Associations between an educational attainment polygenic score with educational attainment in an African American sample.

Polygenic propensity for educational attainment has been associated with higher education attendance, academic achievement and criminal offending in predominantly European samples; however, less is known about whether this polygenic propensity is associated with these outcomes among African Americans. Using an educational attainment polygenic score (EA PGS), the present study examined whether this score was associated with post-secondary education, academic achievement and criminal offending in an urban, African American sample. Three cohorts of participants (N = 1050; 43.9% male) were initially recruited for an elementary school-based universal prevention trial in a Mid-Atlantic city and followed into young adulthood. Standardized tests of reading and math achievement were administered in first grade. At age 20, participants reported on their level of education attained, and records of incarceration were obtained from Maryland's Criminal Justice Information System. In young adulthood, DNA was collected and extracted from blood or buccal swabs and genotyped. An EA PGS was created using results from a large-scale genome-wide association study on educational attainment. A higher EA PGS was associated with a greater log odds of post-secondary education. The EA PGS was not associated with reading achievement, although a significant relationship was found with math achievement in the third cohort. These findings contribute to the dearth of molecular genetics work conducted in African American samples and highlight that polygenic propensity for educational attainment is associated with higher education attendance.

Children's and adolescents' use of mental health care is a family matter.

This article discusses the influence of family structure on children's use of mental health services and explores whether a family's dependency on government assistance compensates for the effect of family income on children's use of services. Children in nontraditional families are at greater risk of using mental health services and have more mental health visits. Family participation in government subsidies programs offsets the influence of family income on the use of mental health services.

A prospective cohort study of bladder cancer risk in relation to active cigarette smoking and household exposure to secondhand cigarette smoke.

Active cigarette smoking is a major risk factor for bladder cancer. Secondhand exposure to cigarette smoke may also contribute to bladder carcinogenesis. The authors conducted a prospective cohort study to examine the influence of both active smoking and household exposure to secondhand smoke (SHS) on subsequent bladder cancer risk. The study population included persons from two cohorts established from private censuses conducted in Washington County, Maryland, in 1963 (n = 45,749; 93 cases) and 1975 (n = 48,172; 172 cases). Poisson regression models were fitted to estimate the relative risk of bladder cancer associated with active and passive smoke exposure in the two cohorts (referent category: never smokers who did not live with any smokers). Current smokers had an elevated risk of bladder cancer in both the 1963 cohort (relative risk (RR) = 2.7, 95% confidence limits (CL): 1.6, 4.7) and the 1975 cohort (RR = 2.6, 95% CL: 1.7, 3.9) after adjustment for age, education, and marital status. Among nonsmoking women, current household SHS exposure was associated with bladder cancer risk in the 1963 cohort (RR = 2.3, 95% CL: 1.0, 5.4) but not in the 1975 cohort (RR = 0.9, 95% CL: 0.4, 2.3). This study further solidifies the evidence that active smoking is causally associated with bladder cancer. Additional studies are needed to determine whether passive smoking is a risk factor for bladder cancer.

Active cigarette smoking, household passive smoke exposure, and the risk of developing pancreatic cancer.

OBJECTIVE: The objective of this study was to examine the association between active cigarette smoking, household passive smoke exposure, and pancreatic cancer risk using a prospective cohort design. METHODS: Two cohorts were established in Washington County, Maryland in 1963 (n = 45,749) and 1975 (n = 48,172). The Washington County Cancer Registry was used to ascertain the occurrence of pancreatic cancer in the 1963 cohort from 1963-1978 and in the 1975 cohort from 1975-1994. Poisson regression was used to analyze the associations between active smoking and household passive smoke exposure and pancreatic cancer risk. RESULTS: Current active smoking was associated with a two-fold increased risk of pancreatic cancer in both cohorts. Among never-smokers in each cohort, exposure to household passive smoke was not associated with an increased risk of pancreatic cancer, although the confidence limits were wide due to a small number of cases. CONCLUSIONS: This study further documents the approximate doubling of pancreatic cancer risk in current active smokers. Our results also indicate that household passive smoke exposure is not associated with pancreatic cancer risk, although our risk estimates lacked precision.

High interocular corneal symmetry in average simulated keratometry, central corneal thickness, and posterior elevation.

PURPOSE: The purpose of this study was to assess interocular corneal symmetry in average simulated keratometry, corneal thickness, and posterior corneal elevation. METHODS: This retrospective analysis included data from scanning slit topography (Orbscan II; Bausch and Lomb, Rochester, NY) on 242 eyes from 121 consecutive patients undergoing standard evaluation for consideration of elective laser vision correction. The symmetry between the right and left eye in average simulated keratometry, minimum central corneal thickness, and posterior corneal elevation was assessed by comparative data analysis. RESULTS: Simulated keratometry ranged from 39.9 to 48.6 D. The interocular difference in average simulated keratometry was 0.47 D (standard deviation [SD] 0.43). The interocular Pearson correlation coefficient for average simulated keratometry was 0.90 (p < 0.001). The range of minimum corneal thickness was 432 to 628 microm. The interocular Pearson correlation coefficient for minimum central corneal thickness was 0.95 (p < 0.001). Right and left eye minimum corneal thickness differed by an average 8 microm (SD 7). The range of posterior elevation was -4 to 54 microm. The average difference in posterior corneal elevation between the right and left eye was 6 microm (SD 5). The interocular Pearson correlation coefficient for posterior corneal elevation was 0.72 (p < 0.001). The average posterior elevation was 19 microm (SD 11). CONCLUSIONS: Although a wide range of values exists in simulated keratometry, minimum corneal thickness, and posterior corneal elevation, interocular symmetry in all these parameters was very high in this group of consecutive patients. Asymmetry of these interocular parameters may warrant repeat clinical testing for accuracy and may predict corneal abnormalities. Normative data on posterior cornea elevation is presented. This study points out potentially clinically important high interocular corneal symmetry data in simulated keratometry, corneal thickness, and posterior corneal elevation.

Social network characteristics and cognition in middle-aged and older adults.

We examined the relationship between social network characteristics and global cognitive status in a community-based sample of 354 adults aged 50+ and with Mini-Mental State Examination (MMSE) scores of 28+ at baseline. Multivariate analyses indicated that interaction in larger social networks related to better maintenance of MMSE scores and reduced odds of decline to population-based lower quartile MMSE scores at follow-up 12 years later. At follow-up, higher levels of interpersonal activity (more frequent contacts in larger social networks) and exposure to emotional support independently related positively to MMSE. The findings suggest that interaction in larger social networks is a marker that portends less cognitive decline, and that distinct associational paths link interpersonal activity and emotional support to cognitive function.

Macular translocation in patients with recurrent subfoveal choroidal neovascularization after laser photocoagulation for nonsubfoveal choroidal neovascularization.

PURPOSE: To report visual outcomes and to examine surgical factors affecting outcomes in patients undergoing macular translocation for recurrent subfoveal choroidal neovascularization after laser photocoagulation for nonsubfoveal choroidal neovascularization. DESIGN: Retrospective, noncomparative, interventional case series. PARTICIPANTS: A consecutive series of 31 eyes of 29 patients who underwent macular translocation for recurrent subfoveal choroidal neovascularization after laser photocoagulation for nonsubfoveal choroidal neovascularization. INTERVENTION: Inferior macular translocation with punctate retinotomy performed by a single surgeon. OUTCOME MEASURES: Surgical and visual outcomes at 3 and 6 months after surgery and complications data are reported. Associations between surgical factors and visual outcomes were analyzed statistically. RESULTS: Effective translocation was achieved in 77.4% of eyes. At 6 months, 54% of eyes achieved visual acuity (VA) better than 20/100, and 46% of eyes gained the equivalent of > or =2 Early Treatment Diabetic Retinopathy Study lines of vision. No association between size of recurrent choroidal neovascularization and visual outcome was identified. Eyes with a larger scar size experienced lower VA at 3 and 6 months, but scar size was not associated with change in VA at 3 and 6 months. Subretinal dissection during surgery to detach the macula was required in 8 of 31 eyes and was associated with a significantly increased incidence of peripheral retinal breaks. However, there was no difference in either VA or change in VA in eyes with and without subretinal dissection. Retinal detachment (RD) occurred in 6 of 31 eyes. No significant difference in the RD rate was observed between groups with or without subretinal dissection (P = 0.30). CONCLUSION: Our pilot data suggest that macular translocation can result in favorable surgical outcomes in patients with recurrent subfoveal choroidal neovascularization after laser photocoagulation for nonsubfoveal choroidal neovascularization. Use of subretinal dissection intraoperatively in these patients does not seem to affect visual outcome adversely, but may be associated with increased risk of peripheral retinal breaks.

Substance use, dependence, and service utilization among the US uninsured nonelderly population.

OBJECTIVES: We examined the prevalence and correlates of substance use, dependence, and service utilization among uninsured persons aged 12 to 64 years. METHODS: We drew study data from the 1998 National Household Survey on Drug Abuse. RESULTS: An estimated 80% of uninsured nonelderly persons reported being uninsured for more than 6 months in the prior year. Only 9% of these uninsured persons who were dependent on alcohol or drugs had received any substance abuse service in the past year. Non-Hispanic Whites were an estimated 3 times more likely than Blacks to receive substance abuse services. CONCLUSIONS: Compared with the privately insured, uninsured persons had increased odds of having alcohol/drug dependence and appeared to face substantial barriers to health services for substance use problems.

Force comparison of air currents produced by a standard and modified infusion cannula.

OBJECTIVE: To develop and characterize an infusion cannula that reduces the intraocular jet forces created during fluid-air exchange. METHODS: A new infusion cannula was manufactured by adding a baffle 1.0 mm perpendicular to the distal opening of a 20-gauge infusion. The forces generated by the modified and standard cannulas were measured at a constant air infusion pressure of 50 mmHg by using a force sensor coupled to a schematic eye with eight radial positions from 0 degrees to 180 degrees along the circumference. Five different orientations relative to the baffle support of the modified cannula were evaluated at each position to assess the turbulent flow. RESULTS: The standard cannula produced a maximum force of 0.14 mmHg at 180 degrees from the sensor. The modified cannula generated a maximum pressure of 0.017 mmHg at 67.5 degrees from the sensor. Overall, the force from the modified cannula was an order of magnitude less than the standard infusion cannula (P < 0.01). CONCLUSIONS: The modifications of the new infusion cannula are passive with respect to its surgical performance. However, the additional baffle transforms laminar air currents into turbulent ones and allows dispersion of the jet forces, which should reduce barotrauma and desiccation of the retina during fluid-air exchange.