| 1. |
- Blessman, James, et al.
(författare)
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Barriers to at-home-preparedness in public health employees : implications for disaster preparedness training
- 2007
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Ingår i: Journal of Occupational and Environmental Medicine. - 1076-2752 .- 1536-5948. ; 49:3, s. 318-326
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To assess "at-home" preparedness and barriers to preparedness in a cohort of public health employees. METHOD: Conducted a cross-sectional survey involving 100 employees attending emergency preparedness training that emphasized incident command training and included a segment on "at-home" preparedness. RESULTS: Fifteen percent of participants were rated as "better prepared," and only 8% of participants would be considered "most prepared." There was no relationship between the concern for bioterrorism and other disasters and preparedness. The principal barrier involved challenges in getting the task done versus lack of desire or knowledge. CONCLUSIONS: There is great potential for distraction of public health workers during an emergent event if they are not prepared at home and have concern for family members. At-home preparedness training efforts that emphasize what should be done and why are likely to have limited impact on changing behavior. Strategies that ensure that small steps are taken are likely to be more successful.
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| 2. |
- Arfken, Cynthia L, et al.
(författare)
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Alcohol use among Arab Americans : what is the prevalence?
- 2011
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 13:4, s. 713-718
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Tidskriftsartikel (refereegranskat)abstract
- Information is limited on alcohol use among Arab Americans. The purpose of this study was to describe and analyze the alcohol use pattern among Arab Americans by reviewing existing surveys using an acculturation model. Secondary data analysis. Nationally, English-speaking immigrant Arab Americans reported lower rates of lifetime alcohol use (50.8%), past month use (26.4%) and binge drinking (10%) than the White majority group. In a state survey, self-identified English-speaking Arab Americans were less likely to report past month use (45.6%) than the White majority group but reported similar rate of binge drinking (17.0%). Locally, lifetime drinking was reported by 46.2% of the immigrants but only 13.4% of refugees fleeing war. Few databases are available to estimate alcohol use pattern among Arab Americans; the limited data suggest a drinking pattern consistent with acculturation. However, the potential influence of other factors is unknown and needs to be investigated.
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| 3. |
- Arnetz, Bengt, et al.
(författare)
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1991 Gulf War exposures and adverse birth outcomes
- 2013
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Ingår i: U.S. Army Medical Department journal. - 1524-0436. ; , s. 58-65
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Tidskriftsartikel (refereegranskat)abstract
- We studied 1991 Gulf War (GW)-related environmental exposures and adverse birth outcomes in Iraqis. A random cross-sectional sample of 307 Iraqi families that immigrated to the United States responded to a structured interview covering socioeconomics, lifestyle, environmental exposures, and birth outcome. Data per each family was collected either from the man or the woman in the respective family. The respondents were divided into those that resided in Iraq during and following the GW (post-GW, n=185) and those that had left before (pre-GW, n=122). The primary outcome was lifetime prevalence of adverse birth outcomes, ie, congenital anomalies, stillbirth, low birth weight, and preterm delivery and its relationship to GW exposures. Mean number of adverse birth outcomes increased from 3.43 (SD=2.11) in the pre-GW to 4.63 (SD=2.63) in the post-GW group (P<.001). Mean chemical (Ch) and nonchemical (NCh) environmental exposure scores increased from pre-GW scores of 0.38 units (SD=1.76) and 0.43 (SD=1.86), respectively, to post-GW scores of 5.65 units (SD=6.23) and 7.26 (SD=5.67), P<.001 between groups for both exposures. There was a significant dose-response relationship between Ch environmental exposure (P=.001), but not NCh exposure, and number of adverse birth outcomes. Exposure to burning oil pits and mustard gas increased the risks for specific adverse birth outcomes by 2 to 4 times. Results indicate that Gulf War Ch, but not NCh exposures are related to adverse birth outcomes. Pregnancies in women with a history of war exposures might benefit from more intensive observation.
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| 4. |
- Arnetz, Bengt, et al.
(författare)
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1991 Gulf War exposures and pregnancy outcomes : a retrospective study of Iraqi immigrants
- 2012
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Ingår i: American Journal of Obstetrics and Gynecology. - : Elsevier BV. - 0002-9378 .- 1097-6868. ; 206:1 S, s. 261-262
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Tidskriftsartikel (refereegranskat)abstract
- We studied 1991 Gulf War (GW)-related environmental exposures and adverse birth outcomes in Iraqis. A random cross-sectional sample of 307 Iraqi families that immigrated to the United States responded to a structured interview covering socioeconomics, lifestyle, environmental exposures, and birth outcome. Data per each family was collected either from the man or the woman in the respective family. The respondents were divided into those that resided in Iraq during and following the GW (post-GW, n=185) and those that had left before (pre-GW, n=122). The primary outcome was lifetime prevalence of adverse birth outcomes, ie, congenital anomalies, stillbirth, low birth weight, and preterm delivery and its relationship to GW exposures. Mean number of adverse birth outcomes increased from 3.43 (SD=2.11) in the pre-GW to 4.63 (SD=2.63) in the post-GW group (P<.001). Mean chemical (Ch) and nonchemical (NCh) environmental exposure scores increased from pre-GW scores of 0.38 units (SD=1.76) and 0.43 (SD=1.86), respectively, to post-GW scores of 5.65 units (SD=6.23) and 7.26 (SD=5.67), P<.001 between groups for both exposures. There was a significant dose-response relationship between Ch environmental exposure (P=.001), but not NCh exposure, and number of adverse birth outcomes. Exposure to burning oil pits and mustard gas increased the risks for specific adverse birth outcomes by 2 to 4 times. Results indicate that Gulf War Ch, but not NCh exposures are related to adverse birth outcomes. Pregnancies in women with a history of war exposures might benefit from more intensive observation.
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| 5. |
- Arnetz, Bengt B, et al.
(författare)
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Obstructive sleep apnea, posttraumatic stress disorder, and health in immigrants
- 2012
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Ingår i: Psychosomatic Medicine. - 0033-3174 .- 1534-7796. ; 74:8, s. 824-831
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine whether obstructive sleep apnea mediates the relationship between posttraumatic stress disorder (PTSD) and psychosomatic and somatic disorders and its implications for self-rated health (SRH) among Iraqi immigrants in the United States.METHODS: A random sample of immigrants who had left Iraq before the 1991 Gulf War (n = 145) or after (n = 205) and are residing in metropolitan Detroit responded to a structured interview covering questions on sociodemographics, premigration trauma, SRH, physician-diagnosed and -treated obstructive sleep apnea, somatic disorders, and psychosomatic disorders. Structural equation modeling was used to evaluate the relationship between premigration trauma scores and health, as well as to explore mediating pathways between PTSD, obstructive sleep apnea, and health.RESULTS: The prevalence of obstructive sleep apnea among post-Gulf Warimmigrants (30.2%) was significantly higher than among pre-Gulf War immigrants (0.7%; p < .001). Premigration trauma scores were positively associated with depression and PTSD. Structural equation modeling supported a model in which obstructive sleep apnea mediated the relationship between PTSD and psychosomatic and somatic disorders. Premigration trauma also related directly to SRH.CONCLUSIONS: Part of the PTSD-associated adverse health effects observed in Iraqi immigrants is mediated by obstructive sleep apnea. Because sleep apnea in the current study is based on medical history and current treatment, there is a need for future confirmatory polysomnographic studies.
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| 6. |
- Arnetz, Bengt B, et al.
(författare)
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Specific Trauma Subtypes Improve the Predictive Validity of the Harvard Trauma Questionnaire in Iraqi Refugees
- 2014
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Ingår i: Journal of Immigrant and Minority Health. - : Springer Science and Business Media LLC. - 1557-1912 .- 1557-1920. ; 16:6, s. 1055-1061
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Tidskriftsartikel (refereegranskat)abstract
- Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10 %, respectively) than did the cumulative trauma index (7 and 3 %, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.
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| 7. |
- Arnetz, Bengt B., et al.
(författare)
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War-related mental health disorders among Iraqis 10 years after the 1991 Gulf War : A comparative study of soldiers and civilians living under sustained socio-environmental stress
- 2009
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Ingår i: The New Iraqi Journal of Medicine. - 1817-5562. ; 5:1, s. 9-21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Prior studies of mental health consequences of the Gulf War (GW) have been confined to Allied forces, limiting the ability to control for important geographically and culturally-related factors. We conducted an epidemiological mental health study among Iraqi soldiers and civilians who are still residing in Iraq. This group has been exposed to sustained socio-environmental stress. Methods: A cross-sectional sample of 742 Iraqi GW veterans and 413 civilians responded to a validated mental health survey. The response rate was 96.3%. Mental health disorders, including post traumatic stress disorder (PTSD), were classified using both self-reports and validated scales. War-related exposure was calculated using the sum score of items assessing trauma exposure. Results: Iraqi soldiers reported significantly more depression (Odds Ratio [OR] 4.9; 95% confidence interval [CI] 2.2-11.1) and anxiety (OR 3.9; 95% CI, 1.2-13.3) compared to civilians, adjusting for age, education, and smoking. Soldiers closest to Kuwait during the GW reported significantly more depression compared to soldiers deployed further away from the war epicenter (OR 104.6; 95% CI, 28.0-390.8) and anxiety (OR 4.1; 95% CI, 1.5-11.1). The highest self-reported trauma exposure occurred in the southwest of Iraq. Conclusion: Iraqi soldiers that took part in the GW are at increased risk suffering from many of the same mental health disorders plaguing Allied soldiers. Soldiers closest to Kuwait were more at risk, suggesting a direct link to war-specific environmental exposures, although self-reported trauma exposure was higher in the southwest of Iraq. The study offers additional insights into the mental health consequences of living under sustained socio-environmental stress, originating from the Iraqi war. The study points out socio-environmental factors worthy of further explorations.
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| 8. |
- Arnetz, Bengt, 1954-, et al.
(författare)
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Neighborhood air pollution and household environmental health as it relates to respiratory health and healthcare utilization among elderly persons with asthma
- 2020
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Ingår i: Journal of Asthma. - : Taylor & Francis. - 0277-0903 .- 1532-4303. ; 57:1, s. 28-39
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The study investigated the associations between fine particulate matter (PM2.5; <2.5 mu m in diameter), indoor environment, pulmonary function, and healthcare utilization in a vulnerable group of elderly persons with asthma. We hypothesized that environmental conditions were associated with adverse pulmonary health outcomes.Methods: The study involved elderly (n = 76; mean age 64.6 years; 48 women) vulnerable persons in Detroit, Michigan, USA, with physician-diagnosed asthma. Exposure variables included measured outdoor PM2.5, self-rated outdoor and household environmental pollutants. Outcome variables were self-rated and measured pulmonary function, and asthma-related healthcare utilization.Results: Mean ambient PM2.5 concentrations during the study was 14.14 +/- (S.D. 6.36) mu g/m(3) during the summer and 14.20 (6.33) during the winter (p = 0.95). In multiple regression analyses, adjusting for age and gender, mean 6-month concentration of PM2.5 was related to shortness of breath (SHOB; standardized beta = 0.26, p = 0.02) and inversely with self-rated respiratory health (SRRH; beta = 0.28, p = 0.02). However, PM2.5 did not predict lung function (FEV1% predicted and FEV1/FVC). However, PM2.5 was related to use of asthma controller drugs (beta = 0.38, p = 0.001). Participants' air pollution ratings predicted total healthcare utilization (beta = 0.33, p = 0.01).Conclusions: In elderly persons with asthma, living near heavy industry and busy highways, objective and perceived environmental pollution relate to participants' respiratory health and healthcare utilization. Importantly, air pollution might increase use of asthma controller drugs containing corticosteroids with implication for elderly persons' risk to develop osteoporosis and cardiovascular disease.
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| 9. |
- Arnetz, Judith, et al.
(författare)
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Resilience as a Protective Factor Against the Development of Psychopathology Among Refugees
- 2013
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Ingår i: Journal of Nervous and Mental Disease. - 0022-3018 .- 1539-736X. ; 201:3, s. 167-172
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Tidskriftsartikel (refereegranskat)abstract
- Refugee research, to date, has predominantly focused on factors that make refugees more vulnerable for developing posttraumatic stress disorder (PTSD) and/or psychological distress. Few articles have studied potential protective factors such as resilience. A targeted nonrandom sample of Iraqi refugees (n = 75) and a control group of non-Iraqi Arab immigrants (n = 53) were recruited from a number of Iraqi/Arab community institutions in Michigan to complete a questionnaire that included measures for psychological distress, PTSD symptoms, exposure to trauma, and resilience. The refugees reported significantly more PTSD symptoms (t-test, p < 0.01) and psychological distress (p < 0.05) compared with the immigrants. There was no difference in resilience between the two groups. In linear regression, premigration exposure to violence was a significant predictor of psychological distress (p < 0.01) and PTSD symptoms (p < 0.01). After controlling for migrant status and violence exposure, resilience was a significant inverse predictor of psychological distress (p < 0.001) but not of PTSD. Resilience is associated with less trauma-related psychological distress and should be considered in assessing risk and protective factors among victims of war-related violence.
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| 10. |
- Jamil, Hikmet, et al.
(författare)
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Do Household Smoking Behaviors Constitute a Risk Factor for Hookah Use?
- 2011
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Ingår i: Nicotine & tobacco research. - : Oxford University Press (OUP). - 1462-2203 .- 1469-994X. ; 13:5, s. 384-388
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Much research has focused on the role played by families in cigarette smoking behavior. However, there is a lack of such research for hookah (waterpipe) smoking. This study focuses on the role of family members' hookah smoking behaviors as a possible risk factor for hookah smoking. Methods: Eight hundred and one adults in southeast Michigan responded to an anonymous self-administered survey regarding personal and family members' hookah smoking behavior and perceptions of health risks related to hookah smoking. Multinomial logistic regression modeling was used to examine risk factors for hookah use. Results The prevalence of current hookah smoking in the study population was 26%. The odds ratio for an individual to smoke hookah were 9.5 (95% CI = 2.37-38.47, p < .01), 8.6 (95% CI = 3.92-19.02, p < .001), and 1.2 (95% CI = 1.14-1.41, p < .05) if the father, mother, or sibling, respectively, smoked hookah at home. Male gender and younger age were also significantly associated with hookah smoking. Household hookah smoking behaviors were also significant risk factors among former hookah smokers compared with nonsmokers, but there were no significant risk factors when comparing former hookah smokers with current hookah smokers. Conclusions: Having a father, mother, or sibling smoking hookah at home, male gender and younger age are significant risk factors for current hookah smoking.
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