105 results on '"Adam J. Milam"'
Search Results
2. The role of methadone in cardiac surgery for management of postoperative pain
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Jordan N. Edwards, Madeline A. Whitney, Bradford B. Smith, Megan K. Fah, Skye A. Buckner Petty, Omar Durra, Kristen A. Sell-Dottin, Erica Portner, Erica D. Wittwer, and Adam J. Milam
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acute pain ,cardiac surgery ,methadone ,opioids ,postoperative complications ,Anesthesiology ,RD78.3-87.3 - Abstract
Background: This retrospective study evaluated the efficacy and safety of intraoperative methadone compared with short-acting opioids. Methods: Patients undergoing cardiac surgery with cardiopulmonary bypass (n=11 967) from 2018 to 2023 from a single health system were categorised into groups based on intraoperative opioid administration: no methadone (Group O), methadone plus other opioids (Group M+O), and methadone only (Group M). Results: Patients in Groups M and M+O had lower mean pain scores until postoperative day (POD) 7 compared with Group O after adjusting for covariates (P
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- 2024
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3. Diversity, Equity, and Inclusion Among Anesthesiology Trainees
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Shyam Patel, Keldon K. Lin, Adam J. Milam, Soojie Yu, Gwendolyn Raynor, Khurmi Narjeet, Ricardo Verdiner, Marlene E. Girardo, and Lopa Misra
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diversity ,ethnicity ,gender ,gender identity ,race ,sexual orientation ,Gynecology and obstetrics ,RG1-991 ,Public aspects of medicine ,RA1-1270 - Abstract
Background: Historically in medicine, women and minorities have been underrepresented. This trend is especially significant in the anesthesiology workforce. Objective: The goals of this study were to quantify the current state of diversity by race/ethnicity, gender, and sexual orientation among anesthesiology residents. Methods: An institutionally reviewed and validated survey was delivered through Qualtrics to 130 anesthesiology program directors. Topics addressed included gender identity, sexual orientation, racial and ethnic background, rationale for pursuing anesthesiology, and medical training experiences. The study was administered from February to April 2021; 135 anesthesiology residents responded to the survey. Results: The sample was 44.4% white (n?=?60), 54.1% male (n?=?73), and 83.7% (n?=?113) of respondents self-reported as straight or heterosexual. Respondents indicated that role models/mentors were somewhat or very important in their desire to pursue anesthesiology (n?=?85; 67.2%), 42% reported that having women/diverse faculty was somewhat or very important in their decision to pursue anesthesiology. Discrimination during the anesthesiology residency application process or as a resident ranged from 4.4% due to sexual orientation to 18.7% due to gender/gender identity and race/ethnicity. Conclusions: Experiences of discrimination based on race/ethnicity, gender, and gender identity continues to be a concern among anesthesiology trainees. Creating an environment that is inclusive and supportive of all trainees regardless of race/ethnicity, gender/gender identity, and sexual orientation is needed. Interventions and strategies to create an inclusive environment may improve diversity within anesthesiology.
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- 2022
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4. Intraoperative Pulmonary Embolism Diagnosed by Rescue Transesophageal Echocardiography in a Morbidly Obese Patient Undergoing Orthopedic Surgery following Motor Vehicle Crash
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Patrick H. Lam, Adam J. Milam, Eric J. Ley, Roya Yumul, and Omar Durra
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Anesthesiology ,RD78.3-87.3 - Abstract
A case of intraoperative pulmonary embolism diagnosed by rescue transesophageal echocardiography in a morbidly obese patient undergoing orthopedic surgery following motor vehicle crash, who developed acute and persistent tachycardia, hypotension, and reduction of end-tidal CO2 during general and regional anesthesia, is described.
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- 2019
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5. Matters of the Heart: Examining Motivating Factors and Unconscious Bias in the Adult Cardiothoracic Anesthesiology Fellowship
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Soojie Yu, Frank Tavarez-Mora, Adam J. Milam, Lopa Misra, Oscar Aljure, Kathryn Glas, and Sasha Shillcutt
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Anesthesiology and Pain Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
6. Health Data Disparities in Opioid-Involved Overdose Deaths From 1999 to 2018 in the United States
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Adam J. Milam, Debra Furr-Holden, Ling Wang, and Kevin M. Simon
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business.industry ,Public Health, Environmental and Occupational Health ,030508 substance abuse ,Hispanic or Latino ,United States ,White People ,Health data ,Black or African American ,03 medical and health sciences ,Opiate Overdose ,0302 clinical medicine ,Opioid ,Socioeconomic Factors ,Environmental health ,Ethnicity ,Medicine ,Humans ,Public Health Surveillance ,030212 general & internal medicine ,Healthcare Disparities ,0305 other medical science ,business ,medicine.drug - Abstract
Objectives. To examine temporal trends in the classification of opioid-involved overdose deaths (OODs) and racial variation in the classification of specific types of opioids used. Methods. We analyzed OODs coded as other or unspecified narcotics from 1999 to 2018 in the United States using data from the National Vital Statistics System and the Centers for Disease Control and Prevention. Results. The total proportion of OODs from unspecified narcotics decreased from 32.4% in 1999 to 1.9% in 2018. The proportion of OODs from unspecified narcotics among African American persons was approximately 2-fold greater than that of non-Hispanic White persons until 2012. Similarly, the proportion of OODs from unspecified narcotics among Hispanic persons was greater than that of White persons until 2015. After we controlled for death investigation system, African American persons had a higher incidence rate of OODs from unspecified narcotics compared with White persons. Conclusions. There have been significant improvements in the specification OODs over the past 20 years, and there has been significant racial disparity in the classification of OODs until about 2015. The findings suggest a health data disparity; the excessive misclassification of OODs is likely attributable to the race/ethnicity of the decedent.
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- 2023
7. Health disparities in regional anesthesia and analgesia for the management of acute pain in trauma patients
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John W. Patton, Brittany N. Burton, Adam J. Milam, Edward R. Mariano, and Rodney A. Gabriel
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Anesthesiology and Pain Medicine - Published
- 2022
8. Derivation and Validation of Clinical Phenotypes of the Cardiopulmonary Bypass–Induced Inflammatory Response
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Adam J. Milam, Chen Liang, Junhui Mi, Edward J. Mascha, Sven Halvorson, Manshu Yan, Edward Soltesz, and Andra E. Duncan
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Anesthesiology and Pain Medicine - Published
- 2022
9. Experiences of Discrimination, Institutional Responses to Seminal Race Events, and Depressive Symptoms in Black U.S. Medical Students
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Adam J. Milam, Italo Brown, Jennifer Edwards-Johnson, Leon McDougle, Aron Sousa, and Debra Furr-Holden
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Students, Medical ,Depression ,Surveys and Questionnaires ,Humans ,General Medicine ,Anxiety ,Schools, Medical ,Article ,Education - Abstract
PURPOSE: To examine the relationship between experiences of discrimination, institutional responses to seminal race events, and depressive symptoms among Black medical students. METHOD: This study collected data from a convenience sample of Black U.S. medical students via an anonymous electronic questionnaire in August 2020 that was distributed through the Student National Medical Association and Organization of Student Representatives listservs and an author’s social media accounts. It included questions on demographics, institutional responses to seminal race events, experiences of discrimination, and symptoms of depression. Path models were used to examine the relationship between experiences of discrimination, institutional responses to seminal race events, and depressive symptoms among Black medical students. RESULTS: Of the 750 students completing the survey, 733 (97.7%) were Black. Experiences of discrimination and a lack of institutional responses to seminal race events were associated with more depressive symptoms (b = 0.19, 95% CI: 0.11, 0.26; P < .001 and b = 0.12, 95% CI: 0.04, 0.20; P = .01). After controlling for gender and clinical diagnosis of depression or anxiety prior to medical school, there was a relationship between experiences of discrimination and institutional responses to seminal race events such that students who reported more experiences of discrimination were more likely to report that their institution did not respond to seminal race events (b = 0.41, 95% CI: 0.34, 0.48; P < .001). Experiences of discrimination moderated the relationship between institutional responses to seminal race events and depressive symptoms (i.e., the relationship between a lack of institutional responses to seminal race events and depressive symptoms was stronger among students who reported more frequent experiences of discrimination). CONCLUSIONS: Institutions dedicated to supporting Black medical student wellness must be diligent in cultivating a culture intolerant of discrimination and deft in their responses to seminal race events in the larger culture.
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- 2023
10. Racial Disparities in Compensation Among US Anesthesiologists: Results of a National Survey of Anesthesiologists
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Megan T. Vandenberg, Molly Kraus, Lopa Misra, Linda Hertzberg, Skye Buckner-Petty, Asha Padmanabhan, Luis E. Tollinche, and Adam J. Milam
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Anesthesiology and Pain Medicine - Published
- 2023
11. Predicting Survival After HeartMate 3 Left Ventricular Assist Device Implantation—Progress Continues
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Adam J. Milam and Harish Ramakrishna
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Anesthesiology and Pain Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2023
12. Testing gene by community disadvantage moderation of sexual health outcomes among urban women.
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Terrinieka W Powell, Jill A Rabinowitz, Michelle R Kaufman, Adam J Milam, Kelly Benke, Danielle Y Sisto, George Uhl, Brion S Maher, and Nicholas S Ialongo
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Medicine ,Science - Abstract
We examined whether the interplay between community disadvantage and a conduct disorder polygenic risk score (CD PRS) was associated with sexual health outcomes among urban women. Participants (N = 511; 75.5% African American) were originally recruited to participate in a school-based intervention and were followed into adulthood. Community disadvantage was calculated using census data when participants were in first grade. At age 20, blood or saliva samples were collected and participants reported on their condom use, sexual partners, and sexually transmitted infections. A CD PRS was created based on a genome-wide association study conducted by Dick et al. [2010]. Higher levels of community disadvantage was associated with greater sexually transmitted infections among women with a higher CD PRS. Implications of the study findings are discussed.
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- 2019
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13. Racial Differences in 30-Day Reintubation After Head and Neck Surgery
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Brittany N Burton, Pelle V Wall, Danny Le, Adam J Milam, and Rodney A Gabriel
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General Engineering - Published
- 2023
14. Residential mobility, neighborhood cohesion, and depressive symptoms among urban‐dwelling African American adolescents
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Andrew A. Gepty, Sharon F. Lambert, Adam J. Milam, and Nicholas S. Ialongo
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Black or African American ,Adolescent ,Urban Population ,Social Psychology ,Depression ,Residence Characteristics ,Population Dynamics ,Humans - Abstract
Mechanisms linking residential mobility and depressive symptoms among urban-dwelling African American adolescents have received little attention. This study examined neighborhood cohesion as a possible mechanism. Participants were 358 urban-dwelling African American adolescents (M
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- 2022
15. Symptoms of Depression and Anxiety Among Black Medical Students: the Role of Peer Connectedness and Perceived Discrimination
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Aliyya Terry, Osose Oboh, Clara B. Barajas, C. Debra M. Furr-Holden, Jennifer Edwards-Johnson, Adam J. Milam, Zackary Brown, and Kevin M. Simon
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Male ,medicine.medical_specialty ,Students, Medical ,Health (social science) ,Sociology and Political Science ,Perceived Discrimination ,Social connectedness ,media_common.quotation_subject ,education ,Anxiety ,Peer Group ,Article ,Structural equation modeling ,Discrimination ,Epidemiology ,medicine ,Humans ,African American ,Association (psychology) ,Depression (differential diagnoses) ,media_common ,Depression ,Health Policy ,Public Health, Environmental and Occupational Health ,Mental health ,Feeling ,Black ,Anthropology ,Female ,medicine.symptom ,Psychology ,Clinical psychology - Abstract
This study examined the association between discrimination, peer connectedness, and mental health symptoms among Black medical students. Data were collected from a convenience sample of Black medical students via an anonymous electronic questionnaire (n = 733) in year 2020. The Patient-Reported Outcomes Measurement Information System Depression and Anxiety forms were used to measure depression and anxiety symptoms. Structural equation modeling was used to examine the association between discrimination, peer connectedness, and mental health symptoms (Mplus 7.3). The majority of the participants were female (80%), approximately 40% were third or fourth year medical school students, and 13% had a clinical diagnosis of depression/anxiety before medical school. About half of the students reported being watched more closely than their classmates, and 66% reported feeling the need to work twice as hard as others to get the same treatment or evaluation. The majority of students reported that their peers were supportive of their academic success (60.7%), and 53% reported that students often or always invited them to social outings. The mean T-score for depressive symptoms was 53.6 (SD = 7.8), and the mean T-score for anxiety symptoms was 58.6 (SD = 8.4). Overall, findings indicated a high prevalence of anxiety and depression symptoms among Black medical students, and increased discrimination was associated with more mental health symptoms among males. Additionally, increased peer connectedness was associated with fewer symptoms of anxiety among males and females and fewer depressive symptoms among females. Addressing discrimination among medical students may improve mental health among Black medical students. Supplementary Information The online version contains supplementary material available at 10.1007/s40615-021-01157-7.
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- 2021
16. Open Versus Endovascular Repair of Descending Thoracic Aneurysms: Analysis of Outcomes
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Adam J. Milam, Penny Hung, A. Steven Bradley, Demian Herrera-Quiroz, Ina Soh, and Harish Ramakrishna
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Anesthesiology and Pain Medicine ,Cardiology and Cardiovascular Medicine - Published
- 2022
17. Impact of the Sachet Alcohol Ban on Alcohol Availability in Uganda
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Nazarius Mbona Tumwesigye, Mieka Smart, Adam J. Milam, Aloysius Mutebi, and Hilbert Mendoza
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Marketing ,medicine.medical_specialty ,Health (social science) ,Alcohol Drinking ,Ethanol ,Extramural ,Public health ,Commerce ,Alcohol ,Toxicology ,Psychiatry and Mental health ,chemistry.chemical_compound ,Alcohol Policy Research ,chemistry ,Retail food ,Environmental health ,medicine ,Humans ,Uganda ,Business ,Alcohol availability - Abstract
OBJECTIVE: Alcohol use continues to be a major public health problem in Uganda. This study sought to estimate the availability of sachet alcohol among retail food and beverage establishments in two Ugandan districts (Kampala and Jinja) before and after enactment of the national sachet alcohol ban. METHOD: Independent observations in 100 establishments were conducted by a pair of trained observers during the peak hours of 7 P.M. to 1 A.M. Using a standardized checklist, observers recorded indications of alcohol availability before and after enactment of the sachet alcohol ban. RESULTS: Availability of (a) alcohol and (b) sachet alcohol were significantly affected by the ban. Before the ban, 69% of all establishments sold alcohol; there was a significant reduction in alcohol availability after enactment of the ban to 43% of the establishments (p < .001). This reduction was observed in off-premise establishments (p < .001), but not in on-premise establishments (p = .710). Additionally, before the sachet alcohol ban, 52% of all establishments sold sachet alcohol; however, there was a significant reduction in sachet availability after enactment of the ban (1.4%, p < .001). CONCLUSIONS: Legislation banning the manufacture and sale of sachet alcohol has the potential to reduce sachet availability. Future studies should examine changes in alcohol consumption following the sachet alcohol ban.
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- 2021
18. Superwoman, Racial Identity, and Teen Dating Violence Victimization among Young Black Women
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Katrina J. Debnam, Adam J. Milam, and Nadine M. Finigan-Carr
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Adolescent ,media_common.quotation_subject ,Vulnerability ,Intimate Partner Violence ,Identity (social science) ,050109 social psychology ,Stereotype ,Violence ,Developmental psychology ,Humans ,0501 psychology and cognitive sciences ,Dating violence ,Crime Victims ,Applied Psychology ,media_common ,Oppression ,Black women ,05 social sciences ,Bullying ,Romance ,Clinical Psychology ,Adolescent Behavior ,Female ,Teen dating violence ,Psychology ,050104 developmental & child psychology - Abstract
Young Black women consistently report the highest rates of teen dating violence (TDV) in the United States. They are also navigating a world in which they are facing historical marginalization and intersectional oppression. The Superwoman stereotypic role, in which Black women showcase strength and resist vulnerability, is often adapted in reaction to this normalized existence. Yet little research has examined how these constructs are related. In addition, research suggests that a positive racial identity may function as a psychological buffer against society’s negative view of Black Americans and reduce involvement in violence. The current study examined the relationship between endorsement of a Superwoman role and TDV victimization among young Black women. A total of 481 Black women, aged 18–19, completed online survey measures assessing their racial identity beliefs, endorsement of racial stereotypes, and TDV experiences. The results of the path models showed that endorsement of a Superwoman role was associated with increased TDV victimization. Results also showed that racial centrality was inversely associated with TDV; the more the young women felt that being Black was a central part of their identity, the less they reported victimization. Findings suggest a need for attention to stereotype development and racial identity in the development of healthy romantic relationships for Black youth.
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- 2021
19. The Influence of Social Media on Applicant Perceptions of Anesthesiology Residency Programs during the COVID-19 Pandemic (Preprint)
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Tyler Michael Dunn, Shyam Patel, Adam J Milam, Joseph Brinkman, Andrew Gorlin, and Monica Harbell
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Education - Published
- 2022
20. Comparing the Mutual Interchangeability of ECOM, FloTrac/Vigileo, 3D-TEE, and ITD-PAC Cardiac Output Measuring Systems in Coronary Artery Bypass Grafting
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Spurthy Narreddy, Joffer Hakim, Adam J. Milam, Vennela Reddy, Nakul Kumar, Sandeep Krishnan, Jon Lucaj, and Farhad Ghoddoussi
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medicine.medical_specialty ,Cardiac output ,Concordance ,Thermodilution ,Hemodynamics ,030204 cardiovascular system & hematology ,Interchangeability ,law.invention ,03 medical and health sciences ,symbols.namesake ,0302 clinical medicine ,030202 anesthesiology ,law ,Monitoring, Intraoperative ,Internal medicine ,Cardiopulmonary bypass ,Humans ,Medicine ,Cardiac Output ,Coronary Artery Bypass ,business.industry ,Reproducibility of Results ,Pearson product-moment correlation coefficient ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Bypass surgery ,Catheterization, Swan-Ganz ,Cardiology ,symbols ,Cardiology and Cardiovascular Medicine ,business ,Artery - Abstract
Objective The aim of this study was to compare the mutual interchangeability of 4 cardiac output measuring devices by comparing their accuracy, precision, and trending ability. Design A single-center prospective observational study. Design Nonuniversity teaching hospital, single center. Participants Forty-four consecutive patients scheduled for elective, nonemergent coronary artery bypass grafting (CABG). Interventions The cardiac output was measured for each participant using 4 methods: intermittent thermodilution via pulmonary artery catheter (ITD-PAC), Endotracheal Cardiac Output Monitor (ECOM), FloTrac/Vigileo System (FLOTRAC), and 3-dimensional transesophageal echocardiography (3D-TEE). Measurements and Main Results Measurements were performed simultaneously at 5 time points: presternotomy, poststernotomy, before cardiopulmonary bypass, after cardiopulmonary bypass, and after sternal closure. A series of statistical and comparison analyses including ANOVA, Pearson correlation, Bland-Altman plots, quadrant plots, and polar plots were performed, and inherent precision for each method and percent errors for mutual interchangeability were calculated. For the 6 two-by-two comparisons of the methods, the Pearson correlation coefficients (r), the percentage errors (% error), and concordance ratios (CR) were as follows: ECOM_versus_ITD-PAC (r = 0.611, % error = 53%, CR = 75%); FLOTRAC_versus_ITD-PAC (r = 0.676, % error = 49%, CR = 77%); 3D-TEE versus ITD-PAC (r = 0.538, % error = 64%, CR = 67%); FLOTRAC_versus_ECOM (r = 0.627, % error = 51%, CR = 75%); 3D-TEE_versus ECOM (r = 0.423, % error = 70%, CR = 60%), and 3D-TEE_versus_FLOTRAC (r = 0.602, % error = 59%, CR = 61%). Conclusions Based on the recommended statistical measures of interchangeability, ECOM, FLOTRAC, and 3D-TEE are not interchangeable with each other or to the reference standard invasive ITD-PAC method in patients undergoing nonemergent cardiac bypass surgery. Despite the negative result in this study and the majority of previous studies, these less-invasive methods of CO have continued to be used in the hemodynamic management of patients. Each device has its own distinct technical features and inherent limitations; it is clear that no single device can be used universally for all patients. Therefore, different methods or devices should be chosen based on individual patient conditions, including the degree of invasiveness, measurement performance, and the ability to provide real-time, continuous CO readings.
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- 2021
21. African Americans now outpace whites in opioid‐involved overdose deaths: a comparison of temporal trends from 1999 to 2018
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Ling Wang, Adam J. Milam, Richard C. Sadler, and Debra Furr-Holden
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medicine.medical_specialty ,Joinpoint regression ,business.industry ,030508 substance abuse ,Medicine (miscellaneous) ,Disease control ,Health equity ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Epidemiology ,medicine ,Population data ,Racial differences ,030212 general & internal medicine ,0305 other medical science ,business ,Demography - Abstract
AIMS To estimate racial differences in rates of opioid-involved overdose deaths (OOD) between whites and African Americans in the United States from 1999 to 2018 to (1) identify racial variation in the temporal trends of OOD during the 20-year period and (2) compare trends in OOD rates between whites and African Americans using the Centers for Disease Control and Prevention's (CDC) three defined OOD epidemic periods. METHODS Data were obtained from the CDC wide-ranging on-line data for epidemiological research, which combines OOD data from the National Vital Statistics System, and population data from the US Census Bureau. Joinpoint regression models were used to estimate age-adjusted annual percentage change (APC) in OOD by race from 1999 to 2018. RESULTS The temporal trends of OOD varied by race. African Americans had a persistently low rate of OOD and statistically non-significant rate of change in OOD from 1999 to 2012 (APC = 0.47; P > 0.05), with a statistically significant and rapid acceleration in OOD rates in 2012 that persisted to 2018 (APC = 26.16; P
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- 2020
22. Discrepancies in Local, State, and National Alcohol Outlet Listings: Implications for Research and Interventions
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Adam J. Milam, C. Debra M. Furr-Holden, Zachary Buchalski, Ling Wang, Richard C. Sadler, and Clara B. Barajas
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Health (social science) ,Alcohol Drinking ,media_common.quotation_subject ,Psychological intervention ,030508 substance abuse ,Medicine (miscellaneous) ,Article ,03 medical and health sciences ,0302 clinical medicine ,State (polity) ,Residence Characteristics ,Environmental health ,Humans ,030212 general & internal medicine ,National data ,media_common ,Models, Statistical ,Maryland ,Alcoholic Beverages ,Commerce ,Public Health, Environmental and Occupational Health ,Psychiatry and Mental health ,Income ,Alcohol outlet ,Business ,0305 other medical science - Abstract
BACKGROUND: The availability of local, state, and national data on alcohol outlet density have important implications for policies and interventions aiming to reduce alcohol-related problems. High-quality data on locations of alcohol outlets is important to accurately inform community interventions and public health initiatives, but such data is often not maintained, readily available, or of sufficient quality. OBJECTIVES: This study aims to examine the discrepancies between alcohol outlet databases and how neighborhood characteristics (i.e., income, majority racial population, urbanicity) are associated with the discrepancies between databases. METHODS: Data was collected from national (n=1), local (n=2), and state databases (n=3). Negative binomial regression modes were used to assess discrepancies in alcohol outlet count at the ZIP code level based on the data source. RESULTS: The average density of alcohol outlets (per 1000 residents) ranged from 0.71 to 2.17 in Maryland, 1.65 to 5.17 in Wisconsin, and 1.09 to 1.22 in Oregon based on different sources of data. Findings suggest high income areas (>200% poverty level) have fewer discrepancies (IR = 0.775, p < 0.01), low income areas (below poverty level) have greater discrepancies (IR = 4.990, p < 0.01), and urban areas tend to have fewer discrepancies (IR = 0.378, p < 0.01) between datasets. CONCLUSION: Interventions and policies depend on valid and reliable data; researchers, policymakers, and local agencies need to collaborate to develop methods to maintain accurate and accessible data.
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- 2020
23. Using Zoning as a Public Health Tool to Reduce Alcohol Outlet Oversaturation, Promote Compliance, and Guide Future Enforcement: a Preliminary Analysis of Transform Baltimore
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Adam J. Milam, Elizabeth D. Nesoff, Philip J. Leaf, Richard C. Sadler, Sabriya L. Linton, Beth A. Reboussin, and C. Debra M. Furr-Holden
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medicine.medical_specialty ,Health (social science) ,Alcohol Drinking ,Alcoholic Beverages ,Public health ,Commerce ,Public Health, Environmental and Occupational Health ,Poison control ,Suicide prevention ,Article ,Occupational safety and health ,Health equity ,Urban Studies ,Law Enforcement ,Paraphernalia ,Residence Characteristics ,Local government ,Environmental health ,Baltimore ,medicine ,Humans ,Household income ,Public Health ,Business ,Forecasting - Abstract
Alcohol outlet oversaturation often exacerbates negative public health outcomes. Recently, Baltimore City passed an extensive zoning rewrite (“TransForm Baltimore”) that sought to give local government and residents a tool to reduce alcohol outlet oversaturation through land use regulation. The present investigation evaluated the outlet and neighborhood characteristics of stores impacted by two components of TransForm Baltimore: (1) a requirement that taverns licensed for on-premise consumption in addition to off-premise, carryout sales generate at least 50% of their business from on-premise sales, and (2) a requirement to close, repurpose, or relocate all package stores (i.e., off-premise alcohol outlets) that have been operating as “non-conforming” in residential zones since 1971. Research assistants visited every off-premise alcohol outlet in the city (n = 685) to complete an observational assessment. Approximately 77% (n = 530) of these off-premise alcohol outlets were open, including 292 taverns and 238 package stores. t tests and chi-square tests were used to compare neighborhood characteristics (neighborhood disadvantage, median household income, and racial segregation) of sham taverns (i.e., taverns with less than 50% space dedicated for on-premise sales that were primarily operating as a package store) and non-conforming package stores. Of the 292 taverns accessible during the study, the remainder were chronically closed (n = 130); 24 (8.2%) were deemed sham taverns. Sham taverns were more likely to be located in communities with more economic disadvantage and lower median household income (t test; p
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- 2020
24. Measurement of Social Processes at the Neighborhood Level in Baltimore City
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Stacey C. Williams, Carlos Castillo Salgado, Adam J. Milam, and C. Debra M. Furr-Holden
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Adult ,Male ,Typology ,medicine.medical_specialty ,Health (social science) ,Adolescent ,Substance-Related Disorders ,Applied psychology ,Psychological intervention ,Poison control ,Context (language use) ,Population health ,Violence ,Social Environment ,Young Adult ,03 medical and health sciences ,Residence Characteristics ,medicine ,Humans ,0501 psychology and cognitive sciences ,Applied Psychology ,Physical disorder ,030505 public health ,Public health ,05 social sciences ,Public Health, Environmental and Occupational Health ,Social environment ,Middle Aged ,Socioeconomic Factors ,Baltimore ,Female ,Factor Analysis, Statistical ,0305 other medical science ,Psychology ,050104 developmental & child psychology - Abstract
Small-area ecological research is critical to inform place-based interventions at the neighborhood level; however, objective measurement of the social context has been limited. The current study extends the application of the Neighborhood Inventory for Environmental Typology (NIfETy) through the development and evaluation of measures of social context for a longer period of observation (3 years) and at a larger area of aggregation (census tract clusters) compared to previous studies using measures at the block-face level from a single observation. Observations from the 172-item inventory were collected from a random sample of block faces (n = 793) in Baltimore City annually over a three-year period. Through a multistep process including replication of previous measures, data reduction, and factor analysis, six unique neighborhood-level indices were generated to describe the environmental context: drug and alcohol use, violence, physical disorder, epicenter, youth activity, and improvements. An assessment of measurement consistency and validity provided support for some indices, while others had notable limitations. These indices can assist local policymakers and public health practitioners assessing the needs of individual neighborhoods and evaluating the effectiveness of place-based interventions designed to improve the neighborhood environment and population health outcomes.
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- 2020
25. The Violence Prevention Potential of Reducing Alcohol Outlet Access in Baltimore, Maryland
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Pamela J. Trangenstein, Debra Furr-Holden, Raimee H. Eck, Carl A. Latkin, Yi Lu, Jacky M. Jennings, David H. Jernigan, Adam J. Milam, and Daniel W. Webster
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Health (social science) ,Cost-Benefit Analysis ,030508 substance abuse ,Public policy ,Poison control ,Policy Studies ,Public Policy ,Violence ,Toxicology ,Suicide prevention ,Occupational safety and health ,03 medical and health sciences ,Criminal Law ,Environmental health ,Injury prevention ,Humans ,Medicine ,Crime Victims ,Cost–benefit analysis ,business.industry ,Alcoholic Beverages ,Commerce ,Human factors and ergonomics ,Psychiatry and Mental health ,Baltimore ,Homicide ,0305 other medical science ,Zoning ,business - Abstract
OBJECTIVE: There are few cost-effectiveness analyses that model alcohol outlet zoning policies. This study determines the potential decreases in homicides, disability-adjusted life years (DALYs), and victim and criminal justice costs associated with four policy options that would reduce the alcohol outlet access in Baltimore. METHOD: This cost-effectiveness analysis used associations between on-premise (incidence rate ratio [IRR] = 1.41), off-premise (IRR = 1.76), and combined on- and off-premise outlet density (IRR = 1.07) and homicide in Baltimore. We determined the potential change in the level of homicide that could occur with changes in the density of alcohol outlets, assuming that 50% of the association was causal. RESULTS: Reducing alcohol outlet density in Baltimore City by one quintile was associated with decreases of 51 homicides per year, $63.7 million, and 764 DALYs. Removing liquor stores in residential zones was associated with 22 fewer homicides, which would cost $27.5 million and lead to 391 DALYs. Removing bars/taverns operating as liquor stores was associated with a decrease of one homicide, $1.2 million, and 17 DALYs. Removing both the liquor stores in residential zones and the bars/taverns operating as liquor stores was associated with 23 fewer homicides, which translated to $28.7 million and 409 DALYs. CONCLUSIONS: For preventing homicides, the strategy of removing liquor stores in residential zones was preferred because it was associated with substantial reductions in homicides without closing unacceptably high numbers of outlets. It is possible that policies that close the bars/taverns operating as liquor stores would be associated with decreases in other types of violent crime.
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- 2020
26. Expanding Tools for Investigating Neighborhood Indicators of Drug Use and Violence: Validation of the NIfETy for Virtual Street Observation
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Elizabeth D. Nesoff, Adam J. Milam, Clara B. Barajas, and C. Debra M. Furr-Holden
- Subjects
Typology ,Substance-Related Disorders ,Geographic Mapping ,Poison control ,Observation ,Violence ,Risk Assessment ,Article ,03 medical and health sciences ,Residence Characteristics ,Urban planning ,Environmental health ,Humans ,0501 psychology and cognitive sciences ,Environmental justice ,030505 public health ,Data collection ,05 social sciences ,Public Health, Environmental and Occupational Health ,Human factors and ergonomics ,Exploratory factor analysis ,Search Engine ,Scale (social sciences) ,Baltimore ,Factor Analysis, Statistical ,0305 other medical science ,Psychology ,Forecasting ,050104 developmental & child psychology - Abstract
A growing body of evidence suggests that characteristics of the neighborhood environment in urban areas significantly impact risk for drug use behavior and exposure to violent crime. Identifying areas of community need, prioritizing planning projects, and developing strategies for community improvement require inexpensive, easy to use, evidence-based tools to assess neighborhood disorder that can be used for a variety of research, urban planning, and community needs with an environmental justice frame. This study describes validation of the Neighborhood Inventory for Environmental Typology (NIfETy), a neighborhood environmental observational assessment tool designed to assess characteristics of the neighborhood environment related to violence, alcohol, and other drugs, for use with Google Street View (GSV). GSV data collection took place on a random sample of 350 blocks located throughout Baltimore City, Maryland, which had previously been assessed through in-person data collection. Inter-rater reliability metrics were strong for the majority of items (ICC ≥ 0.7), and items were highly correlated with in-person observations (r ≥ 0.6). Exploratory factor analysis and constrained factor analysis resulted in one, 14-item disorder scale with high internal consistency (alpha = 0.825) and acceptable fit indices (CFI = 0.982; RMSEA = 0.051). We further validated this disorder scale against locations of violent crimes, and we found that disorder score was significantly and positively associated with neighborhood crime (IRR = 1.221, 95% CI = (1.157, 1.288), p
- Published
- 2019
27. In Reply to Yung and Morris
- Author
-
Adam J, Milam, Leon, McDougle, and Debra, Furr-Holden
- Subjects
General Medicine ,Education - Published
- 2022
28. Alcohol outlets, drug paraphernalia sales, and neighborhood drug overdose
- Author
-
Brian W. Weir, Amy R. Knowlton, Elizabeth D. Nesoff, Christopher N. Morrison, Silvia S. Martins, Debra Furr-Holden, Charles C. Branas, and Adam J. Milam
- Subjects
medicine.medical_specialty ,Alcohol Drinking ,030508 substance abuse ,Medicine (miscellaneous) ,Alcohol ,Drug overdose ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Paraphernalia ,Policy decision ,Environmental health ,medicine ,Humans ,030212 general & internal medicine ,Harm reduction ,Drug paraphernalia ,business.industry ,Health Policy ,Public health ,Alcoholic Beverages ,medicine.disease ,Census block ,Cross-Sectional Studies ,chemistry ,Pharmaceutical Preparations ,cardiovascular system ,Drug Overdose ,0305 other medical science ,business ,human activities - Abstract
Background Alcohol outlets have been associated with various forms of injury and may contribute to neighborhood disparities in drug overdose. Few studies have examined the associations between alcohol outlets and drug overdose. This study investigated whether alcohol outlets were associated with the neighborhood drug overdose rate and whether the sale of drug paraphernalia contributes to this association. Methods A cross-sectional ecological spatial analysis was conducted within census block groups in Baltimore City (n = 653). Outcomes were counts of EMS calls for any drug overdose in 2015 (n = 3,856). Exposures of interest were counts of alcohol outlets licensed for off-premise and on-premise consumption and the proportion of off-premise outlets selling drug paraphernalia (e.g., blunt wrappers, baggies, pipes). Negative binomial regression was used to assess the relationship between outlet count and overdose rate, and if paraphernalia sales altered this relationship, controlling for other neighborhood factors. Spatial autocorrelation was assessed and regression inference adjusted accordingly. Results Each additional off-premise alcohol outlet was associated with a 16.6% increase in the neighborhood overdose rate (IRR=1.17, 95%CI=(1.11, 1.23)), adjusted for other neighborhood variables. On-premise alcohol outlets were not significantly associated with overdose rate when adjusting for off-premise alcohol outlets (IRR=1.01, 95% CI=(0.97, 1.06)). The proportion of off-premise outlets that sold drug paraphernalia was negatively associated with overdose rate (IRR=0.55, 95% CI=(0.41, 0.74)) and did not alter the relationship between off-premise outlets and overdose. Conclusion This study provides preliminary public health evidence for informing policy decisions about alcohol outlet licensing and zoning. Alcohol outlets could be potential community partners for harm reduction strategies such as health communication in identifying overdose symptoms or Good Samaritan Laws.
- Published
- 2021
29. Vaccine hesitance and vaccine access in minority communities
- Author
-
Lee Kirksey, Adam J Milam, Ahmed A. Sorour, and Caleb W. Curry
- Subjects
Coronavirus disease 2019 (COVID-19) ,business.industry ,Community organization ,media_common.quotation_subject ,Staffing ,Equity (finance) ,Distribution (economics) ,General Medicine ,Public relations ,Vaccination ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Beauty ,Medicine ,030212 general & internal medicine ,business ,media_common - Abstract
Attaining equity in vaccination distribution is a moral and ethical goal that ensures all members of our community are properly cared for. We suggest a comprehensive approach that involves allocating community resources based on local economic, demographic, and COVID-19 infection data, removing technology barriers by staffing vaccine appointment call-in centers, distributing vaccines based on objective factors (eg, household density) rather than on a "first come, first served" basis, and creating pop-up vaccination sites at trusted community organizations such as federally qualified healthcare centers, churches, libraries, and barber/beauty shops. Until every community is safe, no community will be safe.
- Published
- 2021
30. Evaluation of a Local Ordinance to Prevent Any Underage Purchases in Liquor Stores: The Need for Enforcement
- Author
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Pamela J. Trangenstein, Elizabeth D. Nesoff, Adam J. Milam, and C. Debra M. Furr-Holden
- Subjects
African american ,Male ,medicine.medical_specialty ,Health (social science) ,Adolescent ,Public health ,Alcoholic Beverages ,Commerce ,Liquor store ,Advertising ,Legislation ,Policy Studies ,Toxicology ,Product (business) ,Psychiatry and Mental health ,Young Adult ,Residence Characteristics ,Baltimore ,medicine ,Household income ,Humans ,Business ,Public Health ,Enforcement - Abstract
OBJECTIVE: In June 2012, Baltimore City, MD, enacted legislation (commonly referred to as the Mosby Bill) prohibiting all liquor stores (outlets that primarily sell alcoholic beverages) from selling “any food, goods, wares, supplies, or other merchandise to any person under the age of 18.” Three years after enactment, we evaluated the impact of this legislation on non-alcohol product sales among youth. METHOD: Research assistants (RAs) ages 16–20 were trained in using a standardized observational tool to quantify and record characteristics of the outlets, including products sold. A trained pair comprising one RA age 16 to 20 and one RA exactly age 18 were sent into every liquor store (i.e., packaged goods stores and bar/taverns with packaged goods sales) in Baltimore to conduct the assessment and make a non-alcohol purchase. Since the research was not conducted in concert with the police, the 18-year-old RA made the purchase attempt while the other (age 16 to 20) RA completed the assessment. RESULTS: Purchase attempts were made at 502 liquor stores, and 352 of those attempts were successful (able to make purchase without being asked for identification or age; noncompliance rate = 68.1%). Noncompliance was highest among packaged goods stores compared with bar/taverns, and in neighborhoods with a lower median household income and a higher proportion of African American residents (p < .050). Noncompliant outlets were also located closer to public schools (p < .050). CONCLUSIONS: This evaluation demonstrates that, in the absence of enforcement, ordinances are neither likely to be honored nor to achieve the intended public health benefits.
- Published
- 2021
31. Coping, Discrimination, and Physical Health Conditions Among Predominantly Poor, Urban African Americans: Implications for Community-Level Health Services
- Author
-
Thomas A. LaVeist, Shawn C. T. Jones, Clara B. Barajas, C. Debra M. Furr-Holden, Darrell J. Gaskin, Roland J. Thorpe, and Adam J. Milam
- Subjects
Male ,Gerontology ,Coping (psychology) ,Health (social science) ,Urban Population ,Health Status ,media_common.quotation_subject ,Ethnic group ,Overweight ,Racism ,Article ,03 medical and health sciences ,0302 clinical medicine ,Health care ,Diabetes Mellitus ,medicine ,Humans ,Community Health Services ,Obesity ,030212 general & internal medicine ,Poverty ,media_common ,030505 public health ,business.industry ,Public Health, Environmental and Occupational Health ,Mental health ,humanities ,John Henryism ,Black or African American ,Cross-Sectional Studies ,Chronic Disease ,Hypertension ,Community health ,Female ,medicine.symptom ,0305 other medical science ,business ,Psychology - Abstract
African Americans and ethnic minorities experience racial discrimination in a variety of settings. Racial discrimination is a potent stressor that has been linked to psychosocial stress and poor physical health. To cope with discriminatory experiences and daily life event stressors, African Americans frequently use the concept of John Henryism (a high effort coping strategy with prolonged exposure to stress). This cross-sectional analysis explored the relationship between racism/discrimination, John Henryism, and health problems in a predominately African American sample. Data were collected through health care screenings for hypertension, diabetes, and obesity and a self-report survey to assess experiences of discrimination and use of John Henryism. Logistic and linear regression models were used to assess the relationship between the John Henryism score, racism/discrimination score, and health problems among 352 participants. John Henryism was associated with a decrease in systolic blood pressure (b = − 12.50, 95% CI = − 23.05, − 1.95) among men, after adjusting for experiences of racism/discrimination and demographic characteristics. Experiences of racism/discrimination were associated with an increase in systolic blood pressure (b = 11.23, 95% CI = 0.38, 22.09) among men, after adjusting for John Henryism and demographic characteristics. Among women, there was no association found between John Henryism and experiences of racism/discrimination with systolic blood pressure. No association was found between John Henryism and experiences of racism/discrimination with being overweight/obese in women nor men. The study found that John Henryism was positively associated with the health of men, while experiences of racism/discrimination were negatively associated with their health. Limitations of the study are discussed, and recommendations are made to guide future research exploring the concept of John Henryism as a relevant factor between stress, racial discrimination and poor health.
- Published
- 2019
32. Social Influences on Drinking Trajectories From Adolescence to Young Adulthood in an Urban Minority Sample
- Author
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Beth A. Reboussin, Victoria Nelson, Pamela A. Matson, Brion S. Maher, Kerry M. Green, Jill A. Rabinowitz, Adam J. Milam, Debra Furr-Holden, and Nicholas S. Ialongo
- Subjects
Male ,Parents ,Health (social science) ,Adolescent ,Alcohol Drinking ,030508 substance abuse ,Poison control ,Underage Drinking ,Toxicology ,Suicide prevention ,Peer Group ,Occupational safety and health ,Developmental psychology ,Young Adult ,03 medical and health sciences ,Residence Characteristics ,Risk Factors ,Injury prevention ,Epidemiological Studies ,Humans ,Longitudinal Studies ,Young adult ,Child ,Social Behavior ,Minority Groups ,Social influence ,Human factors and ergonomics ,Peer group ,Black or African American ,Psychiatry and Mental health ,Adolescent Behavior ,Female ,0305 other medical science ,Psychology - Abstract
OBJECTIVE: Research on the heterogeneity in drinking patterns of urban minorities within a socioecological framework is rare. The purpose of this study was to explore multiple, distinct patterns of drinking from adolescence to young adulthood in a sample of urban minority youth and to examine the influence of neighborhood, family, and peers on these trajectories. METHOD: Data are from a longitudinal study of 584 (56% male) primarily Black (87%) youth who were first sampled in childhood based on their residence in low-income neighborhoods in Baltimore City and followed up annually through age 26. Data were analyzed using group-based trajectory modeling and multinomial logistic regression. RESULTS: Modeling revealed six trajectories from ages 14 to 26: abstainer, experimenter, adult increasing, young adult increasing, adolescent limited, and adolescent increasing. Neighborhood disadvantage was a risk factor for drinking regardless of the timing of onset. Perceptions of availability, peer drinking, and parental approval for drinking were risk factors for underage drinking trajectories, whereas parental supervision was a significant protective factor. Positive social activities in neighborhoods was protective against increased drinking, whereas a decline in perceptions of peer drinking was associated with adolescent-limited drinking. CONCLUSIONS: Our findings uniquely highlight the importance of developing interventions involving parents for urban minority youth for whom family is particularly relevant in deterring underage drinking. Perhaps most importantly, our data suggest that interventions that support positive social activities in disadvantaged neighborhoods are protective against adolescent drinking and altering perceptions of peer drinking may reduce adolescent drinking among low-income, urban minority youth.
- Published
- 2019
33. Contributions of an Internalizing Symptoms Polygenic Risk Score and Contextual Factors to Alcohol-Related Disorders in African American Young Adults
- Author
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Kelly S. Benke, Rashelle J. Musci, Gail M. Rosenbaum, Brion S. Maher, Adam J. Milam, Danielle Y. Sisto, Nicholas S. Ialongo, George R. Uhl, Jill A. Rabinowitz, and Beth A. Reboussin
- Subjects
Adult ,Male ,African american ,Multifactorial Inheritance ,Alcohol-related disorders ,Health (social science) ,Adolescent ,Genotype ,business.industry ,Alcohol Studies ,Toxicology ,Black or African American ,Alcoholism ,Young Adult ,Psychiatry and Mental health ,Risk Factors ,Humans ,Medicine ,Female ,Polygenic risk score ,Young adult ,business ,Genome-Wide Association Study ,Clinical psychology - Abstract
OBJECTIVE: Alcohol-related disorders (i.e., abuse and dependence) are significant problems that may result in numerous negative consequences. Although a number of studies have examined factors that predict alcohol abuse and dependence in European samples, only a few studies have examined whether genetic and environmental factors influence the pathogenesis of alcohol-related disorders among African Americans. The present study examined whether gene (internalizing symptoms polygenic risk score) by environment (parental monitoring, community disadvantage) interactions were associated with alcohol-related disorders in a sample of African American adults. METHOD: Participants (N = 640; 39.7% male) were initially recruited for an elementary school–based universal prevention trial in a mid-Atlantic city and followed into adulthood. Participants reported on their perceptions of parental monitoring in sixth grade. At 30 years of age, participants reported on their alcohol abuse and dependence, and DNA was obtained and genotyped using Affymetrix 6.0 microarrays. An internalizing symptoms polygenic risk score was created using discovery samples results from a genome-wide association study (GWAS) that involved three large population-based studies. Community disadvantage was calculated based on census data when participants were in first grade. RESULTS: There was a significant interaction between the internalizing symptoms polygenic risk score and community disadvantage such that exposure to higher community disadvantage was associated with lower risk for alcohol-related disorders among participants with a higher internalizing symptoms polygenic risk score. CONCLUSIONS: Our findings highlight that higher genetic loading for internalizing symptoms may protect urban African Americans from alcohol-related disorders, particularly in more disadvantaged areas.
- Published
- 2019
34. When Are We Going to Address the Lack of Diversity in Cardiothoracic Anesthesiology?
- Author
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Michael Essandoh, Stewart A Smith, Ashley P Oliver, TomMario Davis, and Adam J. Milam
- Subjects
medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,MEDLINE ,Anesthesiology and Pain Medicine ,Anesthesiology ,Family medicine ,Anesthesia, Cardiac Procedures ,medicine ,Humans ,Fellowships and Scholarships ,Cardiology and Cardiovascular Medicine ,business ,Cardiothoracic anesthesiology ,Diversity (politics) ,media_common - Published
- 2021
35. The interplay between externalizing disorders polygenic risk scores and contextual factors on the development of marijuana use disorders
- Author
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Jill A. Rabinowitz, Brion S. Maher, George R. Uhl, Rashelle J. Musci, Kelly S. Benke, Adam J. Milam, Danielle Y. Sisto, and Nicholas S. Ialongo
- Subjects
Conduct Disorder ,Male ,Marijuana Abuse ,Multifactorial Inheritance ,Parental monitoring ,Adolescent ,Comorbidity ,Toxicology ,Article ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Marijuana use ,Externalizing disorders ,medicine ,Humans ,0501 psychology and cognitive sciences ,Pharmacology (medical) ,Child ,Disadvantage ,Genetic association ,Pharmacology ,business.industry ,05 social sciences ,medicine.disease ,Psychiatry and Mental health ,Attention Deficit Disorder with Hyperactivity ,Conduct disorder ,Etiology ,Female ,Marijuana Use ,Polygenic risk score ,Disease Susceptibility ,business ,030217 neurology & neurosurgery ,Genome-Wide Association Study ,050104 developmental & child psychology ,Clinical psychology - Abstract
Externalizing disorders have been extensively linked to substance use problems. However, less is known about whether genetic factors underpinning externalizing disorders and environmental features interact to predict substance use disorders (i.e., marijuana abuse and dependence) among urban, African-Americans. We examined whether polygenic risk scores for conduct disorder (CD PRS) and attention-deficit hyperactivity disorder (ADHD PRS) interacted with contextual factors (i.e., parental monitoring, community disadvantage) to influence risk for marijuana use disorders in a sample of African-American youth. Participants (N=1,050; 44.2% male) were initially recruited for an elementary school-based universal prevention trial in a Mid-Atlantic city and followed through age 20. Participants reported on their parental monitoring in sixth grade and whether they were diagnosed with marijuana abuse or dependence at age 20. Blood or saliva samples were genotyped using the Affymetrix 6.0 microarrays. The CD and ADHD PRS were created based on genome-wide association studies conducted by Dick et al. (2010) and Demontis et al. (2017), respectively. Community disadvantage was calculated based on census data when participants were in sixth grade. There was an interaction between the CD PRS and community disadvantage such that a higher CD PRS was associated with greater risk for a marijuana use disorder at higher levels of neighborhood disadvantage. This finding should be interpreted with caution owing to the number of significance tests performed. Implications for etiological models and future research directions are presented.
- Published
- 2018
36. Teacher-Student Incongruence in Perceptions of School Equity: Associations with Student Connectedness in Middle and High Schools
- Author
-
Catherine P. Bradshaw, Katrina J. Debnam, Jessika H. Bottiani, and Adam J. Milam
- Subjects
Student perceptions ,Medical education ,Staff perceptions ,Schools ,School climate ,Adolescent ,Social connectedness ,media_common.quotation_subject ,education ,Multilevel model ,Public Health, Environmental and Occupational Health ,Equity (finance) ,Achievement ,Faculty ,Education ,Philosophy ,Perception ,Humans ,Psychology ,Students ,media_common - Abstract
BACKGROUND School equity refers to the extent to which students are treated fairly, ensuring that each student receives what they need to be successful. School staff can play a vital role in creating an equitable school climate for adolescents, but little is known about how staff perceive equity in their school and how this in turn may relate to students' perceptions. This study sought to explore congruence between teacher and student perceptions of school equity and how congruence or incongruence related to students' sense of connectedness to school. METHODS Data for the study came from the Maryland Safe and Supportive Schools Climate Survey, which was administered online to 5523 school staff and 59,218 students across 104 middle and high schools. RESULTS Multilevel models indicated that, compared to high staff and high student ratings, there was lower connectedness among the schools with low staff, low student ratings of equity as well as the schools with high staff, low student and low staff, high student ratings of equity. CONCLUSIONS The findings suggest that staff perceptions of school equity are often higher than students and incongruence in perceptions may have a negative impact on students' connection to school.
- Published
- 2021
37. Preparing Students for Success: Differential Outcomes by Preschool Experience in Baltimore City, Maryland
- Author
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Clara B. Barajas, Faith Connolly, Philip J. Leaf, Linda Steffel Olson, Stacey C. Williams, and Adam J. Milam
- Subjects
Gerontology ,medicine.medical_specialty ,education ,Psychological intervention ,Academic achievement ,Article ,03 medical and health sciences ,medicine ,Early Intervention, Educational ,Humans ,0501 psychology and cognitive sciences ,Students ,030505 public health ,Academic year ,Academic Success ,Schools ,Public health ,05 social sciences ,Public Health, Environmental and Occupational Health ,Health psychology ,Head start ,Child, Preschool ,Cohort ,Baltimore ,Regression Analysis ,Educational Measurement ,0305 other medical science ,Psychology ,Universal preschool ,050104 developmental & child psychology ,Program Evaluation - Abstract
An early adopter of public preschool (i.e., pre-kindergarten, "pre-k"), evidence from Baltimore City, Maryland, can provide insight for those working to improve access to early education opportunities. We followed a cohort of children entering kindergarten in Baltimore City Public Schools during the 2007-2008 year through the 2010-2011 academic year. Students were grouped by pre-k experience: public pre-k (n = 2828), Head Start (n = 839), Head Start plus public pre-k (n = 247), private pre-k (n = 993), or informal care (n = 975). After adjusting for individual- and school-level characteristics, students from the Head Start plus public pre-k group were the most likely to enter kindergarten with the foundational skills and behaviors needed to be successful (vs. all groups, P ≤ .001). Students in informal care were the least likely to enter kindergarten with this skillset (vs. all pre-k groups P ≤ .001). Children from informal care were also significantly more likely than all other groups to be chronically absent in kindergarten (P ≤ .001). By third grade, children from informal care were least likely to be reading on grade level and most likely to have been retained a grade (vs. all pre-k groups P ≤ .001). Children from disadvantaged populations who were not enrolled in pre-k faced significant difficulties keeping up with their peers throughout elementary school; interventions to improve their transition to school and increase their likelihood of academic success are warranted. Universal preschool is likely to improve education outcomes for children in urban areas.
- Published
- 2020
38. Polygenic and Environmental Influences on the Course of African Americans’ Alcohol Use from Early Adolescence through Young Adulthood
- Author
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Brion S. Maher, Beth A. Reboussin, George R. Uhl, Danielle Y. Sisto, Jill A. Rabinowitz, Adam J. Milam, Rashelle J. Musci, Nicholas S. Ialongo, and Kelly S. Benke
- Subjects
Adult ,Parental monitoring ,Multifactorial Inheritance ,Adolescent ,Alcohol Drinking ,Early adolescence ,030508 substance abuse ,Alcohol ,Article ,03 medical and health sciences ,chemistry.chemical_compound ,Young Adult ,Early adulthood ,Developmental and Educational Psychology ,Humans ,0501 psychology and cognitive sciences ,Young adult ,Child ,Disadvantage ,05 social sciences ,Antisocial Personality Disorder ,Disadvantaged ,Black or African American ,Psychiatry and Mental health ,chemistry ,Polygenic risk score ,0305 other medical science ,Psychology ,050104 developmental & child psychology ,Demography ,Genome-Wide Association Study - Abstract
The study examined (a) whether alcohol use subgroups could be identified among African Americans assessed from adolescence through early adulthood, and (b) whether subgroup membership was associated with the interaction between internalizing symptoms and antisocial behavior polygenic risk scores (PRSs) and environmental characteristics (i.e., parental monitoring, community disadvantage). Participants (N = 436) were initially recruited for an elementary school-based prevention trial in a Mid-Atlantic city. Youths reported on the frequency of their past year alcohol use from ages 14–26. DNA was obtained from participants at age 21. Internalizing symptoms and antisocial behavior PRSs were created based on a genome-wide association study (GWAS) conducted by Benke et al. (2014) and Tielbeek et al. (2017), respectively. Parental monitoring and community disadvantage were assessed at age 12. Four classes of past year alcohol use were identified: (a) early-onset, increasing; (b) late-onset, moderate use; (c) low steady; and (d) early-onset, decreasing. In high community disadvantaged settings, participants with a higher internalizing symptoms PRS were more likely to be in the early-onset, decreasing class than the low steady class. When exposed to elevated community disadvantage, participants with a higher antisocial behavior PRS were more likely to be in the early-onset, increasing class than the early-onset, decreasing and late-onset, moderate use classes.
- Published
- 2020
39. Alcohol Advertising and Violence
- Author
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Raimee H. Eck, Pamela J. Trangenstein, Adam J. Milam, C. Debra M. Furr-Holden, David H. Jernigan, and Naomi Greene
- Subjects
Complete data ,Alcohol Drinking ,Epidemiology ,Violence ,Violent crime ,01 natural sciences ,Article ,03 medical and health sciences ,0302 clinical medicine ,Advertising ,Residence Characteristics ,mental disorders ,Humans ,030212 general & internal medicine ,0101 mathematics ,health care economics and organizations ,Population Density ,Spatial Analysis ,Extramural ,Alcoholic Beverages ,010102 general mathematics ,Ownership ,Public Health, Environmental and Occupational Health ,social sciences ,Geography ,Socioeconomic Factors ,Alcohol advertising ,Baltimore ,cardiovascular system ,Alcohol outlet ,Square mile ,Homicide ,human activities ,Demography - Abstract
INTRODUCTION: Numerous studies have found associations between alcohol outlet density and violence, but it is unknown whether alcohol advertisements (ads) visible outside outlets are also associated with violent crime. Baltimore City, Maryland enacted restrictions on retail alcohol establishment advertising practices as of June 5, 2017. This study examines the association between alcohol ads visible outside off-premise alcohol outlets and violent crime prior to this restriction. METHODS: Outlet observations (n=653) were conducted in summer 2015, and violent crime data (n=24,085) were from June 5, 2015 through June 4, 2017. The number of violent crimes per square mile within 1,000 feet of outlets was summed using kernel density estimation. In 20182019, authors used mixed models with Simes-Benjamini-Hochberg correction for multiple testing. RESULTS: Roughly half (47%, n=267) of the outlets with complete data (n=572) had alcohol ads visible from the exterior. Outlets with alcohol ads had 15% more violent crimes per square mile within 1,000 feet (ê=1.15, 95% CI=1.07, 1.25, q
- Published
- 2020
40. Health-related Risks for Involvement in Bullying among Middle and High School Youth
- Author
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Catherine P. Bradshaw, Krista R. Mehari, Tracy Evian Waasdorp, and Adam J. Milam
- Subjects
050103 clinical psychology ,Bullying perpetration ,education ,05 social sciences ,Health related ,social sciences ,Overweight ,medicine.disease ,Logistic regression ,Obesity ,humanities ,Odds ,Sleep difficulties ,behavior and behavior mechanisms ,Developmental and Educational Psychology ,medicine ,0501 psychology and cognitive sciences ,medicine.symptom ,Life-span and Life-course Studies ,Psychology ,health care economics and organizations ,050104 developmental & child psychology ,Clinical psychology ,Asthma - Abstract
Rates of victimization and bullying perpetration may vary by adolescents’ health status. The purpose of this study was to examine risk for bullying and victimization while considering multiple health conditions and health-related behaviors. Self-reported data were collected from 64,670 youth (50.3% female; 48.8% White; 25.7% Black/African American) enrolled at 107 middle and high schools across the state of Maryland. Two-level logistic regressions examined the association between health conditions and other health-related behaviors (i.e., physical activity, asthma, healthy eating, sleep troubles, obesity, and being overweight) and bullying. Results indicated that obese youth had higher odds of being a victim or bully-victim. Youth with asthma were more likely to be victimized, both in-person and online, and were more likely to be cyberbully-victims. Sleep difficulties were consistently associated with involvement in bullying, having higher odds of being a victim or bully-victim in-person and online as well as higher odds of perpetration of bullying. In contrast, healthy food consumption was associated with significantly lower odds of bullying perpetration, and physical activity was associated with significantly lower odds of being a bully-victim. Taken together, the findings suggest that various conditions and health-related behaviors may be important risk factors for both bullying victimization and perpetration.
- Published
- 2018
41. Testing gene by community disadvantage moderation of sexual health outcomes among urban women
- Author
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Jill A. Rabinowitz, Brion S. Maher, Kelly S. Benke, George R. Uhl, Nicholas S. Ialongo, Terrinieka W. Powell, Danielle Y. Sisto, Adam J. Milam, and Michelle R. Kaufman
- Subjects
Male ,Multifactorial Inheritance ,Heredity ,Social Sciences ,law.invention ,0302 clinical medicine ,5. Gender equality ,law ,Outcome Assessment, Health Care ,Medicine and Health Sciences ,Odds Ratio ,Urban Health Services ,Medicine ,Psychology ,Ethnicities ,Public and Occupational Health ,African American people ,Reproductive health ,African american ,0303 health sciences ,Multidisciplinary ,Genomics ,Population groupings ,Moderation ,Socioeconomic Aspects of Health ,Women's Health Services ,Infectious Diseases ,Conduct disorder ,Female ,Genetic Load ,Sexual Health ,Research Article ,Science ,Sexually Transmitted Diseases ,03 medical and health sciences ,Condom ,Intervention (counseling) ,Genetics ,Genome-Wide Association Studies ,Humans ,Genetic Predisposition to Disease ,Genetic Testing ,Disadvantage ,030304 developmental biology ,Behavior ,business.industry ,Urban Health ,Biology and Life Sciences ,Computational Biology ,Human Genetics ,medicine.disease ,Genome Analysis ,Health Care ,Women's Health ,Polygenic risk score ,Human Sexual Behavior ,People and places ,business ,030217 neurology & neurosurgery ,Demography - Abstract
We examined whether the interplay between community disadvantage and a conduct disorder polygenic risk score (CD PRS) was associated with sexual health outcomes among urban women. Participants (N = 511; 75.5% African American) were originally recruited to participate in a school-based intervention and were followed into adulthood. Community disadvantage was calculated using census data when participants were in first grade. At age 20, blood or saliva samples were collected and participants reported on their condom use, sexual partners, and sexually transmitted infections. A CD PRS was created based on a genome-wide association study conducted by Dick et al. [2010]. Higher levels of community disadvantage was associated with greater sexually transmitted infections among women with a higher CD PRS. Implications of the study findings are discussed.
- Published
- 2019
42. The Impact of the Urban Neighborhood Environment on Marijuana Trajectories During Emerging Adulthood
- Author
-
Renee M. Johnson, Nicholas S. Ialongo, Kerry M. Green, Debra Furr-Holden, Beth A. Reboussin, and Adam J. Milam
- Subjects
Adult ,Male ,Marijuana Abuse ,medicine.medical_specialty ,Adolescent ,Urban Population ,Marijuana Smoking ,Article ,Odds ,Young Adult ,03 medical and health sciences ,Residence Characteristics ,mental disorders ,medicine ,Humans ,0501 psychology and cognitive sciences ,Longitudinal Studies ,Young adult ,030505 public health ,Public health ,05 social sciences ,Public Health, Environmental and Occupational Health ,Marijuana user ,Black or African American ,Health psychology ,Increased risk ,Socioeconomic Factors ,Female ,Marijuana Use ,Residence ,Alcohol outlet ,0305 other medical science ,Psychology ,050104 developmental & child psychology ,Demography - Abstract
Although there is little difference in rates of marijuana use between White and Black youth, Blacks have significantly higher rates of marijuana use and disorder in young adulthood. Theory suggests that factors tied to social disadvantage may explain this disparity, and neighborhood setting may be a key exposure. This study sought to identify trajectories of marijuana use in an urban sample during emerging adulthood, neighborhood contexts that predict these trajectories and social role transitions or "turning points" that may redirect them. Data are from a longitudinal cohort study of 378 primarily Black emerging adults who were first sampled in childhood based on their residence in low-income neighborhoods in Baltimore City and followed up annually. Group-based trajectory modeling identified three groups: No Use (68.8%), Declining Use (19.6%), and Chronic Use (11.7%). Living in close proximity to an alcohol outlet, and living in a neighborhood with more female-headed households and higher rates of violent crime increased the odds of membership in the Chronic Use group relative to No Use. Living in a neighborhood with more positive social activity increased the odds of membership in the Declining Use group relative to No Use. Not receiving a high school diploma or GED, pregnancy, and parenting also increased the odds of membership in the Declining Use group relative to No Use. These findings provide support that minority youth living in socially toxic and disordered neighborhoods are at increased risk of continuing on a trajectory of marijuana use during emerging adulthood while positive social activity in neighborhoods has the potential to redirect these negative trajectories. Besides taking on the responsibilities of parenting, emerging adults in the marijuana user groups had similar educational and family outcomes, suggesting that early marijuana use may have long-term implications.
- Published
- 2018
43. Neighbourhood alcohol environment and injury risk: a spatial analysis of pedestrian injury in Baltimore City
- Author
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Elizabeth D. Nesoff, Keshia M. Pollack, Adam J. Milam, Frank C. Curriero, Janice V. Bowie, Amy R. Knowlton, Debra Furr-Holden, and Andrea Carlson Gielen
- Subjects
Adult ,Male ,Risk analysis ,Alcohol Drinking ,Cross-sectional study ,Level design ,Pedestrian ,Article ,03 medical and health sciences ,0302 clinical medicine ,Residence Characteristics ,Risk Factors ,Environmental health ,Humans ,Medicine ,030212 general & internal medicine ,Neighbourhood (mathematics) ,Pedestrians ,Spatial Analysis ,business.industry ,Accidents, Traffic ,Public Health, Environmental and Occupational Health ,Liquor store ,Regression analysis ,social sciences ,030229 sport sciences ,Cross-Sectional Studies ,Baltimore ,Attributable risk ,population characteristics ,Regression Analysis ,Wounds and Injuries ,Environment Design ,Female ,Crime ,business ,human activities - Abstract
ObjectivesThe purpose of this study was to investigate the contribution of neighbourhood disorder around alcohol outlets to pedestrian injury risk.MethodsA spatial analysis was conducted on census block groups in Baltimore City. Data included pedestrian injury EMS records from 1 January 2014 to 15 April 2015 (n=858), off-premise alcohol outlet locations for 2014 (n=693) and neighbourhood disorder indicators and demographics. Negative binomial regression models were used to determine the relationship between alcohol outlet count and pedestrian injuries at the block group level, controlling for other neighbourhood factors. Attributable risk was calculated by comparing the total population count per census block group to the injured pedestrian count.ResultsEach one-unit increase in the number of alcohol outlets was associated with a 14.2% (95% CI 1.099 to 1.192, PConclusionsThis study identifies modifiable risk factors for pedestrian injury previously unexplored in the literature and may provide evidence for alcohol control strategies (eg, liquor store licencing, zoning and enforcement).
- Published
- 2018
44. Protecting Our Most Vulnerable Populations During the COVID-19 Pandemic
- Author
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Adam J. Milam
- Subjects
Mental Health Services ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,COVID-19 ,Comorbidity ,General Medicine ,Los Angeles ,Vulnerable Populations ,Virology ,Health Services Accessibility ,Trainee-Authored Letters to the Editor ,Education ,Emergency Shelter ,Ill-Housed Persons ,Pandemic ,Humans ,Medicine ,business - Published
- 2021
45. Teen Dating Violence Victimization Among High School Students: A Multilevel Analysis of School-Level Risk Factors
- Author
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Sarah Lindstrom Johnson, Elizabeth M. Parker, Katrina J. Debnam, Adam J. Milam, and Catherine P. Bradshaw
- Subjects
Male ,Adolescent ,Alcohol Drinking ,media_common.quotation_subject ,Psychology, Adolescent ,education ,Intimate Partner Violence ,Affect (psychology) ,Education ,03 medical and health sciences ,Risk-Taking ,0302 clinical medicine ,Paraphernalia ,Humans ,Interpersonal Relations ,0501 psychology and cognitive sciences ,030212 general & internal medicine ,Risk factor ,Students ,Crime Victims ,health care economics and organizations ,Physical disorder ,media_common ,Maryland ,05 social sciences ,Multilevel model ,Courtship ,Public Health, Environmental and Occupational Health ,social sciences ,Philosophy ,Feeling ,Adolescent Behavior ,Female ,Observational study ,Teen dating violence ,Psychology ,050104 developmental & child psychology ,Clinical psychology - Abstract
BACKGROUND Much etiologic research has focused on individual-level risk factors for teen dating violence (TDV); therefore, less is known about school-level and neighborhood-level risk factors. We examined the association between alcohol outlet density around high schools and TDV victimization and the association between markers of physical disorder around schools and TDV victimization among adolescents. METHODS Data come from high school students participating in the Maryland Safe and Supportive Schools Initiative. Alcohol outlet density was calculated using walking distance buffers around schools. An observational tool was used to assess indicators of physical disorder on school property (eg, alcohol and drug paraphernalia). Hierarchical linear modeling was used to identify student- and school-level predictors associated with TDV victimization. RESULTS Overall, 11% of students reported experiencing physical TDV and 11% reported experiencing psychological TDV over the past year. Recent alcohol use was a risk factor for TDV victimization for both sexes, whereas feeling safe at school was protective against TDV victimization for both sexes. Greater alcohol outlet density was associated with decreased TDV victimization for males, however, it was nonsignificant for females. Physical disorder around schools was not associated with TDV victimization for either sex. CONCLUSION Although the school-level predictors were not associated with TDV victimization, alcohol use and perceptions of safety at school were significantly associated with TDV victimization. Prevention efforts to address alcohol use may affect TDV victimization.
- Published
- 2017
46. Assessing the association between observed school disorganization and school violence: Implications for school climate interventions
- Author
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Anne H. Cash, Sarah Lindstrom Johnson, Catherine P. Bradshaw, Katrina J. Debnam, Tracy Evian Waasdorp, and Adam J. Milam
- Subjects
Health (social science) ,Social Psychology ,School climate ,05 social sciences ,Psychological intervention ,050301 education ,School violence ,Developmental psychology ,0501 psychology and cognitive sciences ,Observation method ,School environment ,Association (psychology) ,Psychology ,School based intervention ,0503 education ,Social psychology ,Applied Psychology ,050104 developmental & child psychology ,Multilevel mediation - Published
- 2017
47. School environments and obesity: The mediating role of personal stress
- Author
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Adam J. Milam, Catherine P. Bradshaw, Katrina J. Debnam, and Chandria D. Jones
- Subjects
Social Psychology ,education ,Stressor ,030209 endocrinology & metabolism ,Overweight ,medicine.disease ,Obesity ,Structural equation modeling ,03 medical and health sciences ,0302 clinical medicine ,Stress (linguistics) ,medicine ,School environment ,030212 general & internal medicine ,medicine.symptom ,Association (psychology) ,Psychology ,Weight status ,Demography - Abstract
Background Youth spend a large amount of time in the school environment. Given the multiple influences of teachers, peers, and food and physical activity options, youth are likely to experience stressors that can influence their weight. This study examines the association between school climate and weight status. Method Students (n = 28,582; 58 schools) completed an online, anonymous school climate survey as part of the Maryland Safe and Supportive Schools Project. Multilevel structural equation modeling was used to explore the association between school climate, personal stress, and obesity. Analyses were stratified by gender. Results At the individual level, poor school climate (bullying, physical safety, and lack of whole-school connectedness) was associated with an increased likelihood of being overweight among females (β =.115, p = .019) but not males (β = .138; p =.244), after controlling for age, race, and physical activity. There was no association between school climate at the school level and being overweight among males or females. A second model included stress as a potential mediator; stress attenuated the relationship between poor school-related climate and being overweight (β = .039; p = .048) among females. Conclusion Findings suggest that stress related to school climate can play a role in the health and weight status of youth.
- Published
- 2017
48. Management of major airway obstruction: cricoid cartilage fracture with laryngeal hematoma
- Author
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Roya Yumul, Omar Durra, Eric J. Ley, Adam J. Milam, and Patrick H. Lam
- Subjects
medicine.medical_specialty ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,business.industry ,Cricoid cartilage ,medicine ,Fracture (geology) ,Airway obstruction ,Critical Care and Intensive Care Medicine ,business ,medicine.disease ,Surgery ,LARYNGEAL HEMATOMA - Published
- 2020
49. Neighborhood Profiles and Associations with Coping Behaviors among Low-Income Youth
- Author
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Kerry M. Green, Jill A. Rabinowitz, Darius Tandon, Terrinieka W. Powell, Beth A. Reboussin, Debra Furr-Holden, Richard C. Sadler, Amanda D. Latimore, Adam J. Milam, and Mieka Smart
- Subjects
Male ,Coping (psychology) ,Social Psychology ,Adolescent ,Urban Population ,Poison control ,050109 social psychology ,Violence ,Suicide prevention ,Article ,Education ,Interpersonal relationship ,Residence Characteristics ,Surveys and Questionnaires ,Adaptation, Psychological ,Developmental and Educational Psychology ,Humans ,0501 psychology and cognitive sciences ,Interpersonal Relations ,Poverty ,Maryland ,Social perception ,Cognitive restructuring ,05 social sciences ,Collective efficacy ,Black or African American ,Aggression ,Health psychology ,Social Perception ,Socioeconomic Factors ,Female ,Crime ,Psychology ,Social Sciences (miscellaneous) ,050104 developmental & child psychology ,Demography - Abstract
Extant research has typically examined neighborhood characteristics in isolation using variable-centered approaches; however, there is reason to believe that perceptions of the neighborhood environment influence each other, requiring the use of person-centered approaches to study these relationships. The present study sought to determine profiles of youth that differ in their perceptions of their neighborhoods and objective neighborhood characteristics, and whether these profiles are associated with youth coping. Participants were low-income, African American youth (N = 733; 51.0% female, M age = 18.76 years, SD = 1.71) from a metropolitan city who were originally recruited for the Youth Opportunity program in Baltimore, Maryland. A latent profile analysis was conducted which included self-reported neighborhood social cohesion, collective efficacy, disorder, violence, and disadvantage derived from census data. Coping behaviors, specifically positive cognitive restructuring, problem-focused coping, distraction strategies, and avoidant behaviors were assessed via self-reported questionnaires. Four neighborhood profiles were identified: highest disorder (20.0%); highest violence/highest disadvantage (5.2%); high violence (26.6%); and highest cohesion/lowest disorder (48.2%). Individuals in the highest violence/highest disadvantage profile reported higher positive cognitive restructuring and problem-focused coping than the other profiles. These findings warrant an investigation into the individual assets and contextual resources that may contribute to more positive coping behaviors among youth in more violent and disadvantaged neighborhoods, which has the potential to improve resilient outcomes among youth in similar at-risk settings.
- Published
- 2019
50. Neighborhood Context and Transitions in Marijuana Use among Urban Young Adults
- Author
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Kerry M. Green, Nicholas S. Ialongo, Renee M. Johnson, Adam J. Milam, Beth A. Reboussin, and C. Debra M. Furr-Holden
- Subjects
Male ,Marijuana Abuse ,Health (social science) ,Adolescent ,Social Problems ,Urban Population ,Psychological intervention ,Medicine (miscellaneous) ,Context (language use) ,Marijuana Smoking ,Article ,Young Adult ,Marijuana use ,Residence Characteristics ,Humans ,Young adult ,Social Behavior ,Poverty ,Physical disorder ,Public Health, Environmental and Occupational Health ,Collective efficacy ,Black or African American ,Psychiatry and Mental health ,Female ,Marijuana Use ,Neighborhood context ,Psychology ,Demography - Abstract
Background In emerging adulthood when many youth are maturing out of marijuana use, Blacks continue to have high rates of use and disorder. Theory suggests that factors tied to neighborhood disadvantage may partially explain this phenomenon but research is limited. Objectives This study examines the influence of neighborhood physical and social disorder on transitions in marijuana use during emerging adulthood in a low-income urban sample. Methods 379 primarily Black young adults residing in low-income neighborhoods in Baltimore City were followed-up annually from ages 18 to 21. Neighborhood environment was evaluated using a valid and reliable field-rater assessment of the residential block. Longitudinal latent class and latent transition analyses were performed. Results Fit indices supported three-classes of marijuana use: no use, infrequent use and frequent use. Between ages 18 and 21, young adults tended to transition toward lower levels of use. However, neighborhood physical disorder was associated with transitioning to increased marijuana use (no use to frequent use; AOR = 2.712; p = .023) while positive neighborhood social activity was associated with a decreased risk (AOR = 0.002; p = .013). Neighborhood social activity was also associated with decreases in use (frequent to infrequent use; AOR = 2.342; p = .020). Conclusions/Importance: These findings demonstrate that physical disorder within the context of a low-income urban neighborhood adversely impacts marijuana use. However, even in the presence of physical disorder, interventions that foster collective efficacy among residents through positive social activity may prevent initiation and progression of marijuana use.
- Published
- 2019
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