Caregiver Experiences With Oral Bilingualism in Children Who Are Deaf and Hard of Hearing in the United States: Impact on Child Language Proficiency.

PURPOSE: Best practices recommend promoting the use of the home language and allowing caregivers to choose the language(s) that they want to use with their child who is deaf or hard of hearing (DHH). We examined whether Spanish-speaking caregivers of children who are DHH receive professional recommendations on oral bilingualism that follow best practices. We also assessed whether professional recommendations, caregiver beliefs, and language practices had an impact on child language(s) proficiency. METHOD: Sixty caregivers completed a questionnaire on demographic questions, language(s) use and recommendations, beliefs on bilingualism, and child language proficiency measures in English, Spanish, and American Sign Language (ASL). Professional recommendations on oral bilingualism were reported descriptively, and linear regression was used to identify the predictors of child language(s) proficiency. RESULTS: We found that only 23.3% of the caregivers were actively encouraged to raise their child orally bilingual. Language practices predicted child proficiency in each language (English, Spanish, and ASL), but professional recommendations and caregiver beliefs did not. CONCLUSIONS: Our results revealed that most caregivers received recommendations that do not follow current best practices. Professional training is still needed to promote bilingualism and increase cultural competence when providing services to caregivers who speak languages different from English. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21644846.

Association between diet quality in adolescence and adulthood and knee symptoms in adulthood: a 25-year cohort study.

We aimed to describe associations between diet quality in adolescence and adulthood and knee symptoms in adulthood. Two hundred seventy-five participants had adolescent diet measurements, 399 had adult diet measurements and 240 had diet measurements in both time points. Diet quality was assessed by Dietary Guidelines Index (DGI), reflecting adherence to Australian Dietary Guidelines. Knee symptoms were collected using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Data were analysed using zero-inflated negative binomial regressions. The overall adolescent DGI was not associated with adult knee symptoms, although lower intake of discretionary foods (e.g. cream, alcohol, bacon and cake) in adolescence was associated with lower pain (mean ratio (MR) 0·96) and dysfunction (MR 0·94). The overall adult DGI was not associated with knee symptoms; however, limiting saturated fat was associated with lower WOMAC (Pain: MR 0·93; stiffness: MR 0·93; dysfunction: MR 0·91), drinking water was associated with lower stiffness (MR 0·90) and fruit intake was associated with lower dysfunction (MR 0·90). Higher DGI for dairy products in adulthood was associated with higher WOMAC (Pain: MR 1·07; stiffness: MR 1·13; dysfunction: MR 1·11). Additionally, the score increases from adolescence to adulthood were not associated with adult knee symptoms, except for associations between score increase in limiting saturated fat and lower stiffness (MR 0·89) and between score increase in fruit intake and lower dysfunction (MR 0·92). In conclusion, the overall diet quality in adolescence and adulthood was not associated with knee symptoms in adulthood. However, some diet components may affect later knee symptoms.

Associations between childhood to adulthood socio-economic mobility and adult diet quality.

The impact of change in socio-economic status (SES) from childhood to adulthood (SES mobility) on adult diet is not well understood. This study examined associations between three SES mobility variables (area disadvantage, education, occupation) and adult diet quality. 1482 Australian participants reported childhood area-level SES in 1985 (aged 10-15 years) and retrospectively reported highest parental education and main occupation (until participant age 12) and own area-level SES, education, occupation and dietary intake in 2004-2006 (aged 26-36 years). A Dietary Guidelines Index (DGI) was calculated from food frequency and habit questionnaires. A higher score (range 0-100) indicated better diet quality. Sex-stratified linear regression models adjusted for confounders. Area-level SES mobility was not associated with diet quality. Compared with stable high (university) education, stable low (school only) was associated with lower DGI scores (males: ß = -5·5, 95 % CI: -8·9, -2·1; females: ß = -6·3, 95 % CI: -9·3, -3·4), as was downward educational mobility (participant's education lower than their parents) (males: ß = -5·3, 95 % CI: -8·5, -2·0; females: ß = -4·5, 95 % CI: -7·2, -1·7) and stable intermediate (vocational) education among males (ß = -3·9, 95 % CI: -7·0, -0·7). Compared with stable high (professional/managerial) occupation, stable low (manual/out of workforce) males (ß = -4·9, 95 % CI: -7·6, -2·2), and participants with downward occupation mobility (males: ß = -3·2, 95 % CI: -5·3, -1·1; females: ß = -2·8, 95 % CI: -4·8, -0·8) had lower DGI scores. In this cohort, intergenerational low education and occupation, and downward educational and occupational mobility, were associated with poor adult diet quality.

Associations between diet quality and DSM-IV mood disorders during young- to mid-adulthood among an Australian cohort.

PURPOSE: Many studies have reported associations between diet and depression, but few have used formal diagnoses of mood disorder as the outcome measure. We examined if overall diet quality was associated cross-sectionally or longitudinally with DSM-IV mood disorders among an adult cohort. METHODS: Participants from the Australian Childhood Determinants of Adult Health study were followed up during 2004-06 (n = 1974, age 26-36 years), 2009-11 (n = 1480, 31-41 years), and 2014-19 (n = 1191, 36-49 years). Dietary Guidelines Index (DGI) scores were calculated from food frequency questionnaires at each time-point (higher DGI reflects better diet quality). DSM-IV mood disorders (dysthymia or depression) during the periods between, and 12 months prior to each follow-up were determined using the Composite International Diagnostic Interview. Sex-stratified risk and prevalence ratios (PR) and 95% confidence intervals (CI) were estimated using log-binomial regression. Covariates included age, self-perceived social support index score, marital status, parenting status, education, occupation, physical activity, BMI, and usual sleep duration. RESULTS: A 10-point higher DGI was cross-sectionally associated with lower prevalence of mood disorders at the third follow-up only (females PR = 0.73, 95% CI = 0.56, 0.95; males PR = 0.72, 95% CI = 0.53, 0.97), but was attenuated after covariate adjustment (females PR = 0.92, 95% CI = 0.73, 1.16; males PR = 0.92, 95% CI = 0.69, 1.22). Adjustment for social support in the final model had attenuated the association for both sexes from 18% reduced prevalence to 8%. DGI scores were not longitudinally associated with mood disorder risk. CONCLUSIONS: Crude cross-sectional associations between diet quality and mood disorders at ages 36-49 years were explained by sociodemographic and lifestyle factors, particularly social support.

The Role of Music in Everyday Life During the First Wave of the Coronavirus Pandemic: A Mixed-Methods Exploratory Study.

Although music is known to be a part of everyday life and a resource for mood and emotion management, everyday life has changed significantly for many due to the global coronavirus pandemic, making the role of music in everyday life less certain. An online survey in which participants responded to Likert scale questions as well as providing free text responses was used to explore how participants were engaging with music during the first wave of the pandemic, whether and how they were using music for mood regulation, and how their engagement with music related to their experiences of worry and anxiety resulting from the pandemic. Results indicated that, for the majority of participants, while many felt their use of music had changed since the beginning of the pandemic, the amount of their music listening behaviors were either unaffected by the pandemic or increased. This was especially true of listening to self-selected music and watching live streamed concerts. Analysis revealed correlations between participants' use of mood for music regulation, their musical engagement, and their levels of anxiety and worry. A small number of participants described having negative emotional responses to music, the majority of whom also reported severe levels of anxiety.

Lymphatic and Mixed Malformations.

Lymphatic and mixed malformations are rare and variable in presentation. They arise due to errors in vascular and lymphatic formation during early embryonic development. This leads to persistent infiltration of lymph fluid into soft tissues and causes a locally invasive mass with pathologic sequelae. Departing from historically descriptive terminology, such as "cystic hygroma," lymphatic malformations are now categorized as macrocystic, microcystic, or mixed lesions, based on size. Advances in imaging modalities, such as ultrasonography and magnetic resonance imaging, have made accurate characterization of these lesions possible and ultimately allow for early diagnosis and implementation of appropriate treatment based on the morphology of the lymphatic malformation. Management of lymphatic malformations can be quite challenging, and a multidisciplinary approach is most effective for optimum aesthetic and functional outcomes. New discoveries in the molecular biology of lymphatic malformations have provided treatment targets and established a role for pharmacotherapy. Sclerotherapy, laser, and radiofrequency ablation have all proven to be effective as minimally invasive treatment options for lymphatic malformations. Surgical intervention has a role in the treatment of focal lesions recalcitrant to these less invasive techniques. Operative planning is dictated by clinical goals, size, anatomic location, characteristics, and extent of infiltration.

An age- and sex-specific dietary guidelines index is a valid measure of diet quality in an Australian cohort during youth and adulthood.

Measuring diet quality over time is important due to health impacts, but to our knowledge, a Dietary Guidelines Index (DGI) with consistent scoring across childhood/adolescence (youth) and adulthood has not been validated. We hypothesized that a DGI that reflected age- and sex-specific guidelines would be a valid measure of diet quality in youth and adulthood. The DGI is based on the 2013 Australian Dietary Guidelines to reflect current understanding of diet quality and comprises 9 indicators, with a maximum score of 100 points. DGI scores were calculated for participants of the Australian Childhood Determinants of Adult Health study, which included a 24-hour food record during youth (1985, n = 5043, age: 10-15 years) and a 127-item food frequency questionnaire during adulthood (2004-2006, n = 2689, age: 26-36 years). We evaluated construct validity (distribution of scores, principal components analysis, correlation with nutrient density of intakes) and criterion validity (linear regression with population characteristics). DGI scores were multidimensional in underlying structure and normally distributed. Among youth, a lower DGI was significantly associated (P < .05) with smoking and with lower academic achievement and socioeconomic status. DGI scores were negatively correlated with energy, sugar, and fat and positively correlated with fiber, protein, and micronutrients. Among adults, a lower DGI was associated with lower education and self-reported health and higher waist circumference, insulin resistance, and total and low-density lipoprotein serum cholesterol. The DGI is an appropriate measure of diet quality in youth and adulthood because higher scores reflect nutrient-dense, rather than energy-dense, intake and discriminate between population characteristics consistent with the literature.