An Action Research Collaboration to Promote Mental Wellbeing Among Men of Color

Background: Action research seeks to affect social change by prioritizing partnership and participation. This approach fosters the equitable engagement of marginalized populations in research. In Boston, the marginalization of men of color has resulted in inequitable outcomes in education, employment, health, and other indicators of wellbeing. Objectives: A Boston-based coalition of community organizations was tasked with developing an action plan to promote mental wellbeing among men of color. The coalition engaged in action research to identify the individual, organizational, and community-level factors that contribute to mental wellbeing. Methods: The coalition collected 174 surveys and facilitated focus groups with 55 men. The planning process created valuable opportunities for relationship building and partnership development. Lessons Learned: The planning process reinforced the importance of proactive community engagement, continuous capacity building, inclusive data collection, and cross-sector collaboration.    Conclusions: Centering lived experience resulted in community-driven, culturally sensitive solutions to promote mental wellbeing among men of color

An Action Research Collaboration to Promote Mental Wellbeing Among Men of Color

Background: Action research seeks to affect social change by prioritizing partnership and participation. This approach fosters the equitable engagement of marginalized populations in research. In Boston, the marginalization of men of color has resulted in inequitable outcomes in education, employment, health, and other indicators of wellbeing. Objectives: A Boston-based coalition of community organizations was tasked with developing an action plan to promote mental wellbeing among men of color. The coalition engaged in action research to identify the individual, organizational, and community-level factors that contribute to mental wellbeing. Methods: The coalition collected 174 surveys and facilitated focus groups with 55 men. The planning process created valuable opportunities for relationship building and partnership development. Lessons Learned: The planning process reinforced the importance of proactive community engagement, continuous capacity building, inclusive data collection, and cross-sector collaboration.    Conclusions: Centering lived experience resulted in community-driven, culturally sensitive solutions to promote mental wellbeing among men of color

Childhood Abuse and Age at Menarche

Purpose—Physical and sexual abuse are prevalent social hazards. We sought to examine the association between childhood physical and sexual abuse and age at menarche. Methods—Among 68,505 participants enrolled in the Nurses’ Health Study II we investigated the association between childhood physical abuse and sexual abuse on menarche prior to age 11 (early) or after age 15 (late) using multivariate logistic regression analysis, mutually adjusting for both types of abuse. Results—Fifty-seven percent of respondents reported some form of physical or sexual abuse in childhood. We found a positive dose-response association between severity of sexual abuse in childhood and risk for early menarche. Compared to women who reported no childhood sexual abuse, the adjusted odds ratio [AOR] for early menarche was 1.20 (95% confidence interval [CI], 1.10, 1.37) for sexual touching and 1.49 (95% CI, 1.34, 1.66) for forced sexual activity. Only severe physical abuse predicted early menarche (AOR=1.22, 95% CI, 1.10–1.37). Childhood physical abuse had a dose-response association with late age at menarche: AOR 1.17 (95% CI, 1.04, 1.32) for mild, 1.20 (95% CI, 1.08, 1.33) for moderate, and 1.50 (95% CI, 1.27, 1.77) for severe physical abuse. Sexual abuse was not associated with late menarche. Conclusion—Childhood abuse was very prevalent in this large cohort of U.S. women. Severity of childhood sexual abuse was associated with risk for early onset of menarche, and physical abuse was associated with both early and late onset menarche. Implications and Contribution—The severity of childhood sexual abuse and severe physical abuse were associated with risk for accelerated menarche, while severity of childhood physical was associated with risk for delayed onset of menarche. The nature of the association between different forms of childhood adversities and reproductive lifespan may vary

Child maltreatment and hypertension in young adulthood

Maltreatment during childhood and adolescence has been associated with chronic conditions in adulthood including cardiovascular disease. However, less is known about the effects of childhood maltreatment on cardiovascular risk factors prior to development of cardiovascular disease, or whether these effects are evident in young adulthood. Furthermore, few studies have examined sex differences and most studies have relied on self-reported outcome measures that are subject to misclassification. We examined the relationship between child maltreatment and hypertension in young adulthood in the National Longitudinal Study of Adolescent Health, a nationally representative school-based sample of US adolescents. Participants retrospectively (mean age 29.9, n = 11384) reported on their experiences of child maltreatment prior to the 6th grade (prior to age 11) during follow-up. Child neglect, physical and sexual violence as well as a measure of social services visits to the home were examined. Blood pressure was measured during an in-home visit. Hypertension was defined as measured SBP of at least 140 mmHg or DBP of at least 90 mmHG measured in adulthood, or self-reported use of antihypertensive medications. In adjusted models, women who experienced sexual abuse in early childhood had a higher prevalence of hypertension (Prevalence Ratio (PR) 1.43 95% CI 1.00, 2.05) compared to women who did not experience sexual abuse. Among men, experiencing sexual abuse was not statistically significantly associated with hypertension. Experiencing neglect, physical abuse or having visitations by social services at home during childhood was not associated with hypertension among either women or men. Sexual abuse in early childhood is associated with hypertension in young women

Neighborhood-Level Interventions to Improve Childhood Opportunity and Lift Children Out of Poverty

Abstract Population health is associated with the socioeconomic characteristics of neighborhoods. There is considerable scientific and policy interest in community-level interventions to alleviate child poverty. Intergenerational poverty is associated with inequitable access to opportunities. Improving opportunity structures within neighborhoods may contribute to improved child health and development. Neighborhood-level efforts to alleviate poverty for all children require alignment of cross-sector efforts, community engagement, and multifactorial approaches that consider the role of people as well as place. We highlight several accessible tools and strategies that health practitioners can engage to improve regional and local systems that influence child opportunity. The Child Opportunity Index is a population-level surveillance tool to describe community-level resources and inequities in US metropolitan areas. The case studies reviewed outline strategies for creating higher opportunity neighborhoods for pediatricians interested in working across sectors to address the impact of neighborhood opportunity on child health and well-being

Reframing the early childhood obesity prevention narrative through an equitable nurturing approach

High-quality mother-child interactions during the first 2,000 days, from conception to age 5 years, are considered crucial for preventing obesity development during early life stages. However, mother-child dyads interact within and are influenced by broader socio-ecological contexts involved in shaping child development outcomes, including nutrition. Hence, the coexistence of both undernutrition and obesity has been noted in inequitable social conditions, with drivers of undernutrition and overnutrition in children sharing common elements, such as poverty and food insecurity. To date, a holistic life-course approach to childhood obesity prevention that includes an equitable developmental perspective has not emerged. The World Health Organization (WHO) Nurturing Care Framework provides the foundation for reframing the narrative to understand childhood obesity through the lens of an equitable nurturing care approach to child development from a life-course perspective. In this perspective, we outline our rationale for reframing the childhood narrative by integrating an equitable nurturing care approach to childhood obesity prevention. Four key elements of reframing the narrative include: (a) extending the focus from the current 1,000 to 2,000 days (conception to 5 years); (b) highlighting the importance of nurturing mutually responsive child-caregiver connections to age 5; (c) recognition of racism and related stressors, not solely race/ethnicity, as part of adverse child experiences and social determinants of obesity; and (d) addressing equity by codesigning interventions with socially marginalized families and communities. An equitable, asset-based engagement of families and communities could drive the transformation of policies, systems and social conditions to prevent childhood obesity

Family composition and age at menarche: findings from the international Health Behaviour in School-Aged Children Study

This research was funded by The University of St Andrews and NHS Health Scotland.Background Early menarche has been associated with father absence, stepfather presence and adverse health consequences in later life. This article assesses the association of different family compositions with the age at menarche. Pathways are explored which may explain any association between family characteristics and pubertal timing. Methods Cross-sectional, international data on the age at menarche, family structure and covariates (age, psychosomatic complaints, media consumption, physical activity) were collected from the 2009–2010 Health Behaviour in School-aged Children (HBSC) survey. The sample focuses on 15-year old girls comprising 36,175 individuals across 40 countries in Europe and North America (N = 21,075 for age at menarche). The study examined the association of different family characteristics with age at menarche. Regression and path analyses were applied incorporating multilevel techniques to adjust for the nested nature of data within countries. Results Living with mother (Cohen’s d = .12), father (d = .08), brothers (d = .04) and sisters (d = .06) are independently associated with later age at menarche. Living in a foster home (d = −.16), with ‘someone else’ (d = −.11), stepmother (d = −.10) or stepfather (d = −.06) was associated with earlier menarche. Path models show that up to 89% of these effects can be explained through lifestyle and psychological variables. Conclusions Earlier menarche is reported amongst those with living conditions other than a family consisting of two biological parents. This can partly be explained by girls’ higher Body Mass Index in these families which is a biological determinant of early menarche. Lower physical activity and elevated psychosomatic complaints were also more often found in girls in these family environments.Publisher PDFPeer reviewe

Myomectomy during cesarean delivery

BackgroundThe optimal management of leiomyomas during cesarean delivery is unclear.ObjectivesTo assess the safety of myomectomy performed during cesarean delivery.Search strategyPubMed, MEDLINE, EMBASE, and Cochrane Library were searched to identify potentially relevant studies published prior to June 30, 2012.Selection criteriaCase‐control study comparing myomectomy with no myomectomy in patients undergoing cesarean delivery.Data collection and analysisThe quality of the studies was assessed and data were extracted independently by 2 authors.Main resultsNine studies, including 1 082 women with leiomyomas, met the inclusion criteria; 443 (41.0%) women underwent cesarean myomectomy and 639 (59.1%) underwent cesarean delivery alone. The drop in hemoglobin after surgery was 0.30 g/dL greater in the cesarean myomectomy group than in the control group, but the difference was not significant. The operative time was 4.94 minutes longer in the cesarean myomectomy group, but again the difference was not significant. The overall incidence of fever was comparable in the 2 groups. No hysterectomies were performed in any of the included studies.ConclusionsCesarean myomectomy may be a reasonable option for some women with leiomyoma. However, no definite conclusion can be drawn because the data included in the meta‐analysis were of low quality.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/135417/1/ijgo208.pd

Medically certified sickness absence with insurance benefits in women with and without children

Background: Sickness absence in Sweden is high, particularly in young women and the reasons are unclear. Many Swedish women combine parenthood and work and are facing demands that may contribute to impaired health and well-being. We compared mothers and women without children under different conditions, assuming increased sickness absence in mothers, due to time-based stress and psychological strain. Methods: All women born in 1960–79 (1.2 million) were followed from 1993 to 2003. Information on children in the home for each year was related to medically certified sickness absence with insurance benefits the year after. We used age and time-stratified proportional hazard regression models accounting for the individual's changes on study variables over time. Data were retrieved from national administrative registers. Results: Sickness absence was higher in mothers than in women without children, the relative risks decreased by age, with no effect after the age of 35 years. An effect appeared in lonely women irrespective of age, while in cohabiting women only for the ages 20–25 years. Mothers showed increased sickness absence in all subgroups of country of birth, education, income, sector of employment and place of residence. The relation between number of children and sickness absence was nonlinear, with the highest relative risks for mothers of one child. The upward trend of sickness absence at the end of 1990s was steeper for mothers compared to women without children. Conclusion: Despite the well-developed social security system and child care services in Sweden, parenthood predicts increased sickness absence, particularly in young and in lone women

Age‐Specific Associations Between Violence Exposure and Past 30‐Day Marijuana and Alcohol Use

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149511/1/jora12399.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149511/2/jora12399_am.pd