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Franklin, NC, United States

Reynolds H.W.,Carolina Population Center
East African medical journal | Year: 2010

To test whether a single take home dose of infant nevirapine increased infant uptake without decreasing institutional deliveries. Cluster randomised post-test only study with control group. Ten hospitals in urban areas of Coast, Rift Valley, and Western provinces, Kenya. Pregnant women with HIV, 18 years and older, and at least 32 weeks gestation recruited during antenatal care and followed up at home approximately one week after delivery. In the intervention group, women were given a single infant's dose of nevirapine to take home prior to delivery. In the control group, no changes were made to the standard of care. Mothers' reports of infant uptake of nevirapine and place of delivery. Uptake of the infant's nevirapine dose was high, 94% in the intervention group and 88% in the control group (p=0.096). Among women who delivered at home, uptake was higher significantly among infants whose mothers got the take home dose compared to women who did not get the dose (93% vs. 53%, p<0.01). The intervention did not influence place of delivery. Providers were positive about the take home dose concept; difficulties were attributed to HIV-related stigma. Making take home infant nevirapine available, either as a single dose administered within 72 hours of birth or as part of a more complex six week postnatal regimen, will increase infant uptake especially among women who deliver at home without affecting place of delivery.

Popkin B.M.,Carolina Population Center | Popkin B.M.,The Interdisciplinary Center
Health Affairs | Year: 2010

Nationally representative surveys of food intake in U.S. children show large increases in snacking between the 1989-91 to 1994-98 and 1994-98 to 2003-06 periods. Childhood snacking trends are moving toward three snacks per day, and more than 27 percent of children's daily calories are coming from snacks. The largest increases have been in salty snacks and candy. Desserts and sweetened beverages remain the major sources of calories from snacks. © 2010 Project HOPE-The People-to-People Health Foundation, Inc.

Buckley J.P.,University of North Carolina at Chapel Hill | Palmieri R.T.,University of North Carolina at Chapel Hill | Matuszewski J.M.,University of North Carolina at Chapel Hill | Herring A.H.,University of North Carolina at Chapel Hill | And 5 more authors.
Journal of Exposure Science and Environmental Epidemiology | Year: 2012

Human phthalate exposure is ubiquitous, but little is known regarding predictors of urinary phthalate levels. To explore this, 50 pregnant women aged 18-38 years completed two questionnaires on potential phthalate exposures and provided a first morning void. Urine samples were analyzed for 12 phthalate metabolites. Associations with questionnaire items were evaluated via Wilcoxon tests and t-tests, and r-squared values were calculated in multiple linear regression models. Few measured factors were statistically significantly associated with phthalate levels. Individuals who used nail polish had higher levels of mono-butyl phthalate (P = 0.048) than non-users. Mono-benzyl phthalate levels were higher among women who used eye makeup (P = 0.034) or used makeup on a regular basis (P = 0.004). Women who used cologne or perfume had higher levels of di-(2-ethylhexyl) phthalate metabolites. Household products, home flooring or paneling, and other personal care products were also associated with urinary phthalates. The proportion of variance in metabolite concentrations explained by questionnaire items ranged between 0.31 for mono-ethyl phthalate and 0.42 for mono-n-methyl phthalate. Although personal care product use may be an important predictor of urinary phthalate levels, most of the variability in phthalate exposure was not captured by our relatively comprehensive set of questionnaire items. © 2012 Nature America, Inc. All rights reserved.

Saville B.R.,Vanderbilt University | Herring A.H.,University of North Carolina at Chapel Hill | Herring A.H.,Carolina Population Center | Koch G.G.,University of North Carolina at Chapel Hill
Statistics in Medicine | Year: 2010

We consider regulatory clinical trials that require a prespecified method for the comparison of two treatments for chronic diseases (e.g. Chronic Obstructive Pulmonary Disease) in which patients suffer deterioration in a longitudinal process until death occurs. We define a composite endpoint structure that encompasses both the longitudinal data for deterioration and the time-to-event data for death, and use multivariate time-to-event methods to assess treatment differences on both data structures simultaneously, without a need for parametric assumptions or modeling. Our method is straightforward to implement, and simulations show that the method has robust power in situations in which incomplete data could lead to lower than expected power for either the longitudinal or survival data. We illustrate the method on data from a study of chronic lung disease. Copyright © 2009 John Wiley & Sons, Ltd.

Siddiqi A.,Carolina Population Center
Journal of Epidemiology and Community Health | Year: 2010

Background: Cross-national comparisons allow the examination of the malleability of associations between race and health. Racial inequities in chronic conditions, indicators of health status and behavioural risk factors between two similar advanced capitalist countries were compared. It was hypothesised that racial inequities will be mitigated in Canada compared with the USA. Methods: Population-based, cross-sectional data from the 2002-3 Joint Canada-USA Survey of Health (JCUSH) with 4953 adult respondents from the USA and 3455 from Canada. Models adjusted for age, sex, foreign birth, marital status, health insurance, education, income and home ownership. Results: Compared with the USA, racial inequities in health were attenuated in Canada. In the USA, racial inequities in chronic diseases and fair or poor self-rated health were largely driven by inequities found among the native born. Strikingly, in Canada, however, there were few significant racial inequities and those occurred exclusively among the foreign born. Within strata of race and foreign birth, Canadians fared better, with both white people and non-white people reporting better health than their American counterparts. Foreign-born Canadians and Americans were more similar to each other in terms of health than native-born Canadians and Americans. Only among the native born did American white people and American non-white people have higher adjusted odds of hypertension, diabetes and obesity than Canadian white people and Canadian non-white people respectively. Self-rated health was worse for non-white Americans than non-white Canadians regardless of foreign birth. Conclusion: The influence of race on health is context dependent. There is no necessary link between race and a variety of health indicators.

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