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Biomedical subjects

Katherine Kaufer Christoffel

Publications and source records attributed to Katherine Kaufer Christoffel.

10 recordsLinked to original sources
PubMed2006

Identification of contrastive and comparable school neighborhoods for childhood obesity and physical activity research.

UNLABELLED: The neighborhood social and physical environments are considered significant factors contributing to children's inactive lifestyles, poor eating habits, and high levels of childhood obesity. Understanding of neighborhood environmental profiles is needed to facilitate community-based research and the development and implementation of community prevention and intervention programs. We sought to identify contrastive and comparable districts for childhood obesity and physical activity research studies. We have applied GIS technology to manipulate multiple data sources to generate objective and quantitative measures of school neighborhood-level characteristics for school-based studies. GIS technology integrated data from multiple sources (land use, traffic, crime, and census tract) and available social and built environment indicators theorized to be associated with childhood obesity and physical activity. We used network analysis and geoprocessing tools within a GIS environment to integrate these data and to generate objective social and physical environment measures for school districts. We applied hierarchical cluster analysis to categorize school district groups according to their neighborhood characteristics. We tested the utility of the area characterizations by using them to select comparable and contrastive schools for two specific studies. RESULTS: We generated school neighborhood-level social and built environment indicators for all 412 Chicago public elementary school districts. The combination of GIS and cluster analysis allowed us to identify eight school neighborhoods that were contrastive and comparable on parameters of interest (land use and safety) for a childhood obesity and physical activity study. CONCLUSION: The combination of GIS and cluster analysis makes it possible to objectively characterize urban neighborhoods and to select comparable and/or contrasting neighborhoods for community-based health studies.

Adolescent↗
PubMed2006

Prevalence of overweight and risk of overweight among 3- to 5-year-old Chicago children, 2002-2003.

This article reports the first estimates of overweight prevalence in Chicago children entering school (aged 3-5 years). Chicago data are compared with those from the National Health and Nutrition Examination Survey (NHANES) and the Early Childhood Longitudinal Study (ECLS). Data were from 2 separate convenience samples of children aged 3-5 years attending either 18 Chicago Public Schools or 10 Chicago Catholic School pre-K programs (n = 1517). Data were taken from students' Certificate of Child Health Examination (CCHE), completed by a health professional. Overall, the prevalence of overweight subjects (body mass index >or=95th percentile) was 24%, more than twice that of the national prevalence of 10% for 2- to 5-year olds documented by NHANES (1999-2002) and 3 times that of the 1998-1999 ECLS prevalence estimate of 8% for 5- to 7-year olds in the Midwest region. The data reported here document that nearly one quarter of children entering school in Chicago are already overweight. This clearly establishes a need for local schools to develop protocols and procedures to support the physical and mental health needs of affected and at-risk children. The findings also make it plain that ongoing weight status monitoring is needed and that current plans to implement this should go forward.

Chicago↗
PubMed2006

Pediatrician characteristics associated with child abuse identification and reporting: results from a national survey of pediatricians.

Pediatrician experience with child protective services (CPS) and factors associated with identifying and reporting suspected child physical abuse were examined by a survey of members of the American Academy of Pediatrics (AAP). Respondents provided information about their demographics and experience, attitudes and practices with child abuse. They indicated their diagnosis and management of a child in a purposely ambiguous clinical vignette. Pediatricians who had received recent child abuse education were more confident in their ability to identify and manage child abuse. High confidence in ability to manage child abuse and positive attitude about domestic violence screening and value of anticipatory guidance predicted that pediatricians would have high suspicion that the child in the vignette was abused and that they would report the child to CPS. Future efforts to improve medical intervention in child abuse should focus on physician attitudes and experience, as well as cognitive factors.

Attitude↗
PubMed2004

Risk factors for overweight in five- to six-year-old Hispanic-American children: a pilot study.

The objective of this study was to determine the prevalence of and possible risk factors for overweight in a sample of 5- to 6-year-old Hispanic (predominantly Mexican American) children in Chicago, Illinois, to see if overweight is more common in more highly acculturated immigrant families. There were 250 kindergarten students (92% of those eligible) attending two public elementary schools serving primarily Mexican American neighborhoods measured for height and weight. Consenting mothers were interviewed (n = 80) and measured (n = 38). The interview tool covered demography, acculturation, infant and toddler feeding practices, current eating patterns and food preparation habits, physical activity, and psychosocial family characteristics. Overweight was conservatively defined as weight-for-height at or above the National Center for Health Statistics 95th percentile. The data were used to describe the prevalence of overweight. Overweight and nonoverweight children were compared on all survey variables using appropriate statistical tests, with significance set at.05. There were 23% of the total sample of children (n = 250) and 26% of the subsample of children (those whose mothers were interviewed) who were overweight. Analysis limited to children in the subsample explored risk factors. The median score on the Acculturation Scale was 4.0 (range 2.4 - 10.4) on a scale of 2.4 (entirely not acculturated) to 12 (fully acculturated). There was no significant association between overweight and Acculturation Scale score. Overweight children were more likely than those not overweight to watch television for more than 3 hours during weekend days (48% vs. 22%, P =.03). Overweight children were also more likely to consume sweetened beverages (powdered drinks, soda pop, atole) daily (67% vs. 39%, P =.03). There was a trend indicating that free access to food at home increased the risk of overweight (P = 0.06). No other family- or child-level variables were related to overweight. Only 40% of mothers with an overweight child correctly assessed these children as overweight. Approximately one quarter of the children in the study were overweight. Our hypothesis that their obesity was linked to acculturation was not confirmed. Longer hours of child television viewing on weekends and higher levels of sweetened beverage consumption were important behaviors associated with the occurrence of overweight. These data should be considered when designing future studies in this population.

Acculturation↗
PubMed2004

Obesity.

Explore the source record for details and available documents.

Adipose Tissue↗
PubMed2002

The contribution of prone sleeping position to the racial disparity in sudden infant death syndrome: the Chicago Infant Mortality Study.

BACKGROUND: Rates of sudden infant death syndrome (SIDS) are over twice as high among African Americans compared with Caucasians. Little is known, however, about the relationship between prone sleeping, other sleep environment factors, and the risk of SIDS in the United States and how differences in risk factors may account for disparities in mortality. OBJECTIVE: To assess the contribution of prone sleeping position and other potential risk factors to SIDS risk in a primarily high-risk, urban African American population. DESIGN, SETTING, AND POPULATION: Case-control study consisting of 260 infants ages birth to 1 year who died of SIDS between November 1993 and April 1996. The control group consists of an equal number of infants matched on race, age, and birth weight. Prospectively collected data from the death scene investigation and a follow-up home interview for case infants were compared with equivalent questions for living control participants to identify risk factors for SIDS. MAIN OUTCOME MEASURES: Risk of SIDS related to prone sleeping position adjusting for potential confounding variables and other risk factors for SIDS, and comparisons by race-ethnicity. RESULTS: Three quarters of the SIDS infants were African American. There was more than a twofold increased risk of SIDS associated with being placed prone for last sleep compared with the nonprone positions (odds ratio [OR]: 2.4; 95% confidence interval [CI]: 1.6-3.7). This OR increased after adjusting for potential confounding variables and other sleep environment factors (OR: 4.0; 95% CI: 1.8-8.8). Differences were found for African Americans compared with others (OR: 1.8; 95% CI: 1.2-2.6 and OR: 10.3, 95% CI: 10.3 [3.2-33.8, respectively]). The population attributable risk was 31%. Fewer case mothers (46%) than control mothers (64%) reported being advised about sleep position in the hospital after delivery. Of those advised, a similar proportion of case mothers as control mothers were incorrectly told or recalled being told to use the prone position, but prone was recommended in a higher proportion of black mothers (cases and controls combined) compared with nonblack mothers. CONCLUSIONS: Prone sleeping was found to be a significant risk factor for SIDS in this primarily African American urban sample, and approximately one third of the SIDS deaths could be attributed to this factor. Greater and more effective educational outreach must be extended to African American families and the health personnel serving them to reduce prone prevalence during sleep, which appears, in part, to contribute to the higher rates of SIDS among African American infants.

Adolescent↗
PubMedDate not supplied

Evaluating computer capabilities in a primary care practice-based research network.

PURPOSE: We wanted to assess computer capabilities in a primary care practice-based research network and to understand how receptive the practices were to new ideas for automation of practice activities and research. METHOD: This study was conducted among members of the Pediatric Practice Research Group (PPRG). A survey to assess computer capabilities was developed to explore hardware types, software programs, Internet connectivity and data transmission; views on privacy and security; and receptivity to future electronic data collection approaches. RESULTS: Of the 40 PPRG practices participating in the study during the autumn of 2001, all used IBM-compatible systems. Of these, 45% used stand-alone desktops, 40% had networked desktops, and approximately 15% used laptops and minicomputers. A variety of software packages were used, with most practices (82%) having software for some aspect of patient care documentation, patient accounting (90%), business support (60%), and management reports and analysis (97%). The main obstacles to expanding use of computers in patient care were insufficient staff training (63%) and privacy concerns (82%). If provided with training and support, most practices indicated they were willing to consider an array of electronic data collection options for practice-based research activities. CONCLUSIONS: There is wide variability in hardware and software use in the pediatric practice setting. Implementing electronic data collection in the PPRG would require a substantial start-up effort and ongoing training and support at the practice site.

Ambulatory Care Information Systems↗
PubMedDate not supplied

Firearm-related death and injury among children and adolescents.

As the articles in this journal issue show, gun violence affects children and youth in many ways: psychologically, emotionally, financially, and legally. But first and foremost, gun violence affects children's physical safety. Therefore, this issue opens with an overview of the physical toll that firearms exact upon children and youth, reviewing the incidence of firearm-related injury and death among Americans under age 20. This article analyzes trends and current status in firearm death and injury, based on nationwide data collected by the federal government. Several key findings emerge from the data: Firearm death rates among children and youth in the United States have declined dramatically since 1993, but remain high compared with historical rates in this country and rates in other developed nations. A majority of these deaths are homicides. Certain groups of children and youth, especially adolescents, boys, minority youth, and those residing outside the Northeast, are particularly at risk for firearm death. The problem is most acute among black teenage males. Firearm injuries are much more likely to result in death than are other injuries for which children and youth visit emergency departments--a reflection of the extreme lethality of firearms. Given these findings, the authors call for a concerted effort to reduce youth firearm deaths to levels comparable to those of other industrialized nations, using a wide variety of approaches that span the public health, criminal justice, and educational spheres. They also recommend improved data systems to track firearm injury and death, so that researchers can better analyze these incidents and evaluate intervention strategies.

Accidents↗