Bruce Lanphear

Summary

Affiliation: Cincinnati Children's Hospital Medical Center
Country: USA

Publications

  1. ncbi Protecting children from environmental toxins
    Bruce P Lanphear
    Environmental Health Center at Cincinnati Children's Hospital Medical Center, Ohio, USA
    PLoS Med 2:e61. 2005
  2. ncbi The conundrum of unmeasured confounding: Comment on: "Can some of the detrimental neurodevelopmental effects attributed to lead be due to pesticides? by Brian Gulson"
    Bruce P Lanphear
    Cincinnati Children s Environmental Health Center, Department of Pediatrics and of Environmental Health, Cincinnati Children s Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio, USA
    Sci Total Environ 396:196-200. 2008
  3. ncbi Invited commentary: asthma surveillance in US children
    Bruce P Lanphear
    Cincinnati Children's Environmental Health Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229-3039, USA
    Am J Epidemiol 158:105-7; discussion 108-9. 2003
  4. ncbi Persistent snoring in preschool children: predictors and behavioral and developmental correlates
    Dean W Beebe
    Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children s Hospital Medical Center, MLC 3015, 3333 Burnet Ave, Cincinnati, OH 45229 3039, USA
    Pediatrics 130:382-9. 2012
  5. ncbi Associations between secondhand smoke exposure and sleep patterns in children
    Kimberly Yolton
    Cincinnati Children s Hospital Medical Center, Division of General and Community Pediatrics, 3333 Burnet Ave, ML 7035, Cincinnati, OH 45229 3039, USA
    Pediatrics 125:e261-8. 2010
  6. ncbi Low-level prenatal exposure to nicotine and infant neurobehavior
    Kimberly Yolton
    Cincinnati Children s Hospital Medical Center, Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati, Ohio 45229 3039, USA
    Neurotoxicol Teratol 31:356-63. 2009
  7. ncbi Environmental tobacco smoke exposure and child behaviors
    Kimberly Yolton
    Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati Children s Hospital Medical Center, Cincinnati, OH 45229 3039, USA
    J Dev Behav Pediatr 29:450-7. 2008
  8. ncbi Evaluation of resident communication skills and professionalism: a matter of perspective?
    William B Brinkman
    Department of Pediatrics, Cincinnati Children s Hospital Medical Center, MLC 70353333 Burnet Ave, Cincinnati, OH 45229 3039, USA
    Pediatrics 118:1371-9. 2006
  9. ncbi Environmental exposures and exhaled nitric oxide in children with asthma
    Adam J Spanier
    Cincinnati Children s Environmental Health Center, Division of General and Community Pediatrics, and the Division of Allergy and Clinical Immunology, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio, USA
    J Pediatr 149:220-6. 2006
  10. ncbi A randomized controlled trial of home injury hazard reduction: the HOME injury study
    Kieran J Phelan
    Center for Children s Environmental Health, University of Cincinnati, Cincinnati Children s Hospital Medical Center, Cincinnati, OH 45229 3039, USA
    Arch Pediatr Adolesc Med 165:339-45. 2011

Detail Information

Publications51

  1. ncbi Protecting children from environmental toxins
    Bruce P Lanphear
    Environmental Health Center at Cincinnati Children's Hospital Medical Center, Ohio, USA
    PLoS Med 2:e61. 2005
  2. ncbi The conundrum of unmeasured confounding: Comment on: "Can some of the detrimental neurodevelopmental effects attributed to lead be due to pesticides? by Brian Gulson"
    Bruce P Lanphear
    Cincinnati Children s Environmental Health Center, Department of Pediatrics and of Environmental Health, Cincinnati Children s Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio, USA
    Sci Total Environ 396:196-200. 2008
    ..The alternative, to perpetually permit children to be exposed to lead and other emerging toxicants, is both absurd and unacceptable...
  3. ncbi Invited commentary: asthma surveillance in US children
    Bruce P Lanphear
    Cincinnati Children's Environmental Health Center, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, OH 45229-3039, USA
    Am J Epidemiol 158:105-7; discussion 108-9. 2003
  4. ncbi Persistent snoring in preschool children: predictors and behavioral and developmental correlates
    Dean W Beebe
    Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children s Hospital Medical Center, MLC 3015, 3333 Burnet Ave, Cincinnati, OH 45229 3039, USA
    Pediatrics 130:382-9. 2012
    ..To clarify whether persistent snoring in 2- to 3-year-olds is associated with behavioral and cognitive development, and to identify predictors of transient and persistent snoring...
  5. ncbi Associations between secondhand smoke exposure and sleep patterns in children
    Kimberly Yolton
    Cincinnati Children s Hospital Medical Center, Division of General and Community Pediatrics, 3333 Burnet Ave, ML 7035, Cincinnati, OH 45229 3039, USA
    Pediatrics 125:e261-8. 2010
    ..The objective of this study was to investigate the relationship between exposure to secondhand smoke (SHS) and child sleep patterns among a group of children with asthma who were exposed regularly to tobacco smoke at home...
  6. ncbi Low-level prenatal exposure to nicotine and infant neurobehavior
    Kimberly Yolton
    Cincinnati Children s Hospital Medical Center, Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati, Ohio 45229 3039, USA
    Neurotoxicol Teratol 31:356-63. 2009
    ..To examine the association between prenatal exposure to nicotine from tobacco smoke and infant neurobehavior using tobacco biomarkers and a sensitive and comprehensive measure of infant neurobehavior...
  7. ncbi Environmental tobacco smoke exposure and child behaviors
    Kimberly Yolton
    Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati Children s Hospital Medical Center, Cincinnati, OH 45229 3039, USA
    J Dev Behav Pediatr 29:450-7. 2008
    ..Emerging evidence suggests that exposure to environmental tobacco smoke (ETS) may be linked with behavior problems in childhood, but previous research has relied primarily on parent report of exposure, and results are inconclusive...
  8. ncbi Evaluation of resident communication skills and professionalism: a matter of perspective?
    William B Brinkman
    Department of Pediatrics, Cincinnati Children s Hospital Medical Center, MLC 70353333 Burnet Ave, Cincinnati, OH 45229 3039, USA
    Pediatrics 118:1371-9. 2006
    ..The objective of this study was to determine whether parent and nurse ratings of specific resident behaviors significantly differ from those of attending physicians...
  9. ncbi Environmental exposures and exhaled nitric oxide in children with asthma
    Adam J Spanier
    Cincinnati Children s Environmental Health Center, Division of General and Community Pediatrics, and the Division of Allergy and Clinical Immunology, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio, USA
    J Pediatr 149:220-6. 2006
    ..To evaluate the relation of environmental factors with exhaled nitric oxide (FENO) concentrations among asthmatic children...
  10. ncbi A randomized controlled trial of home injury hazard reduction: the HOME injury study
    Kieran J Phelan
    Center for Children s Environmental Health, University of Cincinnati, Cincinnati Children s Hospital Medical Center, Cincinnati, OH 45229 3039, USA
    Arch Pediatr Adolesc Med 165:339-45. 2011
    ..To test the efficacy of installing safety devices in the homes of young children on total injury rates and on injuries deemed a priori modifiable by the installation of these devices...
  11. ncbi Screening housing to prevent lead toxicity in children
    Bruce P Lanphear
    Cincinnati Children s Environmental Health Center, Children s Hospital Medical Center, Cincinnati, OH 45229 3039, USA
    Public Health Rep 120:305-10. 2005
    ..The purpose of this study was to identify and validate housing characteristics associated with children having elevated blood lead levels (> or = 10 microg/dl)...
  12. ncbi Effect of multisource feedback on resident communication skills and professionalism: a randomized controlled trial
    William B Brinkman
    Department of Pediatrics, Cincinnati Children s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA
    Arch Pediatr Adolesc Med 161:44-9. 2007
    ..To determine whether augmenting standard feedback on resident performance with a multisource feedback intervention improved pediatric resident communication skills and professionalism...
  13. ncbi Interactive effects of a DRD4 polymorphism, lead, and sex on executive functions in children
    Tanya E Froehlich
    Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
    Biol Psychiatry 62:243-9. 2007
    ..Prior studies have examined independent effects of a dopamine receptor D4 polymorphism (DRD4-7) and lead exposure on executive functions but not their interaction or the role of sex as a modifier of their effects...
  14. ncbi Prevalence, recognition, and treatment of attention-deficit/hyperactivity disorder in a national sample of US children
    Tanya E Froehlich
    Cincinnati Children s Hospital Medical Center, Cincinnati, OH 45229, USA
    Arch Pediatr Adolesc Med 161:857-64. 2007
    ..To determine the US national prevalence of attention-deficit/hyperactivity disorder (ADHD) and whether prevalence, recognition, and treatment vary by socioeconomic group...
  15. ncbi Seasonal variation and environmental predictors of exhaled nitric oxide in children with asthma
    Adam J Spanier
    Cincinnati Children s Environmental Health Center, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio 45229 3039, USA
    Pediatr Pulmonol 43:576-83. 2008
    ..Clinicians and researchers may need to consider an individual's baseline FeNO levels to manage children with asthma...
  16. ncbi Decreased brain volume in adults with childhood lead exposure
    Kim M Cecil
    Cincinnati Children s Environmental Health Center, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio, United States of America
    PLoS Med 5:e112. 2008
    ..In this study, we examined the relationship between childhood lead exposure and adult brain volume using magnetic resonance imaging (MRI). We also explored how volume changes correlate with historic neuropsychological assessments...
  17. ncbi Environmental exposures, nitric oxide synthase genes, and exhaled nitric oxide in asthmatic children
    Adam J Spanier
    Cincinnati Children s Environmental Health Center, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio, USA
    Pediatr Pulmonol 44:812-9. 2009
    ..We conclude that genetic differences may explain some of the conflicting results in studies of the effects of tobacco smoke exposure on FeNO levels and may make FeNO interpretation difficult for a subset of children with asthma...
  18. ncbi Association of tobacco and lead exposures with attention-deficit/hyperactivity disorder
    Tanya E Froehlich
    Department of Pediatrics, Cincinnati Children s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229, USA
    Pediatrics 124:e1054-63. 2009
    ....
  19. ncbi Low-level environmental lead exposure and children's intellectual function: an international pooled analysis
    Bruce P Lanphear
    Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio 45229 3039, USA
    Environ Health Perspect 113:894-9. 2005
    ..5 microg/dL (p = 0.015). We conclude that environmental lead exposure in children who have maximal blood lead levels < 7.5 microg/dL is associated with intellectual deficits...
  20. ncbi Environmental neurotoxins
    Bruce P Lanphear
    Department of Pediatrics, Cincinnati Children's Environmental Health Center, Cincinnati Children's Hospital, Medical Center University of Cincinnati, Cincinnati, Ohio, USA
    Pediatr Rev 26:191-7; quiz 198. 2005
  21. ncbi Role of dopamine transporter genotype and maternal prenatal smoking in childhood hyperactive-impulsive, inattentive, and oppositional behaviors
    Robert S Kahn
    Division of General and Community Pediatrics, and Children s Environmental Health Center, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio 45229 3039, USA
    J Pediatr 143:104-10. 2003
    ..To examine the joint effects of a dopamine transporter (DAT) polymorphism and maternal prenatal smoking on childhood hyperactivity-impulsivity and inattentiveness...
  22. ncbi Vitamin D receptor Fok1 polymorphism and blood lead concentration in children
    Erin N Haynes
    Cincinnati Children s Environmental Health Center and General and Community Pediatrics, Cincinnati Children s Hospital Medical Center, and Department of Environmental Health, University of Cincinnati, Cincinnati, Ohio, USA
    Environ Health Perspect 111:1665-9. 2003
    ..These data suggest that VDR -Fok1 is an effect modifier of the relationship of floor dust lead exposure and blood lead concentration...
  23. ncbi Environmental lead exposure during early childhood
    Bruce P Lanphear
    General and Community Pediatrics Department, Children's Hospital Medical Center, Cincinnati, OH 45229, USA
    J Pediatr 140:40-7. 2002
    ..Black children remain at increased risk for higher blood lead concentration after adjusting for environmental lead exposures and dietary intake...
  24. ncbi Exposure to environmental tobacco smoke and cognitive abilities among U.S. children and adolescents
    Kimberly Yolton
    Cincinnati Children s Environmental Health Center, Department of Pediatrics, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio 45229 3039, USA
    Environ Health Perspect 113:98-103. 2005
    ..These data, which indicate an inverse association between ETS exposure and cognitive deficits among children even at extremely low levels of exposure, support policy to further restrict children's exposure...
  25. ncbi The effect of soil abatement on blood lead levels in children living near a former smelting and milling operation
    Bruce P Lanphear
    Cincinnati Children s Environmental Health Center, Children s Hospital Medical Center, OH 45229, USA
    Public Health Rep 118:83-91. 2003
    ..To evaluate the effect of soil abatement on children's blood lead concentrations and on environmental levels of lead and arsenic...
  26. ncbi Age of greatest susceptibility to childhood lead exposure: a new statistical approach
    Richard W Hornung
    Cincinnati Children s Environmental Health Center, Cincinnati Children s Hospital Medical Center, Cincinnati, Ohio 45229 3039, USA
    Environ Health Perspect 117:1309-12. 2009
    ..Susceptibility to lead toxicity is often assumed to be greatest during early childhood (e.g., 2 years of age), but recent studies suggest that blood lead concentrations (BPb) taken at 5-7 years of age are more strongly associated with IQ...
  27. ncbi Prevalence, patterns, and persistence of sleep problems in the first 3 years of life
    Kelly C Byars
    Division of Pulmonary Medicine, Cincinnati Children s Hospital Medical Center, Cincinnati, OH 45229 3039, USA
    Pediatrics 129:e276-84. 2012
    ..Examine the prevalence, patterns, and persistence of parent-reported sleep problems during the first 3 years of life...
  28. ncbi Residential injuries in U.S. children and adolescents
    Kieran J Phelan
    Division of Health Policy and Clinical Effectiveness, Cincinnati Children s Hospital Medical Center and Cincinnati Children s Environmental Health Center, Cincinnati, OH 45229, USA
    Public Health Rep 120:63-70. 2005
    ..S. children, but little research exists on injury in the home environment. The purpose of this study was to estimate the rate and severity of and trends in unintentional residential injury for U.S. children <20 years for 1993-1999...
  29. ncbi Association of prenatal and childhood blood lead concentrations with criminal arrests in early adulthood
    John Paul Wright
    Cincinnati Children s Environmental Health Center, Division of Criminal Justice, University of Cincinnati, Cincinnati, Ohio, United States of America
    PLoS Med 5:e101. 2008
    ..The objective of this study was to determine if prenatal and childhood blood lead concentrations are associated with arrests for criminal offenses...
  30. ncbi Altered myelination and axonal integrity in adults with childhood lead exposure: a diffusion tensor imaging study
    Christopher J Brubaker
    Cincinnati Children s Environmental Health Center at the Cincinnati Children s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
    Neurotoxicology 30:867-75. 2009
    ..This study indicates that childhood lead exposure is associated with a significant and persistent impact on white matter microstructure as quantified with diffusivity changes suggestive of altered myelination and axonal integrity...
  31. ncbi The impact of early childhood lead exposure on brain organization: a functional magnetic resonance imaging study of language function
    Weihong Yuan
    Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA
    Pediatrics 118:971-7. 2006
    ..CONCLUSION: This study indicates that childhood lead exposure has a significant and persistent impact on brain reorganization associated with language function...
  32. ncbi Racial differences in exposure to environmental tobacco smoke among children
    Stephen E Wilson
    Division of General Internal Medicine, University of Cincinnati, Cincinnati, Ohio, USA
    Environ Health Perspect 113:362-7. 2005
    ..Identifying causes and consequences of increased cotinine may help explain the striking differences in tobacco-related illnesses...
  33. ncbi The influence of age of lead exposure on adult gray matter volume
    Christopher J Brubaker
    Cincinnati Children s Environmental Health Center, Cincinnati Children s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
    Neurotoxicology 31:259-66. 2010
    ..This study demonstrates that maximum blood lead levels do not fully account for gray matter changes associated with childhood lead exposure, particularly in the frontal lobes of young men...
  34. ncbi The role of air nicotine in explaining racial differences in cotinine among tobacco-exposed children
    Stephen E Wilson
    University of Cincinnati, 231 Albert Sabin Way, Room 6603, Cincinnati, OH 45267, USA
    Chest 131:856-62. 2007
    ..The objective of this study was to test whether African-American children have higher levels of cotinine compared to white children while accounting for ambient measures of tobacco smoke...
  35. ncbi Trials and tribulations of protecting children from environmental hazards
    Bruce P Lanphear
    Cincinnati Children s Environmental Health Center, Cincinnati Children s Hospital Medical Center, Department of Pediatrics, University of Cincinnati, Cincinnati, Ohio 45229 3039, USA
    Environ Health Perspect 114:1609-12. 2006
    ....
  36. ncbi Reporting individual test results of environmental chemicals in breastmilk: potential for premature weaning
    Sheela R Geraghty
    Division of General and Community Pediatrics, Cincinnati Children s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio 45229 3039, USA
    Breastfeed Med 3:207-13. 2008
    ..The purpose of this study was to determine if mothers want to know if chemicals are in their breastmilk and if knowing the results would alter their breastfeeding practices...
  37. ncbi Milk intake during childhood and adolescence, adult bone density, and osteoporotic fractures in US women
    Heidi J Kalkwarf
    Division of General and Community Pediatrics, Children s Hospital Medical Center, Cincinnati, OH 45229 3039, USA
    Am J Clin Nutr 77:257-65. 2003
    ..Calcium supplements increase bone mass in children, but the effect does not persist once supplementation is discontinued...
  38. ncbi Prevention of lead toxicity in US children
    Bruce P Lanphear
    Cincinnati Children s Environmental Health Center, Department of Pediatrics, Children s Hospital Medical Center, Ohio 45229, USA
    Ambul Pediatr 3:27-36. 2003
    ..This article reviews the epidemiology and control of childhood lead exposure, focusing especially on steps necessary to shift toward primary prevention...
  39. ncbi The effect of interior lead hazard controls on children's blood lead concentrations: a systematic evaluation
    Erin Haynes
    University of Michigan School of Public Health, Ann Arbor, Michigan, USA
    Environ Health Perspect 110:103-7. 2002
    ....
  40. ncbi Intellectual impairment in children with blood lead concentrations below 10 microg per deciliter
    Richard L Canfield
    Division of Nutritional Sciences, College of Human Ecology, Cornell University, Ithaca, NY 14853, USA
    N Engl J Med 348:1517-26. 2003
    ..483 micromol per liter), little is known about children's neurobehavioral functioning at lead concentrations below this level...
  41. ncbi Association of environmental toxicants and conduct disorder in U.S. children: NHANES 2001-2004
    Joseph M Braun
    Department of Epidemiology, University of North Carolina Chapel Hill, Chapel Hill, NC 27599 7435, USA
    Environ Health Perspect 116:956-62. 2008
    ..The purpose of this study was to examine the association of tobacco smoke and environmental lead exposure with conduct disorder (CD)...
  42. ncbi Human health risks from low-level environmental exposures: no apparent safety thresholds
    Donald T Wigle
    McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, Ottawa, Canada
    PLoS Med 2:e350. 2005
  43. ncbi Comments on "Recent developments in low-level lead exposure and intellectual impairment in children"
    Todd A Jusko
    Environ Health Perspect 113:A16; author reply A16-7. 2005
  44. ncbi Exposures to environmental toxicants and attention deficit hyperactivity disorder in U.S. children
    Joe M Braun
    College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
    Environ Health Perspect 114:1904-9. 2006
    ..S. children. CONCLUSIONS: We conclude that exposure to prenatal tobacco and environmental lead are risk factors for ADHD in U.S. children...
  45. ncbi The conquest of lead poisoning: a Pyrrhic victory
    Bruce P Lanphear
    Environ Health Perspect 115:A484-5. 2007
  46. ncbi The effects of housing interventions on child health
    Megan Sandel
    Boston University Medical School, Boston, MA, USA
    Pediatr Ann 33:474-81. 2004
    ..With research in more effective environmental interventions and pediatric-public-health partnerships, primary and secondary prevention of diseases from residential hazards may become a reality in the future...
  47. ncbi The training and career paths of fellows in the National Research Service Award (NRSA) Program for Research in Primary Medical Care
    John F Steiner
    Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, USA
    Acad Med 77:712-8. 2002
    ..The amounts of direct research time during these fellowships may need to be increased to enhance the likelihood of subsequent research success...
  48. ncbi Indicators of early research productivity among primary care fellows
    John F Steiner
    Division of General Internal Medicine, University of Colorado Health Sciences Center, Denver, Colo, USA
    J Gen Intern Med 17:845-51. 2002
    ..Our goal was to identify characteristics of research fellows and their training associated with subsequent publications and research funding...
  49. ncbi Blood lead concentrations < 10 microg/dL and child intelligence at 6 years of age
    Todd A Jusko
    Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA
    Environ Health Perspect 116:243-8. 2008
    ..Few studies provide data directly relevant to the question of whether blood lead concentrations < 10 microg/dL adversely affect children's cognitive function...
  50. ncbi Trends in otitis media among children in the United States
    Peggy Auinger
    Department of Pediatrics, University of Rochester School of Medicine and Dentistry and the American Academy of Pediatrics Center for Child Health Research, Rochester, New York 14620, USA
    Pediatrics 112:514-20. 2003
    ..The prevalence of repeated otitis media (OM) increased during the 1980s, but it is unknown if the increase has continued...
  51. ncbi Childhood lead poisoning prevention: too little, too late
    Bruce P Lanphear
    JAMA 293:2274-6. 2005

Research Grants9

  1. NEUROBEHAVIORAL EFFECTS OF LOW LEVEL LEAD EXPOSURE
    Bruce Lanphear; Fiscal Year: 2001
    ....
  2. A RANDOMIZED TRIAL TO REDUCE ETS IN CHILDREN WITH ASTHMA
    Bruce Lanphear; Fiscal Year: 2003
    ....
  3. A Community-Based Trial to Prevent Lead Poisoning and Injuries
    Bruce Lanphear; Fiscal Year: 2007
    ..Our partnership with the National Center for Healthy Housing will enhance our ability to translate and disseminate the research results to affected communities locally and nationally. ..
  4. A Community-Based Trial to Prevent Lead Poisoning and Injuries
    Bruce Lanphear; Fiscal Year: 2009
    ..Our partnership with the National Center for Healthy Housing will enhance our ability to translate and disseminate the research results to affected communities locally and nationally. ..
  5. A Community-Based Trial to Prevent Lead Poisoning and Injuries
    Bruce P Lanphear; Fiscal Year: 2010
    ..Our partnership with the National Center for Healthy Housing will enhance our ability to translate and disseminate the research results to affected communities locally and nationally. ..