Alcohol Availability and Violence among Inner‐City Adolescents: A Multi‐Level Analysis of the Role of Alcohol Outlet Density

Researchers recognize that the connection between alcohol and peer violence may relate to community level ecological factors, such as the location of businesses that sell alcohol. Building on previous research among adults, this study examines the relationship between alcohol outlet density and violent behaviors among adolescents, taking into account demographic characteristics, individual alcohol use, and neighborhood level socioeconomic indicators. Data drawn from a diverse Emergency Department based sample of 1,050 urban adolescents, combined with tract level data from the state liquor control commission and U.S. Census, were analyzed. Results of multivariate multi‐level regression analysis indicate that alcohol outlet density is significantly related to adolescents' violent behaviors, controlling for demographic characteristics and individual alcohol use. Census tract level socioeconomic indicators were not significantly associated with youth violence. Findings suggest that alcohol outlet density regulation should be considered as part of broader violence prevention strategies for urban adolescents.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/117032/1/ajcp9353.pd

Three-month Follow-up of Brief Computerized and Therapist Interventions for Alcohol and Violence Among Teens

Alcohol use and violent behaviors are well documented among adolescents and have enormous effects on morbidity and mortality. The authors hypothesized that universal computer screening of teens in an inner-city emergency department (ED), followed by a brief intervention (BI), would be 1) feasible (as measured by participation and completion of BI during the ED visit) and well received by teens (as measured by posttest process measures of intervention acceptability) and 2) effective at changing known precursors to behavior change such as attitudes, self-efficacy, and readiness to change alcohol use and violence.Adolescent patients (ages 14–18 years) at an urban ED were approached to complete a computerized survey. The survey was conducted daily from 12 noon to 11  pm from September 2006 through November 2008. Adolescents reporting both alcohol use and violence in the past year were randomized to a control group or a 35-minute BI delivered by a computer or therapist as part of the SafERteens study. Validated measures were administered, including demographics, alcohol use, attitudes toward alcohol and violence, self-efficacy for alcohol and violence, readiness to change alcohol and violence, and process questions, including likeability of intervention.A total of 2,423 adolescents were screened. Thirteen percent of those approached refused. The population was 45% male, 58% African American, and 6.2% Hispanic. Of those screened, 637 adolescents (26%) screened positive; 533 were randomized to participate, and 515 completed the BI prior to discharge. The BIs were well received by the adolescents overall; 97% of those randomized to a BI self-reported that they found one intervention section “very helpful.” At posttest, significant reductions in positive attitudes for alcohol use and violence and significant increases in self-efficacy related to alcohol/violence were found for both therapist and computer interventions. At 3-month follow-up there was 81% retention, and generalized estimating equations (GEE) analysis showed that participants in both interventions had significant reductions in positive attitudes for alcohol use (therapist p = 0.002, computer p = 0.0001) and violence (therapist p = 0.012, computer p = 0.007) and significant increases in self-efficacy related to violence (therapist p = 0.0.04, computer p = 0.002); alcohol self-efficacy improved in the therapist BI condition only (therapist p = 0.050, computer p = 0.083). Readiness to change was not significantly improved.This initial evaluation of the SafERteens study shows that universal computerized screening and BI for multiple risk behaviors among adolescents is feasible, well received, and effective at altering attitudes and self-efficacy. Future evaluations of the SafERteens study will evaluate the interventions’ effects on behavioral change (alcohol use and violence) over the year following the ED visit.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/78665/1/j.1553-2712.2009.00513.x.pd

Dating Violence: Outcomes Following a Brief Motivational Interviewing Intervention Among At‐risk Adolescents in an Urban Emergency Department

Objectives A recent study demonstrated the efficacy of the SafERteens intervention in reducing peer violence among adolescents presenting to the emergency department (ED). The objective of this study was to determine the efficacy of this ED‐based brief intervention (BI) on dating violence 1 year following the ED visit among the subsample of adolescents in the original randomized controlled trial reporting past‐year dating violence. Methods Patients (aged 14 to 18 years) at an ED were eligible for inclusion if they had past‐year violence and alcohol use. Participants were randomized to one of three conditions (BI delivered by a computer [CBI], BI delivered by a therapist and a computer (T+CBI), or control) and completed follow‐ups at 3, 6, and 12 months. In addition to content on alcohol misuse and peer violence, adolescents reporting dating violence received a tailored module on dating violence. The outcome of interest was frequency of moderate and severe dating violence victimization and aggression (baseline and 3, 6, and 12 months after ED visit). Results Among eligible adolescents, 55% ( n  = 397) reported dating violence and were included in these analyses. Compared to the control group (who received a resource brochure only), participants in the CBI showed reductions in moderate dating victimization at 3 months (inter‐rater reliability [IRR] = 0.71; 95% confidence interval [CI] = 0.51 to 0.99; p < 0.05) and 6 months (IRR = 0.56; 95% CI = 0.38 to 0.83; p < 0.01). Models examining interaction effects were significant for the CBI on moderate dating victimization at 3 months (IRR = 0.81; 95% CI = 0.67 to 0.98; p < 0.05) and 6 months (IRR = 0.81; 95% CI = 0.66 to 0.99; p < 0.05). Significant interaction effects were found for the T+CBI on moderate dating violence victimization at 6 months (IRR = 0.81; 95% CI = 0.69 to 0.96; p < 0.01) and 12 months (IRR = 0.76; 95% CI = 0.63 to 0.90; p < 0.001) and severe dating violence victimization at 3 months (IRR = 0.76; 95% CI = 0.59 to 0.96; p < 0.05). Conclusions ED‐based BIs tailored to address multiple risk behaviors (i.e., peer violence, alcohol use, and dating violence) show promise for reducing moderate and severe dating victimization for up to 1 year following an ED visit. Resumen La Violencia de Pareja: Resultados tras una Intervención mediante una Entrevista Breve Motivacional entre los Adolescentes en Riesgo en un Servicio de Urgencias Urbano Objetivos Un estudio reciente demostró la eficacia de la intervención SafERteens en reducir la violencia entre los adolescentes que acuden al servicio de urgencias (SU). El objetivo de este estudio fue determinar la eficacia de esta intervención breve (IB) en los SU en la violencia de pareja al año tras la visita al SU en una muestra de adolescentes del ensayo clínico original controlado y aleatorizado que documentó la violencia de pareja del pasado año. Metodología Se incluyeron los pacientes entre 14 y 18 años de edad del SU que tenían antecedentes de violencia o consumo de alcohol en el pasado año. Los participantes fueron aleatorizados a una de las tres situaciones: IB realizada por un ordenador (IBO), IB realizada por un terapeuta y un ordenador (IBO + T), o control; y completaron 3, 6, y 12 meses de seguimiento. Además de contener abuso de alcohol y violencia entre iguales, los adolescentes que documentaron la violencia de pareja recibieron un módulo adaptado en violencia de pareja. El resultado de interés fue la frecuencia de violencia de pareja moderada o grave como víctima y agresor (basal, 3, 6 y 12 meses tras la visita). Resultados Entre los adolescentes elegibles, el 55% (n=397) documentó datos de violencia de pareja y fueron incluidos en estos análisis. En comparación con el grupo control (que recibieron sólo el recurso de un folleto informativo), los participantes en la IBO mostraron una reducción en la violencia de pareja moderada como víctima a los 3 meses (concordancia entre evaluadores [K] 0,71; IC 95% = 0,51 a 0,99; p < 0,05) y a los 6 meses (K 0,56; IC 95%= 0,38 a 0,83; p < 0,01); los modelos que examinaron los efectos de interacción fueron significativos para la IBO en la violencia de pareja moderada como víctima a los 3 meses (K 0,81; IC 95% = 0,67 a 0,98; p < 0,05) y a los 6 meses (K 0,81; IC 95% = 0,66 a 0,99; p < 0,05). Se hallaron efectos de interacción significativos para la IBO+T en la violencia de pareja moderada como víctima a los 6 meses (K 0,81; IC 95% = 0,69 a 0,96; p < 0,01) y a los 12 meses (K 0,76; IC 95% = 0,63 a 0,90; p < 0,001), y en la violencia de pareja grave como víctima a los 3 meses (K 0.76; IC 95% = 0,59 a 0,96; p < 0,05). Conclusiones Las IB en el SU adaptadas para valorar múltiples comportamientos de riesgo (ej: violencia entre iguales, consumo de alcohol y violencia de pareja) son prometedores para reducir la violencia de pareja moderada y grave como víctima hasta un año tras la visita al SU.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/98214/1/acem12151.pd

Reconnecting Downtown to the Riverfront. Springfield, MA. Senior Urban Design Studio,

The work of this urban design studio illustrates visions for the revitalization of Springfield’s downtown riverfront through landscape architecture facing the challenges of a dissecting I-91 highway corridor. Re-Connecting people to the riverfront capi­talizes on the great Connecticut River and will revitalize the city to attract and engage residents and visitors alike. The proposals foster creating spaces in Riverfront Park for multiple activities such as recreation, places for arts and culture, education and enhancement of the River’s ecology. They further promote pedestrian/bicycle arteries to and along the riverfront that are embedded in a livable, mixed-use, diverse neighborhood. The work explores a community service learning strategy within the framework of an urban design studio with the goal of revitalizing the city of Springfield, Massachusetts, through sustainable design, planning, and engagement with the community. This studio produced six tangible visions and are based on three scenarios; 1) Scenario 1keeps the highway I-91 on an elevated level above ground; 2) Scenario 2 lowers I-91 down to an on-ground level; 3) Scenario 3 lowers I-91 underground as a completely or partially covered corridor. All six design visions share the following recommendations and principles to create a livable and sustainable city that engages the riverfront as a place for people and as a landscape that will be crucial for a great future of Springfield’s downtown: Creating spaces in Riverfront Park that are more centered and generous for multiple activities; add floodplains to improve the ecology of the River and educate the public. Creating pedestrian/bicycle arteries from Main Street to the riverfront. Elimination of on- and off- ramps within the core of downtown to prioritize pedestrian movement to the Connecticut River and reduce noise. Eliminate parking structures underneath the highway for visibility of the River. Redesigning East and West Columbus Avenue as pedestrian- and bicycle-friendly corridors through a road diet and speed reduction. Foster mixed-use development along East Columbus Avenue at the edge of the South End Neighborhood. Connect the Connecticut River Walk and Bikeway to Forest Park in the south

Green Infrastructure for Framingham, Massachusetts: Greenway Planning and Cultural Landscape Design

The senior undergraduate, Bachelors of Landscape Architecture studio at the University of Massachusetts, Amherst developed a town-wide greenway plan for the Town of Framingham’s Department of Community and Economic Development. This conceptual plan connects the town’s natural, cultural, and recreational resources through a network of pedestrian and bike trails. This plan also seeks to connect the diverse neighborhoods within the Town to these resources and provide alternative means of local residents to access jobs, schools, and retail centers. The greenway plan builds on Framingham’s Open Space and Recreation Plan (2013), which identified the need for a regional greenway system to link the town to the many local and regional recreational, cultural, ecological, and economic resources. This capstone planning and design studio began with an analysis and assessment of the Town of Framingham’s natural, recreational, cultural, and transportation/land use resources. Teams of students developed alternative greenway plans for the town and region, respectively. These plans were synthesized halfway through the class to produce the composite greenway plan shown in this report. For the second half of the class, individual students developed neighborhood and site specific greenway and park designs for key linkages within the greenway network in the rural northeast section of Framingham, industrial village of Saxonville, historic Framingham Center, the Tech Park, and downtown Framingham. These detailed designs form the body of this report

Comprehensive molecular characterization of gastric adenocarcinoma

Gastric cancer is a leading cause of cancer deaths, but analysis of its molecular and clinical characteristics has been complicated by histological and aetiological heterogeneity. Here we describe a comprehensive molecular evaluation of 295 primary gastric adenocarcinomas as part of The Cancer Genome Atlas (TCGA) project. We propose a molecular classification dividing gastric cancer into four subtypes: tumours positive for Epstein–Barr virus, which display recurrent PIK3CA mutations, extreme DNA hypermethylation, and amplification of JAK2, CD274 (also known as PD-L1) and PDCD1LG2 (also knownasPD-L2); microsatellite unstable tumours, which show elevated mutation rates, including mutations of genes encoding targetable oncogenic signalling proteins; genomically stable tumours, which are enriched for the diffuse histological variant and mutations of RHOA or fusions involving RHO-family GTPase-activating proteins; and tumours with chromosomal instability, which show marked aneuploidy and focal amplification of receptor tyrosine kinases. Identification of these subtypes provides a roadmap for patient stratification and trials of targeted therapies

Novel genetic loci associated with hippocampal volume

The hippocampal formation is a brain structure integrally involved in episodic memory, spatial navigation, cognition and stress responsiveness. Structural abnormalities in hippocampal volume and shape are found in several common neuropsychiatric disorders. To identify the genetic underpinnings of hippocampal structure here we perform a genome-wide association study (GWAS) of 33,536 individuals and discover six independent loci significantly associated with hippocampal volume, four of them novel. Of the novel loci, three lie within genes (ASTN2, DPP4 and MAST4) and one is found 200 kb upstream of SHH. A hippocampal subfield analysis shows that a locus within the MSRB3 gene shows evidence of a localized effect along the dentate gyrus, subiculum, CA1 and fissure. Further, we show that genetic variants associated with decreased hippocampal volume are also associated with increased risk for Alzheimer's disease (rg =-0.155). Our findings suggest novel biological pathways through which human genetic variation influences hippocampal volume and risk for neuropsychiatric illness

ENIGMA and global neuroscience: A decade of large-scale studies of the brain in health and disease across more than 40 countries

This review summarizes the last decade of work by the ENIGMA (Enhancing NeuroImaging Genetics through Meta Analysis) Consortium, a global alliance of over 1400 scientists across 43 countries, studying the human brain in health and disease. Building on large-scale genetic studies that discovered the first robustly replicated genetic loci associated with brain metrics, ENIGMA has diversified into over 50 working groups (WGs), pooling worldwide data and expertise to answer fundamental questions in neuroscience, psychiatry, neurology, and genetics. Most ENIGMA WGs focus on specific psychiatric and neurological conditions, other WGs study normal variation due to sex and gender differences, or development and aging; still other WGs develop methodological pipelines and tools to facilitate harmonized analyses of "big data" (i.e., genetic and epigenetic data, multimodal MRI, and electroencephalography data). These international efforts have yielded the largest neuroimaging studies to date in schizophrenia, bipolar disorder, major depressive disorder, post-traumatic stress disorder, substance use disorders, obsessive-compulsive disorder, attention-deficit/hyperactivity disorder, autism spectrum disorders, epilepsy, and 22q11.2 deletion syndrome. More recent ENIGMA WGs have formed to study anxiety disorders, suicidal thoughts and behavior, sleep and insomnia, eating disorders, irritability, brain injury, antisocial personality and conduct disorder, and dissociative identity disorder. Here, we summarize the first decade of ENIGMA's activities and ongoing projects, and describe the successes and challenges encountered along the way. We highlight the advantages of collaborative large-scale coordinated data analyses for testing reproducibility and robustness of findings, offering the opportunity to identify brain systems involved in clinical syndromes across diverse samples and associated genetic, environmental, demographic, cognitive, and psychosocial factors

Novel genetic loci underlying human intracranial volume identified through genome-wide association

Intracranial volume reflects the maximally attained brain size during development, and remains stable with loss of tissue in late life. It is highly heritable, but the underlying genes remain largely undetermined. In a genome-wide association study of 32,438 adults, we discovered five novel loci for intracranial volume and confirmed two known signals. Four of the loci are also associated with adult human stature, but these remained associated with intracranial volume after adjusting for height. We found a high genetic correlation with child head circumference (ρgenetic=0.748), which indicated a similar genetic background and allowed for the identification of four additional loci through meta-analysis (Ncombined = 37,345). Variants for intracranial volume were also related to childhood and adult cognitive function, Parkinson’s disease, and enriched near genes involved in growth pathways including PI3K–AKT signaling. These findings identify biological underpinnings of intracranial volume and provide genetic support for theories on brain reserve and brain overgrowth

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups