Mostrando recursos 1 - 20 de 1.939

  1. Uncoupling of Metabolic Health from Longevity through Genetic Alteration of Adipose Tissue Lipid-Binding Proteins

    Charles, Khanichi N.; Li, Min-Dian; Engin, Feyza; Arruda, Ana Paula; Inouye, Karen; Hotamisligil, Gokhan S.
    Deterioration of metabolic health is a hallmark of aging and generally assumed to be detrimental to longevity. Exposure to a high-calorie diet impairs metabolism and accelerates aging; conversely, calorie restriction (CR) prevents age-related metabolic diseases and extends lifespan. However, it is unclear whether preservation of metabolic health is sufficient to extend lifespan. We utilized a genetic mouse model lacking Fabp4/5 that confers protection against metabolic diseases and shares molecular and lipidomic features with CR to address this question. Fabp-deficient mice exhibit extended metabolic healthspan, with protection against insulin resistance and glucose intolerance, inflammation, deterioration of adipose tissue integrity, and fatty...

  2. Uncoupling of Metabolic Health from Longevity through Genetic Alteration of Adipose Tissue Lipid-Binding Proteins

    Charles, Khanichi N.; Li, Min-Dian; Engin, Feyza; Arruda, Ana Paula; Inouye, Karen; Hotamisligil, Gokhan S.
    Deterioration of metabolic health is a hallmark of aging and generally assumed to be detrimental to longevity. Exposure to a high-calorie diet impairs metabolism and accelerates aging; conversely, calorie restriction (CR) prevents age-related metabolic diseases and extends lifespan. However, it is unclear whether preservation of metabolic health is sufficient to extend lifespan. We utilized a genetic mouse model lacking Fabp4/5 that confers protection against metabolic diseases and shares molecular and lipidomic features with CR to address this question. Fabp-deficient mice exhibit extended metabolic healthspan, with protection against insulin resistance and glucose intolerance, inflammation, deterioration of adipose tissue integrity, and fatty...

  3. Predictors of blood lead concentrations in the lead-free gasoline era

    Nielsen, Jesper B.; Grandjean, Philippe; Jørgensen, Poul J.
    OBJECTIVES: Blood lead concentrations in a Danish reference population were related to information from an extensive questionnaire on work, environment, and life-style. METHODS: Data were gathered for 209 persons by means of a questionnaire and blood lead analyses. RESULTS: The mean concentration of lead in blood was 0.167 micromol/l (ie, significantly lower than in previous studies). This finding is in accordance with the fact that less than 10% of the gasoline used in Denmark contains lead additives (up to 0.15 g/l). An important finding was that the well-documented predictors for lead in blood at higher concentration levels, such as age, gender, menopausal status, and intake...

  4. Predictors of blood lead concentrations in the lead-free gasoline era

    Nielsen, Jesper B.; Grandjean, Philippe; Jørgensen, Poul J.
    OBJECTIVES: Blood lead concentrations in a Danish reference population were related to information from an extensive questionnaire on work, environment, and life-style. METHODS: Data were gathered for 209 persons by means of a questionnaire and blood lead analyses. RESULTS: The mean concentration of lead in blood was 0.167 micromol/l (ie, significantly lower than in previous studies). This finding is in accordance with the fact that less than 10% of the gasoline used in Denmark contains lead additives (up to 0.15 g/l). An important finding was that the well-documented predictors for lead in blood at higher concentration levels, such as age, gender, menopausal status, and intake...

  5. Lead as a Cause of SIDS

    Lyngbye, T; Hansen, O. N.; Vangbert, L.; Grandjean, Philippe

  6. Lead as a Cause of SIDS

    Lyngbye, T; Hansen, O. N.; Vangbert, L.; Grandjean, Philippe

  7. Psychological dysfunctions in lead-exposed workers: Relation to biological parameters of exposure.

    Grandjean, Philippe; Arnvig, E; Beckmann, J
    Insidious neurotoxic effects of lead have been studied in a population of 42 lead-exposed workers and a reference group of 22 comparable workers with no lead exposure. The age of the individuals ranged from 18 to 50 years. The complete Wechler Adult Intelligence Scale, as well as psychomotor and memory tests, was included in the test battery. The exposure was assessed by means of the lead concentration in blood and hair and the ratio between zinc protoporphyrin and hemoglobin in the blood. Significant differences were found between the two groups of workers, especially concerning long-term memory, verbal and visuospatial abstraction,...

  8. Psychological dysfunctions in lead-exposed workers: Relation to biological parameters of exposure.

    Grandjean, Philippe; Arnvig, E; Beckmann, J
    Insidious neurotoxic effects of lead have been studied in a population of 42 lead-exposed workers and a reference group of 22 comparable workers with no lead exposure. The age of the individuals ranged from 18 to 50 years. The complete Wechler Adult Intelligence Scale, as well as psychomotor and memory tests, was included in the test battery. The exposure was assessed by means of the lead concentration in blood and hair and the ratio between zinc protoporphyrin and hemoglobin in the blood. Significant differences were found between the two groups of workers, especially concerning long-term memory, verbal and visuospatial abstraction,...

  9. Modifiers of the effect of maternal multiple micronutrient supplementation on stillbirth, birth outcomes, and infant mortality: a meta-analysis of individual patient data from 17 randomised trials in low-income and middle-income countries

    Smith, Emily Rose; Shankar, Anuraj H.; Wu, Lee S-F; Aboud, Said; Adu-Afarwuah, Seth; Ali, Hasmot; Agustina, Rina; Arifeen, Shams; Ashorn, Per; Bhutta, Zulfiqar A; Christian, Parul; Devakumar, Delanjathan; Dewey, Kathryn G; Friis, Henrik; Gomo, Exnevia; Gupta, Piyush; Kæstel, Pernille; Kolsteren, Patrick; Lanou, Hermann; Maleta, Kenneth; Mamadoultaibou, Aissa; Msamanga, Gernard; Osrin, David; Persson, Lars-Åke; Ramakrishnan, Usha; Rivera, Juan A; Rizvi, Arjumand; Sachdev, H P S; Urassa, Willy; West, Keith P; Zagre, Noel; Zeng, Lingxia; Zhu, Zhonghai; Fawzi, Wafaie W.; Sudfeld, Christopher Robert
    Abstract Objective To identify individual-level effect modifiers of the effect of multiple micronutrient supplementation (MMS) containing iron and folic acid (IFA) during pregnancy, compared to IFA alone, on the risk of stillbirth, infant mortality, and birth outcomes. Methods We performed an individual patient data meta-analysis. Study-specific estimates were generated, and we pooled subgroup estimates using fixed effects models. Findings We included 17 randomized controlled trials (including 112,953 pregnancies). MMS resulted in greater reductions in low birthweight (RR 0.81; 95% CI: 0.74–0.89), small-for-gestational age births (RR 0.91; 95% CI: 0.87–0.96), and six-month mortality (RR: 0.71; 95% CI: 0.60–0.86) among anemic (hemoglobin <110g/L) as compared...

  10. A qualitative and quantitative performance evaluation of Swaziland’s Rural Health Motivator program

    Geldsetzer, Pascal; Vaikath, Maria; de Neve, Jan-Walter J.l.m.; Bärnighausen, Till; Bossert, Thomas John
    Background: Community health workers (CHWs) are increasingly used to increase access to primary healthcare, and considered to be a key health worker cadre to achieve the UNAIDS 90-90-90 target. Despite the recent policy interest in effectively designing, implementing, and evaluating new CHW programs, there is limited evidence on how long-standing CHW programs are performing. Using the CHW Performance Logic model as an evaluation framework, this study aims to assess the performance of Swaziland’s long-standing national CHW program, called the rural health motivator (RHM) program. Methods: This study was carried out in the Manzini and Lubombo regions of Swaziland. We conducted...

  11. Quantifying underreporting of law-enforcement-related deaths in United States vital statistics and news-media-based data sources: A capture–recapture analysis

    Feldman, Justin Michael; Gruskin, Sofia; Coull, Brent Andrew; Krieger, Nancy
    Background Prior research suggests that United States governmental sources documenting the number of law-enforcement-related deaths (i.e., fatalities due to injuries inflicted by law enforcement officers) undercount these incidents. The National Vital Statistics System (NVSS), administered by the federal government and based on state death certificate data, identifies such deaths by assigning them diagnostic codes corresponding to “legal intervention” in accordance with the International Classification of Diseases–10th Revision (ICD-10). Newer, nongovernmental databases track law-enforcement-related deaths by compiling news media reports and provide an opportunity to assess the magnitude and determinants of suspected NVSS underreporting. Our a priori hypotheses were that underreporting by...

  12. Quantifying underreporting of law-enforcement-related deaths in United States vital statistics and news-media-based data sources: A capture–recapture analysis

    Feldman, Justin Michael; Gruskin, Sofia; Coull, Brent Andrew; Krieger, Nancy
    Background Prior research suggests that United States governmental sources documenting the number of law-enforcement-related deaths (i.e., fatalities due to injuries inflicted by law enforcement officers) undercount these incidents. The National Vital Statistics System (NVSS), administered by the federal government and based on state death certificate data, identifies such deaths by assigning them diagnostic codes corresponding to “legal intervention” in accordance with the International Classification of Diseases–10th Revision (ICD-10). Newer, nongovernmental databases track law-enforcement-related deaths by compiling news media reports and provide an opportunity to assess the magnitude and determinants of suspected NVSS underreporting. Our a priori hypotheses were that underreporting by...

  13. A randomized controlled trial of an intervention to reduce low literacy barriers in inflammatory arthritis management

    Rudd, Rima E.; Blanch, Danielle C.; Gall, Victoria; Chibnik, Lori; Wright, Elizabeth A; Reichmann, William; Liang, Matthew Heng; Katz, Jeffrey Neil
    Objective Test the efficacy of educational interventions to reduce literacy barriers and enhance health outcomes among patients with inflammatory arthritis. Methods The intervention consisted of plain language information materials and/or two individualized sessions with an arthritis educator. Randomization was stratified by education level. Principal outcomes included adherence to treatments, self-efficacy, satisfaction with care, and appointment keeping. Secondary outcomes included health status and mental health. Data were collected at baseline, six, and twelve months post. Results Of the 127 patients, half had education beyond high school and three quarters had disease duration greater than five years. There were no differences in the primary outcome measures between...

  14. A randomized controlled trial of an intervention to reduce low literacy barriers in inflammatory arthritis management

    Rudd, Rima E.; Blanch, Danielle C.; Gall, Victoria; Chibnik, Lori; Wright, Elizabeth A; Reichmann, William; Liang, Matthew Heng; Katz, Jeffrey Neil
    Objective Test the efficacy of educational interventions to reduce literacy barriers and enhance health outcomes among patients with inflammatory arthritis. Methods The intervention consisted of plain language information materials and/or two individualized sessions with an arthritis educator. Randomization was stratified by education level. Principal outcomes included adherence to treatments, self-efficacy, satisfaction with care, and appointment keeping. Secondary outcomes included health status and mental health. Data were collected at baseline, six, and twelve months post. Results Of the 127 patients, half had education beyond high school and three quarters had disease duration greater than five years. There were no differences in the primary outcome measures between...

  15. Predictors of refusal during a multi-step recruitment process for a randomized controlled trial of arthritis education

    Blanch, Danielle C.; Rudd, Rima E.; Wright, Elizabeth A; Gall, Victoria; Katz, Jeffrey Neil
    Objective Randomized controlled trials in patient education often have difficulty enrolling vulnerable populations – specifically, older, poorer and less educated individuals. We undertook a randomized controlled trial (RCT) of an educational intervention for arthritis management, which included strategies to remove literacy-related barriers to participation. This paper reports on the multi-stage recruitment process and assesses whether refusal to participate was related to education, age, gender, working status or insurance status. Methods The recruitment protocol was designed to eliminate literacy-related barriers to participation. Patients were never asked to read or fill out forms. Interactions were oral, using everyday terms and short, clear sentences. Patients who...

  16. Predictors of refusal during a multi-step recruitment process for a randomized controlled trial of arthritis education

    Blanch, Danielle C.; Rudd, Rima E.; Wright, Elizabeth A; Gall, Victoria; Katz, Jeffrey Neil
    Objective Randomized controlled trials in patient education often have difficulty enrolling vulnerable populations – specifically, older, poorer and less educated individuals. We undertook a randomized controlled trial (RCT) of an educational intervention for arthritis management, which included strategies to remove literacy-related barriers to participation. This paper reports on the multi-stage recruitment process and assesses whether refusal to participate was related to education, age, gender, working status or insurance status. Methods The recruitment protocol was designed to eliminate literacy-related barriers to participation. Patients were never asked to read or fill out forms. Interactions were oral, using everyday terms and short, clear sentences. Patients who...

  17. Improving the performance of community health workers in Swaziland: findings from a qualitative study

    Geldsetzer, Pascal; de Neve, Jan-Walter J.l.m.; Boudreaux, Chantelle Marie; Bärnighausen, Till; Bossert, Thomas John
    Background: The performance of community health workers (CHWs) in Swaziland has not yet been studied despite the existence of a large national CHW program in the country. This qualitative formative research study aimed to inform the design of future interventions intended to increase the performance of CHW programs in Swaziland. Specifically, focusing on four CHW programs, we aimed to determine what potential changes to their program CHWs and CHW program managers perceive as likely leading to improved performance of the CHW cadre. Methods: The CHW cadres studied were the rural health motivators, mothers-to-mothers (M2M) mentors, HIV expert clients, and a...

  18. Improving the performance of community health workers in Swaziland: findings from a qualitative study

    Geldsetzer, Pascal; de Neve, Jan-Walter J.l.m.; Boudreaux, Chantelle Marie; Bärnighausen, Till; Bossert, Thomas John
    Background: The performance of community health workers (CHWs) in Swaziland has not yet been studied despite the existence of a large national CHW program in the country. This qualitative formative research study aimed to inform the design of future interventions intended to increase the performance of CHW programs in Swaziland. Specifically, focusing on four CHW programs, we aimed to determine what potential changes to their program CHWs and CHW program managers perceive as likely leading to improved performance of the CHW cadre. Methods: The CHW cadres studied were the rural health motivators, mothers-to-mothers (M2M) mentors, HIV expert clients, and a...

  19. Adaptation of the health literacy universal precautions toolkit for rheumatology and cardiology – Applications for pharmacy professionals to improve self-management and outcomes in patients with chronic disease

    Callahan, Leigh F.; Hawk, Victoria; Rudd, Rima E.; Hackney, Betsy; Bhandari, Sonia; Prizer, Lindsay P.; Bauer, Thomas K.; Jonas, Beth; Mendys, Philip; DeWalt, Darren
    Over a decade of research in health literacy has provided evidence of strong links between literacy skills of patients and health outcomes. At the same time, numerous studies have yielded insight into efficacious action that health providers can take to mitigate the negative effects of limited literacy. This small study focuses on the adaptation, review and use of two new health literacy toolkits for health professionals who work with patients with two of the most prevalent chronic conditions, arthritis and cardiovascular disease. Pharmacists have a key role in communicating with patients and caregivers about various aspects of disease self-management, which...

  20. A Mismatch Between Patient Education Materials About Sickle Cell Disease and the Literacy Level of Their Intended Audience

    McClure, Elizabeth; Ng, Jared; Vitzthum, Kelly; Rudd, Rima E.
    Introduction Despite the first goal of the 2010 National Action Plan to Improve Health Literacy, the literacy demands of much health information exceeds the reading skills of most US adults. The objective of this study was to assess the health literacy level of publicly available patient education materials for people with sickle cell disease (SCD). Methods We used 5 validated tools to evaluate 9 print and 4 online patient education materials: the simple measure of gobbledygook (SMOG) to assess reading grade level, the Peter Mosenthal and Irwin Kirsch readability formula (PMOSE/IKIRSCH) to assess structure and density, the Patient Education Materials Assessment Tool (PEMAT)...

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