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PubMed2006

Do mothers understand healthy eating principles for low-birth-weight infants?

OBJECTIVES: To describe feeding patterns and mothers' perceptions of desirable feeding practices in low-birth-weight (LBW) infants after hospital discharge in England and to test for the association of inappropriate practices/perceptions with identifiable demographics. DESIGN: Postal questionnaires from 198 mothers of LBW infants in London, Liverpool and Winchester were analysed regarding infant demographics, mothers' demographics, infant milks used, solid feeding practices and mothers' perceptions of infant feeding practices. RESULTS: At birth, the median weight, independent of gestational age, was 1.80 kg (range 0.6-2.50 kg) and 37.1% of infants received breast milk exclusively; 83.7% were breast-fed at some stage, a practice favoured more by first-time mothers (90.2%) than multiparous mothers (73.4%) (P = 0.004) as well as by mothers of higher social groups (P = 0.019). The median age of solid food introduction was 17 postnatal weeks (range 8-36 weeks); the timing correlated strongly with infant birth weight (P < 0.001). A high-fibre diet and a low-fat diet were incorrectly considered important for their infants by 67.1% and 51.6% of mothers, respectively. Regarding a high-fibre diet as important was associated with being a multiparous mother (P = 0.006), while regarding a low-fat diet as important was associated with low social group (P = 0.018). A quarter of mothers did not consider 'plenty of calories' to be important for their infants, reflecting similar attitudes in 1990 for mothers of term infants; this incorrect attitude exhibited an association with being a first-time mother (P = 0.047). CONCLUSIONS: Infant feeding practices were very variable, showing poor concordance with national and international recommendations for term infants. In selecting foods for their infants, many mothers appeared to be applying principles more appropriate to planning a healthy diet for adults. There is an urgent need to develop and implement evidence-based guidelines for feeding LBW infants after hospital discharge, with special attention given to multiparous mothers as well as mothers from lower social groups.

Adolescent↗
PubMed2003

Motor adaptation in children with myelomeningocele: comparison to children with ADHD and healthy siblings.

Myelomeningocele is a common developmental malformation of the central nervous system that usually results in motor deficits. Previous studies of myelomeningocele have not examined motor adaptation, which involves changes in the control of movements that occur as a result of repeated task exposure but do not depend on conscious recall of the exposure. We studied motor adaptation in 17 children with myelomeningocele and shunted hydrocephalus, 19 children with attention deficit/hyperactivity disorder (ADHD), and 20 healthy siblings. All children were 8 to 15 years of age. They were administered 2 measures of motor adaptation known to be sensitive to subcortical abnormalities in adult neurological disorders. One task assessed the biasing in weight judgments that occurs after exposure to heavy versus light weights, and the other assessed the adaptation in reaching movements that occurs when vision is laterally displaced by prisms. Contrary to expectations, the groups did not differ in motor adaptation. Children in all 3 groups displayed significant biasing in their weight judgments and improvement in the accuracy of pointing during prism adaptation trials. Performance on the 2 motor adaptation tasks was not related to age or IQ. Weight biasing was positively related to a measure of response disinhibition. The findings suggest that myelomeningocele does not result in global impairment of motor skills, but instead in a profile of intact and impaired motor functions that potentially may be decomposed in accordance with the neuroscience of motor skills.

Adaptation, Physiological↗
PubMed2004

Changes in weight and body image over time in women with eating disorders.

BACKGROUND: This study examined the changes in body image and weight in young women with an adolescent eating disorder, relative to women without an eating disorder (noED). METHOD: Three diagnostic groups, anorexia nervosa (AN; n = 10), bulimia nervosa (BN; n = 27), and binge eating disorder (BED; n = 42) and three comparison groups (noED; n = 659 each) were compared on body mass index (BMI) and self-reported current body size, ideal body size, and weight dissatisfaction. Dependent variables were examined 2 and 1 year before the onset, the onset year, and 1 and 2 years after the onset of the eating disorder in a model that was adjusted for ethnicity and BMI. RESULTS: BMI was lower in the AN group at all time points except 2 years before onset. AN girls evidenced a significantly stronger relation between BMI and current self-ratings and weight dissatisfaction than noED girls. BMI did not differ between the BN group and the noED group. Girls with BN reported larger current body sizes and greater weight dissatisfaction across all time points. The BED group had higher BMI than the noED group across time. BED girls reported greater current body size ratings and weight dissatisfaction than the noED girls. Girls with AN, BN, or BED did not differ from the noED girls on body ideal ratings. DISCUSSION: Body weight seems to influence perception of body size more so for girls with AN than for noED girls. No support was found for an accelerated weight gain over time for BN. Weight may increase over time for the BED group relative to the noED group, but larger studies are needed. Across all three groups, ideal body size appears to be unrelated to diagnostic status. Rather, the risk for developing an eating disorder appears to arise from size overestimation and related weight dissatisfaction.

Adolescent↗
PubMed1976

Quantity conceptions in university students: another look.

One hundred and thirty-eight post-graduate students enrolled in a Diploma in Education course were tested for their ability to converse weight and volume. A methodological criticism of the earlier work or Elkind (1962) and Towler & Wheatley (1971) is offered which casts doubt on the extremely high proportion of non-conservers of volume reported in those studies. Nevertheless, using a modified version of Elkind's methodology, 18 per cent of our sample were non-conservers of volume, a result providing some support for the generaltiy of Elkind's findings. The results are discussed under the four headings of horizontal decalage, sex differences, possible effects of pre-graduate courses of study and educational implications. The importance of the individual as constructor and interpreter of his own experience is emphasized.

Adult↗
PubMed2006

Effects of nandrolone decanoate compared with placebo or testosterone on HIV-associated wasting.

Objectives Current research is unclear about the most effective pharmacological agents for managing the loss of weight and fat-free mass common in HIV/AIDS. The aim of this study was to compare nandrolone decanoate with placebo and testosterone. Methods The study was a multicentre randomized double-blind placebo-controlled trial. Three hundred and three adult HIV-positive male patients with a weight loss of 5-15% in the last 12 months, or a body mass index of 17-19 kg/m(2), or a body cell mass/height ratio lower than 13.5 kg/m, were randomly assigned to receive nandrolone decanoate (150 mg), testosterone (250 mg) or placebo intramuscularly every 2 weeks for 12 weeks. Fat-free mass, weight, immune markers and perception of treatment were the main outcome measures. Results Treatment with nandrolone resulted in significantly greater increases in fat-free mass [mean increase 1.34 kg; 95% confidence interval (CI) 0.60; 2.08 kg] and in weight (mean increase 1.48 kg; 95% CI 0.82; 2.14 kg) compared with placebo. The mean increase in weight with nandrolone of 1.00 kg (95% CI 0.27; 1.74 kg) when compared with testosterone was significant, although the difference in fat free mass did not reach significance (mean increase 0.69 kg; 95% CI-0.13; 1.51 kg). Patient perception of benefit was significantly greater in the nandrolone group when compared with both the placebo and the testosterone groups. Conclusions Treatment with nandrolone decanoate increased body weight when compared with placebo and testosterone. Nandrolone decanoate treatment resulted in greater increases in fat-free mass than placebo and demonstrated a trend for a significant increase when compared with testosterone.

Adult↗
PubMed2000

Perception of voiceless fricatives by normal-hearing and hearing-impaired children and adults.

This study examined the perceptual-weighting strategies and performance-audibility functions of 11 moderately hearing-impaired (HI) children, 11 age-matched normal-hearing (NH) children, 11 moderately HI adults, and 11 NH adults. The purpose was to (a) determine the perceptual-weighting strategies of HI children relative to the other groups and (b) determine the audibility required by each group to achieve a criterion level of performance. Stimuli were 4 nonsense syllables (see text). The vowel, transition, and fricative segments of each nonsense syllable were identified along the temporal domain, and each segment was amplified randomly within each syllable during presentation. Point-biserial correlation coefficients were calculated using the amplitude variation of each segment and the correct and incorrect responses for the corresponding syllable. Results showed that for /see text/ and /see text/, all four groups heavily weighted the fricative segments during perception, whereas the vowel and transition segments received little or no weight. For /see text/, relatively low weights were given to each segment by all four groups. For /see text/, the NH children and adults weighted the transition segment more so than the vowel and fricative segments, whereas the HI children and adults weighted all three segments equally low. Performance-audibility functions of the fricative segments of /see text/ and /see text/ were constructed for each group. In general, maximum performance for each group was reached at lower audibility levels for /see text/ than for /see text/ and steeper functions were observed for the HI groups relative to the NH groups. A decision theory approach was used to confirm the audibility required by each group to achieve a > or =90% level of performance. Results showed both hearing sensitivity and age effects. The HI listeners required lower levels of audibility than the NH listeners to achieve similar levels of performance. Likewise, the adult listeners required lower levels of audibility than the children, although this difference was more substantial for the NH listeners than for the HI listeners.

Adolescent↗
PubMed2004

Mectizan Donation Program: evaluation of a public-private partnership.

The Mectizan Donation Program (MDP) has been perceived as a highly effective public health programme, and as a possible model for addressing future problems in international health. This evaluation examines how the MDP partnership has been functioning from the perspectives of partner organizations. The results of a survey of 25 partners show that the perceived benefits far outweigh the problems, and that the direct costs to the organizations have been minimal. The partnership is rated highly on many aspects of governance and management, with relatively few problems identified. A factor analysis demonstrated that a wide range of factors have influenced the partners' perceptions. The benefits with the largest weights appear to be those related to external perceptions of the organization, and those indicating that the organization feels that its opinions will matter and lead to action in the partnership. The biggest factors influencing the positive perceptions on the governance and management of the MDP partnership appear to be the involvement of senior leaders from different organizations, and being able to agree on priorities. The MDP has been able to involve a large and heterogeneous number of partner organizations through relatively informal mechanisms that rely on goodwill and reciprocity. The survey results show how there was a strong alignment of the MDP with the interests of the various partners, and that a manageable number of problems were addressed and services provided. While having long-term goals, the MDP and the onchocerciasis control programmes have been effective at demonstrating the effectiveness of the approach through regular, professional, and outcome-oriented evaluations. Although the MDP is considered to be central to concerns of national officials, this feature is not rated as high as public perceptions, the internal characteristics of the partnership, or its accomplishments. Similarly, the need to secure resources is not viewed as a major determinant of the partnership's success, perhaps because resources were readily available through Merck and the partner organizations and programmes. These findings, along with the strategic and operational success of the MDP confirm the view that this type of public-private partnership should be pursued vigorously in other areas of public health. Other potential partnerships would do well to examine the characteristics of the MDP partnership, with careful attention to the features of its governance and the management, including a strong alignment of interests with partners, balancing a long-term vision with clarity of roles and intensive management of coordination, and professional and results-oriented accountability.

Developing Countries↗
PubMedDate not supplied

Development of hearing in hereditarily deaf white mink (Hedlund) and normal mink (standard) and the subsequent deterioration of the auditory response in Hedlund mink.

Behavioural responses have been elicited to acoustic stimuli in hereditarily deaf white mink (Hedlund). This revealed onset of auditory function at an average age of 31 days. The period of hearing lasted on the average only 7 days. Similar observations have been reported in other hereditarily deaf animals (cat, mouse, guinea pig). It is suggested that the onset of auditory function follows a progressive pattern which corresponds to the circulation of blood in the cochlea. Moreover, it is suggested that the subsequent deterioration of hearing follows a regression of this vascular pattern and thus a vascular pathogenesis may be responsible for this type of genetic deafness.

Acoustic Impedance Tests↗
PubMed1990

Stereotypical beliefs about appearance: implications for retailing and consumer issues.

This research was designed to identify current stereotypical beliefs about obese men and women, assess subjects' desire to work with individuals described as "normal" weight as opposed to obese, examine subjects' perceptions of their own body size, inquire about subjects' personal desire to gain and lose weight, and identify subjects' diet and consumption behavior. The data indicate sex differences in subjects' perceptions of bodily appearance, desire to work with obese people, perceptions of their own weight, desire to lose rather than gain weight, and consumption and diet behavior.

Adult↗
PubMed2000

Care giver perception of children's obesity-related health risk: a study of African American families.

OBJECTIVE: To examine care giver perception of children's weight-related health risk in African American families. RESEARCH METHODS AND PROCEDURES: One-hundred and eleven families (representing 48 boys and 63 girls) screened for participation in a diabetes prevention study participated. Care givers completed a health awareness questionnaire that assessed their perception of the child's weight, eating habits, appearance, exercise habits, and health risk. The care givers also reported each subject's family history of obesity, diabetes, and other chronic diseases. After a physical examination, height and weight were used to compute an age- and sex-adjusted body mass index for each child. RESULTS: Despite the fact that a substantial number of children were obese (57%) and super-obese (12%), only 44% of the care givers perceived the child's weight to be a potential health problem. Regression analysis showed that 21% of the variance in parental perception of obesity-related health risk could be predicted by child age, body mass index, perception of frame size, and perception of exercise habits. DISCUSSION: A number of reasons for the apparent minimization of child health risk are discussed, including cultural differences in the acceptance of a large body habitus, lack of knowledge about the connection between childhood obesity and future health risk, and an optimistic bias in the perception of personal health risk.

Adult↗
PubMed2005

Long-term weight loss maintenance.

There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that approximately 20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity ( approximately 1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2-5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success. National Weight Control Registry members provide evidence that long-term weight loss maintenance is possible and help identify the specific approaches associated with long-term success.

Body Mass Index↗
PubMed1989

Static, dynamic, and relational properties in vowel perception.

The present work reviews theories and empirical findings, including results from two new experiments, that bear on the perception of English vowels, with an emphasis on the comparison of data analytic "machine recognition" approaches with results from speech perception experiments. Two major sources of variability (viz., speaker differences and consonantal context effects) are addressed from the classical perspective of overlap between vowel categories in F1 x F2 space. Various approaches to the reduction of this overlap are evaluated. Two types of speaker normalization are considered. "Intrinsic" methods based on relationships among the steady-state properties (F0, F1, F2, and F3) within individual vowel tokens are contrasted with "extrinsic" methods, involving the relationships among the formant frequencies of the entire vowel system of a single speaker. Evidence from a new experiment supports Ainsworth's (1975) conclusion [W. Ainsworth, Auditory Analysis and Perception of Speech (Academic, London, 1975)] that both types of information have a role to play in perception. The effects of consonantal context on formant overlap are also considered. A new experiment is presented that extends Lindblom and Studdert-Kennedy's finding [B. Lindblom and M. Studdert-Kennedy, J. Acoust. Soc. Am. 43, 840-843 (1967)] of perceptual effects of consonantal context on vowel perception to /dVd/ and /bVb/ contexts. Finally, the role of vowel-inherent dynamic properties, including duration and diphthongization, is briefly reviewed. All of the above factors are shown to have reliable influences on vowel perception, although the relative weight of such effects and the circumstances that alter these weights remain far from clear. It is suggested that the design of more complex perceptual experiments, together with the development of quantitative pattern recognition models of human vowel perception, will be necessary to resolve these issues.

Humans↗
PubMed2000

Nematode parasite control practices of sheep and goat farmers in the region of Trikala, Greece.

Information concerning worm control practices of sheep and goat farmers in the region of Trikala (central Greece) was collected through a questionnaire survey by visiting farms and interviewing farmers. Questionnaires from 57 farmers residing in 23 rural communities were collected. Anthelmintics were used by 89% of the farmers. On average, lambs, kids and goats were treated once annually, while sheep were treated either once or twice annually. Only 2% of farmers reported treatment of animals with anthelmintics when moving to new pastures. The most common broad-spectrum anthelmintics used were those belonging to the benzimidazoles and probenzimidazoles. Fifty nine percent of the farmers used the same anthelmintic group for 3 or more years and 34% used two or more anthelmintic groups in the same year. Almost all farmers reported estimating live weights for calculating anthelmintic doses through visual perception on the basis of an average weight (96%). Tablets and boluses were the most preferred anthelmintic formulation used by 96% of farmers. The selection of an anthelmintic was based for 58% of farmers on recommendation by a veterinarian and for 39% of farmers on the cost of the drug. The most common occasions for deworming the animals were at turn out (86%) and after parturition (31%). Only 6% of farmers reported deworming new animals before introducing them onto the farm. Farmers preferred to seek information about the use of anthelmintics and worm control strategies from veterinarians (63%) and other farmers (37%).

Animal Husbandry↗
PubMed2000

Maternal child feeding practices and obesity: a discordant sibling analysis.

BACKGROUND: The relationship between maternal feeding practices and weight status of 7-12 year-old obese and nonobese siblings was evaluated in 18 families using a discordant sibling design. METHOD: Mothers completed measures of concern and perception of children's weight and eating behavior, their control over child feeding, and maternal eating behavior. RESULTS: Intraclass correlations suggested similarity between obese and nonobese siblings in maternal control over feeding. Mothers perceived differences between their obese and nonobese children's eating regulation. Mothers' weight status was positively associated with disinhibition of their own eating as well as concern about both their obese and nonobese children's weight and health. DISCUSSION: These findings fail to support the hypothesis that maternal control over child feeding is related to childhood obesity, but highlight the impact of maternal weight history and eating habits on her impression of children's future weight and health independent of the child's weight status.

Adult↗
PubMed1996

Dietary intakes of young children with cystic fibrosis: is there a difference?

Caloric intakes of preadolescent and adolescent girls and boys with cystic fibrosis (CF) were compared in order to evaluate the possibility that poor caloric intake contributes to poor nutritional status and high mortality among girls with CF. Fifty-six CF patients (26 girls and 30 boys), 10-15 years old, completed a 3-day food record, answered a short questionnaire, and underwent anthropometric and pulmonary function assessment. The mean ages of the girls and boys were similar, but the height and weight percentiles of the girls were lower than those of the boys (p = 0.02). Mean caloric intakes were no different (116% and 112% of the recommended nutrient intake in the girls and boys, respectively). Nutritional status, as determined by weight as a percentage of ideal weight for height, mean triceps skinfold thickness, and midarm muscle circumference, was normal and similar in both sexes. Most girls and boys with CF in this study had an appropriate perception of their body weight. Pulmonary function tests suggested mild lung disease with no significant difference between girls and boys (forced expiratory volume in 1 s of 82.2% and 79.8% of predicted values, respectively). The similar nutritional and pulmonary status of the girls and boys with CF in this age group is in contrast to previous reports. This finding may be the result of our policy, introduced > 15 years ago, of expecting normal growth, by paying close attention to enzyme therapy and encouraging high energy intake from the time of diagnosis. It remains to be seen whether boys and girls continue to maintain similar nutritional and pulmonary status at a later age and whether both sexes experience a similar mortality rate as they age.

Adolescent↗
PubMed1975

The effect of heartbeat sound stimulation on the weight development of newborn infants.

The weight development of 175 infants was followed from birth to the sixth day after birth. 92 infants were exposed to the sound of an adult's heartbeat 12 hours a day during all 6 days. 83 were not so exposed. No significant difference was found in the weight development of the two groups, thus failing to replicate the previous findings of Salk.

Acoustic Stimulation↗
PubMed1999

Physicians' neonatal resuscitation of extremely low-birth-weight preterm infants.

PURPOSE: To examine the perceptions of physicians who make delivery room decisions to resuscitate extremely low-birth-weight (ELBW) neonates at marginal viability. Nurses, parents, economists, and ethicists have questioned resuscitation of ELBW neonates, many of whom experience high levels of morbidity and mortality. Yet no systematic studies were found that addressed physicians' perceptions and delivery room decisions. DESIGN: Descriptive, using naturalistic inquiry. A national U.S. convenience sample was obtained in 1996-1997 of 54 physicians in five perinatal subspecialties who resuscitated ELBW neonates. METHODS: Tape-recorded and transcribed interviews were analyzed using NUD*IST software and line-by-line constant comparison. FINDINGS: Despite awareness of the high morbidity and mortality, 96% of the physicians offered resuscitation to all ELBW neonates in the delivery room. The main factors affecting their decisions were "the role of physician;" having been "trained to save lives;" the belief that "if called, I resuscitate;" the inability to determine gestational age; requests from parents to "do everything;" and the need to move from a "chaotic" delivery room to a controlled neonatal intensive care unit. Six major themes were: role expectation, uncertainty, awareness, internal and external forces, burden, and continuing quandaries. Physicians were burdened by the devastated and dying babies, by their inability to predict which neonates had a chance for intact survival, and by conflicts with colleagues about viability. Statistical probability of survival, legal constraints, and cost of care did not appear to affect greatly their decisions. Physicians asked that society and national policy makers set parameters for resuscitation. CONCLUSIONS: The American Academy of Pediatrics' Neonatal Resuscitation Protocol needs revision to delineate the ethical criteria for resuscitation. Early prenatal education for families which clearly teaches the margins of viability and outcomes of early deliveries is also recommended. Physicians must be supported in changing the recessitation paradigm.

Decision Making↗
PubMed2000

Physicians' neonatal resuscitation of extremely low-birth-weight preterm infants.

PURPOSE: To examine the perceptions of physicians who make delivery room decisions to resuscitate extremely low-birth-weight (ELBW) neonates at marginal viability. Nurses, parents, economists, and ethicists have questioned resuscitation of ELBW neonates, many of whom experience high levels of morbidity and mortality. Yet no systematic studies were found that addressed physicians' perceptions and delivery room decisions. DESIGN: Descriptive, using naturalistic inquiry. A national U.S. convenience sample was obtained in 1996-1997 of 54 physicians in five perinatal subspecialties who resuscitated ELBW neonates. METHODS: Tape-recorded and transcribed interviews were analyzed using NUD*IST software and line-by-line constant comparison. FINDINGS: Despite awareness of the high morbidity and mortality, 96 percent of the physicians offered resuscitation to all ELBW neonates in the delivery room. The main factors affecting their decisions were "the role of the physician;" having been "trained to save lives;" the belief that "if called, I resuscitate;" the inability to determine gestational age; requests from parents to "do everything;" and the need to move from a "chaotic" delivery room to a controlled neonatal intensive care unit. Six major themes were: role expectation, uncertainty, awareness, internal and external forces, burden, and continuing quandaries. Physicians were burdened by the devastated and dying babies, by their inability to predict which neonates had a chance for intact survival, and by conflicts with colleagues about viability. Statistical probability of survival, legal constraints, and cost of care did not appear to affect greatly their decisions. Physicians asked that society and national policy makers set parameters for resuscitation. CONCLUSIONS: The American Academy of Pediatrics' Neonatal Resuscitation Protocol needs revision to delineate the ethical criteria for resuscitation. Early prenatal education for families which clearly teaches the margins of viability and outcomes of early deliveries is also recommended. Physicians must be supported in changing the resuscitation paradigm.

Data Collection↗