Maureen Sanderson

Physical and mental health effects of intimate partner violence for men and women.

BACKGROUNDnFew population-based studies have assessed the physical and mental health consequences of both psychological and physical intimate partner violence (IPV) among women or men victims. This study estimated IPV prevalence by type (physical, sexual, and psychological) and associated physical and mental health consequences among women and men.nnnMETHODSnThe study analyzed data from the National Violence Against Women Survey (NVAWS) of women and men aged 18 to 65. This random-digit-dial telephone survey included questions about violent victimization and health status indicators.nnnRESULTSnA total of 28.9% of 6790 women and 22.9% of 7122 men had experienced physical, sexual, or psychological IPV during their lifetime. Women were significantly more likely than men to experience physical or sexual IPV (relative risk [RR]=2.2, 95% confidence interval [CI]=2.1, 2.4) and abuse of power and control (RR=1.1, 95% CI=1.0, 1.2), but less likely than men to report verbal abuse alone (RR=0.8, 95% CI=0.7, 0.9). For both men and women, physical IPV victimization was associated with increased risk of current poor health; depressive symptoms; substance use; and developing a chronic disease, chronic mental illness, and injury. In general, abuse of power and control was more strongly associated with these health outcomes than was verbal abuse. When physical and psychological IPV scores were both included in logistic regression models, higher psychological IPV scores were more strongly associated with these health outcomes than were physical IPV scores.nnnCONCLUSIONSnBoth physical and psychological IPV are associated with significant physical and mental health consequences for both male and female victims.

Severe Dating Violence and Quality of Life Among South Carolina High School Students

BACKGROUNDnLittle research has addressed the impact of dating violence and forced-sex victimization and perpetration on adolescent well-being. In this cross-sectional study, we provide (1) estimates of severe dating violence (SDV) by victimization and perpetration status, (2) estimates of lifetime forced-sex victimization and perpetration, (3) demographic and health behaviors correlated with SDV, and (4) associations between SDV and forced sex and well-being as assessed by (1) health-related quality of life (H-R QOL) and (2) life satisfaction measures.nnnMETHODSnWe used a stratified cluster sample of 5414 public high school students, grades 9 through 12, who responded to the 1997 self-administered South Carolina Youth Risk Behavior Survey.nnnRESULTSnNearly 12% of adolescents self-reported SDV as a victim (7.6%) or a perpetrator (7.7%), and SDV rates (victimization/perpetration combined) are higher in girls (14.4%) than boys (9.1%). Race, aggressive behaviors, substance use, and sexual risk-taking are correlates of SDV. Among young women, SDV victimization, not perpetration, was associated with recent poor H-R QOL and suicide ideation or attempts, but not lower life-satisfaction scores. Among young men, SDV perpetration, not victimization, was strongly associated with poor H-R QOL and suicide attempts, and lower scores for all domains of life satisfaction.nnnCONCLUSIONSnThis research provides evidence that SDV and forced sex are associated with poor H-R QOL, low life-satisfaction scores, and adverse health behaviors in adolescent female victims and male perpetrators. Screening for dating violence is needed to identify and intervene early to reduce the impact of dating violence.

PHYSICAL VIOLENCE DURING PREGNANCY: MATERNAL COMPLICATIONS AND BIRTH OUTCOMES

OBJECTIVEnTo assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.nnnMETHODSnWe used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on womens physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.nnnRESULTSnThe prevalence of physical violence was 11.1%. Among women who experienced physical violence, 54% reported having been involved in physical fights only and 46% had been hurt by husbands or partners. In the latter group, 70% also reported having been involved in fighting. Compared with those not reporting physical violence, women who did were more likely to deliver by cesarean and be hospitalized before delivery for maternal complications such as kidney infection, premature labor, and trauma due to falls or blows to the abdomen.nnnCONCLUSIONnPhysical violence during the 12 months before delivery is common and is associated with adverse maternal conditions. The findings support the need for research on how to screen for physical violence early in pregnancy and to prevent its consequences.

Racial Disparity and Socioeconomic Status in Association With Survival in Older Men with Local/Regional Stage Prostate Cancer: Findings From a Large Community-Based Cohort

Few studies have examined the outcomes for Hispanic men with prostate carcinoma and incorporated socioeconomic factors in association with race/ethnicity in affecting survival, adjusting for factors on cancer stage, grade, comorbidity, and treatment.

Co-morbidity associated with dementia.

Purpose: The purpose of this study was to identify common co-morbid conditions associated with dementia subtypes and to evaluate the association of hypertension, diabetes mellitus, atrial fibrillation, congestive heart failure, and anemia with dementia subtypes relative to controls. Methods: Hospital discharge data were used to identify 15,013 subjects from South Carolina with a diagnosis of dementia between 1998 and 1999. A control group of 15,013 persons without dementia was randomly sampled from hospital discharge records and matched to persons with dementia on the basis of age, race, and gender. Multiple hospitalizations for each patient were merged, and repeated diagnoses during separate hospitalizations were counted once. Results: After adjusting for age, race, and gender, persons with Alzheimers disease and dementia associated with medical conditions were less likely to be diagnosed with hypertension, diabetes, congestive heart failure, and atrial fibrillation than were controls. Patients with multiinfarct dementia were also less likely to have congestive heart failure, but were more likely to have diabetes. Anemia was not associated with any dementia subtype. Conclusions: There are distinct differences in comorbid conditions among dementia subtypes. Our research does not support previous studies that suggest a circulatory component to the development of Alzheimers disease.

A case–control study of farming and prostate cancer in African‐American and Caucasian men

Objective: To determine the risk of prostate cancer associated with farming by duration, recency and specific activities among African-Americans and Caucasians. Methods: This population-based case–control study had information on farming-related activities for 405 incident prostate cancer cases and 392 controls matched for age, race and region in South Carolina, USA, from 1999 to 2001. Cases with histologically confirmed, primary invasive prostate cancer who were aged between 65 and 79 years were ascertained through the South Carolina Central Cancer Registry. Appropriately matched controls were identified from the Health Care Financing Administration Medicare Beneficiary File. Data were collected using computer-assisted telephone interviewing, and adjusted odds ratios (aOR) were estimated using unconditional logistic regression. Results: Farming was associated with increased risk of prostate cancer in Caucasians (aOR 1.8; 95% confidence interval (CI) 1.3 to 2.7) but not in African-Americans (aOR 1.0; 95% CI 0.6 to 1.6). Regarding specific farming activities, farmers who mixed or applied pesticides had a higher risk of prostate cancer (aOR 1.6; 95% CI 1.2 to 2.2). Increased risk of prostate cancer was observed only for those farming <5 years. Conclusions: Increased risk of prostate cancer for farmers in this study may be attributable to pesticide exposure. Racial differences in the association between farming and prostate cancer may be explained by different farming activities or different gene–environment interactions by race.

Suspicion of intrauterine growth restriction: Use of abdominal circumference alone or estimated fetal weight below 10%

Objective. To determine, among patients at risk for intrauterine growth restriction (IUGR), the peripartum outcomes and predictive accuracy for those with normal abdominal circumference (AC) and estimated fetal weight (EFW) for gestational age (GA; group 1) versus those with AC ≤ 10% for GA but EFW>10% (group 2) versus those with AC and EFW ≤ 10% for GA (group 3). Study design. We identified, retrospectively, non-anomalous singleton pregnancies with reliable GA, and delivery within 21 days of the examination who were referred for possible IUGR. Odds ratios (OR) and 95% confidence intervals (CI) were calculated, as were likelihood ratios (LR) for detection of small for gestational age (SGA) (birth weight ≤ 10% for GA; SGA). Results. Among the 169 consecutive patients who met the inclusion criteria, the prevalence of SGA was significantly higher for group 3 (80%) than group 1 (42%; OR 4.26, 95% CI 1.94–9.16) or group 2 (49%; OR 5.49, 95% CI 2.13–13.85). The rate of admission to the neonatal intensive care unit (67%, 34%, and 36% for groups 3, 2, and 1, respectively) and the combined perinatal morbidity (35%, 23%, and 15%) were different for the three groups. The LR for detection of SGA was 1.2 (95% CI 1.0–1.4) for group 2 and 2.8 (95% CI 1.6–4.9) for group 3. Conclusions. Among patients suspected for IUGR, the peripartum outcome is poorest for those with AC and EFW ≤ 10% for GA, than for those with AC ≤ 10% but EFW>10%. The detection of SGA is poor regardless of whether just AC or AC plus EFW are ≤ 10%.

Predicting adolescent risk behaviors based on an ecological framework and assets.

OBJECTIVESnTo examine the relationship between an aggregate risk score (smoking, drinking, and number of sex partners) and measures of youth assets in a sample of 3439 youth aged 14-18 years.nnnMETHODSnLinear regression models for African American and white males and females predicted an aggregate risk score.nnnRESULTSnAfter adjustments, the youth asset most predictive of risk was self/peer values regarding risk behaviors. Perceived school support was also predictive.nnnCONCLUSIONSnTaking an ecological approach to the measurement of adolescent health behaviors contributes to our understanding of these risk behaviors.

Intensive Care Noise and Mean Arterial Blood Pressure in Extremely Low-Birth-Weight Neonates

Noise in neonatal intensive care units (NICUs) may impede growth and development for extremely low-birth-weight (ELBW, < 1000 g) newborns. We calculated correlations between NICU sound levels and ELBW neonates heart rate and arterial blood pressure to evaluate whether this population experiences noise-induced stress. Sound levels inside the incubator, heart rate (HR), and arterial blood pressure recordings were simultaneously collected for eight ELBW neonates for 15 minutes during the first week of life. Cross-correlation functions were calculated for NICU noise, HR, and mean arterial blood pressure (MABP) recordings for each subject. ELBW neonates HR and MABP were significantly correlated ( R = 0.16 at 2-second lag time), with stronger correlation apparent for higher-birth-weight ELBW newborns (0.22 versus 0.10). Lower-birth-weight newborns responded to increased noise with HR acceleration from 45 to 130 seconds after noise events, and higher-birth-weight infants initially responded with an HR deceleration at 25 to 60 seconds, then HR acceleration ~175 seconds after noise increased. MABP was not as strongly correlated with NICU sound levels, although some correlation coefficients were slightly outside the 95% confidence interval. Higher-birth-weight newborns more mature neurological systems may be responsible for stronger correlations between HR and MABP. NICU noise influenced newborns HR, indicating that these infants hear and respond to NICU sounds. ELBW newborns in the first week of life seem to maintain a relatively stable blood pressure in response to moderate NICU sound levels (50 to 60 dBA).

Diabetes Genes and Prostate Cancer in the Atherosclerosis Risk in Communities Study

There is a known inverse association between type 2 diabetes (T2D) and prostate cancer (PrCa) that is poorly understood. Genetic studies of the T2D-PrCa association may provide insight into the underlying mechanisms of this association. We evaluated associations in the Atherosclerosis Risk in Communities study between PrCa and nine T2D single nucleotide polymorphisms from genome-wide association studies of T2D (in CDKAL1, CDKN2A/B, FTO, HHEX, IGF2BP2, KCNJ11, PPARG, SLC30A8, and TCF7L2) and four T2D single nucleotide polymorphisms from pre–genome-wide association studies (in ADRB2, CAPN10, SLC2A2, and UCP2). From 1987 to 2000, there were 397 incident PrCa cases among 6,642 men ages 45 to 64 years at baseline. We used race-adjusted Cox proportional hazards models to estimate associations between PrCa and increasing number of T2D risk-raising alleles. PrCa was positively associated with the CAPN10 rs3792267 G allele [hazard ratio (HR) 1.20; 95% confidence interval (CI), 1.00-1.44] and inversely associated with the SLC2A2 rs5400 Thr110 allele (HR, 0.85; 95% CI, 0.72, 1.00), the UCP2 rs660339 Val55 allele (HR, 0.84; 95% CI, 0.73, 0.97) and the IGF2BP2 rs4402960 T allele (HR, 0.79; 95% CI, 0.61-1.02; blacks only). The TCF7L2 rs7903146 T allele was inversely associated with PrCa using a dominant genetic model (HR, 0.79; 95% CI, 0.65-0.97). Further knowledge of T2D gene-PrCa mechanisms may improve understanding of PrCa etiology. Cancer Epidemiol Biomarkers Prev; 19(2); 558–65