Ariel - Volume 11 Number 2

Executive Editors Ellen Feldman Leonardo S. Nasca, Jr. Business .Managers Barbara L. Davies Martin B. Getzow News Editor Aaron D. Bleznak Features Editor Hugh A. Gelabert CAHS Editor Joan M. Greco Editorial Page Editor Samuel Markind Photography Editor Leonardo S. Nasca, Jr. Sports Editor Paul F. Mansfiel

Examining the Link Between Gentrification, Children’s Egocentric Food Environment, and Obesity

While advocates argue that gentrification changes the neighborhood food environment critical to children’s diet and health, we have little evidence documenting such changes or the consequences for their health outcomes. Using rich longitudinal, individual-level data on nearly 115,000 New York City children, including egocentric measures of their food environment and BMI, we examine the link between neighborhood demographic change (“gentrification”) and children’s access to restaurants and supermarkets and their weight outcomes. We find that children in rapidly gentrifying neighborhoods see increased access to fast food and wait-service restaurants and reduced access to corner stores and supermarkets compared to those in non-gentrifying areas. Boys and girls have higher BMI following gentrification, but only boys are more likely to be obese or overweight. We find public housing moderates the deleterious effect of gentrification on children’s weight outcomes, possibly due to different changes to the food environment

Ariel - Volume 11 Number 1

Executive Editors Ellen Feldman Leonardo S. Nasca, Jr. Business Managers Barbara L. Davies Martin B. Getzow News Editor Aaron D. Bleznak Features Editor Dave Van Wagoner CAHS Editor Joan M. Greco Editorial Page Editor Samuel Markind Photography Editor Leonardo S. Nasca, Jr. Sports Editor Paul F. Mansfiel

Study protocol: The Improving Care of Acute Lung Injury Patients (ICAP) study

INTRODUCTION: The short-term mortality benefit of lower tidal volume ventilation (LTVV) for patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) has been demonstrated in a large, multi-center randomized trial. However, the impact of LTVV and other critical care therapies on the longer-term outcomes of ALI/ARDS survivors remains uncertain. The Improving Care of ALI Patients (ICAP) study is a multi-site, prospective cohort study that aims to evaluate the longer-term outcomes of ALI/ARDS survivors with a particular focus on the effect of LTVV and other critical care therapies. METHODS: Consecutive mechanically ventilated ALI/ARDS patients from 11 intensive care units (ICUs) at four hospitals in the city of Baltimore, MD, USA, will be enrolled in a prospective cohort study. Exposures (patient-based, clinical management, and ICU organizational) will be comprehensively collected both at baseline and throughout patients' ICU stay. Outcomes, including mortality, organ impairment, functional status, and quality of life, will be assessed with the use of standardized surveys and testing at 3, 6, 12, and 24 months after ALI/ARDS diagnosis. A multi-faceted retention strategy will be used to minimize participant loss to follow-up. RESULTS: On the basis of the historical incidence of ALI/ARDS at the study sites, we expect to enroll 520 patients over two years. This projected sample size is more than double that of any published study of long-term outcomes in ALI/ARDS survivors, providing 86% power to detect a relative mortality hazard of 0.70 in patients receiving higher versus lower exposure to LTVV. The projected sample size also provides sufficient power to evaluate the association between a variety of other exposure and outcome variables, including quality of life. CONCLUSION: The ICAP study is a novel, prospective cohort study that will build on previous critical care research to improve our understanding of the longer-term impact of ALI/ARDS, LTVV and other aspects of critical care management. Given the paucity of information about the impact of interventions on long-term outcomes for survivors of critical illness, this study can provide important information to inform clinical practice

Lung protective mechanical ventilation and two year survival in patients with acute lung injury: prospective cohort study

Objective To evaluate the association of volume limited and pressure limited (lung protective) mechanical ventilation with two year survival in patients with acute lung injury

Family Relationships, Mental, and Physical Health Outcomes after Late Life Divorce

Although the divorce rate in the United States has remained fairly stable since 1980, the divorce rate for couples over age 50 has more than doubled in the past decade. The current study aims to better understand families experiencing a late life divorce and has three main goals: 1) investigate the differences in parent/offspring relationship quality in parent/offspring dyads that have experienced a late life divorce and those from married families; 2) compare the mental and physical health outcomes of parent/offspring dyads who experience late life divorce and those from married families and; 3) explore whether parent/offspring sex combination (i.e. mother/son, father/daughter, mother/daughter, father/son) serves as a moderator in the relationship between parental marital status and relationship quality, mental health outcomes, and physical health outcomes. There were no significant differences between late life divorced families and married families in parent/offspring relationship quality. Further, linguistic ambivalence was negatively correlated with the quantitative measure of ambivalence. I found no support for the main study hypotheses in that parent/offspring dyad sex combination acts as a moderator between parental marital status and parent/offspring relationship quality or measures of mental and physical health; however, there were differences among married and late life divorced families in that those who have experienced a late life divorce reported higher levels of depression, stress, and anxiety. Families who experience a late life divorce struggle with similar mental health outcomes as families who experience a divorce earlier in life. It is important to better understand these families to develop and test interventions to be the most effective for divorce in later life