Publications by authors named "Michael Spencer"

152 Publications

Cost-Effectiveness of a Diabetes Self-Management Education and Support Intervention Led by Community Health Workers and Peer Leaders: Projections From the Racial and Ethnic Approaches to Community Health Detroit Trial.

Diabetes Care 2021 May 6;44(5):1108-1115. Epub 2021 May 6.

Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI.

Objective: To simulate the long-term cost-effectiveness of a peer leader (PL)-led diabetes self-management support (DSMS) program following a structured community health worker (CHW)-led diabetes self-management education (DSME) program in reducing risks of complications in people with type 2 diabetes (T2D).

Research Design And Methods: The trial randomized 222 Latino adults with T2D to ) enhanced usual care (EUC); ) a CHW-led, 6-month DSME program and 6 months of CHW-delivered monthly telephone outreach (CHW only); or ) a CHW-led, 6-month DSME program and 12 months of PL-delivered weekly group sessions with telephone outreach to those unable to attend (CHW PL). Empirical data from the trial and the validated Michigan Model for Diabetes were used to estimate cost and health outcomes over a 20-year time horizon from a health care sector perspective, discounting both costs and benefits at 3% annually. The primary outcome measure was the incremental cost-effectiveness ratio (ICER).

Results: Over 20 years, the CHW + PL intervention had an ICER of $28,800 and $5,900 per quality-adjusted life-year (QALY) gained compared with the EUC and CHW-only interventions, respectively. The CHW-only intervention had an ICER of $430,600 per QALY gained compared with the EUC intervention. In sensitivity analyses, the results comparing the CHW + PL with EUC and CHW-only interventions were robust to changes in intervention effects and costs.

Conclusions: The CHW + PL-led DSME/DSMS intervention improved health and provided good value compared with the EUC intervention. The 6-month CHW-led DSME intervention without further postintervention CHW support was not cost effective in Latino adults with T2D.
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http://dx.doi.org/10.2337/dc20-0307DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132331PMC
May 2021

Examining the Boundary Sharpness Coefficient as an Index of Cortical Microstructure in Autism Spectrum Disorder.

Cereb Cortex 2021 Jun;31(7):3338-3352

Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal H4H 1R3, Canada.

Autism spectrum disorder (ASD) is associated with atypical brain development. However, the phenotype of regionally specific increased cortical thickness observed in ASD may be driven by several independent biological processes that influence the gray/white matter boundary, such as synaptic pruning, myelination, or atypical migration. Here, we propose to use the boundary sharpness coefficient (BSC), a proxy for alterations in microstructure at the cortical gray/white matter boundary, to investigate brain differences in individuals with ASD, including factors that may influence ASD-related heterogeneity (age, sex, and intelligence quotient). Using a vertex-based meta-analysis and a large multicenter structural magnetic resonance imaging (MRI) dataset, with a total of 1136 individuals, 415 with ASD (112 female; 303 male), and 721 controls (283 female; 438 male), we observed that individuals with ASD had significantly greater BSC in the bilateral superior temporal gyrus and left inferior frontal gyrus indicating an abrupt transition (high contrast) between white matter and cortical intensities. Individuals with ASD under 18 had significantly greater BSC in the bilateral superior temporal gyrus and right postcentral gyrus; individuals with ASD over 18 had significantly increased BSC in the bilateral precuneus and superior temporal gyrus. Increases were observed in different brain regions in males and females, with larger effect sizes in females. BSC correlated with ADOS-2 Calibrated Severity Score in individuals with ASD in the right medial temporal pole. Importantly, there was a significant spatial overlap between maps of the effect of diagnosis on BSC when compared with cortical thickness. These results invite studies to use BSC as a possible new measure of cortical development in ASD and to further examine the microstructural underpinnings of BSC-related differences and their impact on measures of cortical morphology.
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http://dx.doi.org/10.1093/cercor/bhab015DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8196259PMC
June 2021

Lack of phenological shift leads to increased camouflage mismatch in mountain hares.

Proc Biol Sci 2020 12 16;287(1941):20201786. Epub 2020 Dec 16.

Wildlife Biology Program and Office of Research and Creative Scholarship, University of Montana, Missoula, MT 59812, USA.

Understanding whether organisms will be able to adapt to human-induced stressors currently endangering their existence is an urgent priority. Globally, multiple species moult from a dark summer to white winter coat to maintain camouflage against snowy landscapes. Decreasing snow cover duration owing to climate change is increasing mismatch in seasonal camouflage. To directly test for adaptive responses to recent changes in snow cover, we repeated historical (1950s) field studies of moult phenology in mountain hares () in Scotland. We found little evidence that population moult phenology has shifted to align seasonal coat colour with shorter snow seasons, or that phenotypic plasticity prevented increases in camouflage mismatch. The lack of responses resulted in 35 additional days of mismatch between 1950 and 2016. We emphasize the potential role of weak directional selection pressure and low genetic variability in shaping the scope for adaptive responses to anthropogenic stressors.
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http://dx.doi.org/10.1098/rspb.2020.1786DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7779512PMC
December 2020

Environmental Justice, Indigenous Knowledge Systems, and Native Hawaiians and Other Pacific Islanders.

Hum Biol 2020 11;92(1):45-57

School of Environmental and Forest Sciences, University of Washington, Seattle, Washington, USA.

Native Hawaiian and other Pacific Islanders, and the environment they are in relationship with, have been the targets of exploitation, extraction, and destruction. Environmental atrocities throughout the Pacific have demonstrated how imperialism, capitalism, and white supremacy drive destruction through efforts to dominate and exploit for material gain. The relationship between Pacific people and the environment, which defines who they are socially, spiritually, and ancestrally, continues to be damaged and even severed by these injustices. The purpose of this article is to provide examples of major environmental injustices in the Pacific and to develop a deeper understanding of the relationship between settler colonialism and environmental injustices. Indigenous knowledge, with a focus on traditional ecological knowledge, is incorporated not just to demonstrate the deep impact of injustices on Pacific people's cultures but also to highlight how this way of knowing cultivates a path to revitalization and community resilience. Cultural practices rooted in traditional ecological knowledge, such as the preservation of food systems, promote reciprocity between living beings and self-determination, necessary for community flourishing. With this understanding, Pacific peoples' relationship with their land offers further evidence of the critical role culture and Indigenous knowledge can play in environmental justice policies and practices.
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http://dx.doi.org/10.13110/humanbiology.92.1.06DOI Listing
November 2020

Weaving Indigenous Science into Ecological Sciences: Culturally Grounding Our Indigenous Scholarship.

Hum Biol 2020 11;92(1):5-9

School of Social Work, Indigenous Wellness Research Institute, University of Washington, Seattle, Washington, USA,

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http://dx.doi.org/10.13110/humanbiology.92.1.05DOI Listing
November 2020

The Migratory Properties and Numbers of T Regulatory Cell Subsets in Circulation Are Differentially Influenced by Season and Are Associated With Vitamin D Status.

Front Immunol 2020 19;11:685. Epub 2020 May 19.

National Health Service Blood and Transplant, Oxford, United Kingdom.

The control of peripheral immune responses by FOXP3 T regulatory (Treg) cells is essential for immune tolerance. However, at any given time, Treg frequencies in whole blood can vary more than fivefold between individuals. An understanding of factors that influence Treg numbers and migration within and between individuals would be a powerful tool for cellular therapies that utilize the immunomodulatory properties of Tregs to control pathology associated with inflammation. We sought to understand how season could influence Treg numbers and phenotype by monitoring the proportion of natural thymus-derived Tregs (nTregs) defined as (CD3CD4CD25FOXP3CD127 ) cells as a proportion of CD4 T cells and compared these to all FOXP3 Tregs (allTregs, CD3CD25FOXP3CD127 ). We were able to determine changes within individuals during 1 year suggesting an influence of season on nTreg frequencies. We found that, between individuals at any given time, nTreg/CD4 T cells ranged from 1.8% in February to 8.8% in the summer where median nTreg/CD4 in January and February was 2.4% (range 3.75-1.76) and in July and August was 4.5% (range 8.81-3.17) = 0.025. Importantly we were able to monitor individual nTreg frequencies throughout the year in donors that started the year with high or low nTregs. Some nTreg variation could be attributed to vitamin D status where normal linear regression estimated that an absolute increase in nTreg/CD4 by 0.11% could be expected with 10 nmol increase in serum 25 (OH) vitamin D3 ( = 0.005, 95% CI: 0.03-0.19). We assessed migration markers on Tregs for the skin and/or gut. Here cutaneous lymphocyte associated antigen (CLA) expression on CD25FOXP3CD4/CD4 was compared with the same population expressing the gut associated integrin, β7. Gut tropic CD25FOXP3β7Tregs/CD4 had similar dynamics to nTreg/CD4. Conversely, CD25FOXP3CLATregs/CD4 showed no association with vitamin D status. Important for cellular therapies requiring isolation of Tregs, the absolute number of β7CD4CD25FOXP3Tregs was positively associated with 25(OH)vitamin D3 ( = 0.0208, = 0.184, = 0.021) whereas the absolute numbers of CLACD4CD25FOXP3Tregs in the periphery were not influenced by vitamin D status. These baseline observations provide new opportunities to utilize seasonal variables that influence Treg numbers and their migratory potential in patients or donors.
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http://dx.doi.org/10.3389/fimmu.2020.00685DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7248210PMC
March 2021

Efficacy of a Community Health Worker-Based Intervention in Improving Dietary Habits Among Community-Dwelling Older People: A Controlled, Crossover Trial in Japan.

Health Educ Behav 2020 02;47(1):47-56

Tohoku University, Miyagi, Japan.

Community health workers (CHWs), often called "health promotion volunteers" in Japan, are individuals who act as a natural helping resource in the community. This study tested the efficacy of a CHW-based intervention to improve dietary habits among community-dwelling older people in Japan, using a controlled, crossover design. Seventy-eight people aged 65 to 74 years with poor dietary variety living in four administrative districts in Hikone City (Shiga Prefecture, Japan) were nonrandomly allocated to an immediate-intervened group (IIG; = 41) or a delayed-intervened group (DIG; = 37). Participants joined a biweekly, four-session program (120 minutes/session), comprising "CHW drama-style lectures," "group discussion among participants and CHWs," "tasting of dishes," and "take-home practical activities." For the initial 2-month period, the IIG received the intervention and the DIG did not. The groups were crossed over for the subsequent 2-month period. The primary outcome measure was participants' dietary variety score (score range: 0-10). The dietary variety score in the IIG significantly increased in the initial 2-month period compared with the DIG (effect size 1.60 points; 95% confidence interval: 0.75, 2.45). The intervention had a similar effect in the DIG in the subsequent 2-month period. Moreover, an analysis within the IIG showed that the intervention effects persisted for at least 2 months after the intervention. The CHW-based intervention improved dietary habits among older people. Our findings provide evidence that a CHW-based natural helping approach is a possible solution to promote healthy aging in the community.
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http://dx.doi.org/10.1177/1090198119891975DOI Listing
February 2020

Light-Matter Interaction and Lasing in Lead Halide Perovskites.

Acc Chem Res 2019 Oct 1;52(10):2950-2959. Epub 2019 Oct 1.

Department of Chemistry , Columbia University , New York , New York 10027 , United States.

Lead halide perovskites (LHPs) are attractive material systems for light emission, thanks to the ease and diverse routes of synthesis, the broad tunability in color, the high emission quantum efficiencies, and the strong light-matter coupling which may potentially lead to exciton-polariton condensation. This account contrasts the laser-like coherent light emission from highly lossy Fabry-Perot cavities, formed naturally from LHP nanowires (NWs) and nanoplates (NPs), with highly reflective cavities made of LHP gain media, sandwiched between two distributed Bragg reflector (DBR) mirrors. The mechanism responsible for the operation of conventional semiconductor lasers involves stimulated emission of electron and hole pairs bound by the Coulomb potential, i.e., excitons or, at excitation density above the so-called Mott threshold, an electron-hole plasma (EHP). We discuss how lasing from LHP NWs or NPs likely originates from stimulated emission of an EHP, not excitons or exciton-polaritons. A character central to this kind of lasing is the dynamically changing photonic properties in the naturally formed cavity. In contrast to the more static conditions of a DBR cavity, lasing modes and gain profiles are extremely sensitive to material properties and excitation conditions in an NW/NP cavity. While such unstable photonic cavities pose engineering challenges in the application of NW/NP lasers, they provide excellent probes of many-body physics in the LHP material. For sufficiently strong light-matter coupling expected for LHPs in DBR cavities, an exciton-polariton, i.e., the superposition state between the exciton and the cavity photon, can form. An exciting prospect of strong light-matter coupling is the potential formation of an exciton polariton condensate, which possesses many interesting quantum and nonlinear effects, such as superfluidity, long-range coherence, and laserlike light emission. However, it is difficult to distinguish coherent light from an exciton-polariton condensate and that from conventional stimulated laser emission. Several reports have established the condition of strong coupling for LHPs in DBR cavities. We stress, however, that these studies have not included necessary experiments to unambiguously establish the formation of exciton-polariton condensation, and several experiments and routes of analysis are needed to make a more convincing case for exciton-polariton condensation in LHP based systems. The potential of exciton-polariton condensation expands the horizon of LHP materials from conventional optoelectronics to quantum devices.
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http://dx.doi.org/10.1021/acs.accounts.9b00382DOI Listing
October 2019

Controlling Singlet Fission by Molecular Contortion.

J Am Chem Soc 2019 08 9;141(33):13143-13147. Epub 2019 Aug 9.

Department of Chemistry , Columbia University , New York , New York 10027 , United States.

Singlet fission, the generation of two triplet excited states from the absorption of a single photon, may potentially increase solar energy conversion efficiency. A major roadblock in realizing this potential is the limited number of molecules available with high singlet fission yields and sufficient chemical stability. Here, we demonstrate a strategy for developing singlet fission materials in which we start with a stable molecular platform and use strain to tune the singlet and triplet energies. Using perylene diimide as a model system, we tune the singlet fission energetics from endoergic to exoergic or iso-energetic by straining the molecular backbone. The result is an increase in the singlet fission rate by 2 orders of magnitude. This demonstration opens a door to greatly expanding the molecular toolbox for singlet fission.
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http://dx.doi.org/10.1021/jacs.9b05357DOI Listing
August 2019

Waimānalo Pono Research Hui: A Community-Academic Partnership to Promote Native Hawaiian Wellness through Culturally Grounded and Community-Driven Research and Programming.

Am J Community Psychol 2019 09 19;64(1-2):107-117. Epub 2019 Jul 19.

Waimānalo Pono Research Hui, Waimānalo, HI, USA.

Although Hawai'i is often portrayed as an idyllic paradise and is recognized as one of the healthiest States in the United States, pervasive health disparities exist among Native Hawaiians. Similar to other indigenous populations across the globe, these disparities are linked to unjust social and economic policies rooted in colonization and historical trauma. Western-centric efforts to address these disparities have yielded limited results. Consequently, indigenous frameworks to decolonize western-centric research processes have emerged. The Waimānalo Pono Research Hui is an example of a community-academic partnership that uses indigenous methodologies and principles of community-based participatory research as the foundation to engage Native Hawaiian community members in research. Monthly gatherings are held where community members and academic researchers share a meal and discuss community priorities with the goal of shaping research and programming that are rooted in Native Hawaiian values. A mission for the group has been created as well as protocols for community engagement to ensure all projects that work with the Waimānalo Pono Research Hui are ethically sound and grounded in the community's preferences, cultural knowledge, and lived experiences. Our community members continually report that the Waimānalo Pono Research Hui has positively transformed their perception of and willingness to engage in research. Similarly, university students and academic researchers express how much their knowledge about working with communities has grown and inspired them. Creating spaces for communities and researchers to build authentic relationships and engage in ongoing conversations can promote culturally grounded and community-driven research and programming.
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http://dx.doi.org/10.1002/ajcp.12355DOI Listing
September 2019

Large-scale analyses of the relationship between sex, age and intelligence quotient heterogeneity and cortical morphometry in autism spectrum disorder.

Mol Psychiatry 2020 03 26;25(3):614-628. Epub 2019 Apr 26.

Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, QC, Canada.

Significant heterogeneity across aetiologies, neurobiology and clinical phenotypes have been observed in individuals with autism spectrum disorder (ASD). Neuroimaging-based neuroanatomical studies of ASD have often reported inconsistent findings which may, in part, be attributable to an insufficient understanding of the relationship between factors influencing clinical heterogeneity and their relationship to brain anatomy. To this end, we performed a large-scale examination of cortical morphometry in ASD, with a specific focus on the impact of three potential sources of heterogeneity: sex, age and full-scale intelligence (FIQ). To examine these potentially subtle relationships, we amassed a large multi-site dataset that was carefully quality controlled (yielding a final sample of 1327 from the initial dataset of 3145 magnetic resonance images; 491 individuals with ASD). Using a meta-analytic technique to account for inter-site differences, we identified greater cortical thickness in individuals with ASD relative to controls, in regions previously implicated in ASD, including the superior temporal gyrus and inferior frontal sulcus. Greater cortical thickness was observed in sex specific regions; further, cortical thickness differences were observed to be greater in younger individuals and in those with lower FIQ, and to be related to overall clinical severity. This work serves as an important step towards parsing factors that influence neuroanatomical heterogeneity in ASD and is a potential step towards establishing individual-specific biomarkers.
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http://dx.doi.org/10.1038/s41380-019-0420-6DOI Listing
March 2020

Integrating Native Hawaiian tradition with the modern technology of aquaponics.

Glob Health Promot 2019 04;26(3_suppl):87-92

7 School of Social Work and Indigenous Wellness Research Institute, University of Washington, Seattle, Washington, USA.

Prior to western arrival in 1778, Native Hawaiians possessed a sophisticated culture and resource management system conducive to an island ecosystem. However, disenfranchisement from ancestral lands and traditional food sources as a result of colonization led to Native Hawaiians being forced to abandon many of their traditional practices. Today, many Native Hawaiians experience food insecurity, placing them at further risk for obesity and other nutrition-related chronic diseases. Consequently, there is a growing need for place-based and culturally relevant strategies rooted in Hawaiian epistemology to address these issues. This paper describes the history and development of one such intervention - the MALAMA study - in the community of Waimānalo that innovatively merges the modern technology of aquaponics with traditional Native Hawaiian practices and values.
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http://dx.doi.org/10.1177/1757975919831241DOI Listing
April 2019

The oxytocin receptor gene predicts brain activity during an emotion recognition task in autism.

Mol Autism 2019 12;10:12. Epub 2019 Mar 12.

2Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.

Background: Autism is a highly varied and heritable neurodevelopmental condition, and common variants explain approximately 50% of the genetic variance of autism. One of the genes implicated in autism is the oxytocin receptor (). The current study combined genetic and brain imaging (fMRI) data to examine the moderating effect of genotype on the association between diagnosis and brain activity in response to a test of cognitive empathy.

Methods: Participants were adolescents (mean age = 14.7 ± 1.7) who were genotyped for single nucleotide polymorphisms (SNPs) within the and underwent functional brain imaging while completing the adolescent version of the 'Reading the Mind in the Eyes' Test (Eyes Test).

Results: Two (rs2254298, rs53576) of the five SNPs examined were significantly associated with brain activity during the Eyes Test, and three of the SNPs (rs2254298, rs53576, rs2268491) interacted with diagnostic status to predict brain activity. All of the effects localized to the right supramarginal gyrus (rSMG) and an overlap analysis revealed a large overlap of the effects. An exploratory analysis showed that activity within an anatomically defined rSMG and genotype can predict diagnostic status with reasonable accuracy.

Conclusions: This is one of the first studies to investigate and brain function in autism. The findings suggest a neurogenetic mechanism by which -dependent activity within the rSMG is related to the aetiology of autism.
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http://dx.doi.org/10.1186/s13229-019-0258-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6419364PMC
May 2019

How lasing happens in CsPbBr perovskite nanowires.

Nat Commun 2019 01 16;10(1):265. Epub 2019 Jan 16.

Department of Chemistry, Columbia University, New York, NY, 10027, USA.

Lead halide perovskites are emerging as an excellent material platform for optoelectronic processes. There have been extensive discussions on lasing, polariton formation, and nonlinear processes in this material system, but the underlying mechanism remains unknown. Here we probe lasing from CsPbBr perovskite nanowires with picosecond (ps) time resolution and show that lasing originates from stimulated emission of an electron-hole plasma. We observe an anomalous blue-shifting of the lasing gain profile with time up to 25 ps, and assign this as a signature for lasing involving plasmon emission. The time domain view provides an ultra-sensitive probe of many-body physics which was obscured in previous time-integrated measurements of lasing from lead halide perovskite nanowires.
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http://dx.doi.org/10.1038/s41467-018-07972-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6335413PMC
January 2019

Citizen science evidence from the past century shows that Scottish rivers are warming.

Sci Total Environ 2019 Apr 23;659:53-65. Epub 2018 Dec 23.

Biomathematics and Statistics Scotland, Aberdeen AB15 8QH, United Kingdom.

Salmonid species are highly sensitive to river water temperature. Although long-term river temperature monitoring is essential for assessing drivers of change in ecological systems, these data are rarely available from statutory monitoring. We utilized a 105-year citizen science data set of river water temperature from the River Spey, North-East Scotland, gathered during the fishing season (April-October) between 1912 and 2016. As there were gaps in the records we applied generalised additive models to reconstruct long-term daily river temperature in the fishing season from air temperature, cumulative air temperature, day length and runoff. For that, continuous hydrometeorological data have been obtained from statutory monitoring and process-based models. Long-term warming trends of river temperature, namely an increase of 0.2 K per decade after 1961, have been mostly related to increasing air temperature of the same magnitude. Indirect impacts of rising air temperatures include less snow accumulation and snow melt as well as earlier snow melt. The snow free period starts around 2 days earlier per decade throughout the study period and 7 days earlier per decade after 1965. Consequently, the contribution of snow melt and its cooling properties to river temperature in spring are declining. Citizen science delivered a data set that filled a vital knowledge gap in the long-term historical assessment of river temperatures. Such information provides a robust basis for future assessments of global change and can help inform decision-makers about the potential importance of enhancing the resilience of rivers and aquatic ecology to climate change.
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http://dx.doi.org/10.1016/j.scitotenv.2018.12.325DOI Listing
April 2019

Not one Brexit: How local context and social processes influence policy analysis.

PLoS One 2018 17;13(12):e0208451. Epub 2018 Dec 17.

Scotland's Rural College, Edinburgh, United Kingdom.

This paper develops an empirical agent-based model to assess the impacts of Brexit on Scottish cattle farms. We first identify several trends and processes among Scottish cattle farms that were ongoing before Brexit: the lack of succession, the rise of leisure farming, the trend to diversify and industrialise, and, finally, the phenomenon of the "disappearing middle", characterised by the decline of medium-sized farms and the polarization of farm sizes. We then study the potential impact of Brexit amid the local context and those ongoing social processes. We find that the impact of Brexit is indeed subject to pre-Brexit conditions. For example, whether industrialization is present locally can significantly alter the impact of Brexit. The impact of Brexit also varies by location: we find a clear divide between constituencies in the north (highland and islands), the middle (the central belt) and the south. Finally, we argue that policy analysis of Brexit should consider the heterogeneous social context and the complex social processes under which Brexit occurs. Rather than fitting the world into simple system models and ignoring the evidence when it does not fit, we need to develop policy analysis frameworks that can incorporate real world complexities, so that we can assess the impacts of major events and policy changes in a more meaningful way.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0208451PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296738PMC
May 2019

Effectiveness of a Community Health Worker-Led Diabetes Intervention among Older and Younger Latino Participants: Results from a Randomized Controlled Trial.

Geriatrics (Basel) 2018 09 2;3(3). Epub 2018 Aug 2.

Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI 48109, USA.

Diabetes management for older Latino adults is complex, given a higher incidence of multiple coexisting medical conditions and psychosocial barriers to self-management. Community health workers (CHWs) may be effective in reducing these barriers. The REACH Detroit CHW randomized controlled intervention studies with Latino/as with diabetes found improvements in self-management behaviors and glucose control after participating in a CHW-led intervention. Using data from the REACH Detroit Partnership's cohort 3, this study used descriptive statistics and multiple linear regression analyses to evaluate whether the six-month CHW intervention had a greater effect on older Latino/as (ages 55 and older) than younger participants between baseline and post-intervention follow-up at six months. There were significant intervention effects by age group that varied by outcome. Compared to a control group that received enhanced usual care, there were statistically significant intervention effects demonstrating greater self-efficacy scores 1.27 (0.23, 2.32); < 0.05, and reductions in HbA1c 1.02 (-1.96,-0.07); < 0.05, among older participants in the CHW intervention, and increases in diabetes support 0.74 (0.34, 1.13); < 0.001; and understanding of diabetes management 0.39 (0.08, 0.70); < 0.01 among younger participants.
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http://dx.doi.org/10.3390/geriatrics3030047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6192048PMC
September 2018

Environmental governance in China: Interactions between the state and "nonstate actors".

J Environ Manage 2018 Aug 26;220:126-135. Epub 2018 May 26.

New York University Shanghai, Shanghai, China; Fundacao Dom Cabral, Brazil.

In the West, limited government capacity to solve environmental problems has triggered the rise of a variety of "nonstate actors" to supplement government efforts or provide alternative mechanisms for addressing environmental issues. How does this development - along with our efforts to understand it - map onto environmental governance processes in China? China's efforts to address environmental issues reflect institutionalized governance processes that differ from parallel western processes in ways that have major consequences for domestic environmental governance practices and the governance of China "going abroad." China's governance processes blur the distinction between the state and other actors; the "shadow of the state" is a major factor in all efforts to address environmental issues. The space occupied by nonstate actors in western systems is occupied by shiye danwei ("public service units"), she hui tuanti ("social associations") and e-platforms, all of which have close links to the state. Meanwhile, international NGOs and multinational corporations are also significant players in China. As a result, the mechanisms of influence that produce effects in China differ in important ways from mechanisms familiar from the western experience. This conclusion has far-reaching implications for those seeking to address global environmental concerns, given the importance of China's growing economy and burgeoning network of trade relationships.
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http://dx.doi.org/10.1016/j.jenvman.2018.04.104DOI Listing
August 2018

Strong confinement of optical fields using localized surface phonon polaritons in cubic boron nitride.

Opt Lett 2018 May;43(9):2177-2180

Phonon polaritons (PhPs) are long-lived electromagnetic modes that originate from the coupling of infrared (IR) photons with the bound ionic lattice of a polar crystal. Cubic-boron nitride (cBN) is such a polar, semiconductor material which, due to the light atomic masses, can support high-frequency optical phonons. Here we report on random arrays of cBN nanostructures fabricated via an unpatterned reactive ion etching process. Fourier-transform infrared reflection spectra suggest the presence of localized surface PhPs within the reststrahlen band, with quality factors in excess of 38 observed. These can provide the basis of next-generation IR optical components such as antennas for communication, improved chemical spectroscopies, and enhanced emitters, sources, and detectors.
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http://dx.doi.org/10.1364/OL.43.002177DOI Listing
May 2018

Outcomes at 18 Months From a Community Health Worker and Peer Leader Diabetes Self-Management Program for Latino Adults.

Diabetes Care 2018 07 27;41(7):1414-1422. Epub 2018 Apr 27.

University of Michigan, Ann Arbor, MI.

Objective: This study evaluated the effectiveness of a community health worker (CHW) diabetes self-management education (DSME) program, followed by two different approaches to maintain improvements in HbA and other clinical and patient-centered outcomes over 18 months.

Research Design And Methods: The study randomized 222 Latino adults with type 2 diabetes and poor glycemic control from a federally qualified health center to ) a CHW-led, 6-month DSME program or ) enhanced usual care (EUC). After the 6-month program, participants randomized to the CHW-led DSME were further randomized to ) 12 months of CHW-delivered monthly telephone outreach (CHW-only) or ) 12 months of weekly group sessions delivered by peer leaders (PLs) with telephone outreach to those unable to attend (CHW+PL). The primary outcome was HbA. Secondary outcomes were blood pressure, lipid levels, diabetes distress, depressive symptoms, understanding of diabetes self-management, and diabetes social support. Assessments were conducted at baseline and at 6, 12, and 18 months.

Results: Participants in the CHW intervention at the 6-month follow-up had greater decreases in HbA (-0.45% [95% CI -0.87, -0.03]; < 0.05) and in diabetes distress (-0.3 points [95% CI -0.6, -0.03]; < 0.05) compared with EUC. CHW+PL participants maintained HbA improvements at 12 and 18 months, and CHW-only participants maintained improvements in diabetes distress at 12 and 18 months. CHW+PL participants also had significantly fewer depressive symptoms at 18 months compared with EUC (-2.2 points [95% CI -4.1, -0.3]; < 0.05). Participants in CHW-led DSME had significant improvements in diabetes social support and in understanding of diabetes self-management at 6 months relative to EUC, but these intervention effects were not sustained at 18 months.

Conclusions: This study demonstrates the effectiveness of a 6-month CHW intervention on key diabetes outcomes and of a volunteer PL program in sustaining key achieved gains. These are scalable models for health care centers in low-resource settings for achieving and maintaining improvements in key diabetes outcomes.
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http://dx.doi.org/10.2337/dc17-0978DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6014532PMC
July 2018

Racial/Ethnic Discrimination and Diabetes-Related Outcomes Among Latinos with Type 2 Diabetes.

J Immigr Minor Health 2019 Feb;21(1):105-114

Community Health and Social Services Center, Inc., 5635 W Fort St., Detroit, MI, 48209, USA.

Discrimination is associated with adverse health outcomes, but few studies have examined the association of discrimination with diabetes-related outcomes including mental health and glycemic control, particularly for immigrant and US-born Latinos. We analyzed survey data (n = 222) collected at baseline of a diabetes intervention. Using multiple linear regression, we examined the association of racial/ethnic discrimination with depressive symptoms, diabetes-related distress, and HbA1c, and variation in these associations by nativity and, for immigrants, length of US residence. Racial/ethnic discrimination was positively associated with depressive symptoms (b = 2.57, SE = 0.45, p < 0.01) and diabetes-related distress (b = 0.30, SE = 0.09, p < 0.01). We could not reject the null hypothesis of no cross-sectional association of racial/ethnic discrimination with HbA1c (b = - 0.27, SE = 0.18, p = 0.14). Although racial/ethnic discrimination did not directly affect HbA1c, racial/ethnic discrimination had a significant mediating effect on HbA1c through diabetes-related distress (p = 0.02). Results suggest that racial/ethnic discrimination is detrimental for health for Latinos with diabetes.
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http://dx.doi.org/10.1007/s10903-018-0710-0DOI Listing
February 2019

Flexible robust binder-free carbon nanotube membranes for solid state and microcapacitor application.

Nanotechnology 2018 Jan;29(3):035605

Department of Physics, Altoona College, The Pennsylvania State University, Altoona, PA 16601, United States of America. Materials Research Institute, The Pennsylvania State University, University Park, PA 16802, United States of America.

We present a liquid phase post synthesis self-assemble protocol that transforms trillions of carbon nanotubes (CNTs) in powder form into densely packed flexible, robust and binder-free macroscopic membranes with a hierarchical pore structure. We employ charge transfer engineering to spontaneously disperse the CNTs in a liquid medium. The processing protocol has limited or no impact on the intrinsic properties of the CNTs. As the thickness of the CNT membrane is increased, we observed a gradual transition from high flexibility to buckling and brittleness in the flexural properties of the membranes. The binder-free CNT membranes have bulk mass density greater than that of water (1.0 g cm). We correlate the mass of the CNTs in the membrane to the thickness of the membrane and obtained a bulk mass density of ∼1.11 g cm ± 0.03 g cm. We demonstrate the use of the CNT membranes as electrode in a pristine and oxidized single/stacked solid-state capacitor as well as pristine interdigitated microcapacitor that show time constant of ∼32 ms with no degradation in performance even after 10 000 cycles. The capacitors show very good temperature dependence over a wide range of temperatures with good cycling performance up to 90 °C. The specific capacitance of the pseudocapacitive CNT electrode at room temperature was 72 F g and increased to 100 F g at 70 °C. The leakage current of bipolar stacked solid state capacitor was ∼100 nA cm at 2.5 V when held for 72 h.
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http://dx.doi.org/10.1088/1361-6528/aa9d31DOI Listing
January 2018

Chemical Vapor Deposition Growth of Large Single-Crystal Mono-, Bi-, Tri-Layer Hexagonal Boron Nitride and Their Interlayer Stacking.

ACS Nano 2017 12 22;11(12):12057-12066. Epub 2017 Nov 22.

School of Electrical and Computer Engineering, Cornell University , Ithaca, New York 14853, United States.

Two-dimensional hexagonal boron nitride (h-BN) is a wide bandgap material which has promising mechanical and optical properties. Here we report the realization of an initial nucleation density of h-BN <1 per mm using low-pressure chemical vapor deposition (CVD) on polycrystalline copper. This enabled wafer-scale CVD growth of single-crystal monolayer h-BN with a lateral size up to ∼300 μm, bilayer h-BN with a lateral size up to ∼60 μm, and trilayer h-BN with a lateral size up to ∼35 μm. Based on the large single-crystal monolayer h-BN domain, the sizes of the as-grown bi- and trilayer h-BN grains are 2 orders of magnitude larger than typical h-BN multilayer domains. In addition, we achieved coalesced h-BN films with an average grain size ∼100 μm. Various flake morphologies and their interlayer stacking configurations of bi- and trilayer h-BN domains were studied. Raman signatures of mono- and multilayer h-BN were investigated side by side in the same film. It was found that the Raman peak intensity can be used as a marker for the number of layers.
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http://dx.doi.org/10.1021/acsnano.7b04841DOI Listing
December 2017

Supercritical Antisolvent Precipitation of Amorphous Copper-Zinc Georgeite and Acetate Precursors for the Preparation of Ambient-Pressure Water-Gas-Shift Copper/Zinc Oxide Catalysts.

ChemCatChem 2017 05 7;9(9):1621-1631. Epub 2017 Apr 7.

Cardiff Catalysis Institute, School of Chemistry Cardiff University Main Building, Park Place Cardiff CF10 3AT UK.

A series of copper-zinc acetate and zincian georgeite precursors have been produced by supercritical CO antisolvent (SAS) precipitation as precursors to Cu/ZnO catalysts for the water gas shift (WGS) reaction. The amorphous materials were prepared by varying the water/ethanol volumetric ratio in the initial metal acetate solutions. Water addition promoted georgeite formation at the expense of mixed metal acetates, which are formed in the absence of the water co-solvent. Optimum SAS precipitation occurs without water to give high surface areas, whereas high water content gives inferior surface areas and copper-zinc segregation. Calcination of the acetates is exothermic, producing a mixture of metal oxides with high crystallinity. However, thermal decomposition of zincian georgeite resulted in highly dispersed CuO and ZnO crystallites with poor structural order. The georgeite-derived catalysts give superior WGS performance to the acetate-derived catalysts, which is attributed to enhanced copper-zinc interactions that originate from the precursor.
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http://dx.doi.org/10.1002/cctc.201601603DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5485020PMC
May 2017

A new class of Cu/ZnO catalysts derived from zincian georgeite precursors prepared by co-precipitation.

Chem Sci 2017 Mar 3;8(3):2436-2447. Epub 2017 Jan 3.

Cardiff Catalysis Institute , School of Chemistry , Cardiff University , Main Building, Park Place , Cardiff , CF10 3AT , UK . Email:

Zincian georgeite, an amorphous copper-zinc hydroxycarbonate, has been prepared by co-precipitation using acetate salts and ammonium carbonate. Incorporation of zinc into the georgeite phase and mild ageing conditions inhibits crystallisation into zincian malachite or aurichalcite. This zincian georgeite precursor was used to prepare a Cu/ZnO catalyst, which exhibits a superior performance to a zincian malachite derived catalyst for methanol synthesis and the low temperature water-gas shift (LTS) reaction. Furthermore, the enhanced LTS activity and stability in comparison to that of a commercial Cu/ZnO/AlO catalyst, indicates that the addition of alumina as a stabiliser may not be required for the zincian georgeite derived Cu/ZnO catalyst. The enhanced performance is partly attributed to the exclusion of alkali metals from the synthesis procedure, which are known to act as catalyst poisons. The effect of residual sodium on the microstructural properties of the catalyst precursor was investigated further from preparations using sodium carbonate.
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http://dx.doi.org/10.1039/c6sc04130bDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5369406PMC
March 2017

SMAP L-Band Microwave Radiometer: Instrument Design and First Year on Orbit.

IEEE Trans Geosci Remote Sens 2017 Apr 5;55(4):1954-1966. Epub 2017 Jan 5.

NASA Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 USA.

The Soil Moisture Active-Passive (SMAP) L-band microwave radiometer is a conical scanning instrument designed to measure soil moisture with 4% volumetric accuracy at 40-km spatial resolution. SMAP is NASA's first Earth Systematic Mission developed in response to its first Earth science decadal survey. Here, the design is reviewed and the results of its first year on orbit are presented. Unique features of the radiometer include a large 6-m rotating reflector, fully polarimetric radiometer receiver with internal calibration, and radio-frequency interference detection and filtering hardware. The radiometer electronics are thermally controlled to achieve good radiometric stability. Analyses of on-orbit results indicate that the electrical and thermal characteristics of the electronics and internal calibration sources are very stable and promote excellent gain stability. Radiometer NEDT 1 K for 17-ms samples. The gain spectrum exhibits low noise at frequencies 1 MHz and 1/f noise rising at longer time scales fully captured by the internal calibration scheme. Results from sky observations and global swath imagery of all four Stokes antenna temperatures indicate that the instrument is operating as expected.
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http://dx.doi.org/10.1109/tgrs.2016.2631978DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357195PMC
April 2017

The effect of sodium species on methanol synthesis and water-gas shift Cu/ZnO catalysts: utilising high purity zincian georgeite.

Faraday Discuss 2017 04;197:287-307

Cardiff Catalysis Institute, Cardiff University, Main Building, Park Place, Cardiff, CF10 3AT, UK.

The effect of sodium species on the physical and catalytic properties of Cu/ZnO catalysts derived from zincian georgeite has been investigated. Catalysts prepared with <100 ppm to 2.1 wt% Na, using a supercritical CO antisolvent technique, were characterised and tested for the low temperature water-gas shift reaction and also CO hydrogenation to methanol. It was found that zincian georgeite catalyst precursor stability was dependent on the Na concentration, with the 2.1 wt% Na-containing sample uncontrollably ageing to malachite and sodium zinc carbonate. Samples with lower Na contents (<100-2500 ppm) remained as the amorphous zincian georgeite phase, which on calcination and reduction resulted in similar CuO/Cu particle sizes and Cu surface areas. The aged 2.1 wt% Na containing sample, after calcination and reduction, was found to comprise of larger CuO crystallites and a lower Cu surface area. However, calcination of the high Na sample immediately after precipitation (before ageing) resulted in a comparable CuO/Cu particle size to the lower (<100-2500 ppm) Na containing samples, but with a lower Cu surface area, which indicates that Na species block Cu sites. Activity of the catalysts for the water-gas shift reaction and methanol yields in the methanol synthesis reaction correlated with Na content, suggesting that Na directly poisons the catalyst. In situ XRD analysis showed that the ZnO crystallite size and consequently Cu crystallite size increased dramatically in the presence of water in a syn-gas reaction mixture, showing that stabilisation of nanocrystalline ZnO is required. Sodium species have a moderate effect on ZnO and Cu crystallite growth rate, with lower Na content resulting in slightly reduced rates of growth under reaction conditions.
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http://dx.doi.org/10.1039/c6fd00202aDOI Listing
April 2017

Does Racial/Ethnic Identity Influence the Effectiveness of a Community Health Worker Intervention for African American and Latino Adults With Type 2 Diabetes?

Health Educ Behav 2017 06 9;44(3):485-493. Epub 2016 Dec 9.

2 University of Michigan, Ann Arbor, MI, USA.

Background: Community health worker (CHW) interventions are known to be an effective strategy to improve health behaviors and outcomes in relation to diabetes, particularly for racial/ethnic communities. Although understanding the function of identity with same race/ethnicity among clients of CHW interventions could contribute to more effective program design, few studies have explored whether levels of racial/ethnic identity among participants can influence the effectiveness of CHW interventions.

Aims: We tested the relationship between level of racial/ethnic identity and changes in hemoglobin A1c and diabetes self-efficacy among low-income African American and Latino adults with type 2 diabetes who participated in a CHW intervention.

Methods: Data came from a randomized controlled trial of the CHW intervention with a 6-month delayed control group design for 164 African American and Latino adults in Detroit, Michigan. Racial/ethnic identity was created from two items and classified into high, moderate, and low. We combined the two arms (immediate and delayed) into one because there was no significant difference in baseline characteristics, other than age and postintervention self-efficacy, and multivariable linear regression models were applied in the analysis.

Results: Possession of high racial/ethnic identity was associated with greater improvement both in hemoglobin A1c and diabetes self-efficacy at 6 months. Moreover, among those with high hemoglobin A1c at preintervention, higher racial/ethnic identity had a greater impact on hemoglobin A1c improvement, compared with those with lower identity.

Conclusions: This study suggests the importance of considering racial/ethnic identity of the participants in designing and operating the CHW intervention for racial/ethnic minority population.
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http://dx.doi.org/10.1177/1090198116673821DOI Listing
June 2017

An Exploratory Study of the Impact of Gender on Health Behavior Among African American and Latino Men With Type 2 Diabetes.

Am J Mens Health 2017 Mar 5;11(2):344-356. Epub 2016 Dec 5.

2 University of Michigan, Ann Arbor, MI, USA.

This study explores gender values and beliefs among Latino and African American men with diabetes and examines how these values and beliefs may influence their health behaviors. Participants were recruited from individuals who participated in one of three Racial and Ethnic Approaches to Community Health Detroit Partnership diabetes self-management interventions. One focus group was conducted with African American men ( n = 10) and two focus groups were conducted with Latino men ( n = 12) over a 3-month period. Sessions lasted 90 minutes, were audiotaped, and analyzed using thematic content analysis techniques. Two themes emerged that characterize gender identity and its relationship to health behavior in men: (a) men's beliefs about being men (i.e., key aspects of being a man including having respect for themselves, authority figures, and peers; fulfilling the role as breadwinner; being responsible for serving as the leader of the family; and maintaining a sense of chivalry) and (b) influence of gender values and beliefs on health behavior (i.e., the need to maintain a strong image to the outside world, and the need to maintain control of themselves served as barriers to seeking out and engaging in diabetes self-management behaviors). Results suggest that gender values and beliefs may have implications for how health behaviors among men with diabetes. Future research should study the direct impact masculine identity has on health behaviors among men with diabetes.
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http://dx.doi.org/10.1177/1557988316681125DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675282PMC
March 2017

Predictors of care home and hospital admissions and their costs for older people with Alzheimer's disease: findings from a large London case register.

BMJ Open 2016 11 18;6(11):e013591. Epub 2016 Nov 18.

Psychological Medicine Department, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

Objectives: To examine links between clinical and other characteristics of people with Alzheimer's disease living in the community, likelihood of care home or hospital admission, and associated costs.

Design: Observational data extracted from clinical records using natural language processing and Hospital Episode Statistics. Statistical analyses examined effects of cognition, physical health, mental health, sociodemographic factors and living circumstances on risk of admission to care home or hospital over 6 months and associated costs, adjusting for repeated observations.

Setting: Catchment area for South London and Maudsley National Health Service Foundation Trust, provider for 1.2 million people in Southeast London.

Participants: Every individual with diagnosis of Alzheimer's disease seen and treated by mental health services in the catchment area, with at least one rating of cognition, not resident in care home at time of assessment (n=3075).

Interventions: Usual treatment.

Main Outcome Measures: Risk of admission to, and days spent in three settings during 6-month period following routine clinical assessment: care home, mental health inpatient care and general hospital inpatient care.

Results: Predictors of probability of care home or hospital admission and/or associated costs over 6 months include cognition, functional problems, agitation, depression, physical illness, previous hospitalisations, age, gender, ethnicity, living alone and having a partner. Patterns of association differed considerably by destination.

Conclusions: Most people with dementia prefer to remain in their own homes, and funding bodies see this as cheaper than institutionalisation. Better treatment in the community that reduces health and social care needs of Alzheimer's patients would reduce admission rates. Living alone, poor living circumstances and functional problems all raise admission rates, and so major cuts in social care budgets increase the risk of high-cost admissions which older people do not want. Routinely collected data can be used to reveal local patterns of admission and costs.
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http://dx.doi.org/10.1136/bmjopen-2016-013591DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5128896PMC
November 2016