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1.
Ashley V. Hill Natacha M. De Genna Maria J. Perez-Patron Tamika D. Gilreath Carmen Tekwe Brandie DePaoli Taylor 《The Journal of adolescent health》2019,64(3):319-326
Purpose
Syndemic theory suggests that the convergence of social, environmental, and ecological factors can interact to exacerbate behavioral health problems and are often intensified by social conditions and disparities. This study used latent class analysis (LCA) to determine gender and racial/ethnic specific classes for sexually transmitted infection (STI) risk.Methods
LCA included 18 measured socioeconomic, depression, substance use, and sexual behavioral variables from 1,664 young adults ages 18–25 in the NHANES. Models were stratified by gender and then by race/ethnicity. Logistic regression determined associations between latent class membership and testing positive for one or more STIs (Chlamydia trachomatis, HIV or herpes simplex virus-II). For each stratified analysis, classes with the lowest probability of reported risk factors in the LCA were the reference groups.Results
Class 3 in females (highest probability of reporting both socioeconomic and behavioral factors) and class 3 in males (majority behavioral factors) had increased odds of STI (females: OR?=?2.7, 95% CI 1.6–4.5; males: OR 2.5, 95% CI 1.3–4.6). By race for females, depression (highest in Hispanics), poverty, and less educated households (highest in blacks and Hispanics) were evident in classes associated with STI. Class 1 black males (majority behavioral factors) had a higher odds of STI compared with low risk white males (OR?=?16.4 95% CI 3.7–72.0) However, no other associations were observed among males.Conclusions
Risk patterns for STI differed by gender and race/ethnicity. Consistent with syndemic theory, effective STI interventions need to address socioeconomic factors and mental health rather than individual behaviors, particularly for minority women. 相似文献2.
Heald Brandie Hampel Heather Church James Dudley Beth Hall Michael J. Mork Maureen E. Singh Aparajita Stoffel Elena Stoll Jessica You Y. Nancy Yurgelun Matthew B. Kupfer Sonia S. 《Familial cancer》2020,19(3):223-239
Familial Cancer - Multigene panel tests for hereditary cancer syndromes are increasingly utilized in the care of colorectal cancer (CRC) and polyposis patients. However, widespread availability of... 相似文献
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Jordana E. Hoppe Brandie D. Wagner Frank J. Accurso Edith T. Zemanick Scott D. Sagel 《Journal of cystic fibrosis》2018,17(6):760-768
Background
Pulmonary exacerbations (PEx) in children with cystic fibrosis (CF) are frequently treated in the outpatient setting with oral antibiotics. However, little is known about the characteristics of PEx managed on an outpatient basis and the effectiveness of oral antibiotic therapy. We sought to prospectively evaluate clinical and laboratory changes associated with oral antibiotic treatment for PEx.Methods
Children with CF between 8 and 18?years of age prescribed two weeks of oral antibiotics for a PEx were eligible to enroll. The study consisted of a visit within 48?h of starting antibiotics and a second visit within one week of antibiotic completion. Twenty-eight participants were evaluated by exacerbation score, quality of life measurements, lung function, sputum microbiology and inflammation.Results
Oral antibiotic treatment was associated with a significant improvement in exacerbation score and quality of life measured by the CF Questionnaire-Revised (CFQ-R) respiratory domain. Following treatment, forced expiratory volume in 1?s (FEV1) % predicted increased [median (range)] 9% (?8%, 31%), and 22 (81%) subjects returned to 90% or higher of baseline FEV1. Bacterial density of the primary organism identified on sputum culture decreased significantly with a median (range) decrease of 0.8 log10 cfu/mL (?8 log10, 2 log10, p?=?0.03). Sputum neutrophil elastase [?37?μg/mL (?464, 272), p?=?0.02] and IL-1β [?2.8?×?103μg/mL (?6.9?×?104, 3.3?×?104), p?=?0.03] decreased significantly following treatment in this cohort.Conclusions
Treatment of PEx with oral antibiotics was associated with measurable improvements in patient reported outcomes, lung function, bacterial density and sputum inflammatory markers. 相似文献6.
Steck AK Wong R Wagner B Johnson K Liu E Romanos J Wijmenga C Norris JM Eisenbarth GS Rewers MJ 《Diabetes》2012,61(3):753-758
We assessed the effects of non-HLA gene polymorphisms on the risk of islet autoimmunity (IA) and progression to type 1 diabetes in the Diabetes Autoimmunity Study in the Young. A total of 1,743 non-Hispanic, white children were included: 861 first-degree relatives and 882 general population children identified as having high-risk HLA-DR/DQ genotypes for type 1 diabetes. Of those, 109 developed IA and 61 progressed to diabetes. Study participants were genotyped for 20 non-HLA polymorphisms, previously confirmed as type 1 diabetes susceptibility loci. PTPN22 and UBASH3A predicted both IA and diabetes in regression models controlling for family history of type 1 diabetes and presence of HLA-DR3/4-DQB1*0302 genotype. In addition, PTPN2 predicted IA whereas INS predicted type 1 diabetes. The final multivariate regression models for both IA and type 1 diabetes included PTPN22, UBASH3A, and INS, in addition to family history of type 1 diabetes and HLA-DR3/4. In general population children, the most frequent combinations including these five significant predictors conferred hazard ratio of up to 13 for IA and >40 for type 1 diabetes. Non-HLA susceptibility alleles may help estimate risk for development of type 1 diabetes in the general population. These findings require replication in different populations. 相似文献
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In spite of limited empirical data to guide their use, nonverbal neuropsychological measures are frequently utilized in the assessment of non-native English speakers in an effort to minimize cultural and linguistic factors that may influence performance. In this study, three groups of participants from different cultural and linguistic backgrounds were compared on two brief, nonverbal substitution tasks sensitive to cerebral dysfunction: WAIS-R Digit Symbol and the Symbol Digit Modalities Test. Within each group, participants exhibited a similar pattern of performance, earning higher scores on Digit Symbol. However, when dominant Spanish speakers were further subdivided into higher and lower education groups, less educated Spanish speakers achieved lower scores compared to all other groups on both tasks, and failed to show the performance advantage for Digit Symbol. In spite of differences in the respective countries of educational experience, the more highly educated dominant Spanish speakers performed as well as monolingual nonHispanic and Hispanic bilingual participants on both tasks. Years of formal education appears to be the most relevant variable in explaining performance differences across cultural and linguistic groups on these tasks. 相似文献
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