Baltimore, MD, United States
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Ward B.W.,University of Maryland University College | Shields R.T.,Florida State University | Cramer B.R.,Center for Health Promotion
Crisis | Year: 2011

Background: Recently, suicide in the United States has begun to be viewed as a preventable public health issue. This has led to the creation of a National Violent Death Reporting System that collects and integrates data on the social circumstances surrounding suicides. Aims: The study examines data on social circumstances surrounding suicides as collected by the medical examiner report (ME) and police report (PR) and subsequently integrated into the state of Maryland's violent death reporting system. Methods: Reported data on social circumstances surrounding suicides occurring in the years 2003-2006 in Maryland (n = 1,476) were analyzed by examining their prevalence in the ME and PR, strength of association, and integration. Results: With the exception of three circumstances, there was variation among reported circumstances in the ME and PR. Furthermore, there was only a moderately strong relationship between the ME and PR for most circumstances, while a significant increase occurred in the prevalence of these circumstances when ME and PR were integrated. Conclusions: The integration of ME and PR has the potential to increase our knowledge of the circumstances surrounding suicide and to better inform prevention efforts. However, before this potential can be reached, there are still issues that must be considered. © 2011 Hogrefe Publishing.


Peacock J.M.,Center for Health Promotion | Keo H.H.,University of Minnesota | Keo H.H.,University of Bern | Duval S.,University of Minnesota | And 6 more authors.
Preventing Chronic Disease | Year: 2011

Introduction: Critical limb ischemia (CLI) is the most severe manifestation of peripheral artery disease (PAD), is associated with high rates of myocardial infarction, stroke, and amputation, and has a high health economic cost. The objective of this study was to estimate the incidence of lower limb amputation, the most serious consequence of CLI, and to create a surveillance methodology for the incidence of ischemic amputation in Minnesota. Methods: We assessed the incidence of ischemic amputation using all inpatient hospital discharge claims in Minnesota from 2005 through 2008. We identified major and minor ischemic amputations via the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) procedure codes for lower limb amputation not due to trauma or cancer and assessed geographic and demographic differences in the incidence of ischemic amputation. Results: The age-adjusted annual incidence of lower limb ischemic amputation in Minnesota during the 4-year period was 20.0 per 100,000 (95% confidence interval, 19.4-20.6). Amputations increased significantly with age, were more common in men and in people with diabetes, and were slightly more common in rural residents. The number of amputation-related hospitalizations was steady over 4 years. The median total charge for each amputation was $32,129, and cumulative inpatient hospitalization charges were $56.5 million in 2008. Conclusion: The incidence of ischemic amputation is high and results in major illness and health economic costs. These data represent the first population-based estimate of ischemic amputation at the state level and provide a national model for state-based surveillance.


Prizment A.E.,University of Minnesota | Gross M.,University of Minnesota | Rasmussen-Torvik L.,Northwestern University | Peacock J.M.,Center for Health Promotion | Anderson K.E.,University of Minnesota
Pancreas | Year: 2012

Objectives: Type 2 diabetes is associated with increased pancreatic cancer risk; however, the nature of this relationship is not clear. We examined the link between 10 diabetes-related single-nucleotide polymorphisms and pancreatic cancer in a case-control study conducted in 1994 to 1998. Methods: Cases (n = 162) were ascertained from hospitals in the Twin Cities and Mayo Clinic, Minn. Controls (n = 540) from the general population were frequency matched by age, sex, and race. Unconditional logistic regression provided odds ratios of pancreatic cancer and 95% confidence intervals (95% CIs). Results: In a multivariate-adjusted model, a significant association was observed only for rs780094 in the glucokinase regulator (GCKR) gene: odds ratios for pancreatic cancer were 1.00 for TT, 1.35 (95% CI, 0.71-2.58) for CT, and 2.14 (95% CI, 1.12-4.08) for CC genotypes (P trend = 0.01) and did not change after the adjustment for diabetes. Conclusions: This study provides the first evidence that GCKR rs780094, a single-nucleotide polymorphism related to diabetes, may be associated with pancreatic cancer risk. Although the results from this analysis are preliminary, there is a biologic plausibility for such an association. Copyright © 2012 by Lippincott Williams & Wilkins.


Misialek J.R.,University of Minnesota | Lopez F.L.,University of Minnesota | Lutsey P.L.,University of Minnesota | Huxley R.R.,University of Minnesota | And 6 more authors.
Circulation Journal | Year: 2013

Background: Low serum magnesium (Mg) has been associated with an increased risk of cardiovascular disease (CVD), including ventricular arrhythmias, but the association between serum or dietary Mg and atrial fibrillation (AF) has not been investigated. Methods and Results: A total of 14,290 men and women (75% white; 53% female; mean age, 54 years) free of AF at baseline participating in the Atherosclerosis Risk in Communities study in the United States, were studied. Incident AF cases through 2009 were ascertained from electrocardiograms, hospital discharge codes, and death certificates. Multivariate Cox proportional hazards regression was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for AF associated with serum and dietary Mg quintiles. Over a median follow-up time of 20.6 years, 1,755 incident AF cases were identified. In multivariate models, lower serum Mg was associated with higher AF risk: compared to individuals in the middle quintile (≥0.80-0.83 mmol/L), the HR (95% CI) of AF in quintiles 1, 2, 4, and 5 were 1.34 (1.16-1.54), 0.99 (0.85-1.16), 1.04 (0.90-1.22), and 1.06 (0.91-1.23), respectively. There was no evidence of significant interactions between serum Mg and sex or race. No association between dietary Mg and AF risk was observed. Conclusions: Lower serum Mg was associated with a higher AF risk, and this association was not different between whites and African Americans. Dietary Mg was not associated with AF risk.


Herbert L.,Center for Translational Science | Shemesh E.,Mount Sinai School of Medicine | Bender B.,Center for Health Promotion
Journal of Allergy and Clinical Immunology: In Practice | Year: 2016

Current estimates indicate that 4% to 8% of children in the United States are diagnosed with food allergy, and more than 40% of US children with food allergy experience severe allergic reactions. Families trying to avoid foods that may trigger an allergic reaction and ensure adequate treatment of allergic reactions that do occur face numerous challenges. The rise in the number of children diagnosed with food allergies underscores the importance of food allergy-related interventions to address elevated psychosocial concerns, such as parenting stress, anxiety, and worries about bullying. This review provides an overview of common psychosocial concerns among children with food allergy and their families across the developmental spectrum, and offers guidance to medical providers regarding the identification and treatment of food allergy-related psychosocial challenges. © 2016 American Academy of Allergy, Asthma & Immunology.


PubMed | Center for Health Promotion, Mount Sinai School of Medicine and Center for Translational Science
Type: Journal Article | Journal: The journal of allergy and clinical immunology. In practice | Year: 2016

Current estimates indicate that 4% to 8% of children in the United States are diagnosed with food allergy, and more than 40% of US children with food allergy experience severe allergic reactions. Families trying to avoid foods that may trigger an allergic reaction and ensure adequate treatment of allergic reactions that do occur face numerous challenges. The rise in the number of children diagnosed with food allergies underscores the importance of food allergy-related interventions to address elevated psychosocial concerns, such as parenting stress, anxiety, and worries about bullying. This review provides an overview of common psychosocial concerns among children with food allergy and their families across the developmental spectrum, and offers guidance to medical providers regarding the identification and treatment of food allergy-related psychosocial challenges.


PubMed | Center for Health Promotion, Center for Health Data and Analysis and Brown University
Type: Journal Article | Journal: American journal of preventive medicine | Year: 2016

Mortality from injuries, particularly violent injuries, is more common among the young. Although traditional epidemiologic measures describe burden of death using rate-related mortalities, this method may not accurately represent burden of premature death. Years of life lost (YLLs) incorporate time discounting and age weighting to more accurately estimate the burden of death. To the authors knowledge, there has been no examination of YLLs using the Rhode Island Violent Death Reporting System data. This studys objective was to assess the burden of violent death in Rhode Island in terms of YLLs.This study used 2006-2013 Rhode Island Violent Death Reporting System data. YLLs as a result of premature violent deaths were assessed overall and by age, sex, race/ethnicity, and manner of death. Data were analyzed in 2015.Suicide made the largest contribution to the overall YLLs (61.3%), followed by homicide (24.0%), whereas undetermined intent deaths captured by the system accounted for 14.8% of YLLs. In Rhode Island, people aged 25-44 years had the highest YLLs due to suicide, and Hispanics had the highest YLLs due to homicide/legal intervention. By comparison, using crude mortality rate calculations, people aged 45-64 years had the highest suicide mortality rate and non-Hispanic blacks had the highest homicide mortality rate.YLL calculations provide a different picture than crude mortality-based assessments of the population at highest risk for violent death. This study demonstrates the strengths of using YLL to assess the burden of violent death at the state level.


Wei C.,Center for Health Promotion
Minnesota medicine | Year: 2012

The Centers for Disease Control and Prevention has identified traumatic brain injury (TBI) as a public health problem in the United States; it is notable that some variables of work-related TBI are different from those of non-work-related TBI. The Minnesota Department of Health has been conducting epidemiologic surveillance of cases of hospitalized TBI since 1993. Although most of the surveillance efforts have focused on all TBIs, the department does collect data on work-related TBIs and their associated outcomes. This article summarizes trends for nonfatal, work-related TBI cases over person, place, and time in Minnesota from 1999 to 2008. The greatest proportion of cases involved persons 35 to 44 years of age, and the most common causes were falls, motor vehicle traffic crashes, and being struck by objects. Most injuries occurred in the home, a location not routinely subjected to oversight for occupational safety concerns. The work-related TBI rate has been decreasing since 2004. This article also discusses the role of the physician in identifying and treating TBI.


Bender B.G.,Center for Health Promotion
Population Health Management | Year: 2014

Many Americans are failing to engage in both the behaviors that prevent and those that effectively manage chronic health conditions, including pulmonary disorders, cardiovascular conditions, diabetes, and cancer. Expectations that health care providers are responsible for changing patients' health behaviors often do not stand up against the realities of clinical care that include large patient loads, limited time, increasing co-pays, and restricted access. Organizations and systems that might share a stake in changing health behavior include employers, insurance payers, health care delivery systems, and public sector programs. However, although the costs of unhealthy behaviors are evident, financial resources to address the problem are not readily available. For most health care organizations, the return on investment for developing behavior change programs appears highest when addressing treatment adherence and disease self-management, and lowest when promoting healthy lifestyles. Organizational strategies to improve adherence are identified in 4 categories: patient access, provider training and support, incentives, and information technology. Strategies in all 4 categories are currently under investigation in ongoing studies and have the potential to improve self-management of many chronic health conditions. © Mary Ann Liebert, Inc.


PubMed | Center for Health Promotion
Type: Journal Article | Journal: [Nihon koshu eisei zasshi] Japanese journal of public health | Year: 2016

ObjectiveThe purpose of this study was to evaluate the comprehensive health program Sumida TAKE10!, which aims to improve dietary habits and promote physical activity among community-dwelling older adults including the pre-frail elderly. This study has been ongoing since 2005 in Sumida Ward, Tokyo with the ultimate aim of preventing or delaying the need for long-term nursing care. We used the term pre-frail elderly for older adults who are at risk of requiring long-term care.MethodsSumida TAKE10! consists of a general lecture in a public hall followed by 5 educational sessions biweekly at 4-6 community centers. From 2008 to 2013, 402 participants aged 65 years were enrolled and included as subjects of the study. The main outcome measures were changes in 10 food intake frequencies, food frequency score (FFS), dietary variety score (DVS), frequency of exercise (obtained via questionnaire) and physical fitness (5-meter maximal walking time, 5-meter walking time, handgrip strength, one-leg standing time with eyes opened (time to upright posture for standing on one leg with eyes open), and the timed up & go test). The secondary outcome measures were changes in the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence score, appetite, frequency of walking and sports, self-rated health, frequency of leaving the house, communication with neighbors, engagement in hobbies, participation in group activities and participation in volunteer activities (obtained via questionnaire).ResultsCompared to baseline, all outcomes showed significant improvement. Sumida TAKE10! can improve dietary habits and increase the physical activity of participants. Positive secondary effects were seen for life function, self-rated health, and social activities. Almost identical positive results were obtained from the pre-frail elderly group, while improvement was also seen in the dietary habits of the subjects who do not cook.ConclusionThese results suggest that this program may be useful for population-based approach programs. In addition, comprehensive programs like TAKE10! may increase the health consciousness of community-dwelling older adults.

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