Comprehensive cancer control programs and coalitions: partnering to launch successful colorectal cancer screening initiatives
Seeff LC , Major A , Townsend JS , Provost E , Redwood D , Espey D , Dwyer D , Villanueva R , Larsen L , Rowley K , Leonard B . Cancer Causes Control 2010 21 (12) 2023-31 Colorectal cancer control has long been a focus area for Comprehensive Cancer Control programs and their coalitions, given the high burden of disease and the availability of effective screening interventions. Colorectal cancer control has been a growing priority at the national, state, territorial, tribal, and local level. This paper summarizes several national initiatives and features several Comprehensive Cancer Control Program colorectal cancer control successes. |
Discriminative accuracy of genomic profiling comparing multiplicative and additive risk models.
Moonesinghe R , Khoury MJ , Liu T , Janssens AC . Eur J Hum Genet 2010 19 (2) 180-5 Genetic prediction of common diseases is based on testing multiple genetic variants with weak effect sizes. Standard logistic regression and Cox Proportional Hazard models that assess the combined effect of multiple variants on disease risk assume multiplicative joint effects of the variants, but this assumption may not be correct. The risk model chosen may affect the predictive accuracy of genomic profiling. We investigated the discriminative accuracy of genomic profiling by comparing additive and multiplicative risk models. We examined genomic profiles of 40 variants with genotype frequencies varying from 0.1 to 0.4 and relative risks varying from 1.1 to 1.5 in separate scenarios assuming a disease risk of 10%. The discriminative accuracy was evaluated by the area under the receiver operating characteristic curve. Predicted risks were more extreme at the lower and higher risks for the multiplicative risk model compared with the additive model. The discriminative accuracy was consistently higher for multiplicative risk models than for additive risk models. The differences in discriminative accuracy were negligible when the effect sizes were small (<1.2), but were substantial when risk genotypes were common or when they had stronger effects. Unraveling the exact mode of biological interaction is important when effect sizes of genetic variants are moderate at the least, to prevent the incorrect estimation of risks. European Journal of Human Genetics advance online publication, 17 November 2010; doi:10.1038/ejhg.2010.165. |
Regulation of the expression of the varicella-zoster virus open reading frame 66 gene.
Folster JM , Jensen NJ , Ruyechan WT , Inoue N , Schmid DS . Virus Res 2010 155 (1) 334-42 The varicella-zoster virus (VZV) open reading frame (ORF) 66 encodes a serine/threonine kinase that phosphorylates the major viral transactivator protein, immediate-early (IE) 62, preventing its nuclear importation. Cytoplasmic sequestration of IE62 may alter viral gene transcription and could serve as a mechanism for maintaining VZV latency. We examined the regulation of expression of the ORF66 gene by mapping the promoter region, which was localized to within 150 bases of the start codon. The ORF66 promoter was activated by two viral regulatory proteins, IE62 and IE63. We evaluated the binding of viral regulatory proteins and cellular transcription factors based on recognized cellular transcription factor binding sites identified within the ORF66 promoter. These included Sp1 and TBP binding sites, several of which were essential for optimal promoter activity. Site-directed mutations in Sp1 and TBP binding sites led to varying degrees of impairment of ORF66 gene expression in the context of VZV infection. We also examined the effect of Sp1 and TBP mutations on IE62, Sp1, and TBP binding. These studies reveal that host cell-derived and viral factors contribute to and cooperate in the expression of this important viral kinase gene. |
Preventing AIDS through live movement and sound: efficacy of a theater-based HIV prevention intervention delivered to high-risk male adolescents in juvenile justice settings
Lauby JL , LaPollo AB , Herbst JH , Painter TM , Batson H , Pierre A , Milnamow M . AIDS Educ Prev 2010 22 (5) 402-16 Male adolescents who cycle through the juvenile justice system are at high risk for HIV infection, yet there are few HIV prevention interventions for this high-risk population. This study evaluates the efficacy of Preventing AIDS through Live Movement and Sound (PALMS), an innovative, theory-based HIV risk reduction intervention that uses theatrical performances and role-play. The study used a nonrandomized concurrent comparison group design. A total of 289 predominantly African American males aged 12-18 from two juvenile justice facilities in Philadelphia, PA were enrolled. At 6-month follow-up, PALMS participants demonstrated greater increases in HIV and condom use knowledge and improved attitudes toward HIV testing and toward persons living with HIV/AIDS than did those in the comparison condition. PALMS participants were also significantly more likely to use a condom during their last sexual contact with a non-main female partner than comparison participants. This theater-based HIV prevention intervention is a potential resource for changing knowledge, attitudes, and behaviors of adolescents in juvenile justice settings. |
Single-dose mucosal immunization with a candidate universal influenza vaccine provides rapid protection from virulent H5N1, H3N2 and H1N1 viruses
Price GE , Soboleski MR , Lo CY , Misplon JA , Quirion MR , Houser KV , Pearce MB , Pappas C , Tumpey TM , Epstein SL . PLoS One 2010 5 (10) e13162 BACKGROUND: The sudden emergence of novel influenza viruses is a global public health concern. Conventional influenza vaccines targeting the highly variable surface glycoproteins hemagglutinin and neuraminidase must antigenically match the emerging strain to be effective. In contrast, "universal" vaccines targeting conserved viral components could be used regardless of viral strain or subtype. Previous approaches to universal vaccination have required protracted multi-dose immunizations. Here we evaluate a single dose universal vaccine strategy using recombinant adenoviruses (rAd) expressing the conserved influenza virus antigens matrix 2 and nucleoprotein. METHODOLOGY/PRINCIPAL FINDINGS: In BALB/c mice, administration of rAd via the intranasal route was superior to intramuscular immunization for induction of mucosal responses and for protection against highly virulent H1N1, H3N2, or H5N1 influenza virus challenge. Mucosally vaccinated mice not only survived, but had little morbidity and reduced lung virus titers. Protection was observed as early as 2 weeks post-immunization, and lasted at least 10 months, as did antibodies and lung T cells with activated phenotypes. Virus-specific IgA correlated with but was not essential for protection, as demonstrated in studies with IgA-deficient animals. CONCLUSION/SIGNIFICANCE: Mucosal administration of NP and M2-expressing rAd vectors provided rapid and lasting protection from influenza viruses in a subtype-independent manner. Such vaccines could be used in the interval between emergence of a new virus strain and availability of strain-matched vaccines against it. This strikingly effective single-dose vaccination thus represents a candidate off-the-shelf vaccine for emergency use during an influenza pandemic. |
Prevalence and characteristics of general and football-specific emergency medical service activations by high school and collegiate certified athletic trainers: a national study
Decoster LC , Swartz EE , Cappaert TA , Hootman JM . Clin J Sport Med 2010 20 (6) 436-44 OBJECTIVE: To describe frequency and characteristics of emergency medical services (EMS) activations by certified athletic trainers (ATs) and effects of pre-season planning meetings on interactions between ATs and EMS both generally and specifically during football head/neck emergencies. DESIGN: Retrospective cross-sectional survey. SETTING: 2009 Web-based survey. PARTICIPANTS: Athletic trainers (n = 1884; participation rate, 28%) in high school and collegiate settings. INDEPENDENT VARIABLES: Athletic trainer work setting, AT demographics, history of pre-season planning meetings. MAIN OUTCOME MEASURES: Proportions and 95% confidence intervals (CIs) estimated the prevalence of EMS activation, planning meetings, and characteristics of AT-EMS interactions (eg, episodes of AT-perceived inappropriate care and on-field disagreements). Chi square tests tested differences (P < 0.05) in proportions. Associations (odds ratio = OR and 95% CI) between work setting, demographics, preseason meetings and fall 2008 1) episodes of AT-perceived inappropriate care, and 2) on-field disagreements were assessed using multivariate logistic regression. RESULTS: High school ATs activated EMS more frequently than collegiate ATs (eg, fall 2008 EMS activation for football injury, 59.9% vs 27.5%; P < 0.01) and reported fewer pre-season planning meetings (eg, met with EMS to practice, 38.1% vs 55.8%; P < 0.01). During the Fall 2008 football season, high school ATs perceived more episodes of inappropriate care (10.4% vs 3.9%; P < 0.01) and on-field disagreements (5.4 vs 2.2%; P < 0.01) than collegiate ATs. High school work setting was independently associated with episodes of AT-perceived inappropriate care (adjusted OR = 2.76; 95% CI, 1.65-4.62) and on-field disagreements (adjusted OR = 2.33; 95% CI, 1.17-4.64). CONCLUSIONS: Athletic trainer-EMS interactions are common and sometimes involve AT-perceived episodes of inappropriate care and on-field disagreements between emergency care providers. |
Measurement of multiple drugs in urine, water, and on surfaces using fluorescence covalent microbead immunosorbent assay
Smith J , Sammons D , Robertson S , Biagini R , Snawder J . Toxicol Mech Methods 2010 20 (9) 587-593 There are a range of applications that require the measurement of multiple drugs such as urine analysis, drug determination in water, and screening for drug contamination on surfaces. Some of the procedures used such as enzyme-linked immunosorbent assay (ELISA) are simple but can only determine one drug at a time, and others such as GC-MS or LC-MS are complex, time-consuming, and expensive. In this study, fluorescence covalent microbead immunosorbent assay (FCMIA) was investigated as a simple method for the measurement of multiple drugs simultaneously in three matrices: diluted urine, water, and on surfaces. Five different drugs of abuse or their metabolites (methamphetamine, caffeine, benzoylecgonine (a metabolite of cocaine), tetrahydrocannabinol (THC), the active ingredient in marijuana, and oxycodone) were studied over the range 0-15ng/ml. There was no measureable cross-reactivity among the drugs at the concentrations studied. Urine dilutions from 1/50 to 1/2.5 were studied and dilutions less than 1/20 had a significant effect on the methamphetamine assay but limited effects on the benzoylecgonine and oxycodone assays and almost no effect on the THC assay. For assays performed in 1/20 urine dilution, water, and diluted surface sampling buffer, least detectable doses (LDD) were 1ng/ml or less for the drugs. Surfaces spiked with drugs were sampled with swabs wetted with surface sampling buffer and recoveries were linear over the range 0-100ng/100cm2 surface loading for all drugs. FCMIA has potential to be used for the measurement of multiple drugs in the matrices studied. | |
Multilaboratory comparison of Streptococcus pneumoniae opsonophagocytic killing assays and their level of agreement for the determination of functional antibody activity in human reference sera
Rose CE , Romero-Steiner S , Burton RL , Carlone GM , Goldblatt D , Nahm MH , Ashton L , Haston M , Ekstrom N , Haikala R , Kayhty H , Henckaerts I , Durant N , Poolman JT , Fernsten P , Yu X , Hu BT , Jansen KU , Blake M , Simonetti E , Hermans PW , Plikaytis BD . Clin Vaccine Immunol 2010 18 (1) 135-42 Antibody mediated killing of Streptococcus pneumoniae (pneumococcus) by phagocytes is an important mechanism of protection of the human host against pneumococcal infections. Measurement of opsonophagocytic antibodies using a standardized opsonophagocytic assay (OPA) is important for the evaluation of candidate vaccines and a requirement for the licensure of new pneumococcal conjugate vaccine formulations. We assessed agreement among six laboratories that used their own optimized OPAs on a panel of 16 human reference sera for 13 pneumococcal serotypes. Consensus titers, estimated using an analysis of variance (ANOVA) mixed-effects model, provided a common reference to assess agreement among these laboratories. Agreement was evaluated using assay accuracy, reproducibility, repeatability, precision and bias. We also reviewed four acceptance criteria intervals for assessing the comparability of protocols when assaying the same reference sera. The precision, accuracy and concordance results among laboratories and the consensus titers revealed acceptable agreement. Results of this study indicate that the bioassays evaluated in this study are robust and the resultant OPA values are reproducible for the determination of functional antibody titers specific to 13 pneumococcal serotypes when performed by laboratories using highly standardized but not identical assays. The statistical methodologies employed in this study may serve as a template to evaluate future multilaboratory studies. |
Multivalent dendrimeric compounds containing carbohydrates expressed on immune cells inhibit infection by primary isolates of HIV-1
Rosa Borges A , Wieczorek L , Johnson B , Benesi AJ , Brown BK , Kensinger RD , Krebs FC , Wigdahl B , Blumenthal R , Puri A , McCutchan FE , Birx DL , Polonis VR , Schengrund CL . Virology 2010 408 (1) 80-8 Specific glycosphingolipids (GSL), found on the surface of target immune cells, are recognized as alternate cell surface receptors by the human immunodeficiency virus type 1 (HIV-1) external envelope glycoprotein. In this study, the globotriose and 3'-sialyllactose carbohydrate head groups found on two GSL were covalently attached to a dendrimer core to produce two types of unique multivalent carbohydrates (MVC). These MVC inhibited HIV-1 infection of T cell lines and primary peripheral blood mononuclear cells (PBMC) by T cell line-adapted viruses or primary isolates, with IC(50)s ranging from 0.1 to 7.4 mug/ml. Inhibition of Env-mediated membrane fusion by MVC was also observed using a dye-transfer assay. These carbohydrate compounds warrant further investigation as a potential new class of HIV-1 entry inhibitors. The data presented also shed light on the role of carbohydrate moieties in HIV-1 virus-host cell interactions. |
Improved selectivity for the analysis of maternal serum and cord serum for polyfluoroalkyl chemicals
Kato K , Basden BJ , Needham LL , Calafat AM . J Chromatogr A 2010 1218 (15) 2133-7 Perfluorooctane sulfonic acid (PFOS) and perfluorooctanoic acid, two of the most widely studied polyfluoroalkyl chemicals (PFCs), can cross the placenta. Therefore, data on the exposure to PFCs of the very young are needed to evaluate the potential health effects associated with such exposure. Human serum, especially serum collected from pregnant women and cord serum, may contain endogenous components that can interfere in the separation by high performance liquid chromatography (HPLC) of PFOS and another PFC of interest, perfluorohexane sulfonic acid (PFHxS), from other serum biomolecules. The presence of such interferences may prevent the adequate quantification of PFOS and PFHxS in cord serum or serum collected from pregnant women, and potentially hinder the assessment of gestational exposure to these important PFCs using biomonitoring. We have modified our on-line solid phase extraction-HPLC-isotope dilution-tandem mass spectrometry analytical method for measuring PFCs in serum and developed an approach that allows for the elimination of these potential interferences without compromising analytical sensitivity and throughput. The combination of acetonitrile as the HPLC mobile phase organic solvent and a Betasil C8 HPLC column provided the best separation of PFOS and PFHxS from interferent peaks. In addition to eliminating these interferences, the acetonitrile method has a shorter runtime and is more sensitive for most PFCs (limits of detection were 0.1ng/mL except for PFOS (0.2ng/mL)) than our previous method that used methanol for the HPLC separation. The present method should improve the precise and selective analysis of maternal and cord serum for PFCs. |
Interlaboratory evaluation of a standardized inductively coupled plasma-mass spectrometry method for the determination of trace elements in air filter samples: preliminary results
Ashley K , Brisson MJ , Howe AM . Anal Methods 2010 2 (11) 1823-26 An interlaboratory evaluation of a standardized inductively coupled plasma-mass spectrometry (ICP-MS) method for determining trace elements in workplace air samples was carried out, toward fulfillment of method validation requirements for international voluntary consensus standard test methods. The interlaboratory study was performed in accordance with an applicable ASTM International standard practice, ASTM E691, which describes statistical procedures for investigating interlaboratory precision. Performance evaluation materials, prepared by a contract laboratory, consisted of mixed-cellulose ester filters that were spiked with 21 elements of interest at levels of 0.50 or 5.0 micrograms ([small micro]g) per filter. Triplicates of each spiked filter, plus media blanks spiked with blank reagent, were conveyed to each volunteer laboratory; spiking levels were unknown to the participants. The laboratories were requested to prepare the filter samples by one of the three sample preparation procedures (hotplate or microwave digestion or hotblock extraction) that are described in the standard test method, ASTM D7439. Participants were then asked to analyze aliquots of the prepared samples by ICP-MS using ASTM D7439, and to report their data in units of [small micro]g per filter sample. Preliminary interlaboratory precision and recovery estimates from 20 volunteer laboratories are reported. |
Intestinal epithelia activate anti-viral signaling via intracellular sensing of rotavirus structural components
Frias AH , Vijay-Kumar M , Gentsch JR , Crawford SE , Carvalho FA , Estes MK , Gewirtz AT . Mucosal Immunol 2010 3 (6) 622-32 Rotavirus (RV), a leading cause of severe diarrhea, primarily infects intestinal epithelial cells (IECs) causing self-limiting illness. To better understand innate immunity to RV, we sought to define the extent to which IEC activation of anti-viral responses required viral replication or could be recapitulated by inactivated RV or its components. Using model human intestinal epithelia, we observed that RV-induced activation of signaling events and gene expression typically associated with viral infection was largely mimicked by administration of ultraviolet (UV)-inactivated RV. Use of anti-interferon (IFN) neutralizing antibodies revealed that such replication-independent anti-viral gene expression required type I IFN signaling. In contrast, RV-induction of nuclear factor-kappaB-mediated interleukin-8 expression was dependent on viral replication. The anti-viral gene expression induced by UV-RV was not significantly recapitulated by RV RNA or RV virus-like particles although the latter could enter IEC. Together, these results suggest that RV proteins mediate viral entry into epithelial cells leading to intracellular detection of RV RNA that generates an anti-viral response. |
Cross-platform evaluation of commercial real-time reverse transcription PCR master mix kits using a quantitative 5'nuclease assay for Ebola virus
Stephens KW , Hutchins RJ , Dauphin LA . Mol Cell Probes 2010 24 (6) 370-5 Selection of optimal reaction master mix reagents is essential to obtain the best performance with diagnostic real-time reverse transcription polymerase chain reaction (RT-PCR) assays. Every year the number of commercially available master mix kits increases, so it is prudent to periodically evaluate kits on the market. In this study we evaluated five commercial real-time RT-PCR master mix kits, the RealMasterMix RT-PCR ROX kit, the AgPath-ID One-Step RT-PCR kit, the SuperScript III Platinum One-step Quantitative RT-PCR system, the QuantiTect Probe RT-PCR kit, and the LightCycler RNA HybProbe amplification kit, using a 5'nuclease assay for Ebola virus. The kits were evaluated using the manufacturer's recommended conditions, as well as conditions which have been used with the Ebola virus assay during outbreaks. When evaluated for use in Ebola virus RNA detection, the AgPath-ID kit resulted in the greatest sensitivity in comparison to the other four kits. The efficacy of the AgPath-ID kit was instrument-independent in the five real-time PCR platforms tested. This study demonstrated that Ebola virus RNA detection was not equivalent among the master mix reagents studied and, thus, that this variable can affect real-time RT-PCR assay sensitivity. Furthermore, this study rates the master mix reagents for their suitability, providing diagnostic laboratories the option to select from these kits to suit their specific laboratory needs for real-time RT-PCR. |
Dispersion of single-walled carbon nanotubes by a natural lung surfactant for pulmonary in vitro and in vivo toxicity studies
Wang L , Castranova V , Mishra A , Chen B , Mercer RR , Schwegler-Berry D , Rojanasakul Y . Part Fibre Toxicol 2010 7 31 BACKGROUND: Accumulating evidence indicate that the degree of dispersion of nanoparticles has a strong influence on their biological activities. The aims of this study were to develop a simple and rapid method of nanoparticle dispersion using a natural lung surfactant and to evaluate the effect of dispersion status of SWCNT on cytotoxicity and fibrogenicity in vitro and in vivo. RESULTS: The natural lung surfactant Survanta(R) was used to disperse single-walled carbon nanotubes (SWCNT) in a biological medium. At physiologically relevant concentrations, Survanta(R) produced well dispersed SWCNT without causing a cytotoxic or fibrogenic effect. In vitro studies show that Survanta(R)-dispersed SWCNT (SD-SWCNT) stimulated proliferation of lung epithelial cells at low doses (0.04-0.12 mug/ml or 0.02-0.06 mug/cm(2) exposed surface area) but had a suppressive effect at high doses. Non-dispersed SWCNT (ND-SWCNT) did not exhibit these effects, suggesting the importance of dispersion status of SWCNT on bioactivities. Studies using cultured human lung fibroblasts show that SD-SWCNT stimulated collagen production of the cells. This result is supported by a similar observation using Acetone/sonication dispersed SWCNT (AD-SWCNT), suggesting that Survanta(R) did not mask the bioactivity of SWCNT. Likewise, in vivo studies show that both SD-SWCNT and AD-SWCNT induced lung fibrosis in mice, whereas the dispersing agent Survanta(R) alone or Survanta(R)-dispersed control ultrafine carbon black had no effect. CONCLUSIONS: The results indicate that Survanta(R) was effective in dispersing SWCNT in biological media without causing cytotoxic effects at the test concentrations used in this study. SD-SWCNT stimulated collagen production of lung fibroblasts in vitro and induced lung fibrosis in vivo. Similar results were observed with AD-SWCNT, supporting the conclusion that Survanta(R) did not mask the bioactivities of SWCNT and thus can be used as an effective dispersing agent. Since excessive collagen production is a hallmark of lung fibrosis, the results of this study suggest that the in vitro model using lung fibroblasts may be an effective and rapid screening tool for prediction of the fibrogenic potential of SWCNT in vivo. |
Distinguishing acute from chronic Hepatitis C Virus (HCV) infection based on antibody reactivities to specific HCV structural and non-structural proteins
Araujo AC , Astrakhantseva IV , Fields HA , Kamili S . J Clin Microbiol 2010 49 (1) 54-7 Currently available serological assays for detection of antibodies to hepatitis C virus (HCV) cannot reliably discriminate acute from chronic HCV infection. We developed a multiplexed, flow-cytometric microsphere immunoassay to measure anti-HCV-IgG reactivities to core, NS3, NS4 and NS5 HCV recombinant proteins and applied it to 99 serum samples from 24 anti-HCV seroconvertors and 141 anti-HCV-IgG and HCV-RNA-positive plasma specimens from chronically infected people. Differences in the geometric means or mean of signal/cut-off ratios between the two sample sets were statistically significant for all the antigens tested. A multivariate logistic regression model correctly classified the samples in two groups with a cross-validation accuracy of 90.8% for the acute group and 97.2% for the chronic group. The immunoassay described has potential to distinguish acute from chronic HCV infection. |
Mother-to-child transmission of HIV: pathogenesis, mechanisms and pathways
Kourtis AP , Bulterys M . Clin Perinatol 2010 37 (4) 721-37 More than 400,000 children were infected with (HIV-1) worldwide in 2008, or more than 1000 children per day. Mother-to-child transmission (MTCT) of HIV-1 is the most important mode of HIV acquisition in infants and children. MTCT of HIV-1 can occur in utero, intrapartum, and postnatally through breastfeeding. Great progress has been made in preventing such transmission, through the use of antiretroviral prophylactic regimens to the mother during gestation and labor and delivery and to either mother or infant during breast feeding. The timing and mechanisms of transmission, however, are multifactorial and remain incompletely understood. This article summarizes what is known about the pathogenetic mechanisms and routes of MTCT of HIV-1, and includes virologic, immunologic, genetic, and mucosal aspects of transmission. |
Preface. Perinatal HIV infection
Kourtis AP , Bulterys M . Clin Perinatol 2010 37 (4) xix-xxi These are exciting times in the prevention of perinatal (mother-to-child) transmission of HIV and the clinical care and treatment of pregnant HIV-positive women and their children. Since the first cases of AIDS in infants and young children were described in the United States in the early 1980s, tremendous progress has been made in the prevention and care of HIV infection in infants and children. The Centers for Disease Control and Prevention reports a more than 90% decline in the number of perinatally acquired AIDS cases in children in the United States during the past 16 years and potent new antiretroviral regimens are highly effective in preventing progression of disease and improving the quality of life. The December 2010 issue of Clinics in Perinatology entitled “Perinatal HIV Infection” is a comprehensive review of the biology, epidemiology, and prevention of perinatal HIV transmission as well as the clinical care and optimal management of the pregnant mother and her exposed or infected infant. | The first article in this volume provides an overview of perinatal HIV/AIDS in the United States and worldwide and describes progress that has been made in recent years towards an HIV-free generation of infants. The second article outlines the biology of perinatal HIV transmission and deals with timing and known virologic and immunologic risk factors. Article 3 serves as a comprehensive introduction to viral sequencing from HIV-infected mothers and their infants and the molecular evolution and diversity that exists in mother-infant HIV transmission. Article 4 covers the diagnosis of perinatally acquired HIV infection. Articles 5 through 7 include the latest information on antiretroviral drug strategies, the role of Caesarean section, and immune-based approaches to reduce mother-to-child transmission of HIV. Article 8 reviews the biology of breastfeeding and HIV transmission and incorporates the most recent research advances in the prevention of postnatal HIV transmission. Article 9 focuses on HIV drug resistance and perinatal HIV transmission and the reasons drug resistance should be assiduously avoided, whenever possible. Article 10 summarizes the compelling epidemiologic data on the risks and benefits of various infant feeding practices for HIV-infected mothers living in different resource environments. Article 11 provides a contemporary view on the clinical care of the HIV-exposed infant, while article 12 reviews the recommendations and evidence for initiating antiretroviral therapy and other clinical care interventions in HIV-infected infants. Article 13 focuses on the complex challenge of prematurity and HIV. The final article reviews current knowledge of the pharmacology of antiretroviral drugs during pregnancy and in the newborn period, highlighting those pharmacologic issues critical to the safe and effective use of these drugs in the perinatal period. |
Prevention of mother-to-child transmission of HIV-1: the role of cesarean delivery
Legardy-Williams JK , Jamieson DJ , Read JS . Clin Perinatol 2010 37 (4) 777-85 The risk of mother-to-child transmission (MTCT) of HIV can be reduced through cesarean delivery prior to the onset of labor and prior to rupture of the membranes (elective cesarean delivery [ECD]). As a result of this evidence, the American College of Obstetricians and Gynecologists and the Department of Health and Human Services Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission developed guidelines recommending ECD for HIV-infected women with plasma viral loads of more than 1000 copies/mL. Since the release of the recommendations, an increase in ECD has been seen among HIV-infected women in the United States. This article discusses the evidence on efficacy of ECD, current recommendations in the United States, and risks and morbidity related to ECD. Although the benefit of ECD in preventing MTCT of HIV is substantial, some questions remain. Specifically, the benefit of ECD for women with very low viral loads or for women using combination antiretroviral regimens is unclear, as is the timeframe after onset of labor or rupture of membranes within which ECD will still confer preventive benefits. |
HIV drug resistance and mother-to-child transmission of HIV
Weidle PJ , Nesheim S . Clin Perinatol 2010 37 (4) 825-42 This article covers HIV drug resistance among pregnant women and the implications of transmission of resistant HIV to the infant. Resistance to antiretroviral drugs may be acquired or can emerge while HIV-infected pregnant women are on antiretroviral therapy, either before or during pregnancy. Resistance to antiretroviral drugs among HIV-infected infants may be acquired from the mother in utero or during the intrapartum period. Resistance may also emerge from exposure to antiretroviral drugs given to the infant for prophylaxis against HIV transmission. In settings where breastfeeding is practiced, ongoing transmission of HIV from breastfeeding may lead to transmission of resistant HIV from the mother. If the mother is taking antiretroviral drugs while breastfeeding, resistance to antiretroviral drugs may emerge in an HIV-infected infant from ingestion of antiretroviral drugs via breast milk. The magnitude and implications of antiretroviral resistance among HIV-infected pregnant women and HIV-infected infants are summarized. |
HIV-1 and breastfeeding: biology of transmission and advances in prevention
Bulterys M , Ellington S , Kourtis AP . Clin Perinatol 2010 37 (4) 807-24 Breastfeeding accounts for about 40% of mother-to-child transmission of HIV-1 worldwide and carries an estimated risk of transmission of 0.9% per month after the first month of breastfeeding. It is recommended that HIV-1-infected women completely avoid breastfeeding in settings where safe feeding alternatives exist. However, as replacement feeding is not safely available in many parts of the world, and because breastfeeding provides optimal nutrition and protection against other infant infections, there is intense ongoing research to make breastfeeding safe for HIV-1-infected mothers in resource-limited settings. More research is needed to determine the optimal duration of breastfeeding, optimal weaning practices, and which individual antiretroviral prophylactic regimen is best for HIV-1-infected mothers and their infants in a particular setting. |
Contributions of enriched cereal-grain products, ready-to-eat cereals, and supplements to folic acid and vitamin B-12 usual intake and folate and vitamin B-12 status in US children: National Health and Nutrition Examination Survey, 2003-2006
Yeung LF , Cogswell ME , Carriquiry AL , Bailey LB , Pfeiffer CM , Berry RJ . Am J Clin Nutr 2010 93 (1) 172-85 BACKGROUND: US children consume folic acid from multiple sources. These sources may contribute differently to usual intakes above the age-specific tolerable upper intake level (UL) for folic acid and to folate and vitamin B-12 status. OBJECTIVE: We estimated usual daily folic acid intakes above the UL and adjusted serum and red blood cell folate, serum vitamin B-12, homocysteine, and methylmalonic acid (MMA) concentrations in US children by age group and by the following 3 major folic acid intake sources: enriched cereal-grain products (ECGP), ready-to-eat cereals (RTE), and supplements containing folic acid (SUP). DESIGN: We analyzed data in 4 groups of children aged 1-3, 4-8, 9-13, and 14-18 y from the National Health and Nutrition Examination Survey (NHANES), 2003-2006 (n = 7161). RESULTS: A total of 19-48% of children consumed folic acid from ECGP only. Intakes above the UL varied from 0-0.1% of children who consumed ECGP only to 15-78% of children who consumed ECGP+RTE+SUP. In children aged 1-8 y, 99-100% of those who consumed ≥200 mug folic acid/d from supplements exceeded their UL. Although <0.5% of children had folate deficiency or low vitamin B-12 status, the consumption of RTE or SUP with folic acid was associated with higher mean folate and vitamin B-12 concentrations and, in some older children, with lower homocysteine and MMA concentrations. CONCLUSIONS: Our data suggest that the majority of US children consume more than one source of folic acid. Postfortification, the consumption of RTE or SUP increases usual daily intakes and blood concentrations of folate and vitamin B-12. |
Risk of lung cancer associated with quantitative beryllium exposure metrics within an occupational cohort
Schubauer-Berigan MK , Deddens JA , Couch JR , Petersen MR . Occup Environ Med 2010 68 (5) 354-60 OBJECTIVES: Beryllium has been identified as a human carcinogen on the basis of animal and epidemiological studies. The authors recently reported updated associations between lung cancer and beryllium exposure in a large, pooled occupational cohort. The authors conducted the present study to evaluate the shape of exposure-response associations between different exposure metrics and lung cancer in this cohort, considering potential confounders (race, plant, professional and short-term work status, and exposure to other lung carcinogens). METHODS: The authors conducted Cox proportional hazards regression analyses of lung cancer risk with cumulative, mean and maximum 'daily weighted average' (DWA) exposure among 5436 workers, using age-based risk sets. Different exposure-response curves were fitted to the exposure metrics, including categorical, power, restricted cubic spline and piecewise log-linear fits. RESULTS: The authors found significant positive associations between lung cancer and mean (p<0.0001) and maximum (p<0.0001) exposure, adjusting for age, birth cohort and plant, and for cumulative (p=0.0017) beryllium exposure, adjusting for these factors plus short-term work status and exposure to asbestos. The best-fitting models were generally categorical or piecewise log-linear, with the steepest increase in lung cancer risk between 0 and 10 mug/m(3) for both mean and maximum DWA exposure and between 0 and 200 mug/m(3)-days for cumulative DWA exposure. The estimated mean DWA beryllium exposure associated with 10(-3) excess lifetime risk based on the piecewise log-linear model is 0.033 mug/m(3). CONCLUSION: This study provides evidence that lung cancer risk is elevated at levels near the current US Occupational Safety and Health Administration beryllium exposure limit of 2.0 mug/m(3) DWA for workers. |
Postural stability effects of random vibration at the feet of construction workers in simulated elevation
Simeonov P , Hsiao H , Powers J , Ammons D , Kau T , Amendola A . Appl Ergon 2010 42 (5) 672-81 The risk of falls from height on a construction site increases under conditions which degrade workers' postural control. At elevation, workers depend heavily on sensory information from their feet to maintain balance. The study tested two hypotheses: "sensory enhancement" - sub-sensory (undetectable) random mechanical vibrations at the plantar surface of the feet can improve worker's balance at elevation; and "sensory suppression" - supra-sensory (detectable) random mechanical vibrations can have a degrading effect on balance in the same experimental settings. Six young (age 20-35) and six aging (age 45-60) construction workers were tested while standing in standard and semi-tandem postures on instrumented gel insoles. The insoles applied sub- or supra-sensory levels of random mechanical vibrations to the feet. The tests were conducted in a surround-screen virtual reality system, which simulated a narrow plank at elevation on a construction site. Upper body kinematics was assessed with a motion-measurement system. Postural stability effects were evaluated by conventional and statistical mechanics sway measures, as well as trunk angular displacement parameters. Analysis of variance did not confirm the "sensory enhancement" hypothesis, but provided evidence for the "sensory suppression" hypothesis. The supra-sensory vibration had a destabilizing effect, which was considerably stronger in the semi-tandem posture and affected most of the sway variables. Sensory suppression associated with elevated vibration levels on a construction site may increase the danger of losing balance. Construction workers at elevation, e.g., on a beam or narrow plank might be at increased risk of fall if they can detect vibrations under their feet. To reduce the possibility of losing balance, mechanical vibration to supporting structures used as walking/working surfaces should be minimized when performing construction tasks at elevation. |
Factors associated with the prevalence of non-ROPS tractors on farms in the U.S.
Myers JR . J Agric Saf Health 2010 16 (4) 267-80 Rollover protective structures (ROPS) are an effective engineering control known to prevent tractor overturn deaths, the leading cause of occupational fatalities for farmers and farm workers in the U.S. However, the use of ROPS is known to vary greatly from farm to farm. A national sample of 11,458 farm operators from the 2004 Occupational Injury Surveillance of Production Agriculture (OISPA) survey was used to assess the association between the prevalence of ROPS and ten farm operator and farm demographic variables using logistic regression. The variable were: operator's age, operator's sex, operator's education, farm sales, full- or part-time farming, acreage, type of operation, number of hired workers, number of injuries, and region. All ten variables were found to have significant associations with the prevalence of non-ROPS tractors on farms in the univariate logistic regressions. For the multivariate model, all variables except for the sex of the farm operator remained significant. Farms with less than three adult injuries, no hired workers, less than 300 acres in size, a Midwest location, and a primary farm type of tobacco, fruit and nuts, dairy, or poultry and eggs all had adjusted odds ratios of 2 or greater. Increasing the prevalence of ROPS-equipped tractors is essential for reducing the leading cause of death on farms, tractor overturns. Economic factors play a major role in the prevalence and distribution of non-ROPS tractors on farms. The identified associations can be used to effectively target areas of the U.S. for ROPS promotion activities. | |
Injury surveillance for youth on farms in the U.S., 2006
Hendricks KJ , Goldcamp EM . J Agric Saf Health 2010 16 (4) 279-91 In order to provide injury surveillance for youth on farms in the U.S., the National Institute for Occupational Safety and Health (NIOSH), in partnership with the USDA, developed the Childhood Agricultural Injury Survey (CAIS). CAIS data for all youth less than 20 years of age on farms have been collected for the calendar years of 1998, 2001, 2004, and 2006. CAIS data from 2006 indicated that an estimated 30.7 million youth lived on, worked on, or visited U.S. farms. These youth experienced almost 23,000 injuries while on the farm. The majority of these injuries occurred to males (15,223) and youth between the ages of 10 and 15 years (10,158). Approximately 25% (5,773) of the injuries were related to work being done on the farm. Youth living on the farm incurred 51% (11,654) of the injuries, hired youth sustained 6% (1,363), and 40% were to visiting youth (9,729). Although youth injuries on farms have declined by 30% since 1998, the numbers are still unacceptably high. Further in-depth evaluation of subsets of the youth population may serve to better direct safety intervention programs and research. |
The diesel exhaust in miners study: I. Overview of the exposure assessment process
Stewart PA , Coble JB , Vermeulen R , Schleiff P , Blair A , Lubin J , Attfield M , Silverman DT . Ann Occup Hyg 2010 54 (7) 728-746 This report provides an overview of the exposure assessment process for an epidemiologic study that investigated mortality, with a special focus on lung cancer, associated with diesel exhaust (DE) exposure among miners. Details of several components are provided in four other reports. A major challenge for this study was the development of quantitative estimates of historical exposures to DE. There is no single standard method for assessing the totality of DE, so respirable elemental carbon (REC), a component of DE, was selected as the primary surrogate in this study. Air monitoring surveys at seven of the eight study mining facilities were conducted between 1998 and 2001 and provided reference personal REC exposure levels and measurements for other agents and DE components in the mining environment. (The eighth facility had closed permanently prior to the surveys.) Exposure estimates were developed for mining facility/department/job/year combinations. A hierarchical grouping strategy was developed for assigning exposure levels to underground jobs [based on job titles, on the amount of time spent in various areas of the underground mine, and on similar carbon monoxide (CO, another DE component) concentrations] and to surface jobs (based on the use of, or proximity to, diesel-powered equipment). Time trends in air concentrations for underground jobs were estimated from mining facility-specific prediction models using diesel equipment horsepower, total air flow rates exhausted from the underground mines, and, because there were no historical REC measurements, historical measurements of CO. Exposures to potentially confounding agents, i.e. respirable dust, silica, radon, asbestos, and non-diesel sources of polycyclic aromatic hydrocarbons, also were assessed. Accuracy and reliability of the estimated REC exposures levels were evaluated by comparison with several smaller datasets and by development of alternative time trend models. During 1998-2001, the average measured REC exposure level by facility ranged from 40 to 384 mu g m(-3) for the underground workers and from 2 to 6 mu g m(-3) for the surface workers. For one prevalent underground job, 'miner operator', the maximum annual REC exposure estimate by facility ranged up to 685% greater than the corresponding 1998-2001 value. A comparison of the historical CO estimates from the time trend models with 1976-1977 CO measurements not used in the modeling found an overall median relative difference of 29%. Other comparisons showed similar levels of agreement. The assessment process indicated large differences in REC exposure levels over time and across the underground operations. Method evaluations indicated that the final estimates were consistent with those from alternative time trend models and demonstrated moderate to high agreement with external data. |
The diesel exhaust in miners study: II. Exposure monitoring surveys and development of exposure groups
Coble JB , Stewart PA , Vermeulen R , Yereb D , Stanevich R , Blair A , Silverman DT , Attfield M . Ann Occup Hyg 2010 54 (7) 747-761 Air monitoring surveys were conducted between 1998 and 2001 at seven non-metal mining facilities to assess exposure to respirable elemental carbon (REC), a component of diesel exhaust (DE), for an epidemiologic study of miners exposed to DE. Personal exposure measurements were taken on workers in a cross-section of jobs located underground and on the surface. Air samples taken to measure REC were also analyzed for respirable organic carbon (ROC). Concurrent measurements to assess exposure to nitric oxide (NO) and nitrogen dioxide (NO2), two gaseous components of DE, were also taken. The REC measurements were used to develop quantitative estimates of average exposure levels by facility, department, and job title for the epidemiologic analysis. Each underground job was assigned to one of three sets of exposure groups from specific to general: (i) standardized job titles, (ii) groups of standardized job titles combined based on the percentage of time in the major underground areas, and (iii) larger groups based on similar area carbon monoxide (CO) air concentrations. Surface jobs were categorized based on their use of diesel equipment and proximity to DE. A total of 779 full-shift personal measurements were taken underground. The average REC exposure levels for underground jobs with five or more measurements ranged from 31 to 58 mu g m(-3) at the facility with the lowest average exposure levels and from 313 to 488 mu g m(-3) at the facility with the highest average exposure levels. The average REC exposure levels for surface workers ranged from 2 to 6 mu g m(-3) across the seven facilities. There was much less contrast in the ROC compared with REC exposure levels measured between surface and underground workers within each facility, as well as across the facilities. The average ROC levels underground ranged from 64 to 195 mu g m(-3), while on the surface, the average ROC levels ranged from 38 to 71 mu g m(-3) by facility, an similar to 2- to 3-fold difference. The average NO and NO2 levels underground ranged from 0.20 to 1.49 parts per million (ppm) and from 0.10 to 0.60 ppm, respectively, and were similar to 10 times higher than levels on the surface, which ranged from 0.02 to 0.11 ppm and from 0.01 to 0.06 ppm, respectively. The ROC, NO, and NO2 concentrations underground were correlated with the REC levels (r = 0.62, 0.71, and 0.62, respectively). A total of 80% of the underground jobs were assigned an exposure estimate based on measurements taken for the specific job title or for other jobs with a similar percentage of time spent in the major underground work areas. The average REC exposure levels by facility were from 15 to 64 times higher underground than on the surface. The large contrast in exposure levels measured underground versus on the surface, along with the differences between the mining facilities and between underground jobs within the facilities resulted in a wide distribution in the exposure estimates for evaluation of exposure-response relationships in the epidemiologic analyses. |
The diesel exhaust in miners study: III. Interrelations between respirable elemental carbon and gaseous and particulate components of diesel exhaust derived from area sampling in underground non-metal mining facilities
Vermeulen R , Coble JB , Yereb D , Lubin JH , Blair A , Portengen L , Stewart PA , Attfield M , Silverman DT . Ann Occup Hyg 2010 54 (7) 762-773 Diesel exhaust (DE) has been implicated as a potential lung carcinogen. However, the exact components of DE that might be involved have not been clearly identified. In the past, nitrogen oxides (NOx) and carbon oxides (COx) were measured most frequently to estimate DE, but since the 1990s, the most commonly accepted surrogate for DE has been elemental carbon (EC). We developed quantitative estimates of historical exposure levels of respirable elemental carbon (REC) for an epidemiologic study of mortality, particularly lung cancer, among diesel-exposed miners by back-extrapolating 1998-2001 REC exposure levels using historical measurements of carbon monoxide (CO). The choice of CO was based on the availability of historical measurement data. Here, we evaluated the relationship of REC with CO and other current and historical components of DE from side-by-side area measurements taken in underground operations of seven non-metal mining facilities. The Pearson correlation coefficient of the natural log-transformed (Ln)REC measurements with the Ln(CO) measurements was 0.4. The correlation of REC with the other gaseous, organic carbon (OC), and particulate measurements ranged from 0.3 to 0.8. Factor analyses indicated that the gaseous components, including CO, together with REC, loaded most strongly on a presumed 'Diesel exhaust' factor, while the OC and particulate agents loaded predominantly on other factors. In addition, the relationship between Ln(REC) and Ln(CO) was approximately linear over a wide range of REC concentrations. The fact that CO correlated with REC, loaded on the same factor, and increased linearly in log-log space supported the use of CO in estimating historical exposure levels to DE. |
The diesel exhaust in miners study: IV. Estimating historical exposures to diesel exhaust in underground non-metal mining facilities
Vermeulen R , Coble JB , Lubin JH , Portengen L , Blair A , Attfield MD , Silverman DT , Stewart PA . Ann Occup Hyg 2010 54 (7) 774-788 We developed quantitative estimates of historical exposures to respirable elemental carbon (REC) for an epidemiologic study of mortality, including lung cancer, among diesel-exposed miners at eight non-metal mining facilities [the Diesel Exhaust in Miners Study (DEMS)]. Because there were no historical measurements of diesel exhaust (DE), historical REC (a component of DE) levels were estimated based on REC data from monitoring surveys conducted in 1998-2001 as part of the DEMS investigation. These values were adjusted for underground workers by carbon monoxide (CO) concentration trends in the mines derived from models of historical CO (another DE component) measurements and DE determinants such as engine horsepower (HP; 1 HP = 0.746 kW) and mine ventilation. CO was chosen to estimate historical changes because it was the most frequently measured DE component in our study facilities and it was found to correlate with REC exposure. Databases were constructed by facility and year with air sampling data and with information on the total rate of airflow exhausted from the underground operations in cubic feet per minute (CFM) (1 CFM = 0.0283 m(3) min(-1)), HP of the diesel equipment in use (ADJ HP), and other possible determinants. The ADJ HP purchased after 1990 (ADJ HP1990+) was also included to account for lower emissions from newer, cleaner engines. Facility-specific CO levels, relative to those in the DEMS survey year for each year back to the start of dieselization (1947-1967 depending on facility), were predicted based on models of observed CO concentrations and log-transformed (Ln) ADJ HP/CFM and Ln(ADJ HP1990+). The resulting temporal trends in relative CO levels were then multiplied by facility/department/job-specific REC estimates derived from the DEMS surveys personal measurements to obtain historical facility/department/job/year-specific REC exposure estimates. The facility-specific temporal trends of CO levels (and thus the REC estimates) generated from these models indicated that CO concentrations had been generally greater in the past than during the 1998-2001 DEMS surveys, with the highest levels ranging from 100 to 685% greater (median: 300%). These levels generally occurred between 1970 and the early 1980s. A comparison of the CO facility-specific model predictions with CO air concentration measurements from a 1976-1977 survey external to the modeling showed that our model predictions were slightly lower than those observed (median relative difference of 29%; range across facilities: 49 to -25%). In summary, we successfully modeled past CO concentration levels using selected determinants of DE exposure to derive retrospective estimates of REC exposure. The results suggested large variations in REC exposure levels both between and within the underground operations of the facilities and over time. These REC exposure estimates were in a plausible range and were used in the investigation of exposure-response relationships in epidemiologic analyses. |
Range of motion measurements: reference values and a database for comparison studies
Soucie JM , Wang C , Forsyth A , Funk S , Denny M , Roach KE , Boone D . Haemophilia 2010 17 (3) 500-7 SUMMARY: Many diseases and injuries can impair joint mobility. Normal reference values are needed to determine extent of impairment to assess and monitor joint motion. There is very little published data describing normal joint range of motion (ROM) for healthy men and women across a wide span of ages. We enrolled male and female subjects aged between 2 and 69 years who were free from conditions that could potentially limit joint mobility for the study. Nine licensed physical therapists used universal goniometers to determine passive joint motion bilaterally of elbow flexion, extension, supination and pronation, shoulder flexion, hip flexion and extension, knee flexion and extension, and ankle dorsiflexion and plantarflexion. Descriptive statistics were calculated for male and female subjects in four age groups: 2-8, 9-19, 20-44 and 45-69 years. Joint ROM measurements were obtained on a total of 674 (53.6% female) healthy, normal subjects aged 2-69 years. Female subjects had greater joint mobility in all age groups in nearly all joints and the gender difference was most obvious in measures of ankle plantarflexion, elbow pronation and supination. Range of motion average values for all joints decreased with advancing age for both men and women and, in most cases, were significantly different than most commonly used normative values. Our study of ROM measurements taken by trained physical therapists on a large sample of healthy individuals revealed significant gender- and age-related variation that may be an important consideration in patient assessment. |
Strategies used by community-based organizations to evaluate their locally developed HIV prevention interventions: lessons learned from the CDC's innovative interventions project
Painter TM , Ngalame PM , Lucas B , Lauby JL , Herbst JH . AIDS Educ Prev 2010 22 (5) 387-401 Community-based organizations (CBOs) play an important role in health promotion efforts and the delivery of HIV prevention interventions for at-risk minority populations. CBOs may also develop their own interventions but often lack the capacity or funds to rigorously evaluate them. The Innovative Interventions project of the Centers for Disease Control and Prevention (CDC) funded three CBOs to rigorously evaluate the efficacy of interventions they had developed and were delivering to Black women, Black men who have sex with men (MSM), and adolescent males in juvenile justice settings, respectively. The evaluation results have been reported elsewhere. This article describes operational issues that the CBOs identified as being particularly salient to their evaluations and the strategies they developed to address the issues and successfully complete their evaluations. These issues included the development of organizational capacity to conduct a rigorous outcome evaluation, difficulties with recruitment and retention of evaluation participants, and the use of process monitoring data to improve intervention delivery. The strategies described in this article can be used by CBOs when evaluating their locally developed HIV prevention interventions and may be of interest to funding agencies and researchers that collaborate with CBOs to evaluate their interventions. |
Effectiveness of policies maintaining or restricting days of alcohol sales on excessive alcohol consumption and related harms
Middleton JC , Hahn RA , Kuzara JL , Elder R , Brewer R , Chattopadhyay S , Fielding J , Naimi TS , Toomey T , Lawrence B . Am J Prev Med 2010 39 (6) 575-589 Local, state, and national laws and policies that limit the days of the week on which alcoholic beverages may be sold may be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness for preventing excessive alcohol consumption and related harms of laws and policies maintaining or reducing the days when alcoholic beverages may be sold. Outcomes assessed in 14 studies that met qualifying criteria were excessive alcohol consumption and alcohol-related harms, including motor vehicle injuries and deaths, violence-related and other injuries, and health conditions. Qualifying studies assessed the effects of changes in days of sale in both on-premises settings (at which alcoholic beverages are consumed where purchased) and off-premises settings (at which alcoholic beverages may not be consumed where purchased). Eleven studies assessed the effects of adding days of sale, and three studies assessed the effects of imposing a ban on sales on a given weekend day. The evidence from these studies indicated that increasing days of sale leads to increases in excessive alcohol consumption and alcohol-related harms and that reducing the number of days that alcoholic beverages are sold generally decreases alcohol-related harms. Based on these findings, when the expansion of days of sale is being considered, laws and policies maintaining the number of days of the week that alcoholic beverages are sold at on- and off-premises outlets in local, state, and national jurisdictions are effective public health strategies for preventing excessive alcohol consumption and related harms. |
Effectiveness of policies restricting hours of alcohol sales in preventing excessive alcohol consumption and related harms
Hahn RA , Kuzara JL , Elder R , Brewer R , Chattopadhyay S , Fielding J , Naimi TS , Toomey T , Middleton JC , Lawrence B . Am J Prev Med 2010 39 (6) 590-604 Local, state, and national policies that limit the hours that alcoholic beverages may be available for sale might be a means of reducing excessive alcohol consumption and related harms. The methods of the Guide to Community Preventive Services were used to synthesize scientific evidence on the effectiveness of such policies. All of the studies included in this review assessed the effects of increasing hours of sale in on-premises settings (in which alcoholic beverages are consumed where purchased) in high-income nations. None of the studies was conducted in the U.S. The review team's initial assessment of this evidence suggested that changes of less than 2 hours were unlikely to significantly affect excessive alcohol consumption and related harms; to explore this hypothesis, studies assessing the effects of changing hours of sale by less than 2 hours and by 2 or more hours were assessed separately. There was sufficient evidence in ten qualifying studies to conclude that increasing hours of sale by 2 or more hours increases alcohol-related harms. Thus, disallowing extensions of hours of alcohol sales by 2 or more should be expected to prevent alcohol-related harms, while policies decreasing hours of sale by 2 hours or more at on-premises alcohol outlets may be an effective strategy for preventing alcohol-related harms. The evidence from six qualifying studies was insufficient to determine whether increasing hours of sale by less than 2 hours increases excessive alcohol consumption and related harms. |
Translating HIV interventions into practice: community-based organizations' experiences with the diffusion of effective behavioral interventions (DEBIs)
Dolcini MM , Gandelman AA , Vogan SA , Kong C , Leak TN , King AJ , Desantis L , O'Leary A . Soc Sci Med 2010 71 (10) 1839-46 Efficacious behavioral interventions developed to address the spread of HIV/STIs are currently being disseminated in the USA through a national diffusion program (DEBI) spearheaded by the Centers for Disease Control and Prevention (CDC). Understanding how interventions are translated to real world settings is necessary to further scientific knowledge of this process and to facilitate future translation efforts in public health. Prior studies have begun to elucidate how agencies translate behavioral interventions into practice, but further work is needed. Guided by the ADAPT framework, we examined agencies' assessment, preparation, and implementation of interventions. Our qualitative interview-based study focused on six community-based agencies in California (United States) funded to implement three group-level HIV interventions. Findings showed considerable variation in the extent to which agencies engaged in assessment and broad-based preparation and in the ease with which agencies implemented the interventions. The findings provide insight into the process that agencies undergo in the translation of effective behavioral interventions and illustrate how agencies can inform logic models that guide translation. We also identify relevant dimensions of existing models, including the ADAPT framework and Rogers's (1995, 2005) diffusion of innovations in organizations, that have value for agencies that are translating research to practice. |
Community responses to naturally occurring asbestos: implications for public health practice
Culley MR , Zorland J , Freire K . Health Educ Res 2010 25 (5) 877-91 We used a qualitative community case study design to examine stakeholder responses to naturally occurring asbestos (NOA), a newly emerging environmental threat. The community of interest represents the first residential setting in the United States to receive substantial federal, state and local regulatory attention where NOA exposures largely resulted from local development. Because NOA is an emerging problem that will require evidence-based public health responses in the United States and elsewhere, we explored stakeholder responses to NOA and examined how these responses fit with what is known about individual, community and institutional responses to environmental hazards. The convergence of findings from multiple data sources, including interviews with stakeholder groups and documents, revealed a myriad of challenges associated with environmental and public health interventions in this community. What unfolded was consistent with the social sciences literature about communities facing similar hazards. 'Natural' and 'human-made' elements, the toxic nature of the threat and inadequate institutional responses to the threat combined to spark community conflict and other significant challenges. Implications for improved public health practice are discussed. |
Development, reliability, and validity of an urban trail use survey
Spruijt-Metz D , Wolch J , Jerrett M , Byrne J , Hsieh S , Myles R , Xie B , Wang L , Chou CP , Reynolds KD . Am J Health Promot 2010 25 (1) 2-11 PURPOSE: To evaluate the psychometric characteristics of the Research on Urban Trail Environments (ROUTES) Trail Use Questionnaire. DESIGN: Test-retest reliability was assessed by repeated measures (study 1); validity was assessed by comparing reported trail use to self-reported and objectively measured physical activity (PA) levels (study 2). SETTING: Study 1: a religious institution situated near a Los Angeles trail. Study 2: 1-mile buffer zones surrounding three urban trails (Chicago, Dallas, and Los Angeles). SUBJECTS: Thirty-four adults between 40 and 60 years of age (10 men and 24 women) completed the ROUTES questionnaire twice (study 1). Study 2 participants were 490 adults (48% female and 73% white), mean age 48 years. MEASURES: Trail use for recreation and transportation purposes, time and distance spent on trails, and characteristics of the trail and other trail users. PA was measured using the International Physical Activity Questionnaire and accelerometry. ANALYSES: Pearson correlation coefficients and kappa statistics were used for test-retest reliability for continuous and categorical variables, respectively. Generalized linear models were used to evaluate hypotheses on PA comparing trail users and nonusers. RESULTS: Test-retest statistics were acceptable (kappa = .57, r = .66). Validity was supported by correlations between indices of trail use with self-reported PA and accelerometry, and significant group differences between trail users and nonusers in PA levels. CONCLUSIONS: The ROUTES Trail Use Questionnaire demonstrated good reliability and validity. |
Content Index (Achived Edition)
- Chronic Diseases and Conditions
- Genetics and Genomics
- Health Communication and Education
- Immunity and Immunization
- Injury and Violence
- Laboratory Sciences
- Maternal and Child Health
- Nutritional Sciences
- Occupational Safety and Health
- Occupational Safety and Health - Mining
- Physical Activity
- Program Evaluation
- Public Health Law
- Public Health Leadership and Management
- Social and Behavioral Sciences
- Statistics as Topic
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