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Puumala S.E.,Center for Health Outcomes and Prevention Research | Puumala S.E.,University of South Dakota | Ross J.A.,University of Minnesota | Aplenc R.,Childrens Hospital of Philadelphia | Spector L.G.,University of Minnesota
Pediatric Blood and Cancer | Year: 2013

Although leukemia is the most common childhood cancer diagnosis, the subtype, acute myeloid leukemia (AML), is less common and fewer etiologic studies exist. This review summarizes the major risk factors for AML. We searched the literature using PubMed for articles on childhood AML and reviewed 180 articles. While few risk factors are definitive, we identified several with consistent evidence of a possible effect. Thorough analysis of genetic and epigenetic factors is missing from this literature and methodological issues are unresolved. Future studies should more closely examine causal mechanisms, improve exposure measurement, and include analysis using genetic and epigenetic factors. © 2013 Wiley Periodicals, Inc.

Himes S.K.,U.S. National Institute on Drug Abuse | Dukes K.A.,DM Statistics Inc. | Tripp T.,DM Statistics Inc. | Petersen J.M.,DM Statistics Inc. | And 8 more authors.
Clinical Chemistry | Year: 2015

BACKGROUND: We investigated agreement between selfreported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE. METHODS: Meconium fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG), and ethyl sulfate (EtS) were quantified by LC-MS/MS in 0.1 g meconium from infants of Safe Passage Study participants. Detailed PAE information was collected from women with a validated timeline follow-back interview. Because meconium formation begins during weeks 12-20, maternal selfreported drinking at or beyond 19 weeks was our exposure variable. RESULTS: Of 107 women, 33 reported no alcohol consumption in pregnancy, 16 stopped drinking by week 19, and 58 drank beyond 19 weeks (including 45 thirdtrimester drinkers). There was moderate to substantial agreement between self-reported PAE at ≥19 weeks and meconium EtG ≥30 ng/g (κ = 0.57, 95% CI 0.41-0.73). This biomarker and associated cutoff was superior to a 7 FAEE sum ≥2 nmol/g and all other individual and combination marker cutoffs. With meconium EtG ≥30 ng/g as the gold standard condition and maternal selfreport at ≥19 weeks' gestation as the test condition, 82% clinical sensitivity (95% CI 71.6-92.0) and 75% specificity (95% CI 63.2- 86.8) were observed. A significant dose- concentration relationship between self-reported drinks per drinking day and meconium EtG ≥30 ng/g also was observed (all P < 0.01). CONCLUSIONS: Maternal alcohol consumption at ≥19 weeks was better represented by meconium EtG ≥30 ng/g than currently used FAEE cutoffs. © 2014 American Association for Clinical Chemistry.

Nothwehr F.,University of Iowa | Hanson J.D.,Center for Health Outcomes and Prevention Research
Topics in Clinical Nutrition | Year: 2013

Food and nutrition interventions are often designed to enhance outcome expectations in hopes of influencing dietary intake. However, outcome expectations in the context of dietary behavior have not been studied extensively. This study examined this association in a sample of 384 adults, of whom 59% were women (mean age, 56 years). Analyses examined the cross-sectional and longitudinal association between outcome expectations and use of specific diet-related behavioral strategies and dietary intake. Results suggest that outcome expectations are associated with strategy use. When measurement of dietary intake is impractical, measures of strategy use could be beneficial and sensitive indicators of program impact. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Noble K.G.,Columbia University | Engelhardt L.E.,University of Texas at Austin | Brito N.H.,Columbia University | Mack L.J.,University of Iowa | And 5 more authors.
Developmental Psychobiology | Year: 2015

Socioeconomic status (SES) is strongly associated with cognition and achievement. Socioeconomic disparities in language and memory skills have been reported from elementary school through adolescence. Less is known about the extent to which such disparities emerge in infancy. Here, 179 infants from socioeconomically diverse families were recruited. Using a cohort-sequential design, 90 infants were followed at 9 and 15 months, and 89 were followed at 15 and 21 months. SES disparities in developmental trajectories of language and memory were present such that, at 21 months of age, children of highly educated parents scored approximately.8 standard deviations higher in both language and memory than children of less educated parents. The home language and literacy environment and parental warmth partially accounted for disparities in language, but not memory development. © 2015 Wiley Periodicals, Inc.

Payne N.R.,Childrens Hospitals and Clinics of Minnesota | Puumala S.E.,Center for Health Outcomes and Prevention Research
Pediatric Emergency Care | Year: 2013

OBJECTIVE: The objective of this study was to examine the association of race and language on laboratory and radiological testing in the pediatric emergency department (ED). METHODS: This retrospective, case-cohort study examined laboratory and radiological testing among patients discharged home from 2 urban, pediatric EDs between March 2, 2009, and March 31, 2010. RESULTS: There were 75,254 visits among 49,164 unique patients, of whom 31.0% had laboratory and 30.5% had radiological testing. African American (adjusted odds ratio [aOR], 0.93; confidence interval [CI], 0.89-0.98; P = 0.004) and biracial racial categories (aOR, 0.91; CI, 0.86-0.98; P = 0.007) were associated with decreased odds of laboratory testing compared with non-Hispanic whites. Similarly, Native American (aOR, 0.82; CI, 0.73-0.94), African American (aOR0.81; CI, 0.72-0.81), biracial (aOR, 0.82; CI, 0.77-0.88), Hispanic (aOR.76; CI, 0.72-0.81), and "other" (aOR, 0.84; CI, 0.73-0.97) racial categories were each associated with lower odds of radiological testing compared with non-Hispanic whites. Subgroup analysis of visits with a final diagnosis of fever and upper respiratory tract infection, conditions for which there were few treatment protocols, confirmed the racial differences. Subgroup analysis in visits for head injury, for which there is an established evaluation protocol, did not find a lower odds of laboratory or radiological testing by race compared with non-Hispanic whites. CONCLUSIONS: Racial disparities in laboratory and radiological testing were present in pediatric ED visits. No racial differences were seen in the radiological and laboratory charges in the head injury subgroup, suggesting that evaluation algorithms can ameliorate racial disparities in pediatric ED care. Copyright © 2013 by Lippincott Williams & Wilkins.

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