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News Article | April 20, 2017
Site: www.eurekalert.org

Scientists at the Center for Infection and Immunity (CII) at Columbia University's Mailman School of Public Health report elevated levels of a pathogen responsible for the tick-borne disease babesiosis in Suffolk County, New York, where rates are the highest in the state. Results are published in the journal mSphere. Researchers developed and employed a method to simultaneously test for five common pathogens carried by deer ticks: Babesia microti, the pathogen behind babesiosis; Borrelia burgdorferi, the cause of Lyme disease; as well as Anaplasma phagocytophilum, Borrelia miyamotoi, and Powassan virus -- pathogens responsible for other tick-borne infections. The team collected and tested 318 adult and nymph ticks at five sites in Suffolk County (Southampton, Mannorville, Southold, Islip, Huntington) and three sites in Connecticut (Mansfield, Stamford, Greenwich). Nymphal ticks are about the size of a poppy seed, emerge in warmer months, and are responsible for the majority of tick-borne disease. The new test uses a DNA amplification technique called polymerase chain reaction or PCR to test for tick-borne pathogens. Most existing tests use this method to test ticks for each agent individually. Even the tests that have the ability to test for more than one agent typically only test for up to three, not five agents, and never for Powassan virus, the rarest but most pathogenic of the five. The scientists say the technique has several advantages: it lowers costs, facilitates testing for agents (B. miyamotoi, and especially Powassan virus) that are rarely tested for, and provides risk assessments for co-infections which may adversely affect the course of disease. Tests found B. microti present in a higher proportion of ticks in Suffolk County than Connecticut, including 17 vs. 7 percent of nymphal ticks. In both locations, B. burgdorferi, the causative agent for Lyme disease, was the most frequently detected agent in ticks tested while A. phagocytophilum, B. miyamotoi and Powassan virus were more rare. One-quarter of B. burgdorferi-positive nymphs were also positive for B. microti suggesting a risk of co-infection with both agents from a single tick bite. "Gathering data on co-infections is particularly important in light of the fact that antibiotics used for Lyme disease may be ineffective for babesiosis," says first author Rafal Tokarz, a research scientist at CII. The number of counties in the Northeast with high rates of Lyme disease has more than tripled since the 1990s -- a sign that ticks that spread disease have expanded their range. Rates of tick-borne illness may be much higher than reported: one study in Minnesota found 79 percent of cases were not reported to health authorities. Symptoms include fever and headaches, and, more rarely, neurological complications like encephalitis. "This new test can strengthen surveillance for tick-borne illnesses which are underreported and growing rapidly," says W. Ian Lipkin director of CII and John Snow Professor of Epidemiology at the Mailman School. Co-authors including Teresa Tagliafierro and Stephen Sameroff at CII and D. Moses Cucura and Ilia Rochlin at the Suffolk County Department of Public Works. This study was funded through grants from the Steven and Alexandra Cohen Foundation and National Institute of Allergies and Infectious Diseases (U19 AI109761).


April 24, 2017 -- In newly updated clinical guidelines from the Society for Integrative Oncology (SIO), researchers at Columbia University's Mailman School of Public Health and the Herbert Irving Comprehensive Cancer Center with an interdisciplinary team of colleagues at MD Anderson Cancer Center, University of Michigan, Memorial Sloan Kettering Cancer Center, and other institutions in the U.S. and Canada, analyzed which integrative treatments are most effective and safe for patients with breast cancer. This systematic review adds to the growing literature on integrative therapies for patients with breast cancer and other cancer populations. The latest results are published online and in print in CA: A Cancer Journal for Clinicians, a publication of the American Cancer Society. The researchers evaluated more than 80 different therapies and developed grades of evidence. Based on those findings, the Society for Integrative Oncology makes the following recommendations: "Studies show that up to 80 percent of people with a history of cancer use one or more complementary and integrative therapies, but until recently, evidence supporting the use of many of these therapies had been limited," said Heather Greenlee, ND, PhD, assistant professor of Epidemiology at Columbia University's Mailman School of Public Health, and past president of SIO. "Our goal is to provide clinicians and patients with practical information and tools to make informed decisions on whether and how to use a specific integrative therapy for a specific clinical application during and after breast cancer treatment," Greenlee continues. In their systematic evaluation of peer-reviewed randomized clinical trials, the researchers assigned letter grades to therapies based on the strength of evidence. A letter grade of "A" indicates that a specific therapy is recommended for a particular clinical indication, and there is high certainty of substantial benefit for the patient. Meditation had the strongest evidence supporting its use, and is recommended for reducing anxiety, treating symptoms of depression, and improving quality of life, based on results from five trials. Music therapy, yoga, and massage received a B grade for the same symptoms, as well as for providing benefits to breast cancer patients. Yoga received a B grade for improving quality of life based on two recent trials. Yoga and hypnosis received a C for fatigue. "The routine use of yoga, meditation, relaxation techniques, and passive music therapy to address common mental health concerns among patients with breast cancer is supported by high levels of evidence," said Debu Tripathy, MD, chair of Breast Oncology at The University of Texas MD Anderson Cancer Center, and a past president of SIO. "Given the indication of benefit coupled with the relatively low level of risk, , these therapies can be offered as a routine part of patient care, especially when symptoms are not well controlled." Acupressure and acupuncture received a B grade as an addition to drugs used for reducing chemotherapy-induced nausea and vomiting. In general, there was a lack of strong evidence supporting the use of ingested dietary supplements and botanical natural products as part of supportive cancer care and to manage treatment-related side effects. "Clinicians and patients need to be cautious about using therapies that received a grade of C or D and fully understand the potential risks of not using a conventional therapy that may effectively treat cancer or help manage side effects associated with cancer treatment," warned Lynda Balneaves, RN, PhD, associate professor, College of Nursing, Rady Faculty of Health Sciences, Winnipeg, Canada, and president-elect of SIO. "Patients are using many forms of integrative therapies with little or no supporting evidence and that remain understudied," noted Dr. Greenlee. "This paper serves as a call for further research to support patients and healthcare providers in making more informed decisions that achieve meaningful clinical results and avoid harm." Additional co-authors: Melissa J. DuPont-Reyes, Department of Epidemiology, Mailman School of Public Health, Columbia University; Linda Carlson, Department of Oncology, University of Calgary, Calgary, AB, Canada; Misha Cohen, American College of Traditional Chinese Medicine at California Institute of Integral Studies, and Chicken Soup Chinese Medicine, San Francisco; Gary Deng, Integrative Oncology, Memorial Sloan Kettering Cancer Center, New York City; Jillian A. Johnson, Department of Biobehavioral Health, The Pennsylvania State University, University Park; Matthew Mumber, Department of Radiation Oncology,Harbin Clinic, Rome, GA; Dugald Seely, Ottawa Integrative Cancer Center, Ottawa, ON, and Canadian College of Naturopathic Medicine, Toronto, ON; Suzanna M. Zick, Department of Family Medicine, University of Michigan Health System, and Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor; and Lindsay M. Boyce, Memorial Sloan Kettering Library, Memorial Sloan Kettering Cancer Center, New York City. Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit http://www. .


News Article | April 4, 2017
Site: www.medicalnewstoday.com

Chronic fatigue syndrome (CFS), also sometimes referred to as myalgic encephalomyelitis (ME), affects more than 1 million people in the United States. The disease is usually most prevalent in women in their 40s and 50s, with CFS being four times more frequent in women than in men. Symptoms include joint pain, painful lymph nodes, having trouble sleeping, and headaches, as well as difficulty concentrating and remembering things. Medical professionals do not yet know what causes the disease. CFS is difficult to identify as there is no test for it, and because it shares some of its symptoms with other illnesses. However, new research investigates the biological basis for the illness and identifies two subgroups of CFS that go on to develop differently: the so-called classical CFS and an "atypical" variant. The study was carried out by researchers at the Center for Infection and Immunity (CII) at Columbia University's Mailman School of Public Health in New York, and it was led by Dr. Mady Hornig, director of translational research at CII and associate professor of epidemiology at the university. The results were published in the journal Translational Psychiatry. Hornig and team performed immunoassays to measure 51 immune biomarkers in the cerebrospinal fluid of 32 people with classical CFS, and another 27 with atypical CFS. The tests showed lower levels of immune molecules in those with atypical CFS than in those with the classical variant. The analyses revealed drastically lower levels of interleukin 7 (a protein that plays a key role in the adaptive immune response to infections), interleukin 17A, and chemokine ligand 9 (molecules with a key role in the adaptive immunity to neurological illnesses). Additionally, these biological features were accompanied by different trajectories of disease history and comorbidities. Those with atypical CFS tended to have a history of viral encephalitis and tended to fall ill after traveling abroad or receiving a blood transfusion. Furthermore, people with atypical CFS went on to develop simultaneous conditions such as seizure disorders, several types of cancers, or demyelinating disorders - that is, multiple sclerosis-like diseases that damage myelin, the protective sheath around the nerve cells in our brains and spinal cords. The senior author of the study and director of CII, Dr. Ian Lipkin, also explains the contribution of the findings: "Multiple biological pathways are likely involved in the pathogenesis of ME/CFS, with a range of clinical subtypes relating to variability in the types of environmental triggers, genetic and epigenetic vulnerability, as well as comorbidity patterns," he says. "Shedding light on these pathways may help us to identify the various agents that precipitate disease as well as to design more precise, targeted treatments." Overall, both atypical and classical CFS patients were revealed to have an abnormal immune system when compared with the general population. However, only people with classical CFS displayed the previously discovered 3-year mark of CFS - namely, after 3 years of having an "overzealous" immune system, CFS patients show signs of immune "exhaustion," with dramatic drops in their levels of immune molecules. In this new study, only those with classical CFS had this drop in immune molecules after 3 years, whereas those with atypical CFS displayed steady or increased levels of cytokines and chemokines - proteins that control the development and activation of immune cells. Study co-author Dr. Daniel L. Peterson, principal clinician at Sierra Internal Medicine in Incline Village, NV, comments on the significance of these findings: "Early identification of patients who meet the usual clinical criteria when first diagnosed but then go on to develop atypical features would help clinicians like myself identify and treat these complex cases and even prevent fatal outcomes." Hornig speculates on the mechanism that might be responsible for the differences between the two subgroups. She suggests that atypical patients may go through a "smoldering inflammatory process," in which their body's immune system is trying to recover, but she notes that further research is needed in order to test this hypothesis. She also suggests that genetic predispositions may cause the immune system to respond differently in atypical individuals. Researchers at CII continue to investigate other subgroups of CFS patients, such as patients with allergies, cognitive impairment, and gastrointestinal problems. Learn how altered gut bacteria could cause CFS.


April 27, 2017 (New York) -- Children in low-income families have an increased chance of thriving when their caregiver relationships include certain positive characteristics, according to new research from the National Center for Children in Poverty (NCCP) at Columbia University's Mailman School of Public Health. Using data from more than 2,200 low-income families surveyed as part of the Fragile Families and Child Wellbeing Study, NCCP researchers found that school-age children who reported high levels of parent involvement and supervision were more likely to report behaviors associated with positive emotional development and social growth. According to Strong at the Broken Places: The Resiliency of Low-Income Parents, an estimated 14 million families with at least one child earned below 200 percent of the poverty threshold in 2015 - a total of 65 percent of low-income families. Research has found that living in poverty can produce environmental stressors that lead to negative behaviors in children, such as inattention, impulsivity, aggression, withdrawal, depression, anxiety, or fearfulness. Furthermore, children living in poor families are significantly more likely to have trouble developing social-emotional competence -- the ability to manage emotions, express needs and feelings, deal with conflict, and get along with others. "Too often, when poor families are discussed, the focus is on deficits," said Renée Wilson-Simmons, DrPH, NCCP director and a co-author of the report. "And chief among those deficits is what's seen as parents' inability to successfully parent their children." Dr. Wilson-Simmons challenged the deficits focus, adding that despite the multitude of obstacles that low-income parents face, many of them succeed in helping their children flourish. "They raise children who possess the social-emotional competence needed to develop and keep friendships; establish good relationships with parents, teachers, and other adults; and experience a range of achievements that contribute to their self-confidence, self-esteem, and self-efficacy. These families have something to teach us all about thriving amidst adversity." Available online at http://www. , Strong at the Broken Places presents findings from the survey responses of 2,210 nine-year-olds who lived in low-income families for three to five years. The report also cites additional research involving low-income families from diverse backgrounds and geographic areas showing certain common attributes among parents who are able to function well when faced with challenges. Those effective protective factors range from exhibiting a positive outlook, establishing family routines, and spending sufficient family time together to having good financial management skills, an adequate support network, and the willingness to seek help. The major finding presented in the report is that low-income parents who provide their children with warmth and nurturance as well as rules and consequences are helping them develop both socially and emotionally in ways that will serve them well as they move from childhood to adolescence to young adulthood: Overall, most of the nine-year-olds surveyed rated their caregiver high on all of the factors NCCP researchers used to measure resiliency in low-income families: "The good news is that parents who struggle financially are still finding ways to have the kinds of interactions with their children that help them to develop socially and emotionally, despite the many external stressors competing for their attention," said co-author Yang Jiang, PhD, who led data analysis. "Since we know that children do better when their families do better, it's important that advocates and policymakers bolster families' efforts by supporting policies and programs that help parents develop strong connections with their children." To promote family resiliency, NCCP researchers also recommended two-generation approaches that enhance the well-being and life opportunities of both parents and their children. The following policy strategies, outlined in Strong at the Broken Places, help stabilize low-income households so that parents are better able to engage with their children: To speak with an NCCP expert about Strong at the Broken Places, contact Tiffany Thomas Smith, communications/media relations consultant for the National Center for Children in Poverty, at 443-986-5621 / TiffanyTSmith@nccp.org. Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit http://www. . Part of Columbia University's Mailman School of Public Health, the National Center for Children in Poverty (NCCP) is the nation's leading public policy center dedicated to promoting the economic security, health, and well-being of America's low-income families and children. Visit NCCP online at http://www. . Like us on Facebook


News Article | May 1, 2017
Site: www.eurekalert.org

Development assistance for health targets largely ignores older age groups, with 90 percent of the assistance going to people below the age of 60, according to a new study led by a researcher at the Robert N. Butler Columbia Aging Center, Mailman School of Public Health. Children below the age of 5 receive the most development assistance for health. Findings from the study, Vast Majority of Development Assistance for Health Funds Target Those Below Age Sixty, will be published online and in the May issue of the journal, Health Affairs. Development assistance for health globally was $3.13 per person younger than age 60 in recipient countries, per DALY, defined as the sum of years lived with disability and years of life lost because of premature mortality. This is in contrast to $0.91 per person aged 60 and older. The gap was even higher at the extremes of the age distribution: People ages 70 and older received only $0.80 per DALY. Funds earmarked for low- and middle-income countries to improve health have more than quadrupled since 1990, reaching $36.4 billion U.S. dollars in 2015. The researchers used publicly available data from the Institute for Health Metrics and Evaluation's Financing Global Health 2015 report and the Global Burden of Disease Study 2015. They examined 27 assistance program areas that identified the cause of disease or the type of intervention targeted for the period 1990-2013. Country- and year-specific disability-adjusted life-years were calculated for each cause. "When we compared changes in development assistance for health and DALYs from 1990 to 2013 -- a period of epidemiological and demographic change during which the disease burden shifted toward older ages--we found that assistance was directed increasingly to children," said the study's lead author, Vegard Skirbekk, PhD, of the Columbia Aging Center and professor of Population and Family Health at the Mailman School of Public Health. For example, people younger than age five had $6.49 billion more assistance in 2013 than they had in 1990. The largest increases were for people ages 5-14 years. People in their twenties and thirties also received relatively large amounts of the spending for development assistance for health, some of it driven by HIV/AIDS funding. In 2013 the assistance benefited people younger than age five the most, with spending on this age group over three times more than any other age group. Many programs areas benefit this age group, especially assistance for child health, maternal and newborn health, and malaria. "Our results revealed that development assistance for health is likely to target diseases that occur early in life," noted Skirbekk. One driver for prioritizing younger over older populations may be that children are seen as representing the future. "Another idea is that younger people--especially children--should be given priority because they are more innocent, and that health risks and diseases that affect them are hardly due to behavior for which they could be held responsible," observed Skirbekk. Co-authors: Trygve Ottersen, Norwegian Institute of Public Health and Centre for Global Health, University of Oslo; Hannah Hamavid, Nafis Sadat, and Joseph L. Dieleman, Institute for Health Metrics and Evaluation, University of Washington. The study was supported by the Robert N. Butler Columbia Aging Center at Columbia University, the Norwegian Institute of Public Health, and Bill & Melinda Gates Foundation. Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit http://www. .


News Article | April 26, 2017
Site: www.eurekalert.org

Scientists identify abnormal levels of specific gut bacteria in individuals with chronic fatigue syndrome, including those with and without co-morbid IBS Scientists at the Center for Infection and Immunity (CII) at Columbia University's Mailman School of Public Health have discovered abnormal levels of specific gut bacteria related to chronic fatigue syndrome/myalgic encephalomyelitis, or ME/CFS, in patients with and without concurrent irritable bowel syndrome, or IBS. Findings are published in the journal Microbiome. The study is among the first to disentangle imbalances in the gut bacteria in individuals with ME/CFS and IBS. ME/CFS is a complex, debilitating disorder characterized by extreme fatigue after exertion and other symptoms including muscle and joint pain, cognitive dysfunction, sleep disturbance, and orthostatic intolerance. Up to 90 percent of ME/CFS patients also have IBS. The researchers followed 50 patients and 50 matched healthy controls recruited at four ME/CFS clinical sites. They tested for bacterial species in fecal samples, and for immune molecules in blood samples. "Individuals with ME/CFS have a distinct mix of gut bacteria and related metabolic disturbances that may influence the severity of their disease," says co-lead investigator Dorottya Nagy-Szakal, postdoctoral research scientist at CII. "Our analysis suggests that we may be able to subtype patients with ME/CFS by analyzing their fecal microbiome," says co-lead investigator Brent L. Williams, assistant professor of Pathology and Cell Biology at CII. "Subtyping may provide clues to understanding differences in manifestations of disease." "Much like IBS, ME/CFS may involve a breakdown in the bidirectional communication between the brain and the gut mediated by bacteria, their metabolites, and the molecules they influence," says senior author W. Ian Lipkin, director of CII and John Snow Professor of Epidemiology at Columbia's Mailman School. "By identifying the specific bacteria involved, we are one step closer to more accurate diagnosis and targeted therapies." The study was supported by the Chronic Fatigue Initiative of the Hutchins Family Foundation; the National Institutes of Health Center for Research in Diagnostics and Discovery (AI109761); John, Cynthia, and Lisa Gunn; and anonymous donors through the Crowdfunding Microbe Discovery Project. Additional co-authors include Nischay Mishra, Xiaoyu Che, Bohyun Lee, Komal Jain, Meredith L. Eddy, and Mady Hornig at CII; Lucinda Bateman at the Fatigue Consultation Clinic, Salt Lake City; Nancy G. Klimas at Nova Southeastern University; Anthony L. Komaroff at Harvard Medical School; Susan Levine at Levine Clinic, New York City; Jose G. Montoya at Stanford University; Daniel L. Peterson at Sierra Internal Medicine, Incline Village, NV; and Devi Ramanan at Ayasdi, Inc., Menlo Park, CA.


News Article | April 17, 2017
Site: www.eurekalert.org

April 12, 2017 -- B vitamins can mitigate the impact of fine particle pollution on cardiovascular disease, according to new research conducted at Columbia University's Mailman School of Public Health. Healthy non-smokers who took vitamin B supplements nearly reversed any negative effects on their cardiovascular and immune systems, weakening the effects of air pollution on heart rate by 150 percent, total white blood count by 139 percent, and lymphocyte count by 106 percent. This is the first clinical trial to evaluate whether B vitamin supplements change the biologic and physiologic responses to ambient air pollution exposure. The study initiates a course of research for developing preventive pharmacological interventions using B vitamins to contain the health effects of air pollution. The findings are published online in the Nature Publishing Group journal, Scientific Reports. Ambient fine particulate pollution contributes to 3.7 million premature deaths annually worldwide, predominantly through acute effects on the cardiovascular system. Particulate matter pollution is the most frequent trigger for myocardial infarction at the population level. "Ambient PM2.5 pollution is one of the most common air pollutants and has a negative effect on cardiac function and the immune system," said Jia Zhong, PhD, principal investigator, and postdoctoral research officer in the Department of Environmental Health Sciences at Columbia's Mailman School. "For the first time, our trial provides evidence that B-vitamin supplementation might attenuate the acute effects of PM2.5 on cardiac dysfunction and inflammatory markers." The paper builds on research published in March that found B vitamins reduce the negative effects of air pollution as measured by epigenetic markers. In the new study, researchers recruited ten healthy, 18 to 60-year-old, non-smoking volunteers who were not on any form of B vitamin supplements or other medication. All volunteers received a placebo for four weeks preceding a two-hour exposure experiment to concentrated ambient PM2.5 (250 μ g/m3), after which they were administered B vitamin supplements for four weeks before the next two-hour exposure experiment to PM2.5. A particle-free two-hour exposure was included to provide baseline data. The controlled exposure experiments were conducted from July 2013 to February 2014 at the same time of day and adjusted for season, temperature, and humidity. "Our results showed that a two-hour exposure to concentrated ambient PM2.5 had substantial physiologic impacts on heart rate, heart rate variability, and white blood counts. Further, we demonstrated that these effects are nearly reversed with four-week B-vitamin supplementation," noted Andrea Baccarelli, MD, PhD, chair and Leon Hess Professor of Environmental Health Sciences at the Mailman School. Because the researchers studied healthy adults from lightly polluted urban environment, they caution that their findings might not be generalizable to populations that are at higher risk for pollution-induced cardiovascular effects, including children, older adults, individuals with pre-existing cardiovascular disease, and individuals residing in heavily polluted areas. "With ambient PM2.5 levels far exceeding air quality standards in many large urban areas worldwide, pollution regulation remains the backbone of public health protection against its cardiovascular health effects. Studies like ours cannot diminish--nor be used to underemphasize--the urgent need to lower air pollution levels to--at a minimum--meet the air quality standards set forth in the United States and other countries. However, residual risk remains for those who are sensitive, and high exposures are, unfortunately, the rule still in many megacities throughout the world," said Dr. Baccarelli. The study, conducted with colleagues at Harvard's T. H. Chan School of Public Health, in Sweden, China, Singapore, and Canada, was supported by NIH grants (R21ES021895, R01ES021733, R01ES020836, R01ES021357, T32ES007142, P30ES000002) and by U.S. Environmental Protection Agency grants (RD-834798, RD-832416). The authors declare no competing financial interests. Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit http://www. .


News Article | April 26, 2017
Site: www.eurekalert.org

Illicit cannabis use and cannabis use disorders increased at a greater rate in states that passed medical marijuana laws than in other states, according to new research at Columbia University's Mailman School of Public Health and Columbia University Medical Center. The findings will be published online in JAMA Psychiatry. Laws and attitudes regarding cannabis have changed over the last 20 years. In 1991, no Americans lived in states with medical marijuana laws, while in 2012, more than one-third lived in states with medical marijuana laws, and fewer view cannabis use as entailing any risks. The new study is among the first to analyze the differences in cannabis use and cannabis use disorders before and after states passed medical marijuana laws, as well as differentiate between earlier and more recent periods and additionally examine selected states separately. The researchers used data from three national surveys collected from 118,497 adults: the 1991-1992 National Longitudinal Alcohol Epidemiologic Survey, the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions and the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III. Overall, between 1991-1992 and 2012-2013, illicit cannabis use increased significantly more in states that passed medical marijuana laws than in other states, as did cannabis use disorders. In particular, between 2001-2002 and 2012-2013, increases in use ranged from 3.5 percentage points in states with no medical marijuana laws to 7.0 percentage points in Colorado. Rates of increase in the prevalence of cannabis use disorder followed similar patterns. "Medical marijuana laws may benefit some with medical problems. However, changing state laws -- medical or recreational -- may also have adverse public health consequences, including cannabis use disorders," said author Deborah Hasin, PhD, associate professor of Epidemiology at the Mailman School of Public Health and in the Department of Psychiatry at Columbia University Medical Center. "A prudent interpretation of our results is that professionals and the public should be educated on risks of cannabis use and benefits of treatment, and prevention/intervention services for cannabis disorders should be provided." While illicit use of marijuana decreased and marijuana use disorder changed little between 1991-1992 and 2001-2002, both use and disorder rates increased between 2001-2002 and 2012-2013. In 1991-1992, predicted prevalences of use and disorder were higher in California than other states with early-medical marijuana laws (use: 7.6 percent vs. 4.5 percent; disorder: 2 percent vs. 1.15 percent). However, the predicted prevalence of past year use in California did not differ significantly from states that passed laws more recently. In contrast, the prevalences of use and disorder increased in the other 5 states with early medical marijuana laws. "Future studies are needed to investigate mechanisms by which increased cannabis use is associated with medical marijuana laws, including increased perceived safety, availability, and generally permissive attitudes," Dr. Hasin also noted. Co-authors: Aaron Sarvet and Malka Stohl, Columbia University Medical Center; Katherine Keyes and Melanie Wall, Mailman School of Public Health; Sandro Galea, Boston University School of Public Health; and Magdalena Cerda, University of California, Davis. The study was supported by the National Institute on Alcohol Abuse and Alcoholism (grant K01AA021511), National Institutes of Health (R01DA034244, National Institute on Drug Abuse (grants K01AA021511, R01Dao40924-01A), and the New York State Psychiatric Institute. Founded in 1922, Columbia University's Mailman School of Public Health pursues an agenda of research, education, and service to address the critical and complex public health issues affecting New Yorkers, the nation and the world. The Mailman School is the third largest recipient of NIH grants among schools of public health. Its over 450 multi-disciplinary faculty members work in more than 100 countries around the world, addressing such issues as preventing infectious and chronic diseases, environmental health, maternal and child health, health policy, climate change & health, and public health preparedness. It is a leader in public health education with over 1,300 graduate students from more than 40 nations pursuing a variety of master's and doctoral degree programs. The Mailman School is also home to numerous world-renowned research centers including ICAP (formerly the International Center for AIDS Care and Treatment Programs) and the Center for Infection and Immunity. For more information, please visit http://www. . Columbia University Department of Psychiatry Columbia Psychiatry is ranked among the best departments and psychiatric research facilities in the nation and has contributed greatly to the understanding and treatment of psychiatric disorders. Located at the Columbia University Medical Center campus in Washington Heights, the department enjoys a rich and productive collaborative relationship with physicians in various disciplines at Columbia University's College of Physician's and Surgeons. Columbia Psychiatry is home to distinguished clinicians and researchers noted for their clinical and research advances in the diagnosis and treatment of depression, suicide, schizophrenia, bipolar and anxiety disorders, eating disorders, and childhood psychiatric disorders. Visit http://columbiapsychiatry. for more information.

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