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Author Moaddab, A.; Dildy, G.A.; Brown, H.L.; Bateni, Z.H.; Belfort, M.A.; Sangi-Haghpeykar, H.; Clark, S.L. file  url
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Title Health Care Disparity and State-Specific Pregnancy-Related Mortality in the United States, 2005-2014 Type
Year 2016 Publication Obstetrics and Gynecology Abbreviated Journal Obstet Gynecol  
Volume 128 Issue 4 Pages 869-875  
Keywords Centers for Disease Control and Prevention (U.S.); Ethnic Groups/statistics & numerical data; Female; *Healthcare Disparities; Humans; Infant; Infant Mortality; Maternal Mortality; *Maternal-Child Health Services; *Perinatal Care; Pregnancy; United States/epidemiology  
Abstract OBJECTIVE: To investigate factors associated with differential state maternal mortality ratios and to quantitate the contribution of various demographic factors to such variation. METHODS: In a population-level analysis study, we analyzed data from the Centers for Disease Control and Prevention National Center for Health Statistics database and the Detailed Mortality Underlying Cause of Death database (CDC WONDER) that contains mortality and population counts for all U.S. counties. Bivariate correlations between maternal mortality ratio and all maternal demographic, lifestyle, health, and medical service utilization characteristics were calculated. We performed a maximum likelihood factor analysis with varimax rotation retaining variables that were significant (P<.05) in the univariate analysis to deal with multicollinearity among the existing variables. RESULTS: The United States has experienced a continued increase in maternal mortality ratio since 2007 with rates of 21-22 per 100,000 live births in 2013 and 2014. This increase in mortality was most dramatic in non-Hispanic black women. There was a significant correlation between state mortality ranking and the percentage of non-Hispanic black women in the delivery population. Cesarean deliveries, unintended births, unmarried status, percentage of non-Hispanic black deliveries, and four or less prenatal visits were significantly (P<.05) associated with increased maternal mortality ratio. CONCLUSION: Interstate differences in maternal mortality ratios largely reflect a different proportion of non-Hispanic black or unmarried patients with unplanned pregnancies. Racial disparities in health care availability, access, or utilization by underserved populations are an important issue faced by states in seeking to decrease maternal mortality.  
Call Number Serial 2252  
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Author Schechter, D.S.; Coots, T.; Zeanah, C.H.; Davies, M.; Coates, S.W.; Trabka, K.A.; Marshall, R.D.; Liebowitz, M.R.; Myers, M.M. file  url
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Title Maternal mental representations of the child in an inner-city clinical sample: violence-related posttraumatic stress and reflective functioning Type Journal Article
Year 2005 Publication Attachment & Human Development Abbreviated Journal Attach Hum Dev  
Volume 7 Issue 3 Pages 313-331  
Keywords Adolescent; Adult; Analysis of Variance; Child Abuse/prevention & control/psychology; Child of Impaired Parents/psychology; Child, Preschool; Female; Humans; Infant; Logistic Models; *Mental Processes; Middle Aged; *Mother-Child Relations; Parenting/*psychology; Poverty Areas; Risk Factors; *Social Perception; Stress Disorders, Post-Traumatic/*psychology; United States; Violence/*psychology  
Abstract Parental mental representations of the child have been described in the clinical literature as potentially useful risk-indicators for the intergenerational transmission of violent trauma. This study explored factors associated with the quality and content of maternal mental representations of her child and relationship with her child within an inner-city sample of referred, traumatized mothers. Specifically, it examined factors that have been hypothesized to support versus interfere with maternal self- and mutual-regulation of affect: posttraumatic stress disorder (PTSD) and maternal reflective functioning (RF). More severe PTSD, irrespective of level of RF, was significantly associated with the distorted classification of non-balanced mental representations on the Working Model of the Child Interview (WMCI) within this traumatized sample. Higher Levels of RF, irrespective of PTSD severity, were significantly associated with the balanced classification of maternal mental representations on the WMCI. Level of maternal reflective functioning and severity of PTSD were not significantly correlated in this sample. Clinical implications are discussed.  
Call Number Serial 2171  
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Author Wilens, T.E.; Biederman, J.; Kwon, A.; Ditterline, J.; Forkner, P.; Moore, H.; Swezey, A.; Snyder, L.; Henin, A.; Wozniak, J.; Faraone, S.V. file  url
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Title Risk of substance use disorders in adolescents with bipolar disorder Type Journal Article
Year 2004 Publication Journal of the American Academy of Child and Adolescent Psychiatry Abbreviated Journal J Am Acad Child Adolesc Psychiatry  
Volume 43 Issue 11 Pages 1380-1386  
Keywords Adolescent; Adolescent Behavior; Bipolar Disorder/*complications/*psychology; Case-Control Studies; Child; Female; Humans; Male; Risk Factors; Substance-Related Disorders/*etiology/*psychology  
Abstract OBJECTIVE: Previous work in adults and youths has suggested that juvenile onset bipolar disorder (BPD) is associated with an elevated risk of substance use disorders (SUD). Considering the public health importance of this issue, the authors now report on a controlled study of adolescents with and without BPD to evaluate the risk of SUD. METHOD: Probands with DSM-IV BPD (n=57, mean age +/- SD=13.3 +/- 2.4 years) and without DSM-IV BPD (n=46, 13.6 +/- 2.2 years) were studied. Structured psychiatric interviews and multiple measures of SUD were collected. RESULTS: Bipolar disorder was associated with a highly significant risk factor for SUD (32% versus 7%, Z=2.9, p=.004) that was not accounted for by conduct disorder (adjusted odds ratio=5.4, p=.018). Adolescent-onset BPD (> or =13 years) was associated with a higher risk of SUD compared with those with child-onset BPD (chi1=9.3, p=.002). CONCLUSIONS: These findings strongly indicate that BPD, especially adolescent onset, is a significant risk factor for SUD independently of conduct disorder.  
Call Number Serial 2170  
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Author Joshi, S.V.; Hartley, S.N.; Kessler, M.; Barstead, M. file  url
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Title School-based suicide prevention: content, process, and the role of trusted adults and peers Type Journal Article
Year 2015 Publication Child and Adolescent Psychiatric Clinics of North America Abbreviated Journal Child Adolesc Psychiatr Clin N Am  
Volume 24 Issue 2 Pages 353-370  
Keywords Adolescent; Adolescent Behavior; Humans; Mental Disorders/*psychology; Peer Group; Preventive Health Services/*methods; Risk-Taking; *School Health Services; Students/*psychology; Suicide/*prevention & control; Child/adolescent; High-risk behaviors; School mental health; School-based suicide prevention; Suicide prevention; Suicide/self-harm; Supporting alliance  
Abstract Suicide is a leading cause of preventable death in youth, and numerous curricula and other prevention and intervention programs have been developed in the last 15 years. Comprehensive suicide prevention planning should include the 4 components of health promotion, prevention/education, intervention, and postvention. School-based suicide prevention and mental health education programs have become more common as an efficient and cost-effective way to reach youth. Process considerations that are based on the principles of therapeutic engagement with patients and families can provide mental health professionals with strategies that can assist education professionals, students, and the larger school community simultaneously.  
Call Number Serial 2169  
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Author Lanigan, J.D. file  url
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Title The substance and sources of young children's healthy eating and physical activity knowledge: implications for obesity prevention efforts Type Journal Article
Year 2011 Publication Child: Care, Health and Development Abbreviated Journal Child Care Health Dev  
Volume 37 Issue 3 Pages 368-376  
Keywords Child Development; Child Welfare; Child, Preschool; Drinking; Eating/*psychology; Exercise/*psychology; Female; *Health Knowledge, Attitudes, Practice; Humans; Information Dissemination/methods; Male; Motor Activity; Obesity/epidemiology/prevention & control; Preventive Health Services; Qualitative Research  
Abstract BACKGROUND: The prevalence of overweight among young children is increasing at an alarming rate. Global efforts to address the issue can benefit from understanding how young children's experiences across multiple contexts shape their perspectives of healthy weight. METHODS: This qualitative study examines the substance and sources of young American children's knowledge related to healthy eating, physical activity and media practices. Role play and semi-structured interviews were conducted in child-care settings with 81 children aged 3-5 who represented diverse socio-economic statuses and ethnic backgrounds. RESULTS: Children demonstrated better understanding of the benefits of healthy eating compared with physical activity. Snacks and beverages consumed outside mealtime were less likely to be healthy even among the 40% of children who demonstrated an understanding of healthy nutrition. The majority of children's leisure activity selections involved media and minimally active pursuits. Three quarters of the children were unable to articulate reasons for healthy choices or identify the sources of their health understandings. The media was listed as source of health information more frequently than adults. CONCLUSION: Obesity prevention efforts targeting young children need to use consistent messaging across all contexts in which children develop in order to increase their understanding that physical activity and eating choices support health. Efforts need to counter inaccurate information and address the rationale for health practices. Key gaps in young children's understanding include: the importance of drinking water, that snacks are part of nutritional intake and the benefits of engaging in physical activities.  
Call Number Serial 2127  
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