibiotic use/infection as well as grandmother's education level. There was a statistically significant total effect of both individual- and combined individual- and neighborhood-level prenatal socioeconomic disadvantage on high inflammatory response among all neonates as well as among term neonates only, and a positive but not statistically significant direct effect in both groups. The indirect effects via preterm and SGA birth were both negative, but not statistically significant. Our findings suggest prenatal socioeconomic disadvantage contributes to elevated neonatal inflammatory response, but via pathways outside of these adverse birth outcomes.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Meng Xiong
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Jennifer M P Woo
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Cheng Zheng
- Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, USA
| | - Yuan S Zhang
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Helen C S Meier
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Allison E Aiello
- Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
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3
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Ukraintseva S, Duan M, Simanek AM, Holmes R, Bagley O, Rajendrakumar AL, Yashkin AP, Akushevich I, Tropsha A, Whitson H, Yashin A, Arbeev K. Vaccination Against Pneumonia May Provide Genotype-Specific Protection Against Alzheimer's Disease. J Alzheimers Dis 2023; 96:499-505. [PMID: 37807778 PMCID: PMC10657669 DOI: 10.3233/jad-230088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/29/2023] [Indexed: 10/10/2023]
Abstract
Vaccine repurposing that considers individual genotype may aid personalized prevention of Alzheimer's disease (AD). In this retrospective cohort study, we used Cardiovascular Health Study data to estimate associations of pneumococcal polysaccharide vaccine and flu shots received between ages 65-75 with AD onset at age 75 or older, taking into account rs6859 polymorphism in NECTIN2 gene (AD risk factor). Pneumococcal vaccine, and total count of vaccinations against pneumonia and flu, were associated with lower odds of AD in carriers of rs6859 A allele, but not in non-carriers. We conclude that pneumococcal polysaccharide vaccine is a promising candidate for genotype-tailored AD prevention.
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Affiliation(s)
- Svetlana Ukraintseva
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Matt Duan
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Amanda M. Simanek
- Department of Foundational Sciences and Humanities, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Rachel Holmes
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Olivia Bagley
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Aravind L. Rajendrakumar
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Arseniy P. Yashkin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Igor Akushevich
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Alexander Tropsha
- Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Heather Whitson
- Center for Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Anatoliy Yashin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Konstantin Arbeev
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
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4
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Golos AM, Guntuku SC, Piltch-Loeb R, Leininger LJ, Simanek AM, Kumar A, Albrecht SS, Dowd JB, Jones M, Buttenheim AM. Dear Pandemic: A topic modeling analysis of COVID-19 information needs among readers of an online science communication campaign. PLoS One 2023; 18:e0281773. [PMID: 36996093 PMCID: PMC10062627 DOI: 10.1371/journal.pone.0281773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 02/01/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic was accompanied by an "infodemic"-an overwhelming excess of accurate, inaccurate, and uncertain information. The social media-based science communication campaign Dear Pandemic was established to address the COVID-19 infodemic, in part by soliciting submissions from readers to an online question box. Our study characterized the information needs of Dear Pandemic's readers by identifying themes and longitudinal trends among question box submissions. METHODS We conducted a retrospective analysis of questions submitted from August 24, 2020, to August 24, 2021. We used Latent Dirichlet Allocation topic modeling to identify 25 topics among the submissions, then used thematic analysis to interpret the topics based on their top words and submissions. We used t-Distributed Stochastic Neighbor Embedding to visualize the relationship between topics, and we used generalized additive models to describe trends in topic prevalence over time. RESULTS We analyzed 3839 submissions, 90% from United States-based readers. We classified the 25 topics into 6 overarching themes: 'Scientific and Medical Basis of COVID-19,' 'COVID-19 Vaccine,' 'COVID-19 Mitigation Strategies,' 'Society and Institutions,' 'Family and Personal Relationships,' and 'Navigating the COVID-19 Infodemic.' Trends in topics about viral variants, vaccination, COVID-19 mitigation strategies, and children aligned with the news cycle and reflected the anticipation of future events. Over time, vaccine-related submissions became increasingly related to those surrounding social interaction. CONCLUSIONS Question box submissions represented distinct themes that varied in prominence over time. Dear Pandemic's readers sought information that would not only clarify novel scientific concepts, but would also be timely and practical to their personal lives. Our question box format and topic modeling approach offers science communicators a robust methodology for tracking, understanding, and responding to the information needs of online audiences.
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Affiliation(s)
- Aleksandra M Golos
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Sharath Chandra Guntuku
- Department of Computer and Information Science, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia, PA, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Rachael Piltch-Loeb
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
- Emergency Preparedness Research Evaluation and Practice Program, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Lindsey J Leininger
- Tuck School of Business, Dartmouth College, Hanover, NH, United States of America
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States of America
| | - Aparna Kumar
- College of Nursing, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Sandra S Albrecht
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic Science, University of Oxford, Oxford, United Kingdom
- Department of Sociology, University of Oxford, Oxford, United Kingdom
- Nuffield College, University of Oxford, Oxford, United Kingdom
| | - Malia Jones
- Applied Population Laboratory, Department of Community and Environmental Sociology, College of Agricultural and Life Sciences, University of Wisconsin-Madison, Madison, WI, United States of America
| | - Alison M Buttenheim
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA, United States of America
- Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, United States of America
- Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia, PA, United States of America
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5
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Woo JMP, Parks CG, Hyde EE, Auer PL, Simanek AM, Konkel RH, Taylor J, Sandler DP, Meier HCS. Early life trauma and adult leucocyte telomere length. Psychoneuroendocrinology 2022; 144:105876. [PMID: 35939862 PMCID: PMC9446387 DOI: 10.1016/j.psyneuen.2022.105876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Telomere length, a biomarker of cell division and cellular aging, has been associated with multiple chronic disease endpoints. Experienced trauma over the life course may contribute to telomere shortening via mechanisms of stress embodiment. However, it is unclear how patterns of co-occurring trauma during sensitive periods (e.g., early life) throughout the life course may influence telomere shortening. We examine the relationship between co-occurring early life trauma on adult telomere length and the extent to which adulthood trauma, socioeconomic position, and health and lifestyle factors may mediate this relationship. METHODS We use data from a sample of participants in the Sister Study (N = 740, analytic sample: n = 602), a prospective cohort of U.S. self-identified females aged 35-74 years at enrollment (2003-2009) for whom leukocyte telomere length was measured in baseline blood samples. Participants reported their experience of 20 different types of trauma, from which we identified patterns of co-occurring early life trauma (before age 18) using latent class analysis. We estimated the direct and indirect effects of early life trauma on leukocyte telomere length using structural equation modeling, allowing for mediating adult pathways. RESULTS Approximately 47 % of participants reported early life trauma. High early life trauma was associated with shorter telomere length compared to low early life trauma (β = -0.11; 95 % CI: -0.22, -0.004) after adjusting for age and childhood socioeconomic position. The inverse association between early life trauma and adult leukocyte telomere length was largely attributable to the direct effect of early life trauma on telomere length (β = -0.12; 95 %CI: -0.23, -0.01). Mediating indirect pathways via adult trauma, socioeconomic position, and health metrics did not substantively contribute the overall association. CONCLUSIONS These findings highlight the role of patterns of co-occurring early life trauma on shortened telomere length independent of adult pathways.
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Affiliation(s)
- Jennifer M P Woo
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th Street, Milwaukee, WI, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
| | - Emily E Hyde
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th Street, Milwaukee, WI, USA; Wisconsin Population Health Fellowship, University of Wisconsin-Madison, 610 Walnut Street, 575 WARF, Madison, WI, USA
| | - Paul L Auer
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th Street, Milwaukee, WI, USA; Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI, USA
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th Street, Milwaukee, WI, USA
| | - Rebecca H Konkel
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, 2400 E. Hartford Avenue, Milwaukee, WI, USA
| | - Jack Taylor
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Research Triangle Park, NC 27709, USA
| | - Helen C S Meier
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th Street, Milwaukee, WI, USA; Survey Research Center, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, USA.
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6
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Simanek AM, Manansala R, Woo JMP, Meier HCS, Needham BL, Auer PL. Prenatal Socioeconomic Disadvantage and Epigenetic Alterations at Birth Among Children Born to White British and Pakistani Mothers in the Born in Bradford Study. Epigenetics 2022; 17:1976-1990. [PMID: 35837690 DOI: 10.1080/15592294.2022.2098569] [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: 11/03/2022] Open
Abstract
Prenatal socioeconomic disadvantage (SD) has been linked to DNA methylation (DNAm) in adulthood, but whether such epigenetic alterations are present at birth remains unclear. We carried out an epigenome-wide analysis of the association between several measures of individual- and area-level prenatal SD and DNAm assessed in neonatal cord blood via the Infinium EpicBeadChip among offspring born to mothers of White British (N = 455) and Pakistani (N = 493) origin in the Born in Bradford Study. Models were adjusted for mother's age, ethnicity, and education level as well as cell-type fractions and then for maternal health behaviours and neonate characteristics, and last, stratified by mother's ethnicity. P-values were corrected for multiple testing and a permutation-based approach was used to account for small cell sizes. Among all children, housing tenure (owning versus renting) as well as father's occupation (manual versus non-manual) were each associated with DNAm of one CpG site and index of multiple deprivation (IMD) was associated with DNAm of 11 CpG sites. Among children born to White British mothers, father's occupation (student or unemployed versus non-manual) was associated with DNAm of 1 CpG site and IMD with DNAm of 3 CpG sites. Among children born to Pakistani mothers, IMD was associated with DNAm of 1 CpG site. Associations were largely unchanged after further adjustment for maternal health behaviours or neonate characteristics and remained statistically significant. Our findings suggest that individual- and area-level prenatal SD may shape alterations to the neonatal epigenome, but associations vary across ethnic groups.
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Affiliation(s)
- Amanda M Simanek
- University of Wisconsin-Milwaukee Joseph J. Zilber School of Public Health, Milwaukee, WI, USA
| | - Regina Manansala
- Centre for Health Economics Research & Modelling Infectious Diseases (CHERMID), Vaccine & Infectious Disease Institute (VAXINFECTIO) WHO Collaborating Centre, University of Antwerp, Antwerp, Belgium
| | - Jennifer M P Woo
- University of Wisconsin-Milwaukee Joseph J. Zilber School of Public Health, Milwaukee, WI, USA.,Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
| | - Helen C S Meier
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Belinda L Needham
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, USA
| | - Paul L Auer
- Division of Biostatistics and Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
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Albrecht SS, Aronowitz SV, Buttenheim AM, Coles S, Dowd JB, Hale L, Kumar A, Leininger L, Ritter AZ, Simanek AM, Whelan CB, Jones M. Lessons Learned From Dear Pandemic, a Social Media-Based Science Communication Project Targeting the COVID-19 Infodemic. Public Health Rep 2022; 137:449-456. [PMID: 35238241 PMCID: PMC9066238 DOI: 10.1177/00333549221076544] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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] [Indexed: 01/31/2023] Open
Abstract
The World Health Organization has identified excessive COVID-19 pandemic-related information as a public health crisis, calling it an "infodemic." Social media allows misinformation to spread quickly and outcompete scientifically grounded information delivered via other methods. Dear Pandemic is an innovative, multidisciplinary, social media-based science communication project whose mission is to educate and empower individuals to successfully navigate the overwhelming amount of information circulating during the pandemic. This mission has 2 primary objectives: (1) to disseminate trustworthy, comprehensive, and timely scientific content about the pandemic to lay audiences via social media and (2) to promote media literacy and information-hygiene practices, equipping readers to better manage the COVID-19 infodemic within their own networks. The volunteer team of scientists publishes 8-16 posts per week on pandemic-relevant topics. Nearly 2 years after it launched in March 2020, the project has a combined monthly reach of more than 4 million unique views across 4 social media channels, an email newsletter, and a website. We describe the project's guiding principles, lessons learned, challenges, and opportunities. Dear Pandemic has emerged as an example of a promising new paradigm for public health communication and intervention. The contributors deliver content in ways that are personal, practical, actionable, responsive, and native to social media platforms. The project's guiding principles are a model for public health communication targeting future infodemics and can bridge the chasm between the scientific community and the practical daily decision-making needs of the general public.
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Affiliation(s)
- Sandra S. Albrecht
- Department of Epidemiology, Mailman
School of Public Health at Columbia University, New York, NY, USA,Sandra S. Albrecht, PhD, MPH, Columbia
University Mailman School of Public Health, Department of Epidemiology, 722 West
168th St, New York, NY 10032, USA.
| | - Shoshana V. Aronowitz
- Department of Family and Community
Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Alison M. Buttenheim
- Department of Family and Community
Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Sarah Coles
- Department of Family, Community and
Preventive Medicine, University of Arizona College of Medicine–Phoenix, Phoenix, AZ,
USA
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic
Science, University of Oxford, Oxford, United Kingdom
| | - Lauren Hale
- Department of Family, Population, and
Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook,
NY, USA
| | - Aparna Kumar
- Thomas Jefferson University College of
Nursing, Philadelphia, PA, USA
| | | | - Ashley Z. Ritter
- National Clinician Scholar Program,
University of Pennsylvania, Philadelphia, PA, USA
| | - Amanda M. Simanek
- Joseph J. Zilber School of Public
Health, University of Wisconsin–Milwaukee, Milwaukee, WI, USA
| | | | - Malia Jones
- Applied Population Laboratory,
University of Wisconsin–Madison, Madison, WI, USA
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Simanek AM, Meier HCS, D'Aloisio AA, Sandler DP. Objective and subjective childhood socioeconomic disadvantage and incident depression in adulthood: a longitudinal analysis in the Sister Study. Soc Psychiatry Psychiatr Epidemiol 2021; 56:1201-1210. [PMID: 33881563 PMCID: PMC8580191 DOI: 10.1007/s00127-020-02013-5] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 12/08/2020] [Indexed: 01/04/2023]
Abstract
Understanding of the role of objective versus subjective childhood socioeconomic disadvantage (SD) in depression onset in adulthood among women, independent of later life SD, and across birth cohorts, is limited. We examined the association between objective (i.e., household education level) and subjective (i.e., rank of family income and report of not enough food to eat) SD during childhood and diagnosis of clinical depression after age 30 among 47,055 women in the Sister Study. We used Cox proportional hazard models adjusting for women's race/ethnicity, childhood household composition, mother's age at her birth adulthood educational attainment, and calendar year of birth. Analyses were repeated stratified by 10-year birth group. A total of 8036 (17.1%) women were diagnosed with clinical depression over a mean follow-up of 24.0 (± 9.9) years. Those reporting being poor (versus well-off) or not having enough food to eat in childhood had a 1.28 (95% confidence interval (CI) 1.13, 1.44) and 1.30 (95% CI 1.21, 1.41) times higher rate of depression diagnosis, respectively, with consistent associations observed across birth year groups. An inverse association between low household education level and incident depression was observed at baseline (i.e., age 30) becoming positive over time in the total sample but only among women born between 1935-1954 in analyses stratified by 10-year birth group. Our findings suggest that subjective SD in childhood is a largely consistent predictor of depression onset among women in adulthood whereas the effects of household education level in childhood may vary across women born into different birth cohorts, and for some, across the lifecourse.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St, Milwaukee, WI, 53205, USA.
| | - Helen C S Meier
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, 1240 N. 10th St, Milwaukee, WI, 53205, USA
| | | | - Dale P Sandler
- National Institute of Environmental Health Sciences, Epidemiology Branch, Research Triangle Park, NC, USA
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Ritter AZ, Aronowitz S, Leininger L, Jones M, Dowd JB, Albrecht S, Buttenheim AM, Simanek AM, Hale L, Kumar A. Dear Pandemic: Nurses as key partners in fighting the COVID-19 infodemic. Public Health Nurs 2021; 38:603-609. [PMID: 33876450 PMCID: PMC8251166 DOI: 10.1111/phn.12903] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/12/2021] [Accepted: 03/15/2021] [Indexed: 12/29/2022]
Abstract
The COVID‐19 pandemic and subsequent proliferation of misinformation have created parallel public health crises. Social media offers a novel platform to amplify evidence‐based communication to broader audiences. This paper describes the application of science communication engagement on social media platforms by an interdisciplinary team of female scientists in a campaign called Dear Pandemic. Nurses are trusted professionals trained in therapeutic communication and are central to this effort. The Dear Pandemic campaign now has more than 97,000 followers with international and multilingual impact. Public health strategies to combat misinformation and guide individual behavior via social media show promise, and require further investment to support this novel dissemination of science communication.
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Affiliation(s)
- Ashley Z Ritter
- National Clinician Scholar Program, University of Pennsylvania, Philadelphia, PA, USA
| | - Shoshana Aronowitz
- National Clinician Scholar Program, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Malia Jones
- Applied Population Laboratory, University of Wisconsin-Madison, Madison, WI, USA
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic Science, University of Oxford, Oxford, UK
| | - Sandra Albrecht
- Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, NY, USA
| | - Alison M Buttenheim
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Lauren Hale
- Program in Public Health Department of Family, Population, and Preventative Medicine, Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Aparna Kumar
- College of Nursing, Thomas Jefferson University, Philadelphia, PA, USA
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10
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Kirkham F, Pera A, Simanek AM, Bano A, Morrow G, Reus B, Caserta S, Smith HE, Davies KA, Rajkumar C, Kern F. Cytomegalovirus infection is associated with an increase in aortic stiffness in older men which may be mediated in part by CD4 memory T-cells. Theranostics 2021; 11:5728-5741. [PMID: 33897878 PMCID: PMC8058738 DOI: 10.7150/thno.58356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 03/07/2021] [Indexed: 12/31/2022] Open
Abstract
Human Cytomegalovirus (CMV) infection is associated with atherosclerosis, higher cardiovascular disease (CVD) risk, and an increase in memory T-cells (Tmem). T-cells have also been implicated in CVD, independently of CMV infection. To better understand the CMV-associated CVD risk, we examined the association between CMV (IgG) serostatus and central aortic (carotid-to-femoral) pulse wave velocity (cfPWV), an early, independent predictor of CVD. We also investigated if such an association might be reflected by the distribution of Tmem and/or other T-cell subsets. Methods: Healthy older volunteers (60-93 years) underwent routine clinical and laboratory evaluation, including assessment of cfPWV in eligible participants. Flow-cytometry was used to assess proportions of memory T-cells, CD28null T-cells, and CMV-specific T-cells. The following associations were examined; CMV serostatus/cfPWV, CMV serostatus/proportion of Tmem, proportion of Tmem/cfPWV, CD28null T-cells/cfPWV, and CMV-specific T-cells/cfPWV. Linear regression models were used to adjust for age, sex, socioeconomic status, smoking, waist-to-hip ratio, cholesterol, and blood pressure as required. Results: Statistically significant positive associations were found (P-values for the fully adjusted models are given); CMV serostatus/cfPWV in men (P ≤ 0.01) but not in women, CMV serostatus/proportions of CD4 Tmem in men (P ≤ 0.05) but not in women; proportions of CD4 Tmem/cfPWV among CMV seropositive (CMV+) people (P ≤ 0.05) but not CMV seronegative (CMV-) people. Conclusion: CMV infection increases the CVD risk of older men by increasing cfPWV. This may be mediated in part by increased proportions of CD4 Tmem, higher numbers of which are found in CMV+ older people and more so among men than women. Given the high prevalence of CMV worldwide, our findings point to a significant global health issue. Novel strategies to mitigate the increased CVD risk associated with CMV may be required.
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King AL, Garnier‐Villarreal M, Simanek AM, Johnson NL. Testing allostatic load factor structures among adolescents: A structural equation modeling approach. Am J Hum Biol 2019; 31:e23242. [DOI: 10.1002/ajhb.23242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 01/23/2019] [Accepted: 03/10/2019] [Indexed: 01/13/2023] Open
Affiliation(s)
- Amanda L. King
- Marquette University, College of Nursing Milwaukee Wisconsin
| | | | - Amanda M. Simanek
- University of Wisconsin, Joseph T. Zilber School of Public Health Milwaukee Wisconsin
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12
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Simanek AM, Zheng C, Yolken R, Haan M, Aiello AE. A Longitudinal Study of the Association Between Persistent Pathogens and Incident Depression Among Older U.S. Latinos. J Gerontol A Biol Sci Med Sci 2019; 74:634-641. [PMID: 30084944 PMCID: PMC6477673 DOI: 10.1093/gerona/gly172] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Indexed: 11/12/2022] Open
Abstract
Depression is estimated to affect more than 6.5 million Americans 65 years of age and older and compared with non-Latino whites older U.S. Latinos have a greater incidence and severity of depression, warranting further investigation of novel risk factors for depression onset among this population. We used data on 771/1,789 individuals ≥60 years of age from the Sacramento Area Latino Study on Aging (1998-2008) who were tested for cytomegalovirus (CMV), herpes simplex virus, varicella zoster, Helicobacter pylori, Toxoplasma gondii, and C-reactive protein (CRP) and interleukin-6 (IL-6) level. Among those without elevated depressive symptoms at baseline, we examined the association between each pathogen, inflammatory markers and incident depression over up to nearly 10 years of follow-up using discrete-time logistic regression. We found that only CMV seropositivity was statistically significantly associated with increased odds of incident depression (odds ratio [OR]: 1.38, 95% confidence interval [CI]: 1.00-1.90) in the total sample as well as among women only (OR: 1.70, 95% CI: 1.01-2.86). These associations were not mediated by CRP or IL-6 levels. Our findings suggest that CMV seropositivity may serve as an important risk factor for the onset of depression among older U.S. Latinos, but act outside of inflammatory pathways.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee
| | - Cheng Zheng
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee
| | - Robert Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Mary Haan
- Department of Epidemiology and Biostatistics, University of California, San Francisco School of Medicine
| | - Allison E Aiello
- Department of Epidemiology, University of North Carolina Gillings School of Public Health, Chapel Hill
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13
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Simanek AM, Parry A, Dowd JB. Differences in the association between persistent pathogens and mood disorders among young- to middle-aged women and men in the U.S. Brain Behav Immun 2018; 68:56-65. [PMID: 28965957 DOI: 10.1016/j.bbi.2017.09.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 09/08/2017] [Accepted: 09/27/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND A growing literature supports the role of immune system alterations in the etiology of mood regulation, yet there is little population-based evidence regarding the association between persistent pathogens, inflammation and mood disorders among younger women and men in the U.S. METHODS We used data from the National Health and Nutrition Examination Survey III on individuals 15-39 years of age assessed for major depression, dysthymia, and/or bipolar disorder I and tested for cytomegalovirus (N=6825), herpes simplex virus (HSV)-1 (N=5618) and/or Helicobacter pylori (H. pylori) (N=3167) seropositivity as well as C-reactive protein (CRP) level (N=6788). CMV immunoglobulin G (IgG) antibody level was also available for a subset of women (N=3358). We utilized logistic regression to estimate the odds ratio (OR) and 95% confidence interval (CI) for the association between pathogens, CRP levels and each mood disorder overall and among women and men, separately. RESULTS H. pylori seropositivity was associated with increased odds of dysthymia (OR 2.37, 95% confidence interval (CI): 1.07, 5.24) among women, but decreased odds among men (OR 0.51, 95% CI: 0.28, 0.92). CMV seropositivity was also associated with lower odds of depression (OR 0.54, 95% CI: 0.32, 0.91) among men, while elevated CMV IgG level was marginally associated with increased odds of mood disorders among women. Associations were not mediated by CRP level. CONCLUSIONS Our findings suggest that persistent pathogens such as CMV and H. pylori may differentially influence mood disorders among women and men, warranting further investigation into biological and/or sociocultural explanations for the contrasting associations observed.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States.
| | - Amy Parry
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Jennifer B Dowd
- Department of Global Health and Social Medicine, King's College London, London, UK; Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, New York, NY, United States
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14
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Meier HCS, Haan MN, Mendes de Leon CF, Simanek AM, Dowd JB, Aiello AE. Early life socioeconomic position and immune response to persistent infections among elderly Latinos. Soc Sci Med 2016; 166:77-85. [PMID: 27543684 DOI: 10.1016/j.socscimed.2016.07.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 12/04/2015] [Revised: 07/01/2016] [Accepted: 07/04/2016] [Indexed: 02/07/2023]
Abstract
Persistent infections, such as cytomegalovirus (CMV), herpes simplex virus-1 (HSV-1), Helicobacter pylori (H. pylori), and Toxoplasma gondii (T. gondii), are common in the U.S. but their prevalence varies by socioeconomic status. It is unclear if early or later life socioeconomic position (SEP) is a more salient driver of disparities in immune control of these infections. Using data from the Sacramento Area Latino Study on Aging, we examined whether early or later life SEP was the strongest predictor of immune control later in life by contrasting two life course models, the critical period model and the chain of risk model. Early life SEP was measured as a latent variable, derived from parental education and occupation, and food availability. Indicators for SEP in later life included education level and occupation. Individuals were categorized by immune response to each pathogen (seronegative, low, medium and high) with increasing immune response representing poorer immune control. Cumulative immune response was estimated using a latent profile analysis with higher total immune response representing poorer immune control. Structural equation models were used to examine direct, indirect and total effects of early life SEP on each infection and cumulative immune response, controlling for age and gender. The direct effect of early life SEP on immune response was not statistically significant for the infections or cumulative immune response. Higher early life SEP was associated with lower immune response for T. gondii, H. pylori and cumulative immune response through pathways mediated by later life SEP. For CMV, higher early life SEP was both directly associated and partially mediated by later life SEP. No association was found between SEP and HSV-1. Findings from this study support a chain of risk model, whereby early life SEP acts through later life SEP to affect immune response to persistent infections in older age.
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Affiliation(s)
- Helen C S Meier
- Epidemiology Branch, National Institute of Environmental Health Sciences, 111 T.W. Alexander Dr., P.O. Box 12233, MD A3-05, Research Triangle Park, NC 27709, United States.
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 15th Street, San Francisco, CA 94158, United States.
| | - Carlos F Mendes de Leon
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States.
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201, United States.
| | - Jennifer B Dowd
- Department of Epidemiology and Biostatistics, CUNY School of Public Health, Hunter College, City University of New York, 2180 Third Ave., New York, NY 10035, United States.
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, 135 Dauer Dr. 2101B McGavran-Greenberg Hall, CB 7435, Chapel Hill, NC 27599, United States.
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15
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Abstract
OBJECTIVE Socioeconomic disadvantage may contribute to poor health through immune-related biological mechanisms. We examined the associations between socioeconomic status, as measured by annual household income, and T-cell markers of aging, including the ratios of CD4 and CD8 effector cells to naïve cells (E/N ratio) and the CD4/CD8 T-cell ratio. We hypothesized that participants with a lower income would have higher E/N ratios and lower CD4/CD8 ratios compared with participants with a higher income, and that these associations would be partially mediated by elevated cytomegalovirus (CMV) IgG antibody levels, a virus implicated in aging and clonal expansion of T cells. METHODS Data were from 79 individuals who participated in the population-based Detroit Neighborhood Health Study. We used linear regression to quantify the association between a $10,000 decrease in income and each ratio outcome. RESULTS After adjustment for age, sex, race, smoking, medication use, and lifetime history of mental health conditions, lower income was associated with a 0.41 (95% confidence interval = 0.09-0.72) log-unit increase in the CD4 E/N ratio and a 0.20 (95% confidence interval = 0.02-0.39) log-unit increase in the CD8 E/N ratio. CMV immunoglobulin G antibody level partially mediated these associations. CONCLUSIONS Our study suggests that low socioeconomic status is associated with immunological aging as measured by the E/N ratio and that impaired immune control of CMV may partially mediate these associations.
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Affiliation(s)
- Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;
| | - Lydia Feinstein
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA;
| | - Jennifer B Dowd
- CUNY School of Public Health, Hunter College, City University of New York, NY, USA;
| | - Graham Pawelec
- Department of Internal Medicine II, Centre for Medical Research, University of Tubingen, Tubingen, Germany;
| | - Evelyna Derhovanessian
- Department of Internal Medicine II, Centre for Medical Research, University of Tubingen, Tubingen, Germany;
| | - Sandro Galea
- Boston University School of Public Health, Boston University, Boston, MA, USA;
| | - Monica Uddin
- Department of Psychology and Carl R. Woese Institute for Genomic Biology, University of Illinois Urbana-Champaign, Urbana, IL;
| | - Derek E. Wildman
- Department of Molecular and Integrative Physiology, University of Illinois at Urbana-Champaign, Urbana, IL USA;
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA;
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16
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Aiello AE, Simanek AM, Eisenberg MC, Walsh AR, Davis B, Volz E, Cheng C, Rainey JJ, Uzicanin A, Gao H, Osgood N, Knowles D, Stanley K, Tarter K, Monto AS. Design and methods of a social network isolation study for reducing respiratory infection transmission: The eX-FLU cluster randomized trial. Epidemics 2016; 15:38-55. [PMID: 27266848 PMCID: PMC4903923 DOI: 10.1016/j.epidem.2016.01.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [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: 03/12/2015] [Revised: 01/09/2016] [Accepted: 01/19/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Social networks are increasingly recognized as important points of intervention, yet relatively few intervention studies of respiratory infection transmission have utilized a network design. Here we describe the design, methods, and social network structure of a randomized intervention for isolating respiratory infection cases in a university setting over a 10-week period. METHODOLOGY/PRINCIPAL FINDINGS 590 students in six residence halls enrolled in the eX-FLU study during a chain-referral recruitment process from September 2012-January 2013. Of these, 262 joined as "seed" participants, who nominated their social contacts to join the study, of which 328 "nominees" enrolled. Participants were cluster-randomized by 117 residence halls. Participants were asked to respond to weekly surveys on health behaviors, social interactions, and influenza-like illness (ILI) symptoms. Participants were randomized to either a 3-Day dorm room isolation intervention or a control group (no isolation) upon illness onset. ILI cases reported on their isolation behavior during illness and provided throat and nasal swab specimens at onset, day-three, and day-six of illness. A subsample of individuals (N=103) participated in a sub-study using a novel smartphone application, iEpi, which collected sensor and contextually-dependent survey data on social interactions. Within the social network, participants were significantly positively assortative by intervention group, enrollment type, residence hall, iEpi participation, age, gender, race, and alcohol use (all P<0.002). CONCLUSIONS/SIGNIFICANCE We identified a feasible study design for testing the impact of isolation from social networks in a university setting. These data provide an unparalleled opportunity to address questions about isolation and infection transmission, as well as insights into social networks and behaviors among college-aged students. Several important lessons were learned over the course of this project, including feasible isolation durations, the need for extensive organizational efforts, as well as the need for specialized programmers and server space for managing survey and smartphone data.
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Affiliation(s)
- Allison E Aiello
- University of North Carolina-Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, United States.
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, United States
| | - Marisa C Eisenberg
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, United States
| | - Alison R Walsh
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, United States
| | - Brian Davis
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, United States
| | | | - Caroline Cheng
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, United States
| | - Jeanette J Rainey
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Amra Uzicanin
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Hongjiang Gao
- Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Nathaniel Osgood
- University of Saskatchewan, Department of Computer Science, Saskatoon, SK, Canada
| | - Dylan Knowles
- University of Saskatchewan, Department of Computer Science, Saskatoon, SK, Canada
| | - Kevin Stanley
- University of Saskatchewan, Department of Computer Science, Saskatoon, SK, Canada
| | - Kara Tarter
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, United States
| | - Arnold S Monto
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, United States
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17
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Markovitz AA, Simanek AM, Yolken RH, Galea S, Koenen KC, Chen S, Aiello AE. Toxoplasma gondii and anxiety disorders in a community-based sample. Brain Behav Immun 2015; 43:192-7. [PMID: 25124709 DOI: 10.1016/j.bbi.2014.08.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 07/28/2014] [Accepted: 08/04/2014] [Indexed: 01/13/2023] Open
Abstract
A growing body of literature suggests that exposure to the neurotropic parasite Toxoplasma gondii (T. gondii) is associated with increased risk of mental disorders, particularly schizophrenia. However, a potential association between T. gondii exposure and anxiety disorders has not been rigorously explored. Here, we examine the association of T. gondii infection with both anxiety and mood disorders. Participants (n=484) were drawn from the Detroit Neighborhood Health Study, a population-representative sample of Detroit residents. Logistic regression was used to examine the associations between T. gondii exposure (defined by seropositivity and IgG antibody levels) and three mental disorders: generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD) and depression. We found that T. gondii seropositivity was associated with a 2 times greater odds of GAD (odds ratio (OR), 2.25; 95% confidence interval (CI), 1.11-4.53) after adjusting for age, gender, race, income, marital status, and medication. Individuals in the highest antibody level category had more than 3 times higher odds of GAD (OR, 3.35; 95% CI, 1.41-7.97). Neither T. gondii seropositivity nor IgG antibody levels was significantly associated with PTSD or depression. Our findings indicate that T. gondii infection is strongly and significantly associated with GAD. While prospective confirmation is needed, T. gondii infection may play a role in the development of GAD.
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Affiliation(s)
- Adam A Markovitz
- Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, MI 48109, United States
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, United States
| | - Robert H Yolken
- Department of Pediatrics, Stanley Division of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, United States
| | - Sandro Galea
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, United States
| | - Karestan C Koenen
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY 10032, United States
| | - Shu Chen
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, United States
| | - Allison E Aiello
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC 27599, United States.
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18
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Simanek AM, Cheng C, Yolken R, Uddin M, Galea S, Aiello AE. Herpesviruses, inflammatory markers and incident depression in a longitudinal study of Detroit residents. Psychoneuroendocrinology 2014; 50:139-48. [PMID: 25218654 PMCID: PMC4306348 DOI: 10.1016/j.psyneuen.2014.08.002] [Citation(s) in RCA: 40] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 08/01/2014] [Accepted: 08/01/2014] [Indexed: 01/16/2023]
Abstract
BACKGROUND Depression is predicted to become the leading cause of disability worldwide by 2030 and moreover, socioeconomic inequalities in depression persist. Herpesviruses, which are more prevalent among socioeconomically disadvantaged populations, subject to stress-induced reactivation and are associated with increased levels of pro-inflammatory cytokines implicated in the etiology of depression, may serve as novel risk factors for depression onset. METHODS Data are from individuals in the Detroit Neighborhood Health Study tested for herpes simplex virus-1 (HSV-1) and cytomegalovirus (CMV) seropositivity/immunoglobulin G (IgG) antibody levels (N=263) as well as interleukin-6 (IL-6) (N=245) and C-reactive protein (CRP) (N=236) levels and assessed for incident depression via the Patient Health Questionnaire-9. Linear and logistic regression models were used to examine associations between pathogen seropositivity/IgG antibody levels, pro-inflammatory markers and incident depression over approximately one-year of follow-up. RESULTS For every one unit increase in CMV IgG antibody level, the odds of incident depression increased by 26% and individuals with IgG antibody levels in the highest quartile had over three times greater odds of incident depression (odds ratio 3.87, 95% confidence interval 1.47, 10.19), compared to those in the lower three quartiles. Neither CMV or HSV-1 seropositivity nor HSV-1 IgG antibody level were associated with IL-6 or CRP levels at Wave 1, nor were IL-6 or CRP levels associated with incident depression at Wave 2. CONCLUSIONS Further examination of the biological pathways linking CMV and depression are warranted.
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Affiliation(s)
- Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
| | - Caroline Cheng
- Department of Epidemiology, University of Michigan-School of Public Health, Ann Arbor, MI, USA; Center for Social Epidemiology & Population Health, University of Michigan-School of Public Health, Ann Arbor, MI, USA
| | - Robert Yolken
- Department of Pediatrics, Stanley Division of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Monica Uddin
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, USA; Institute of Genomic Biology, University of Illinois Urbana-Champaign, Urbana IL
| | - Sandro Galea
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Allison E Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
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19
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Sansoni P, Vescovini R, Fagnoni FF, Akbar A, Arens R, Chiu YL, Cičin-Šain L, Dechanet-Merville J, Derhovanessian E, Ferrando-Martinez S, Franceschi C, Frasca D, Fulöp T, Furman D, Gkrania-Klotsas E, Goodrum F, Grubeck-Loebenstein B, Hurme M, Kern F, Lilleri D, López-Botet M, Maier AB, Marandu T, Marchant A, Matheï C, Moss P, Muntasell A, Remmerswaal EBM, Riddell NE, Rothe K, Sauce D, Shin EC, Simanek AM, Smithey MJ, Söderberg-Nauclér C, Solana R, Thomas PG, van Lier R, Pawelec G, Nikolich-Zugich J. New advances in CMV and immunosenescence. Exp Gerontol 2014; 55:54-62. [PMID: 24703889 DOI: 10.1016/j.exger.2014.03.020] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Revised: 03/21/2014] [Accepted: 03/24/2014] [Indexed: 12/16/2022]
Abstract
Immunosenescence, defined as the age-associated dysregulation and dysfunction of the immune system, is characterized by impaired protective immunity and decreased efficacy of vaccines. An increasing number of immunological, clinical and epidemiological studies suggest that persistent Cytomegalovirus (CMV) infection is associated with accelerated aging of the immune system and with several age-related diseases. However, current evidence on whether and how human CMV (HCMV) infection is implicated in immunosenescence and in age-related diseases remains incomplete and many aspects of CMV involvement in immune aging remain controversial. The attendees of the 4th International Workshop on "CMV & Immunosenescence", held in Parma, Italy, 25-27th March, 2013, presented and discussed data related to these open questions, which are reported in this commentary.
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Affiliation(s)
- Paolo Sansoni
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy.
| | - Rosanna Vescovini
- Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy
| | | | - Arne Akbar
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Ramon Arens
- Department of Immunohematology and Blood Transfusion, Leiden University Medical Center, Leiden, Netherlands
| | - Yen-Ling Chiu
- Institute of Cell Engineering, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Luka Cičin-Šain
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Julie Dechanet-Merville
- Composantes Innées de la Response Immunitaire et Différenciation, University of Bordeaux, Bordeaux, France
| | - Evelyna Derhovanessian
- Department of Internal Medicine II, Center for Medical Research University of Tübingen, Tübingen, Germany
| | - Sara Ferrando-Martinez
- Laboratorio de InmunoBiología Molecular, Hospital General Universitario Gregorio Marañón and Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Spain
| | - Claudio Franceschi
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - Daniela Frasca
- Department of Microbiology and Immunology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Tamas Fulöp
- Division of Geriatrics and Research Center on Aging, Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - David Furman
- Composantes Innées de la Response Immunitaire et Différenciation, University of Bordeaux, Bordeaux, France; Department of Microbiology & Immunology, School of Medicine, Stanford University, CA, USA
| | | | - Felicia Goodrum
- Department of Immunobiology and the Arizona Center on Aging, University of Arizona College of Medicine, Tucson, AZ, USA
| | | | - Mikko Hurme
- Department of Microbiology and Immunology, University of Tampere, Tampere, Finland
| | - Florian Kern
- Division of Medicine, Pathogen Host Interaction (PHI), Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Daniele Lilleri
- Laboratori Sperimentali di Ricerca, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Miguel López-Botet
- Immunology Unity, University Pompeu Fabra and Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Andrea B Maier
- Section of Gerontology and Geriatrics, Department of Internal Medicine, VU University Medical Center, Amsterdam, Netherlands
| | - Thomas Marandu
- Department of Vaccinology and Applied Microbiology, Helmholtz Centre for Infection Research, Braunschweig, Germany
| | - Arnaud Marchant
- Institute for Medical Immunology, Université Libre de Bruxelles, Charleroi, Belgium
| | - Catharina Matheï
- KU Leuven, Department of Public Health and Primary Care, Leuven, Belgium
| | - Paul Moss
- School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Aura Muntasell
- Immunology Unity, University Pompeu Fabra and Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Ester B M Remmerswaal
- Department of Experimental Immunology and Renal Transplant Unit, Department of Internal Medicine, Amsterdam, Netherlands
| | - Natalie E Riddell
- Division of Infection and Immunity, University College London, London, United Kingdom
| | - Kathrin Rothe
- Section of Rheumatology, University of Leipzig, Leipzig, Germany
| | - Delphine Sauce
- INSERM, Infections and Immunity, Université Pierre et Marie Curie, Hôpital Pitié-Salpêtrière, Paris, France
| | - Eui-Cheol Shin
- Laboratory of Immunology and Infectious Diseases (LIID), Graduate School of Medical Science and Engineering, KAIST, Daejeon, Korea
| | - Amanda M Simanek
- Joseph J. Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA
| | - Megan J Smithey
- Department of Immunobiology and the Arizona Center on Aging, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Cecilia Söderberg-Nauclér
- Department of Medicine, Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Rafael Solana
- Immunology Unit, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Paul G Thomas
- Department of Immunology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Rene van Lier
- Division of Research, Sanquin Blood Supply Foundation, Amsterdam, Netherlands
| | - Graham Pawelec
- Department of Internal Medicine II, Center for Medical Research University of Tübingen, Tübingen, Germany
| | - Janko Nikolich-Zugich
- Department of Immunobiology and the Arizona Center on Aging, University of Arizona College of Medicine, Tucson, AZ, USA.
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Tarter KD, Simanek AM, Dowd JB, Aiello AE. Persistent viral pathogens and cognitive impairment across the life course in the third national health and nutrition examination survey. J Infect Dis 2014; 209:837-44. [PMID: 24253286 PMCID: PMC3935478 DOI: 10.1093/infdis/jit616] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 10/02/2013] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Herpesviruses have been linked to cognitive impairment in older individuals but little is known about the association in the general US population. METHODS We determined whether cytomegalovirus (CMV) and herpes simplex virus 1 (HSV-1) seropositivity were associated with cognitive impairment among children (aged 6-16 years) and adults aged 20-59 or ≥60 years, using data from the National Health and Nutrition Examination Survey (NHANES) III. Linear and logistic regression models were used to examine the associations between pathogen seropositivity and cognitive impairment. RESULTS Among children, HSV-1 seropositivity was associated with lower reading and spatial reasoning test scores (β, -0.69; 95% confidence interval [CI], -1.18 to -.21 and β, -0.82; 95% CI, -1.29 to -.36, respectively). Among middle-aged adults, HSV-1 and CMV seropositivity were associated with impaired coding speed (odds ratio [OR], 1.54; 95% CI, 1.13-2.11, and OR, 1.41; 95% CI, 1.09-1.82, respectively). CMV seropositivity was also associated with impaired learning and recall (OR, 1.43; 95% CI, 1.14-1.80). Among older adults, HSV-1 seropositivity was associated with immediate memory impairment (OR, 3.26; 95% CI, 1.68-6.32). CONCLUSIONS Future studies examining the biological pathways by which herpesviruses influence cognitive impairment across the life course are warranted.
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Affiliation(s)
- Kara D. Tarter
- Department of Epidemiology, Center for Social Epidemiology & Population Health, University of Michigan School of Public Health, Ann Arbor, MI
| | - Amanda M. Simanek
- University of Wisconsin-Milwaukee, Joseph J. Zilber School of Public Health, Milwaukee, WI
| | - Jennifer B. Dowd
- CUNY School of Public Health, Hunter College, City University of New York, NY
| | - Allison E. Aiello
- Department of Epidemiology, Center for Social Epidemiology & Population Health, University of Michigan School of Public Health, Ann Arbor, MI
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Aiello AE, Simanek AM, Galea S. Population levels of psychological stress, herpesvirus reactivation and HIV. AIDS Behav 2010; 14:308-17. [PMID: 18264753 DOI: 10.1007/s10461-008-9358-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 01/22/2008] [Indexed: 12/26/2022]
Abstract
Nearly 40,000 Americans are newly infected with Human Immunodeficiency Virus (HIV) each year. Recently, studies have demonstrated associations between group-level characteristics and the prevalence and incidence of HIV/Acquired Immune Deficiency Syndrome (AIDS) and other sexually transmitted diseases. Two mechanisms previously posited to explain these associations are neighborhood effects on risk behaviors and social or institutional policies. In this paper, we hypothesize that adversity at the population level, such as neighborhood poverty, also influences HIV risk through stress-mediated aberrations in immunological susceptibility by reviewing existing data examining each of these pathways. In particular, we review the evidence showing that: (1) Neighborhood ecologic stressors influence neighborhood- and individual-levels of mental health, psychosocial stress, and HIV/AIDS risk, (2) Individual-level psychosocial stressors influence progression from HIV to AIDS through stress-related hormonal changes, and (3) Individual-level psychosocial stressors influence HIV acquisition via stress-related reactivation of latent herpesviruses, specifically EBV and HSV-2. Our review indicates that further studies are needed to examine the joint pathways linking neighborhood-level sources of psychosocial stress, stress-related reactivation of HSV-2 and EBV, and increased acquisition rates of HIV. We suggest using a multi-level framework for targeting HIV prevention efforts that address not only behavioral risk factors, but structural, political, and institutional factors associated with neighborhood disadvantage, levels of psychosocial stress, and prevention or treatment of HSV-2 and EBV.
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Abstract
BACKGROUND The notion that chronic stress contributes to health inequalities by socio-economic status (SES) through physiological wear and tear has received widespread attention. This article reviews the literature testing associations between SES and cortisol, an important biomarker of stress, as well as the summary index of allostatic load (AL). METHODS A search of all published literature on the PubMed and ISI Web of Knowledge literature search engines was conducted using broad search terms. The authors reviewed abstracts and selected articles that met the inclusion criteria. A total of 26 published studies were included in the review. RESULTS Overall, SES was not consistently related to cortisol. Although several studies found an association between lower SES and higher levels of cortisol, many found no association, with some finding the opposite relationship. Lower SES was more consistently related to a blunted pattern of diurnal cortisol secretion, but whether this corresponded to higher or lower overall cortisol exposure varied by study. Approaches to collecting and analysing cortisol varied widely, likely contributing to inconsistent results. Lower SES was more consistently related to higher levels of AL, but primarily via the cardiovascular and metabolic components of AL rather than the neuroendocrine markers. CONCLUSIONS Current empirical evidence linking SES to cortisol and AL is weak. Future work should standardize approaches to measuring SES, chronic stress and cortisol to better understand these relationships.
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Affiliation(s)
- Jennifer B Dowd
- School of Health Sciences, Hunter College, City University of New York, New York, NY 10010, USA.
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Simanek AM, Dowd JB, Aiello AE. Persistent pathogens linking socioeconomic position and cardiovascular disease in the US. Int J Epidemiol 2009; 38:775-87. [PMID: 19109247 PMCID: PMC2689394 DOI: 10.1093/ije/dyn273] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [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: 11/17/2008] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Numerous studies have documented a strong inverse association between cardiovascular disease and socioeconomic position (SEP). Several infections are associated with both cardiovascular disease and SEP; hence infection may form an important link between SEP and cardiovascular disease. This study examines whether seropositivity to cytomegalovirus (CMV), to herpes simplex virus type-1 (HSV-1), and/or to both pathogens mediates the relationship between SEP and cardiovascular disease history in a nationally representative sample of the United States. METHODS We conducted a cross-sectional study of subjects > or =45 years of age, who were tested for seropositivity to CMV, HSV-1 or both pathogens and assessed for cardiovascular disease history in the National Health and Nutrition Examination Survey III. Cardiovascular disease history was defined as history of stroke, heart attack and/or congestive heart failure and SEP as education level. RESULTS SEP was associated with CMV, HSV-1 and seropositivity to both pathogens. CMV seropositivity was associated with cardiovascular disease history even after adjusting for confounders as well as SEP. The odds of reporting a history of cardiovascular disease for those with less than a high school education compared with those with more than a high school education decreased by 7.7% after adjusting for CMV (Sobel mediation test for CMV, P = 0.0006). In contrast, neither seropositivity to HSV-1 nor to both pathogens was associated with cardiovascular disease history after adjusting for SEP. CONCLUSIONS Persistent pathogens such as CMV infection may explain a portion of the relationship between SEP and cardiovascular disease in the United States. Further studies examining additional pathogens and sociobiological mechanisms are warranted.
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Affiliation(s)
- Amanda M Simanek
- Center for Social Epidemiology & Population Health School of Public Health-University of Michigan, Ann Arbor, MI 48109-2029, USA
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Aiello AE, Haan MN, Pierce CM, Simanek AM, Liang J. Persistent infection, inflammation, and functional impairment in older Latinos. J Gerontol A Biol Sci Med Sci 2008; 63:610-8. [PMID: 18559636 DOI: 10.1093/gerona/63.6.610] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND The objective of this study was to examine whether cytomegalovirus (CMV), herpes simplex virus type-1 (HSV-1), and C-reactive protein (CRP) are associated with functional impairment in older Latinos. METHODS A cross-sectional analysis of a cohort study was conducted with a community-dwelling elderly population. The sample was a subset (N = 1559/1789) of participants in the Sacramento Area Latino Study on Aging (SALSA) ages 60-101 with available serum samples and functional impairment measures. Baseline serum samples were assayed for levels of immunoglobulin G antibodies to CMV and HSV-1 and for levels of CRP. Several measures were used to assess functional impairment, including activities of daily living (ADL), instrumental activities of daily living (IADL), and walking pace. RESULTS CMV and CRP showed statistically significant graded associations with ADL functional impairment, even after controlling for age and gender. The relationship between CMV and ADL was slightly attenuated, and the confidence interval contained the null value when adjusted for total number of health conditions, body mass index, and household income. Only high levels of CRP were significantly related to ADL and IADL impairment even after adjusting for all other covariates. CONCLUSION Inflammation is clearly linked to physical functioning among aging Latinos. This study also suggests a role for CMV infection in relation to ADL impairment. Further research examining the influence of infection, immune response, and inflammation on longitudinal trajectories of physical functioning is warranted.
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Affiliation(s)
- Allison E Aiello
- Department of Epidemiology, Center for Social Epidemiology & Population Health, 1214 S. University, 2nd Floor, Ann Arbor, MI 48104-2548, USA.
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