High Children Research Articles

Association of the Quality Rating and Improvement System, Texas Rising Star, on Physical Activity and Screen Time Policies and Practices in Texas Child Care Centers

Quality rating and improvement systems (QRIS) are systems approaches to assist states in providing high quality early childhood education. Texas Rising Star (TRS), a voluntary QRIS, exceeds state licensing standards and meets some obesity prevention guidelines. This study examines differences in physical activity, screen time, and outdoor policies and practices by QRIS certification. Cross-sectional. Online. After exclusion criteria, respondents were 431 Texas childcare centers. 2016 survey of policies and Go NAPSACC best practices. Chi-square and t-tests indicated differences in 1) practices and 2) policies by QRIS status. TRS-certified centers reported more policies for physical activity (M = 4.57 ± 3.07 vs. 3.61 ± 2.95, p = 0.009) and screen time (M = 1.91 ± 1.84 vs. 1.28 ± 1.56, p < 0.001) than non-certified centers. TRS-certified centers reported significantly higher frequencies for 7 of 14 physical activity practices, however no significant differences for screen time practices were found. Additionally, TRS-certified centers reported more outdoor practices, including more classrooms/storage (p < 0.001) and vegetable gardens (p = 0.025). TRS-certified centers reported more physical activity policies and practices, more screen time policies, and more outdoor practices. TRS certification was not associated with screen time practices. QRIS can be a practical way to insert obesity prevention in early care and education. Using items from a widely used survey enables comparisons, however future research is needed in larger-scale studies. Some COVID-19 implications are discussed.

Understanding Adverse Childhood Experiences as Predictors of Cigarette and E-Cigarette Use

Adverse childhood experiences contribute to both short- and long-term health issues and negative health behaviors that affect the individual as well as families and communities. Exposure to ≥4 of the 11 adverse childhood experiences (high adverse childhood experiences) compounds the problems in later life. This study assesses the associations among tobacco use, adverse childhood experiences, mental health, and community health. This study was a secondary data analysis utilizing a large 2019 data set from a Community Health Needs Assessment in Florida (N=14,056). Investigators utilized inferential statistics to determine adverse childhood experiences as a predictor of tobacco use (vaping and cigarette use). In addition, they examined whether a shorter, 2-question adverse childhood experience scale was equivalent to the full scale when predicting tobacco use. The results indicated that parental divorce was the most common household stressor, followed by mental illness and alcoholism. High adverse childhood experiences were found to be most prominent in marginalized individuals. For those individuals experiencing ≥4 adverse childhood experiences, parental divorce continued to rank high, followed by mental illness. Household stressors included emotional and physical abuse as the most prevalent in the ≥4 adverse childhood experience group. High adverse childhood experiences were associated with current cigarette smoking (AOR=1.56) after controlling for individual mental health and social/community health variables. High adverse childhood experiences were also associated with E-cigarette use (AOR=1.81) but not dual cigarette/E-cigarette use. Social and community health was inversely associated with tobacco use. A 2-item adverse childhood experiences measure was sufficient in identifying tobacco users. Including adverse childhood experiences in community needs assessments provides important information for tobacco control efforts and prevention of chronic disease.

A preregistered study of the relationship between childhood socioeconomic background, life history strategies and conformity

We conducted a high powered pre-registered study to investigate the relationship between childhood socioeconomic status, the adoption of different life history strategies and conformity. Contrary to our expectation we found no direct relationship between childhood socioeconomic background and conformity. However, we discovered a significant association between life history strategies and conformity. People who adopt fast (slow) life history strategies conform less (more) to social suggestions. Furthermore, we found a relationship between childhood socioeconomic background and life history strategies, with people from low (high) childhood socioeconomic backgrounds adopting fast (slow) life history strategies.

The relationship of socioeconomic status in childhood and adulthood with compassion: A study with a prospective 32-year follow-up.

The objective of this study was to investigate (i) whether childhood family SES predicts offspring’s compassion between ages 20–50 years and (ii) whether adulthood SES predicts compassion or vice versa. We used the prospective population-based Young Finns data (N = 637–2300). Childhood family SES was evaluated in 1980; participants’ adulthood SES in 2001 and 2011; and compassion for others in 1997, 2001, and 2012. Compassion for others was evaluated with the Compassion scale of the Temperament and Character Inventory. The results showed that high childhood family SES (a composite score of educational level, occupational status, unemployment status, and level of income) predicted offspring’s higher compassion between ages 30–40 years but not in early adulthood or middle age. These results were obtained independently of a variety of potential confounders (disruptive behavior in childhood; parental mental disorder; frequency of parental alcohol use and alcohol intoxication). Moreover, high compassion for others in adulthood (a composite score of educational level, occupational status, and unemployment status) predicted higher adulthood SES later in their life (after a 10-year follow-up), but not vice versa. In conclusion, favorable socioeconomic environment in childhood appears to have a positive effect on offspring’s compassion in their middle adulthood. This effect may attenuate by middle age. High compassion for others seems to promote the achievement of higher SES in adulthood.

Prenatal exposure to maternal stressful life events and earlier age at menarche: the Raine Study.

Is there an association between prenatal exposure to stressful life events and age at menarche, and does childhood BMI mediate this association? Girls exposed to prenatal stress had a slightly earlier age at menarche, but this association did not show a dose-response effect and was not mediated by childhood offspring BMI. Prenatal stress may impact on reproductive function in females including age at menarche, but human data are very limited. High childhood BMI is known to be associated with earlier age at menarche. Only one small study has measured the association between maternal stress and age at menarche and reported that childhood BMI mediated the association between maternal stress and earlier age at menarche. However, neither maternal stress nor age at menarche was prospectively recorded and the study was limited to 31 mother-daughter pairs. The Raine Study is a large prospective population-based pregnancy cohort study (n = 1414 mother-daughter pairs) continuously followed from prenatal life through to adolescence. In the present study, we examined the association between exposure to maternal stressful life events during early, late and total gestation and age at menarche in offspring using 753 mother-daughter pairs with complete case information. Mothers prospectively reported stressful life events during pregnancy at 18 and 34 weeks using a standardized 10-point questionnaire. Exact date of menarche was assessed using a purpose-designed questionnaire at 8, 10, 14 and 17 years of age. Complete information on exposure, outcome and confounding variables was obtained from 753 mothers-daughter pairs. Multivariate linear regression complete case analysis was used to examine associations between maternal stressful life event exposure and age at menarche. Potential selection bias was evaluated using multiple imputations (50 datasets). The mediating effects of offspring childhood BMI (ages 5, 8, or 10 years) on these associations were measured in separate sub-analyses. Most (580/753, 77%) daughters were exposed to at least one prenatal stressful life event. Exposure to maternal stressful life events during the entire pregnancy was associated with a non-linear earlier age at menarche. Exposure to one event and two or more psychological stressful events was associated with a 3.5 and 1.7-month earlier onset of puberty, respectively when compared to the reference group with no exposure maternal stressful life events. The estimates from multiple imputation with 50 datasets were comparable with complete case analysis confirming the existence of an underlying effect. No separate significant effects were observed for exposure during early or late gestation. The association between prenatal stressful events and age at menarche was not mediated by childhood BMI in the offspring. Stressful life events may have affected pregnant women in different ways and self-perceived maternal stress severity may have provided a more precise estimate of gestational psychological stress. The observed non-linear U-shape of the association between maternal psychological stress and age at menarche did not reflect a dose-response. This suggests that the first exposure to prenatal stress exerts a greater effect on fetal reproductive development. A potential mechanism is via dramatic initial activation of the hypothalamic-pituitary-adrenal (HPA) axis following the first stressful life event which is greater than that observed following subsequent exposure to two or more maternal stressful life events. Whilst we adjusted for a priori chosen confounders, we cannot exclude residual confounding or confounding by factors we did not include. Maternal age at menarche was not available so the effects of familial history/genetics could not be assessed. There was a large loss due to the number of girls with no information on date of menarche and missing confounder information implying risk of selection bias and multiple imputation analyses did not fully exclude this risk (similar direction but slightly weaker estimate magnitude). Menarche is a sentinel reproductive event and earlier age at menarche carries implications for psychological, social and reproductive health and for long-term risk of common non-communicable diseases. Understanding the factors regulating age at menarche has extensive health implications. This is the first population-based cohort study in humans to demonstrate that prenatal psychological stress might directly modify age at menarche. Dr. Bräuner and Trine Koch's salaries were supported by Doctor Sofus Carl Emil Friis and spouse Olga Doris Friis foundation, The Danish Cancer Society (Kræftens Bekæmpelse, RP15468, R204-A12636, Denmark) and The Danish Health Foundation (Helsefonden, F-22181-23, Denmark). Martha Hickey was funded by NHMRC Practitioner Fellowships. The funding bodies played no role in the design, collection, analysis, or interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication. Dr. Hart has received personal fees in his function as the Medical Director of Fertility Specialists of Western Australia and received educational sponsorship grants from MSD, Merck-Serono and from Ferring Pharmaceuticals. Dr Hart has also received personal fees from Shareholders in Western IVF outside the submitted work. NA.

Community partnerships in emerging immigrant communities: Lessons learned addressing Latino childhood weight disparities.

Latino children have disproportionately high childhood obesity rates, and U.S.-born Latino children of immigrant parents experience higher overweight/obesity rates than other Latino children. Community-based participatory research (CBPR) to engage Latino immigrant families and Latino-serving community organizations is one mechanism to address the lack of effective and practical interventions addressing childhood obesity disparities among Latino children. We present lessons learned from applying CBPR methods to a partnership focused on developing a child obesity treatment program for Latino immigrant families in an emerging Latino immigrant destination to inform the use of CBPR methods in other partnerships in emerging immigrant communities. We encountered challenges working within the partnership related to entrenched sociopolitical hierarchies that were not inclusive of immigrant community leaders, capacity building for partners with limited literacy and administrative experience, and how best to use complementary methods and frameworks to support a community-engaged research process. This work is one way to promote shared learning among the community of researchers using CBPR and other engagement methods to partner with emerging immigrant communities. Together with our community partners, we can identify strategies to more effectively partner to promote health equity and work toward social justice for all members of our communities.

Thoracoscopic oesophago-oesophagostomy in the prone position for oesophageal stenosis caused by dilated azygos vein in polysplenia-associated heterotaxy.

Background:Heterotaxy syndrome is associated with a plethora of cardiovascular and other multi-system anomalies with a high childhood mortality. A dilated azygos vein as part of the polysplenia variant of heterotaxy syndrome may cause oesophageal stenosis owing to a prolonged compression. We describe our technique of extramediastinal oesophago-oesophagostomy in the prone position for this rare congenital syndromic malformation with an excellent outcome.Patients and Methods:A 17-year-old boy with heterotaxy syndrome presented with intermittent dysphagia and postprandial emesis with failure to thrive. Despite the presence of diverse anatomic abnormalities, it was only his symptom of dysphagia due to oesophageal stricture that merited surgical intervention. He underwent an azygos-preserving extramediastinal oesophago-oesophagostomy in the prone position without segmental resection with the establishment of continuity using a modified Collard-type anastomosis.Results:The patient had an uneventful convalescence, with imaging after 1 year showing no re-stenosis. After a follow-up of 3 years, the patient is free of symptoms and has gained weight.Conclusion:Oesophageal stenosis may result from prolonged compression by anomalous vasculature. An isolated correctable anatomic derangement, young age with good functional reserve, other associated anomalies not causing any symptoms, the physiological advantages of executing the surgery in a prone position and availability of expertise in minimally invasive surgery ensured excellent outcomes. The hitherto unreported technique may open up avenues for further research regarding the behaviour of the oesophageal muscular tube with transection and re-anastomosis for rare benign abnormalities.

Associations between Home Environment, Children's and Parents' Characteristics and Children's TV Screen Time Behavior.

In Ireland, television (TV) screen time is a highly prevalent sedentary behavior among children aged less than five years. Little is known about the influence of parental rules and policies or screen time availability and accessibility within the home on children’s TV screen time behaviors. This cross-sectional study aimed to examine the extent to which parents’ sociodemographic and sedentary behaviors are associated with children’s TV screen time; and to determine the associations between parents’ rules and practices, home physical environment and children’s daily TV viewing. Three hundred and thirty-two children aged 3–5 years and their parents participated in the study. Children’s TV screen time and home environmental characteristics (parents’ rules and practices and the physical environment) were assessed using questions from standardized and validated questionnaires. The data were analyzed using binary logistic regression. Within the different sedentary behaviors evaluated, parents’ TV viewing was positively associated with children’s TV screen time (OR 1.65, 95%CI 1.09–2.50, p = 0.018). Leaving the TV on, whether or not it was being watched, was associated with a 38% increased probability of children watching ≥ 1 h TV daily. Children whose parents restricted their outdoor activity were more likely to watch ≥ 1 h TV daily (OR 2.01, 95%CI 1.04–3.88, p = 0.036). Findings from the study demonstrated that parents’ own screen time behaviors, leaving the TV on whether it was being watched or not and restricting outdoor play were associated with higher children’s TV viewing in the home environment. This knowledge is essential to inform future interventions aimed to address the increase in screen time among young children.

599 Associations between adverse childhood experiences and obstetrical outcomes in an urban underserved population

Adverse childhood experiences (ACEs) such as abuse, neglect, and household dysfunction are strongly associated with poor adult health outcomes in a dose-dependent manner. Less is known about the impact of ACEs on pregnancy, especially in vulnerable populations. The objective of this study was to examine the relationship between ACEs and obstetric outcomes. This is a single-center retrospective cohort study of pregnant women referred to a mental health care coordinator due to elevated psychosocial risks and/or behavioral concerns. Women younger than age 18 and those who did not speak English were excluded. Patients completed validated mental and behavioral health screening tools including the ACE questionnaire. Medical charts were reviewed for obstetric outcomes. The associations between ACE score and adverse obstetric outcomes including preterm birth (<37 weeks), low birth weight (<2500 g), and hypertensive disorders of pregnancy (gestational hypertension and preeclampsia), were analyzed using bivariate analysis and multivariate logistic regression, adjusting for confounding factors (significant at p< 0.1 in bivariate analysis). Our cohort included 92 women of whom 49% had elevated cumulative ACE score ≥ 4 and 26% had a cumulative ACE score ≥ 6. Women with elevated ACE score were significantly more likely to have chronic hypertension; otherwise there were no differences on demographic characteristics or potential obstetric confounds between groups (Table 1). In univariate analysis, ACE score ≥ 4 was not associated with adverse obstetric outcomes, however a score ≥ 6 was associated with an increased risk of preterm birth (OR 3.7, 95% CI 1.2-11.4) and low birth weight (OR 4.9, 95% CI 1.4-17.2). This association did not remain statistically significant after controlling for chronic hypertension. A high level of childhood adversity was associated with chronic hypertension and both prematurity and low birth weight. Future studies should examine whether chronic illnesses help account for poor obstetric outcomes in pregnant women with high childhood adversity.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Regional characteristics of children's blood lead levels in China: A systematic synthesis of national and subnational population data

The blood lead levels (BLLs) of children in China remain notably high in many areas. We aimed to summarise the relevant regional characteristics, identifying problematic areas and the causes of lead pollution. We searched the databases of PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang Data, systematically reviewing 219 articles published from January 2010 to September 2020. In doing so, we assessed the BLLs noted in 220 prefectures across China. Data were organised using Geographic Information Systems (GIS) mapping. Out of a total of 629,627 children sampled, we found that the average blood lead level (BLL) of children included in our study is 50.61 ± 13.63 μg/L, which slightly exceeds the 50.00 μg/L US standard. Within the sample, 8.75% had BLLs higher than 100.00 μg/L. Children living in Liaoning, Hebei, Shanxi, Jiangxi, Anhui, Fujian, Guizhou, Yunnan, and Guangxi had notably high BLLs, at more than 60.00 μg/L. A total of 112 municipalities had an average children's BLL above 50.00 μg/L. Furthermore, Chenzhou, Linfen, Yuncheng, and Hechi had the highest children's BLLs, with average values above 100.00 μg/L. The leading contributors to lead pollution are lead mining, lead recovery and the smelting industry. Nonetheless, the lead-acid battery industry needs more attention. Although data suggest that BLLs are decreasing in China, many areas still have high BLLs that need to be monitored. Moreover, national standards must improve to decrease acceptable BLL thresholds for children.

Sister chromatid cohesion defects are associated with chromosomal copy number heterogeneity in high hyperdiploid childhood acute lymphoblastic leukemia.

High hyperdiploid acute lymphoblastic leukemia (ALL) is one of the most common malignancies in children. The main driver event of this disease is a nonrandom aneuploidy consisting of gains of whole chromosomes but without overt evidence of chromosomal instability (CIN). Here, we investigated the frequency and severity of defective sister chromatid cohesion—a phenomenon related to CIN—in primary pediatric ALL. We found that a large proportion (86%) of hyperdiploid cases displayed aberrant cohesion, frequently severe, to compare with 49% of ETV6/RUNX1‐positive ALL, which mostly displayed mild defects. In hyperdiploid ALL, cohesion defects were associated with increased chromosomal copy number heterogeneity, which could indicate increased CIN. Furthermore, cohesion defects correlated with RAD21 and NCAPG mRNA expression, suggesting a link to reduced cohesin and condensin levels in hyperdiploid ALL. Knockdown of RAD21 in an ALL cell line led to sister chromatid cohesion defects, aberrant mitoses, and increased heterogeneity in chromosomal copy numbers, similar to what was seen in primary hyperdiploid ALL. In summary, our study shows that aberrant sister chromatid cohesion is frequent but heterogeneous in pediatric high hyperdiploid ALL, ranging from mild to very severe defects, and possibly due to low cohesin or condensin levels. Cases with high levels of aberrant chromosome cohesion displayed increased chromosomal copy number heterogeneity, possibly indicative of increased CIN. These abnormalities may play a role in the clonal evolution of hyperdiploid pediatric ALL.

Effects of Autonomic Nervous System Functioning and Tornado Exposure on Long-Term Outcomes of Aggressive Children.

This study examined whether pre-disaster indicators of sympathetic and parasympathetic activity moderated the relation between degree of disaster exposure from an EF-4 tornado and changes in the externalizing and internalizing behavior problems of children at-risk for aggression. Participants included 188 children in 4th-6th grades (65% male; 78% African American; ages 9-13) and their parents from predominantly low-income households who were participating in a prevention study when the tornado occurred in 2011. Fourth-grade children who exhibited elevated levels of aggressive behavior were recruited in three annual cohorts. Parent-rated externalizing and internalizing problems were assessed prior to the tornado (Wave 1; W1), and at 4-12months (W2), 16-24months (W3), 42-28months (W4) and 56-60months (W5) post-tornado. Children's pre-tornado Skin Conductance Level (SCL) reactivity and Respiratory Sinus Arrhythmia (RSA) withdrawal were assessed at W1 using SCL and RSA measured during resting baseline and during the first 5min of the Iowa Gambling Task (IGT). Children and parents reported their exposure to tornado-related trauma and disruptions at Wave 3. Children displayed less reduction in externalizing problems if there had been higher child- or parent-reported tornado exposure and less RSA withdrawal, or if they had lower parent-reported TORTE and less SCL reactivity or lower SCL baseline. Highlighting the importance of children's pre-disaster arousal, higher levels of disaster exposure negatively affected children's level of improvement in externalizing problems when children had less vagal withdrawal, and when tornado exposure disrupted the protective effects of higher SCL reactivity and higher SCL baseline.

СОЦИАЛЬНО-ПСИХОЛОГИЧЕСКИЙ АСПЕКТ АКАДЕМИЧЕСКОЙ ОДАРЕННОСТИ СОВРЕМЕННЫХ МЛАДШИХ ШКОЛЬНИКОВ

The results of several empirical research generalizations are represented in this article. The congruence of teachers’ and parents’ thinking about different kinds of giftedness and its manifestations of primary school academically gifted learners is discussed here. The specific features analysis of personal characteristics of academically and intellectual gifted today’s children is performed. Sample: total 586 persons: teachers – 60, 240 primary school learners, 286 – learners’ parents. The following idea is proved: a child’s self-evaluation depends on parents’ opinion about their child and it conforms to parents’ expectations. It’s determined that the higher parents evaluate self-regulation level, the level of independence, the higher child’s indicators of self-control and motivation for success are. We have made conclusions that primary schoolchildren can try to draw attention to themselves in order to get acceptance and approval by grown-ups and peers, they also have excessive anxiety level connected with school fears: control and the assessment of knowledge. Authorial express diagnostics was used to study teachers’ and parents’ ideas about different kinds of child’s giftedness and its manifestation. It turned out that at the beginning of studies primary school teachers are less aware of potential giftedness of their children: behavioral and artistic. The spectrum of views about grown-ups’ giftedness broadens to the end of primary school, especially it concerns motivational criteria. The focus group method to estimate the formation level of teachers’ thinking components when working with gifted learners was used. It is found that not only at primary school but also at secondary and high school we can see insufficient representation and formation of teachers knowledge about their work with gifted learners and it is the perspective for further work. It is shown that regular work with teachers stimulates the transformation of professional thinking characteristics from situational up to supra-situational: prediction, reflexivity, the depth and broadness of analysis, self-development orientation are changed.

The Investment Side of College Savings

This paper studies how households make portfolio allocation decisions to save for children's college, and how these decisions affect children's college enrollment and student debt. I first document that more than 85% of households allocate college savings to risky assets, in particular more than 60% to stocks. I also demonstrate that college savings motives explain approximately one-third of stock market participation probability outside of retirement accounts for households with children. My results show that the allocation of college savings to stocks is associated with higher children's college enrollment rates and lower student loan participation rates after controlling for family and student characteristics. Exploiting exogenous variation in the portfolio allocation of 529 accounts, I find that holding a 10% greater share of 529 accounts in stocks during the school years increases the accumulated amount of college savings up to 20% and leads to a higher probability of enrollment in a selective four-year college and a lower student loan participation for 529 account beneficiaries from middle- and high-income households.

Predicting selection into ECEC of higher quality in a universal context: The role of parental education and income

There is consensus about the positive effects of high quality Early Childhood Education and Care (ECEC) on children’s development, particularly for children from lower socioeconomic backgrounds. However, limited knowledge exists on the access to quality in ECEC in a universal context. This study investigates potential socioeconomic selection into ECEC of higher structural quality in the context of a universal, heavily subsidized, and regulated system in Norway, intended to provide equal access to high quality ECEC. Furthermore, we explore the impact of SES and structural quality in ECEC on student-teacher relationship quality. Our conceptual model takes into account how readily accessible information on different quality aspects is for parents. We use data from the Norwegian Mother, Father and Child Cohort Study linked with teacher-reported ECEC quality for children born in 2006–2009 (N 7,226), supplemented by registry data at ECEC and municipality level. We find that higher parental education, and to a lesser degree income, predict child attendance of ECEC with higher structural quality as rated by ECEC teachers. Further, higher parental SES and structural quality (i.e., developmental material, staff competence and stability) predict better student-teacher relationship quality in terms of higher level of closeness and less conflict. These findings suggest that ambitions of universal equal access to high quality ECEC are not entirely realized and more efforts are needed to ensure higher structural quality in ECEC and enhance relationship quality for children from less advantageous socioeconomic backgrounds.

Differential response to SSRI versus Placebo and distinct neural signatures among data-driven subgroups of patients with major depressive disorder

Objective: To identify data-driven subgroups in Major Depressive Disorder (MDD) in order to elucidate underlying neural correlates and determine if these subgroups have utility in predicting response to antidepressant versus placebo. Methods: Using 27 clinical measures at baseline of Establishing Moderators and Biosignatures of Antidepressant Response for Clinical Care for Depression (EMBARC) study, participants with MDD (n=244) were sub grouped using principal component (PC) analysis. Baseline-to-week-8 changes in depression severity with sertraline versus placebo were compared in these subgroups. Resting-state functional connectivity of these subgroups were compared to those of healthy controls (n=38). Results: Eight subgroups were identified from four PCs: (PC1) severity of depression-associated symptoms, (PC2) sub-threshold mania and anhedonia, (PC3) childhood trauma, medical comorbidities, and sexual dysfunction, and (PC4) personality traits of openness and agreeableness. Participants with high childhood trauma experienced greater improvement with sertraline (Cohen's d=0.87), whereas those with either higher levels of subthreshold hypomanic symptoms (Cohen's d=0.67) or with lower levels of agreeableness and openness experienced greater improvement with placebo (Cohen's d=0.71). Participants with high childhood trauma had greater connectivity between salience and dorsal attention networks, whereas those with higher levels of subthreshold hypomanic symptoms and lower levels of agreeableness and openness had greater connectivity within limbic network and that of visual network with hippocampus and dorsal attention network. Conclusion: Assessing history of childhood trauma, presence of subthreshold hypomanic symptoms and personality traits may help to identify subgroups of patients with MDD who respond differentially to sertraline or placebo and have distinct neural signatures.

Exploring Correlates of Preschool-Aged Children's Locomotor Skills: Individual and Parent Demographics and Home Environment.

We examined individual and parental demographics and home environment factors associated with locomotor skills in predominantly Hispanic preschool-aged children. We used questionnaires to survey parents, included inquiries regarding parenting practices, parents' physical activity levels, and home-based physical activity resources; and we administered the Progressive Aerobic Cardiovascular Endurance Run (PACER) and the CHAMPS Motor Skills Protocol (CMSP) to children to measure the quantity and quality of their locomotor skills. Participants were 144 parents and their children (78.9% Hispanic, 49.3% girls) recruited from urban, community-based childcare and education centers. We examined the relationship between survey measures and PACER and CMSP scores with forward-selection stepwise linear regression models. Overall, 142 children completed the PACER, and 91 completed the CMSP. At the individual level, a child's age was positively associated with both PACER and CMSP scores, and girls had lower PACER scores than boys. In the home environment, parental promotion of more screen time was associated with a higher children's PACER score. In addition, higher parent concern for children's safety was associated with a lower PACER score. We identified several physical activity promoting parent practices as new home environment factors related to the preschool-aged children's locomotor development. Additional studies are needed to test new hypotheses generated from these data. ClinicalTrials.gov Identifier: NCT03261492 (date of registration 8/25/17).

Life Course Socioeconomic Status and Late-Life Cognition and Cognitive Decline in the Rush Memory and Aging Project

The relationships among life course socioeconomic status (SES) measures with later life cognition and cognitive decline are unclear. We test the hypothesis that life-course SES is associated with late life level of cognition and rate of cognitive decline. The Rush Memory and Aging Project enrolled 1,864 dementia-free people aged ≥65 years between 1994 – 2018. Participants reported early life (parental education, number of siblings, and childhood financial need), mid-life (income at 40 years), and late life (baseline income) SES. Global cognitive function is a composite of 19 neuropsychological tests, administered annually. We utilized marginal structural models to assess the effect of SES (dichotomized at the median) at three life-course stages on late life global cognitive function and decline. We calculated inverse probability weights to adjust for socio-demographic confounders at each life-course stage. A total 1,063 participants had all relevant variables. Average follow-up was 4.4 years, and mean baseline age was 80.4 years. Most respondents were non-Hispanic white (89.7%) and female (74.1%). In the fully adjusted model, high childhood SES (coefficient 0.10; 95% CI 0.01, 0.20) and high late-life SES were associated with higher cognition intercept (coefficient 0.21; 95% CI 0.09, 0.32). High mid-life SES was associated with slower rate of cognitive decline (coefficient 0.02; 95% CI 0.001, 0.05). Childhood and late-life SES measures were not related to cognitive decline. Childhood and adult SES may reflect processes in building cognitive capacity, while midlife SES may reflect cognition maintenance. Interventions relating to SES across the life-course may benefit later life cognition.

Temperament and Health-Related Quality of Life in Newly Diagnosed Pediatric Inflammatory Bowel Disease.

Health-related quality of life (HRQOL) is typically examined from a deficit standpoint, meaning that little is known about factors associated with higher HRQOL in pediatric illness samples. The aim of the current study was to investigate demographic, disease, and temperamental factors associated with child and parent-report of HRQOL in youth newly diagnosed with inflammatory bowel disease (IBD). Participants included 52 youth ages 8-17 diagnosed with IBD and their caregivers who each completed ratings of the child's HRQOL. Parents rated their child's emotional reactivity, conceptualized as a temperamental risk factor, and adaptability, conceptualized as a temperamental protective factor. Disease symptoms were rated by youth, and physician global assessment of disease activity was obtained. HRQOL was rated lower by children and their parents as self-reported disease symptoms and parent-rated emotional reactivity increased. Conversely, total HRQOL was higher for children with higher parent-ratings of adaptability. In multiple regression analyses, higher levels of adaptability along with male sex and lower child-reported disease symptoms were associated with higher child and parent-reported HRQOL. Higher HRQOL at time of diagnosis in pediatric IBD is associated with greater adaptability when accounting for variability due to child sex and disease symptoms. Consideration of temperament, including emotional reactivity and adaptability, may offer insight into patients' typical ways of responding when stressed and provide preliminary information about factors related to post-diagnosis HRQOL. Attention should be given to both protective and risk factors to inform future intervention development, including strengths-based approaches.

Racial Disparities in Mental Health Outcomes Among Women With Early Pregnancy Loss.

To explore the relationship between race and depression symptoms among participants in an early pregnancy loss clinical trial. We performed a planned secondary analysis of a randomized trial by comparing treatments for medical management of early pregnancy loss. We hypothesized that Black participants would have higher odds of risk for major depression (measured with the CES-D [Center for Epidemiological Studies-Depression] scale) 30 days after early pregnancy loss treatment when compared with non-Black participants. We analyzed the data as a cohort, with the primary exposure being race and secondary exposure being high adverse childhood experience scores (measured with the Adverse Childhood Experience scale). Our primary outcome was risk for major depression (score of 21 or higher on the CES-D scale) 30 days after early pregnancy loss treatment. Three hundred participants diagnosed with a nonviable intrauterine pregnancy from 5 to 12 weeks of gestation were randomized as part of the original trial from May 2014 to April 2017. Of 275 respondents included in this analysis, 120 [44%] self-identified as Black and 155 [56%] self-identified as non-Black. After early pregnancy loss treatment, 65 [24%] participants were at risk for major depression. Black participants had an increased risk for major depression (57%) after early pregnancy loss treatment compared with non-Black participants (43%; odds ratio [OR] 2.02; 95% CI 1.15-3.55). After adjustment for risk for baseline depression, adverse childhood experience score, and parity, the odds of risk for major depression 30 days after pregnancy loss treatment remained higher for Black participants when compared with non-Black participants (OR 2.02; 95% CI 1.15-3.55; adjusted OR 2.48; 95% CI 1.28-4.81). Overall, approximately one quarter of women who experience an early pregnancy loss are at an increased risk for major depression 30 days after treatment. This risk is about twice as high for Black women compared with non-Black women. There is a need for appropriate mental health resources for women undergoing early pregnancy loss care. ClinicalTrials.gov, NCT02012491.