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Johnston A, Smith GN, Tanuseputro P, Coutinho T, Edwards JD. Assessing cardiovascular disease risk in women with a history of hypertensive disorders of pregnancy: A guidance paper for studies using administrative data. Paediatr Perinat Epidemiol 2024; 38:254-267. [PMID: 38220144 DOI: 10.1111/ppe.13043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 12/29/2023] [Accepted: 01/03/2024] [Indexed: 01/16/2024]
Abstract
BACKGROUND Hypertensive disorders of pregnancy (HDP) are a major cause of maternal morbidity and mortality, and their association with increased cardiovascular disease (CVD) risk represents a major public health concern. However, assessing CVD risk in women with a history of these conditions presents unique challenges, especially when studies are carried out using routinely collected data. OBJECTIVES To summarise and describe key challenges related to the design and conduct of administrative studies assessing CVD risk in women with a history of HDP and provide concrete recommendations for addressing them in future research. METHODS This is a methodological guidance paper. RESULTS Several conceptual and methodological factors related to the data-generating mechanism and study conceptualisation, design/data management and analysis, as well as the interpretation and reporting of study findings should be considered and addressed when designing and carrying out administrative studies on this topic. Researchers should develop an a priori conceptual framework within which the research question is articulated, important study variables are identified and their interrelationships are carefully considered. CONCLUSIONS To advance our understanding of CVD risk in women with a history of HDP, future studies should carefully consider and address the conceptual and methodological considerations outlined in this guidance paper. In highlighting these challenges, and providing specific recommendations for how to address them, our goal is to improve the quality of research carried out on this topic.
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Affiliation(s)
- Amy Johnston
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Graeme N Smith
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Kingston Health Sciences Centre, Queens University, Kingston, Ontario, Canada
| | - Peter Tanuseputro
- ICES, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Thais Coutinho
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jodi D Edwards
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Brain and Heart Nexus Research Program, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
- ICES, Ottawa, Ontario, Canada
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Bhattarai A, King N, Adhikari K, Dimitropoulos G, Devoe D, Byun J, Li M, Rivera D, Cunningham S, Bulloch AG, Patten SB, Duffy A. Childhood Adversity and Mental Health Outcomes Among University Students: A Longitudinal Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:510-520. [PMID: 36000272 PMCID: PMC10408556 DOI: 10.1177/07067437221111368] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Mental health concerns are common among university students and maybe elevated among those with specific risk exposures. The study examined the association between childhood adversities and mental health outcomes among undergraduate university students and assessed whether psychosocial and behavioral factors mediate those associations. METHODS The Queen's University Student Well-Being and Academic Success Survey identified two large cohorts of first-year undergraduate students entering university in Fall 2018 and 2019 (n = 5,943). At baseline, students reported sociodemographic information, family-related mental health history, childhood physical abuse, sexual abuse, peer bullying, and parental separation or divorce. Baseline and follow-up surveys in Spring 2019, Fall 2019, and Spring 2020 included validated measures of anxiety (7-item Generalized Anxiety Disorder) and depressive symptoms (9-item Patient Health Questionnaire ), non-suicidal self-harm, and suicidality, along with psychological processes and lifestyle variables. Repeated measures logistic regression using Generalized Estimating Equations was used to characterize the associations between childhood adversities and mental health outcomes and examine potential mediation. RESULTS Adjusting for age, gender, ethnicity, familial mental illness, and parental education, any childhood abuse (odds ratio: 2.89; 95% confidence interval, 2.58 to 3.23) and parental separation or divorce (odds ratio: 1.29; 95% confidence interval, 1.12 to 1.50) were significantly associated with a composite indicator of mental health outcomes (either 9-item Patient Health Questionnaire score ≥10 or 7-item Generalized Anxiety Disorderscore ≥10 or suicidality or self-harm). The association with childhood abuse weakened when adjusted for perceived stress, self-esteem, and insomnia (odds ratio: 2.05; 95% confidence interval, 1.80 to 2.34), and that with parental divorce weakened when adjusted for self-esteem (odds ratio: 1.17; 95% confidence interval, 1.00 to 1.36). CONCLUSION Childhood abuse and parental separation or divorce were associated with mental health concerns among university students. Childhood adversities may impact later mental health through an association with stress sensitivity, self-esteem, and sleep problems. The findings suggest that prevention and early intervention focusing on improving sleep, self-esteem, and coping with stress while considering the individual risk profile of help-seeking students may help support student mental health.
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Affiliation(s)
- Asmita Bhattarai
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nathan King
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Kamala Adhikari
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Provincial Population and Public Health, Alberta Health Services, Calgary, Alberta, Canada
| | | | - Dan Devoe
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Jin Byun
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Melanie Li
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Daniel Rivera
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada
| | - Simone Cunningham
- Department of Biomedical and Molecular Sciences, Queen’s University, Kingston, Ontario, Canada
| | - Andrew G.M. Bulloch
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Scott B. Patten
- Departments of Community Health Sciences & Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anne Duffy
- Department of Public Health Sciences, Queen’s University, Kingston, Ontario, Canada
- Department of Psychiatry, Queen’s University, Kingston, Ontario, Canada
- Department of Psychiatry, University of Oxford, Oxford, UK
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Goode LK, Fusilier AR, Remiszewski N, Reeves JM, Abiraman K, Defenderfer M, Paul JR, McMahon LL, Gamble KL. Examination of Diurnal Variation and Sex Differences in Hippocampal Neurophysiology and Spatial Memory. eNeuro 2022; 9:ENEURO.0124-22.2022. [PMID: 36265903 PMCID: PMC9668349 DOI: 10.1523/eneuro.0124-22.2022] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/29/2022] [Accepted: 10/10/2022] [Indexed: 12/24/2022] Open
Abstract
Circadian rhythms are biological processes that cycle across 24 h and regulate many facets of neurophysiology, including learning and memory. Circadian variation in spatial memory task performance is well documented; however, the effect of sex across circadian time (CT) remains unclear. Additionally, little is known regarding the impact of time-of-day on hippocampal neuronal physiology. Here, we investigated the influence of both sex and time-of-day on hippocampal neurophysiology and memory in mice. Performance on the object location memory (OLM) task depended on both circadian time and sex, with memory enhanced at night in males but during the day in females. Long-term synaptic potentiation (LTP) magnitude at CA3-CA1 synapses was greater at night compared with day in both sexes. Next, we measured spontaneous synaptic excitation and inhibition onto CA1 pyramidal neurons. Frequency and amplitude of inhibition was greater during the day compared with night, regardless of sex. Frequency and amplitude of excitation was larger in females, compared with males, independent of time-of-day, although both time-of-day and sex influenced presynaptic release probability. At night, CA1 pyramidal neurons showed enhanced excitability (action potential firing and/or baseline potential) that was dependent on synaptic excitation and inhibition, regardless of sex. This study emphasizes the importance of sex and time-of-day in hippocampal physiology, especially given that many neurologic disorders impacting the hippocampus are linked to circadian disruption and present differently in men and women. Knowledge about how sex and circadian rhythms affect hippocampal physiology can improve the translational relevancy of therapeutics and inform the appropriate timing of existing treatments.
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Affiliation(s)
- Lacy K Goode
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham 35233, AL
| | - Allison R Fusilier
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham 35233, AL
| | - Natalie Remiszewski
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham 35233, AL
| | - Jacob M Reeves
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham 35233, AL
| | | | - Matthew Defenderfer
- Research Computing, Information Technology, University of Alabama at Birmingham, Birmingham 35233, AL
| | - Jodi R Paul
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham 35233, AL
| | - Lori L McMahon
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham 35233, AL
| | - Karen L Gamble
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham Heersink School of Medicine, Birmingham 35233, AL
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Richards VL, Leeman RF, Wang Y, Cook C, Prins C, Ennis N, Spencer EC, Cook RL. Identifying the best measures of alcohol consumption to predict future HIV viral suppression trajectories. AIDS Behav 2022; 26:3242-3253. [PMID: 35380289 PMCID: PMC9474662 DOI: 10.1007/s10461-022-03674-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 11/01/2022]
Abstract
Alcohol use is associated with poor outcomes among people living with HIV (PLWH), but it remains unclear which alcohol use measures best predict future HIV viral non-suppression over time. This study aimed to compare the ability of five alcohol use measures to predict risk of suboptimal HIV viral load trajectories over 36 months. We analyzed data from a cohort of PLWH in Florida including survey data linked to the state HIV surveillance system on prospective HIV viral loads over 36 months (n = 783; 66% male; 55% Black; Mage=46, SD = 11). Four trajectory patterns for HIV viral load were identified: consistently low (65.1%), decreasing (15.9%), increasing (10.6%), and consistently high (8.4%). Past year alcohol use frequency (OR = 2.1, CI:1.0-4.4), drinks consumed on a typical drinking day (OR = 2.2, CI:1.2-4.1), frequency of binge drinking (OR = 2.6, CI:1.3-5.2), and alcohol-related problems score (OR = 1.7, CI:1.1-2.7) were the measures predictive of the risk of future viral non-suppression above specific thresholds.
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Affiliation(s)
| | - Robert F Leeman
- Department of Health Education and Behavior, University of Florida, Gainesville, FL, USA
| | - Yan Wang
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Christa Cook
- College of Nursing, University of Central Florida, Orlando, FL, USA
| | - Cindy Prins
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
| | - Nicole Ennis
- Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA
| | - Emma C Spencer
- Bureau of Communicable Diseases, Florida Department of Health, Tallahassee, FL, USA
| | - Robert L Cook
- Department of Epidemiology, University of Florida, Gainesville, FL, USA
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Fuster D, Sanvisens A, Bolao F, Rivas I, Tor J, Muga R. Alcohol use disorder and its impact on chronic hepatitis C virus and human immunodeficiency virus infections. World J Hepatol 2016; 8:1295-1308. [PMID: 27872681 PMCID: PMC5099582 DOI: 10.4254/wjh.v8.i31.1295] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 08/04/2016] [Accepted: 08/29/2016] [Indexed: 02/06/2023] Open
Abstract
Alcohol use disorder (AUD) and hepatitis C virus (HCV) infection frequently co-occur. AUD is associated with greater exposure to HCV infection, increased HCV infection persistence, and more extensive liver damage due to interactions between AUD and HCV on immune responses, cytotoxicity, and oxidative stress. Although AUD and HCV infection are associated with increased morbidity and mortality, HCV antiviral therapy is less commonly prescribed in individuals with both conditions. AUD is also common in human immunodeficiency virus (HIV) infection, which negatively impacts proper HIV care and adherence to antiretroviral therapy, and liver disease. In addition, AUD and HCV infection are also frequent within a proportion of patients with HIV infection, which negatively impacts liver disease. This review summarizes the current knowledge regarding pathological interactions of AUD with hepatitis C infection, HIV infection, and HCV/HIV co-infection, as well as relating to AUD treatment interventions in these individuals.
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