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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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Kim DJ, Nascimento TD, Lim M, Danciu T, Zubieta JK, Scott PJH, Koeppe R, Kaciroti N, DaSilva AF. Exploring HD-tDCS Effect on μ-opioid Receptor and Pain Sensitivity in Temporomandibular Disorder: A Pilot Randomized Clinical Trial Study. J Pain 2024; 25:1070-1081. [PMID: 37956741 DOI: 10.1016/j.jpain.2023.11.001] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 10/05/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
This study explored the association between experimentally-induced pain sensitivity and µ-opioid receptor (μOR) availability in patients with temporomandibular disorder (TMD) and further investigated any changes in the pain and μOR availability following high-definition transcranial direct current stimulation (HD-tDCS) over the primary motor cortex (M1) with pilot randomized clinical trials. Seven patients with TMD completed either active (n = 3) or sham treatment (n = 4) for 10 daily sessions and underwent positron emission tomography (PET) scans with [11C]carfentanil, a selective μOR agonist, a week before and after treatment. PET imaging consisted of an early resting and late phase with the sustained masseteric pain challenge by computer-controlled injection of 5% hypertonic saline. We also included 12 patients with TMD, obtained from our previous study, for baseline PET analysis. We observed that patients with more sensitivity to pain, indicated by lower infusion rate, had less μOR availability in the right amygdala during the late phase. Moreover, active M1 HD-tDCS, compared to sham, increased μOR availability post-treatment in the thalamus during the early resting phase and the amygdala, hippocampus, and parahippocampal gyrus during the late pain challenge phase. Importantly, increased μOR availability post-treatment in limbic structures including the amygdala and hippocampus was associated with decreased pain sensitivity. The findings underscore the role of the μOR system in pain regulation and the therapeutic potential of HD-tDCS for TMD. Nonetheless, large-scale studies are necessary to establish the clinical significance of these results. TRIAL REGISTRATION: ClinicalTrial.gov (NCT03724032) PERSPECTIVE: This study links pain sensitivity and µ-opioid receptors in patients with TMD. HD-tDCS over M1 improved µOR availability, which was associated with reduced pain sensitivity. Implications for TMD pain management are promising, but larger clinical trials are essential for validation.
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Affiliation(s)
- Dajung J Kim
- Headache and Orofacial Pain Effort (H.O.P.E.) Laboratory, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan; Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan
| | - Thiago D Nascimento
- Headache and Orofacial Pain Effort (H.O.P.E.) Laboratory, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan; Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan
| | - Manyoel Lim
- Food Processing Research Group, Food Convergence Research Division, Korea Food Research Institute, Jeollabuk-do, Republic of Korea
| | - Theodora Danciu
- Department of Periodontics & Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan
| | - Jon-Kar Zubieta
- Department of Psychiatry, Mass General Brigham, Newton-Wellesley Hospital, Newton, Massachusetts
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, Michigan
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan
| | - Alexandre F DaSilva
- Headache and Orofacial Pain Effort (H.O.P.E.) Laboratory, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, Michigan; Michigan Neuroscience Institute, University of Michigan, Ann Arbor, Michigan
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Kaciroti N, Jamerson KA, Brook RD. Cardiovascular Protection Beyond Blood Pressure-Lowering Redux: The ACCOMPLISH trial. Hypertension 2024; 81:e13-e15. [PMID: 38354269 PMCID: PMC10868869 DOI: 10.1161/hypertensionaha.123.22425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Affiliation(s)
- Niko Kaciroti
- Departments of Pediatrics and Biostatistics (N.K.), University of Michigan, Ann Arbor, MI
| | - Kenneth A Jamerson
- Division of Cardiovascular Medicine (K.A.J.), University of Michigan, Ann Arbor, MI
| | - Robert D Brook
- Division of Cardiovascular Diseases, Department of Internal Medicine, Wayne State University, Detroit, MI (R.D.B.)
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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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Robbins LB, Ling J, Pfeiffer KA, Kerver JM, Resnicow K, McCaffery H, Hilliard A, Hobbs L, Donald S, Kaciroti N. Intervention to increase physical activity and healthy eating among under-represented adolescents: GOAL trial protocol. BMJ Open 2024; 14:e080437. [PMID: 38171630 PMCID: PMC10773393 DOI: 10.1136/bmjopen-2023-080437] [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: 10/01/2023] [Accepted: 10/19/2023] [Indexed: 01/05/2024] Open
Abstract
INTRODUCTION To reduce obesity-related disparities, reaching economically disadvantaged and/or minority status adolescents to assist them in meeting physical activity (PA) and nutrition recommendations is important. To address the problem, a 16-week intervention called Guys/Girls Opt for Activities for Life (GOAL) was designed. The purpose of this randomised controlled trial is to evaluate any effect of the intervention, compared with a control condition, on improving: (1) adolescents' % body fat (primary outcome), moderate-to-vigorous PA (MVPA), diet quality and cardiorespiratory fitness from 0 to 4 months; (2) body mass index (BMI), overweight/obesity percentage and quality of life from 0 to 4 months and to 13 months; and (3) perceived social support, self-efficacy and motivation from 0 to 4 months with evaluation of any mediating effect on adolescent PA and diet quality. An exploratory aim is to evaluate any effect of the intervention, compared with the control, on improving parents'/guardians' home environment, MVPA and diet quality from 0 to 4 months; and BMI from 0 to 4 months and to 13 months. METHODS AND ANALYSIS Adolescents (fifth to eighth grade) in 14 schools located in underserved urban communities are randomly assigned to the intervention or usual school offerings. One parent per adolescent is enrolled (882 dyads total). Cohort 1 includes four schools (2022-2023). Cohorts 2 and 3 include 5 schools in 2023-2024 and 2024-2025, respectively. The 16-week intervention has three components: (1) after-school GOAL club for adolescents to engage in PA and healthy eating/cooking activities; (2) three parent-adolescent meetings to empower parents to assist adolescents; and (3) GOAL social networking website for parents to share how they helped their adolescent. ETHICS AND DISSEMINATION The Michigan State University Biomedical Institutional Review Board provided ethical approval for the study. Findings will be shared via the trial registration database, peer-reviewed publications, conferences and community-oriented strategies. TRIAL REGISTRATION NUMBER NCT04213014.
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Affiliation(s)
- Lorraine B Robbins
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Karin A Pfeiffer
- Department of Kinesiology, College of Education, Michigan State University, East Lansing, Michigan, USA
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Harlan McCaffery
- Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, Michigan, USA
| | - Aisha Hilliard
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Logan Hobbs
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Sheldon Donald
- College of Nursing, Michigan State University, East Lansing, Michigan, USA
| | - Niko Kaciroti
- Department of Pediatrics, Medical School, University of Michigan, Ann Arbor, Michigan, USA
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Wang CW, Di Gianfilippo R, Kaciroti N, Ou A, Feng SW, Wang HL. Stability of peri-implantitis surgical reconstructive therapy-a (> 2 years) follow-up of a randomized clinical trial. Clin Oral Investig 2023; 28:30. [PMID: 38147180 DOI: 10.1007/s00784-023-05457-6] [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] [Received: 08/07/2023] [Accepted: 12/18/2023] [Indexed: 12/27/2023]
Abstract
OBJECTIVES This follow-up study aimed to report the 24- and 30-month outcomes of a cohort previously enrolled in a randomized clinical trial on surgical reconstructive treatment of peri-implantitis. METHODS Twenty-four patients were diagnosed with peri-implantitis and treated with surgical reconstructive therapy with or without the adjunctive use of Er:YAG laser. Within-group and between-group comparisons were tested with mixed model with repeated measures. RESULTS Regarding peri-implant pocket depth (PPD) reduction (control vs. laser test group) between 6 months (- 1.85 vs. - 2.65 mm) and 30 months (- 1.84 vs. - 3.04 mm), the laser group showed statistically significant changes but not the control group. In terms of radiographic marginal bone loss (RMBL) at 6 months (- 1.1 vs. - 1.46 mm) to 24 months (- 1.96 vs. - 2.82 mm), both groups showed statistical difference compared to baseline. The six explanted implants all were featured by severe peri-implantitis and mostly with no or limited keratinized tissue (< 2 mm) at baseline and membrane exposure after surgery. Among the 15 retained cases, eight cases achieved more than 50% peri-implant bone level gain. CONCLUSIONS Within the limitation and follow-up time frame of this trial, the outcome of the surgical reconstructive therapy sustained or improved in most of the cases. However, 25% of the implants with severe peri-implantitis failed 2 years after the surgical reconstructive therapy. The use of Er:YAG laser favors PPD reduction in the longer term up to 30 months. CLINICAL RELEVANCE Longer-term follow-up on reconstructive therapy of peri-implantitis revealed sustained or improved stability in certain cases, but the survival of implants with severe peri-implantitis has its limitation, especially when there is limited keratinized tissue (< 2 mm or no KT). TRIAL REGISTRATION Clinical Trials Registration Number: NCT03127228 and HUM00160290.
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Affiliation(s)
- Chin-Wei Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA.
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Riccardo Di Gianfilippo
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Alice Ou
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Sheng-Wei Feng
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Dentistry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
| | - Hom-Lay Wang
- Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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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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McCaffery H, Zaituna J, Busch S, Kaciroti N, Miller AL, Lumeng JC, Rosenblum KL, Gearhardt A, Pesch MH. Developmental trajectories of eating behaviors and cross-lagged associations with weight across infancy. Appetite 2023; 188:106978. [PMID: 37495177 PMCID: PMC10844930 DOI: 10.1016/j.appet.2023.106978] [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] [Received: 02/08/2023] [Revised: 07/01/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023]
Abstract
Examining typical developmental trajectories of infant eating behaviors, correlates of those trajectories, and cross-lagged associations between eating behaviors and anthropometry, is important to understand the etiology of these behaviors and their relevance to growth early in the lifespan. Mothers (N = 276) completed the Baby Eating Behavior Questionnaire (BEBQ) and infant anthropometrics were measured at ages 1, 2, 4, 6, and 10 months. Infant and maternal characteristics were collected by maternal report. Trajectories of eating behaviors were identified using latent class growth modeling and bivariate analyses examined associations of infant eating behavior trajectory membership with infant and maternal characteristics. Cross-lagged analyses examined associations between BEBQ subscales and infant weight-for-length z-score. Infant eating behavior trajectories included: Consistently High (62%) and Consistently Moderate (38%) Enjoyment of Food; Consistently High (9%), Moderate & Decreasing (43%), and Low & Decreasing (48%) Food Responsiveness; and Consistently High (62%) and Moderate & Decreasing (38%) General Appetite. Trajectory group membership was not associated with infant sex, gestational age, birthweight, or having been exclusively fed breastmilk at 2 months. Consistently High trajectories for Enjoyment of Food, Food Responsiveness, and General Appetite were associated with maternal demographic markers of psychosocial risk (e.g., lower maternal age and educational attainment). Food Responsiveness and General Appetite tracked strongly across infancy within individuals. Cross-lagged associations of Enjoyment of Food, Food Responsiveness, and General Appetite with weight-for-length z-score across infancy were generally null. Much additional work is needed to understand eating behaviors in infancy, their development, and their etiology. Further understanding of infant eating behaviors will provide the basis for future interventions to improve life course nutrition, growth, and health.
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Affiliation(s)
- Harlan McCaffery
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Julie Zaituna
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Sophie Busch
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Julie C Lumeng
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA; School of Public Health, University of Michigan, Ann Arbor, Michigan, USA.
| | | | - Ashley Gearhardt
- Department of Psychology, College of Literature, Science, and the Arts, University of Michigan, Ann Arbor, MI, USA
| | - Megan H Pesch
- Division of Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
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Stein SF, Rios JM, Gearhardt AN, Nuttall AK, Riley HO, Kaciroti N, Rosenblum KL, Lumeng JC, Miller AL. Food addiction and dietary restraint in postpartum women: The role of childhood trauma exposure and postpartum depression. Appetite 2023; 187:106589. [PMID: 37146651 PMCID: PMC11079996 DOI: 10.1016/j.appet.2023.106589] [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] [Received: 05/25/2022] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 05/07/2023]
Abstract
The early postpartum period is a sensitive time for understanding women's high-risk eating (i.e., eating behavior associated with negative health outcomes) given potential long-term eating behavior implications for infants. Food addiction and dietary restraint are two high-risk eating phenotypes associated with long-term negative health outcomes that have been theoretically linked. Yet, no research has considered how much these constructs overlap during the early postpartum period. The present study sought to characterize these two high-risk eating phenotypes in postpartum women to examine whether these are distinct constructs with specific etiologies and to inform future targets of intervention. Women (N = 277) in the early postpartum period reported on high-risk eating, childhood trauma exposure, depression symptoms, and pre-pregnancy weight. Women's height was measured and pre-pregnancy BMI was calculated. We conducted bivariate correlations and path analysis to characterize the relationship between food addiction and dietary restraint, controlling for pre-pregnancy BMI. Results showed that food addiction and dietary restraint were not significantly associated and that women's childhood trauma exposure and postpartum depression were associated with food addiction but not dietary restraint. Sequential mediation revealed that higher levels of childhood trauma exposure were associated with worse postpartum depression and, in turn, greater food addiction during the early postpartum period. Findings suggest that food addiction and dietary restraint have distinct psychosocial predictors and etiological pathways, which suggests important construct validity differences between the two high-risk eating phenotypes. Interventions seeking to address food addiction in postpartum women and mitigate the impact of this high-risk eating phenotype on the next generation may benefit from treating postpartum depression, especially in women with histories of childhood trauma exposure.
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Affiliation(s)
- Sara F Stein
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA; School of Social Work, University of Michigan, 1080 S. University Ave., Ann Arbor, MI, 48109, USA.
| | - Julia M Rios
- Department of Psychology, University of Michigan College of Literature, Science and the Arts, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan College of Literature, Science and the Arts, 530 Church St., Ann Arbor, MI, 48109, USA
| | - Amy K Nuttall
- Department of Human Development and Family Studies, Michigan State University, 552 West Circle Drive, East Lansing, MI, 48824, USA
| | - Hurley O Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
| | - Katherine L Rosenblum
- Department of Psychiatry, Michigan Medicine, 4250 Plymouth Rd., Ann Arbor, MI, 48109, USA
| | - Julie C Lumeng
- Department of Pediatrics, Michigan Medicine, 1522 Simpson Rd. East., Ann Arbor, MI, 48109, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI, 48109, USA
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DaSilva AF, Kim DJ, Lim M, Nascimento TD, Scott PJH, Smith YR, Koeppe RA, Zubieta JK, Kaciroti N. Effect of High-Definition Transcranial Direct Current Stimulation on Headache Severity and Central µ-Opioid Receptor Availability in Episodic Migraine. J Pain Res 2023; 16:2509-2523. [PMID: 37497372 PMCID: PMC10368121 DOI: 10.2147/jpr.s407738] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/27/2023] [Indexed: 07/28/2023] Open
Abstract
Objective The current understanding of utilizing HD-tDCS as a targeted approach to improve headache attacks and modulate endogenous opioid systems in episodic migraine is relatively limited. This study aimed to determine whether high-definition transcranial direct current stimulation (HD-tDCS) over the primary motor cortex (M1) can improve clinical outcomes and endogenous µ-opioid receptor (µOR) availability for episodic migraineurs. Methods In a randomized, double-blind, and sham-controlled trial, 25 patients completed 10-daily 20-min M1 HD-tDCS, repeated Positron Emission Tomography (PET) scans with a selective agonist for µOR. Twelve age- and sex-matched healthy controls participated in the baseline PET/MRI scan without neuromodulation. The primary endpoints were moderate-to-severe (M/S) headache days and responder rate (≥50% reduction on M/S headache days from baseline), and secondary endpoints included the presence of M/S headache intensity and the use of rescue medication over 1-month after treatment. Results In a one-month follow-up, at initial analysis, both the active and sham groups exhibited no significant differences in their primary outcomes (M/S headache days and responder rates). Similarly, secondary outcomes (M/S headache intensity and the usage of rescue medication) also revealed no significant differences between the two groups. However, subsequent analyses showed that active M1 HD-tDCS, compared to sham, resulted in a more beneficial response predominantly in higher-frequency individuals (>3 attacks/month), as demonstrated by the interaction between treatment indicator and baseline frequency of migraine attacks on the primary outcomes. These favorable outcomes were also confirmed for the secondary endpoints in higher-frequency patients. Active treatment also resulted in increased µOR concentration compared to sham in the limbic and descending pain modulatory pathway. Our exploratory mediation analysis suggests that the observed clinical efficacy of HD-tDCS in patients with higher-frequency conditions might be potentially mediated through an increase in µOR availability. Conclusion The 10-daily M1 HD-tDCS can improve clinical outcomes in episodic migraineurs with a higher baseline frequency of migraine attacks (>3 attacks/month). This improvement may be, in part, facilitated by the increase in the endogenous µOR availability. Clinical Trial Registration www.ClinicalTrials.gov, identifier - NCT02964741.
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Affiliation(s)
- Alexandre F DaSilva
- Headache and Orofacial Pain Effort (H.O.P.E.) Laboratory, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - Dajung J Kim
- Headache and Orofacial Pain Effort (H.O.P.E.) Laboratory, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - Manyoel Lim
- Headache and Orofacial Pain Effort (H.O.P.E.) Laboratory, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - Thiago D Nascimento
- Headache and Orofacial Pain Effort (H.O.P.E.) Laboratory, Department of Biologic and Materials Sciences & Prosthodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA
- Michigan Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - Peter J H Scott
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Yolanda R Smith
- Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Robert A Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - Jon-Kar Zubieta
- Department of Psychiatry, Mass General Brigham, Newton-Wellesley Hospital, Newton, MA, USA
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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11
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Brook RD, Brook AJ, Jamerson K, Levy PD, Kaciroti N. Worse Blood Pressure Levels and Control During Nonsummer Months in Rigorously Treated Patients With Hypertension: The ACCOMPLISH Trial. J Am Heart Assoc 2023:e030696. [PMID: 37421293 PMCID: PMC10382103 DOI: 10.1161/jaha.123.030696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/14/2023] [Indexed: 07/10/2023]
Affiliation(s)
- Robert D Brook
- Division of Cardiovascular Diseases, Department of Internal Medicine Wayne State University Detroit MI USA
| | | | - Kenneth Jamerson
- Division of Cardiovascular Medicine University of Michigan Ann Arbor MI USA
| | - Phillip D Levy
- Department of Emergency Medicine and Integrative Biosciences Center Wayne State University Detroit MI USA
| | - Niko Kaciroti
- Departments of Pediatrics and Biostatistics University of Michigan Ann Arbor MI USA
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12
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Brophy-Herb HE, Martoccio TL, Kerver JM, Choi HH, Jeanpierre LA, Williams J, Mitchell K, Martin CK, Sturza J, Contreras DA, Horodynski MA, Van Egeren LA, Kaciroti N, Lumeng JC. Simply Dinner: A Randomized Controlled Trial of Home Meal Delivery. Acad Pediatr 2023; 23:952-962. [PMID: 36351512 PMCID: PMC10163170 DOI: 10.1016/j.acap.2022.10.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/26/2022] [Accepted: 10/30/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To determine the effect of a bundled intervention (home meal delivery and provision of cooking/serving resources) on preschoolers' body mass index z-score (BMIz), dietary quality, and family meal frequency. METHODS Participants (299 families; mean child age 4.4 years, 47% male, 55% White, 18% Black, 27% Hispanic or other race and ethnicity, and 25% were overweight or obese) were randomized to a control group or to provision of cooking/serving resources plus home meal delivery for 12 weeks (meals provided by Meals on Wheels [MOW cohort, n = 83] or a commercial service [COM cohort, n = 216]). Outcomes were child dietary quality, family meal frequency, and child BMIz. RESULTS The intervention increased dinnertime intake of red and orange vegetables in the full sample (MOW cohort+COM cohort) (0.10 pre- to 0.15 cup equivalents (CE) post-in the intervention group vs 0.10 pre- to 0.09 post- in the control group; P = .01) and the COM cohort (0.11 pre- to 0.17 CE post- vs 0.11 pre- to 0.09 post-; P = .002), and typical daily dietary intake of fruit and fruit juice in the MOW cohort (1.50 CE pre- to 1.66 post- vs 1.48 pre- to 1.19 post-; P = .05). The intervention did not change meal frequency or BMIz. CONCLUSIONS Short-term home meal delivery with provision of cooking/serving resources improved dietary quality among preschool-aged children but did not change meal frequency or BMIz. Expansion of Meals on Wheels programs to preschool-aged children may be a promising intervention to improve dietary quality. Family meals, when already frequent, are not further increased by reducing the burden of meal preparation.
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Affiliation(s)
- Holly E Brophy-Herb
- Department of Human Development and Family Studies (HE Brophy-Herb, J Williams, K Mitchell, MA Horodynski), Michigan State University, East Lansing, Mich.
| | - Tiffany L Martoccio
- Department of Human Development and Quantitative Methodology (TL Martoccio), University of Maryland, College Park, Md
| | - Jean M Kerver
- Department of Epidemiology and Biostatistics (JM Kerver), Michigan State University, East Lansing, Mich
| | - Hailey Hyunjin Choi
- Department of Childhood Education and Family Studies (HH Choi), Missouri State University, Springfield, Mo
| | - L Alexandra Jeanpierre
- Department of Pediatrics (LA Jeanpierre, J Sturza, N Kaciroti, JC Lumeng), University of Michigan Medical School, Ann Arbor, Mich
| | - Jessica Williams
- Department of Human Development and Family Studies (HE Brophy-Herb, J Williams, K Mitchell, MA Horodynski), Michigan State University, East Lansing, Mich
| | - Koi Mitchell
- Department of Human Development and Family Studies (HE Brophy-Herb, J Williams, K Mitchell, MA Horodynski), Michigan State University, East Lansing, Mich
| | - Corby K Martin
- Pennington Biomedical Research Center (CK Martin), Louisiana State University, Baton Rouge, La
| | - Julie Sturza
- Department of Pediatrics (LA Jeanpierre, J Sturza, N Kaciroti, JC Lumeng), University of Michigan Medical School, Ann Arbor, Mich
| | - Dawn A Contreras
- Michigan State University Extension (DA Contreras), Michigan State University, East Lansing, Mich
| | - Mildred A Horodynski
- Department of Human Development and Family Studies (HE Brophy-Herb, J Williams, K Mitchell, MA Horodynski), Michigan State University, East Lansing, Mich
| | - Laurie A Van Egeren
- Office of University Outreach and Engagement (LA Van Egeren), Michigan State University, East Lansing, Mich
| | - Niko Kaciroti
- Department of Pediatrics (LA Jeanpierre, J Sturza, N Kaciroti, JC Lumeng), University of Michigan Medical School, Ann Arbor, Mich; Department of Biostatistics (N Kaciroti), University of Michigan, Ann Arbor, Mich
| | - Julie C Lumeng
- Department of Pediatrics (LA Jeanpierre, J Sturza, N Kaciroti, JC Lumeng), University of Michigan Medical School, Ann Arbor, Mich; Department of Nutritional Sciences (JC Lumeng), University of Michigan School of Public Health, Ann Arbor, Mich
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13
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Abstract
Clinical trials often collect intermediate or surrogate endpoints other than their true endpoint of interest. It is important that the treatment effect on the surrogate endpoint accurately predicts the treatment effect on the true endpoint. There are settings in which the proposed surrogate endpoint is positively correlated with the true endpoint, but the treatment has opposite effects on the surrogate and true endpoints, a phenomenon labeled "surrogate paradox". Covariate information may be useful in predicting an individual's risk of surrogate paradox. In this work, we propose methods for incorporating covariates into measures of assessing the risk of surrogate paradox using the meta-analytic causal association framework. The measures calculate the probability that a treatment will have opposite effects on the surrogate and true endpoints and determine the size of a positive treatment effect on the surrogate endpoint that would reduce the risk of a negative treatment effect on the true endpoint as a function of covariates, allowing the effects of covariates on the surrogate and true endpoint to vary across trials.
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Affiliation(s)
- Fatema Shafie Khorassani
- Department of Biostatistics, School of Public Health, University of
Michigan, Ann Arbor, MI 48109, USA
| | - Jeremy M. G. Taylor
- Department of Biostatistics, School of Public Health, University of
Michigan, Ann Arbor, MI 48109, USA
| | - Niko Kaciroti
- Department of Biostatistics, School of Public Health, University of
Michigan, Ann Arbor, MI 48109, USA
| | - Michael R. Elliott
- Department of Biostatistics, School of Public Health, University of
Michigan, Ann Arbor, MI 48109, USA
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14
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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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15
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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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16
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Miller AL, Albright D, Bauer KW, Riley HO, Hilliard ME, Sturza J, Kaciroti N, Lo SL, Clark KM, Lee JM, Fredericks EM. Self-Regulation as a Protective Factor for Diabetes Distress and Adherence in Youth with Type 1 Diabetes During the COVID-19 Pandemic. J Pediatr Psychol 2022; 47:873-882. [PMID: 35609567 PMCID: PMC9213854 DOI: 10.1093/jpepsy/jsac045] [Citation(s) in RCA: 3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE The COVID-19 pandemic increased economic, social, and health stressors for families, yet its impacts on families of youth with chronic conditions, such as type 1 diabetes (T1D), are not well understood. Self-regulation (SR)-or the capacities to control emotions, cognition, and behavior in response to challenge-is known to support T1D management and coping in the face of stress. Strong SR may have protected youth with T1D from the impacts of pandemic-related stressors. This study compared youth and parent emotional functioning and T1D management before and after the pandemic's onset in relation to family pandemic-related stress and youth SR. METHODS Parents of youth with T1D (N = 88) and a subset of these youth (N = 43; Mean age 15.3 years [SD 2.2]) completed surveys regarding SR, stress, emotional functioning, and T1D-related functioning prior to and after March 2020. Outcomes were compared using mixed effects models adjusting for covariates. Family pandemic-related stress experiences and youth SR were tested as moderators of change. RESULTS Parents' responsibility for T1D management increased across pandemic onset and their diabetes-related distress decreased. Family pandemic-related stress was associated with decreased emotional functioning over time. Youth SR, particularly emotional and behavioral aspects, predicted better emotional and T1D-related functioning. DISCUSSION While youth with T1D whose families experienced higher pandemic-related stress had poorer adjustment, strong emotional and behavioral SR appeared to protect against worsening youth mood and adherence across pandemic onset. Both social-contextual and individual factors are important to consider when working with families managing T1D.
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Affiliation(s)
- Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Dana Albright
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Katherine W Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hurley O Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Marisa E Hilliard
- Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Sharon L Lo
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Katy M Clark
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Joyce M Lee
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, MI, USA
| | - Emily M Fredericks
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA.,Department of Pediatrics, Susan B. Meister Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, MI, USA
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17
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Fisher JO, Hughes SO, Miller AL, Horodynski MA, Brophy-Herb HE, Contreras DA, Kaciroti N, Peterson KE, Rosenblum KL, Appugliese D, Lumeng JC. Correction: Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: a person-centered analysis. Int J Behav Nutr Phys Act 2022; 19:103. [PMID: 35941588 PMCID: PMC9358796 DOI: 10.1186/s12966-022-01341-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Jennifer Orlet Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA.
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Dawn A Contreras
- Health and Nutrition Institute, Michigan State University Extension, East Lansing, MI, USA.,Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
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18
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Fisher JO, Hughes SO, Miller AL, Horodynski MA, Brophy-Herb HE, Contreras DA, Kaciroti N, Peterson KE, Rosenblum KL, Appugliese D, Lumeng JC. Characteristics of eating behavior profiles among preschoolers with low-income backgrounds: a person-centered analysis. Int J Behav Nutr Phys Act 2022; 19:91. [PMID: 35870976 PMCID: PMC9308918 DOI: 10.1186/s12966-022-01323-y] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Individual differences in eating behaviors among young children are well-established, but the extent to which behaviors aggregate within individuals to form distinct eating behavior profiles remains unknown. Our objectives were to identify eating behavior profiles among preschool-aged children and evaluate associations with temperament and weight. METHODS A secondary, cross-sectional analysis of baseline data from 2 cohort studies was conducted involving 1004 children aged 3-4 years and their parents with low-income backgrounds. Children's eating behaviors and temperament were assessed by parental report. Body mass index z-scores and weight status were calculated using measured heights and weights. Latent profile analysis (LPA) was used to generate profiles and bivariate analyses were used to evaluate associations with temperament and weight status. RESULTS LPA revealed the presence of 3 eating behavior profiles among children. Children with High Food Approach profiles (21.2%) had lower temperamental inhibitory control and the highest percent of children with obesity relative to the other profiles. Children with High Food Avoidant profiles (35.6%) had lower temperamental impulsivity and lower BMI z-scores relative to the other profiles, whereas children with Moderate Eating profiles (intermediary levels of all behaviors; 43.2%) had higher temperamental inhibitory control and lower anger/frustration, than other profiles. CONCLUSIONS Young children's eating behaviors appear to aggregate within individuals to form empirically distinct profiles reflecting food approach, food avoidance, and moderate approaches to eating that are differentiated by aspects of temperament and weight. Future work should seek to understand the extent to which health promotion and obesity prevention approaches should be tailored to take into account children's fundamental dispositions towards eating.
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Affiliation(s)
- Jennifer Orlet Fisher
- Center for Obesity Research and Education, College of Public Health, Temple University, Philadelphia, PA, USA.
| | - Sheryl O Hughes
- USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, TX, USA
| | - Alison L Miller
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI, USA
| | - Dawn A Contreras
- Health and Nutrition Institute, Michigan State University Extension, East Lansing, MI, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Karen E Peterson
- Department of Nutritional Sciences, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
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19
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Kerver JM, Brophy-Herb HE, Sturza J, Horodynski MA, Contreras DA, Stein M, Garner E, Hebert S, Williams JM, Kaciroti N, Martoccio T, Van Egeren LA, Choi H, Martin CK, Mitchell K, Dalimonte-Merckling D, Jeanpierre LA, Robinson CA, Lumeng JC. Supporting family meal frequency: Screening Phase results from the Simply Dinner Study. Appetite 2022; 174:106009. [PMID: 35337884 PMCID: PMC9058229 DOI: 10.1016/j.appet.2022.106009] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 03/10/2022] [Accepted: 03/17/2022] [Indexed: 11/28/2022]
Abstract
We aimed to test main, additive, interactive effects, and feasibility of all possible combinations of six intervention components implemented for 8 weeks (Cooking/Serving Resources; Meal Delivery; Ingredient Delivery; Community Kitchen; Nutrition Education; Cooking Demonstrations). Primary outcomes were family meal frequency and preschoolers' dietary quality; secondary outcomes included family meal preparation type, meal preparation barriers, family functioning, and kitchen inventory adequacy. All possible intervention combinations were tested using a randomized factorial trial design in the first phase of a Multiphase Optimization Strategy (MOST). Feasibility was assessed via attendance, delivery logs, and satisfaction. Parent-reported data collection included: socio-demographics, frequency and type of family meals; preschooler dietary intake; perceived barriers to meal planning and preparation; assessment of family functioning; and a kitchen inventory of materials generally needed for meal preparation. Participants (n = 499) were recruited at two Head Start agencies in mid-Michigan with data collection and delivery of some intervention components in participants' homes. Promising intervention bundles were identified by evaluating pre-to post-intervention effect sizes. The combination of Cooking/Serving Resources and Meal Delivery increased family meal frequency (Cohen's d = 0.17), cooking dinner from scratch (d = 0.21), prioritization of family meals (d = 0.23), and kitchen inventory (d = 0.46) and decreased use/consumption of ready-made (d = -0.18) and fast foods (d = -0.23). Effects on diet quality were in the expected direction but effect sizes were negligible. Community Kitchen, Nutrition Education, and Cooking Demonstration showed poor feasibility due to low attendance while Ingredient Delivery was infeasible due to staffing challenges related to its labor intensity. Additionally, although not one of our pre-specified outcomes, Cooking/Serving Resources (RR = 0.74) and Meal Delivery (RR = 0.73) each decreased food insecurity. Cooking/Serving Resources combined with Meal Delivery showed promise as a strategy for increasing family meal frequency.
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Affiliation(s)
- Jean M. Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, 909 Wilson Road, East Lansing, MI 48824
| | - Holly E. Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, 552 W Circle Drive, East Lansing, MI 48824
| | - Julia Sturza
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI
| | - Mildred A. Horodynski
- College of Nursing, Michigan State University, 1355 Bogue St, East Lansing, MI 48824
| | - Dawn A. Contreras
- Michigan State University Extension, Michigan State University, East Lansing, MI 48824
| | - Mara Stein
- Department of Human Development and Family Studies, Michigan State University, 552 W Circle Drive, East Lansing, MI 48824
| | - Erika Garner
- Michigan State University Extension, Michigan State University, East Lansing, MI 48824
| | - Sheilah Hebert
- Michigan State University Extension, Michigan State University, East Lansing, MI 48824
| | - Jessica M. Williams
- Department of Human Development and Family Studies, Michigan State University, 552 W Circle Drive, East Lansing, MI 48824
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan, Ann Arbor, MI
| | - Tiffany Martoccio
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD
| | - Laurie A. Van Egeren
- University Outreach and Engagement, Michigan State University, East Lansing, MI 48824
| | - Hailey Choi
- Department of Human Development and Family Studies, Missouri State University, Springfield, MO
| | - Corby K. Martin
- Pennington Biomedical Research Institution, Louisiana State University, Baton Rouge, LA
| | - Koi Mitchell
- Department of Human Development and Family Studies, Michigan State University, 552 W Circle Drive, East Lansing, MI 48824
| | - Danielle Dalimonte-Merckling
- Department of Human Development and Family Studies, Michigan State University, 552 W Circle Drive, East Lansing, MI 48824
| | | | - Chelsea A. Robinson
- Department of Epidemiology and Biostatistics, Michigan State University, 909 Wilson Road, East Lansing, MI 48824
| | - Julie C. Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI
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20
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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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21
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Stein SF, Riley HO, Kaciroti N, Rosenblum KL, Sturza JM, Gearhardt AN, Grogan-Kaylor AC, Lumeng JC, Miller AL. Infant Distress in a Food Delay Task Changes With Development and Predicts Amount Consumed. Front Nutr 2022; 9:786022. [PMID: 35464039 PMCID: PMC9021754 DOI: 10.3389/fnut.2022.786022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/08/2022] [Indexed: 12/05/2022] Open
Abstract
Objective Eating behavior regulation emerges during early development and involves general self-regulation (emotional, behavioral), appetite regulation (homeostatic metabolic need) and appetite self-regulation (including both Bottom-Up Food Approach and Bottom-Up Food Avoidance and top-down purposeful self-control of eating). Limited research has investigated developmental trajectories of the regulation of eating behavior before the preschool years. The current study used a novel food delay task to assess infant distress as an early emerging marker of eating behavior regulation constructs across early infancy and examine associations with amount of milk consumed. Method Mother-infant dyads (n = 179) completed the Ability to Delay Gratification for Food in Infants Task (ATDG-FIT) at 2 weeks, 8 weeks, and 16 weeks of age. The ATDG-FIT required infants to wait before being fed while their bottle was present, but not accessible (3-min Pre-Feeding Delay). After this, the infant was fed for 1 min, then the feeding was paused for 30 s (Mid-Feeding Delay). Infant distress was coded during each feeding delay period and the amount of milk consumed was measured. Results The mean proportion of distress during the Pre-Feeding Delay period decreased from 8 to 16 weeks of age (F(2,230) = 15.02, p < 0.001), whereas the mean proportion of distress during the Mid-Feeding Delay increased from 2 to 8 weeks of age (F(2,230) = 27.04, p < 0.001). There was a positive interaction between distress during Mid-Feeding Delay and infant age predicting the amount consumed in the protocol (ß = 0.30, p = 0.022), suggesting that the association between distress during this part of the task and amount consumed strengthens as infants get older. Conclusion The ATDG-FIT may be an effective method to assess emerging eating behavior regulation constructs during early infancy.
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Affiliation(s)
- Sara F. Stein
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
- *Correspondence: Sara F. Stein,
| | - Hurley O. Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | | | - Julie M. Sturza
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, United States
| | - Ashley N. Gearhardt
- Department of Psychology, University of Michigan College of Literature, Science, and the Arts, Ann Arbor, MI, United States
| | | | - Julie C. Lumeng
- Department of Pediatrics, Michigan Medicine, Ann Arbor, MI, United States
| | - Alison L. Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, United States
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22
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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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23
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Muir LA, Cho KW, Geletka LM, Baker NA, Flesher CG, Ehlers AP, Kaciroti N, Lindsly S, Ronquist S, Rajapakse I, O'Rourke RW, Lumeng CN. Human CD206+ macrophages associate with diabetes and adipose tissue lymphoid clusters. JCI Insight 2022; 7:146563. [PMID: 34990410 PMCID: PMC8855803 DOI: 10.1172/jci.insight.146563] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 12/15/2021] [Indexed: 12/03/2022] Open
Abstract
Increased adipose tissue macrophages (ATMs) correlate with metabolic dysfunction in humans and are causal in development of insulin resistance in mice. Recent bulk and single-cell transcriptomics studies reveal a wide spectrum of gene expression signatures possible for macrophages that depends on context, but the signatures of human ATM subtypes are not well defined in obesity and diabetes. We profiled 3 prominent ATM subtypes from human adipose tissue in obesity and determined their relationship to type 2 diabetes. Visceral adipose tissue (VAT) and s.c. adipose tissue (SAT) samples were collected from diabetic and nondiabetic obese participants to evaluate cellular content and gene expression. VAT CD206+CD11c- ATMs were increased in diabetic participants, were scavenger receptor-rich with low intracellular lipids, secreted proinflammatory cytokines, and diverged significantly from 2 CD11c+ ATM subtypes, which were lipid-laden, were lipid antigen presenting, and overlapped with monocyte signatures. Furthermore, diabetic VAT was enriched for CD206+CD11c- ATM and inflammatory signatures, scavenger receptors, and MHC II antigen presentation genes. VAT immunostaining found CD206+CD11c- ATMs concentrated in vascularized lymphoid clusters adjacent to CD206-CD11c+ ATMs, while CD206+CD11c+ were distributed between adipocytes. Our results show ATM subtype-specific profiles that uniquely contribute to the phenotypic variation in obesity.
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Affiliation(s)
| | | | | | - Nicki A Baker
- Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Carmen G Flesher
- Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Anne P Ehlers
- Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Surgery, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan, USA.,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Stephen Lindsly
- Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Scott Ronquist
- Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Indika Rajapakse
- Department of Computational Medicine and Bioinformatics, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Mathematics and.,Department of Biomedical Engineering, University of Michigan, Ann Arbor, Michigan, USA
| | - Robert W O'Rourke
- Department of Surgery, University of Michigan Medical School, Ann Arbor, Michigan, USA.,Department of Surgery, Ann Arbor Veterans Affairs Healthcare System, Ann Arbor, Michigan, USA
| | - Carey N Lumeng
- Department of Pediatrics and.,Molecular and Integrative Physiology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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24
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Munzer TG, Miller AL, Yeo S, Wang Y, McCaffery H, Kaciroti N, Radesky J. Parent Verbalizations and Toddler Responses With Touchscreen Tablet Nursery Rhyme Apps. Pediatrics 2021; 148:e2021049964. [PMID: 34841433 PMCID: PMC10777329 DOI: 10.1542/peds.2021-049964] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES In some studies, parents and toddlers verbalize less when engaging with a tablet versus a print book. More needs to be known regarding child contributions to specific parent verbalizations. We examined parent-toddler contingent interactions with tablet applications versus print books, as well as moderators of these associations. METHODS We conducted a laboratory-based, within-subjects counterbalanced study of 72 parent-toddler dyads engaging with a nursery rhyme application (with enhanced + autonarration [E+A] and enhanced formats) and print book. We coded parent verbalizations (eg, dialogic, nondialogic) and proportions of child responses to these in 5-second epochs. Poisson regressions were used to analyze within-subjects variance by tablet or print format. We tested effect modification by child emotion regulation and home media practices. RESULTS Children responded more to parent overall (print 0.38; E+A 0.31, P = .04; enhanced 0.11, P = .01), dialogic (print 0.21; E+A 0.13, P = .04; enhanced 0.1, P = .02), and nondialogic (print 0.45; E+A 0.27, P < .001; enhanced 0.32, P < .001) verbalizations during print book versus tablet. Stronger child emotion regulation, greater frequency of co-viewing, and instructive practices moderated associations such that differences between conditions were no longer significant for some parent verbalizations and child responses. CONCLUSIONS Parent-toddler reciprocal verbal interactions occurred less frequently with tablet versus print book use. Child emotion regulation and parent home media practices moderated some of these associations. Pediatricians may wish to promote co-viewing and instructive media practices but may also consider that child emotion regulation may determine response to interactive tablet design.
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Affiliation(s)
| | | | | | - Yujie Wang
- Department of Pediatrics, Medical School
| | | | - Niko Kaciroti
- Department of Pediatrics, Medical School
- Biostatistics, School of Public Health, University of Michigan, Ann Arbor, Michigan
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25
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Lo SL, Riley HO, Sturza J, Vazquez DM, Rosenblum K, Kaciroti N, Lumeng JC, Miller AL. Cortisol in early childhood moderates the association between family routines and observed affective balance in children from low-income backgrounds. Dev Psychobiol 2021; 63:e22204. [PMID: 34813102 DOI: 10.1002/dev.22204] [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] [Received: 10/30/2020] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 11/10/2022]
Abstract
The study of emotion regulation often addresses control of negative emotion. Researchers have proposed that affective balance is an indicator of emotion regulation that incorporates the role of positive emotion in the context of negative emotional experiences. Environmental and individual factors, such as family processes and biological stress regulation, are known to shape emotion regulation. The present study investigated whether child diurnal cortisol, an indicator of biological stress regulation, moderated the association between family routines and observed affective balance. Children (N = 222; M age = 4.70 years, SD = 0.60) from low-income households provided saliva samples to measure diurnal cortisol and completed a behavioral task designed to elicit negative emotions. Affective balance was defined as the difference score between the proportion of positive and negative emotional expressions displayed during the task. A higher affective balance score indicated greater positive compared with negative emotional displays. Simple slope analyses indicated that for children with a low morning cortisol intercept, more frequent family routines were associated with more affective balance. This pattern was not observed in children with average or high morning cortisol. Positive family routines may play an important role in shaping affective balance among children with disrupted cortisol levels from low-income backgrounds.
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Affiliation(s)
- Sharon L Lo
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Hurley O Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Delia M Vazquez
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Katherine Rosenblum
- Department of Psychiatry, University of Michigan Medical School, 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
| | - Julie C Lumeng
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, 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
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26
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Bauer KW, Branch JM, Appugliese DP, Pesch MH, Miller AL, Lumeng JC, Kaciroti N. Emerging Ideas Brief Report. How Do Low-Income Mothers Talk to Children About Weight and Body Shape? Fam Relat 2021; 70:1477-1484. [PMID: 34955577 PMCID: PMC8694111 DOI: 10.1111/fare.12550] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Identify mothers' perceptions of how they talk about weight and body shape with their children and examine how approaches vary by mother and child characteristics. BACKGROUND Youth who report that their parents talk with them about their weight experience poor health. However, very little is known about the content of these conversations. METHOD Mothers and their 6- to 11-year-old children (N = 188 dyads) participated in a mixed-methods study. Themes in mothers' responses to the interview question "How do you talk to your child about weight or body shape?" were identified, and latent class analysis was used to characterize patterns of weight and shape talk. RESULTS Seven themes of weight and shape talk were identified, including talking about "Healthy Habits" (39.9%), "Avoids Weight and Body Talk" (21.8%), and tells "Cautionary Tales" (18.6%). Three patterns emerged from themes: talk to promote health, avoid talking about weight and shape, and talk to build children's self-esteem. Mothers of children with obesity were more likely to talk to promote health versus other patterns. CONCLUSION The content of family conversations about weight and shape is diverse. IMPLICATIONS FOR EMERGING IDEAS Future research is needed to understand the impacts of specific ways parents talk about weight and shape.
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27
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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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28
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Hu XS, Beard K, Sherbel MC, Nascimento TD, Petty S, Pantzlaff E, Schwitzer D, Kaciroti N, Maslowski E, Ashman LM, Feinberg SE, DaSilva AF. Brain Mechanisms of Virtual Reality Breathing Versus Traditional Mindful Breathing in Pain Modulation: Observational Functional Near-infrared Spectroscopy Study. J Med Internet Res 2021; 23:e27298. [PMID: 34636731 PMCID: PMC8548979 DOI: 10.2196/27298] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 01/19/2023] Open
Abstract
Background Pain is a complex experience that involves sensory-discriminative and cognitive-emotional neuronal processes. It has long been known across cultures that pain can be relieved by mindful breathing (MB). There is a common assumption that MB exerts its analgesic effect through interoception. Interoception refers to consciously refocusing the mind’s attention to the physical sensation of internal organ function. Objective In this study, we dissect the cortical analgesic processes by imaging the brains of healthy subjects exposed to traditional MB (TMB) and compare them with another group for which we augmented MB to an outside sensory experience via virtual reality breathing (VRB). Methods The VRB protocol involved in-house–developed virtual reality 3D lungs that synchronized with the participants’ breathing cycles in real time, providing them with an immersive visual-auditory exteroception of their breathing. Results We found that both breathing interventions led to a significant increase in pain thresholds after week-long practices, as measured by a thermal quantitative sensory test. However, the underlying analgesic brain mechanisms were opposite, as revealed by functional near-infrared spectroscopy data. In the TMB practice, the anterior prefrontal cortex uniquely modulated the premotor cortex. This increased its functional connection with the primary somatosensory cortex (S1), thereby facilitating the S1-based sensory-interoceptive processing of breathing but inhibiting its other role in sensory-discriminative pain processing. In contrast, virtual reality induced an immersive 3D exteroception with augmented visual-auditory cortical activations, which diminished the functional connection with the S1 and consequently weakened the pain processing function of the S1. Conclusions In summary, our study suggested two analgesic neuromechanisms of VRB and TMB practices—exteroception and interoception—that distinctively modulated the S1 processing of the ascending noxious inputs. This is in line with the concept of dualism (Yin and Yang).
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Affiliation(s)
- Xiao-Su Hu
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Katherine Beard
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Mary Catherine Sherbel
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States.,Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Thiago D Nascimento
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Sean Petty
- 3D Lab, Digital Media Commons, University of Michigan, Ann Arbor, MI, United States
| | - Eddie Pantzlaff
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - David Schwitzer
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Niko Kaciroti
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States.,Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States
| | | | - Lawrence M Ashman
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States.,Department of Oral & Maxillofacial Surgery, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Stephen E Feinberg
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States.,Department of Oral & Maxillofacial Surgery, University of Michigan School of Dentistry, Ann Arbor, MI, United States
| | - Alexandre F DaSilva
- Headache & Orofacial Pain Effort Lab, Biologic and Materials Sciences & Prosthodontics Department, University of Michigan School of Dentistry, Ann Arbor, MI, United States
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Abstract
BACKGROUND Bleeding is the most common complication of circumcisions in newborns. Gomco clamps are used to perform neonatal circumcisions. Although a clamp time of 5 minutes is recommended, there is no evidence to support this recommendation. METHODS Circumcisions performed by attending physicians from the Division of Pediatric Hospital Medicine at an academic children's hospital were split into 2 groups. Group 1 had a clamp time of 5 minutes. Group 2 did not have a clamp time minimum. Nursing staff examined for bleeding at intervals of 15- and 30-minutes' postprocedure. Bleeding was determined to be significant if pressure and/or a microfibrillar collagen hemostat agent was applied. RESULTS The study sample contained 23 physicians who saw a total of 1252 patients: 13 physicians (647 patients) in group 1 and 10 physicians (605 patients) in group 2. The average clamp time in group 2 was 2 minutes, 5 seconds. The estimated percentage of circumcisions that required microfibrillar collagen hemostat application was 5.1% (95% confidence interval [CI], 3.1-8.1) for group 1 and 5.6% (95% CI: 3.5-8.8]) for group 2. Circumcisions that had pressure applied were estimated to be 0.6% (95% CI: 0.2-1.7) for group 1 and 1.3% (95% CI: 0.5-3.1) for group 2. The difference between groups, in both categories, was not statistically significant. CONCLUSIONS In this prospective study we evaluated clamp time duration and bleeding outcomes for neonatal circumcision. Clamp time does not appear to have an association with bleeding risk. Providers need not maintain a 5-minute clamp time to decrease postprocedural bleeding.
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Affiliation(s)
| | - Perra Razoky
- Department of Pediatrics, C.S. Mott Children's Hospital
| | - Shannon Murphy
- Department of Pediatrics, Children's Hospital, University of Illinois Hospital & Health Sciences System, Chicago, Illinois
| | | | | | - Harlan McCaffery
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan
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Brook RD, Kaciroti N, Jamerson T, Jamerson KA. Cardiovascular Benefits of Combination Angiotensin-Converting Enzyme Inhibition Plus Calcium Channel Blockade in Black Hypertensive Patients. Hypertension 2021; 78:1150-1152. [PMID: 34420368 DOI: 10.1161/hypertensionaha.121.17990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Robert D Brook
- Division of Cardiovascular Diseases, Wayne State University, Detroit, MI (R.D.B.)
| | - Niko Kaciroti
- Center for Human Growth and Development and Department of Biostatistics (N.K.), University of Michigan, Ann Arbor
| | | | - Kenneth A Jamerson
- Division of Cardiovascular Medicine (K.A.J.), University of Michigan, Ann Arbor
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Hahn SL, Sonneville KR, Kaciroti N, Eisenberg D, Bauer KW. Relationships between patterns of technology-based weight-related self-monitoring and eating disorder behaviors among first year university students. Eat Behav 2021; 42:101520. [PMID: 33991833 PMCID: PMC8462031 DOI: 10.1016/j.eatbeh.2021.101520] [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] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/29/2021] [Accepted: 05/04/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To identify patterns of technology-based weight-related self-monitoring (WRSM) and assess associations between identified patterns and eating disorder behaviors among first year university students. METHODS First year university students (n = 647) completed a web-based survey to assess their use of technology-based WRSM and eating disorder behaviors. The cross-sectional data were analyzed using gender-stratified latent class analysis to identify patterns of WRSM, followed by logistic regression to calculate the predicted probability of eating disorder behaviors for each pattern of WRSM. RESULTS Technology-based WRSM is common among first year university students, with patterns of WRSM differing by student gender. Further, unique patterns of WRSM were associated with differing probability of engaging in eating disorder behaviors. For example, compared to the 67.0% of females who did not use technology-based WRSM, females engaging in high amounts of technology-based WRSM (33.0%) were more likely to report fasting, skipping meals, excessively exercising, and using supplements. Among males, those who reported all forms of WRSM (9.5%) were more likely to report fasting, skipping meals, purging, and using supplements but those who only used exercise self-monitoring (11.9%) did not have increased likelihood of eating disorder behaviors. CONCLUSIONS Using multiple forms of technology-based WRSM is associated with increased likelihood of engaging in eating disorder behaviors among both female and male, first year university students. Assessing technology-based WRSM may be a simple method to screen for elevated eating disorder risk among first year students.
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Affiliation(s)
- Samantha L. Hahn
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, 1300 S 2nd St Unit 300, Minneapolis, MN 55454,Department of Psychiatry, University of Minnesota Medical School, 2312 S. 6th St. Floor 2, Minneapolis, MN 55454,Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Kendrin R. Sonneville
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109
| | - Daniel Eisenberg
- Department of Health Policy and Management, University of California Los Angeles School of Public Health, 650 Charles Young Dr, Los Angeles, CA 90095
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109
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32
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Brook RD, Kaciroti N, Bakris G, Dahlöf B, Pitt B, Velazquez E, Weber MA, Jamerson KA. Cardiovascular Benefits of Angiotensin-Converting Enzyme Inhibition Plus Calcium Channel Blockade in Patients Achieving Tight Blood Pressure Control and With Resistant Hypertension. Am J Hypertens 2021; 34:531-539. [PMID: 33216879 DOI: 10.1093/ajh/hpaa192] [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: 07/25/2020] [Revised: 10/13/2020] [Accepted: 11/17/2020] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The 2017 hypertension guidelines lowered systolic blood pressure (BP) goals to <130 mm Hg and redefined resistant hypertension. We investigated if these changes alter the cardiovascular benefits demonstrated by combining a calcium channel blocker (CCB), rather than hydrochlorothiazide (HCTZ), with an angiotensin-converting enzyme inhibitor (ACEI). METHODS In this post hoc analysis of the Avoiding Cardiovascular Events Through Combination Therapy in Patients Living with Systolic Hypertension trial (n = 11,506), we compared the primary composite outcome (cardiovascular death, myocardial infarction, stroke, hospitalization for angina, resuscitation after sudden cardiac death, and coronary revascularization) between the 2 combination-treatment limbs in patients achieving a systolic BP ≤130 mm Hg and those with "apparent resistant hypertension" (prescribed ≥4 antihypertensive medications). RESULTS Among study patients, 5,221 (45.4%) achieved a systolic BP ≤130 mm Hg. There were fewer primary endpoints in the amlodipine/benazepril (9.2%) vs. the HCTZ/benazepril (10.9%) limb (adjusted hazard ratio [HR] 0.83, 95% confidence interval [CI], 0.70-0.99). There were also fewer primary endpoints in the amlodipine/benazepril (12.8%) vs. the HCTZ/benazepril (15.2%) limb (n = 4,451, 38.7%) among patients with apparent resistant hypertension (HR 0.81, 95% CI, 0.70-0.95). CONCLUSIONS Combination therapy adding a CCB, rather than HCTZ, to an ACEI was more effective in preventing composite cardiovascular events even in hypertensive patients achieving aggressive systolic BP targets as well as in those with apparent resistant hypertension. Our findings add support that most patients, including those following contemporary clinical guidelines, will benefit from this combination. CLINICAL TRIALS REGISTRATION Trial Number NCT00170950.
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Affiliation(s)
- Robert D Brook
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Niko Kaciroti
- Center for Human Growth and Development and Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
| | - George Bakris
- The University of Chicago Medicine, Chicago, Illinois, USA
| | - Björn Dahlöf
- Sahlgrenska University Hospital Östra, Göthenburg, Sweden
| | - Bertrtam Pitt
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Eric Velazquez
- Duke University School of Medicine, Durham, North Carolina, USA
| | - Michael A Weber
- State University of New York Downstate, Brooklyn, New York, USA
| | - Kenneth A Jamerson
- Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Bravender T, Selkie E, Sturza J, Martin DM, Griffith KA, Kaciroti N, Jagsi R. Association of Salary Differences Between Medical Specialties With Sex Distribution. JAMA Pediatr 2021; 175:524-525. [PMID: 33555312 PMCID: PMC7871206 DOI: 10.1001/jamapediatrics.2020.5683] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 11/14/2022]
Abstract
This cohort study examines the association between the percentage of female clinicians in a medical specialty and the mean and median salaries for the specialty.
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Affiliation(s)
- Terrill Bravender
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Ellen Selkie
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Julie Sturza
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Donna M. Martin
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor
| | - Kent A. Griffith
- Center for Bioethics and Social Sciences in Medicine, University of Michigan Medical School, Ann Arbor
| | - Niko Kaciroti
- University of Michigan School of Public Health, Ann Arbor
| | - Reshma Jagsi
- Department of Radiation Oncology, University of Michigan Medical School, Ann Arbor
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Lo SL, Gearhardt AN, Fredericks EM, Katz B, Sturza J, Kaciroti N, Gonzalez R, Hunter CM, Sonneville K, Chaudhry K, Lumeng JC, Miller AL. Targeted self-regulation interventions in low-income children: Clinical trial results and implications for health behavior change. J Exp Child Psychol 2021; 208:105157. [PMID: 33910138 DOI: 10.1016/j.jecp.2021.105157] [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: 11/13/2019] [Revised: 02/02/2021] [Accepted: 03/16/2021] [Indexed: 10/21/2022]
Abstract
Self-regulation, known as the ability to harness cognitive, emotional, and motivational resources to achieve goals, is hypothesized to contribute to health behaviors across the lifespan. Enhancing self-regulation early in life may increase positive health outcomes. During pre-adolescence, children assume increased autonomy in health behaviors (e.g., eating; physical activity), many of which involve self-regulation. This article presents results from a clinical trial (NCT03060863) that used a factorial design to test behavioral interventions designed to enhance self-regulation, specifically targeting executive functioning, emotion regulation, future-oriented thinking, and approach biases. Participants were 118 children (9-12 years of age, M = 10.2 years) who had a history of living in poverty. They were randomized to receive up to four interventions that were delivered via home visits. Self-regulation was assayed using behavioral tasks, observations, interviews, and parent- and child-report surveys. Results were that self-regulation targets were reliably assessed and that interventions were delivered with high fidelity. Intervention effect sizes were very small to moderate (d range = .02-.65, median = .14), and most were not statistically significant. Intercorrelation analyses indicated that associations between measures within each target varied based on the self-regulation target evaluated. Results are discussed with regard to the role of self-regulation-focused interventions in child health promotion. Implications of findings are reviewed for informing next steps in behavioral self-regulation interventions among children from low-income backgrounds.
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Affiliation(s)
- Sharon L Lo
- School of Graduate Psychology, Pacific University, Hillsboro, OR 97123, USA; School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Emily M Fredericks
- Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Benjamin Katz
- Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA 24061, USA
| | - Julie Sturza
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Niko Kaciroti
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Richard Gonzalez
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD 20892, USA
| | - Kendrin Sonneville
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Kiren Chaudhry
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Julie C Lumeng
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Alison L Miller
- School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
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35
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Hahn SL, Bauer KW, Kaciroti N, Eisenberg D, Lipson SK, Sonneville KR. Relationships between patterns of weight-related self-monitoring and eating disorder symptomology among undergraduate and graduate students. Int J Eat Disord 2021; 54:595-605. [PMID: 33399230 PMCID: PMC8549082 DOI: 10.1002/eat.23466] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 08/20/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To characterize patterns of weight-related self-monitoring (WRSM) among US undergraduate and graduate students and examine associations between identified patterns of WRSM and eating disorder symptomology. METHOD Undergraduate and graduate students from 12 US colleges and universities (N = 10,010) reported the frequency with which they use WRSM, including self-weighing and dietary self-monitoring. Eating disorder symptomology was assessed using the Eating Disorder Examination Questionnaire. Gender-specific patterns of WRSM were identified using latent class analysis, and logistic regressions were used to identify differences in the odds of eating disorder symptomology across patterns of WRSM. RESULTS Among this sample, 32.7% weighed themselves regularly; 44.1% reported knowing the nutrition facts of the foods they ate; 33.6% reported knowing the caloric content of the foods they ate; and 12.8% counted the calories they ate. Among women, four patterns of WRSM were identified: "no WRSM," "all forms of WRSM," "knowing nutrition/calorie facts," and "self-weigh only." Compared with the "no WRSM" pattern, women in all other patterns experienced increased eating disorder symptomology. Among men, three patterns were identified: "no WRSM," "all forms of WRSM," and "knowing nutrition/calorie facts." Only men in the "all forms WRSM" pattern had increased eating disorder symptomatology compared with those in the "no WRSM" pattern. DISCUSSION In a large sample of undergraduate and graduate students, engaging in any WRSM was associated with increased eating disorder symptomology among women, particularly for those who engaged in all forms. Among men, engaging in all forms of WRSM was the only pattern associated with higher eating disorder symptomology.
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Affiliation(s)
- Samantha L. Hahn
- Department of Nutritional Sciences, University of Michigan School of Public Health,Division of Epidemiology & Community Health, University of Minnesota School of Public Health,Department of Psychiatry, University of Minnesota Medical School
| | - Katherine W. Bauer
- Department of Nutritional Sciences, University of Michigan School of Public Health
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health
| | - Daniel Eisenberg
- Department of Health Policy and Management, University of California Los Angeles School of Public Health
| | - Sarah K. Lipson
- Department of Health Law Policy and Management, Boston University School of Public Health
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Torres C, Brophy-Herb HE, McCaffery H, Struza J, Williams JM, Choi HH, Horodynski MA, Contreras D, Kerver J, Kaciroti N, Lumeng JC. Maternal Mindfulness Is Associated With Lower Child Body Mass Index Z Score. Acad Pediatr 2021; 21:70-75. [PMID: 32590057 PMCID: PMC7755689 DOI: 10.1016/j.acap.2020.06.012] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Parental mindfulness may be a novel intervention target for child obesity prevention. OBJECTIVE To examine associations between maternal mindfulness and child body mass index z-score (BMIz). METHODS In a secondary data analysis of preintervention data from a randomized controlled trial, we assessed survey and anthropometric data from English-speaking mother/child dyads enrolled in Head Start in south central Michigan (n = 105). Surveys included demographic information, child dietary intake, family meal frequency, and the Philadelphia Mindfulness Questionnaire. Multivariable linear regression examined associations between maternal mindfulness and child BMIz, child intake of fruits and vegetables, and frequency of family meals. RESULTS Children were M = 53.7 (standard deviation [SD] 7.5) months old, and mothers were M = 31.6 (SD 8.3) years old. The sample of children was 39% white, 26% black, 14% Hispanic, and 35% of children were overweight or obese. Mean maternal BMI was 32.0 (SD 8.3). Greater mindfulness was associated with child BMIz (β = -.02 (SE 0.01), P = .027) adjusting for child race/ethnicity, household food security, maternal education, maternal age, and maternal BMI. Mindfulness was not associated with child fruit intake, child vegetable intake or frequency of family meals. The results were consistent with alternative outcomes of BMI percentile (P = .016) and BMI at the trend level (P = .0595) at the trend level. CONCLUSIONS Greater maternal mindfulness was associated with lower child BMIz. Future work should consider mechanisms of association. Pediatric providers might consider supporting maternal mindfulness as one element of multicomponent strategies for child obesity prevention.
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Affiliation(s)
- Chioma Torres
- Department of Pediatrics, University of Michigan Medical School (C Torres, J Struza, and JC Lumeng), Ann Arbor, Mich.
| | - Holly E. Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, 552 W Circle Dr, East Lansing, MI 48823, United States
| | - Harlan McCaffery
- Center for Human Growth and Development, University of Michigan, 300 N Ingalls St, Ann Arbor, MI 48104, United States
| | - Julie Struza
- Department of Pediatrics, University of Michigan Medical School,1540 E Hospital Dr, Ann Arbor, MI 48109, United States
| | - Jessica M. Williams
- Department of Human Development and Family Studies, Michigan State University, 552 W Circle Dr, East Lansing, MI 48823, United States
| | - Hailey Hyunjin Choi
- Department of Human Development and Family Studies, Michigan State University, 552 W Circle Dr, East Lansing, MI 48823, United States
| | - Mildred A. Horodynski
- College of Nursing, Michigan State University, 1355 Bogue St, East Lansing, MI, 48824, United States
| | - Dawn Contreras
- Michigan State University Extension, Michigan State University, 446 West Circle Drive, East Lansing, MI 48824, United States
| | - Jean Kerver
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48823, United States
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, 300 N Ingalls St, Ann Arbor, MI 48104, United States
| | - Julie C. Lumeng
- Department of Pediatrics, University of Michigan Medical School,1540 E Hospital Dr, Ann Arbor, MI 48109, United States,Center for Human Growth and Development, University of Michigan, 300 N Ingalls St, Ann Arbor, MI 48104, United States,Department of Nutritional Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States
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Munzer TG, Miller AL, Wang Y, Kaciroti N, Radesky JS. Tablets, toddlers and tantrums: The immediate effects of tablet device play. Acta Paediatr 2021; 110:255-256. [PMID: 32735726 PMCID: PMC7749045 DOI: 10.1111/apa.15509] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/22/2020] [Accepted: 07/27/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Tiffany G Munzer
- Department of Pediatrics, University of Michigan Medical School, 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
| | - Yujie Wang
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Jenny S Radesky
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
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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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39
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Contreras DA, Martoccio TL, Brophy-Herb HE, Horodynski M, Peterson KE, Miller AL, Senehi N, Sturza J, Kaciroti N, Lumeng JC. Rural-urban differences in body mass index and obesity-related behaviors among low-income preschoolers. J Public Health (Oxf) 2020; 43:e637-e644. [PMID: 32964933 DOI: 10.1093/pubmed/fdaa162] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 01/07/2020] [Revised: 08/10/2020] [Accepted: 08/21/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND With one in eight preschoolers classified as obese in the USA, childhood obesity remains a significant public health issue. This study examined rural-urban differences in low-income preschoolers' body mass index z-scores (BMIz), eating behaviors, dietary quality, physical activity (PA) and screen time. METHODS Pre-intervention data from 572 preschooler-parent dyads participating in a randomized, controlled obesity prevention trial in the Midwest USA were analyzed. We examined the associations among living in rural versus urban areas, child BMIz and child obesity-related behaviors, including eating behaviors, dietary quality, PA and screen time. RESULTS Rural children had higher BMIz, more emotional overeating behaviors and more time spent playing outdoors compared with urban children. We found no associations between children living in rural versus urban areas and dietary quality and screen time. CONCLUSIONS The study found that rural-urban differences in BMIz may start as early as 3-4 years of age, if not earlier. To reverse the weight-related health disparities between rural and urban low-income preschoolers, structural changes in rural locations and family supports around coping skills may be needed.
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Affiliation(s)
- Dawn A Contreras
- Michigan State University Extension, Michigan State University, East Lansing, MI 48824, USA
| | - Tiffany L Martoccio
- Department of Human Development and Quantitative Methodology, University of Maryland College Park, College Park, MD 20742, USA
| | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, MI 48824, USA
| | - Mildred Horodynski
- College of Nursing, Michigan State University, East Lansing, MI 48824, USA
| | - Karen E Peterson
- Department of the Nutritional Sciences, University of Michigan, 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
| | - Neda Senehi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Julie Sturza
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI 48109, USA
| | - Niko Kaciroti
- Department of Pediatrics and Department of Biostatistics, University of Michigan, Ann Arbor, MI 48109, USA
| | - Julie C Lumeng
- Department of Pediatrics and Department of Nutritional Sciences, University of Michigan, Ann Arbor, MI 48109, USA
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40
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Rios JM, Miller AL, Lumeng JC, Rosenblum K, Appugliese DP, Kaciroti N, Gearhardt AN. Behavioral Responses to Sucrose as an Indicator of Positive Hedonic Response Across the First Six Months of Infancy. Physiol Behav 2020; 223:112914. [PMID: 32450104 DOI: 10.1016/j.physbeh.2020.112914] [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] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 11/28/2022]
Abstract
Behavioral responses to sucrose provide an index of positive hedonic response in newborns. In 118 infants, the current study used repeated assessments to explore behavioral responses to sucrose solutions (24%/50% sucrose) compared to water across the first six months of infancy. Lip smacking and bringing fingers to mouth are more likely to occur in response to 24% sucrose relative to water. Tongue protrusions are also more likely to occur for 50% sucrose relative to water. Behavioral responses to sucrose may provide an index of positive hedonic response and could be used to investigate individual differences in the first six months of infancy.
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Affiliation(s)
- Julia M Rios
- Department of Psychology, University of Michigan, 530 Church St, Ann Arbor, MI, United States.
| | - Alison L Miller
- School of Public Health, University of Michigan, 300 N Ingalls St, Ann Arbor, MI, United States.
| | - Julie C Lumeng
- School of Medicine, Department of Pediatrics, University of Michigan, 1301 Catherine St, Ann Arbor, MI, United States.
| | - Katherine Rosenblum
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI, United States.
| | - Danielle P Appugliese
- Appugliese Professional Advisors, LLC, P.O. Box 71, North Easton, MA, United States.
| | - Niko Kaciroti
- School of Public Health, University of Michigan, 300 N Ingalls St, Ann Arbor, MI, United States.
| | - Ashley N Gearhardt
- Department of Psychology, University of Michigan, 530 Church St, Ann Arbor, MI, United States.
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41
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Shao J, Richards B, Kaciroti N, Zhu B, Clark KM, Lozoff B. Contribution of iron status at birth to infant iron status at 9 months: data from a prospective maternal-infant birth cohort in China. Eur J Clin Nutr 2020; 75:364-372. [PMID: 32814856 PMCID: PMC7878278 DOI: 10.1038/s41430-020-00705-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Revised: 06/22/2020] [Accepted: 08/04/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND/OBJECTIVES The contribution of iron status at birth to iron status in infancy is not known. We used a physiologic framework to evaluate how iron status at birth related to iron status at 9 months, taking iron needs and sources into account. SUBJECTS/METHODS In a longitudinal birth cohort in China, iron status measures in cord blood and venous blood in infancy (9 months) and clinical data were prospectively collected in 545 healthy term maternal–infant dyads. We used structural equation modeling (SEM) to create a 9-month iron composite and to assess direct and indirect contributions of multiple influences on 9-month iron status. Logistic regression was used to calculate odds ratios (OR) for iron deficiency (ID), iron deficiency anemia (IDA), and anemia. RESULTS Approximately 15% (78/523) of infants were born with cord SF<75 μg/l, suggesting fetal-neonatal ID. At 9 months, 34.8% (186/535) and 19.6% (105/535) of infants had ID and IDA, respectively. The following factors were independently associated with poorer 9-month iron status: higher cord zinc protoporphyrin/heme (ZPP/H) (adjusted estimate −0.18, P< 0.001) and serum transferrin receptor (sTfR) (−0.11, P=0.004), lower cord hemoglobin (Hb) (0.13, P=0.004), lower birth weight (0.15, P< 0.001), male sex (0.10, P=0.013), older age at testing (−0.26, P<0.001), higher 9-month weight (−0.12, P=0.006) and breastfeeding (0.38, P<0.001). Breastfeeding at 9 months showed the strongest association, adjusting for all other factors. Compared to formula-fed infants, the odds of IDA were 19.1 (95%CI: 6.92, 52.49, P< 0.001) and 3.6 (95%CI: 1.04, 12.50, P=0.043) times higher in breastfed and mixed-fed infants, respectively. CONCLUSIONS Indicators of iron status at birth, postnatal iron needs, and iron sources independently related to iron status at 9 months. Sex was an additional factor. Public health policies to identify and protect infants at increased risk of ID should be prioritized.
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Affiliation(s)
- Jie Shao
- Children's Hospital Zhejiang University School of Medicine, Hangzhou, 310052, China. .,National Clinical Research Center for Child Health, Hangzhou, 310052, China.
| | - 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
| | - Bingquan Zhu
- Children's Hospital Zhejiang University School of Medicine, Hangzhou, 310052, China
| | - Katy M Clark
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Betsy Lozoff
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA.,Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA
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42
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Kaciroti N, DosSantos MF, Moura B, Bellile EL, Nascimento TD, Maslowski E, Danciu TE, Donnell A, DaSilva AF. Sensory-Discriminative Three-Dimensional Body Pain Mobile App Measures Versus Traditional Pain Measurement With a Visual Analog Scale: Validation Study. JMIR Mhealth Uhealth 2020; 8:e17754. [PMID: 32124732 PMCID: PMC7468641 DOI: 10.2196/17754] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 02/29/2020] [Accepted: 03/01/2020] [Indexed: 01/13/2023] Open
Abstract
Background To quantify pain severity in patients and the efficacy treatments, researchers and clinicians apply tools such as the traditional visual analog scale (VAS) that leads to inaccurate interpretation of the main sensory pain. Objective This study aimed to validate the pain measurements of a neuroscience-based 3D body pain mobile app called GeoPain. Methods Patients with temporomandibular disorder (TMD) were assessed using GeoPain measures in comparison to VAS and positive and negative affect schedule (PANAS), pain and mood scales, respectively. Principal component analysis (PCA), scatter score analysis, Pearson methods, and effect size were used to determine the correlation between GeoPain and VAS measures. Results The PCA resulted in two main orthogonal components: first principal component (PC1) and second principal component (PC2). PC1 comprises a combination score of all GeoPain measures, which had a high internal consistency and clustered together in TMD pain. PC2 included VAS and PANAS. All loading coefficients for GeoPain measures in PC1 were above 0.70, with low loadings for VAS and PANAS. Meanwhile, PC2 was dominated by a VAS and PANAS coefficient >0.4. Repeated measure analysis revealed a strong correlation between the VAS and mood scores from PANAS over time, which might be related to the subjectivity of the VAS measure, whereas sensory-discriminative GeoPain measures, not VAS, demonstrated an association between chronicity and TMD pain in locations spread away from the most commonly reported area or pain epicenter (P=.01). Analysis using VAS did not detect an association at baseline between TMD and chronic pain. The long-term reliability (lag >1 day) was consistently high for the pain area and intensity number summation (PAINS) with lag autocorrelations averaging between 0.7 and 0.8, and greater than the autocorrelations for VAS averaging between 0.3 and 0.6. The combination of higher reliability for PAINS and its objectivity, displayed by the lack of association with PANAS as compared with VAS, indicated that PAINS has better sensitivity and reliability for measuring treatment effect over time for sensory-discriminative pain. The effect sizes for PAINS were larger than those for VAS, consequently requiring smaller sample sizes to assess the analgesic efficacy of treatment if PAINS was used versus VAS. The PAINS effect size was 0.51 SD for both facial sides and 0.60 SD for the right side versus 0.35 SD for VAS. Therefore, the sample size required to detect such effect sizes with 80% power would be n=125 per group for VAS, but as low as n=44 per group for PAINS, which is almost a third of the sample size needed by VAS. Conclusions GeoPain demonstrates precision and reliability as a 3D mobile interface for measuring and analyzing sensory-discriminative aspects of subregional pain in terms of its severity and response to treatment, without being influenced by mood variations from patients.
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Affiliation(s)
- Niko Kaciroti
- Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States.,Headache & Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, United States.,Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Marcos Fabio DosSantos
- Instituto de Ciências Biomédicas (ICB), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Programa de Pós-Graduação em Medicina (Radiologia), Universidade Federal do Rio de Janeiro (UFRJ)., Rio de Janeiro, Brazil
| | - Brenda Moura
- Headache & Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, United States.,Programa de Pós-Graduação em Medicina (Radiologia), Universidade Federal do Rio de Janeiro (UFRJ)., Rio de Janeiro, Brazil
| | - Emily Light Bellile
- Department of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Thiago Dias Nascimento
- Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States
| | | | - Theodora E Danciu
- Department of Periodontics and Medicine School of Dentistry, University of Michigan, Ann Arbor, Michigan, MI, United States
| | - Adam Donnell
- Orthodontics, Department of Developmental Biology, Harvard University, Boston, MA, United States
| | - Alexandre F DaSilva
- Center for Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, United States.,Headache & Orofacial Pain Effort (H.O.P.E.), Department of Biologic and Materials Sciences, School of Dentistry, University of Michigan, Ann Arbor, MI, United States
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43
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Robbins LB, Ling J, Sharma DB, Dalimonte-Merckling DM, Voskuil VR, Resnicow K, Kaciroti N, Pfeiffer KA. Intervention Effects of "Girls on the Move" on Increasing Physical Activity: A Group Randomized Trial. Ann Behav Med 2020; 53:493-500. [PMID: 29985968 DOI: 10.1093/abm/kay054] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Limited intervention success in increasing and sustaining girls' moderate-to-vigorous physical activity (MVPA) underscores a need for continued research. PURPOSE The aim of this study was to evaluate the effect of a 17-week Girls on the Move (GOTM) intervention on increasing MVPA among fifth- to eighth-grade girls. METHODS This study is a group (cluster) randomized trial, including 24 schools, pair matched and assigned to intervention (n = 12) or control (n = 12) conditions. Participants included 1,519 girls in racially diverse public schools in urban, underserved areas of the Midwestern USA. The intervention included three components: (i) 90-min after-school physical activity (PA) club offered 3 days/week; (ii) two motivational, individually tailored counseling sessions; and (iii) an interactive Internet-based session at the midpoint of the intervention. Main outcome measures were weighted mean minutes of MVPA per week post-intervention and at 9-month follow-up measured via accelerometer. RESULTS No between-group differences occurred for weighted mean minutes of MVPA per week at post-intervention (B = -0.08, p = .207) or 9-month follow-up (B = -0.09, p = .118) while controlling for baseline MVPA. CONCLUSIONS Research is needed to identify interventions that assist girls in attaining and maintaining adequate PA. CLINICALTRIALS.GOV IDENTIFIER NCT01503333.
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Affiliation(s)
| | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Dhruv B Sharma
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, USA
| | | | - Vicki R Voskuil
- Department of Nursing, A. Paul Schaap Science Center, Hope College, Holland, MI, USA
| | - Kenneth Resnicow
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Niko Kaciroti
- Department of Biostatistics and Center for Human Growth and Development (CHGD), University of Michigan, Ann Arbor, MI, USA
| | - Karin A Pfeiffer
- Department of Kinesiology, College of Education, Michigan State University, East Lansing, MI, USA
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44
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Martoccio TL, Senehi N, Brophy-Herb HE, Miller AL, Horodynski MA, Kaciroti N, Contreras D, Peterson KE, Lumeng JC. Cross-lagged associations between behaviour problems and obesity in head start preschoolers. Pediatr Obes 2020; 15:e12627. [PMID: 32103623 DOI: 10.1111/ijpo.12627] [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: 07/08/2019] [Revised: 12/05/2019] [Accepted: 01/27/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Behaviour problems and obesity are related but research findings have been inconclusive regarding the direction of effects. OBJECTIVES This study examined the cross-lagged associations between behaviour problems, body mass index (BMI) and obesity in preschoolers, and whether sex modified these associations. METHODS Repeated measures of teacher-reported externalizing (EXT) and internalizing behaviour problems (clinically significant T scores were >90th percentile), BMI z-scores (BMI-Z) and obesity status (BMI ≥95th for age and sex) were assessed in the fall (T1) and spring (T2) of the school year in Head Start preschoolers (N = 423). Associations were examined with cross-lagged modelling. RESULTS Prospective paths from T1 clinically significant EXT to both T2 BMI-Z (β = .05) and obesity (β = .18) were significant. There was no evidence that T1 BMI-Z or obesity preceded T2 behaviour problems. However, sex-specific models indicated that T1 BMI-Z was prospectively associated with higher T2 EXT for boys (β = .13), but not girls. T1 EXT was predictive of subsequent BMI-Z (β = .09) and obesity (β = .33) at T2 for girls only. CONCLUSION Findings suggest that behaviour problems, particularly externalizing behaviours, are prospectively related to childhood obesity, and early prevention methods should reflect sex-specific modifications.
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Affiliation(s)
- Tiffany L Martoccio
- Department of Human Development and Quantitative Methodology, University of Maryland College Park, College Park, Maryland
| | - Neda Senehi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Holly E Brophy-Herb
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan
| | - Alison L Miller
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Mildred A Horodynski
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan
| | - Niko Kaciroti
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Dawn Contreras
- Michigan State University Extension, East Lansing, Michigan
| | - Karen E Peterson
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Julie C Lumeng
- Center for Human Growth and Development, University of Michigan, Ann Arbor, Michigan.,Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.,Department of Pediatrics, University of Michigan Medical School, Ann Arbor, Michigan
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45
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Fernandez C, McCaffery H, Miller AL, Kaciroti N, Lumeng JC, Pesch MH. Trajectories of Picky Eating in Low-Income US Children. Pediatrics 2020; 145:peds.2019-2018. [PMID: 32457215 PMCID: PMC7263050 DOI: 10.1542/peds.2019-2018] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [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: 02/25/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Picky eating is common, yet little is known about trajectories of picky eating in childhood. Our objectives were to examine trajectories of child picky eating in low-income US children from ages 4 to 9 years and associations of those trajectories with participant characteristics, including child BMI z score (BMIz) and maternal feeding-behavior trajectories. METHODS Mother-child dyads (N = 317) provided anthropometry and reported on picky eating and maternal feeding behaviors via questionnaires at child ages 4, 5, 6, 8, and 9 years. At baseline, mothers reported on demographics and child emotional regulation. Trajectories of picky eating and maternal feeding behaviors were identified by using latent class analysis. Bivariate analyses examined associations of picky-eating trajectory membership with baseline characteristics and maternal feeding-behavior trajectory memberships. A linear mixed model was used to examine the association of BMIz with picky-eating trajectories. RESULTS Three trajectories of picky eating emerged: persistently low (n = 92; 29%), persistently medium (n = 181; 57%), and persistently high (n = 44; 14%). Membership in the high picky-eating trajectory was associated with higher child emotional lability and lower child emotional regulation. Picky eating was associated with restriction (P = .01) and demandingness (P < .001) trajectory memberships, such that low picky eating was associated with low restriction and high picky eating was associated with high demandingness. Medium and high picky-eating trajectories were associated with lower BMIz. CONCLUSIONS Picky eating appears to be traitlike in childhood and may be protective against higher BMIz.
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Affiliation(s)
| | - Harlan McCaffery
- Center for Human Growth and Development, University
of Michigan, Ann Arbor, Michigan
| | - Alison L. Miller
- School of Public Health, and,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
| | - Julie C. Lumeng
- Division of Developmental Behavioral Pediatrics,
Department of Pediatrics,,School of Public Health, and,Center for Human Growth and Development, University
of Michigan, Ann Arbor, Michigan
| | - Megan H. Pesch
- Center for Human Growth and Development, University
of Michigan, Ann Arbor, Michigan
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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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Riley HO, Lo SL, Rosenblum K, Sturza J, Kaciroti N, Lumeng JC, Miller AL. Sex Differences in the Association between Household Chaos and Body Mass Index z-Score in Low-Income Toddlers. Child Obes 2020; 16:265-273. [PMID: 32155340 PMCID: PMC7262641 DOI: 10.1089/chi.2019.0186] [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] [Indexed: 12/13/2022]
Abstract
Background: Associations between household chaos and childhood overweight have been identified, but the mechanisms of association are not clearly established in young children, with some studies linking higher chaos to increased obesity risk, whereas other studies link higher chaos to lower obesity risk. Given the lack of consistent findings and early sex differences in vulnerability to chaos, we examined child sex as a moderator of the chaos-child overweight association. We also tested these associations with self-regulation, as self-regulation has been implicated in understanding the chaos-obesity risk association in low-income toddlers. Methods: Parent-reported household chaos and observed child self-regulation were collected at baseline [n = 132; M age 23.0 months (standard deviation 2.8)]. Children's body mass index z-score (BMIz) was measured at 33 months. Multivariate linear regression models were used to assess whether child sex moderated the chaos-BMIz association. A three-way interaction between chaos, child sex, and self-regulation was also tested. Results: Child sex moderated the chaos-BMIz association (b = -0.11, p = 0.04) such that chaos was positively associated with BMIz among boys (b = 0.12, p = 0.003), but unrelated in girls (b = 0.01, p = 0.78). A three-way interaction with self-regulation indicated that a positive chaos-BMIz association existed only for boys with average (b = 0.12, p = 0.004) and low (b = 0.22, p < 0.001) self-regulation. Conclusions: Boys with poor self-regulation may be particularly vulnerable to obesogenic effects of chaotic households.
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Affiliation(s)
- Hurley O. Riley
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Address correspondence to: Hurley O. Riley, MPH, Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA
| | - Sharon L. Lo
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Katherine Rosenblum
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Julie Sturza
- 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.,Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - 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
| | - Alison L. Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
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Miller AL, Lo SL, Albright D, Lee JM, Hunter CM, Bauer KW, King R, Clark KM, Chaudhry K, Kaciroti N, Katz B, Fredericks EM. Adolescent Interventions to Manage Self-Regulation in Type 1 Diabetes (AIMS-T1D): randomized control trial study protocol. BMC Pediatr 2020; 20:112. [PMID: 32145739 PMCID: PMC7060523 DOI: 10.1186/s12887-020-2012-7] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 02/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-regulation (SR), or the capacity to control one's thoughts, emotions, and behaviors in order to achieve a desired goal, shapes health outcomes through many pathways, including supporting adherence to medical treatment regimens. Type 1 Diabetes (T1D) is one specific condition that requires SR to ensure adherence to daily treatment regimens that can be arduous and effortful (e.g., monitoring blood glucose). Adolescents, in particular, have poor adherence to T1D treatment regimens, yet it is essential that they assume increased responsibility for managing their T1D as they approach young adulthood. Adolescence is also a time of rapid changes in SR capacity and thus a compelling period for intervention. Promoting SR among adolescents with T1D may thus be a novel method to improve treatment regimen adherence. The current study tests a behavioral intervention to enhance SR among adolescents with T1D. SR and T1D medical regimen adherence will be examined as primary and secondary outcomes, respectively. METHODS We will use a randomized control trial design to test the impact of a behavioral intervention on three SR targets: Executive Functioning (EF), Emotion Regulation (ER), and Future Orientation (FO); and T1D medical regimen adherence. Adolescents with T1D (n = 94) will be recruited from pediatric endocrinology clinics and randomly assigned to treatment or control group. The behavioral intervention consists of working memory training (to enhance EF), biofeedback and relaxation training (to enhance ER), and episodic future thinking training (to enhance FO) across an 8-week period. SR and treatment regimen adherence will be assessed at pre- and post-test using multiple methods (behavioral tasks, diabetes device downloads, self- and parent-report). We will use an intent-to-treat framework using generalized linear mixed models to test our hypotheses that: 1) the treatment group will demonstrate greater improvements in SR than the control group, and 2) the treatment group will demonstrate better treatment regimen adherence outcomes than the control group. DISCUSSION If successful, SR-focused behavioral interventions could improve health outcomes among adolescents with T1D and have transdiagnostic implications across multiple chronic conditions requiring treatment regimen adherence. TRIAL REGISTRATION ClinicalTrials.gov: NCT03688919; registered September 28, 2018.
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Affiliation(s)
- Alison L Miller
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH I Room 3718, Ann Arbor, MI, 48109-2029, USA.
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA.
| | - Sharon L Lo
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH I Room 3718, Ann Arbor, MI, 48109-2029, USA
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
| | - Dana Albright
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Joyce M Lee
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
- Susan B. Meister Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, MI, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Christine M Hunter
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, MD, USA
| | - Katherine W Bauer
- Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
- Department of Nutritional Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Rosalind King
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Katy M Clark
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH I Room 3718, Ann Arbor, MI, 48109-2029, USA
| | - Kiren Chaudhry
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, 1415 Washington Heights, SPH I Room 3718, Ann Arbor, MI, 48109-2029, USA
| | - Niko Kaciroti
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Benjamin Katz
- Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA, USA
| | - Emily M Fredericks
- Department of Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
- Susan B. Meister Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, MI, USA
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Pfeiffer KA, Robbins LB, Ling J, Sharma DB, Dalimonte-Merckling DM, Voskuil VR, Kaciroti N, Resnicow K. Effects of the Girls on the Move randomized trial on adiposity and aerobic performance (secondary outcomes) in low-income adolescent girls. Pediatr Obes 2019; 14:e12559. [PMID: 31267695 PMCID: PMC6982403 DOI: 10.1111/ijpo.12559] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 09/21/2018] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Limited, mixed evidence exists regarding the effectiveness of physical activity interventions on adiposity and aerobic performance in adolescent underrepresented populations. OBJECTIVE To examine effects of Girls on the Move on body mass index z-scores (BMI-z), percent (%) body fat, and aerobic performance in fifth- to eighth-grade underrepresented girls. METHODS A group randomized trial, involving 12 intervention and 12 control schools in low-income areas, was conducted. Participants (n = 1519) were low-active girls. The 17-week intervention included (a) a physical activity club, (b) two motivational interviewing sessions, and (c) one Internet-based session. BMI-z was determined from measured height and weight; % body fat was assessed using bioelectric impedance. Aerobic performance was assessed using a shuttle run. Demographics, physical activity (accelerometer), and pubertal development were assessed. Linear mixed models, adjusting for baseline, were used to examine group differences in postintervention. RESULTS No significant between-group differences in BMI-z existed at postintervention, but % body fat increased less among intervention than control group girls (Mchange = 0.43% vs 0.73%). Aerobic performance decreased less in intervention vs control (Mchange = -0.39 vs -0.57). CONCLUSIONS Although the intervention positively impacted % body fat and aerobic performance in underrepresented girls, more research is necessary to determine optimal implementation for yielding greater effects.
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Affiliation(s)
- Karin A. Pfeiffer
- Department of Kinesiology, Michigan State University, East Lansing, MI, USA
| | | | - Jiying Ling
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Dhruv B. Sharma
- Center for Statistical Training and Consulting, Michigan State University, East Lansing, MI, USA
| | | | | | - Niko Kaciroti
- University of Michigan Center for Growth and Development, Department of Biostatistics, and Center for Computational Medicine and Bioinformatics
| | - Kenneth Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, USA
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50
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Nascimento T, Yang N, Salman D, Jassar H, Kaciroti N, Bellile E, Danciu T, Koeppe R, Stohler C, Zubieta J, Ellingrod V, DaSilva A. µ-Opioid Activity in Chronic TMD Pain Is Associated with COMT Polymorphism. J Dent Res 2019; 98:1324-1331. [PMID: 31490699 PMCID: PMC6806132 DOI: 10.1177/0022034519871938] [Citation(s) in RCA: 10] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Clinicians have the dilemma of prescribing opioid or nonopioid analgesics to chronic pain patients; however, the impact of pain on our endogenous µ-opioid system and how our genetic profile (specifically catechol-O-methyltransferase [COMT] polymorphisms) impacts its activation are currently unknown. Twelve chronic temporomandibular disorder (TMD) patients and 12 healthy controls (HCs) were scanned using positron emission tomography (PET) with [11C]carfentanil, a selective radioligand for µ-opioid receptors (µORs). The first 45 min of each PET measured the µOR nondisplaceable binding potential (BPND) at resting state, and the last 45 min consisted of a 20-min masseteric pain challenge with an injection of 5% hypertonic saline. Participants were also genotyped for different COMT alleles. There were no group differences in µOR BPND at resting state (early phase). However, during the masseteric pain challenge (late phase), TMD patients exhibited significant reductions in µOR BPND (decreased [11C]carfentanil binding) in the contralateral parahippocampus (P = 0.002) compared to HCs. The µOR BPND was also significantly lower in TMD patients with longer pain chronicity (P < 0.001). When considering COMT genotype and chronic pain suffering, TMD patients with the COMT158Met substitution had higher pain sensitivity and longer pain chronicity with a 5-y threshold for µOR BPND changes to occur in the parahippocampus. Together, the TMD diagnosis, COMT158Met substitution, and pain chronicity explained 52% of µOR BPND variance in the parahippocampus (cumulative R2 = 52%, P < 0.003, and HC vs. TMD Cohen's effect size d = 1.33 SD). There is strong evidence of dysregulation of our main analgesic and limbic systems in chronic TMD pain. The data also support precision medicine by helping identify TMD patients who may be more susceptible to chronic pain sensitivity and opioid dysfunction based on their genetic profile.
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Affiliation(s)
- T.D. Nascimento
- Headache and Orofacial Pain Effort (H.O.P.E.),
Biologic and Materials Sciences Department, University of Michigan School of Dentistry, Ann
Arbor, MI, USA
| | - N. Yang
- Headache and Orofacial Pain Effort (H.O.P.E.),
Biologic and Materials Sciences Department, University of Michigan School of Dentistry, Ann
Arbor, MI, USA
| | - D. Salman
- Headache and Orofacial Pain Effort (H.O.P.E.),
Biologic and Materials Sciences Department, University of Michigan School of Dentistry, Ann
Arbor, MI, USA
| | - H. Jassar
- Headache and Orofacial Pain Effort (H.O.P.E.),
Biologic and Materials Sciences Department, University of Michigan School of Dentistry, Ann
Arbor, MI, USA
| | - N. Kaciroti
- Department of Biostatistics, University of
Michigan, Ann Arbor, MI, USA
- Center for Human Growth and Development,
University of Michigan, Ann Arbor, MI, USA
- Center for Computational Medicine and
Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - E. Bellile
- Department of Biostatistics, University of
Michigan, Ann Arbor, MI, USA
| | - T. Danciu
- Department of Periodontics and Oral Medicine,
University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - R. Koeppe
- PET Physics Section, Division of Nuclear
Medicine, Radiology Department, University of Michigan, Ann Arbor, MI, USA
| | - C. Stohler
- College of Dental Medicine, Columbia
University, New York, NY, USA
| | - J.K. Zubieta
- Department of Psychiatry and Behavioral
Health, Stony Brook University, Stony Brook, NY, USA
| | - V. Ellingrod
- College of Pharmacy, University of Michigan,
Ann Arbor, MI, USA
| | - A.F. DaSilva
- Headache and Orofacial Pain Effort (H.O.P.E.),
Biologic and Materials Sciences Department, University of Michigan School of Dentistry, Ann
Arbor, MI, USA
- Center for Human Growth and Development,
University of Michigan, Ann Arbor, MI, USA
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