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Purpose: This study explored the association of maternal age at menarche (AAM) with pubertal timing among girls and boys in Chongqing, China., Methods: Pubertal development of 1,237 children (542 girls and 695 boys) were examined half-yearly through inspection and palpation from April 2014 to June 2019. Characteristics of parents and maternal AAM were collected by a parental questionnaire at baseline. Maternal AAM was used both as a continuous and a categorical variable in Cox regression models., Results: A total of 1,198 children (528 girls and 670 boys) were included in the study. In the simple Cox model, earlier maternal AAM was associated with girls' earlier menarche, breast and pubic hair development, and boys' first ejaculation, testicular development, and genital development. When adjusting for children's body mass index z-scores (BMIz) and socioeconomic covariates, we found that girls whose mothers had early AAM had a higher risk of earlier onset of menarche (hazard ratio [HR]: .922, 95% confidence interval [CI]: .852-.998 for continuous maternal AAM, HR: 1.297, 95% CI: 1.041-1.616 for maternal AAM ≤13 years), and boys whose mother achieved menarche earlier experienced a higher risk of earlier onset of first ejaculation (HR: .896, 95% CI: .830-.968). Children's BMIz were related to all nine pubertal milestones. Parental education and relationship, birth weight, parity, and family type were also associated with pubertal timing., Conclusions: Earlier maternal AAM was related to earlier pubertal timing in both girls and boys in Chongqing, especially girls' age at menarche and boys' first ejaculation. Children's BMIz was the most consistent factor for pubertal timing. Children's BMIz and socioeconomic conditions had greater influence on most pubertal milestones than maternal AAM., (Copyright © 2020 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.)

Aims: Since childhood exposure to polycyclic aromatic hydrocarbons (PAHs) have been associated with a variety of adverse health outcomes, the aims of this study were to1) document PAH exposure levels among children in Chongqing, China by measuring urinary concentrations of four PAH metabolites, 1-hydroxypyrene (1-OHPyr), 2-hydroxynaphthalene (2-OHNap), 2-hydroxyfluorine (2-OHFlu) and 9-hydroxyphenanthrene (9-OHPhe), and 2) assess the associations of urinary concentrations of these PAH metabolites with risk factors related to sources of PAHs inhalation and ingestion exposures and with personal attributes such as sex, age, and BMI., Methods: The present study is a cross-sectional analysis using data drawn from the third follow up of a longitudinal study. Purposive sampling was used with all students in grades one to four in four schools being eligible to participate. The baseline survey included a total of 1237 students 5.8 to 12.2years of age. At the third follow up survey, 1.5years after the baseline survey, 1230 of the children had a physical exam and provided urine samples. Their parents completed a questionnaire including social-demographic information and possible sources of children's exposure to PAHs. Urine samples were measured for the four OH-PAHs using an HPLC-MS/MS technique. Concentrations were corrected by specific gravity. Linear regression analysis was used to investigate factors related to sources of PAHs exposure., Results: The urinary concentrations were highest for 9-OHPhe (median at the range of 3661ng/L), followed by 2-OHNap (3189ng/L), 2-OHFlu (1116ng/L), and 1-OHPyr (250ng/L). In multiple linear regressions, being female (P=0.04), school location near a thermal power plant (P=0.02) and higher maternal age at birth (P<0.01) were associated with increased concentrations of urinary 1-OHPyr; no significant associations were found for 2-OHNap; school location near a thermal power plant (P<0.01) and lower family income (P<0.01) were associated with increased concentrations of urinary 2-OHFlu; higher age (P<0.01), school location near a thermal power plant (P=0.01), frequent consumption of smoked foods (P=0.04) and lower family income (P=0.07) were all found to be associated with increased concentrations of 9-OHPhe., Conclusions: Urinary concentrations of OH-PAHs, especially 9-OHPhe, were elevated in Chongqing Children compared to children in other countries. Being female, older age, school location near an industrial site, frequent consumption of smoked foods and lower family income were all associated with higher OH-PAHs concentrations. Further cohort studies are needed to confirm the associations between potential exposure sources and children's exposure to PAHs, in order to provide recommendations to reduce exposure., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objective: Experiencing the death of a child is associated with negative short-term mental health consequences, but less is known about cognitive outcomes and whether such associations extend to late life. We tested the hypothesis that experiencing an offspring death (OD) is associated with an increased rate of cognitive decline in late life., Methods: This population-based longitudinal study observed four cognitive statuses spaced 3-4 years apart, linked to an extensive database containing objective genealogic and vital statistics data. Home visits were conducted with 3,174 residents of a rural county in northern Utah, initially without dementia, aged 65-105. Cognitive status was measured with the Modified Mini-Mental State Exam at baseline and at 3-, 7-, and 10-year follow-ups. OD was obtained from the Utah Population Database, which contains statewide birth and death records., Results: In linear mixed models, controlling for age, gender, education, and apolipoprotein E status, subjects who experienced OD while younger than age 31 years experienced a significantly faster rate of cognitive decline in late life, but only if they had an ε4 allele. Reclassifying all OD (regardless of age) according to subsequent birth of another child, OD was only related to faster cognitive decline when there were no subsequent births., Conclusion: Experiencing OD in early adulthood has a long-term association with cognitive functioning in late life, with a gene-environment interaction at the apolipoprotein E locus. Subsequent birth of another child attenuates this association., (Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)

Objective: Evidence suggests that physicians' use of motivational interviewing (MI) techniques helps patients lose weight. We assessed patient, physician, relationship, and systems predictors of length of weight-loss discussions and whether physicians' used MI techniques., Methods: Forty primary care physicians and 461 of their overweight or obese patients were audio recorded and surveyed., Results: Weight-related topics were commonly discussed (nutrition 78%, physical activity 82%, and BMI/weight 72%). Use of MI techniques was low. A multivariable linear mixed model was fit to time spent discussing weight, adjusting for patient clustering within physician. More time was spent with obese patients (p=.0002), by African American physicians (p=.03), family physicians (p=.02), and physicians who believed patients were embarrassed to discuss weight (p=.05). Female physicians were more likely to use MI techniques (p=.02); African American physicians were more likely to use MI-inconsistent techniques (p<.001)., Conclusion: Primary care physicians routinely counsel about weight and are likely to spend more time with obese than with overweight patients. Internists spend less time on weight. Patient and systems factors do not seem to influence physicians' use MI techniques., Practice Implications: All physicians, particularly, male and African American physicians, could increase their use of MI techniques to promote more weight loss among patients., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Objective: Examine primary care physicians' use of counseling techniques when treating overweight and obese patients and the association with mediators of behavior change as well as change in nutrition, exercise, and weight loss attempts., Methods: We audio recorded office encounters between 40 physicians and 461 patients. Encounters were coded for physician use of selected counseling techniques using the Motivational Interviewing Treatment Integrity (MITI) scale. Patient motivation and confidence as well as Fat and Fiber Diet score (1-4), Framingham physical activity questionnaire (MET-minutes), and weight loss attempts (yes/no) were assessed by surveys. Generalized linear models were fit, including physician, patient, and visit level covariates., Results: Patients whose physicians were rated higher in empathy improved their Fat and Fiber intake 0.18 units (95% CI 0, 0.4). When physicians used "MI consistent" techniques, patients reported higher confidence to improve nutrition (OR 2.57, 95% CI 1.2, 5.7)., Conclusion: When physicians used counseling techniques consistent with MI principles, some of their patients' weight-related attitudes and behaviors improved., Practice Implications: Physicians may not be able to employ formal MI during a clinic visit. However, use of counseling techniques consistent with MI principles, such as expression of empathy, may improve patients' weight-related attitudes and behaviors., (Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.)

Background: Prevention of childhood obesity is a public health priority. Parents influence a child's weight by modeling healthy behaviors, controlling food availability and activity opportunities, and appropriate feeding practices. Thus interventions should target education and behavioral change in the parent, and positive, mutually reinforcing behaviors within the family., Methods: This paper presents the design, rationale and baseline characteristics of Kids and Adults Now! - Defeat Obesity (KAN-DO), a randomized controlled behavioral intervention trial targeting weight maintenance in children of healthy weight, and weight reduction in overweight children. 400 children aged 2-5 and their overweight or obese mothers in the Triangle and Triad regions of North Carolina are randomized equally to control or the KAN-DO intervention, consisting of mailed family kits encouraging healthy lifestyle change. Eight (monthly) kits are supported by motivational counseling calls and a single group session. Mothers are targeted during a hypothesized "teachable moment" for health behavior change (the birth of a new baby), and intervention content addresses: parenting skills ((e.g., emotional regulation, authoritative parenting), healthy eating, and physical activity., Results: The 400 mother-child dyads randomized to trial are 75% white and 22% black; 19% have a household income of $30,000 or below. At baseline, 15% of children are overweight (85th-95th percentile for body mass index) and 9% are obese (≥ 95th percentile)., Conclusion: This intervention addresses childhood obesity prevention by using a family-based, synergistic approach, targeting at-risk children and their mothers during key transitional periods, and enhancing maternal self-regulation and responsive parenting as a foundation for health behavior change., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Background: Weight gain in the postpartum period is a risk factor for long-term obesity. Investigations of dietary intake among lactating and nonlactating overweight women might identify nutritional concerns specific to this population., Objective: To compare nutrient, meal, and snack intakes, food-group servings and prevalence of dieting among fully breastfeeding (BF), mixed breast and formula feeding (MF), and formula feeding (FF) overweight and obese women. The second aim was to compare nutrient intakes and food-group servings to the Dietary Reference Intake and MyPyramid recommendations, respectively., Design: Data were collected from September 2004 through April 2006 in Durham, NC. Infant feeding practices and dietary information were collected on 450 women between 6 and 9 weeks postpartum. Two 24-hour dietary recalls were completed by phone, using Nutrition Data Systems for Research. Analysis of covariance was used to compare infant feeding groups in dietary quality (nutrient intake per 1,000 kcal) and food-group servings, controlling for prepregnancy body mass index, race, age, education, income, and marital status. χ² analysis was performed to determine differences in meal and snack intake and dieting among infant feeding groups., Results: BF women consumed more energy (2,107 ± 50 kcal) than MF (1,866 ± 56 kcal) or FF (1,657 ± 50 kcal) women (P < 0.001). Adjusted nutrient intake did not differ between groups. All groups were at risk for inadequate intakes of vitamins A, E, C, and folate and did not meet recommended servings of all food groups. BF women consumed lunch and snacks more frequently, were less likely to diet, and reported higher intakes of grains and desserts than MF and FF women., Conclusions: To help increase intakes of nutrients lacking in the diet and prevent postpartum weight gain, overweight women should be encouraged to increase fruits, vegetables, low-fat dairy, whole grains, legumes, and healthy types of fat, while decreasing refined grains, regular soda, sweetened beverages, and desserts., (Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All rights reserved.)

Objective: The purpose of this study was to examine the association between gestational weight gain (GWG) in a woman's first and second pregnancies., Study Design: We conducted a retrospective observational cohort study of 27,771 women with their first and second births in North Carolina's Pregnancy Nutrition Surveillance System database from 1996-2004. GWG was categorized as inadequate, appropriate, or excessive, according to 2009 Institute of Medicine guidelines. Covariate adjusted polytomous logistic regression was used to test the association between GWG category in the first and second pregnancy., Results: Compared with women with appropriate GWG in their first pregnancy, women with excessive GWG in their first pregnancy had an odds ratio of 2.6 (95% confidence interval, 2.4-2.7) for excessive GWG in their second pregnancy. Women with inadequate GWG in their first pregnancy were similarly likely to repeat this category in their subsequent pregnancy., Conclusion: GWG category in a woman's first pregnancy is a significant predictor of GWG category in her subsequent pregnancy., (Copyright 2010 Mosby, Inc. All rights reserved.)

Objective: To describe North American dissertation research in human nutrition from 1986 through 1995., Design: A census collection., Subjects/setting: The unit of observation was the dissertation abstract submitted to Dissertation Abstracts International for the years 1986 through 1995. Only dissertations written in English with a human nutrition subject code (0570) that lead to a PhD, DrPH, EdD, or ScD at a North American university were included (N = 2,044). Abstracts were reviewed by 2 raters who extracted pertinent data on variables describing the dissertation research (e.g., topic of dissertation, type of sample)., Analyses: Analyses were descriptive., Results: The majority (n = 1,147) of doctoral dissertations were completed by female students. Male students were more likely to study in vitro samples than female students (11% vs 4%) and female students were more likely to study human subjects (64%). Male students tended to have male advisers, although overall male advisers appeared to predominate (34% men, 24% women, 42% unknown or missing). Topic areas for dissertation work reflected gender differences. Popular topics for dissertation research have changed over time; biochemical-, micronutrient-, and obesity-related research decreased and research in development of theoretical constructs and examination of dietary habits of selected groups increased., Conclusions: From 1986 through 1995 there was an increase in the proportion of female doctoral students. Female and male students varied in the type of sample studied, gender of advisers, age group of human subjects, and topics of their dissertations. Universities emphasized different topic areas and methodologies. There appears to have been an increase in areas of applied research (e.g., dietary habits) and a decrease in basic science topic areas (e.g., micronutrients) over the 10-year period examined.

Background: Epidemiology and biostatistics graduate students have diverse backgrounds, but many have little prior training in medicine or biology. This lack of content knowledge in future health researchers has recently been raised as a concern., Methods: As part of a graduate course on the epidemiology of major diseases, the television series ER was used as a vehicle for learning more about diseases in general, and to become familiar with medical terminology and the ICD-10 by practicing coding on the patients seen. Furthermore, we wanted to provide human faces to the type of disease data students usually work with., Results: In this article, the authors discuss how the ER sessions were organized and the problems that were encountered. The course evaluation concluded that the students found the exercise to be an interesting break from regular teaching.