International journal of child health and human development : IJCHD最新文献

Housing instability is a thought to be a major influence on children's healthy growth and development. However, little is known about the factors that influence housing instability, limiting the identification of effective interventions. The goals of this study were to 1) explore factors, including material hardship, satisfaction with living conditions and housing disrepair, that predict housing instability (total number of moves that a child experienced in the first seven years); and 2) examine the relationship between housing instability and child behavior at age 7, measured by the Child Behavior Checklist. We analyzed these associations among children enrolled in the Columbia Center for Children's Environmental Health (CCCEH) Mothers and Newborns study. In our analysis, we found that housing disrepair predicted residential change after 3 years of age, but not before. Persistent material hardship over the seven-year time period from pregnancy through age 7 was associated with increased number of moves. Children who experienced more than three moves in the first 7 years had significantly more thought- and attention-related problems compared to children who experienced less than 3 moves over the same time period. Children who experienced more than 3 moves also had higher total and internalizing problem behavior scores, although these differences were not statistically significant. We conclude that housing instability is significantly associated with problem behavior in early childhood and that interventions to reduce socioeconomic strain may have the greatest impact in breaking the cycle of children's environmental health disparities related to housing instability.

The goal of this study was to ascertain whether the effect of prenatal ETS exposure on behavioral symptoms at age 7 years is modified by the quality of the home environment. In a cohort of 417 children enrolled in a longitudinal birth cohort in New York City, prenatal ETS exposure, child behavior and home environment were assessed. Prenatal ETS was measured by questionnaire and blood cotinine. Child Behavior Checklist (CBCL) and Early Childhood HOME Inventory Scale (HOME) were also used. We detected a significant interaction between prenatal ETS exposure and living in a "better" home environment on reported problems in the rule breaking and externalizing domains (p-value for interaction terms: 0.002 and 0.04, respectively), such that there was no significant adverse impact of ETS exposure on behavior among those who experienced a "better" environment. We also detected a significant interaction between prenatal ETS exposure and living in a "worse" home environment on reported problems in the aggressive and externalizing domains (p-value for interaction terms: 0.03 and 0.02, respectively), such that there was a significant adverse effect of ETS exposure on behavior among children who experienced a "worse" environment. Aspects of the HOME environment, both positive and negative, moderated the effects of prenatal ETS exposure on selected behaviors at 7 years of age. This finding suggests that some negative developmental behavioral effects associated with ETS exposure early in life may be modified by the provision of an enriched learning environment as measured by the HOME inventory.

There is a paucity of research regarding the contextual factors that influence health behaviors to inform the development of programs and services for youth during the transition from adolescence to young adulthood. Researchers are thus in need of efficient strategies for surveying diverse populations of young adults. This study among a population-based sample of young adults aimed to 1) examine response to a mixed-mode survey design (web and mailed surveys) and 2) identify demographic correlates of response mode. Young adults who participated in previous study waves were invited to participate in the third wave of a 10-year longitudinal study (Project EAT-III: 2008-2009) examining factors associated with weight-related behaviors. Participants were mailed invitation letters providing the web address and a unique password for completing the survey. Nonresponders were mailed three reminder invitations; the third mailing included the paper form, and all other mailings included a postage-paid card for requesting the paper form. Most completed surveys (82.1% of n=2,287) were returned by respondents within the first four months of fielding prior to the mailing which included the paper form. Nearly all of these early responders (92.6% of n=1,878) and 86.5% of the full respondent sample (n=1,979 of 2,287) completed the web form. Response to the web versus mailed paper form of the survey was associated with age >25 years, higher socioeconomic status, current employment, student status, and having no children. The combination of web and mailed survey modes is an effective strategy for conducting data collection in demographically diverse, young adult populations.

The achievement gap continues to be an important educational issue, with disadvantaged groups exhibiting poorer school performance. Recently, literature has shown that even very low levels of early lead exposure affect cognitive and academic performance. As individuals at the lower end of the socioeconomic spectrum are more likely to be exposed to lead, this exposure may be an important contributor to the achievement gap. In this paper, we explore whether early childhood blood lead levels are associated with membership in exceptionality designation groups. In addition, we examine the racial and socioeconomic composition of these exceptional groups. Data from the North Carolina Childhood Lead Poisoning Prevention Program surveillance registry were linked at the individual child level to educational outcomes available through the North Carolina Education Research Data Center. Designation into exceptionality groups was obtained from the end-of-grade (EOG) data. Both standard bivariate and multivariate analyses were employed. Bivariate analyses indicate that blood lead levels and reading EOG scores differ by exceptionality, as well as by race and enrollment in free/reduced lunch. Logistic regression confirmed the relationship between blood lead levels and likelihood of exceptionality. Contextual factors - enrollment in the free/reduced lunch program, race, and parental education - are also significant with regard to exceptionality. This study demonstrates that early childhood lead exposure significantly influences the likelihood of being designated exceptional. These results provide additional evidence that early childhood lead exposure is a significant explanator of the achievement gap.

Prepartum and postpartum depression have negative, and sometimes devastating, effects on women and their families. As inflammatory processes are related to depression in general, we hypothesized that inflammatory perturbations, prepartum and postpartum, contribute to triggering and worsening of symptoms of peripartum depression. We conducted a longitudinal preliminary study on 27 women at high risk for developing postpartum depression measuring SIGH-SAD scores at three time points: 35-38 weeks gestation, 1-5 days postpartum, and 5-6 weeks postpartum. Serum C-reactive protein and interleukin-6, both markers of inflammation, as well as tryptophan, kynurenine, and the kynurenine/tryptophan ratio, as consequences of inflammation and pathophysiological steps towards depression, were measured at each time point. C-reactive protein levels were found to be positively related to atypical and total depression scores in the prepartum period and with atypical depression scores in the early postpartum period. Tryptophan was found to be negatively associated with total depression scores in the prepartum, as well. These findings warrant further investigation that could lead to novel interventions to decrease poor outcomes from peripartum depression.

Depression and obesity have been recognized as major public health issues in youths. Although they have traditionally been compartmentalized as separate physical and emotional health conditions, evidence suggests interactions and common pathways between them, implying that successful treatment should ideally target shared underlying mechanisms. The purpose of the present article is to review the pediatric diagnostic criteria for depression and obesity, highlight similarities in their clinical presentation, identify common pathways and underlying mechanisms, describe their developmental trajectories, and suggest areas for future study to guide development of innovative prevention and treatment initiatives.

Suicide is the third-leading cause of death for adolescents between 15 and 24 years of age in the United States and its rate has been increasing. Factors that contribute to rate of, risks for, or protection against depression and suicide may be different for people from cultures with different values and health beliefs. Although typically seen as affecting Caucasians more than other groups in the U.S., the rates of suicide among African Americans, Latinos, and others have been increasing. 87 studies were reviewed looking at rates for suicide/suicidal ideation, risk factors for suicide, protective factors/coping mechanisms, service delivery/barriers to care, and specific treatment or management of suicidal thoughts for adolescents from different ethnic groups in the U.S. The following ethnic groups in the U.S. were compared: African American, Latino, Asian American, Native American/Alaskan Native, and Hawaiian American. Although studies report conflicting rates, most studies still show an overall higher risk for suicidal behavior among Caucasian youth than any other group. Rates for suicidal behavior are growing for African American teens (perhaps more in boys), Latino teens (especially Latina girls), Asian American youth, Native American youth, Alaskan Native youth, and Hawaiian American youth. Details about these differences are discussed along with recommendations for clinicians working with youth at risk for suicide from minority cultures in the U.S.