Greater Pittsburgh Research Articles

Trends in Spatiotemporal Exposure to Air Pollutants and Adult Cardiovascular Emergency Room Visits in the Greater Pittsburgh, Pennsylvania, USA

Introduction The acute effects of air pollution and cardiovascular disease (CVD) have been studied, but very few studies have focused on spatiotemporally modeled exposure to air pollutants at the population level. This study aims to examine the short-term association of fine particulate matter (PM2.5), Ozone (O3), Nitrogen Dioxide (NO2) and Sulfur Dioxide (SO2) and CVD emergency room visits (ERV) in Allegheny County for a 13-year period using a case-crossover study design. Aim We sought to estimate the effects of acute exposure to these four pollutants adjusting for temperature on CVD ERV and to compare outcomes in 1999-2005 compared to 2006-2011. Methods Land-use regression was used to model the ground level exposures to PM2.5, O3, NO2 and SO2. CVD ER visits were requested from the local hospitals of the two health networks in Allegheny County, which operate the majority of the ER services. The discharge International Classification of Diseases-9 (ICD-9) codes were used to identify the CVD cases and CVD subgroups. We linked the Zone Improvement Plan (ZIP) code level air pollution data with the patients’ ZIP code (residence) to determine the individual level exposure estimation of both case days and control days. Conditional logistic regression with multi-pollutant and distributed lags of 0-3-days was applied to estimate the effect of acute exposure of these pollutants to CVD ER visits (ERV), adjusting for temperature. Results In the overall analyses, for every interquartile increase of O3 exposure (25.52 ppb), there was a 6.6% (95% CI: 0.8%-12.7%) increase in the odds of an acute myocardial infarction ERV. This was consistent across both time periods. Among women and Black ERV, we observed an association of PM2.5 with acute myocardial infarction, and with ischemic heart disease. Some of these associations persisted in the later years of the study period. The gaseous pollutants (NO2, SO2 and O3) were shown to increase risk of cardiovascular events in both time periods. Conclusion We found an association of PM2.5 and NO2 with CVD ER visits, and this association persisted in the stratified analyses, as well as in the later years with lower exposure levels. The findings suggest that further actions to reduce the pollution level in this area should be taken. Ozone and NO2 were related to increased risk for all CVD, ischemic heart disease (IHD) and acute myocardial infarction (AMI) underscoring the importance of gaseous pollutants and their effect on coronary heart disease (CHD) risk.

Antibody Responses After mRNA-Based COVID-19 Vaccination in Residential Older Adults: Implications for Reopening

ObjectiveCOVID-19 disproportionately impacts residents in long-term care facilities. Our objective was to quantify the presence and magnitude of antibody response in vaccinated, older adult residents at assisted living, personal care, and independent living communities.DesignA cross-sectional quality improvement study was conducted March 15 – April 1, 2021 in the greater Pittsburgh region.Setting and PopulationParticipants were older adult residents at assisted living, personal care, and independent living communities, who received mRNA-based COVID-19 vaccine. Conditions that impair immune responses were exclusionary criteria.MethodsSera were collected to measure IgG anti-SARS-CoV-2 antibody level with reflex to total anti-SARS-CoV-2 immunoglobulin levels, and blinded evaluation of SARS-CoV-2 pseudovirus neutralization titers. Descriptive statistics, Pearson correlation coefficients, and multiple linear regression analysis evaluated relationships between factors potentially associated with antibody levels. Spearman correlations were calculated between antibody levels and neutralization titers.ResultsAll participants (N = 70) had received two rounds of vaccination and were found to have antibodies with wide variation in relative levels. Antibody levels trended lower in males, advanced age, current use of steroids, and longer length of time from vaccination. Pseudovirus neutralization titer levels were strongly correlated (P < .001) with Beckman Coulter antibody levels [D614 G NT50, rs = 0.91; B.1.1.7 (UK) NT50, rs = 0.91].Conclusions and ImplicationsHigher functioning, healthier, residential older adults mounted detectable antibody responses when vaccinated with mRNA-based COVID-19 vaccines. Data suggests some degree of immunity is present during the immediate period following vaccination. However, protective effects remain to be determined in larger studies as clinical protection is afforded by ongoing adaptive immunity, which is known to be decreased in older adults. This study provides important preliminary results on level of population risk in older adult residents at assisted living, personal care, and independent living communities to inform reopening strategies, but are not likely to be translatable for residents in nursing homes.

0037 Melanopsin Driven Pupil Responses and Physical Activity: Stability of Activity from Day-to-Day in Winter in Seasonal Affective Disorder

Abstract Introduction The post-illumination pupil response (PIPR) is a measure of the responsivity of intrinsically photosensitive retinal ganglion cells (ipRGCs), and reflects the cell biology of the photoentrainment pathway projecting from the retina to the circadian clock. Adequate signaling from the ipRGCs in the retina to the circadian clock is necessary to result in robust circadian output which we hypothesize would increase inter-daily stability (IS), a non-parametric modeling technique that examines stability of rest activity rhythms across successive days. Methods Participants were aged 18–66 years and recruited from the greater Pittsburgh area during the Winter with Seasonal Affective Disorder who completed both actigraphy and pupillometry (n = 16). PIPR measures were collected after a 1 second red or blue light pulse, and are calculated as the Net difference between red and blue at multiple time frames: at 6 seconds post stimulus (PIPR 6), from 10–30 seconds post-stimulus (PIPR 20), or from 10–40 seconds post-stimulus (PIPR 30). Using actigraphy, inter-daily stability (IS) was calculated as the amount of overall variability in the recording that is accounted for by the typical 24-hour profile, and reflects stability of the mean 24-h profile day-to-day. Results Inter-daily stability (IS) was associated with Net PIPR 20 (Β = 0.561; p = .031) and Net PIPR 30 (Β = 0.551; p = .034; all Β’s are standardized), but not Net PIPR 6 (Β = 0.298; p = .304). Retinal irradiance was calculated for each participant based on age and pupil diameter, to account for age-related differences in transmission of the stimulus to the retina. All raw Net PIPR values were adjusted for calculated retinal irradiance, and gender and time since wake were included as covariates. Conclusion Inter-daily stability (IS) values indicate greater stability of 24-hour activity profiles across days. If reduced responsivity to entraining pulses of light is associated with day-to-day instability in activity rhythms, as shown here, we might expect that amplifying entraining light through environmental changes or bright light therapy would normalize inter-daily stability in SAD, or the reverse, stabilizing activity profiles across days could improve depression and/or normalize retinal ipRGC responsivity. Support NIMH K.A.R. MH103303

Rhythm, colour, and movements: narratives of art and life in black Pittsburgh

ABSTRACTThis essay draws on two extended oral histories in comparing and contrasting two African American visual artists based in Greater Pittsburgh, Thaddeus Mosley and Elizabeth Asche Douglas. By probing the artistic and activist careers of both, the essay explores how the interrelated dimensions of their lives and art overlap with the context of African American life in mid-century Pittsburgh.

Delivering mobile eye care to underserved communities while providing training in ophthalmology to medical students: experience of the Guerrilla Eye Service.

ObjectiveThe objective of the study was to characterize the population served by the student-led Guerrilla Eye Service (GES), a mobile outreach program that delivers comprehensive ophthalmic care to underserved communities in the greater Pittsburgh area.Patients and methodsPatients attending GES missions at a single urban free clinic from 2012 through 2017 were included in this retrospective case series. All patients underwent a comprehensive eye examination at no cost, with referral to a university eye clinic if necessary. Demographic characteristics, past ocular history, reasons for attendance, and ophthalmic diagnoses were recorded. Attendance rates and treatment outcomes of patients referred to the university eye clinic were also reviewed.ResultsWe reviewed records of 360 GES patients (mean age 43 years, age range 1–79 years; 56% [200] male; 37% [133] non-English speakers). The most common reasons for attending were blurry vision (28% [101]), need for new glasses (22% [80]), and referral for a diabetic eye exam (18% [63]). The most common diagnosis made was refractive error (59% [214]), and vouchers for free spectacles were provided. One-third of diabetic patients had retinopathy (32% [38]). Glaucoma suspect (11% [40]), narrow angles (4% [13]), treatment-requiring diabetic eye disease (4% [14]), and visually-significant cataract (3% [11]) were diagnoses that most often prompted referral to the university clinic. In all, 114 patients were referred (32%), of whom 82 (72%) attended the follow-up visit. Other patients continued to receive longitudinal care through GES.ConclusionMedical student-led outreach programs under the supervision of an attending ophthalmologist can deliver regular eye care to underserved communities while providing referrals to a university clinic for those with advanced disease.

Applying an Hybrid Input-Output Model and Network Analysis to Regional Economies

We address a practical problem often faced by economic development organizations using data from the Greater Pittsburgh area. Local economic development organizations are often tasked with promoting the health and vitality of the regional economy. However, the unique composition of each geographical area calls for a distinct approach that reflects the peculiarities of the local economy. The study presents an approach by which the information obtained from input-output analysis and conventional metrics of economic development are enriched by the concepts and metrics of social network analysis. We illustrate this approach by analyzing the local economy of the Greater Pittsburgh area of Western Pennsylvania, USA.

Estimating ambient particulate organic carbon concentrations and partitioning using thermal optical measurements and the volatility basis set

ABSTRACTWe introduce a new method to estimate the mass concentration of particulate organic carbon (POC) collected on quartz filters, demonstrating it using quartz-filter samples collected in greater Pittsburgh. This method combines thermal-optical organic carbon and elemental carbon (OC/EC) analysis and the volatility basis set (VBS) to quantify the mass concentration of semi-volatile POC on the filters. The dataset includes ambient samples collected at a number of sites in both summer and winter as well as samples from a highway tunnel. As a reference we use the two-filter bare-Quartz minus Quartz-Behind-Teflon (Q-QBT) approach to estimate the adsorbed gaseous fraction of organic carbon (OC), finding a substantial fraction in both the gas and particle phases under all conditions. In the new method we use OC fractions measured during different temperature stages of the OC/EC analysis for the single bare-quartz (BQ) filter in combination with partitioning theory to predict the volatility distributions of ...

Intimate partner violence victims as mothers: their messages and strategies for communicating with children to break the cycle of violence.

Children whose mothers are victims of intimate partner violence (IPV) are at increased risk of adverse health and psychosocial consequences, including becoming victims or perpetrators of violence in their own relationships. This study aimed to understand the role mothers may play in preventing the perpetuation of violence in their children's lives. We performed semistructured interviews with 18 IPV victims who are mothers and were living at the Women's Center & Shelter of Greater Pittsburgh from July through November 2011. We sought to understand how they communicate with their children about IPV and relationships. These mothers described a desire to explain their IPV experience and offer advice about avoiding violence in relationships. As foundations for these discussions, they emphasized the importance of close relationships and open communication with their children. Although mothers are interested in talking about IPV and relationships and identify communication strategies for doing so, many have never discussed these topics with their children. These mothers need and want an intervention to help them learn how to communicate with their children to promote healthy relationships. Development of a program to facilitate communication between IPV victims and their children could create an important tool to empower mothers to break the cross-generational cycle of domestic violence.

Who Are Connected to the Pittsburgh Jewish Community?

The United Jewish Federation of Greater Pittsburgh (PUJF) began a campaign to improve community planning, especially to determine programmatic priorities. Among the many questions they sought to answer was the relationship between childhood programs and retention of adults as active members of the community. We propose a new model to examine the relationship between childhood activities and adult connection to the community that looks at the adult activities in the community at the same time, while avoiding ad hoc indexes of connection. Using this model, we find evidence that childhood trips to Israel and participation in youth groups are most related to active adult members of the community. These results are robust to several model assumptions, including the assumption that the survey nonresponse did not bias the results.

From Sales Tool to Site Development: The Evolution of Destination Marketing on the Web

The travel industry increasingly uses Web marketing to reach its customers, both actual and potential. This is not surprising given that more than 63 million people used the Web to make their travel plans in 2004. Although considerable attention has been paid to website rankings and effectiveness, researchers know comparatively little about the contexts of how sites were created, nor how they continue to evolve, and the successes and challenges involved in travel-related website creation and maintenance. This article reviews the literature concerning destination management organizations (DMOs) and Web marketing on the international scale. It reviews the evolution of Web development through three CVBs in the US—Greater Pittsburgh Convention and Visitors Bureau, Chattanooga Area Convention and Visitors Bureau, and Durham Convention and Visitors Bureau—that have demonstrated innovation in using the Web as a powerful and successful marketing tool. By using this evolutionary lens as the article's comparative framework, practitioners and researchers may better anticipate technological innovation in Web marketing for destination management organizations. These organizations serve as models for sales, revenues, and site development, respectively. The case studies offer “lessons learned,” providing possibilities for adoption and point the way to further research.

Approaches for a Successful Regional Flow Monitoring Program In the Greater Pittsburgh Area

Approaches for a Successful Regional Flow Monitoring Program In the Greater Pittsburgh Area

Getting wired for innovation

PurposeThe purpose of this article is to examine the nature and influence of entrepreneurs' advice networks on the innovative performance of their companies from both economic and social perspectives. Specifically, it aims to address three research questions: Does information typically flow both ways in advice dyads? How important is trust in these relationships? What is the ideal structure of an advice network?Design/methodology/approachAs part of a larger study, executives at 20 entrepreneurial software companies in the Greater Pittsburgh, Pennsylvania, region of the USA were interviewed in person to determine the nature and structure of their advice networks.FindingsThe executives reported sharing business and technical advice with their contacts, both within and outside of their own organizations. Entrepreneurs who maintained diverse, uncommonly connected advice networks led organizations that were perceived as more innovative than those with more densely connected networks.Research limitations/implicationsFuture studies should examine these research questions in economic and cultural settings outside the USA, and examine the influence of advice‐network size and different network environments on advice‐network value and productivity.Practical implicationsEntrepreneurs should be careful to not take trust in these networks lightly.Originality/valueEntrepreneurs may be able to leverage their advice networks for maximum innovation by adding new advice contacts not connected to their current advice contacts. Entrepreneurs should be careful to not take trust in these networks lightly.

Teaching Elderly Adults to Use the Internet to Access Health Care Information: Before-After Study

BackgroundMuch has been written about the Internet's potential to revolutionize health care delivery. As younger populations increasingly utilize Internet-based health care information, it will be essential to ensure that the elderly become adept at using this medium for health care purposes, especially those from minority, low income, and limited educational backgrounds.ObjectiveThis paper presents the results of a program designed to teach elderly adults to use the Internet to access health care information. The objective was to examine whether the training led to changes in participant's perceptions of their health, perceptions of their interactions with health care providers, health information–seeking behaviors, and self-care activities.MethodsParticipants attended a 5-week training course held in public libraries and senior community centers within the greater Pittsburgh and Allegheny County region. Classes within each seminar lasted 2 hours and consisted of lecture and hands-on training. Baseline surveys were administered prior to the course, 5-week follow-up surveys were administered immediately after the course, and final surveys were mailed 1 year later. Instruments included the Multidimensional Health Locus of Control (MHLC) Scale, which measures three domains of locus of control (internal, external, and chance); the Krantz Health Opinion Survey (HOS); and the Lau, Hartman, and Ware Health Value Survey. Two additional questionnaires included multiple choice and qualitative questions designed to measure participants' Internet utilization and levels of health care participation. The Health Participation Survey was administered with the baseline survey. The Internet Use Survey was administered at the 1-year mark and contained several items from the Health Participation Survey, which allowed comparison between baseline and 1-year responses.ResultsOf the 60 elderly adults who began the training course, 42 (mean age 72) completed the entire 5-week training program and the 5-week follow-up questionnaire administered immediately after the program, and 27 completed the 1-year follow-up survey. Statistically significant differences were found between baseline and 5-week follow-up results for MHLC chance subscores in males (P = .02) and females (P = .05), as well as total HOS information seeking scores (P = .05). However, these statistically significant findings disappeared when all 60 original participants were included using a “last observation carried forward” imputation. No statistically significant changes were found between baseline and 5-week follow-up surveys for MHLC external (P = .44) and internal (P = .97) locus of control scores in both genders, or for the HOS behavioral involvement subscale (P = .65).ConclusionsWe failed to show robust before-after effects for most of the outcomes measured. Elderly adults may be willing to use the Internet as a source for general health information; however, when making decisions about their health care, our participants seemed to adhere to a physician-centered model of care. Demographic and situational variables may play a large role in determining which seniors will use the Internet for making behavioral decisions about their health care and in which scenarios they will do so.

Impacts of Rainfall Data on Model Refinement in Greater Pittsburgh

Impacts of Rainfall Data on Model Refinement in Greater Pittsburgh

Steel and Steelworkers: Race and Class Struggle in Twentieth-Century Pittsburgh. By John Hinshaw. (Albany: State University of New York Press, 2002.) and Steeltown U.S.A.: Work and Memory in Youngstown. By Sherry Lee Linkon and John Russo. (Lawrence: University Press of Kansas, 2002.)

John Hinshaw's Steel and Steelworkers and Sherry Lee Linkon and John Russo's Steeltown U.S.A. offer a compelling “deindustrialization tale of two cities,” tracing the history of two steel-producing centers—Pittsburgh, Pennsylvania, and Youngstown, Ohio—and the process of economic restructuring and redefining civic identity in the postindustrial era. Both books chart the historical trajectory and denouement of the steel industry and the deleterious impact of corporate downsizing upon steelworkers and their communities. Taking different methodological approaches, these studies also address the legacy of racism within the steel industry and its historical implications for the respective communities. Hinshaw has written a meticulously researched social history of Pittsburgh that focuses on the dynamics of class, race, and gender and on how intersecting forces—big business, the state, and organized labor—shaped the fate of steelworkers and greater Pittsburgh's development in the twentieth century. Drawing upon labor and corporate archives, census data, and state and municipal government primary source materials, he offers an original interpretative framework to understand the political economy of steel production and to contextualize industrial relation within a declining industry that once defined Pittsburgh's identity over the course of a century.

Impacts of Rainfall Data on Model Refinement in Greater Pittsburgh

The Allegheny County Sanitary Authority (ALCOSAN) and its 83 member municipalities in the greater Pittsburgh, Pennsylvania region are in the process of impleme…

Original Research: How Did You Hear About the Study? Or, How to Reach Lesbian and Bisexual Women of Diverse Ages, Ethnicity, and Educational Attainment for Research Projects

Lesbians and bisexual women are often recruited for research via convenience sampling, but there has been little focus on the sources through which these women are recruited. This article focuses on two research projects that successfully recruited large samples of lesbian and bisexual women. The first, on lesbians and their bisexual and heterosexual sisters, contacted all lesbian periodicals, religious organizations, bars, bookstores, campus groups, and ethnic/multicultural groups listed in the Gayellow Pages. Different fictional P.O. box numbers appeared in the return address in each case, allowing us to see exactly where lesbians and bisexual women (and also older women and women of color) heard about the study. The second study, on health status of sexual minority women living in the greater Pittsburgh, Pennsylvania, area, formed a community advisory board to reach all segments of the community. Questionnaires were sent to individuals on lesbian/gay mailing lists and social organizations; the research team also attended lesbian events and used a snowball distribution method. The results show the relative response rate of women reached through mailing lists, organizations, events, and networks, respectively. The results of both studies indicate that multiple sources of recruitment are ideal in order to reach a diverse sample of lesbian and bisexual women.

Assessing sources of variability in measurement of ambient particulate matter

AbstractParticulate matter (PM), a component of ambient air pollution, has been the subject of United States Environmental Protection Agency regulation in part due to many epidemiological studies examining its connection with health. Better understanding the PM measurement process and its dependence on location, time, and other factors is important for both modifying regulations and better understanding its effects on health. In light of this, in this paper, we will explore sources of variability in measuring PM including spatial, temporal and meteorological effects. In addition, we will assess the degree to which there is heterogeneity in the variability of the micro‐scale processes, which may suggest important unmeasured processes, and the degree to which there is unexplained heterogeneity in space and time. We use Bayesian hierarchical models and restrict attention to the greater Pittsburgh (USA) area in 1996. The analyses indicated no spatial dependence after accounting for other sources of variability and also indicated heterogeneity in the variability of the micro‐scale processes over time and space. Weather and temporal effects were very important and there was substantial heterogeneity in these effects across sites. Copyright © 2001 John Wiley &amp; Sons, Ltd.

Hospital Admissions for Asthma from 1986 to 1992 Continue to Increase at Children's Hospital of Pittsburgh

Hospital admissions for asthma to Children's Hospital of Pittsburgh have continued to increase. Asthma accounted for 8% of hospital admissions between 1986 and 1992. Twice as many males were admitted with asthma as females. Non white children comprise 41% of admissions. Air quality has greatly improved in the greater Pittsburgh area. Asthma admissions peak during the months of September through November. Hopefully the National Asthma Education Program Guidelines distributed in 1992 will have an impact on the rate of asthma hospitalizations.

Physical Activity Behaviors in Lower and Higher Socioeconomic Status Populations

Few data on physical activity habits among populations of low socioeconomic status have been published. The authors studied physical activity habits--leisure-time physical activity, job-related physical activity, household physical activity, and walking--among 172 lower socioeconomic status women and 84 lower socioeconomic status men and compared their habits with those of 208 higher socioeconomic status women and 95 higher socioeconomic status men. All subjects resided in the greater Pittsburgh, Pennsylvania, area. Data collection occurred throughout 1986. Lower socioeconomic status women, the least active group, averaged 1,536 +/- 1,701 minutes/week (+/- standard deviation) of total physical activity, whereas higher socioeconomic status women, the most active group, averaged 2,079 +/- 1,807 minutes/week (p less than 0.0001). Higher socioeconomic status men averaged 1,952 +/- 1,799 minutes/week, and lower socioeconomic status men averaged 1,948 +/- 1,916 minutes/week. Higher socioeconomic status women spent significantly more time each week in leisure-time physical activity, job-related physical activity, and household physical activity than did lower socioeconomic status women. Lower socioeconomic status men spent significantly more time each week walking and doing household chores, whereas higher socioeconomic status men tended to be more active in leisure-time physical activity. These data suggest important quantitative and qualitative differences in physical activity among population subgroups. In view of the important role of physical activity in promoting physical and mental health, reasons for the differences among groups of varying socioeconomic status must be examined and elucidated.