A meta-analysis of blood lead levels in India and the attributable burden of disease

Ericson, B., Dowling, R., Dey, S., Caravanos, J., Mishra, N., Fisher, S., Ramirez, M., Sharma, P., McCartor, A., Guin, P., Taylor, M. P., & Fuller, R.

Publication year

2018

Journal title

Environment International

Volume

121

Page(s)

461-470
Abstract
Multiple studies in India have found elevated blood lead levels (BLLs) in target populations. However the data have not yet been evaluated to understand population-wide exposure levels. We used arithmetic mean blood lead data published from 2010 to 2018 on Indian populations to calculate the average BLLs for multiple subgroups. We then calculated the attributable disease burden in IQ decrement and Disability Adjusted Life Years (DALYs). Our Pubmed search yielded 1066 articles. Of these, 31 studies representing the BLLs of 5472 people in 9 states met our study criteria. Evaluating these, we found a mean BLL of 6.86 μg/dL (95% CI: 4.38–9.35) in children and 7.52 μg/dL (95% CI: 5.28–9.76) in non-occupationally exposed adults. We calculated that these exposures resulted in 4.9 million DALYs (95% CI: 3.9–5.6) in the states we evaluated. Population-wide BLLs in India remain elevated despite regulatory action to eliminate leaded petrol, the most significant historical source. The estimated attributable disease burden is larger than previously calculated, particularly with regard to associated intellectual disability outcomes in children. Larger population-wide BLL studies are required to inform future calculations. Policy responses need to be developed to mitigate the worst exposures.

Voting as a Tool to Improve Public Health

November 2, 2018

 

A Message from Dean Cheryl Healton

 

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Evolution in Nicotine Consumption

October 26, 2018

The race to save lives from premature death is in full effect as noncombustible tobacco products are on the rise. Drs. David Abrams and Raymond Niaura discussion how the buzz around adolescent vaping ...
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Culturally tailored, peer-based sleep health education and social support to increase obstructive sleep apnea assessment and treatment adherence among a community sample of blacks: Study protocol for a randomized controlled trial 11 Medical and Health Sciences 1117 Public Health and Health Services 11 Medical and Health Sciences 1102 Cardiorespiratory Medicine and Haematology

Seixas, A. A., Trinh-Shevrin, C., Ravenell, J., Ogedegbe, G., Zizi, F., & Jean-Louis, G.

Publication year

2018

Journal title

Trials

Volume

19

Issue

1
Abstract
Background: Compared to whites, blacks are at increased risk for obstructive sleep apnea (OSA) yet less likely to adhere to physician-recommended sleep assessment and treatment. Poor OSA health literacy and lack of social support to navigate the current healthcare system are two potential barriers to adequate OSA care. This study is designed to address these barriers by evaluating the effectiveness of a peer-based sleep health education program on adherence to OSA assessment and treatment among blacks at risk for OSA. Method/Design: In a two-arm, randomized controlled trial, we will ascertain the effectiveness of peer-based sleep health education and social support in increasing OSA evaluation and treatment rates among 398 blacks at low to high OSA risk. Participants at risk of OSA will receive quality controlled, culturally, and linguistically tailored peer education based on Motivational Enhancement principles over a period of 12 months. During this 12-month period, participants are encouraged to participate in a sleep home study to determine risk of OSA and, if found to be at risk, they are invited to undergo a diagnostic sleep assessment at a clinic. Participants who are diagnosed with OSA and who are prescribed continuous positive airway pressure treatment will be encouraged, through peer-based education, to adhere to recommended treatment. Recruitment for the project is ongoing. Discussion: The use of a culturally tailored sleep health education program, peer health educators trained in sleep health, and home-based sleep assessment are novel approaches in improving OSA assessment and treatment adherence in blacks who are significantly at risk for OSA. Empirical evidence from this trial will provide clinical and population level solutions on how to improve and increase assessment and treatment of OSA among blacks. Trial registration: NCT02427815. Registered on 20 April 2015. ClinicalTrials.gov title: Sleep Health Education and Social Support Among Blacks With OSA.

Race, Ancestry, and Reporting in Medical Journals

Cooper, R. S., Nadkarni, G. N., & Ogedegbe, G.

Publication year

2018

Journal title

JAMA - Journal of the American Medical Association

Page(s)

E1-E2

Nonlinear dynamics, mathematical biology, and social science

Epstein, J. M.

Publication year

2018
Abstract
These lectures develop simple models of complex social processes using nonlinear dynamics and mathematical biology. Dynamical analogies between seemingly disparate social and biological phenomena, revolutions and epidemics, arms races, and ecosystem dynamics, are revealed and exploited. Nonlinear Dynamics, Mathematical Biology, and Social Science invites social scientists to relax, in some cases abandon, the predominant assumption of perfectly informed utility maximization and explore social dynamics from such perspectives as epidemiology and predator-prey theory. The volume includes a concentrated course on nonlinear dynamical systems.

A qualitative investigation of healthcare engagement among young adult gay men in New York City: A P18 cohort substudy

Griffin, M., Krause, K. D., Kapadia, F., & Halkitis, P. N.

Publication year

2018

Journal title

LGBT health

Volume

5

Issue

6

Page(s)

368-374
Abstract
Purpose: We used in-depth interviews with a cohort of young adult gay men (YAGM) to provide a more detailed understanding of their current healthcare engagement, including experiences with the healthcare system, provider knowledge of healthcare needs, and desired provider characteristics. Methods: Qualitative interviews were conducted with a sample of 40 YAGM in New York City. The interview guide examined healthcare engagement across key developmental stages: Childhood (birth-12), adolescence (13-18), young adulthood (19-22), and the present (23-26). All transcripts were coded using a consensual qualitative research approach to identify crosscutting topics. The interviews were conducted between September and October 2015. Results: The following topics were identified: Experiences with the healthcare system, provider knowledge of healthcare needs, and desired provider characteristics. Common barriers to healthcare access were financial concerns, lack of insurance, and dissatisfaction with the care provided. Reasons for dissatisfaction with care were based on perceptions of providers' anti-gay attitudes, judgment of same-sex sexual behavior, and lack of provider knowledge about YAGM's health needs. This often led men in this study to seek sexual healthcare from providers other than their primary care provider. When asked about desired provider characteristics, participants noted that basic demographics were of less importance than skills-based characteristics such as rapport, comfort discussing sexual health issues, and knowledge of YAGM's health. Conclusion: YAGM have unique challenges to engaging in healthcare, including provider stigma and lack of provider knowledge of YAGM's health needs, which are not faced by other young adult populations. The results from this study highlight the need for more extensive and standardized training in medical school and as part of continuing medical education for healthcare providers.

Motivations for alcohol use to intoxication among young adult gay, bisexual, and other MSM in New York City: The P18 Cohort Study

Ristuccia, A., LoSchiavo, C., Kapadia, F., & Halkitis, P. N.

Publication year

2019

Journal title

Addictive Behaviors

Volume

89

Page(s)

44-50
Abstract
Introduction: Motivations for alcohol use to intoxication vary among young adults depending on social setting and other contextual factors. However, there is limited research exploring the role of different drinking motivations among young men who have sex with men (YMSM). Methods: Data from a racially/ethnically and socioeconomically diverse sample of YMSM (n = 426) were used to examine associations between recent (last 30 days) alcohol use to intoxication and scores on three distinct drinking motivation subscales: convivial, intimate, and negative coping drinking. Multinomial logistic regression models were constructed to examine associations between drinking motivations and days of alcohol use to intoxication, controlling for sociodemographic characteristics. Results: YMSM who scored higher on all three drinking motivation subscales were more likely to engage in recent alcohol use to intoxication compared to those who reported no alcohol use to intoxication. In multivariable models, Black and Hispanic YMSM had lower odds of intoxication compared to White YMSM, and those reporting lower perceived familial SES had lower odds compared to higher SES. In a final model including all three motivations, only convivial drinking was significantly associated with days of intoxication (1–2 days: AOR = 1.22; 3+ days: AOR = 1.45). Conclusions: This study identifies distinct associations between different motivations for drinking and alcohol use to intoxication in a sample of YMSM. These findings highlight a need to incorporate an understanding of motivations for alcohol use to intoxication into research and clinical practice with YMSM, as different reasons for drinking carry respective potential health risks.
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