The impact of enhanced Milieu teaching with phonological emphasis (EMT + PE) on the speech and language outcomes for toddlers with cleft palate in Brazil and the United States of America.

PURPOSE: The purpose of this study was to compare the speech and language outcomes of children with cleft palate with or without cleft lip (CP+/-L) in the USA to children with CP+/-L in Brazil who underwent intervention with enhanced Milieu teaching with phonological emphasis (EMT + PE), as there are few cross-country intervention comparisons for children with CP+/-L. METHOD: This is a retrospective analysis of 29 participants from the USA and 24 participants from Brazil who were matched on age. The US participants were between the ages of 13-35 months (M = 23.76), spoke Standard American English in the home, and were recruited from East Tennessee State University and Vanderbilt University. The Brazilian participants were between the ages of 20-34 months (M = 25.04), spoke Brazilian Portuguese in the home, and were recruited from the Hospital de Reabilitação de Anomalias Craniofaciais-Universidade de São Paulo. All treatment participants received EMT + PE from trained speech-language pathologists in hospital-university clinics. RESULT: The treatment groups demonstrated greater gains than comparison groups in percent consonants correct, number of different words, and expressive/receptive vocabulary. There was no main effect nor interaction by country. CONCLUSION: The application of EMT + PE in a second culture and language is a viable early intervention option for participants with CP+/-L.

Cusp Catastrophe Regression and Its Application in Public Health and Behavioral Research.

The cusp catastrophe model is an innovative approach for investigating a phenomenon that consists of both continuous and discrete changes in one modeling framework. However, its application to empirical health and behavior data has been hindered by the complexity in data-model fit. In this study, we reported our work in the development of a new modeling method-cusp catastrophe regression (RegCusp in short) by casting the cusp catastrophe into a statistical regression. With the RegCusp approach, unbiased model parameters can be estimated with the maximum likelihood estimation method. To validate the RegCusp method, a series of simulations were conducted to demonstrate the unbiasedness of parameter estimation. Since the estimated residual variance with the Fisher information matrix method was over-dispersed, a bootstrap re-sampling procedure was developed and used as a remedy. We also demonstrate the practical applicability of the RegCusp with empirical data from an NIH-funded project to evaluate an HIV prevention intervention program to educate adolescents in the Bahamas for condom use. Study findings indicated that the model parameters estimated with RegCusp were practically more meaningful than those estimated with comparable methods, especially the estimated cusp point.

Disordered eating behaviors in young adult Mexican American women: prevalence and associations with health risks.

Recent research has shown that disordered eating behaviors are as prevalent in heterogenous samples of Latinas living in the U.S. as in non-Hispanic white women, yet less is known about the prevalence in women of Mexican origin. The primary purpose of this study is to report the prevalence and associations among DE behaviors and health risk of alcohol, tobacco use and obesity in a sample of N = 472 young adult college enrolled Mexican American (MA) women living in the United States. This report focuses on baseline data from a 12-month repeated measures longitudinal study. Ecological momentary assessment (EMA) was used to capture the prevalence of disordered eating and health risk behaviors in the context of everyday activities. Disordered eating behaviors including purging, binge eating, fasting and exercise were reported by approximately 15% of the sample. Food/calorie restricting, was the most prevalent behavior reported by 48% of the sample and along with binge eating was a positive predictor of BMI. Fasting was the only disordered eating behavior associated with tobacco use. These findings suggest that subclinical levels of DE behaviors are prevalent in a community sample of women of Mexican origin and are associated with health risks of tobacco use and higher BMI. Early identification of DE behaviors and community-based interventions targeting MA women may help reduce disparities associated with overweight and obesity in this population.