Housing quality, housing instability, and maternal mental health.

Poor housing conditions and residential instability have been associated with distress among women; however, this association could be the result of other social factors related to housing, such as intimate partner violence (IPV) and economic hardship. We examined associations of housing conditions and instability with maternal depression and generalized anxiety disorder (GAD) while accounting for IPV and economic hardship in the Fragile Families and Child Wellbeing Study (N = 2,104). In the third study wave, interviewers rated indoor housing quality, including housing deterioration (e.

Cumulative Stress and Cortisol Disruption among Black and Hispanic Pregnant Women in an Urban Cohort.

While adult hypothalamic-pituitary-adrenocortical (HPA) axis functioning is thought to be altered by traumatic experiences, little data exist on the effects of cumulative stress on HPA functioning among pregnant women or among specific racial and ethnic groups. Individuals may be increasingly vulnerable to physiological alterations when experiencing cumulative effects of multiple stressors. These effects may be particularly relevant in urban poor communities where exposure to multiple stressors is more prevalent.

Asthma and obesity in three-year-old urban children: role of sex and home environment.

Objective: To examine whether the relationship between obesity and asthma in young girls and boys can be explained by social and physical characteristics of the home environment.

Study Design: We examined the relationship between asthma and obesity in children in the Fragile Families and Child Wellbeing Study (n=1815). Asthma was determined through maternal report of asthma diagnosis by a doctor (active in past 12 months).

Association between maternal intimate partner violence and incident obesity in preschool-aged children: results from the Fragile Families and Child Well-being Study.

Objective: To examine the impact of chronicity of maternal intimate partner violence (IPV) on obesity risk among preschool-aged children.

Design: Prospective cohort study.

Setting: Several large US cities.

Children's exposure to violence and distress symptoms: influence of caretakers' psychological functioning.

Background: Previous studies linking violence exposure to adverse child behavior have typically relied on parental report of child symptoms without accounting for the informant's mental well-being, despite evidence that parental mental health can influence children's mental health and the parent's report of distress symptoms.

Purpose: We assess the influence of maternal depression on the violence exposure and child distress association in a subset of the Maternal Infant Smoking Study of East Boston, a prospective birth cohort.

Methods: Mothers reported on their children's violence exposure using the Survey of Children's Exposure to Community Violence (ETV) and completed the Checklist of Child Distress Symptoms (CCDS).

Association between exposure to political violence and intimate-partner violence in the occupied Palestinian territory: a cross-sectional study.

Background: Intimate-partner violence might increase during and after exposure to collective violence. We assessed whether political violence was associated with male-to-female intimate-partner violence in the occupied Palestinian territory.

Methods: A nationally representative, cross-sectional survey was done between Dec 18, 2005, and Jan 18, 2006, by the Palestinian Central Bureau of Statistics.

Social and environmental stressors in the home and childhood asthma.

Background: Both physical environmental factors and chronic stress may independently increase susceptibility to asthma; however, little is known on how these different risks may interact. The authors examined the relationship between maternal intimate partner violence (IPV), housing quality and asthma among children in the Fragile Families and Child Wellbeing Study (N=2013).

Methods: Maternal reports of IPV were obtained after the child's birth and at 12 and 36 months.

Relationships among prenatal aeroallergen exposure and maternal and cord blood IgE: project ACCESS.

Background: Whereas some evidence suggests that antigen sensitization may begin prenatally, the influence of maternal allergen exposure during pregnancy has not been fully elucidated.

Objectives: We examined the relationship between prenatal maternal aeroallergen exposure and cord blood total IgE and the potential mediating/indirect effect of maternal immune response.

Methods: This study was performed in 301 mother-infant pairs enrolled in the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project, a study examining the effects of prenatal and early life social and physical environmental exposures on urban asthma risk.

Posttraumatic stress symptoms related to community violence and children's diurnal cortisol response in an urban community-dwelling sample.

Background: While community violence has been linked to psychological morbidity in urban youth, data on the physiological correlates of violence and associated posttraumatic stress symptoms are sparse. We examined the influence of child posttraumatic stress symptoms reported in relationship to community violence exposure on diurnal salivary cortisol response in a population based sample of 28 girls and 15 boys ages 7-13, 54% self-identified as white and 46% as Hispanic.

Methods: Mothers' reported on the child's exposure to community violence using the Survey of Children's Exposure to Community Violence and completed the Checklist of Children's Distress Symptoms (CCDS) which captures factors related to posttraumatic stress; children who were eight years of age or greater reported on their own community violence exposure.

Maternal intimate partner violence and increased asthma incidence in children: buffering effects of supportive caregiving.

Objectives: To examine the relationship between maternal intimate partner violence (IPV) and asthma onset in children and the role of supportive caregiving factors in modifying this relationship.

Design: Prospective birth cohort.

Setting: In-person interview at enrollment as well as in-home interviews during study follow-up.

Creation of a community violence exposure scale: accounting for what, who, where, and how often.

Previous research has used the Rasch model, a method for obtaining a continuous scale from dichotomous survey items measuring a single latent construct, to create a scale of community violence exposure. The authors build upon previous work and describe the application of a Rasch model using the continuation ratio model to create an exposure to community violence (ETV) scale including event circumstance information previously shown to modify the impact of experienced events. They compare the Rasch ETV scale to a simpler sum ETV score, and estimate the effect of ETV on child posttraumatic stress symptoms.

Association between traffic-related black carbon exposure and lung function among urban women.

Background: Although a number of studies have documented the relationship between lung function and traffic-related pollution among children, few have focused on adult lung function or examined community-based populations.

Objective: We examined the relationship between black carbon (BC), a surrogate of traffic-related particles, and lung function among women in the Maternal-Infant Smoking Study of East Boston, an urban cohort in Boston, Massachusetts.

Methods: We estimated local BC levels using a validated spatiotemporal land-use regression model, derived using ambient and indoor monitor data.

Transdisciplinary research strategies for understanding socially patterned disease: the Asthma Coalition on Community, Environment, and Social Stress (ACCESS) project as a case study.

As we have seen a global increase in asthma in the past three decades it has also become clear that it is a socially patterned disease, based on demographic and socioeconomic indicators clustered by areas of residence. This trend is not readily explained by traditional genetic paradigms or physical environmental exposures when considered alone. This has led to consideration of the interplay among physical and psychosocial environmental hazards and the molecular and genetic determinants of risk (i.

A maximum likelihood latent variable regression model for multiple informants.

Studies pertaining to childhood psychopathology often incorporate information from multiple sources (or informants). For example, measurement of some factor of particular interest might be collected from parents, teachers as well as the children being studied. We propose a latent variable modeling framework to incorporate multiple informant predictor data.

Association between lung function and cognition among children in a prospective birth cohort study.

Objectives: To examine the relationship between lung function and cognition among children in the Maternal-Infant Smoking Study of East Boston, a prospective cohort of women and children enrolled before 20 weeks of gestation. A number of studies have demonstrated a relationship between lung function and cognition among adults, but this relationship has not been studied among children.

Methods: At 6 years of age, children completed lung function tests.

Patient follow-up in primary care after behavioral health screening in an urban public hospital system: a prospective, observational study of 2686 patients.

Objective: Patients with psychiatric conditions are known to experience poor and often disparate health outcomes. To investigate one potential mechanism for this phenomenon, we examined whether patients who screen positive for psychiatric comorbidity are lost to follow-up from primary care at higher rates than screen-negative controls.

Method: Patients in a public hospital system were followed prospectively for an 18-month period after an initial routine behavioral health screening in neighborhood health centers.

Violence exposure, a chronic psychosocial stressor, and childhood lung function.

Objective: Chronic psychosocial stressors, including violence, and neuropsychological and behavioral development in children as well as physiologic alterations that may lead to broader health effects.

Methods: We studied the relationship between violence and childhood lung function in a prospective birth cohort of 313 urban children (age range = 6-7 years). Mothers reported on their child's lifetime exposure to community violence (ETV) and interparental conflict in the home (Conflict Tactics Scale (CTS)) within 1 year of the lung function assessment.

Synergistic effects of traffic-related air pollution and exposure to violence on urban asthma etiology.

Background: Disproportionate life stress and consequent physiologic alteration (i.e., immune dysregulation) has been proposed as a major pathway linking socioeconomic position, environmental exposures, and health disparities.

Evaluating an end-of-life curriculum in a medical residency program.

The ability to meet patient needs at the end of life is important. Boston University Residency Program in Medicine initiated a 1-week-long end-of-life curriculum that included a hospice care orientation, core articles, and home hospice visits. Evaluated was the impact of the rotation on participant knowledge and attitude.

Mental health screening in pediatric practice: factors related to positive screens and the contribution of parental/personal concern.

Objectives: The goals were to examine factors related to positive Pediatric Symptom Checklist scores in an urban practice and to examine the relative contribution of parental/personal concern about emotional and behavioral problems to mental health problem identification.

Methods: Annual screening using the Pediatric Symptom Checklist was implemented in Cambridge Pediatrics (Cambridge, MA). A social worker was colocated in the clinic to provide therapeutic interventions for patients.