HOME Scores Research Articles

Evaluating the association between duration of breastfeeding and fine motor development among children aged 20 to 24 months in Butajira, Ethiopia: a case-control study

BackgroundA Suitable environment and proper child nutrition are paramount to a child’s physical and mental development. Different environmental factors contribute to proper child development. Breast milk is an important source of nutrition during the early years of life and contains essential nutrients that are the building blocks for growth and development.ObjectiveTo assess the association between the duration of breastfeeding and fine motor development among children aged 20 to 24 months living in Butajira, southern Ethiopia.MethodCommunity-based case-control study design was employed among mother-child dyads of children aged 20 to 24 months in Butajira Southern Ethiopia. Children were screened for fine motor delay using the Denver II developmental screening and identified as cases and controls. A repeated visit was done to gather the rest of the information and 332 samples, 83 cases, and 249 controls were available and assessed. Epi-data version 4.4.2.1 software was used to prepare a data entry template, which was later exported to and analyzed using STATA version 14 statistical software. Finally, a Multivariable logistic regression model was used to adjust for confounders and estimate the independent effect of breastfeeding duration on fine motor development.ResultWe didn’t find a significant association between the duration of breastfeeding from 21 to 24 months and fine motor delay compared to children who were breastfed less than 18 months[AOR: 0.86, 95% CI: (0.36, 2.05)]. Children who have mothers > 35 years of age were 78% less likely than children who had mothers younger than 25 years, Children who had mothers in secondary school and above were 77% less likely than mothers who didn’t have formal education, Females were 1.86 times more likely than males, and Children who scored 20–29 on the Home score were 51% less likely than Children who scored < 20 to have fine motor delay.ConclusionDuration of breastfeeding was not significantly associated with fine motor delay for children aged 20 to 24 months old. The age of the mother, the educational status of the mother, being female, and Home score were identified to have a significant association with fine motor delay. Improving the educational status and empowerment of women is essential. Further work should be done on avoiding gender differences starting from a young age and creating a conducive environment for child development is crucial.

ACADEMIC STRESS AND COPING SELF-EFFICACY OF SENIOR HIGH SCHOOL STUDENTS ATTENDING DISTANCE LEARNING DURING SARS-COV-2 PANDEMIC

Purpose – Throughout the high school years, especially for senior high school (SHS) level, academic stress emerges as the prevalentpsychological state among students, particularly due to the simultaneous occurrence of adolescence and the increased intensityof academic obligations and responsibilities that must be fulfilled during this stage. As they approach college, they face the addedpressure of making important career-related choices, which further intensifies the challenges they encounter during this phase. Withclasses transitioning to online platforms as an alternative measure for schools during the SARS-CoV-2 outbreak in the Philippines, presented numerous challenges and difficulties, it is crucial to examine the academic stress and coping self-efficacy among SHS students during this transition period. Additionally, this study aimed to investigate the predictors of academic stress and coping self-efficacy utilizing the sociodemographic profile of the participants. Methodology – A descriptive research design was employed in the study. A total of 446 SHS students from Grade 11 to Grade 12 in one of the academic institutions in Quezon City were purposively selected to participate by answering two self-administered online measures on academic stress (Educational Stress Scale for Adolescents) and coping self-efficacy (Coping Self-Efficacy Scale). The collected data analyzed using SPSS v25. Findings – Results revealed that self-expectation (M = 3.65) and workload (M = 3.45) are the primary sources of academic stress, andSHS students are more confident utilizing problem-solving (M = 6.17) to cope with academic stress. Further, being female (P= 0.01), level (P = 0.08), and belonging to the HUMSS (Humanities and Social Sciences) strand (P = .08) increase stress scores. A significant negative correlation of -0.26 (95% CI:-0.35, -0.17) between stress and coping self-efficacy was also found, which suggests that as academic stress increases, coping self-efficacy decreases. Further, being a female, SHS2, and in the HUMSS strandtends to increase academic stress, while being a female who is unemployed and/or a mother whose working at home scores relatively low with coping self-efficacy. Significance – These findings have educational implications. It highlights the factors to be considered by offering guidance to counselors and educators in developing intervention programs, focusing on psychological well-being and skill enhancement that would help mitigate the adverse outcomes of this period of disruption.

Factors influencing sleep quality in the intensive care unit: a descriptive pilot study.

As sleep disturbances are common in the intensive care unit (ICU), this study assessed the sleep quality in the ICU and identified barriers to sleep. Patients admitted to the ICUs of a tertiary hospital between June 2022 and December 2022 who were not mechanically ventilated at enrollment were included. The quality of sleep (QoS) at home was assessed on a visual analog scale as part of an eight-item survey, while the QoS in the ICU was evaluated using the Korean version of the Richards-Campbell Sleep Questionnaire (K-RCSQ). Good QoS was defined by a score of ≥50. Of the 30 patients in the study, 19 reported a QoS score <50. The Spearman correlation coefficient showed no meaningful relationship between the QoS at home and overall K-RCSQ QoS score in the ICU (r=0.16, P=0.40). The most common barriers to sleep were physical discomfort (43%), being awoken for procedures (43%), and feeling unwell (37%); environmental factors including noise (30%) and light (13%) were also identified sources of sleep disruption. Physical discomfort (32 [28-38] vs. 69 [42-80]; P=0.004), patient care interactions (36 [20-48] vs. 54 [36-80]; P=0.044), and feeling unwell (31 [18-42] vs. 54 [40-76]; P=0.013) were associated with lower K-RCSQ scores. In the ICU, physical discomfort, patient care interactions, and feeling unwell were identified as barriers to sleep.

Identifying older adults at increased risk of medication-related readmission to hospital within 30 days of discharge: development and validation of a risk assessment tool

ObjectiveDeveloping and validating a risk assessment tool aiming to identify older adults (≥65 years) at increased risk of possibly medication-related readmission to hospital within 30 days of discharge.DesignRetrospective cohort study.SettingThe...

Grasp Analysis in the Home Environment as a Measure of Hand Function After Cervical Spinal Cord Injury

Background Following a spinal cord injury, regaining hand function is a top priority. Current hand assessments are conducted in clinics, which may not fully represent real-world hand function. Grasp strategies used in the home environment are an important consideration when examining the impact of rehabilitation interventions. Objective The main objective of this study is to investigate the relationship between grasp use at home and clinical scores. Method We used a previously collected dataset in which 21 individuals with spinal cord injuries (SCI) recorded egocentric video while performing activities of daily living in their homes. We manually annotated 4432 hand-object interactions into power, precision, intermediate, and non-prehensile grasps. We examined the distributions of grasp types used and their relationships with clinical assessments. Results Moderate to strong correlations were obtained between reliance on power grasp and the Spinal Cord Independence Measure III (SCIM; P < .05), the upper extremity motor score (UEMS; P < .01), and the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) Prehension (P < .01) and Strength (P < .01). Negative correlations were observed between the proportion of non-prehensile grasping and SCIM (P < .05), UEMS (P < .05), and GRASSP Prehension (P < .01) and Strength (P < .01). Conclusion The types of grasp types used in naturalistic activities at home are related to upper limb impairment after cervical SCI. This study provides the first direct demonstration of the importance of hand grasp analysis in the home environment.

Mothers with Neuroticism: Parenting When Faced with Challenges

SYNOPSIS Objective. The study documents how the personality trait of neuroticism is implicated in two aspects of parenting under two forms of challenge, low income and rearing a difficult child. Design. Relations of maternal neuroticism with sensitivity and stimulation in parenting and the total HOME score were examined when children were 54 months old and 5th grade, with a focus on how neuroticism moderates the effect of low household income and child temperament on parenting. Results. Mothers high in neuroticism were less likely to manifest sensitivity or provide stimulation. Maternal neuroticism moderated the effects of low income on sensitivity, stimulation, and the overall home environment, particularly at 54 months. However, significant interactions between maternal neuroticism and child difficult temperament were only found for the total HOME score at age 11. Conclusions. Living in adverse circumstances may make it difficult for mothers with neuroticism to engage productively in parenting.

Investigating the drivers for antibiotic use and misuse amongst medical undergraduates-perspectives from a Sri Lankan medical school.

Medical undergraduates are a unique group who gain the theoretical knowledge on prescribing antibiotics but are not authorized to prescribe till full licensure. This unique situation may result in self-medication and unauthorized prescription of antibiotics. This cross-sectional study was conducted among medical students of the Faculty of Medicine, University of Peradeniya, Sri Lanka in 2021 to identify patterns and drivers for antibiotic use and misuse among medical undergraduates. A validated, self-administered Google forms-based online questionnaire was used to gather information on antibiotic use, misuse, and associated factors: demographics, knowledge and perceptions. Two scores; a practice score and a knowledge score were calculated to compare with the associated factors. The study population consisted of 347 medical students with a mean age of 24 (SD1.7) years and 142/347 (40.9%) were male participants. The patterns of misuses identified included; use of antibiotics without a prescription (161/347, 46.4%), keeping left-over antibiotics for future use (111/347, 32.0%), not completing the course of antibiotics (81/347, 23.3%), use of left-over antibiotics (74/347, 21.3%), prescribing to animals (61/347, 17.6%), prescribing antibiotics to family members or friends (51/347, 14.7%), antibiotic self-medication (25/347, 7.2%) and not following the dosage regime prescribed (24/347, 6.9%). The practice score ranged from 33% to 100% (median 87%, IQR 80.0-93.3) and did not differ significantly with either the gender or the year of study. The knowledge score ranged from 4% to 100% (median 87%, IQR: 71.5-95.4) differing significantly according to the year of study. Antibiotic prescription by medical undergraduates was perceived as unacceptable (329/347, 94.8%) by the majority. Individual misuse patterns were associated favourably or unfavourably with gender, year of study, having a health care worker at home and knowledge score. The knowledge score increased with the advancement in training at the medical school while the practice score remained indifferent, highlighting the need to identify the additional drivers of antibiotic misuse among medical undergraduates.

Association of Perceived Neighborhood Health With Hypertension Self-care

Hypertension self-management is recommended for optimal blood pressure (BP) control, but self-identified residential contextual factors that hinder hypertension self-care are understudied. To quantify perceived neighborhood health and hypertension self-care and assess interactions with the area deprivation index (ADI) and healthy food availability at home. A cross-sectional study was conducted in Baltimore, Maryland, including primary care adults enrolled in the Achieving Blood Pressure Control Together trial between September 1, 2013, and June 30, 2014. Participants were Black and had at least 2 BP readings greater than or equal to 140/90 mm Hg in the 6 months before enrollment. Analyses were conducted from August 5, 2021, to January 28, 2022. Participants' perceived neighborhood health, defined as the mean standardized score across 4 subdomains of aesthetic quality, walkability, safety, and violence, with a higher score signifying better neighborhood health. Hypertension self-care behavior and self-efficacy. Multivariable generalized linear models were fit regressing each outcome on perceived neighborhood health (higher scores on each domain signify better perceived neighborhood health), adjusted for confounders, and interaction terms between neighborhood health and potential modifiers (ADI [higher percentiles correspond to more deprivation] and healthy food availability [higher scores indicate greater availability]) of the primary association were included. Among 159 participants (median [IQR] age, 57 [49-64] years; mean [SD] age, 57 (11) years; 117 women [74%]), median (IQR) hypertension self-care behavior was 50 (45-56) and self-efficacy was 64 (57-72). Better perceived neighborhood health was associated with greater hypertension self-care behavior (β, 2.48; 95% CI, 0.63-4.33) and self-efficacy (β, 4.42; 95% CI, 2.25-6.59); these associations persisted for all neighborhood health subdomains except aesthetic quality. There were no statistically significant interactions between perceived neighborhood health or its subdomains with ADI on self-care behavior (P = .74 for interaction) or self-efficacy (P = .85 for interaction). However, better perceived neighborhood aesthetic quality had associations with greater self-care behavior specifically at higher healthy food availability at home scores: β at -1 SD, -0.29; 95% CI, -2.89 to 2.30 vs β at 1 SD, 2.97; 95% CI, 0.46-5.47; P = .09 for interaction). Likewise, associations of perceived worse neighborhood violence with lower self-care behavior were attenuated at higher healthy food availability at home scores (β for -1 SD, 3.69; 95% CI, 1.31-6.08 vs β for 1 SD, 0.01; 95% CI, -2.53 to 2.54; P = .04 for interaction). In this cross-sectional study, better perceived neighborhood health was associated with greater hypertension self-care among Black individuals with hypertension, particularly among those with greater in-home food availability. Thus, optimizing hypertension self-management may require multifaceted interventions targeting both the patients' perceived contextual neighborhood barriers to self-care and availability of healthy food resources in the home.

Responsiveness and trajectory of changes in the rating of everyday arm-use in the community and home (REACH) scale over the first-year post-stroke

Objective To examine the trajectory of the Rating of Everyday Arm-use in the Community and Home (REACH) scores over the first-year post-stroke, determine if REACH scores are modified by baseline impairment level and explore the responsiveness of the REACH scale through hypothesis testing. Design Consecutive sample longitudinal study. Setting Participants were recruited from an acute stroke unit and followed up at three, six, and 12 months post-stroke. Participants Seventy-three participants with upper limb weakness (Shoulder Abduction and Finger Extension score ≤ 8). Main Measures The REACH scale is a six-level self-report classification scale that captures how the affected upper limb is being used in one's own environment. The Fugl-Meyer Upper Limb Assessment (FMA-UL), Stroke Upper Limb Capacity Scale (SULCS), accelerometer-based activity count ratio and Global Rating of Change Scale (GRCS) were used to capture upper limb impairment, capacity, and use. Results The following proportions of participants improved at least one REACH level: 64% from baseline to three months, 37% from three to six months and 13% from six to 12 months post-stroke. The trajectory of REACH scores over time was associated with baseline impairment. Change in REACH had a moderate correlation to change in SULCS and the GRCS but not FMA-UL or the activity count ratio. Conclusions Results of hypothesis testing provide preliminary evidence of the responsiveness of the REACH scale. On average, individuals with severe impairment continued to show improvement in use over the first year, while those with mild/moderate impairment plateaued and a small proportion decreased in the early chronic phase.

Housing as a determinant of Inuit mental health: associations between improved housing measures and decline in psychological distress after rehousing in Nunavut and Nunavik.

In 2014-2015, more than 400 public housing units were constructed in Nunavut and Nunavik, two of the four Inuit regions in Canada. This provided the opportunity to assess the impact of improved housing conditions from a population health perspective in 12 Inuit communities where housing needs were the most severe. The aim of theresearch is to examine the associations between changes in housing conditions and changes in psychological distress pre-post rehousing. A pre-post uncontrolled study was conducted in collaboration with Nunavut- and Nunavik-based organizations. Applicants at the top of public housing waitlists were recruited by local housing officers; participants completed questionnaires 1-6 months before rehousing, and 15-18 months after. Change in psychological distress was measured with the Kessler 6-item scale. Changes in three housing measures were examined: number of adults per household, number of children per household, and sense of home score. For each housing measure, a categorical variable stratified participants into three categories. The reference category included participants reporting significant change in the concerned housing measure; the two other categories included participants reporting little or no change. Associations were tested with linear multilevel regression models for change. A total of 102 Inuit adults completed the study. A reduction in the number of adults per household (living with 2 adults or less after rehousing) and an increase in sense of home were associated with significant decline in psychological distress pre-post rehousing (p < 0.001). Increased investments leading to such improvements in housing circumstances are promising ways to promote mental health in Inuit regions.

Outcomes of Propofol or Thiopental Sodium and Oral Midazolam as an Induction Agent for Day Care Surgery

Background: The increasing popularity of outpatient surgery has prompted the search for new anesthetic agent that can provide safe and effective anesthesia with a rapid and smooth recovery. Day care surgical procedure is extensively accepted and has been attaining recognition for over a time. The cost effectiveness and early recovery are an essential part of day-care surgical treatment in evolving countries. Aim: To compare the recovery score and cost-effectiveness after oral induction of midazolam and thiopental sodium with propofol alone in day-care surgical procedure. Methods: Eighty patients were selected, 40 in each ASA grade I and II group. In A group; patients were administered propofol at dose of 2 mg / kg for induction, and in group B; 0 2.5 mg / kg thiopental sodium and 0.25 mg / kg midazolam orally were given 30-mints prior to induction. Perioperative heart rate, time to ready to go home, blood pressure and recovery score were observed. The average induction cost was determined in group A and B. Results: After 30 minutes of reversal, the score of recovery in groups A and B were 8.90 ± 1.82 and 8.02 ± 1.01, correspondingly. The group B has significantly lesser cost (PKR 90.25±10.73) in comparison to the group A (PKR 700.0 ± 100.0) (p &lt;0.05). Conclusions: Preoperative induction of oral midazolam and low doses of thiopental sodium is comparatively cost effective compared to induction of propofol in day-care surgical procedure. Keywords: Oral midazolam, Day care surgery, Propofol and Thiopental sodium.

Exposure to metal mixtures and neuropsychological functioning in middle childhood

Elevated exposure to multiple trace metals can be neurotoxic even at relatively low levels. These findings are primarily evident from adult occupational studies as well as in children exposed prenatally or in early childhood. Less research has focused on the neurodevelopmental impacts of exposure to metals among school-aged children. We examined associations between exposure to a mixture of four metals (arsenic, cadmium, manganese, lead) measured in hair and markers of cognition, attention, and behavior among 222 6–12 year old children who participated in a 2009–2010 neurodevelopmental follow-up to the C8 Health Project. Using quantile-based g-computation we estimated the adjusted overall metal mixture effect ψ (95 % CI) as the change in outcome per decile increase in all metals in the mixture. Hair metal levels varied by metal, with cadmium being lowest (median 0.007, interquartile range (IQR) 0.013 μg/g) and lead the highest concentration (median 0.152, IQR 0.252 μg/g). Children’s cognitive skills and development, attention/impulsivity, and behavior were all close to standardized population means. Each decile increase in all metals was associated with a Full Scale IQ reduction of 1.01 points (95 % confidence interval (CI) –1.88, –0.15) and Verbal IQ reduction of 1.11 points (95 % CI –1.97, –0.25), adjusted for child age, sex, secondhand smoke exposure, HOME score, maternal education, maternal IQ, and examiner. Maternal report of ADHD-like behaviors and executive functioning also showed adverse associations with the metal mixture. Our findings suggest that similar to exposure during prenatal and early childhood periods, recent exposure to metals during middle childhood is associated with adverse neurodevelopmental consequences. Middle childhood may also be a developmental window of susceptibility to the negative consequences of exposure to environmental neurotoxicants.

Telework potential in the Philippines

AbstractUsing work from home (WFH) scores obtained by matching Philippine occupations with U.S. O*NET occupations, this paper estimates that only 12.38% of all workers can WFH and 25.7% of Philippine occupations are teleworkable––mostly from the following occupational groups: professionals, clerical support workers, and technicians and associate professionals. The education, real estate and, professional, scientific and technical sectors account for the largest share of teleworkable jobs. Those workers belonging to lower per capita income deciles, who are male, who have lower levels of education, who are self-employed, aged 55 and older, and who are working in sectors such as agriculture and retail, are also less likely to be in teleworkable occupations.

Relationships between maternal body mass index and child cognitive outcomes at 3 years of age are buffered by specific early environments in a prospective Canadian birth cohort.

Fetal and child development are shaped by early life exposures, including maternal health states, nutrition and educational and home environments. We aimed to determine if suboptimal pre-pregnancy maternal body mass index (BMI; underweight, overweight, obese) would associate with poorer cognitive outcomes in children, and whether early life nutritional, educational and home environments modify these relationships. Self-reported data were obtained from mother-infant dyads from the pan-Canadian prospective Maternal-Infant Research on Environmental Chemicals cohort. Relationships between potential risk factors (pre-pregnancy maternal BMI, breastfeeding practices and Home Observation Measurement of the Environment [HOME] score) and child cognitive development at age three (Weschler's Preschool and Primary Scale of Intelligence, Third Edition scale and its subcategories) were each evaluated using analysis of variance, multivariable regression models and moderating analyses. Amongst the 528 mother-child dyads, increasing maternal pre-pregnancy BMI was negatively associated with scores for child full-scale IQ (β [95% CI]; -2.01 [-3.43, -0.59], p = 0.006), verbal composite (-1.93 [-3.33, -0.53], p = 0.007), and information scale (-0.41 [-0.70, -0.14], p = 0.003) scores. Higher maternal education level or HOME score attenuated the negative association between maternal pre-pregnancy BMI and child cognitive outcome by 30%-41% and 7%-22%, respectively, and accounted for approximately 5%-10% greater variation in male children's cognitive scores compared to females. Maternal education and higher quality home environment buffer the negative effect of elevated maternal pre-pregnancy BMI on child cognitive outcomes. Findings suggest that relationships between maternal, social and environmental factors must be considered to reveal pathways that shape risk for, and resiliency against, suboptimal cognitive outcomes in early life.

Examining Older Adults' Home Functioning Using the American Housing Survey.

Identifying individuals at risk of experiencing functional difficulty at home would support timely home safety assessment and modification services, which could lead to reducing home incidents such as falls. The objective of this study was to calculate older adults’ functional difficulty at home scores using the 12 physical function items in the American Housing Survey National and Metropolitan Data (AHS). Among the 28,474 older adults selected for this study, we used 19,932 for measurement model development and 8542 for model testing. Confirmatory factor analysis confirmed an adequate fit of the one-dimensional model with all AHS 12 items loading on one latent construct (functional difficulty at home) (RMSEA: 0.034, CFI: 0.990, and TLI: 0.988). Based on our model selection process, we determined that the Graded Response Model was an optimal model for our analysis and separated two detected differential functioning items for each sex. Using the testing dataset, we validated that the estimated functional difficulty scores showed an expected item hierarchy and statistically significant differences in their association with housing and demographic conditions (p < 0.001). Our results demonstrated the process of using the 12 AHS physical function at home items to produce validated scores of older adults’ functional difficulty at home.

Associations Between Prenatal Fluoride Exposure and Performance IQ in Canadian Preschool Aged Children: A Multilevel Modeling Approach

BACKGROUND AND AIM: Prenatal fluoride exposure is associated with reduced IQ in children, especially Performance IQ (PIQ; nonverbal intelligence), but studies have not accounted for hierarchical clustering. We examined the association between sex-specific prenatal fluoride exposure and PIQ using multilevel modeling (MLM) to account for nesting of 448 mother-child pairs within 184 postal codes and six cities. METHODS: Our sample was from the Maternal-Infant Research on Environmental Chemicals (MIREC) prospective Canadian birth cohort. Variables included maternal urinary fluoride (MUF; adjusted for dilution), PIQ scores at age 3-4 years from the WPPSI, and participant level covariates (HOME scores, maternal education level, and maternal race). A series of three-level MLMs were fit to estimate associations between within-postal code and within-city centered MUF and PIQ. RESULTS:Median MUF concentration was 0.44 mg/L (IQR= 0.35), with average PIQ of 102 (SD= 14) for boys and 105 (SD= 14) for girls. A three-level intra-class correlation revealed that 3.8% and 9.1% of the variance in PIQ was accounted for by nesting of dyads in postal codes and cities, respectively. The interaction between child sex and MUF and the covariate effects were fixed across postal codes and cities in the optimal model. The interaction between child sex and within-postal-code MUF was significant (p .05).For boys, a 1 mg/L increase in within-postal-code MUF was significantly associated with PIQ, B= -7.9 (95% CI: -13.6, -2.2); for girls, the association was not significant, B= 1.7 (95% CI: -5.0, 8.5). Centering MUF within city resulted in a weaker effect among boys (B= -5.7 95% CI: -10.2, -1.2), and a stronger, but nonsignificant effect among girls (B= 3.3, 95% CI: -2.7, 9.3). CONCLUSIONS:For boys, the stronger effect of MUF in postal codes than cities shows the importance of accounting for hierarchical clustering in the MIREC cohort to examine associations between prenatal fluoride exposure and PIQ. KEYWORDS: biomarkers of exposure, children’s environmental health, epidemiology, fluoride, neurodevelopmental outcomes

Prenatal Fluoride Exposure and Autism Spectrum Disorder-Like Behaviors in a Sample of Canadian Preschool Aged Children: The MIREC Study

BACKGROUND AND AIM: A growing body of evidence indicates that prenatal exposure to fluoride is neurotoxic to child development. However, epidemiologic research examining fluoride’s effect on autism spectrum disorder (ASD) is lacking. Our aim was to examine the association of prenatal fluoride exposure with ASD-like behaviors in a sample of preschool aged children living in regions with fluoridated and non-fluoridated community water. METHODS: We analyzed 502 mother-child pairs from the Maternal-Infant Research on Environmental Chemicals (MIREC), a prospective multicentered Canadian birth cohort, with available data on prenatal fluoride exposure, ASD-like behaviors, and covariates. We measured fluoride exposure by averaging maternal urinary fluoride adjusted for specific gravity (MUFsg) across three trimesters. We assessed children’s ASD-like behaviors at 3-4 years of age using the parent-reported Social Responsiveness Scale-2 (SRS-2) Preschool Form, with higher scores indicating more behavioral symptomology. Covariate adjusted linear and quantile regression models were used to estimate the difference in the relationship between MUFsg and SRS-2 conditional mean and quantile subscale T-scores, respectively. We adjusted all regression models for baseline maternal age, second-hand smoke, marital status, parity, child sex, study site, and the HOME score that was assessed at child follow-up visit. RESULTS:Mean MUFsg concentration was 0.53 mg/L (SD=0.38), and mean SRS-2 Total T-score was 45.3 (SD=6.2). In multiple linear regression, a 1 mg/L increase in MUFsg concentration was not statistically associated with SRS-2 Total T-score (β=0.12; 95% CI, -1.36, 1.60; P=0.87). Likewise, we observed no statistical association for all other SRS-2 subscale T-scores. In quantile regression, there was no statistical association between MUFsg and SRS-2 Total T-score across percentiles: 0.1, 0.3, 0.5, 0.7 and 0.9. Effect modification by sex was not observed. CONCLUSIONS:In this Canadian cohort, we found no evidence of a statistical association between prenatal fluoride exposure and ASD-like behaviors among preschool aged children. KEYWORDS: biomarkers of exposure, children’s environmental health, epidemiology, fluoride, neurodevelopmental outcomes

The effects of community participation program on smoke-free homes in a suburban community of Thailand.

INTRODUCTIONSmoking inside the home affects the health of both the smoker and family members via secondhand exposure. This research examined the impact of a community participation program on creating smoke-free homes in a suburban community in Thanyaburi district, Pathumthani province in Thailand.METHODSThe study involved families, with a smoker in the home, that were randomly assigned to intervention and control groups each containing 27 families. The intervention group was administered with the community participation program for smoke-free homes for 5 sessions during the 6-month period of study. The program included providing information on secondhand smoking and harms, knowledge about quitting smoking and healthcare support, practice skills, campaigns in the community, visiting and encouraging, and reflecting and evaluation. The control group was normally treated by the community committee and health volunteers. Data collection was undertaken at baseline and at 6 months after implementation by an interview with questionnaires.RESULTSOur results show that after the implementation, the intervention group reported significantly higher mean score on skills in negotiating with smokers for a smoking-ban inside home and mean score on emotional support for non-smoking inside the home than those at baseline and those of the control group. The proportion having smoking ban home rules in the intervention group was significantly higher than at baseline and that of the control group (92.6% vs 18.5%). The proportion of smoke-free homes was higher in the intervention than in the control group (75% vs 0%).CONCLUSIONSThese findings suggest that community participation programs for smoke-free home may be effective in raising awareness on the impact of secondhand smoke among family members and in working together to manage smoke-free home environments. The program may be applicable for further development within communities to achieve smoke-free homes.

Home environment: Short-term trends and predictors in early childhood from an Indian community birth cohort.

BackgroundEarly childhood home environment is intricately linked to child development and later cognitive and academic skills. There is limited literature evaluating home environmental trends and predictors in the low‐ and middle‐income country settings.AimsDetermine the trends of early childhood home environment changes between 6 and 36 months of age, and the factors associated with these changes.Study designLongitudinal community‐based birth cohort follow‐up study in a semi‐urban slum in Vellore, South India.SubjectsConsecutive sampling of a birth cohort between March 2010 and February 2012.Outcome measuresHome environment was objectively assessed using the ‘Home Observation for the Measurement of the Environment’ (HOME) scale. Predictors of change in the home environment over time also were analyzed. Multivariable linear regression models and linear mixed effect models were used to identify the factors associated with HOME score at individual time points and over‐a‐time period, respectively.ResultsThe birth cohort enrolled 251 children with a follow‐up of 235, 228 and 218 children at 6, 24 and 36 months, respectively. The socio‐economic status (SES) was the single biggest predictor for the HOME score at each time point, with increasing strength over time. Maternal education predicted home environment at 24 months, while maternal depression was negatively associated at 6 and 24 months of age. SES and maternal factors contributed to the overall change in the HOME score. Maternal factors predicted relational home environmental change over time.ConclusionSES and maternal factors consistently predicted early childhood home environment at 6, 24 and 36 months of age and its change over time. It is important to support maternal education and wellbeing along with socio‐economic measures to optimize early childhood environment.

Computers in education: the association between computer use and test scores in primary school

ABSTRACT This paper analyses the associations between computer use in schools and at home and test scores by using TIMSS data covering over 900,000 children in fourth grade. When controlling for school fixed effects, pupils who use computers at school, especially those who use them frequently are found to achieve less than students who never use computers. Daily computer use at home is negatively associated with test scores, although monthly, and sometimes weekly, use is positively associated with pupil performance. There is no significant difference between subjects and only small gender and country differences are observed. Moreover, the result suggests that the negative association of computer use at school is larger among low-performing pupils than for high-performing pupils. The findings suggest a negative association of computer use at school and test scores but do not reject the possibility that computers have a positive impact on test scores if computers are used optimally.