Journal Articles & Publications

Peruse a collection of peer-reviewed journal articles and publications that provide new insight and data relevant to the county's health priorities. Click the title to access each document. Articles are organized by publication date.

Mechanisms of sleep deprivation-induced hepatic steatosis and insulin resistance in mice

November 7, 2018

Researchers at Toho University Graduate School of Medicine in Japan found that sleep-deprived mice had higher blood glucose levels and fat content in the liver—both of which are linked to insulin resistance and diabetes. For the experiment, researchers looked at two groups of mice. One group was kept awake for six hours and the other group could sleep as they wanted. Both groups has access to high-fat food and sugar water (to parallel human’s food habits) and were given a limited opportunity for physical activity. After the trial period, researchers measured glucose levels and fat content of the liver and found that the sleep-deprived group had significantly higher blood glucose levels and increased triglyceride levels and production of glucose in the liver—all factors that play into diabetes risk.

Published in: American Physiological Society

Similar study (2015): Diabetology & Metabolic Syndrome

Use of rapid fentanyl test strips among young adults who use drugs

October 18, 2018

Among more than 72,000 deaths in the U.S. last year, fentanyl factored into many of cases. In the search for solutions, a team of researchers at Brown University’s School of Public Health provided rapid-acting fentanyl test strips to young adults at risk of overdose in the state. New research by the team found that most of those young adults used the strips — and many who detected fentanyl reported changing their behavior to reduce overdose risk. They also found that fentanyl test strips are an effective harm-reduction tool to prevent overdose and can be a life-saving intervention for many young adults who use drugs.

Published in: International Journal of Drug Policy

View a quick video HERE or the press release HERE.

Corporal punishment bans and physical fighting in adolescents: an ecological study of 88 countries

October 16, 2018

Study looking at 400,000 youths from 88 countries around the world suggests physical punishment bans are making a difference in reducing youth violence. Of the countries included in the study, 30 have passed laws fully banning physical punishment of children, both in schools and in homes. The rates of fighting among adolescents were substantially lower than the 20 countries with no bans in place: by 69 percent for adolescent males and 42 less for females. The other 38 countries in the study — which include the United States, Canada, and the U.K. — have partial bans, in schools only. In those countries, adolescent females showed a 56 percent lower rate of physical fighting, with no change among males.

Read the full article at: BMJ Open

Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants

September 25, 2018

The study, led by Oxford University researchers, tracked nearly 500,000 people aged 40-69 enrolled in the UK Biobank database. Over seven years, 5,081 people had their first heart attack and one in three of them were women. Although the risk of having a heart attack is lower in women than in men of all ages, certain risk factors appeared to have a greater impact on women. Women who smoked were three times more likely to have a heart attack than women who did not smoke - but in men, smoking only doubled their risk. High blood pressure increased a woman's risk by an extra 83% relative to its effect in a man. Type 1 and type 2 diabetes both had a greater impact on the heart attack risk of women compared to men, the study found.

Read the full article at: BMJ Open

Association between maternal gluten intake and type 1 diabetes in offspring

July 26, 2018

A high gluten intake by mothers during pregnancy is associated with an increased risk of their child developing type 1 diabetes, suggests a study published by The BMJ. This is an observational study, so no firm conclusions can be drawn about cause and effect. However, the researchers say this was a high quality study with a large sample size, and they were able to adjust for a number of factors that could have affected the results.

Published in: TheBMJ

The Burden of Opioid-Related Mortality in the United States

June, 2018

In a serial cross-sectional study, researchers found that the percentage of all deaths attributable to opioids increased 292% (from 0.4% to 1.5%) between 2001 and 2016, resulting in approximately 1.68 million person-years of life lost in 2016 alone (5.2 per 1000 population). The burden was particularly high among adults aged 24 to 35 years; in 2016, 20% of deaths in this age group involved opioids.

Published in: JAMA Network

Intimate Partner Violence, Depression, and Child Growth and Development

June, 2018

Among the many adverse childhood experiences, one must consider are the effects of maternal depression and of mothers being the victim of physical or sexual violence. What is the toll of these on children?  Neamah et al. decided to evaluate this by looking at the strength of such an association on the cognitive development as well as physical growth of over a thousand toddlers between 18 to 36 months living in Tanzania. The results of the data collected are quite troubling and show that when both depression and intimate partner violence (IPV) were present in a mother, there was developmental delay in multiple cognitive modalities.  In addition, IPV even without maternal depression was associated with expressive communication delay.  While depression did not show an association with poor growth, IPV did increase the odds of a child showing stunted growth compared to toddlers whose mothers did not experience IPV.  

Published in: American Academy of Pediatrics

Incidence of iatrogenic opioid dependence or abuse in patients with pain who were exposed to opioid analgesic therapy: a systematic review and meta-analysis.

April 21, 2018

Study reviewed eligible 6164 articles and 12 studies and found that opioid dependence or abuse only occurs in 4.7% percent of patients prescribed opioids for pain.

Published in: British Journal of Anesthesiology

Vitamin D deficiency linked to greater risk of Type II diabetes

April 19, 2018

The scientists studied a cohort of 903 healthy adults (mean age: 74) with no indications of either pre-diabetes or diabetes during clinic visits from 1997 to 1999, and then followed the participants through 2009. Vitamin D levels in blood were measured during these visits, along with fasting plasma glucose and oral glucose tolerance.

Over the course of time, there were 47 new cases of diabetes and 337 new cases of pre-diabetes, in which blood sugar levels are higher than normal but not yet high enough to be categorized as type 2 diabetes.

Persons with 25-hydroxyvitamin D levels below 30 ng/ml were considered vitamin D deficient. These persons, the researchers found, were up to five times at greater risk for developing diabetes than people with levels above 50 ng/ml.

Published in: PLOS

The relationship among breakfast time, morningness–eveningness preference and body mass index in Type 2 diabetes

April 13, 2018

"Going to bed later is linked with obesity in people with type 2 diabetes, and the main factor that drives this relationship is eating breakfast later." This was the conclusion of a new study led by Sirimon Reutrakul, who is an associate professor of endocrinology, diabetes, and metabolism in the College of Medicine at the University of Illinois at Chicago.

Prof. Reutrakul suggests that eating later causes a shift in the biological clock that regulates day-night patterns. Other studies have proposed that this can disrupt energy metabolism

Published in: Journal of Diabetic Medicine

Night Shift Work, Genetic Risk, and Type 2 Diabetes in the UK Biobank

April 4, 2018

From 2006 to 2010, the UK Biobank recruited 502,620 individuals from across the U.K. Their findings show that night shift work, especially rotating shift work including night shifts, is associated with higher type 2 diabetes odds and that the number of night shifts worked per month appears most relevant for type 2 diabetes odds. Also, shift work exposure does not modify genetic risk for type 2 diabetes, a novel finding that warrants replication.

Published in: Diabetes Care

Association Between US State Medical Cannabis Laws and Opioid Prescribing in the Medicare Part D Population

April 2, 2018

Researchers at the University of Georgia, Athens, looked at Medicare Part D prescriptions for people over the age of 65 between 2010 and 2015. They found that prescriptions for all opioids decreased by 2.11 million daily doses per year from an average of 23.08 million daily doses per year when a state instituted any medical cannabis law. When a state opened marijuana dispensaries, opioid prescriptions dropped by 3.7 million daily doses per year.

The researchers concluded: “Medical cannabis laws are associated with significant reductions in opioid prescribing in the Medicare Part D population. This finding was particularly strong in states that permit dispensaries, and for reductions in hydrocodone and morphine prescriptions.”

Published in: JAMA Internal Medicine

Similar study: Association of Medical and Adult-Use Marijuana Laws With Opioid Prescribing for Medicaid Enrollees


The healthy diabetic cavefish conundrum

March 21, 2018

Some Mexican cavefish have a mutation in an insulin receptor protein that affects blood-glucose regulation. The same mutation causes diabetes and health problems in humans, but the diabetic cavefish thrive.

Published in: Nature

Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients With Chronic Back Pain or Hip or Knee Osteoarthritis Pain: The SPACE Randomized Clinical Trial

March 6, 2018

In patients with stubborn back aches or hip or knee arthritis, opioids worked no better than over-the-counter drugs or other nonopioids at reducing problems with walking or sleeping. And they provided slightly less pain relief.

Published in: Journal of the American Medical Association

Parents may help prep kids for healthier, less violent relationships

February 13, 2018

Researchers found that when adolescents reported a positive family climate and their parents using more effective parenting strategies -- like providing reasons for decisions and refraining from harsh punishments -- those adolescents tended to go on to have better relationship problem-solving skills and less-violent romantic relationships as young adults.

Published in: Journal of Youth and Adolescence

Press Release: ScienceDaily


Community service provider perceptions of implementing older adult fall prevention in Ontario, Canada: a qualitative study

February 1, 2018

Previous research has shown that staff lacked sufficient knowledge regarding fall prevention services in addition to having limited resources required to run the program. This study determined how those involved in community organizations run perceived the barriers and strategies to fall prevention success.

The results of this qualitative study provide organizations with strategies on how to optimize fall prevention services in Canadian communities. Lead directors should be mindful of the program’s resource allocation, budgetary spending, and quality of deliverance, to facilitate successful prevention services. Furthermore, education, teamwork and policy change are other strategies that allow organizations to individualize services to clients that can participate.

Published in: BMC Geriatrics

Being Raised in Greener Neighborhoods May Have Beneficial Effects on Brain Development

February 22, 2018

A study by ISGlobal, in collaboration with Hospital del Mar and UCLA's Fielding School of Public Health, shows for the first time that exposure to green space during childhood is associated with beneficial structural changes in the developing brain.

Published in: Environmental Health Perspectives

The Use of Language in Diabetes Care and Education

December, 2017

Language is powerful and can have a strong impact on perceptions as well as behavior. This literature supports the need for a language movement in diabetes care and education. It also provides recommendations for language used by health care professionals and others when discussing diabetes through spoken or written words.

Published in: Diabetes Care journal

Social isolation may increase the risk of type 2 diabetes developing

December 18, 2017

According to a new study from the Netherlands, people who are socially isolated are more likely to develop type 2 diabetes, compared with people who have a larger social circle.

The study involved 2861 men and women (aged 40 to 75 years) from the southern part of the Netherlands. As reported in the article, a lack of participation in clubs or other social groups was associated with a 60% increased risk of pre-diabetes and 112% increased risk of type 2 diabetes in women, while in men it was associated with a 42% greater risk of type 2 diabetes.

Published in: BMC Public Health Journal

Coupling Policymaking with Evaluation — The Case  of the Opioid Crisis

December 14, 2017

A major challenge for policymakers is how to design effective opioid-prescription policies to stem the flood of overdoses without having to wait several years to accumulate additional evidence. One possible solution is to couple policymaking with an evaluation plan that uses existing databases with nearly real-time health data.

Published in: New England Journal of Medicine

FSU researcher finds link between excessive screen time and suicide risk

November 14, 2017

Study showed adolescents who spent more time on new media (including social media and electronic devices such as smartphones) were found more likely to report mental health issues, and adolescents who spent more time on nonscreen activities (in-person social interaction, sports/exercise, homework, print media, and attending religious services) were less likely.

Published in: Clinical Psychological Science

Pilot Test of a Culturally Appropriate Diabetes Prevention Intervention for At-Risk Latina Women

October 23, 2017

Culturally tailored Diabetes Prevention Programs have shown potential as a feasible way of reducing risks associated with the development of Type 2 diabetes in at-risk Latina women.

Published in: SAGE Publications

Increase in the Incidence of Diabetes and Its Implications

April 13, 2017

Diabetes mellitus is among the most prevalent and morbid chronic diseases, affecting the health of millions of persons worldwide. According to the Global Burden of Disease (GBD) report for 2015, the prevalence of diabetes rose from approximately 333 million persons in 2005 to approximately 435 million persons in 2015, an increase of 30.6%.1 During the same interval, the annual number of deaths from diabetes rose from 1.2 million to 1.5 million

Published in: The New England Journal of Medicine

The Clinical Implications of Youth Sports Concussion Laws: A Review

December 21, 2016

The recent passage of state youth sports concussion laws across the country introduces clinical implications for health care professionals caring for student-athletes. Although the laws were established to provide protections for student-athletes and prevent adverse outcomes, efforts aimed at implementation have uncovered various challenges in concussion diagnosis and management. 

This review describes the various components of state youth sports concussion laws relevant to clinical practice and nuances that health care professionals should appreciate in this context. Additionally, concussion tools and strategies that can be used in clinical practice are discussed.

Published in: The American Journal of Lifestyle Medicine


Community Engagement in Youth Violence Prevention: Crafting Methods to Context

March 11, 2016

Researchers explore aspects of community engagement employed by three centers that operate in very different contexts: a rural county in North Carolina; a suburban area of Denver, Colorado; and an urban setting in Flint, Michigan. While previous research has addressed theories supporting community involvement in youth violence prevention, there has been less attention to the implementation challenges of achieving and sustaining participation. In three case examples, researchers describe the foci and methods for community engagement in diverse YVPC sites and detail the barriers and facilitating factors that have influenced implementation.

Published in: Journal of Primary Prevention



Diabetes Is a Community Issue: The Critical Elements of a Successful Outreach and Education Model on the U.S.-Mexico Border

December 15, 2014

The Border Health Strategic Initiative (Border Health ¡SI!) collaboratively developed a culturally relevant diabetes outreach and education program. The model included a five-week series of free diabetes education classes that assisted participants in gaining the knowledge and skills necessary to be physically active, control diet, monitor blood sugar, take medications, and be aware of complications. Central to the model was the use of community health workers — or promotores de salud — to conduct outreach, participate in patient education, and provide individual support.

Published in: CDC Preventing Chronic Disease. Preventing Chronic Disease


Focused deterrence and the prevention of violent gun injuries: Practice, theoretical principles, and scientific evidence. Annual review of public health.

First Published: December 10, 2014

This study examines deterrent strategies as a means of preventing gun violence injuries. Although more research is needed, the evidence suggests that deterrence may be an effective means of reducing overall gun violence related injuries.

Published in: Review in Advance


Health Systems Tackling Social Determinants of Health: Promises, Pitfalls, and Opportunities of Current Policies

November, 2016

Take-away points include modifications to 3 policies driving health systems toward intervening on social determinants of health:

  • The Internal Revenue Service should strengthen the Community Health Needs Assessment program by requiring nonprofit hospitals to address identified needs as part of the standard for nonprofit tax exemption.

  • Value-based payment models should incorporate financial support for at-risk hospitals implementing strategies to address social determinants because of their influence on quality-of-care outcomes.

  • The Accountable Health Communities program by CMS should test and evaluate models that allow health systems to fund social services directly

Published in: American Journal of Managed Care

A Brief Vestibular/Ocular Motor Screening (VOMS) Assessment to Evaluate Concussions:

October, 2014

Background—Vestibular and ocular motor impairments and symptoms have been documented in patients with sport-related concussions. However, there is no current brief clinical screen to assess and monitor these issues.

Purpose—To describe and provide initial data for the internal consistency and validity of a brief clinical screening tool for vestibular and ocular motor impairments and symptoms after sport-related concussions.

Published in: American Journal of Sports Medicine

Major depression can be prevented.

May - June, 2012

Randomized controlled trials have shown that the incidence of major depressive episodes can be significantly reduced. Meta-analyses suggest that 22% to 38% of major depressive episodes could be prevented with currently available methods. This article arguea that if major depressive episodes can be prevented, the health care system should provide routine access to evidence-based depression prevention interventions, just as it provides inoculations for other common and debilitating health problems.

Published in: American Psychologist


Postpartum Depression Prevalence and Impact on Infant Health, Weight, and Sleep in Low-Income and Ethnic Minority Women...

May, 2011

This study finds that there is a high prevalence of clinically significant depressive symptoms in very low income mothers in a predominately Hispanic sample. These symptoms have an adverse effect on the physical health of the infant children.

Published in: Maternal and Child Health Journal