Geospatial analysis of Mediterranean diet adherence in the United States.

Objective: The current study aims to describe the Mediterranean diet (MD) adherence across the US regions, and explore the predictive factors of MD adherence among US adults.

Design: Cross-sectional secondary data analysis. MD adherence score (0-9) was calculated using the Block 98 FFQ.

Does Adherence to Mediterranean Diet Mediate the Association Between Food Environment and Obesity Among Non-Hispanic Black and White Older US Adults? A Path Analysis.

Purpose: This study aims to test the hypothesis that in addition to a direct effect of food environment on obesity, food environment is indirectly associated with obesity through consuming Mediterranean diet (MD).

Design: Cross-sectional secondary data analysis.

Setting: Nationwide community-dwelling residency.

Association of community food environment and obesity among US adults: a geographical information system analysis.

Background: Emerging studies have investigated the contribution of food environment to obesity in the USA. However, the findings were inconsistent. Methodological explanations for the inconsistent findings included: (1) using individual store/restaurant exposure as food environment indicator, and (2) not accounting for non-stationarity assumption.

Smoking duration alone provides stronger risk estimates of chronic obstructive pulmonary disease than pack-years.

Background: Cigarette smoking is the strongest risk factor for COPD. Smoking burden is frequently measured in pack-years, but the relative contribution of cigarettes smoked per day versus duration towards the development of structural lung disease, airflow obstruction and functional outcomes is not known.

Methods: We analysed cross-sectional data from a large multicentre cohort (COPDGene) of current and former smokers.

Effectiveness of Non-Primary Care-Based Smoking Cessation Interventions for Adults with Diabetes: A Systematic Literature Review.

Diabetes is a chronic disease that affects over 25 million adults, many of whom are smokers. The negative health impact of diabetes and comorbid smoking is significant and requires comprehensive interdisciplinary management. The National Diabetes Education Program has identified specific providers, known as PPOD, who include pharmacists, podiatrists, optometrists, and dentists, as key individuals to improve diabetes-related clinical outcomes.

A novel iterative-learner simulation model: fellows as teachers.

Background: Simulation is an effective method for teaching clinical skills but has not been widely adopted to educate trainees about how to teach.

Objective: We evaluated a curriculum for pediatrics fellows by using high-fidelity simulation (mannequin with vital signs) to improve pedagogical skills.

Intervention: The intervention included a lecture on adult learning and active-learning techniques, development of a case from the fellows' subspecialties, and teaching the case to residents and medical students.

Interprofessional simulation training improves knowledge and teamwork in nursing and medical students during internal medicine clerkship.

Simulation is effective at improving healthcare students' knowledge and communication. Despite increasingly interprofessional approaches to medicine, most studies demonstrate these effects in isolation. We enhanced an existing internal medicine curriculum with immersive interprofessional simulations.

Disparities in lung transplantation before and after introduction of the lung allocation score.

Background: In May 2005, the Lung Allocation Score (LAS) became the primary method for determining allocation of lungs for organ transplantation for those at least 12 years of age in the United States. During the pre-LAS period, black patients were more likely than white patients to become too sick or die while awaiting transplant. The association between gender and lung transplant outcomes has not been widely studied.

Inappropriate home albuterol use during an acute asthma exacerbation.

Background: Increased asthma morbidity and mortality is associated with inappropriate home self-management skills.

Objectives: To examine the proportion of children presenting to the emergency department (ED) with an acute asthma exacerbation with incorrect home use of their albuterol inhaler and to identify factors associated with improper treatment.

Methods: Caregivers of children with asthma aged 4 to 14 years, presenting to the ED with an asthma exacerbation, participated in the study.

Can a school-based hand hygiene program reduce asthma exacerbations among elementary school children?

Background: Viral upper respiratory tract infections have been implicated as a major cause of asthma exacerbations among school-aged children. Regular hand washing is the most effective method to prevent the spread of viral respiratory tract infections, but effective hand-washing practices are difficult to establish in schools.

Objectives: This randomized controlled trial evaluated whether a standardized regimen of hand washing plus alcohol-based hand sanitizer could reduce asthma exacerbations more than schools' usual hand hygiene practices.

Measurement characteristics of the pediatric asthma health outcome measure.

Introduction: The Pediatric Asthma Health Outcome Measure (PAHOM) was designed to measure quality-adjusted life years (QALYs) in children with asthma. Our objective was to compare parent- and child-reported PAHOM scores to each other, to parent-reported scores on the Juniper Asthma Control Questionnaire (ACQ), and to physician-rated asthma control.

Methods: A convenience sample of primarily African-American parent-child dyads (N = 261) was recruited from asthma clinics between May 2008 and May 2010.

Redesigning a large school-based clinical trial in response to changes in community practice.

Background: Asthma exacerbations are seasonal with the greatest risk in elementary-age students occurring shortly after returning to school following summer break. Recent research suggests that this seasonality in children is primarily related to viral respiratory tract infections. Regular hand washing is the most effective method to prevent the spread of viral respiratory infections; unfortunately, achieving hand washing recommendations in schools is difficult.

Increasing adherence to inhaled steroid therapy among schoolchildren: randomized, controlled trial of school-based supervised asthma therapy.

Objective: We aimed to determine the effectiveness of school-based supervised asthma therapy in improving asthma control. The primary hypothesis was that the supervised-therapy group would have a smaller proportion of children experiencing an episode of poor asthma control each month, compared with those in the usual-care group.

Methods: Children were eligible if they had physician-diagnosed persistent asthma, the need for daily controller medication, and the ability to use a dry-powder inhaler and a peak flowmeter.

Internet-based monitoring of asthma symptoms, peak flow meter readings, and absence data in a school-based clinical trial.

Background: Asthma is the most common chronic childhood disease and has significant impact on morbidity and mortality in children. Proper adherence to asthma medication has been shown to reduce morbidity among those with asthma; however, adherence to medications is known to be low, especially among low-income urban populations. We conducted a randomized clinical trial to examine the effectiveness of an intervention designed to increase adherence to asthma medication among children with asthma that required daily collection of data.

Images of sexual stereotypes in rap videos and the health of African American female adolescents.

Objective: This study sought to determine whether perceiving portrayals of sexual stereotypes in rap music videos was associated with adverse health outcomes among African American adolescent females.

Methods: African American female adolescents (n = 522) were recruited from community venues. Adolescents completed a survey consisting of questions on sociodemographic characteristics, rap music video viewing habits, and a scale that assessed the primary predictor variable, portrayal of sexual stereotypes in rap music videos.

Design of the supervised asthma therapy study: implementing an adherence intervention in urban elementary schools.

Background: Inhaled corticosteroids, when properly used, can offer considerable protection against asthma-related morbidity. However, adherence to prescribed inhaled steroids among children is low and rates differ markedly by population. The lowest rates of adherence and highest rates of morbidity are among inner-city and low income populations.

Predictors of inconsistent contraceptive use among adolescent girls: findings from a prospective study.

Purpose: To assess the independent effects of various behavioral and psychosocial antecedents on contraceptive use among a sample of low-income African-American adolescent females.

Methods: Stepwise logistic regression was used to calculate odds ratios for baseline predictors of inconsistent contraceptive use six months later. Study participants include 375 nonpregnant African-American girls aged 14-18 years who reported sexual activity in the previous six months.

Efficacy of an HIV prevention program among female adolescents experiencing gender-based violence.

Objectives: We examined the efficacy of an HIV prevention intervention among African American female adolescents reporting a history of gender-based violence.

Methods: In this analysis of a subgroup of participants involved in a randomized controlled trial, consistent condom use, psychosocial mediators associated with HIV-preventive behaviors, and presence of sexually transmitted diseases were assessed at 6- and 12-month follow-ups. The intervention emphasized ethnic and gender pride, HIV knowledge, condom attitudes, healthy relationships, communication, and condom use skills.

Adverse health consequences that co-occur with depression: a longitudinal study of black adolescent females.

Objective: The purpose of this study was to identify adverse health consequences that may co-occur with depression among black female adolescents.

Methods: Adolescents were recruited from high-risk neighborhoods in Birmingham, Alabama. The sample comprised 460 black female adolescents (aged 14-18 years) who completed assessments at baseline and at 6 and 12 months.

Self-esteem and theoretical mediators of safer sex among African American female adolescents: implications for sexual risk reduction interventions.

Theories of health behavior posit that change is accomplished by modifying factors deemed as mediators. A set of mediators from several theoretical models used in sexual risk reduction programs was assessed among a sample of 522 African American female adolescents. The goal was to determine whether self-esteem was associated with sexually transmitted disease (STD), pregnancy, and the set of theoretical mediators controlling for covariates.

Self-concept and adolescents' refusal of unprotected sex: a test of mediating mechanisms among African American girls.

During adolescence, girls form self-concepts that facilitate the transition to adulthood. This process may entail engaging in risky sexual behaviors resulting in STD infection and pregnancy. This study assessed the relation between self-concept and unwanted, unprotected sex refusal among 335 African American adolescent girls.

The role of social support in the psychological well-being of African American girls who experience dating violence victimization.

The goals of this study were to test the relationship between dating violence victimization (i.e., verbal, emotional, and physical abuse) and psychological well-being (i.

Efficacy of an HIV prevention intervention for African American adolescent girls: a randomized controlled trial.

Context: African American adolescent girls are at high risk for human immunodeficiency virus (HIV) infection, but interventions specifically designed for this population have not reduced HIV risk behaviors.

Objective: To evaluate the efficacy of an intervention to reduce sexual risk behaviors, sexually transmitted diseases (STDs), and pregnancy and enhance mediators of HIV-preventive behaviors.

Design, Setting, And Participants: Randomized controlled trial of 522 sexually experienced African American girls aged 14 to 18 years screened from December 1996 through April 1999 at 4 community health agencies.

Using cognitive mapping to develop a community-based family intervention.

Objective: To describe the development of a consumer-oriented intervention for increasing intake of fruits and vegetables (FVs) in families (n=265).

Method: A cognitive-mapping approach was used to specify intervention performance objectives and a tailoring strategy.

Results: MDS and hierarchical cluster analysis indicated that FV perceptions are organized into 6 clusters arrayed along 3 dimensions.

Identification of strategies for promoting condom use: a prospective analysis of high-risk African American female teens.

Condom promotion strategies for adolescents typically include provision of STD/HIV-associated knowledge, fostering favorable attitudes toward condom use, promoting positive peer norms regarding condom use, improving condom-related communication skills and self-efficacy, and overcoming barriers to condom use. The purpose of this study was to identify which of these constructs were prospectively associated with condom use among a high-risk sample of African American adolescent females reporting sexual activity with a steady male partner. Adolescents, 14-18 years old, were recruited from schools and health clinics.