3 resultados para Indicators

em DRUM (Digital Repository at the University of Maryland)


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African Americans are disproportionately affected by colorectal cancer (CRC) incidence and mortality. CRC early detection leads to better treatment outcomes and, depending on the screening test, can prevent the development of CRC. African Americans, however, are screened less often than Whites. Aspects of decision making (e.g., decisional conflict, decision self-efficacy) can impact decision making outcomes and may be influenced by social determinants of health, including health literacy. However the relationship between social determinants of health and indicators of decision making in this population is not fully understood. Additionally, individuals have a choice between different CRC screening tests and an individual’s desire to use a particular screening test may be associated with social determinants of health such as health literacy. This study aimed to examine the relationship between social determinants of health and indicators of decision making for CRC screening among African Americans. A total of 111 participants completed a baseline and 14-month follow-up survey assessing decisional conflict, decision self-efficacy, decisional preference (shared versus informed decision making), and CRC test preference. Health literacy was negatively associated with decisional conflict and positively associated with decision self-efficacy (ps < .05). Individuals who were unemployed or working part-time had significantly greater decisional conflict than individuals working full-time (ps < .05). Individuals with a first-degree family history of CRC had significantly lower decision self-efficacy than individuals without a family history (p < .05). Women were significantly more likely to prefer making a shared decision rather than an informed decision compared to men (p < .05). Lastly, previous CRC screening behavior was significantly associated with CRC test preference (e.g., individuals previously screened using colonoscopy were significantly more likely to prefer colonoscopy for their next screening test; ps < .05). These findings begin to identify social determinants of health (e.g., health literacy, employment) that are related to indicators of decision making for CRC among African Americans. Furthermore, these findings suggest further research is needed to better understand these relationships to help with the future development and improvement of interventions targeting decision making outcomes for CRC screening in this population.

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Environmental indicators have been proposed as a means to assess ecological integrity, monitoring both chemical and biological stressors. In this study, we used nestling bald eagles as indicators to quantify direct or indirect tertiary-level contaminant exposure. The spatial and temporal trends of polychlorinated biphenyl (PCB) congeners were evaluated in nestling plasma from 1999–2014. Two hexa-chlorinated congeners, PCB-138 and 153, were detected with the highest frequency and greatest concentrations throughout Michigan. Less-chlorinated congeners such as PCB-52 and 66 however, comprised a greater percentage of total PCB concentrations in nestlings proximate to urbanized areas, such as along the shorelines of Lake Erie. Toxic equivalents were greatest in the samples collected from nestlings located on Lake Erie, followed by the other Great Lakes spatial regions. Nestling plasma samples were also used to measure concentrations of the most heavily-used group of flame retardants, brominated diphenyl ethers (BDEs), and three groups of alternative flame retardants, non-BDE Brominated Flame Retardants (NBFRS), Dechloranes, and organophosphate esters (OPs). BDE-47, 99 and 100 contributed the greatest to total BDE concentrations. Concentrations of structurally similar NBFRs found in this study and recent atmospheric studies indicate that they are largely used as replacements to previously used BDE mixtures. A variety of Dechloranes, or derivatives of Mirex and Dechlorane Plus, were measured. Although, measured at lesser concentrations, environmental behavior of these compounds may be similar to mirex and warrant future research in aquatic species. Concentrations of OPs in nestling plasma were two to three orders of magnitude greater than all other groups of flame retardants. In addition to chemical indicators, bald eagles have also been proposed as indicators to identify ecological stressors using population measures that are tied to the fitness of individuals and populations. Using mortality as a population vitality rate, vehicle collisions were found to be the main source of mortality with a greater incidence for females during white-tailed deer (Odocoileus virginianus) hunting months and spring snow-melt. Lead poisoning was the second greatest source of mortality, with sources likely due to unretrieved hunter-killed, white-tailed deer carcasses, and possibly exacerbated by density-dependent effects due to the growing population in Michigan.