An ecologic comparison study of the impact of economic disadvantage on Texas Assessment of Knowledge and Skills performance, graduation rates, and readiness for higher education for students attending public and charter schools in Texas from 2004 to 2006

Purpose. No Child Left Behind aimed to "improve the academic achievement of the disadvantaged." The primary research question considered how academic achievement of those from economic disadvantage compared to those not from disadvantage? ^ Economically disadvantaged students can potentially have added academic disadvantage. Research shows low academic achievement can potentially result in drug abuse, youth violence, and teen pregnancy. ^ Methods. To compare the student populations, measures included TAKS results and academic indicator data collected by the Texas Education Agency. ^ Results. T-test analyses showed a significant difference between the economically and non-economically disadvantaged student populations in meeting the TAKS passing standard, graduation, and preparation for higher education.^ Conclusions. The achievement gap between students remained as indicated by the Texas testing program. More research and time are needed to observe if the desired impact on those from economic disadvantage will be reflected by academic achievement data.^

Individual, Family, and Neighborhood Characteristics and Children's Food Insecurity

A growing body of work documents the influence of neighborhood environments on child health and well-being. Food insecurity is likely linked to neighborhood characteristics via mechanisms of social disadvantage, including access to and availability of healthy foods and the social cohesion of neighbors. In this paper, we utilize restricted, geo-coded data from the Early Childhood Longitudinal Study, which allows us to link individual children with their neighborhood's census characteristics, to assess how the neighborhoods of food secure and food insecure children differ at both the kindergarten level and in third grade. The average food insecure child lives in a neighborhood with a higher proportion of black and Hispanic residents, a higher proportion of residents living in poverty, and a higher proportion of foreign-born and linguistically isolated residents. After accounting for individual and household-level characteristics, children living in neighborhoods with a high proportion of Hispanic and foreign-born residents have a significantly increased risk of food insecurity compared to children living in neighborhoods which are predominantly white and have high socioeconomic status. We argue that interventions which take neighborhood context into account may be most efficacious for curbing child food insecurity.

An examination of the relationship between maternal and neighborhood-level characteristics and intrauterine growth retardation in Harris County, Texas, 1999--2001

The persistence of low birth weight and intrauterine growth retardation (IUGR) in the United States has puzzled researchers for decades. Much of the work that has been conducted on adverse birth outcomes has focused on low birth weight in general and not on IUGR. Studies that have examined IUGR specifically thus far have focused primarily on individual-level maternal risk factors. These risk factors have only been able to explain a small portion of the variance in IUGR. Therefore, recent work has begun to focus on community-level risk factors in addition to the individual-level maternal characteristics. This study uses Social Ecology to examine the relationship of individual and community-level risk factors and IUGR. Logistic regression was used to establish an individual-level model based on 155, 856 births recorded in Harris County, TX during 1999-2001. IUGR was characterized using a fetal growth ratio method with race/ethnic and sex specific mean birth weights calculated from national vital records. The spatial distributions of 114,460 birth records spatially located within the City of Houston were examined using choropleth, probability and density maps. Census tracts with higher than expected rates of IUGR and high levels of neighborhood disadvantage were highlighted. Neighborhood disadvantage was constructed using socioeconomic variables from the 2000 U.S. Census. Factor analysis was used to create a unified single measure. Lastly, a random coefficients model was used to examine the relationship between varying levels of community disadvantage, given the set of individual-level risk factors for 152,997 birth records spatially located within Harris County, TX. Neighborhood disadvantage was measured using three different indices adapted from previous work. The findings show that pregnancy-induced hypertension, previous preterm infant, tobacco use and insufficient weight gain have the highest association with IUGR. Neighborhood disadvantage only slightly further increases the risk of IUGR (OR 1.12 to 1.23). Although community level disadvantage only helped to explain a small proportion of the variance of IUGR, it did have a significant impact. This finding suggests that community level risk factors should be included in future work with IUGR and that more work needs to be conducted. ^

Prevalence and risk factors for polyomavirus reactivation in solid-organ transplantation

Background. Polyomavirus reactivation is common in solid-organ transplant recipients who are given immunosuppressive medications as standard treatment of care. Previous studies have shown that polyomavirus infection can lead to allograft failure in as many as 45% of the affected patients. Hypothesis. Ubiquitous polyomaviruses when reactivated by post-transplant immunosuppressive medications may lead to impaired renal function and possibly lower survival prospects. Study Overview. Secondary analysis of data was conducted on a prospective longitudinal study of subjects who were at least 18 years of age and were recipients of liver and/or kidney transplant at Mayo Clinic Scottsdale, Arizona. Methods. DNA extractions of blinded urine and blood specimens of transplant patients collected at Mayo Clinic during routine transplant patient visits were performed at Baylor College of Medicine using Qiagen kits. Virologic assays included testing DNA samples for specific polyomavirus sequences using QPCR technology. De-identified demographic and clinical patient data were merged with laboratory data and statistical analysis was performed using Stata10. Results. 76 patients enrolled in the study were followed for 3.9 years post transplantation. The prevalence of BK virus and JC virus urinary excretion was 30% and 28%. Significant association was observed between JC virus excretion and kidney as the transplanted organ (P = 0.039, Pearson Chi-square test). The median urinary JCV viral loads were two logs higher than those of BKV. Patients that excreted both BKV and JCV appeared to have the worst renal function with a mean creatinine clearance value of 71.6 millimeters per minute. A survival disadvantage was observed for dual shedders of BKV and JCV, log-rank statistics, p = 0.09; 2/5 dual-shedders expired during the study period. Liver transplant and male sex were determined to be potential risk factors for JC virus activation in renal and liver transplant recipients. All patients tested negative for SV40 and no association was observed between polyomavirus excretion and type of immunosuppressive medication (tacrolimus, mycophenolate mofetil, cyclosporine and sirolimus). Conclusions. Polyomavirus reactivation was common after solid-organ transplantation and may be associated with impaired renal function. Male sex and JCV infection may be potential risk factors for viral reactivation; findings should be confirmed in larger studies.^

The role of AKT-mediated phosphorylation in suppression of MAD1 and the development of new approach in protein complex detection

MAX dimerization protein 1 (MAD1) is a basic-helix-loop-helix transcription factors that recruits transcription repressor such as HDAC to suppress target genes transcription. It antagonizes to MYC because the promoter binding sites for MYC are usually also serve as the binding sites for MAD1 so they compete for it. However, the mechanism of the switch between MYC and MAD1 in turning on and off of genes' transcription is obscure. In this study, we demonstrated that AKT-mediated MAD1 phosphorylation inhibits MAD1 transcription repression function. The association between MAD1 and its target genes' promoter is reduced after been phosphorylated by AKT; therefore, consequently, allows MYC to occupy the binding site and activates transcription. Mutation of such phosphorylation site abrogates the inhibition from AKT. In addition, functional assays demonstrated that AKT suppressed MAD1-mediated transcription repression of its target genes hTERT and ODC. Cell cycle and cell growth were also been released from inhibition by MAD1 in the presents of AKT. Taken together, our study suggests that MAD1 is a novel substrate of AKT and AKT-mediated MAD1 phosphorylation inhibits MAD1function; therefore, activates MAD1 target genes expression. ^ Furthermore, analysis of protein-protein interaction is indispensable for current molecular biology research, but multiplex protein dynamics in cells is too complicated to be analyzed by using existing biochemical methods. To overcome the disadvantage, we have developed a single molecule level detection system with nanofluidic chip. Single molecule was analyzed based on their fluorescent profile and their profiles were plotted into 2 dimensional time co-incident photon burst diagram (2DTP). From this 2DTP, protein complexes were characterized. These results demonstrate that the nanochannel protein detection system is a promising tool for future molecular biology. ^

Impact of hormonal therapy on survival and racial disparities in a large community-based cohort of older men with local/regional prostate cancer

Prostate cancer (CaP) is the most diagnosed non-cutaneous malignancy and the second leading cause of cancer mortality among United States males. Major racial disparities in incidence, survival, as well as treatment persist. The mortality is three times higher among African Americans (AAs) compared with Caucasians. Androgen carcinogenesis has been persistently implicated but results are inconsistent; and hormone manipulation has been the main stay of treatment for metastatic disease, supportive of the androgen carcinogenesis. The survival disadvantage of AAs has been attributed to the differences in socioeconomic factors (SES), tumor stage, and treatment. We hypostasized that HT prolongs survival in CaP and that the racial disparities in survival is influenced by variation in HT and primary therapies as well as SES. To address these overall hypothesis, we first utilized a random-effect meta-analytic design to examine evidence from randomized trials on the efficacy of androgen deprivation therapy in localized and metastatic disease, and assessed, using Cox proportional hazards models, the effectiveness of HT in prolonging survival in a large community-based cohort of older males diagnosed with local/regional CaP. Further we examined the role of HT and primary therapies on the racial disparities in CaP survival. The results indicated that adjuvant HT compared with standard care alone is efficacious in improving overall survival, whereas HT has no significant benefit in the real world experience in increasing the overall survival of older males in the community treated for local/regional disease. Further, racial differences in survival persist and were explained to some extent by the differences in the primary therapies (radical prostatectomy, radiation and watchful waiting) and largely by SES. Therefore, given the increased used of hormonal therapy and the cost-effectiveness today, more RCTs are needed to assess whether or not survival prolongation translates to improved quality of life, and to answer the research question on whether or not the decreased use of radical prostatectomy by AAs is driven by the Clinicians bias or AAs's preference of conservative therapy and to encourage AAs to seek curative therapies, thus narrowing to some degree the persistent mortality disparities between AAs and Caucasians. ^

Environmental influences on self-reported leisure-time physical activity in the Austin/Travis County STEPS survey 2005--2009

This study was an examination of environmental and social correlates of physical inactivity in a socio-economically disadvantaged community. This study was a secondary analysis of data collected by the Austin/Travis County Department of Health and Human Services. The study included an analysis of perceived environmental influences (e.g. access to physical support features like sidewalks and streetlights). This study also investigated several features of the social environment (e.g. perceived neighborhood crime and social influence). Participants’ beliefs and attitudes about the neighborhood were investigated. Results included estimates of the association between neighborhood factors and physical inactivity controlling for age, gender and education. This study found significant associations for social and environmental variables with physical inactivity. The goal of this work was to identify factors that contribute to inactivity and address a number of environmental and neighborhood risk factors that contribute to sedentary behaviors in a population of relative social and economic disadvantage.^

REPRODUCTIVE PERFORMANCE IN THE DES-EXPOSED DAUGHTERS

This research examined the relation between prenatal exposure to diethylstilbestrol (DES) and subsequent reproductive performance in females. Although previous studies have agreed that unfavorable pregnancy outcomes (spontaneous abortions, stillbirths, ectopic pregnancies, and premature births) occur with greater frequency in the exposed as compared to unexposed women, the role of exposure to DES in-utero on subsequent fertility (pregnancy achievement) remains controversial. Also, the possibility that the reproductive dysfunction reported in exposed women might be due to familial predisposition to reproductive dysfunction rather than to DES exposure has not been examined heretofore.^ The purposes of the research were to: (1) measure the overall differences in rates of live births between exposed and unexposed women; (2) determine if infertility or early unrecognized spontaneous miscarriages (as opposed to recognized fetal death) contributes to poor reproductive performance in the exposed; and (3) determine if constitutional predisposition contributes to poor reproductive performance in exposed daughters.^ The study population comprised those participants in the National Cooperative Diethylstilbestrol Adenosis (DESAD) Project who were identified through review of prenatal records. Birth interval curves (survival analyses) were used to compare the reproductive performance of exposed daughters and unexposed women. Birth interval curves were also constructed for unexposed siblings (of exposed participants) and unexposed nonsiblings to determine the role of constitutional predisposition in the reproductive performance of exposed daughters.^ The DES-daughters, as compared to unexposed women, were found to be at a reproductive disadvantage when the overall differences in rates of live births were compared.^ When the differences in rates of live births due specifically to infertility or early unrecognized spontaneous miscarriages (as opposed to recognized fetal death) were examined, the exposed maintained the reproductive disadvantage. This analysis was suggestive but not statistically significant for the first-birth-interval and was neither suggestive nor significant in the second-birth-interval. (Abstract shortened with permission of author.) ^

A health disparities perspective on developing emerging infectious disease preparedness

A systematic review of the literature yielded 10 articles that explored the interaction between race/ethnicity, citizenship, socioeconomic status, and health literacy domains with respect to preparedness agenda development. Current emerging infectious disease (EID) preparedness plans do not adequately address the needs of vulnerable populations for the events before, during, and after an epidemic. Central to the disadvantage of most vulnerable populations are various health disparity domains that persist as barriers for individuals and communities alike to engage in preparedness efforts. Seven out of the ten articles discussed the importance of including health disparity domains in preparedness policy. Two proposed frameworks for an emerging infectious disease framework that considers health disparities are presented in this study. ^ Framework 1 is beneficial for the evaluation phase after a disaster has struck and preparedness efforts have been initiated. It considers several existing disparities and remediation strategies at the individual, community, and system levels to reach adequate restructuring of preparedness aims. Framework 2 serves as a "how to" carry out preparedness during a disaster event. It is a revision of a framework proposed by Blumenshine et al. (2008) and explores those characteristics central to pandemic preparedness plan development/deployment. Although two frameworks were devised, no one framework will adequately address the needs of vulnerable populations during an epidemic. However, the two frameworks propose to demonstrate the inclusion of important health disparity domains in preparedness plan development. ^ The National Consensus Panel for Emergency Preparedness and Cultural Diversity has released guidelines that are considered the leading strategies necessary to reorient preparedness infrastructure. In order for vulnerable populations to benefit from ample protection during a disaster, inclusion of health disparity domains in the development phases of preparedness must occur prior to full deployment in communities. Although "promising practices" and other methods at the frontier of exploring these multidimensional constraints has entered the research arena, new studies on adequate preparedness merit further investigation and support.^

Understanding mental illness in Nigeria: Bringing culture and traditional medicine into mental health policy

One of the major challenges in treating mental illness in Nigeria is that the health care facilities and mental health care professionals are not enough in number or well equipped to handle the burden of mental illness. There are several barriers to treatment for individual Nigerians which include the following: such as the lack of understanding of the root causes of mental illness, lack of financial support to get mental treatment, lack of social support (family, friends, neighbors), the fear of stigmatization concerning being labeled as mentally ill or being in association with the mentally ill, and the consultation of traditional native healers who may be unknowingly prolonging illness, rather than addressing and treating them due to lack of formal education and standardization of their treatments. Another barrier is the non-health nature of the mental health services in Nigeria. Traditional healers are essentially the mental health system. The elderly, women, and children are the most vulnerable groups in times of strife and hardships. Their mental well-being must be taken into account as well as their special needs in times of personal or societal crisis. ^ Nigerian mental health policy is geared toward forming a mental health system, but in actuality only a mental illness care system is the observed result of the policy. The government of Nigeria has drafted a mental health policy, yet its actual implementation into the Nigerian health infrastructure and society waits to be materialized. The limited health legislation or policy implementations tend to favor those who have access to these urban areas and the facilities' health services. Nigerians living in rural areas are at a disadvantage; many of them may not even be aware of services available to help them understand and treat mental illness. Perhaps, government driven health interventions geared toward mental illness in rural areas would reach an underserved Nigerians and Africans in general. Issues with political instability and limited infrastructure often hinder crucial financial resources and legislation from reaching the people that are truly in need of governmental leadership in regards to mental health policy.^ Traditional healers are a severely untapped resource in the treatment of mental illness within the Nigerian population. They are abundant within Nigerian communities and are meeting a real need for the mentally ill. However, much can be done to remove the barriers that prevent the integration of traditional healers within the mental health system and improve the quality of care they administer within the population. Mental illness is almost exclusively coped with through traditional medicine practices. Mobilization and education from each strata of Nigerian society and government as well as input from the medical community can improve how traditional medicine is utilized as a treatment for clinical illness and help alleviate the heavy burden of mental illness in Nigeria. Currently, there is no existing policy making structure for a working mental health system in Nigeria, and traditional healers are not taken into account in any formulation of mental health policy. Advocacy for mental illness is severely inadequate due to fear of stigmatization, with no formally recognized national of regional mental health association.^

Family Structure and Obesity Among U.S. Children

Child obesity in the U.S. is a significant public health issue, particularly among children from disadvantaged backgrounds. Thus, the roles of parents’ human and financial capital and racial and ethnic background have become important topics of social science and public health research on child obesity. Less often discussed, however, is the role of family structure, which is an important predictor of child well-being and indicator of family socioeconomic status. The goal of this study, therefore, is to investigate how preschool aged children’s risk of obesity varies across a diverse set of family structures and whether these differences in obesity are moderated by family poverty status and the mothers’ education. Using a large nationally representative sample of children from the Early Childhood Longitudinal Study – Birth Cohort, we find that preschoolers raised by two biological cohabiting parents or a relative caregiver (generally the grandparent) have greater odds of being obese than children raised by married biological parents. Also, poor children in married biological parent households and non-poor children in married step parent households have greater obesity risks, while poor children in father only, unmarried step, and married step parent families actually have lower odds of obesity than children in non-poor intact households. The implications of these findings for policy and future research linking family structure to children’s weight status are discussed.