Mi Cuerpo, Nuestra Responsabilidad: Using Photovoice to describe the assets and barriers to sexual and reproductive health among Latinos in North Carolina

Latinos in North Carolina experience disparities in sexual and reproductive health. To identify and explore assets for and barriers to sexual and reproductive health in the Latino community, an academic-community partnership engaged community health workers (CHW) in Photovoice, a participatory qualitative research methodology. Five sessions were completed in which CHW agreed on photo assignments and discussed the photos. Themes included the role of men, cultural taboos, and the effect of undocumented immigrant status on access to resources. Findings were presented at a community forum. Building on the strengths of CHW to reduce barriers to sexual and reproductive health is a viable strategy to address disparities

Thalamocortical functional connectivity and behavioral disruptions in neonates with prenatal cocaine exposure

Prenatal cocaine exposure (PCE) affects neurobehavioral development, however, disentangling direct drug-related mechanisms from contextual effects (e.g., socioeconomic status) has proven challenging in humans. The effects of environmental confounds are minimal immediately after birth thus we aimed to delineate neurobehavioral correlates of PCE in a large cohort of neonates (2–6 weeks of age, N = 152) with and without drug exposure using resting state functional magnetic resonance imaging (rsfMRI) and developmental assessments at 3 months with the Bayley Scales of Infant & Toddler Development, 3rd edition. The cohort included healthy controls and neonates with similar poly-drug exposure ± cocaine. We focused on the thalamus given its critical importance in early brain development and its unique positioning in the dopamine system. Our results revealed PCE-related hyper-connectivity between the thalamus and frontal regions and a drug-common hypo-connective signature between the thalamus and motor-related regions. PCE-specific neonatal thalamo-frontal connectivity was inversely related to cognitive and fine motor scores and thalamo-motor connectivity showed a positive relationship with composite (gross plus fine) motor scores. Finally, cocaine by selective-serotonin-reuptake-inhibitor (SSRI) interactions were detected, suggesting the combined use of these drugs during pregnancy could have additional consequences on fetal development. Overall, our findings provide the first delineation of PCE-related disruptions of thalamocortical functional connectivity, neurobehavioral correlations, and drug-drug interactions during infancy

Measurement error in a multi-level analysis of air pollution and health: a simulation study.

BACKGROUND: Spatio-temporal models are increasingly being used to predict exposure to ambient outdoor air pollution at high spatial resolution for inclusion in epidemiological analyses of air pollution and health. Measurement error in these predictions can nevertheless have impacts on health effect estimation. Using statistical simulation we aim to investigate the effects of such error within a multi-level model analysis of long and short-term pollutant exposure and health. METHODS: Our study was based on a theoretical sample of 1000 geographical sites within Greater London. Simulations of "true" site-specific daily mean and 5-year mean NO2 and PM10 concentrations, incorporating both temporal variation and spatial covariance, were informed by an analysis of daily measurements over the period 2009-2013 from fixed location urban background monitors in the London area. In the context of a multi-level single-pollutant Poisson regression analysis of mortality, we investigated scenarios in which we specified: the Pearson correlation between modelled and "true" data and the ratio of their variances (model versus "true") and assumed these parameters were the same spatially and temporally. RESULTS: In general, health effect estimates associated with both long and short-term exposure were biased towards the null with the level of bias increasing to over 60% as the correlation coefficient decreased from 0.9 to 0.5 and the variance ratio increased from 0.5 to 2. However, for a combination of high correlation (0.9) and small variance ratio (0.5) non-trivial bias (> 25%) away from the null was observed. Standard errors of health effect estimates, though unaffected by changes in the correlation coefficient, appeared to be attenuated for variance ratios > 1 but inflated for variance ratios < 1. CONCLUSION: While our findings suggest that in most cases modelling errors result in attenuation of the effect estimate towards the null, in some situations a non-trivial bias away from the null may occur. The magnitude and direction of bias appears to depend on the relationship between modelled and "true" data in terms of their correlation and the ratio of their variances. These factors should be taken into account when assessing the validity of modelled air pollution predictions for use in complex epidemiological models

Assessment of infant feeding styles among low-income African-American mothers: Comparing reported and observed behaviors

This study’s goal was to provide a detailed description of feeding styles adopted by a sample of African-American women in feeding their infants in North Carolina, and to examine the correspondence between reported and observed feeding styles. Cross-sectional semi-structured interview and videotaped data were gathered in the homes of 20 participating low-income mothers of infants aged 3-20 months. Feeding styles were characterized through a tailored coding scheme (the Infant Feeding Styles Video Coding Scheme, IFSVCS) applied to both interview and video-taped data. We found that the most frequent feeding styles identified for both interviews and videotaped observations was restrictive, but that mothers were roughly equally divided among predominantly controlling (pressuring or restrictive) and less controlling (laissez-faire or indulgent) styles across methods. However, for over 2/3 of the sample, there was a lack of correspondence between interview and video-taped feeding styles. This unique characterization and comparison of observed and reported infant feeding styles provides additional insights into parental feeding approaches among mothers of infants at high risk of obesity, and highlights the need for further study of feeding style assessment and potential impact on infant weight outcomes

Improving Informed Consent: The Medium Is Not the Message

An important type of research on informed consent involves empirically testing interventions designed to improve the consent process. Here we report on the experience of eight teams that conducted research involving interventions designed primarily to impact one of three categories: decision-making, knowledge, and the therapeutic misconception

Frequency of spontaneous BOLD signal shifts during infancy and correlates with cognitive performance

Numerous studies have been conducted to delineate the early development of different functional networks, based on measuring the temporal synchronization of spontaneous blood oxygenation level-dependent (BOLD) signals acquired using resting state functional MRI (rsfMRI). However, little attention has been paid to the change of the frequency properties of these signals during early brain development. Such frequency properties may reflect important physiological changes and potentially have significant cognitive consequences. In this study, leveraging a large (N=86 subjects), longitudinal sample of human infants scanned during the first two years of life, we aimed to specifically delineate the developmental changes of the frequency characteristics of spontaneous BOLD signals. Both whole-brain and network-level examinations were carried out and the frequency-behavior relationship was explored. Our results revealed a clear right-ward shift of BOLD signal frequency during the first year of life. Moreover, the power at the peak-frequency for sensorimotor and lateral visual networks correlates with domain-specific Mullen Scales in 1-year-olds, suggesting the behavioral significance of the BOLD signal frequency during infancy. Findings from this study shed light into early functional brain development and provide a new perspective for future searches for functional developmental abnormalities

Lactational Exposure to Polychlorinated Biphenyls, Dichlorodiphenyltrichloroethane, and Dichlorodiphenyldichloroethylene and Infant Neurodevelopment: An Analysis of the Pregnancy, Infection, and Nutrition Babies Study

BackgroundPolychlorinated biphenyls (PCBs) and dichlorodiphenyltrichloroethane (DDT) are persistent, bioaccumulative, and toxic pollutants that were broadly used in the United States until the 1970s. Common exposure to PCBs, DDT, and dichlorodiphenyldichloroethylene (DDE), the most stable metabolite of DDT, may influence children’s neurodevelopment, but study results are not consistent.ObjectivesWe examined the associations between lactational exposure to PCBs, DDT, and DDE and infant development at 12 months, using data from the Pregnancy, Infection, and Nutrition Babies Study, 2004–2006.MethodsWe measured PCBs, DDT, and DDE in breast milk at the third month postpartum. Lactational exposure of these chemicals was estimated by the product of chemical concentrations and the duration of breast-feeding. Infant development at 12 months of age was measured by the Mullen Scales of Early Learning (n = 231) and the Short Form: Level I (infant) of the MacArthur–Bates Communicative Development Indices (n = 218).ResultsNo consistent associations were observed between lactational exposure to PCBs, DDT, and DDE through the first 12 months and the measures of infant development. However, DDE was associated with scoring below average on the gross motor scale of the Mullen among males only (adjusted odds ratio = 1.9; 95% confidence interval, 1.1–3.3).ConclusionInfant neurodevelopment at 12 months of age was not impaired by PCBs, DDT, and DDE at the concentrations measured here, in combination with benefits from long duration of breast-feeding in this population

Lactational exposure to polychlorinated biphenyls, dichlorodiphenyltrichloroethane, and dichlorodiphenyldichloroethylene and infant growth: an analysis of the Pregnancy, Infection, and Nutrition Babies Study: Lactational exposure to persistent environmental pollutants

Polychlorinated biphenyls (PCBs), 2,2-bis(p-chlorophenyl)-1,1,1-trichloroethane (p,p’-DDT) and 2,2-bis(p-chlorophenyl)-1,1-dichloroethylene (p,p’-DDE), the most stable metabolite of p,p’-DDT, are persistent organic pollutants and environmental endocrine disruptors. Infant exposure to these chemicals through breast feeding may influence children’s growth, but this potential adverse effect could be complicated by the co-existing benefits of breast feeding. This study examined the associations between lactational exposure to these chemicals and infant growth in the first 12 months by using data from the Pregnancy, Infection and Nutrition Babies Study in central North Carolina, United States, 2004–2006. The study population was restricted to the infants who were breastfed for 6 months or longer. PCBs, p,p’-DDT and p,p’-DDE were measured in breast milk at 3 months postpartum. Lactational exposure through 12 months was estimated as the product of chemical concentrations and the duration of breast feeding. The infant’s weight and length were recorded from the medical record for each routine pediatric well-child visit in the first 12 months. Women-child pairs who breastfed for 6 months or longer and returned the growth card (n=210), were included in the study. Linear mixed effects models were used to assess the associations between chemical concentrations in breast milk and longitudinal infant weight and length measurements in the first 6 months. Multivariable linear regression models were used to assess the relationships between lactational exposure to chemicals through 12 months and the z-scores of infant weight, length and weight-for-length at 12 months. Overall, no association was observed. Breast feeding for 6 months or longer, with lactational exposure to PCBs, p,p’-DDT and p,p’-DDE at the low background level concentrations studied here, results in no measurable influence on infant growth in the first 12 months

Treatment of Colorectal Peritoneal Carcinomatosis With Systemic Chemotherapy: A Pooled Analysis of North Central Cancer Treatment Group Phase III Trials N9741 and N9841

Symptoms and complications of metastatic colorectal cancer (mCRC) differ by metastatic sites. There is a paucity of prospective survival data for patients with peritoneal carcinomatosis colorectal cancer (pcCRC). We characterized outcomes of patients with pcCRC enrolled onto two prospective randomized trials of chemotherapy and contrasted that with other manifestations of mCRC (non-pcCRC)

Exclusion and reappropriation: Experiences of contemporary enclosure among children in three East Anglian schools

Transformations of the landscapes which children inhabit have significant impacts on their lives; yet, due to the limited economic visibility of children’s relationships with place, they have little stake in those transformations. Their experience, therefore, illustrates in an acute way the experience of contemporary enclosure as a mode of subordination. Following fieldwork in three primary schools in South Cambridgeshire, UK, we offer an ethnographic account of children’s experiences of socio-spatial exclusion. Yet, we suggest that such exclusion is by no means an end-point in children’s relationships with place. Challenging assumptions that children are disconnected from nature, we argue that through play and imaginative exploration of their environments, children find ways to rebuild relationships with places from which they find themselves excluded. This is the author accepted manuscript. The final version is available from SAGE via http://dx.doi.org/10.1177/026377581664194