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Trasande L, Comstock SS, Herbstman JB, Margolis A, Alcedo G, Afanasyeva Y, Yu K, Lee W, Lawrence DA. Associations of SARS-CoV-2 antibodies with birth outcomes: Results from three urban birth cohorts in the NIH environmental influences on child health outcomes program. PLoS One 2023; 18:e0293652. [PMID: 37992059 PMCID: PMC10664934 DOI: 10.1371/journal.pone.0293652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/17/2023] [Indexed: 11/24/2023] Open
Abstract
Studies suggest perinatal infection with SARS-CoV-2 can induce adverse birth outcomes, but studies published to date have substantial limitations. We therefore conducted an observational study of 211 births occurring between January 2020-September 2021 in three urban cohorts participating in the Environmental Influences on Child Health Outcomes Program. Serology was assessed for IgG, IgM and IgA antibodies to nucleocapsid, S1 spike, S2 spike, and receptor-binding domain. There were no differences in gestational age (GA), birth weight, preterm birth (PTB) or low birth weight (LBW) among seropositive mothers. However, the few (n = 9) IgM seropositive mothers had children with lower BW (434g, 95% CI: 116-752), BW Z score-for-GA (0.73 SD, 95% CI 0.10-1.36) and were more likely to deliver preterm (OR 8.75, 95% CI 1.22-62.4). Though there are limits to interpretation, the data support efforts to prevent SARS-CoV-2 infections in pregnancy.
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Affiliation(s)
- Leonardo Trasande
- Division of Environmental Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States of America
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
- Department of Environmental Health, NYU Grossman School of Medicine, New York, NY, United States of America
- NYU Wagner School of Public Service, New York, NY, United States of America
- NYU School of Global Public Health, New York, NY, United States of America
| | - Sarah S. Comstock
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, United States of America
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia Mailman School of Public Health, New York, NY, United States of America
| | - Amy Margolis
- Department of Psychiatry, Columbia University Medical Center, New York, NY, United States of America
| | - Garry Alcedo
- Division of Environmental Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Yelena Afanasyeva
- Division of Environmental Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States of America
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, United States of America
| | - Keunhyung Yu
- Division of Environmental Pediatrics, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY, United States of America
| | - William Lee
- Wadsworth Laboratories, New York State Department of Health, Albany, NY, United States of America
- School of Public Health, University at Albany, Albany, NY, United States of America
| | - David A. Lawrence
- Wadsworth Laboratories, New York State Department of Health, Albany, NY, United States of America
- School of Public Health, University at Albany, Albany, NY, United States of America
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McGowan EC, McGrath M, Law A, O’Shea TM, Aschner JL, Blackwell CK, Fry RC, Ganiban JM, Higgins R, Margolis A, Sathyanarayana S, Taylor G, Alshawabkeh AN, Cordero JF, Spillane NT, Hudak ML, Camargo CA, Dabelea D, Dunlop AL, Elliott AJ, Ferrara AM, Talavera-Barber M, Singh AM, Karagas MR, Karr C, O’Connor TG, Paneth N, Wright RJ, Wright RO, Cowell W, Stanford JB, Bendixsen C, Lester BM. Health Care Utilization During the COVID-19 Pandemic Among Individuals Born Preterm. JAMA Netw Open 2023; 6:e2310696. [PMID: 37115545 PMCID: PMC10148204 DOI: 10.1001/jamanetworkopen.2023.10696] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/16/2023] [Indexed: 04/29/2023] Open
Abstract
Importance Limited data exist on pediatric health care utilization during the COVID-19 pandemic among children and young adults born preterm. Objective To investigate differences in health care use related to COVID-19 concerns during the pandemic among children and young adults born preterm vs those born at term. Design, Setting, and Participants In this cohort study, questionnaires regarding COVID-19 and health care utilization were completed by 1691 mother-offspring pairs from 42 pediatric cohorts in the National Institutes of Health Environmental Influences on Child Health Outcomes Program. Children and young adults (ages 1-18 years) in these analyses were born between 2003 and 2021. Data were recorded by the August 31, 2021, data-lock date and were analyzed between October 2021 and October 2022. Exposures Premature birth (<37 weeks' gestation). Main Outcomes and Measures The main outcome was health care utilization related to COVID-19 concerns (hospitalization, in-person clinic or emergency department visit, phone or telehealth evaluations). Individuals born preterm vs term (≥37 weeks' gestation) and differences among preterm subgroups of individuals (<28 weeks', 28-36 weeks' vs ≥37 weeks' gestation) were assessed. Generalized estimating equations assessed population odds for health care used and related symptoms, controlling for maternal age, education, and psychiatric disorder; offspring history of bronchopulmonary dysplasia (BPD) or asthma; and timing and age at COVID-19 questionnaire completion. Results Data from 1691 children and young adults were analyzed; among 270 individuals born preterm, the mean (SD) age at survey completion was 8.8 (4.4) years, 151 (55.9%) were male, and 193 (71.5%) had a history of BPD or asthma diagnosis. Among 1421 comparison individuals with term birth, the mean (SD) age at survey completion was 8.4 (2.4) years, 749 (52.7%) were male, and 233 (16.4%) had a history of BPD or asthma. Preterm subgroups included 159 individuals (58.5%) born at less than 28 weeks' gestation. In adjusted analyses, individuals born preterm had a significantly higher odds of health care utilization related to COVID-19 concerns (adjusted odds ratio [aOR], 1.70; 95% CI, 1.21-2.38) compared with term-born individuals; similar differences were also seen for the subgroup of individuals born at less than 28 weeks' gestation (aOR, 2.15; 95% CI, 1.40-3.29). Maternal history of a psychiatric disorder was a significant covariate associated with health care utilization for all individuals (aOR, 1.44; 95% CI, 1.17-1.78). Conclusions and Relevance These findings suggest that during the COVID-19 pandemic, children and young adults born preterm were more likely to have used health care related to COVID-19 concerns compared with their term-born peers, independent of a history of BPD or asthma. Further exploration of factors associated with COVID-19-related health care use may facilitate refinement of care models.
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Affiliation(s)
- Elisabeth C. McGowan
- The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
| | - Monica McGrath
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Andrew Law
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Judy L. Aschner
- Albert Einstein College of Medicine, New York, New York
- Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | | | - Rebecca C. Fry
- The University of North Carolina at Chapel Hill, Chapel Hill
| | - Jody M. Ganiban
- George Washington University, Washington, District of Columbia
| | - Rosemary Higgins
- Department of Global and Community Health, College of Health and Human Sciences, George Mason University, Fort Myers, Florida
- Marieb College of Health and Human Services, Florida Gulf Coast University, Fort Myers
| | - Amy Margolis
- Columbia University Irving Medical Center, New York, New York
| | - Sheela Sathyanarayana
- University of Washington, Seattle
- Seattle Children’s Research Institute, Seattle, Washington
| | | | | | - José F. Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens
| | - Nicole T. Spillane
- Hackensack University Medical Center and Hackensack Meridian School of Medicine, Hackensack, New Jersey
| | - Mark L. Hudak
- Department of Pediatrics, University of Florida College of Medicine, Jacksonville
| | | | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora
| | | | | | | | - Maria Talavera-Barber
- Avera McKennan Hospital, Sioux Falls, South Dakota
- University Health Center, Avera Research Institute, Sioux Falls, South Dakota
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison
| | | | - Catherine Karr
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle
| | | | - Nigel Paneth
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing
| | - Rosalind J. Wright
- Institute for Exposomic Research, Icahn School of Medicine Mount Sinai, New York, New York
| | - Robert O. Wright
- Institute for Exposomic Research, Icahn School of Medicine Mount Sinai, New York, New York
| | - Whitney Cowell
- Department of Pediatrics, NYU Grossman School of Medicine, New York, New York
| | | | - Casper Bendixsen
- Marshfield Clinic Research Institute, Marshfield Clinic Health System, Marshfield, Wisconsin
| | - Barry M. Lester
- The Warren Alpert School of Medicine, Brown University, Providence, Rhode Island
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Hong SJ, Mottron L, Park BY, Benkarim O, Valk SL, Paquola C, Larivière S, Vos de Wael R, Degré-Pelletier J, Soulieres I, Ramphal B, Margolis A, Milham M, Di Martino A, Bernhardt BC. A convergent structure-function substrate of cognitive imbalances in autism. Cereb Cortex 2023; 33:1566-1580. [PMID: 35552620 PMCID: PMC9977381 DOI: 10.1093/cercor/bhac156] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 03/28/2022] [Accepted: 03/29/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Autism spectrum disorder (ASD) is a common neurodevelopmental diagnosis showing substantial phenotypic heterogeneity. A leading example can be found in verbal and nonverbal cognitive skills, which vary from elevated to impaired compared with neurotypical individuals. Moreover, deficits in verbal profiles often coexist with normal or superior performance in the nonverbal domain. METHODS To study brain substrates underlying cognitive imbalance in ASD, we capitalized categorical and dimensional IQ profiling as well as multimodal neuroimaging. RESULTS IQ analyses revealed a marked verbal to nonverbal IQ imbalance in ASD across 2 datasets (Dataset-1: 155 ASD, 151 controls; Dataset-2: 270 ASD, 490 controls). Neuroimaging analysis in Dataset-1 revealed a structure-function substrate of cognitive imbalance, characterized by atypical cortical thickening and altered functional integration of language networks alongside sensory and higher cognitive areas. CONCLUSION Although verbal and nonverbal intelligence have been considered as specifiers unrelated to autism diagnosis, our results indicate that intelligence disparities are accentuated in ASD and reflected by a consistent structure-function substrate affecting multiple brain networks. Our findings motivate the incorporation of cognitive imbalances in future autism research, which may help to parse the phenotypic heterogeneity and inform intervention-oriented subtyping in ASD.
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Affiliation(s)
- Seok-Jun Hong
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Center for Neuroscience Imaging Research, Institute for Basic Science, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon 16419, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon 16419, South Korea.,Center for the Developing Brain, Child Mind Institute, 101 East 56th Street, New York, NY 10022, United States
| | - Laurent Mottron
- Centre de Recherche du CIUSSSNIM and Department of Psychiatry and Addictology, Université de Montréal, 7070 boulevard Perras, Montréal, Quebec H1E 1A4, Canada
| | - Bo-Yong Park
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Center for Neuroscience Imaging Research, Institute for Basic Science, Sungkyunkwan University, Seobu-ro 2066, Jangan-gu, Suwon 16419, South Korea.,Department of Data Science, Inha Univerisity, Incheon 22212, South Korea
| | - Oualid Benkarim
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada
| | - Sofie L Valk
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Otto Hahn group Cognitive neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Stephanstraβe 1A. Leipzig D-04103, Germany.,Institute of Neuroscience and Medicine, Research Centre Wilhelm-Johnen-Strasse, Jülich 52425, Germany.,Institute of Systems Neuroscience, Heinrich Heine University, Moorenstr. 5, Düsseldorf 40225, Germany
| | - Casey Paquola
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Institute of Neuroscience and Medicine, Research Centre Wilhelm-Johnen-Strasse, Jülich 52425, Germany
| | - Sara Larivière
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada
| | - Reinder Vos de Wael
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada
| | - Janie Degré-Pelletier
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada.,Department of Psychology, Université du Québec à Montréal, 100 rue Sherbrooke Ouest, Montréal, Québec H2X 3P2, Canada
| | - Isabelle Soulieres
- Department of Psychology, Université du Québec à Montréal, 100 rue Sherbrooke Ouest, Montréal, Québec H2X 3P2, Canada
| | - Bruce Ramphal
- Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians Surgeons, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States
| | - Amy Margolis
- Department of Psychiatry, The New York State Psychiatric Institute and the College of Physicians Surgeons, Columbia University, 1051 Riverside Drive, New York, NY 10032, United States
| | - Michael Milham
- Center for the Developing Brain, Child Mind Institute, 101 East 56th Street, New York, NY 10022, United States.,Center for Biomedical Imaging and Neuromodulation, Nathan Kline Institute, 140 Old Orangeburg Road, Orangeburg, NY 10962, United States
| | - Adriana Di Martino
- Autism Center, Child Mind Institute, 101 East 56th Street, New York, NY 10022, United States
| | - Boris C Bernhardt
- Multimodal Imaging and Connectome Analysis Laboratory, McConnell Brain Imaging Centre, Department of Neurology and Neurosurgery and Montreal Neurological Institute and Hospital, McGill University, 3801 University Street, Montreal, Quebec H3A2B4, Canada
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4
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Beebe B, Crown CL, Jasnow M, Sossin KM, Kaitz M, Margolis A, Lee SH. The vocal dialogue in 9/11 pregnant widows and their infants: Specificities of co-regulation. Infant Behav Dev 2023; 70:101803. [PMID: 36565493 DOI: 10.1016/j.infbeh.2022.101803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/08/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022]
Abstract
Mothers who were pregnant and widowed on September 11, 2001, and their 4-6-month infants (in utero on 9/11) were filmed during face-to-face interaction and their vocal dialogues were examined via microanalysis. Mothers were White, well-educated, mean age 34.3 years, and far from the World Trade Center site on 9/11; infants were 4-6 months, half female. We examined the bi-directional, moment-by-moment co-regulation of the timing of vocal dialogue, and particularly turn taking, in mother-infant and stranger-infant interactions, with time-series models. We analyzed the contingent coordination of durations of (1) vocalizations of the turn-holder, and (2) switching-pauses at the moment of the turn exchange. The switching pause is an aspect of the rhythm of the turn-holder who, after taking a turn, yields the floor to the partner through the switching pause. Turn taking is the lynchpin of dialogue, and the bi-directional contingent coordination of the switching-pause regulates the turn exchange. Both partners showed signs of risk and resilience. The 9/11 mothers did not coordinate the timing of turn taking with their infants, a highly unusual finding. In contrast, the 9/11 infants did coordinate the timing of turn taking with their mothers, and with the "stranger," forms of resilience. We propose that the 9/11 mother's difficulty coordinating with the infant's turn taking rhythm is a mode of transmission of her trauma to the infant. This work expands our knowledge of the specificities of co-regulation in the context of the 9/11 trauma.
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Affiliation(s)
- Beatrice Beebe
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
| | | | | | - K Mark Sossin
- Department of Psychology, Pace University, New York, NY, USA.
| | - Marsha Kaitz
- Department of Psychology, Hebrew University, Jerusalem, Israel.
| | - Amy Margolis
- Department of Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
| | - Sang Han Lee
- The Nathan Kline Institute, Orangeburg, NY, USA.
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5
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Lucchini M, Bekelman TA, Li M, Knapp EA, Dong Y, Ballard S, Deoni S, Dunlop AL, Elliott AJ, Ferrara A, Friedman C, Galarce M, Gilbert-Diamond D, Glueck D, Hedderson M, Hockett CW, Karagas MR, LeBourgeois MK, Margolis A, McDonald J, Ngai P, Pellerite M, Sauder K, Ma T, Dabelea D. Impact of the COVID-19 pandemic on children's sleep habits: an ECHO study. Pediatr Res 2023; 93:586-594. [PMID: 36195633 PMCID: PMC9531212 DOI: 10.1038/s41390-022-02309-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 08/04/2022] [Accepted: 08/30/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND Sleep in childhood is affected by behavioral, environmental, and parental factors. We propose that these factors were altered during the COVID-19 pandemic. This study investigates sleep habit changes during the pandemic in 528 children 4-12 years old in the US, leveraging data from the Environmental Influences on Child Health Outcomes (ECHO) Program. METHODS Data collection occurred in July 2019-March 2020 (pre-pandemic) and two pandemic periods: December 2020-April 2021 and May-August 2021. Qualitative interviews were performed in 38 participants. RESULTS We found no changes in sleep duration, but a shift to later sleep midpoint during the pandemic periods. There was an increase in latency at the first pandemic collection period but no increase in the frequency of bedtime resistance, and a reduced frequency of naps during the pandemic. Qualitative interviews revealed that parents prioritized routines to maintain sleep duration but were more flexible regarding timing. Children from racial/ethnic minoritized communities slept less at night, had later sleep midpoint, and napped more frequently across all collection periods, warranting in-depth investigation to examine and address root causes. CONCLUSIONS The COVID-19 pandemic significantly impacted children sleep, but parental knowledge of the importance of sleep might have played a significant protective role. IMPACT During the COVID-19 pandemic, US children changed their sleep habits, going to bed and waking up later, but their sleep duration did not change. Sleep latency was longer. Parental knowledge of sleep importance might have played a protective role. Regardless of data collection periods, children from racial/ethnic minoritized communities slept less and went to bed later. This is one of the first study on this topic in the US, including prospective pre-pandemic qualitative and quantitative data on sleep habits. Our findings highlight the pandemic long-term impact on childhood sleep. Results warrants further investigations on implications for overall childhood health.
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Affiliation(s)
- Maristella Lucchini
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
| | - Traci A Bekelman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mingyi Li
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emily A Knapp
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yanan Dong
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Suyin Ballard
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sean Deoni
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Anne L Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Amy J Elliott
- Avera Research Institute, Sioux Falls, SD, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, USA
| | - Assiamira Ferrara
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Chloe Friedman
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Maren Galarce
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Diane Gilbert-Diamond
- Department of Epidemiology, Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Deborah Glueck
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Monique Hedderson
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Christine W Hockett
- Avera Research Institute, Sioux Falls, SD, USA
- Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, USA
| | - Margaret R Karagas
- Department of Epidemiology, Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Monique K LeBourgeois
- Department of Pediatrics, Warren Alpert Medical School at Brown University, Providence, RI, USA
| | - Amy Margolis
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Julia McDonald
- Kaiser Permanente Northern California Division of Research, Oakland, CA, USA
| | - Pakkay Ngai
- Division of Pediatric Pulmonology, Department of Pediatrics, Hackensack Meridian School of Medicine, Hackensack, NJ, USA
| | | | - Katherine Sauder
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Tengfei Ma
- Michigan State University College of Human Medicine, Grand Rapids, MI, USA
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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6
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Bastain TM, Knapp EA, Law A, Algermissen M, Avalos LA, Birnhak Z, Blackwell C, Breton CV, Duarte C, Frazier J, Ganiban J, Greenwood P, Herbstman J, Hernandez-Castro I, Hofheimer J, Karagas MR, Lewis J, Pagliaccio D, Ramphal B, Saxbe D, Schmidt R, Velez-Vega C, Tang X, Hamra GB, Margolis A. COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US. JAMA Netw Open 2022; 5:e2247330. [PMID: 36525271 PMCID: PMC9856510 DOI: 10.1001/jamanetworkopen.2022.47330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/24/2022] [Indexed: 12/23/2022] Open
Abstract
Importance The primary outcomes of the COVID-19 pandemic on the mental health of women with children remain largely unknown. Objectives To identify and describe clusters of mothers of children participating in the Environmental influences on Child Health Outcomes (ECHO) Program that characterize pandemic-associated hardships, coping mechanisms, and behaviors, and to evaluate associations between pandemic-associated hardships, coping strategies, and behavior changes with pandemic-associated traumatic stress symptoms. Design, Setting, and Participants This multicenter cohort study investigated experiences during the COVID-19 pandemic between April 2020 and August 2021 among maternal caregivers of children participating in the ECHO Program. Data from self-identified mothers of ECHO-enrolled children from 62 US cohorts were included in analyses. Data were analyzed from November 2021 to July 2022. Exposures The primary exposures were pandemic-associated changes in mothers' health, health care utilization, work and finances, coping strategies, and health-associated behaviors. Exposures were assessed via a self-reported questionnaire designed by ECHO investigators. Main Outcomes and Measures The primary outcome was the total symptoms score of pandemic-associated traumatic stress (PTS), defined as the number of items endorsed at least sometimes or more frequently, from a 10-item self-report measure. Results The study surveyed 11 473 mothers (mean [SD] age, 37.8 [7.4] years; 342 American Indian [2.98%], 378 Asian [3.29%], 1701 Black [14.83%], and 7195 White [62.71%]; 2184 with Hispanic/Latina ethnicity [19.04%]) and identified 2 clusters that best characterized their COVID-19 pandemic experiences-one characterized by higher life disruptions (eg, to work and health care), higher social isolation, more coping behaviors to mitigate the outcomes of the pandemic, and more changes to their health behavior routines (high change [1031 mothers]) and the other characterized by lower changes (low change [3061 mothers]). The high change cluster was more socioeconomically advantaged and reported higher PTS (mean [SD] number of symptoms, 3.72 [2.44] vs 2.51 [2.47]). Across both clusters, higher pandemic-associated hardships, coping mechanisms, and behavior changes were associated with higher PTS, and these associations were greater in the low change cluster. Conclusions and Relevance In this study of more than 11 000 US mothers, associations between socioeconomic factors, stressful life events, and mental health sequelae were complex. Accordingly, programs, policies, and practices targeting mental health during public health crises such as the COVID-19 pandemic should consider the range and configuration of hardships in designing the most effective interventions to mitigate long-term outcomes.
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Affiliation(s)
- Theresa M. Bastain
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles
| | - Emily A. Knapp
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Andrew Law
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Zoe Birnhak
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles
| | | | - Carrie V. Breton
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles
| | - Cristiane Duarte
- Columbia University–New York State Psychiatric Institute, New York
| | - Jean Frazier
- University of Massachusetts Chan Medical School, Worcester
| | - Jody Ganiban
- Department of Psychological and Brain Sciences, Columbian College of Arts and Sciences, George Washington University, Washington, DC
| | - Paige Greenwood
- Columbia University Irving Medical Center, New York, New York
| | - Julie Herbstman
- Columbia Mailman School of Public Health, New York City, New York
| | - Ixel Hernandez-Castro
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles
| | - Julie Hofheimer
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill
| | | | - Johnnye Lewis
- College of Pharmacy, University of New Mexico, Albuquerque
| | | | - Bruce Ramphal
- Harvard University Medical School, New York, New York
| | - Darby Saxbe
- Dornsife College, University of Southern California, Los Angeles
| | - Rebecca Schmidt
- Department of Public Health Sciences, University of California, Davis, Davis
| | - Carmen Velez-Vega
- Graduate School of Public Health, University of Puerto Rico Medical Sciences Campus, San Juan
| | - Xiaodan Tang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Ghassan B. Hamra
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Amy Margolis
- Columbia University Irving Medical Center, New York, New York
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7
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Wang Y, Kessel E, Lee S, Hong S, Raffanello E, Hulvershorn LA, Margolis A, Peterson BS, Posner J. Causal effects of psychostimulants on neural connectivity: a mechanistic, randomized clinical trial. J Child Psychol Psychiatry 2022; 63:1381-1391. [PMID: 35141898 PMCID: PMC9360200 DOI: 10.1111/jcpp.13585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Psychostimulants are frequently used to treat attention-deficit/hyperactivity disorder (ADHD), but side effects are common leading to many patients discontinuing treatment. Identifying neural mechanisms by which psychostimulants attenuate symptoms may guide the development of more refined and tolerable therapeutics. METHODS We conducted a 12-week, randomized, placebo-controlled trial (RCT) of a long-acting amphetamine, lisdexamfetamine (LDEX), in patients with ADHD, ages 6-25 years old. Of the 58 participants who participated in the RCT, 49 completed pre- and post-RCT magnetic resonance imaging scanning with adequate data quality. Healthy controls (HCs; n = 46) were included for comparison. Treatment effects on striatal and thalamic functional connectivity (FC) were identified using static (time-averaged) and dynamic (time-varying) measures and then correlated with symptom improvement. Analyses were repeated in independent samples from the Adolescent Brain Cognitive Development study (n = 103) and the ADHD-200 Consortium (n = 213). RESULTS In 49 participants (25 LDEX; 24 Placebo), LDEX increased static and decreased dynamic FC (DFC). However, only DFC was associated with the therapeutic effects of LDEX. Additionally, at baseline, DFC was elevated in unmedicated-ADHD participants relative to HCs. Independent samples yielded similar findings - ADHD was associated with increased DFC, and psychostimulants with reduced DFC. Static FC findings were inconsistent across samples. CONCLUSIONS Changes in dynamic, but not static, FC were associated with the therapeutic effects of psychostimulants. While prior research has focused on static FC, DFC may offer a more reliable target for new ADHD interventions aimed at stabilizing network dynamics, though this needs confirmation with subsequent investigations.
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Affiliation(s)
- Yun Wang
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Ellen Kessel
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Seonjoo Lee
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Susie Hong
- New York State Psychiatric Institute, New York, NY, USA
| | | | | | - Amy Margolis
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
| | - Bradley S. Peterson
- Department of Psychiatry, Keck School of Medicine, Los Angeles, CA, USA,Institute for the Developing Mind, Saban Research Institute, CHLA, Los Angeles, CA, USA
| | - Jonathan Posner
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA,New York State Psychiatric Institute, New York, NY, USA
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8
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Peterson BS, Bansal R, Sawardekar S, Nati C, Elgabalawy ER, Hoepner LA, Garcia W, Hao X, Margolis A, Perera F, Rauh V. Prenatal exposure to air pollution is associated with altered brain structure, function, and metabolism in childhood. J Child Psychol Psychiatry 2022; 63:1316-1331. [PMID: 35165899 DOI: 10.1111/jcpp.13578] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Prenatal exposure to air pollution disrupts cognitive, emotional, and behavioral development. The brain disturbances associated with prenatal air pollution are largely unknown. METHODS In this prospective cohort study, we estimated prenatal exposures to fine particulate matter (PM2.5 ) and polycyclic aromatic hydrocarbons (PAH), and then assessed their associations with measures of brain anatomy, tissue microstructure, neurometabolites, and blood flow in 332 youth, 6-14 years old. We then assessed how those brain disturbances were associated with measures of intelligence, ADHD and anxiety symptoms, and socialization. RESULTS Both exposures were associated with thinning of dorsal parietal cortices and thickening of postero-inferior and mesial wall cortices. They were associated with smaller white matter volumes, reduced organization in white matter of the internal capsule and frontal lobe, higher metabolite concentrations in frontal cortex, reduced cortical blood flow, and greater microstructural organization in subcortical gray matter nuclei. Associations were stronger for PM2.5 in boys and PAH in girls. Youth with low exposure accounted for most significant associations of ADHD, anxiety, socialization, and intelligence measures with cortical thickness and white matter volumes, whereas it appears that high exposures generally disrupted these neurotypical brain-behavior associations, likely because strong exposure-related effects increased the variances of these brain measures. CONCLUSIONS The commonality of effects across exposures suggests PM2.5 and PAH disrupt brain development through one or more common molecular pathways, such as inflammation or oxidative stress. Progressively higher exposures were associated with greater disruptions in local volumes, tissue organization, metabolite concentrations, and blood flow throughout cortical and subcortical brain regions and the white matter pathways interconnecting them. Together these affected regions comprise cortico-striato-thalamo-cortical circuits, which support the regulation of thought, emotion, and behavior.
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Affiliation(s)
- Bradley S Peterson
- Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Department of Psychiatry, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
| | - Ravi Bansal
- Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, CA, USA.,Department of Pediatrics, Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA
| | - Siddhant Sawardekar
- Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Carlo Nati
- Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Eman R Elgabalawy
- Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Lori A Hoepner
- Department of Environmental and Occupational Health Sciences, SUNY Downstate School of Public Health, Brooklyn, NY, USA
| | - Wanda Garcia
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Xuejun Hao
- Department of Psychiatry, Columbia Presbyterian Medical Center & New York State Psychiatric Institute, New York, NY, USA
| | - Amy Margolis
- Department of Psychiatry, Columbia Presbyterian Medical Center & New York State Psychiatric Institute, New York, NY, USA
| | - Frederica Perera
- Columbia Center for Children's Environmental Health, New York, NY, USA.,Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Virginia Rauh
- Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY, USA.,Columbia Center for Children's Environmental Health, New York, NY, USA
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Lyall K, Ning X, Aschner JL, Avalos LA, Bennett DH, Bilder DA, Bush NR, Carroll KN, Chu SH, Croen LA, Dabelea D, Daniels JL, Duarte C, Elliott AJ, Fallin MD, Ferrara A, Hertz-Picciotto I, Hipwell AE, Jensen ET, Johnson SL, Joseph RM, Karagas M, Kelly RS, Lester BM, Margolis A, McEvoy CT, Messinger D, Neiderhiser JM, O’Connor TG, Oken E, Sathyanarayana S, Schmidt RJ, Sheinkopf SJ, Talge NM, Turi KN, Wright RJ, Zhao Q, Newschaffer C, Volk HE, Ladd-Acosta C, Environmental Influences on Child Health Outcomes OBOPCF. Cardiometabolic Pregnancy Complications in Association With Autism-Related Traits as Measured by the Social Responsiveness Scale in ECHO. Am J Epidemiol 2022; 191:1407-1419. [PMID: 35362025 PMCID: PMC9614927 DOI: 10.1093/aje/kwac061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 03/07/2022] [Accepted: 03/25/2022] [Indexed: 01/28/2023] Open
Abstract
Prior work has examined associations between cardiometabolic pregnancy complications and autism spectrum disorder (ASD) but not how these complications may relate to social communication traits more broadly. We addressed this question within the Environmental Influences on Child Health Outcomes program, with 6,778 participants from 40 cohorts conducted from 1998-2021 with information on ASD-related traits via the Social Responsiveness Scale. Four metabolic pregnancy complications were examined individually, and combined, in association with Social Responsiveness Scale scores, using crude and adjusted linear regression as well as quantile regression analyses. We also examined associations stratified by ASD diagnosis, and potential mediation by preterm birth and low birth weight, and modification by child sex and enriched risk of ASD. Increases in ASD-related traits were associated with obesity (β = 4.64, 95% confidence interval: 3.27, 6.01) and gestational diabetes (β = 5.21, 95% confidence interval: 2.41, 8.02), specifically, but not with hypertension or preeclampsia. Results among children without ASD were similar to main analyses, but weaker among ASD cases. There was not strong evidence for mediation or modification. Results suggest that common cardiometabolic pregnancy complications may influence child ASD-related traits, not only above a diagnostic threshold relevant to ASD but also across the population.
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Affiliation(s)
- Kristen Lyall
- Correspondence to Dr. Kristen Lyall, 3020 Market Street, Suite 560, Philadelphia, PA 19104 (e-mail: )
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10
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Blackwell CK, Mansolf M, Sherlock P, Ganiban J, Hofheimer JA, Barone CJ, Bekelman TA, Blair C, Cella D, Collazo S, Croen LA, Deoni S, Elliott AJ, Ferrara A, Fry RC, Gershon R, Herbstman JB, Karagas MR, LeWinn KZ, Margolis A, Miller RL, O’Shea TM, Porucznik CA, Wright RJ. Youth Well-being During the COVID-19 Pandemic. Pediatrics 2022; 149:e2021054754. [PMID: 35301542 PMCID: PMC9169239 DOI: 10.1542/peds.2021-054754] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The family stress model proposes economic hardship results in caregiver distress and relational problems, which negatively impact youth outcomes. We extend this model to evaluate the impact of coronavirus disease 2019 pandemic-related family hardships on caregiver and youth stress, and, in turn, youth's psychological well-being. We also investigate how social supports moderate this relationship. METHODS We used 2 samples of cross-sectional survey data collected between May 2020 and May 2021: children aged 2 to 12 years (n = 977) and adolescents aged 11 to 17 years (n = 669). Variables included pandemic-related family hardships, stress, social support, and youth life satisfaction. Data were analyzed using structural equation modeling. RESULTS Experiencing more pandemic-related family hardships was associated with increased caregiver and youth stress (b = 0.04 to 0.21, SE = 0.01-0.02) and, in turn, decreased youth life satisfaction (b = -0.36 to -0.38, SE = 0.04-0.07). Social connectedness (b^ = 0.11-0.17, SE = 0.04) and family engagement (b^ = 0.12-0.18, SE = 0.05-0.06) had direct positive associations with life satisfaction; for children aged 2 to 12 years, greater family engagement was associated with decreased effect of child stress on life satisfaction (b^ = 0.15, SE = 0.05). For adolescents, females had higher levels of stress compared with males (b^ = 0.40, SE = 0.6), and having anxiety and/or depression was associated with decreased life satisfaction (b^ = -0.24, SE = 0.11). CONCLUSIONS Caregivers and youth who experienced more coronavirus disease 2019 pandemic hardships had higher levels of stress, particularly adolescent females. Although stress negatively impacted life satisfaction across all ages, family engagement was a protective factor for children aged 2 to 12 years, whereas having anxiety and/or depression was a risk factor for adolescents. For all youth, however, being more socially connected and engaged with family promoted life satisfaction.
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Affiliation(s)
- Courtney K. Blackwell
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Maxwell Mansolf
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Phillip Sherlock
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Jody Ganiban
- Department of Psychology & Brain Sciences, Columbian School of Arts and Sciences, George Washington University, Washington, DC
| | | | - Charles J. Barone
- Department of Pediatrics, Henry Ford Health System, Detroit, Michigan; School of Medicine, Wayne State University, Detroit, Michigan
| | | | - Clancy Blair
- New York University Langone Health, New York, New York
| | - David Cella
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Shaina Collazo
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Lisa A. Croen
- Kaiser Permanente North California, Oakland, California
| | - Sean Deoni
- Rhode Island Hospital, Brown University, Providence, Rhode Island
| | - Amy J. Elliott
- Avera Research Institute & Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, South Dakota
| | | | - Rebecca C. Fry
- University of North Carolina, Chapel Hill, North Carolina
| | - Richard Gershon
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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11
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Volk HE, Perera F, Braun JM, Kingsley SL, Gray K, Buckley J, Clougherty JE, Croen LA, Eskenazi B, Herting M, Just AC, Kloog I, Margolis A, McClure LA, Miller R, Levine S, Wright R. Prenatal air pollution exposure and neurodevelopment: A review and blueprint for a harmonized approach within ECHO. Environ Res 2021; 196:110320. [PMID: 33098817 PMCID: PMC8060371 DOI: 10.1016/j.envres.2020.110320] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 10/01/2020] [Accepted: 10/08/2020] [Indexed: 05/09/2023]
Abstract
BACKGROUND Air pollution exposure is ubiquitous with demonstrated effects on morbidity and mortality. A growing literature suggests that prenatal air pollution exposure impacts neurodevelopment. We posit that the Environmental influences on Child Health Outcomes (ECHO) program will provide unique opportunities to fill critical knowledge gaps given the wide spatial and temporal variability of ECHO participants. OBJECTIVES We briefly describe current methods for air pollution exposure assessment, summarize existing studies of air pollution and neurodevelopment, and synthesize this information as a basis for recommendations, or a blueprint, for evaluating air pollution effects on neurodevelopmental outcomes in ECHO. METHODS We review peer-reviewed literature on prenatal air pollution exposure and neurodevelopmental outcomes, including autism spectrum disorder, attention deficit hyperactivity disorder, intelligence, general cognition, mood, and imaging measures. ECHO meta-data were compiled and evaluated to assess frequency of neurodevelopmental assessments and prenatal and infancy residential address locations. Cohort recruitment locations and enrollment years were summarized to examine potential spatial and temporal variation present in ECHO. DISCUSSION While the literature provides compelling evidence that prenatal air pollution affects neurodevelopment, limitations in spatial and temporal exposure variation exist for current published studies. As >90% of the ECHO cohorts have collected a prenatal or infancy address, application of advanced geographic information systems-based models for common air pollutant exposures may be ideal to address limitations of published research. CONCLUSIONS In ECHO we have the opportunity to pioneer unifying exposure assessment and evaluate effects across multiple periods of development and neurodevelopmental outcomes, setting the standard for evaluation of prenatal air pollution exposures with the goal of improving children's health.
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Affiliation(s)
- Heather E Volk
- Department of Mental Health and Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Frederica Perera
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | | | - Kimberly Gray
- National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Jessie Buckley
- Department of Environmental Health and Engineering and Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jane E Clougherty
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Lisa A Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children's Health, School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Megan Herting
- Department of Preventive Medicine, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, USA
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Amy Margolis
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Leslie A McClure
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Rachel Miller
- Department of Medicine, Department of Pediatrics, The College of Physicians and Surgeons, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Sarah Levine
- Columbia Center for Children's Environmental Health, Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Rosalind Wright
- Department of Environmental Medicine and Public Health, And Pediatrics, Institute for Exposomics Research, Kravis Children's Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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12
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Perzanowski M, Rauh V, Ramphal B, Acosta L, Hoepner L, Perera F, Herbstman J, Miller R, Margolis A. Infant rhinorrhea and watery eyes and adolescent Attention Deficit Hyperactivity Disorder. J Allergy Clin Immunol 2021. [DOI: 10.1016/j.jaci.2020.12.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Abstract
Until recently, federal programs had not explicitly focused on improving the outcomes of highly vulnerable teen parents. Established in 2010, the Pregnancy Assistance Fund (PAF) aims to improve the health, social, educational, and economic outcomes for expectant and parenting teens and young adults, their children, and their families, through providing grants to states and tribes. This article introduces the Maternal and Child Health Journal supplement “Supporting Expectant and Parenting Teens: The Pregnancy Assistance Fund,” which draws together the perspectives of researchers and practitioners to provide insights into serving expectant and parenting teens through the PAF program. The articles in the supplement include examples of programs that use different intervention strategies to support teen parents, with programs based in high school, college, and community settings in both urban and rural locations. Some of the articles provide rigorous evidence of what works to support teen parents. In addition, the articles demonstrate key lessons learned from implementation, including allowing some flexibility in implementation while clearly outlining core programmatic components, using partnerships to meet the multifaceted needs of young parents, hiring the right staff and providing extensive training, using strategies for engaging and recruiting teen parents, and planning for sustainability early. The studies use a range of qualitative and quantitative methods to evaluate programs to support teen parents, and three articles describe how to implement innovative and cost effective methods to evaluate these kinds of programs. By summarizing findings across the supplement, we increase understanding of what is known about serving expectant and parenting teens and point to next steps for future research.
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Affiliation(s)
| | - Susan Zief
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | - Amy Farb
- Office of Population Affairs, Washington, DC, USA
| | - Amy Margolis
- Office of Population Affairs, Washington, DC, USA
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14
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Margolis A, Rice T, Banikya-Leaseburg M, Person AE, Clary E, Zief S, Adamek K, Harding JF. Meeting the Multifaceted Needs of Expectant and Parenting Young Families Through the Pregnancy Assistance Fund. Matern Child Health J 2020; 24:76-83. [PMID: 32385692 PMCID: PMC7497367 DOI: 10.1007/s10995-020-02922-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The Pregnancy Assistance Fund (PAF) program funds states and tribes to provide a wide range of services to improve health, social, educational, and economic outcomes for expectant and parenting teens and young adults, their children, and their families. This introductory article to the Maternal and Child Health Journal supplement Supporting Expectant and Parenting Teens: The Pregnancy Assistance Fund provides a description of the PAF program, including the program goals and structure, participants and communities served, and services provided; presents data on the reach and success of the program; and describes lessons learned from PAF grantees on how to enhance programs and services to have the best outcomes for expectant and parenting young families. METHODS Performance measure data are used to describe the reach and success of the PAF program, and implementation experiences and lessons learned from PAF grantees were gathered through a standardized review of grantee applications and from interviews with grant administrators. RESULTS Since its establishment in 2010, the PAF program has served 109,661 expectant and parenting teens, young adults, and their families across 32 states, including the District of Columbia, and seven tribal organizations; established more than 3400 partnerships; and trained more than 7500 professionals. Expectant and parenting teens and young adults who participated in the PAF program stay in high school, make plans to attend college, and have low rates of repeat pregnancy within a year. CONCLUSIONS Expectant and parenting teens and young adults in the PAF program demonstrated success in meeting their educational goals and preventing repeat unintended pregnancies. In addition, the staff who implemented the PAF programs learned many lessons for how to enhance programs and services to have the best outcomes for expectant and parenting young families, including creating partnerships to meet the multifaceted needs of teen parents and using evidence-based programs to promote program sustainability.
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Affiliation(s)
- Amy Margolis
- Division of Program Development and Operations, Office of Population Affairs, Department of Health and Human Services (HHS), 1101 Wootton Parkway, Suite 200, Rockville, MD, 20850, USA.
| | - Tara Rice
- Division of Program Development and Operations, Office of Population Affairs, Department of Health and Human Services (HHS), 1101 Wootton Parkway, Suite 200, Rockville, MD, 20850, USA
| | - Mousumi Banikya-Leaseburg
- Division of Program Development and Operations, Office of Population Affairs, Department of Health and Human Services (HHS), 1101 Wootton Parkway, Suite 200, Rockville, MD, 20850, USA
| | - Ann E Person
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | | | - Susan Zief
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
| | - Katie Adamek
- Mathematica, P.O. Box 2393, Princeton, NJ, 08543-2393, USA
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Beebe B, Hoven CW, Kaitz M, Steele M, Musa G, Margolis A, Ewing J, Sossin KM, Lee SH. Urgent engagement in 9/11 pregnant widows and their infants: Transmission of trauma. Infancy 2020; 25:165-189. [PMID: 32749044 DOI: 10.1111/infa.12323] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 10/22/2019] [Accepted: 12/19/2019] [Indexed: 11/30/2022]
Abstract
The potential effects of maternal trauma on mother-infant interaction remain insufficiently studied empirically. This study examined the effects of the September 11, 2001, trauma on mother-infant interaction in mothers who were pregnant and widowed on 9/11, and their infants aged 4-6 months. Split-screen videotaped interaction was coded on a one-second basis for infant gaze, facial affect, and vocal affect; and mother gaze, facial affect, and touch. We examined the temporal dynamics of communication: self-contingency and interactive contingency of behavior by time-series methods. We documented heightened maternal and infant efforts at engagement in the 9/11 (vs. control) dyads. Both partners had difficulty tolerating moments of looking away as well as moments of negative behavior patterns. Heightened efforts to maintain a positive visual engagement may be adaptive and a potential source of resilience, but these patterns may also carry risk: working too hard to make it work. A vigilant, hyper-contingent, high-arousal engagement was the central mode of the interpersonal transmission of the trauma to these infants, with implications for intervention.
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Affiliation(s)
- Beatrice Beebe
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Christina W Hoven
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Marsha Kaitz
- Department of Psychology, Hebrew University, Jerusalem, Israel
| | - Miriam Steele
- Department of Psychology, The New School for Social Research, New York, New York
| | - George Musa
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Amy Margolis
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - Julie Ewing
- Department of Psychiatry, New York State Psychiatric Institute, New York, New York
| | - K Mark Sossin
- Department of Psychology, Pace University, New York, New York
| | - Sang Han Lee
- The Nathan Kline Institute, Orangeburg, New York
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Margolis A, Soletic L, Naik K, Wasmuht-Perroud V. A Presurgery Oral Health Clearance Pathway. J Oral Maxillofac Surg 2019. [DOI: 10.1016/j.joms.2019.06.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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17
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Horton MK, Hsu L, Claus Henn B, Margolis A, Austin C, Svensson K, Schnaas L, Gennings C, Hu H, Wright R, Rojo MMT, Arora M. Dentine biomarkers of prenatal and early childhood exposure to manganese, zinc and lead and childhood behavior. Environ Int 2018; 121:148-158. [PMID: 30205321 PMCID: PMC6373872 DOI: 10.1016/j.envint.2018.08.045] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 08/20/2018] [Accepted: 08/20/2018] [Indexed: 05/04/2023]
Abstract
BACKGROUND Metal exposure alters neurodevelopmental outcomes; little is known about critical windows of susceptibility when exposure exerts the strongest effect. OBJECTIVE To examine associations between dentine biomarkers of manganese (Mn), zinc (Zn) and lead (Pb) and later childhood behaviors. METHODS Subjects enrolled in a longitudinal birth cohort study in Mexico City provided naturally shed deciduous teeth. We estimated weekly prenatal and postnatal dentine Mn, Zn and Pb concentrations in teeth using laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS) and measured behavior at ages 8-11 years of age using the Behavior Assessment System for Children, 2nd edition (BASC-2). We used distributed lag models and lagged weighted quantile sum regression to identify the role of individual and combined dentine biomarkers of Mn, Zn and Pb on behavioral outcomes controlling for maternal education and gestational age. RESULTS Among the 133 subjects included in this study, prenatal and early postnatal dentine Mn appeared protective against childhood behavioral problems, specifically hyperactivity and attention. Postnatal dentine Mn was associated with increased reporting of internalizing problems, specifically anxiety. At 6 months, a 1-unit increase (unit = 1 SD of log concentration) in Mn was associated with a 0.18-unit (unit = 1 SD of BASC-2 score) increase in internalizing symptoms score and a 0.25-unit increase in anxiety. Postnatal Pb was associated with increasing anxiety symptoms; at 12 months, a 1-unit increase in Pb was associated with a 0.4 unit increase in anxiety symptoms. When examined as a metal mixture, we observed two potential windows of susceptibility to increased anxiety symptoms: the first window (0-8 months) appeared driven by Mn, the second window (8-12 months) was driven by the metal mixture and dominated by Pb. A 1-unit increase in the mixture index was associated with a 0.7-unit increase in SD of anxiety symptoms. CONCLUSIONS Childhood behaviors may demonstrate postnatal windows of susceptibility to individual and mixed metal concentrations measured in deciduous teeth. Prenatal dentine Mn may be protective, while excessive early postnatal Mn may increase risk for adverse behaviors. In combination, higher concentrations of Mn, Zn and Pb may have an adverse impact on behavior.
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Affiliation(s)
- Megan K Horton
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Birgit Claus Henn
- Department of Environmental Health, Boston University School of Public Health, 715 Albany St., Boston, MA 02118, United States of America
| | - Amy Margolis
- Division of Child and Adolescent Psychiatry, Columbia University Medical Center, 1051 Riverside Drive New York, New York 10032, United States of America
| | - Christine Austin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Katherine Svensson
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Lourdes Schnaas
- Division of Research in Community Interventions, Instituto Nacional de Perinatología, Montes Urales 800, Lomas Virreyes, Mexico City CP 11000, Mexico
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Howard Hu
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6(th) floor, Toronto M5T 3M7, Canada
| | - Robert Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
| | - Martha María Téllez Rojo
- Center for Nutrition and Health Research, National Institute of Public Health (Mexico), Universidad 655, Cuernavaca 62100, Mexico.
| | - Manish Arora
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1057, New York, NY 10029, United States of America
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Cowell WJ, Margolis A, Rauh VA, Sjödin A, Jones R, Wang Y, Garcia W, Perera F, Wang S, Herbstman JB. Associations between prenatal and childhood PBDE exposure and early adolescent visual, verbal and working memory. Environ Int 2018; 118:9-16. [PMID: 29787900 PMCID: PMC6460908 DOI: 10.1016/j.envint.2018.05.004] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/12/2018] [Accepted: 05/01/2018] [Indexed: 05/19/2023]
Abstract
BACKGROUND Prenatal and childhood exposure to polybrominated diphenyl ether (PBDE) flame retardants has been inversely associated with cognitive performance, however, few studies have measured PBDE concentrations in samples collected during both prenatal and postnatal periods. METHODS We examined prenatal (cord) and childhood (ages 2, 3, 5, 7 and 9 years) plasma PBDE concentrations in relation to memory outcomes assessed between the ages of 9 and 14 years. The study sample includes a subset (n = 212) of the African American and Dominican children enrolled in the Columbia Center for Children's Environmental Health Mothers and Newborns birth cohort. We used multivariable linear regression to examine associations between continuous log10-transformed PBDE concentrations and performance on tests of visual, verbal and working memory in age-stratified models. We additionally used latent class growth analysis to estimate trajectories of exposure across early life, which we analyzed as a categorical variable in relation to memory outcomes. We examined interactions between PBDE exposure and sex using cross-product terms. RESULTS Associations between prenatal exposure and working memory significantly varied by sex (p-interaction = 0.02), with inverse relations observed only among girls (i.e. βBDE-47 = -7.55, 95% CI: -13.84, -1.24). Children with sustained high concentrations of BDEs-47, 99 or 100 across childhood scored approximately 5-8 standard score points lower on tests of visual memory. Children with PBDE plasma concentrations that peaked during toddler years performed better on verbal domains, however, these associations were not statistically significant. CONCLUSIONS Exposure to PBDEs during both prenatal and postnatal periods may disrupt memory domains in early adolescence. These findings contribute to a substantial body of evidence supporting the developmental neurotoxicity of PBDEs and underscore the need to reduce exposure among pregnant women and children.
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Affiliation(s)
- Whitney J Cowell
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Amy Margolis
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Child and Adolescent Psychiatry, Columbia University, New York, NY 10032, USA
| | - Virginia A Rauh
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Andreas Sjödin
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Richard Jones
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Ya Wang
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Wanda Garcia
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Heilbrunn Department of Population and Family Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Frederica Perera
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Shuang Wang
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Julie B Herbstman
- Columbia Center for Children's Environmental Health, Mailman School of Public Health, Columbia University, New York, NY 10032, USA; Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.
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Bates DW, Baysari MT, Dugas M, Haefeli WE, Kushniruk AW, Lehmann CU, Liu J, Mantas J, Margolis A, Miyo K, Nohr C, Peleg M, de Quirós FGB, Slight SP, Starmer J, Takabayashi K, Westbrook JI. Discussion of “Attitude of Physi -cians Towards Automatic Alerting in Computerized Physician Order Entry Systems”. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1627055] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
With these comments on the paper “Attitude of Physicians Towards Automatic Alerting in Computerized Physician Order Entry Systems”, written by Martin Jung and co authors, with Dr. Elske Ammenwerth as senior author [1], the journal wants to stimulate a broad discussion on computerized physi cian order entry systems. An international group of experts have been invited by the editor of Methods to comment on this paper. Each of the invited commentaries forms one section of this paper.
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Hopson MB, Margolis A, Rauh V, Herbstman J. Impact of the home environment on the relationship between prenatal exposure to environmental tobacco smoke and child behavior. Int J Child Health Hum Dev 2016; 9:453-464. [PMID: 28845210 PMCID: PMC5570618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The goal of this study was to ascertain whether the effect of prenatal ETS exposure on behavioral symptoms at age 7 years is modified by the quality of the home environment. In a cohort of 417 children enrolled in a longitudinal birth cohort in New York City, prenatal ETS exposure, child behavior and home environment were assessed. Prenatal ETS was measured by questionnaire and blood cotinine. Child Behavior Checklist (CBCL) and Early Childhood HOME Inventory Scale (HOME) were also used. We detected a significant interaction between prenatal ETS exposure and living in a "better" home environment on reported problems in the rule breaking and externalizing domains (p-value for interaction terms: 0.002 and 0.04, respectively), such that there was no significant adverse impact of ETS exposure on behavior among those who experienced a "better" environment. We also detected a significant interaction between prenatal ETS exposure and living in a "worse" home environment on reported problems in the aggressive and externalizing domains (p-value for interaction terms: 0.03 and 0.02, respectively), such that there was a significant adverse effect of ETS exposure on behavior among children who experienced a "worse" environment. Aspects of the HOME environment, both positive and negative, moderated the effects of prenatal ETS exposure on selected behaviors at 7 years of age. This finding suggests that some negative developmental behavioral effects associated with ETS exposure early in life may be modified by the provision of an enriched learning environment as measured by the HOME inventory.
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Affiliation(s)
- Madeleine B Hopson
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, United States of America
| | - Amy Margolis
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, United States of America
| | - Virginia Rauh
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, United States of America
| | - Julie Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, United States of America
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Abstract
Principles of a dynamic, dyadic systems view of mother-infant face-to-face communication, which considers self- and interactive processes in relation to one another, were tested. The process of interaction across time in a large low-risk community sample at infant age 4 months was examined. Split-screen videotape was coded on a 1-s time base for communication modalities of attention, affect, orientation, touch, and composite facial-visual engagement. Time-series approaches generated self- and interactive contingency estimates in each modality. Evidence supporting the following principles was obtained: (a) Significant moment-to-moment predictability within each partner (self-contingency) and between the partners (interactive contingency) characterizes mother-infant communication. (b) Interactive contingency is organized by a bidirectional, but asymmetrical, process: Maternal contingent coordination with infant is higher than infant contingent coordination with mother. (c) Self-contingency organizes communication to a far greater extent than interactive contingency. (d) Self- and interactive contingency processes are not separate; each affects the other in communication modalities of facial affect, facial-visual engagement, and orientation. Each person's self-organization exists in a dynamic, homoeostatic (negative feedback) balance with the degree to which the person coordinates with the partner. For example, those individuals who are less facially stable are likely to coordinate more strongly with the partner's facial affect and vice versa. Our findings support the concept that the dyad is a fundamental unit of analysis in the investigation of early interaction. Moreover, an individual's self-contingency is influenced by the way the individual coordinates with the partner. Our results imply that it is not appropriate to conceptualize interactive processes without simultaneously accounting for dynamically interrelated self-organizing processes.
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Affiliation(s)
- Beatrice Beebe
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute
| | | | | | - Amy Margolis
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute
| | - Karen A Buck
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute
| | - Henian Chen
- Department of Epidemiology and Biostatistics, University of South Florida
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Roen EL, Wang Y, Calafat AM, Wang S, Margolis A, Herbstman J, Hoepner LA, Rauh V, Perera FP. Bisphenol A exposure and behavioral problems among inner city children at 7-9 years of age. Environ Res 2015; 142:739-45. [PMID: 25724466 PMCID: PMC4545741 DOI: 10.1016/j.envres.2015.01.014] [Citation(s) in RCA: 110] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 01/14/2015] [Accepted: 01/16/2015] [Indexed: 05/22/2023]
Abstract
BACKGROUND Bisphenol A (BPA) is a ubiquitous endocrine disrupting compound. Several experimental and epidemiological studies suggest that gestational BPA exposure can lead to neurodevelopmental and behavioral problems in early-life, but results have been inconsistent. We previously reported that prenatal BPA exposure may affect child behavior and differently among boys and girls at ages 3-5 years. OBJECTIVES We investigated the association of prenatal and early childhood BPA exposure with behavioral outcomes in 7-9 year old minority children and hypothesized that we would observe the same sex-specific pattern observed at earlier ages. METHODS African-American and Dominican women enrolled in an inner-city prospective cohort study and their children were followed from mother's pregnancy through children's age 7-9 years. Women during the third trimester of pregnancy and children at ages 3 and 5 years provided spot urine samples. BPA exposure was categorized by tertiles of BPA urinary concentrations. The Child Behavioral Checklist (CBCL) was administered at ages 7 and 9 to assess multiple child behavior domains. Associations between behavior and prenatal (maternal) BPA concentrations and behavior and postnatal (child) BPA concentration were assessed via Poisson regression in models stratified by sex. These models accounted for potential confounders including prenatal or postnatal urinary BPA concentrations, child age at CBCL assessment, ethnicity, gestational age, maternal intelligence, maternal education and demoralization, quality of child's home environment, prenatal environmental tobacco smoke exposure, and prenatal mono-n-butyl phthalate concentration. RESULTS The direction of the associations differed between boys and girls. Among boys (n=115), high prenatal BPA concentration (upper tertile vs. lower two tertiles) was associated with increased internalizing (β=0.41, p<0.0001) and externalizing composite scores (β=0.40, p<0.0001) and with their corresponding individual syndrome scales. There was a general decrease in scores among girls that was significant for the internalizing composite score (β=-0.17, p=0.04) (n=135). After accounting for possible selection bias, the results remained consistent for boys. Conversely, high postnatal BPA concentration was associated with increased behaviors on both the internalizing composite (β=0.30, p=0.0002) and externalizing composite scores (β=0.33, p<0.0001) and individual subscores in girls but fewer symptoms in boys. These results remained significant in girls after accounting for selection bias. CONCLUSION These results suggest BPA exposure may affect childhood behavioral outcomes in a sex-specific manner and differently depending on timing of exposure.
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Affiliation(s)
- Emily L Roen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722W. 168th St., New York, NY 10032, USA
| | - Ya Wang
- Columbia Center for Children's Environmental Health, Columbia University, 722W. 168th St., New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, 722W. 168th St., New York, NY 10032, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Hwy, MS F53, Atlanta, GA 30341, USA
| | - Shuang Wang
- Columbia Center for Children's Environmental Health, Columbia University, 722W. 168th St., New York, NY 10032, USA; Department of Biostatistics, Mailman School of Public Health, Columbia University, 722W. 168th St., New York, NY 10032, USA
| | - Amy Margolis
- Columbia Center for Children's Environmental Health, Columbia University, 722W. 168th St., New York, NY 10032, USA; Division of Child & Adolescent Psychiatry and the Center for Developmental Neuropsychiatry, Department of Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, 1051 Riverside Drive, New York, NY 10032, USA
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722W. 168th St., New York, NY 10032, USA
| | - Lori A Hoepner
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722W. 168th St., New York, NY 10032, USA
| | - Virginia Rauh
- Columbia Center for Children's Environmental Health, Columbia University, 722W. 168th St., New York, NY 10032, USA; The Heilbrunn Department of Population and Family Health, Columbia University, 60 Haven Avenue, New York, NY 10032, USA
| | - Frederica P Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722W. 168th St., New York, NY 10032, USA; Columbia Center for Children's Environmental Health, Columbia University, 722W. 168th St., New York, NY 10032, USA.
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Davis K, Margolis A. B-106Understanding and Treating Learning Disorders. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Perera FP, Chang HW, Tang D, Roen EL, Herbstman J, Margolis A, Huang TJ, Miller RL, Wang S, Rauh V. Early-life exposure to polycyclic aromatic hydrocarbons and ADHD behavior problems. PLoS One 2014; 9:e111670. [PMID: 25372862 PMCID: PMC4221082 DOI: 10.1371/journal.pone.0111670] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/06/2014] [Indexed: 12/25/2022] Open
Abstract
Importance Polycyclic aromatic hydrocarbons are widespread urban air pollutants from combustion of fossil fuel and other organic material shown previously to be neurotoxic. Objective In a prospective cohort study, we evaluated the relationship between Attention Deficit Hyperactivity Disorder behavior problems and prenatal polycyclic aromatic hydrocarbon exposure, adjusting for postnatal exposure. Materials and Methods Children of nonsmoking African-American and Dominican women in New York City were followed from in utero to 9 years. Prenatal polycyclic aromatic hydrocarbon exposure was estimated by levels of polycyclic aromatic hydrocarbon- DNA adducts in maternal and cord blood collected at delivery. Postnatal exposure was estimated by the concentration of urinary polycyclic aromatic hydrocarbon metabolites at ages 3 or 5. Attention Deficit Hyperactivity Disorder behavior problems were assessed using the Child Behavior Checklist and the Conners Parent Rating Scale- Revised. Results High prenatal adduct exposure, measured by elevated maternal adducts was significantly associated with all Conners Parent Rating Scale-Revised subscales when the raw scores were analyzed continuously (N = 233). After dichotomizing at the threshold for moderately to markedly atypical symptoms, high maternal adducts were significantly associated with the Conners Parent Rating Scale-Revised DSM-IV Inattentive (OR = 5.06, 95% CI [1.43, 17.93]) and DSM-IV Total (OR = 3.37, 95% CI [1.10, 10.34]) subscales. High maternal adducts were positivity associated with the DSM-oriented Attention Deficit/Hyperactivity Problems scale on the Child Behavior Checklist, albeit not significant. In the smaller sample with cord adducts, the associations between outcomes and high cord adduct exposure were not statistically significant (N = 162). Conclusion The results suggest that exposure to polycyclic aromatic hydrocarbons encountered in New York City air may play a role in childhood Attention Deficit Hyperactivity Disorder behavior problems.
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Affiliation(s)
- Frederica P. Perera
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
- * E-mail:
| | - Hsin-wen Chang
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Deliang Tang
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
| | - Emily L. Roen
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
| | - Julie Herbstman
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
| | - Amy Margolis
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
- Division of Child & Adolescent Psychiatry and the Center for Developmental Neuropsychiatry, Department of Psychiatry, the New York State Psychiatric Institute and the College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Tzu-Jung Huang
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Rachel L. Miller
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
- Division of Pulmonary, Allergy and Critical Care of Medicine, Department of Medicine, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Shuang Wang
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Virginia Rauh
- Columbia Center for Children's Environmental Health, Columbia University, New York, New York, United States of America
- The Heilbrunn Department of Population and Family Health, Columbia University, New York, New York, United States of America
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Bates DW, Baysari MT, Dugas M, Haefeli WE, Kushniruk AW, Lehmann CU, Liu J, Mantas J, Margolis A, Miyo K, Nohr C, Peleg M, de Quirós FGB, Slight SP, Starmer J, Takabayashi K, Westbrook JI. Discussion of "Attitude of physicians towards automatic alerting in computerized physician order entry systems". Methods Inf Med 2013; 52:109-127. [PMID: 23508343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
With these comments on the paper "Attitude of Physicians Towards Automatic Alerting in Computerized Physician Order Entry Systems", written by Martin Jung and co-authors, with Dr. Elske Ammenwerth as senior author [1], the journal wants to stimulate a broad discussion on computerized physician order entry systems. An international group of experts have been invited by the editor of Methods to comment on this paper. Each of the invited commentaries forms one section of this paper.
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Affiliation(s)
- D W Bates
- Centre for Patient Safety Research and Practice, Division of General Internal Medicine and Primary Care, Brigham and Women’s Hospital, Boston, Massachusetts 02120, USA.
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D'Anna L, Margolis A, Warner L, Korosteleva O, O'Donnell L, Rietmeijer C, Klausner J, Malotte CK. P2-S4.10 Characteristics associated with condom breakage/slippage or partial use during vaginal sex with main and non-main partners: findings from the Safe City Project Study. Br J Vener Dis 2011. [DOI: 10.1136/sextrans-2011-050108.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beebe B, Steele M, Jaffe J, Buck KA, Chen H, Cohen P, Kaitz M, Markese S, Andrews H, Margolis A, Feldstein S. MATERNAL ANXIETY SYMPTOMS AND MOTHER-INFANT SELF- AND INTERACTIVE CONTINGENCY. Infant Ment Health J 2011; 32:174-206. [PMID: 25983359 DOI: 10.1002/imhj.20274] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Associations of maternal self-report anxiety-related symptoms with mother-infant 4-month face-to-face play were investigated in 119 pairs. Attention, affect, spatial orientation, and touch were coded from split-screen videotape on a 1-s time base. Self- and interactive contingency were assessed by time-series methods. Because anxiety symptoms signal emotional dysregulation, we expected to find atypical patterns of mother-infant interactive contingencies, and of degree of stability/lability within an individual's own rhythms of behavior (self-contingencies). Consistent with our optimum midrange model, maternal anxiety-related symptoms biased the interaction toward interactive contingencies that were both heightened (vigilant) in some modalities and lowered (withdrawn) in others; both may be efforts to adapt to stress. Infant self-contingency was lowered ("destabilized") with maternal anxiety symptoms; however, maternal self-contingency was both lowered in some modalities and heightened (overly stable) in others. Interactive contingency patterns were characterized by intermodal discrepancies, confusing forms of communication. For example, mothers vigilantly monitored infants visually, but withdrew from contingently coordinating with infants emotionally, as if mothers were "looking through" them. This picture fits descriptions of mothers with anxiety symptoms as overaroused/fearful, leading to vigilance, but dealing with their fear through emotional distancing. Infants heightened facial affect coordination (vigilance), but dampened vocal affect coordination (withdrawal), with mother's face-a pattern of conflict. The maternal and infant patterns together generated a mutual ambivalence.
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Smith LA, Colson ER, Rybin D, Margolis A, Colton T, Lister G, Corwin MJ. Maternal assessment of physician qualification to give advice on AAP-recommended infant sleep practices related to SIDS. Acad Pediatr 2010; 10:383-8. [PMID: 21075318 PMCID: PMC3209617 DOI: 10.1016/j.acap.2010.08.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 08/08/2010] [Accepted: 08/10/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The American Academy of Pediatrics (AAP) strongly recommends the supine-only sleep position for infants and issued 2 more sudden infant death syndrome (SIDS) reduction recommendations: avoid bed sharing and use pacifiers during sleep. In this study, we investigated the following: 1) if mothers from at risk populations rate physicians as qualified to give advice about sleep practices and 2) if these ratings were associated with reports of recommended practice. METHODS A cross-sectional survey of mothers (N=2355) of infants aged <8 months was conducted at Women, Infants, and Children (WIC) Program centers in 6 cities from 2006 to 2008. The predictor measures were maternal rating of physician qualification to give advice about 3 recommended sleep practices and reported nature of physician advice. The dependent measures were maternal report of usage of recommended behavior: 1) "infant usually placed supine for sleep," 2) "infant usually does not share a bed with an adult during sleep," and 3) "infant usually uses a pacifier during sleep." RESULTS Physician qualification ratings varied by topic: sleep position (80%), bed sharing (69%), and pacifier use (60%). High ratings of physician qualification were associated with maternal reports of recommended behavior: supine sleep (adjusted odds ratio [AOR] 2.1, 95% confidence interval [CI], 1.6-2.6); usually no bed sharing (AOR 1.5, 95% CI, 1.2-1.9), and usually use a pacifier during sleep (AOR 1.2, 95% CI, 1.0-1.5). CONCLUSIONS High maternal ratings of physician qualification to give advice on 2 of the 3 recommended sleep practices targeted to reduce the risk of SIDS were significantly associated with maternal report of using these behaviors. Lower ratings of physician qualification to give advice about these sleep practices may undermine physician effectiveness in promoting the recommended behavior.
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Affiliation(s)
- Lauren A Smith
- Department of Pediatrics, Boston University School of Medicine, Boston, Mass, USA.
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Vero A, Bessonart L, Barbiel A, Ferla M, Margolis A. Health Information Systems Training for a Countrywide Implementation in Uruguay. Yearb Med Inform 2009. [DOI: 10.1055/s-0038-1638655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Summary
Objectives Health Information systems training is one of the bottlenecks in clinical systems implementation. In this article, a strategy to massively create and train interdisciplinary coordinating teams is described for a project in Uruguay at FEMI, a non-academic setting which includes 23 health care institutions across the country and a tertiary referral center in Montevideo.
Methods A series of educational activities were designed for the local coordinating teams. They included both onsite and online formats, site visits, integrated with some of the project tasks.
Results In total, 128 professionals from all the Institutions participated in one or more of the training sessions (onsite and online) and 87 of them accomplished one of the forms of training.
Conclusions Massive basic health informatics training was possible in Uruguay through collaboration with academic institutions at the country and regional level. Next steps include an active involvement of nurses in the educational events and planning of massive training of end users.
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Margolis A, Vero A, Bessonart L, Barbiel A, Ferla M. Health information systems training for a countrywide implementation in Uruguay. Yearb Med Inform 2009:153-157. [PMID: 19855889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
OBJECTIVES Health Information systems training is one of the bottlenecks in clinical systems implementation. In this article, a strategy to massively create and train interdisciplinary coordinating teams is described for a project in Uruguay at FEMI, a non-academic setting which includes 23 health care institutions across the country and a tertiary referral center in Montevideo. METHODS A series of educational activities were designed for the local coordinating teams. They included both onsite and online formats, site visits, integrated with some of the project tasks. RESULTS In total, 128 professionals from all the Institutions participated in one or more of the training sessions (onsite and online) and 87 of them accomplished one of the forms of training. CONCLUSIONS Massive basic health informatics training was possible in Uruguay through collaboration with academic institutions at the country and regional level. Next steps include an active involvement of nurses in the educational events and planning of massive training of end users.
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Affiliation(s)
- A Margolis
- Federación Médica del Interior, Cufré 1781, Montevideo Uruguay CP 11200.
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Colson ER, Levenson S, Rybin D, Calianos C, Margolis A, Colton T, Lister G, Corwin MJ. Barriers to following the supine sleep recommendation among mothers at four centers for the Women, Infants, and Children Program. Pediatrics 2006; 118:e243-50. [PMID: 16882769 DOI: 10.1542/peds.2005-2517] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The risk for sudden infant death syndrome in black infants is twice that of white infants, and their parents are less likely to place them in the supine position for sleep. We previously identified barriers for parents to follow recommendations for sleep position. Our objective with this study was to quantify these barriers, particularly among low-income, primarily black mothers. DESIGN/METHODS We conducted face-to-face interviews with 671 mothers, 64% of whom were black, who attended Women, Infants, and Children Program centers in Boston, Massachusetts, Dallas, Texas, Los Angeles, California, and New Haven, Connecticut. We used univariate analyses to quantify factors that were associated with choice of sleeping position and multivariate logistic regression to calculate adjusted odds ratios for the 2 outcome variables: "ever" (meaning usually, sometimes, or last night) put infant in the prone position for sleep and "usually" put infant in the supine position to sleep. RESULTS Fifty-nine percent of mothers reported supine, 25% side, 15% prone, and 1% other as the usual position. Thirty-four percent reported that they ever placed infants in the prone position. Seventy-two percent said that a nurse, 53% a doctor, and 38% a female friend or relative provided source of advice. Only 42% reported that a nurse, only 36% a doctor, and only 15% a female friend or relative recommended the supine position for sleep. When a female friend or relative recommended the prone position, mothers were more likely ever to place their infants in the prone position and less likely usually to choose supine compared with those who received no advice from friends or relatives. When a doctor or a nurse recommended a nonsupine position, the mothers were less likely to choose supine compared with those who received no advice from a doctor or a nurse. Mothers who trusted the opinion of a doctor or a nurse about infant sleeping position were more likely to place their infants in the supine position. Half of the mothers believed that infants were more likely to choke when supine, and they were less likely to place their infants supine. Mothers who believed that infants are more comfortable in the prone position (36%) were more likely to place their infants prone. Twenty-nine percent believed that having their infants sleep with an adult helps prevent sudden infant death syndrome, and only 43% believed that sudden infant death syndrome is related to sleeping position. CONCLUSIONS We identified specific barriers to placing infants in the supine position for sleep (lack of or wrong advice, lack of trust in providers, knowledge and concerns about safety and comfort) in low-income, primarily black mothers that should be considered when designing interventions to get more infants onto their back for sleep.
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Affiliation(s)
- Eve R Colson
- Department of Pediatrics, School of Medicine, Yale University, New Haven, Connecticut, USA.
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Abstract
The prefrontal cortex (PFC) is relatively smaller, and the corpus callosum (CC) larger, in adults with Tourette syndrome (TS). The authors explored the possible roles of the PFC and the CC in mediating interhemispheric interference and coordination in TS adults. They measured performance on M. Kinsbourne and J. Cook's (1971) verbal-manual interference task and on the bimanual Purdue Pegboard in 38 adults with TS and 34 healthy adults. Compared with controls, TS subjects were impaired on the bimanual Purdue Pegboard. On the dual task, right-hand performance did not differ between groups, but the normally expected left-hand advantage (opposite hemisphere condition) was absent in TS subjects. In the control group only, better left-hand performance accompanied larger PFC volumes but not CC cross-sectional area. PFC dysfunction might have precluded executive control of interference in the TS group.
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Affiliation(s)
- Amy Margolis
- Brooklyn Learning Center, Brooklyn, NY 10032, USA
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Naglieri JA, Drasgow F, Schmit M, Handler L, Prifitera A, Margolis A, Velasquez R. Psychological Testing on the Internet: New Problems, Old Issues. American Psychologist 2004; 59:150-62. [PMID: 15222858 DOI: 10.1037/0003-066x.59.3.150] [Citation(s) in RCA: 134] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Internet has significantly changed the way people conduct business, communicate, and live. In this article, the authors' focus is on how the Internet influences the practice of psychology as it relates to testing and assessment. The report includes 5 broad sections: background and context, new problems yet old issues, issues for special populations, ethical and professional issues, and recommendations for the future. Special attention is paid to implications for people with disabling conditions and culturally and linguistically diverse persons. The authors conclude that ethical responsibilities of psychologists and current psychometric standards, particularly those regarding test reliability and validity, apply even though the way in which the tests are developed and used may be quite different.
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Affiliation(s)
- Jack A Naglieri
- Department of Psychology, George Mason University, Fairfax, VA, USA.
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Langerman L, Steingart RA, Margolis A, Yanai J. A method of reducing the opioid withdrawal intensity using progressively increasing doses of naloxone. J Pharmacol Toxicol Methods 1999; 42:115-9. [PMID: 10964008 DOI: 10.1016/s1056-8719(00)00039-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We assessed the withdrawal intensity in acutely morphine-dependent mice using a pretreatment with escalating doses of naloxone. All animals received a single dose of morphine (100 mg/kg) for the induction of acute opioid dependency. Group 1 (control) received three injections of normal saline and then naloxone 0.8 mg/kg. Group 2 received increasing pretreatment doses of naloxone (0.1, 0.2, and 0.4 mg/kg) and a challenge dose of 0.8 mg/kg. Group 3 received three injections of naloxone 0.1 mg/kg and a challenge dose of 0.8 mg/kg. Groups 4 and 5 were used to verify whether ED(50) found in previous studies was comparable with values obtained in the current experiments. The withdrawal intensity was determined by the number of jumps. The mice of group 1 exhibited significantly more jumps after 0.8 mg/kg of naloxone as compared with group 2. The number of jumps in response to naloxone between groups 1 and 2 and groups 2 and 3 was not significantly different. The results show that pretreatment with increasing naloxone doses significantly reduced the withdrawal intensity as compared with the control group; whereas pretreatment with repeated low antagonist did not reduce it significantly.
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Affiliation(s)
- L Langerman
- Ross Laboratory, Department of Anatomy and Cell Embryology, Hadassah University Hospital, PO Box 12272, 91120, Jerusalem, Israel.
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Margolis A, Vázquez R, Mendoza G, Zignago A, López A, Lucián H. New uses of legacy systems: examples in perinatal care. Proc AMIA Symp 1999:854-8. [PMID: 10566481 PMCID: PMC2232838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023] Open
Abstract
In this article, new uses of the Perinatal Information System at the Uruguayan Social Security health care facilities are described. The perinatal information system has been in place for over 13 years, with about 40 thousand clinical records on electronic files. A newly created Web interface allows a distributed access to existing perinatal information within the National Social Security Wide Area a Network. Perinatal data is also exported to a management information system, allowing to dynamically answer questions and make managerial decisions, and eventually link these data with other sources. Future steps regarding clinical information systems are outlined.
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Affiliation(s)
- A Margolis
- Repartición Prestaciones de Salud, Banco de Previsión Social, Uruguay.
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Abstract
We have previously demonstrated that human fetal epidermal melanocytes are dopa-negative. The present study was conducted to test the hypothesis that human fetal melanocytes can be activated to produce melanin under conditions differing from their natural in utero environment. To address this question, dopa staining activity of fetal epidermal sheets, obtained from seven aborted fetuses with estimated gestational ages of 13-20 weeks, was evaluated before and after engraftment on to nude mice. Dopa staining became positive 7 days post-engraftment. The intensity of the dopa reaction and the mean number of melanocytes increased by day 14 post-engraftment, and these changes were even greater by day 30. These observations indicate that human fetal melanocytes, potentially capable of synthesizing melanin under conditions differing from their normal in utero environment, are either inhibited, or not stimulated to do so.
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Affiliation(s)
- A Gilhar
- Skin Research Laboratory, Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Margolis A, Bray BE, Gilbert EM, Warner HR. Computerized practice guidelines for heart failure management: the HeartMan system. Proc Annu Symp Comput Appl Med Care 1995:228-32. [PMID: 8563274 PMCID: PMC2579089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
In this paper we discuss the initial stages of development and evaluation of the HeartMan system, a set of computerized practice guidelines for heart failure management. The concept of computerized guidelines as a hybrid of expert systems and practice guidelines methodologies and techniques is proposed. We show the results of the initial evaluation of the system, which are very promising, although the sample size is small, and the study is retrospective: Of 177 messages, 90% were considered appropriate, of which 97.5% would have been followed. Eight percent of the messages were classified as neutral, and 2% classified as inappropriate. The errors were correctable by changing the logic. The potential technical and sociological barriers to the complete development and clinical use of the system are discussed.
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Affiliation(s)
- A Margolis
- Department of Medical Informatics, University of Utah, Salt Lake City, USA
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Margolis A, Flores F, Kierszenbaum M, Cavallo Z, Botti B, D'Ottone E, Tavella N, Torres J. Warfarin 2.0--a computer program for warfarin management. Design and clinical use. Proc Annu Symp Comput Appl Med Care 1994:846-50. [PMID: 7950044 PMCID: PMC2247857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Warfarin 2.0 is a computer program that helps physicians optimize treatment of outpatients with warfarin. The main reason for its development was to achieve a good anticoagulation level, avoiding both undertreatment--which causes thromboembolic complications--and overtreatment--which causes hemorrhagic complications. The program was also designed to help educate the anticoagulated patient, standardize warfarin management and audit results of what had been done. The philosophy of continuous quality improvement was applied. Warfarin 2.0 is in clinical operation in the University Hospital, Montevideo, Uruguay, and it has also been used since the end of 1993 in the Favaloro Foundation, Dept. of Hematology, Buenos Aires, Argentina. The results from the first 15 months of use in Montevideo showed an increase in the number of patients being followed (from 91 to 132) and the average number of visits per patient (from one visit every 10.6 weeks to one every 6.5 weeks): The frequency of visits has been in the internationally accepted ranges since the program was implemented. Better anticoagulation levels were achieved after an adjusting period. Unfortunately, the number of undertreated patients is still large, and a thorough analysis of the data is going to be undertaken to continue improving warfarin management.
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Affiliation(s)
- A Margolis
- Clínica Médica C, Hospital de Clínicas, Montevideo, Uruguay
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Abstract
BACKGROUND Although the protective efficacy of pneumococcal polysaccharide vaccine has been demonstrated in randomized trials in young African gold miners, there has been controversy about its efficacy in older Americans at risk for serious pneumococcal infections. To assess the vaccine's protective efficacy against invasive pneumococcal infections, we conducted a hospital-based case-control study of the efficacy of pneumococcal vaccine in adults with a condition recognized to be an indication for receiving the vaccine. METHODS From 1984 to 1990, adults in whom Streptococcus pneumoniae was isolated from any normally sterile site were identified by prospective surveillance in the microbiology laboratories of 11 large hospitals; those with an indication for pneumococcal vaccine were enrolled as case patients. For each case patient, one control was matched according to age, underlying illness, and site of hospitalization. We contacted all providers of medical care to ascertain each subject's history of immunization with pneumococcal vaccine. Isolates of S. pneumoniae were serotyped by an investigator unaware of the subject's vaccination history. RESULTS Thirteen percent of the 1,054 case patients and 20 percent of the 1,054 matched controls had received pneumococcal vaccine (P less than 0.001). When vaccine was given in either its 14-valent or its 23-valent form, its aggregate protective efficacy (calculated as a percentage: 1 minus the odds ratio of having been vaccinated times 100) against infections caused by the serotypes represented in the vaccine was 56 percent (95 percent confidence interval, 42 percent to 67 percent; P less than 0.00001) for all 983 patients infected with a serotype represented in the vaccine, 61 percent for a subgroup of 808 immunocompetent patients (95 percent confidence interval, 47 percent to 72 percent; P less than 0.00001), and 21 percent for a subgroup of 175 immunocompromised patients (95 percent confidence interval, -55 percent to 60 percent; P = 0.48). The vaccine was not efficacious against infections caused by serotypes not represented in the vaccine (protective efficacy, -73 percent; 95 percent confidence interval, -263 percent to 18 percent; P = 0.15). CONCLUSIONS Polyvalent pneumococcal vaccine is efficacious in preventing invasive pneumococcal infections in immunocompetent patients with indications for its administration. This vaccine should be used more widely.
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Affiliation(s)
- E D Shapiro
- Department of Pediatrics, Yale University School of Medicine, New Haven, Conn 06510-8064
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Pothier D, Margolis A. Analysis of growth and light interception of balsam fir and white birch saplings following precommercial thinning. ACTA ACUST UNITED AC 1991. [DOI: 10.1051/forest:19910201] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Horrigan RW, Moyers JR, Johnson BH, Eger EI, Margolis A, Goldsmith S. Etomidate vs. thiopental with and without fentanyl--a comparative study of awakening in man. Anesthesiology 1980; 52:362-4. [PMID: 7362059 DOI: 10.1097/00000542-198004000-00018] [Citation(s) in RCA: 26] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Smotherman WP, Margolis A, Levine S. Flavor preexposures in a conditioned taste aversion situation: a dissociation of behavioral and endocrine effects in rats. J Comp Physiol Psychol 1980; 94:25-35. [PMID: 6246148 DOI: 10.1037/h0077643] [Citation(s) in RCA: 40] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
A series of experiments examined the effects of flavor preexposures on pituitary-adrenal/behavior relations in a conditioned taste aversion paradigm. It was found that reexposure to a novel milk solution paired earlier with lithium chloride (LiCl) elicited conditioned activation of the pituitary-adrenal system (Experiment 1). The unconditioned response to LiCl (measured by changes in plasma levels of corticosterone) did not vary as a function of prior (2 and 5 vs. 10) exposures to the milk solution (Experiment 2). Increased familiarity with the substance (resulting from 10 prior exposures) rendered the conditioning of a taste aversion to this substance less effective. Further, reexposure to this familiar substance after its pairing with LiCl was not accompanied by the characteristic conditioned pituitary-adrenal activation (Experiment 3). By titrating the number of conditioned stimulus (CS) preexposures (Experiment 4) it was found that within the range of preexposures manipulated (5-10), subjects exhibited (a) a coupling of behavioral and pituitary-adrenocortical responses when the conditioned taste aversion to the milk solution was paralleled by elevated plasma corticosterone (5-6 preexposures), (b) a coupling of these two response systems when flavor consumption was accompanied by suppressed plasma titers of corticoids (9-10 preexposures), or (c) a dissociation of the two system when the conditioned taste aversion was not accompanied by conditioned adrenocortical activity (7-8 preexposures). These data are discussed in terms of a dissociation in the effects of CS preexposures on conditioned adrenocortical and behavioral response systems.
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Margolis A, Ricour C, Harouchi A, Guyot M, Laouari D, Balsan S. Intestinal calcium-binding protein 3 months after massive small bowel resection in the piglet. Am J Clin Nutr 1977; 30:2041-6. [PMID: 930874 DOI: 10.1093/ajcn/30.12.2041] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Changes in intestinal calcium-binding protein and calcium binding activity were studied at resection and 3 months after 90% small bowel resection in piglets and one adult pig. A calcium-binding protein (MW congruent to 11.000) with calcium-dependent eletrophoretic mobility was partially purified from mucosal extract of proximal jejunum, mid-gut, and ileum. The concentration of calcium-binding protein and the calcium-binding activity of the intact animals were found highest in the proximal jejunal segment, lowest in the ileal segment. After resection in the four surviving animals out of nine, a significant increase in calcium-binding activity was observed in the proximal jejunum and in the distal ileal segment. The change in calcium-binding activity was much more marked in the ileum than the jejunum. These data demonstrate that pig intestinal mucosa possesses an adaptive capacity to increase the synthesis of calcium-binding protein after massive small bowel resection.
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Margolis A, Kleinknecht C, Bonnissol C, Gaiffe M, Sahyoun S, Broyer M. [Serum antibodies before and after vaccination of hemodialyzed children. Preliminary results]. J Urol Nephrol (Paris) 1977; 83:700-4. [PMID: 926232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Witmer G, Margolis A, Fontaine O, Fritsch J, Lenoir G, Broyer M, Balsan S. Effects of 25-hydroxycholecalciferol on bone lesions of children with terminal renal failure. Kidney Int 1976; 10:395-408. [PMID: 794558 DOI: 10.1038/ki.1976.125] [Citation(s) in RCA: 59] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Quantitative histology was performed on serial iliac crest biopsies obtained from 14 children with terminal renal failure. A long-term study on the comparative effects of vitamin D2 and 25-hydroxycholecalciferol [25-(OH)D3], in five patients with severe lesions of osteomalacia and/or osteitis fibrosa, demonstrated the efficiency of 25 to 200 mug/day of 25-(OH)D3 and the lack of therapeutic action of 345 to 685 mug/day of vitamin D2. In nine subjects with normal roentgenograms or minimal skeletal alterations, the first biopsy taken at the beginning of intermittent hemodialysis showed evidence of defective mineralization and/or lesions of resorption. Four of these children were treated with 25-(OH)D3 (25 to 50 mug/day) and calcium supplementation orally (0.5 to 1.5 g/day); five children received calcium orally (0.5 to 0.75 g/day) alone. Aggravation of bone lesions during intermittent hemodialysis was observed in patients treated with calcium supplements alone. In subjects who were given 25-(OH)D3, mineralization improved and marrow fibrosis disappeared. However, as the two groups of patients were different in composition and in the manner in which they were treated, it is difficult to state whether the beneficial effects observed were solely attributable to 25-(OH)D3 administration. 25-(OH)D3 therapy induced severe intoxication in two patients. A rise in plasma calcium concentration to 11.0 to 11.5 mg/100 ml was observed in two other patients. It is concluded that: a) pharmacologic doses of 25-(OH)D3 are highly effective in healing bone lesions of children with terminal renal failure; b) such treatment requires strict clinical surveillance as 25-(OH)D3 intoxication may occur even in anephric patients.
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Margolis A, Dziatkowiak H, Bugala I, Konopińska A, Borek K, Zalewska K. [Urine acidification ability in infants. II. Urinary excretion of hydrogen ions in infants with diarrhea and chronic metabolic acidosis]. Pediatr Pol 1972; 47:979-83. [PMID: 5074005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Margolis A, Dziatkowiak H, Bugalowa I, Kostenko D. [Bacteriuria in infants following generalized infections]. Pediatr Pol 1972; 47:823-32. [PMID: 5054572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Margolis A, Planeta-Malecka I, Konopińska H, Michalak A. [Study of the calcium-phosphorus metabolism in a case of congenital hypothyroidism associated with urolithiasis]. Pediatr Pol 1970; 45:783-90. [PMID: 5449786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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