The Association between Mobility and HIV Risk: an Analysis of Ten High Prevalence ZIP Codes of Atlanta, Georgia

Studies from developing countries disagree on whether mobility is a risk factor or a protective factor for HIV risk. The difference is often determined by gender. Few studies exist, however, examining the relationship among high risk populations in developed nations. This study seeks to examine that relationship in 10 high risk ZIP codes of Atlanta, Georgia using data gathered from the Geography Project by Rothenberg and colleagues. Logistic regression was used to examine the relationship between HIV risk and five independent variables of mobility. Results were stratified by gender. After controlling for demographic and behavioral variables, use of public transportation by men was significantly protective of HIV risk. Significant associations were also observed with ever injection drug use and recent condom use, indicating that high risk behaviors may be the real driver of the epidemic in these neighborhoods

Long-Term Acute Care Hospitals and Georgia Medicaid: Utilization, Outcomes, and Cost

Because most research on long-term acute care hospitals has focused on Medicare, the objective of this research is to describe the Georgia Medicaid population who received care at a long-term acute care hospital, the type and volume of services provided by these long-term acute care hospitals, and the costs and outcomes of these services. For those with select respiratory conditions, we descriptively compare costs and outcomes to those of patients who received care for the same services in acute care hospitals

Redressing Past Wrongs: Changing the Common Rule to Increase Minority Voices in Research

Numerous diseases disproportionately affect African Americans across socioeconomic, age, gender, and geographic groups. Despite the need for research into these disparities, African Americans are often underrepresented in research. The Tuskegee Syphilis Study receives much of the blame for this problem, but other contributing factors have also been identified. To date, government policies seeking to increase African American participation have had limited success, and recently proposed changes to the Common Rule do not address this problem. Therefore, we have proposed 3 changes: treating racial minorities as vulnerable, requiring community consultation in minority research, and increasing minority representation on institutional review boards. Coupled with other efforts, these changes could help increase minority representation in researching health disparities

Redressing Past Wrongs: Changing the Common Rule to Increase Minority Voices in Research

The range of hosts a pathogen infects (host specificity) is a key element of disease risk that may be influenced by both shared phylogenetic history and shared ecological attributes of prospective hosts. Phylospecificity indices quantify host specificity in terms of host relatedness, but can fail to capture ecological attributes that increase susceptibility. For instance, similarity in habitat niche may expose phylogenetically unrelated host species to similar pathogen assemblages. Using a recently proposed method that integrates multiple distances, we assess the relative contributions of host phylogenetic and functional distances to pathogen host specificity (functional–phylogenetic host specificity). We apply this index to a data set of avian malaria parasite (Plasmodium and Haemoproteus spp.) infections from Melanesian birds to show that multihost parasites generally use hosts that are closely related, not hosts with similar habitat niches. We also show that host community phylogenetic ß-diversity (Pßd) predicts parasite Pßd and that individual host species carry phylogenetically clustered Haemoproteus parasite assemblages. Our findings were robust to phylogenetic uncertainty, and suggest that phylogenetic ancestry of both hosts and parasites plays important roles in driving avian malaria host specificity and community assembly. However, restricting host specificity analyses to either recent or historical timescales identified notable exceptions, including a ‘habitat specialist’ parasite that infects a diversity of unrelated host species with similar habitat niches. This work highlights that integrating ecological and phylogenetic distances provides a powerful approach to better understand drivers of pathogen host specificity and community assembly

Methods of multivariate analysis

xxv, 758 p. : ill. ; 25 cm

Addressing Choice of Law Challenges in Multi-State Precision Medicine Research: Experts\u27 Assessment of Key Factors

Precision medicine research implicates numerous state laws that may affect participants\u27 rights and protections and are not preempted by federal law. The choice of which state\u27s laws apply, and under what circumstances, can have significant impact on research design and oversight. But neither of the traditional approaches to choice of law issues--contractual agreement or determination by a court after a dispute arises--fit the research context well. We hosted a series of workshops with choice of law experts and research law and ethics experts to identify factors that are most crucial to account for in a future choice of law precision medicine research framework. Our workshops focused on precision medicine ‘places\u27 and choice of law factors; there was consensus that ‘place where the harm occurred’ was relevant and best represented by where the participant resides and/or where the research/institution is located. Our experts identified factors that need to be accounted for in a future choice of law framework. They also identified potential approaches, including a federal law or model state law as ways of achieving more uniformity of protections and a comprehensive database of laws, which merit further consideration to provide IRBs and researchers the guidance they require

Addressing Choice of Law Challenges in Multi-State Precision Medicine Research: Experts\u27 Assessment of Key Factors

Precision medicine research implicates numerous state laws that may affect participants\u27 rights and protections and are not preempted by federal law. The choice of which state\u27s laws apply, and under what circumstances, can have significant impact on research design and oversight. But neither of the traditional approaches to choice of law issues--contractual agreement or determination by a court after a dispute arises--fit the research context well. We hosted a series of workshops with choice of law experts and research law and ethics experts to identify factors that are most crucial to account for in a future choice of law precision medicine research framework. Our workshops focused on precision medicine ‘places\u27 and choice of law factors; there was consensus that ‘place where the harm occurred’ was relevant and best represented by where the participant resides and/or where the research/institution is located. Our experts identified factors that need to be accounted for in a future choice of law framework. They also identified potential approaches, including a federal law or model state law as ways of achieving more uniformity of protections and a comprehensive database of laws, which merit further consideration to provide IRBs and researchers the guidance they require