Publications by authors named "Hena Din"

10 Publications

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Mental Health Outcomes in Adolescent and Young Adult Female Cancer Survivors of a Sexual Minority.

J Adolesc Young Adult Oncol 2021 04 27;10(2):148-155. Epub 2020 Jul 27.

Department of Obstetrics, Gynecology, & Reproductive Science and Moores Cancer Center, University of California, San Diego, La Jolla, California, USA.

Sexual minority (SM) individuals experience higher rates of anxiety and depression. Previous research on mental health disparities for SM cancer survivors has largely focused on adult survivors; however, studies are limited in the adolescent and young adult (AYA) population. This study's objective is to compare depression and anxiety symptoms between AYA, female cancer survivors who identify as an SM and those who identify as heterosexual. A cross-sectional analysis of 1025 AYA survivors aged 18-40 years (2015-2017) was performed. Patients self-reported SM identification and depression and anxiety symptoms, as measured by the Patient Health Questionnaire (PHQ8) and Generalized Anxiety Disorder Scale (GAD7), respectively. Multivariable logistic regression tested associations between SM identification and depression and anxiety. Sixty-four participants (6%) identified as an SM. In adjusted analyses, SM participants had 1.88 higher odds of anxiety (odds ratio [OR] 1.88, confidence interval [95% CI] 1.05-3.35,  = 0.033) compared with heterosexual participants. SM participants did not have significantly higher odds of depression (OR 1.36, CI 0.75-2.47,  = 0.31). More social support was significantly associated with lower odds of depression (OR 0.91, CI 0.89-0.93,  < 0.001) and anxiety (OR 0.93, CI 0.91-0.94,  < 0.001). AYA cancer survivors identifying as an SM had nearly twice the odds of anxiety, with social support that is protective for both anxiety and depression. While mental health screening is recommended throughout the cancer care continuum, these data support the need for reliable screening, clinician awareness of increased vulnerability in the AYA, SM survivor population, and clinician training on culturally competent care and generation of evidence-based interventions.
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April 2021

Differential expression of nuclear genes encoding mitochondrial proteins from urban and rural populations in Morocco.

Cell Stress Chaperones 2020 11 21;25(6):847-856. Epub 2020 Apr 21.

Department of Surgery, School of Medicine, University of California San Diego, La Jolla, CA, 92093, USA.

Urbanization in low-income countries represents an important inflection point in the epidemiology of disease, with rural populations experiencing high rates of chronic and recurrent infections and urban populations displaying a profile of noncommunicable diseases. To investigate if urbanization alters the expression of genes encoding mitochondrial proteins, we queried gene microarray data from rural and urban populations living in Morocco (GSE17065). The R Bioconductor packages edgeR and limma were used to identify genes with different expression. The experimental design was modeled upon location and sex. Nuclear genes encoding mitochondrial proteins were identified from the MitoCarta2.0 database. Of the 1158 genes listed in the MitoCarta2.0 database, 847 genes (73%) were available for analysis in the Moroccan dataset. The urban-rural comparison with the greatest environmental differences showed that 76.5% of the MitoCarta2.0 genes were differentially expressed, with 97% of the genes having an increased expression in the urban area. Enrichment analysis revealed 367 significantly enriched pathways (adjusted p value < 0.05), with oxidative phosphorylation, insulin secretion and glucose regulations (adj.p values = 6.93E-16) being the top three. Four significantly perturbed KEGG disease pathways were associated with urbanization-three degenerative neurological diseases (Huntington's, Alzheimer's, and Parkinson's diseases) and herpes simplex infection (false discover rate corrected p value (PGFdr) < 0.2). Mitochondrial RNA metabolic processing and translational elongation were the biological processes that had the greatest enrichment (enrichment ratios 14.0 and 14.8, respectively, FDR < 0.5). Our study links urbanization in Morocco with changes in the expression of the nuclear genes encoding mitochondrial proteins.
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November 2020

Health-Related Quality of Life in Craniofacial Conditions: Concordance Between Child and Parent Reports.

Ann Plast Surg 2020 05;84(5S Suppl 4):S295-S299

Department of Psychology, San Diego State University, San Diego, CA.

Introduction: Craniofacial conditions (CFCs) profoundly influence health-related quality of life (HRQoL). In children with CFCs, patient-reported outcome measures have become an integral adjunct to more objective surgical outcome measures. Patient-reported outcome measures are designed to assess HRQoL domains. Few studies have evaluated parent and child agreement about HRQoL in the context of CFCs. The aims of this study were to explore the impact of CFCs on HRQoL domains in children and their parents and to determine whether patient and parent perspectives converge.

Methods: The Craniofacial Conditions Quality of Life Scale (CFC-QoL) is a newly developed 5-domain survey available in child self-report and parent report and in English- and Spanish-language versions. The 5 domains are the following: social impact, psychological function, physical function, family impact, and appearance impact. Children with CFCs (ages 7-21 years) and parents of children with CFCs were recruited via the craniofacial care team clinic at a major metropolitan children's hospital. All children and parents completed the CFC-QoL Scale in their preferred language of English or Spanish. Scale internal consistencies were calculated for child patients and parents, for English and Spanish versions. Scores on the 5 domains were compared for children and parents across English versus Spanish versions.

Results: For children with CFCs (N = 75), the sex was distributed almost equally. Patients were mostly Hispanic (69.3%), and their ages ranged from 7 to 21 years old (M = 13.2, SD = 3.62). The mean values for patient and parent scores were low, suggesting good HRQoL across all 5 domains. Pearson correlation coefficients were computed to explore the interrelationships between patient and parent report for each of the 5 CFC-QoL subscales. For the total sample, patient and parent scores were significantly and moderately positively correlated for all subscales. When analyzed separately based on sex, ethnicity, and diagnostic group, the correlation patterns were not identical to those found for the total sample. When analyzed separately for diagnostic group, there was less consistency in patterns, with patient-parent dyads showing different levels of agreement based on child's diagnostic grouping.

Conclusions: Although there is substantial agreement between parents and patients when considered on a group level, there is moderate agreement between patients and parents when considered at the dyadic level, underscoring the importance of measuring and considering both perspectives.
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May 2020

Psychometric Evaluation of the Nasal Obstruction Symptom Evaluation Scale for Pediatric Patients.

Otolaryngol Head Neck Surg 2020 Feb 10;162(2):248-254. Epub 2019 Dec 10.

University of California San Diego School of Medicine, San Diego, California, USA.

Objective: To evaluate the psychometric properties of the nasal obstruction symptom scale within a sample of pediatric patients undergoing septoplasty or functional septorhinoplasty.

Study Design: This was a prospective study with nasal obstruction symptom scale evaluations conducted pre- and postoperatively.

Setting: A tertiary care pediatric hospital.

Subjects And Methods: Pediatric patients underwent septoplasty or functional septorhinoplasty (FSR) from January 2013 to January 2017. Reliability of the scale was assessed through measures of internal consistency. In addition, item response models of each item were evaluated to assess how well each item captured individuals with varying levels of nasal obstruction. Study authors assessed face validity, and construct validity was assessed by correlation measures between items and exploratory factor analysis.

Results: A total of 136 patients, ages 8 to 18 years with a mean age of 15.7 ± 2.1 years, completed pre- and postoperative evaluations. Internal consistency of the scale was high (Cronbach's α = 0.83). Predominantly a unidimensional scale resulted from exploratory factor analyses. Item response models indicate questions capture low to moderate levels of nasal obstruction within this population. Additional analyses show the scale functions similarly between septoplasty and FSR patients.

Conclusion: The Nasal Obstruction Symptom Evaluation scale is a robust tool that may be incorporated as a subjective evaluation of severity of nasal obstruction among pediatric patients undergoing a septoplasty or functional septorhinoplasty.
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February 2020

Profiles of a Health Information-Seeking Population and the Current Digital Divide: Cross-Sectional Analysis of the 2015-2016 California Health Interview Survey.

J Med Internet Res 2019 05 14;21(5):e11931. Epub 2019 May 14.

School of Public Health, San Diego State University, San Diego, CA, United States.

Background: Internet use for health information is important, given the rise of electronic health (eHealth) that integrates technology into health care. Despite the perceived widespread use of the internet, a persistent "digital divide" exists in which many individuals have ready access to the internet and others do not. To date, most published reports have compared characteristics of internet users seeking health information vs nonusers. However, there is little understanding of the differences between internet users seeking health information online and users who do not seek such information online. Understanding these differences could enable targeted outreach for health interventions and promotion of eHealth technologies.

Objective: This study aims to assess population-level characteristics associated with different types of internet use, particularly for seeking online health information.

Methods: The 2015-2016 California Health Interview Survey datasets were used for this study. Internet use was classified as never used the internet (Never use), ever used the internet but not to search for health information in the last 12 months (Use not for health), and ever used the internet and have used it to search for health information in the last 12 months (Use for health). Weighted multinomial logistic regression was used to assess sociodemographic and health characteristics associated with types of internet use. Findings are reported as odds ratios (ORs) with 95% CIs.

Results: Among 42,087 participants (weighted sample of 29,236,426), 19% reported Never Use of the internet, 27.9% reported Use not for health, and 53.1% reported Use for health. Compared to Never Use individuals, Use for health individuals were more likely to be younger (OR: 0.1, 95% CI 0.1-0.2 for ≥60 years vs <60 years), female (OR: 1.6, 95% CI 1.3-1.9 compared to males), and non-Hispanic white (OR: 0.54, 95% CI 0.4-0.7 for Latinos and OR: 0.2, 95% CI 0.2-0.4 for African Americans) and have a higher socioeconomic status (>400% of Federal Poverty Guidelines; OR: 1.3, 95% CI 1.4-2.4). Overall, characteristics for the Use not for health and Use for health groups were similar, except for those with lower levels of education and respondents not having visited a physician in the last year. For these two characteristics, the Use not for health group was more similar to the Never Use group.

Conclusions: Our findings indicate that a digital divide characterized by sociodemographic and health information exists across three types of users. Our results are in line with those of previous studies on the divide, specifically with regard to disparities in use and access related to age, race/ethnicity, and socioeconomic status. Disparities in online health-seeking behavior may reflect existing disparities in health care access extending into a new era of health technology. These findings support the need for interventions to target internet access and health literacy among Never Use and Use not for health groups.
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May 2019

Changing Mammography-Related Beliefs Among American Muslim Women: Findings from a Religiously-Tailored Mosque-Based Intervention.

J Immigr Minor Health 2019 Dec;21(6):1325-1333

Section of General Internal Medicine, The Univezrsity of Chicago, Chicago, IL, USA.

Background To advance the literature on religiously-tailored interventions and on Muslim cancer screening disparity research, we report on a behavioral intervention that used religiously-tailored messages to address salient mammography-related barrier beliefs. Methods We crafted specific, religiously-tailored messages and designed a two-session, peer-led, mosque-based educational program to deploy them. t-tests assessed pre- and post-intervention changes in mammography knowledge, intention to obtain mammography, and levels of agreement with mammography-related barrier and facilitator beliefs, while ordered logistic regression models assessed predictors of change. Results 58 women participated, 29 who were South-Asian and 18 Arab. Mean mammography knowledge increased post-intervention. Participants' overall mean agreement with facilitator beliefs trended upward and there was a significant decrease in agreement with the belief "Breast Cancer Screening is not important because God decides who will get cancer," Discussion Religiously-tailored messages provide an opportunity for addressing barriers to preventive health in a theologically consonant way.
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December 2019

Pediatric septoplasty and functional septorhinoplasty: A quality of life outcome study.

Int J Pediatr Otorhinolaryngol 2018 Aug 25;111:16-20. Epub 2018 May 25.

Division of Pediatric Otolaryngology, Rady Children's Hospital, 3020 Children's Way, San Diego, CA 92123, USA; University of California San Diego School of Medicine, 9500 Gilman Drive, San Diego, CA 92093, USA.

Objective: This study assessed disease-specific quality-of-life outcomes among pediatric patients undergoing septoplasty or functional septorhinoplasty. The Nasal Obstruction Symptom Evaluation (NOSE) score was obtained pre- and post-operatively. Additional analyses determined whether demographics, nasal trauma, prior nasal surgery, or allergic rhinitis history affected NOSE scores.

Methods: Patients undergoing septoplasty or functional septorhinoplasty were evaluated prospectively at a tertiary children's hospital. NOSE scores were assessed pre- and post-operatively. Change in NOSE score was analyzed using the Wilcoxon Signed Rank test, while multiple regression analysis evaluated factors associated with NOSE score change.

Results: 136 patients (mean age 15.7 ± 2.1 years) were evaluated; 52 (38.2%) underwent septoplasty while 84 (61.8%) underwent functional septorhinoplasty. Mean follow-up was 3.6 ± 5.1 months. There was a statistically significant decrease in NOSE score from pre-operative septoplasty and functional septorhinoplasty: median = 75 to post-operative septoplasty: median = 20 (z = -5.9, p < 0.001) and functional septorhinoplasty: median = 15 (z = -7.9, p < 0.001). Gender, age, nasal trauma, prior nasal surgery, and allergic rhinitis did not have a significant effect on NOSE score change for either group. Additional surgery at the time of procedure was not a confounding variable in the relationship between surgery type and NOSE score. A NOSE Scale reliability analysis demonstrated high internal consistency with Cronbach's α of 0.83 across septoplasty and functional septorhinoplasty patients.

Conclusion: There was significant improvement in disease-specific quality-of-life in pediatric patients undergoing septoplasty or functional septorhinoplasty. Gender, nasal trauma, prior nasal surgery, and allergic rhinitis did not significantly affect NOSE scores in either group.
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August 2018

Patient Portal Usage in Pediatric Urology: Is it Meaningful Use for Everyone?

Urol Pract 2018 Jul 3;5(4):279-285. Epub 2017 Jun 3.

Department of Urology, University of California San Diego, San Diego, California.

Introduction: The Affordable Care Act promotes multiple directives for meaningful use of the Electronic Health Record, such as patient/provider portals, to increase patient engagement. Although portal use is common within adult healthcare, little information exists regarding pediatric portal use. We examined pediatric urology patient portal enrollment and activation patterns at a tertiary pediatric hospital in Southern California by race/ethnicity, preferred language, gender, and residential region.

Methods: Retrospective Electronic Health Record analysis of enrollment in patient portal from January 2010 to May 2016 among 10,464 patients with at least one outpatient urology clinic visit. Differences in adoption rates were examined using logistic regression for the following categories: activated (or caregiver activated); code accepted not activated; declined; or activated/then deactivated.

Results: Overall, 46.5% of patients/caregivers activated the portal. Primarily Spanish-speaking patients were less likely to activate (OR 0.25, <.001) than English-speaking patients. Males (OR 0.89, =.004); those self-identifying racially as (not White, Asian, or African American) (OR 0.47, <.001); and Hispanic patients (OR 0.49, <.001) were less likely to activate. Suburban patients were up to 3 times more likely to activate portals than central urban patients depending on the region (OR 2.94, <.001). Multivariate logistic regression demonstrated Spanish-speaking patients were 3 times less likely to activate while controlling for demographic and region variables.

Conclusions: Primary language and socioeconomic factors may be significant barriers to portal adoption. Patient education to reduce these barriers may increase portal acceptance and increase meaningfulness to the portal for patients/parents and providers.
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July 2018

Unilateral extravesical ureteral reimplantation via inguinal incision for the correction of vesicoureteral reflux: a 10-year experience.

Int Braz J Urol 2017 Sep-Oct;43(5):917-924

Rady Children's Hospital, San Diego, CA, USA.

Introduction And Objective: Multiple options exist for the surgical management of vesicoureteral reflux (VUR). We report on our 10-year experience using the inguinal approach to extravesical ureteral reimplantation (EVR).

Materials And Methods: Patient characteristics of age, gender, and reflux grade were obtained and outcomes of operative time, hospital stay, and radiographic resolution were assessed.

Results: 71 girls and 20 boys with a mean age of 74 months (range 14-164) underwent inguinal EVR via a 3.5-cm inguinal mini-incision. Mean follow up was 10.9 months (range 0.4-69.7). Average grade of reflux was 2.80. Average operative time was 91 minutes (range 51-268). The procedure was successful in 87 of 91 patients (95.6%). The 3 cases of reflux that persisted were all grade 1 and managed expectantly. Contralateral reflux developed in 9 cases, all of which resolved after treatment with either Deflux or ureteral reimplant. There were 4 case of urinary retention that resolved after a brief period of CIC or indwelling catheterization. There were no cases of ureteral obstruction. Most patients were discharged on post-operative day 1 (85/91) and no hospitalization extended beyond 3 days.

Conclusions: The inguinal approach to extravesical ureteral reimplantation should be considered as a potentially minimally invasive alternative to endoscopic and robotic treatment of VUR with a success rate more comparable to traditional open approaches. We feel it is the method of choice in cases of unilateral VUR requiring surgical correction.
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November 2017

Correlates of measured prehypertension and hypertension in Latina women living along the US-Mexico border, 2007-2009.

Prev Chronic Dis 2014 Oct 23;11:E186. Epub 2014 Oct 23.

Graduate School of Public Health, San Diego State University and San Diego Prevention Research Center and the Institute for Behavioral and Community Health of the San Diego State University Research Foundation, San Diego, California.

Introduction: Although Latinos have lower hypertension rates than non-Latino whites and African Americans, they have a higher prevalence of undiagnosed and uncontrolled hypertension. Research on predictors of hypertension has mostly focused on intrapersonal factors with no studies assessing the combined influence of intrapersonal, interpersonal, and environmental factors. The purpose of this study was to assess a broad range of correlates including intrapersonal, interpersonal, and environmental factors on measured blood pressure category (nonhypertensive, prehypertensive, and hypertensive) in a sample of Latina women residing in San Diego, California.

Methods: This cross-sectional study used baseline data from the San Diego Prevention Research Center's Familias Sanas y Activas program, a promotora-led physical activity intervention. The sample was 331 Latinas who self-selected into this program. Backward conditional logistic regression analysis was conducted to determine the strongest correlates of measured blood pressure category.

Results: Logistic regression analysis suggested that the strongest correlates of prehypertension were soda consumption (odds ratio [OR] = 1.34, [1.00-1.80], P ≤ .05) and age (OR = 1.03, [1.00-1.05], P ≤ .05). The strongest correlates of hypertension were soda consumption (OR = 1.92, [1.20-3.07], P ≤ .01), age (OR = 1.09, [1.05-1.13], P ≤ .001), and measured body mass index (OR = 1.13, [1.05-1.22], P ≤ .001). All analyses controlled for age and education. No interpersonal or environmental correlates were significantly associated with blood pressure category.

Conclusion: Future research should aim to further understand the role of soda consumption on risk for hypertension in this population. Furthermore, interventions aimed at preventing hypertension may want to focus on intrapersonal level factors.
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October 2014