Kevin E Kip

University of South Florida, Tampa, Florida, United States

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Publications (177)1181.7 Total impact

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    ABSTRACT: Our aim was to compare the biopsychosocial characteristics of young women with those of older women who were enrolled in cardiac rehabilitation (CR). The baseline characteristics of women who prematurely terminated CR participation were also explored. Baseline physiological and psychosocial indices of women ≤ 55 years compared with older women eligible for CR were evaluated 1 week before enrolling in either a traditional CR or a gender-specific, motivationally enhanced CR. A greater proportion of young women (n = 65) compared with their older counterparts (n = 187) were diagnosed with acute myocardial infarction during their index hospitalization. They demonstrated lower high-density lipoprotein cholesterol, higher total cholesterol/high-density lipoprotein cholesterol ratios, and greater body weight compared with older women and were more likely to be active smokers. Young women compared with older women reported significantly worse health perceptions, quality of life, optimism, hope, social support, and stress and significantly more symptoms of depression and anxiety. Women who prematurely terminated CR participation were younger, more obese, with worse quality of life, and greater symptoms of depression and anxiety compared with women completing CR. Notable differences in physiological and psychosocial profiles of young women compared with older women enrolled in CR were evident, placing them at high risk for nonadherence to secondary prevention interventions as well as increased risk for disease progression and subsequent cardiac adverse events. Continued existence of these health differentials represents an important public health problem and warrants further research to address these age-related and sex-specific health disparities among women with coronary heart disease.
    Journal of cardiopulmonary rehabilitation and prevention 11/2014; · 1.68 Impact Factor
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    ABSTRACT: Identification of racial differences in the burden and correlates of carotid intima media thickness (CIMT) and coronary artery calcium (CAC) may provide the basis for the development of race-specific cardiovascular disease (CVD) risk prediction algorithms.
    Netherlands heart journal: monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation 10/2014; 23(1). · 2.26 Impact Factor
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    ABSTRACT: Sleep apnea and obesity are strongly associated, and both increase the risk for coronary artery disease. Several cross-sectional studies have reported discrepant results regarding the role obesity plays in the relation between sleep apnea and coronary artery calcium (CAC), a marker of subclinical coronary disease. The aim of the present study was to investigate the association between sleep apnea and the presence of CAC in a community cohort of middle-aged men and women without preexisting cardiovascular disease, stratified by body mass index (<30 vs ≥30 kg/m(2)). Participants underwent electron-beam computed tomography to measure CAC and underwent home sleep testing for sleep apnea. The presence of CAC was defined as an Agatston score >0. Sleep apnea was analyzed categorically using the apnea-hypopnea index. The sample was composed of primarily men (61%) and Caucasians (56%), with a mean age of 61 years. The prevalence of CAC was 76%. In participants with body mass indexes <30 kg/m(2) (n = 139), apnea-hypopnea index ≥15 (vs <5) was associated with 2.7-fold odds of having CAC, but the effect only approached significance. Conversely, in participants with body mass indexes ≥30 kg/m(2), sleep apnea was not independently associated with CAC. In conclusion, sleep apnea is independently associated with early atherosclerotic plaque burden in nonobese patients.
    The American Journal of Cardiology 09/2014; · 3.43 Impact Factor
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    ABSTRACT: Background. Limited research has been conducted on the moderating effect of race/ethnicity on objective sleep disturbances in breast cancer survivors (BCSs). Objective. To explore racial/ethnic differences in objective sleep disturbances among BCSs and their relationship with self-reported symptoms. Intervention/Methods. Sleep disturbance and symptoms were measured using actigraphy for 72 hours and self-reported questionnaires, respectively, among 79 BCSs. Analysis of covariance, Pearson's correlation, and multivariate regression were used to analyze data. Results. Sixty (75.9%) participants listed their ethnicity as white, non-Hispanic and 19 (24.1%) as minority. Total sleep time was 395.9 minutes for white BCSs compared to 330.4 minutes for minority BCSs. Significant correlations were seen between sleep onset latency (SOL) and depression, SOL and fatigue, and sleep efficiency (SE) and fatigue among minority BCSs. Among white BCSs, significant correlations were seen between SE and pain and wake after sleep onset (WASO) and pain. The association between depression and SOL and fatigue and SOL appeared to be stronger in minority BCSs than white BCSs. Conclusions. Results indicate that white BCSs slept longer than minority BCSs, and race/ethnicity modified the effect of depression and fatigue on SOL, respectively. Implications for Practice. As part of survivorship care, race/ethnicity should be included as an essential component of comprehensive symptom assessments.
    Nursing research and practice. 07/2014; 2014:858403.
    This article is viewable in ResearchGate's enriched format
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    ABSTRACT: The purpose of this study was to investigate the effects of mindfulness-based stress reduction for breast cancer survivors (MBSR(BC)) on multiple measures of objective and subjective sleep parameters among breast cancer survivors (BCS).
    Psycho-Oncology 06/2014; · 4.04 Impact Factor
  • Journal of Nursing Measurement. 05/2014; In press.
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    ABSTRACT: As many as 70% of veterans with chronic pain treated within the US Veterans Administration (VA) system may have posttraumatic stress disorder (PTSD), and conversely, up to 80% of those with PTSD may have pain. We describe pain experienced by US service members and veterans with symptoms of PTSD, and report on the effect of Accelerated Resolution Therapy (ART), a new, brief exposure-based therapy, on acute pain reduction secondary to treatment of symptoms of PTSD.
    European Journal of Psychotraumatology 05/2014; 5. · 2.40 Impact Factor
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    ABSTRACT: TIMI frame count (TFC) predicts outcomes in patients with obstructive coronary artery disease (CAD); it remains unclear whether TFC predicts outcomes in patients without obstructive CAD. TFC was determined in a sample of women with no obstructive CAD enrolled in the Women's Ischemia Syndrome Evaluation (WISE) study. Because TFC is known to be higher in the left anterior descending artery (LAD), TFC determined in the LAD was divided by 1.7 to provide a corrected TFC (cTFC). A total of 298 women, with angiograms suitable for TFC analysis and long-term (6-10 year) follow up data, were included in this sub-study. Their age was 55±11 years, most were white (86%), half had a history of smoking, and half had a history of hypertension. Higher resting cTFC was associated with a higher rate of hospitalization for angina (34% in women with a cTFC >35, 15% in women with a cTFC ≤35, P<0.001). cTFC provided independent prediction of hospitalization for angina after adjusting for many baseline characteristics. In this cohort, resting cTFC was not predictive of major events (myocardial infarction, heart failure, stroke, or all-cause death), cardiovascular events, all-cause mortality, or cardiovascular mortality. In women with signs and symptoms of ischemia but no obstructive CAD, resting cTFC provides independent prediction of hospitalization for angina. Larger studies are required to determine if resting TFC is predictive of major events in patients without obstructive coronary artery disease.
    PLoS ONE 05/2014; 9(5):e96630. · 3.53 Impact Factor
  • Article: Reply.
    Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 03/2014; · 5.64 Impact Factor
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    ABSTRACT: Mindfulness-based stress reduction (MBSR) reduces symptoms of depression, anxiety, and fear of recurrence among breast cancer (BC) survivors. However, the effects of MBSR (BC) on telomere length (TL) and telomerase activity (TA), known markers of cellular aging, psychological stress, and disease risk, are not known. This randomized, wait-listed, controlled study, nested within a larger trial, investigated the effects of MBSR (BC) on TL and TA. BC patients (142) with Stages 0-III cancer who had completed adjuvant treatment with radiation and/or chemotherapy at least 2 weeks prior to enrollment and within 2 years of completion of treatment with lumpectomy and/or mastectomy were randomly assigned to either a 6-week MBSR for BC program or a usual care. Assessments of TA and TL were obtained along with psychological measurements at baseline, 6 weeks, and 12 weeks after completing the MBSR(BC) program. The mean age of 142 participants was 55.3 years; 72% were non-Hispanic White; 78% had Stage I or II cancer; and 36% received both chemotherapy and radiation. In analyses adjusted for baseline TA and psychological status, TA increased steadily over 12 weeks in the MBSR(BC) group (approximately 17%) compared to essentially no increase in the control group (approximately 3%, p < .01). In contrast, no between-group difference was observed for TL (p = .92). These results provide preliminary evidence that MBSR(BC) increases TA in peripheral blood mononuclear cells from BC patients and have implications for understanding how MBSR(BC) may extend cell longevity at the cellular level.
    Biological Research for Nursing 01/2014; · 1.34 Impact Factor
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    ABSTRACT: Researchers focused on patient-centered medicine are increasingly trying to identify baseline factors that predict treatment success. Because the quantity and function of lymphocyte subsets change during stress, we hypothesized that these subsets would serve as stress markers and therefore predict which breast cancer patients would benefit most from mindfulness-based stress reduction (MBSR)-facilitated stress relief. The purpose of this study was to assess whether baseline biomarker levels predicted symptom improvement following an MBSR intervention for breast cancer survivors (MBSR[BC]). This randomized controlled trial involved 41 patients assigned to either an MBSR(BC) intervention group or a no-treatment control group. Biomarkers were assessed at baseline, and symptom change was assessed 6 weeks later. Biomarkers included common lymphocyte subsets in the peripheral blood as well as the ability of T cells to become activated and secrete cytokines in response to stimulation with mitogens. Spearman correlations were used to identify univariate relationships between baseline biomarkers and 6-week improvement of symptoms. Next, backward elimination regression models were used to identify the strongest predictors from the univariate analyses. Multiple baseline biomarkers were significantly positively related to 6-week symptom improvement. The regression models identified B-lymphocytes and interferon-γ as the strongest predictors of gastrointestinal improvement (p < .01), +CD4+CD8 as the strongest predictor of cognitive/psychological (CP) improvement (p = .02), and lymphocytes and interleukin (IL)-4 as the strongest predictors of fatigue improvement (p < .01). These results provide preliminary evidence of the potential to use baseline biomarkers as predictors to identify the patients likely to benefit from this intervention.
    Biological Research for Nursing 01/2014; · 1.34 Impact Factor
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    ABSTRACT: A previous randomized, placebo-controlled study showed that infliximab maintenance therapy prevented recurrence of Crohn's disease 1 year after an ileo-colonic resection. We evaluated recurrence of Crohn's disease, based on endoscopic examination and/or the need for additional surgical resection, beyond the first postoperative year. In a prospective, open-label, long-term follow-up study, 24 patients, previously randomly assigned to receive infliximab for 1 year after an ileocolonic resection, were given the option to continue, stop, or start infliximab therapy. The primary endpoint was the time to recurrence of Crohn's disease, based on endoscopic evidence (endoscopic recurrence), from the initial assignment to postoperative infliximab or placebo. Secondary endpoints were rate of endoscopic recurrence, time to reoperation, and rate of surgical recurrence in relation to the total time on infliximab. All patients were followed for at least 5 years after surgery. Patients assigned to the infliximab group in the first year after surgery had a longer mean time to first endoscopic recurrence (1231±747 days) than patients originally assigned to the placebo group (460±121 days, P=.003). Colonoscopies identified Crohn's disease recurrence in 22.2% in patients who received long-term infliximab and 93.9% in those not on infliximab (P <.0001). Compared to no infliximab, the adjusted rate ratio for being in endoscopic remission while on infliximab was 13.47 (95% confidence interval, 3.52-61.53, P=.0001). Patients originally assigned to the infliximab group had a mean longer time to surgery (1798±359 days) than patients originally assigned to the placebo group (1058±529 days, P=0.04). The rate of surgical recurrence (required additional surgical resection,) was significantly lower among patients who received infliximab for most of the follow-up period than patients who received it for shorter periods (20.0% vs 64.3%, P=.047). Postoperative infliximab maintenance, beyond 1 year, prevents recurrence of Crohn's disease.
    Clinical gastroenterology and hepatology: the official clinical practice journal of the American Gastroenterological Association 01/2014; · 5.64 Impact Factor
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    ABSTRACT: This article describes a new, brief exposure-based psychotherapy known as Accelerated Resolution Therapy (ART) that is currently being evaluated as a treatment for combat-related post-traumatic stress disorder (PTSD). We describe a case report of an Army veteran with combat-related PTSD who was treated with 2 sessions of ART and experienced significant clinical improvement. We then discuss the theoretical basis and major components of the ART protocol, including use of lateral left-right eye movements, and differentiate ART with evidence-based psychotherapies currently endorsed by the Department of Defense and Veterans Administration. The number of military personnel who have served in the wars in Iraq and Afghanistan and are afflicted with PTSD is likely in the hundreds of thousands. The ART protocol, which is delivered in 2 to 5 sessions and without homework, uses the psychotherapeutic practices of imaginal exposure and imagery rescripting (IR) facilitated through sets of eye movements. In addition to its brevity, a novel component of ART is use of IR to "replace" negative imagery (and other sensations) with positive imagery. This theoretical description of ART and single case report provide a rationale for future formal evaluation of ART for treatment of military-related PTSD.
    Military medicine. 01/2014; 179(1):31-37.
  • Clinical Gastroenterology and Hepatology. 01/2014;
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    ABSTRACT: Insomnia and sleep apnea frequently co-occur and are independently associated with an increased risk of cardiovascular disease, but little is known about cardiovascular disease risk among individuals with comorbid insomnia and sleep apnea. The current study examined traditional risk factors and a physiologic biomarker of cardiovascular risk in comorbid insomnia and sleep apnea. Community-based participatory research study. The sample comprised 795 participants without preexisting cardiovascular disease from the Heart Strategies Concentrating On Risk Evaluation (Heart SCORE) study. Participants were assessed for symptoms of insomnia and sleep apnea risk, as well as for presence of obesity, smoking, a sedentary lifestyle, hypertension, dyslipidemia, and diabetes. Baseline resting brachial artery diameter was measured by B-mode ultrasonography. A total of 138 participants (17.4%) met criteria for insomnia syndrome alone, 179 (22.5%) were at high risk for sleep apnea alone, 95 (11.9%) reported both insomnia syndrome and high sleep apnea risk, and 383 (48.2%) reported having neither insomnia nor sleep apnea symptoms Both high sleep apnea risk alone and comorbid insomnia and high sleep apnea risk groups had greater frequencies of obesity, sedentary lifestyle, hypertension, and three or more traditional cardiovascular risk factors and significantly larger brachial artery diameters than the insomnia alone group and those without insomnia or sleep apnea symptoms. No differences in traditional cardiovascular risk factors or brachial artery diameter were found between the high sleep apnea risk and comorbid groups. These findings suggest that sleep apnea is a major contributor to cardiovascular risk and co-occurring insomnia does not appear to add to this risk. Luyster FS; Kip KE; Buysse DJ; Aiyer AN; Reis SE; Strollo PJ. Traditional and nontraditional cardiovascular risk factors in comorbid insomnia and sleep apnea. SLEEP 2014;37(3):593-600.
    Sleep 01/2014; 37(3):593-600. · 5.06 Impact Factor
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    ABSTRACT: Therapies for post-traumatic stress disorder (PTSD) endorsed by the Department of Defense and Veterans Administration are relatively lengthy, costly, and yield variable success. We evaluated Accelerated Resolution Therapy (ART) for the treatment of combat-related psychological trauma. A randomized controlled trial of ART versus an Attention Control (AC) regimen was conducted among 57 U.S. service members/veterans. After random assignment, those assigned to AC were offered crossover to ART, with 3-month follow-up on all participants. Self-report symptoms of PTSD and comorbidities were analyzed among study completers and by the intention-to-treat principle. Mean age was 41 ± 13 years with 19% female, 54% Army, and 68% with prior PTSD treatment. The ART was delivered in 3.7 ± 1.1 sessions with a 94% completion rate. Mean reductions in symptoms of PTSD, depression, anxiety, and trauma-related guilt were significantly greater (p < 0.001) with ART compared to AC. Favorable results for those treated with ART persisted at 3 months, including reduction in aggression (p < 0.0001). Adverse treatment-related events were rare and not serious. ART appears to be a safe and effective treatment for symptoms of combat-related PTSD, including refractory PTSD, and is delivered in significantly less time than therapies endorsed by the Department of Defense and Veterans Administration.
    Military medicine. 12/2013; 178(12):1298-309.
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    ABSTRACT: Young women are increasingly diagnosed with sexually transmitted infections (STIs), including HIV. The aim of this study was to test various types of mass media and their associations with interpersonal communication about sex and HIV or AIDS among female college students, stratified by race. The study used a nonexperimental cross-sectional design and an electronic survey. The sample consisted of female college students (N = 776) at a 4-year public university in the southeast. We found that the race of college women influenced their preferred media source for reception of information about sex and HIV/AIDS, which subsequently either motivated or was insignificant to communication with parents and/or partners.
    SAGE Open 10/2013; 3(4).
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    ABSTRACT: BACKGROUND: Treatment guidelines for lipids have become increasingly more aggressive. However, naturally low or therapeutically reduced cholesterol levels may be associated with adverse psychological health symptoms, including depression, aggression, and hostility. OBJECTIVE: To examine relationships between low total cholesterol (TC) and low-density lipoprotein (LDL) cholesterol levels and measures of psychosocial status among middle-aged adults. METHODS: A total of 1995 subjects enrolled in the Heart Strategies Concentrating on Risk Evaluation study with data on TC, LDL cholesterol, and self-reported ratings of psychological health were evaluated. To quantify ratings of depression, aggression, cynicism, and hostility, psychological measures included the Center for Epidemiologic Studies Depression Scale (CES-D) and Cook-Medley Hostility Inventory. RESULTS: Of 1995 participants, 25.1% were taking a lipid-lowering agent at baseline. Mean CES-D scores were similar between participants with low (<150 mg/dL) versus greater (≥150 mg/dL) TC and low (<100 mg/dL) versus higher (≥100 mg/dL) LDL cholesterol. However, among 22 participants with LDL cholesterol <70 mg/dL, the prevalence of clinically significant depressive symptomatology (CES-D score ≥16) was 31.8% compared with 12.1% in the remaining cohort (P = .005). In multivariable analysis, low LDL cholesterol (<100 mg/dL) was associated with cynicism (partial r = -0.14, P = .02) and hostility (partial r = -0.18, P = .004), but only in the subgroup of white subjects currently taking lipid-lowering medications. Low LDL cholesterol (versus non-low) was associated with greater aggression scores but only among participants currently taking psychiatric medications (3.4 ± 1.7 vs 2.8 ± 1.5, P = .02). CONCLUSIONS: Our data indicate mixed evidence for independent relationships between low total and LDL cholesterol levels and impaired psychological health.
    Journal of Clinical Lipidology 05/2013; 7(3):208-216. · 3.59 Impact Factor
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    ABSTRACT: PURPOSE: To identify factors associated with attrition in a longitudinal study of cardiovascular prevention. METHODS: Demographic, clinical, and psychosocial variables potentially associated with attrition were investigated in 1841 subjects enrolled in the southwestern Pennsylvania Heart Strategies Concentrating on Risk Evaluation study. Attrition was defined as study withdrawal, loss to follow-up, or missing 50% or more of study visits. RESULTS: Over 4 years of follow-up, 291 subjects (15.8%) met criteria for attrition. In multivariable regression models, factors that were independently associated with attrition were black race (odds ratio [OR], 2.21; 95% confidence interval [CI], 1.55-3.16; P < .001), younger age (OR per 5-year increment, 0.88; 95% CI, 0.79-0.99; P < .05), male gender (OR, 1.79; 95% CI, 1.27-2.54; P < .05), no health insurance (OR, 2.04; 95% CI, 1.20-3.47; P < .05), obesity (OR, 1.80; 95% CI, 1.07-3.02; P < .05), CES-D depression score 16 or higher (OR, 2.02; 95% CI, 1.29-3.19; P < .05), and higher ongoing life events questionnaire score (OR, 1.09; 95% CI, 1.04-1.13; P < .001). Having a spouse/partner participating in the study was associated with lower odds of attrition (OR, 0.60; 95% CI, 0.37-0.97; P < .05). A synergistic interaction was identified between black race and depression. CONCLUSIONS: Attrition over 4 years was influenced by sociodemographic, clinical, and psychological factors that can be readily identified at study entry. Recruitment and retention strategies targeting these factors may improve participant follow-up in longitudinal cardiovascular prevention studies.
    Annals of epidemiology 03/2013; · 2.95 Impact Factor
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    ABSTRACT: BACKGROUND:: Crohn's disease (CD) is a chronic inflammatory, relapsing, and progressive condition that leads to bowel damage and subsequent stricturing or penetrating complications. Tumor necrosis factor (TNF) α antagonists (e.g., infliximab) can achieve sustained remission in CD. However, a paradox exists as to whether use of these medications, which effectively treat psoriasis, also confer risk of developing psoriasiform lesions. METHODS:: Data from the Food and Drug Administration Adverse Event Reporting System (2004-2011) were analyzed. Adverse event reports for the TNF-α antagonists infliximab, adalimumab, and certolizumab were reviewed. Primary "control" drugs examined included the non-CD drugs propranolol and lithium because of their recognized association with risk of psoriasis and the nonbiological CD drug mesalamine. Proportional reporting ratios for psoriasis adverse events were calculated for TNF-α antagonists versus control drugs. RESULTS:: From more than 13 million reports in Adverse Event Reporting System, the biological group included 5432 reports with psoriasis listed (infliximab = 1789; adalimumab = 3475; and certolizumab = 168) compared with just 88 psoriasis reports for the control group (propranolol = 24; mesalamine = 24; and lithium = 40). Compared with control drugs, the psoriasis proportional reporting ratios for TNF-α antagonists were as follows: infliximab (6.61), adalimumab (12.13), and certolizumab (5.43) (P < 0.0001). The aggregate "class" proportional reporting ratio for all TNF-α antagonists versus control drugs was 9.24 (P < 0.0001). Similar results were observed when psoriasis reports were compared between TNF-α antagonists and other drugs used to treat CD, including azathioprine, 6-mercaptopurine, methotrexate, corticosteroids, ciprofloxacin, and the antimalarial drug, hydroxychloroquine. CONCLUSIONS:: Data from the Food and Drug Administration Adverse Event Reporting System suggest that TNF-α antagonists used in the treatment of CD confer an increased risk of psoriasiform adverse events.
    Inflammatory Bowel Diseases 03/2013; · 5.12 Impact Factor

Publication Stats

5k Citations
1,181.70 Total Impact Points


  • 2001–2014
    • University of South Florida
      • • College of Nursing
      • • Department of Cardiology
      • • Department of Mental Health Law & Policy
      Tampa, Florida, United States
    • University of Texas Southwestern Medical Center
      • Department of Ophthalmology
      Dallas, TX, United States
    • Johns Hopkins Bloomberg School of Public Health
      • Department of Epidemiology
      Baltimore, Maryland, United States
  • 2013
    • Wuhan University
      • School of Public Health
      Wuhan, Hubei, China
    • Pontifical Catholic University of Chile
      • División Medicina
      Santiago, Region Metropolitana de Santiago, Chile
  • 1996–2013
    • University of Pittsburgh
      • • Department of Dermatology
      • • School of Nursing
      • • Center for Inflammatory Bowel Disease
      • • Department of Pediatrics
      • • Department of Epidemiology
      Pittsburgh, Pennsylvania, United States
  • 2012
    • McGill University
      Montréal, Quebec, Canada
    • University of Rochester
      Rochester, New York, United States
    • Penn State Hershey Medical Center and Penn State College of Medicine
      Hershey, Pennsylvania, United States
  • 2009–2012
    • Shanghai Jiao Tong University
      • • School of Public Health
      • • School of Medicine
      Shanghai, Shanghai Shi, China
    • Johns Hopkins University
      • Department of Medicine
      Baltimore, MD, United States
  • 2006–2011
    • Brown University
      • Division of Cardiology
      Providence, RI, United States
  • 2008
    • Emory University
      • Division of Cardiology
      Atlanta, GA, United States
    • Cedars-Sinai Medical Center
      • Division of Cardiology
      Los Angeles, CA, United States
  • 2007
    • Northwestern University
      Evanston, Illinois, United States
    • Mayo Clinic - Rochester
      • Department of Cardiovascular Diseases
      Rochester, Minnesota, United States
    • Rhode Island Hospital
      Providence, Rhode Island, United States
    • Montefiore Medical Center
      • Department of Cardiology
      New York City, NY, United States
  • 2005
    • Uniformed Services University of the Health Sciences
      Maryland, United States
  • 2002
    • UHN: Toronto General Hospital
      Toronto, Ontario, Canada
    • Cleveland Clinic
      • Department of Cardiology
      Cleveland, Ohio, United States
    • University of Massachusetts Medical School
      Worcester, Massachusetts, United States
  • 2000
    • Jaeb Center for Health Research
      Tampa, Florida, United States
  • 1999
    • Montreal Heart Institute
      • Department of Medicine
      Montréal, Quebec, Canada