Mostrando recursos 1 - 20 de 1.908

  1. Education and Coronary Heart Disease Risk

    Loucks, Eric B.; Gilman, Stephen Edward; Howe, Chanelle J.; Kawachi, Ichiro; Kubzansky, Laura Diane; Martin, Laurie T.; Nandi, Arijit; Wilhelm, Aude; Buka, Stephen L.; Rudd, Rima E.
    OBJECTIVE Education is inversely associated with coronary heart disease (CHD) risk, however the mechanisms are poorly understood. The study objectives were to evaluate the extent to which rarely measured factors (literacy, time preference, sense of control) and more commonly measured factors (income, depressive symptomatology, body mass index) in the education-CHD literature explain the associations between education and CHD risk. METHOD The study sample included 346 participants, aged 38–47 years (59.5% women), of the New England Family Study birth cohort. Ten-year CHD risk was calculated using the validated Framingham risk algorithm that utilizes diabetes, smoking, blood pressure, total cholesterol, HDL cholesterol, age and gender....

  2. Education and Coronary Heart Disease Risk

    Loucks, Eric B.; Gilman, Stephen Edward; Howe, Chanelle J.; Kawachi, Ichiro; Kubzansky, Laura Diane; Martin, Laurie T.; Nandi, Arijit; Wilhelm, Aude; Buka, Stephen L.; Rudd, Rima E.
    OBJECTIVE Education is inversely associated with coronary heart disease (CHD) risk, however the mechanisms are poorly understood. The study objectives were to evaluate the extent to which rarely measured factors (literacy, time preference, sense of control) and more commonly measured factors (income, depressive symptomatology, body mass index) in the education-CHD literature explain the associations between education and CHD risk. METHOD The study sample included 346 participants, aged 38–47 years (59.5% women), of the New England Family Study birth cohort. Ten-year CHD risk was calculated using the validated Framingham risk algorithm that utilizes diabetes, smoking, blood pressure, total cholesterol, HDL cholesterol, age and gender....

  3. Which literacy skills are associated with smoking?

    Martin, Laurie T; Haas, Ann; Schonlau, Matthias; Derose, Kathryn Pitkin; Rosenfeld, Lindsay; Rudd, Rima E.; Buka, Stephen L.
    Background Research has demonstrated associations between smoking and reading skills, but other literacy skills such as speaking, listening and numeracy are less studied despite our dependence on the use of numbers and the oral exchange to deliver information on the risks of smoking. Methods We used multivariable logistic regression to examine the effects of reading, numeracy, speaking and listening skills on 1) becoming a regular smoker and 2) smoking cessation. Further, multivariable linear regression was used to examine the relation between literacy skills and amount smoked among current smokers. Models controlled for education, gender, age, race/ethnicity, income, and, when relevant, age they became...

  4. Which literacy skills are associated with smoking?

    Martin, Laurie T; Haas, Ann; Schonlau, Matthias; Derose, Kathryn Pitkin; Rosenfeld, Lindsay; Rudd, Rima E.; Buka, Stephen L.
    Background Research has demonstrated associations between smoking and reading skills, but other literacy skills such as speaking, listening and numeracy are less studied despite our dependence on the use of numbers and the oral exchange to deliver information on the risks of smoking. Methods We used multivariable logistic regression to examine the effects of reading, numeracy, speaking and listening skills on 1) becoming a regular smoker and 2) smoking cessation. Further, multivariable linear regression was used to examine the relation between literacy skills and amount smoked among current smokers. Models controlled for education, gender, age, race/ethnicity, income, and, when relevant, age they became...

  5. Patient Activation and Advocacy: Which Literacy Skills Matter Most?

    Martin, Laurie T.; Schonlau, Matthias; Haas, Ann; Derose, Kathryn Pitkin; Rosenfeld, Lindsay; Buka, Stephen L.; Rudd, Rima E.
    Attention to the effect of a patient's literacy skills on health care interactions is relatively new. So too are studies of either structural or personal factors that inhibit or support a patient's ability to navigate health services and systems and to advocate for their own needs within a service delivery system. Contributions of the structural environment, of interpersonal dynamics, and of a variety of psychological and sociological factors in the relationship between patients and providers have long been under study. Less frequently examined is the advocacy role expected of patients. However, the complex nature of health care in the U.S....

  6. Patient Activation and Advocacy: Which Literacy Skills Matter Most?

    Martin, Laurie T.; Schonlau, Matthias; Haas, Ann; Derose, Kathryn Pitkin; Rosenfeld, Lindsay; Buka, Stephen L.; Rudd, Rima E.
    Attention to the effect of a patient's literacy skills on health care interactions is relatively new. So too are studies of either structural or personal factors that inhibit or support a patient's ability to navigate health services and systems and to advocate for their own needs within a service delivery system. Contributions of the structural environment, of interpersonal dynamics, and of a variety of psychological and sociological factors in the relationship between patients and providers have long been under study. Less frequently examined is the advocacy role expected of patients. However, the complex nature of health care in the U.S....

  7. Patients' Literacy Skills: More Than Just Reading Ability

    Schonlau, Matthias; Martin, Laurie; Haas, Ann; Derose, Kathryn Pitkin; Rudd, Rima E.
    Limited literacy contributes to suboptimal care and outcomes for patients. The Institute of Medicine noted that future work in health literacy should consider multiple literacy skills. However, lacking empirical evidence of the relationship between different literacy skills, reading skills are often used as proxies of literacy in research and practice. Using a community-based sample of 618 individuals residing in Boston, MA and Providence, RI, we conducted a principal component analysis on measures of four literacy skills: reading, numeracy, oral (speaking) and aural (listening) to examine whether and to what extent literacy can, or should, be represented by a single measure....

  8. Patients' Literacy Skills: More Than Just Reading Ability

    Schonlau, Matthias; Martin, Laurie; Haas, Ann; Derose, Kathryn Pitkin; Rudd, Rima E.
    Limited literacy contributes to suboptimal care and outcomes for patients. The Institute of Medicine noted that future work in health literacy should consider multiple literacy skills. However, lacking empirical evidence of the relationship between different literacy skills, reading skills are often used as proxies of literacy in research and practice. Using a community-based sample of 618 individuals residing in Boston, MA and Providence, RI, we conducted a principal component analysis on measures of four literacy skills: reading, numeracy, oral (speaking) and aural (listening) to examine whether and to what extent literacy can, or should, be represented by a single measure....

  9. Beyond reading alone: The relationship between aural literacy and asthma management

    Rosenfeld, Lindsay; Rudd, Rima E.; Emmons, Karen Maria; Acevedo-García, Dolores; Martin, Laurie; Buka, Stephen L.
    Objectives To examine the relationship between literacy and asthma management with a focus on the oral exchange. Methods Study participants, all of whom reported asthma, were drawn from the New England Family Study (NEFS), an examination of links between education and health. NEFS data included reading, oral (speaking), and aural (listening) literacy measures. An additional survey was conducted with this group of study participants related to asthma issues, particularly asthma management. Data analysis focused on bivariate and multivariable logistic regression. Results In bivariate logistic regression models exploring aural literacy, there was a statistically significant association between those participants with lower aural literacy skills and less...

  10. Beyond reading alone: The relationship between aural literacy and asthma management

    Rosenfeld, Lindsay; Rudd, Rima E.; Emmons, Karen Maria; Acevedo-García, Dolores; Martin, Laurie; Buka, Stephen L.
    Objectives To examine the relationship between literacy and asthma management with a focus on the oral exchange. Methods Study participants, all of whom reported asthma, were drawn from the New England Family Study (NEFS), an examination of links between education and health. NEFS data included reading, oral (speaking), and aural (listening) literacy measures. An additional survey was conducted with this group of study participants related to asthma issues, particularly asthma management. Data analysis focused on bivariate and multivariable logistic regression. Results In bivariate logistic regression models exploring aural literacy, there was a statistically significant association between those participants with lower aural literacy skills and less...

  11. Developing and testing the health literacy universal precautions toolkit

    DeWalt, Darren A.; Broucksou, Kimberly A.; Hawk, Victoria; Brach, Cindy; Hink, Ashley; Rudd, Rima E.; Callahan, Leigh
    The health literacy demands of the healthcare system often exceed the health literacy skills of Americans. This article reviews the development of the Health Literacy Universal Precautions (HLUP) Toolkit, commissioned by the Agency for Healthcare Research and Quality and designed to help primary care practices structure the delivery of care as if every patient may have limited health literacy. The development of the toolkit spanned 2 years and consisted of 3 major tasks: (1) developing individual tools (modules explaining how to use or implement a strategy to minimize the effects of low health literacy), using existing health literacy resources when...

  12. Developing and testing the health literacy universal precautions toolkit

    DeWalt, Darren A.; Broucksou, Kimberly A.; Hawk, Victoria; Brach, Cindy; Hink, Ashley; Rudd, Rima E.; Callahan, Leigh
    The health literacy demands of the healthcare system often exceed the health literacy skills of Americans. This article reviews the development of the Health Literacy Universal Precautions (HLUP) Toolkit, commissioned by the Agency for Healthcare Research and Quality and designed to help primary care practices structure the delivery of care as if every patient may have limited health literacy. The development of the toolkit spanned 2 years and consisted of 3 major tasks: (1) developing individual tools (modules explaining how to use or implement a strategy to minimize the effects of low health literacy), using existing health literacy resources when...

  13. Quantifying Word Use to Study Health Literacy in Doctor–Patient Communication

    Koch-Weser, Susan; Rudd, Rima E.; DeJong, William
    Most health literacy research to date has assessed health literacy using either general reading tests or text-based appraisals of reading and numeracy skills, yet the definition of health literacy includes domains beyond reading ability. Effective oral communication between doctor and patient is an important component of health literacy, but only recently have efforts been made to develop measures that tap into domains beyond those that can be assessed with text-based measures. Focusing on oral exchange, this paper describes computer-assisted approaches to quantifying word use and the development of three word-use measures that can be used to study health literacy in...

  14. Quantifying Word Use to Study Health Literacy in Doctor–Patient Communication

    Koch-Weser, Susan; Rudd, Rima E.; DeJong, William
    Most health literacy research to date has assessed health literacy using either general reading tests or text-based appraisals of reading and numeracy skills, yet the definition of health literacy includes domains beyond reading ability. Effective oral communication between doctor and patient is an important component of health literacy, but only recently have efforts been made to develop measures that tap into domains beyond those that can be assessed with text-based measures. Focusing on oral exchange, this paper describes computer-assisted approaches to quantifying word use and the development of three word-use measures that can be used to study health literacy in...

  15. Changes in the food environment over time: examining 40 years of data in the Framingham Heart Study

    James, Peter; Seward, Michael W.; James O’Malley, A.; Subramanian, SV; Block, Jason P.
    Background: Research has explored associations between diet, body weight, and the food environment; however, few studies have examined historical trends in food environments. Methods: In the Framingham Heart Study Offspring (N = 3321) and Omni (N = 447) cohorts, we created food environment metrics in four Massachusetts towns utilizing geocoded residential, workplace, and food establishment addresses from 1971 to 2008. We created multilevel models adjusted for age, sex, education, and census tract poverty to examine trends in home, workplace, and commuting food environments. Results: Proximity to and density of supermarkets, fast-food, full service restaurants, convenience stores, and bakeries increased over...

  16. Circulating concentrations of biomarkers and metabolites related to vitamin status, one-carbon and the kynurenine pathways in US, Nordic, Asian, and Australian populations123

    Midttun, Øivind; Theofylaktopoulou, Despoina; McCann, Adrian; Fanidi, Anouar; Muller, David C; Meyer, Klaus; Ulvik, Arve; Zheng, Wei; Shu, Xiao-Ou; Xiang, Yong-Bing; Prentice, Ross; Thomson, Cynthia A; Pettinger, Mary; Giles, Graham G; Hodge, Allison; Cai, Qiuyin; Blot, William J; Wu, Jie; Johansson, Mikael; Hultdin, Johan; Grankvist, Kjell; Stevens, Victoria L; McCullough, Marjorie L; Weinstein, Stephanie J; Albanes, Demetrius; Langhammer, Arnulf; Hveem, Kristian; Næss, Marit; Sesso, Howard D; Gaziano, J Michael; Buring, Julie E; Lee, I-Min; Severi, Gianluca; Zhang, Xuehong; Han, Jiali; Stampfer, Meir J; Smith-Warner, Stephanie A; Zeleniuch-Jacquotte, Anne; le Marchand, Loic; Yuan, Jian-Min; Butler, Lesley M; Koh, Woon-Puay; Wang, Renwei; Gao, Yu-Tang; Ericson, Ulrika; Sonestedt, Emily; Ziegler, Regina G; Freedman, Neal D; Visvanathan, Kala; Jones, Miranda R; Relton, Caroline; Brennan, Paul; Johansson, Mattias; Ueland, Per M
    Background: Circulating concentrations of biomarkers that are related to vitamin status vary by factors such as diet, fortification, and supplement use. Published biomarker concentrations have also been influenced by the variation across laboratories, which complicates a comparison of results from different studies. Objective: We robustly and comprehensively assessed differences in biomarkers that are related to vitamin status across geographic regions. Design: The trial was a cross-sectional study in which we investigated 38 biomarkers that are related to vitamin status and one-carbon and tryptophan metabolism in serum and plasma from 5314 healthy control subjects representing 20 cohorts recruited from the United...

  17. Systematic genomic and translational efficiency studies of uveal melanoma

    Johnson, Chelsea Place; Kim, Ivana K.; Esmaeli, Bita; Amin-Mansour, Ali; Treacy, Daniel J.; Carter, Scott L.; Hodis, Eran; Wagle, Nikhil; Seepo, Sara; Yu, Xiaoxing; Lane, Anne Marie; Gragoudas, Evangelos S.; Vazquez, Francisca; Nickerson, Elizabeth; Cibulskis, Kristian; McKenna, Aaron; Gabriel, Stacey B.; Getz, Gad; Van Allen, Eliezer M.; ‘t Hoen, Peter A. C.; Garraway, Levi A.; Woodman, Scott E.
    To further our understanding of the somatic genetic basis of uveal melanoma, we sequenced the protein-coding regions of 52 primary tumors and 3 liver metastases together with paired normal DNA. Known recurrent mutations were identified in GNAQ, GNA11, BAP1, EIF1AX, and SF3B1. The role of mutated EIF1AX was tested using loss of function approaches including viability and translational efficiency assays. Knockdown of both wild type and mutant EIF1AX was lethal to uveal melanoma cells. We probed the function of N-terminal tail EIF1AX mutations by performing RNA sequencing of polysome-associated transcripts in cells expressing endogenous wild type or mutant EIF1AX. Ribosome...

  18. Obesity, metabolic factors and risk of different histological types of lung cancer: A Mendelian randomization study

    Carreras-Torres, Robert; Johansson, Mattias; Haycock, Philip C.; Wade, Kaitlin H.; Relton, Caroline L.; Martin, Richard M.; Davey Smith, George; Albanes, Demetrius; Aldrich, Melinda C.; Andrew, Angeline; Arnold, Susanne M.; Bickeböller, Heike; Bojesen, Stig E.; Brunnström, Hans; Manjer, Jonas; Brüske, Irene; Caporaso, Neil E.; Chen, Chu; Christiani, David C.; Christian, W. Jay; Doherty, Jennifer A.; Duell, Eric J.; Field, John K.; Davies, Michael P. A.; Marcus, Michael W.; Goodman, Gary E.; Grankvist, Kjell; Haugen, Aage; Hong, Yun-Chul; Kiemeney, Lambertus A.; van der Heijden, Erik H. F. M.; Kraft, Peter; Johansson, Mikael B.; Lam, Stephen; Landi, Maria Teresa; Lazarus, Philip; Le Marchand, Loïc; Liu, Geoffrey; Melander, Olle; Park, Sungshim L.; Rennert, Gad; Risch, Angela; Haura, Eric B.; Scelo, Ghislaine; Zaridze, David; Mukeriya, Anush; Savić, Milan; Lissowska, Jolanta; Swiatkowska, Beata; Janout, Vladimir; Holcatova, Ivana; Mates, Dana; Schabath, Matthew B.; Shen, Hongbing; Tardon, Adonina; Teare, M Dawn; Woll, Penella; Tsao, Ming-Sound; Wu, Xifeng; Yuan, Jian-Min; Hung, Rayjean J.; Amos, Christopher I.; McKay, James; Brennan, Paul
    Background: Assessing the relationship between lung cancer and metabolic conditions is challenging because of the confounding effect of tobacco. Mendelian randomization (MR), or the use of genetic instrumental variables to assess causality, may help to identify the metabolic drivers of lung cancer. Methods and findings We identified genetic instruments for potential metabolic risk factors and evaluated these in relation to risk using 29,266 lung cancer cases (including 11,273 adenocarcinomas, 7,426 squamous cell and 2,664 small cell cases) and 56,450 controls. The MR risk analysis suggested a causal effect of body mass index (BMI) on lung cancer risk for two of...

  19. Cardiovascular health status between standard and nonstandard workers in Korea

    Seon, Jong Ju; Lim, Yu Jin; Lee, Hae Won; Yoon, Jae Moon; Kim, Sang June; Choi, Seulggie; Kawachi, Ichiro; Park, Sang Min
    Objectives: The effect of employment insecurity on employee health is an important public health issue due to the recent effects of neoliberalism and the global financial crisis (2007–2008) on labor markets. This study aims to evaluate the differences in cardiovascular health status and the use of preventive screening services between standard and nonstandard workers. Methods: Waged employees (N = 5,338) between the ages of 20 and 64 were grouped into standard (full-time, permanent) and nonstandard (part-time, temporary, or daily) employees. Data from the Fourth Korea National Health and Nutrition Examination Survey, 2007–2009, a nationwide representative survey, were examined, including cardiovascular...

  20. Association of Long-Term Near-Highway Exposure to Ultrafine Particles with Cardiovascular Diseases, Diabetes and Hypertension

    Li, Yu; Lane, Kevin J.; Corlin, Laura; Patton, Allison P.; Durant, John L.; Thanikachalam, Mohan; Woodin, Mark; Wang, Molin; Brugge, Doug
    Ultrafine particle (UFP) concentrations are elevated near busy roadways, however, their effects on prevalence of cardiovascular diseases, diabetes, and hypertension are not well understood. To investigate these associations, data on demographics, diseases, medication use, and time of activities were collected by in-home surveys for 704 participants in three pairs of near-highway and urban background neighborhoods in and near Boston (MA, USA). Body mass index (BMI) was measured for a subset of 435 participants. Particle number concentration (PNC, a measure of UFP) was collected by mobile monitoring in each area. Intra-neighborhood spatial-temporal regression models (approximately 20 m resolution) were used to...

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