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Munzer TG, Miller AL, Weeks HM, Kaciroti N, Radesky J. Greater mobile device-prompted phone pickups are associated with daily parent stress. Acta Paediatr 2024. [PMID: 38698532 DOI: 10.1111/apa.17260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024]
Abstract
AIM No studies have examined notifications as they relate to parent stress. We aimed to examine associations between objective daily mobile device notifications and pickups with daily parenting stress. METHODS This was a within- and between-subjects, cross-sectional study that took place from 2020 to 2021. The study occurred during the coronavirus disease of 2019 pandemic. Data were collected in a low-contact home visit. This study included 62 parents of 62 children aged 48-71 months. Parents downloaded a passive sensing app on their Android mobile devices collecting data on duration, device notifications and device pickups. Parents completed an end-of-day stress survey for 4 days. We used random effects models to examine the variation of daily stress with smartphone duration, notification frequency, pickup frequency and device-initiated pickups, adjusting for covariates. RESULTS Parents were on average 37.3 years old (SD ± 5.7) and were predominantly mothers (82.3%). On average, parents received 293 daily notifications and picked up their phones 93 times. Duration of smartphone use and notification frequency were not associated with daily stress. Device-initiated pickups were associated with daily parent stress. CONCLUSION When notifications prompted parents to pick up their phones more often, parents experienced greater stress.
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Affiliation(s)
- Tiffany G Munzer
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - Jenny Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
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Shah PE, Poehlmann J, Weeks HM, Spinelli M, Richards B, Suh J, Kaciroti N. Developmental trajectories of late preterm infants and predictors of academic performance. Pediatr Res 2024; 95:684-691. [PMID: 37626121 DOI: 10.1038/s41390-023-02756-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 05/08/2023] [Accepted: 06/08/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND The trajectories of late preterm development from infancy to kindergarten reading and math, and predictors of academic resilience and risk are unknown. METHODS Sample included 1200 late preterm infants (LPIs) from the Early Childhood Longitudinal Study, Birth Cohort. Objective measurements of development at 9 and 24 months (Bayley-SFR) and reading and math academic achievement at preschool and kindergarten were standardized; trajectories of late preterm development from 9 months to kindergarten reading and math were identified using latent class growth analysis. Multinomial logistic regression [aOR, 95% CI] identified predictors of academic resilience and risk. RESULTS Four trajectory groups were observed for reading and three for math. More optimal trajectories (in reading and math) and academic resilience were associated with experiencing sensitive parenting and preschool attendance. Suboptimal (at-risk) trajectories (in reading or math) and an increased odds of academic risk were associated with CONCLUSIONS LPI trajectories varied from infancy to kindergarten. More sensitive parenting and preschool attendance predicted academic resilience, and should be encouraged. Select risk factors (prenatal smoking, twin/multiple gestation, male sex, IMPACT Late preterm infants (LPIs) have developmental risks compared to full terms. LPI trajectories of early reading and math varied from infancy to kindergarten. We identified predictors of academic resilience and risk, which can help inform anticipatory guidance provided to LPIs prior to kindergarten. Promotive factors (sensitive parenting and preschool enrollment) predicted academic resilience. Select maternal and neonatal characteristics (
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Affiliation(s)
- Prachi E Shah
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, MI, USA.
| | - Julie Poehlmann
- Department of Human Development and Family Studies, University of Wisconsin, Madison, WI, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Maria Spinelli
- Department of Neurosciences, Imaging and Clinical Sciences, University G. D'Annunzio Chieti-Pescara, Chieti, Italy
| | - Blair Richards
- Michigan Institute for Clinical & Health Research (MICHR), University of Michigan, Ann Arbor, MI, USA
| | - Joohee Suh
- Research Foundation for Mental Hygiene, New York, NY, USA
| | - Niko Kaciroti
- Department of Biostatistics, School of Public of Health, University of Michigan, Ann Arbor, MI, USA
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Sonneville KR, Thurston IB, Gordon AR, Richmond TK, Weeks HM, Lipson SK. Weight Stigma Associated With Mental Health Concerns Among College Students. Am J Prev Med 2024; 66:260-268. [PMID: 37758003 DOI: 10.1016/j.amepre.2023.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/21/2023] [Accepted: 09/21/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Weight stigma is widespread and exists across numerous domains including health care, educational institutions, workplaces, mass media, and interpersonal relationships. Weight stigma experienced during the college years may be particularly consequential because the college years are a period of increased vulnerability for the development of mental health concerns. The purpose of the present study was to examine how experiences of weight stigma relate to mental health concerns, including symptoms of eating disorders, anxiety, and depression, among college students. METHODS Prevalence of interpersonal and anticipated weight stigma was examined among 2,707 students participating in the 2018-2019 and 2019-2020 Healthy Minds Study and tested for differences in prevalence across student characteristics. Logistic regression was used to explore relationships between measures of weight stigma and student mental health. Analyses were conducted in 2021-2023. RESULTS Interpersonal and anticipated weight stigma were reported by 12.3% and 15.3% of students, respectively. Experiences of interpersonal and anticipated weight stigma were generally lowest among cisgender male students, heterosexual students, those with the fewest financial concerns, and those who did not perceive themselves to be "overweight." Both interpersonal and anticipated weight stigma were associated with elevated odds of high weight concerns, past-month binge eating, past-month purging, high eating disorder risk, moderate/severe anxiety symptoms, and moderate/severe depressive symptoms. CONCLUSIONS Findings implicate interpersonal and anticipated weight stigma as potential risk factors for a range of mental health concerns. Weight stigma is an under-recognized and under-funded public health problem.
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Affiliation(s)
- Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
| | - Idia B Thurston
- Departments of Health Sciences and Applied Psychology, Institute for Health Equity and Social Justice Research, Northeastern University, Boston, Massachusetts
| | - Allegra R Gordon
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Tracy K Richmond
- Division of Adolescent/Young Adult Medicine, Department of Pediatrics, Harvard Medical School, Boston Children's Hospital, Boston, Massachusetts
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Sarah K Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health, Boston, Massachusetts
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Schmid J, Linxwiler A, Owen E, Caplan H, Jenkins KR, Bauer KW, Zawistowski M, Weeks HM, Sonneville KR. Weight-inclusive, intuitive eating-based workplace wellness program associated with improvements in intuitive eating, eating disorder symptoms, internalized weight stigma, and diet quality. Eat Behav 2024; 52:101840. [PMID: 38134818 PMCID: PMC11002983 DOI: 10.1016/j.eatbeh.2023.101840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION The use of weight-inclusive programming within a workplace wellness context remains understudied. METHODS The present study is a pilot/feasibility study of a 3-month, virtual, weight-inclusive, intuitive eating-based workplace wellness program. Program participants (n = 114), who were all employees at a large public university in the Midwest, received weekly emails with a link to an instructional video related to intuitive eating and were encouraged to meet virtually with their health coach. Participants provided self-report data on behavioral and psychological outcomes including intuitive eating, internalized weight stigma, eating disorder symptoms, and diet quality at baseline, post-intervention (3 months from baseline), and follow-up (6 months from baseline). Changes in behavioral and psychological outcomes from baseline to post-intervention and follow-up were examined using paired t-tests, with Cohen's d effect sizes reported. Generalized linear models were used to examine whether participant characteristics and program engagement were associated with program outcomes. RESULTS Increases in intuitive eating and decreases in internalized weight stigma and eating disorder symptoms were seen from baseline to post-intervention (Cohen's d = 1.02, -0.47, and -0.63, respectively) and follow-up (Cohen's d = 0.86, -0.31, and -0.60). No changes in dietary quality were seen at post-intervention, but a significant reduction in intake of added sugars, fast food, and sugar sweetened beverages were observed at follow-up (Cohen's d = -0.35, -0.23, -0.25). CONCLUSIONS This study provide preliminary support for the acceptability and potential impact of a weight-inclusive workplace wellness program that should be tested in a rigorous randomized trial.
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Affiliation(s)
- Jane Schmid
- Department of Nutritional Sciences, University of Michigan School of Public Health, United States of America.
| | - Ashley Linxwiler
- Department of Nutritional Sciences, University of Michigan School of Public Health, United States of America.
| | - Erica Owen
- MHealthy, University of Michigan Health and Well-Being Services, United States of America.
| | - Heather Caplan
- Weight Inclusive Nutrition and Dietetics, United States of America.
| | - Kristi Rahrig Jenkins
- MHealthy, University of Michigan Health and Well-Being Services, United States of America.
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, United States of America.
| | - Matthew Zawistowski
- Department of Biostatistics, University of Michigan School of Public Health, United States of America.
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, United States of America.
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, United States of America.
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Ardila SM, Weeks HM, Dahmer MK, Kaciroti N, Quasney M, Sapru A, Curley MAQ, Flori HR. A Targeted Analysis of Serial Cytokine Measures and Nonpulmonary Organ System Failure in Children With Acute Respiratory Failure: Individual Measures and Trajectories Over Time. Pediatr Crit Care Med 2023; 24:727-737. [PMID: 37195096 PMCID: PMC10524322 DOI: 10.1097/pcc.0000000000003286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVES There is a need for research exploring the temporal trends of nonpulmonary organ dysfunction (NPOD) and biomarkers in order to identify unique predictive or prognostic phenotypes. We examined the associations between the number and trajectories of NPODs and plasma biomarkers of early and late inflammatory cascade activation, specifically plasma interleukin-1 receptor antagonist (IL-1ra) and interleukin-8 (IL-8), respectively, in the setting of acute respiratory failure (ARF). DESIGN Secondary analysis of the Randomized Evaluation for Sedation Titration for Respiratory Failure clinical trial and Biomarkers in Acute Lung Injury (BALI) ancillary study. SETTING Multicenter. PATIENTS Intubated pediatric patients with ARF. INTERVENTIONS NPODs were evaluated against plasma IL-1ra and IL-8 levels on individual days (1 to 4 d after intubation) and longitudinally across days. MEASUREMENTS AND MAIN RESULTS Within the BALI cohort, 432 patients had at least one value for IL-1ra or IL-8 within days 0 through 5. 36.6% had a primary diagnosis of pneumonia, 18.5% had a primary diagnosis of sepsis and 8.1% died. Multivariable logistic regression models showed that increasing levels of both plasma IL-1ra and IL-8 were statistically significantly associated with increasing numbers of NPODs (IL-1ra: days 1-3; IL-8: days 1-4), independent of sepsis diagnosis, severity of oxygenation defect, age, and race/ethnicity. Longitudinal trajectory analysis identified four distinct NPOD trajectories and seven distinct plasma IL-1ra and IL-8 trajectories. Multivariable ordinal logistic regression revealed that specific IL-1ra and IL-8 trajectory groups were associated with greater NPOD trajectory group ( p = 0.004 and p < 0.0001, respectively), independent of severity of oxygenation defect, age, sepsis diagnosis, and race/ethnicity. CONCLUSIONS Both the inflammatory biomarkers and number of NPODs exhibit distinct trajectories over time with strong associations with one another. These biomarkers and their trajectory patterns may be useful in evaluating the severity of multiple organ dysfunction syndrome in critically ill children and identifying those phenotypes with time-sensitive, treatable traits.
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Affiliation(s)
- Silvia M Ardila
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Mary K Dahmer
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
| | - Michael Quasney
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Anil Sapru
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA
| | - Martha A Q Curley
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA
- Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA
- Anesthesia and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Research Institute, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
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Firoozi R, Weeks HM, Ludwig-Borcyz E, Clayson M, Zawistowski M, Needham B, Bauer KW. Federal Food Program Participation and Beverage Intake Among Families With Low Household Income. J Nutr Educ Behav 2023; 55:469-479. [PMID: 37422323 PMCID: PMC10754373 DOI: 10.1016/j.jneb.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE Examine beverage intake among families with low income by household participation in federal food assistance programs. DESIGN Cross-sectional study conducted in fall/winter 2020 via an online survey. PARTICIPANTS Mothers of young children insured by Medicaid at the time of the child's birth (N = 493). VARIABLES MEASURED Mothers reported household federal food assistance program participation, later categorized as Supplementation Nutrition Program for Women, Infants, and Children (WIC) only, Supplemental Nutrition Assistance Program-Education (SNAP) only, both WIC and SNAP, and neither. Mothers reported beverage intake for themselves and their children aged 1-4 years. ANALYSIS Negative binomial and ordinal logistic regression. RESULTS After accounting for sociodemographic differences between groups, mothers from households participating in WIC and SNAP consumed sugar-sweetened beverages (incidence rate ratio, 1.63; 95% confidence interval [CI], 1.14-2.30; P = 0.007) and bottled water (odds ratio, 1.76; 95% CI, 1.05-2.96; P = 0.03) more frequently than mothers from households in neither program. Children from households participating in WIC and SNAP also consumed soda (incidence rate ratio, 6.07; 95% CI, 1.80-20.45; P = 0.004) more frequently than children in either program. Few differences in intake were observed for mothers or children participating in only WIC or SNAP vs both programs or neither program. CONCLUSION AND IMPLICATIONS Households participating in both WIC and SNAP may benefit from additional policy and programmatic interventions to limit sugar-sweetened beverage intake and reduce spending on bottled water.
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Affiliation(s)
- Roya Firoozi
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Elizabeth Ludwig-Borcyz
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Michelle Clayson
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Matt Zawistowski
- Department of Biostatistics University of Michigan School of Public Health, Ann Arbor, MI
| | - Belinda Needham
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI.
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Kilpatrick SK, Bauer KW, Heard-Garris N, Malone AM, Abdou CM, Weeks HM, Clayson M, Allgood KL, Dokshina D, Needham BL. Experiences of the Flint Water Crisis Among Reproductive-Age Michigan Women in Communities Outside of Flint: Differences by Race and Ethnicity. J Racial Ethn Health Disparities 2023; 10:993-1005. [PMID: 35320509 PMCID: PMC8941828 DOI: 10.1007/s40615-022-01287-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 02/17/2022] [Accepted: 02/19/2022] [Indexed: 11/02/2022]
Abstract
We sought to understand how women in Michigan communities outside of Flint experienced the Flint water crisis, an avoidable public health disaster widely attributed to structural racism. Using survey data from 950 Michigan women aged 18-45 from communities outside of Flint, we examined racial and ethnic differences in personal connections to Flint, perceived knowledge about the water crisis, and beliefs about the role of anti-Black racism in the water crisis factors that could contribute to poor health via increased psychological stress. We found that White (OR = 0.32; 95% CI: 0.22, 0.46) and Hispanic (OR = 0.21; 95% CI: 0.09, 0.49) women had lower odds than Black women of having family or friends who lived in Flint during the water crisis. Compared to Black women, White women were less likely to be moderately or very knowledgeable about the water crisis (OR = 0.58; 95% CI: 0.41, 0.80). White women (OR = 0.26; 95% CI: 0.18, 0.37), Hispanic women (OR = 0.38; 95% CI: 0.21, 0.68), and women of other races (OR = 0.28; 95% CI: 0.15, 0.54) were less likely than Black women to agree that the water crisis happened because government officials wanted to hurt Flint residents. Among those who agreed, White women (OR = 0.47; 95% CI: 0.30, 0.74) and women of other races (OR = 0.33; 95% CI: 0.12, 0.90) were less likely than Black women to agree that government officials wanted to hurt people in Flint because most residents are Black. We conclude that the Flint water crisis was a racialized stressor, with potential implications for the health of reproductive-age Black women.
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Affiliation(s)
- Sidonie K. Kilpatrick
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Nia Heard-Garris
- Division of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine, and Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation Center, Stanley Manne Children’s Research Institute, Ann & Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, Chicago, IL 60611 USA
| | - Anita M. Malone
- Division of Women’s Health, Department of Obstetrics and Gynecology, University of Michigan Medical School, Michigan Medicine Health, 1500 E. Medical Center Dr., Ann Arbor, MI 48109 USA
| | - Cleopatra M. Abdou
- Suzanne Dworak-Peck School of Social Work, University of Southern California, 669 W 34th St, Los Angeles, CA 90089 USA
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Michelle Clayson
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Kristi L. Allgood
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Darya Dokshina
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
| | - Belinda L. Needham
- Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48104 USA
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Shah PE, Hirsh-Pasek K, Spinelli M, Ozor J, Weeks HM, McCaffery H, Kaciroti N. Ecological contexts associated with early childhood curiosity: Neighborhood safety, home and parenting quality, and socioeconomic status. Front Psychol 2023; 14:986221. [PMID: 36925599 PMCID: PMC10011070 DOI: 10.3389/fpsyg.2023.986221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 02/06/2023] [Indexed: 03/08/2023] Open
Abstract
Introduction Curiosity is an important social-emotional process underlying early learning. Our previous work found a positive association between higher curiosity and higher academic achievement at kindergarten, with a greater magnitude of benefit for children with socioeconomic disadvantage. Because characteristics of the early caregiving and physical environment impact the processes that underlie early learning, we sought to examine early environmental experiences associated with early childhood curiosity, in hopes of identifying modifiable contexts that may promote its expression. Methods Using data from a nationally representative sample of 4,750 children from the United States, this study examined the association of multi-level ecological contexts (i.e., neighborhood safety, parenting quality, home environment, and center-based preschool enrollment) on early childhood curiosity at kindergarten, and tested for moderation by socioeconomic status. Results In adjusted, stratified models, children from lower-resourced environments (characterized by the lowest-SES tertile) manifested higher curiosity if they experienced more positive parenting, higher quality home environments, and if they lived in "very safe" neighborhoods. Discussion We discuss the ecological contexts (i.e., parenting, home, and neighborhood environments) that are promotive of early childhood curiosity, with an emphasis on the role of the neighborhood safety and the "neighborhood built environment" as important modifiable contexts to foster early childhood curiosity in lower-resourced families.
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Affiliation(s)
- Prachi E. Shah
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Kathy Hirsh-Pasek
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Maria Spinelli
- Department of Neuroscience, Imaging and Clinical Science, University Gabriele d’Annunzio Chieti-Pescara, Chieti, Italy
| | - Jenny Ozor
- Department of Public Policy and Government Affairs, CareFirst Blue Cross Blue Shield, Washington, DC, United States
| | - Heidi M. Weeks
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Harlan McCaffery
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
| | - Niko Kaciroti
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
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Radesky JS, Kaciroti N, Weeks HM, Schaller A, Miller AL. Longitudinal Associations Between Use of Mobile Devices for Calming and Emotional Reactivity and Executive Functioning in Children Aged 3 to 5 Years. JAMA Pediatr 2022; 177:62-70. [PMID: 36508199 PMCID: PMC9857453 DOI: 10.1001/jamapediatrics.2022.4793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
IMPORTANCE Mobile devices are often used to keep young children occupied or calm, but it is not known whether this practice influences child development. OBJECTIVE To examine the longitudinal, bidirectional associations between the parent-reported frequency of using mobile devices to calm young children and children's executive functioning (EF) and emotional reactivity, testing moderation by child sex and temperament. DESIGN, SETTING, AND PARTICIPANTS This prospective cohort study included a community-based convenience sample of English-speaking parents of typically developing children aged 3 to 5 years. The study duration was from August 2018 to January 2020, with baseline (T1), 3-month follow-up (T2), and 6-month follow-up (T3) waves. EXPOSURES Parent-reported frequency of use of mobile devices to calm children when upset (5-point Likert scale). MAIN OUTCOMES AND MEASURES At each wave, the child's EF was assessed with the Behavior Rating Inventory of Executive Function-Preschool Version Global Executive Composite and emotional reactivity with the Child Behavior Checklist Emotional Reactivity subscale. Structural equation models were built to examine cross-lagged associations of the use of devices for calming, EF, and emotional reactivity, testing for moderation by child sex or temperament (Child Behavior Questionnaire-Very Short Form surgency score, median split). RESULTS Of 422 eligible parents with data at T1, 375 (88.9%) provided data at T2 and 366 (86.7%) at T3. At baseline, the mean (SD) age of the 422 children was 3.8 (0.5) years, the number of boys in the sample was 224 (53.1%), the number of individuals of non-Hispanic White race and ethnicity was 313 (74.2%), and among the parents, 254 (60.2%) had a college degree or higher. Among the boys, the use of devices to calm at T2 was associated with higher emotional reactivity at T3 (r [standardized regression coefficient] = 0.20; 95% CI, 0.10-0.30), while higher emotional reactivity at T2 had a nonsignificant association with increased device use for calming at T3 (r = 0.10; 95% CI, -0.01 to 0.21). Among children with high temperamental surgency, the use of devices to calm at T2 was associated with increased emotional reactivity at T3 (r = 0.11; 95% CI, 0.01-0.22), while higher emotional reactivity at T2 was associated with increased device use for calming at T3 (r = 0.13; 95% CI, 0.02-0.24). CONCLUSIONS AND RELEVANCE The findings of this study suggest that the frequent use of mobile devices for calming young children may displace their opportunities for learning emotion-regulation strategies over time; therefore, pediatric health care professionals may wish to encourage alternate calming approaches.
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Affiliation(s)
- Jenny S. Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor
| | | | - Alison L. Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
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Danet M, Miller AL, Weeks HM, Kaciroti N, Radesky JS. Children aged 3-4 years were more likely to be given mobile devices for calming purposes if they had weaker overall executive functioning. Acta Paediatr 2022; 111:1383-1389. [PMID: 35238076 DOI: 10.1111/apa.16314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/26/2022] [Accepted: 02/28/2022] [Indexed: 12/30/2022]
Abstract
AIM Young children with weaker self-regulation use more digital media, but studies have been limited by parent-reported screen time measures. We examine associations between early childhood executive functioning and objective mobile device usage. METHODS The parents of 368 American children (51.6% male) aged 3-4 years of age completed standardised measures of executive functioning, parenting stress and household chaos. They provided mobile sampling data for 1 week in 2018-2019 and reported how often the children used mobile devices to calm themselves. RESULTS The children's mean age was about 3.8 years. A third of the children who were given devices to calm them down had weaker executive functioning in the overall and multivariable models, including working memory, planning and organisation. So did 39.7% of the children who used educational apps. Streaming videos, using age-inappropriate apps and using the mobile device for more than1 h per day were not associated with executive functioning levels. Parenting stress and household chaos did not moderate the associations. CONCLUSION This study confirms previous studies that suggesting that children with weaker overall executive functioning used devices more for calming purposes. It also raises questions about whether children with weaker executive functioning should use educational apps.
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Affiliation(s)
- Marie Danet
- University of Lille Univ. Lille, ULR 4072–PSITEC–Psychologie: Interactions, Temps, Emotions, Cognition Lille France
| | - Alison L. Miller
- School of Public Health University of Michigan Ann Arbor Michigan USA
| | - Heidi M. Weeks
- School of Public Health University of Michigan Ann Arbor Michigan USA
| | - Niko Kaciroti
- School of Public Health University of Michigan Ann Arbor Michigan USA
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11
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Radesky J, Hiniker A, McLaren C, Akgun E, Schaller A, Weeks HM, Campbell S, Gearhardt AN. Prevalence and Characteristics of Manipulative Design in Mobile Applications Used by Children. JAMA Netw Open 2022; 5:e2217641. [PMID: 35713902 PMCID: PMC9206186 DOI: 10.1001/jamanetworkopen.2022.17641] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
IMPORTANCE Manipulative design features (known as dark patterns) are common in video games and adult-directed technologies, but their prevalence in children's interactive media has not been described. OBJECTIVES To develop a reliable coding scheme for gathering data on manipulative digital designs, describe their prevalence within apps used by a community-based sample of young children, and test hypotheses about associations of manipulative design features with socioeconomic status (SES). DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study of a convenience sample of parents of children aged 3 to 5 years was conducted online. Eligible parents were legal guardians of a 3-to-5-year-old child, lived with their child at least 5 days per week, understood English, and were part of a family that owned at least 1 Android or iOS tablet or smartphone. For each participant, the 3 apps used for the longest duration by children with their own mobile devices were downloaded, played, and coded. Data were analyzed between April and August 2021. EXPOSURES Child SES, operationalized as parent educational attainment and household income-to-needs ratio. MAIN OUTCOMES AND MEASURES Researchers assigned each child a prevalence score for manipulative design features (overall, gameplay pressure, purchase pressure, and advertisement viewing pressure) within the apps children played. RESULTS Of 160 children in the sample, mean (SD) age was 4.0 (0.6) years; 120 children (75.0%) were non-Hispanic White, and 96 (60.0%) had a parent with a college degree or more. Manipulative designs promoted prolonged gameplay or purchases through 4 user experience typologies: parasocial relationship pressure occurred in 33 (24.8%) and 25 (18.8%) apps with characters; time pressure in 23 (17.3%) and 14 (10.5%) apps; navigation constraints in 61 (45.9%) and 49 (36.8%) apps; and attractive lures in 60 (45.1%) and 61 (45.9%) apps, respectively. Children from households whose parents had lower education levels had higher manipulative design prevalence scores than children whose parents had graduated from college (median [IQR] 3.7 [2.5-5.0] vs 3.0 [2.0-4.0]; P = .02), gameplay-prolonging design (2.3 [1.6-3.0] vs 2.0 [1.5-2.8]; P = .047), and purchase pressure (1.0 [0.5-1.5] vs 0.6 [0-1.3]; P = .02). Purchase pressure prevalence scores were higher for children from households with lower income (R = -0.18; P = .02). CONCLUSIONS AND RELEVANCE Design features that encourage monetization of children's digital experiences were common in this sample and disproportionately occurred in apps used by children with lower SES.
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Affiliation(s)
- Jenny Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | | | - Caroline McLaren
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Eliz Akgun
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | | | - Heidi M. Weeks
- University of Michigan School of Public Health, Ann Arbor
| | - Scott Campbell
- Department of Communication and Media Studies, University of Michigan, Ann Arbor
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12
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Bauer KW, Weeks HM, Clayson M, Needham B. Perceptions of tap water associated with low-income Michigan mothers' and young children's beverage intake. Public Health Nutr 2022; 25:1-10. [PMID: 35570674 PMCID: PMC9666652 DOI: 10.1017/s1368980022001136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 03/14/2022] [Accepted: 04/19/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To quantify perceptions of tap water among low-income mothers with young children residing in Michigan and examine associations between perceptions of tap water, mothers' and young children's beverage intake, and mothers' infant feeding practices. DESIGN Cross-sectional study. SETTING Online survey. PARTICIPANTS Medicaid-insured individuals who had given birth at a large Midwestern US hospital between fall 2016 and fall 2020 were invited by email to complete a survey in winter 2020 (N 3881); 15·6 % (N 606) completed eligibility screening, 550 (90·8 %) were eligible to participate, and 500 (90·9 %) provided valid survey data regarding perceptions of tap water, self and child beverage intake, and infant feeding practices. RESULTS Two-thirds (66·2 %) of mothers reported that their home tap water was safe to drink without a filter, while 21·6 % were unsure about the safety of their home tap water. Mothers' perceptions of their home tap water were associated with their own tap and bottled water intake and their young children's tap water and bottled water intake. Mothers with more negative perceptions of tap water in general, independent of their perceptions about their home tap water, consumed more bottled water and sugar-sweetened beverages, and their young children drank bottled water and fruit drinks more frequently. Few associations were observed between mothers' perceptions of tap water and infant feeding practices. CONCLUSIONS Uncertainty about tap water safety and negative perceptions of tap water are common among low-income Michigan mothers. These beliefs may contribute to less healthful and more costly beverage intake among mothers and their young children.
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Affiliation(s)
- Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI48104, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI48104, USA
| | - Michelle Clayson
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI48104, USA
| | - Belinda Needham
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
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13
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Radesky JS, Seyfried JL, Weeks HM, Kaciroti N, Miller AL. Video-Sharing Platform Viewing Among Preschool-Aged Children: Differences by Child Characteristics and Contextual Factors. Cyberpsychol Behav Soc Netw 2022; 25:230-236. [PMID: 35426731 PMCID: PMC9051865 DOI: 10.1089/cyber.2021.0235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Free video-sharing platforms such as YouTube are highly popular among young children but may contain low-quality and highly commercialized content. This study aimed to describe the prevalence, duration, and timing of objectively measured mobile YouTube viewing in preschool-aged children and test hypotheses about associations with child individual differences and contextual factors. We analyzed mobile sampling data from 349 English-speaking children aged 3-4.99 years whose parents completed surveys about child, parent, and household characteristics. We assessed whether the child ever viewed YouTube during the sampling week and calculated average daily duration in a subsample of 121 participants with their own mobile devices. We built multivariable logistic regression models to test correlates of mobile YouTube viewership and duration. Children were 3.82 years (SD 0.53), 74.6 percent white non-Hispanic; parents were mostly mothers (93.7 percent), 34.0 (SD 4.6) years, and 37.9 percent had less than a college degree. Mobile YouTube viewing (37.0 percent of children) was more likely in children who used Android devices, shared mobile devices with family members, were older, attended home-based childcare, or had parents with lower educational attainment. Median YouTube duration was 61.2 min/day, with longer durations in children whose parents had lower educational attainment. These results demonstrate that many young children use free video-sharing platforms on mobile devices for long durations, and this practice may be disproportionately higher in children from lower socioeconomic status. Longitudinal research is needed on video-sharing platform viewing and child outcomes.
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Affiliation(s)
- Jenny S. Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Address correspondence to: Dr. Jenny S. Radesky, Department of Pediatrics, University of Michigan Medical School, 300 N Ingalls Street, #1107, Ann Arbor, MI 48109, USA
| | - Jennifer L. Seyfried
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Alison L. Miller
- Department of Health Behavior and Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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14
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Dahmer MK, Yang G, Zhang M, Quasney MW, Sapru A, Weeks HM, Sinha P, Curley MAQ, Delucchi KL, Calfee CS, Flori H, Matthay MA, Bateman ST, Berg MD, Borasino S, Bysani GK, Cowl AS, Bowens CD, Faustino VS, Fineman LD, Godshall AJ, Hirshberg EL, Kirby AL, McLaughlin GE, Medar SS, Oren PP, Schneider JB, Schwarz AJ, Shanley TP, Source LR, Truemper EJ, Vender Heyden MA, Wittmayer K, Zuppa AF, Wypij D. Identification of phenotypes in paediatric patients with acute respiratory distress syndrome: a latent class analysis. Lancet Respir Med 2022; 10:289-297. [PMID: 34883088 PMCID: PMC8897230 DOI: 10.1016/s2213-2600(21)00382-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Previous latent class analysis of adults with acute respiratory distress syndrome (ARDS) identified two phenotypes, distinguished by the degree of inflammation. We aimed to identify phenotypes in children with ARDS in whom developmental differences might be important, using a latent class analysis approach similar to that used in adults. METHODS This study was a secondary analysis of data aggregated from the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) clinical trial and the Genetic Variation and Biomarkers in Children with Acute Lung Injury (BALI) ancillary study. We used latent class analysis, which included demographic, clinical, and plasma biomarker variables, to identify paediatric ARDS (PARDS) phenotypes within a cohort of children included in the RESTORE and BALI studies. The association of phenotypes with clinically relevant outcomes and the performance of paediatric data in adult ARDS classification algorithms were also assessed. FINDINGS 304 children with PARDS were included in this secondary analysis. Using latent class analysis, a two-class model was a better fit for the cohort than a one-class model (p<0·001). Latent class analysis identified two classes: class 1 (181 [60%] of 304 patients with PARDS) and class 2 (123 [40%] of 304 patients with PARDS), referred to as phenotype 1 and 2 hereafter. Phenotype 2 was characterised by higher concentrations of inflammatory biomarkers, a higher incidence of vasopressor use, and more frequent diagnosis of sepsis, consistent with the adult hyperinflammatory phenotype. All levels of severity of PARDS were observed across both phenotypes. Children with the hyperinflammatory phenotype (phenotype 2) had worse clinical outcomes than those with the hypoinflammatory phenotype (phenotype 1), with a longer duration of mechanical ventilation (median 10·0 days [IQR 6·3-21·0] for phenotype 2 vs 6·6 days [4·1-10·8] for phenotype 1, p<0·0001), and higher incidence of mortality (17 [13·8%] of 123 patients vs four [2·2%] of 181 patients, p=0·0001). When using adult phenotype classification algorithms in children, the soluble tumour necrosis factor receptor-1 (sTNFr1), vasopressor use, and interleukin (IL)-6 variables gave an area under the curve (AUC) of 0·956, and the sTNFr1, vasopressor use, and IL-8 variables gave an AUC of 0·954, compared with the gold standard of latent class analysis. INTERPRETATION Latent class analysis identified two phenotypes in children with ARDS with characteristics similar to those in adults, including worse outcomes among patients with the hyperinflammatory phenotype. PARDS phenotypes should be considered in design and analysis of future clinical trials in children. FUNDING US National Institutes of Health.
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Affiliation(s)
- Mary K Dahmer
- Department of Pediatrics, Division of Critical Care Medicine, University of Michigan, Ann Arbor, MI, USA.
| | - Guangyu Yang
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Min Zhang
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Michael W Quasney
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Anil Sapru
- Department of Pediatrics, University of California, Los Angeles, Los Angeles, CA
| | - Heidi M. Weeks
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI
| | - Pratik Sinha
- Department of Anesthesia, Washington University, St. Louis, MO
| | - Martha AQ Curley
- Department of Family and Community Health (School of Nursing), Division of Anesthesia and Critical Care Medicine (Perelman School of Medicine) University of Pennsylvania, Philadelphia, PA; Research Institute; Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Kevin L Delucchi
- Department of Psychiatry & Behavioral Sciences, University of California, San Francisco, San Francisco, CA
| | - Carolyn S Calfee
- Department of Medicine, Division of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, San Francisco, CA
| | - Heidi Flori
- Department of Pediatrics, Division of Critical Care Medicine, University of Michigan, Ann Arbor, MI
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15
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Luan D, Foster GD, Fisher JO, Weeks HM, Polonsky HM, Davey A, Sherman S, Abel ML, Bauer KW. Breakfast in the Classroom Initiative Does Not Improve Attendance or Standardized Test Scores among Urban Students: A Cluster Randomized Trial. J Acad Nutr Diet 2021; 122:1168-1173.e2. [PMID: 34923177 DOI: 10.1016/j.jand.2021.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 12/09/2021] [Accepted: 12/13/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Breakfast in the Classroom (BIC), a common approach to implementing the federal School Breakfast Program, is advocated as a method to improve students' academic performance. However, the impacts of BIC on academic outcomes are unclear. OBJECTIVE To examine the effect of a BIC initiative which provided free, universal BIC on attendance and standardized test performance over 2.5 years, versus free universal breakfast served in the cafeteria before school, among students in an urban school district serving a low-income population. DESIGN Secondary analysis of data from a cluster randomized controlled trial conducted between 2013 and 2016; sixteen kindergarten through 8th grade public schools in Philadelphia, Pennsylvania were enrolled and randomized to condition. Baseline data for 1,362 4th through 6th grade students were provided by the school district. Midpoint data were collected after 1.5 years and endpoint data after 2.5 years. PARTICIPANTS/SETTING Schools were eligible if ≥50% of students qualified for free/reduced-priced meals, did not offer BIC, and received programming as part of the USDA's Supplemental Nutrition Assistance Program. Parents consented for their children to participate. INTERVENTION Intervention schools provided BIC and breakfast-related nutrition promotion activities. Control schools provided breakfast in the cafeteria before the school day. MAIN OUTCOME MEASURES Student attendance and standardized exam scores. STATISTICAL ANALYSES PERFORMED Weighted generalized estimating equations were used to evaluate differences in outcomes between conditions at midpoint and endpoint. RESULTS The BIC initiative did not impact attendance (Beta (SE) = 0.004 (0.06), P = 0.94) or standardized reading exam scores (Beta (SE) = 0.02 (0.06), P = 0.79) after 2.5 years. Students in BIC initiative schools had lower standardized math exam scores than those in control schools although this difference was small (Beta (SE) = -0.20 (0.07), P = 0.005). CONCLUSIONS BIC did not improve academic outcomes among students attending low-income, urban schools.
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Affiliation(s)
- Danny Luan
- Graduate student at the University of Michigan School of Public Health, Ann Arbor, MI at the time of this research. Mr. Luan is currently a medical student at Weill Cornell Medicine, New York, NY
| | - Gary D Foster
- WW International, New York NY and Adjunct Professor, Center for Weight and Eating Disorders, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA
| | - Jennifer O Fisher
- Department of Social & Behavioral Sciences, College of Public Health, Temple University, Philadelphia PA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor MI
| | - Heather M Polonsky
- Study coordinator Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia PA at the time of this research. Ms. Polonsky is currently Associate Director of Evaluation, FoodCorps, Portland OR
| | - Adam Davey
- College of Health Sciences and Department of Behavioral Health and Nutrition, University of Delaware, Newark DE
| | | | - Michelle L Abel
- School Breakfast Policy Manager at The Food Trust, Philadelphia PA at the time of this research. Ms. Abel is currently a Program Manager at Children's Hospital of Philadelphia, Philadelphia PA
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor MI.
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16
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Shah PE, Hirsh-Pasek K, Kashdan TB, Harrison K, Rosenblum K, Weeks HM, Singh P, Kaciroti N. Daily television exposure, parent conversation during shared television viewing and socioeconomic status: Associations with curiosity at kindergarten. PLoS One 2021; 16:e0258572. [PMID: 34710118 PMCID: PMC8553096 DOI: 10.1371/journal.pone.0258572] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 09/30/2021] [Indexed: 11/23/2022] Open
Abstract
Objective To examine the main and interactive effects of the amount of daily television exposure and frequency of parent conversation during shared television viewing on parent ratings of curiosity at kindergarten, and to test for moderation by socioeconomic status (SES). Study design Sample included 5100 children from the Early Childhood Longitudinal Study, Birth Cohort. Hours of daily television exposure and frequency of parent screen-time conversation were assessed from a parent interview at preschool, and the outcome of early childhood curiosity was derived from a child behavior questionnaire at kindergarten. Multivariate linear regression examined the main and interactive effects of television exposure and parent screen-time conversation on kindergarten curiosity and tested for moderation by SES. Results In adjusted models, greater number of hours of daily television viewing at preschool was associated with lower curiosity at kindergarten (B = -0.14, p = .008). More frequent parent conversation during shared screen-time was associated with higher parent-reported curiosity at kindergarten with evidence of moderation by SES. The magnitude of association between frequency of parent conversation during television viewing and curiosity was greater for children from low SES environments, compared to children from high SES environments: (SES ≤ median): B = 0.29, p < .001; (SES > median): B = 0.11, p < .001. Conclusions Higher curiosity at kindergarten was associated with greater frequency of parent conversation during shared television viewing, with a greater magnitude of association in low-SES families. While the study could not include measures of television program content, digital media use and non-screen time conversation, our results suggest the importance of parent conversation to promote early childhood curiosity, especially for children with socioeconomic disadvantage.
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Affiliation(s)
- Prachi E. Shah
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, United States of America
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, United States of America
- * E-mail:
| | - Kathy Hirsh-Pasek
- Department of Psychology, Temple University, Philadelphia, PA, United States of America
| | - Todd B. Kashdan
- Department of Psychology and Center for the Advancement of Well-Being, George Mason University, Fairfax, VA, United States of America
| | - Kristen Harrison
- Department of Communication and Media, University of Michigan, Ann Arbor, MI, United States of America
| | - Katherine Rosenblum
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, United States of America
| | - Heidi M. Weeks
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
| | - Priya Singh
- Department of Pediatrics, University of Cincinnati Medical School, Cincinnati, OH, United States of America
| | - Niko Kaciroti
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States of America
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17
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Hahn SL, Barry MR, Weeks HM, Miller AL, Lumeng JC, Sonneville KR. Parental perceptions of actual and ideal body weight in early childhood prospectively predict adolescent perceptions of actual and ideal body weight among a low-income population. Eat Weight Disord 2021; 26:2371-2379. [PMID: 33389717 PMCID: PMC10370320 DOI: 10.1007/s40519-020-01088-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/01/2020] [Indexed: 11/27/2022] Open
Abstract
PURPOSE To examine the longitudinal associations between parental perceptions of their child's actual weight (PPCA = parental perception of child's actual) and ideal weight (PPCI = parental perception of child ideal) in early childhood and the child's own perceptions of their actual weight (APA = adolescent perceived actual) and ideal weight (API = adolescent perceived ideal) during early adolescence among a low-income population. METHODS Using a longitudinal study design, 136 child/parent pairs were asked to assess the child's actual and ideal weight using figure rating scales. When children were 4-7 years old, parents reported on their perception of their child's weight; when children were 10-12 years old, the child reported on their own weight perceptions. Actual weight, ideal weight, and the difference between ideal and actual weight perception were assessed at the respective timepoints. Regressions were used to examine the relationship between parental weight perceptions (PPCA and PPCI) and later adolescent weight perception (APA and API). RESULTS On average, PPCI was higher than PPCA, whereas API was lower than APA. We found a positive relationship between PPCI and API (β = 0.309, p = .029). PPCA was positively associated with API (β = 0.304, p = .015) and marginally positively associated with the APA (β = 0.242, p = .077). However, the difference between PPCI and PPCA did not predict either APA or API. CONCLUSIONS Parental perception of their child's weight may relate to the adolescent's weight perception, particularly ideal weight. However, several null and marginal associations suggest that parental weight perception in early childhood may not be the most salient factor in determining weight perception in early adolescence. LEVEL OF EVIDENCE Level III, well-designed longitudinal cohort study.
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Affiliation(s)
- Samantha L Hahn
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, 55454, USA.
- Department of Psychiatry and Behavioral Health, Medical School, University of Minnesota, Minneapolis, MN, 55454, USA.
| | - Mikayla R Barry
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
| | - Julie C Lumeng
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, 48109, USA
| | - Kendrin R Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA
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18
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Quinn M, Herty L, Weeks HM, Kwan J, Haines J, Bauer KW. Low-income mothers' perspectives on the involvement of family members in child feeding. Appetite 2021; 168:105683. [PMID: 34496273 DOI: 10.1016/j.appet.2021.105683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 11/02/2022]
Abstract
Nearly all research on child feeding has focused on mothers. Very little is known about other family members' roles in feeding children nor how mothers engage with these family members regarding child feeding. The objective of this study was to examine mothers' perceptions of other family members' child feeding roles and practices within low-income families, including the challenges experienced and strategies employed by mothers when sharing responsibility for child feeding. Low-income mothers (n = 100) of pre-adolescent children participated in semi-structured interviews regarding child feeding including shared responsibility for child feeding. A content analysis was then conducted to identify main themes in mothers' responses, with three main themes arising from the interviews. First, many family members were actively involved in child feeding and food-related decision-making. The majority of mothers (85%) reported that another family member was involved in feeding their child including fathers and father figures, who were involved in feeding in 63% of families. Other family members, mainly grandparents, were involved in feeding in 35% of families. Mothers identified several concerns regarding their child's eating when with other family members, particularly when grandparents fed children. Finally, mothers employed several strategies to control their children's eating when children were cared for by other family members. Future interventions to promote healthy child feeding among low-income families may benefit from helping mothers negotiate child feeding with other family members, particularly grandparents, and supporting family members' engagement in child feeding.
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Affiliation(s)
- Martha Quinn
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Lauren Herty
- Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Janice Kwan
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jess Haines
- Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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19
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Gorlick JC, Gorman CV, Weeks HM, Pearlman AT, Schvey NA, Bauer KW. "I Feel Like Less of a Mom": Experiences of Weight Stigma by Association among Mothers of Children with Overweight and Obesity. Child Obes 2021; 17:68-75. [PMID: 33373542 PMCID: PMC7815062 DOI: 10.1089/chi.2020.0199] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: Parents of children with higher weight are blamed and shamed for their children's weight. However, parents' experiences of this form of stigma, termed weight stigma by association, are poorly understood. The objective of this study was to investigate the sources, forms, and impacts of weight stigma by association among mothers of children with overweight or obesity. Methods: In this qualitative study, mothers who reported concern about their children's weight participated in semistructured interviews administered by the research team. A coding scheme was developed and reliably applied to interview transcripts. Mothers' self-reported sociodemographic information, and height and weight were measured. Results: Thirty-four mothers (Mage: 43.4 years; 26.5% non-Hispanic Black or African American, 70.6% with obesity) participated in the study. Mothers reported that family members were a common source of negative comments about their children's weight; these comments were often critical of mothers' parenting and in some cases contributed to negative affect among mothers. Many mothers also reported negative experiences during children's physicians' visits as a result of their children's weight. Almost all mothers expressed guilt and sadness for their perceived role in their children's weight status, expressing regret that they did not parent differently. Conclusions: Mothers of children with overweight and obesity are frequently the target of weight stigma by association and experience negative cognitions and emotions regarding their perceived role in their children's weight. Continued research is needed to elucidate the impacts of stigma by association due to child weight on parents' health, the parent/child relationship, and children's health.
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Affiliation(s)
- Jenna C. Gorlick
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Claire V. Gorman
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Arielle T. Pearlman
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Natasha A. Schvey
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
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20
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Abstract
IMPORTANCE Child-directed mobile applications (apps) have been found to collect digital identifiers and transmit them to third-party companies, a potential violation of federal privacy rules. This study seeks to examine the differences in app data collection and sharing practices by evaluating the sociodemographic characteristics of the children who play them. OBJECTIVE To examine data collection and sharing practices of 451 apps played by young children and to test associations with child sociodemographic characteristics. DESIGN, SETTING, AND PARTICIPANTS This study used data from the baseline phase of the Preschooler Tablet Study, a prospective cohort study conducted from August 2018 to January 2020. This study used a population-based sample. A convenience sample of the parents of preschool-aged children was recruited from pediatric offices, childcare centers, social media posts, and an online participant registry. Eligibility criteria included (1) parent or guardian of a child aged 3 to 5 years, (2) parent or guardian who lived with the child at least 5 days per week, (3) participants who spoke English, and (4) a child who used an Android (Google LLC) device. All interactions with participants were through email, online surveys, and mobile device sampling. EXPOSURES Sociodemographic characteristics were assessed by parental report. MAIN OUTCOMES AND MEASURES This study tested the hypothesis that data transmissions to third-party domains are more common in apps played by children from low-socioeconomic-status homes. Child app usage was assessed via a mobile sampling app for an average of 9 days. Persistent identifier data transmissions to third-party domains were quantified for each app using an instrumented Android environment with monitoring of network traffic; for each child, the counts of total data transmissions were calculated, and the total third-party domains were detected for the apps they played. RESULTS Our sample comprised 124 children who used Android devices (35 tablets, 89 smartphones; 65 girls [52%]; mean [SD] age, 3.85 [0.57] years; 87 non-Hispanic White [71%]). One hundred twenty of participating parents (97%) were women. Of 451 apps tested, 303 (67%) transmitted persistent identifiers to 1 to 33 third-party domains. Child data transmission counts ranged from 0 to 614 (median [interquartile range], 5.0 [1-17.5]) and third-party domain counts from 0 to 399 (4.0 [1-12.5]). In multivariable negative binomial regression models, higher transmission and third-party domain rates per app were positively associated with older age (rate ratio, 1.67 [95% CI, 1.20-2.33]; P = .002 and 1.69 [95% CI, 1.26-2.27]; P < .001, respectively) and lower parent educational attainment (eg, high school or General Educational Development or less rate ratio, 2.29 [95% CI, 1.20-4.39]; P = .003 and 2.05 [95% CI, 1.13-3.70]; P < .02, respectively), but not with household income. CONCLUSIONS AND RELEVANCE This study found that apps used by young children had a high frequency of persistent identifier transmissions to third-party companies, suggesting that federal privacy rules are not being enforced. Older children, those with their own devices, or those from lower-education households may be at higher risk of potential privacy violations.
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Affiliation(s)
- Fangwei Zhao
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Serge Egelman
- Usable Security and Privacy Group, International Computer Science Institute, Berkeley, California
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor
| | - Alison L. Miller
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | - Jenny S. Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor ,Center for Human Growth and Development, University of Michigan, Ann Arbor
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21
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Ward SL, Dahmer MK, Weeks HM, Sapru A, Quasney MW, Curley MAQ, Liu KD, Matthay MA, Flori HR. Association of patient weight status with plasma surfactant protein D, a biomarker of alveolar epithelial injury, in children with acute respiratory failure. Pediatr Pulmonol 2020; 55:2730-2736. [PMID: 32725941 PMCID: PMC8087214 DOI: 10.1002/ppul.24990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 01/01/2023]
Abstract
AIMS AND OBJECTIVES Alveolar epithelial injury is a key determinant of acute respiratory failure (ARF) severity. Plasma surfactant protein D (SP-D), a biomarker of alveolar epithelial injury, is lower in obese adults with ARF compared to their lean peers. We aimed to determine if children with ARF have similar variance in plasma SP-D associated with their weight status on admission. METHODS Plasma SP-D was measured on days 0, 1, or 2 in children (1-18 years) with ARF enrolled in the genetic variation and biomarkers in children with acute lung injury and RESTORE studies. Weight classification (underweight, normal, overweight, and obese) was based on body mass index or weight-for-height z-scores. Associations between weight group and SP-D on each day were tested. RESULTS Inclusion criteria were met in 212 subjects, 24% were obese. There were no differences among weight groups in SP-D levels on days 0 and 1. However, on day 2, there was a statistically significant linear trend for lower SP-D levels as weight increased in both the univariate analysis (P = .02) and when adjusting for age, ethnicity, and diagnosis of pediatric acute respiratory distress syndrome (P = .05). CONCLUSIONS Obesity was associated with lower plasma SP-D levels on day 2 of ARF. This finding may be explained by altered ARF pathogenesis in obese individuals or a reduced incidence of ventilator-induced lung injury.
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Affiliation(s)
- Shan L Ward
- Division of Critical Care, Department of Pediatrics, UCSF Benioff Children's Hospitals, San Francisco and Oakland, California
| | - Mary K Dahmer
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Anil Sapru
- Division of Critical Care Medicine, Department of Pediatrics, Mattel Children's Hospital at UCLA Medical Center, Los Angeles, California
| | - Michael W Quasney
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
| | - Martha A Q Curley
- Division of Anesthesia and Critical Care Medicine, Department of Family and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Children's Hospital of Philadelphia Research Institute, Philadelphia, Pennsylvania
| | - Kathleen D Liu
- Department of Medicine, UCSF Medical Center, San Francisco, California
| | - Michael A Matthay
- Department of Anesthesia, UCSF Medical Center, San Francisco, California.,UCSF Medical Center, Cardiovascular Research Institute, San Francisco, California
| | - Heidi R Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, Michigan
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22
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Bauer KW, Weeks HM, Shah K, Ludwig-Borycz E, Riley H, Lumeng JC, Miller AL. Observed restrictive feeding practices among low-income mothers of pre-adolescents. Pediatr Obes 2020; 15:e12666. [PMID: 32537901 DOI: 10.1111/ijpo.12666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 04/25/2020] [Accepted: 04/28/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To describe verbal and non-verbal restrictive feeding practices used by low-income mothers with their pre-adolescent children during a laboratory-based protocol, and examine associations between mother/child anthropometrics, child appetitive traits and mothers' restrictive practices. METHODS Mothers and children (dyad n = 108, mean child age = 11.0 years [SD = 1.2]) were provided a standardized meal and then buffet of desserts. Sessions were video-recorded, and trained coders reliably identified positive and negative restrictive statements, non-verbal restrictive behaviours and redirection to healthier foods. Mother/child anthropometrics were measured by trained study staff and child appetitive traits reported by mothers using subscales of the Children's Eating Behaviours Questionnaire. Negative binomial regression was used to examine associations between mother/child characteristics and restrictive practices. RESULTS Nearly all mothers (89.8%) engaged in restrictive feeding during the dessert buffet. Positive restrictive statements were the most common form of restriction (mean statements/10 minutes = 3.2 [SD = 3.1]). No associations were observed between children's body mass index (BMI) or appetitive traits and mothers' restrictive feeding practices. Associations of small effect size were observed between mothers' BMI, use of positive restrictive statements (incidence rate ratio [IRR] = 0.98 [0.96-0.996]) and non-verbal restrictive behaviours (IRR = 0.96 [0.93-0.99]). CONCLUSIONS Laboratory-based feeding protocols can objectively assess nuances in restrictive feeding practices. Further research is needed to understand how specific approaches to restriction affect children's eating behaviours and weight.
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Affiliation(s)
- Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Kinari Shah
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Elizabeth Ludwig-Borycz
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hurley Riley
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Julie C Lumeng
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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23
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Radesky JS, Weeks HM, Ball R, Schaller A, Yeo S, Durnez J, Tamayo-Rios M, Epstein M, Kirkorian H, Coyne S, Barr R. Young Children's Use of Smartphones and Tablets. Pediatrics 2020; 146:peds.2019-3518. [PMID: 32482771 PMCID: PMC7329252 DOI: 10.1542/peds.2019-3518] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/18/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Child mobile device use is increasingly prevalent, but research is limited by parent-report survey methods that may not capture the complex ways devices are used. We aimed to implement mobile device sampling, a set of novel methods for objectively measuring child mobile device use. METHODS We recruited 346 English-speaking parents and guardians of children aged 3 to 5 years to take part in a prospective cohort study of child media use. All interactions with participants were through e-mail, online surveys, and mobile device sampling; we used a passive-sensing application (Chronicle) in Android devices and screenshots of the battery feature in iOS devices. Baseline data were analyzed to describe usage behaviors and compare sampling output with parent-reported duration of use. RESULTS The sample comprised 126 Android users (35 tablets, 91 smartphones) and 220 iOS users (143 tablets, 77 smartphones); 35.0% of children had their own device. The most commonly used applications were YouTube, YouTube Kids, Internet browser, quick search or Siri, and streaming video services. Average daily usage among the 121 children with their own device was 115.3 minutes/day (SD 115.1; range 0.20-632.5) and was similar between Android and iOS devices. Compared with mobile device sampling output, most parents underestimated (35.7%) or overestimated (34.8%) their child's use. CONCLUSIONS Mobile device sampling is an unobtrusive and accurate method for assessing mobile device use. Parent-reported duration of mobile device use in young children has low accuracy, and use of objective measures is needed in future research.
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Affiliation(s)
| | - Heidi M. Weeks
- Department of Nutritional Sciences, School of Public
Health, University of Michigan, Ann Arbor, Michigan
| | - Rosa Ball
- Department of Pediatrics, Medical School and
| | | | | | | | | | | | - Heather Kirkorian
- Department of Human Development and Family Studies,
University of Wisconsin–Madison, Madison, Wisconsin
| | - Sarah Coyne
- Department of Family Life, Brigham Young University,
Provo, Utah; and
| | - Rachel Barr
- Department of Psychology, Georgetown University,
Washington, District of Columbia
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24
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Kohne JG, Dahmer MK, Weeks HM, Kaciroti N, Quasney MW, Sapru A, Curley MA, Matthay M, Flori H. Impact of Bilateral Infiltrates on Inflammatory Biomarker Levels and Clinical Outcomes of Children With Oxygenation Defect. Crit Care Med 2020; 48:e498-e504. [PMID: 32317601 PMCID: PMC10910885 DOI: 10.1097/ccm.0000000000004316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The 2015 definition for pediatric acute respiratory distress syndrome did not require the presence of bilateral infiltrates. We tested the hypothesis that pediatric patients meeting oxygenation criteria for pediatric acute respiratory distress syndrome but without bilateral infiltrates would have different inflammatory biomarker levels and clinical outcomes than those with bilateral infiltrates. DESIGN Secondary analysis of a prospective cohort study. SETTING Twenty-two PICUs. PATIENTS Four-hundred forty-six patients age 2 weeks to 17 years intubated for respiratory failure with oxygenation index greater than or equal to 4 or oxygenation saturation index greater than or equal to 5 on the day of intubation or the day after. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Patients with bilateral infiltrates, either on the day of intubation or within the following 2 days, were compared with children who never developed bilateral infiltrates. Two analyses were performed to test 1) whether bilateral infiltrates are associated with elevated interleukin-1 receptor antagonist or interleukin-8 and 2) whether bilateral infiltrates are associated with worse clinical outcomes. Patients with bilateral infiltrates more often had a primary diagnosis of pneumonia (41% vs 28%; p = 0.02) and less often asthma (8% vs 23%; p < 0.01). After controlling for age, gender, and primary diagnosis, interleukin-1 receptor antagonist was higher on study days 1 and 2 in patients with bilateral infiltrates. There was no difference in interleukin-8 levels. After adjusting for age, gender, Pediatric Risk of Mortality score, and severity of oxygenation defect, presence of bilateral infiltrates was associated with longer duration of mechanical ventilation in survivors (hazard ratio, 0.64; 95% CI, 0.49-0.82; p < 0.01); this association was independent of primary diagnosis. Overall mortality was 9%; mortality was higher in those without bilateral infiltrates (14% vs 8%; p = 0.04). CONCLUSIONS Children meeting pediatric acute respiratory distress syndrome oxygenation criteria with bilateral infiltrates on chest radiograph experience a more intense early inflammatory response. Bilateral infiltrates are associated with longer time on the ventilator independent of oxygenation defect severity.
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Affiliation(s)
- Joseph G. Kohne
- Division of Critical Care Medicine, Department of Pediatrics, University of Michigan
| | - Mary K. Dahmer
- Division of Critical Care Medicine, Department of Pediatrics, University of Michigan
| | - Heidi M. Weeks
- Department of Nutritional Sciences, School of Public Health, University of Michigan
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan; and Department of Biostatistics, University of Michigan School of Public Health
| | - Michael W. Quasney
- Division of Critical Care Medicine, Department of Pediatrics, University of Michigan
| | - Anil Sapru
- Department of Pediatrics, University of California, Los Angeles, CA
| | - Martha A.Q. Curley
- Division of Anesthesia and Critical Care Medicine, Department of Family and Community Health (School of Nursing), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
- Research Institute, Children’s Hospital of Philadelphia, Philadelphia, PA
| | - Michael Matthay
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA
| | - Heidi Flori
- Division of Critical Care Medicine, Department of Pediatrics, University of Michigan
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25
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Lumeng JC, Weeks HM, Asta K, Sturza J, Kaciroti NA, Miller AL, Rosenblum K, Gearhardt AN. Sucking behavior in typical and challenging feedings in association with weight gain from birth to 4 Months in full-term infants. Appetite 2020; 153:104745. [PMID: 32439604 DOI: 10.1016/j.appet.2020.104745] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 04/26/2020] [Accepted: 05/15/2020] [Indexed: 02/05/2023]
Abstract
Sucking behavior has been described as an obesity risk marker. Sucking behavior in response to challenge has not been examined as a prospective predictor of infant weight gain. Healthy, full term infants had sucking behavior assessed at ages 2 weeks and/or 2 months via a sucking pressure measurement device in two feeding conditions: during a standard feeding and during a feeding with a more challenging nipple. Weight and length were measured at 2 weeks, 2 months, and 4 months and weight-for-length z-score (WLZ) calculated. Among 45 full term infants, adjusted for age at measurement and time since last feeding, the challenging versus typical feedings differed with regard to amount consumed (54.1g vs. 65.6g, p < .05), maximum sucking pressure (121.3 mmHg vs. 99.2 mmHg, p < .05), mean burst duration (17.5s vs. 28.4s, p < .05), and feeding duration (18.51 min vs. 13.89 min, p < .01). Grams consumed in the challenging, but not typical, feeding, adjusted for age and time since last feeding, predicted rate of change in WLZ from time of measurement to age 4 months (r = 0.46, p = .013 for challenging, r = -0.07, p = .702 for typical). Nipples that are more challenging to suck from change the sucking behavior and intake among full term infants. Infants who consume more when the nipple is more challenging have greater prospective weight gain. This persistent sucking behavior in the face of challenge may reflect that a greater willingness to work for food, a known obesity risk factor, is detectable in early infancy.
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Affiliation(s)
- Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA; Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA.
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Katharine Asta
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Julie Sturza
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Niko A Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA; Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Katherine Rosenblum
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
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26
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Dahmer MK, Flori H, Sapru A, Kohne J, Weeks HM, Curley MAQ, Matthay MA, Quasney MW. Surfactant Protein D Is Associated With Severe Pediatric ARDS, Prolonged Ventilation, and Death in Children With Acute Respiratory Failure. Chest 2020; 158:1027-1035. [PMID: 32275979 DOI: 10.1016/j.chest.2020.03.041] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Revised: 02/03/2020] [Accepted: 03/09/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Elevated surfactant protein D (SP-D) is a relatively specific indicator of lung injury and is associated with both acute and chronic lung disease in adults and respiratory distress syndrome in premature infants. The relationship between plasma SP-D and lung injury in children with acute respiratory failure is unclear. RESEARCH QUESTION Is plasma SP-D associated with lung injury or outcome in children with acute respiratory failure? STUDY DESIGN AND METHODS This was a prospective cohort study in children 2 weeks to 17 years of age with acute respiratory failure who participated in the BALI multi-center study. Analyses were done using SP-D levels in plasma from the first sample taken on either the day of intubation or one of the following 2 days. SP-D level was measured by enzyme-linked immunosorbent assay. RESULTS Plasma samples from 350 patients were used in the analysis; 233 had pediatric ARDS (PARDS). SP-D levels varied across primary diagnoses (P < .001). Elevated SP-D levels were associated with severe PARDS after adjusting for age, pediatric risk of mortality III (PRISM-III), and primary diagnosis (OR = 1.02; CI = 1.01-1.04; P = .011). Multivariable analyses also indicated that elevated SP-D levels were associated with death (OR = 1.02; CI = 1.01-1.04; P = .004), duration of mechanical ventilation (P = .012), PICU length of stay (P = .019), and highest oxygenation index (P = .040). SP-D levels also correlated with age (rs = 0.16, P = .002). INTERPRETATION Elevated plasma SP-D levels are associated with severe PARDS and poor outcomes in children with acute respiratory failure. Future studies will determine whether SP-D can be used to predict the degree of lung injury or response to treatment and whether SP-D is useful in identifying PARDS endotypes.
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Affiliation(s)
- Mary K Dahmer
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Heidi Flori
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Anil Sapru
- Department of Pediatrics, University of California, Los Angeles, CA
| | - Joseph Kohne
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Martha A Q Curley
- Department of Family and Community Health (School of Nursing), Division of Anesthesia and Critical Care Medicine (Perelman School of Medicine) University of Pennsylvania, and the Research Institute, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Michael A Matthay
- Departments of Medicine and Anesthesia, Cardiovascular Research Institute, University of California, San Francisco, CA
| | - Michael W Quasney
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Michigan, Ann Arbor, MI.
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27
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Bauer KW, Foster GD, Weeks HM, Polonsky HM, Davey A, Sherman S, Abel ML, Ruth KJ, Dale LC, Fisher JO. Breakfast in the Classroom Initiative and Students' Breakfast Consumption Behaviors: A Group Randomized Trial. Am J Public Health 2020; 110:540-546. [PMID: 32078356 PMCID: PMC7067086 DOI: 10.2105/ajph.2019.305511] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2019] [Indexed: 11/04/2022]
Abstract
Objectives. To identify the effect of a Breakfast in the Classroom (BIC) initiative on the foods and drinks students consume in the morning.Methods. Sixteen public schools in Philadelphia, Pennsylvania, that provide universal breakfast participated in a group randomized trial to examine the effects of BIC with complementary nutrition promotion between 2013 and 2016. Control schools (n = 8) offered breakfast in the cafeteria before school. Baseline data were collected from 1362 students in grades 4 to 6. Endpoint data were collected after 2.5 years. Students self-reported the foods and drinks they consumed in the morning.Results. At endpoint, there was no effect of the intervention on breakfast skipping. Nearly 30% of intervention students consumed breakfast foods or drinks from multiple locations, as compared with 21% of control students. A greater proportion of intervention students than control students consumed 100% juice, and a smaller proportion consumed sugar-sweetened beverages and foods high in saturated fat and added sugar.Conclusions. A BIC initiative led to improvements in the types of foods and drinks students consumed in the morning. However, the program did not reduce breakfast skipping and increased the number of locations where students ate.
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Affiliation(s)
- Katherine W Bauer
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Gary D Foster
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Heidi M Weeks
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Heather M Polonsky
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Adam Davey
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Sandy Sherman
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Michelle L Abel
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Karen J Ruth
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Lauren C Dale
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
| | - Jennifer O Fisher
- Katherine W. Bauer and Heidi M. Weeks are with the Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor. Gary D. Foster is with WW International (formerly known as Weight Watchers), New York, NY. Heather M. Polonsky and Jennifer O. Fisher are with the Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA. Adam Davey is with the College of Health Sciences and the Department of Behavioral Health and Nutrition, University of Delaware, Newark. Sandy Sherman, Michelle L. Abel, and Lauren C. Dale are with The Food Trust, Philadelphia. Karen J. Ruth is with the Fox Chase Cancer Center, Temple Health, Philadelphia
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28
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Boone-Heinonen J, Weeks HM, Sturza J, Miller AL, Lumeng JC, Bauer KW. Prenatal predictors of objectively measured appetite regulation in low-income toddlers and preschool-age children. Pediatr Obes 2019; 14:e12554. [PMID: 31215152 PMCID: PMC6812586 DOI: 10.1111/ijpo.12554] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 04/14/2019] [Accepted: 05/03/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prenatal nutrition impacts offspring appetite regulation in animal models. However, evidence from humans is scarce. OBJECTIVE To determine associations between indicators of prenatal nutrition and appetite regulation among young children. METHODS Participants included 454 low-income mother/child dyads (mean child age = 45.2 months [SD = 9.7]). Children's appetite regulation was ascertained with the maternal-reported Child Eating Behavior Questionnaire and objectively assessed using the Eating in the Absence of Hunger protocol. Using hierarchical linear regression, we modelled child appetite regulation measures as a function of prenatal nutrition indicators (child birthweight z scores [BWz, BWz2 ]; maternal pre-pregnancy body mass index [BMI], gestational weight gain [GWG]), adjusted for sociodemographic characteristics. RESULTS Among girls, higher and lower birthweight were associated with greater energy consumed in the absence of hunger, primarily sweet foods, coeff (95% CI): BWz 0.17 (0.05, 0.28), BWz2 0.15 (0.04, 0.26), but not food responsiveness or food enjoyment. Higher birthweight was also associated with greater satiety responsiveness among girls. Among boys, birthweight was unrelated to measures of appetite regulation. Associations between maternal BMI and GWG and child appetite regulation were inconsistent. CONCLUSIONS Among low-income girls, but not boys, indicators of adverse prenatal conditions were associated with poor objectively measured appetite regulation during early childhood.
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Affiliation(s)
- Janne Boone-Heinonen
- School of Public Health, Oregon Health & Science
University, Portland, OR, USA,Corresponding author: 3181 SW Sam Jackson Park Rd,
CB669, Portland, OR 97239,
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan
School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan Medical
School, Ann Arbor, MI
| | - Alison L. Miller
- Center for Human Growth and Development, University of
Michigan, Ann Arbor, MI, USA,Department of Health Behavior and Health Education,
University of Michigan School of Public Health, University of Michigan, Ann Arbor,
MI, USA
| | - Julie C. Lumeng
- Department of Nutritional Sciences, University of Michigan
School of Public Health, University of Michigan, Ann Arbor, MI, USA,Department of Pediatrics, University of Michigan Medical
School, Ann Arbor, MI,Center for Human Growth and Development, University of
Michigan, Ann Arbor, MI, USA
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan
School of Public Health, University of Michigan, Ann Arbor, MI, USA,Center for Human Growth and Development, University of
Michigan, Ann Arbor, MI, USA
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29
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Abstract
IMPORTANCE Although the American Academy of Pediatrics recommends parent-child joint engagement with digital media, recent evidence suggests this may be challenging when tablets contain interactive enhancements. OBJECTIVE To examine parent-toddler social reciprocity while reading enhanced (eg, with sound effects, animation) and basic tablet-based books compared with print books. DESIGN, SETTING, AND PARTICIPANTS This within-participants comparison included 37 parent-toddler dyads in a counterbalanced crossover, video-recorded laboratory design at the University of Michigan from May 31 to November 7, 2017. The volunteer sample was recruited from an online research registry and community sites. Dyads included children aged 24 to 36 months with no developmental delay or serious medical condition, parents who were the legal guardians and read English sufficiently for consent, and parents and children without uncorrected hearing or vision impairments. Data were analyzed from October 18, 2017, through April 30, 2018. EXPOSURES Reading an enhanced tablet-based book, a basic tablet-based book, and a print book in counterbalanced order for 5 minutes each. MAIN OUTCOMES AND MEASURES Video recordings were coded continuously for nonverbal aspects of parent-toddler social reciprocity, including body position (child body posture limiting parental book access coded in 10-second intervals), control behaviors (child closing the book, child grabbing the book or tablet, parent or child pivoting their body away from the other), and intrusive behaviors (parent or child pushing the other's hand away). Coding intracorrelation coefficients were greater than 0.75. Poisson regression was used to compare each outcome by book format. RESULTS Among the 37 parent-child dyads, mean (SD) parent age was 33.5 (4.0) years; 30 (81%) were mothers, and 28 (76%) had a 4-year college degree or greater educational attainment. Mean (SD) age of children was 29.2 (4.2) months, 20 (54%) were boys, 21 (57%) were white non-Hispanic, and 6 (16%) were black non-Hispanic. Compared with print books, greater frequency of child body posture limiting parental book access (mean [SD], 7.9 [1.9; P = .01] for enhanced; 8.4 [1.8; P = .006] for basic), child closing the book (mean [SD], 1.2 [0.4; P = .007] for enhanced; 1.2 [0.5; P < .001] for basic), parent pivoting (mean [SD], 0.4 [0.2; P = .05] for enhanced; 0.9 [0.4; P = .004] for basic), child pushing parent's hand (mean [SD], 0.6 [0.2; P < .001] for enhanced; 0.4 [0.2; P = .002] for basic), and parent pushing child's hand (mean [SD], 1.7 [0.3; P < .001] for enhanced; 2.4 [0.5; P < .001] for basic) occurred while reading enhanced and basic tablet-based books. Child pivots occurred more frequently while reading basic tablet-based books than print (mean [SD], 1.0 [0.3] vs 0.3 [0.1]; P = .005). CONCLUSIONS AND RELEVANCE In this study, toddlers and parents engaged in more frequent social control behaviors and less social reciprocity when reading tablet-based vs print books. These findings suggest that toddlers may have difficulty engaging in shared tablet experiences with their parents.
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Affiliation(s)
- Tiffany G. Munzer
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Alison L. Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor,Department of Biostatistics, University of Michigan, Ann Arbor
| | - Jenny Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
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30
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Yuan N, Weeks HM, Ball R, Newman MW, Chang YJ, Radesky JS. How much do parents actually use their smartphones? Pilot study comparing self-report to passive sensing. Pediatr Res 2019; 86:416-418. [PMID: 31195401 PMCID: PMC6764893 DOI: 10.1038/s41390-019-0452-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/22/2019] [Accepted: 05/29/2019] [Indexed: 12/04/2022]
Affiliation(s)
- Nalingna Yuan
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI
| | - Heidi M. Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
| | - Rosa Ball
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI
| | - Mark W. Newman
- School of Information, University of Michigan, Ann Arbor, MI
| | - Yung-Ju Chang
- Department of Computer Science, National Chiao Tung University, Hsinchu, Taiwan
| | - Jenny S. Radesky
- Division of Developmental Behavioral Pediatrics, Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI
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31
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Abstract
OBJECTIVES Previous research has documented less dialogic interaction between parents and preschoolers during electronic-book reading versus print. Parent-toddler interactions around commercially available tablet-based books have not been described. We examined parent-toddler verbal and nonverbal interactions when reading electronic versus print books. METHODS We conducted a videotaped, laboratory-based, counterbalanced study of 37 parent-toddler dyads reading on 3 book formats (enhanced electronic [sound effects and/or animation], basic electronic, and print). We coded verbalizations in 10-second intervals for parents (dialogic, nondialogic, text reading, format related, negative format-related directives, and off task) and children (book related, negative, and off task). Shared positive affect and collaborative book reading were coded on a scale of 1 to 5 (5 = high). Proc Genmod and Proc Mixed analyzed within-subjects variance by book format. RESULTS Parents showed significantly more dialogic (print 11.9; enhanced 6.2 [P < .001]; basic 8.3 [P < .001]), text-reading (print 14.3; enhanced 10.6 [P = .003]; basic 14.4 [P < .001]), off-task (print 2.3; enhanced 1.3 [P = .007]), and total (29.5; enhanced 28.1 [P = .003]; basic 29.3 [P = .005]) verbalizations with print books and fewer format-related verbalizations (print 1.9; enhanced 10.0 [P < .001]; basic 8.3 [P < .001]). Toddlers showed more book-related verbalizations (print 15.0; enhanced 11.5 [P < .001]; basic 12.5 [P = .005]), total verbalizations (print 18.8; enhanced 13.8 [P < .001]; basic 15.3 [P < .001]), and higher collaboration scores (print 3.1; enhanced 2.7 [P = .004]; basic 2.8 [P = .02]) with print-book reading. CONCLUSIONS Parents and toddlers verbalized less with electronic books, and collaboration was lower. Future studies should examine specific aspects of tablet-book design that support parent-child interaction. Pediatricians may wish to continue promoting shared reading of print books, particularly for toddlers and younger children.
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Affiliation(s)
| | - Alison L Miller
- Departments of Health Behavior and Health Education
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan
| | | | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan
- Biostatistics, School of Public Health, and
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32
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Quist M, Kaciroti N, Poehlmann-Tynan J, Weeks HM, Asta K, Singh P, Shah PE. Interactive Effects of Infant Gestational Age and Infant Fussiness on the Risk of Maternal Depressive Symptoms in a Nationally Representative Sample. Acad Pediatr 2019; 19:917-924. [PMID: 30867136 PMCID: PMC6736763 DOI: 10.1016/j.acap.2019.02.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2018] [Revised: 12/22/2018] [Accepted: 02/08/2019] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine the interactive effects of gestational age and infant fussiness on the risk of maternal depressive symptoms in a nationally representative sample. METHODS Our sample included 8200 children from the Early Childhood Longitudinal Study, Birth Cohort. Gestational age categories were very preterm (VPT, 24-31 weeks), moderate/late preterm (MLPT, 32-36 weeks) and full term (FT, 37-41 weeks). Maternal depressive symptoms (categorized as nondepressed/mild/moderate-severe), from the modified Center for Epidemiological Studies Depression Questionnaire, and infant fussiness (categorized as fussy/not fussy) were assessed at 9 months from parent-report questionnaires. We examined the interactive effects of infant fussiness and gestational age categories and estimated adjusted odds ratios (aOR) and 95% confidence intervals (CI) of maternal depressive symptoms using multinomial logistic regression. RESULTS Infant fussiness interacted with gestational age categories in predicting maternal depressive symptoms (P = .04), with severity varying by gestational age and infant fussiness. Compared with mothers of VPT infants without fussiness, mothers of VPT infants with fussiness had greater odds of mild depressive symptoms (aOR, 2.32; 95% CI, 1.19-4.53). Similarly, compared with mothers of MLPT and FT infants without fussiness, mothers of fussy MLPT and FT infants had greater odds of moderate-severe symptoms (aOR, 2.30; 95% CI, 1.40-3.80, and aOR, 1.74; 95% CI, 1.40-2.16, respectively). CONCLUSIONS Mothers of MLPT and FT infants with fussiness had increased odds of moderate-severe depressive symptoms, and mothers of VPT infants with fussiness had increased risk of mild symptoms. Early screening for infant fussiness in preterm and FT may help identify mothers with depressive symptoms in need of support.
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Affiliation(s)
- Megan Quist
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan School of Medicine (M Quist and PE Shah)
| | - Niko Kaciroti
- Center for Human Growth and Development (N Kaciroti and PE Shah)
| | | | - Heidi M Weeks
- Department of Nutritional Sciences, School of Public of Health (HM Weeks), University of Michigan, Ann Arbor
| | | | - Priya Singh
- Northeast Ohio Medical University, Rootstown (P Singh)
| | - Prachi E Shah
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan School of Medicine (M Quist and PE Shah); Center for Human Growth and Development (N Kaciroti and PE Shah).
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33
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Shah PE, Weeks HM, Richards B, Kaciroti N. Early childhood curiosity and kindergarten reading and math academic achievement. Pediatr Res 2018; 84:380-386. [PMID: 29884846 PMCID: PMC6203666 DOI: 10.1038/s41390-018-0039-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 01/05/2018] [Accepted: 02/06/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although children's curiosity is thought to be important for early learning, the association of curiosity with early academic achievement has not been tested. We hypothesized that greater curiosity would be associated with greater kindergarten academic achievement in reading and math. METHODS Sample included 6200 children in the Early Childhood Longitudinal Study, Birth Cohort. Measures at kindergarten included direct assessments of reading and math, and a parent-report behavioral questionnaire from which we derived measures of curiosity and effortful control. Multivariate linear regression examined associations of curiosity with kindergarten reading and math academic achievement, adjusting for effortful control and confounders. We also tested for moderation by effortful control, sex, and socioeconomic status (SES). RESULTS In adjusted models, greater curiosity was associated with greater kindergarten reading and math academic achievement: breading = 0.11, p < 0.001; bmath = 0.12, p < 0.001. This association was not moderated by effortful control or sex, but was moderated by SES (preading = 0.01; pmath = 0.005). The association of curiosity with academic achievement was greater for children with low SES (breading = 0.18, p < 0.001; bmath = 0.20, p < 0.001), versus high SES (breading = 0.08, p = 0.004; bmath = 0.07, p < 0.001). CONCLUSIONS Curiosity may be an important, yet under-recognized contributor to academic achievement. Fostering curiosity may optimize academic achievement at kindergarten, especially for children with low SES.
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Affiliation(s)
- Prachi E Shah
- Department of Pediatrics, School of Medicine, Division of Developmental Behavioral Pediatrics, University of Michigan, Ann Arbor, MI, USA.
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA.
| | - Heidi M Weeks
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Blair Richards
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
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34
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Abstract
It has been hypothesized that an important function of the cerebellum is predicting the state of the body during movement. Yet, the extent of cerebellar involvement in perception of limb state (i.e., proprioception, specifically limb position sense) has yet to be determined. Here, we investigated whether patients with cerebellar damage have deficits when trying to locate their hand in space (i.e., proprioceptive localization), which is highly important for everyday movements. By comparing performance during passive robot-controlled and active self-made multi-joint movements, we were able to determine that some cerebellar patients show improved precision during active movement (i.e., active benefit), comparable to controls, whereas other patients have reduced active benefit. Importantly, the differences in patient performance are not explained by patient diagnosis or clinical ratings of impairment. Furthermore, a subsequent experiment confirmed that active deficits in proprioceptive localization occur during both single-joint and multi-joint movements. As such, it is unlikely that localization deficits can be explained by the multi-joint coordination deficits occurring after cerebellar damage. Our results suggest that cerebellar damage may cause varied impairments to different elements of proprioceptive sense. It follows that proprioceptive localization should be adequately accounted for in clinical testing and rehabilitation of people with cerebellar damage.
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Affiliation(s)
- Heidi M Weeks
- Department of Biomedical Engineering, The Johns Hopkins School of Medicine, Baltimore, MD, USA.,Kennedy Krieger Institute, 707 N. Broadway, G04, Baltimore, MD, 21205, USA
| | - Amanda S Therrien
- Kennedy Krieger Institute, 707 N. Broadway, G04, Baltimore, MD, 21205, USA.,Department of Neuroscience, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Amy J Bastian
- Kennedy Krieger Institute, 707 N. Broadway, G04, Baltimore, MD, 21205, USA. .,Department of Neuroscience, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
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35
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Weeks HM, Therrien AS, Bastian AJ. The cerebellum contributes to proprioception during motion. J Neurophysiol 2017; 118:693-702. [PMID: 28404825 DOI: 10.1152/jn.00417.2016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Revised: 04/06/2017] [Accepted: 04/08/2017] [Indexed: 11/22/2022] Open
Abstract
Proprioception, the sense of limb position and motion, is essential for generating accurate movements. Limb position sense has typically been studied under static conditions (i.e., the fixed position of a limb in space), with less known about dynamic position sense (i.e., limb position during movement). Here we investigated how a person's estimate of hand position varies when using spatial or temporal information to judge the unseen hand's location during reaching. We assessed the acuity of dynamic position sense in two directions, orthogonal to hand movement, which only requires spatial information, and in line with hand movement, which has both spatial and temporal components. Our results showed that people have better proprioceptive acuity in the orthogonal condition where only spatial information is used. We then assessed whether cerebellar damage impairs proprioceptive acuity in both tasks during passive and active movement. Cerebellar patients showed reduced acuity in both tasks and in both movement conditions relative to age-matched controls. However, patients' deficits were most apparent when judgments of active movement relied on temporal information. Furthermore, both cerebellar patient and control performance correlated with the trial-to-trial variability of their active movements: subjects are worse at the proprioceptive tasks when movements are variable. Our results suggest that, during active movements, proprioceptive acuity may be reliant on the motor system's ability to predict motor output. Therefore, the resultant proprioceptive deficits occurring after cerebellar damage may be related to a more general impairment in movement prediction.NEW & NOTEWORTHY We assessed limb position sense during movement in patients with cerebellar damage and found deficits in proprioceptive acuity during both passive and active movement. The effect of cerebellar damage was most apparent when individuals relied on both timing and spatial information during active movement. Thus proprioceptive acuity during active movements may be reliant on the motor system's ability to predict motor output.
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Affiliation(s)
- Heidi M Weeks
- Department of Biomedical Engineering, The Johns Hopkins School of Medicine, Baltimore, Maryland.,Kennedy Krieger Institute, Baltimore, Maryland; and
| | - Amanda S Therrien
- Kennedy Krieger Institute, Baltimore, Maryland; and.,Department of Neuroscience, The Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Amy J Bastian
- Kennedy Krieger Institute, Baltimore, Maryland; and .,Department of Neuroscience, The Johns Hopkins School of Medicine, Baltimore, Maryland
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36
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Wanda PA, Fine MS, Weeks HM, Gross AM, Macy JL, Thoroughman KA. Brevity of haptic force perturbations induces heightened adaptive sensitivity. Exp Brain Res 2013; 226:407-20. [PMID: 23468159 DOI: 10.1007/s00221-013-3450-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2012] [Accepted: 02/11/2013] [Indexed: 11/25/2022]
Abstract
We have exposed human participants to both full-movement and pulsatile viscous force perturbations to study the effect of force duration on the incremental transformation of sensation into adaptation. Traditional views of movement biomechanics could suggest that pulsatile forces would largely be attenuated as stiffness and viscosity act as a natural low-pass filter. Sensory transduction, however, tends to react to changes in stimuli and therefore could underlie heightened sensitivity to briefer, pulsatile forces. Here, participants adapted within perturbation duration conditions in a manner proportionate to sensed force and positional errors. Across perturbation conditions, we found participants had greater adaptive sensitivity when experiencing pulsatile forces rather than full-movement forces. In a follow-up experiment, we employed error-clamped, force channel trials to determine changes in predictive force generation. We found that while participants learned to closely compensate for the amplitude and breadth of full-movement forces, they exhibited a persistent mismatch in amplitude and breadth between adapted motor output and experienced pulsatile forces. This mismatch could generate higher salience of error signals that contribute to heightened sensitivity to pulsatile forces.
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Affiliation(s)
- Paul A Wanda
- Department of Biomedical Engineering, Washington University in St. Louis, One Brookings Drive, Campus Box 1097, St. Louis, MO 63130, USA
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