Improving Awareness of Workplace Opioid Use and Addiction Prevention: A Train-the-Trainer Approach.

Background: The National Institute of Environmental Health Sciences Worker Training Program developed instructor curriculum, a training tool, and materials to prepare trainees to conduct opioids workplace awareness training. courses were held during three instructor-led online programs.

Methods: The OWPR TTT was evaluated using an online pre- and posttest among registered participants, and an assessment of discussion among trainees during the training program.

Effect of Alirocumab on Incidence of Atrial Fibrillation After Acute Coronary Syndromes: Insights from the ODYSSEY OUTCOMES Trial.

Background: Using data from the ODYSSEY OUTCOMES trial (NCT01663402), we sought to identify factors associated with the development of incident atrial fibrillation in patients with recent acute coronary syndrome without prior atrial fibrillation and to determine whether alirocumab treatment influenced risk of incident atrial fibrillation.

Methods: ODYSSEY OUTCOMES compared alirocumab treatment with placebo in 18,924 patients with recent acute coronary syndrome and dyslipidemia despite high-intensity or maximum-tolerated statin therapy. The primary outcome of major adverse cardiovascular events (MACE) comprised death from coronary heart disease, non-fatal myocardial infarction, fatal or non-fatal ischemic stroke, or unstable angina requiring hospitalization.

Prenatal exposure to air pollution is associated with altered brain structure, function, and metabolism in childhood.

Background: Prenatal exposure to air pollution disrupts cognitive, emotional, and behavioral development. The brain disturbances associated with prenatal air pollution are largely unknown.

Methods: In this prospective cohort study, we estimated prenatal exposures to fine particulate matter (PM ) and polycyclic aromatic hydrocarbons (PAH), and then assessed their associations with measures of brain anatomy, tissue microstructure, neurometabolites, and blood flow in 332 youth, 6-14 years old.

Alirocumab after acute coronary syndrome in patients with a history of heart failure.

Aims: Patients with heart failure (HF) have not been shown to benefit from statins. In a post hoc analysis, we evaluated outcomes in ODYSSEY OUTCOMES in patients with vs. without a history of HF randomized to the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab or placebo.

Recognizing careworkers' contributions to improving the social determinants of health: A call for supporting healthy carework.

Workers engaged in reproductive labor-the caring work that maintains society and supports its growth-contribute to societal health while also enduring the harms of precarious labor and substantial work stress. How can we conceptualize the effects of reproductive labor on workers and society simultaneously? In this commentary, we analyze four types of more relational and less relational careworkers-homeless shelter workers, school food workers, home care aides, and household cleaners-during the COVID-19 pandemic. We then make a case for a new model of societal health that recognizes the contributions of careworkers and healthy carework.

The Impact of Restrictive Policies on Mexican Immigrant Parents and Their Children's Access to Health Care.

This study assessed whether policies that limit Mexican immigrants' access to care affects their children's access to a regular source of care, health insurance, and timely preventive health visits. This was a cross-sectional study among Mexican immigrant parents who attended a health promotion program in Texas, Nevada, New York, and Illinois. A sociodemographic survey, including parental and child variables, was administered.

Opioids and the Workplace Prevention and Response Train-the-Trainer and Leadership Training Mixed Methods Follow-up Evaluation.

Objectives: This study was designed to evaluate the outcomes of a national summer 2020 'Opioids and the Workplace' Prevention and Response (OWPR) Train-the-Trainer (TTT) and Leadership training tool and program at 6-month follow-up. The TTT program goal is to help instructors plan and conduct education and training on opioids and the workplace awareness. The Leadership program goal is to help trainees, who are in a position to take organizational level actions, implement policies, and programs related to opioid and substance use and injury prevention.

Associations between Experiences of Police Contact and Discrimination by the Police and Courts and Health Outcomes in a Representative Sample of Adults in New York City.

Communities marginalized because of racism, heterosexism, and other systems of oppression have a history of being aggressively policed, and in those contexts, researchers have observed associations between a range of negative experiences with police and poor physical, mental, and behavioral health outcomes. However, past studies have been limited in that experiences of police contacts were aggregated at the neighborhood level and, if police contacts were self-reported, the sample was not representative. To address these limitations, we employed NYC Department of Health and Mental Hygiene 2017 Social Determinants of Health Survey (n = 2335) data to examine the associations of self-reported police contacts and discrimination by police and the courts with measures of physical (poor physical health), mental (poor mental health, serious psychological distress), and behavioral health (binge drinking).

Introduction to the Special Issue: Opioids and the Workplace - Risk Factors and Solutions.

The workplace has been a neglected element in the national response to the opioid crisis. This ignores that workplace safety and health and drug policies have become important factors in opioid use disorder among workers. This results from physical or emotional pain related to workplace injuries, illnesses, and stress, and through punitive workplace drug policies, failure to address stigma, and inadequate access to treatment and recovery resources.

Prevalence of Positive Cervical Cancer Screening Tests Past the Age of 65 Years With Prior Adequate Negative Screening.

Objectives: Cervical cancer screening recommendations suggest that cessation can be offered above the age of 65 years if specific prior negative screening criteria are met. We investigated the prevalence of abnormal results in individuals who continue screening despite satisfying the American Society for Colposcopy and Cervical Pathology guidelines for cessation.

Materials And Methods: In this retrospective study, medical records 2008-2019 from a single urban hospital-based clinic were queried.

Lipoprotein(a) and Benefit of PCSK9 Inhibition in Patients With Nominally Controlled LDL Cholesterol.

Background: Guidelines recommend nonstatin lipid-lowering agents in patients at very high risk for major adverse cardiovascular events (MACE) if low-density lipoprotein cholesterol (LDL-C) remains ≥70 mg/dL on maximum tolerated statin treatment. It is uncertain if this approach benefits patients with LDL-C near 70 mg/dL. Lipoprotein(a) levels may influence residual risk.

Predicting new major depression symptoms from long working hours, psychosocial safety climate and work engagement: a population-based cohort study.

Objectives: This study sought to assess the association between long working hours, psychosocial safety climate (PSC), work engagement (WE) and new major depression symptoms emerging over the next 12 months. PSC is the work climate supporting workplace psychological health.

Setting: Australian prospective cohort population data from the states of New South Wales, Western Australia and South Australia.

Upper extremity musculoskeletal disorders and work exposures among railroad maintenance-of-way workers.

Background: Our objective was to examine occupational risk factors for musculoskeletal disorders of the shoulders, elbows, wrists, and hands among railroad maintenance-of-way (MOW) workers. Little systematic research on musculoskeletal disorders has been conducted in this occupational group.

Methods: In total, 3995 active members of the Brotherhood of Maintenance of Way Employes Division (BMWED) completed a standardized survey focusing on disorders caused by hand-transmitted vibration.

Fragmentation of Care Among Black Women With Breast Cancer and Comorbidities: The Role of Health Systems.

Purpose: Black women are disproportionately burdened by comorbidities and breast cancer. The complexities of coordinating care for multiple health conditions can lead to adverse consequences. Care coordination may be exacerbated when care is received outside the same health system, defined as care fragmentation.

Opioids and the Workplace Prevention and Response Awareness Training: Mixed Methods Follow-Up Evaluation.

The National Institute of Environmental Health Sciences Worker Training Program piloted an Opioids and the Workplace: Prevention and Response training tool and program in 2019. The pilot trainees ( = 97) were surveyed (= 27) and interviewed ( = 6) six months posttraining, and those who downloaded the training tool from the Worker Training Program website (= 87) were surveyed ( = 19) and interviewed ( = 1) two to six months postdownload, to evaluate the impact of the training program. Workplace policy and program-level actions were reported less frequently than individual-level actions by trainees, except for planning and conducting training and education.

Intensity of statin treatment after acute coronary syndrome, residual risk, and its modification by alirocumab: insights from the ODYSSEY OUTCOMES trial.

Aims: Statins are pivotal to the secondary prevention of major adverse cardiovascular events, but some patients are statin-intolerant. We examined the effects of the proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor alirocumab on the risk of major adverse cardiovascular events according to the intensity of background statin treatment.

Methods And Results: The ODYSSEY OUTCOMES trial compared alirocumab with placebo in 18,924 patients with acute coronary syndrome and dyslipidaemia despite intensive or maximum-tolerated statin treatment (including no statin if intolerance was documented).

Relation of Lipoprotein(a) Levels to Incident Type 2 Diabetes and Modification by Alirocumab Treatment.

Objective: In observational data, lower levels of lipoprotein(a) have been associated with greater prevalence of type 2 diabetes. Whether pharmacologic lowering of lipoprotein(a) influences incident type 2 diabetes is unknown. We determined the relationship of lipoprotein(a) concentration with incident type 2 diabetes and effects of treatment with alirocumab, a PCSK9 inhibitor.

Clinical Efficacy and Safety of Alirocumab After Acute Coronary Syndrome According to Achieved Level of Low-Density Lipoprotein Cholesterol: A Propensity Score-Matched Analysis of the ODYSSEY OUTCOMES Trial.

Background: Recent international guidelines have lowered recommended target levels of low-density lipoprotein cholesterol (LDL-C) for patients at very high risk for major adverse cardiovascular events (MACE). However, uncertainty persists whether additional benefit results from achieved LDL-C levels below the conventional targets. Inferences from previous analyses are limited because patients who achieve lower versus higher LDL-C on lipid-lowering therapy differ in other characteristics prognostic for MACE and because few achieved very low LDL-C levels.

Patterns of chronic disease management and health outcomes in a population-based cohort of Black women with breast cancer.

Purpose: Diabetes and hypertension are two common comorbidities that affect breast cancer patients, particularly Black women. Disruption of chronic disease management during cancer treatment has been speculated. Therefore, this study examined the implementation of clinical practice guidelines and health outcomes for these comorbidities before and during cancer treatment.