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Summary: Background: Few tools exist to quantify body mass index visually. Objective: To examine the inter‐rater reliability and validity (sensitivity and specificity for overweight/obesity and obesity) of a three‐dimensional visual rating system to quantify body mass index (BMI) in young children. Methods: Children (n = 242, mean age 5.9 years, 50.0% male; 40.5% overweight/ obese) participated in a videotaped protocol and weight and height were measured. Research staff applied a novel three‐dimensional computer‐based figure rating system ( shapecoder) to the child's videotaped image. Inter‐rater reliability was calculated, as well as correlation with measured body mass index (BMI) and sensitivity, specificity, positive predictive value and negative predictive value for overweight/obesity and obesity. Results: Inter‐rater reliability was excellent (intraclass correlation coefficient = 0.98). The correlation of shapecoder‐generated BMI with measured BMI was 0.89. For overweight/obesity, the sensitivity, specificity, positive predictive value and negative predictive value were 62%, 97%, 94% and 79% respectively. For obesity, these values were 65%, 99%, 97% and 92% respectively. Conclusion: shapecoder provides a method to quantify child BMI from video images with high inter‐rater reliability, fair sensitivity and good specificity for overweight/obesity and obesity. The approach offers an improvement over existing two‐dimensional rating scales for BMI. [ABSTRACT FROM AUTHOR]

Background Mothers' goals are important for health behavior change, and engagement in child obesity interventions. It is unknown if maternal feeding goals are associated with observed home mealtime or feeding practices. The objective of this study was to examine the association of four common feeding goals (restrict junk food, promote fruit or vegetable intake, promote autonomy in eating and prevent obesity) with mothers' observed home mealtime and feeding practices. Methods Low-income mothers ( N = 265) of children (mean child age 70.8 months) participated in a semi-structured interview about child feeding. A coding scheme was developed and reliably applied to identify mothers' feeding goals from transcripts. Mothers' observed home mealtime and feeding practices were reliably coded from home mealtimes and a laboratory eating protocol. Mothers completed a questionnaire and reported demographics. Participant weights and heights were obtained. Regression models were used to test the association of each feeding goal with observed maternal practices, controlling for covariates. Results The goal of restricting junk food was associated with the child always eating at a table (OR 2.87, 95% CI (1.39-5.96) p = 0.005), but not with the mother restricting junk food. The goal of promoting fruit or vegetable intake was associated with observationally promoting vegetables (OR 1.41, 95% CI (1.09-1.84), p = 0.01). The goals of promoting autonomy and preventing obesity were not associated with any observed maternal home mealtime or feeding practices. Conclusions While mothers' goals to restrict junk food and promote fruit or vegetable intake were associated with observed home mealtime and feeding practices, promoting autonomy and preventing obesity were not. Increased understanding of why low-income mothers may not translate certain feeding goals into practices may inform childhood obesity interventions. [ABSTRACT FROM AUTHOR]

Summary: Background: Temperament is associated with obesity risk. However, the mechanisms linking temperament and eating behaviour to childhood adiposity are unclear. Objectives: To examine whether three temperament dimensions (surgency, effortful control and negative lability) are uniquely associated with an increased BMI z score (BMIz) concurrently and an excessive rate of change in BMIz longitudinally through four eating behaviours (food responsiveness, enjoyment of food, emotional overeating and satiety responsiveness) among low‐income pre‐schoolers, independent of home environment quality. Methods: 379 pre‐schoolers were recruited from Head Start in the Midwest region of the United States. Primary caregivers reported child temperament, eating behaviours and the level of chaos at home. Child BMIz was derived from weight and height measurements at ages 4, 5 and 6 years on average. Results: Path analyses revealed that higher levels of surgency predicted more food responsiveness and enjoyment of food, which was in turn associated with higher concurrent BMIz, independent of effortful control, negative lability and home chaos. Conclusion: Low‐income surgent pre‐schoolers were more likely to have elevated BMIz as they were more inclined to eat in response to external cues and have a high appetitive drive. Obesity prevention programmes might target low‐income children with surgent temperaments, and the identified eating behaviours. [ABSTRACT FROM AUTHOR]

Summary: Objective: This study aimed to examine the association of birth order and number and sex of siblings with overweight or obesity among 4‐ to 8‐year‐olds. Methods: This is a cross‐sectional study involving 273 low‐income mother–child dyads. Questionnaires and anthropometry were completed. Multiple logistic regression was used to examine the association of birth order, having younger siblings, having older siblings, having at least one brother and having at least one sister with odds of overweight or obesity. Analyses were repeated to additionally include non‐biological siblings. Models were adjusted for potential confounders and intermediate variables. Results: Prevalence of child overweight or obesity was 42.5%. Adjusting for covariates, only children and youngest siblings had higher odds of overweight or obesity compared with oldest siblings (odds ratio [OR]: 4.18, 95% confidence interval [CI]: 1.67, 10.46 and OR: 3.21, 95% CI: 1.41, 7.33, respectively). Having one or more younger siblings and having at least one brother were associated with lower odds (OR: 0.38, 95% CI: 0.21, 0.69 and OR: 0.47, 95% CI: 0.28, 0.81, respectively). Including non‐biological siblings did not meaningfully change the associations. Conclusion: Birth order and sibship composition are associated with overweight or obesity among 4‐ to 8‐year‐olds. Future studies identifying the underlying behavioural mechanism can help inform family‐based intervention programmes. [ABSTRACT FROM AUTHOR]

Background: Periodontal disease is an inflammatory reaction to the bacteria in dental plaque. The present study compared the prevalence of periodontal disease in patients using as a diagnostic either probing depth measurements, an inflammatory marker such as numbers of white blood cells in plaque samples, or microbiological markers such as the microscopic count and the benzoyl-DL-arginine naphthylamide (BANA) test. Methods: Teeth with the most inflammation and/or deepest pockets in each quadrant were probed and subgingival plaque was sampled from 1,043 consecutive new patients enrolled in a private practice. Multivariate "diagnostic" models were developed based upon the probing depth (general linear models), percentage of white blood cell-positive and percentage of BANA positive plaques (logistic regression models) to determine the prevalence of patients with periodontal disease. Results: Plaque samples were removed from 3,694 sites. Fifty two percent of sampled pockets were >4 mm; 49% of sites were inflamed, using the presence of white blood cells, and 28% were infected using the BANA test. Diagnostic models were highly significant at P<0.0001. The white blood cell model was the most parsimonious as demonstrated by the lowest Akaike information criteria statistic and had the highest receiver operator characteristic (ROC) curve relative to the probing depth and BANA models. Conclusions: Periodontal disease can be diagnosed chair-side by the presence of white blood cells in plaque samples, a finding that reflects the inflammatory nature of the disease process. This approach would reduce the misclassification of subjects as having periodontal disease (130 patients in the present study who had pockets) but minimal evidence of an inflammatory response. [ABSTRACT FROM AUTHOR]

Summary: Background: Little is known about how mothers respond to their child eating palatable foods. Objectives: The objectives of the study are to examine maternal behaviours when children are presented with a large portion of energy‐dense palatable food in an experimental setting and to examine differences by child weight status. Methods: Mother–child dyads (N = 37) (mean child age 70.8 months) participated in a videotaped eating protocol with cupcakes. Anthropometrics were measured. Videos were analysed using discourse analysis and were reliably coded for the presence or absence of the most salient theme. Analysis of variance examined theme presence by child and mother weight status. Results: Mothers disavowed responsibility for their child's eating. Mothers were observed to roll their eyes at the child, throw their hands up in exasperation and distance themselves both physically and emotionally when the child ate the cupcakes voraciously or with high enjoyment. Mothers of children with obesity (vs recommended weight) engaged in more counts of disavowal (p = 0.01). Conclusions: Mothers of children with obesity distanced themselves from their child, seeming to disavow responsibility for the child's eating of 'junk food'. Mothers may respond to their child's seemingly gluttonous eating by disavowing responsibility due to the stigma of being a parent of a child with obesity. [ABSTRACT FROM AUTHOR]

Aim: No studies have examined notifications as they relate to parent stress. We aimed to examine associations between objective daily mobile device notifications and pickups with daily parenting stress., Methods: This was a within- and between-subjects, cross-sectional study that took place from 2020 to 2021. The study occurred during the coronavirus disease of 2019 pandemic. Data were collected in a low-contact home visit. This study included 62 parents of 62 children aged 48-71 months. Parents downloaded a passive sensing app on their Android mobile devices collecting data on duration, device notifications and device pickups. Parents completed an end-of-day stress survey for 4 days. We used random effects models to examine the variation of daily stress with smartphone duration, notification frequency, pickup frequency and device-initiated pickups, adjusting for covariates., Results: Parents were on average 37.3 years old (SD ± 5.7) and were predominantly mothers (82.3%). On average, parents received 293 daily notifications and picked up their phones 93 times. Duration of smartphone use and notification frequency were not associated with daily stress. Device-initiated pickups were associated with daily parent stress., Conclusion: When notifications prompted parents to pick up their phones more often, parents experienced greater stress., (© 2024 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Aim: Young children with weaker self-regulation use more digital media, but studies have been limited by parent-reported screen time measures. We examine associations between early childhood executive functioning and objective mobile device usage., Methods: The parents of 368 American children (51.6% male) aged 3-4 years of age completed standardised measures of executive functioning, parenting stress and household chaos. They provided mobile sampling data for 1 week in 2018-2019 and reported how often the children used mobile devices to calm themselves., Results: The children's mean age was about 3.8 years. A third of the children who were given devices to calm them down had weaker executive functioning in the overall and multivariable models, including working memory, planning and organisation. So did 39.7% of the children who used educational apps. Streaming videos, using age-inappropriate apps and using the mobile device for more than1 h per day were not associated with executive functioning levels. Parenting stress and household chaos did not moderate the associations., Conclusion: This study confirms previous studies that suggesting that children with weaker overall executive functioning used devices more for calming purposes. It also raises questions about whether children with weaker executive functioning should use educational apps., (© 2022 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Background: The ACCOMPLISH (Avoiding Cardiovascular Events Through Combination Therapy in Patients Living with Systolic Hypertension) trial demonstrated that combination therapy using amlodipine, rather than hydrochlorothiazide, in conjunction with benazepril provided greater cardiovascular risk reduction among high-risk hypertensive patients. Few trials have evaluated the effect of prior antihypertensive therapy used among participants on the study outcomes., Methods and Results: In a post hoc observational analysis, we examined the characteristics of the drug regimens taken before trial enrollment in the context of the primary composite outcome (death from cardiovascular causes, nonfatal myocardial infarction, nonfatal stroke, hospitalization for angina, resuscitation after sudden cardiac death, and coronary revascularization). In the "primary subgroup" (n=4475), patients previously taking any renin-angiotensin system blockade plus either a diuretic or a calcium channel blocker alone or as part of their antihypertensive regimen, there were 206 of 2193 (9.4%) versus 281 of 2282 (12.3%) primary composite events among those randomized to combination therapy involving amlodipine versus hydrochlorothiazide, respectively (adjusted Cox proportional hazard ratio, 0.74; 95% confidence interval, 0.62-0.89; P =0.0015). All other participants (n=6975) previously taking any antihypertensive regimen not included in the primary subgroup also benefited from randomization to amlodipine plus benazepril (adjusted hazard ratio, 0.84; 95% confidence interval, 0.72-0.98; P =0.024). Outcomes among most other subgroups, including patients previously taking lipid-lowering medications or dichotomized by prior blood pressure control status, showed similar results., Conclusions: When combined with an angiotensin-converting enzyme inhibitor, amlodipine provides cardiovascular risk reduction superior to hydrochlorothiazide, largely regardless of prior medication use. These findings add further support for the initial use of this combination regimen among high-risk hypertensive patients., (© 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.)

Cognitive determinants of emotion regulation, such as effortful control, have been hypothesized to modulate young children's physiological response to emotional stress. It is unknown, however, whether this model of emotion regulation generalizes across Western and non-Western cultures. The current study examined the relation between both behavioral and questionnaire measures of effortful control and densely sampled, stress-induced cortisol trajectories in U.S. and Chinese preschoolers. Participants were 3- to 5- year-old children recruited from the United States (N = 57) and Beijing, China (N = 60). Consistent with our hypothesis, U.S. children showed a significant negative relation between maternal-rated inhibitory control and both cortisol reactivity and recovery. However, this was not replicated in the Chinese sample. Children in China showed a significant positive relation between maternal-rated attentional focusing and cortisol reactivity that was not seen in the U.S. Results suggest that children who reside in Western and non-Western cultures have different predictors of their emotion-related stress response., (© 2014 John Wiley & Sons Ltd.)

Auditory processing capabilities at the subcortical level have been hypothesized to impact an individual's development of both language and reading abilities. The present study examined whether auditory processing capabilities relate to language development in healthy 9-month-old infants. Participants were 71 infants (31 boys and 40 girls) with both Auditory Brainstem Response (ABR) and language assessments. At 6 weeks and/or 9 months of age, the infants underwent ABR testing using both a standard hearing screening protocol with 30 dB clicks and a second protocol using click pairs separated by 8, 16, and 64-ms intervals presented at 80 dB. We evaluated the effects of interval duration on ABR latency and amplitude elicited by the second click. At 9 months, language development was assessed via parent report on the Chinese Communicative Development Inventory - Putonghua version (CCDI-P). Wave V latency z-scores of the 64-ms condition at 6 weeks showed strong direct relationships with Wave V latency in the same condition at 9 months. More importantly, shorter Wave V latencies at 9 months showed strong relationships with the CCDI-P composite consisting of phrases understood, gestures, and words produced. Likewise, infants who had greater decreases in Wave V latencies from 6 weeks to 9 months had higher CCDI-P composite scores. Females had higher language development scores and shorter Wave V latencies at both ages than males. Interestingly, when the ABR Wave V latencies at both ages were taken into account, the direct effects of gender on language disappeared. In conclusion, these results support the importance of low-level auditory processing capabilities for early language acquisition in a population of typically developing young infants. Moreover, the auditory brainstem response in this paradigm shows promise as an electrophysiological marker to predict individual differences in language development in young children., (© 2012 Blackwell Publishing Ltd.)

This research investigates children's use of social categories in their food selection. Across three studies, we presented preschoolers with sets of photographs that contrasted food-eating models with different characteristics, including model gender, race (Black, White), age (child or adult), and/or expression (acceptance or rejection of the food). Children were asked to pick between the photographs to choose which food they would like for snack. Results demonstrated that preschoolers prefer foods being eaten by models with positive over negative expressions, foods being eaten by child over adult models, and foods being eaten by child models of the same gender as themselves over models of the other gender. This work connects with previous research on children's understanding of social categories and also has important practical implications for how characteristics of a food-eating model can affect children's willingness to try new foods., (© 2011 Blackwell Publishing Ltd.)

Prev Cardiol. Long-term exposure to secondhand smoke (SHS) is associated with impaired vascular function. The authors investigated the vascular and blood pressure (BP) reactions to acute SHS exposure. Twenty-five healthy nonsmoking adults underwent a 1-hour exposure to SHS (mean fine particulate matter < 2.5 μm level = 315 ± 116 μg/m(3) ). Microvascular endothelial-dependent vasodilatation (EDV) (EndoPAT, Itamar Medical, Caesarea, Israel) and aortic hemodynamics/compliance (SphygmoCor, AtCor Medical, West Ryde, Australia) were measured before and after the SHS exposure with BP measured every 15 minutes during and for a 24-hour period before and after the exposure. SHS exposure did not change EDV, aortic hemodynamics, arterial compliance, or 24-hour BP. However, diastolic BP significantly increased during the SHS exposure period by 3.4 ± 5.6 mm Hg. Our brief SHS exposure did not impair microvascular endothelial function or arterial compliance in healthy nonsmoking adults, but brachial diastolic BP increased., (© 2010 Wiley Periodicals, Inc.)