bluuebunny/crossref_metadata_2025_split huggingface dataset:
Special Supplemental Nutrition Program for Women, Infants, and Children and Infant Feeding Practices
Authors: Jacknowitz Alison , Novillo Daniel , Tiehen Laura 
Published: February 2007

OBJECTIVE. This study examined the association between participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and adherence to 4 American Academy of Pediatrics recommendations on infant feeding.METHODS. We used data from the Early Childhood Longitudinal Study-Birth Cohort, which is nationally representative of children born in 2001. We estimated regression models to assess relationships between program participation and adherence to American Academy of Pediatrics recommendations on exclusive breastfeeding and the introduction of infant formula, cow's milk, and solid foods.RESULTS. Regression results indicated that WIC participation was associated with a 5.9-percentage point decrease in the likelihood of exclusive breastfeeding for ≥4 months and a 1.9-percentage point decrease in the likelihood of exclusive breastfeeding for ≥6 months. Program mothers were 8.5 percentage points less likely than nonparticipants to adhere to the American Academy of Pediatrics recommendation to delay introduction of infant formula until month 6. Program mothers were 2.5 percentage points more likely than nonparticipants to delay the introduction of cow's milk until month 8. Program participants were 4.5 percentage points less likely than nonparticipants to delay the introduction of solid foods for ≥4 months. However, the difference between participants and nonparticipants disappeared by month 6.CONCLUSIONS. Results suggest that, although program participants are less likely to breastfeed exclusively than eligible nonparticipants, program-provided infant formula is an important option for mothers who do not breastfeed exclusively. The program faces the challenge to encourage breastfeeding without undermining incentives to follow other recommended infant feeding practices. Recent changes proposed to the food packages by the US Department of Agriculture Food and Nutrition Service are consistent with the goal of increasing adherence to recommended infant feeding practices among participants.
Reduced Time in Bed and Obstructive Sleep-Disordered Breathing in Children Are Associated With Cognitive Impairment
Authors: Suratt Paul M. , Barth Jeffrey T. , Diamond Robert , D'Andrea Lynn , Nikova Margarita , Perriello Vito A. , Carskadon Mary A. , Rembold Christopher 
Published: February 2007

OBJECTIVE. The purpose of this study was to determine if reduced time in bed as well as the degree of obstructive sleep-disordered breathing predicted the risk of impaired cognitive function in children with adenotonsillar hypertrophy suspected of having obstructive sleep-disordered breathing.
DESIGN. We studied 56 children, aged 6 to 12 years, with adenotonsillar hypertrophy referred for suspected obstructive sleep-disordered breathing. Children were given a sleep diary and underwent wrist actigraphy for 6 consecutive days and nights. On day 7, the children were given general cognitive tests, memory tests, and continuous performance tests followed by attended polysomnography that night. Parents completed snoring and behavior questionnaires.
RESULTS. Shorter mean time in bed for 6 nights and a history of nightly snoring were highly predictive of lower scores for the vocabulary and similarities cognitive function tests. Children who had a mean time in bed of 557 minutes and did not snore nightly were predicted to have vocabulary and similarities scores more than 1 standard deviation higher than children who had a mean time in bed of 521 minutes and snored nightly. Shorter mean time in bed and the log of the apnea hypopnea index also predicted lower vocabulary and similarities scores. Greater night to night variability in time in bed was significantly predictive of lower vocabulary and similarities scores, but variability was not as predictive as mean time in bed. Neither mean time in bed nor the coefficient of variation of time in bed predicted other cognitive or behavioral scores.
CONCLUSIONS. Short or variable time in bed and nightly snoring or higher apnea hypopnea index predicted impaired vocabulary and similarities scores in children with adenotonsillar hypertrophy suspected of having obstructive sleep-disordered breathing. The degree of cognitive impairment attributable to short time in bed and obstructive sleep-disordered breathing is clinically very significant.
The Association of Health Insurance and Continuous Primary Care in the Medical Home on Vaccination Coverage for 19- to 35-Month-Old Children
Authors: Allred Norma J. , Wooten Karen G. , Kong Yuan 
Published: February 2007

OBJECTIVE. Our goal was to examine the association of continuous care in the medical home and health insurance on up-to-date vaccination coverage by using data from the National Survey of Children's Health and the National Immunization Survey.METHODS. Interviews were conducted with 5400 parents of 19- to 35-month-old children to collect data on demographics and medically-verified vaccinations. Health insurance coverage was categorized as always, intermittently, or uninsured for the previous 12 months. Insurance types were private, public, or uninsured. Having a personal doctor or nurse and receiving preventive health care in either the past 12 or 24 months constituted continuous primary care in the medical home. Children were up-to-date if they received all vaccinations by 19 to 35 months of age (≥4 doses of diphtheria and tetanus toxoids and pertussis vaccine, ≥3 doses of poliovirus vaccine, ≥1 dose of any measles-containing vaccine, ≥3 doses of Haemophilus influenzae type b vaccine, and ≥3 doses of hepatitis B vaccine).RESULTS. Bivariate analyses revealed children who were always insured had significantly higher vaccination coverage (83%) than those with lapses or uninsured during the past 12 months (75% and 71%, respectively). Those with continuous primary care in the medical home had significantly higher coverage than those who did not (83% vs 75%, respectively). In multivariate analysis, the same pattern of association was observed for insurance status and medical home, but the only statistically significant association was for children of never-married mothers who had significantly lower coverage (74%) compared with children of married mothers (84%).CONCLUSIONS. Among children with the same insurance status and continuity of care in the medical home, children of single mothers were less likely to be up-to-date than children of married mothers. Interventions assisting single mothers to obtain preventive care for their children should be a priority.
The Health and Well-being of Adopted Children
Authors: Bramlett Matthew D. , Radel Laura F. , Blumberg Stephen J. 
Published: February 2007

OBJECTIVE. We compared the health and well-being of adopted and biological children and examined whether observed differences may be a result of differences between these 2 groups in demographic characteristics and special health care needs.METHODS. The 2003 National Survey of Children's Health was funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, and was conducted as a module of the State and Local Area Integrated Telephone Survey by the National Center for Health Statistics, Centers for Disease Control and Prevention. The nationally representative sample consisted of 102 353 children, including 2903 adopted children. We compared estimates for 31 indicators of health and well-being for adopted and biological children and present adjusted estimates that control for differences in demographic characteristics and special health care needs prevalence.RESULTS. Adopted children are more likely than biological children to have special health care needs, current moderate or severe health problems, learning disability, developmental delay or physical impairment, and other mental health difficulties. However, adopted children are more likely than biological children to have had a preventive medical visit or a combination of preventive medical and dental visits during the previous year, to receive needed mental health care, and to receive care in a medical home; they are more likely to have consistent health insurance coverage, to be read to daily, or to live in neighborhoods that are supportive, and they are less likely to live in households in which someone smokes. These differences between adopted and biological children remain statistically significant even after adjustments for differences in demographic characteristics and the prevalence of special health care needs.CONCLUSION. The results suggest that, although adopted children may have poorer health than biological children, their parents may be doing more to ensure that they have needed health care and supportive environments.
The Prevalence of Violent Disagreements in US Families: Effects of Residence, Race/Ethnicity, and Parental Stress
Authors: Moore Charity G. , Probst Janice C. , Tompkins Mark , Cuffe Steven , Martin Amy B. 
Published: February 2007

CONTEXT. Witnessing domestic violence increases a child's chance of emotional or behavioral problems during childhood and entering abusive relationships in adulthood, even without co-occurring child maltreatment.
OBJECTIVE. Our goals were to estimate the prevalence of reported violent disagreements in the homes of US children and to assess prevalence differences by race/ethnicity, residence, and reported parenting stress.
PATIENTS AND METHODS. Data were drawn from the 2003 National Survey of Children's Health. Case subjects with unknown gender, race/ethnicity, or residence were excluded, yielding 99660 observations. Disagreements were classified on the basis of how the family deals with serious disagreement. If disagreements involved hitting or throwing, even rarely, the household was categorized as having violent disagreements. Households reporting heated argument and shouting were classified as having heated disagreement.
RESULTS. Nationally, 10.3% of children lived in homes with reported violent disagreements. Violent disagreements were most prevalent among black households (15.1%), followed by “other” (12.1%), Hispanic (11.3%), and white (8.6%) households. Urban areas had higher prevalence (10.7%) than did small through large rural counties (8.3%–9.9%). In multinomial logistic analysis, parents living in rural counties were less likely to report violent disagreements compared with those in urban. Black children were more likely to be exposed to both violent and heated disagreements than were white children. Parents reporting high parenting stress had higher odds of violent and heated disagreement than parents reporting less stress.
CONCLUSIONS. A substantial number of children are exposed to violent disagreement. Although demographic and cultural factors may also influence disagreement style, parental stress seems instrumental in the development of violent disagreements. Parents who experience difficulty with parenting constitute a high-risk population. Helping parents understand and address child behavior may reduce such stress.
A Multilevel Study of the Associations Between Economic and Social Context, Stage of Adolescence, and Physical Activity and Body Mass Index
Authors: McKay Caroline Mae , Bell-Ellison Bethany A. , Wallace Kirsten , Ferron John M. 
Published: February 2007

OBJECTIVE. Prevention efforts targeting adolescent risk behavior have had limited effectiveness, partly because of the reliance on individual-level interventions that do not consider the context within which behavior occurs. In addition, the role of development has not been well studied regarding its possible moderating effects on contextual influences on behavior. The purpose of this study was to examine the influence of economic and social context on the odds of being inactive or having above-normal weight and whether the influence differed on the basis of stage of adolescence.METHODS. Analysis used a subset of adolescents aged 10 to 17 years from the National Survey of Children's Health (n = 37930) from all states and the District of Columbia (n = 51). Dependent variables included physical activity and BMI. State-level economic context was measured by the proportion of families living below 200% of the federal poverty level. Social context was measured by aggregated means of responses to 2 indicators of social capital: mutual aid and social trust. Multilevel modeling was conducted to investigate associations between state-level economic and social context and physical activity and BMI, while controlling for individual sociodemographic characteristics, and whether these associations were dependent on an individual's stage of adolescence.RESULTS. Both state-level mutual aid and social trust were significantly related to the odds of an adolescent not meeting current physical activity recommendations, yet state-level poverty was not. For BMI, all 3 state-level variables were significant predictors of having an above-normal BMI. Evidence was found of the moderating influence of stage of adolescence for both outcomes.CONCLUSIONS. These findings point to the need for the inclusion of contextual-level data in surveillance systems assessing risk behavior in adolescents and consideration of the multilevel nature of the growing problem of inactivity and above-normal weight when focusing public health prevention efforts.
Associations Between Breastfeeding Practices and Young Children's Language and Motor Skill Development
Authors: Dee Deborah L. , Li Ruowei , Lee Li-Ching , Grummer-Strawn Laurence M. 
Published: February 2007

OBJECTIVES. We examined the associations of breastfeeding initiation and duration with language and motor skill development in a nationally representative sample of US children aged 10 to 71 months.
METHODS. Using cross-sectional data on 22399 children from the 2003 National Survey of Children's Health, we examined relationships between breastfeeding practices and children's language and motor skills development. Outcomes were based on each mother's response to questions regarding her level of concern (a lot, a little, not at all) about her child's development of expressive language, receptive language, fine motor skills, and gross motor skills. Breastfeeding data were based on mothers' recall. Methods of variance estimation were applied and multivariate polynomial regression modeling was done to estimate the effects of breastfeeding initiation and duration on children's development after adjustment for confounders.
RESULTS. Mean age of the sample was 2.79 years; 67% were non-Hispanic white, 16% were Hispanic, and 9% were non-Hispanic black. Approximately 17% of mothers reported concerns about their child's expressive language development; ∼10% had receptive language concerns; ∼6% had concerns about fine motor skills; and 5% reported general motor skills concerns. Multivariate analysis revealed that mothers who initiated breastfeeding were less likely than mothers of never-breastfed children to be concerned a lot about their child's expressive and receptive language development and fine and general motor skills. Mothers of children breastfed 3 to 5.9 months were less likely than mothers of never-breastfed children to be concerned a lot about their child's expressive and receptive language and fine and general motor skills.
CONCLUSIONS. As with all cross-sectional data, results should be interpreted with caution. Our findings suggest breastfeeding may protect against delays in young children's language and motor skill development. Fewer concerns about language and motor skill development were evident for children breastfed ≥3 months, and concerns generally decreased as breastfeeding continued ≥9 months.
Systolic Blood Pressure in Childhood Predicts Hypertension and Metabolic Syndrome Later in Life
Authors: Sun Shumei S. , Grave Gilman D. , Siervogel Roger M. , Pickoff Arthur A. , Arslanian Silva S. , Daniels Stephen R. 
Published: February 2007

OBJECTIVE. The goal was to link hypertension and the metabolic syndrome in adulthood directly to blood pressures measured decades earlier for the same individuals as children and to establish criterion values for blood pressure that predict hypertension and the metabolic syndrome later in life.
METHODS. We analyzed serial data for 240 men and 253 women in the Fels Longitudinal Study. We derived age- and gender-specific childhood blood pressures that predict hypertension and the metabolic syndrome in adulthood, and we validated these criterion values in a larger sample.
RESULTS. Blood pressure diverged between adults with and without the metabolic syndrome beginning at age 5 for boys and age 8 for girls. The odds ratios for developing hypertension at ≥30 years of age ranged from 1.1 for 14- to 18-year-old boys to 3.8 for 5- to 7-year-old boys and from 2.7 for 8- to 13-year-old girls to 4.5 for 5- to 7-year-old girls, if their blood pressure exceeded criterion values at a single examination in childhood. The corresponding odds ratios for the metabolic syndrome, with or without hypertension, ranged from 1.2 for 14- to 18-year-old boys to 2.6 for 8- to 13-year-old boys and from 1.5 for 14- to 18-year-old girls to 3.1 for 5- to 7-year-old girls. The relative risk of adult hypertension ranged from 1.5 to 3.8 for boys and from 1.5 to 4.7 for girls, and that of the metabolic syndrome ranged from 1.1 to 1.8 for boys and from 1.2 to 5.6 for girls. These relative risks varied directly with the number of examinations at which systolic blood pressure exceeded criterion values.
CONCLUSION. Children with systolic blood pressures above the criterion values established in this longitudinal study are at increased risk of hypertension and the metabolic syndrome later in life.
A clinical approach to the management of thrombosis in obstetrics. Part 2: diagnosis and treatment of venous thromboembolism
Authors: Asghar Farah , Bowman Paul 
Published: February 2007

Key content

The diagnosis of venous thromboembolism requires objective testing, which can be done safely throughout pregnancy.
Low molecular weight heparin is the most suitable agent for both prophylaxis and treatment of venous thromboembolism in pregnancy.
Once labour has commenced, heparin should not be administered.
It is recommended that anticoagulants be resumed 4–6 hours after vaginal delivery and 6–12 hours after caesarean delivery.

Learning objectives

To be able to choose the most appropriate diagnostic tests for venous thromboembolism in pregnancy.
To be able to prescribe the most appropriate anticoagulants.
To be able to manage women on anticoagulants appropriately during the different stages of pregnancy.

Ethical issues

The risks to the fetus of anticoagulant therapy are outweighed by the health benefits to the mother.
Women of reproductive age on oral anticoagulants should know about warfarin embryopathy.

Please cite this article as: Asghar F, Bowman P. A clinical approach to the management of thrombosis in obstetrics. Part 2: diagnosis and treatment of venous thromboembolism. The Obstetrician & Gynaecologist 2007;9:3–8.
Putting risk into context
Authors: Drife James 
Published: February 2007

Key content

Risks are measured in various ways by epidemiologists and portrayed with varying degrees of accuracy by the media.
Doctors should examine their motives for explaining risks. These may include the wish to avoid litigation or to persuade women to take a specific course of action.
Communicating risk requires a background knowledge of how risk is measured and a relationship of trust between doctors and women.
Words and numbers are useful in communicating risk and decision aids are now available to help this process.
Understanding the woman's view is essential – remembering that it may change during pregnancy – and there are techniques for learning this skill.

Learning objectives

To understand how risks are measured and how they are perceived by women.
To be aware of the importance of the doctor's attitude to risks.
To know the prerequisites for communicating risk and the range of techniques for doing so effectively.

Ethical issues

Does the doctor's opinion bias the information he or she gives?
When a woman finds it difficult to take a decision herself, should the doctor do this for her?

Please cite this article as: Drife J. Putting risk into context. The Obstetrician & Gynaecologist 2007;9:42–47.
Importance and Predictability of Cannibalism in Rainbow Smelt
Authors: Parker Stetter Sandra L. , Thomson Jennifer L. Stritzel , Rudstam Lars G. , Parrish Donna L. , Sullivan Patrick J. 
Published: February 2007

AbstractCannibalism is a key interaction between young of year (age‐0) and older fish in many freshwater ecosystems. Density and spatial overlap between age‐groups often drive cannibalism. Because both density and overlap can be quantified, the magnitude of cannibalism may be predictable. Our study considered cannibalism in rainbow smelt Osmerus mordax in Lake Champlain (New York–Vermont, United States, and Quebec, Canada). We used acoustic estimates of the density and distribution of age‐0 and yearling‐and‐older (age‐1+) rainbow smelt to predict cannibalism in the diets of age‐1+ fish during 2001 and 2002. Experienced density, a measure combining density and spatial overlap, was the strongest predictor (R2 = 0.89) of the proportion of cannibals in the age‐1+ population. Neither spatial niche overlap (R2 = 0.04) nor age‐0 density (R2 = 0.30) alone was a good predictor of cannibalism. Cannibalism among age‐1+ rainbow smelt was highest in June, lowest in July, and high in September owing to differences in thermal stratification and habitat shifts by age‐0 fish. Between July and September, age‐1+ rainbow smelt consumed 0.1–11% of the age‐0 population each day. This resulted in a 38–93% mortality of age‐0 fish due to cannibalism. These estimated mortality rates did not differ significantly from observed declines in age‐0 rainbow smelt abundances between sampling dates. Age‐1+ rainbow smelt are probably the primary predators on age‐0 rainbow smelt during the summer and early fall in Lake Champlain.
Tagging as a Social Literacy Practice
Authors: MacGillivray Laurie , Curwen Margaret Sauceda 
Published: February 2007

Tagging is not simply an act of vandalism or violence; it is a social practice with its own rules and codes—a literacy practice imbued with intent and meaning. Three aspects of tagging reflect its nature as a literate practice:The purpose of tagging to achieve particular social goals and group affiliationsThe role of talent to be considered a competent engagerThe value of the quantity of tagging to achieve statusThe participants in this study had various reasons for engaging in tagging. Findings highlight these varying purposes to sustain relationships, carry on dialogue, provide social commentary, and establish an identity by being recognized and known. In general, youths are a segment of the population whose ability to use literacy tools to navigate their complex social world is often unaddressed in literacy research. It is critical to understand more clearly the meanings behind these symbolic forms of expression used by adolescents and to explore their often‐cloaked purposes for writing.