Building better bones in childhood: a randomized controlled study to test the efficacy of a dietary intervention program to increase calcium intake.

BACKGROUND/OBJECTIVES: Many children do not consume the recommended daily allowance of calcium. Inadequate calcium intake in childhood may limit bone accrual. The objective of this study was to determine if a behavioral modification and nutritional education (BM-NE) intervention improved dietary calcium intake and bone accrual in children. SUBJECTS/METHODS: 139 (86 female) healthy children, 7-10 years of age, were enrolled in this randomized controlled trial conducted over 36 months. Participants randomized to the BM-NE intervention attended five sessions over a 6-week period designed to increase calcium intake to 1500 mg/day. Participants randomized to the usual care (UC) group received a single nutritional counseling session. The Calcium Counts Food Frequency Questionnaire was used to assess calcium intake; dual energy X-ray absorptiometry was used to assess areal bone mineral density (aBMD) and bone mineral content (BMC). Longitudinal mixed effects models were used to assess for an effect of the intervention on calcium intake, BMC and aBMD. RESULTS: BM-NE participants had greater increases in calcium intake that persisted for 12 months following the intervention compared with UC. The intervention had no effect on BMC or aBMD accrual. Secondary analyses found a negative association between calcium intake and adiposity such that greater calcium intake was associated with lesser gains in body mass index and fat mass index. CONCLUSIONS: A family-centered BM-NE intervention program in healthy children was successful in increasing calcium intake for up to 12 months but had no effect on bone accrual. A beneficial relationship between calcium intake and adiposity was observed and warrants future study.

Parental perception of time and decision-making in neonatal research.

OBJECTIVE: To assess the impact of time on parental decision-making for research participation for neonates with congenital heart disease. STUDY DESIGN: Interviews were conducted with 37 parents of 19 neonates with congenital heart disease who were eligible for three different studies: genetic etiology of congenital heart disease, heart rate variability (HRV) and structural and functional cranial magnetic resonance imaging (MRI). All parents were asked the same questions: (1) 'Did you have adequate time to make a decision about research?' and (2) 'Why?' Differences between groups (reporting adequate and inadequate time) were evaluated using Fisher's exact tests; central themes were examined using qualitative analysis. RESULT: Of those parents who reported having adequate time to make their decision (22 of 37), the majority chose to participate when compared to those who reported inadequate time (genetics study, P<0.01; HRV, P=0.05; MRI, P<0.01). For the parents reporting inadequate time, consistent themes emerged: insufficient time to make an educated choice (n=10), consideration of study logistics (n=8), spouse not present at the time of decision (n=7) and insufficient time to discuss the studies (n=4). CONCLUSION: Parental perception of adequate time to decide about research participation was associated with parental willingness to enroll the child in research. Despite any time limitations, parents were satisfied with the decisions they made. Optimizing the time available for the parental permission process could enhance research participation in the neonatal period.

Effects of a unit of instruction in mental health on rural adolescents' conceptions of mental illness and attitudes about seeking help.

The present study investigated the effects of a unit of instruction in mental health on rural adolescents' conceptions of mental illness and their attitudes about seeking professional help for emotional problems. Forty students enrolled in a rural Mississippi high school participated. Twenty were designated as the treatment group and twenty served as the control group. Results indicated that scores on both dependent variables (attitudes about seeking professional help and conceptions of mental illness) increased significantly for the treatment group and, further, these scores did not decrease significantly when the students were tested again twelve weeks later. The findings are discussed in the context of educating rural youth about mental illness with the express purpose of removing the stigma associated with the help-seeking process.

Metals and school learning: a review of investigative techniques.

A growing body of literature suggests a relationship between metals and a threatened health status among children, adolescents, and adults. Recently, several investigators have reported a direct link between exposure to metal and diminished affective, behavioral, and cognitive performance of school children. The purpose of the present study was to review and analyze methods and procedures used to understand the relationship between exposure to metals and cognitive, social, and motor functioning of school children.

Community integration of young adults with mental retardation: a multivariate analysis of adjustment.

The purpose of the present study was to determine whether differences in community adjustment existed for three groups of young adults with mental retardation using data organized on the basis of four empirically validated factors identified in prior research. A descriptive discriminant function analysis was used as a follow-up to a statistically significant multivariate analysis of variance F-ratio. Results obtained from the discriminant analysis indicated that five variables (number of limiting factors, earned income, number of support services, living arrangement, number of daytime activities) contributed substantively to separation of the three group centroids.

Adjustment of young adults with mental retardation in community settings: comparison of parametric and nonparametric statistical techniques.

The impact of four different statistical techniques on the interpretive process using data obtained from young adults with mental retardation in applied settings was evaluated. Our hypothesis was that no difference exists across levels of mental retardation for four dependent variables, jointly or separately, using (a) parametric multivariate analysis of variance, (b) nonparametric multivariate analysis of variance, (c) multiple nonparametric analyses of variance, and (d) multinomial logistic regression. The pattern of significance remained the same across the three classical and quasi-classical designs. Substantive differences were found using the fourth technique, multinomial logistic regression. The four techniques were compared using interpretational as well as statistical criteria.

Factor structure of maladaptive behavior across the lifespan of persons with mental retardation.

Data obtained on a sample of persons with mild to profound degrees of mental retardation (N = 8255) and ranging from birth to 98 years of age were factor analyzed to provide information on the structure of maladaptive behavior relative to age and degree of mental retardation. Using the Problem Behavior scales of the Inventory for Client and Agency Planning, two principal factors emerged for children with mild to profound degrees of retardation: Internalized Maladaptive and Externalized Maladaptive. For adolescents and young adults, a three-factor solution which varied by degree of retardation was most appropriate. For middle and older adults, three- and four-factor solutions were identified across all ages and degrees of retardation. Across all samples as many as six different types of dimensions were identified, indicating that the structure of maladaptive behavior may well be influenced by age and level of mental retardation.