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1.  Incarceration and adult weight gain in the National Survey of American Life (NSAL) 
Preventive medicine  2015;81:380-386.
The United States has the unenviable distinction of having both the highest obesity rate among Organisation for Economic Co-operation and Development (OECD) member countries and the highest incarceration rate in the world. Further, both are socially patterned by race/ethnicity and socioeconomic position. Incarceration involves various health behaviors that could influence adult weight trajectory. We evaluated the associations between history and duration of adult incarceration and weight gain using the National Survey of American Life (N=6,082 adults residing in the 48 contiguous states between February 2001 and March 2003). We propensity score-matched individuals to control for the probability of having a history of incarceration. To examine the relation between prior incarceration and adult weight gain, we fit gender-stratified generalized estimating equations controlling for propensity of incarceration history, age, education, income, race/ethnicity, and marital status. For males (N=563), incarceration was associated with about a 1.77 kg/m2 lower gain in body mass index (BMI) during adulthood, after adjusting for age, education, income, race/ethnicity, and marital status in addition to the propensity of having a history of incarceration (95% CI: −2.63, −0.92). For females (N=286), no significant overall relationship was found between a history of incarceration and adult weight gain. In subgroup analyses among those with an incarceration history, we found no overall association between duration of incarceration and adult weight gain in men or women. In sensitivity analyses, neither tobacco smoking nor parity changed the results. The results of this study indicate that incarceration is associated with a lower transition of weight gain in males, but not females.
PMCID: PMC4958024  PMID: 26456214
incarceration; body weight
2.  MR parkinsonism index predicts vertical supranuclear gaze palsy in patients with PSP–parkinsonism 
Neurology  2016;87(12):1266-1273.
To identify a biomarker for predicting the appearance of vertical supranuclear gaze palsy (VSGP) in patients affected by progressive supranuclear palsy–parkinsonism (PSP-P).
Twenty-four patients with PSP-P were enrolled in the current study. Patients were clinically followed up every 6 months until the appearance of VSGP or the end of the follow-up (4 years). Participants underwent MRI at baseline and at the end of follow-up. Magnetic resonance parkinsonism index (MRPI), an imaging measure useful for diagnosing PSP, was calculated.
Twenty-one patients with PSP-P completed follow-up, and 3 patients dropped out. Eleven of 21 patients with PSP-P developed VSGP after a mean follow-up period of 28.5 months (range 6–48 months), while the remaining 10 patients with PSP-P did not develop VSGP during the 4-year follow-up period. At baseline, patients with PSP-P who later developed VSGP had MRPI values significantly higher than those of patients not developing VSGP without overlapping values between the 2 groups. MRPI showed a higher accuracy (100%) in predicting VSGP than vertical ocular slowness (accuracy 33.3%) or postural instability with or without vertical ocular slowness (accuracy 71.4% and 42.9%, respectively).
Our study demonstrates that MRPI accurately predicted, on an individual basis, the appearance of VSGP in patients with PSP-P, thus confirming clinical diagnosis in vivo.
PMCID: PMC5035983  PMID: 27558375
3.  Can You Party Your Way to Better Health? A Propensity Score Analysis of Block Parties and Health 
While other indicators of social capital have been linked to health, the role of block parties on health in Black neighborhoods and on Black residents is understudied. Block parties exhibit several features of bonding social capital and are present in nearly 90% of Philadelphia’s predominantly Black neighborhoods. This analysis investigated: (1) whether or not block parties are an indicator of bonding social capital in Black neighborhoods; (2) the degree to which block parties might be related to self-rated health in the ways that other bonding social indicators are related to health; and (3) whether or not block parties are associated with average self-rated health for Black residents particularly. Using census tract-level indicators of bonding social capital and records of block parties from 2003 to 2008 for 381 Philadelphia neighborhoods (defined by census tracts), an ecological-level propensity score was generated to assess the propensity for a block party, adjusting for population demographics, neighborhood characteristics, neighborhood resources and violent crime. Results indicate that in multivariable regression, block parties were associated with increased bonding social capital in Black neighborhoods; however, the calculation of the average effect of the treatment on the treated (ATT) within each propensity score strata showed no effect of block parties on average self-rated health for Black residents. Block parties may be an indicator of bonding social capital in Philadelphia’s predominantly Black neighborhoods, but this analysis did not show a direct association between block parties and self-rated health for Black residents. Further research should consider what other health outcomes or behaviors block parties may be related to and how interventionists can leverage block parties for health promotion.
PMCID: PMC4500646  PMID: 26117555
Philadelphia, Pennsylvania, USA; social capital; block parties; Black/African-American neighborhoods; self-rated health; propensity score
4.  Multidimensional religious involvement and tobacco smoking patterns over 9–10 years: A prospective study of middle-aged adults in the United States 
This study examined the relationship between multiple dimensions of religious involvement and transitions of tobacco smoking abstinence, persistence, cessation and relapse over 9–10 years of follow-up in a national sample of adults in the United States. Using data provided at baseline and follow-up, participants were categorized as non-smokers, persistent smokers, ex-smokers, and relapsed smokers. Religious involvement over the two time points were categorized into combinations of “high” and “low” involvement within the domains of (a) religious attendance, (b) religious importance, (c) spiritual importance, (d) religious/spiritual comfort seeking, and (e) religious/spiritual decision-making. High levels of religious involvement across five dimensions (religious attendance, religious importance, spiritual importance, religious/spiritual comfort-seeking, and religious/spiritual decision-making) were associated with lower odds of being a persistent smoker or ex-smoker. Religious involvement was not associated with smoking cessation among smokers at baseline. Interventions to increase smoking abstinence may be more effective if they draw on ties to religious and spiritual organizations and beliefs. Meanwhile, religious involvement is unlikely to affect smoking cessation effectiveness.
PMCID: PMC4578868  PMID: 26093070
USA; Religious involvement; Religion; Tobacco smoking; Smoking cessation
5.  Two-Photon Autofluorescence Imaging Reveals Cellular Structures Throughout the Retina of the Living Primate Eye 
Although extrinsic fluorophores can be introduced to label specific cell types in the retina, endogenous fluorophores, such as NAD(P)H, FAD, collagen, and others, are present in all retinal layers. These molecules are a potential source of optical contrast and can enable noninvasive visualization of all cellular layers. We used a two-photon fluorescence adaptive optics scanning light ophthalmoscope (TPF-AOSLO) to explore the native autofluorescence of various cell classes spanning several layers in the unlabeled retina of a living primate eye.
Three macaques were imaged on separate occasions using a custom TPF-AOSLO. Two-photon fluorescence was evoked by pulsed light at 730 and 920 nm excitation wavelengths, while fluorescence emission was collected in the visible range from several retinal layers and different locations. Backscattered light was recorded simultaneously in confocal modality and images were postprocessed to remove eye motion.
All retinal layers yielded two-photon signals and the heterogeneous distribution of fluorophores provided optical contrast. Several structural features were observed, such as autofluorescence from vessel walls, Müller cell processes in the nerve fibers, mosaics of cells in the ganglion cell and other nuclear layers of the inner retina, as well as photoreceptor and RPE layers in the outer retina.
This in vivo survey of two-photon autofluorescence throughout the primate retina demonstrates a wider variety of structural detail in the living eye than is available through conventional imaging methods, and broadens the use of two-photon imaging of normal and diseased eyes.
PMCID: PMC4771181  PMID: 26903224
ophthalmic imaging; Müller cells; vasculature; photoreceptors; nuclear layers
6.  In Vivo Two-Photon Fluorescence Kinetics of Primate Rods and Cones 
The retinoid cycle maintains vision by regenerating bleached visual pigment through metabolic events, the kinetics of which have been difficult to characterize in vivo. Two-photon fluorescence excitation has been used previously to track autofluorescence directly from retinoids and pyridines in the visual cycle in mouse and frog retinas, but the mechanisms of the retinoid cycle are not well understood in primates.
We developed a two-photon fluorescence adaptive optics scanning light ophthalmoscope dedicated to in vivo imaging in anesthetized macaques. Using pulsed light at 730 nm, two-photon fluorescence was captured from rods and cones during light and dark adaptation through the eye's pupil.
The fluorescence from rods and cones increased with light exposure but at different rates. During dark adaptation, autofluorescence declined, with cone autofluorescence decreasing approximately 4 times faster than from rods. Rates of autofluorescence decrease in rods and cones were approximately 4 times faster than their respective rates of photopigment regeneration. Also, subsets of sparsely distributed cones were less fluorescent than their neighbors immediately following bleach at 565 nm and they were comparable with the S cone mosaic in density and distribution.
Although other molecules could be contributing, we posit that these fluorescence changes are mediated by products of the retinoid cycle. In vivo two-photon ophthalmoscopy provides a way to monitor noninvasively stages of the retinoid cycle that were previously inaccessible in the living primate eye. This can be used to assess objectively photoreceptor function in normal and diseased retinas.
PMCID: PMC4771186  PMID: 26903225
ophthalmic imaging; photoreceptors; visual cycle; pigment regeneration
9.  Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study 
BMC Psychiatry  2016;16:214.
This study examined the association between the type, and cumulative number of lifetime potentially traumatic events (PTEs), and chronic physical conditions, in a South African sample. PTE exposures have been associated with an increased risk for a wide range of chronic physical conditions, but it is unclear whether psychiatric disorders mediate this association. Given the established differences in trauma occurrence, and the epidemiology of posttraumatic stress disorder (PTSD) in South Africa relative to other countries, examining associations between PTEs and chronic physical conditions, particularly while accounting for psychiatric comorbidity is important.
Data were drawn from the South African Stress and Health Study, a cross-sectional population-representative study of psychological and physical health of South African adults. Twenty-seven PTEs, based on the World Health Organization Composite International Diagnostic Interview Version 3.0, DSM-IV PTSD module were grouped into seven PTE types (war events, physical violence, sexual violence, accidents, unexpected death of a loved one, network events, and witnessing PTEs). Five clusters of physical conditions (cardiovascular, arthritis, respiratory, chronic pain, and other health conditions) were examined. Logistic regressions assessed the odds of reporting a physical condition in relation to type and cumulative number of PTEs. Cochran-Armitage test for trend was used to examine dose-response effect of cumulative PTEs on physical conditions.
After adjusting for sociodemographic variables and psychiatric disorders, respondents with any PTE had increased odds of all assessed physical conditions, ranging between 1.48 (95 % CI: 1.06–2.07) for arthritis and 2.07 (95 % CI: 1.57–2.73) for respiratory conditions, compared to those without PTE exposure. Sexual violence, physical violence, unexpected death of a loved one, and network PTEs significantly increased the odds of all or nearly all the physical conditions assessed. There was a dose-response relationship between number of PTEs and increased odds of all physical conditions.
Results from this study, the first in an African general population, are consistent with other population-based studies; PTEs confer a broad-spectrum risk for chronic physical conditions, independent of psychiatric disorders. These risks increase with each cumulative PTE exposure. Clinically, comprehensive evaluations for risk of mental and physical health morbidities should be considered among PTE survivors.
PMCID: PMC4936266  PMID: 27389090
Trauma; Physical health; South Africa; Posttraumatic stress disorder
10.  An exploration of how psychotic-like symptoms are experienced, endorsed, and understood from the National Latino and Asian American Study and National Survey of American Life 
Ethnicity & health  2014;20(3):273-292.
To examine racial/ethnic differences in the endorsement and attribution of psychotic-like symptoms in a nationally representative sample of African Americans, Asians, Caribbean Blacks, and Latinos living in the United States.
Data were drawn from a total of 979 respondents who endorsed psychotic-like symptoms as part of the National Latino and Asian American Study (NLAAS) and the National Survey of American Life (NSAL). We use a mixed qualitative and quantitative analytical approach to examine sociodemographic and ethnic variations in the prevalence and attributions of hallucinations and other psychotic-like symptoms in the NLAAS and NSAL. The lifetime presence of psychotic-like symptoms was assessed using the World Health Organization Composite International Diagnostic Interview (WMH-CIDI) psychotic symptom screener. We used logistic regression models to examine the probability of endorsing the four most frequently occurring thematic categories for psychotic-like experiences by race/ethnicity (n>100). We used qualitative methods to explore common themes from participant responses to open ended questions on their attributions for psychotic-like symptoms.
African Americans were significantly less likely to endorse visual hallucinations compared to Caribbean Blacks (73.7% and 89.3%, p<.001), but they endorsed auditory hallucinations symptoms more than Caribbean Blacks (43.1% and 25.7, p<.05). Endorsing delusions of reference and thought insertion/withdrawal were more prevalent for Latinos than for African Americans (11% and 4.7%, p<.05; 6.3% and 2.7%, p<.05, respectively). Attribution themes included: supernatural, ghosts/unidentified beings, death and dying, spirituality or religiosity, premonitions, familial and other. Respondents differed by race/ethnicity in the attributions given to psychotic like symptoms.
Findings suggest that variations exist by race/ethnicity in both psychotic-like symptom endorsement and in self-reported attributions/understandings for these symptoms on a psychosis screening instrument. Racial/ethnic differences could result from culturally sanctioned beliefs and idioms of distress that deserve more attention in conducting culturally informed and responsive screening, assessment and treatment.
PMCID: PMC4930554  PMID: 24920148
Psychotic Symptoms; System Endorsement; Hallucinations; Delusions; Culture; Ethnicity; Race
11.  Sources of Interactional Problems in a Survey of Racial/Ethnic Discrimination 
Cross-cultural variability in respondent processing of survey questions may bias results from multiethnic samples. We analyzed behavior codes, which identify difficulties in the interactions of respondents and interviewers, from a discrimination module contained within a field test of the 2007 California Health Interview Survey. In all, 553 (English) telephone interviews yielded 13,999 interactions involving 22 items. Multilevel logistic regression modeling revealed that respondent age and several item characteristics (response format, customized questions, length, and first item with new response format), but not race/ethnicity, were associated with interactional problems. These findings suggest that item function within a multi-cultural, albeit English language, survey may be largely influenced by question features, as opposed to respondent characteristics such as race/ethnicity.
PMCID: PMC4495735  PMID: 26166949
12.  No sweat: African American adolescent girls’ opinions of hairstyle choices and physical activity 
BMC obesity  2016;3:31.
Obesity prevalence is higher among African American adolescent (AAA) girls than among non-black girls. Lower levels of physical activity (PA) likely contribute to this disparity; this may be impacted by hairstyle concerns.
In 2011, focus groups were conducted with AAA girls 14-17 years old (n = 36) in Michigan (n = 9), California (n = 11), and Georgia (n = 16). Groups addressed perceptions of hairstyles, exercise, and relationships between the two. Groups were recorded, transcripts reviewed, and themes identified. Adolescents completed a standardized ethnic identity (EI) measure and a survey addressing demographics and PA. Linear regression was used to examine associations between self-reported activity and participants’ characteristics.
Four themes emerged: 1) between ages 8 and 15, when concerns about hairstyles began, participants changed from “juvenile” (natural) styles to “adult” (straightened) styles; 2) participants avoided getting wet or sweating during exercise because their straightened hair became “nappy;” 3) braids with extensions and natural styles were viewed as better for exercise but not very attractive; 4) participants almost universally selected long, straight hairstyles as most attractive. In Michigan and California, EI was positively associated with levels of PA (p < 0.05) and overall having extensions was also positively associated with levels of PA.
A preference for straight hair may contribute to AAA girls avoiding certain activities due to concerns about sweat affecting their hair. Furthermore, EI and hairstyle choice appear to be associated with levels of PA for some participants. Efforts to increase AAA girls’ PA may benefit from approaches that address hairstyle choices and EI.
PMCID: PMC4929729  PMID: 27386139
Physical activity; Adolescents; African American; Disparities; Ethnic identity
13.  Conformational effects and stereocontrol in synthesis studies of medium-ring dolabellane carbocycles 
Tetrahedron letters  2014;56(23):3200-3203.
Stereoselective reactions are described which lead to functionalization of the dolabellane skeleton. The stereoselectivity is attributed to conformational effects imposed by the eleven-membered ring. An efficient pathway provides for the stereocontrolled synthesis of nonracemic 6(S)-hydroxy-4(E)-dolabellene-3-one 12 and related derivatives.
Graphical Abstract
PMCID: PMC4484730  PMID: 26139943
Dolabellane diterpenes; Medium-ring carbocycles; Stereoselective synthesis; Conformational studies
14.  Preface: Minority Men's Health 
Ethnicity & Disease  null;25(3):237-239.
PMCID: PMC4671421  PMID: 26673951
Life Expectancy; Life Course
15.  Proportion of patients without mental disorders being treated in mental health services worldwide 
The British Journal of Psychiatry  2015;206(2):101-109.
Previous research suggests that many people receiving mental health treatment do not meet criteria for a mental disorder but are rather ‘the worried well’.
To examine the association of past-year mental health treatment with DSM-IV disorders.
The World Health Organization’s World Mental Health (WMH) Surveys interviewed community samples of adults in 23 countries (n = 62 305) about DSM-IV disorders and treatment in the past 12 months for problems with emotions, alcohol or drugs.
Roughly half (52%) of people who received treatment met criteria for a past-year DSM-IV disorder, an additional 18% for a lifetime disorder and an additional 13% for other indicators of need (multiple subthreshold disorders, recent stressors or suicidal behaviours). Dose-response associations were found between number of indicators of need and treatment.
The vast majority of treatment in the WMH countries goes to patients with mental disorders or other problems expected to benefit from treatment.
PMCID: PMC4312965  PMID: 25395690
16.  Cone and Rod Loss in Stargardt Disease Revealed by Adaptive Optics Scanning Light Ophthalmoscopy 
JAMA ophthalmology  2015;133(10):1198-1203.
Stargardt disease (STGD1) is characterized by macular atrophy and flecks in the retinal pigment epithelium. The causative ABCA4 gene encodes a protein localizing to photoreceptor outer segments. The pathologic steps by which ABCA4 mutations lead to clinically detectable retinal pigment epithelium changes remain unclear. We investigated early STGD1 using adaptive optics scanning light ophthalmoscopy.
Adaptive optics scanning light ophthalmoscopy imaging of 2 brothers with early STGD1 and their unaffected parents was compared with conventional imaging. Cone and rod spacing were increased in both patients (P <.001) with a dark cone appearance. No foveal cones were detected in the older brother. In the younger brother, foveal cones were enlarged with low density (peak cone density, 48.3 × 103 cones/mm2). The ratio of cone to rod spacing was increased in both patients, with greater divergence from normal approaching the foveal center, indicating that cone loss predominates centrally and rod loss increases peripherally. Both parents had normal photoreceptor mosaics. Genetic testing revealed 3 disease-causing mutations.
Conclusions and Relevance
This study provides in vivo images of rods and cones in STGD1. Although the primary clinical features of STGD1 are retinal pigment epithelial lesions, adaptive optics scanning light ophthalmoscopy reveals increased cone and rod spacing in areas that appear normal in conventional images, suggesting that photoreceptor loss precedes clinically detectable retinal pigment epithelial disease in STGD1.
PMCID: PMC4600048  PMID: 26247787
17.  Latino Adolescents’ Perceived Discrimination in Online and Offline Settings: An Examination of Cultural Risk and Protective Factors 
Developmental psychology  2015;51(1):87-100.
Guided by a risk and resilience framework, the current study examined the associations between Latino adolescents’ (n = 219; Mage 14.35; SD = 1.75) perceptions of ethnic discrimination in multiple settings (e.g., online, school) and several domains of adjustment (e.g., mental health, academic), and tested whether developmentally salient cultural assets (i.e., ethnic identity) directly promoted youth adjustment or moderated the negative impact of discrimination on adjustment. Each of the 3 ethnic identity components (i.e., exploration, resolution, affirmation) demonstrated evidence of promoting positive outcomes among Latino youth; furthermore, there was some evidence that the promotive effects of affirmation and resolution were significantly stronger for older versus younger adolescents. In addition, with the exception of experiences with discrimination from adults outside of the school setting, there was evidence of ethnic identity interacting with each type of discrimination to predict Latino adolescents’ self-esteem, depressive symptoms, and externalizing problems. Findings suggest directions for future research and identify potential targets for intervention that may prove fruitful in programming efforts with Latino adolescents.
PMCID: PMC4752111  PMID: 25546597
ethnic identity; racial identity; risk; resilience; discrimination
18.  Association between witnessing traumatic events and psychopathology in the South African Stress and Health Study 
The high burden of witnessing traumatic events has been demonstrated in previous research in South Africa. However, previous work has focused on PTSD rather than a broader range of psychopathological outcomes. This study examined the association between witnessing trauma and multiple outcomes including mood, anxiety, and substance use disorders.
Regression models measured the odds of mood, anxiety, and substance use disorders among those who reported witnessing in the South African Stress and Health Study. Discrete-time survival analysis was used to examine whether witnessing was associated with earlier onset of mental disorders.
Witnessing trauma was more commonly reported among males and those with low-average education. Posttraumatic stress disorder, mood, and anxiety disorders varied significantly with witnessing status, and witnessing was associated with exposure to a higher number of traumatic events compared to other types of traumatic events. Respondents reporting witnessing trauma had elevated odds of mood and anxiety disorders, but not substance use disorders.
Witnessing trauma is common in the South African population and results in increased risk of mood and anxiety disorders. Interventions aimed at reducing the burden of trauma and its outcomes must now increase their focus on bystanders and other observers, rather than just focusing on those directly affected.
PMCID: PMC4747238  PMID: 25773525
Trauma; Witnessing; Anxiety disorders; Mood disorders; Africa
19.  Impacts of Long-Term Obesity on the Health Status of Samoan and Tongan Men in the United States: Results from the Pacific Islander Health Study 
Ethnicity & Disease  null;25(3):279-286.
To examine the impacts of long-standing obesity (BMIs ≥ 30.0 kg/m2) on health outcomes among Samoan and Tongan men (aged ≥ 18 years) in California using a life course perspective.
Cross-sectional analysis of 103 males from the Pacific Islander Health Study (PIHS), a probability sample modeled after the National Health Interview Survey (NHIS).
Urban residential neighborhoods in San Mateo and Los Angeles counties using a multistage, cluster sample design.
Main Outcome Measures
BMI, diabetes, hypertension, total cholesterol, smoking, drinking, arthritis, gout and migraines.
Bivariate analysis shows high rates of poor health outcomes distributed throughout the obese and non-obese sample. Logistic analysis finds that being obese does not significantly increase observed negative health outcomes. After controlling for socio-demographic characteristics, the presence of obesity results in non-significant findings for hypertension (OR=1.02; CI: .21, 4.91), and high cholesterol (OR=.52; CI: .10, 2.73), while obesity significantly reduces the risk of diabetes by 60% (OR=.40; CI: .14, 1.17). When applying disease counts, obese men have a significantly lower risk of reporting multiple health conditions (OR=.72; CI: .52, 1.00).
Overall, the health of Samoan and Tongan males in California is uniformly poor and obesity alone does not significantly increase risks of poor health outcomes. Using a life course perspective, the analysis offers new insights on the basic health of this understudied population.
PMCID: PMC4671413  PMID: 26672474
Samoan; Tongan; Life Course; Men’s Health; Obesity; Chronic Disease; Vulnerable Population; Pacific Islander
20.  Racial/Ethnic Disparities in Short Sleep Duration by Occupation: The Contribution of Immigrant Status 
Sleep duration, associated with increased morbidity/mortality, has been shown to vary by race and occupation. Few studies have examined the additional influence of immigrant status. Using a nationally-representative sample of 175,244 US adults from the National Health Interview Survey from 2004-2011, we estimated prevalence ratios (PRs) for short sleep duration (<7 hours/per day) among US- and non-US born Blacks and Latinos by occupation compared to their White counterparts using adjusted Poisson regression models with robust variance. Non-US born participants’ mean age was 46 years, 55% were men, 58% were Latino, and 65% lived in the US ≥15 years. Short sleep prevalence was highest among US- and non-US born Blacks in all occupations, and the prevalence generally increased with increasing professional/management roles in Blacks and Latinos while it decreased among Whites. Adjusted short sleep was more prevalent in US-born Blacks compared to Whites in professional/management (PR=1.52 [95% confidence interval (CI): 1.42-1.63]), support services (PR=1.31 [95% CI: 1.26-1.37]), and laborers (PR=1.11 [95% CI: 1.06-1.16]). The Black-White comparison was even higher for non-US born Black laborers (PR=1.50 [95% CI: 1.24-1.80]). Similar for non-US born Latinos, Latinos born in the US had a higher short sleep prevalence in professional/management (PR=1.14 [95% CI: 1.04-1.24]) and support services (PR=1.06 [95% CI: 1.01-1.11]), but a lower prevalence among laborers (PR=0.77 [95% CI: 0.74-0.81]) compared to Whites. Short sleep varied within and between immigrant status for some ethnicities in particular occupations, further illuminating the need for tailored interventions to address sleep disparities among US workers.
PMCID: PMC4744798  PMID: 25108693
United States; Sleep; Immigrant; Occupation; Race; Ethnicity
21.  Proactive tobacco cessation outreach to smokers of low socioeconomic status: a randomized clinical trial 
JAMA internal medicine  2015;175(2):218-226.
Widening socioeconomic disparities in mortality in the United States are largely explained by slower declines in tobacco use between low- and high-socioeconomic status (SES) groups, suggesting the need for targeted tobacco cessation interventions. Documentation of smoking status in electronic health records (EHRs), provides health systems with an opportunity to proactively offer tobacco treatment to disadvantaged smokers.
To evaluate a proactive strategy to provide tobacco treatment that addresses socio-contextual mediators of tobacco use for low-SES smokers.
Design, Setting, Participants
Prospective, randomized controlled trial for low-SES adult smokers who described their race/ethnicity as black, Hispanic or white and received primary care at one of 13 practices in greater-Boston (intervention n=399, control n=308).
We used interactive voice response (IVR)-facilitated outreach to eligible individuals using EHR-coded smoking status. Consenting patients were randomized to a control group which received usual care from their health care team or to an intervention group that included a treatment program of: (1) telephone-based motivational counseling, (2) 6-weeks of free nicotine replacement therapy (NRT), (3) access to community-based referrals to address socio-contextual mediators of tobacco use, and (4) integration of this program with an individual’s care team through the EHR.
Main Outcome
Self-reported past 7-day tobacco abstinence 9-months after randomization (“quitting”), assessed by automated caller or blinded study staff.
The intervention group had a higher quit rate than the usual care group (17.8% vs. 8.1%, odds ratio 2.5, 95% confidence interval 1.5-4.0, number-needed-to-treat=10). We examined whether use of intervention components was associated with quitting among individuals in the intervention group; individuals who participated in the telephone counseling were more likely to quit compared to those who did not (21.2% vs. 10.4%, p=0.0009). There was no difference in quitting by use of NRT. Quitting did not differ by a request for a community referral, but individuals who used their referral were more likely to quit than those who did not (43.6% vs. 15.3%, p<0.0001).
Conclusions and Relevance
Proactive, IVR-facilitated outreach enables engagement with low-SES smokers. Providing counseling, nicotine replacement therapy, and access to community-based resources to address socio-contextual mediators among smokers reached in this setting is effective.
PMCID: PMC4590783  PMID: 25506771
tobacco control; surveillance; health disparities
22.  An adaptive optics imaging system designed for clinical use: publisher’s note 
Biomedical Optics Express  2015;6(8):2864.
This publisher’s note amends the author list and Acknowledgments of a recent publication [Biomed. Opt. Express 6, 2120 (2015)26114033].
PMCID: PMC4541514  PMID: 26309750
(110.1080) Active or adaptive optics; (120.3890) Medical optics instrumentation; (170.3880) Medical and biological imaging; (170.4470) Ophthalmology; (330.2210) Vision - eye movements
23.  Calibration-free sinusoidal rectification and uniform retinal irradiance in scanning light ophthalmoscopy 
Optics letters  2015;40(1):85-88.
Sinusoidal rectification (i.e. desinusoiding) is necessary for scanning imaging systems and is typically achieved by calculating a rectification transform from a calibration image such as a regular grid. This approach is susceptible to error due to electronic or mechanical instability that can alter the phase of the imaging window with respect to the calibration transform. Here we show a calibration-free rectification method implemented from live video of a scanning light ophthalmoscope (SLO) with or without adaptive optics (AO). This approach, which capitalizes on positional differences in the images obtained in the forward and backward scan directions, dynamically keeps the imaging window in phase with the motion of the sinusoidal resonant scanner, preventing errors from signal drift over time. A benefit of this approach is that it allows the light power across the field-of-view (FOV) to be modulated inversely to achieve uniform irradiance on the retina, a feature desirable for functional imaging methods and light safety in scanning light ophthalmoscopes.
PMCID: PMC4455553  PMID: 25531615
24.  Race, Gender, and Conceptualizations of Fear 
This study used qualitative methods and quantitative statistical analyses to examine whether race and gender are associated with reasons for which adults perceive a situation or object as fearful. The sample consists of 197 African-American and White adults (ages 18–85) recruited through a convenience sample and community sources in the Midwest. A cognitive interviewing instrument was utilized to examine respondents understanding of words and phrases from a mental health instrument. Using qualitative methods, free-response answers were content coded using 5 “fear-codes” (i.e., harm/danger, external locus of control, self-perception, and past experience), developed by the researchers. Results from logistic regression analyses indicate that race significantly predicts usage of specific fear codes (p<.05). In addition, a race by gender interaction was found.
PMCID: PMC4629513  PMID: 26538802
cognitive interview; phobia; qualitative research; race; anxiety; fear
25.  Worksite safety climate, smoking, and the use of protective equipment by blue collar building workers enrolled in the MassBUILT smoking cessation trial 
In order to assess potential contributors to high injury rates and smoking prevalence among construction workers, we investigated the association of safety climate with personal protective equipment (PPE) use, and smoking behaviors.
Logistic regression models estimated risk ratios for PPE use and smoking using data from participants in MassBUILT smoking cessation intervention (n=1,725).
Contractor safety climate was negatively associated with use of dust masks (RR=0.88,95%CI:0.83–0.94); respirators (RR=0.82,95%CI:0.75–0.89); general equipment (RR=0.98,95%CI:0.95–1.00); and fall protection (RR=0.94,95%CI:0.91–0.98) and positively associated with current smoking (RR=1.12,95%CI:1.01–1.25) but not smoking cessation. Coworker safety climate was negatively associated with use of dust masks (RR=0.87,95%CI:0.82–0.92); respirators (RR=0.80,95%CI:0.74–0.87); general equipment (RR=0.96,95%CI:0.94–0.98); fall (RR=0.92,95%CI:0.89–0.96) and hearing (RR=0.88,95%CI:0.83–0.93) protection but not smoking.
Worksite safety climate may be important for PPE use and smoking, but further research is needed.
PMCID: PMC4187209  PMID: 25285831
safety climate; construction; blue collar; smoking; safety equipment

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