Introduction
Adolescents with an immigrant background, whether first‐generation (born abroad) or second‐generation (at least one parent born abroad), face challenges that could compromise their ...psychological adjustment compared to their third‐plus generation peers. Yet, many are developing positively despite the presence of adversity. To understand what contributes to these adolescents' resilience, it can be useful to study the coping strategies they use.
Methods
A total of 1036 Canadian secondary school students participated in this quantitative cross‐sectional study (Mage = 12.9; 56% females; 26% first‐generation; 34% second generation; 39% third‐plus generation). Coping strategies (coping orientation to problems experienced inventory) were assessed and their differentiated associations with self‐esteem, anxiety (Screen for Child Anxiety Related Emotional Disorders), and depressive symptoms (Center for Epidemiologic Studies Depression Scale) were analyzed through path analysis and invariance testing.
Results
First‐generation adolescents reported more acceptance/reinterpretation and substance use than second‐ and third‐plus generation adolescents. First‐ and second‐generation adolescents reported using religion more than third‐plus generation adolescents. First‐generation adolescents used self‐distraction more often than second‐generation adolescents, who used it more often than third‐plus generation. The use of humor was more prevalent in second‐generation adolescents compared with their third‐plus generation peers. In addition, some associations between coping strategies and psychological adjustment differed across generations. In first‐generation adolescents, behavioral disengagement was significantly associated with fewer anxiety symptoms. The same trend was observed in second‐generation adolescents who used self‐distraction. These avoidant strategies are generally associated with poor psychological adjustment.
Conclusions
This study adds new knowledge about differences across generations in the coping strategies used by adolescents to deal with stress. Further practical implications are discussed.
Background & Aims Medications are a major cause of acute liver failure (ALF) in the United States, but no population-based studies have evaluated the incidence of ALF from drug-induced liver injury. ...We aimed to determine the incidence and outcomes of drug-induced ALF in an integrated health care system that approximates a population-based cohort. Methods We performed a retrospective cohort study using data from the Kaiser Permanente Northern California (KPNC) health care system between January 1, 2004, and December 31, 2010. We included all KPNC members age 18 years and older with 6 months or more of membership and hospitalization for potential ALF. The primary outcome was drug-induced ALF (defined as coagulopathy and hepatic encephalopathy without underlying chronic liver disease), determined by hepatologists who reviewed medical records of all KPNC members with inpatient diagnostic and laboratory criteria suggesting potential ALF. Results Among 5,484,224 KPNC members between 2004 and 2010, 669 had inpatient diagnostic and laboratory criteria indicating potential ALF. After medical record review, 62 (9.3%) were categorized as having definite or possible ALF, and 32 (51.6%) had a drug-induced etiology (27 definite, 5 possible). Acetaminophen was implicated in 18 events (56.3%), dietary/herbal supplements in 6 events (18.8%), antimicrobials in 2 events (6.3%), and miscellaneous medications in 6 events (18.8%). One patient with acetaminophen-induced ALF died (5.6%; 0.06 events/1,000,000 person-years) compared with 3 patients with non–acetaminophen-induced ALF (21.4%; 0.18/1,000,000 person-years). Overall, 6 patients (18.8%) underwent liver transplantation, and 22 patients (68.8%) were discharged without transplantation. The incidence rates of any definite drug-induced ALF and acetaminophen-induced ALF were 1.61 events/1,000,000 person-years (95% confidence interval, 1.06–2.35) and 1.02 events/1,000,000 person-years (95% confidence interval, 0.59–1.63), respectively. Conclusions Drug-induced ALF is uncommon, but over-the-counter products and dietary/herbal supplements are its most common causes.
Abstract Background and Aims Endoscopist fatigue may impact colonoscopy quality, but prior studies conflict, and minimal data exist from community-based practices where most colonoscopies are ...performed. Methods Within a large, community-based integrated healthcare system, we evaluated the associations among 4 measures of endoscopist fatigue and colonoscopic adenoma detection during the years 2010 to 2013. Fatigue measures included afternoon versus morning colonoscopy and the number of GI procedures performed before a given colonoscopy, including consideration of prior procedure complexity. Analyses were adjusted for potential confounders using multivariate logistic regression. Results We identified 126 gastroenterologists who performed 259,064 total GI procedures (median: 6/day, range: 1-24), including 76,445 screening and surveillance colonoscopies. Compared with morning examinations, colonoscopies in the afternoon were not associated with lower adenoma detection for screening examinations, surveillance examinations, or their combination (odds ratio (OR) for combination 0.99; 95% confidence interval (CI), 0.96-1.03). The number of procedures performed before a given colonoscopy, with or without consideration of prior procedure complexity, was also not inversely associated with adenoma detection (OR for adenoma detection for colonoscopies in the fourth quartile of fatigue based on the number of prior procedures performed versus colonoscopies performed as the first procedure of the day 0.99; 95% CI, 0.94-1.04). Conclusions In a large community-based setting, adenoma detection for screening and surveillance colonoscopies was not associated with either time of day or the number of prior procedures performed by the endoscopist, within the range of procedure volumes evaluated. The lack of association persisted after accounting for prior procedure complexity.
Adolescent obesity is a national public health concern with significant immediate and long-term health consequences. Certain social groups in the United States, such as immigrant adolescents, have ...been identified as particularly vulnerable to overweight and obesity. A pattern of results coined the "immigrant paradox" that refers to the phenomenon wherein obesity is less prevalent in first-generation immigrant youth when compared with second- and third-generation peers. Seeking to better understand this concerning trend, this study examined the mediating role of several health behaviors on the relation between generation status and body mass index (BMI).
Participants were 2292 Latino immigrant adolescents and emerging adults enrolled in the National Longitudinal Study of Adolescent Health.
Multiple linear regression models indicated that sedentary behaviors partially mediated the relation between generation status and BMI.
The findings indicate the unique role that sedentary behaviors play in explaining weight gain among Latino immigrants.
Associations among 53 primiparous women's Adult Attachment Interview classifications (secure—autonomous vs. insecure—dismissing) and physiological and self-reported responses to infant crying were ...explored. Heart rate, skin conductance levels, and respiratory sinus arrhythmia (RSA) were recorded continuously. In response to the cry, secure—autonomous women demonstrated RSA declines, consistent with approach-oriented responses. Insecure—dismissing women displayed RSA and electrodermal increases, consistent with behavioral inhibition. Furthermore, insecure—dismissing women rated the cries as more aversive than secure—autonomous women. Nine months postpartum, secure—autonomous women, who prenatally manifested an approach-oriented response to the unfamiliar cry stimulus, were observed as more sensitive when responding to their own distressed infant, whereas women classified prenatally as insecure—dismissing were observed as less sensitive with their own infants.
The United States is often conceptualized as a country of immigrants, with an origin story of multicultural, multilingual, diverse foreign-born populations coming together to create the fabric of the ...nation. This narrative emerges through many domains of American society, frequently depicting an image of opportunity for all. Yet historically and contemporarily, immigration has been racialized and wrought with oppressive practices and policies. Research has shown that white Americans tend to define “American” as synonymous with “white” and subsequently perceive those who appear phenotypically not white (e.g., darker skin tones) as “less American.” This phenomenon is reflected in immigration policy and lived experiences of minoritized immigrants. Vast theoretical and empirical literature documents the deleterious consequences of discrimination across domains of physical (e.g., hypertension, compromised immune functioning) and psychological health (e.g., ethno-racial trauma, depression). While it is critical to highlight the harmful effects of racism and xenophobia on immigrant well-being, the intent of this article is to also explore how indigenous, restorative healing practices may help communities and individuals heal from xenophobia and discrimination. Thus, the aim of this piece is twofold; (1) briefly discuss and contextualize the systems of oppression impacting immigrants, specifically Latinx communities in the United States, and (2) provide a framework for restoration and radical healing for Latinx immigrants.
Few studies have evaluated the ability of laboratory tests to predict risk of acute liver failure (ALF) among patients with drug-induced liver injury (DILI). We aimed to develop a highly sensitive ...model to identify DILI patients at increased risk of ALF. We compared its performance with that of Hy's Law, which predicts severity of DILI based on levels of alanine aminotransferase or aspartate aminotransferase and total bilirubin, and validated the model in a separate sample.
We conducted a retrospective cohort study of 15,353 Kaiser Permanente Northern California members diagnosed with DILI from 2004 through 2010, liver aminotransferase levels above the upper limit of normal, and no pre-existing liver disease. Thirty ALF events were confirmed by medical record review. Logistic regression was used to develop prognostic models for ALF based on laboratory results measured at DILI diagnosis. External validation was performed in a sample of 76 patients with DILI at the University of Pennsylvania.
Hy's Law identified patients that developed ALF with a high level of specificity (0.92) and negative predictive value (0.99), but low level of sensitivity (0.68) and positive predictive value (0.02). The model we developed, comprising data on platelet count and total bilirubin level, identified patients with ALF with a C statistic of 0.87 (95% confidence interval CI, 0.76-0.96) and enabled calculation of a risk score (Drug-Induced Liver Toxicity ALF Score). We found a cut-off score that identified patients at high risk patients for ALF with a sensitivity value of 0.91 (95% CI, 0.71-0.99) and a specificity value of 0.76 (95% CI, 0.75-0.77). This cut-off score identified patients at high risk for ALF with a high level of sensitivity (0.89; 95% CI, 0.52-1.00) in the validation analysis.
Hy's Law identifies patients with DILI at high risk for ALF with low sensitivity but high specificity. We developed a model (the Drug-Induced Liver Toxicity ALF Score) based on platelet count and total bilirubin level that identifies patients at increased risk for ALF with high sensitivity.
Pesticide Toxicity and the Developing Brain Eskenazi, Brenda; Rosas, Lisa G.; Marks, Amy R. ...
Basic & clinical pharmacology & toxicology,
February 2008, Volume:
102, Issue:
2
Journal Article, Conference Proceeding
Peer reviewed
Open access
: Organochlorine pesticides are used in some countries for malaria control and organophosphate pesticides are widely used in agriculture and in homes. Previous literature documents children's ...exposure to these chemicals both in utero and during development. Animal studies suggest that many of these chemicals are neurodevelopmental toxicants even in moderate doses, but there are few studies in human beings. Associations of children's pesticide exposure with neurodevelopment from studies being conducted worldwide are summarized. In addition, we present the work of the CHAMACOS study, a longitudinal birth cohort study of Mexican‐American children living in the Salinas Valley of California. In this study, we investigated the relationship of children's neurodevelopment with maternal dichlorodiphenyltrichloroethane and dichlorodiphenyldichloroethylene serum levels, as well as prenatal and child organophosphate urinary metabolite levels. We have examined the association with children's performance on the Brazelton Neonatal Assessment Scales and at 6, 12 and 24 months on the Bayley Scales of Infant Development (mental development and psychomotor development) and mothers report on the Child Behaviour Checklist. We observed a negative association of prenatal dichlorodiphenyltrichloroethane exposure and child mental development. We also observed adverse associations of prenatal but not postnatal organophosphate pesticide exposure with mental development and pervasive developmental disorder at 24 months.
Existing literature suggests that metformin, the most commonly used biguanide, may lower colorectal cancer risk. Because most colorectal cancers originate in precancerous adenomas, we examined ...whether metformin use lowered colorectal adenoma risk after polypectomy in patients with type-2 diabetes.
Retrospective cohort study of 40- to 89-year-old Kaiser Permanente Northern California patients who had type 2 diabetes, and ≥1 adenoma detected at baseline colonoscopy during 2000 to 2009 and a repeat colonoscopy 1 to 10 years from baseline adenoma diagnosis through 2012. Cox models evaluated the association between metformin use during follow-up and subsequent adenoma diagnoses, controlling for age, race/ethnicity, sex, body mass index, and repeat examination indication.
Study included 2,412 patients followed for a median of 4.5 years; cumulatively, 1,117 (46%) patients had ≥1 adenoma at repeat colonoscopy. Compared with patients not receiving diabetes medications (n = 1,578), metformin-only use (n = 457) was associated with lower adenoma recurrence risk adjusted HR, 0.76; 95% confidence interval (CI), 0.65-0.89, and the association was stronger with increasing total metformin dose quartile (Q) 1: HR, 0.90; 95% CI, 0.72-1.12; Q2: HR, 0.89; 95% CI, 0.70-1.12; Q3: HR, 0.80; 95% CI, 0.63-1.01; Q4: HR, 0.50; 95% CI, 0.42-0.60, Ptrend < 0.001. Findings were unchanged in sensitivity analyses, including evaluating only outcomes during the 3- to 10-year period from baseline.
Our study suggests a potential benefit of metformin use in lowering the risk of subsequent adenomas after polypectomy in patients with type 2 diabetes.
Metformin may lower colorectal cancer risk by reducing the formation of precancerous lesions, reinforcing the potential additional benefits of its use.
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