Most US women intend and initiate breastfeeding, yet many do not breastfeed as long as desired. N... more Most US women intend and initiate breastfeeding, yet many do not breastfeed as long as desired. Not meeting one's own prenatal expectations is a plausible mechanism for the previously observed association between lack of breastfeeding and postpartum depression (PPD). This study explored whether meeting prenatal expectations for exclusive breastfeeding was associated with PPD symptoms. The 2005 Infant Feeding Practices Study II (IFPSII) followed US mothers, primarily white women with higher education and income, from midpregnancy to 1 year postpartum. Depressive symptoms were defined as Edinburgh Postnatal Depression Scale (EPDS) of 10 or higher, measured at 2 months postpartum. Logistic regression analysis evaluated the odds of maternal depressive symptoms as a function of meeting prenatal expectations for exclusive breastfeeding, accounting for breastfeeding behavior, demographics, and postnatal experiences. Among IFPSII participants, 1501 intended exclusive breastfeeding and c...
Journal of human lactation : official journal of International Lactation Consultant Association, Jan 9, 2015
Breastfeeding expectations predict breastfeeding duration. The extent to which expectations for d... more Breastfeeding expectations predict breastfeeding duration. The extent to which expectations for duration are met remains unknown. To evaluate prospective measures of expected breastfeeding duration, changes in expectations over time, and factors associated with meeting expectations. The Infant Feeding Practices Study II followed women from late pregnancy to 1 year postpartum. Expected breastfeeding duration was assessed 5 times. Logistic regression identified factors associated with met prenatal expectations. Subgroup analysis compared met prenatal expectations to satisfaction with breastfeeding duration. One-year postpartum, 34.7% of 1802 participants had met prenatal expected breastfeeding duration, and 23.9% were still breastfeeding. Fifty-eight percent of women met expectations stated at 7 months postpartum. Modifiable risk factors associated with meeting prenatal expectations included early regular breast pump use (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.18-2.07)...
Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well ... more Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well into the 20s. This has prompted intense interest in linking neuromaturation to maturity of judgment. Public policy is struggling to keep up with burgeoning interest in cognitive neuroscience and neuroimaging. However, empirical evidence linking neurodevelopmental processes and adolescent real-world behavior remains sparse. Nonetheless, adolescent brain development research is already shaping public policy debates about when individuals should be considered mature for policy purposes. With this in mind, in this article we summarize what is known about adolescent brain development and what remains unknown, as well as what neuroscience can and cannot tell us about the adolescent brain and behavior. We suggest that a conceptual framework that situates brain science in the broader context of adolescent developmental research would help to facilitate research-topolicy translation. Furthermore, although contemporary discussions of adolescent maturity and the brain often use a deficit-based approach, there is enormous opportunity for brain science to illuminate the great strengths and potentialities of the adolescent brain. So, too, can this information inform policies that promote adolescent health and well-being.
Effective service interventions greatly enhance the well-being of foster youth. A study of 262 fo... more Effective service interventions greatly enhance the well-being of foster youth. A study of 262 foster youth examined one such intervention, therapeutic mentoring. Results showed that mentored youth improved significantly in the areas of family and social functioning, school behavior, and recreational activities, as well as in the reduction of expressed symptoms of traumatic stress. Study results suggest that therapeutic mentoring shows promise for enhancing treatment interventions.
Pediatric allergy, immunology, and pulmonology, 2014
Background: Physicians' assumptions about patients' socioeconomic status (SES) have been ... more Background: Physicians' assumptions about patients' socioeconomic status (SES) have been shown to influence clinical decision making in adult patients. The goal of this study is to assess the factors associated with pediatric pulmonologists' (PPs') subjective ratings of their patients' SES, and whether these factors differ by patient race/ethnicity. Methods: Parents of children with asthma (n=171) presenting for pulmonary care reported their SES using the MacArthur Subjective SES 10-rung ladder. The PPs (n=7) also estimated each family's SES. Two-level linear regression models with random intercepts (level 1: PP's SES ratings; level 2: PPs) were used to assess the predictors of PP-estimated family SES. The analyses were then stratified by race/ethnicity. Results: Parental educational, insurance type, age, and race/ethnic background were associated with PPs' SES ratings. Black/African American families were rated lower than white families, accounting f...
Psychosocial stressors like intimate partner violence (IPV) exposure are associated with increase... more Psychosocial stressors like intimate partner violence (IPV) exposure are associated with increased risk of childhood asthma. Longitudinal studies have not investigated the role of hypothalamic-pituitary-adrenal (HPA) axis reactivity (and associated alterations in cortisol release) in the child IPV exposure-asthma association. We sought to investigate this association, and to assess whether this relationship differs by child HPA reactivity. This secondary analysis used longitudinal cohort data from the Family Life Project. Participants included 1,292 low-income children and mothers; maternal interview and child biomarker data, including maternal report of IPV and child asthma, and child salivary cortisol obtained with validated stress reactivity paradigms, were collected when the child was 7, 15, 24, 35, and 48 months. Using structural equation modeling, maternal IPV when the child was 7 months of age predicted subsequent reports of childhood asthma (B=0.18, p=.002). This association...
Although preconception 1,1,1-trichloro-2,2,bis(p-chlorophenyl)ethane (DDT) exposure and B-vitamin... more Although preconception 1,1,1-trichloro-2,2,bis(p-chlorophenyl)ethane (DDT) exposure and B-vitamin deficiencies have each been shown to negatively affect human reproductive outcomes, little is known about their joint effect. We sought to examine whether B-vitamin sufficiency protects against adverse effects of DDT on clinical pregnancy (CP) and subclinical early pregnancy loss (EPL). We measured preconception concentrations of plasma B vitamins (vitamin B-6, vitamin B-12, and folate) and serum total DDT [sum of p,p' and o,p' isomers of DDT and 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene] in 291 nulligravid women from Anhui, China, who were studied in 1996-1998. The women were followed prospectively from the time they stopped contraception until CP (gestational age ≥42 d) or 12 mo (whichever occurred first). EPL was identified by using daily urinary human chorionic gonadotropin. The women were categorized according to B-vitamin status (deficiency compared with sufficiency) an...
Purpose: Adolescent risk taking may result from heightened susceptibility to environmental cues, ... more Purpose: Adolescent risk taking may result from heightened susceptibility to environmental cues, particularly emotion and potential rewards. This study evaluated the impact of social stress on adolescent risk taking, accounting for individual differences in risk taking under nonstressed conditions. Methods: Eighty-nine older adolescents completed a computerized risk-taking and decision-making battery at baseline. At follow-up, participants were randomized to a control condition, which repeated this battery, or an experimental condition, which included a social and cognitive stressor before the battery. Baseline risk-taking data were cluster-analyzed to create groups of adolescents with similar risk-taking tendencies. The degree to which these risk-taking tendencies predicted risk taking by stress condition was assessed at follow-up. Results: Participants in the stress condition took more risks than those in the no-stress condition. However, differences in risk taking under stress were related to baseline risk-taking tendencies. We observed three types of risk-takers: conservative, calculated, and impulsive. Impulsives were less accurate and planful under stress; calculated risk takers took fewer risks; and conservatives engaged in low risk taking regardless of stress. Conclusions: As a group, adolescents are more likely to take risks in "hot cognitive" than in "cold cognitive" situations. However, there is significant variability in adolescents' behavioral responses to stress related to trait-level risk-taking tendencies.
Background: The prevalence of illicit drug use among correctional populations is high, and associ... more Background: The prevalence of illicit drug use among correctional populations is high, and associated with high levels of drug related morbidity risks and harms. The purpose of this study was to examine temporal and regional patterns of illicit drug use among a sample of Canadian federal correctional inmates participating in correctional methadone maintenance treatment (MMT). Methods: Socio-demographic and drug use data collected from 1272 male federal offenders admitted to Correctional Service Canada's (CSC) MMT program between 2003 and 2008 were examined. Univariate analyses were conducted on inmates' key demographic and correctional characteristics, pre-MMT opioid use and other problematic drug use, and opioid and injecting use while incarcerated. Bivariate associations on drug use measures across regions and over time were computed. Results: Prevalence of heroin use decreased, and prevalence of prescription opioid (PO) use increased over the study period. Significant regional differences existed for PO use, specifically for morphine/hydromorphone and oxycodone use. The majority used opioids and injected while incarcerated, with overall downward trends over time and regional variations. Approximately half the sample indicated a history of lifetime non-opioid problematic drug use, most commonly cocaine (72%) for which substantial regional differences were found. Conclusions: Pre-MMT opioid and other problematic non-opioid drug use in the sample was high. Temporal and regional patterns of drug use observed may reflect developments in the general population, e.g. increasing PO misuse. The observed drug use patterns underscore the need for targeted drug specific prevention/treatment measures in correctional environments beyond existing interventions.
Most US women intend and initiate breastfeeding, yet many do not breastfeed as long as desired. N... more Most US women intend and initiate breastfeeding, yet many do not breastfeed as long as desired. Not meeting one's own prenatal expectations is a plausible mechanism for the previously observed association between lack of breastfeeding and postpartum depression (PPD). This study explored whether meeting prenatal expectations for exclusive breastfeeding was associated with PPD symptoms. The 2005 Infant Feeding Practices Study II (IFPSII) followed US mothers, primarily white women with higher education and income, from midpregnancy to 1 year postpartum. Depressive symptoms were defined as Edinburgh Postnatal Depression Scale (EPDS) of 10 or higher, measured at 2 months postpartum. Logistic regression analysis evaluated the odds of maternal depressive symptoms as a function of meeting prenatal expectations for exclusive breastfeeding, accounting for breastfeeding behavior, demographics, and postnatal experiences. Among IFPSII participants, 1501 intended exclusive breastfeeding and c...
Journal of human lactation : official journal of International Lactation Consultant Association, Jan 9, 2015
Breastfeeding expectations predict breastfeeding duration. The extent to which expectations for d... more Breastfeeding expectations predict breastfeeding duration. The extent to which expectations for duration are met remains unknown. To evaluate prospective measures of expected breastfeeding duration, changes in expectations over time, and factors associated with meeting expectations. The Infant Feeding Practices Study II followed women from late pregnancy to 1 year postpartum. Expected breastfeeding duration was assessed 5 times. Logistic regression identified factors associated with met prenatal expectations. Subgroup analysis compared met prenatal expectations to satisfaction with breastfeeding duration. One-year postpartum, 34.7% of 1802 participants had met prenatal expected breastfeeding duration, and 23.9% were still breastfeeding. Fifty-eight percent of women met expectations stated at 7 months postpartum. Modifiable risk factors associated with meeting prenatal expectations included early regular breast pump use (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.18-2.07)...
Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well ... more Longitudinal neuroimaging studies demonstrate that the adolescent brain continues to mature well into the 20s. This has prompted intense interest in linking neuromaturation to maturity of judgment. Public policy is struggling to keep up with burgeoning interest in cognitive neuroscience and neuroimaging. However, empirical evidence linking neurodevelopmental processes and adolescent real-world behavior remains sparse. Nonetheless, adolescent brain development research is already shaping public policy debates about when individuals should be considered mature for policy purposes. With this in mind, in this article we summarize what is known about adolescent brain development and what remains unknown, as well as what neuroscience can and cannot tell us about the adolescent brain and behavior. We suggest that a conceptual framework that situates brain science in the broader context of adolescent developmental research would help to facilitate research-topolicy translation. Furthermore, although contemporary discussions of adolescent maturity and the brain often use a deficit-based approach, there is enormous opportunity for brain science to illuminate the great strengths and potentialities of the adolescent brain. So, too, can this information inform policies that promote adolescent health and well-being.
Effective service interventions greatly enhance the well-being of foster youth. A study of 262 fo... more Effective service interventions greatly enhance the well-being of foster youth. A study of 262 foster youth examined one such intervention, therapeutic mentoring. Results showed that mentored youth improved significantly in the areas of family and social functioning, school behavior, and recreational activities, as well as in the reduction of expressed symptoms of traumatic stress. Study results suggest that therapeutic mentoring shows promise for enhancing treatment interventions.
Pediatric allergy, immunology, and pulmonology, 2014
Background: Physicians' assumptions about patients' socioeconomic status (SES) have been ... more Background: Physicians' assumptions about patients' socioeconomic status (SES) have been shown to influence clinical decision making in adult patients. The goal of this study is to assess the factors associated with pediatric pulmonologists' (PPs') subjective ratings of their patients' SES, and whether these factors differ by patient race/ethnicity. Methods: Parents of children with asthma (n=171) presenting for pulmonary care reported their SES using the MacArthur Subjective SES 10-rung ladder. The PPs (n=7) also estimated each family's SES. Two-level linear regression models with random intercepts (level 1: PP's SES ratings; level 2: PPs) were used to assess the predictors of PP-estimated family SES. The analyses were then stratified by race/ethnicity. Results: Parental educational, insurance type, age, and race/ethnic background were associated with PPs' SES ratings. Black/African American families were rated lower than white families, accounting f...
Psychosocial stressors like intimate partner violence (IPV) exposure are associated with increase... more Psychosocial stressors like intimate partner violence (IPV) exposure are associated with increased risk of childhood asthma. Longitudinal studies have not investigated the role of hypothalamic-pituitary-adrenal (HPA) axis reactivity (and associated alterations in cortisol release) in the child IPV exposure-asthma association. We sought to investigate this association, and to assess whether this relationship differs by child HPA reactivity. This secondary analysis used longitudinal cohort data from the Family Life Project. Participants included 1,292 low-income children and mothers; maternal interview and child biomarker data, including maternal report of IPV and child asthma, and child salivary cortisol obtained with validated stress reactivity paradigms, were collected when the child was 7, 15, 24, 35, and 48 months. Using structural equation modeling, maternal IPV when the child was 7 months of age predicted subsequent reports of childhood asthma (B=0.18, p=.002). This association...
Although preconception 1,1,1-trichloro-2,2,bis(p-chlorophenyl)ethane (DDT) exposure and B-vitamin... more Although preconception 1,1,1-trichloro-2,2,bis(p-chlorophenyl)ethane (DDT) exposure and B-vitamin deficiencies have each been shown to negatively affect human reproductive outcomes, little is known about their joint effect. We sought to examine whether B-vitamin sufficiency protects against adverse effects of DDT on clinical pregnancy (CP) and subclinical early pregnancy loss (EPL). We measured preconception concentrations of plasma B vitamins (vitamin B-6, vitamin B-12, and folate) and serum total DDT [sum of p,p' and o,p' isomers of DDT and 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene] in 291 nulligravid women from Anhui, China, who were studied in 1996-1998. The women were followed prospectively from the time they stopped contraception until CP (gestational age ≥42 d) or 12 mo (whichever occurred first). EPL was identified by using daily urinary human chorionic gonadotropin. The women were categorized according to B-vitamin status (deficiency compared with sufficiency) an...
Purpose: Adolescent risk taking may result from heightened susceptibility to environmental cues, ... more Purpose: Adolescent risk taking may result from heightened susceptibility to environmental cues, particularly emotion and potential rewards. This study evaluated the impact of social stress on adolescent risk taking, accounting for individual differences in risk taking under nonstressed conditions. Methods: Eighty-nine older adolescents completed a computerized risk-taking and decision-making battery at baseline. At follow-up, participants were randomized to a control condition, which repeated this battery, or an experimental condition, which included a social and cognitive stressor before the battery. Baseline risk-taking data were cluster-analyzed to create groups of adolescents with similar risk-taking tendencies. The degree to which these risk-taking tendencies predicted risk taking by stress condition was assessed at follow-up. Results: Participants in the stress condition took more risks than those in the no-stress condition. However, differences in risk taking under stress were related to baseline risk-taking tendencies. We observed three types of risk-takers: conservative, calculated, and impulsive. Impulsives were less accurate and planful under stress; calculated risk takers took fewer risks; and conservatives engaged in low risk taking regardless of stress. Conclusions: As a group, adolescents are more likely to take risks in "hot cognitive" than in "cold cognitive" situations. However, there is significant variability in adolescents' behavioral responses to stress related to trait-level risk-taking tendencies.
Background: The prevalence of illicit drug use among correctional populations is high, and associ... more Background: The prevalence of illicit drug use among correctional populations is high, and associated with high levels of drug related morbidity risks and harms. The purpose of this study was to examine temporal and regional patterns of illicit drug use among a sample of Canadian federal correctional inmates participating in correctional methadone maintenance treatment (MMT). Methods: Socio-demographic and drug use data collected from 1272 male federal offenders admitted to Correctional Service Canada's (CSC) MMT program between 2003 and 2008 were examined. Univariate analyses were conducted on inmates' key demographic and correctional characteristics, pre-MMT opioid use and other problematic drug use, and opioid and injecting use while incarcerated. Bivariate associations on drug use measures across regions and over time were computed. Results: Prevalence of heroin use decreased, and prevalence of prescription opioid (PO) use increased over the study period. Significant regional differences existed for PO use, specifically for morphine/hydromorphone and oxycodone use. The majority used opioids and injected while incarcerated, with overall downward trends over time and regional variations. Approximately half the sample indicated a history of lifetime non-opioid problematic drug use, most commonly cocaine (72%) for which substantial regional differences were found. Conclusions: Pre-MMT opioid and other problematic non-opioid drug use in the sample was high. Temporal and regional patterns of drug use observed may reflect developments in the general population, e.g. increasing PO misuse. The observed drug use patterns underscore the need for targeted drug specific prevention/treatment measures in correctional environments beyond existing interventions.
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Papers by Sara Johnson