Cross-border marriage and disparities in early childhood development in a population-based birth cohort study: the mediation of the home environment.

BACKGROUND: Taiwan has experienced a large influx of cross-border marriage migrants in recent years. The majority have been women in their childbearing ages and have come from countries with lower average standards of living than Taiwan. This trend has changed the ethnic composition of children who live in Taiwan, and it has generated considerable social concern over the future health status of Taiwan's citizens. This study aimed to examine: (1) whether there are disparities in development between children reared in families characterized by cross-border marriages and children reared in families with two Taiwanese-born parents; and (2) whether the quality of home environment explains the group differences in early childhood development. METHODS: Data came from the Taiwan Birth Cohort Study. A total of 19,499 participants who completed 6-month, 18-month and 3-year surveys were included for analysis. Cross-border marriage status was defined by mother's original nationality and categorized into three broad groups: Taiwanese-born, Chinese cross-border and South-East Asian (SEA) cross-border. Early childhood development was measured at age 3 years, and covered the domains of gross motor, fine motor, language and socio-emotional competence. Hierarchical linear regressions were used to examine the mediation effects of the home environment. RESULTS: Children of Chinese and SEA cross-border groups scored lower in fine motor, language and socio-emotional competence than those of their Taiwanese-born counterpart at age 3 years. Chinese-Taiwanese group differences in all three developmental domains became insignificant after the addition of home environment, while SEA-Taiwanese group differences in fine motor and language development remained, yet were noticeably reduced. The mediation of home environment was further confirmed using the Sobel test. CONCLUSIONS: Home environment plays a central role in reducing the disparities in developmental outcomes among children of different marriage groups. Interventions should be directed towards enhancing the quality of early home environment for children reared in families of cross-border marriages.

Parenting and the decline of physical activity from age 9 to 15.

BACKGROUND: There is a rapid decline in moderate-to-vigorous physical activity (MVPA) during middle childhood and adolescence. Information on the environmental factors implicated in this decline is limited. This study focuses on family factors associated with the rate of decline in objectively measured physical activity during middle childhood and adolescence. METHODS: Longitudinal analysis of 801 participants from 10 US sites in the NICHD Study of Early Child Care and Youth Development whose data included accelerometer-determined levels of moderate-to-vigorous physical activity (MVPA) between ages 9 and 15 years, as well as family process, BMI and demographic information. The sample included an even split of boys (49%) and girls (51%), was predominantly white (77%), and contained about 26% low income and 19% single parent families. The outcome measure was mean MVPA. It was based on 4 to 7 days of monitored physical activity. RESULTS: Boys with lower parental monitoring scores and more days of parental encouragement had significantly more minutes of MVPA at age 9 years. The effect of parental monitoring, however, was moderated by early puberty. High parental monitoring was associated with decreased activity levels for boys experiencing later puberty and increased activity for boy experiencing early puberty. Minutes of MVPA for boys living in the Midwest decreased at significantly faster rates than boys living in any other region; and boys in the South declined faster than boys in the West. Girls in the Midwest and South declined faster than girls in the West and Northeast. Among girls, more days of parental exercise and transportation to activities were associated with more MVPA per day at age 9. However, more parental transportation to activities and less monitoring was associated with faster linear declines in daughters' MVPA between the ages of 9 and 15 years. For girls who experienced puberty early, parental encouragement was associated with more MVPA. CONCLUSIONS: Parenting processes, such as monitoring and encouragement, as well as the parents' own level of physical activity, showed significant, but small, gender-specific associations with MVPA levels at age nine and the linear rate of decline in MVPA between ages 9 and 15.

Hydration-dehydration of adsorbed protein films studied by AFM and QCM-D.

The hydration-dehydration process of an adsorbed human serum albumin film has been studied using atomic force microscopy (AFM) and a quartz crystal microbalance (QCM). All measurements were performed with identically prepared protein films deposited on highly hydrophilic substrates. Both techniques are shown to be suitable for following in situ the kinetics of protein hydration, and for providing quantitative values of the adsorbed adlayer mass. The results obtained by the two methods have been compared and combined to study changes of physical properties of the films in terms of viscosity, shear, Young's modulus, density and film thickness. These properties were found to be reversible during hydration-dehydration cycles.

The influence of electrostatic forces on protein adsorption.

In this paper we investigate the importance of electrostatic double layer forces on the adsorption of human serum albumin by UV-ozone modified polystyrene. Electrostatic forces were measured between oxidized polystyrene surfaces and gold-coated atomic force microscope (AFM) probes in phosphate buffered saline (PBS) solutions. The variation in surface potential with surface oxygen concentration was measured. The observed force characteristics were found to agree with the theory of electrical double layer interaction under the assumption of constant potential. Chemically patterned polystyrene surfaces with adjacent 5 microm x 5 microm polar and non-polar domains have been studied by AFM before and after human serum albumin adsorption. A topographically flat surface is observed before protein adsorption indicating that the patterning process does not physically modify the surface. Friction force imaging clearly reveals the oxidation pattern with the polar domains being characterised by a higher relative friction compared to the non-polar, untreated domains. Far-field force imaging was performed on the patterned surface using the interleave AFM mode to produce two-dimensional plots of the distribution of electrostatic double-layer forces formed when the patterned polystyrene surfaces is immersed in PBS. Imaging of protein layers adsorbed onto the chemically patterned surfaces indicates that the electrostatic double-layer force was a significant driving force in the interaction of protein with the surface.

Orientation and confinement of cells on chemically patterned polystyrene surfaces.

UV/ozone oxidation was combined with a photomasking technique to produce adjacent regions of different chemistry on polystyrene (PS) surfaces. The surface chemistry and topography were studied using AFM, XPS and contact angle measurements. The physicochemical patterns were visualised by the condensation of water vapour upon the surfaces and by the differential attachment of Chinese hamster ovarian (CHO) cells. The orientation of CHO cells on 55 and 125 microm wide oxidised PS strips were measured and found to be highly dependent on the width of the oxidised feature. CHO cells in relatively close proximity to a linear polar/non-polar border showed significant axial alignment along the border. CHO cells can also be confined to specific regions of the polymer surface. Cells attached to larger areas (75 microm x 75 microm) were found to have a smaller average cell size than cells attached to the smaller (56 microm x 56 microm) areas.

Improved cellular adhesion to acetone plasma modified polystyrene surfaces.

The plasma polymerization of acetone has been used to modify polystyrene substrates for the controlled growth of human fibroblast cells. The surface modified polystyrene was studied by X-ray photoelectron spectroscopy, water contact angle and atomic force microscopy. This showed the surface oxygen levels and wettability to increase rapidly with exposure to the acetone plasma. High-resolution XPS allowed the determination of the relative amounts of surface hydroxyl, carbonyl and carboxyl groups. This showed that there was little incorporation of carboxyl groups in the deposited films. AFM measurements revealed the films to be conformal with a surface roughness equivalent to that of the underlying polystyrene substrate with film growth rates of approximately 0.5 nm min(-1). High edge-definition patterns were produced with a simple masking procedure and allowed the confinement of cells to selected areas of the substrate. These chemically patterned surfaces allowed the study of cells confined to particular regions of the substrate as a function of incubation time.

N-[acetyl-3H] wheat germ agglutinin: anatomical and biochemical studies of a sensitive bidirectionally transported axonal tracer.

Both retrograde and anterograde autoradiographic axonal labeling were associated with the appropriate pathways after injections of N-[acetyl-3H] wheat germ agglutinin within numerous structures in the central nervous system of mice. Sections processed for light microscopic autoradiography following the placement of injections mainly within the neocortex, neostriatum, or cerebellum have revealed patterns of bidirectional axonal labeling in various thalamic, monoaminergic, deep cerebellar and precerebellar nuclei that were similar to that seen after similarly placed horseradish peroxidase injections. Small injections of N-[acetyl-3H] wheat germ agglutinin, by way of an extremely limited extracellular spread of the tracer, yield large amounts of autoradiographic retrograde and anterograde axonal labeling. High specific activities, in addition to the sensitivity displayed by this tracer, allow the use of relatively short autoradiographic exposure times that still lead to an extensive signal over labeled neurons. Biochemical analysis of this radiolabeled derivative of wheat germ agglutinin was carried out using sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Results from Coomassie blue staining and fluorography of the gels have revealed that affinity-purified N-[acetyl-3H] wheat germ agglutinin migrates predominantly as a monomer (molecular weight 18,000 +/- 1000 daltons) as well as a dimer (35,100 +/- 1000 daltons) when compared with native wheat germ agglutinin and molecular weight standards. Gels run on the native preparation, prior to derivatization, radiolabeling and affinity purification, in addition to containing species that co-migrate with the monomeric and dimeric forms of the tagged lectin, also reveal several other bands with molecular weights above and below those values for the monomer and dimer. When scintillation counting was performed on fresh gels of N-[acetyl-3H] wheat germ agglutinin, the predominant species was again found to be the monomeric and dimeric forms; however, small peaks were also present around 12,000 daltons as well as above 43,000 daltons. Coomassie blue staining and fluorography never revealed banding below 18,000 daltons, though some trace of labeling was present, but not in the form of discrete bands, above 36,000 daltons. The presence, albeit small in comparison to the monomer and dimer, of these other higher and lower molecular weight species might in part result from fragments produced by proteolytic digestion of intact subunits of N-[acetyl-3H] wheat germ agglutinin that may or may not possess intact binding sites.(ABSTRACT TRUNCATED AT 400 WORDS)

Risk factors and outcomes for failure to thrive in low birth weight preterm infants.

OBJECTIVE: To determine the epidemiology, clinical characteristics, and outcomes for low birth weight (LBW) infants with growth deficiency, or failure to thrive (FTT, the term commonly used by pediatric providers to describe growth deficiency or faltering in early childhood). DESIGN: Three-year prospective cohort study with matched case-control study of outcomes. SETTING: Eight large university hospital sites throughout the United States. SAMPLE: 914 LBW infants inborn at the sites and meeting study criteria. RESULTS: FTT was a common condition in this cohort, with 180 (19.7%) of 914 LBW infants meeting case criteria by 30 months. New cases of FTT peaked at 8 months gestation-corrected age. In addition to expected differences in growth between infants with and without FTT, infants with FTT had lower developmental indices and less stimulating home environments. At 36 months, FTT infants had lower IQ scores and were much smaller than infants without FTT. CONCLUSIONS: Growth deficiency, or FTT, is a common clinical condition for those involved in the follow-up care of LBW infants. Worse cognitive and growth outcomes were observed for those meeting the restrictive case criteria employed in this study. More than 80% of the cases in this LBW cohort did not involve any chronic medical disorders, but several biological and environmental differences were found between those who developed FTT and those who did not.

Cellular attachment and spatial control of cells using micro-patterned ultra-violet/ozone treatment in serum enriched media.

Ultra-violet Ozone (UVO) modified polystyrene (PS) surfaces were analyzed by X-ray photoelectron spectroscopy (XPS), atomic force microscopy (AFM), contact angle (CA), optical microscopy (OM) and cell culture experiments. UV/Ozone treatment up to 900 s was used to increase the surface oxygen concentration of PS surfaces from 0% to approximately 35% (unwashed) and 0% to approximately 27% (washed). The observed differences in oxygen concentration, between washed and unwashed surfaces, have been previously attributed to the removal of low molecular weight debris produced in this treatment process. Surface roughness (Rq) is known to affect cellular attachment and proliferation. AFM studies of the UV/Ozone treated PS surfaces show the surface roughness is an order of magnitude less than that expected to cause an effect. UV/Ozone treatment of PS showed a marked change in CA which decreased to approximately 60 degrees after 900 s treatment. The increased attachment and proliferation of Chinese hamster ovarian (CHO) and mouse embryo 3T3-L1 (3T3) cells on the treated surfaces compared to untreated PS were found to correlate strongly with the increase in surface oxygen concentration. Surface chemical oxidation patterns on the PS were produced using a simple masking technique and a short UV/Ozone treatment time, typically 20-45 s. The chemical patterns on PS were visualized by water condensation and the spatially selective attachment of CHO and 3T3-L1 cells cultured with 10% (v/v) serum. This paper describes an easily reproducible, one step technique to produce a well-defined, chemically heterogeneous surface with a cellular resolution using UV/Ozone modification. By using a variety of cell types, that require different media conditions, we have been able to expand the potential applications of this procedure.

A multifaceted intervention for infants with failure to thrive. A prospective study.

OBJECTIVE: To determine whether a multifaceted intervention decreased the incidence of failure to thrive (FTT) in a group of preterm infants with low birth weights and improved the 3-year intelligence, health, growth, and behavior status of the children with FTT. DESIGN: Three-year, prospective, randomized, clinical trial. SETTING: Eight large university hospital sites throughout the United States. SAMPLE: Nine hundred fourteen preterm infants with low birth weights who were born at the sites and met study criteria. INTERVENTION: Home visits weekly during the first year of life and biweekly thereafter until the age of 3 years to provide family support and implement two curricula; and attendance at a child development center from 12 months until 3 years of age, 5 days a week, to deliver an early childhood educational intervention. RESULTS: The incidence of FTT did not differ between the treatment and control groups (20% vs 22%). Overall, children with FTT in the treatment group were not different from children with FTT in the follow-up group on any of the outcome variables. However, after controlling for other factors, treatment group membership significantly contributed to the prediction model of 36-month IQ (P = .005) for the children with FTT. In addition, children with FTT in the intervention group with higher compliance demonstrated higher 3-year IQ and better behavior scores than the children with FTT in the low-compliance group. CONCLUSIONS: The intervention did not change the incidence of FTT or the 3-year outcomes in this low-birth-weight, preterm cohort. After controlling for multiple independent variables, marked effects on 3-year IQ were noted. In addition, these beneficial effects were most pronounced in families that were most complaint with the intervention.

Developmental intervention: a pediatric clinical review.

We have attempted to review developmental intervention for pediatricians in a way that is of clinical relevance to primary care pediatricians. In so doing, we chose not to evaluate certain topics such as therapeutic intervention for handicapped children or center-based educational programs because these have been adequately addressed elsewhere. It is clear that pediatricians have a unique and important role to play in developmental intervention for the following reasons: pediatricians have easy and routinely accepted access to infants and families in the prenatal, perinatal, and preschool periods: pediatricians possess a socially accepted role of authority; and pediatricians can integrate understanding of the child's health and developmental status within the context of the family and social environment to make clinical interpretation regarding the child's developmental status and prognosis. Pediatricians are thus in the best position to convince parents of their impact on their child's development. The following general roles have been identified for pediatricians. First, pediatricians should be aware of the child's biologic status and family environmental situation and the relative degree of risk for developmental problems. This clinical awareness, in combination with the use of appropriate screening instruments of the child's development and family environment, will allow clinical judgment regarding the frequency and type of child health supervision, the need for further diagnostic evaluation, and the need for referral to intervention programs and other resources. Second, the pediatrician should develop an approach for developmental intervention for all children, whatever their degree of biological risk. This review of medical, educational, and psychological literature demonstrate the following recurring important themes as goals for primary intervention: Improve parental understanding of normal child development and developmental expectations. Assist parent's understanding of the individual developmental characteristics and temperamental style of their child. Promote parental sensitivity to the social nature of infant behaviors. Encourage parent responsiveness to the social behaviors. Improve parental feelings of confidence and competence to affect their child's development. Pediatricians can be influential in supporting structural changes that can have beneficial effects on children's development. Support of humanization of obstetric and nursery practices, and the increased use of child health supervision to parents in groups are examples of such efforts.(ABSTRACT TRUNCATED AT 400 WORDS)

A comprehensive substance abuse treatment program for women and their children: an initial evaluation.

This article examines a comprehensive, residential substance abuse treatment program for women and their children. A majority of the 72 participants studied were African American single mothers, for whom crack/cocaine was the drug of choice. The women and their children were assessed repeatedly during treatment, and at 3, 6, and 12 months postdischarge. Program impact was estimated by comparing the outcomes of three groups that differed in the amount of treatment they received: early dropouts, late dropouts, and treatment graduates. Program graduates showed more positive outcomes than the nongraduate comparison groups in the areas of drug use and negative consequences of use, employment and self-sufficiency, and family interaction skills. Young children enrolled in treatment with their mothers were assessed using a developmental screening test, and older children with a measure of drug refusal skills. Results from both child measures suggest substantial improvement.

UV-ozone modification of plasma-polymerised acetonitrile films for enhanced cell attachment.

Plasma polymerisation is of great interest for modifying the surface properties of biomedical devices in order to control, for example, protein adsorption and cell attachment. In this paper we present results for plasma-polymerised acetonitrile deposited onto silicon or polystyrene substrates. The chemistry of films deposited under a range of experimental conditions was studied by X-ray photoelectron spectroscopy (XPS) and Fourier transform infrared spectroscopy (FTIR). XPS provided evidence that the elemental composition of the films varied with rf power to flow rate parameter (W/F) with films produced at higher W/F being deficient in nitrogen. FTIR revealed that the plasma deposited film contained a wide range of nitrogen functional groups including amine, imine and nitrile. Oxidation of the films by exposure to radiation from a low pressure mercury vapour lamp in an air ambient increased the surface oxygen levels from 3 to 17at.% after 300 s exposure. XPS also revealed that the oxidation process proceeded via the formation of carbonyl groups at short exposure times (<60s) while longer treatment times (>60s) resulted in an increase in the concentration of carboxyl groups. To assess their potential to support cell growth, polystyrene culture dishes coated with plasma deposited films and UV-ozone oxidised films were seeded with 1BR.3.N human fibroblast cells and incubated for up to 72 h. Un-oxidised plasma-polymerised acetonitrile films were found to give comparable cell attachment densities as tissue culture polystyrene. The greatest cell attachment density was found with plasma polymer films which had been UV-ozone treated for the longest time (300 s). Enhanced attachment to this surface was attributed to the high level of carboxylic groups found on this substrate.

The impact of the home environment on children's development: clinical relevance for the pediatrician.

Pediatricians utilize standardized screening techniques to monitor children's development. Typically, however, pediatricians fail to assess the quality of the child's home environment. This paper selectively reviews the literature which demonstrates the major impact of the environment on children's development in the three developmental high-risk categories. Specific aspects of the home environment which optimize or impede developmental progression are discussed. Finally, the various instruments which are available to screen the home environment are presented. Information regarding the environment increases accuracy of developmental predictions, facilitates more appropriate treatment plans, and serves as a basis for specific counseling. The optimal clinical instrument for screening the child's social and inanimate environment has not yet been developed.

Pediatric clinical assessment of mother-child interaction: concurrent and predictive validity.

This study examines whether clinical assessments of mother-infant interactions collected at 8-month health supervision visits are associated with standardized measures of the home environment and mother-child interaction collected at later dates in other settings, and whether these clinical assessments are associated with the child's future developmental and behavioral status. The observation component of the Pediatric Review of Children's Environmental Support and Stimulation (PROCESS) was collected on 46 consecutive mother-infant pairs during an 8-month health supervision visit. The Home Observation Measurement of Environment (HOME) Inventory was collected on these infants' families at 12 and 36 months of age, and mother-child interaction was assessed in a laboratory setting at 30 months. The Bayley Scales of Infant Development were collected at 12 and 24 months, and the Stanford Binet Intelligence Test and the Achenbach Child Behavior Checklist were collected at 36 months of age. The 8-month clinical ratings were strongly associated with the measures of the home environment and mother-child interaction and with child developmental and behavioral problem status at 36 months. These findings attest to the power and usefulness of systematic observations of maternal behavior by the clinician during health supervision visits.

The clinical assessment of a child's social and physical environment during health visits.

The quality of a child's home environment plays a critical role in long-term developmental status. The Pediatric Review and Observation of Children's Environmental Support and Stimulation (PROCESS) Inventory was developed to clinically assess aspects of the child's physical environment and the parent-child interaction during a health supervision visit. The final version was used with 76 mother-child pairs by two pediatricians. The Home Observation for Measurement of the Environment (HOME) Inventory was performed within 3 weeks on all pairs, and a laboratory observation of parent-child interaction was completed with 30 of the pairs. Correlations of the PROCESS with the HOME Inventory and parent-child interaction were 0.84 and 0.86 (less than 0.001), respectively. These significant correlations persisted while controlling for family income and education. When high and low scores of the HOME Inventory known to correlate with positive and negative developmental outcomes were cross-tabulated with PROCESS scores, low scores on the PROCESS identified 77% of low HOME Inventory scores and high scores on the PROCESS identified 95% of the high HOME Inventory scores. The PROCESS provides pediatricians a brief, easy-to-score, clinically useful, reliable, and valid method to measure children's home environments.

Uses of the HOME inventory for families with handicapped children.

The use of the HOME Inventory with families of children with handicaps was described. Normative and psychometric information for the Infant-Toddler, Early Childhood, and Middle Childhood versions of the Inventory was provided for groups of children with diverse handicaps and groups of children with mental retardation. Moderate correlations were observed between HOME and family social status measures, minimal between HOME and life stress measures, and low to moderate between HOME and social support measures. Low to moderate correlations were observed between HOME and child competence measures.

Moderating effect of perceived amount of family conflict on the relation between home environmental processes and the well-being of adolescents.

This study examined the extent that perceived amount of conflict in the family moderates the relation between proximal aspects of the home environment and adolescent well-being. Regression models consisting of Home Observation for Measurement of the Environment (HOME) subscale scores (Responsivity, Learning Materials, Variety of Experiences), family conflict, and the interaction between HOME scores and family conflict were tested for each of 6 dependent measures: academic achievement, task orientation, being considerate, self-efficacy as it pertains to school, self-efficacy as it pertains to family, and school grades. Results indicated moderation in all 3 ethnic groups examined (European Americans, African Americans, and Chinese Americans). For all 3 groups, relations were stronger in families with high conflict, suggesting a heightened sensitivity to social exchanges and events within the family.

Experiences in day care and social competence among maltreated children.

The experience of 39 preschool-age maltreated children from 13 child care facilities was examined to determine the extent to which the children's social development was related to the quality of day-care service. Maltreated children assigned by the Arkansas Department of Social Services to three different types of child care facilities were observed: specialized day-care programs, regular day-care centers and family day homes. The children scored below average in intelligence and were rated by their parents as displaying higher than normal rates of disturbed behavior. While no comparison group of non-maltreated children was included in the study, observations of the maltreated children in the child care setting revealed substantially more positive than negative social behavior. The children were reasonably effective in interacting with adult caregivers in day care. The maltreated children were also productive in most encounters with peers. Ratings of the quality of care received in day care were significantly correlated with the children's social competence in child care. Aspects of social behavior in maltreated children were related to the organization of the program, the physical facilities, traits of the caregiver, and caregiver expectations for the children.

Coaches' goals for young children in a recreational sports program.

Almost all children participate in sports at some time, and programs are being established for even younger children. Adults who coach the children largely determine what the children's sports experience will be. Coaches' perceptions of what is important for the young children they instruct have not yet been carefully investigated. This study was designed, therefore, to determine coaches' goals for young children. Data were gathered by use of an attitude questionnaire administered to 29 coaches of a recreational basketball program of children ranging in age from 6 to 10 years old. Of the 12 goals, feeling part of a team, learning to do my best, and having fun and excitement were most highly rated as extremely important, while becoming popular was lowest rated as not important. Results revealed that coaches in general are able to clearly define their goals and priorities, and these goals seem developmentally appropriate for the children. However, coaches make little differentiation in goals based on age.