Racial and Socioeconomic Disparities in Melanoma Incidence Rates in Georgia: 2000-2011

Background: The objective of this research was to investigate melanoma incidence rates and health outcomes in Georgia over time and by race, socio-economic status (SES), and gender. Methods: Age-adjusted melanoma incidence rates were obtained from the Georgia Comprehensive Cancer Registry SEER*Stat Database (2000-2011). To compare incidence rates across counties, and public health districts and by race, SES and gender, maps were generated using Geographic Information Systems (GIS). A cluster analysis was performed by use of SaTScan, and maps were created to visualize clusters of melanoma cases. Results: In Georgia, from 2000-2011, age-adjusted incidence rates for melanoma were higher among Whites than Blacks (28.0 vs. 1.1 per 100,000 population). For both races, high rates were found to be associated with high SES. For Whites, high rates were concentrated in urban areas relative to Blacks in rural areas. Clusters of melanoma incident cases were found mainly in the north central region of Georgia. Conclusions: For Georgia, results for map comparisons are consistent with previous research findings that higher melanoma incidence rates are associated with high SES for Whites and, to a lesser extent, for Blacks. Melanoma interventions in Georgia should focus on urban White and rural Black at-risk populations, especially those with high SES

Communicating serum chemical concentrations to study participants: follow up survey

<p>Abstract</p> <p>Background</p> <p>A considerable literature now supports the importance of effective communication with study participants, including how best to develop communication plans focusing on the uncertainty of health risks associated with particular environmental exposures. Strategies for communicating individual concentrations of environmental chemicals in human biological samples in the absence of clearly established safe or hazardous levels have been discussed from a conceptual basis and to a lesser extent from an empirical basis. We designed and evaluated an empirically based communication strategy for women of reproductive age who previously participated in a prospective study focusing on persistent environmental chemicals and reproductive outcomes.</p> <p>Methods</p> <p>A cohort of women followed from preconception through pregnancy or up to 12 menstrual cycles without pregnancy was given their individual serum concentrations for lead, dichloro-2,2-bis<it>p</it>-chlorophenyl ethylene, and select polychlorinated biphenyl congeners. Two versions of standardized letters were prepared depending upon women's exposure status, which was characterized as low or high. Letters included an introduction, individual concentrations, population reference values and guidance for minimizing future exposures. Participants were actively monitored for any questions or concerns following receipt of letters.</p> <p>Results</p> <p>Ninety-eight women were sent letters informing them of their individual concentrations to select study chemicals. None of the 89 (91%) participating women irrespective of exposure status contacted the research team with questions or concerns about communicated exposures despite an invitation to do so.</p> <p>Conclusions</p> <p>Our findings suggest that study participants can be informed about their individual serum concentrations without generating unnecessary concern.</p

Spatial Environmental Modeling of Autoantibody Outcomes among an African American Population

In this study of autoimmunity among a population of Gullah African Americans in South Carolina, the links between environmental exposures and autoimmunity (presence of antinuclear antibodies (ANA)) have been assessed. The study population included patients with systemic lupus erythematosus (n = 10), their first degree relatives (n = 61), and unrelated controls (n = 9) where 47.5% (n = 38) were ANA positive. This paper presents the methodology used to model ANA status as a function of individual environmental influences, both self-reported and measured, while controlling for known autoimmunity risk factors. We have examined variable dimension reduction and selection methods in our approach. Following the dimension reduction and selection methods, we fit logistic spatial Bayesian models to explore the relationship between our outcome of interest and environmental exposures adjusting for personal variables. Our analysis also includes a validation “strip” where we have interpolated information from a specific geographic area for a subset of the study population that lives in that vicinity. Our results demonstrate that residential proximity to exposure site is important in this form of analysis. The use of a validation strip network demonstrated that even with small sample numbers some significant exposure-outcome relationships can be detected

Temporal Trends in Cardiovascular Hospital Discharges Following a Mass Chlorine Exposure Event in Graniteville, South Carolina

Background: On January 6, 2005, a train derailed in Graniteville, South Carolina, releasing nearly 60,000 kg of toxic chlorine gas. The disaster left nine people dead and was responsible for hundreds of hospitalizations and outpatient visits in the subsequent weeks. While chlorine gas primarily affects the respiratory tract, a growing body of evidence suggests that acute exposure may also cause vascular injury and cardiac toxicity. Here, we describe the incidence of cardiovascular hospitalizations among residents of the zip codes most affected by the chlorine gas plume, and compare the incidence of cardiovascular discharges in the years leading up to the event (2000–2004) to the incidence in the years following the event (2005–2014). Methods: De-identified hospital discharge information was collected from the South Carolina Revenue and Fiscal Affairs Office for individuals residing in the selected zip codes for the years 2000 to 2014. A quasi-experimental study design was utilized with a population-level interrupted time series model to examine hospital discharge rates for Graniteville-area residents for three cardiovascular diagnoses: hypertension (HTN), acute myocardial infarction (AMI), and coronary heart disease (CHD). We used linear regression with autoregressive error correction to compare slopes for pre- and post-spill time periods. Data from the 2000 and 2010 censuses were used to calculate rates and to provide information on potential demographic shifts over the course of the study. Results: A significant increase in hypertension-related hospital discharge rates was observed for the years following the Graniteville chlorine spill (slope 8.2, p \u3c 0.001). Concurrent changes to CHD and AMI hospital discharge rates were in the opposite direction (slopes −3.2 and −0.3, p \u3c 0.01 and 0.14, respectively). Importantly, the observed trend cannot be attributed to an aging population. Conclusions: An unusual increase in hypertension-related hospital discharge rates in the area affected by the Graniteville chlorine spill contrasts with national and state-level trends. A number of factors related to the spill may be contributing the observation: disaster-induced hypertension, healthcare services access issues, and, possibly, chlorine-induced susceptibility to vascular pathologies. Due to the limitations of our data, we cannot determine whether the individuals who visited the hospital were the ones exposed to chlorine gas, however, the finding warrants additional research. Future studies are needed to determine the etiology of the increase and whether individuals exposed to chlorine are at a heightened risk for hypertensive heart disease

Mechanisms of Alcohol Addiction: Bridging Human and Animal Studies

Aim: The purpose of this brief narrative review is to address the complexities and benefits of extending animal alcohol addiction research to the human domain, emphasizing Allostasis and Incentive Sensitization, two models that inform many pre-clinical and clinical studies. Methods: The work reviewed includes a range of approaches, including: a) animal and human studies that target the biology of craving and compulsive consumption; b) human investigations that utilize alcohol self-administration and alcohol challenge paradigms, in some cases across 10 years; c) questionnaires that document changes in the positive and negative reinforcing effects of alcohol with increasing severity of addiction; and d) genomic structural equation modeling based on data from animal and human studies. Results: Several general themes emerge from specific study findings. First, positive reinforcement is characteristic of early stage addiction and sometimes diminishes with increasing severity, consistent with both Allostasis and Incentive Sensitization. Second, evidence is less consistent for the predominance of negative reinforcement in later stages of addiction, a key tenant of Allostasis. Finally, there are important individual differences in motivation to drink at a given point in time as well as person-specific change patterns across time. Conclusions: Key constructs of addiction, like stage and reinforcement, are by necessity operationalized differently in animal and human studies. Similarly, testing the validity of addiction models requires different strategies by the two research domains. Although such differences are challenging, they are not insurmountable, and there is much to be gained in understanding and treating addiction by combining pre-clinical and clinical approaches.Fil: Kramer, John. University of Iowa; Estados UnidosFil: Dick, Danielle M.. University of Virginia; Estados UnidosFil: King, Andrea. University of Chicago; Estados UnidosFil: Ray, Lara A.. University of California at Los Angeles; Estados UnidosFil: Sher, Kenneth J.. University of Missouri; Estados UnidosFil: Vena, Ashley. University of Chicago; Estados UnidosFil: Vendruscolo, Leandro F.. National Institutes of Health; Estados UnidosFil: Acion, Laura. University of Iowa; Estados Unidos. Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Calculo. - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Calculo; Argentin

Patterns of Sedentary Behavior and Mortality in U.S. Middle-Aged and Older Adults: A National Cohort Study

Background: Excessive sedentary time is ubiquitous in Western societies. Previous studies have relied on self-reporting to evaluate the total volume of sedentary time as a prognostic risk factor for mortality and have not examined whether the manner in which sedentary time is accrued (in short or long bouts) carries prognostic relevance. Objective: To examine the association between objectively measured sedentary behavior (its total volume and accrual in prolonged, uninterrupted bouts) and all-cause mortality. Design: Prospective cohort study. Setting: Contiguous United States. Participants: 7985 black and white adults aged 45 years or older. Measurements: Sedentary time was measured using a hip-mounted accelerometer. Prolonged, uninterrupted sedentariness was expressed as mean sedentary bout length. Hazard ratios (HRs) were calculated comparing quartiles 2 through 4 to quartile 1 for each exposure (quartile cut points: 689.7, 746.5, and 799.4 min/d for total sedentary time; 7.7, 9.6, and 12.4 min/bout for sedentary bout duration) in models that included moderate to vigorous physical activity. Results: Over a median follow-up of 4.0 years, 340 participants died. In multivariable-adjusted models, greater total sedentary time (HR, 1.22 [95% CI, 0.74 to 2.02]; HR, 1.61 [CI, 0.99 to 2.63]; and HR, 2.63 [CI, 1.60 to 4.30]; P for trend < 0.001) and longer sedentary bout duration (HR, 1.03 [CI, 0.67 to 1.60]; HR, 1.22 [CI, 0.80 to 1.85]; and HR, 1.96 [CI, 1.31 to 2.93]; P for trend < 0.001) were both associated with a higher risk for all-cause mortality. Evaluation of their joint association showed that participants classified as high for both sedentary characteristics (high sedentary time [≥12.5 h/d] and high bout duration [≥10 min/bout]) had the greatest risk for death. Limitation: Participants may not be representative of the general U.S. population. Conclusion: Both the total volume of sedentary time and its accrual in prolonged, uninterrupted bouts are associated with all-cause mortality, suggesting that physical activity guidelines should target reducing and interrupting sedentary time to reduce risk for death

O Controlo da Atividade de Investigação Criminal na Guarda Nacional Republicana

O presente Relatório Científico procura retratar o controlo da atividade de Investigação Criminal no seio da GNR. O controlo constitui-se como uma forma de colmatar erros que possam estar a ocorrer e simultaneamente prejudiquem o normal desenrolar de determinada tarefa, no sentido da melhoria e do aumento da proficiência para o desenvolvimento de uma atividade, neste caso em concreto, da Investigação Criminal. No final deste estudo, o principal objetivo consiste em concluir como se pode melhorar o controlo da atividade de Investigação Criminal na GNR. São três as fases essenciais que constituem esta investigação. Uma primeira, Fase exploratória, relacionada essencialmente com aspetos de cariz teórico, onde se apresentam os principais conceitos inerentes à realização deste trabalho. De seguida, numa fase mais vocacionada para o trabalho de campo, Fase analítica, são apresentados os resultados estatísticos fruto da análise dos dados obtidos. Posteriormente, na Fase conclusiva, apresentam-se as conclusões obtidas com a realização deste estudo, propondo melhorias que no futuro poderão aumentar a capacidade da instituição nesta área. A recolha de dados efetuou-se com recurso ao inquérito por questionário, sendo que posteriormente esses mesmos dados foram alvo de análise estatística. Conclui-se com este trabalho que existem algumas lacunas no que concerne a esta temática do controlo da atividade de Investigação Criminal, das quais se destaca a formação dos militares com funções nesta matéria, que segundo os resultados obtidos fica aquém do pretendido.Abstract This Scientific Report seeks to portray the control of Criminal Investigation activity within the GNR. The control it is as a manner to overcome errors that are affecting the normal path of a specific task, in order to improve and increase proficiency during the development of an activity, in this particular case, the Criminal Investigation activity. The main objective of this study seeks to demonstrate how the control of GNR Criminal Investigation could be improved. For this specific research were defined three key stages. The first, an Exploratory Phase, primarily related to aspects of theoretical nature, with the purpose to present the main concepts involved in this schoolwork. A second a phase specifically dedicated to the field research, considered as the Analytical phase, where the statistical results of data analysis are presented. And a third phase, at the conclusions of this scientific research, where were also presented some suggestions or improvements that in the future could enhance the capability of the institution in this area of knowledge. The survey questionnaires were the basis for the data gathering that was later submitted to statistical analysis. The principle conclusion of this study points to the facts that are a few shortcomings in the control of the GNR Criminal Investigation activity. The results obtained show that GNR Criminal Investigation specific training is lower than desirable

Association Between Objectively Measured Physical Activity and Cognitive Function in Older Adults—The Reasons for Geographic and Racial Differences in Stroke Study

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/116310/1/jgs13829_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/116310/2/jgs13829.pd

Mercury in fish and adverse reproductive outcomes: results from South Carolina

Mercury is a metal with widespread distribution in aquatic ecosystems and significant neurodevelopmental toxicity in humans. Fish biomonitoring for total mercury has been conducted in South Carolina (SC) since 1976, and consumption advisories have been posted for many SC waterways. However, there is limited information on the potential reproductive impacts of mercury due to recreational or subsistence fish consumption. To address this issue, geocoded residential locations for live births from the Vital Statistics Registry (1995–2005, N = 362,625) were linked with spatially interpolated total mercury concentrations in fish to estimate potential mercury exposure from consumption of locally caught fish. Generalized estimating equations were used to test the hypothesis that risk of low birth weight (LBW, <2,500 grams) or preterm birth (PTB, <37 weeks clinical gestation) was greater among women living in areas with elevated total mercury in fish, after adjustment for confounding. Separate analyses estimated term LBW and PTB risks using residential proximity to rivers with fish consumption advisories to characterize exposure. Term LBW was more likely among women residing in areas in the upper quartile of predicted total mercury in fish (odds ratio [OR] = 1.04; 95% confidence interval [CI]: 1.00-1.09) or within 8 kilometers of a river with a ‘do not eat’ fish advisory (1.05; 1.00-1.11) compared to the lowest quartile, or rivers without fish consumption restrictions, respectively. When stratified by race, risks for term LBW or PTB were 10-18% more likely among African-American (AA) mothers living in areas with the highest total fish mercury concentrations. To our knowledge, this is the first study to examine the relationship between fish total mercury concentrations and adverse reproductive outcomes in a large population-based sample that included AA women. The ecologic nature of exposure assessment in this study precludes causal inference. However, the results suggest a need for more detailed investigations to characterize patterns of local fish consumption and potential dose–response relationships between mercury exposure and adverse reproductive outcomes, particularly among AA mothers.https://doi.org/10.1186/1476-072X-13-3