Evolution of obesity in a low birth weight cohort.

OBJECTIVE: The objective of this study was to determine the evolution of obesity status (OS) in a longitudinal cohort of low birth weight preterm (LBWPT) infants to an age of 8 years, and to determine whether rapid weight gain in the first year of life independently predicts 8-year OS. STUDY DESIGN: In total, 985 infants (birth weight ≤2500 g, gestation age ≤37 weeks) were recruited from the nursery in an eight-site intervention research program and were evaluated at an age of 3, 5, 6.5 and 8 years. Weight and height were measured by standard protocol at each visit and body mass index was calculated. Obesity status is ≥95% for age and sex. Multiple logistic analyses were performed on 8-year OS with predictor variables including infant race, gender, small for gestational age status, birth weight category, neonatal health index, treatment group and first-year weight gain; maternal education and weight status before conception; and HOME Inventory. RESULT: Overall, 2.3% were OS at an age of 3 years, 6.1% at an age of 5 years, 7.7% at age 6.5 years and 8.7% at an age 8 years. OS varied by birth weight category at each visit. The infants born ≤1500 g had the lowest prevalence of OS at each age. In the logistic regression, maternal race (Hispanic) (adjusted odds ratio=2.8, confidence interval=1.2 to 6.8), maternal obese status (adjusted odds ratio 3.4, confidence interval=1.5 to 7.8) and first-year weight gain (adjusted odds ratio=2.7, confidence interval=1.9 to 3.9), significantly predicted 8-year OS. CONCLUSION: OS is common in LBWPT infants during childhood, and prevalence varies by birth weight category. High weight gain in the first year of life is an important predictor of the development of OS in LBWPT children.

Cross-border marriage and disparities in early childhood development in a population-based birth cohort study: the mediation of the home environment.

BACKGROUND: Taiwan has experienced a large influx of cross-border marriage migrants in recent years. The majority have been women in their childbearing ages and have come from countries with lower average standards of living than Taiwan. This trend has changed the ethnic composition of children who live in Taiwan, and it has generated considerable social concern over the future health status of Taiwan's citizens. This study aimed to examine: (1) whether there are disparities in development between children reared in families characterized by cross-border marriages and children reared in families with two Taiwanese-born parents; and (2) whether the quality of home environment explains the group differences in early childhood development. METHODS: Data came from the Taiwan Birth Cohort Study. A total of 19,499 participants who completed 6-month, 18-month and 3-year surveys were included for analysis. Cross-border marriage status was defined by mother's original nationality and categorized into three broad groups: Taiwanese-born, Chinese cross-border and South-East Asian (SEA) cross-border. Early childhood development was measured at age 3 years, and covered the domains of gross motor, fine motor, language and socio-emotional competence. Hierarchical linear regressions were used to examine the mediation effects of the home environment. RESULTS: Children of Chinese and SEA cross-border groups scored lower in fine motor, language and socio-emotional competence than those of their Taiwanese-born counterpart at age 3 years. Chinese-Taiwanese group differences in all three developmental domains became insignificant after the addition of home environment, while SEA-Taiwanese group differences in fine motor and language development remained, yet were noticeably reduced. The mediation of home environment was further confirmed using the Sobel test. CONCLUSIONS: Home environment plays a central role in reducing the disparities in developmental outcomes among children of different marriage groups. Interventions should be directed towards enhancing the quality of early home environment for children reared in families of cross-border marriages.

Parenting and the decline of physical activity from age 9 to 15.

BACKGROUND: There is a rapid decline in moderate-to-vigorous physical activity (MVPA) during middle childhood and adolescence. Information on the environmental factors implicated in this decline is limited. This study focuses on family factors associated with the rate of decline in objectively measured physical activity during middle childhood and adolescence. METHODS: Longitudinal analysis of 801 participants from 10 US sites in the NICHD Study of Early Child Care and Youth Development whose data included accelerometer-determined levels of moderate-to-vigorous physical activity (MVPA) between ages 9 and 15 years, as well as family process, BMI and demographic information. The sample included an even split of boys (49%) and girls (51%), was predominantly white (77%), and contained about 26% low income and 19% single parent families. The outcome measure was mean MVPA. It was based on 4 to 7 days of monitored physical activity. RESULTS: Boys with lower parental monitoring scores and more days of parental encouragement had significantly more minutes of MVPA at age 9 years. The effect of parental monitoring, however, was moderated by early puberty. High parental monitoring was associated with decreased activity levels for boys experiencing later puberty and increased activity for boy experiencing early puberty. Minutes of MVPA for boys living in the Midwest decreased at significantly faster rates than boys living in any other region; and boys in the South declined faster than boys in the West. Girls in the Midwest and South declined faster than girls in the West and Northeast. Among girls, more days of parental exercise and transportation to activities were associated with more MVPA per day at age 9. However, more parental transportation to activities and less monitoring was associated with faster linear declines in daughters' MVPA between the ages of 9 and 15 years. For girls who experienced puberty early, parental encouragement was associated with more MVPA. CONCLUSIONS: Parenting processes, such as monitoring and encouragement, as well as the parents' own level of physical activity, showed significant, but small, gender-specific associations with MVPA levels at age nine and the linear rate of decline in MVPA between ages 9 and 15.

The science of pterygia.

Pterygium is an ocular surface disease of humans attributed to chronic ultraviolet-B exposure. Clinically, the condition involves invasive centripetal growth with associated inflammation and neovascularisation. Previous clinical studies focused primarily on the clinical characteristics and surgical management of pterygia and, because of this, the pathogenesis of pterygia remains incompletely understood. However, considerable progress in this area has been achieved, providing additional insight into this complex disease. This recent evidence implicates antiapoptotic mechanisms, immunological mechanisms, cytokines, growth factors, extracellular matrix modulators, genetic factors, viral infections and other possible causative factors. Limited investigation regarding differences in pathogenesis of primary and recurrent pterygia has been performed. We summarise many of these recent discoveries concerning the pathogenesis of pterygia and describe reported differences between primary and recurrent pterygia.

Hydration-dehydration of adsorbed protein films studied by AFM and QCM-D.

The hydration-dehydration process of an adsorbed human serum albumin film has been studied using atomic force microscopy (AFM) and a quartz crystal microbalance (QCM). All measurements were performed with identically prepared protein films deposited on highly hydrophilic substrates. Both techniques are shown to be suitable for following in situ the kinetics of protein hydration, and for providing quantitative values of the adsorbed adlayer mass. The results obtained by the two methods have been compared and combined to study changes of physical properties of the films in terms of viscosity, shear, Young's modulus, density and film thickness. These properties were found to be reversible during hydration-dehydration cycles.

Orientation and confinement of cells on chemically patterned polystyrene surfaces.

UV/ozone oxidation was combined with a photomasking technique to produce adjacent regions of different chemistry on polystyrene (PS) surfaces. The surface chemistry and topography were studied using AFM, XPS and contact angle measurements. The physicochemical patterns were visualised by the condensation of water vapour upon the surfaces and by the differential attachment of Chinese hamster ovarian (CHO) cells. The orientation of CHO cells on 55 and 125 microm wide oxidised PS strips were measured and found to be highly dependent on the width of the oxidised feature. CHO cells in relatively close proximity to a linear polar/non-polar border showed significant axial alignment along the border. CHO cells can also be confined to specific regions of the polymer surface. Cells attached to larger areas (75 microm x 75 microm) were found to have a smaller average cell size than cells attached to the smaller (56 microm x 56 microm) areas.

The influence of electrostatic forces on protein adsorption.

In this paper we investigate the importance of electrostatic double layer forces on the adsorption of human serum albumin by UV-ozone modified polystyrene. Electrostatic forces were measured between oxidized polystyrene surfaces and gold-coated atomic force microscope (AFM) probes in phosphate buffered saline (PBS) solutions. The variation in surface potential with surface oxygen concentration was measured. The observed force characteristics were found to agree with the theory of electrical double layer interaction under the assumption of constant potential. Chemically patterned polystyrene surfaces with adjacent 5 microm x 5 microm polar and non-polar domains have been studied by AFM before and after human serum albumin adsorption. A topographically flat surface is observed before protein adsorption indicating that the patterning process does not physically modify the surface. Friction force imaging clearly reveals the oxidation pattern with the polar domains being characterised by a higher relative friction compared to the non-polar, untreated domains. Far-field force imaging was performed on the patterned surface using the interleave AFM mode to produce two-dimensional plots of the distribution of electrostatic double-layer forces formed when the patterned polystyrene surfaces is immersed in PBS. Imaging of protein layers adsorbed onto the chemically patterned surfaces indicates that the electrostatic double-layer force was a significant driving force in the interaction of protein with the surface.

Improved cellular adhesion to acetone plasma modified polystyrene surfaces.

The plasma polymerization of acetone has been used to modify polystyrene substrates for the controlled growth of human fibroblast cells. The surface modified polystyrene was studied by X-ray photoelectron spectroscopy, water contact angle and atomic force microscopy. This showed the surface oxygen levels and wettability to increase rapidly with exposure to the acetone plasma. High-resolution XPS allowed the determination of the relative amounts of surface hydroxyl, carbonyl and carboxyl groups. This showed that there was little incorporation of carboxyl groups in the deposited films. AFM measurements revealed the films to be conformal with a surface roughness equivalent to that of the underlying polystyrene substrate with film growth rates of approximately 0.5 nm min(-1). High edge-definition patterns were produced with a simple masking procedure and allowed the confinement of cells to selected areas of the substrate. These chemically patterned surfaces allowed the study of cells confined to particular regions of the substrate as a function of incubation time.

UV-ozone modification of plasma-polymerised acetonitrile films for enhanced cell attachment.

Plasma polymerisation is of great interest for modifying the surface properties of biomedical devices in order to control, for example, protein adsorption and cell attachment. In this paper we present results for plasma-polymerised acetonitrile deposited onto silicon or polystyrene substrates. The chemistry of films deposited under a range of experimental conditions was studied by X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared spectroscopy (FTIR). XPS provided evidence that the elemental composition of the films varied with rf power to flow rate parameter (W/F) with films produced at higher W/F being deficient in nitrogen. FTIR revealed that the plasma deposited film contained a wide range of nitrogen functional groups including amine, imine and nitrile. Oxidation of the films by exposure to radiation from a low pressure mercury vapour lamp in an air ambient increased the surface oxygen levels from 3 to 17at.% after 300 s exposure. XPS also revealed that the oxidation process proceeded via the formation of carbonyl groups at short exposure times (<60s) while longer treatment times (>60s) resulted in an increase in the concentration of carboxyl groups. To assess their potential to support cell growth, polystyrene culture dishes coated with plasma deposited films and UV-ozone oxidised films were seeded with 1BR.3.N human fibroblast cells and incubated for up to 72 h. Un-oxidised plasma-polymerised acetonitrile films were found to give comparable cell attachment densities as tissue culture polystyrene. The greatest cell attachment density was found with plasma polymer films which had been UV-ozone treated for the longest time (300 s). Enhanced attachment to this surface was attributed to the high level of carboxylic groups found on this substrate.

Cellular attachment and spatial control of cells using micro-patterned ultra-violet/ozone treatment in serum enriched media.

Ultra-violet Ozone (UVO) modified polystyrene (PS) surfaces were analyzed by X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), contact angle (CA), optical microscopy (OM) and cell culture experiments. UV/Ozone treatment up to 900 s was used to increase the surface oxygen concentration of PS surfaces from 0% to approximately 35% (unwashed) and 0% to approximately 27% (washed). The observed differences in oxygen concentration, between washed and unwashed surfaces, have been previously attributed to the removal of low molecular weight debris produced in this treatment process. Surface roughness (Rq) is known to affect cellular attachment and proliferation. AFM studies of the UV/Ozone treated PS surfaces show the surface roughness is an order of magnitude less than that expected to cause an effect. UV/Ozone treatment of PS showed a marked change in CA which decreased to approximately 60 degrees after 900 s treatment. The increased attachment and proliferation of Chinese hamster ovarian (CHO) and mouse embryo 3T3-L1 (3T3) cells on the treated surfaces compared to untreated PS were found to correlate strongly with the increase in surface oxygen concentration. Surface chemical oxidation patterns on the PS were produced using a simple masking technique and a short UV/Ozone treatment time, typically 20-45 s. The chemical patterns on PS were visualized by water condensation and the spatially selective attachment of CHO and 3T3-L1 cells cultured with 10% (v/v) serum. This paper describes an easily reproducible, one step technique to produce a well-defined, chemically heterogeneous surface with a cellular resolution using UV/Ozone modification. By using a variety of cell types, that require different media conditions, we have been able to expand the potential applications of this procedure.

A comprehensive substance abuse treatment program for women and their children: an initial evaluation.

This article examines a comprehensive, residential substance abuse treatment program for women and their children. A majority of the 72 participants studied were African American single mothers, for whom crack/cocaine was the drug of choice. The women and their children were assessed repeatedly during treatment, and at 3, 6, and 12 months postdischarge. Program impact was estimated by comparing the outcomes of three groups that differed in the amount of treatment they received: early dropouts, late dropouts, and treatment graduates. Program graduates showed more positive outcomes than the nongraduate comparison groups in the areas of drug use and negative consequences of use, employment and self-sufficiency, and family interaction skills. Young children enrolled in treatment with their mothers were assessed using a developmental screening test, and older children with a measure of drug refusal skills. Results from both child measures suggest substantial improvement.

Effects of Serum on the Kinetics of CHO Attachment to Ultraviolet-Ozone Modified Polystyrene Surfaces.

Attachment kinetics of Chinese hamster ovarian (CHO) cells were investigated on ultraviolet-ozone oxidized polystyrene (UVO-PS) dishes in the presence and absence of serum. The surface chemistry of UVO-PS has been extensively characterized. Although cells attached rapidly to the oxidized dishes with serum present it was found that serum actually inhibits the rate of attachment. Spreading of attached cells was favored by the presence of serum. It is suggested that the increased quantity of hydrophilic carboxyl groups on longer exposed UVO-PS leads to a change in the protein layer adsorbed from serum and also a higher affinity of the surface for extracellular proteins secreted by the attached cells. The UVO-PS surfaces present a new way of producing tissue culture grade polystyrene (TCPS) in a highly controllable method, which would ensure greater consistency in TCPS surfaces. Copyright 2001 Academic Press.

The home environments of children in the United States part I: variations by age, ethnicity, and poverty status.

Although measures of the home environment have gained wide acceptance in the child development literature, what constitutes the "average" or 'typical" home environment in the United States, and how this differs across ethnic groups and poverty status is not known. Item-level data from the National Longitudinal Survey of Youth on four age-related versions of the Home Observation for Measurement of the Environment-Short Form (HOME-SF) from five biennial assessments (1986-1994) were analyzed for the total sample and for four major ethnic groups: European Americans, Asian Americans, African Americans, and Hispanic Americans. The percentages of homes receiving credit on each item of all four versions of the HOME-SF are described. For the majority of items at all four age levels differences between poor and nonpoor families were noted. Differences were also obtained among African American, European American, and Hispanic American families, but the magnitude of the effect for poverty status was greater than for ethnicity, and usually absorbed most of the ethnic group effects on HOME-SF items. For every item at every age, the effects of poverty were proportional across European American, African American, and Hispanic American groups.

The home environments of children in the United States part II: relations with behavioral development through age thirteen.

This study examined the frequency with which children were exposed to various parental actions, materials, events, and conditions as part of their home environments, and how those exposures related to their well-being. Part 1 focused on variations by age, ethnicity, and poverty status. In Part 2 of the study, relations between major aspects of the home environment (including maternal responsiveness, learning stimulation, and spanking) and developmental outcomes for children from birth through age 13 were investigated. The outcomes examined were early motor and social development, vocabulary development, achievement, and behavior problems. These relations were examined in both poor and nonpoor European American, African American, and Hispanic American families using hierarchical linear modeling. The most consistent relations found were those between learning stimulation and children's developmental status, with relations for parental responsiveness and spanking varying as a function of outcome, age, ethnicity, and poverty status. The evidence indicated slightly stronger relations for younger as compared with older children.

Moderating effect of perceived amount of family conflict on the relation between home environmental processes and the well-being of adolescents.

This study examined the extent that perceived amount of conflict in the family moderates the relation between proximal aspects of the home environment and adolescent well-being. Regression models consisting of Home Observation for Measurement of the Environment (HOME) subscale scores (Responsivity, Learning Materials, Variety of Experiences), family conflict, and the interaction between HOME scores and family conflict were tested for each of 6 dependent measures: academic achievement, task orientation, being considerate, self-efficacy as it pertains to school, self-efficacy as it pertains to family, and school grades. Results indicated moderation in all 3 ethnic groups examined (European Americans, African Americans, and Chinese Americans). For all 3 groups, relations were stronger in families with high conflict, suggesting a heightened sensitivity to social exchanges and events within the family.

Fatherhood in the twenty-first century.

The twentieth century has been characterized by four important social trends that have fundamentally changed the social cultural context in which children develop: women's increased labor force participation, increased absence of nonresidential fathers in the lives of their children, increased involvement of fathers in intact families, and increased cultural diversity in the U.S.. In this essay, we discuss how these trends are changing the nature of father involvement and family life, and in turn affecting children's and fathers' developmental trajectories. We end with an eye toward the twenty-first century by examining how the children of today will construct their expectations about the roles of fathers and mothers as they become the parents of tomorrow. This life-span approach to fatherhood considers the broader sociohistorical context in which fatherhood develops, and emphasizes the urgent need to consider mothers, fathers, and family structure in future research as we seek to understand and model the effects of parenting on children's development.

Effects of poverty on home environment: an analysis of three-year outcome data for low birth weight premature infants.

Investigated the relationship between poverty and parenting in a sample of low birth weight (< or = 2,500 grams) premature (LBWPT) infants (gestation < or = 37 weeks) who were control subjects in the Infant Health and Development Program. When classified using federal poverty levels, poor families scored lower on the HOME inventory (used to measure the caregiving environment) than nonpoor families. A regression model including poverty, race, site, and representative environmental, maternal, and child variables accounted for 60% of variance in total HOME scores. Poverty and maternal IQ had significant and independent effects on HOME scores, whereas maternal distress accounted for little of the variance. In a LBWPT sample, our results find a strong relationship between parenting and poverty, suggest a modest role for maternal psychological distress in this relationship, and indicate that the influence of poverty likely extends beyond commonly measured environmental, maternal, and child factors.

Home environment and adaptive social behavior among premature, low birth weight children: alternative models of environmental action.

Used data from 465 premature, low birth weight children representing three major sociocultural groups (Caucasian, African American, Hispanic) to examine the relation between children's home environments and their adaptive social behavior. Results showed low to moderate associations between scores on the HOME Inventory at 1 and 3 years and scores on two measures of adaptive social behavior at 30 to 36 months, the Adaptive Social Behavior Inventory, and observations of mother-child interaction in a structured laboratory situation. Results indicated that responsive, nurturant care at both 1 and 3 years are related to child adaptive social behavior, as are cognitively stimulating experiences and materials. However, canonical correlational analysis indicated that only Acceptance and Variety of Experience, measured at age 3, and Variety of Experience measured at age 1 accounted for independent amounts of variance in adaptive social behavior as perceived by mothers. Also, only sociocultural group status and Learning Materials at 36 months contributed to the prediction of persistence and enthusiasm as observed in the laboratory setting.

The amobarbital sodium interview in conversion disorders: use of video feedback in therapy.

The prognosis in treating acute conversion disorder is good, but it demands considerable time in the form of an intensive, and often extensive, hospital stay. With the increasing trend to limiting hospital stays, the family practitioner working with a psychiatrist in the hospital setting is pressured to find new approaches in order to limit the use of inpatient units. The authors describe a case of classic conversion disorder and outline a successful approach that uses a video recording of the interview, during which the patient is under the influence of amobarbital sodium. The videotape then provides valuable feedback during future therapy sessions in the treatment of this persistent disorder.