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Petralias A.,Institute of Preventive Medicine | Petralias A.,National and Kapodistrian University of Athens | Petralias A.,Athens University of Economics and Business | Papadimitriou E.,Institute of Preventive Medicine | And 6 more authors.
European Journal of Public Health | Year: 2016

Background: We had a unique opportunity to establish the extent of food insecurity and the potential impact of a large-scale school-based nutritional program, in low-socioeconomic status districts of Greece, during the current economic crisis. Methods: Around 162 schools with 25 349 students participated during the 2012-2013 school year. Each student received a daily healthy meal designed by nutrition specialists. Food insecurity levels, measured using the Food Security Survey Module were assessed at baseline and after a 1-8-month intervention period. Pre-post intervention responses were matched at an individual level. Results: Around 64.2% of children's households experienced food insecurity at baseline. This percentage decreased to 59.1% post-intervention, P < 0.001. On an individual level, food insecurity score diminished by 6.5%, P < 0.001. After adjustment for various socioeconomic factors, for each additional month of participation, the odds of reducing the food insecurity score increased by 6.3% (OR = 1.06, 95% CI: 1.02-1.11). Those experiencing food insecurity with hunger at baseline were more likely to improve food insecurity score than those who did not (OR = 3.51, 95%CI: 2.92-4.21). Conclusion: Children and families residing in low socioeconomic areas of Greece, experience high levels of food insecurity. Our findings suggest that participation in a school-based food aid program may reduce food insecurity for children and their families in a developed country in times of economic hardship. © The Author 2016. Published by Oxford University Press on behalf of the European Public Health Association. Source


Davis M.A.,Dartmouth College | Higgins J.,Collaboratory for Healthcare and Biomedical Informatics | Li Z.,Childrens Environmental Health and Disease Prevention Research Center at Dartmouth | Gilbert-Diamond D.,Childrens Environmental Health and Disease Prevention Research Center at Dartmouth | And 3 more authors.
Environmental Health: A Global Access Science Source | Year: 2015

Background: Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero. Methods: Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth measures (converted to Z-scores based on reference populations for estimated fetal weight, head, and other body measures) at approximately 18 weeks of gestation. Results: In a preliminary cross-sectional analysis of 223 out of 272 pregnancies, maternal urinary arsenic concentration (excluding arsenobetaine) was associated with a reduction in head circumference Z-score (Spearman correlation coefficient, rs = -0.08, p-value = 0.21) and a stronger association was observed among female fetuses at approximately 18 weeks of gestation (rs = - 0.21, p-value < 0.05). Although, associations were attenuated in adjusted analyses - among female fetuses a 1 μg/L increase in maternal urinary arsenic concentration was associated with a decrease of 0.047 (95% CI: -0.115, 0.021) in head circumference and 0.072 (95% CI: -0.151, 0.007) decrease in biparietal head diameter Z-score. Conclusions: Our study demonstrates that useful data can be extracted directly from electronic medical records for epidemiologic research. We also found evidence that exposure to low-level arsenic may be associated with reduced head circumference in a sex dependent manner that warrants further investigation. © 2015 Davis et al.; licensee BioMed Central. Source


Davis M.A.,Childrens Environmental Health and Disease Prevention Research Center at Dartmouth | Davis M.A.,Dartmouth College | Davis M.A.,University of Michigan | Higgins J.,Collaboratory for Healthcare and Biomedical Informatics | And 8 more authors.
Environmental Health: A Global Access Science Source | Year: 2015

Background: Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero. Methods: Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth measures (converted to Z-scores based on reference populations for estimated fetal weight, head, and other body measures) at approximately 18 weeks of gestation. Results: In a preliminary cross-sectional analysis of 223 out of 272 pregnancies, maternal urinary arsenic concentration (excluding arsenobetaine) was associated with a reduction in head circumference Z-score (Spearman correlation coefficient, rs∈=∈-0.08, p-value∈=∈0.21) and a stronger association was observed among female fetuses at approximately 18 weeks of gestation (rs∈=∈- 0.21, p-value∈<∈0.05). Although, associations were attenuated in adjusted analyses - among female fetuses a 1 μg/L increase in maternal urinary arsenic concentration was associated with a decrease of 0.047 (95% CI: -0.115, 0.021) in head circumference and 0.072 (95% CI: -0.151, 0.007) decrease in biparietal head diameter Z-score. Conclusions: Our study demonstrates that useful data can be extracted directly from electronic medical records for epidemiologic research. We also found evidence that exposure to low-level arsenic may be associated with reduced head circumference in a sex dependent manner that warrants further investigation. © 2015 Davis et al.; licensee BioMed Central. Source


Davis M.A.,Childrens Environmental Health and Disease Prevention Research Center at Dartmouth | Davis M.A.,Dartmouth College | Davis M.A.,University of Michigan | Gilbert-Diamond D.,Childrens Environmental Health and Disease Prevention Research Center at Dartmouth | And 9 more authors.
PLoS ONE | Year: 2014

Purpose: Our goal was to perform a novel dietary-wide association study (DWAS) to identify specific dietary sources of lead, cadmium, mercury, and arsenic exposure in US children and adults.Methods: We combined data from the National Health and Nutrition Examination Survey with data from the US Department of Agriculture's Food Intakes Converted to Retail Commodities Database to examine associations between 49 different foods and environmental metal exposure. Using blood and urinary biomarkers for lead, cadmium, mercury, and arsenic, we compared sources of dietary exposure among children to that of adults.Results: Diet accounted for more of the variation in mercury and arsenic than lead and cadmium. For instance we estimate 4.5% of the variation of mercury among children and 10.5% among adults is explained by diet. We identified a previously unrecognized association between rice consumption and mercury in a US study population - adjusted for other dietary sources such as seafood, an increase of 10 g/day of rice consumption was associated with a 4.8% (95% CI: 3.6, 5.2) increase in blood mercury concentration. Associations between diet and metal exposure were similar among children and adults, and we recapitulated other known dietary sources of exposure.Background: A growing body of evidence suggests that exposure to toxic metals occurs through diet but few studies have comprehensively examined dietary sources of exposure in US populations. Copyright:Conclusion: Utilizing this combination of data sources, this approach has the potential to identify and monitor dietary sources of metal exposure in the US population. © 2014 Davis et al. Source


Karagas M.R.,Childrens Environmental Health and Disease Prevention Research Center at Dartmouth | Zens M.S.,Childrens Environmental Health and Disease Prevention Research Center at Dartmouth | Li Z.,Childrens Environmental Health and Disease Prevention Research Center at Dartmouth | Stukel T.A.,University of Toronto | And 4 more authors.
Pediatrics | Year: 2014

OBJECTIVE: Indoor tanning with UV radiation - emitting lamps is common among adolescents and young adults. Rising incidence rates of basal cell carcinoma (BCC) have been reported for the United States and elsewhere, particularly among those diagnosed at younger ages. Recent epidemiologic studies have raised concerns that indoor tanning may be contributing to early occurrence of BCC, and younger people may be especially vulnerable to cancer risk associated with this exposure. Therefore, we sought to address these issues in a population-based case-control study from New Hampshire. METHODS: Data on indoor tanning were obtained on 657 cases of BCC and 452 controls ≤50 years of age. RESULTS: Early-onset BCC was related to indoor tanning, with an adjusted odds ratio (OR) of 1.6 (95% confidence interval, 1.3-2.1). The strongest association was observed for first exposure as an adolescent or young adult, with a 10% increase in the OR with each age younger at first exposure (OR per year of age ≤23 = 1.1; 95% confidence interval, 1.0-1.2). Associations were present for each type of device examined (ie, sunlamps, tanning beds, and tanning booths). CONCLUSIONS: Our findings suggest early exposure to indoor tanning increases the risk of early development of BCC. They also underscore the importance of counseling adolescents and young adults about the risks of indoor tanning and for discouraging parents from consenting minors to this practice. Copyright © 2014 by the American Academy of Pediatrics. Source

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