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At least 973 records · Page 54Linked to original sources
PubMed2003

Health services use by children of migratory agricultural workers: exploring the role of need for care.

OBJECTIVE: For migrant children: 1). to assess the determinants of health services use among users and nonusers of health services; 2). to evaluate the association between health status and health services use, while controlling for potential confounders. DESIGN: A cross-sectional household survey using multistage, partially random sampling to identify migrant families in eastern North Carolina. PARTICIPANTS: Adult caretakers of 1 randomly selected child under 13 years old. RESULTS: Forty-four percent of children (N = 300) visited a doctor in the preceding 3 months. Those visiting a doctor disproportionately reported having less than very good health (29% vs 10%), insurance (46% vs 11%), interpreters (45% vs 27%), a family member receiving Special Supplemental Nutrition Program for Women, Infants, and Children (50% vs 16%), and a legal caretaker (30% vs 18%). Compared with those without a doctor visit, a larger proportion of children visiting a doctor were 6 years or younger in age (71% vs 35%), born in the United States (51% vs 15%), female (64% vs 45%), and had not moved in 6 or more months (19% vs 10%). Controlling for enabling resource and sociodemographic confounders, children with less than very good health were 2.4 times more likely than those in very good health to have visited a doctor (95% confidence interval [1.1-5.2]). CONCLUSIONS: Migrant children using health services are distinct from nonusers with regards to sociodemographic factors, enabling resources, and need for care. Health services use is associated with less than very good perceived health, despite resource barriers and sociodemographic disadvantages. More efforts are needed to improve access to health care for migrant children.

Adolescent↗
PubMed2003

Counting the shots: a model for immunization screening and referral in nonmedical settings.

BACKGROUND: Clinics of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) have become important partners in efforts to improve vaccination coverage in low income children. However, the time required to assess all antigens in each child's vaccination record may exceed the capacity of many of these clinics. Seeking a solution, experts recommended assessing up-to-date (UTD) status only for the diphtheria-tetanus-acellular-pertussis (DTaP) vaccine and treating this as a proxy measure for all vaccines in the childhood schedule. Whether this single vaccine screening method represents an acceptable alternative to the traditional multiple-vaccine method as a basis for improving overall immunization coverage levels in this vulnerable population has not been demonstrated. OBJECTIVE: To evaluate the validity of the proposed simplified method for assessing immunization status in a nationally representative population of infants and children who had ever been enrolled in WIC before 35 months old. METHODS: This was a cross-sectional analysis of the 2000 National Immunization Survey representing children ages 3 to 24 months who had ever been enrolled in WIC. For the 6277 children in the study population, we compared personal records of completion status for DTaP with personal records of completion status for all immunizations appropriate for age in the combination 4:3:1:3 schedule to see which of the 2 (single vs multiple screening) methods would better predict the child's true (provider-reported) status for the 4:3:1:3 series. The main outcome measures were the comparative sensitivity, specificity, and overall test efficiency of the 2 methods in correctly identifying underimmunized WIC children. RESULTS: Completion status for DTaP was less sensitive than completion status for all vaccinations in correctly identifying truly underimmunized children (sensitivity = 70% and 77%, respectively). However, it was more specific in correctly identifying children who were truly UTD for age (specificity = 86% and 82%, respectively). The 2 methods were essentially identical with respect to overall test efficiency (82% and 81% for DTaP assessment and assessment of all vaccines, respectively). CONCLUSIONS: Given limited resources to do immunization screening and referral in nonmedical settings such as WIC, simplifying the process by using DTaP from the personal vaccination record as a proxy for the 4:3:1:3 series is a viable option. Loss in sensitivity may well be offset by gains in the capacity of WIC clinics to screen more children.

Child, Preschool↗
PubMed2004

Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy.

OBJECTIVE: Knowing risk factors at birth for the development of childhood obesity could help to identify children who are in need of early obesity prevention efforts. The objective of this study was to determine whether children whose mothers were obese in early pregnancy were more likely to be obese at 2 to 4 years of age. METHODS: A retrospective cohort study was conducted of 8494 low-income children who were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Ohio and were followed from the first trimester of gestation until 24 to 59 months of age. Measured height and weight data from WIC were linked to birth certificate records for children who were born in the years 1992-1996. Obesity among 2- to 4-year-olds was defined as a body mass index (BMI) > or =95th percentile for age and gender. Mothers were classified as obese (BMI > or =30 kg/m2) or nonobese (BMI <30 kg/m2) on the basis of BMI measured in the first trimester of the child's gestation. RESULTS: The prevalence of childhood obesity was 9.5%, 12.5%, and 14.8% at 2, 3, and 4 years of age, respectively, and 30.3% of the children had obese mothers. By 4 years of age, 24.1% of children were obese if their mothers had been obese in the first trimester of pregnancy compared with 9.0% of children whose mothers had been of normal weight (BMI 18.5 and <25 kg/m2). After controlling for the birth weight, birth year, and gender of the children plus the mothers' age, race/ethnicity, education level, marital status, parity, weight gain, and smoking during pregnancy, the relative risk of childhood obesity associated with maternal obesity in the first trimester of pregnancy was 2.0 (95% confidence interval [CI]: 1.7-2.3) at 2 years of age, 2.3 (95% CI: 2.0-2.6) at 3 years of age, and 2.3 (95% CI: 2.0-2.6) at 4 years of age. CONCLUSION: Among low-income children, maternal obesity in early pregnancy more than doubles the risk of obesity at 2 to 4 years of age. In developing strategies to prevent obesity in preschoolers, special attention should be given to newborns with obese mothers.

Body Mass Index↗
PubMed1989

Pre- and postoperative fluid management in infancy.

The fluid and electrolyte management of the infant either before or following surgery is not difficult if the several principles are carefully followed: (1) Fluid requirements include maintenance therapy, correction of ongoing losses, and replacement of deficit losses. (2) Calculation for fluid requirements in the postoperative period will include maintenance therapy, correction of ongoing losses, and provision of fluid lost by internal shifts. (3) Maintenance needs for fluid in infants equals 100 to 120 mL/kg per 24 hours, and Na+ at 3 mEq/kg per 24 hours and K+ at 2 to 3 mEq/kg per 24 hours are needed. (4) Infants with pyloric stenosis should be anticipated to have hypokalemic, hypochloremic metabolic alkalosis, and dehydration. These electrolyte abnormalities should be corrected before surgery is performed. A pyloromyotomy is not an emergency procedure. (5) Ileostomy losses can equal 90 mEq/L of Na+ and up to 110 mEq/L of HCO3. Thus, adequate fluid replacement results in volume depletion and metabolic acidosis. (6) Children whose nutritional status is marginal and whose bowels cannot be used for nutrient absorption should receive their fluid and electrolyte needs as part of a total parenteral nutrition program.

Energy Metabolism↗
PubMed2006

[Pancreas transplantation in Mauriac Syndrome: clinical and biochemical parameters after one year follow up].

In select cases of type 1 diabetes mellitus (DM1) the pancreas transplantation has been shown to ameliorate the disease, to reduce the need for exogenous insulin and normalize glycosylated hemoglobin (A1c) levels. The efficacy of this therapy in Mauriac Syndrome (SM) is not yet well established. We report a patient with MS treated with intensive insulin therapy, physical activity program, nutritional and psychological assistance, with persistently elevated fast glycemia and A1c levels, inadequate lipid profile and decreased IGF-1 (insulin like growth factor) levels. Due to a poorly metabolic control, pancreas transplantation was indicated. After one year follow up, the patient had no symptoms and showed persistent insulin independence with fast glucose <110 mg/dl, normal lipid profile and IGF-1 levels and significant decrease in A1c (4.6%). The pancreas transplantation improved diabetes control and promoted better quality of life for this patient. Pancreas transplantation proved to be an effective treatment strategy in patients with MS, improving their clinical and biochemical derangements. In this report we present the first case of MS controlled by pancreas transplantation registered in the indexed medical literature, as an alternative therapy in this group of patients.

Adolescent↗
PubMed2004

Overweight and aerobic fitness in children in the United States/Mexico border region.

OBJECTIVE: To study overweight and aerobic fitness among children in the third and fourth grades of elementary schools in a city in the United States of America (El Paso, Texas) and a city in Mexico (Chihuahua, Chihuahua) that are on or near the border between those two countries, and to compare the results from those two cities with earlier findings for other children in the United States. METHODS: We followed the El Paso children (427 boys and 385 girls, 93% of them of Mexican descent) from third to fourth grade and assessed the change in their body mass index (BMI). In the city of Chihuahua we cross-sectionally measured the BMI of a sample of third grade children (221 boys and 237 girls) and a sample of fourth grade children (268 boys and 215 girls). BMI and triceps skinfolds were measured for all the children studied in the two cities. BMI was used to assess risk for overweight (at least the 85th percentile BMI for age and gender) and overweight (at least the 95th percentile BMI for age and gender) in all the children. The distance that El Paso children ran in nine minutes was used to assess their aerobic fitness (aerobic fitness was not measured in the Chihuahua children). The data from El Paso were collected in 1999, 2000, and 2001, and the Chihuahua data were collected in 2000 and 2001. RESULTS: In the El Paso boys, overweight significantly increased in the one year from third grade to fourth grade, from 22% to 28%, while risk for overweight significantly increased, from 37% to 44%. In the El Paso girls, risk for overweight significantly increased over the same one-year period, from 29% to 37%. The El Paso boys and girls were significantly less fit when compared to samples of children from throughout the United States. Third and fourth grade children from Chihuahua had similar rates of risk for overweight and of overweight when compared to the children from the same grades in El Paso. CONCLUSIONS: Children in both El Paso and Chihuahua were more overweight than were non-Hispanic white children throughout the United States. In addition, the children in El Paso were less aerobically fit than were non-Hispanic white children and than were other Mexican-American children in the United States. These results clearly show that efforts should be made in the border regions of both Mexico and the United States to develop physical activity and nutrition programs to help stem rising rates of overweight.

Child↗
PubMed1995

Does WIC participation improve breast-feeding practices?

The effects of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on breast-feeding behavior have been sometimes found inadequate. The determinants of breast-feeding initiation and duration among WIC participants and nonparticipants were modeled by using retrospective cross-sectional data from the 1988 National Maternal and Infant Health Survey. This study corrects for self-selection bias as far as the data allow, in addition to controlling for parents' ages, education, race, and family income. Findings suggest that prenatal WIC participation, combined with breast-feeding advice, significantly increases the initiation of breast-feeding but does not affect duration. The exact nature of effective breast-feeding advice given prenatally at WIC clinics is unclear and warrants further research.

Adolescent↗
PubMed1998

The effect of WIC participation on small-for-gestational-age births: Michigan, 1992.

OBJECTIVE: This study examined the relationship between enrollment in the Special Supplemental Nutrition Program for women, Infants, and Children (WIC) and delivery of small-for-gestational-age infants. METHODS: WIC records were linked with birth certificates for 1992 full-term births; 41,234 WIC records and 18,34 non-WIC records were identified. Length of participation was defined by gestational age at enrollment. Logistic regression was used to examine the association between WIC participation and small-for-gestational-age births. RESULTS: Odds ratios for small-for-gestational-age birth decreased with increasing length of enrollment in WIC. CONCLUSIONS: Enrollment in WIC is associated with a lower prevalence of small-for-gestational-age deliveries.

Adolescent↗
PubMed2000

Smoking cessation counseling with pregnant and postpartum women: a survey of community health center providers.

OBJECTIVES: This study assessed providers' performance of smoking cessation counseling steps with low-income pregnant and postpartum women receiving care at community health centers. METHODS: WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) program staff, obstetric clinicians, and pediatric clinicians at 6 community health centers were asked to complete surveys. Smoking intervention practices (performance), knowledge and attitudes, and organizational facilitators were measured. Factors associated with performance were explored with analysis of variance and regression analysis. RESULTS: Performance scores differed significantly by clinic and provider type. Providers in obstetric clinics had the highest scores and those in pediatric clinics had the lowest scores. Nurse practitioners and nutritionists had higher scores than other providers. Clinic type, greater smoking-related knowledge, older age, and perception of smoking cessation as a priority were independently related to better counseling performance. CONCLUSIONS: Mean performance scores demonstrated room for improvement in all groups. Low scores for performance of steps beyond assessment and advice indicate a need for emphasis on the assistance and follow-up steps of national guidelines. Providers' own commitment to helping mothers stop smoking was important.

Adult↗
PubMed2003

Why do WIC participants fail to pick up their checks? An urban study in the wake of welfare reform.

OBJECTIVES: This study explored whether work or immigration concerns affect women's participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). METHODS: The sample included women who had withdrawn from the WIC program and current WIC clients from 1 center in New York City. Logistic regression analyses were used to predict noncollection of checks; demographic characteristics, program participation, and problems with the WIC program were independent variables. RESULTS: Strong predictors of noncollection of checks were job conflicts, transportation or illness problems, and WIC receipt by the woman herself (rather than by her children). CONCLUSIONS: Employment conflicts were related to failure to pick up WIC checks; immigration concerns were not. As a means of enhancing WIC participation, flexibility is recommended in terms of center hours, locations, and staffing and program check distribution policies.

Adult↗
PubMed2004

Effects of WIC participation on children's use of oral health services.

OBJECTIVES: We estimated the effects of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) on dental services use by Medicaid children in North Carolina. METHODS: We used linked Medicaid claims and enrollment files, WIC files, and the area resource file to compare dental services use for children enrolled in WIC with those not enrolled. We used multivariate models that controlled for child clustering and employed 2-step methodology to control for selection bias. RESULTS: Children who participated in WIC had an increased probability of having a dental visit, were more likely to use preventive and restorative services, and were less likely to use emergency services. CONCLUSIONS: Children's WIC participation improved access to dental care services that should lead to improved oral health.

Aid to Families with Dependent Children↗
PubMed2004

WIC participation, breastfeeding practices, and well-child care among unmarried, low-income mothers.

We estimated the effect of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) participation in 1999 to 2000 on breastfeeding initiation and duration and well-child care. We applied multivariate regression to a sample of 2136 unmarried, low-income, urban mothers from the Fragile Families and Child Wellbeing Study. WIC participation was associated with small increases in the probabilities of initiating breastfeeding and having had at least 4 well-child visits since birth-behaviors that benefit infants beyond the newborn period-but not with breastfeeding duration.

Breast Feeding↗
PubMed2002

A controlled evaluation of staging dietary patterns to reduce the risk of diabetes in African-American women.

OBJECTIVE: This study evaluated the 3-month follow-up data of the Eat Well, Live Well Nutrition Program, a culturally specific, peer-led dietary change program designed to reduce the risk of type 2 diabetes in low-income African-American women. This peer-led program was delivered in the community and was tailored to the participants' stage of change for individual dietary patterns. We report the results of the 3-month intervention and the extent to which dietary changes and other key outcomes were maintained at a 3-month follow-up assessment. RESEARCH DESIGN AND METHODS: Using an experimental control group design, 294 overweight African-American women (ages 25-55 years), recruited in collaboration with a neighborhood organization, completed pre- and posttest and 3-month follow-up interviews of dietary behaviors, knowledge, attitudes, fat intake, and weight. RESULTS: Significant reductions were found in fat intake among women in the treatment condition when compared with women in the control group; these reductions were maintained at 3-month follow-up assessment. Likewise, significant changes in dietary patterns were reported after the study and were maintained, except for one dietary pattern (replacement). CONCLUSIONS: This model of health promotion, which individually tailors dietary patterns through staging and use of peer educators, has the potential for decreasing fat intake and increasing and maintaining specific low-fat dietary patterns among overweight African-American women at risk for diabetes.

Adult↗
PubMed2005

Long-term impact of breast-feeding on body weight and glucose tolerance in children of diabetic mothers: role of the late neonatal period and early infancy.

OBJECTIVE: Offspring of diabetic mothers (ODM) are at increased risk of developing overweight and impaired glucose tolerance (IGT). Recently, we observed that early neonatal ingestion of breast milk from diabetic mothers (DBM) may dose-dependently increase the risk of overweight in childhood. Here, we investigate whether DBM intake during the late neonatal period and early infancy also influences later adipogenic and diabetogenic risk in ODM. RESEARCH DESIGN AND METHODS: A total of 112 ODM were evaluated for influence of DBM ingestion during the late neonatal period (2nd-4th neonatal week) and early infancy on relative body weight (RBW) and glucose tolerance in early childhood. RESULTS: Exclusive breast-feeding was associated with increased childhood RBW (P = 0.011). Breast-fed ODM had an increased risk of overweight (odds ratio 1.98 [95% CI 1.12-3.50]). Breast-feeding duration was also positively related to childhood RBW (P = 0.004) and 120-min blood glucose during an oral glucose tolerance test (P = 0.022). However, adjustment for the DBM volume ingested during the early neonatal period, i.e., 1st week of life, eliminated all these relations with late neonatal breast-feeding and its duration. Interestingly, no relationship was observed between maternal blood glucose in the middle of the third trimester and the outcome. CONCLUSIONS: Neither late neonatal DBM intake nor the duration of breast-feeding has an independent influence on childhood risk of overweight or IGT in ODM. Therefore, the 1st week of life appears to be the critical window for nutritional programming in ODM by ingestion of maternal "diabetic" breast milk.

Adult↗
PubMed2004

Peripartal propylene glycol supplementation and metabolism, animal health, fertility, and production in dairy cows.

The effect of peripartal supplementation with concentrate enriched at 10% propylene glycol (PG) on metabolism, animal health, fertility, and milk production was studied using 234 cows from 8 dairy farms with production averages of 8019 to 10,656 kg/yr. The feeding schedule for the PG group (n=117) was as follows: 13 d antepartum: 1.5 kg/d (= 150 mL PG); 12 d antepartum until parturition: 3 kg/d (= 300 mL PG); 1 to 12 d postpartum: 1 kg/d (= 100 mL PG). Control cows (n=117) received the same concentrate without PG. From a subset of cows (PG: n = 43; control: n = 40), blood samples were collected at 6, 3, and 1 wk antepartum, 3 d antepartum, on the day of parturition, and 1, 3, 5, 7, 9, and 11 wk postpartum for the determination of nonesterified fatty acids (NEFA), beta-hydroxybutyrate (BHBA), insulin-like growth factor (IGF)-I, and activities of aspartate-aminotransferase (AST) and glutamate-dehydrogenase (GLDH). From another subset of cows (PG: n=11; control: n=10), blood samples were collected 1 wk antepartum, on the day of parturition, and 1 wk postpartum to determine immunophenotypical and functional parameters of blood neutrophils. From 1 wk antepartum to 1 d postpartum, concentrations of NEFA were significantly lower in cows receiving PG compared with controls. Also, concentrations of BHBA in cows receiving PG were significantly lower from 1 wk antepartum until 7 wk postpartum. Concentrations of IGF-I were significantly higher in the PG group, from 1 wk antepartum until 1 wk postpartum than in the control group. Activities of AST and GLDH did not differ between groups. Immunophenotypical and functional characteristics of blood neutrophils were not influenced by treatment nor were animal health, reproduction, or milk production. Although indicators of metabolic status were improved by peripartal use of PG-enriched concentrate, economic benefits are questionable for dairy farms with good nutritional programs, as economically important factors such as milk production, animal health, and fertility were not influenced.

3-Hydroxybutyric Acid↗
PubMedDate not supplied

Increasing the report of alcohol use among low-income pregnant women.

PURPOSE: To increase the report of prenatal alcohol use in a community setting. METHODS: A self-administered alcohol screening tool was developed and introduced at 12 randomly selected sites that administer the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A matched sample of 12 WIC sites continued to use the existing verbal standard of care for assessing alcohol use. RESULTS: Rates of reported prenatal alcohol consumption at the 12 WIC intervention sites were compared with rates at 12 control WIC sites using a repeated-measures analysis of variance (ANOVA) and independent-samples t-tests. Within 8 months of study commencement, rates of reported prenatal alcohol consumption were significantly higher at the intervention sites than at the control sites. DISCUSSION: Use of a brief, self-administered screening tool in the WIC setting significantly increased reports of prenatal alcohol use, a key first step in the reduction of prenatal alcohol use. The WIC setting represents an excellent place to address the significant public health issue of prenatal alcohol exposure.

Adult↗
PubMedDate not supplied

Statewide intervention to reduce television viewing in WIC clients and staff.

PURPOSE: To evaluate a statewide campaign that was designed to reduce television viewing by clients and staff of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Television reduction is frequently recommended as a strategy for preventing pediatric overweight. METHODS: Data were collected from a convenience sample of 10,445 clients and staff who attended clinics during a 3-week period before the intervention and 9188 clients and staff who attended clinics after the intervention. Chi-square tests were used to compare the proportion of WIC clients watching television 2 or 3 hours per day before and after the intervention. Within the context of WIC, which is a large and complex public health program, it was not possible to measure individual exposures or response rates. RESULTS: At baseline, 64.2% of WIC clients reported watching 2 or less hours of television per day. After the intervention, 70.5% limited television viewing to this recommended level. CONCLUSIONS: It is feasible to deliver television-reduction messages in large public health programs.

Health Promotion↗
PubMed1977

Rusa deer (Cervus timorensis) as a host for the cattle tick (Boophilus microplus) in Papua New Guinea.

The rusa deer (Cervus timorensis) is more resistant to the cattle tick (Boophlilus microplus) than are Britsh breed cattle in Papua New Guinea. The average yield of replete female ticks from deer was 1.6% (0.3-3.2%) as compared to 11.2% (3.4-23.1%) from calves. Ticks from deer were more slender, lighter in weight and produced fewer eggs (mean 1,800) than did ticks from calves (mean 2,200) but the deer was shown to be an effective host. A cervid population can maintain a tick population in the absence of bovine hosts thus presenting an important factor in eradication programs. Nutritional stress appears to result in a higher seasonal prevalence of infestation amongst males and non-pregnant females.

Animals↗