Publications by authors named "DOWNS S"

Background: The impact of pre-infection vaccination on the risk of long COVID remains unclear in the pediatric population. We aim to assess the effectiveness of BNT162b2 on long COVID risks with various strains of the SARS-CoV-2 virus in children and adolescents, using comparative effectiveness methods. We further explore if such pre-infection vaccination can mitigate the risk of long COVID beyond its established protective benefits against SARS-CoV-2 infection using causal mediation analysis.

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Background: Food environments are rapidly changing in low- and middle-income countries (LMICs), leading to dietary shifts. Many gaps exist in the measurement of food environments in LMICs making it difficult to characterize the linkages between food environments and diets.

Objective: The objective of this study was to examine the feasibility of implementing USAID Advancing Nutrition's Market Food Environment Assessment (MFEA)-a suite of 7 non-resource intensive food environment assessments.

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Introduction: More than 5 million children in the United States experience food insecurity (FI), yet little guidance exists regarding screening for FI. A prediction model of FI could be useful for healthcare systems and practices working to identify and address children with FI. Our objective was to predict FI using demographic, geographic, medical, and historic unmet health-related social needs data available within most electronic health records.

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Background: Intensive blood pressure (BP) control in youth with chronic kidney disease (CKD) slows progression, delaying the need for kidney replacement therapy (KRT). Most youth with CKD have hypertension and BP control is difficult to achieve outside of controlled experimental settings. Implementing effective BP control strategies in this population may be cost-saving despite requiring additional resources.

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Background: Patient care informatics are becoming more advanced with digital capacity and server functionality. The intensive care unit (ICU) is becoming paperless for prescribing, charting, and monitoring care. A further challenge is to include all life sustaining therapies in this digital space.

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The consumption of animal-source foods, and particularly red meat from ruminants, is a major contributor to greenhouse gas emissions, freshwater use, and loss of biodiversity. Reducing red meat consumption has been identified as a key strategy to mitigate climate change; however, little is known about how to effectively intervene to promote its reduction in the United States (US). This study aimed to examine meat (red, unprocessed, and poultry) and seafood consumption patterns, the factors influencing their consumption (including a reduction in their consumption over time), and how these differed based on socioeconomic variables.

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Article Synopsis
  • The Rutgers School of Public Health created a project to improve diversity, equity, and inclusion (DEI) in their teaching.
  • They developed a special tool to help teachers reflect on how well their courses promote DEI, using feedback from professors, students, and staff.
  • The project offers a detailed 6-step plan to help schools develop better DEI programs and adapt to different challenges they face.
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Streptococcus pneumoniae is a leading cause of pneumonia and meningitis worldwide. Many different serotypes co-circulate endemically in any one location. The extent and mechanisms of spread and vaccine-driven changes in fitness and antimicrobial resistance remain largely unquantified.

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  • The study highlights the unknown long-term effects of hypertension in youth, despite its rising rates and high adult cardiovascular mortality.
  • The Study of the Epidemiology of Pediatric Hypertension (SUPERHERO) aims to address past research limitations by gathering a large, diverse registry of youth with hypertension through standardized electronic health records.
  • SUPERHERO focuses on improving cardiovascular outcomes and developing top-notch biomedical informatics methods for managing youth hypertension, with inclusion criteria for patients under 19 with specific hypertension disorders.
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Objectives: In 2005, the American Academy of Pediatrics founded the Partnership for Policy Implementation (PPI). The PPI has collaborated with authors to improve the quality of clinical guidelines, technical reports, and policies that standardize care delivery, improve care quality and patient outcomes, and reduce variation and costs.

Methods: In this article, we describe how the PPI trained informaticians apply a variety of tools and techniques to these guidance documents, eliminating ambiguity in clinical recommendations and allowing guideline recommendations to be implemented by practicing clinicians and electronic health record (EHR) developers more easily.

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Food environments, or interfaces between consumers and their food systems, are a useful lens for assessing global dietary change. Growing inclusivity of nature-dependent societies in lower-and middle-income countries is driving recent developments in food environment frameworks. Downs et al.

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Food environments are a critical place within the food system to implement interventions aimed at enabling sustainable diets. In this perspective article, we argue for the need for food environment research to more comprehensively examine the different types of food environments that people access within their communities to ensure that interventions and programs are better aligned with people's lived experiences. We highlight the potential ways in which participatory mapping (PM) can be leveraged to better design food environment research by: (1) identifying the different food environment types that are accessed within a given community; (2) providing insight into the timing for data collection; (3) informing the prioritization of where to conduct food environment assessments; and (4) highlighting the dynamism of food environments over time (e.

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Persistent tuberculosis (TB) in cattle populations in England has been associated with an exchange of infection with badgers (Meles meles). A badger control policy (BCP) commenced in 2013. Its aim was to decrease TB incidence in cattle by reducing the badger population available to provide a wildlife reservoir for bovine TB.

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The Mediterranean dietary pattern (MDP) and Japanese dietary pattern (JDP) have received increasing attention from the scientific community and media, predominantly due to their association with increased longevity and health. Although similarities between the two dietary patterns are evident, a detailed comparison between them is still relatively unexplored. This narrative review aimed to explore the similarities and differences between the MDP and JDP in terms of longevity while also reflecting on the adoption of these diets by other populations outside their regions of origin.

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Article Synopsis
  • Researchers tested a multi-step process to select comparison groups for patient studies using electronic medical records (EMRs) in North Carolina.
  • They identified nine key variables for comparison (like age and race) and successfully created 100 matched comparators for 1.8 million patients quickly (under 100 minutes).
  • This EMR-based method is promising for generating efficient and reproducible comparison data for observational studies, although further testing is necessary.
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Convenience is a major driver of food choice throughout the world, yet it is often inconsistently conceptualised, defined and measured. This limits the scope for food systems policy and interventions to leverage convenience to improve diet and nutrition outcomes. We conducted a systematic literature review to determine how convenience is both defined and measured in food environment and nutrition research.

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  • The study addresses the challenges in diagnosing small-fiber neuropathy (SFN) due to its subjective nature and limited testing options, leading to the creation of the Massachusetts General Hospital Neuropathy Exam Tool (MAGNET) to enhance diagnostic accuracy.
  • Researchers assessed MAGNET’s performance on 160 symptomatic patients and 37 healthy volunteers, comparing various physical examination findings against objective SFN tests, such as skin biopsies and autonomic function tests.
  • The results demonstrated strong reliability and predictive accuracy for MAGNET, achieving 80%-85% accuracy in identifying patients with SFN, particularly highlighting reduced pin sharpness sensitivity in toes as a common abnormality.
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Value-based payment models may improve patient health by targeting quality of care over quantity of health services. Social workers in primary care settings are well-positioned to improve the quality of health services for vulnerable patients by identifying and addressing patients' social determinants of health. This case study describes a Plan Do Study Act (PDSA) quality improvement approach implemented and refined by social workers to proactively address clinical quality gaps in one family medicine practice.

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Background: Deployment of non-pharmaceutical interventions such as face masking and physical distancing during the COVID-19 pandemic could have altered the transmission dynamics and carriage of respiratory organisms. We evaluated colonisation with Streptococcus pneumoniae and other upper respiratory tract bacterial colonisers before and during the COVID-19 pandemic.

Methods: We did two cross-sectional surveys in Soweto, South Africa from July 3 to Dec 13, 2018 (pre-COVID-19 period) and from Aug 4, 2021, to March 31, 2022 (COVID-19 period) in healthy children (aged ≤60 months) who had recorded HIV status and had not received antibiotics in the 21 days before enrolment.

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Behavior change communication (BCC) strategies have the potential to improve infant feeding and nutrition outcomes among infants and young children in low- and middle-income countries. More recently, there has been a shift toward the adoption of mHealth interventions-the use of mobile phones to transmit health-related information or direct care-to promote recommended BCC strategies among the caregivers of infants and young children. In Senegal, most infants and young children are not fed according to recommended practices leading to a high prevalence of undernutrition and micronutrient deficiencies.

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Background: The British Columbia Farmers' Market Nutrition Coupon Program (BC FMNCP) provides households with low incomes with coupons to purchase healthy foods from farmers' markets.

Objective: To examine the impact of the BC FMNCP on the short-term household food insecurity, malnutrition risk, mental well-being, sense of community (secondary outcomes), and subjective social status (exploratory outcome) of adults with low incomes post-intervention and 16 weeks post-intervention.

Design: Secondary analyses from a pragmatic randomized controlled trial conducted in 2019 that collected data at baseline, post-intervention, and 16 weeks post-intervention.

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Motor competence is important for lifelong physical activity (PA). The current study aimed to examine associations between PA and motor competence. In total, 43 children aged 7-12 years with intellectual disabilities and/or autism spectrum disorder completed anthropometric measures, the Bruininks-Oseretsky Test of Motor Proficiency-2, and wore a wrist accelerometer to capture total PA, moderate-to-vigorous PA (MVPA), average acceleration, and intensity gradient.

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