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1.
Child Psychiatry Hum Dev ; 49(1): 86-99, 2018 02.
Article in English | MEDLINE | ID: mdl-28501936

ABSTRACT

Theory underscores the importance of parenting in sleep development, but few studies have examined whether links vary by temperament. To address this gap, we tested whether potential links between early maternal sensitivity and early adolescent sleep problems varied by child negative emotionality and delay of gratification. Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 820), we found that high maternal sensitivity predicted fewer bedtime problems and longer sleep duration at 6th grade for toddlers with high negative emotionality, whereas low maternal sensitivity predicted the reverse. No differences were observed for low negative emotionality. Moreover, delay of gratification predicted fewer bedtime problems at 6th grade, but did not moderate associations between maternal sensitivity, negative emotionality, and sleep. Findings demonstrate that high, but not low, negative emotionality renders toddlers differentially susceptible and receptive to maternal sensitivity in relation to sleep.


Subject(s)
Disease Susceptibility , Emotions , Mothers/psychology , Parenting/psychology , Sleep Wake Disorders/psychology , Sleep/physiology , Temperament , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Sleep Wake Disorders/prevention & control
2.
Mol Cell ; 33(4): 417-27, 2009 Feb 27.
Article in English | MEDLINE | ID: mdl-19250903

ABSTRACT

Lysine 56 acetylation in the helical core of histone H3 opens yeast chromatin and enables histone gene transcription, DNA replication, and DNA repair and prevents epigenetic silencing. While K56Ac is globally abundant in yeast and flies, its presence has been uncertain in mammals. We show here using mass spectrometry and genome-wide analyses that K56Ac is present in human embryonic stem cells (hESCs), overlapping strongly at active and inactive promoters with the binding of the key regulators of pluripotency, NANOG, SOX2, and OCT4. This includes also the canonical histone gene promoters and those for the hESC-specific microRNAs. K56Ac then relocates to developmental genes upon cellular differentiation. Thus the K56Ac state more accurately reflects the epigenetic differences between hESCs and somatic cells than other active histone marks such as H3 K4 trimethylation and K9 acetylation. These results suggest that K56Ac is involved in the human core transcriptional network of pluripotency.


Subject(s)
Embryonic Stem Cells/metabolism , Gene Regulatory Networks , Histones/metabolism , Lysine/metabolism , Acetylation , Animals , Chromatin Immunoprecipitation , Embryonic Stem Cells/cytology , Genome, Human , Homeodomain Proteins/genetics , Homeodomain Proteins/metabolism , Humans , Lysine/chemistry , Mice , Nanog Homeobox Protein , Octamer Transcription Factor-3/genetics , Octamer Transcription Factor-3/metabolism , Protein Processing, Post-Translational/genetics , SOXB1 Transcription Factors/genetics , SOXB1 Transcription Factors/metabolism
3.
Child Psychiatry Hum Dev ; 48(4): 678-689, 2017 08.
Article in English | MEDLINE | ID: mdl-27796623

ABSTRACT

Sleep problems are associated with problematic adjustment in toddlers, but less is known regarding the direction of association between specific sleep problems and adjustment. To address this gap, we used data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (N = 1001) to examine reciprocal associations between sleep problems and behavior problems from 24- to 36-months. Results from cross-lagged path models suggested specificity of associations between type of sleep problem and behavior problem. Specifically, there were reciprocal associations between trouble getting to sleep and internalizing problems, and unidirectional links between externalizing problems and bedtime resistance from 24- to 36-months. Internalizing and externalizing problems at 24 months, however, predicted increases in bedtime resistance from 24- to 36-months for boys, but not girls. Findings highlight specific relations between sleep problems and internalizing and externalizing problems during toddlerhood, and the importance of examining sex differences.


Subject(s)
Child Behavior Disorders , Sleep Wake Disorders , Child Behavior Disorders/epidemiology , Child, Preschool , Comorbidity , Female , Humans , Infant , Male , Sex Factors , Sleep Wake Disorders/epidemiology
4.
Telemed J E Health ; 20(6): 559-62, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24660879

ABSTRACT

BACKGROUND: A telemedicine program was developed between the Children's National Medical Center (CNMC) in Washington, DC, and the Sheikh Khalifa Bin Zayed Foundation in the United Arab Emirates (UAE). A needs assessment and a curriculum of on-site training conferences were devised preparatory to an ongoing telemedicine consultation program for children with neurodevelopmental disabilities in the underserved eastern region of the UAE. MATERIALS AND METHODS: Weekly telemedicine consultations are provided by a multidisciplinary faculty. Patients are presented in the UAE with their therapists and families. Real-time (video over Internet protocol; average connection, 768 kilobits/s) telemedicine conferences are held weekly following previews of medical records. A full consultation report follows each telemedicine session. RESULTS: Between February 29, 2012 and June 26, 2013, 48 weekly 1-h live interactive telemedicine consultations were conducted on 48 patients (28 males, 20 females; age range, 8 months-22 years; median age, 5.4 years). The primary diagnoses were cerebral palsy, neurogenetic disorders, autism, neuromuscular disorders, congenital anomalies, global developmental delay, systemic disease, and epilepsy. Common comorbidities were cognitive impairment, communication disorders, and behavioral disorders. Specific recommendations included imaging and DNA studies, antiseizure management, spasticity management including botulinum toxin protocols, and specific therapy modalities including taping techniques, customized body vests, and speech/language and behavioral therapy. Improved outcomes reported were in clinician satisfaction, achievement of therapy goals for patients, and requests for ongoing sessions. CONCLUSIONS: Weekly telemedicine sessions coupled with triannual training conferences were successfully implemented in a clinical program dedicated to patients with neurodevelopmental disabilities by the Center for Neuroscience at CNMC and the UAE government. International consultations in neurodevelopmental disabilities utilizing telemedicine services offer a reliable and productive method for joint clinical programs.


Subject(s)
Developmental Disabilities/therapy , Patient Education as Topic/methods , Referral and Consultation/organization & administration , Telemedicine/methods , Adolescent , Child , Child, Preschool , Developmental Disabilities/diagnosis , Female , Humans , Infant , Internationality , Male , Quality Control , Technology Assessment, Biomedical , United Arab Emirates , United States , Young Adult
5.
Infant Ment Health J ; 35(3): 274-84, 2014.
Article in English | MEDLINE | ID: mdl-25798481

ABSTRACT

The ability to self-generate positive emotions is an important component of emotion regulation. In this study, we focus on children's latency to express positive emotions following challenging situations and assess whether this ability operates through early maternal sensitivity and children's effortful control. Longitudinal relations between maternal sensitivity, infant negative affect, effortful control, and latency to positive emotion following challenge were examined in 156 children who were 33 months of age. Structural equation models supported the hypothesis that maternal sensitivity during infancy predicted better effortful control and, in turn, shorter latencies to positive emotions following challenge at 33 months. Directions for future research are discussed.


Subject(s)
Child Behavior Disorders/diagnosis , Child Behavior/psychology , Emotions , Mother-Child Relations , Parenting/psychology , Adolescent , Adult , Affect , Child, Preschool , Family , Female , Humans , Infant , Longitudinal Studies , Male , Mothers/psychology , Surveys and Questionnaires , Young Adult
6.
Am J Orthopsychiatry ; 94(2): 180-189, 2024.
Article in English | MEDLINE | ID: mdl-38127511

ABSTRACT

Emotional abuse up to age 18 is associated with depressive symptoms in adulthood, yet few studies have examined these links in Black females. Despite research documenting the moderating role of sleep duration on early adversity and mental health, no studies have examined whether sleep duration during adolescence moderates the relations between emotional abuse up to age 18 and depressive symptoms in adulthood. We examined these relations in 690 Black females from the National Longitudinal Study of Adolescent Health (Add Health)-Public Use. Individuals reported the frequency of emotional abuse up to age 18, hours of sleep during adolescence, and depressive symptoms using the 10-item version of the Center for Epidemiological Studies Depression Scale. Only 55% of adolescents reported sleeping the recommended 8-10 hr per night. Frequent emotional abuse before age 18 years was associated with more adult depressive symptoms for those with shorter, but not longer, sleep duration. Greater attention should be placed on facilitating and promoting sleep health for Black females. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Child Abuse , Depression , Adult , Child , Humans , Adolescent , Female , Depression/epidemiology , Depression/psychology , Longitudinal Studies , Sleep Duration , Emotional Abuse , Child Abuse/psychology
7.
J Interpers Violence ; : 8862605241245361, 2024 Apr 09.
Article in English | MEDLINE | ID: mdl-38591162

ABSTRACT

Following a traumatic event such as intimate partner violence (IPV), survivors often experience stress related to the violence. These high levels of stress related to IPV can be associated with the daily activities of survivors and their relationships with their children, such as maternal-child bonding. The purpose of the current study is to explore the relationship between daily activities, daily stress levels, parenting self-efficacy and behaviors, and maternal-child bonding among survivors living in an IPV shelter using an ecological momentary assessment (EMA) methodology. Twenty-five mothers living in an IPV shelter in two states in the Southern United States completed a baseline survey and completed electronic daily diaries for 14 days. Higher daily stress was associated with the number of times the mothers met with the case manager. Higher daily stress was also related to lower parenting self-efficacy. The number of case management appointments and legal appointments were positively correlated with a higher bonding score. More social support was associated with more positive parenting. IPV and post-traumatic stress disorder symptoms were not significantly associated with maternal-child bonding, parenting behaviors, or parenting self-efficacy. Findings suggest that screening for maternal support may be particularly important for positive bonding and positive parenting. Findings also lend preliminary insight into practical places where service providers could act to protect the bonding process or mitigate risks to impede it. Future research should include objective data about the mother's emotions and her interactive behavior with her child. There is also a need to consider how federal programs fund and incentivize service providers to focus on mother-child dyads and how they can tailor services that promote bonding.

8.
Chronobiol Int ; 40(10): 1404-1418, 2023 10 03.
Article in English | MEDLINE | ID: mdl-37814409

ABSTRACT

Biological changes contribute to preferences for later bed and wake times during adolescence, yet the social constraints of school start times necessitate early wake times. This often results in social jetlag (i.e. misalignment between preferred sleep timing on weekends and school days). We examined whether social jetlag predicts adolescent internalizing and externalizing behavior over time and/or whether associations differ based on sex. We used data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development Study (n = 767) to test whether social jetlag at 6th grade (ages 12-13 years) predicted internalizing and externalizing behavior at age 15 years and whether child sex moderated associations. Controlling for internalizing and externalizing behavior at 6th grade (ages 12-13 years), results were that social jetlag at 6th grade (ages 12-13 years) predicted more internalizing and externalizing behaviors at age 15 for females, but not males. These findings show that social jetlag during early adolescence confers risk for internalizing and externalizing behavior in females at mid-adolescence. Greater attention should be placed on identifying and addressing social jetlag in adolescent females.


Subject(s)
Adolescent Behavior , Child Behavior Disorders , Humans , Adolescent , Female , Child , Circadian Rhythm , Sleep
9.
Child Dev ; 83(3): 1022-36, 2012.
Article in English | MEDLINE | ID: mdl-22469209

ABSTRACT

Despite an extensive history underscoring the role of social processes and child contributions to the development of executive functions (C. Lewis & J. Carpendale, 2009; L. S. Vygotsky, 1987), research on these relations is sparse. To address this gap, 68 mother-child dyads were examined to determine whether maternal attention-directing behaviors (attention maintaining, attention redirection) and toddlers' temperament predicted executive processes during preschool (mean age = 4.5 years, SD = 0.46)-delay and conflict inhibition. Maternal attention maintaining was associated with high levels of conflict inhibition for inhibited and exuberant children, whereas attention redirection was associated with low levels of delay and conflict inhibition for inhibited children. Therefore, maternal attention-directing behaviors may enhance the development of executive functions but only for children with inhibited and exuberant temperaments.


Subject(s)
Child Development/physiology , Emotions/physiology , Executive Function/physiology , Inhibition, Psychological , Child, Preschool , Choice Behavior , Conflict, Psychological , Female , Humans , Infant , Male , Mother-Child Relations , Problem Solving , Random Allocation , Reaction Time , Temperament/physiology
10.
J Racial Ethn Health Disparities ; 9(1): 193-200, 2022 Feb.
Article in English | MEDLINE | ID: mdl-33496956

ABSTRACT

OBJECTIVES: To test the association between racial discrimination and cardiovascular-related conditions and whether PTSD mediates this relationship in a nationally representative sample of non-Hispanic Blacks. METHODS: We used data from the 2013 National Epidemiologic Survey on Alcohol and Related Conditions to conduct logistic regression analyses to examine the association between racial discrimination, PTSD, and cardiovascular-related conditions. We also performed mediation analyses to assess whether the association between racial discrimination and cardiovascular conditions was partly explained by PTSD. RESULTS: Racial discrimination was positively associated with both PTSD and cardiovascular-related conditions. Additionally, PTSD was positively associated with cardiovascular conditions. Results from the fully adjusted mediation models suggest that PTSD significantly mediated the association between racial discrimination and cardiovascular conditions. CONCLUSIONS: Our results demonstrate an association between racial discrimination and cardiovascular-related conditions that is significantly mediated by PTSD. To improve cardiovascular functioning among non-Hispanic Blacks, health care professionals in conjunction with Black communities must adopt culturally competent screening for and treatment for PTSD. To address racial differences in cardiovascular conditions, public health efforts must address institutional policies that negatively alter health opportunities among the Black population.


Subject(s)
Racism , Stress Disorders, Post-Traumatic , Black or African American , Humans , Stress Disorders, Post-Traumatic/epidemiology , United States/epidemiology
11.
Genet Med ; 13(2): 95-101, 2011 Feb.
Article in English | MEDLINE | ID: mdl-21150784

ABSTRACT

PURPOSE: This study evaluated the safety and effectiveness of long-term enzyme replacement therapy with idursulfase (recombinant human iduronate-2-sulfatase) in patients with Hunter syndrome. METHODS: All 94 patients who completed a 53-week double-blinded study of idursulfase enrolled in this open-labeled extension study and received intravenous idursulfase at a dose of 0.5 mg/kg weekly for 2 years, and clinical outcomes and safety were assessed. RESULTS: No change in percent predicted forced vital capacity was seen, but absolute forced vital capacity demonstrated sustained improvement and was increased 25.1% at the end of the study. Statistically significant increases in 6-minute walking test distance were observed at most time points. Mean liver and spleen volumes remained reduced throughout the 2-year extension study. Mean joint range of motion improved for the shoulder and remained stable in other joints. Both the parent- and child-assessed Child Health Assessment Questionnaire Disability Index Score demonstrated significant improvement. Infusion-related adverse events occurred in 53% of patients and peaked at Month 3 of treatment and declined thereafter. Neutralizing IgG antibodies were detected in 23% of patients and seemed to attenuate the improvement in pulmonary function. CONCLUSIONS: Weekly infusions of idursulfase result in sustained clinical improvement during 3 years of treatment.


Subject(s)
Enzyme Replacement Therapy/methods , Iduronate Sulfatase/administration & dosage , Mucopolysaccharidosis II/drug therapy , Adolescent , Child , Child, Preschool , Enzyme Replacement Therapy/adverse effects , Glycosaminoglycans/analysis , Humans , Iduronate Sulfatase/adverse effects , Infusions, Intravenous , Liver/pathology , Mucopolysaccharidosis II/pathology , Organ Size , Spleen/pathology , Treatment Outcome
12.
Am J Orthopsychiatry ; 91(2): 236-245, 2021.
Article in English | MEDLINE | ID: mdl-33983772

ABSTRACT

Racial disparities in sleep have been reported with Black adolescents showing the least amount of sleep relative to other youth. Yet, few within-group studies have examined factors that protect Black adolescents from sleep problems. To address this gap, we tested whether parent ethnic-racial socialization (i.e., instilling a sense of cultural and racial pride) at fourth grade moderated the associations between bedtime sleep problems at third and sixth grade. Using data from a sample of Black parents and children who participated in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n = 173), we found that for children with low, but not high, parent ethnic-racial socialization at fourth grade bedtime problems increased from third and sixth grade. We discuss these findings within the existing parent ethnic-racial socialization and sleep literatures and how they further our understanding of the protective effects of parent ethnic-racial socialization. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Sleep Wake Disorders , Socialization , Adolescent , Black or African American , Humans , Parents , Social Identification
13.
Soc Work ; 66(3): 197-205, 2021 Jul 21.
Article in English | MEDLINE | ID: mdl-34143884

ABSTRACT

As the United States faces the repercussions of the current opioid epidemic, it is important for social workers to be able to identify risks for poor birth outcomes in infants with neonatal abstinence syndrome (NAS). Although some studies have identified single risk factors, no studies have tested associations between total amount of risk (that is, cumulative risk) and birth outcomes in infants with NAS. Authors examined 318 mothers who used opioids during pregnancy and their infants' birthweight, length, head circumference, and Apgar scores (which measure overall infant health after birth). All infants were admitted to a neonatal intensive care unit in Appalachia and were diagnosed with NAS. Authors found that high cumulative risk during pregnancy was associated with lower birthweight and Apgar scores one and five minutes after birth as well as shorter length and smaller head circumference at birth. Social workers are encouraged to assess for the quantity of prenatal adversity experienced by the mothers they serve and to consider multicomponent, comprehensive community-based interventions to reduce cumulative risk.


Subject(s)
Neonatal Abstinence Syndrome , Pregnancy Complications , Analgesics, Opioid/adverse effects , Appalachian Region/epidemiology , Female , Humans , Infant , Infant, Newborn , Neonatal Abstinence Syndrome/drug therapy , Neonatal Abstinence Syndrome/epidemiology , Pregnancy , Pregnancy Complications/chemically induced , Pregnancy Complications/drug therapy , Pregnancy Complications/epidemiology , Social Work , United States
14.
Stem Cells ; 27(1): 18-28, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19224508

ABSTRACT

Human germ cell tumors are often metastatic, presumably due to distal site tumor growth by cancer stem cells. To determine whether cancer stem cells can be identified in a transplantation model of testicular germ cell tumor, we transplanted murine embryonic germ cells (EGCs) into the testis of adult severe combined immunodeficient mice. Transplantation resulted in a locally invasive solid tumor, with a cellular component that generated secondary tumors upon serial transplantation. The secondary tumors were invariably metastatic, a feature not observed in the primary tumors derived from EGCs. To characterize the differences between EGCs and the tumor-derived stem cells, we performed karyotype and microarray analysis. Our results show that generation of cancer stem cells is associated with the acquisition of nonclonal genomic rearrangements not found in the originating population. Furthermore, pretreatment of EGCs with a potent inhibitor of self-renewal, retinoic acid, prevented tumor formation and the emergence of these genetically unstable cancer stem cells. Microarray analysis revealed that EGCs and first- and second-generation cancer stem cells were highly similar; however, approximately 1,000 differentially expressed transcripts could be identified corresponding to alterations in oncogenes and genes associated with motility and development. Combined, the data suggest that the activation of oncogenic pathways in a cellular background of genetic instability, coupled with an inherent ability to self-renew, is involved in the acquisition of metastatic behavior in the cancer stem cell population of tumors derived from pluripotent cells.


Subject(s)
Genomic Instability , Neoplastic Stem Cells/pathology , Pluripotent Stem Cells/pathology , Animals , Cell Line , Cell Proliferation/drug effects , Fluorescent Antibody Technique , Genomic Instability/drug effects , Germ Cells/drug effects , Germ Cells/transplantation , Humans , Lewis X Antigen/metabolism , Male , Mice , Models, Biological , Neoplastic Stem Cells/drug effects , Oligonucleotide Array Sequence Analysis , Pluripotent Stem Cells/drug effects , Testicular Neoplasms/pathology , Tretinoin/pharmacology
15.
Stem Cells ; 27(4): 783-95, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19350678

ABSTRACT

The derivation of germ cells from human embryonic stem cells (hESCs) or human induced pluripotent stem (hIPS) cells represents a desirable experimental model and potential strategy for treating infertility. In the current study, we developed a triple biomarker assay for identifying and isolating human primordial germ cells (PGCs) by first evaluating human PGC formation during the first trimester in vivo. Next, we applied this technology to characterizing in vitro derived PGCs (iPGCs) from pluripotent cells. Our results show that codifferentiation of hESCs on human fetal gonadal stromal cells significantly improves the efficiency of generating iPGCs. Furthermore, the efficiency was comparable between various pluripotent cell lines regardless of origin from the inner cell mass of human blastocysts (hESCs), or reprogramming of human skin fibroblasts (hIPS). To better characterize the iPGCs, we performed Real-time polymerase chain reaction, microarray, and bisulfite sequencing. Our results show that iPGCs at day 7 of differentiation are transcriptionally distinct from the somatic cells, expressing genes associated with pluripotency and germ cell development while repressing genes associated with somatic differentiation (specifically multiple HOX genes). Using bisulfite sequencing, we show that iPGCs initiate imprint erasure from differentially methylated imprinted regions by day 7 of differentiation. However, iPGCs derived from hIPS cells do not initiate imprint erasure as efficiently. In conclusion, our results indicate that triple positive iPGCs derived from pluripotent cells differentiated on hFGS cells correspond to committed first trimester germ cells (before 9 weeks) that have initiated the process of imprint erasure.


Subject(s)
Biological Assay , Cell Differentiation/physiology , Embryonic Stem Cells/cytology , Germ Cells/cytology , Gonads/cytology , Pluripotent Stem Cells/cytology , Stromal Cells/cytology , Biomarkers/metabolism , Coculture Techniques/methods , Embryo, Mammalian , Embryonic Stem Cells/metabolism , Female , Fetus/cytology , Flow Cytometry , Fluorescent Antibody Technique , Germ Cells/metabolism , Gonads/metabolism , Humans , Oligonucleotide Array Sequence Analysis , Pluripotent Stem Cells/metabolism , Pregnancy , Reverse Transcriptase Polymerase Chain Reaction , Stromal Cells/metabolism
16.
Stem Cells ; 27(4): 806-11, 2009 Apr.
Article in English | MEDLINE | ID: mdl-19350680

ABSTRACT

The potential for directed differentiation of human-induced pluripotent stem (iPS) cells to functional postmitotic neuronal phenotypes is unknown. Following methods shown to be effective at generating motor neurons from human embryonic stem cells (hESCs), we found that once specified to a neural lineage, human iPS cells could be differentiated to form motor neurons with a similar efficiency as hESCs. Human iPS-derived cells appeared to follow a normal developmental progression associated with motor neuron formation and possessed prototypical electrophysiological properties. This is the first demonstration that human iPS-derived cells are able to generate electrically active motor neurons. These findings demonstrate the feasibility of using iPS-derived motor neuron progenitors and motor neurons in regenerative medicine applications and in vitro modeling of motor neuron diseases.


Subject(s)
Cell Culture Techniques , Cell Differentiation/physiology , Embryonic Stem Cells/cytology , Motor Neurons/cytology , Pluripotent Stem Cells/cytology , Cell Line , Cell Lineage , Humans , Motor Neuron Disease/pathology , Motor Neuron Disease/therapy , Motor Neurons/physiology , Patch-Clamp Techniques , Regenerative Medicine
17.
Dev Neuropsychol ; 45(5): 309-329, 2020 08.
Article in English | MEDLINE | ID: mdl-32791853

ABSTRACT

Data from the National Institute of Child Health and Human Development Study of Early Child Care were used to test whether maternal sensitivity and stimulation at 15 and 54 months predicted child attention, impulsivity, and delay of gratification at 54 months, and whether toddler attention and temperamental difficultness moderated associations. Maternal sensitivity at 54 months was positively associated with children's delay of gratification and negatively associated with inattention and impulsivity at 54 months. Maternal stimulation at 15 months was negatively associated with inattention at 54 months for toddlers with higher levels of attention focusing and temperamental difficultness. The importance of attending to individual differences is discussed.


Subject(s)
Attention/physiology , Parenting/psychology , Pleasure/physiology , Temperament/physiology , Child, Preschool , Female , Humans , Infant , Male
18.
J Affect Disord ; 262: 16-22, 2020 02 01.
Article in English | MEDLINE | ID: mdl-31698251

ABSTRACT

BACKGROUND: In most studies, religiosity and spirituality (R/S) are positively associated with altruism, whereas depression is negatively associated. However, the cross-sectional designs of these studies limit their epidemiological value. We examine the association of R/S and major depressive disorder (MDD) with altruism in a five year longitudinal study nested in a larger prospective study. METHODS: Depressed and non-depressed individuals and their first- and second-generation offspring were assessed over several decades. At Year30 after baseline, R/S was measured using participants' self-report; MDD, by clinical interview. At Year35, participants completed a measure of altruism. Adjusted odds ratios (AOR) were calculated using multivariate logistic regression; statistical significance, set at p<.05. two-tailed. RESULTS: In the overall sample, both R/S and MDD were significantly associated with altruism, AOR 2.52 (95% CI 1.15-5.49) and AOR 2.43 (95% CI 1.05-5.64), respectively; in the High Risk group alone, the corresponding AORs were 4.69 (95% CI 1.39-15.84) and 4.74 (95% CI 1.92-11.72). Among highly R/S people in the High Risk group, the AOR for MDD with altruism was 22.55 (95% CI 1.23-414.60) p<.04; among the remainder, it was 3.12 (95% CI 0.63-15.30), a substantial but non-significant difference. LIMITATIONS: Altruism is based on self-report, not observation, hence, vulnerable to bias. CONCLUSIONS: MDD's positive association with elevated altruism concurs with studies of posttraumatic growth in finding developmental growth from adversity. The conditions that foster MDD's positive association with altruism and the contribution of R/S to this process requires further study.


Subject(s)
Altruism , Depressive Disorder, Major/psychology , Spirituality , Adult , Cross-Sectional Studies , Female , Humans , Logistic Models , Longitudinal Studies , Male , Middle Aged , Odds Ratio , Prospective Studies
19.
Emotion ; 9(3): 361-8, 2009 Jun.
Article in English | MEDLINE | ID: mdl-19485613

ABSTRACT

Happiness-a composite of life satisfaction, coping resources, and positive emotions-predicts desirable life outcomes in many domains. The broaden-and-build theory suggests that this is because positive emotions help people build lasting resources. To test this hypothesis, the authors measured emotions daily for 1 month in a sample of students (N = 86) and assessed life satisfaction and trait resilience at the beginning and end of the month. Positive emotions predicted increases in both resilience and life satisfaction. Negative emotions had weak or null effects and did not interfere with the benefits of positive emotions. Positive emotions also mediated the relation between baseline and final resilience, but life satisfaction did not. This suggests that it is in-the-moment positive emotions, and not more general positive evaluations of one's life, that form the link between happiness and desirable life outcomes. Change in resilience mediated the relation between positive emotions and increased life satisfaction, suggesting that happy people become more satisfied not simply because they feel better but because they develop resources for living well.


Subject(s)
Emotions , Happiness , Personal Satisfaction , Resilience, Psychological , Female , Health Status , Humans , Male , Models, Psychological , Personality Inventory , Quality of Life/psychology , Surveys and Questionnaires
20.
Surg Infect (Larchmt) ; 9(5): 497-501, 2008 Oct.
Article in English | MEDLINE | ID: mdl-18687049

ABSTRACT

BACKGROUND: Clostridium difficile infection (CDI) is an increasing problem worldwide. To our knowledge, there are no studies evaluating specifically the incidence of CDI in the critically injured trauma population. METHODS: Five hundred eighty-one consecutive critically injured trauma patients were followed prospectively for development of CDI, diagnosed by toxin assay. Testing was ordered on the basis of symptoms. Antibiotic usage was classified as surgical prophylaxis or therapeutic. RESULTS: Nineteen cases of CDI were diagnosed in 581 patients (3.3%). Age, sex, race, and injury severity score (ISS) were similar in patients with and without CDI (p > 0.2); the mean ISS in patients with CDI was 29 points. Intensive care unit length of stay (ICU LOS), ventilator days, and hospital length of stay (HLOS) were significantly higher in the CDI patients. The diagnosis was made a mean of 17 days after admission; however, in four patients (21%), the infections were diagnosed within six days of admission. Fourteen patients (74%) had received therapeutic antibiotics for confirmed or suspected infection prior to the appearance of colitis; four patients (21%) received only intraoperative prophylaxis, and one patient had no antibiotic exposure. These five patients were significantly younger than those who developed CDI after therapeutic antibiotic usage and had significantly shorter HLOS and ICU LOS (p < 0.05). This result persisted after controlling for age using multiple linear regression analysis. CONCLUSIONS: Clostridium difficile infection occurred in 3.3% of patients and was diagnosed as early as the fourth hospital day. We have identified a unique subgroup of younger patients who developed CDI after minimal or no antibiotic exposure. Further study is needed to characterize this population.


Subject(s)
Clostridioides difficile/isolation & purification , Enterocolitis, Pseudomembranous/epidemiology , Enterocolitis, Pseudomembranous/microbiology , Multiple Trauma , Trauma Centers/statistics & numerical data , Adult , Anti-Bacterial Agents/therapeutic use , Enterocolitis, Pseudomembranous/diagnosis , Enterocolitis, Pseudomembranous/drug therapy , Female , Humans , Injury Severity Score , Intensive Care Units , Length of Stay , Male , Maryland , Middle Aged , Young Adult
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