Depeng Jiang

Patterns of Urban Violent Injury: A Spatio-Temporal Analysis

Objectives Injury related to violent acts is a problem in every society. Although some authors have examined the geography of violent crime, few have focused on the spatio-temporal patterns of violent injury and none have used an ambulance dataset to explore the spatial characteristics of injury. The purpose of this study was to describe the combined spatial and temporal characteristics of violent injury in a large urban centre. Methodology/Principal Findings Using a geomatics framework and geographic information systems software, we studied 4,587 ambulance dispatches and 10,693 emergency room admissions for violent injury occurrences among adults (aged 18–64) in Toronto, Canada, during 2002 and 2004, using population-based datasets. We created kernel density and choropleth maps for 24-hour periods and four-hour daily time periods and compared location of ambulance dispatches and patient residences with local land use and socioeconomic characteristics. We used multivariate regressions to control for confounding factors. We found the locations of violent injury and the residence locations of those injured were both closely related to each other and clearly clustered in certain parts of the city characterised by high numbers of bars, social housing units, and homeless shelters, as well as lower household incomes. The night and early morning showed a distinctive peak in injuries and a shift in the location of injuries to a “nightlife” district. The locational pattern of patient residences remained unchanged during those times. Conclusions/Significance Our results demonstrate that there is a distinctive spatio-temporal pattern in violent injury reflected in the ambulance data. People injured in this urban centre more commonly live in areas of social deprivation. During the day, locations of injury and locations of residences are similar. However, later at night, the injury location of highest density shifts to a “nightlife” district, whereas the residence locations of those most at risk of injury do not change.

The Relationship Between Adolescents’ Experience of Family Violence and Dating Violence:

This study examines whether experiences of familial victimization and aggression are potential risk factors for dating violence in male and female teenage relationships. The authors compare 471 adolescents aged 12 to 19 in the care of a youth protection agency and from a community sample. Results show that adolescents carry negative childhood experiences of family violence into their intimate relationships in different ways, depending on gender and level of risk. Female adolescents who had been victimized by either of their parents were at greater risk for revictimization, but not aggression, within their dating relationships. High-risk adolescent males who reported childhood victimization were at a particularly high risk of being aggressive toward their girlfriends, especially if they were harshly disciplined by their father. The extent of aggression toward parents predicted aggression toward dating partners, particularly for girls. The authors discuss these findings in terms of prevention and early intervention efforts.

Developmental pathways of eating problems in adolescents

OBJECTIVE To examine the developmental eating trajectories of adolescents and identify psychological correlates and risk factors associated with those trajectories. METHOD Seven hundred thirty-nine adolescents completed self-reported measures of eating problems, internalizing and externalizing behaviors, alcohol and drug use, peer victimization, and depression. RESULTS Five eating trajectories were obtained. The proportions of males and females were the same in the increasing eating problems trajectory. For both genders, internalizing and externalizing problems were identified as associated risk factors of an eating pathology and reporting at least some eating problems was associated with an increased likelihood of psychological problems. Other risk factors found only in boys were frequency of drug use, victimization, and depressive symptoms. CONCLUSION Externalizing problems in girls and internalizing behaviors in boys with disordered eating should not be overlooked. Atypical eating behaviors in boys are of particular concern since it increases their risk of cooccurring psychopathology.

Developmental Trajectories of Girls’ and Boys’ Delinquency and Associated Problems

Developmental trajectories in delinquency through adolescence were studied along with family and peer relationship problems. Drawing from eight waves of data over seven years, we conducted trajectory analyses with a sample of 746 students (402 girls; 344 boys). Analyzing girls and boys together, a five-class model emerged: 60% of the adolescents rarely reported delinquency; 27.7% reported low initial levels with moderate levels of delinquency over time; 6% in the late onset group reported initially low and rising levels of delinquency; 5% in the early onset group reported moderate initial levels which increased and then decreased in later adolescence. A small group of only boys (1.3%) labeled chronic reported high initial levels of delinquency that increased over time. Group comparisons revealed problems in internalizing, parent and peer relationship problems. The findings provide direction for early identification and interventions to curtail the development of delinquency.

Developmental trajectories of romantic stages and associations with problem behaviours during adolescence

Normative romantic development is theorized to progress through a series of stages: affiliative activities, group-based dating, and romantic relationships. The objectives of this research were threefold: empirically examine this progression of romantic stages during adolescence, determine normative and atypical trajectories, and examine links with internalizing and externalizing symptoms. An eight-wave longitudinal study was conducted with 698 adolescents (53.6% female; M(age) = 11.8 years at start of study). A group-based trajectory approach was employed to identify prototypical trajectories of romantic development and a model with three distinct romantic trajectories (i.e., On-time, Early Starters and Late Bloomers) was identified. Both timing and sequencing of romantic activity differed among trajectory groups. Analysis of Variance (ANOVAs) identified associations between Early Starters and externalizing behaviours in early, middle and later adolescence. The findings support progression through theorized stages of romantic activity and highlight the problems that are linked to early-starting and non-sequenced romantic development.

The linkage between childhood bullying behaviour and future offending

AIM To examine the linkage between bullying behaviour in early childhood and any subsequent contact with the criminal justice system. METHODS A Canadian sample (570 boys and 379 girls) was derived from clients who participated in the evidenced-based programme, SNAP (STOP NOW AND PLAN), between 2001 and 2009. A court order was obtained to access any criminal record data on participants. The Early Assessment Risk Lists (EARL-20B and EARL-21G) and the Child Behavior Checklist (CBCL) were used to identify level of risk and bullying behaviour. Outcome variables included age the child first came in contact with the criminal justice system and frequency. RESULTS Logistic and Cox regression analyses indicate that the risk of onset of criminal offence for bullies was significantly higher than for non-bullies. The hazard of criminal offence for bullies is 1.9 times (95% CI: 1.1-3.2) than that of non-bullies. This holds true even when adjusted for age, gender and other risk factors. CONCLUSION We found a strong linkage between bullying behaviour during childhood and subsequent criminal offending after the age of 12. Criminal convictions for bullies were nearly twice as high for non-bullies up to the childs 18th birthday. EARLs were effective in differentiating risk associated with bullying.

A survey of the attitudes and perceptions of multidisciplinary team members towards family presence at bedside rounds in the intensive care unit

OBJECTIVE To describe the attitudes and perceptions of intensive care unit (ICU) staff [critical care physicians and fellows (MDs), registered nurses (RNs), allied health discipline (HD) and managers] towards family presence at bedside rounds. RESEARCH METHODOLOGY We developed, tested and administered a questionnaire to the multidisciplinary staff. SETTING 24-Bed medical surgical ICU. RESULTS 160/221 (72.4%) individuals responded, including 12 MDs, 95 RNs, 48 HD personnel, 4 managers and 1 unspecified. While most MDs strongly agreed and HD and management groups somewhat agreed, most RNs strongly disagreed with providing family members the option to attend rounds. Over 50% of respondents either strongly or somewhat agreed that the presence of family members prolongs rounds, reduces the medical education provided to the team and constrains delivery of negative medical information. Compared to MDs, RNs expressed greater reservation to family presence at rounds. Among RNs, more experienced RNs, expressed greater reservation with family presence during rounds. CONCLUSION We found significant differences among the attitudes of health care providers towards family presence at bedside rounds with RNs, especially more experienced RNs, expressing the greatest reservation. Qualitative research is required to explore perceived and actual barriers to family member presence at rounds.

Adolescent Romantic Relationships in China and Canada: A Cross-National Comparison.

This study compared the romantic involvements of Canadian and Chinese adolescents as well as linkages with friend and parental relationships. Participants were 496 Chinese adolescents and 395 Canadian adolescents, aged 16—17 years. Chinese adolescents were less likely to have any form of romantic involvement, including a romantic relationship, displayed lower levels of romantic experience, and had fewer close romantic relationships. Gender moderated cultural differences, with Chinese girls least involved in romantic experiences. Although friendships were more intimate in Canada and parent relationships were closer in China, the linkages of parental and friend relationships with romantic experience were quite consistent across the two cultures, with friends being positively linked to romantic experiences and parents indirectly linked through their connection to friends. Among Chinese adolescents, parents also directly connected with romantic experiences in a negative direction. Implications of the findings for understanding the interface between individual growth and cultural context are discussed.

Thresholds for small for gestational age among newborns of East Asian and South Asian ancestry.

OBJECTIVE To determine the risk that newborn infants of East Asian and South Asian ancestry may be misclassified as small for gestational age (SGA). METHODS We performed a single-centre, cross-sectional study of a cohort of liveborn infants born to women who had been born in Canada (n = 2362), East Asia (n = 1565) and South Asia (n = 753) and generated smoothed birth weight curves for males and females. We determined the rate of misclassification of infants of East Asian and South Asian maternal origin as SGA, using conventional weight centile cut-offs, rather than those specific to each ethnic group. RESULTS Infants of Canadian-born mothers had a mean birth weight that was 144 g and 218 g greater than newborns of mothers of East Asian and South Asian origin, respectively. Using the 3rd centile cut-off for infants of Canadian-born mothers, 7 per 1000 female and 14 per 1000 male infants of East Asian maternal origin were potentially miscategorized as SGA at birth. Among female and male infants of mothers of South Asian origin, the corresponding rates were 29 and 46 per 1000. CONCLUSION Birth weight curves may need to be modified for newborns of East Asian and South Asian parentage to make a more accurate diagnosis of SGA.

Regression of left ventricular mass following conversion from conventional hemodialysis to thrice weekly in-centre nocturnal hemodialysis

BackgroundIncreased left ventricular mass (LVM) is associated with adverse outcomes in patients receiving chronic hemodialysis. Among patients receiving conventional hemodialysis (CHD, 3×/week, 4 hrs/session), we evaluated whether dialysis intensification with in-centre nocturnal hemodialysis (INHD, 3×/week, 7-8 hrs/session in the dialysis unit) was associated with regression of LVM.MethodsWe conducted a retrospective cohort study of CHD recipients who converted to INHD and received INHD for at least 6 months. LVM on the first echocardiogram performed at least 6 months post-conversion was compared to LVM pre-conversion. In a secondary analysis, we examined echocardiograms performed at least 12 months after starting INHD. The effect of conversion to INHD on LVM over time was also evaluated using a longitudinal analysis that incorporated all LVM data on patients with 2 or more echocardiograms.ResultsThirty-seven patients were eligible for the primary analysis. Mean age at conversion was 49 ± 12 yrs and 30% were women. Mean pre-conversion LVM was 219 ± 66 g and following conversion, LVM declined by 32 ± 58 g (p = 0.002). Among patients whose follow-up echocardiogram occurred at least 12 months following conversion, LVM declined by 40 ± 56 g (p = 0.0004). The rate of change of LVM decreased significantly from 0.4 g/yr before conversion, to -11.7 g/yr following conversion to INHD (p < 0.0001).ConclusionConversion to INHD is associated with a significant regression in LVM, which may portend a more favourable cardiovascular outcome. Our preliminary findings support the need for randomized controlled trials to definitively evaluate the cardiovascular effects of INHD.