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This study evaluates the efficacy of an early intervention program targeting African American mothers and their premature, low birth weight infants at 3 to 4 months' corrected age from four neonatal intensive care units, 173 families are recruited (84 intervention, 89 control). The 8-session, 20-week intervention consists of a psychoeducational video, serial administrations of the Brazelton Neonatal Behavioral Assessment Scale, and maternally administered infant massage. At postintervention, intervention mothers have higher maternal self-efficacy than control. Extremely low birth weight (ELBW) intervention infants have significantly higher Bayley Mental Development Index (MDI) scores than ELBW control infants, but no intervention effects are observed among heavier preterm infants. Among infants of families living above federally established poverty thresholds, intervention infants have higher MDI scores than control infants. No intervention effects were found for infants of families living in poverty. Findings emphasize the importance of considering meaningful moderators in evaluations of early intervention effects. [ABSTRACT FROM AUTHOR]

Microminerals represent essential vitamins and minerals that must be acquired through diet, fortification, or supplementation. This article reviews evidence on the relationships between 3 microminerals, iodine, iron, and zinc, and cognitive processes in infants and young children. A hypothesized model that includes direct links between microminerals and child development and indirect links through the caregiving environment is presented [ABSTRACT FROM AUTHOR]

This article is a longitudinal investigation of the relationships between maternal victimization, maternal functioning, and children's behavior and development. Participants include 203 mother-child dyads from a low-income population recruited from pediatric primary care clinics. Data are collected when children are 4 and 8 years of age. Child outcomes are evaluated using maternal, teacher, and child self-report and objective measures of cognitive and academic functioning. Maternal victimization history is associated with maternal depressive symptoms, low levels of maternal social support, child internalizing and externalizing behavior problems, and low levels of child socialization. Child behavior problems identified at age 4 are enduring and persist to age 8. The effects of maternal victimization history on both internalizing behavior problems and socialization are mediated by maternal depressive symptoms. The effects of maternal depressive symptoms on externalizing behavior problems, socialization, and anger are mediated by maternal social support. Clinical implications of findings are discussed. [ABSTRACT FROM AUTHOR]

Autoimmune bullous diseases are often associated with significant morbidity and some can even cause mortality, if left untreated. Multiple therapies are now available to treat these blistering conditions. However, few have been evaluated objectively. [ABSTRACT FROM AUTHOR]

The impact of maternal victimization on the behavioral, social, emotional, and cognitive development in a group of 206 low-income, predominantly African American children from inner city, pediatric primary health care clinics was explored using mother, teacher, and self-report data. Results revealed that mothers with a victimization history reported more externalizing and internalizing behaviors in their children, compared to mothers who had not been victimized. Maternal victimization history was not related to teachers' ratings of children's behavior, child reports of social competence and depression, or standardized assessments of cognitive development. The relation between mothers' history of victimization and their reports of internalizing and externalizing behavior problems in their children was mediated by pathways through maternal depression and disciplinary practices (verbal aggression). These findings provide evidence for the link between maternal victimization and children's behavior problems. Treatment for victimized mothers that reduces their depressive symptoms and promotes adaptive parenting practices may lead to fewer behavior problems in their children. [ABSTRACT FROM AUTHOR]

PURPOSE: To investigate fathers' involvement with their children using an ecological model, multiple respondents, and a comprehensive definition of fathers' involvement. The study's primary objectives were: (a) to describe the characteristics of fathers whose infants are born to low-income, urban, African-American adolescent mothers; (b) to describe the ways in which fathers are involved with their children; and (c) to identify factors associated with fathers' involvement. METHODS: A total of 181 first-time mothers (aged <18 years) living in three-generation households (infant, mother, and grandmother) were recruited from three urban hospitals shortly after delivery and invited to participate in a longitudinal study of parenting. Mothers provided the name of their infant's father; 109 (60%) of the fathers also agreed to participate. Baseline interviews of mothers, fathers, and grandmothers addressed demographic characteristics, relationships, and the father's involvement with his child. RESULTS: Three multivariate regression models were used to identify factors associated with paternal involvement, explaining 35% to 51% of the variability in father involvement. Regardless of the respondent (mother, father, or grandmother), paternal involvement was predicted most strongly by the quality of the parents' romantic relationship. The father's employment status, the maternal grandmother's education, and the father's relationship with the baby's maternal grandmother were also associated with paternal involvement. CONCLUSIONS: The study confirmed the value of an ecological perspective that uses multiple informants and a comprehensive definition of father involvement that includes multiple role functions. Efforts to increase paternal involvement should help young parents separate the father's relationship with their child from the romantic relationship between the mother and father, address the roles played by maternal grandmothers, and assist fathers to complete their education, and obtain and keep jobs. [ABSTRACT FROM AUTHOR]

AbstractPregnancy is associated with immunological, endocrine, metabolic and vascular changes that may adversely affect the skin. The specific dermatoses of pregnancy are disease entities almost exclusively related to the pregnancy or the puerperium. Learning objectiveAt the conclusion of this learning activity, participants should be aware of the main entities of the specific pregnancy dermatoses, their clinical presentations, the main diagnostic criteria and therapeutic options. [ABSTRACT FROM AUTHOR]

OBJECTIVE. To evaluate the efficacy of home intervention with drug-abusing women on parenting behavior and attitudes, and on children's development. DESIGN. A randomized, clinical trial of 60 drug-abusing women recruited prenatally and randomized into an intervention (n = 31) or comparison (n = 29) group. There were no group differences in gestational age, 1-minute Apgar scores, duration of hospital stay, or neonatal abstinence score. Intervention infants were slightly heavier (P = .098) and had slightly lower 5-minute Apgar scores (P = .089). Most mothers were single, African-American, multiparous, and non-high school graduates from low income families. Approximately 40% of the women were human immunodeficiency virus (HIV)-positive, all admitted to either cocaine and/or heroin use, and 62% had a history of incarceration. Intervention and comparison group women did not differ on any background variables. INTERVENTIONS. All children received primary care in a multidisciplinary clinic. Biweekly home visits were provided by a nurse beginning before delivery and extending through 18 months of life. The intervention was designed to provide maternal support and to promote parenting, child development, the utilization of informal and formal resources, and advocacy. MEASUREMENTS. Behavioral measures included self-reported ongoing drug abuse, compliance with primary care appointments, and an observation of the child-centered quality of the home (HOME Scale). Parenting attitudes were measured by the Child Abuse Potential Inventory (CAPI) and the Parenting Stress Index. The CAPI was administered before initiating the intervention and the Parenting Stress Index was administered when the children were 3 months of age. Both scales were repeated when the children were 18 months of age. Developmental status was measured with the Bayley Scales of Infant Development administered at 6, 12, and 18 months. ANALYSES. Repeated measures multivariate analyses of variance were used to examine changes in parenting attitudes and children's development. Analyses of covariance were used to examine compliance with primary care appointments and the quality of the home. Logistic regression was used to examine ongoing drug abuse. Birth weight and maternal education were used as covariates in all analyses. To control for social desirability, the faking-good index of the CAPI was included as a covariate in analyses involving self-report measures. MAIN RESULTS. Women in the intervention group were marginally more likely to report being drug-free (P = .059) and were compliant with primary care appointments for their children (P = .069). Based on the HOME Scale, women in the intervention group were more emotionally responsive (P = .033) and provided marginally more opportunities for stimulation (P = .065). At 18 months parents reported more normative attitudes regarding parenting and more child-related stress than they had initially, but the differences were not related to intervention status. At 6 months infants in the intervention group obtained marginally higher cognitive scores (P = .099); at 12 and 18 months there were no differences. CONCLUSIONS. The findings suggest a cautious optimism regarding the efficacy of early home intervention among drug-abusing women in promoting positive behaviors. Subsequent investigations of home intervention should include larger sample sizes and more intensive options. [ABSTRACT FROM AUTHOR]

Folate deficiency in the periconceptional period contributes to neural tube defects; deficits in vitamin B12 (cobalamin) have negative consequences on the developing brain during infancy; and deficits of both vitamins are associated with a greater risk of depression during adulthood. This review examines two mechanisms linking folate and vitamin B12 deficiency to abnormal behavior and development in infants: disruptions to myelination and inflammatory processes. Future investigations should focus on the relationship between the timing of deficient and marginal vitamin B12 status and outcomes such as infant growth, cognition, social development, and depressive symptoms, along with prevention of folate and vitamin B12 deficiency. [ABSTRACT FROM AUTHOR]

CONTEXT: Rates of rapid second births among low-income black adolescent mothers range from 20% to 50%. Most efforts to prevent rapid second births have been unsuccessful. OBJECTIVES: There were 4 objectives: (1) to examine whether a home-based mentoring intervention was effective in preventing second births within 2 years of the adolescent mother's first delivery; (2) to examine whether greater intervention participation increased the likelihood of preventing a second birth; (3) to examine whether second births were better predicted from a risk practice perspective or a family formation perspective, based on information collected at delivery; and (4) to examine how risk practices or family formation over the first 2 years of parenthood were related to a second birth. DESIGN: We conducted a randomized, controlled trial of a home-based intervention curriculum, based on social cognitive theory, and focused on interpersonal negotiation skills, adolescent development, and parenting. The curriculum was delivered biweekly until the infant's first birthday by college-educated, black, single mothers who served as mentors, presenting themselves as 'big sisters.' The control group received usual care. Follow-up evaluations were conducted in the homes 6, 13, and 24 months after recruitment. METHODS: Participants were recruited from urban hospitals at delivery and were 181 first time, black adolescent mothers (< 18 years of age); 82% (149 of 181) completed the 24-month evaluation. RESULTS: Intent-to-treat analyses revealed that control mothers were more likely than intervention mothers to have a second infant. The complier average causal effect was used to account for variability in intervention participation. Having > or = 2 intervention visits increased the odds of not having a second infant more than threefold. Only 1 mother who completed > or = 6 visits had a second infant. At delivery of their first infant, mothers who had a second infant were slightly older (16.7 vs 16.2 years) and were more likely to have been arrested (30% vs 14%). There were no differences in baseline contraceptive use or other measures of risk or family formation. At 24 months, mothers who had a second infant reported high self-esteem, positive life events, and romantic involvement and residence with the first infant's father. At 24 months, there were no differences in marital rates (2%), risk practices, or contraceptive use between mothers who did and did not have a second infant. Mothers who did not have a second infant were marginally more likely to report no plans for contraception in their next sexual contact compared with mothers who had a second infant (22% vs 8%, respectively). CONCLUSIONS: A home-based intervention founded on a mentorship model and targeted toward adolescent development, including negotiation skills, was effective in preventing rapid repeat births among low-income, black adolescent mothers. The effectiveness of the intervention could be seen after only 2 visits and increased over time. There were no second births among mothers who attended > or = 8 sessions. There was no evidence that risk behavior or contraceptive use was related to rapid second births. There was some evidence that rapid second births among adolescent mothers were regarded as desirable and as part of a move toward increasing autonomy and family formation, thereby undermining intervention programs that focus on risk avoidance. Findings suggest the merits of a mentoring program for low-income, black adolescent mothers, based on a relatively brief (6-8 sessions) curriculum targeted toward adolescent development and interpersonal negotiation skills. [ABSTRACT FROM AUTHOR]

Discusses the ecological model for examining feeding problems in children. Conceptualization of children's behavior; Role of caregiver in shaping children's feeding behavior; Caregiver-child interaction during feeding.

Zinc is a trace metal that is present in the brain and contributes to its structure and function. Limited evidence from both animal and human studies suggests that zinc deficiency may lead to delays in cognitive development. Although the mechanisms linking zinc deficiency with cognitive development are unclear, it appears that zinc deficiency may lead to deficits in children's neuropsychologic functioning, activity, or motor development, and thus interfere with cognitive performance. In this article a model is presented that incorporates the influence of social context and the caregiving environment and suggests that the relation between zinc deficiency and cognitive development may vary by age in children and may be mediated by neuropsychologic functioning, activity, and motor development. Suggestions for further research are provided. Copyright (c) 1998 American Society for Clinical Nutrition [ABSTRACT FROM AUTHOR]

The early introduction of non-milk foods among African-American infants has been well documented. Several studies report the addition of semi-solids as early as 1-2 weeks of age. This study investigated, through ethnographic, repeat indepth interviews with teen mothers and grandmothers of infants, the determinants of such feeding practices and the inter-generational factors involved in infant feeding decision-making. Nineteen adolescent mothers were recruited from Baltimore City WIC programs. The teen mothers were interviewed in their homes during four separate visits and the grandmothers at least twice. Ethnographic field guides focused on questions about what, why and how infants were fed and on the 'ethnotheories' of parenting and infant care in this population. All interviews were taped and transcripts were analyzed using text retrieval software. Results confirmed that it is the cultural norm to feed cereal in the bottle and to feed other semi-solid foods within the first month of life. Most grandmothers played the dominant role in deciding what the infant should eat and the timing of the introduction of solids. This pattern occurred both because grandmothers had extensive physical access to their grandchildren and because teen mothers were dependent upon grandmothers. The use of qualitative research methods, with an ecological, multi -generational focus, provides a rich description of the context within which infant feeding decisions are made. [ABSTRACT FROM AUTHOR]