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• 1. [Article] Racial Discrepancies in the Association Between Paternal vs. Maternal Educational Level and Risk of Low Birthweight in Washington State

  Background: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race ...

  Citation × Citation Citation Abstract Copy Title: Racial Discrepancies in the Association Between Paternal vs. Maternal Educational Level and Risk of Low Birthweight in Washington State Author: Nicolaidis, Christina, Ko, Cynthia W., Saha, Somnath, Koepsell, Thomas D. Year: 2004 Background: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW) across different racial groups. Methods: We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789). We assessed the associations between maternal or paternal education and LBW, adjusting for demographic variables, health services factors, and maternal behavioral and obstetrical factors. Results: Paternal educational level was independently associated with LBW after adjustment for race, maternal education, demographic characteristics, health services factors; and other maternal factors. We found an interaction between the race and maternal education on risk of LBW. In whites, maternal education was independently associated with LBW. However, in the remainder of the sample, maternal education had a minimal effect on LBW. Conclusions: The degree of association between maternal education and LBW delivery was different in whites than in members of other racial groups. Paternal education was associated with LBW in both whites and non-whites. Further studies are needed to understand why maternal education may impact pregnancy outcomes differently depending on race and why paternal education may play a more important role than maternal education in some racial categories. Title: Racial Discrepancies in the Association Between Paternal vs. Maternal Educational Level and Risk of Low Birthweight in Washington State Author: Nicolaidis, Christina, Ko, Cynthia W., Saha, Somnath, Koepsell, Thomas D. Year: 2004 Background: The role of paternal factors in determining the risk of adverse pregnancy outcomes has received less attention than maternal factors. Similarly, the interaction between the effects of race and socioeconomic status (SES) on pregnancy outcomes is not well known. Our objective was to assess the relative importance of paternal vs. maternal education in relation to risk of low birth weight (LBW) across different racial groups. Methods: We conducted a retrospective population-based cohort study using Washington state birth certificate data from 1992 to 1996 (n = 264,789). We assessed the associations between maternal or paternal education and LBW, adjusting for demographic variables, health services factors, and maternal behavioral and obstetrical factors. Results: Paternal educational level was independently associated with LBW after adjustment for race, maternal education, demographic characteristics, health services factors; and other maternal factors. We found an interaction between the race and maternal education on risk of LBW. In whites, maternal education was independently associated with LBW. However, in the remainder of the sample, maternal education had a minimal effect on LBW. Conclusions: The degree of association between maternal education and LBW delivery was different in whites than in members of other racial groups. Paternal education was associated with LBW in both whites and non-whites. Further studies are needed to understand why maternal education may impact pregnancy outcomes differently depending on race and why paternal education may play a more important role than maternal education in some racial categories. Close

• 2. [Article] Development and Preliminary Psychometric Testing of the Centrality of Pain Scale

  Objective: To develop and begin to evaluate a new measure of the centrality of pain in patients' lives. Design: Cross-sectional survey and cognitive interviews. Setting: Academic general internal medicine ...

  Citation × Citation Citation Abstract Copy Title: Development and Preliminary Psychometric Testing of the Centrality of Pain Scale Author: Nicolaidis, Christina, Chianello, Teresa, Gerrity, Martha Year: 2011 Objective: To develop and begin to evaluate a new measure of the centrality of pain in patients' lives. Design: Cross-sectional survey and cognitive interviews. Setting: Academic general internal medicine clinic. Patients: 65 adult internal medicine patients with chronic non-malignant pain (CNMP). Outcome measures: We assessed content validity and clarity of the 10-item Centrality of Pain Scale (COPS) by soliciting feedback from chronic pain experts and by conducting cognitive interviews with patients with CNMP. We assessed internal consistency reliability using Cronbach's alpha. We assessed construct validity by comparing the COPS with other measures of chronic pain morbidity including pain severity, depression, anxiety, physical and mental health function, PTSD, quality of life, and provider assessment. Results: Healthcare providers felt the COPS had excellent face validity. Cognitive interviews revealed that patients' understanding of the items matched the intended construct, the scale measured an important concept, and items were easy to understand. The COPS had excellent internal consistency (alpha=0.9). COPS was negatively associated with age (r=−0.29; p=0.02), but not with other demographic characteristics. Higher COPS scores were associated with poorer physical (r=−0.48; p Conclusions: The COPS has excellent internal consistency and construct validity. Additional studies are needed to further validate the scale. Title: Development and Preliminary Psychometric Testing of the Centrality of Pain Scale Author: Nicolaidis, Christina, Chianello, Teresa, Gerrity, Martha Year: 2011 Objective: To develop and begin to evaluate a new measure of the centrality of pain in patients' lives. Design: Cross-sectional survey and cognitive interviews. Setting: Academic general internal medicine clinic. Patients: 65 adult internal medicine patients with chronic non-malignant pain (CNMP). Outcome measures: We assessed content validity and clarity of the 10-item Centrality of Pain Scale (COPS) by soliciting feedback from chronic pain experts and by conducting cognitive interviews with patients with CNMP. We assessed internal consistency reliability using Cronbach's alpha. We assessed construct validity by comparing the COPS with other measures of chronic pain morbidity including pain severity, depression, anxiety, physical and mental health function, PTSD, quality of life, and provider assessment. Results: Healthcare providers felt the COPS had excellent face validity. Cognitive interviews revealed that patients' understanding of the items matched the intended construct, the scale measured an important concept, and items were easy to understand. The COPS had excellent internal consistency (alpha=0.9). COPS was negatively associated with age (r=−0.29; p=0.02), but not with other demographic characteristics. Higher COPS scores were associated with poorer physical (r=−0.48; p Conclusions: The COPS has excellent internal consistency and construct validity. Additional studies are needed to further validate the scale. Close

• 3. [Article] Failure of Intimate Partner Violence Screening Among Patients with Substance Use Disorders

  Objectives: This study examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the emergency department (ED). Methods: This ...

  Citation × Citation Citation Abstract Copy Title: Failure of Intimate Partner Violence Screening Among Patients with Substance Use Disorders Author: Choo, Esther K., Nicolaidis, Christina, Jenkinson, Robert H., Cox, Jessi M., McConnell, Kenneth J. Year: 2010 Objectives: This study examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the emergency department (ED). Methods: This was a retrospective cohort study of adult ED patients presenting to an urban, tertiary care teaching hospital over a 4-month period. An automated electronic data abstraction process identified consecutive patients and retrieved visit characteristics, including results of three violence screening questions, demographic data, triage acuity, time of visit, and ICD-9 diagnosis codes. Data on management were collected using a standardized abstraction tool by two reviewers masked to the study question. Multivariate logistic regression was used to determine predictors of screening and management. Results: In 10,071 visits, 6,563 violence screens were completed. IPV screening was documented in 33.5% of patients with alcohol-related diagnoses (95% CI = 27.7% to 39.3%, ?2 = 116.78, p < 0.001) and 53.3% of patients with drug-related diagnoses (95% CI = 44.3% to 62.3%, ?2 = 7.69, p = 0.006), compared to 66.1% of patients without these diagnoses (95% CI = 65.2% to 67.1%). In the multivariate analysis, alcohol (OR 0.30, 95% CI = 0.22 to 0.40) and drug use (OR 0.56, 95% CI = 0.38 to 0.83) were associated with decreased odds of screening. Of completed screens, 429 (6.5%) were positive, but violence was addressed further in only 55.7% of patients. Substance abuse did not appear to affect the odds of having positive screens addressed further by providers (OR 1.96, 95% CI = 0.39 to 10.14). Conclusions: This study found an association between SUD and decreased odds of IPV screening. Failure to screen for IPV in the setting of substance use may represent a missed opportunity to address a critical health issue, and be a barrier to successful intervention. Title: Failure of Intimate Partner Violence Screening Among Patients with Substance Use Disorders Author: Choo, Esther K., Nicolaidis, Christina, Jenkinson, Robert H., Cox, Jessi M., McConnell, Kenneth J. Year: 2010 Objectives: This study examined the relationship between substance use disorder (SUD) and intimate partner violence screening (IPV) and management practices in the emergency department (ED). Methods: This was a retrospective cohort study of adult ED patients presenting to an urban, tertiary care teaching hospital over a 4-month period. An automated electronic data abstraction process identified consecutive patients and retrieved visit characteristics, including results of three violence screening questions, demographic data, triage acuity, time of visit, and ICD-9 diagnosis codes. Data on management were collected using a standardized abstraction tool by two reviewers masked to the study question. Multivariate logistic regression was used to determine predictors of screening and management. Results: In 10,071 visits, 6,563 violence screens were completed. IPV screening was documented in 33.5% of patients with alcohol-related diagnoses (95% CI = 27.7% to 39.3%, ?2 = 116.78, p < 0.001) and 53.3% of patients with drug-related diagnoses (95% CI = 44.3% to 62.3%, ?2 = 7.69, p = 0.006), compared to 66.1% of patients without these diagnoses (95% CI = 65.2% to 67.1%). In the multivariate analysis, alcohol (OR 0.30, 95% CI = 0.22 to 0.40) and drug use (OR 0.56, 95% CI = 0.38 to 0.83) were associated with decreased odds of screening. Of completed screens, 429 (6.5%) were positive, but violence was addressed further in only 55.7% of patients. Substance abuse did not appear to affect the odds of having positive screens addressed further by providers (OR 1.96, 95% CI = 0.39 to 10.14). Conclusions: This study found an association between SUD and decreased odds of IPV screening. Failure to screen for IPV in the setting of substance use may represent a missed opportunity to address a critical health issue, and be a barrier to successful intervention. Close