Faculty Bibliography
Searched for:
The 22 countries of the East Mediterranean Region (EMR) have large populations of adolescents aged 10-24 years. These adolescents are central to assuring the health, development, and peace of this region. We described their health needs.
school:SOM
Department/Unit:Population Health
Total Results:
12287
Male Undergraduates' HPV Vaccination Behavior: Implications for Achieving HPV-Associated Cancer Equity
Despite the availability of the human papillomavirus (HPV) vaccine for males, uptake of the vaccine has been low, particularly among young adult males. This study aimed to investigate the levels of HPV vaccination and predictors of HPV vaccine completion in college men ages 18-26. We analyzed data from the 2015 College Student Health Survey, which was administered at 17 post-secondary institutions in Midwest areas. We included only responses from male participants who were ages 18-26 years old, resulting in a sample size of 2516. We used Andersen's Behavioral Model of Health Services Utilization to guide our study design. Multivariate logistic regression was used to examine predictors of HPV vaccine receipt. College-aged males in our sample had a HPV vaccine completion rate of 50.0%. Male students who were younger, had at least one parent who held a graduate degree, had initiated sex, and were enrolled at a private 4-year institution were more likely to have been vaccinated. These findings suggest that HPV vaccination in college-aged men are low. Efforts are needed to increase HPV vaccination in male students who are older, from lower socioeconomic statuses, have not initiated sex, and enrolled at public institutions. Findings also indicate important gender disparities in vaccine uptake that must be addressed in order to achieve optimal vaccine uptake in college-aged males.
PMID: 29470802
ISSN: 1573-3610
CID: 5403822
Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery
PMCID:5995321
PMID: 29525764
ISSN: 1524-4539
CID: 2994102
Financial hardship and drug use among men who have sex with men
BACKGROUND:Little is known about the role of financial hardship as it relates to drug use, especially among men who have sex with men (MSM). As such, this study aimed to investigate potential associations between financial hardship status and drug use among MSM. METHODS:We conducted a cross-sectional survey of 580 MSM in Paris recruited using a popular geosocial-networking smartphone application (GSN apps). Descriptive analyses and multivariate analyses were performed. A modified Poisson model was used to assess associations between financial hardship status and use of drugs (any drugs, tobacco, alcohol, marijuana, inhalant nitrites, and club drugs). RESULTS:In our sample, 45.5% reported that it was somewhat, very, or extremely difficult to meet monthly payments of bills (high financial hardship). In multivariate analyses, a high level of financial hardship was significantly associated with an increased likelihood of reporting use of any substance use (adjusted risk ratio [aRR] = 1.15; 95% CI = 1.05-1.27), as well as use of tobacco (aRR = 1.45; 95% CI = 1.19-1.78), marijuana (aRR = 1.48; 95% CI =1.03-2.13), and inhalant nitrites (aRR = 1.24; 95% CI = 1.03-1.50). CONCLUSIONS:Financial hardship was associated with drug use among MSM, suggesting the need for interventions to reduce the burden of financial hardship in this population.
PMCID:5968620
PMID: 29793523
ISSN: 1747-597x
CID: 3129452
Cross-sectional versus longitudinal designs for function estimation, with an application to cerebral cortex development
Motivated by studies of the development of the human cerebral cortex, we consider the estimation of a mean growth trajectory and the relative merits of cross-sectional and longitudinal data for that task. We define a class of relative efficiencies that compare function estimates in terms of aggregate variance of a parametric function estimate. These generalize the classical design effect for estimating a scalar with cross-sectional versus longitudinal data, and are shown to be bounded above by it in certain cases. Turning to nonparametric function estimation, we find that longitudinal fits may tend to have higher aggregate variance than cross-sectional ones, but that this may occur because the former have higher effective degrees of freedom reflecting greater sensitivity to subtle features of the estimand. These ideas are illustrated with cortical thickness data from a longitudinal neuroimaging study.
PMID: 29542142
ISSN: 1097-0258
CID: 3000212
Depression and its psychosocial risk factors in pregnant Kenyan adolescents: a cross-sectional study in a community health Centre of Nairobi
BACKGROUND:Adolescent pregnancies within urban resource-deprived settlements predispose young girls to adverse mental health and psychosocial adversities, notably depression. Depression in sub-Saharan Africa is a leading contributor to years lived with disability (YLD). The study's objective was to determine the prevalence of depression and related psychosocial risks among pregnant adolescents reporting at a maternal and child health clinic in Nairobi, Kenya. METHODS:A convenient sample of 176 pregnant adolescents attending antenatal clinic in Kangemi primary healthcare health facility participated in the study. We used PHQ-9 to assess prevalence of depression. Hierarchical multivariate linear regression was performed to determine the independent predictors of depression from the psychosocial factors that were significantly associated with depression at the univariate analyses. RESULTS:Of the 176 pregnant adolescents between ages 15-18 years sampled in the study, 32.9% (n = 58) tested positive for a depression diagnosis using PHQ-9 using a cut-off score of 15+. However on multivariate linear regression, after various iterations, when individual predictors using standardized beta scores were examined, having experienced a stressful life event (B = 3.27, P = 0.001, β =0.25) explained the most variance in the care giver burden, followed by absence of social support for pregnant adolescents (B = - 2.76, P = 0.008, β = - 0.19), being diagnosed with HIV/AIDS (B = 3.81, P = 0.004, β =0.17) and being young (B = 2.46, P = 0.038, β =0.14). CONCLUSION:Depression is common among pregnant adolescents in urban resource-deprived areas of Kenya and is correlated with well-documented risk factors such as being of a younger age and being HIV positive. Interventions aimed at reducing or preventing depression in this population should target these groups and provide support to those experiencing greatest stress.
PMCID:5960084
PMID: 29776353
ISSN: 1471-244x
CID: 5831042
A pilot educational intervention for headache and concussion: The headache and arts program
OBJECTIVE:Using a science, technology, engineering, arts, and mathematics (STEAM) curriculum, we developed, piloted, and tested the Headache and Arts Program. This program seeks to increase knowledge and awareness of migraine and concussion among high school students through a visual arts-based curriculum. METHODS:values were calculated using SPSS V.24 and Microsoft Excel. RESULTS:Forty-eight students participated in the research program. Students created artwork that integrated STEAM knowledge learned through the program and applied creative methods to teach others about migraine and concussion. At baseline, students' total scores averaged 67.6% correct. Total scores for the longitudinal preassessment, immediate postassessment, and delayed 3-month postassessment averaged 69.4%, 72.8%, and 80.0% correct, respectively. CONCLUSION/CONCLUSIONS:The use of a visual arts-based curriculum may be effective for migraine and concussion education among high school students.
PMCID:5957308
PMID: 29653989
ISSN: 1526-632x
CID: 3037482
Six-Year Changes in Physical Activity and the Risk of Incident Heart Failure: ARIC Study
BACKGROUND:Higher physical activity (PA) is associated with lower heart failure (HF) risk; however, the effect of changes in PA on HF risk is unknown. METHODS:We evaluated 11 351 ARIC study (Atherosclerosis Risk in Communities) participants (mean age 60 years) who attended visit 3 (1993-1995) and did not have a history of cardiovascular disease. Exercise PA was assessed using a modified Baecke questionnaire and categorized according to American Heart Association guidelines as recommended, intermediate, or poor. We used Cox regression models to characterize the association of 6-year changes in PA between the first (1987-1989) and third ARIC visits and HF risk. RESULTS:During a median of 19 years of follow-up, 1750 HF events occurred. Compared with those with poor activity at both visits, the lowest HF risk was seen for those with persistently recommended activity (hazard ratio, 0.69; 95% confidence interval, 0.60-0.80). However, those whose PA increased from poor to recommended also had reduced HF risk (hazard ratio, 0.77; 95% confidence interval 0.63-0.93). Among participants with poor baseline activity, each 1 SD higher PA at 6 years (512.5 METS*minutes/week, corresponding to ≈30 minutes of brisk walking 4 times per week) was associated with significantly lower future HF risk (hazard ratio, 0.89, 95% confidence interval, 0.82-0.96). CONCLUSIONS:Although maintaining recommended activity levels is associated with the lowest HF risk, initiating and increasing PA, even in late middle age, are also linked to lower HF risk. Augmenting PA may be an important component of strategies to prevent HF.
PMCID:6219377
PMID: 29386202
ISSN: 1524-4539
CID: 5584892
Adolescent health in the Eastern Mediterranean Region: findings from the global burden of disease 2015 study
ISI:000433519400010
ISSN: 1661-8556
CID: 3608372
Identifying Geographic Disparities in Diabetes Prevalence Among Adults and Children Using Emergency Claims Data
Geographic surveillance can identify hotspots of disease and reveal associations between health and the environment. Our study used emergency department surveillance to investigate geographic disparities in type 1 and type 2 diabetes prevalence among adults and children. Using all-payer emergency claims data from 2009 to 2013, we identified unique New York City residents with diabetes and geocoded their location using home addresses. Geospatial analysis was performed to estimate diabetes prevalence by New York City Census tract. We also used multivariable regression to identify neighborhood-level factors associated with higher diabetes prevalence. We estimated type 1 and type 2 diabetes prevalence at 0.23% and 10.5%, respectively, among adults and 0.20% and 0.11%, respectively, among children in New York City. Pediatric type 1 diabetes was associated with higher income (P = 0.001), whereas adult type 2 diabetes was associated with lower income (P < 0.001). Areas with a higher proportion of nearby restaurants categorized as fast food had a higher prevalence of all types of diabetes (P < 0.001) except for pediatric type 2 diabetes. Type 2 diabetes among children was only higher in neighborhoods with higher proportions of African American residents (P < 0.001). Our findings identify geographic disparities in diabetes prevalence that may require special attention to address the specific needs of adults and children living in these areas. Our results suggest that the food environment may be associated with higher type 1 diabetes prevalence. However, our analysis did not find a robust association with the food environment and pediatric type 2 diabetes, which was predominantly focused in African American neighborhoods.
PMCID:5920312
PMID: 29719877
ISSN: 2472-1972
CID: 3057122
American journal of respiratory & critical care medicine. 2018:197(9):1219-1220.DOI: 10.1164/rccm.201708-1765LE
Genome-Wide Association Study of 58 Individuals with Fibrosing Mediastinitis Reveals Possible Underlying Genetic Susceptibility [Letter]
PMCID:6019928
PMID: 29043856
ISSN: 1535-4970
CID: 5162042
