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1.
Am J Epidemiol ; 187(3): 474-483, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28595334

RESUMO

Public expenditure on large events such as the London 2012 Olympic Games is often justified by the potential legacy of urban regeneration and its associated health and well-being benefits for local communities. In the Olympic Regeneration in East London Study, we examined whether there was an association between urban regeneration related to the 2012 Games and improved mental health in young people. Adolescents aged 11-12 years attending schools in the Olympic host borough of Newham in London or in 3 adjacent comparison London boroughs completed a survey before the 2012 Games and 6 and 18 months after the Games (in 2013 and 2014, respectively). Changes in depressive symptoms and well-being between baseline and each follow-up were examined. A total of 2,254 adolescents from 25 randomly selected schools participated. Adolescents from Newham were more likely to have remained depressed between baseline and the 6- and 18-month follow-up surveys (for 6-month follow-up, relative risk = 1.78, 95% confidence interval: 1.12, 2.83; for 18-month follow-up, relative risk = 1.93, 95% confidence interval: 1.01, 3.70) than adolescents from the comparison boroughs. No differences in well-being were observed. There was little evidence that urban regeneration had any positive influence on adolescent mental health and some suggestion that regeneration may have been associated with maintenance of depressive symptoms. Such programs may have limited short-term impact on the mental health of adolescents.


Assuntos
Aniversários e Eventos Especiais , Depressão/epidemiologia , Estudantes/psicologia , Reforma Urbana/história , Adolescente , Depressão/etiologia , Depressão/história , Feminino , História do Século XXI , Humanos , Londres/epidemiologia , Masculino , Instituições Acadêmicas , Esportes/história , Inquéritos e Questionários
2.
J Appl Res Intellect Disabil ; 31(6): 1197-1208, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-29963734

RESUMO

BACKGROUND: Past research suggests children with Down syndrome often lack awareness of their disability despite the visibility of their condition. METHOD: This study used novel tasks to investigate their insight. Twenty-eight young people with Down syndrome (aged 8-17 years) were recruited, along with control groups of 67 typically developing young people. Three tasks explored the children's awareness of Down syndrome: (a) choice of partner for social activities, (b) sorting photographs and (c) attributing positive or negative descriptors to photographs. RESULTS: All participants expressed a preference to engage in social activities with typically developing peers. Most participants with Down syndrome identified with the typically developing person. Even though all participants attributed more positive descriptors to the photographs of the typically developing individuals, they remained positive about themselves. CONCLUSION: The early awareness of difference shown by young people with Down syndrome suggests this may play an important role in their developing identities.


Assuntos
Conscientização , Síndrome de Down/psicologia , Relações Interpessoais , Autoimagem , Comportamento Social , Percepção Social , Adolescente , Criança , Feminino , Humanos , Masculino
3.
Infant Child Dev ; 25(1): 95-113, 2016 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-26869855

RESUMO

Recent work suggests that differences in functional brain development are already identifiable in 6- to 9-month-old infants from low socio-economic status (SES) backgrounds. Investigation of early SES-related differences in neuro-cognitive functioning requires the recruitment of large and diverse samples of infants, yet it is often difficult to persuade low-SES parents to come to a university setting. One solution is to recruit infants through early intervention children's centres (CCs). These are often located in areas of high relative deprivation to support young children. Given the increasing portability of eye-tracking equipment, assessment of large clusters of infants could be undertaken in centres by suitably trained early intervention staff. Here, we report on a study involving 174 infants and their parents, carried out in partnership with CCs, exploring the feasibility of this approach. We report the processes of setting up the project and participant recruitment. We report the diversity of sample obtained on the engagement of CC staff in training and the process of assessment itself. We report the quality of the data obtained, and the levels of engagement of parents and infants. We conclude that this approach has great potential for recruiting large and diverse samples worldwide, provides sufficiently reliable data and is engaging to staff, parents and infants.

4.
Hum Psychopharmacol ; 30(4): 290-4, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26216565

RESUMO

OBJECTIVE: This paper aims to review findings from a longitudinal study of prenatal methylenedioxymethamphetamine (MDMA, "ecstasy") on infant development. METHODS: In a prospective, longitudinal cohort design, we followed 28 MDMA-exposed and 68 non-MDMA-exposed infants from birth to 2 years of age. Women recruited voluntarily into a study of recreational drug use during pregnancy were interviewed to obtain type, frequency, and amount of recreational drug use. Their children were followed for a 2-year period after birth. A large number of drug and environmental covariates were controlled. Infants were seen at 1, 4, 12, 18, and 24 months using standardized normative tests of mental and motor development. RESULTS: There were no differences between MDMA-exposed and non-MDMA-exposed infants at birth except that MDMA-exposed infants were more likely to be male. Motor delays were evident in MDMA infants at each age and amount of MDMA exposure predicted motor deficits at 12 months in a dose-dependent fashion. CONCLUSIONS: Prenatal MDMA exposure is related to fine and gross motor delays in the first 2 years of life. Follow-up studies are needed to determine long-term effects.


Assuntos
Desenvolvimento Infantil/efeitos dos fármacos , Deficiências do Desenvolvimento/etiologia , Alucinógenos/efeitos adversos , N-Metil-3,4-Metilenodioxianfetamina/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Adulto , Fatores Etários , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Reino Unido
5.
BMC Public Health ; 15: 150, 2015 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-25884502

RESUMO

BACKGROUND: Populations living in urban areas experience greater health inequalities as well as higher absolute burdens of illness. It is well-established that a range of social and environmental factors determine these differences. Less is known about the relative importance of these factors in determining adolescent health within a super diverse urban context. METHODS: A cross-sectional sample of 3,105 adolescent participants aged 11 to 12 were recruited from 25 schools in the London boroughs of Newham, Tower Hamlets, Hackney and Barking & Dagenham. Participants completed a pseudo-anonymised paper-based questionnaire incorporating: the Warwick-Edinburgh Mental Well-being Scale used for assessing positive mental well-being, the Short Moods and Feelings Questionnaire based on the DSM III-R criteria for assessment of depressive symptoms, the Youth-Physical Activity Questionnaire and a self-assessment of general health and longstanding illness. Prevalence estimates and unadjusted linear models estimate the extent to which positive well-being scores and time spent in physical/sedentary activity vary by socio-demographic and environmental indicators. Logistic regression estimated the unadjusted odds of having fair/(very)poor general health, a long standing illness, or depressive symptoms. Fully adjusted mixed effects models accounted for clustering within schools and for all socio-demographic and environmental indicators. RESULTS: Compared to boys, girls had significantly lower mental well-being and higher rates of depressive symptoms, reported fewer hours physically active and more hours sedentary, and had poorer general health after full adjustment. Positive mental well-being was significantly and positively associated with family affluence but the overall relationship between mental health and socioeconomic factors was weak. Mental health advantage increased as positive perceptions of the neighbourhood safety, aesthetics, walkability and services increased. Prevalence of poor health varied by ethnic group, particularly for depressive symptoms, general health and longstanding illness suggesting differences in the distribution of the determinants of health across ethnic groups. CONCLUSIONS: During adolescence perceptions of the urban physical environment, along with the social and economic characteristics of their household, are important factors in explaining patterns of health inequality.


Assuntos
Disparidades nos Níveis de Saúde , Saúde Mental , Determinantes Sociais da Saúde , Adolescente , Criança , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Londres , Masculino , Características de Residência/estatística & dados numéricos , Fatores Socioeconômicos , Inquéritos e Questionários , Saúde da População Urbana
6.
Hum Psychopharmacol ; 29(1): 1-7, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24424703

RESUMO

OBJECTIVE: The illicit recreational drug 3,4-methylenedioxymethamphetamine (MDMA) or Ecstasy has strong neurohormonal effects. When taken by recreational users at dance clubs and raves, it can generate an 800% increase in the stress hormone cortisol, whereas drug-free users show chronically raised levels of cortisol. The aim here is to critically debate this neurohormonal influence for the children of pregnant MDMA-using mothers. METHODS: High levels of cortisol are known to be damaging for neuropsychobiological well-being in adult humans. MDMA can damage foetal development in laboratory animals, and the prospective Drugs and Infancy Study was established to monitor the effects of MDMA taken recreationally by pregnant women. RESULTS: The Drugs and Infancy Study revealed that young mothers, who took MDMA during the first trimester of pregnancy, gave birth to babies with significant gross psychomotor retardation. These mothers would have experienced high levels of cortisol due to Ecstasy/MDMA use, and since cortisol can cross the placenta, this is likely to have also occurred in the foetus. CONCLUSIONS: In terms of causation, the developmental problems may reflect a combination of neurotransmitter and neurohormonal effects on the hypothalamic-pituitary-adrenal axis, with serotonergic activity being influenced by the high levels of cortisol.


Assuntos
Hidrocortisona/metabolismo , N-Metil-3,4-Metilenodioxianfetamina/toxicidade , Resultado da Gravidez , Animais , Feminino , Desenvolvimento Fetal/efeitos dos fármacos , Alucinógenos/administração & dosagem , Alucinógenos/toxicidade , Humanos , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Sistema Hipotálamo-Hipofisário/metabolismo , Drogas Ilícitas/toxicidade , Recém-Nascido , N-Metil-3,4-Metilenodioxianfetamina/administração & dosagem , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Sistema Hipófise-Suprarrenal/metabolismo , Gravidez , Primeiro Trimestre da Gravidez
7.
Eur J Neurosci ; 38(9): 3363-9, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23889202

RESUMO

Research on audiovisual speech integration has reported high levels of individual variability, especially among young infants. In the present study we tested the hypothesis that this variability results from individual differences in the maturation of audiovisual speech processing during infancy. A developmental shift in selective attention to audiovisual speech has been demonstrated between 6 and 9 months with an increase in the time spent looking to articulating mouths as compared to eyes (Lewkowicz & Hansen-Tift. (2012) Proc. Natl Acad. Sci. USA, 109, 1431-1436; Tomalski et al. (2012) Eur. J. Dev. Psychol., 1-14). In the present study we tested whether these changes in behavioural maturational level are associated with differences in brain responses to audiovisual speech across this age range. We measured high-density event-related potentials (ERPs) in response to videos of audiovisually matching and mismatched syllables /ba/ and /ga/, and subsequently examined visual scanning of the same stimuli with eye-tracking. There were no clear age-specific changes in ERPs, but the amplitude of audiovisual mismatch response (AVMMR) to the combination of visual /ba/ and auditory /ga/ was strongly negatively associated with looking time to the mouth in the same condition. These results have significant implications for our understanding of individual differences in neural signatures of audiovisual speech processing in infants, suggesting that they are not strictly related to chronological age but instead associated with the maturation of looking behaviour, and develop at individual rates in the second half of the first year of life.


Assuntos
Encéfalo/fisiologia , Movimentos Oculares , Percepção da Fala , Percepção Visual , Fatores Etários , Encéfalo/crescimento & desenvolvimento , Potenciais Evocados , Feminino , Humanos , Lactente , Masculino , Desempenho Psicomotor
8.
Dev Sci ; 16(5): 676-87, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24033573

RESUMO

Socioeconomic status (SES) impacts on both structural and functional brain development in childhood, but how early its effects can be demonstrated is unknown. In this study we measured resting baseline EEG activity in the gamma frequency range in awake 6-9-month-olds from areas of East London with high socioeconomic deprivation. Between-subject comparisons of infants from low- and high-income families revealed significantly lower frontal gamma power in infants from low-income homes. Similar power differences were found when comparing infants according to maternal occupation, with lower occupational status groups yielding lower power. Infant sleep, maternal education, length of gestation, and birth weight, as well as smoke exposure and bilingualism, did not explain these differences. Our results show that the effects of socioeconomic disparities on brain activity can already be detected in early infancy, potentially pointing to very early risk for language and attention difficulties. This is the first study to reveal region-selective differences in functional brain development associated with early infancy in low-income families.


Assuntos
Encéfalo/crescimento & desenvolvimento , Desenvolvimento Infantil/fisiologia , Classe Social , Análise de Variância , Eletroencefalografia , Feminino , Humanos , Lactente , Londres , Masculino , Ocupações , Sono/fisiologia , Inquéritos e Questionários
9.
Cognition ; 104(2): 377-96, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16930578

RESUMO

While five-month-old infants show orientation-specific sensitivity to changes in the motion and occlusion patterns of human point-light displays, it is not known whether infants are capable of binding a human representation to these displays. Furthermore, it has been suggested that infants do not encode the same physical properties for humans and material objects. To explore these issues we tested whether infants would selectively apply the principle of solidity to upright human displays. In the first experiment infants aged six and nine months were repeatedly shown a human point-light display walking across a computer screen up to 10 times or until habituated. Next, they were repeatedly shown the walking display passing behind an in-depth representation of a table, and finally they were shown the human display appearing to pass through the table top in violation of the solidity of the hidden human form. Both six- and nine-month-old infants showed significantly greater recovery of attention to this final phase. This suggests that infants are able to bind a solid vertical form to human motion. In two further control experiments we presented displays that contained similar patterns of motion but were not perceived by adults as human. Six- and nine-month-old infants did not show recovery of attention when a scrambled display or an inverted human display passed through the table. Thus, the binding of a solid human form to a display in only seems to occur for upright human motion. The paper considers the implications of these findings in relation to theories of infants' developing conceptions of objects, humans and animals.


Assuntos
Percepção de Forma , Percepção Visual , Humanos , Lactente , Recém-Nascido
10.
Neurotoxicol Teratol ; 54: 22-8, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26806601

RESUMO

BACKGROUND: Recreational use of 3,4 methylenedioxymethamphetamine (ecstasy, MDMA) is increasing worldwide. Its use by pregnant women causes concern due to potentially harmful effects on the developing fetus. MDMA, an indirect monoaminergic agonist and reuptake inhibitor, affects the serotonin and dopamine systems. Preclinical studies of fetal exposure demonstrate effects on learning, motor behavior, and memory. In the first human studies, we found prenatal MDMA exposure related to poorer motor development in the first year of life. In the present study we assessed the effects of prenatal exposure to MDMA on the trajectory of child development through 2 years of age. We hypothesized that exposure would be associated with poorer mental and motor outcomes. MATERIALS AND METHODS: The DAISY (Drugs and Infancy Study, 2003-2008) employed a prospective longitudinal cohort design to assess recreational drug use during pregnancy and child outcomes in the United Kingdom. Examiners masked to drug exposures followed infants from birth to 4, 12, 18, and 24 months of age. MDMA, cocaine, alcohol, tobacco, cannabis, and other drugs were quantified through a standardized clinical interview. The Bayley Scales (III) of Mental (MDI) and Motor (PDI) Development and the Behavior Rating Scales (BRS) were primary outcome measures. Statistical analyses included a repeated measures mixed model approach controlling for multiple confounders. RESULTS: Participants were pregnant women volunteers, primarily white, of middle class socioeconomic status, average IQ, with some college education, in stable partner relationships. Of 96 women enrolled, children of 93 had at least one follow-up assessment and 81 (87%) had ≥ two assessments. Heavier MDMA exposure (M=1.3±1.4 tablets per week) predicted lower PDI (p<.002), and poorer BRS motor quality from 4 to 24 months of age, but did not affect MDI, orientation, or emotional regulation. Children with heavier exposure were twice as likely to demonstrate poorer motor quality as lighter and non-exposed children (O.R.=2.2, 95%, CI=1.02-4.70, p<.05). DISCUSSION: Infants whose mothers reported heavier MDMA use during pregnancy had motor delays from 4 months to two years of age that were not attributable to other drug or lifestyle factors. Women of child bearing age should be cautioned about the use of MDMA and MDMA-exposed infants should be screened for motor delays and possible intervention.


Assuntos
Deficiências do Desenvolvimento/etiologia , Alucinógenos/efeitos adversos , Transtornos Motores/etiologia , N-Metil-3,4-Metilenodioxianfetamina/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Transtornos Psicomotores/etiologia , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Transtornos Relacionados ao Uso de Substâncias/complicações
11.
Br J Psychol ; 94(Pt 4): 529-49, 2003 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-14687460

RESUMO

This paper brings together extensive data from 257 children to explore the relative importance of social-environmental factors during critical periods of children's musical development. The paper also presents preliminary findings from a follow-up of 20 of the most musically successful children 8 years later to determine which childhood factors predict differences in success as adult performers. Those children who continued to play an instrument started at an early age, had higher parental support in lessons, and had first teachers who were friendly but not too technically able. However, these factors alone were not sufficient to predict relative success in childhood. Successful childhood musicians also appear to need teachers who are 'not too relaxed' and also 'not too pushy' and they also need to do substantial amounts of practice. The follow-up study suggested, though, that successful adult performers were not those who did the most practice; rather, the successful adults were those who took part in more concert activities in childhood, did more improvisation, and who had mothers at home in their early years. The results are discussed in relation to theories of musical development and the changing influences of parents, teachers and peers.


Assuntos
Desenvolvimento Infantil , Música , Comportamento Social , Adolescente , Adulto , Criança , Meio Ambiente , Feminino , Seguimentos , Humanos , Masculino , Relações Mãe-Filho , Análise e Desempenho de Tarefas
12.
Downs Syndr Res Pract ; 8(2): 43-52, 2002 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-12407968

RESUMO

Infants and young children with Down syndrome can be engaging and affectionate. It seems that in the early months of life their personal relations may be relatively 'spared' the effects of limitations in their capacities for information-processing. Yet how far is this the case as development proceeds? In this paper we discuss some ways in which social and cognitive development interact and mutually influence one another over the first year or so of life, and present preliminary findings from a longitudinal study of infants with and without Down syndrome. The evidence suggests that the development of 'triadic' (person-person-world) social interactions may be affected by limited information-processing capacities in infants with Down syndrome, through a complex socially-mediated developmental trajectory.


Assuntos
Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/etiologia , Síndrome de Down/complicações , Atenção , Pré-Escolar , Humanos , Lactente , Relações Mãe-Filho
13.
J Psychopharmacol ; 28(1): 55-61, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24327452

RESUMO

BACKGROUND: The recreational drug MDMA (3,4-methylenedioxymethamphetamine) or 'Ecstasy' is associated with heightened psychiatric distress and feelings of depression. The Drugs and Infancy Study (DAISY) monitored the psychiatric symptom profiles of mothers who used Ecstasy/MDMA while pregnant, and followed them over the first year post-partum. METHODS: We compared 28 young women whom took MDMA during their pregnancy with a polydrug control group of 68 women who took other psychoactive drugs while pregnant. The Brief Symptom Inventory (BSI) was completed for several periods: The first trimester of pregnancy; and 1, 4 and 12 months after childbirth. Recreational drug use was monitored at each time point. RESULTS: During the first trimester of pregnancy, MDMA-using mothers reported higher depression scores than the polydrug controls. At 1 year after childbirth, their BSI depression scores were significantly lower, now closer to the control group values. At the same time point, their self-reported use of MDMA became nearly zero, in contrast to their continued use of Cannabis/marijuana, nicotine and alcohol. We found significant symptom reductions in those with BSI obsessive-compulsive and interpersonal sensitivity, following Ecstasy/MDMA cessation. CONCLUSIONS: The findings from this unique prospective study of young recreational drug-using mothers are consistent with previous reports of improved psychiatric health after quitting MDMA.


Assuntos
Depressão/induzido quimicamente , Depressão/psicologia , Usuários de Drogas/psicologia , Drogas Ilícitas/efeitos adversos , Mães/psicologia , N-Metil-3,4-Metilenodioxianfetamina/efeitos adversos , Adulto , Estudos de Casos e Controles , Depressão/complicações , Feminino , Nível de Saúde , Humanos , Gravidez , Escalas de Graduação Psiquiátrica , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Fatores de Tempo , Adulto Jovem
14.
Front Psychol ; 4: 432, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23882240

RESUMO

The use of visual cues during the processing of audiovisual (AV) speech is known to be less efficient in children and adults with language difficulties and difficulties are known to be more prevalent in children from low-income populations. In the present study, we followed an economically diverse group of thirty-seven infants longitudinally from 6-9 months to 14-16 months of age. We used eye-tracking to examine whether individual differences in visual attention during AV processing of speech in 6-9 month old infants, particularly when processing congruent and incongruent auditory and visual speech cues, might be indicative of their later language development. Twenty-two of these 6-9 month old infants also participated in an event-related potential (ERP) AV task within the same experimental session. Language development was then followed-up at the age of 14-16 months, using two measures of language development, the Preschool Language Scale and the Oxford Communicative Development Inventory. The results show that those infants who were less efficient in auditory speech processing at the age of 6-9 months had lower receptive language scores at 14-16 months. A correlational analysis revealed that the pattern of face scanning and ERP responses to audiovisually incongruent stimuli at 6-9 months were both significantly associated with language development at 14-16 months. These findings add to the understanding of individual differences in neural signatures of AV processing and associated looking behavior in infants.

15.
Pediatrics ; 130(3): 407-13, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22908109

RESUMO

OBJECTIVE: A widely used illicit recreational drug among young adults, 3,4-methylenedioxymethamphetamine (MDMA) or ecstasy, is an indirect monoaminergic agonist/reuptake inhibitor affecting the serotonin system. Preclinical studies found prenatal exposure related to long-term learning and memory impairments. There are no studies of sequelae of prenatal MDMA exposure in humans, despite potential harmful effects to the fetus. METHODS: A total of 96 women in the United Kingdom (28 MDMA users; 68 non-MDMA) were interviewed about recreational drug use during pregnancy. Their infants were seen at 12 months using standardized assessments of cognitive, language, and motor development (Preschool Language Scale, Bayley Mental and Motor Development and Behavior Rating Scales [Mental Development Index, Psychomotor Development Index, Behavioral Rating Scale]). Mothers completed the Child Domain Scale of the Parenting Stress Index, The Home Observation of the Environment Scale (in interview), the Brief Symptom Inventory, and the Drug Abuse Screening Test. Women were primarily middle class with some university education, in stable partner relationships, and polydrug users. MDMA and other drug effects were assessed through multiple regression analyses controlling for confounding variables, and analysis of covariance comparing heavier versus lighter and nonexposed groups. RESULTS: Amount of prenatal MDMA exposure predicted poorer infant mental and motor development at 12 months in a dose-dependent manner. Heavily exposed infants were delayed in motor development. Lighter-exposed infants were comparable to nonexposed infants. There were no effects on language, emotional regulation, or parenting stress. CONCLUSIONS: Findings document persistent neurotoxic effects of heavier prenatal MDMA exposure on motor development through the first year of life.


Assuntos
Deficiências do Desenvolvimento/induzido quimicamente , Alucinógenos/efeitos adversos , N-Metil-3,4-Metilenodioxianfetamina/efeitos adversos , Efeitos Tardios da Exposição Pré-Natal , Cognição/efeitos dos fármacos , Deficiências do Desenvolvimento/diagnóstico , Relação Dose-Resposta a Droga , Feminino , Humanos , Lactente , Masculino , Gravidez , Desempenho Psicomotor/efeitos dos fármacos , Fatores Socioeconômicos
16.
Neurotoxicol Teratol ; 34(3): 303-10, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22387807

RESUMO

3,4-methylenedioxymethamphetamine (MDMA) or "Ecstasy" is one of the most widely used illicit recreational drugs among young adults. MDMA is an indirect monoaminergic agonist and reuptake inhibitor that primarily affects the serotonin system. Preclinical studies in animals have found prenatal exposure related to neonatal tremors and long-term learning and memory impairments. To date, there are no prospective studies of the sequelae of prenatal exposure to MDMA in humans, despite concerns about its potential for harmful effects to the fetus. The present study is the first to prospectively identify MDMA-using women during pregnancy and to document patterns and correlates of use with neonatal and early infancy outcomes of offspring. All mothers and infants were prospectively recruited through the Case Western Reserve University (CWRU) and University of East London (UEL) Drugs and Infancy Study (DAISY) that focused on recreational drug use in pregnant women. Women were interviewed about substance use prior to and during pregnancy and infants were seen at 1 and 4 months using standardized, normative assessments of neonatal behavior, and cognitive and motor development, including the NICU Network Neurobehavioral Scale (NNNS), the Bayley Mental and Motor Development Scales (MDI, PDI), and the Alberta Infant Motor Scales (AIMS). The sample was primarily middle class with some university education and in stable partner relationships. The majority of women recruited had taken a number of illicit drugs prior to or during pregnancy. Group differences between those polydrug using women who had specifically used MDMA during pregnancy (n=28) and those who had not (n=68) were assessed using chi-square and t-tests. MDMA and other drug effects were assessed through multiple regression analyses controlling for confounding variables. Women who used MDMA during pregnancy had fewer prior births and more negative sequelae associated with their drug use, including more health, work, and social problems. MDMA exposed infants differed in sex ratio (more male births) and had poorer motor quality and lower milestone attainment at 4 months, with a dose-response relationship to amount of MDMA exposure. These findings suggest risk to the developing infant related to MDMA exposure and warrant continued follow-up to determine whether early motor delays persist or resolve.


Assuntos
Drogas Ilícitas/toxicidade , Comportamento do Lactente/efeitos dos fármacos , N-Metil-3,4-Metilenodioxianfetamina/toxicidade , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Adulto , Feminino , Idade Gestacional , Humanos , Lactente , Comportamento do Lactente/psicologia , Recém-Nascido , Masculino , Testes Neuropsicológicos , Gravidez , Resultado da Gravidez , Efeitos Tardios da Exposição Pré-Natal/psicologia , Estudos Prospectivos
17.
Trials ; 13: 105, 2012 Jul 06.
Artigo em Inglês | MEDLINE | ID: mdl-22769971

RESUMO

BACKGROUND: The Well London program used community engagement, complemented by changes to the physical and social neighborhood environment, to improve physical activity levels, healthy eating, and mental wellbeing in the most deprived communities in London. The effectiveness of Well London is being evaluated in a pair-matched cluster randomized trial (CRT). The baseline survey data are reported here. METHODS: The CRT involved 20 matched pairs of intervention and control communities (defined as UK census lower super output areas (LSOAs); ranked in the 11% most deprived LSOAs in London by the English Indices of Multiple Deprivation) across 20 London boroughs. The primary trial outcomes, sociodemographic information, and environmental neighbourhood characteristics were assessed in three quantitative components within the Well London CRT at baseline: a cross-sectional, interviewer-administered adult household survey; a self-completed, school-based adolescent questionnaire; a fieldworker completed neighborhood environmental audit. Baseline data collection occurred in 2008. Physical activity, healthy eating, and mental wellbeing were assessed using standardized, validated questionnaire tools. Multiple imputation was used to account for missing data in the outcomes and other variables in the adult and adolescent surveys. RESULTS: There were 4,107 adults and 1,214 adolescent respondents in the baseline surveys. The intervention and control areas were broadly comparable with respect to the primary outcomes and key sociodemographic characteristics. The environmental characteristics of the intervention and control neighborhoods were broadly similar. There was greater between-cluster variation in the primary outcomes in the adult population compared to the adolescent population. Levels of healthy eating, smoking, and self-reported anxiety/depression were similar in the Well London adult population and the national Health Survey for England. Levels of physical activity were higher in the Well London adult population but this is likely to be due to the different measurement tools used in the two surveys. CONCLUSIONS: Randomization of social interventions such as Well London is acceptable and feasible and in this study the intervention and control arms are well-balanced with respect to the primary outcomes and key sociodemographic characteristics. The matched design has improved the statistical efficiency of the study amongst adults but less so amongst adolescents. Follow-up data collection will be completed 2012.


Assuntos
Serviços de Saúde Comunitária , Comportamentos Relacionados com a Saúde , Conhecimentos, Atitudes e Prática em Saúde , Promoção da Saúde , Nível de Saúde , Saúde Mental , Adolescente , Comportamento do Adolescente , Adulto , Ansiedade/epidemiologia , Criança , Análise por Conglomerados , Depressão/epidemiologia , Dieta , Comportamento Alimentar , Feminino , Indicadores Básicos de Saúde , Inquéritos Epidemiológicos , Humanos , Londres/epidemiologia , Masculino , Análise por Pareamento , Atividade Motora , Pobreza , Projetos de Pesquisa , Fumar/efeitos adversos , Fumar/epidemiologia , Meio Social , Inquéritos e Questionários
18.
BMJ Open ; 2(4)2012.
Artigo em Inglês | MEDLINE | ID: mdl-22936822

RESUMO

INTRODUCTION: Recent systematic reviews suggest that there is a dearth of evidence on the effectiveness of large-scale urban regeneration programmes in improving health and well-being and alleviating health inequalities. The development of the Olympic Park in Stratford for the London 2012 Olympic and Paralympic Games provides the opportunity to take advantage of a natural experiment to examine the impact of large-scale urban regeneration on the health and well-being of young people and their families. DESIGN AND METHODS: A prospective school-based survey of adolescents (11-12 years) with parent data collected through face-to-face interviews at home. Adolescents will be recruited from six randomly selected schools in an area receiving large-scale urban regeneration (London Borough of Newham) and compared with adolescents in 18 schools in three comparison areas with no equivalent regeneration (London Boroughs of Tower Hamlets, Hackney and Barking & Dagenham). Baseline data will be completed prior to the start of the London Olympics (July 2012) with follow-up at 6 and 18 months postintervention. Primary outcomes are: pre-post change in adolescent and parent mental health and well-being, physical activity and parental employment status. Secondary outcomes include: pre-post change in social cohesion, smoking, alcohol use, diet and body mass index. The study will account for individual and environmental contextual effects in evaluating changes to identified outcomes. A nested longitudinal qualitative study will explore families' experiences of regeneration in order to unpack the process by which regeneration impacts on health and well-being. ETHICS AND DISSEMINATION: The study has approval from Queen Mary University of London Ethics Committee (QMREC2011/40), the Association of Directors of Children's Services (RGE110927) and the London Boroughs Research Governance Framework (CERGF113). Fieldworkers have had advanced Criminal Records Bureau clearance. Findings will be disseminated through peer-reviewed publications, national and international conferences, through participating schools and the study website (http://www.orielproject.co.uk).

19.
J Psychopharmacol ; 24(9): 1403-10, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19939863

RESUMO

While recreational drug use in UK women is prevalent, to date there is little prospective data on patterns of drug use in recreational drug-using women immediately before and during pregnancy. A total of 121 participants from a wide range of backgrounds were recruited to take part in the longitudinal Development and Infancy Study (DAISY) study of prenatal drug use and outcomes. Eighty-six of the women were interviewed prospectively while pregnant and/or soon after their infant was born. Participants reported on use immediately before and during pregnancy and on use over their lifetime. Levels of lifetime drug use of the women recruited were high, with women reporting having used at least four different illegal drugs over their lifetime. Most users of cocaine, 3,4-methylenedioxy-N-methylamphetamine (MDMA) and other stimulants stopped using these by the second trimester and levels of use were low. However, in pregnancy, 64% of the sample continued to use alcohol, 46% tobacco and 48% cannabis. While the level of alcohol use reduced substantially, average tobacco and cannabis levels tended to be sustained at pre-pregnancy levels even into the third trimester (50 cigarettes and/or 11 joints per week). In sum, while the use of 'party drugs' and alcohol seems to reduce, levels of tobacco and cannabis use are likely to be sustained throughout pregnancy. The data provide polydrug profiles that can form the basis for the development of more realistic animal models.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Drogas Ilícitas , Fumar Maconha/epidemiologia , N-Metil-3,4-Metilenodioxianfetamina , Complicações na Gravidez/epidemiologia , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto , Feminino , Alucinógenos , Humanos , Estudos Longitudinais , Gravidez , Trimestres da Gravidez , Detecção do Abuso de Substâncias , Reino Unido/epidemiologia
20.
Cognition ; 104(2): 377-396, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28933345

RESUMO

While five-month-old infants show orientation-specific sensitivity to changes in the motion and occlusion patterns of human point-light displays, it is not known whether infants are capable of binding a human representation to these displays. Furthermore, it has been suggested that infants do not encode the same physical properties for humans and material objects. To explore these issues we tested whether infants would selectively apply the principle of solidity to upright human displays. In the first experiment infants aged six and nine months were repeatedly shown a human point-light display walking across a computer screen up to 10 times or until habituated. Next, they were repeatedly shown the walking display passing behind an in-depth representation of a table, and finally they were shown the human display appearing to pass through the table top in violation of the solidity of the hidden human form. Both six- and nine-month-old infants showed significantly greater recovery of attention to this final phase. This suggests that infants are able to bind a solid vertical form to human motion. In two further control experiments we presented displays that contained similar patterns of motion but were not perceived by adults as human. Six- and nine-month-old infants did not show recovery of attention when a scrambled display or an inverted human display passed through the table. Thus, the binding of a solid human form to a display in only seems to occur for upright human motion. The paper considers the implications of these findings in relation to theories of infants' developing conceptions of objects, humans and animals.

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