Biomedical subjects

Stephen L Buka

Publications and source records attributed to Stephen L Buka.

At least 19 recordsLinked to original sources

PubMed2006

Retail tobacco outlet density and youth cigarette smoking: a propensity-modeling approach.

OBJECTIVES: We examined whether retail tobacco outlet density was related to youth cigarette smoking after control for a diverse range of neighborhood characteristics. METHODS: Data were gathered from 2116 respondents (aged 11 to 23 years) residing in 178 census tracts in Chicago, Ill. Propensity score stratification methods for continuous exposures were used to adjust for potentially confounding neighborhood characteristics, thus strengthening causal inferences. RESULTS: Retail tobacco outlets were disproportionately located in neighborhoods characterized by social and economic disadvantage. In a model that excluded neighborhood confounders, a marginally significant effect was found. Youths in areas at the highest 75th percentile in retail tobacco outlet density were 13% more likely (odds ratio [OR]=1.13; 95% confidence interval [CI]=0.99, 1.28) to have smoked in the past month compared with those living at the lowest 25th percentile. However, the relation became stronger and significant (OR=0.21; 95% CI=1.04, 1.41) after introduction of tract-level confounders and was statistically significant in the propensity score-adjusted model (OR = 1.20; 95% CI = 1.001, 1.44). Results did not differ significantly between minors and those legally permitted to smoke. CONCLUSIONS: Reductions in retail tobacco outlet density may reduce rates of youth smoking.

Adolescent↗

PubMed2006

Behavioral problems and the effects of early intervention on eight-year-old children with learning disabilities.

OBJECTIVES: 1) To investigate the comorbidity of verbal and nonverbal learning disability subtypes with several domains of behavior problems among 8-year-old children. 2) To determine whether receipt of an early intervention modified the association between childhood behavior problems and learning disabilities (LD). METHODS: This is a secondary data analysis of the Infant Health and Development Program (IHDP), a randomized clinical trial of an early intervention provided between ages 0 and 3 involving 985 children born low birthweight and premature. The findings are based on a prospective follow-up of these children at 8 years of age. RESULTS: Compared to children without verbal LD (VLD), those with VLD were twice as likely to exhibit clinical levels of total behavior problems and 89% more likely to exhibit externalizing behavior problems. Analysis of specific subscales of behavior revealed significant associations with anxious/depressed and withdrawn behaviors, as well as an increased likelihood of attention problems among children with VLD. No significant association was found between nonverbal LD (NVLD) and any type of behavior problem. Furthermore, there was a significant interaction between VLD and the intervention, in which the odds of internalizing behavior problems were greater among children with VLD. No interaction effect of the intervention occurred for any type of behavior problem among children with NVLD. CONCLUSIONS: These findings provide evidence that distinct differences exist for different learning disability subtypes with regards to behavioral outcomes and the effects of early intervention services among 8-year-old children.

Child↗

PubMed2006

Treatment outcomes for substance abuse among adolescents with learning disorders.

This paper assesses whether chemically dependent adolescents with comorbid learning disorders (LDs) derived less effective treatment results when compared to chemically dependent adolescents without LD and examines the moderating effects of prior treatments, treatment length, and treatment completion. Two hundred one adolescents were recruited between 1992 and 1993 from Massachusetts residential treatment centers and subsequently followed up 6 months after enrollment. Compared to chemically dependent teenagers without LD, those with LD were twice as likely to re-use substances at least once by follow-up. LD teenagers were more likely to attend Alcoholics/Narcotics Anonymous if they had prior admissions to treatment programs and longer treatment length. LD teenagers who completed treatment also experienced a greater decrease in current depression compared to LD teenagers not completing the treatment. This study is the first to consider outcomes of substance abuse treatment for adolescents with LD and contributes to the growing literature on comorbidity and substance abuse treatment.

Adolescent↗

PubMed2006

The association between suicide and the socio-economic characteristics of geographical areas: a systematic review.

BACKGROUND: Despite an extensive literature, there have been widely divergent findings regarding the direction of the association between area socio-economic characteristics and area suicide rates, with high-quality studies finding either a direct relation (higher rates of suicide in higher socio-economic areas), an inverse relation (lower rates of suicide in higher socio-economic areas) or no association. METHOD: We performed a systematic review of the literature dating from 1897 to 2004 and identified 86 publications with 221 separate analyses that met our inclusion criteria. We examined the percent of direct, inverse and null findings stratified by key study characteristics including size of aggregated area, socio-economic measure used, region of study, control variables and study design. RESULTS: Analyses at the community level are significantly more likely to demonstrate lower rates of suicide among higher socio-economic areas than studies using larger areas of aggregation. Measures of area poverty and deprivation are most likely to be inversely associated with suicide rates and median income is least likely to be inversely associated with suicide rates. Analyses using measures of unemployment and education and occupation were equally likely to demonstrate inverse associations. Study results did not vary significantly by gender or by study design. CONCLUSIONS: The heterogeneity of associations is mostly accounted for by study design features that have largely been neglected in this literature. Enhanced attention to size of region and measurement strategies provide a clearer picture of how suicide rates vary by region. Resources for suicide prevention should be targeted to high poverty/deprivation and high unemployment areas.

Educational Status↗

PubMed2006

Intellectual decline in schizophrenia: evidence from a prospective birth cohort 28 year follow-up study.

It is well established that IQ is lower among persons with schizophrenia than in the general population. However, it remains unclear if there is deterioration beyond a premorbid deficit. In order to assess the question of IQ deterioration, we assessed persons pre- and-post psychosis, comparing those who developed schizophrenia with those who did not. Twenty six patients with schizophrenia and 59 normal controls, evaluated at age 7 in the prospective, longitudinal, National Collaborative Perinatal Project (NCPP), were re-tested approximately 28 years later. We assessed change in an estimate of IQ based on the Vocabulary and Block Design tests from the Wechsler intelligence scales. Persons who later developed schizophrenia were significantly impaired on IQ compared to controls at age 7, especially on measures of attention. At age 35, persons with schizophrenia demonstrated significant impairment and deterioration on both IQ sub-tests compared to controls. Because impairment occurs by early childhood and subsequent deterioration occurs at an unknown period, designs with more frequent assessment of IQ through the premorbid, prodromal and early phases of illness are required to identify the key period of decline. Future research on this sample will evaluate the prospective roles of family history and perinatal complications on cognition, and assess the specificity of these findings.

Achievement↗

PubMed2006

Maternal smoking during pregnancy and offspring overt and covert conduct problems: a longitudinal study.

BACKGROUND: Empirical evidence demonstrates that conduct disorder (CD) symptoms tend to cluster into covert and overt domains. We hypothesized that overt and covert CD symptoms may be distinct constructs with distinct risk factors. An important risk factor for CD is maternal smoking during pregnancy. We further investigated this association, attending to overt and covert CD symptom subtypes. Also, we tested whether gender and socioeconomic status (SES) modified this association. METHOD: Participants were male and female adult offspring (n = 682) of a community sample of pregnant women followed longitudinally from prenatal life to age 22. Prospective assessments of maternal smoking during pregnancy were used to predict self-reported DSM-III CD symptoms. RESULTS: Prenatal exposure to smoking was significantly associated with increased overt CD symptoms for participants of low SES, but not for participants of high SES, whereas covert CD symptoms were not associated with prenatal exposure. Gender did not significantly modify the relationship between maternal smoking and CD symptom subtypes. CONCLUSIONS: These results suggest that the previously documented association between maternal smoking and CD may be specific to overt CD symptoms, providing support for the heuristic value of differentiating overt and covert CD symptoms as distinct syndromes. These findings further support smoking prevention programs for pregnant women.

Adolescent↗

PubMed2006

Utility of indices of gun availability in the community.

OBJECTIVE: To estimate the degree to which the proportion of homicides and suicides committed with a gun is associated with reported availability of firearms across Chicago neighbourhoods. METHODS: Data were collected as part of the Project on Human Development in Chicago Neighborhoods (PHDCN), a combined neighbourhood and individual level study of the city of Chicago. The study used data from 837 PHDCN participants between the ages of 17 and 22, residing in 170 different neighbourhoods. Gun availability was measured via participant reports on whether they had carried a gun and whether they perceived gun access to be easy in their community. Data on suicides and homicides were obtained from the Chicago Department of Health. RESULTS: A 10% change in the proportion of homicides committed by a gun in a neighbourhood was associated with a 20% increase in both the odds of reported gun access and reported gun carrying (p=0.002 and 0.048, respectively). The proportion of firearm related suicides was not associated with either of those self reported measures. CONCLUSIONS: The proportion of firearm related homicides, but not the proportion of firearm related suicides, is a useful predictor of gun availability across small areas such as neighbourhoods.

Adolescent↗

PubMed2006

Early intervention in low birth weight premature infants: results at 18 years of age for the Infant Health and Development Program.

OBJECTIVE: To assess whether improvements in cognitive and behavioral development seen in preschool educational programs persist, we compared those in a multisite randomized trial of such a program over the first 3 years of life (INT) to those with follow-up only (FUO) at 18 months of age. METHODS: This was a prospective follow-up of the Infant Health and Development Program at 8 sites heterogeneous for sociodemographic characteristics. Originally 985 children were randomized to the INT (n = 377) or FUO (n = 608) groups within 2 birth weight strata: heavier low birth weight (HLBW; 2001-2499 g) and lighter low birth weight (LLBW; < or = 2000 g). Primary outcome measures were the Peabody Picture Vocabulary Test (PPVT-III), reading and mathematics subscales of the Woodcock-Johnson Tests of Achievement, youth self-report on the Total Behavior Problem Index, and high-risk behaviors on the Youth Risk Behavior Surveillance System (YRBSS). Secondary outcomes included Weschler full-scale IQ, caregiver report on the Total Behavior Problem Index, and caregiver and youth self-reported physical health using the Medical Outcome Study measure. Assessors were masked as to study status. RESULTS: We assessed 636 youths at 18 years (64.6% of the 985, 72% of whom had not died or refused at prior assessments). After adjusting for cohort attrition, differences favoring the INT group were seen on the Woodcock-Johnson Tests of Achievement in math (5.1 points), YRBSS (-0.7 points), and the PPVT-III (3.8 points) in the HLBW youth. In the LLBW youth, the Woodcock-Johnson Tests of Achievement in reading was higher in the FUO than INT group (4.2). CONCLUSIONS: The findings in the HLBW INT group provide support for preschool education to make long-term changes in a diverse group of children who are at developmental risk. The lack of observable benefit in the LLBW group raises questions about the biological and educational factors that foster or inhibit sustained effects of early educational intervention.

Adolescent↗

PubMed2005

The effect of working memory performance on functional MRI in schizophrenia.

INTRODUCTION: Studies of prefrontal cortical (PFC) function in schizophrenia have been inconsistent, with studies showing both increased and decreased PFC activation compared to healthy controls. Discrepant findings may be due to task performance effects or demographic differences between samples. We report functional magnetic resonance imaging (fMRI) data comparing subjects with schizophrenia and healthy controls performing a 2-back working memory (WM) task, addressing the effects of task performance. METHODS: Twenty-two controls and 14 patients with DSM-IV schizophrenia, scanned on a Siemens 1.5 T scanner, performed a visual letter 2-back task and control task (CPT-X) during fMRI. Data were analyzed using Statistical Parametric Mapping (SPM)-99. RESULTS: After statistical adjustment for performance differences, persons with schizophrenia showed significantly greater activation than controls in the right medial frontal gyrus and left inferior parietal lobule/medial temporal gyrus region (BA 39/40), and a trend toward greater activation in the left ventrolateral PFC. This pattern was also observed in demographically matched subgroups of participants. CONCLUSIONS: Data are consistent with findings reported in recent studies showing increased PFC and parietal activation in schizophrenia when the effects of reduced WM task performance in patients with schizophrenia are addressed. Further studies are needed to clarify the pathophysiological basis of WM load sensitivity in schizophrenia and its relationship to genes.

Adult↗

PubMed2005

Social capital and young adolescents' perceived health in different sociocultural settings.

We conducted a cross-national study to examine the association between neighbourhood socioeconomic deprivation, social capital and child health in two countries and multiple ethnic groups. For our analysis we used data from (1) the Project on Human Development in Chicago Neighborhoods (PHDCN), USA and (2) the Maastricht Quality of Life study (MQoL), the Netherlands. Both the PHDCN and the MQoL collected data on objective neighbourhood socioeconomic deprivation, subjective neighbourhood social capital (i.e. informal social control, ISC, social cohesion and trust, SC&T), and children's perceived health. For the present analyses, 11- and 12-year olds were selected. Multilevel analyses were conducted using both neighbourhood level and individual-level data. Lower socioeconomic deprivation scores and higher levels of ISC as well as SC&T were associated with higher levels of children's perceived health, in both Maastricht and the Chicago Hispanic subsample, but not in the Chicago non-Hispanic samples. The results suggest that associations between the wider social environment and health outcomes vary across different populations and cross-national contexts.

Chicago↗

PubMed2005

Violent behavior by girls reporting violent victimization: a prospective study.

OBJECTIVE: To assess the relationships between individual victimization and neighborhood-level violence on subsequent violent perpetration by adolescent girls in a community-based sample. DESIGN: Longitudinal, multilevel analysis of data collected by the Project on Human Development in Chicago Neighborhoods. Three in-home interviews were conducted approximately 24 months apart between November 1995 and January 2002 with youth and their caregivers. Community-level data also were collected in 1995 from a random sample of Chicago residents. Hierarchical regression models and propensity scores were used. SETTING: Families and neighborhoods in Chicago. PARTICIPANTS: Population-based sample of 637 girls, ages 9 to 15 years at baseline, and the neighborhoods in which they resided. This sample is diverse in race/ethnicity, socioeconomic status, family structure, and neighborhood characteristics. MAIN OUTCOME MEASURE: Self-reports of violent behavior in the 12 months before the third interview. RESULTS: At baseline, 38% of the girls reported perpetrating at least 1 violent behavior in the prior 12 months, 28% reported past year violent behavior at the first follow-up interview, and 14% reported past year violent behavior at the third interview. The odds of violent behavior were 2.2 times higher among girls who reported prior violent victimization, after prior confounding factors and baseline violent behavior were controlled (95% confidence interval, 1.3- 4.4). Homicides and concentrated poverty in girls' neighborhoods also were associated with aggression by girls. CONCLUSIONS: Improving safety in communities and homes may reduce rates of violent perpetration by adolescent girls. Study results suggest that, to facilitate identification of and healing among adolescent survivors of violence, practitioners should recognize perpetration of violence as potential sequelae of prior violent victimization.

Adolescent↗

PubMed2004

What girls need: recommendations for preventing violence among urban girls in the US.

The last decade saw increases in arrests of girls for violent behavior and a corresponding concern that girls' involvement in violence was increasing in the USA. However, there are few empirical studies of the dynamics of violence by girls, leaving providers of violence prevention programs and policy-makers without evidence on which to base gender-appropriate prevention strategies. To address this gap, qualitative interviews were conducted with a diverse sample of 61 urban girls aged 11-17. Findings were compared with quantitative interviews from the prospective cohort of 961 girls from whom these respondents were drawn, from the Project on Human Development in Chicago Neighborhoods. Mixed-method techniques were employed. Qualitative data were analyzed for girls' recommendations for preventing involvement in violence. Data from the larger cohort were used to test these recommendations quantitatively. Due to study design, in the qualitative sample, 36 girls (64%) were involved in recent violence, most often with or against other girls. Pro-social behavior was common among both violent and nonviolent girls. In the overall cohort sample, 24.9% of girls reported violent perpetration and 97% reported pro-social activities. Eight themes regarding staying safe and preventing violence emerged from the qualitative interviews: girls stayed safe by staying home, avoiding dangerous people, staying busy with after-school activities, remaining calm when confronted, using escorts, and fighting back if attacked. Girls' protective influences included: empathic parental involvement, positive relationships with peers and older youth, and involvement in safe and constructive activities. These findings emphasize that safety in community, school, and family settings is critical for girls in avoiding violence and other risky behaviors. Violence prevention programs should focus on enhancing girls' relationships with mothers, older girls, and friends their age.

Adolescent↗

PubMed2004

The retrospective measurement of prenatal and perinatal events: accuracy of maternal recall.

Adverse obstetric events have been implicated as risk factors for schizophrenia. Many studies have relied on retrospective recall of these events, given typical adult onset of schizophrenia, when most studies ascertain their samples. The goal of this study was to assess the validity of an interview for the long-term recall of prenatal and perinatal events. Ninety-six women from the Providence and Boston cohorts of the National Collaborative Perinatal Project were administered a brief structured telephone interview regarding their recall of pregnancy-related events that had occurred 22 years or more prior to interview. Women accurately reported major medical events such as cesarean section, breech delivery, and multiple birth (kappa=1) and demographic items, such as age at birth and parity. Medical interventions and major medical conditions such as placental (kappa=-0.01) and cord (kappa=-0.10) difficulties were not accurately reported. Estimated birthweight, low birthweight, and length of gestation were recalled with reasonable accuracy. Women who completed high school generally recalled events more accurately than those who did not. It is therefore important to attend to the sources of information, the mode of interviewing, the specific type of event, and sociodemographic characteristics of the informant to improve the accuracy of retrospective data on obstetric events, and to increase the validity of findings relating these to the onset of schizophrenia.

Adolescent↗

PubMed2004

Neighborhood predictors of concealed firearm carrying among children and adolescents: results from the project on human development in Chicago neighborhoods.

BACKGROUND: Previous studies of concealed firearm carrying among children and adolescents have focused on individual risk factors. OBJECTIVE: To identify features of neighborhoods associated with concealed firearm carrying among a representative sample of youth from Chicago, Ill. DESIGN: Cross-sectional analysis of individual- and neighborhood-level data collected by the Project on Human Development in Chicago Neighborhoods. SETTING: Families and neighborhoods in Chicago. PARTICIPANTS: Population-based sample of 1842 multiethnic youth aged 9 to 19 years and the 218 neighborhoods in which they resided. Main Outcome Measure Whether youth had ever carried a concealed firearm. RESULTS: Lifetime estimates for concealed firearm carrying were 4.9% for males and 1.1% for females. We found that youth in safer and less disordered neighborhoods were less likely than youth in unsafe and more disordered neighborhoods to carry concealed firearms. Specifically, multilevel nonlinear regression models identified a positive association between concealed firearm carrying and (1) community members' ratings of neighborhoods as unsafe for children; (2) neighborhood social disorder; and (3) neighborhood physical disorder. Neighborhood collective efficacy was negatively associated with concealed firearm carrying. Models controlled for neighborhood economic indicators and individual and family factors associated with the carrying of concealed firearms by youth. CONCLUSIONS: Youth are less likely to carry concealed firearms in areas where there is less violence and increased safety. Interventions to improve neighborhood conditions such as increasing safety, improving collective efficacy, and reducing social and physical disorder may be efficacious in preventing firearm use and its associated injuries and death among youth.

Adolescent↗

PubMed2004

Early manifestations of personality and adult emotional functioning.

Developmental antecedents to adult emotional functioning were investigated in an epidemiologic study using theories of personality and emotion. The authors tested whether different types of adult emotional distress can be linked to childhood personality attributes. Using data from 3,138 children at age 7, measures of 4 childhood personality attributes were developed and validated: Behavioral Inhibition, Distress Proneness, Attention, and Inappropriate Interpersonal Self-Regulation. Sound psychometric properties of these scales are demonstrated by considering the measures across multiple samples and in comparison with established child behavior measures. Emotional distress measures were obtained for 694 of these individuals at age 35. Of the personality attributes, 3 of 4 (except behavioral inhibition) predicted general levels of distress as well as specific aspects of adult emotional functioning.

Adult↗

PubMed2004

Cognitive performance in childhood and early adult illness: a prospective cohort study.

STUDY OBJECTIVE: To evaluate whether cognitive performance in childhood is an early determinant of adult illness. DESIGN: Prospective cohort study covering over 30 years. SETTING: Providence, Rhode Island, USA. PARTICIPANTS: 633 people ages 30-39 followed up since birth as part of the Providence cohort of the national collaborative perinatal project. MAIN RESULTS: Higher cognitive performance at age 7 was related to a significantly reduced risk of serious illness in adulthood, OR = 0.65 (95%CI: 0.47 to 0.89) for a one standard deviation (15 point) increase in IQ score. This association was independent of both parental socioeconomic status and participant's attained level of education. CONCLUSIONS: General cognitive performance may be an important and informative early determinant of adult health. Further evaluation of this association and mechanisms linking cognitive performance and health may provide new and innovative strategies to improve disease management and reduce morbidity.

Adult↗

PubMed2003

Neighborhood support and the birth weight of urban infants.

Differences in maternal characteristics only partially explain the lower birth weights of infants of African-American women. It is hypothesized that economic and social features of urban neighborhoods may further account for these differences. The authors conducted a household survey of 8,782 adults residing in 343 Chicago, Illinois, neighborhoods to assess mean levels of perceived social support and used US Census data to estimate neighborhood economic disadvantage. Data on birth weight and maternal risk factors were gathered from 95,711 birth certificates (1994-1996). Before statistical adjustment of the data, infants born to African-American mothers were found to be, on average, 297 g lighter than those born to White mothers. After adjustment for individual-level risk factors, this difference was reduced to 154 g. For African-American mothers only, mean birth weight decreased significantly as the neighborhood level of economic disadvantage increased. For White mothers only, a significant positive association was found between perceived levels of neighborhood social support and infant birth weight. Adding these neighborhood-level predictors to the model reduced the adjusted White versus African-American difference in birth weight to 124 g. Results support the hypothesis that neighborhood-level factors are significantly associated with infant birth weight.

Adult↗

PubMed2003

Social capital and neighborhood mortality rates in Chicago.

Several empirical studies have suggested that neighborhood characteristics influence health, with most studies having focused on neighborhood deprivation or aspects of the physical environment, such as services and amenities. However, such physical characteristics are not the only features of neighborhoods that potentially affect health. Neighborhoods also matter because of the nature of their social organization. This study examined social capital as a potential neighborhood characteristic influencing health. Using a cross-sectional study design which linked counts of death for persons 45-64 years by race and sex to neighborhood indicators of social capital and poverty for 342 Chicago neighborhoods in the USA, we tested the ecological association between neighborhood-level social capital and mortality rates, taking advantage of the community survey data collected as part of the Project on Human Development in Chicago Neighborhoods. We estimated a hierarchical generalized linear model to examine the association of race and sex specific mortality rates to social capital. Overall, neighborhood social capital-as measured by reciprocity, trust, and civic participation-was associated with lower neighborhood death rates, after adjustment for neighborhood material deprivation. Specifically, higher levels of neighborhood social capital were associated with lower neighborhood death rates for total mortality as well as death from heart disease and "other" causes for White men and women and, to a less consistent extent, for Blacks. However, there was no association between social capital and cancer mortality. Although, the findings from this study extend the state-level findings linking social capital to health to the level of neighborhoods, much work remains to be carried out before social capital can be widely applied to improve population health, including establishing standards of measurement, and exploring the potential "downsides" of social capital.

Cause of Death↗