Faculty Bibliography
Searched for:
school:SOM
Department/Unit:Population Health
Total Results:
12132
Developmental Delays in Executive Function from 3 to 5 Years of Age Predict Kindergarten Academic Readiness
Substantial evidence has established that individual differences in executive function (EF) in early childhood are uniquely predictive of children's academic readiness at school entry. The current study tested whether growth trajectories of EF across the early childhood period could be used to identify a subset of children who were at pronounced risk for academic impairment in kindergarten. Using data that were collected at the age 3, 4, and 5 home assessments in the Family Life Project (N = 1,120), growth mixture models were used to identify 9% of children who exhibited impaired EF performance (i.e., persistently low levels of EF that did not show expected improvements across time). Compared to children who exhibited typical trajectories of EF, the delayed group exhibited substantial impairments in multiple indicators of academic readiness in kindergarten (Cohen's ds = 0.9-2.7; odds ratios = 9.8-23.8). Although reduced in magnitude following control for a range of socioeconomic and cognitive (general intelligence screener, receptive vocabulary) covariates, moderate-sized group differences remained (Cohen's ds = 0.2-2.4; odds ratios = 3.9-5.4). Results are discussed with respect to the use of repeated measures of EF as a method of early identification, as well as the resulting translational implications of doing so.
PMCID:5266699
PMID: 26755570
ISSN: 1538-4780
CID: 2024892
Comparative performance of non-contrast MRI with HASTE vs. contrast-enhanced MRI/3D-MRCP for possible choledocholithiasis in hospitalized patients
PURPOSE: To compare the performance of non-contrast MRI with half-Fourier acquisition single-shot turbo spin echo (HASTE) vs. contrast-enhanced MRI/3D-MRCP for assessment of suspected choledocholithiasis in hospitalized patients. METHODS AND MATERIALS: 123 contrast-enhanced abdominal MRI/MRCP scans in the hospital setting for possible choledocholithiasis were retrospectively evaluated. Endoscopic retrograde cholangiopancreatography, intraoperative cholangiogram or documented clinical resolution served as the reference standard. Readers first evaluated the biliary tree using coronal and axial HASTE and other non-contrast sequences, and later reviewed the entire exam with post-contrast sequences and 3D-MRCP. Test performance for the image sets was compared for choledocholithiasis, acute hepatitis, cholangitis, and acute cholecystitis. Reader agreement, MRCP image quality, and confidence levels were also assessed. Clinical predictors of age and fever were tested for association with perceived need for contrast in biliary assessment. RESULTS: There were 27 cases of choledocholithiasis, 31 cases of acute hepatitis, 37 cases of acute cholecystitis, and 3 clinically diagnosed cases of acute cholangitis. Both the abbreviated and full contrast-enhanced/MRCP image sets resulted in high accuracy for choledocholithiasis (91.1-94.3% vs. 91.9-92.7%). There was no difference in sensitivity or specificity for either reader for any diagnosis between image sets (p > 0.40). 1 reader showed improved confidence (p < 0.001) with inclusion of MRCP and contrast-enhanced images, but neither confidence nor MRCP quality scores were associated with diagnostic accuracy. Patient age and fever did not predict the need for contrast-enhanced images. CONCLUSION: In hospitalized patients with suspected choledocholithiasis, performance of non-contrast abdominal MRI with HASTE is similar to contrast-enhanced MRI with 3D-MRCP, offering potential for decreased scanning time and improved patient tolerability.
PMCID:5457321
PMID: 28154911
ISSN: 2366-0058
CID: 2437032
Exploring regrettable substitution: replacements for bisphenol A
PMID: 29851613
ISSN: 2542-5196
CID: 3136372
Smartphone application for unhealthy alcohol use: a pilot study
BACKGROUND: Technology-delivered interventions are useful tools for addressing unhealthy alcohol use. Smartphones in particular offer opportunities to deliver interventions at the user's convenience. We developed a smartphone application with 5 modules (personal feedback, self-monitoring of drinking, designated driver tool, blood alcohol content calculator, information). We assessed its acceptability and associations between use and drinking outcomes. METHODS: 130 adults with unhealthy alcohol use (>14 (men)/ >7 (women) drinks/week or > = 1 episode/month with 6 or more drinks) recruited in Switzerland (n = 70) and Canada (n = 60) were offered to use the application. Follow-up occurred after 3 months. We assessed appreciation, usefulness and self-reported frequency of use of the modules, and drinking outcomes (drinks/week, binge drinking). Associations between application use and drinking at 3 months were evaluated with negative binomial and logistic regression models, adjusted for baseline values and gender. RESULTS: 48% of participants were women, mean (SD) age: 32.8(10.0). Follow-up rate: 86.2%. There were changes from baseline (BL) to follow-up (FU) in number of drinks/week, BL: 15.0(16.5); FU: 10.9(10.5), p = 0.01, and binge drinking, BL: 95.4%; FU: 64.3%, p<0.0001. All modules had median ratings between 6 and 8 (scale of 1-10). 77% of participants used the application; 76% used the personal feedback module, 41% the self-monitoring of drinking, 22% the designated driver tool, 53% the BAC calculator, and 31% the information module. Participants using the application more than once reported significantly fewer drinks/week at follow up: IRR (number of drinks per week) 0.70 (0.51; 0.96). CONCLUSIONS: A smartphone application for unhealthy alcohol use appears acceptable and useful (although there is room for improvement). Without prompting, its use is infrequent. Those who used the application more than once reported less weekly drinking than those who did not. Efficacy of the application should be tested in a randomized trial with strategies to increase frequency of its use.
PMID: 28113039
ISSN: 1547-0164
CID: 2418302
Adolescent Sexual Behavior Research: Perspectives of Investigators, IRB Members, and IRB Staff about Risk Categorization and IRB Approval
PMCID:5703197
PMID: 29187769
ISSN: 0193-7758
CID: 3663822
Geriatric Presentation of Idiopathic Left Ventricular Aneurysm
PMCID:6058218
PMID: 30062251
ISSN: 2468-6441
CID: 3217042
CKD and Risk for Hospitalization With Infection: The Atherosclerosis Risk in Communities (ARIC) Study
BACKGROUND:Individuals on dialysis therapy have a high risk for infection, but risk for infection in earlier stages of chronic kidney disease has not been comprehensively described. STUDY DESIGN/METHODS:Observational cohort study. SETTING & PARTICIPANTS/METHODS:9,697 participants (aged 53-75 years) in the Atherosclerosis Risk in Communities (ARIC) Study. Participants were followed up from 1996 to 1998 through 2011. PREDICTORS/METHODS:Estimated glomerular filtration rate (eGFR) and urinary albumin-creatinine ratio (ACR). OUTCOMES/RESULTS:Risk for hospitalization with infection and death during or within 30 days of hospitalization with infection. RESULTS:, respectively. Corresponding HRs were 3.76 (95% CI, 1.48-9.58), 1.62 (95% CI, 1.20-2.19), and 0.99 (95% CI, 0.80-1.21) for infection-related death. Compared to ACRs<10mg/g, HRs of incident hospitalization with infection were 2.30 (95% CI, 1.81-2.91), 1.56 (95% CI, 1.36-1.78), and 1.34 (95% CI, 1.20-1.50) for ACRs≥300, 30 to 299, and 10 to 29mg/g, respectively. Corresponding HRs were 3.44 (95% CI, 2.28-5.19), 1.57 (95% CI, 1.18-2.09), and 1.39 (95% CI, 1.09-1.78) for infection-related death. Results were consistent when separately assessing risk for pneumonia, kidney and urinary tract infections, bloodstream infections, and cellulitis and when taking into account recurrent episodes of infection. LIMITATIONS/CONCLUSIONS:Outcome ascertainment relied on diagnostic codes at time of discharge. CONCLUSIONS:Increasing provider awareness of chronic kidney disease as a risk factor for infection is needed to reduce infection-related morbidity and mortality.
PMCID:5438909
PMID: 27884474
ISSN: 1523-6838
CID: 5100602
Bridging Income Generation with Group Integrated Care for cardiovascular risk reduction: Rationale and design of the BIGPIC study
BACKGROUND:Cardiovascular disease (CVD) is the leading cause of mortality worldwide, with >80% of CVD deaths occurring in low and middle income countries (LMICs). Diabetes mellitus and pre-diabetes are risk factors for CVD, and CVD is the major cause of morbidity and mortality among individuals with DM. There is a critical period now during which reducing CVD risk among individuals with diabetes and pre-diabetes may have a major impact. Cost-effective, culturally appropriate, and context-specific approaches are required. Two promising strategies to improve health outcomes are group medical visits and microfinance. METHODS/DESIGN/METHODS:This study tests whether group medical visits integrated into microfinance groups are effective and cost-effective in reducing CVD risk among individuals with diabetes or at increased risk for diabetes in western Kenya. An initial phase of qualitative inquiry will assess contextual factors, facilitators, and barriers that may impact integration of group medical visits and microfinance for CVD risk reduction. Subsequently, we will conduct a four-arm cluster randomized trial comparing: (1) usual clinical care, (2) usual clinical care plus microfinance groups only, (3) group medical visits only, and (4) group medical visits integrated into microfinance groups. The primary outcome measure will be 1-year change in systolic blood pressure, and a key secondary outcome measure is 1-year change in overall CVD risk as measured by the QRISK2 score. We will conduct mediation analysis to evaluate the influence of changes in social network characteristics on intervention outcomes, as well as moderation analysis to evaluate the influence of baseline social network characteristics on effectiveness of the interventions. Cost-effectiveness analysis will be conducted in terms of cost per unit change in systolic blood pressure, percent change in CVD risk score, and per disability-adjusted life year saved. DISCUSSION/CONCLUSIONS:This study will provide evidence regarding effectiveness and cost-effectiveness of interventions to reduce CVD risk. We aim to produce generalizable methods and results that can provide a model for adoption in low-resource settings worldwide.
PMCID:5491075
PMID: 28577673
ISSN: 1097-6744
CID: 3240172
Journal of clinical child & adolescent psychology. 2017:46(4):551-562.DOI: 10.1080/15374416.2015.1041593
Early Childhood Internalizing Problems in Mexican- and Dominican-Origin Children: The Role of Cultural Socialization and Parenting Practices
This study examined mother- and teacher-rated internalizing behaviors (i.e., anxiety, depression, and somatization symptoms) among young children using longitudinal data from a community sample of 661 Mexican and Dominican families and tested a conceptual model in which parenting (mother's socialization messages and parenting practices) predicted child internalizing problems 12 months later. Children evidenced elevated levels of mother-rated anxiety at both time points. Findings also supported the validity of the proposed parenting model for both Mexican and Dominican families. Although there were different pathways to child anxiety, depression, and somatization among Mexican and Dominican children, socialization messages and authoritarian parenting were positively associated with internalizing symptoms for both groups.
PMCID:4670289
PMID: 26042610
ISSN: 1537-4424
CID: 1769472
Corrigendum: 1000 Genomes-based meta-analysis identifies 10 novel loci for kidney function
This corrects the article DOI: 10.1038/srep45040.
PMID: 28548086
ISSN: 2045-2322
CID: 5584602
