Suchergebnisse

One issue for community groups, local and regional planners, and politicians, is that they require relevant information to develop programs and initiatives for incorporating sustainability principles into their physical infrastructure, operations, and decision-making processes. This research project addressed the issue through two research questions. The first research question that this project was designed to address, which was greatly influenced by the vast number of references in the sustainability literature, was an ontological one, "what are the major categories that sustainability decisions can be grouped under, and how might those categories be related?". The second research question that this project answered was, "how can information contained in the sustainability literature be made accessible to users in a convenient format?". The Multi-Sector Sustainability Browser (MSSB) is a decision support tool (DST) designed to synthesize and summarize research in four sustainability decision domains, Land Use, Buildings and Infrastructure, Transportation, and Materials Management in a manner that provides easy and rapid access to information for use in planning and decision making. Weblinks are provided to reference documents and resources from the four sustainability decision domains, allowing users to download relevant documents and extract information in support of sustainability decisions and related program initiatives.

To determine changes in appetite, affect and cortisol in response to an acute bout of resistance exercise (RE) the morning after consuming whey (WP) and casein (CP) protein and a non-caloric placebo (PLA) consumed pre-sleep, 14 active men (n = 5) and women (n = 9) consumed a single dose of 24 g WP, 48 g WP, 24 g CP, 48 g CP, or PLA 30 min pre-sleep. Prior to and immediately after RE, appetite, affect and cortisol were assessed. Significant time effects were observed for Energetic Arousal and Tense Arousal (p = 0.017) and Feeling Scale and Felt Arousal Scale (p < 0.001). Appetite did not change over time or condition. Cortisol levels increased after RE (p = 0.007). Pre-RE, Tense Arousal was correlated with hunger (r = 0.25, p = 0.047) and desire to eat (r = 0.35, p = 0.005). Post-RE, cortisol was found to be significantly related to Feeling Scale (r = 0.32, p = 0.018), Felt Arousal Scale (r = 0.33, p = 0.015) and Energetic Arousal (r = 0.32, p = 0.018). Varying doses of WP and CP pre-sleep did not have an effect on morning appetite and cortisol, but cortisol was found to be related to affect and appetite.

Background: The opioid crisis is one of the most pressing public health issues facing Ohio, with an impact uneven-ly distributed across the state. This work examined geographical barriers to substance abuse treatment in southwestern Ohio through examining geographical areas with limited access to substance abuse treatment services and identifying substance abuse treatment deserts. Methods: The study domain included the 13 counties in the Ohio Mental Health and Addiction Service's Cincinnati region. Publicly available substance use disorders treatment data were collected from government agency resources, pharmaceutical websites, and web searches. Substance abuse treatment deserts were defined as areas in the 13-county study area that were not within a 15-minute drive from a treatment center. Results: We found large portions of the study region that were considered a substance abuse treatment desert for methadone and naltrexone/buprenorphine clinics, behavioral health treatment centers, and both medicated assisted treatment (MAT) and behavioral health treatment combined. Out of the 2 017 337 total persons living in the 13-county study area, 17% (n = 342 872) live in a desert for all MAT and behavioral treatment. Similarly, 19.7% (n = 396 581) live in a desert for naltrexone/buprenorphine treatment, 60.9% (n = 1 227 560) live in a desert for methadone treatment, and 19.7% (n = 396 581) live in a desert for behavioral health treatment. Conclusion: We successfully defined substance abuse treatment deserts in southwestern Ohio, which will be useful for future research to determine its association with opioid-related health outcomes. This resource is publicly available online (https://doi.org/10.5281/zenodo.4011051).

The authors embarked on a study to determine what is on the horizon for undergraduate research (UR) for the future. They reviewed the literature to identify current trends and asked 33 faculty recipients of awards for UR commitment and expertise about their perceptions of UR in the next five to ten years. Results suggest that the next decade may bring more democratization of UR such as greater access to research opportunities for undergraduates from historically underserved groups, those from nontraditional populations, and those with below-average or average academic performance histories. Results also indicate strengthened mentor-student relationships across national and international borders due to enhanced communications technologies.

AbstractIntroductionPrEP is a powerful HIV prevention tool, and locally relevant eligibility criteria are necessary to optimize the prevention impact of PrEP. We assessed performance of existing national and international PrEP eligibility criteria to predict future HIV seroconversion among MSM in Beijing, China.MethodsParticipants were MSM aged ≥18 years who enrolled in a cohort study between July 2009 and March 2016. Participants completed HIV testing, syphilis testing, and a questionnaire on recent sexual health behaviours at each follow‐up visit and were followed until HIV seroconversion or dropout. We assessed PrEP eligibility at the most recent follow‐up visit prior to the final study visit. Participants were classified as indicated for PrEP (or not) based on criteria from guidelines from Europe, Korea, South Africa, Taiwan, the United Kingdom, United States and the World Health Organization. To compare guideline performance, we calculated sensitivity, specificity, Youden's Index (YI), Matthew's Correlation Coefficient (MCC), F1 scores and diagnostic odds ratios. For each guideline, performance measures were compared to random allocation of PrEP by randomly selecting a proportion of participants equal to the proportion indicated.ResultsThere were 287 (17∙3%) incident HIV seroconversions among 1663 MSM. The number of men indicated for PrEP from different guidelines ranged from 556 (33∙4%) to 1569 (94∙2%). Compared to random allocation, sensitivity of algorithms to predict seroconversion ranged from slightly worse (−4∙7%) to 30∙2% better than random. However, in absolute terms, none of the sensitivity values increased by more than 11% when compared to random allocation. For all guidelines, specificity was not meaningfully better than random allocation. No guidelines had high binary classification performance measures.ConclusionsThe performance of international indication guidelines in this sample was only slightly better than random allocation. Using such guidelines to screen out MSM self‐identifying as interested in PrEP could lead to misallocation of resources and to good candidates for PrEP being denied access. For settings in which international guidelines perform poorly, alternative indication approaches should be considered.

Enterotoxigenic Escherichia coli (ETEC) is a common cause of diarrheal illness in the military, travelers, and children living in low- to middle-income countries. Increased antibiotic resistance, the absence of a licensed vaccine, and the lack of broadly practical therapeutics perpetuate the significant health and financial burden resulting from ETEC infection. A critical step in the evaluation of vaccines and therapeutics is preclinical screening in a relevant animal disease model that closely replicates human disease. We previously developed a diarrheal model of class 5a colonization factor (CF) CFA/I-expressing ETEC in the New World owl monkey species Aotus nancymaae using ETEC strain H10407. In order to broaden the use of the model, we report here on the development of A. nancymaae models of ETEC expressing the class 5b CFs CS17 and CS19 with strains LSN03-016011/A and WS0115A, respectively. For both models, we observed diarrheal attack rates of ≥80% after oral inoculation with 5 × 10(11) CFU of bacteria. These models will aid in assessing the efficacy of future ETEC vaccine candidates and therapeutics.

The Act-Belong-Commit 'ABCs of Mental Health' campaign for mental health promotion
A simple research-based model for mental health promotion in practice could improve mental health and wellbeing in the whole population. With mental health declining in most Western countries, there is a need for population-wide strategies to promote and protect mental wellbeing. Whilst both universal mental health promotion and targeted prevention approaches have the potential to prevent deteriorating mental health, universal approaches may reach and impact larger segments of a population. However, universal mental health promotion strategies are scarce and not widely implemented.

BACKGROUND: Options to increase the ease of testing for SARS-CoV-2 infection and immune response are needed. Self-collection of diagnostic specimens at home offers an avenue to allow people to test for SARS-CoV-2 infection or immune response without traveling to a clinic or laboratory. Before this study, survey respondents indicated willingness to self-collect specimens for COVID-related tests, but hypothetical willingness can differ from post-collection acceptability after participants collect specimens. METHODS: 153 US adults were enrolled in a study of the willingness and feasibility of patients to self-collect three diagnostic specimens (saliva, oropharyngeal swab (OPS) and dried blood spot (DBS) card) while observed by a clinician through a telehealth session. After the specimens were collected, 148 participants participated in a survey about the acceptability of the collection, packing and shipping process, and their confidence in the samples collected for COVID-related laboratory testing. RESULTS: A large majority of participants (>84%) reported that collecting, packing and shipping of saliva, OPS, and DBS specimens were acceptable. Nearly nine in 10 (87%) reported being confident or very confident that the specimens they collected were sufficient for laboratory analysis.There were no differences in acceptability for any specimen type, packing and shipping, or confidence in samples, by gender, age, race/ethnicity, or educational level. CONCLUSIONS: Self-collection of specimens for SARS-CoV-2 testing, and preparing and shipping specimens for analysis, were acceptable in a diverse group of US adults. Further refinement of materials and instructions to support self-collection of saliva, OPS and DBS specimens for COVID-related testing is needed.

Hepatitis C virus (HCV) infection is the most commonly reported bloodborne infection in the United States, causing substantial morbidity and mortality and costing billions of dollars annually. To update the estimated HCV prevalence among all adults aged ≥18 years in the United States, we analyzed 2013-2016 data from the National Health and Nutrition Examination Survey (NHANES) to estimate the prevalence of HCV in the noninstitutionalized civilian population, and used a combination of literature reviews and population size estimation approaches to estimate the HCV prevalence and population sizes for four additional populations: incarcerated people, unsheltered homeless people, active-duty military personnel, and nursing home residents. We estimated that during 2013-2016, 1.7% (95% CI 1.4-2.0%) of all adults in the United States, approximately 4.1 (3.4-4.9) million persons, were HCV antibody-positive (indicating past or current infection), and 1.0% (95% CI 0.8-1.1%) of all adults, approximately 2.4 (2.0-2.8) million persons, were HCV RNA-positive (indicating current infection). This includes 3.7 million noninstitutionalized civilian adults in the United States with HCV antibodies and 2.1 million with HCV RNA, and an estimated 0.38 million HCV antibody-positive persons and 0.25 million HCV RNA-positive persons not part of the 2013-2016 NHANES sampling frame. CONCLUSION: Over 2 million people in the United States had current HCV infection during 2013-2016. Compared to past estimates based on similar methodology, HCV antibody prevalence may have increased while RNA prevalence may have decreased, likely reflecting the combination of the opioid crisis, curative treatment for HCV infection, and mortality among the HCV-infected population. Efforts on multiple fronts are needed to combat the evolving HCV epidemic, including increasing capacity for and access to HCV testing, linkage-to-care, and cure.

AbstractIntroductionDue to factors associated with structural racism, Black men who have sex with men (MSM) living with HIV are less likely to be virally suppressed compared to white MSM. Most of these data come from clinical cohorts and modifiable reasons for these racial disparities need to be defined in order to intervene on these inequities. Therefore, we examined factors associated with racial disparities in baseline viral suppression in a community‐based cohort of Black and white MSM living with HIV in Atlanta, GA.MethodsWe conducted an observational cohort of Black and white MSM living with HIV infection in Atlanta. Enrolment occurred from June 2016 to June 2017 and men were followed for 24 months; laboratory and behavioural survey data were collected at 12 and 24 months after enrolment. Explanatory factors for racial disparities in viral suppression included sociodemographics and psychosocial variables. Poisson regression models with robust error variance were used to estimate prevalence ratios (PR) for Black/white differences in viral suppression. Factors that diminished the PR for race by ≥5% were considered to meaningfully attenuate the racial disparity and were included in a multivariable model.ResultsOverall, 26% (104/398) of participants were not virally suppressed at baseline. Lack of viral suppression was significantly more prevalent among Black MSM (33%; 69/206) than white MSM (19%; 36/192) (crude Prevalence Ratio (PR) = 1.6; 95% CI: 1.1 to 2.5). The age‐adjusted Black/white PR was diminished by controlling for: ART coverage (12% decrease), housing stability (7%), higher income (6%) and marijuana use (6%). In a multivariable model, these factors cumulatively mitigated the PR for race by 21% (adjusted PR = 1.1 [95% CI: 0.8 to 1.6]).ConclusionsRelative to white MSM, Black MSM living with HIV in Atlanta were less likely to be virally suppressed. This disparity was explained by several factors, many of which should be targeted for structural, policy and individual‐level interventions to reduce racial disparities.