Structural and Contextual Patterns in Family Health History Knowledge among African American Adults: A Mixed-Methods Social Network Analysis Study*

Background: Family health history is a strong risk factor for many chronic diseases. Ethnic minorities have been found to have a low awareness of their family health history (FHH), which may pose a contributing factor to health disparities. Purpose: The purpose of this mixed-methods social network analysis study was to identify structural and contextual patterns in African American adults’ FHH knowledge based on interpersonal communication exchanges with their family members. Methods: African American adults completed individually administered family network interviews. Participants’ 3-generation family pedigree served as a visual aid to guide their interview. Our primary outcome of interest for this analysis was whether a family member was reported as someone who talks to the participant about their own (i.e., the family member’s) health, which we refer to as a “personal health informant.” To contextualize quantitative findings, participants were asked to describe how they learned about the health history of the relatives they identified during their interview. Results: Participants (n=37) reported an average family network size of 29.4 relatives (SD = 15.5; Range = 10-67). Each participant, on average, named 17% of their familial network as personal health informants. Multivariate regression results showed that participants were more likely to name an alter as a personal health informant if the alter was female (OR = 2.14, p = 0.0519), from the maternal side of the participant’s family (OR = 1.12, p = 0.0006), had one or more chronic health conditions (OR = 2.41, p = 0.0041), was someone who has discussions with the participant about the participant’s health (OR = 16.28, p < 0.0001), was a source of family health information (OR = 3.46, p = 0.0072), and was someone whose health the participant helps to monitor or track (OR = 5.93, p = 0.0002). Complementary qualitative findings indicate that FHH knowledge is facilitated by open, direct communication among relatives. Personal health informants were described as disclosing information for the purposes of informing others for preventive purposes and for gaining social support. Participants also learned about FHH via other methods, including direct observation, during caretaking, and following a relative’s death. Conclusions: Communication and disclosure practices is an important determinant of African Americans’ FHH knowledge. More culturally and contextually meaningful public health efforts are needed to promote family health history sharing, especially regarding paternal family health history, siblings, and extended relatives

Task workflow design and its impact on performance and volunteers' subjective preference in virtual citizen science

Virtual citizen science platforms allow non-scientists to take part in scientific research across a range of disciplines. What they ask of volunteers varies considerably in terms of task type, variety, user judgement required and user freedom, which has received little direct investigation. A study was performed with the Planet Four: Craters project to investigate the effect of task workflow design on both volunteer experience and the scientific results they produce. Participants' feedback through questionnaire responses indicated a preference for interfaces providing greater autonomy and variety, with free-text responses suggesting that autonomy was the more important. This did not translate into improved performance however, with the most autonomous interface not resulting in significantly better performance in data volume, agreement or accuracy compared to other less autonomous interfaces. The interface with the least number of task types, variety and autonomy resulted in the greatest data coverage. Agreement, both between participants and with the expert equivalent, was significantly improved when the interface most directly afforded tasks that captured the required underlying data (i.e. crater position or diameter). The implications for the designers of virtual citizen science platforms is that they have a balancing act to perform, weighing up the importance of user satisfaction, the data needs of the science case and the resources that can be committed both in terms of time and data reduction

Hoosiers’ Health in a Changing Climate: A Report from the Indiana Climate Change Impacts Assessment

In the coming decades, Indiana’s changing climate will bring with it higher temperatures, longer heat waves, more extremely hot days and more frequent extreme storm events. Those changes will affect the health of Hoosiers in every part of the state. This report from the Indiana Climate Change Impacts Assessment (IN CCIA) describes historical and future climate-related health impacts that affect Hoosiers

Young People's Burden: Requirement of Negative CO2 Emissions

Abstract. The rapid rise of global temperature that began about 1975 continues at a mean rate of about 0.18 °C/decade, with the current annual temperature exceeding +1.25 °C relative to 1880–1920. Global temperature has just reached a level similar to the mean level in the prior interglacial (Eemian) period, when sea level was several meters higher than today, and, if it long remains at this level, slow amplifying feedbacks will lead to greater climate change and consequences. The growth rate of climate forcing due to human-caused greenhouse gases (GHGs) increased over 20 % in the past decade mainly due to resurging growth of atmospheric CH4, thus making it increasingly difficult to achieve targets such as limiting global warming to 1.5 °C or reducing atmospheric CO2 below 350 ppm. Such targets now require "negative emissions", i.e., extraction of CO2 from the atmosphere. If rapid phasedown of fossil fuel emissions begins soon, most of the necessary CO2 extraction can take place via improved agricultural and forestry practices, including reforestation and steps to improve soil fertility and increase its carbon content. In this case, the magnitude and duration of global temperature excursion above the natural range of the current interglacial (Holocene) could be limited and irreversible climate impacts could be minimized. In contrast, continued high fossil fuel emissions by the current generation would place a burden on young people to undertake massive technological CO2 extraction, if they are to limit climate change. Proposed methods of extraction such as bioenergy with carbon capture and storage (BECCS) or air capture of CO2 imply minimal estimated costs of 104–570 trillion dollars this century, with large risks and uncertain feasibility. Continued high fossil fuel emissions unarguably sentences young people to either a massive, possibly implausible cleanup or growing deleterious climate impacts or both, scenarios that should provide both incentive and obligation for governments to alter energy policies without further delay

Young people's burden: Requirement of negative CO2 emissions

Global temperature is a fundamental climate metric highly correlated with sea level, which implies that keeping shorelines near their present location requires keeping global temperature within or close to its preindustrial Holocene range. However, global temperature excluding short-term variability now exceeds +1 °C relative to the 1880–1920 mean and annual 2016 global temperature was almost +1.3 °C. We show that global temperature has risen well out of the Holocene range and Earth is now as warm as it was during the prior (Eemian) interglacial period, when sea level reached 6–9 m higher than today. Further, Earth is out of energy balance with present atmospheric composition, implying that more warming is in the pipeline, and we show that the growth rate of greenhouse gas climate forcing has accelerated markedly in the past decade. The rapidity of ice sheet and sea level response to global temperature is difficult to predict, but is dependent on the magnitude of warming. Targets for limiting global warming thus, at minimum, should aim to avoid leaving global temperature at Eemian or higher levels for centuries. Such targets now require negative emissions, i.e., extraction of CO2 from the air. If phasedown of fossil fuel emissions begins soon, improved agricultural and forestry practices, including reforestation and steps to improve soil fertility and increase its carbon content, may provide much of the necessary CO2 extraction. In that case, the magnitude and duration of global temperature excursion above the natural range of the current interglacial (Holocene) could be limited and irreversible climate impacts could be minimized. In contrast, continued high fossil fuel emissions today place a burden on young people to undertake massive technological CO2 extraction if they are to limit climate change and its consequences. Proposed methods of extraction such as bioenergy with carbon capture and storage (BECCS) or air capture of CO2 have minimal estimated costs of USD 89–535 trillion this century and also have large risks and uncertain feasibility. Continued high fossil fuel emissions unarguably sentences young people to either a massive, implausible cleanup or growing deleterious climate impacts or both

Isotretinoin and Timing of Procedural Interventions: A Systematic Review With Consensus Recommendations

Importance: The notion that systemic isotretinoin taken within 6 to 12 months of cutaneous surgery contributes to abnormal scarring or delayed wound healing is widely taught and practiced; however, it is based on 3 small case series from the mid-1980s. Objective: To evaluate the body of literature to provide evidence-based recommendations regarding the safety of procedural interventions performed either concurrently with, or immediately following the cessation of systemic isotretinoin therapy. Evidence Review: A panel of national experts in pediatric dermatology, procedural/cosmetic dermatology, plastic surgery, scars, wound healing, acne, and isotretinoin was convened. A systematic PubMed review of English-language articles published from 1982 to 2017 was performed using the following search terms: isotretinoin, 13-cis-retinoic acid, Accutane, retinoids, acitretin, surgery, surgical, laser, ablative laser, nonablative laser, laser hair removal, chemical peel, dermabrasion, wound healing, safety, scarring, hypertrophic scar, and keloid. Evidence was graded, and expert consensus was obtained. Findings: Thirty-two relevant publications reported 1485 procedures. There was insufficient evidence to support delaying manual dermabrasion, superficial chemical peels, cutaneous surgery, laser hair removal, and fractional ablative and nonablative laser procedures for patients currently receiving or having recently completed isotretinoin therapy. Based on the available literature, mechanical dermabrasion and fully ablative laser are not recommended in the setting of systemic isotretinoin treatment. Conclusions and Relevance: Physicians and patients may have an evidence-based discussion regarding the known risk of cutaneous surgical procedures in the setting of systemic isotretinoin therapy. For some patients and some conditions, an informed decision may lead to earlier and potentially more effective interventions

Isotretinoin and Timing of Procedural Interventions: A Systematic Review With Consensus Recommendations.

Importance: The notion that systemic isotretinoin taken within 6 to 12 months of cutaneous surgery contributes to abnormal scarring or delayed wound healing is widely taught and practiced; however, it is based on 3 small case series from the mid-1980s. Objective: To evaluate the body of literature to provide evidence-based recommendations regarding the safety of procedural interventions performed either concurrently with, or immediately following the cessation of systemic isotretinoin therapy. Evidence Review: A panel of national experts in pediatric dermatology, procedural/cosmetic dermatology, plastic surgery, scars, wound healing, acne, and isotretinoin was convened. A systematic PubMed review of English-language articles published from 1982 to 2017 was performed using the following search terms: isotretinoin, 13-cis-retinoic acid, Accutane, retinoids, acitretin, surgery, surgical, laser, ablative laser, nonablative laser, laser hair removal, chemical peel, dermabrasion, wound healing, safety, scarring, hypertrophic scar, and keloid. Evidence was graded, and expert consensus was obtained. Findings: Thirty-two relevant publications reported 1485 procedures. There was insufficient evidence to support delaying manual dermabrasion, superficial chemical peels, cutaneous surgery, laser hair removal, and fractional ablative and nonablative laser procedures for patients currently receiving or having recently completed isotretinoin therapy. Based on the available literature, mechanical dermabrasion and fully ablative laser are not recommended in the setting of systemic isotretinoin treatment. Conclusions and Relevance: Physicians and patients may have an evidence-based discussion regarding the known risk of cutaneous surgical procedures in the setting of systemic isotretinoin therapy. For some patients and some conditions, an informed decision may lead to earlier and potentially more effective interventions

Isotretinoin and Timing of Procedural Interventions: A Systematic Review With Consensus Recommendations.

ImportanceThe notion that systemic isotretinoin taken within 6 to 12 months of cutaneous surgery contributes to abnormal scarring or delayed wound healing is widely taught and practiced; however, it is based on 3 small case series from the mid-1980s.ObjectiveTo evaluate the body of literature to provide evidence-based recommendations regarding the safety of procedural interventions performed either concurrently with, or immediately following the cessation of systemic isotretinoin therapy.Evidence reviewA panel of national experts in pediatric dermatology, procedural/cosmetic dermatology, plastic surgery, scars, wound healing, acne, and isotretinoin was convened. A systematic PubMed review of English-language articles published from 1982 to 2017 was performed using the following search terms: isotretinoin, 13-cis-retinoic acid, Accutane, retinoids, acitretin, surgery, surgical, laser, ablative laser, nonablative laser, laser hair removal, chemical peel, dermabrasion, wound healing, safety, scarring, hypertrophic scar, and keloid. Evidence was graded, and expert consensus was obtained.FindingsThirty-two relevant publications reported 1485 procedures. There was insufficient evidence to support delaying manual dermabrasion, superficial chemical peels, cutaneous surgery, laser hair removal, and fractional ablative and nonablative laser procedures for patients currently receiving or having recently completed isotretinoin therapy. Based on the available literature, mechanical dermabrasion and fully ablative laser are not recommended in the setting of systemic isotretinoin treatment.Conclusions and relevancePhysicians and patients may have an evidence-based discussion regarding the known risk of cutaneous surgical procedures in the setting of systemic isotretinoin therapy. For some patients and some conditions, an informed decision may lead to earlier and potentially more effective interventions