Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Population Health
Total Results:
12818
The Continuity Research Network (CORNET): What's in it for You? [Editorial]
PMID: 31439173
ISSN: 1097-6833
CID: 4047022
Development of an Outpatient Palliative Care Protocol to Monitor Fidelity in the Emergency Medicine Palliative Care Access Trial
PMID: 31486726
ISSN: 1557-7740
CID: 4067522
Conducting reproductive research during a new childhood cancer diagnosis: ethical considerations and impact on participants
PURPOSE/OBJECTIVE:Research among adults shows benefits and low perceived burden of engaging in behavioral research. However, questions remain regarding the ethics of conducting behavioral research in pediatric populations during sensitive situations, including during a new life-threatening diagnosis or at end-of-life. We examined reactions to participating in a behavioral reproductive research study among male adolescents newly diagnosed with cancer and their parents, as a step towards optimizing fertility preservation utilization in a population where future infertility is common. METHODS:Pediatric literature regarding the ethics of behavioral research was reviewed. In our pilot, forty-four participants (19 mothers, 11 fathers, 14 male adolescents newly diagnosed with cancer) from 20 families completed demographic questionnaires and a fertility preservation decision tool developed by the study team. Qualitative interviews exploring the impact of study participation were subsequently conducted. Verbatim transcripts were coded for thematic content using the constant comparison method. RESULTS:Literature review showed positive reactions to research participation among youth/caregivers. In our pilot study, 89% (n = 17) of mothers, 64% (n = 7) of fathers, and 71% (n = 10) of adolescents reported at least one benefit of participating. Eleven percent (n = 2) of mothers, 36% (n = 4) of fathers, and 29% (n = 4) of adolescents said they were not affected; none of the participants reported a negative effect. CONCLUSION/CONCLUSIONS:Consistent with prior literature, our study suggests behavioral reproductive research prior to cancer treatment can offer direct benefits to participants and society, without increasing burden. These findings will inform future interventions to improve long-term psychosocial and reproductive outcomes for youth with cancer.
PMID: 31372871
ISSN: 1573-7330
CID: 4015462
Prenatal exposure to phenols and lung function, wheeze, and asthma in school-age children from 8 European birth cohorts [Meeting Abstract]
Prenatal exposure to phenolic compounds, widely used in many consumer products, can alter lung development and increase the risk of respiratory disorders in the offspring. However, evidence is scarce and mostly focused on bisphenol-A (BPA), although there are other substitutes that could also interfere with the developing respiratory system. We aim to estimate the association between exposure to 5 phenols during pregnancy (BPA, BPAF, BPB, BPF, and BPS) and lung function, wheeze, and asthma in school-age children. We included 2685 mother-child pairs from 8 European birth cohorts. Phenols concentrations were determined in urinary maternal samples collected during pregnancy (1999-2010). Between 6 and 10 years of age, spirometry was performed, and wheeze and asthma were assessed from questionnaires. Adjusted multivariable linear regression and logistic regression models were used to assess the associations. We performed meta-analyses of cohort-specific estimates. We observed widespread prenatal BPA exposure with 79% of the samples above detectable limits; the other phenols were detected in fewer samples. Median BPA concentrations ranged from 1.04 to 9.54 ng/g of creatinine. Increasing BPA concentrations during pregnancy tended to be associated with lower FVC and FEV1 and were associated with increased odds of wheezing between ages 6 and 10 years (adjusted odds ratio=1.09; 95% CI=0.96, 1.24), but notwith asthma. Final results including associations of the other phenols with respiratory outcomes including wheezing patterns from birth will be presented. Preliminary results showed that prenatal exposure to BPA might increase the odds of wheezing in school-age children
EMBASE:630916626
ISSN: 1399-3003
CID: 4330642
Trends in prevalence of cardiovascular risk factors from 2002 to 2012 among youth early in the course of type 1 and type 2 diabetes. The SEARCH for Diabetes in Youth Study
BACKGROUND:Given diabetes is an important risk factor for cardiovascular disease (CVD), we examined temporal trends in CVD risk factors by comparing youth recently diagnosed with type 1 diabetes (T1D) and type 2 diabetes (T2D) from 2002 through 2012. METHODS:The SEARCH for Diabetes in Youth Study identified youth with diagnosed T1D (n = 3954) and T2D (n = 706) from 2002 to 2012. CVD risk factors were defined using the modified Adult Treatment Panel III criteria for metabolic syndrome: (a) hypertension; (b) high-density lipoprotein cholesterol ≤40 mg/dL; (c) triglycerides ≥110 mg/dL; and (d) waist circumference (WC) >90th percentile. Prevalence of CVD risk factors, stratified by diagnosis year and diabetes type, was reported. Univariate and multivariate logistic models and Poisson regression were fit to estimate the prevalence trends for CVD risk factors individually and in clusters (≥2 risk factors). RESULTS:The prevalence of ≥2 CVD risk factors was higher in youth with T2D than with T1D at each incident year, but the prevalence of ≥2 risk factors did not change across diagnosis years among T1D or T2D participants. The number of CVD risk factors did not change significantly in T1D participants, but increased at an annual rate of 1.38% in T2D participants. The prevalence of hypertension decreased in T1D participants, and high WC increased in T2D participants. CONCLUSION:The increase in number of CVD risk factors including large WC among youth with T2D suggests a need for early intervention to address these CVD risk factors. Further study is needed to examine longitudinal associations between diabetes and CVD.
PMCID:6785186
PMID: 30903717
ISSN: 1399-5448
CID: 4318872
Estimating prevalence of type I and type II diabetes using incidence rates: the SEARCH for diabetes in youth study
PURPOSE/OBJECTIVE:Most surveillance efforts in childhood diabetes have focused on incidence, whereas prevalence is rarely reported. This study aimed to assess whether a mathematical illness-death model accurately estimated future prevalence from baseline prevalence and incidence rates in children. METHODS:SEARCH for Diabetes in Youth is an ongoing population-based surveillance study of prevalence and incidence of diabetes and its complications among youth in the United States. We used age-, sex-, and race/ethnicity-specific SEARCH estimates of the prevalence of type I and type II diabetes in 2001 and incidence from 2002 to 2008. These data were used in a partial differential equation to estimate prevalence in 2009 with 95% bootstrap confidence intervals. Model-based prevalence was compared with the observed prevalence in 2009. RESULTS:Most confidence intervals for the difference between estimated and observed prevalence included zero, indicating no evidence for a difference between the two methods. The width of confidence intervals indicated high precision for the estimated prevalence when considering all races/ethnicities. In strata with few cases, precision was reduced. CONCLUSIONS:Future prevalence of type I and type II diabetes in youth may be accurately estimated from baseline prevalence and incidence. Diabetes surveillance could benefit from potential cost savings of this method.
PMCID:6785183
PMID: 31383511
ISSN: 1873-2585
CID: 4318942
When Crises Converge: Hospital Visits Before And After Shelter Use Among Homeless New Yorkers
People who are homeless use more hospital-based care than average, yet little is known about how hospital and shelter use are interrelated. We examined the timing of emergency department (ED) visits and hospitalizations relative to entry into and exit from New York City homeless shelters, using an analysis of linked health care and shelter administrative databases. In the year before shelter entry and the year following shelter exit, 39.3Â percent and 43.3Â percent, respectively, of first-time adult shelter users had an ED visit or hospitalization. Hospital visits-particularly ED visits-began to increase several months before shelter entry and declined over several months after shelter exit, with spikes in ED visits and hospitalizations in the days immediately before shelter entry and following shelter exit. We recommend cross-system collaborations to better understand and address the co-occurring health and housing needs of vulnerable populations.
PMID: 31479375
ISSN: 1544-5208
CID: 4067112
"It Wasn't Just One Thing": A Qualitative Study of Newly Homeless Emergency Department Patients
OBJECTIVES/OBJECTIVE:Emergency departments (EDs) frequently care for patients who are homeless or unstably housed. One promising approach taken by the homeless services system is to provide interventions that attempt to prevent homelessness before it occurs. Experts have suggested that health care settings may be ideal locations to identify and intervene with patients at risk for homelessness, yet little is known even about the basic characteristics of patients who might benefit from such interventions. METHODS:We conducted in-depth, one-on-one qualitative interviews with ED patients who had become homeless within the past 6 months. Using a semistructured interview guide, we asked patients about their pathways into homelessness and what might have prevented them from becoming homeless. Interviews were digitally recorded and professionally transcribed. Transcripts were coded line by line by multiple investigators who then met as a group to discuss and refine codes in an iterative fashion. RESULTS:Interviews were completed with 31 patients. Mean interview length was 42 minutes. Four main themes emerged: 1) unique stories yet common social and health contributors to homelessness, 2) personal agency versus larger structural forces, 3) limitations in help from family or friends, and 4) homelessness was not expected. CONCLUSIONS:These findings demonstrate gaps in current homeless prevention services and can help inform future interventions for unstably housed and homeless ED patients. More immediately, the findings provide rich, unique context to the lives of a vulnerable patient population commonly seen in EDs.
PMID: 31418514
ISSN: 1553-2712
CID: 4043392
Proceedings of the New York University School of Medicine Reproductive Ethics Conference: Challenges and Solutions [Letter]
PMID: 31346937
ISSN: 1573-7330
CID: 3988242
Patient Characteristics Associated with More Bother from Lower Urinary Tract Symptoms
PURPOSE:Some patients continue to have bothersome lower urinary tract symptoms despite treatment. We examined characteristics associated with bother from lower urinary tract symptoms in a prospective cohort. MATERIALS AND METHODS:In this 1-year prospective, observational cohort study we obtained data on patients with lower urinary tract symptoms who were seeking care at a total of 6 tertiary care centers in the United States. Participants answered the AUA-SI (American Urological Association Symptom Index) global urinary bother question at study entry and 12 months later. Multilevel logistic and linear regression was used to identify factors associated with worsening bother and bother at 12 months, respectively. RESULTS:Of the 756 participants 121 (16%) had worsened lower urinary tract symptom bother during the study period. When adjusted for other variables, worsened lower urinary tract symptom bother was more likely among men who were nonwhite (OR 1.79, 95% CI 0.94-3.40) or who had diabetes (OR 1.68, 95% CI 0.86-3.27) and among women with diabetes (OR 1.77, 95% CI 0.85-3.67), prior treatment of lower urinary tract symptoms (OR 2.58, 95% CI 1.22-5.46) or a higher depression level (OR 1.29, 95% CI 1.10-1.52). Baseline factors associated with more severe bother at 12 months in men included more severe bother at baseline, nonwhite race, worse urinary frequency and incontinence, and higher levels of stress (p <0.05). Among women more severe bother at baseline, urinary urgency and frequency, and worse physical function were associated with more severe bother at 12 months. CONCLUSIONS:Urinary symptom severity at baseline, race, depression and psychological stress were associated with the bother of lower urinary tract symptoms in a prospective cohort of men and women treated at tertiary care facilities. These findings may inform the clinical care of patients with bothersome lower urinary tract symptoms and direct providers to better prognosticate for patients with challenging lower urinary tract symptoms cases.
PMCID:6697227
PMID: 31063049
ISSN: 1527-3792
CID: 4554742
