Occupational groups and lower urinary tract symptoms: A cross-sectional analysis of women in the Boston Area Community Health Study.

Objectives: The objective of this study is to inform our hypothesis that the workplace toileting environment may impact lower urinary tract symptoms (LUTS); we examined the prevalence of LUTS across occupational groups in the Boston Area Community Health Survey.

Methods: At baseline, women (n = 3205) reported their occupation and frequency of 15 LUTS. Using the US Department of Labor's Standard Occupational Classification (SOC) system, we categorized women into 11 standard occupational groups.

Is there an association between physical activity and lower urinary tract symptoms in adolescent girls? Results from the Avon Longitudinal Study of Parents and Children.

Introduction And Hypothesis: Lower urinary tract symptoms (LUTS) are common among adolescent girls. Physical activity (PA) has been implicated as both a risk (high-impact PA) and protective factor (low-impact, moderate to vigorous intensity PA) for LUTS in adult women, but its role in adolescent girls is unclear. This study investigated the prospective association between physical activity and LUTS risk in adolescent girls.

Changes in Bladder Health over Time: A Longitudinal Analysis of Adult Women in the Boston Area Community Health Survey.

Purpose: Our goal was to describe changes in bladder health, defined as "a complete state of physical, mental, and social well-being related to bladder function that permits daily activities, adapts to short-term stressors, and allows optimal well-being," in women over time.

Materials And Methods: We used data on 15 lower urinary tract symptoms (LUTS) and interference from urinary experiences assessed at the baseline and 5-year followup interviews of the BACH (Boston Area Community Health) Survey to estimate changes in bladder health over time in women. Associations between baseline and followup bladder health (defined as the maximum frequency of LUTS or interference at each time point) were calculated by ordinal logistic regression and generalized linear models.

Revisiting the Spectrum of Bladder Health: Relationships Between Lower Urinary Tract Symptoms and Multiple Measures of Well-Being.

Little research to date has investigated the spectrum of bladder health in women, including both bladder function and well-being. Therefore, we expanded our previous baseline analysis of bladder health in the Boston Area Community Health (BACH) Survey to incorporate several additional measures of bladder-related well-being collected at the 5-year follow-up interview, including one developed specifically for women. At follow-up, participants reported their frequency of 15 lower urinary tract symptoms (LUTS), degree of life impact from and thought related to urinary symptoms or pelvic/bladder pain/discomfort, and perception of their bladder condition.

School Toileting Environment, Bullying, and Lower Urinary Tract Symptoms in a Population of Adolescent and Young Adult Girls: Preventing Lower Urinary Tract Symptoms Consortium Analysis of Avon Longitudinal Study of Parents and Children.

Objectives: To examine whether the school toilet environment at age 13, including bullying at toilets, is associated with female lower urinary tract symptoms (LUTS) at ages 13 and 19, as little is known about the association among school toilet environment, voiding behaviors, and LUTS in adolescent girls.

Methods: The sample comprised 3962 female participants from the Avon Longitudinal Study of Parents and Children. At age 13, participants reported on 7 school toilet environment characteristics and a range of LUTS items.

The Spectrum of Bladder Health: The Relationship Between Lower Urinary Tract Symptoms and Interference with Activities.

Little research to date has focused on lower urinary tract symptom (LUTS) prevention and bladder health promotion in women. To address this gap, the Prevention of LUTS Research Consortium developed the following working bladder health definition: "A complete state of physical, mental, and social well-being related to bladder function [that] permits daily activities [and] allows optimal well-being." To begin to inform and quantify this definition, we used data from the Boston Area Community Health Survey, drawing upon its rare collection of information on LUTS and LUTS-specific interference with activities.

Accelerometer-measured physical activity is not associated with two-year weight change in African-origin adults from five diverse populations.

Background: Increasing population-levels of physical activity (PA) is a controversial strategy for managing the obesity epidemic, given the conflicting evidence for weight loss from PA alone . We measured PA and weight change in a three-year prospective cohort study in young adults from five countries (Ghana, South Africa, Jamaica, Seychelles and USA).

Methods: A total of 1,944 men and women had baseline data, and at least 1 follow-up examination including measures of anthropometry (weight/BMI), and objective PA (accelerometer, 7-day) following the three-year study period.

A network model of communication in an interprofessional team of healthcare professionals: A cross-sectional study of a burn unit.

Healthcare teams consist of individuals communicating with one another during patient care delivery. Coordination of multiple specialties is critical for patients with complex health conditions, and requires interprofessional and intraprofessional communication. We examined a communication network of 71 health professionals in four professional roles: physician, nurse, health management, and support personnel (dietitian, pharmacist, or social worker), or other health professionals (including physical, respiratory, and occupational therapists, and medical students) working in a burn unit.

Modeling social norms and social influence in obesity.

The worldwide increase in obesity has led to changes in what is considered "normal" or desirable weight, especially among populations at higher risk. We show that social norms are key to understanding the obesity epidemic, and that social influence mechanisms provide a necessary linkage between individual obesity-related behaviors and population-level characteristics. Because influence mechanisms cannot be directly observed, we show how three complex systems tools may be used to gain insights into observed epidemiologic patterns: social network analysis, agent-based modeling, and systems dynamics modeling.

Together Achieving More: Primary Care Team Communication and Alcohol-Related Healthcare Utilization and Costs.

Background: Identifying and engaging excessive alcohol users in primary care may be an effective way to improve patient health outcomes, reduce alcohol-related acute care events, and lower costs. Little is known about what structures of primary care team communication are associated with alcohol-related patient outcomes.

Methods: Using a sociometric survey of primary care clinic communication, this study evaluated the relation between team communication networks and alcohol-related utilization of care and costs.

Waist Circumference, Body Mass Index, and ESRD in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study.

Background: The association between waist circumference and end-stage renal disease (ESRD) remains poorly explored.

Study Design: Longitudinal population-based cohort.

Setting & Participants: Participants in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study (n=30,239) with information for body mass index (BMI), waist circumference, spot urine albumin-creatinine ratio (ACR), and estimated glomerular filtration rate (eGFR; n=26,960).

Time trends in the association of ESRD incidence with area-level poverty in the US population.

The objective of this study was to examine the temporal trends of the association between area-level poverty status and end-stage renal disease (ESRD) incidence. We hypothesized that the association between area-level poverty status and ESRD incidence has increased significantly over time. Patient data from the United States Renal Data System were linked with data from the 2000 and 2010 US census.

Association of car ownership and physical activity across the spectrum of human development: Modeling the Epidemiologic Transition Study (METS).

Background: Variations in physical activity (PA) across nations may be driven by socioeconomic position. As national incomes increase, car ownership becomes within reach of more individuals. This report characterizes associations between car ownership and PA in African-origin populations across 5 sites at different levels of economic development and with different transportation infrastructures: US, Seychelles, Jamaica, South Africa, and Ghana.

Network interventions on physical activity in an afterschool program: an agent-based social network study.

Objectives: We studied simulated interventions that leveraged social networks to increase physical activity in children.

Methods: We studied a real-world social network of 81 children (average age = 7.96 years) who lived in low socioeconomic status neighborhoods, and attended public schools and 1 of 2 structured afterschool programs.

Early-life course socioeconomic factors and chronic kidney disease.

Kidney failure or ESRD affects approximately 650,000 Americans, whereas the number with earlier stages of CKD is much higher. Although CKD and ESRD are usually associated with adulthood, it is likely that the initial stages of CKD begin early in life. Many of these pathways are associated with low birth weight and disadvantaged socioeconomic status (SES) in childhood, translating childhood risk into later-life CKD and kidney failure.

The Social Network of a Burn Unit Team.

Effective team communication is critical in complex settings like hospital intensive care units. A social network analysis study was conducted in a burn intensive care unit, assuming physicians and key members of the nursing and clinical staff would occupy the core of a robust communication network. Clinical team members reported the frequency (0 to 3+ times) of discussion about patient care issues with every other coworker during a 24-hour period.

Elevated hypertension risk for African-origin populations in biracial societies: modeling the Epidemiologic Transition Study.

Objectives: Blood pressures in persons of African descent exceed those of other racial/ethnic groups in the United States. Whether this trait is attributable to the genetic factors in African-origin populations, or a result of inadequately measured environmental exposures, such as racial discrimination, is not known. To study this question, we conducted a multisite comparative study of communities in the African diaspora, drawn from metropolitan Chicago, Kingston, Jamaica, rural Ghana, Cape Town, South Africa, and the Seychelles.

Physical activity and pre-diabetes-an unacknowledged mid-life crisis: findings from NHANES 2003-2006.

The prevalence of pre-diabetes (PD) among US adults has increased substantially over the past two decades. By current estimates, over 34% of US adults fall in the PD category, 84% of whom meet the American Diabetes Association's criteria for impaired fasting glucose (IFG). Low physical activity (PA) and/or sedentary behavior are key drivers of hyperglycemia.

A mixed ecologic-cohort comparison of physical activity & weight among young adults from five populations of African origin.

Background: Examination of patterns and intensity of physical activity (PA) across cultures where obesity prevalence varies widely provides insight into one aspect of the ongoing epidemiologic transition. The primary hypothesis being addressed is whether low levels of PA are associated with excess weight and adiposity.

Methods: We recruited young adults from five countries (500 per country, 2500 total, ages 25-45 years), spanning the range of obesity prevalence.

Reconciling statistical and systems science approaches to public health.

Although systems science has emerged as a set of innovative approaches to study complex phenomena, many topically focused researchers including clinicians and scientists working in public health are somewhat befuddled by this methodology that at times appears to be radically different from analytic methods, such as statistical modeling, to which the researchers are accustomed. There also appears to be conflicts between complex systems approaches and traditional statistical methodologies, both in terms of their underlying strategies and the languages they use. We argue that the conflicts are resolvable, and the sooner the better for the field.

Lifestyle-related factors, obesity, and incident microalbuminuria: the CARDIA (Coronary Artery Risk Development in Young Adults) study.

Background: Modifiable lifestyle-related factors are associated with risk of coronary heart disease and may also influence kidney disease risk.

Study Design: Community-based prospective cohort study.

Setting & Participants: 2,354 African American and white participants aged 28-40 years without baseline microalbuminuria or estimated glomerular filtration rate <60 mL/min/1.

25-hydroxyvitamin D levels in African American and Nigerian women.

Objectives: African Americans (AA) have substantially lower levels of circulating 25-hydroxyvitamin D (25(OH)D) than whites. We compared population-based samples of 25(OH)D in women of African descent from Nigeria and metropolitan Chicago.

Methods: One hundred women of Yoruba ethnicity from southwest Nigeria and 94 African American women from metropolitan Chicago were recruited and compared using a standardized survey protocol and the same laboratory assay for 25(OH)D.