Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Gore J[original query] |
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Promoting healthy aging: Public health as a leader for reducing dementia risk
Jackson EMJ , O'Brien K , McGuire LC , Baumgart M , Gore J , Brandt K , Levey AI , Lamont H . Public Policy Aging Rep 2023 33 (2) 92-95 Alzheimer’s disease and related dementias (ADRD) remain a public health priority, with prevalence of Alzheimer’s disease—the most common cause of dementia—among people aged 65 years and older living in the United States expected to grow to nearly 13.8 million people by 2060 (Alzheimer’s Association, 2023). ADRD are not normal aging; they impair memory and cognitive functioning, disrupting daily life. Over time, people with ADRD need increased assistance with basic activities of daily living and must rely on others for support, affecting family, friends, professional caregiving infrastructures, health and long-term care systems, and financial institutions designed to pay for care. In 2023, the formal cost of caring for people with ADRD to the health and long-term care systems in the United States is projected to total $345 billion (Alzheimer’s Association, 2023). Additionally, unpaid caregiving by family and friends was valued at nearly $339.5 billion in 2022 (Alzheimer’s Association, 2023). | | The lifetime cost of care for a person with Alzheimer’s disease was more than double the cost of care for a person without Alzheimer’s disease (Alzheimer’s Association, 2023). The total formal cost of ADRD care is projected to reach around $1 trillion in 2050 (Alzheimer’s Association, 2023; Zissimopoulos et al., 2014). These estimates do not consider the loss of quality of life for people with ADRD and their caregivers. It is imperative for the health of our systems and our population that public health address modifiable risk factors of ADRD. |
Promoting healthy aging to reduce the risk of dementia: A public health imperative
Gore J , Denno B , Omura JD , Baumgart M , McGuire LC . Generations 2023 47 (1) Alzheimer's disease and related dementias place an enormous burden on individuals, families, health and long-term care systems, and governmental budgets. As the burden escalates with rising prevalence, attention has increasingly focused on how the risk of developing dementia can be reduced. Evidence indicates there are ways, from a population perspective, to reduce the risk of cognitive decline and possibly dementia, including through healthier lifestyles. It is imperative that the public health community lead the effort to address modifiable risk factors and social determinants of health for dementia and promote healthy aging through public health action. Copyright © 2023 American Society on Aging; all rights reserved. |
Fetal growth and birth weight are independently reduced by malaria infection and curable sexually transmitted and reproductive tract infections in Kenya, Tanzania, and Malawi: A pregnancy cohort study
Mtove G , Chico RM , Madanitsa M , Barsosio HC , Msemo OA , Saidi Q , Gore-Langton GR , Minja DTR , Mukerebe C , Gesase S , Mwapasa V , Phiri KS , Hansson H , Dodd J , Magnussen P , Kavishe RA , Mosha F , Kariuki S , Lusingu JPA , Gutman JR , Alifrangis M , Ter Kuile FO , Schmiegelow C . Int J Infect Dis 2023 135 28-40 OBJECTIVE: Malaria and sexually transmitted and reproductive tract infections (STIs/RTIs) are highly prevalent in sub-Saharan Africa and associated with poor pregnancy outcomes. We investigated the individual and combined effects of malaria and curable STIs/RTIs on fetal growth in Kenya, Tanzania, and Malawi. METHODS: This study was nested within a randomized trial comparing monthly intermittent preventive treatment for malaria in pregnancy with sulfadoxine-pyrimethamine versus dihydroartemisinin-piperaquine, alone or combined with azithromycin. Fetal weight gain was assessed by serial prenatal ultrasound. Malaria was assessed monthly, and Treponema pallidum, Neisseria gonorrhoeae, Trichomonas vaginalis, Chlamydia trachomatis and bacterial vaginosis at enrolment and in the third trimester. The effect of malaria and STIs/RTIs on fetal weight/birthweight Z-scores was evaluated using mixed-effects linear regression. RESULTS: 1,435 pregnant women had fetal/birth weight assessed 3,950 times. Compared to women without malaria or STIs/RTIs (n=399), malaria-only (n=267), STIs/RTIs-only (n=410) or both (n=353) were associated with reduced fetal growth (adjusted mean difference in fetal/birth weight Z-score [95% CI]: malaria=-0.18 [-0.31,-0.04], p=0.01]; STIs/RTIs=-0.14 [-0.26,-0.03], p=0.01]; both=-0.20 [-0.33,-0.07], p=0.003). Paucigravidae experienced the greatest impact. CONCLUSION: Malaria and STIs/RTIs are associated with poor fetal growth especially among paucigravidae women with dual infections. Integrated antenatal interventions are needed to reduce the burden of both malaria and STIs/RTIs. |
Assessment of home care aides' respiratory exposure to total volatile organic compounds and chlorine during simulated bathroom cleaning: An experimental design with conventional and "green" products
Lindberg JE , Quinn MM , Gore RJ , Galligan CJ , Sama SR , Sheikh NN , Markkanen PK , Parker-Vega A , Karlsson ND , LeBouf RF , Virji MA . J Occup Environ Hyg 2021 18 (6) 1-12 Home care (HC) aide visits to clients' homes often involve cleaning and disinfecting (C&D) bathrooms. Some ingredients in C&D household products are associated with respiratory illness, including sodium hypochlorite (bleach) and quaternary ammonium compounds (quats). "Green" products may be safer for the environment, however there are limited quantitative evaluations of their respiratory risks. This study assessed airborne concentrations and time profiles of total volatile organic compounds (TVOC) and chlorine generated during typical bathroom cleaning performed by aides using conventional and green products. Aides performed cleaning tasks in a simulated residential bathroom constructed in an environmental air sampling laboratory. A balanced experimental design involved each aide coming to the lab for four visits during which she performed two 20-min cleaning sessions using one of three C&D products (bleach-based, 1-5% sodium hypochlorite by weight; quats-based, 0.1-1% by weight quaternary ammonium compounds; and "green," 0.05% by weight thymol, a component of botanical thyme oil) or distilled water as a control. TVOC and chlorine direct reading instruments were attached to aides with sample inlets located in the breathing zone. Ten-second averages of TVOC and chlorine gas concentrations and instantaneous peak concentrations were recorded for the sessions' duration. TVOC concentrations by methods of C&D application (spraying, streaming, wiping) also were evaluated. The study completed 169 air sampling sessions with 22 aides. The quats-based product generated more than twice the average TVOC concentrations (mean = 1,210 ppb) than the bleach-based (mean = 593 ppb) or green (mean = 498 ppb) products. Each product generated TVOC concentrations that rose rapidly within the first few minutes of application. Spraying produced the highest TVOC exposures, wiping the lowest. Thirteen aides (65%) experienced peak chlorine exposures above the OSHA PEL ceiling limit (1 ppm) when using the bleach-based product. HC aides may experience respiratory hazards from use of conventional or green C&D products formulated with bleach or other respiratory irritants and sprayed in small, poorly ventilated spaces typical of bathrooms. Spraying should be avoided. |
"Every Newborn-BIRTH" protocol: observational study validating indicators for coverage and quality of maternal and newborn health care in Bangladesh, Nepal and Tanzania
Day LT , Ruysen H , Gordeev VS , Gore-Langton GR , Boggs D , Cousens S , Moxon SG , Blencowe H , Baschieri A , Rahman AE , Tahsina T , Zaman SB , Hossain T , Rahman QS , Ameen S , El Arifeen S , Kc A , Shrestha SK , Kc NP , Singh D , Jha AK , Jha B , Rana N , Basnet O , Joshi E , Paudel A , Shrestha PR , Jha D , Bastola RC , Ghimire JJ , Paudel R , Salim N , Shamb D , Manji K , Shabani J , Shirima K , Mkopi N , Mrisho M , Manzi F , Jaribu J , Kija E , Assenga E , Kisenge R , Pembe A , Hanson C , Mbaruku G , Masanja H , Amouzou A , Azim T , Jackson D , Kabuteni TJ , Mathai M , Monet JP , Moran A , Ram P , Rawlins B , Saebo JI , Serbanescu F , Vaz L , Zaka N , Lawn JE . J Glob Health 2019 9 (1) 010902 Background: To achieve Sustainable Development Goals and Universal Health Coverage, programmatic data are essential. The Every Newborn Action Plan, agreed by all United Nations member states and >80 development partners, includes an ambitious Measurement Improvement Roadmap. Quality of care at birth is prioritised by both Every Newborn and Ending Preventable Maternal Mortality strategies, hence metrics need to advance from health service contact alone, to content of care. As facility births increase, monitoring using routine facility data in DHIS2 has potential, yet validation research has mainly focussed on maternal recall surveys. The Every Newborn - Birth Indicators Research Tracking in Hospitals (EN-BIRTH) study aims to validate selected newborn and maternal indicators for routine tracking of coverage and quality of facility-based care for use at district, national and global levels. Methods: EN-BIRTH is an observational study including >20 000 facility births in three countries (Tanzania, Bangladesh and Nepal) to validate selected indicators. Direct clinical observation will be compared with facility register data and a pre-discharge maternal recall survey for indicators including: uterotonic administration, immediate newborn care, neonatal resuscitation and Kangaroo mother care. Indicators including neonatal infection management and antenatal corticosteroid administration, which cannot be easily observed, will be validated using inpatient records. Trained clinical observers in Labour/Delivery ward, Operation theatre, and Kangaroo mother care ward/areas will collect data using a tablet-based customised data capturing application. Sensitivity will be calculated for numerators of all indicators and specificity for those numerators with adequate information. Other objectives include comparison of denominator options (ie, true target population or surrogates) and quality of care analyses, especially regarding intervention timing. Barriers and enablers to routine recording and data usage will be assessed by data flow assessments, quantitative and qualitative analyses. Conclusions: To our knowledge, this is the first large, multi-country study validating facility-based routine data compared to direct observation for maternal and newborn care, designed to provide evidence to inform selection of a core list of indicators recommended for inclusion in national DHIS2. Availability and use of such data are fundamental to drive progress towards ending the annual 5.5 million preventable stillbirths, maternal and newborn deaths. |
Accelerating the elimination of viral hepatitis: a Lancet Gastroenterology & Hepatology Commission
Cooke GS , Andrieux-Meyer I , Applegate TL , Atun R , Burry JR , Cheinquer H , Dusheiko G , Feld JJ , Gore C , Griswold MG , Hamid S , Hellard ME , Hou J , Howell J , Jia J , Kravchenko N , Lazarus JV , Lemoine M , Lesi OA , Maistat L , McMahon BJ , Razavi H , Roberts TR , Simmons B , Sonderup MW , Spearman CW , Taylor BE , Thomas DL , Waked I , Ward JW , Wiktor SZ . Lancet Gastroenterol Hepatol 2019 4 (2) 135-184 Viral hepatitis is a major public health threat and a leading cause of death worldwide. Annual mortality from viral hepatitis is similar to that of other major infectious diseases such as HIV and tuberculosis. Highly effective prevention measures and treatments have made the global elimination of viral hepatitis a realistic goal, endorsed by all WHO member states. Ambitious targets call for a global reduction in hepatitis-related mortality of 65% and a 90% reduction in new infections by 2030. This Commission draws together a wide range of expertise to appraise the current global situation and to identify priorities globally, regionally, and nationally needed to accelerate progress. We identify 20 heavily burdened countries that account for over 75% of the global burden of viral hepatitis. Key recommendations include a greater focus on national progress towards elimination with support given, if necessary, through innovative financing measures to ensure elimination programmes are fully funded by 2020. In addition to further measures to improve access to vaccination and treatment, greater attention needs to be paid to access to affordable, high-quality diagnostics if testing is to reach the levels needed to achieve elimination goals. Simplified, decentralised models of care removing requirements for specialised prescribing will be required to reach those in need, together with sustained efforts to tackle stigma and discrimination. We identify key examples of the progress that has already been made in many countries throughout the world, demonstrating that sustained and coordinated efforts can be successful in achieving the WHO elimination goals. |
P4-mediated antibody therapy in an acute model of invasive pneumococcal disease
Bangert M , Bricio-Moreno L , Gore S , Rajam G , Ades EW , Gordon SB , Kadioglu A . J Infect Dis 2012 205 (9) 1399-407 New treatments against severe bacterial infections are needed because the response to antibiotic treatment is slow in acute settings and is becoming less effective owing to the emergence of antibiotic-resistant pathogens. P4-mediated antibody therapy offers a unique treatment strategy that combines exogenous immunoglobulin with the immunoactivating peptide P4. In an acute model of pneumococcal disease, mice were infected with Streptococcus pneumoniae and treated intravenously or intranasally with P4 and intravenous immunoglobulin (IVIG). Survival of P4-IVIG-treated mice increased from 0% to 60% among those that received intravenous treatment and from 0% to 100% among those that received intranasal treatment. Importantly, intranasal administration of P4 at an early stage of infection prevented the onset of bacteremia and sepsis. Increased survival was associated with reduced bacterial burden in affected tissues and with recruitment and activation of professional phagocytes, as manifested by increased expression of Fc-gamma receptors. In vitro studies involving P4-stimulated alveolar, peritoneal, and J774.2 murine macrophages showed an increased ability of these immune cells to phagocytose pneumococci independent of capsule. The use of adjunct antibody therapies to treat infectious diseases shows promise. |
Heavy metals and couple fecundity, the LIFE Study
Buck Louis GM , Sundaram R , Schisterman EF , Sweeney AM , Lynch CD , Gore-Langton RE , Chen Z , Kim S , Caldwell KL , Barr DB . Chemosphere 2012 87 (11) 1201-7 The effect of heavy metals at environmentally relevant concentrations on couple fecundity has received limited study despite ubiquitous exposure. In 2005-2009, couples (n=501) desiring pregnancy and discontinuing contraception were recruited and asked to complete interviews and to provide blood specimens for the quantification of cadmium (mcgL(-1)), lead (mcgdL(-1)) and mercury (mcgL(-1)) using inductively coupled plasma-mass spectrometry. Couples completed daily journals on lifestyle and intercourse along with menstruation and pregnancy testing for women. Couples were followed for 12 months or until pregnant. Fecundability odds ratios (FORs) and 95% confidence intervals (CIs) were estimated adjusting for age, body mass index, cotinine, and serum lipids in relation to female then male exposures. FORs <1 denote a longer time to pregnancy. In adjusted models, reduced FORs were observed for both female cadmium (0.78; 95% CI 0.63-0.97) and male lead (0.85; 95% CI 0.73-0.98) concentrations. When jointly modeling couples' exposures, only male lead concentration significantly reduced the FOR (0.82; 95% CI 0.68, 0.97), though the FOR remained <1 for female cadmium (0.80; 95% CI 0.64, 1.00). This prospective couple based cohort with longitudinal capture of time to pregnancy is suggestive of cadmium and lead's reproductive toxicity at environmentally relevant concentrations. |
Designing prospective cohort studies for assessing reproductive and developmental toxicity during sensitive windows of human reproduction and development - the LIFE Study
Buck Louis GM , Schisterman EF , Sweeney AM , Wilcosky TC , Gore-Langton RE , Lynch CD , Boyd Barr D , Schrader SM , Kim S , Chen Z , Sundaram R . Paediatr Perinat Epidemiol 2011 25 (5) 413-424 The relationship between the environment and human fecundity and fertility remains virtually unstudied from a couple-based perspective in which longitudinal exposure data and biospecimens are captured across sensitive windows. In response, we completed the LIFE Study with methodology that intended to empirically evaluate a priori purported methodological challenges: * implementation of population-based sampling frameworks suitable for recruiting couples planning pregnancy; * obtaining environmental data across sensitive windows of reproduction and development; * home-based biospecimen collection; and * development of a data management system for hierarchical exposome data. We used two sampling frameworks (i.e. fish/wildlife licence registry and a direct marketing database) for 16 targeted counties with presumed environmental exposures to persistent organochlorine chemicals to recruit 501 couples planning pregnancies for prospective longitudinal follow-up while trying to conceive and throughout pregnancy. Enrolment rates varied from <1% of the targeted population (n = 424 423) to 42% of eligible couples who were successfully screened; 84% of the targeted population could not be reached, while 36% refused screening. Among enrolled couples, approximately 85% completed daily journals while trying; 82% of pregnant women completed daily early pregnancy journals, and 80% completed monthly pregnancy journals. All couples provided baseline blood/urine samples; 94% of men provided one or more semen samples and 98% of women provided one or more saliva samples. Women successfully used urinary fertility monitors for identifying ovulation and home pregnancy test kits. Couples can be recruited for preconception cohorts and will comply with intensive data collection across sensitive windows. However, appropriately sized sampling frameworks are critical, given the small percentage of couples contacted found eligible and reportedly planning pregnancy at any point in time. |
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