Infant Sleep Problems and Childhood Overweight: Effects of Three Definitions of Sleep Problems

Sleep problems have been defined using a variety of definitions. No study has assessed the longitudinal association between infant sleep problems and childhood overweight or obesity using existing definitions of sleep problems. This study used longitudinal data (n=895) from the multi-site Study of Early Child Care and Youth Development (SECCYD) to investigate the effects of infant sleep problems on childhood weight status in Grade 6. Infants with sleep problems in Phase I (1991) and with complete data through Phase III (2004) of SECCYD were included. Sleep problems were assessed using maternal reports of night wakings and duration of a waking episode. Sleep problems were defined using Richman (1981), Lozoff et al. (1985), and Zuckerman et al. (1987) definitions. Multinomial logistic regression was used to examine the association between sleep problems during infancy and childhood weight status in Grade 6 while controlling for birth weight, race, sex, breastfeeding, maternal poverty, family structure, and maternal education. After adjusting for all covariates, children with a history of sleep problems were found to be overweight in Grade 6 using Zukerman et al. (Odds ratio (OR)=1.68; 95% confidence interval (CI): 1.11–2.55) and Richman (OR=1.76; 95% CI: 1.05–2.97) definitions, but not using Lozoff et al. definition. Infant sleep problems were not found to be associated with being obese. The study found differential effects of infant sleep problems on childhood overweight in Grade 6 per different definitions of sleep problems. Findings highlight the need to construct a single definition of infant sleep problems

Cancer of the Urinary Bladder: Gender Differences as Predictors of Tumor Grade

Group B Streptococcus, or GBS, is a gram positive bacteria commonly found in the gastrointestinal, genital and urinary tract of healthy adults. Between 10% and 30% of all pregnant women are colonized with GBS in the vagina or rectum. While GBS colonized mothers typically show no symptoms or adverse health effects, the bacteria can be passed to their child during labor and delivery. Although significant progress has been made in the identification and treatment of GBS, it remains the leading infectious cause of Page 14 2014 Appalachian Student Research Forum morbidity and mortality among newborns in the United States. The current guidelines recommended by the Center for Disease Control and Prevention (CDC) and endorsed by the American College of Obstetrics and Gynecology (ACOG) is to test pregnant women for GBS colonization between 34-37 weeks of gestation. The current gold standard for identification of GBS colonization is the use of selective enrichment broth (SEB) followed by culture and biochemical testing. Identified concerns with the culture procedure are: 1) the length of time it takes to get the results, 2) the lower sensitivity if the SEB step is left out to improve turn-around-time (TAT) and 3) the limited number of qualified technicians available to perform the complex test. Recently, several semi-automated molecular assays have been developed for identification of GBS which are marketed as having equivalent sensitivity and specificity to SEB followed by culture. The goals of this study were to: 1) validate the sensitivity and specificity of an FDA approved GBS molecular assay (Illumigene, Meridian Bioscience) and 2) evaluate a new testing strategy utilizing SEB followed by the Illumigene GBS assay to see if it offers an improvement in TAT when compared to SEB culture in our in-house microbiology lab and to those sent out to a national reference lab for GBS DNA assay. During the validation process, 20 consecutive samples were submitted to SEB followed by simultaneous in-house culture and Illumigene assay for GBS. The method validation experiments were analyzed using the EP Evaluator version 11 statistical software (Data Innovations). Comparison of TAT was evaluated utilizing a blinded report generated from our Laboratory Information System (Harvest, Orchard Software) for a 2 month period for the GBS tests performed using the SEB followed by Illumigene molecular assay (n=73), in-house SEB followed by culture (n=50) and send-out reference lab GBS DNA assay (n=43) procedures. The TAT (hrs) for each method (Mean±SEM) were determined from the time of collection until result approval. The Illumigene assay had a high sensitivity (100%) and specificity (100%) when compared to SEB followed by culture for identification of GBS. Utilization of the Illumigene assay following SEB significantly (

Infant Sleep Problems Increase the Odds of Childhood Overweight at Grade 6: Differential Effects of Commonly used Definitions of Sleep Problems

Abstract available through Circulation

Abstract P106: Infant Sleep Problems Increase the Odds of Childhood Overweight at Grade 6: Differential Effects of Commonly Used Definitions of Sleep Problems

Introduction: Infant sleep problems have been defined using a variety of definitions. No study has assessed the association between infant sleep problems and childhood overweight or obesity using different definitions of sleep problems. Hypothesis: We assessed the hypothesis that the effect of infant sleep problems on childhood overweight or obesity would differ based on the definition of sleep problems used. Methods: In the multi-site study of Early Child Care and Youth Development of the National Institute of Child Health and Human Development, sleep problems were assessed using Lozoff and colleagues (night waking occurring more than 3 times per week accompanied by parental report of disturbance), Richman and colleagues (waking 5 or more nights per week for the past 3 months in addition to one of the following: co-sleeping with parents, waking 3 or more times per night, or waking event lasting at least 20 minutes), and Zuckerman and colleagues (waking 3 or more times per night, waking event lasting at least 1 hour, or parental report of severe disturbance) definitions. Infants (<24 months of age) with sleep problems (ever versus never) were included in this analysis. Childhood weight status (normal: BMI 5th-< 85th percentile; being overweight: BMI 85th-<95th percentile; or being obese: BMI ≥95th percentile) was defined according to 2000 Centers for Disease Control and Prevention cut-offs (N=895). Multinomial logistic regression was used to examine the association between sleep problems during infancy and the odds of childhood overweight or obesity at grade 6 after adjusting for birth weight, race, sex, breastfeeding, maternal poverty, family structure, and maternal education. Results: The prevalence of childhood overweight and obesity at grade 6 was 15.6% and 19.0%, respectively. The prevalence of having sleep problems during infancy was 24.9% (Zuckerman definition), 12.6% (Richman definition), and 20.6% (Lozoff definition), per different definitions used. Infants with history of having sleep problems were found more likely to be overweight at grade 6 using either Zukerman’s (Odds ratio (OR) = 1.68; 95% Confidence interval (CI) = 1.11-2.55) or Richman’s definition (OR = 1.76; 95% CI = 1.05-2.97), but not using Lozoff’s definition of sleep problems. Conclusion: Infant sleep problems increased the odds of childhood overweight (but not obesity) at grade 6. However, the observed associations varied according to the definition of sleep problems used. More research is needed to construct a single definition of infant sleep problems in order to more accurately predict overweight or obesity later in life

Infant sleep problems and childhood overweight: Effects of three definitions of sleep problems

Sleep problems have been defined using a variety of definitions. No study has assessed the longitudinal association between infant sleep problems and childhood overweight or obesity using existing definitions of sleep problems. This study used longitudinal data (n = 895) from the multi-site Study of Early Child Care and Youth Development (SECCYD) to investigate the effects of infant sleep problems on childhood weight status in Grade 6. Infants with sleep problems in Phase I (1991) and with complete data through Phase III (2004) of SECCYD were included. Sleep problems were assessed using maternal reports of night wakings and duration of a waking episode. Sleep problems were defined using Richman (1981), Lozoff et al. (1985), and Zuckerman et al. (1987) definitions. Multinomial logistic regression was used to examine the association between sleep problems during infancy and childhood weight status in Grade 6 while controlling for birth weight, race, sex, breastfeeding, maternal poverty, family structure, and maternal education. After adjusting for all covariates, children with a history of sleep problems were found to be overweight in Grade 6 using Zukerman et al. (Odds ratio (OR) = 1.68; 95% confidence interval (CI): 1.11–2.55) and Richman (OR = 1.76; 95% CI: 1.05–2.97) definitions, but not using Lozoff et al. definition. Infant sleep problems were not found to be associated with being obese. The study found differential effects of infant sleep problems on childhood overweight in Grade 6 per different definitions of sleep problems. Findings highlight the need to construct a single definition of infant sleep problems. Keywords: Child, Infant, Longitudinal studies, Overweight, Slee

Cannabis use and medication nonadherence in bipolar disorder: A nationwide inpatient sample database analysis.

BACKGROUND: Medication nonadherence among bipolar disorder (BD) is often linked with comorbid substance use disorders. This study aims to investigate cannabis use disorder (CUD) association with medication noncompliance in hospitalized BD patients. METHODS: Using data on 266,303 BD hospitalizations between 2010 and 2014 from the US Nationwide Inpatient Sample database, we obtained medication noncompliance rates stratified by demographics and CUD. Logistic regression was used to evaluate factors associated with medication noncompliance. RESULTS: Overall mean age, the prevalence of CUD, and medication nonadherence were 41.58 (± 0.11) years, 15.0% and 16.1%, respectively. There were 56.6% females in the overall population. There was a significant difference in the characteristics of those in the medication nonadherence vs adherence groups, including age, sex, race, comorbid substance use, income, insurance type, hospital region, and hospital teaching status (p \u3c 0.001). After adjusting for other variables using multivariate analysis, there remained a statistically significant association of medication nonadherence in BD hospitalization and CUD (OR 1.42, 95% CI 1.36-1.48). LIMITATION: Confounding multiple substance use could not be accounted for, and the retrospective nature of the database which includes only inpatients is prone to possible selection and reporting bias. CONCLUSION: CUD statistically predicts increased rates of medication nonadherence among patients with BD. Given the possible association of CUD with medication nonadherence among BD patients, collaborative work between general adult psychiatry and addiction services is imperative in improving the management outcome of patients with BD and comorbid CUD

Investigating the association between multiple substance Use and dating violence involvement among U.S adolescents

Adolescent dating violence and substance use are clinical and public health concerns. Prior meta-analytic studies indicate that about 20% of adolescents reported having experienced physical dating violence (PDV) and 10% reported sexual dating violence (SDV). This study aims to assess the prevalence of dating violence, and the association between substance use and dating violence among adolescents. Our study population is derived from the 2019 Youth Risk Behavior Surveillance System (YRBSS)a cross-sectional, nationally representative survey of United States (U.S) adolescents. The sample comprised 13,677 adolescents between the ages of 13–19 years currently enrolled in school. Descriptive analysis estimated the prevalence of dating violence and substance use. Multiple logistic regression adjusted for confounders of the association between substance use and dating violence. The confounders adjusted for include sex, school grade, race, academic grade, and duration of night sleep. The prevalence of PDV and SDV was each 8.2%. Only 2.6% of this nationally representative sample had experienced both PDV and SDV. Adolescents who used three or more substances had 2.1 times higher odds of PDV (OR = 2.10, 95% CI = 1.27–3.47, p < 0.0001), and SDV (OR = 2.11, 95% CI = 1.34–3.34, p < 0.0001) respectively, and 2.8 (OR = 2.75, 95% CI = 1.34–5.61, p < 0.0001) times higher odds of both PDV and SDV in the past month. Multiple substance use increases the odds of dating violence. Policy and interventions should be focused on preventing substance use initiation among substance-naïve adolescents and to advocate abstinence and gradual reduction of substances used to mitigate the prevalence of dating violence