York City Site Research Articles

Patient Perceptions of Illness Causes and Treatment Preferences for Obsessive-Compulsive Disorder: A Mixed-Methods Study.

Obsessive-compulsive disorder (OCD) is a condition with high patient morbidity and mortality. Research shows that eliciting patient explanations about illness causes and treatment preferences promotes cross-cultural work and engagement in health services. These topics are in the Cultural Formulation Interview (CFI), a semi-structured interview first published in DSM-5 that applies anthropological approaches within mental health services to promote person-centered care. This study focuses on the New York City site of an international multi-site study that used qualitative-quantitative mixed methods to: (1) analyze CFI transcripts with 55 adults with OCD to explore perceived illness causes and treatment preferences, and (2) explore whether past treatment experiences are related to perceptions about causes of current symptoms. The most commonly named causes were circumstantial stressors (n=16), genetics (n=12), personal psychological traits (n=9), an interaction between circumstantial stressors and participants' brains (n=6), and a non-specific brain problem (n=6). The most common treatment preferences were psychotherapy (n=42), anything (n=4), nothing (n=4), and medications (n=2). Those with a prior medication history had twice the odds of reporting a biological cause, though this was not a statistically significant difference. Our findings suggest that providers should ask patients about illness causes and treatment preferences to guide treatment choice.

Improvement on recovery and reproducibility for quantifying urinary mono-hydroxylated polycyclic aromatic hydrocarbons (OH-PAHs)

Efficient and reproducible measurements of multiple polycyclic aromatic hydrocarbon (PAH) metabolites in urinary samples are required to evaluate the complex health effects of PAH exposure. Here, we demonstrate a highly practical, automated off-line solid-phase extraction (SPE) of deconjugated hydroxylated PAHs followed by LC-MS/MS to simultaneously measure eight mono-hydroxylated PAH compounds: 1-hydroxynaphthalene, 2-hydroxynaphthalene, 2-hydroxyfluorene, 1-hydroxyphenanthrene, 2&3-hydroxyphenanthrene, 4-hydroxyphenanthrene and 1-hydroxypyrene. Initially, we observed low recovery rates (e.g., 16% for 1-hydroxypyrene) when using previously published methods. We optimized the procedure by choosing polymeric absorbent-based cartridges, automating the sample loading step by diluting samples with 15% methanol/sodium acetate, and most importantly, replacing acetonitrile with methanol as the eluting solvent. Optimized sample preparation has improved the recovery rates to more than 69% for analytes of interest. This improvement led to higher method sensitivity and detection frequency, especially for 1-hydroxypyrene, in all of 100 urine samples collected in the New York City site of the Legacy Girls Study. The limits of detection ranged from 7.6 pg/mL to 20.3 pg/mL using 1 mL of urine, compared to the 2 mL required in CDC, method 09-OD. The average coefficients of variance of quality control samples (n = 60) ranged between 7 and 21%; variance of repeated measurements (n = 45) was less than 10%. This efficient and reliable method for measuring PAH metabolites will greatly benefit epidemiology studies and biomonitoring programs.

Techs and the Cities: A New Economic Development Paradigm?

Large technology firms pose new challenges for local economic development in the 21st century. They are attractive targets for local economic developers because they have the potential of providing permanent, well-paying jobs. This article examines two mega-economic development deals. Amazon’s proposed second headquarters in Queens and Sidewalk Labs’ Quayside proposal for the Toronto waterfront pit large and prosperous Big Tech firms against local governments with healthy economies. Amazon abandoned the New York City site it had chosen, rather than open new negotiations with local officials and citizens. Sidewalk Labs withdrew from the Quayside proposal after two and a half years of negotiation focusing mostly on the size of the proposed development. Although the potential benefits may be substantial, incentivizing Big Tech’s location decisions may be well beyond the means of most cities, especially those with distressed economies.

Education Research: Changing medical student perceptions of dementia: an arts-centered experience.

Medical students' comfort level working with dementia is poorly understood, and may impact subsequent experiences with patients and caregivers. Early experiences that take place in a nonmedical setting may allow students to gain a more comprehensive understanding of quality of life and disease management in everyday life. We studied Columbia University preclinical medical students' perceptions of dementia relative to attending a nonclinical art-centered, museum-based experience designed for people with dementia and their caregivers. Participants individually attended a single 90-minute museum-based art-centered program designed to engage patients with dementia and caregivers; programs are attended by 6-10 patient-caregiver dyads and led by trained museum educators at existing New York City sites including The Metropolitan Museum of Art, The Cloisters, The Studio Museum in Harlem, and The New-York Historical Society. The Dementia Attitudes Scale (DAS) was administered before and after the intervention (least favorable = 20, neutral = 80, most favorable = 140). A total of 19 students completed baseline and postintervention DAS. At baseline, DAS mean = 97.4 (SD = 11.2). To limit bias of taking the test, 9 students completed a second preintervention DAS (≥1 week apart); among these, DAS increased from 95.7 (SD = 7.7) to 98.7 (SD = 7.4) (p = 0.09). Following the intervention, DAS favorably and significantly increased to 105.8 (SD = 11.0) (p ≤ 0.01 for all comparisons, paired-samples t test); greater differences were identified in comfort than knowledge of dementia. Although further study is warranted to confirm findings, given the increasing availability of such programs, it is reasonable to consider inclusion of these alongside other nonclinical programs that are already part of medical school curricula.

A Controlled Clinical Treatment Trial of Interpersonal Psychotherapy for Depressed Pregnant Women at 3 New York City Sites

While treatment decisions for antepartum depression must be personalized to each woman and her illness, guidelines from the American Psychiatric Association and the American College of Obstetrics and Gynecology include the recommendation of psychotherapy for mild-to-moderate depression in pregnant women. Although we previously demonstrated the efficacy of interpersonal psychotherapy for antepartum depression in a sample of Hispanic women, this study provides a larger, more diverse sample of African American, Hispanic, and white pregnant women from 3 New York City sites in order to provide greater generalizability. A 12-week bilingual, parallel-design, controlled clinical treatment trial compared interpersonal psychotherapy for antepartum depression to a parenting education program control group. An outpatient sample of 142 women who met DSM-IV criteria for major depressive disorder was randomly assigned to interpersonal psychotherapy or the parenting education program from September 2005 to May 2011. The 17-item Hamilton Depression Rating Scale (HDRS-17) was the primary outcome measure of mood. Other outcome scales included the Edinburgh Postnatal Depression Scale (EPDS) and the Clinical Global Impressions scale (CGI). The Maternal Fetal Attachment Scale (MFAS) assessed mother's interaction with the fetus. Although this study replicated previous findings that interpersonal psychotherapy is a beneficial treatment for antepartum depression, the parenting education program control condition showed equal benefit as measured by the HDRS-17, EPDS, CGI, and MFAS. This study supports the recommendation for the use of interpersonal psychotherapy for mild-to-moderate major depressive disorder in pregnancy. The parenting education program may be an alternative treatment that requires further study. ClinicalTrials.gov identifier: NCT00251043

Prenatal and childhood environmental tobacco smoke exposure and age at menarche

Previous studies have reported mixed results regarding the association between age at menarche and environmental tobacco smoke exposure, both prenatally and during early childhood; however, few studies have had data available during both time periods. The present study examined whether exposure to prenatal tobacco smoke (PTS) via maternal smoking during pregnancy or childhood environmental tobacco smoke (ETS) was associated with age at menarche in a multi-ethnic birth cohort. With the uniquely available prospectively collected data on body size and growth at birth and in early life, we further examined whether the association between PTS and ETS exposure and age at menarche was mediated by these variables. From 2001 to 2006, we recruited 262 women born between 1959 and 1963 who were enrolled previously in a New York City site of the National Collaborative Perinatal Project. Mothers who smoked during pregnancy vs. those who did not were more likely to be White, younger, have more education and have lower birthweight babies. Daughters with heavy PTS exposure (≥ 20 cigarettes per day) had a later age at menarche (>12 years vs. ≤ 12 years), odds ratio (OR) =2.1 [95% confidence interval (CI) 0.9, 5.0] compared with daughters with no PTS. Daughters exposed to only childhood ETS had a later age at menarche, OR=2.1 [95% CI 1.0, 4.3], and those exposed to PTS and ETS combined had a statistically significant later age at menarche, OR=2.2 [95% CI 1.1, 4.6] compared with daughters with no PTS and no ETS. These results did not change after further adjustment for birthweight and postnatal growth suggesting that exposure to PTS and ETS is associated with later age at menarche even after considering possible relationships with growth.

Rapid HIV Testing in Transgender Communities by Community-Based Organizations in Three Cities

This article describes the demographic and behavioral characteristics, human immunodeficiency virus (HIV) testing history, and results of HIV testing of transgender (TG) people recruited for rapid HIV testing by community-based organizations (CBOs) in three cities. CBOs in Miami Beach, Florida, New York City, and San Francisco offered TG people rapid HIV testing and prevention services, and conducted a brief survey. Participants were recruited in outreach settings using various strategies. The survey collected information on demographic characteristics, HIV risk behaviors, and HIV testing history. Among 559 male-to-female (MTF) TG participants, 12% were newly diagnosed with HIV infection. None of the 42 female-to-male participants were newly diagnosed with HIV. A large proportion of MTF TG participants reported high-risk behaviors in the past year, including 37% who reported unprotected receptive anal intercourse and 44% who reported commercial sex work. Several factors were independently associated with increased likelihood of being newly diagnosed with HIV infection among MTF TG participants, including having a partner of unknown HIV status in the past year; being 20-29 or > or = 40 years of age; having last been tested for HIV more than 12 months ago; and having been recruited at the New York City site. Based on the high proportion of undiagnosed HIV infection among those tested, TG people represent an important community for enhanced HIV testing and prevention efforts. MTF TG people should be encouraged to have an HIV test at least annually or more often if indicated, based upon clinical findings or risk behaviors. Efforts should continue for developing novel strategies to overcome barriers and provide HIV testing and prevention services to TG people.

Types of Help‐seeking situations for novice users of digital libraries: A preliminary study

AbstractThe Help‐seeking situation is characterized by a person, who is engaged in the process of information seeking with an IR system in order to achieve his/her tasks/goals, and finds him/herself needing some sort of help in that process. To date, there has been little empirical research investigating the specific types of Help‐seeking situations that lead users to look for help. This paper reports the results of a preliminary study, derived from an ongoing large scale research project focusing on the identification of different types of Help‐seeking situations, along with types of help features used and their related problems. Seventeen subjects representing the general public in Milwaukee and New York City sites were selected for this study. Based on the analysis of pre and post questionnaires, think aloud data and transaction logs, the results present 9 types of Help‐seeking situations related to problems in the area of: domain knowledge, system knowledge, information retrieval knowledge, evaluation of results, and collections of digital libraries. Implications for the design of more effective interactive Help mechanisms are also discussed.

Clients' Satisfaction With Project Liberty Counseling Services

Clients' Satisfaction With Project Liberty Counseling Services

Recent HIV testing among general hospital inpatients with schizophrenia: findings from four New York City sites.

While widely acknowledged to be an important clinical and public health issue, HIV assessment, counseling, and testing for the seriously mentally ill has not been well studied. To determine what proportion and which inpatients with schizophrenia have been recently tested for HIV. A sample of 300 inpatients with schizophrenia were recruited from four general hospitals in New York City over a one year period. After confirmation of diagnosis with a structured interview, and elicitation of sociodemographic and drug use information, medical record review identified recent HIV testing. Bivariate and multivariate analyses were used to identify subgroups more likely to be tested. Recent HIV testing had been performed for 17% of the sample and was concentrated among those with higher documented risks. The majority of patients remain untested even in groups with direct risks, such as injection drug use, and indirect risks, such as frequent cocaine use in last year. Some evidence was found that white patients at risk may be less likely to be tested than Hispanic or African American patients. Aggressive efforts are needed to improve knowledge of HIV status among acutely ill patients with schizophrenia.

Landfill and Health, a Municipal Concern or, Telling it Like it Was

Land reclamation in port cities is a worldwide phenomenon that clearly represents economic considerations and, often, intensifying urbanization. Analysis of the fill matrix of two New York City sites suggests that the imposition of municipal controls may be one facet of the urbanizing process documented in the archaeological record. Differences between the fill from the 175 Water Street site, an East River block filled in the 18th century, and Site 1 of the Washington Street Urban Renewal Area adjacent to the Hudson River, an early 19th-century fill site, are best explained by the introduction of city ordinances to regulate land reclamation activities. The historical record, which documents a growing concern with mounting health problems, provides a rationale for these controls.

Impact of the New York Long-Term Home Health Care Program.

The Long-Term Home Health Care Program (LTHHCP), also known as the Nursing Homes Without Walls, is an innovative, comprehensive Medicaid program in New York State that provides nursing home level of care to patients at home. This paper evaluates the performance of the first nine LTHHCP sites over the first 2 years of operation. Across all sites there is clear evidence that the program has been extremely successful in reducing levels of nursing home utilization. In the five upstate sites, considerable cost savings have also been achieved while improving patient survival. In the four New York City sites, patient outcomes have also been favorable, but health care costs for clients have been higher than would have been the case had clients not enrolled in the LTHHCP. Across the entire state, results could have been better if enrollment had been targeted to subsets of the eligible patient groups for whom the LTHHCP is most cost effective.

CHEMICAL COMPOSITION OF SULFATE AS A FUNCTION OF PARTICLE SIZE IN NEW YORK SUMMER AEROSOL *

Aerosol samples from a New York City site have been collected by a variety of sampling techniques during August, 1976 and analyzed for sulfate and related cationic species as a function of particle size from > 7 ..mu..m to 0.95, but there is an indiction of other variable sources of strong acid which somewhat confound the data.