Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Population Health
Total Results:
12799
The Role of Emotion Understanding in the Development of Aggression and Callous-Unemotional Features across Early Childhood
Although prior research suggests that children show rapid change in socioemotional functioning and aggression throughout early childhood, little is known about how these factors may be associated with the development of callous-unemotional (CU) features. This study investigated the parallel development of, and reciprocal relationships between, emotion understanding (EU) and aggression across early childhood, as well as how they play a role in the development of CU features. Parallel latent growth curve modeling was used to examine longitudinal reciprocal relationships between EU and aggression in a sample of 498 primarily Black (i.e., African-American or Afro-Caribbean) preschoolers (49.5% male, 89.2% Black, Mage = 4.1), followed with six waves over a 45-month period from pre-kindergarten through grade 2. CU features were included as a baseline covariate, as well as an outcome, of EU and aggression growth factors. Children with lower levels of EU at age 4 displayed higher linear increases in aggression over time. EU at age 4 had a significant indirect effect on CU features at age 8 via its association with linear increases in aggression. Findings suggest that EU is influential in the early development of aggression, which may in turn influence the development or exacerbation of CU features. Children's EU in early childhood, especially concerning others' distress, may be an important component of preventive intervention efforts for young children at risk for serious antisocial behavior.
PMID: 30155686
ISSN: 1573-2835
CID: 3255962
Human Papillomavirus Vaccination and Infection in Young Sexual Minority Men: The P18 Cohort Study
We examined the prevalence of infection with human papillomavirus (HPV) and HIV in a cohort of young gay, bisexual, and other men who have sex with men [sexual minority men (SMM)]. HPV vaccination uptake was assessed; HIV antibody testing was performed and genetic testing for oral and anal HPV infection was undertaken. We examined both HPV vaccination and infection in relation to key demographic and structural variables. Participants (n = 486) were on average 23 years old; 70% identified as a member of a racial/ethnic minority group, and 7% identified as transgender females. Only 18.1% of the participants indicated having received the full dosage of HPV vaccination and 45.1% were unvaccinated. Slightly over half the participants (58.6%) were infected with HPV, with 58.1% testing positive for anal infection and 8.8% for oral infection. HIV seropositivity was associated with infection to oral HPV [adjusted odds ratio (AOR) = 4.03] and vaccine-preventable HPV, whereas both neighborhood-level poverty (AOR = 1.68) and HIV infection (AOR = 31.13) were associated with anal infection to HPV (AOR = 1.68). Prevalence of HPV infection is high among unvaccinated young SMM, despite the availability and eligibility for vaccination. HPV infection adds further health burden to these populations and is particularly concerning for those who are HIV positive as HIV infection increases the risk of developing HPV-related cancers. These findings underscore a missed prevention opportunity for an at-risk and underserved population and suggest the need for active strategies to increase HPV vaccination uptake in young SMM before the onset of sexual behavior.
PMID: 30932696
ISSN: 1557-7449
CID: 3783482
Epidemiology of paediatric trauma presenting to US emergency departments: 2006-2012
BACKGROUND: Traumatic injury is the leading cause of paediatric morbidity and mortality in the USA. We present updated national data on emergency department (ED) discharges for traumatic injury for a recent 7-year period. METHODS: We conducted a descriptive epidemiological analysis of the Nationwide Emergency Department Sample Survey, the largest and most comprehensive database in the USA, for 2006-2012. Among children and adolescents, we tracked changes in injury mechanism and severity, cost of care, injury intent and the role of trauma centres. RESULTS: There was an 8.3% (95% CI 7.7 to 8.9) decrease in the annual number of ED visits for traumatic injury in children and adolescents over the study period, from 8 557 904 (SE=5861) in 2006 to 7 846 912 (SE=5191) in 2012. The case-fatality rate was 0.04% for all injuries and 3.2% for severely injured children. Children and adolescents with high-mortality injury mechanisms were more than three times more likely to be treated at a level 1 trauma centre (OR=3.5, 95% CI 3.3 to 3.7), but were more no more likely to die (OR=0.96, 95% CI 0.93 to 1.00). Traumatic brain injury diagnoses increased 22.2% (95% CI 20.6 to 23.9) during the study period. Intentional assault accounted for 3% (SE=0.1) of all child and adolescent ED injury discharges and 7.2% (SE=0.3) of discharges among 15-19 year-olds. There was an 11.3% (95% CI 10.0 to 12.6) decline in motor vehicle injuries from 2009 to 2012. The total cost of care was $23 billion (SE=0.01), a 78% increase from 2006 to 2012. CONCLUSIONS: This analysis presents a recent portrait of paediatric trauma across the USA. These analyses indicate the important role and value of trauma centre care for injured children and adolescents, and that the most common causes and mechanisms of injury are preventable.
PMID: 29056586
ISSN: 1475-5785
CID: 2757522
United States Pulmonary Hypertension Scientific Registry (USPHSR): rationale, design, and clinical implications
Diagnostic World Health Organization (WHO) Group 1 pulmonary arterial hypertension (PAH) and Diagnostic Group 1' pulmonary veno-occlusive disease (PVOD) and/or pulmonary capillary hemangiomatosis (PCH) are progressive and fatal disorders. Past registries provided important insights into these disorders, but did not include hormonal exposures or genomic data. The United States Pulmonary Hypertension Scientific Registry (USPHSR) will provide demographic, physiologic, anorexigen and hormone exposure, genomic, and survival data in the current therapeutic era for 499 patients diagnosed with PAH, PVOD, or PCH. The USPHSR also will explore the relationship between pharmacologic, non-pharmacologic, and dietary hormonal exposures and the increased risk for women to develop idiopathic or heritable PAH.
PMCID:6540712
PMID: 31099303
ISSN: 2045-8932
CID: 5162012
Multi-ancestry genome-wide gene-smoking interaction study of 387,272 individuals identifies new loci associated with serum lipids
The concentrations of high- and low-density-lipoprotein cholesterol and triglycerides are influenced by smoking, but it is unknown whether genetic associations with lipids may be modified by smoking. We conducted a multi-ancestry genome-wide gene-smoking interaction study in 133,805 individuals with follow-up in an additional 253,467 individuals. Combined meta-analyses identified 13 new loci associated with lipids, some of which were detected only because association differed by smoking status. Additionally, we demonstrate the importance of including diverse populations, particularly in studies of interactions with lifestyle factors, where genomic and lifestyle differences by ancestry may contribute to novel findings.
PMCID:6467258
PMID: 30926973
ISSN: 1546-1718
CID: 4094682
Searching for origins of sex differences that underlie mental health disorders: are sex differences in brain connectivity evident in humans before birth? [Meeting Abstract]
Background and aims.- Prevalence of psychiatric disorders differs in males and females, and neurological studies suggest that sex-linked variation in the brain may underlie this dissociation. However, the origin of this difference, and how early in human life sexual dimorphism in brain function emerges is a topic that requires further investigation. Here, we address this gap by assessing brain resting-state functional connectivity (RSFC) between and within brain networks as it relates to fetal sex and gestational age (GA). Methods.- We examined 118 typical human fetuses (70 male; 48 female) between 25.9 and 39.6 weeks GA. Infomap was used to derive 16 separable fetal neural networks distributed across cortical, subcortical, and cerebellar regions. Using enrichment analysis, we identified network pairs revealing distinct patterns of GArelated change in males and females. Results.- Sex-dependent variation of between- and within- network RSFC-GA associations was observed: while females exhibited GA-related variation in connectivity between posterior cingulate and temporal pole regions, and between pre-frontal and cerebellar regions, males demonstrated increased intracerebellar RSFC with advancing age. Conclusions.- Such observations confirm that sex-related differences in functional brain development are present before birth. An important next step in this line of research will be to follow children across early development and discover how sex-related variation in network development relates to future health outcomes
EMBASE:639494994
ISSN: 1778-3585
CID: 5366512
Analysing power and politics in health policies and systems
This special issue of Global Public Health presents a collection of articles that analyse power and its mechanisms in health systems and health policy processes. Researchers have long noted that the influence of power is implicated throughout the global health field, yet theories and methods for examining power-its sources, workings, and effects-are rarely applied in health policy and systems research. By engaging with the social sciences and humanities, contributors to this collection aim to analytically sharpen and thematically broaden the study of power and politics in global health. Contributors analyse the exercise of power by actors typically considered powerful on the global stage as well as actors across the health system who may be powerful in national or local contexts. Additionally, the papers draw attention to actors, interest groups, and practices not usually viewed as politically salient in health policy and systems research in low- and middle-income countries. The papers not only analyse power but also identify ways to counteract it, such as by using human rights-based frameworks to investigate and challenge power asymmetries. Collectively, they show how researchers working on global health issues can theorise power and deepen political analysis of health policy and systems.
PMID: 30773135
ISSN: 1744-1706
CID: 5265882
Occurrence of severe hypoglycaemic events among US youth and young adults with type 1 or type 2 diabetes
Objective/UNASSIGNED:Although severe hypoglycaemia (SH) can lead to adverse health outcomes, little is known about its occurrence and re-occurrence among youth with type 1 or type 2 diabetes. Methods/UNASSIGNED:This study included 2740 participants aged <20Â years at diabetes diagnosis and 5-14Â years diabetes duration from the SEARCH for Diabetes in Youth Cohort Study. Participants reported SH events in the past 6Â months. Differences in SH events by demographic and clinical factors were tested using logistic regression models. Results/UNASSIGNED:Â <Â 0.002). The median number of SH events per youth who had at least one SH event in the past 6Â months was 1 for both type 1 type 2 diabetes. For youth with type 1 diabetes, those who reported SH events were older, were more likely to have obesity or to be physically active, and had lower HbA1c. After adjustments, one unit increase in HbA1c was associated with 16% lower likelihood (OR 0.84, 95% CI 0.75, 0.94) and being physically active was associated with an 87% higher likelihood (OR 1.87, 95% CI 1.23, 2.86) of reporting a SH event. There were too few SH events among youth with type 2 diabetes to analyse further. Conclusions/UNASSIGNED:In youth with diabetes, SH was common even within a short 6-month window. Better understanding the causes of SH may help prevent them from occurring.
PMCID:6458461
PMID: 31008365
ISSN: 2398-9238
CID: 4318892
City of love: group sex is associated with risks for HIV and other sexually transmissible infections among gay and bisexual men in Paris, France
Objective:This study explored the relationships between participation in group sex and risk for HIV and other sexually transmissible infections (STIs). Methods: An anonymous online survey collected data from 580 gay and bisexual men using a mobile sex and dating application in Paris, France. Logistic regression analyses were conducted, which controlled for HIV status, HIV pre-exposure prophylaxis (PrEP) use and participants' sociodemographic characteristics. Results: Compared with men with no recent group sex experience, those reporting group sex in the 3 months before the survey (30.7% of the sample) were more likely to have had condomless receptive anal sex at least once in the same period [adjusted odds ratio (aOR)=1.6, 95% confidence interval (CI)=1.1-2.4, P = 0.02], condomless insertive anal sex (aOR=2.0, 95%CI: 2.4-8.7, P < 0.001) and substance use before or during sex (aOR=1.6, 95%CI: 1.1-2.3, P = 0.02). Even when controlling for condom use, men involved with group sex were more likely to be have been diagnosed with a bacterial STI in the previous year (aOR=2.1, 95%CI: 1.3-3.3, P = 0.002). Conclusions: Group sex remains a useful marker of risk among gay and bisexual men, but research is needed that moves beyond individual practice in order to assess the epidemiological networks comprising group sex and the risks they pose relevant to HIV and other STIs.
PMID: 30819325
ISSN: 1448-5028
CID: 3752032
Condomless Group Sex Is Associated With HIV Pre-Exposure Prophylaxis Knowledge and Interest Uptake: A Cross-Sectional Study of Gay and Bisexual Men in Paris, France
As a prevention strategy, HIV pre-exposure prophylaxis (PrEP) may benefit men who participate in group sex, but little is known about PrEP among this group internationally and virtually nothing is known of the European context. This study used an online survey of gay men living in Paris, France to assess associations between group sex and awareness of, use and interest in PrEP in its once-daily, episodic, injectable, and microbicidal forms. Men reporting recent (within 3 months) condomless group sex were much more likely to report once-daily PrEP use than men with no group sex experience (41.5% vs 7.7%, p < .001). Uptake was similarly low among men who had group sex with condoms (8.0%) and those with less-recent experience (6.43%). Overall, willingness to use PrEP-including its non-daily forms-was high among men reporting group sex, suggesting opportunities for outreach and implementation.
PMID: 30917015
ISSN: 1943-2755
CID: 3778882
