EH Program Research Articles

Descriptive Study of Continuity of Care Practice and Children’s Experience of Stability of Care in Early Head Start

Continuity of care (CoC) is a widely endorsed theory-based practice in center-based early childhood programs. Despite its widespread endorsement, however, there are few empirical studies of CoC or children’s actual experience of care stability in infant and toddler group settings. This descriptive study investigated (1) the national percentage of EHS programs with centers implementing CoC, (2) potential differences between EHS programs with all or none of their operating centers implementing CoC, (3) the number of teacher changes children experienced during two consecutive years in EHS, as an indicator of early care stability, and (4) child and family characteristics of children having different levels of care stability during their EHS programs. Using the recently released Early Head Start Family and Child Experiences Study (Baby FACES) dataset, secondary analyses were conducted using descriptive statistics, mean difference tests, and Chi-square tests with sampling weights applied. Results showed that 29% of EHS programs reported no centers implementing CoC practices within their programs, and 57% of programs reported all of their centers implemented CoC. The 57% of EHS programs implementing CoC had greater stability of their administrative staff. Results further showed that during EHS, 29 and 34% of children experienced no or one teacher change, respectively, while 37% of children experienced two to six teacher changes. Child and family characteristics were generally not associated with children’s stability of care in EHS. CoC is not uniformly implemented across EHS programs, and many children experience multiple teacher changes in center-based EHS programs.

The Role of Interleukin-1 Haplotype in the Association between Atherosclerosis and Periodontitis in a Syrian Population

KEYWORDS Chronic Periodontitis. Coronary Heart Disease. IL-1 Haplotype. Single Nucleotide Polymorphism ABSTRACT The role of Interleukin-1 haplotype in the association between chronic periodontitis and atherosclerosis has been established in previous studies. However, no studies of this type have been carried out in Syria to assess such a role. Therefore, the purpose of this study is to compare the frequencies of interleukin1 haplotypes in the chronic periodontitis subjects with and without atherosclerosis in a Syrian Arab population. Two hundred Syrian Arab chronic periodontitis patients (184 males, 16 females; mean age 52.61) were divided into two groups: first group was subjects with atherosclerosis; second group was 100 subjects without atherosclerosis. Blood samples were collected from the patients for genotyping analysis of IL-1+4845, IL-1s+3954, IL-1s-511 and IL-1RN VNTR using PCR-RFLP technique. Chi-square test was used for the statistical study (P<0.05) with SPSS.V17 and EH program for studying interleukin-1 haplotype. Significant differences in the frequencies of interleukin-1 haplotypes between atherosclerosis and non- atherosclerosis groups were shown (p = 0.0148). Pattern2 - which includes allele2 at both the IL-1-511, and at the IL-1RN VNTR as well as allele1 at both loci of IL-1+4845 and IL- 1+3954 - was significantly higher in atherosclerosis group vs. non-atherosclerosis group (20%-10%). T hese findings may suggest that Pattern2 is associated with increased susceptibility to atherosclerosis.

Association of vitamin D receptor gene polymorphisms with chronic and aggressive periodontitis in Jordanian patients

Vitamin D acts through binding with vitamin D receptor (VDR) and is responsible for regulating bone metabolism and mineralization; it also suppresses the immune system. The aim of this study was to investigate if VDR gene polymorphisms are associated with chronic periodontitis (CP) and aggressive periodontitis (AgP) in a Jordanian population. A total of 99 patients with CP, 63 patients with AgP, and 126 controls were genotyped using PCR-restriction fragment length polymorphism (RFLP) for BsmI, ApaI, and TaqI single nucleotide polymorphisms (SNPs). The association was determined after correcting for confounding factors using multivariate logistic regression analysis. Estimation of haplotype frequencies was carried out using the EH program, and haplotypes were constructed using the phase 2.1 program. After correcting for confounding factors, multivariate logistic regression analysis revealed that inheritance of the BsmI bb genotype or the ApaI aa genotype was associated with increased risk of developing CP (OR = 2.4 and OR = 3.4, respectively) but with reduced risk of developing AgP (OR = 0.4 and OR = 0.3, respectively). This was further supported by association of the ba haplotype with CP but not with AgP. This study supports an association of VDR gene polymorphisms with CP and AgP in a Jordanian population; however, the pattern of association was different between the two diseases.

Association of cell adhesion molecule gene polymorphisms with recurrent aphthous stomatitis

Recurrent aphthous stomatitis (RAS) is a common oral ulcerative condition. At ulcer sites vascular adhesion molecule-1 (VCAM-1), E-selectin and intercellular adhesion molecule-1 (ICAM-1) are strongly expressed on blood vessels, and ICAM-1 is expressed on keratinocytes. Expression of these molecules would promote leukocyte accumulation and invasion of the epithelium. Thus, polymorphisms in these candidate genes might contribute to RAS susceptibility. We investigated whether the inheritance of specific selectin, ICAM and VCAM gene polymorphisms is associated with RAS susceptibility. Ninety-six RAS cases and 153 controls were recruited from a Jordanian population. Blood was collected for hematological investigations and genotyping. Six SNPs were genotyped: E-selectin rs5361 and rs1805193, L-selectin, rs2205849, ICAM-1 rs5498, ICAM-5 rs885743 and VCAM-1 rs1800821. Association was determined using chi-square and binary logistic regression analysis after correcting for confounding factors. Linkage disequilibrium was determined using the EH program, and the Phase 2.1 program was used to construct and compare haplotypes between cases and controls. There was a significant association of the A allele (Pcorr =0.027), AA and AC genotypes (OR=10.9 and 9.0, respectively) of the E-selectin rs5361 gene polymorphism and TAA haplotype (rs2205849, rs5361, and rs1805193, respectively; P=0.03) with RAS. None of the other SNPs showed a significant association. This is the first report to link inheritance of the A allele, AA and AC genotypes of the E-selectin rs5361 polymorphism with increased risk of RAS. Further studies in different patient cohorts are needed to confirm the association, and functional analyses might clarify the biological significance of the association.

Expanding EHS programs beyond your comfort zone

Expanding EHS programs beyond your comfort zone

TNFα promoter polymorphism is a risk factor for susceptibility in hepatocellular carcinoma in Korean population

Background The underlying genetic factors for the development and progression of hepatocellular carcinoma (HCC) are largely unknown. TNFα is a well characterized inflammatory mediator and is implicated in the development of HCC. We investigated TNFα polymorphisms for association with HCC. Methods The study population consisted of 227 HCC patients and 365 age and sex matched Korean controls. TNFα polymorphisms (G-238A, C-857T, and C-863A) were genotyped using pyrosequencing analysis. TNFα levels in patients with HCC were determined by enzyme linked immunosorbent assay (ELISA). Logistic regression analysis was used to determine the association with HCC and haplotype was calculated using EH program. Results Of three TNFα polymorphisms investigated in our study, C-863A did not correlate with HCC. However, both G-238A and C-857T were found to be significantly associated with HCC. TNFα −238A allele was more frequent in HCC patients than in control [ P = 0.012; odds ratio (OR), 1.89; 95% confidence interval (CI), 1.14–3.13]. TNFα −857T was significantly associated with HCC patients ( P = 0.001; OR, 1.63; 95% CI, 1.21–2.19). Haplotype analysis revealed that the GTC haplotype (G-238A, C-857T, C-863A) was a risk marker for HCC ( P = 0.0021). Serum TNFα level was significantly increased in HCC patients with CT + TT genotype for TNFα −857 ( P = 0.018). Conclusion Our data imply that TNFα G-238A and C-857T, not C-863A, polymorphisms may confer different susceptibilities to the development of HCC with TNFα −238A and −857T alleles playing as risk factors.

The association of functional catechol-O-methyltransferase haplotypes with risk of Parkinson's disease, levodopa treatment response, and complications

Differences in catechol-O-methyltransferase (COMT) activity and genotype may determine individual variations in the therapeutic response to levodopa or Parkinson's disease (PD) susceptibility. The role of functional COMT haplotypes in PD susceptibility and treatment response has not been examined. In this case-control study, we investigated the association of the most common COMT gene haplotypes (formed by single nucleotide polymorphisms (SNPs): rs6269:A>G; rs4633C>T; rs4818:C>G; and rs4680:A>G) with PD risk and the association of the COMT haplotypes with the dose and complications of levodopa therapy in PD patients. A total of 679 study participants (322 PD and 357 controls) were included. Each participant was genotyped for four SNPs in the COMT gene, located in a common haploblock, that has been shown to influence COMT enzymatic activity. The influence of COMT haplotypes on the dose of levodopa administered during fifth year of treatment, and occurrence of motor complications were examined in PD patients. The EH program (Jurg Ott, Rockefeller University, New York, USA) was used to estimate haplotype frequencies. The estimated frequencies of low (A_C_C_G) and medium (A_T_C_A) activity haplotypes tended to be slightly lower among PD patients when compared with controls (P=0.09, G_C_G_G-high activity haplotype as reference). The frequency of G_C_G_G (high activity) haplotype carriers was higher in late onset PD patients (P=0.04) compared with controls. The mean levodopa dose increased with the activity of the functional haplotypes (low<medium<high). Doses prescribed for G_C_G_G (high activity) haplotype carriers (mean 604.2+/-261.9 mg) were significantly higher than those for the noncarriers (mean 512.2+/-133.5 mg, P<0.05). The COMT haplotype seemed to have little influence on the development of levodopa-induced dyskinesias. Our study showed a possible association of functional COMT haplotypes with the risk of PD. Both nonsynonymous and synonymous SNPs within functional COMT haplotype blocks may be more relevant than individual SNPs in conferring PD susceptibility. The doses of levodopa treatment can be influenced by specific COMT haplotypes and this may be useful in instituting individualized therapy for PD patients.

Genetic Association Between Notch4 Polymorphisms and Alzheimer's Disease in the Japanese Population

It is shown that Notch 4 plays important roles in the pathogenesis of Alzheimer's disease (AD). To investigate whether three single nucleotide polymorphisms (SNPs) of the Notch4 gene are associated with AD, the three SNPs were genotyped by a polymerase chain reaction-restriction fragment length polymorphism method for 243 AD patients and 130 age-matched controls. We also confirmed the linkage disequilibrium among these three SNPs of the gene using the EH program. The three SNPs did not seem to alter risk for AD. Our study suggests that SNPs studied are not associated with AD. The linkage disequilibrium of this locus indicates that there is genetic heterogeneity in the Notch4 gene. We could not confirm the previous synergetic associations of the 5' untranslated region (rs367398) C/C genotype in apolipoprotein E epsilon4 bearers in AD patients. Potential markers nearby the 5' untranslated region polymorphism might affect risk for AD.

Re-evaluation of the .BETA.-globin gene cluster haplotypes in Japanese, Koreans, and three Colombian Amerinds (Wayuu, Kamsa, and Inga tribes)

The EH program for maximum-likelihood (ML) frequencies based on an expectation-maximization (EM) algorithm was employed for re-estimation of the β-globin gene cluster haplotype frequency distributions in Japanese, Koreans, and three Colombian Amerinds (Wayuu, Kamsa, and Inga tribes). The distributions estimated by the EH program (estimation 3) were compared with those of our previous studies obtained from individuals who were homozygous at all polymorphic restriction sites or heterozygous at only one site (estimation 1), or ascertained by family linkage studies in Japanese and Koreans (estimation 2). Average haplotype diversities and Nei’s genetic distances based on estimation 3 were also compared with those based on estimations 1 and 2. Haplotypes of all chromosomes examined, which were based on RFLPs (restriction fragment length polymorphisms) at five or seven sites in the β-globin gene cluster, were determined by the EH program as in the case of a family linkage study. The average haplotype diversities based on estimation 3 were much higher than those based on estimations 1 and 2. The present study based on estimation 3 confirmed the close genetic relationships between Japanese and Koreans, and also between Wayuu and Kamsa. Colombian Amerinds showed some African or European characteristics as well as those of Asians.

Development of rheumatoid arthritis is not associated with two polymorphisms in the Crohn's disease gene CARD15.

It has been proposed that genetic susceptibility loci for rheumatoid arthritis (RA) may be shared with other autoimmune/inflammatory diseases. Recently, common variation in the CARD15 (NOD2) gene on chromosome 16q12 has been associated with Crohn's disease (CD) in several independent populations. CARD15 is an excellent functional and positional candidate gene for RA. Genomic DNA was obtained from 392 RA cases and 471 ethnically matched healthy controls. All samples were genotyped for two polymorphisms in CARD15, 1007fs and R702W, using 5' nuclease reporter assays. Allele frequencies were compared between cases and controls using the chi(2) test. Estimated haplotype frequencies across the two mutations were determined using the EH program. The allele frequency of the 1007fs variant in RA cases was 1.8% compared with 1.6% in normal controls (not significant). The frequency of the R702W variant was 4.0% in both cases and controls. Haplotypes carrying either of the two mutations accounted for 5.6% of possible haplotypes. A haplotype carrying both mutations was rare, with estimated frequency <0.01%. This study provided high power to detect an association of similar magnitude to that in Crohn's disease. These data therefore exclude the possibility that the contribution of these mutations to RA is comparable to that seen in CD. Within defined statistical parameters, we excluded a role for the CARD15 1007fs and R702W variants in RA susceptibility. These data do not preclude a role for other polymorphisms in the CARD15 gene in RA susceptibility. Results from other autoimmune and inflammatory diseases will reveal whether the CARD15 gene is in fact a common autoimmune susceptibility locus.

SNPAnalyzer: Web-Based Workbench for the SNPs Analysis

There are many number of computer programs freely available for studying genetic variation of human. Computer programs like EH program [7] and Haplotyper [6] reconstruct haplotypes from unphased genotype data, and QTL Cartographer [2] is a qtl mapping software. However, these programs have many limitations such as time complexity problem for the analysis of large amount of alleles or SNPs, difficult manipulation for installation, data import, and usage, and low quality visual output. SNPAnalyzer is a new workbench program for the SNP analysis, which consists of 4 main modules: 1) Hardy-Weinberg Equilibrium, 2) Haplotype Estimation, 3) Linkage Disequilibrium, and 4) QTL Mapping. It can handle large amount of alleles and SNPs in rather manageable time with at least two different algorithms, and the data import and format are quite convenient and simple. One outstanding feature of SNPAnalyzer is that it can also deal with qtl (quantitative trait locus) analysis as well as linkage study. All the analysis results are displayed in user-friendly format of tables, graphs, or maps. SNPAnalyzer is developed using C and C++ and can be executed through web-interface.

Outsourcing: A Growing Trend in EHS Management

AbstractThis article explores the recent growth and current trends in outsourcing EHS services. More and more organizations are recognizing that outsourcing can cut costs, save time, improve staffing flexibility, and enhance the overall quality of EHS programs. © 2001 John Wiley &amp; Sons, Inc.

Making business integration work: A survival strategy for EHS managers

AbstractRealizing the benefits of environment, health, and safety (EHS) management systems requires more than just rewriting policies and procedures, EHS tasks and activities must be pushed out into all aspects of the organization. The success of this process necessitates an evolving role for EHS managers. For EHS managers, business integration involves the challenge of integrating environment, health, and safety awareness, responsibility, and action into multiple jobs and business processes, leveraging scarce resources to maximize value and minimize costs. Drawing on recent work in the fields of sociology and political science, this article presents conceptual tools for assisting EHS managers to plan and strategize the changing role of the EHS function. By assessing political opportunities, mobilizing structures, and framing processes, EHS managers can maximize the success of EHS programs, while adding value to companies' core operations.

Leading successful environmental, health, and safety organizations: Ten recommendations for EHS executives

There is no shortage of literature on EHS program design and implementation. What is missing is practical guidance on implementing EHS programs within the framework of evolving corporate management practice. How do you implement change in today's ever-changing corporate world? EHS programs may seem great on paper, but they may or may not get anywhere within the corporate culture of your company. This paper provides practical guidance to EHS managers faced with the real world challenges of getting things done in organizations. The authors of this paper are among the first generation of managers to have dealt with CEO's, officers, and boards of directors to create and implement cutting edge corporate environmental programs. Corporate Environmental Strategy is pleased to bring its readers one of the first environmental journal articles that provides an insider's look at the challenges and opportunities faced when negotiating at the highest levels of corporations. These “Top Ten Principles” can be put to use at any time and may prove especially useful to newly appointed EHS executives. Although designed for implementing programs in large corporations, many of the underlying concepts can be applied within small companies and at any organizational level.