Purpose: Despite the wide usage of World Health Organization Disability Assessment Schedule II (WHODAS 2.0) in psychiatry research and clinical practice, there was limited knowledge on its proxy reliability among people with mental disorders. This paper aimed to compare the 12-item WHODAS 2.0 responses of adult patients with mental disorders to their family caregivers. Methods: In this study, 205 pairs of patients with mental disorders and primary family caregivers were consecutively recruited from one inpatient mental health department in a large hospital in China. All participants completed the 12-item version WHODAS 2.0 to assess patients’ functioning in the 30 days prior to the hospitalization. Measurement invariance, including configural, metric and scalar invariance, was tested across patient and proxy groups, using multi-group confirmatory factor analysis. Agreement between patients and proxies was examined by paired Wilcoxon tests and intraclass correlation coefficients (ICC). Subgroup analyses for proxy reliability were conducted within strata of proxy kinship and patient psychiatric diagnosis. Results: The 12-item WHODAS 2.0 achieved configural, metric and partial scalar invariance across patient and proxy groups. Unsatisfactory consistency was found for most items (ICC < 0.75, P < 0.05), especially for items on Cognition, Getting along, Life activities, and Participation in society (ICC < 0.4, P < 0.05). Spouses agreed with patients more often than parents (ICC ≥ 0.4, P < 0.05). The paired Wilcoxon tests found that impairment of patients with psychotic disorders tended to be overestimated by proxies while proxies tended to underestimate impairment of patients with mood disorders. Conclusion: Our study reveals inconsistency between self and proxy reports in the 12-item WHODAS 2.0 among adult patients with mental disorders. When proxy reports is needed, spouses are preferred than parents. We should be aware of proxies’ impairment overestimation among patients with psychotic disorders and underestimation among patients with mood disorders.

Objectives: This study aimed to examine the association of Per and Polyfluoroalkyl substances (PFAS) and markers of chronic inflammation and oxidative stress. Methods: Using data (n = 6652) from the National Health and Nutrition Examination Survey (NHANES) 2005–2012, generalized linear models were used to examine the association between PFAS and inflammatory (ferritin, alkaline phosphatase, C-reactive protein, absolute neutrophil count and lymphocyte count) and oxidative stress (serum bilirubin, albumin and iron) per unit exposure to PFAS while adjusting for covariates. Study participants were those ≥20 years of age. Outcome variables were markers of chronic inflammation and oxidative stress and exposure variables were PFAS. Resullts: Percentage change in Perfluorohexane sulfonic acid (PFHxS), Perfluorononanoic acid (PFNA), Perfluorooctanoic acid (PFOA), Perfluorooctane sulfonic acid (PFOS), and Perfluorodecanoic acid (PFDA) were all significantly associated with percentage increases in lymphocyte counts, beta (95% confidence interval); 0.04(0.02,0.05), 0.04(0.02,0.05), 0.05(0.03, 0.07), 0.04(0.03,0.05), 0.03(0.13,1.23) and with percentage increases in serum iron 0.07(0.05,0.09), 0.04(0.02,0.07), 0.10(0.07,0.12), 0.05(0.03,0.07), 0.04(0.02,0.06) and increased serum albumin 0.02(0.02,0.02), 0.02(0.02,0.03), 0.03(0.03,0.04), 0.02(0.017, 0.025), 0.01 (0.01, 0.05). Only PFHxS, PFNA, PFOA and PFOS were associated with percentage increases in serum total bilirubin 0.04(0.03,0.05), 0.02(0.00,0.03), 0.06(0.04,0.08), 0.03(0.02,0.05). Similar results were obtained for categorical quintile analysis with PFOA showing a significant trend (P < 0.001) with lymphocyte count, serum iron, serum total bilirubin and serum albumin. Trend for neutrophil count was not significant (p = 0.183). Conclusion: Per and Polyfluoroalkyl substances are associated with markers of chronic inflammation and oxidative stress. Increased exposure leads to increase in serum concentration of these markers meaning these chemicals are associated with both chronic inflammation and oxidative stress.

This study examined associations between the prevalence of HIV testing and factors or behaviors that influence HIV testing in U.S.A. 9th to 12th graders using the 2017 Youth Risk Behavior Surveillance Survey (YRBSS) data. Selection criteria was based on a positive report of sexual debut (Ever had sex? Yes/No). Outcome of interest was having ever tested for HIV. Independent risk factors included age, sex, grade, race, condom use, age at first sexual intercourse, number of lifetime sexual partners, use of contraceptives, use of drug or alcohol before last sexual activity and several other factors. Chi-square and logistic regression analyses were conducted to evaluate factors associated with HIV screening participation. HIV testing prevalence was 20.34%. Females (53.97%) were more likely to participate in HIV screening test than males (67.37% females versus 32.63% males) and had higher odds of testing (OR: 2.229; p <.0001). Those in 11th and 12th grade, aged greater than 16 and with multiple sexual partners had higher rates of HIV testing. Strongest associations with HIV testing were older age at 1st sexual intercourse, odds ratio (OR): 0.413; (p ≤.0001), having three or more sexual partners (OR: 2.023; p ≤.0001), being female (OR: 2.021; p ≤.0001), use of contraceptives (OR: 1.828; p ≤.0001) and describing grades in school as mostly A’s or B’s (OR: 0.696; p ≤.001).

Purpose: We investigated the associations of early onset polysubstance use prior to age 18 with the prevalence of bronchitis among U.S. adults and tested whether the associations differ by gender. Methods: A total of 77,950 adults, of them 2,653 with bronchitis in the past year, were from the combined 2013 and 2014 National Survey on Drug Use and Health data. The variable cluster analysis was used to classify nine variables about substance use prior to age 18 (cigarettes, cigars, smokeless tobacco, marijuana, cocaine, heroin, methamphetamines, ecstasy, and phencyclidine). Weighted multivariate logistic regression analysis (MLR) was used to examine the associations with bronchitis. Results: Nine variables were divided into two clusters: early onset poly tobacco use (three tobacco use variables) and early onset poly drug use (six drug use variables). The overall prevalence of bronchitis was 3.8% (5.1% for females and 2.3% for males). MLR analysis showed that being female, elderly (ages 65 and above), obese, and early onset poly tobacco use were associated with increased odds of bronchitis (p < 0.05). Gender-stratified analyses showed that early-onset poly tobacco use was significantly associated with bronchitis only in males, whereas early onset poly drug use was associated with bronchitis only in females. Moreover, obesity and tobacco use in the past year revealed associations with bronchitis regardless of gender. Conclusions: Obesity, early onset poly tobacco use prior to age 18, and tobacco use in the past year were positively associated with bronchitis; furthermore, the associations of early onset polysubstance use with bronchitis differed by gender, which indicated that gender differences should be considered in developing effective prevention strategies.

Introduction: This study investigated the systemic response of serum bone alkaline phosphatase (SBAP) and urinary N-telopeptide (UNTX) to tobacco exposure and environmental tobacco smoke (ETS) and the possible effect modification (and variability) of this response by racial/ethnic origin. Methods: Data (n=5411) were obtained from the National Health and Nutrition Examination Survey, with data analysis done on adults aged ≥ 20years. Outcome variables were SBAP and UNTX. Independent variable was tobacco exposure measured using serum cotinine levels and adjusted for covariates. Generalized linear models were used to explore associations. Results: A percentage increase in log transformed serum cotinine was associated with a 0.005 percentage increase in log transformed SBAP (CI: 0.002, 0.008) and 0.02 percentage increase in log transformed UNTX (CI: −0.01, 0.04) with interaction between cotinine and race/ethnicity (p=0.01). Stratifying by race/ethnicity, tobacco exposure was associated with significant decreases in UNTX among non-Hispanic Whites–0.008(−0.014, −0.002) and Mexican Americans −0.014 (−0.025, −0.002) only. Categories of serum cotinine were associated with a monotonic increase in SBAP (p for trend <0.001) and monotonic non-linear decrease in UNTX (p for trend>0.05). Conclusions: Tobacco and environmental tobacco exposure are associated with SBAP and increased bone formation. The response of UNTX to these exposures is modified by race/ethnicity with non-Hispanic Whites and Mexican-Americans less sensitive to the resorptive effects of tobacco exposure on bone.

Objectives: To test the hypotheses that mechanobehavior scores (MBS) were correlated with mandibular ramus lengths (Co-Go) and differed between facial phenotypes. Materials and Methods: Subjects gave informed consent to participate. Co-Go (mm), mandibular plane angles (SN-GoGn, °), and three-dimensional anatomy were derived from cephalometric radiography or cone beam computed tomography. Temporomandibular joint (TMJ) energy densities (ED) (mJ/mm3) were measured using dynamic stereometry and duty factors (DF) (%) were measured from electromyography, to calculate MBS (= ED2 3 DF, (mmmJ3)2%) for each TMJ. Polynomial regressions, K-means cluster analysis, and analysis of variance (ANOVA) with Tukey post-hoc tests were employed. Results: Fifty females and 23 males produced replete data. Polynomial regressions showed MBS were correlated with Co-Go (females, R2 = 0.57; males, R2 = 0.81). Cluster analysis identified three groups (P<.001). Dolichofacial subjects, with shorter normalized Co-Go, clustered into two subgroups with low and high MBS compared to brachyfacial subjects with longer Co-Go. SN-GoGn was significantly larger (P<.03) in the dolichofacial subgroups combined (33.0 ± 5.98) compared to the brachyfacial group (29.8 ± 5.58). Conclusions: MBS correlated with Co-Go within sexes and differed significantly between brachyfacial and dolichofacial subjects.

No description available.

No description available.

One challenge facing spatial scientists trying to support public health outreach and intervention in challenging environments is the lack of fine scale spatial data. These data are required to gain a better understanding of both physical and social systems; why disease occurs where it does, and how to disrupt it. While data options exist, including high resolution aerial imagery, remotely sensed data, and even online mapping products like Google Street View, these all come with limitations. One option that has previously been utilized to assess cholera risk is spatial video. Here it is used to map potential mosquito breeding sites in an endemic Dengue and Chikungunya, and emerging Zika impacted community. We show how this method can provide mapping support in the hands of non-specialist public health workers who, working in collaboration with out-of-area geographic information systems (GIS) teams, can identify where to target limited intervention resources. We use a case study of an impoverished informal style Nicaraguan community suffering from a high disease burden to show spatial variation in potential mosquito breeding habitats. A field team collected street-by-street spatial video data to produce fine scale risk maps of standing water and trash locations, which, when interpreted with the associated spatial video imagery, were used to suggest where intervention strategies should be targeted. We also discuss how these same data layers can be used to address other health concerns traditionally found in informal settlements.

Background: Mortality from colorectal cancer (CRC) can be reduced drastically by early detection and early treatment. However, uptake of CRC screening is relatively low, about 50% for those whom the test is highly recommended. Objectives: We examined the influence of and racial differences in depression, insomnia, alcohol use, and tobacco use on CRC screening uptake in the US. Patients and Methods: Analysis of the 2012 National Health Information Survey data was conducted. Both weighted univariate and multiple logistic regression analyses were performed in SAS to estimate the odds ratios (ORs) and their 95% confidence intervals (CIs). A total of 21511 participants were included in the analysis. Results: Prevalence of CRC screening in the participants was 19%. Adjusting for all factors, insomnia (OR = 1.18, 95%CI = 1.06 - 1.32), moderate alcohol drinking (OR = 1.16, 95%CI = 1.01 - 1.30), past smoking (OR = 1.17, 95%CI = 1.04 - 1.32), depression (OR = 1.37, 95%CI = 1.18 - 1.58), African American (AA) race, and cancer history were positively associated with CRC screening. Females and Single were inversely associated with CRC screening prevalence. In stratified analysis by races (White and AA), depression was associated with CRC screening in both races. Marital status, smoking, cancer history and insomnia were associated with CRC screening in Whites only; while alcohol use was associated with CRC screening in AAs only. Conclusions: We have found significant associations between lifestyle factors (alcohol consumption and smoking) and mental health problems (depression and insomnia) and CRC screening uptake. To improve overall CRC screening uptake in the US, it is important to consider racial differences in predictors and tailor appropriate interventions to each racial/ethnic group.