Browsing by Subject "Baltimore"
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Item Open Access Age of first drunkenness and risks for all-cause mortality: A 27-year follow-up from the epidemiologic catchment area study.(Drug and alcohol dependence, 2017-07) Hu, Hui; Eaton, William W; Anthony, James C; Wu, Li-Tzy; Cottler, Linda BEarly-onset drunkenness is associated with an increased risk of developing an alcohol use disorder (AUD), which predicts excess mortality risk. Here, we estimated mortality risk for drinkers with and without early drunkenness.For 14,848 adult participants interviewed about drinking, drunken episodes, and AUD in 1981-83 for the Epidemiologic Catchment Area in New Haven (Connecticut), Baltimore (Maryland), St. Louis (Missouri), and Durham (North Carolina), we linked National Death Index records through 2007.Cox regression modeling estimates showed excess mortality for drinkers with age of first drunkenness earlier than 15 years old (hazard ratio, HR: 1.47, 95% CI: 1.25, 1.72) and when first drunkenness occurred at or after age 15 (HR: 1.20, 95% CI: 1.11, 1.29), as compared with adults who had never been drunk. Consistent results were observed, irrespective of AUD history. That is, early drunkenness signaled excess mortality risk even in absence of AUD.In a large community sample from four cities in the US, early age of onset of drunkenness predicts mortality risk. We discuss experiments to investigate the possible causal significance of this predictive association.Item Open Access Development of a decision aid to inform patients' and families' renal replacement therapy selection decisions.(BMC Med Inform Decis Mak, 2012-12-01) Ameling, Jessica M; Auguste, Priscilla; Ephraim, Patti L; Lewis-Boyer, LaPricia; DePasquale, Nicole; Greer, Raquel C; Crews, Deidra C; Powe, Neil R; Rabb, Hamid; Boulware, L EbonyBACKGROUND: Few educational resources have been developed to inform patients' renal replacement therapy (RRT) selection decisions. Patients progressing toward end stage renal disease (ESRD) must decide among multiple treatment options with varying characteristics. Complex information about treatments must be adequately conveyed to patients with different educational backgrounds and informational needs. Decisions about treatment options also require family input, as families often participate in patients' treatment and support patients' decisions. We describe the development, design, and preliminary evaluation of an informational, evidence-based, and patient-and family-centered decision aid for patients with ESRD and varying levels of health literacy, health numeracy, and cognitive function. METHODS: We designed a decision aid comprising a complementary video and informational handbook. We based our development process on data previously obtained from qualitative focus groups and systematic literature reviews. We simultaneously developed the video and handbook in "stages." For the video, stages included (1) directed interviews with culturally appropriate patients and families and preliminary script development, (2) video production, and (3) screening the video with patients and their families. For the handbook, stages comprised (1) preliminary content design, (2) a mixed-methods pilot study among diverse patients to assess comprehension of handbook material, and (3) screening the handbook with patients and their families. RESULTS: The video and handbook both addressed potential benefits and trade-offs of treatment selections. The 50-minute video consisted of demographically diverse patients and their families describing their positive and negative experiences with selecting a treatment option. The video also incorporated health professionals' testimonials regarding various considerations that might influence patients' and families' treatment selections. The handbook was comprised of written words, pictures of patients and health care providers, and diagrams describing the findings and quality of scientific studies comparing treatments. The handbook text was written at a 4th to 6th grade reading level. Pilot study results demonstrated that a majority of patients could understand information presented in the handbook. Patient and families screening the nearly completed video and handbook reviewed the materials favorably. CONCLUSIONS: This rigorously designed decision aid may help patients and families make informed decisions about their treatment options for RRT that are well aligned with their values.Item Open Access Five-Factor Model personality profiles of drug users.(BMC psychiatry, 2008-04-11) Terracciano, Antonio; Löckenhoff, Corinna E; Crum, Rosa M; Bienvenu, O Joseph; Costa, Paul TBackground
Personality traits are considered risk factors for drug use, and, in turn, the psychoactive substances impact individuals' traits. Furthermore, there is increasing interest in developing treatment approaches that match an individual's personality profile. To advance our knowledge of the role of individual differences in drug use, the present study compares the personality profile of tobacco, marijuana, cocaine, and heroin users and non-users using the wide spectrum Five-Factor Model (FFM) of personality in a diverse community sample.Method
Participants (N = 1,102; mean age = 57) were part of the Epidemiologic Catchment Area (ECA) program in Baltimore, MD, USA. The sample was drawn from a community with a wide range of socio-economic conditions. Personality traits were assessed with the Revised NEO Personality Inventory (NEO-PI-R), and psychoactive substance use was assessed with systematic interview.Results
Compared to never smokers, current cigarette smokers score lower on Conscientiousness and higher on Neuroticism. Similar, but more extreme, is the profile of cocaine/heroin users, which score very high on Neuroticism, especially Vulnerability, and very low on Conscientiousness, particularly Competence, Achievement-Striving, and Deliberation. By contrast, marijuana users score high on Openness to Experience, average on Neuroticism, but low on Agreeableness and Conscientiousness.Conclusion
In addition to confirming high levels of negative affect and impulsive traits, this study highlights the links between drug use and low Conscientiousness. These links provide insight into the etiology of drug use and have implications for public health interventions.Item Open Access How Cities Became Kindling: Racism and the Decline of Two Once-Great American Metropolises, Detroit and Baltimore(2016-05-04) Ruble, Laura*Designated as an exemplary master's project for 2015-16*
Baltimore, Maryland, and Detroit, Michigan, were once sparkling examples of postwar American progress. In the early 20th century, their thriving manufacturing industries and lively cultural scenes brought wealth and acclaim, attracting a steady influx of immigrants and southern Americans searching for a share of their offerings. Like other metropolises across the American Rust Belt, however, the cities have since suffered the effects of postwar deindustrialization. Unemployment and poverty trouble urban centers that once burgeoned during those pre-WWII swells. While the roots of their urban crises are complex, decline in both Detroit and Baltimore demonstrates the powerful impact of racist practices and policies that American cities developed and implemented long before the flight of industry. In this research I explore the role that racism—in both its informal, personal manifestation and its formal, systemic manifestation—had in the decline of both cities. Prewar records including court cases, government ordinances and informal documents demonstrate that Detroit and Baltimore pioneered groundbreaking discriminatory policies and procedures in response to their growing African-American populations in the early 20th century. African Americans were systematically excluded from all but the lowest-level employment positions, resulting in low wages, high unemployment, low work satisfaction and low safety. This discrimination created a grave disparity in wealth between white and black communities within the cities. Concurrent housing discrimination, which controlled the physical residency of black families and their access to wealth investment options via homeownership, further separated the status of racial groups in Detroit and Baltimore. When deindustrialization after the Second World War depleted urban centers of jobs and revenue, white residents of means were able to relocate. This flight of capital from Detroit and Baltimore cities served to concentrate African-American populations—with few resources at their disposal—into census tracts that became plagued with poverty, crime and a lack of opportunity. Detroit and Baltimore city residents—mostly African-American—have experienced continued employment, housing and environmental discrimination since, further damaging their capability to restore the cities themselves. By instituting racist practices in the decades prior to deindustrialization, both cities—in effect—crippled themselves to deal with its consequences.Item Open Access Meta-analysis of genome-wide association studies identifies common variants in CTNNA2 associated with excitement-seeking.(Translational psychiatry, 2011-10-18) Terracciano, A; Esko, T; Sutin, AR; de Moor, MHM; Meirelles, O; Zhu, G; Tanaka, T; Giegling, I; Nutile, T; Realo, A; Allik, J; Hansell, NK; Wright, MJ; Montgomery, GW; Willemsen, G; Hottenga, J-J; Friedl, M; Ruggiero, D; Sorice, R; Sanna, S; Cannas, A; Räikkönen, K; Widen, E; Palotie, A; Eriksson, JG; Cucca, F; Krueger, RF; Lahti, J; Luciano, M; Smoller, JW; van Duijn, CM; Abecasis, GR; Boomsma, DI; Ciullo, M; Costa, PT; Ferrucci, L; Martin, NG; Metspalu, A; Rujescu, D; Schlessinger, D; Uda, MThe tendency to seek stimulating activities and intense sensations define excitement-seeking, a personality trait akin to some aspects of sensation-seeking. This trait is a central feature of extraversion and is a component of the multifaceted impulsivity construct. Those who score high on measures of excitement-seeking are more likely to smoke, use other drugs, gamble, drive recklessly, have unsafe/unprotected sex and engage in other risky behaviors of clinical and social relevance. To identify common genetic variants associated with the Excitement-Seeking scale of the Revised NEO Personality Inventory, we performed genome-wide association studies in six samples of European ancestry (N=7860), and combined the results in a meta-analysis. We identified a genome-wide significant association between the Excitement-Seeking scale and rs7600563 (P=2 × 10(-8)). This single-nucleotide polymorphism maps within the catenin cadherin-associated protein, alpha 2 (CTNNA2) gene, which encodes for a brain-expressed α-catenin critical for synaptic contact. The effect of rs7600563 was in the same direction in all six samples, but did not replicate in additional samples (N=5105). The results provide insight into the genetics of excitement-seeking and risk-taking, and are relevant to hyperactivity, substance use, antisocial and bipolar disorders.Item Open Access Vitamin B12 and Homocysteine Associations with Gait Speed in Older Adults: The Baltimore Longitudinal Study of Aging.(The journal of nutrition, health & aging, 2017-01) Vidoni, ML; Pettee Gabriel, K; Luo, ST; Simonsick, EM; Day, RSThis study aimed to assess the independent associations of serum levels of vitamin B12 and plasma concentrations of homocysteine with gait speed decline.This study utilized longitudinal analysis of participants 50 years or older from The Baltimore Longitudinal Study of Aging, N=774.Gait speed (m/s) was assessed using the 6-meter usual pace test. Vitamin B12 and homocysteine concentrations were collected using standard clinical protocols. Linear mixed effects regression was stratified by baseline age category (50-69, 70-79, and ≥80 years old).Mean follow-up time for the total study sample was 5.4 ± 2.0 years. No association between vitamin B12 and gait speed decline over the follow-up time for any age group was found. Elevated homocysteine concentrations were associated with decline in gait speed after adjustment for covariates (50-69: β= -0.005, p=.057; 70-79: β= -0.013, p<.001, ≥80: β= -0.007, p=.054).Homocysteine and vitamin B12 are inversely related, yet only homocysteine was associated with gait speed decline in this population of healthy older adults. Given these results, future research should be directed towards investigating the relationship in populations with greater variation in vitamin B12 concentrations and other mechanisms influencing homocysteine concentrations.