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Background: Walking to school is an important source of physical activity among children. There is a paucity of research exploring environmental determinants of walking to school among children in urban areas. Methods: A cross-sectional secondary analysis of baseline data (2007) from 365 children in the "Multiple Opportunities to Reach Excellence" (MORE) Study (8 to 13 years; Mean 9.60 years, SD 1.04). Children and caregivers were asked about walking to school and perceived safety. Objective measures of the environment were obtained using a validated environmental neighborhood assessment. Results: Over half (55.83%) of children reported walking to school most of the time. High levels of neighborhood incivilities were associated with lower levels of perceived safety (OR: 0.39, 95% CI: 0.21 to 0.72). Living on a block above the median in incivilities was associated with a 353% increase in odds of walking to school (OR: 3.53; 95% CI: 1.68 to 7.39). Conclusions: Children residing in neighborhoods high in incivilities are more likely to walk to school, in spite of lower levels of perceived safety. As a high proportion of children residing in disadvantaged neighborhoods walk to school, efforts should be directed at minimizing exposure to neighborhood hazards by ensuring safe routes to and from school. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) recommends that women wait at least 24 months after a livebirth before attempting a subsequent pregnancy to reduce the risk of adverse maternal, perinatal, and infant health outcomes. However, the applicability of the WHO recommendations for women in the United States is unclear, as breast feeding, nutrition, maternal age at first birth, and total fertility rate differs substantially between the United States and the low- and middle-resource countries upon which most of the evidence is based.Methods: To inform guideline development for birth spacing specific to women in the United States, the Office of Population Affairs (OPA) convened an expert work group meeting in Washington, DC, on 14-15 September 2017 among reproductive, perinatal, paediatric, social, and public health epidemiologists; obstetrician-gynaecologists; biostatisticians; and experts in evidence synthesis related to women's health.Results: Presentations and discussion topics included the methodological quality of existing studies, evaluation of the evidence for causal effects of short interpregnancy intervals on adverse perinatal and maternal health outcomes, good practices for future research, and identification of research gaps and priorities for future work.Conclusions: This report provides an overview of the presentations, discussions, and conclusions from the expert work group meeting. [ABSTRACT FROM AUTHOR]

Background: Meta-analyses of observational studies have shown that women with a shorter interpregnancy interval (the time from delivery to start of a subsequent pregnancy) are more likely to experience adverse pregnancy outcomes, such as preterm delivery or small for gestational age birth, than women who space their births further apart. However, the studies used to inform these estimates have methodological shortcomings.Methods: In this commentary, we summarise the discussions of an expert workgroup describing good practices for the design, analysis, and interpretation of observational studies of interpregnancy interval and adverse perinatal health outcomes.Results: We argue that inferences drawn from research in this field will be improved by careful attention to elements such as: (a) refining the research question to clarify whether the goal is to estimate a causal effect vs describe patterns of association; (b) using directed acyclic graphs to represent potential causal networks and guide the analytic plan of studies seeking to estimate causal effects; (c) assessing how miscarriages and pregnancy terminations may have influenced interpregnancy interval classifications; (d) specifying how key factors such as previous pregnancy loss, pregnancy intention, and maternal socio-economic position will be considered; and (e) examining if the association between interpregnancy interval and perinatal outcome differs by factors such as maternal age.Conclusion: This commentary outlines the discussions of this recent expert workgroup, and describes several suggested principles for study design and analysis that could mitigate many potential sources of bias. [ABSTRACT FROM AUTHOR]

Hierarchical Bayes models have been used in disease mapping to examine small scale geographic variation. State level geographic variation for less common causes of mortality outcomes have been reported however county level variation is rarely examined. Due to concerns about statistical reliability and confidentiality, county-level mortality rates based on fewer than 20 deaths are suppressed based on Division of Vital Statistics, National Center for Health Statistics (NCHS) statistical reliability criteria, precluding an examination of spatio-temporal variation in less common causes of mortality outcomes such as suicide rates (SRs) at the county level using direct estimates. Existing Bayesian spatio-temporal modeling strategies can be applied via Integrated Nested Laplace Approximation (INLA) in R to a large number of rare causes of mortality outcomes to enable examination of spatio-temporal variations on smaller geographic scales such as counties. This method allows examination of spatiotemporal variation across the entire U.S., even where the data are sparse. We used mortality data from 2005- 2015 to explore spatiotemporal variation in SRs, as one particular application of the Bayesian spatio-temporal modeling strategy in R-INLA to predict year and countyspecific SRs. Specifically, hierarchical Bayesian spatio-temporal models were implemented with spatially structured and unstructured random effects, correlated time effects, time varying confounders and space-time interaction terms in the software RINLA, borrowing strength across both counties and years to produce smoothed county level SRs. Model-based estimates of SRs were mapped to explore geographic variation. Running head: Mapping Geographic Variation in Mortality Rates. [ABSTRACT FROM AUTHOR]

We examined consumption of different types of infant formula (eg, cow’s milk, soy, gentle/lactose-reduced, and specialty) and regular milk among a nationally representative sample of 1864 infants, 0 to 12 months old, from the National Health and Nutrition Examination Survey, 2003-2010. Among the 81% of infants who were fed formula or regular milk, 69% consumed cow’s milk formula, 12% consumed soy formula, 5% consumed gentle/ lactose-reduced formulas, 6% consumed specialty formulas, and 13% consumed regular milk products. There were differences by household education and income in the percentage of infants consuming cow’s milk formula and regular milk products. The majority of infants in the United States who were fed formula or regular milk consumed cow’s milk formula (69%), with lower percentages receiving soy, specialty, gentle/sensitive, or lactose-free/reduced formulas. Contrary to national recommendations, 13% of infants younger than 1 year consumed regular milk, and the percentage varied by household education and income levels. [ABSTRACT FROM AUTHOR]

ObjectiveTo describe the contribution of mixed dishes to vegetable consumption and to estimate vegetable intake according to specific types of vegetables and other foods among US children and adolescents.DesignThe 2003–2008 National Health and Nutrition Examination Survey (NHANES), a nationally representative probability survey conducted in the USA.SettingCivilian non-institutionalized US population.SubjectsAll children and adolescents aged 2–18 years who met eligibility criteria (n 9169).ResultsApproximately 59 % of total vegetable intake came from whole forms of vegetables with 41 % coming from a mixed dish. White potatoes (10·7 (se 0·6) %), fried potatoes (10·2 (se 0·4) %), potato chips (8·6 (se 0·5) %) and other vegetables (9·2 (se 0·5) %) accounted for most vegetables in their whole forms, whereas pasta dishes (9·5 (se 0·4) %), chilli/soups/stews (7·0 (se 0·5) %), pizza/calzones (7·6 (se 0·3) %) and other foods (13·7 (se 0·6) %) accounted for most mixed dishes. Usual mean vegetable intake was 1·02 cup equivalents/d; however, after excluding vegetables from mixed dishes, mean intake fell to 0·54 cup equivalents/d and to 0·32 cup equivalents/d when fried potatoes were further excluded.ConclusionsMixed dishes account for nearly half of overall vegetable intake in US children and adolescents. It is critical for future research to examine various components of vegetable intake carefully in order to inform policy and programmatic efforts aimed at improving dietary intake among children and adolescents. [ABSTRACT FROM AUTHOR]