Cynthia W. Goss

Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder

BACKGROUND The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. OBJECTIVE This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. METHODS This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2-5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The childs primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. RESULTS Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. CONCLUSIONS SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes.

Understanding fall meaning and context in marketing balance classes to older adults.

This study explored older, community-dwelling adults’ attitudes and values about proposed church-delivered balance classes for fall prevention. Community observation, group interviews with stakeholders, key informant interviews, and focus groups with church members ≥60 years of age were analyzed in two ways: first for inductive themes expressing community sentiment about fall prevention for older adults, then for content useful in creating locally tailored social marketing messages. Four themes expressed perceptions of fall-prevention programming: de-emphasizing fall risk and emphasizing strength and independence, moving older adults out of their “comfort zones” to join classes, identifying relationships to support fall-prevention activities, and considering gender-based differences in approaches to fall prevention. A content analysis of the same dataset yielded information about preferred places in the community, promotion through churches, a tolerable price, and the balance class product itself. The qualitative results will inform the social marketing program to increase intervention delivery success.

Unhealthy and unsafe practices associated with symptoms of depression among injured patients

Each year, some 20.9 million US adults suffer from a diagnosable depressive disorder (Kessler, Chiu, Demler & Walters, 2005). Greater numbers have subclinical depressive symptoms, which are associated with increased risk of major depression, physical disability, and medical illness (Kessler, Berglund, Demler, Jin & Walters, 2005; World Health Organization, 2004). Depression, a major contributing factor to deliberate self-harm (McLean, Maxwell, Platt, Harris, & Jepson, 2008), is also associated with increased unintentional injury risk (American Geriatrics Society [AGS], British Geriatrics Society, & American Academy of Orthopaedic Surgeons, 2001, Tiesman et al., 2006). Mood disorders are common in patients presenting for acute injury (Richmond Hollander, Ackerson, Robinson, Gracias, Shults & Amsterdam, 2007). The potential connection between depressive symptoms and poor health and safety practices, which may further contribute to risk of injury, disability and illness, has not been fully delineated (Cannella & Scoloveno, 2003; Yarcheski, Mahon, Yarcheski, & Cannella, 2004). Many studies investigating this relationship have focused solely on young people (Allgower, Wardle, & Steptoe, 2001; Babiss & Gangwisch, 2009; Mahon, Yarcheski, & Yarcheski, 2001; Melnyk et al., 2006; Yarcheski, Mahon, & Yarcheski, 2004), while those investigating adults have been limited by the practices assessed (i.e. physical activity alone) (Farmer, Locke, Moscicki, Dannenberg, Larson & Radloff, 1988) or their restricted study samples (Igna, Julkunen, Vanhanen, Keskivaara, & Verkasalo, 2008; Bonnet, Irving, Terra, Nony, Berthezene & Moulin, 2005; Gazmararian, Baker, Parker, & Blazer, 2000). Only one population-based study has examined a wide variety of health practices among a large sample of adults of all ages (Strine, Mokdad, Dube, Balluz, Gonzalez, Berry & Kroenke, 2008), finding positive associations between current or lifetime depression and smoking, physical inactivity, binge drinking, and heavy drinking. A similar, negative association between depression and safety behaviours (e.g., seat belt use), which are also important health-promoting practices, has been reported in a few studies of young people (Allgower et al., 2001; Mahon et al., 2001; Yarcheski, Mahon, & Yarcheski, 2004) and in one study of adult farm residents (Stallones & Beseler, 2004). However, there is little available evidence on the relationship between safety practices and depressive symptoms in the general adult population. Further, although studies have found that depressive symptoms are an important risk factor for acute injury (AGS et al., 2001; Cox, Kenardy, & Hendrikz, 2008; Richmond et al., 2007; Richmond et al., 2009; Stoddard & Saxe, 2001; Tiesman et al., 2006), we found no studies examining the association between safety or health practices and depression among trauma patients.

Creation of a register on alcohol-impaired driving

Alcohol-impaired driving is a serious problem for industrialized nations. Of the 39 189 fatal crashes in the US last year, 39% were alcohol related.1 Alcohol-impaired driving declined worldwide in the 1980s and 90s, a trend that halted in some countries and even reversed in others after the turn of the current century.2 This plateau could indicate a failure to identify and disseminate effective interventions in the field. A logical first step is to find the most accurate and up-to-date information on prevention strategies by conducting systematic reviews of controlled evaluations. Comprehensive identification of relevant papers distinguishes systematic reviews from traditional reviews by minimizing bias. However, identifying controlled evaluations of the broad array of potential strategies to reduce alcohol-impaired driving offers a notable challenge because