Maternal childhood abuse predicts externalizing behaviour in toddlers: a prospective cohort study.

AIMS: To investigate the impact of maternal childhood abuse on toddlers' behaviour and assess the potential mediation of maternal mental distress for this pathway. METHODS: This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health. The study sample consisted of 25,452 children and their mothers. Maternal childhood abuse was investigated as a potential predictor for child externalizing behaviour at 36 months of age. Maternal mental distress at child age 18 months was assessed as a potential mediator. Hierarchical linear regressions were used for analyses. RESULTS: Childhood emotional abuse alone was reported by 8.3% of the mothers and physical and/or sexual abuse by 8.9%. Mothers with childhood abuse experiences were younger, less educated, more at risk for adult abuse and mental distress, and fewer were married or lived with a partner compared with women not reporting childhood abuse. Children of mothers with childhood abuse experiences showed significantly more externalizing behaviour even after adjusting for maternal age, education, single motherhood, gender and adult abuse experiences. When maternal mental health was entered into the model, the associations remained statistically significant, but were substantially attenuated. CONCLUSIONS: Maternal childhood abuse consistently predicted increased externalizing behaviour in the offspring, and this study suggests that childhood abuse impacts subsequent generations. Multiple pathways are possible, but this study identified increased maternal mental distress as a possible pathway between maternal childhood abuse and increased externalizing behaviour in the offspring.

Familial factors and child characteristics as predictors of injuries in toddlers: a prospective cohort study.

OBJECTIVE: To identify family and child characteristics that put toddlers at risk of injuries. DESIGN: A prospective cohort study. SETTING: This study was based on the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health. PARTICIPANTS: The study sample consisted of 26 087 children and their mothers. OUTCOME MEASURES: Family and child characteristics measured before or at 18 months of age were investigated as potential predictors of hospital-attended injuries that occurred between 18 and 36 months of age. RESULTS: In the multivariable analysis, younger maternal age (OR 0.93, 95% CI 0.86 to 1.00), financial problems (OR 1.18, 95% CI 1.01 to 1.39), maternal mental distress (OR 1.09, 95% CI 1.03 to 1.16), having older siblings (OR 1.22, 95% CI 1.08 to 1.39), increased gestational age at birth (OR 1.04, 95% CI 1.00 to 1.07) and male gender (OR 1.26, 95% CI 1.11 to 1.42) were risk factors for hospital-attended injuries. Children with impaired gross motor development had a decreased risk of injury (OR 0.65, 95% CI 0.42 to 0.99), whereas those with impaired fine motor development had an increased risk (OR 1.55, 95% CI 1.22 to 1.97). Shyness was a protective factor (OR 0.92, 95% CI 0.86 to 0.98). Children with three reported attention problems had a slightly increased risk of hospital-attended injuries (OR 1.33, 95% CI 1.02 to 1.72; p=0.035); otherwise, behaviour was not a significant risk factor. CONCLUSIONS: This study demonstrated that a wide variety of factors were in play as predictors of injuries in young children. Both child-related factors (gender, gestational age at birth, child motor development, shyness and attention) and familial factors (having older siblings, maternal age, financial difficulties and maternal mental health problems) were associated with injuries in toddlers.

The influence of individual and contextual work factors on workers' compliance with health and safety routines.

This study investigated the relationships between workers' compliance with health and safety (H&S) routines and instructions adopted in the company (dependent variable) and psychological demands, decision authority, social support, management support, unionization and H&S management system (independent variables). A cross-sectional questionnaire study was performed among 1051 workers and the managers of 102 small- and medium-sized motor vehicle repair garages. Multilevel modeling was performed to account for the hierarchical structure of the data. At the worker level, high compliance with H&S routines correlated significantly with both social support and H&S-related management support. At the garage level, mean management support and a well-developed H&S management system correlated significantly with high workers' compliance. Changing both the individual and contextual factors in the work environment may thus increase workers' participation in H&S activities.

Sudden infant death syndrome (SIDS)--standardised investigations and classification: recommendations.

Sudden infant death syndrome (SIDS) still accounts for considerable numbers of unexpected infant deaths in many countries. While numerous theories have been advanced to explain these events, it is increasingly clear that this group of infant deaths results from the complex interaction of a variety of heritable and idiosyncratic endogenous factors interacting with exogenous factors. This has been elegantly summarised in the "three hit" or "triple risk" model. Contradictions and lack of consistencies in the literature have arisen from diverse autopsy approaches, variable applications of diagnostic criteria and inconsistent use of definitions. An approach to sudden infant death is outlined with discussion of appropriate tissue sampling, ancillary investigations and the use of controls in research projects. Standardisation of infant death investigations with the application of uniform definitions and protocols will ensure optimal investigation of individual cases and enable international comparisons of trends.

The impact of social and organizational factors on workers' use of personal protective equipment: a multilevel approach.

OBJECTIVE: On the basis of the job demands-control-support model by Karasek and Theorell, we investigated how social and organizational factors influence workers' use of personal protective equipment (PPE). METHODS: A cross-sectional study was performed among 1420 workers in 203 motor vehicle-repair garages. Multilevel modeling was performed to account for the hierarchical structure of the data. RESULTS: Social and management support correlated positively with PPE use at the worker level. Low demands measured at the garage level and having a health and safety management system at the garage also correlated with active use of PPE. An interaction effect between social support and garage-level demands was observed. CONCLUSIONS: In addition to health information and provision of PPE, focusing on social and organizational factors seems necessary to get more workers to comply with the instructions on PPE use.

Kinematic quality of reaching movements in preterm infants.

Many preterm infants may experience so-called minor developmental disorders; however, in general, the problems in motor behavior are not detected until school age. To introduce therapies aimed at the prevention of these problems, we need to increase our knowledge of motor function and dysfunction at early age. The present study focused on the organization of reaching movements in full-term and preterm infants without cerebral palsy. The reaching behavior of premature infants (n = 63) was assessed longitudinally at the corrected ages of 4 and 6 mo. Clinical assessments were made at 6 and 12 mo of age. On the basis of the infant's morbidity during the early stay in the neonatal intensive care unit, the preterm infants were allocated into a high-risk and a low-risk group. Results from a previous study in full-term infants (n = 13) were included. Kinematics of reaching movements in supine position were measured, and the analysis focused on movement velocity and movement units. A compound parameter of kinematic variables was created, reflecting the quality of reaching movements. The present study showed that at the age of 4 mo, low-risk preterm infants showed more often optimal reaching behavior than full-term and preterm high-risk infants. This better reaching performance was related to a better general motor and behavioral development during the first year of life. At the age of 6 mo, the advantage of the low-risk group in reaching behavior had disappeared and a disadvantage in the form of nonoptimal reaching behavior of the high-risk group emerged.