Unpacking the behavioural components and delivery features of early childhood obesity prevention interventions in the TOPCHILD Collaboration: a systematic review and intervention coding protocol.

INTRODUCTION: Little is known about how early (eg, commencing antenatally or in the first 12 months after birth) obesity prevention interventions seek to change behaviour and which components are or are not effective. This study aims to (1) characterise early obesity prevention interventions in terms of target behaviours, delivery features and behaviour change techniques (BCTs), (2) explore similarities and differences in BCTs used to target behaviours and (3) explore effectiveness of intervention components in preventing childhood obesity. METHODS AND ANALYSIS: Annual comprehensive systematic searches will be performed in Epub Ahead of Print/MEDLINE, Embase, Cochrane (CENTRAL), CINAHL, PsycINFO, as well as clinical trial registries. Eligible randomised controlled trials of behavioural interventions to prevent childhood obesity commencing antenatally or in the first year after birth will be invited to join the Transforming Obesity in CHILDren Collaboration. Standard ontologies will be used to code target behaviours, delivery features and BCTs in both published and unpublished intervention materials provided by trialists. Narrative syntheses will be performed to summarise intervention components and compare applied BCTs by types of target behaviours. Exploratory analyses will be undertaken to assess effectiveness of intervention components. ETHICS AND DISSEMINATION: The study has been approved by The University of Sydney Human Research Ethics Committee (project no. 2020/273) and Flinders University Social and Behavioural Research Ethics Committee (project no. HREC CIA2133-1). The study's findings will be disseminated through peer-reviewed publications, conference presentations and targeted communication with key stakeholders. PROSPERO REGISTRATION NUMBER: CRD42020177408.

Degree of Agreement Between Infant Serum and Salivary Concentration of Leptin and Adiponectin and Its Association With Infants' Feeding.

BACKGROUND: Leptin and adiponectin, two adipokines involved in glucose and lipid metabolism, have been linked to regulation of growth in early infancy, energy balance, and metabolic disorders in childhood. The aim of this study was to determine if concentrations of leptin and adiponectin could be measured reliably in infants' saliva, to evaluate the degree of agreement with infant serum levels, and to explore their association with infant feeding status. METHODS: A total of 34 infants were recruited after birth and followed for 20 weeks. After log-transformation of the values, a Bland-Altman graphical approach was used to summarize the direction of the difference between the serum and saliva values. Repeated measures mixed modeling was used to evaluate differences over time in these outcomes by feeding status. RESULTS: Mean concentration of salivary leptin and adiponectin in infants was 3.7 (SD = .8) ng/mL and 2.9 (SD = 0.7) ng/mL, respectively. The degree of agreement between serum and saliva for log-transformed leptin and adiponectin values were relatively robust, albeit with a non-zero bias between the two methods, given that serum values were greater than corresponding saliva values for both adipokines in all infants. Each of the four repeated measures mixed models (one for each adipokine measure) had a significant main effect; however, the interaction between time and feeding status was not significant in any of the models. CONCLUSION: This study demonstrated that leptin and adiponectin can be measured in infant saliva, but in some cases leptin concentrations may be more difficult to detect.

Modeling the Influence of Early Skin-to-Skin Contact on Exclusive Breastfeeding in a Sample of Hispanic Immigrant Women.

Using data from a longitudinal study of breastfeeding in Hispanics, this study evaluated the influence of early skin-to-skin contact (SSC) on initiation and sustained exclusive breastfeeding (EBF) at 1 month postpartum. Two-thirds of the women in the sample participated in early SSC. At discharge, over half of the women were EBF; this proportion decreased to one-third at 1 month postpartum. Controlling for demographic and clinical variables in the model, participation in early SSC was associated with a greater than sevenfold increase in the odds of EBF at discharge (p = .005) but was not predictive of EBF at 1 month post-discharge (p = .7). Younger maternal age and increased prenatal infant feeding intention were associated with an increased likelihood of EBF across both timepoints. Promoting early SSC may help with initiation of EBF, while further breastfeeding support may be needed to maintain EBF following discharge for this vulnerable population.

A Pilot Test of the Everyday Stressors Index-Spanish Version in a Sample of Hispanic Women Attending Prenatal Care.

BACKGROUND AND PURPOSE: Prenatal and postpartum psychosocial stress are associated with adverse pregnancy outcomes. Hispanic women experience higher levels of stress during pregnancy. This pilot study assessed the psychometric characteristics of the Everyday Stressors Index-Spanish (ESI-S) version. METHODS: Secondary analysis in a convenience sample, n = 51 women. RESULTS: The ESI-S showed adequate internal consistency (Cronbach's alpha = .86). Two factors accounted for 40% of the item variance. The greatest sources of stress were "having too many responsibilities" and "not enough money for basics". Higher levels of stressors were associated with older age, living without a partner, and working part or full time. The ESI-S was positively correlated with measures of perinatal depression. CONCLUSIONS: Findings support the reliability and validity of the newly translated ESI-S.

Intention to Breastfeed as a Predictor of Initiation of Exclusive Breastfeeding in Hispanic Women.

Exclusive breastfeeding (EBF) is the most efficacious form of infant feeding and nutrition. Hispanic mothers in the US are more likely than mothers of other racial/ethnic groups to supplement with formula in the first 2 days of life. The purpose of this study was to explore infant feeding intentions during the prenatal period as a predictor of EBF at postpartum discharge in a sample of Hispanic women (n = 99). At discharge, 51 % of the women were EBF, 44 % were breastfeeding and supplementing with formula, and 5 % were feeding only formula. Intention to breastfeed was found to be a strong and potentially modifiable predictor of breastfeeding behavior, showing a significant association with EBF upon discharge from the hospital after birth when linked with acceptance of pregnancy and method of delivery. Prenatal care offers a unique opportunity to enhance intentions to breastfeed that may lead to improved EBF in this health vulnerable population.

Características psicométricas del cuestionario de abuso en contra de la mujer, versión en español: su uso en investigación y práctica clínica / Psycometric characteristic of the women abuse screen, spanish versión: it uses in research and practice

Este artículo describe el proceso de traducción y adaptación del inglés-español del instrumento "Woman Abuse Screen" para uso en investigación. El cuestionario original fue traducido al español por dos traductores e intérpretes bilingües, y posteriormente se condujo una revisión de contenido por expertos asegurándose que incluía elementos relevantes del concepto "violencia". El instrumento traducido "Cuestionario de Abuso en contra de la Mujer" (CACM) fue puesto a prueba con 217 mujeres que iniciaron su control prenatal en clínicas en Monterrey, México. El análisis factorial exploratorio con rotación Varimax agrupó nueve reactivos en tres factores (violencia sexual, física y psicológica) con varianza explicada de 79.8 por ciento. El coeficiente de confiabilidad obtenido fue 0.86 (Alfa de Cronbach). Se concluye que CACM es un instrumento fácil de contestar y que entrega información sobre el tipo de violencia que está siendo víctima la mujer en el presente o el pasado. CACM puede ser utilizado en investigación y/o práctica clínica.

This paper describes the process of English-Spanish translation and adaptation of the "Woman Abuse Screen" for use in research. The original screen was initially translated into Spanish by two bilingual translators-interpreters, followed by a content review conducted by experts to ensure that the screen included relevant aspects of the conceptualization of violence. The Spanish translation "Cuestionario de Abuso en contra de la Mujer" (CACM) was tested with 217 pregnant women initiating prenatal care in outpatient clinics in Monterrey, Mexico. Exploratory factor analysis with Varimax rotation grouped the nine items on three factors (sexual, physical and psychological violence) with an explained variance of 79.8 percent. A reliability coefficient of 0.86 was obtained (Cronbach Alpha). It is concluded that CACM is easy to answer and provides information on previous and present violence experienced by the women. CACM may be utilized in practice and research for screening of interpersonal violence.

Influence of DHEA administration on 24-hour cortisol concentrations.

DHEA is marketed and readily available as a daily nutritional supplement to counteract the effects of aging. The effect of DHEA administration on 24-hour plasma cortisol profiles has not been investigated. In this single-blind placebo-controlled crossover study, the effect of DHEA administration on cortisol concentrations was evaluated in healthy older women and men. Once each morning, subjects took either placebo (Days 1 to 7, and 23 to 29) or oral DHEA 200 mg (Days 8 to 22: doses 1 to 15). Twenty-four hour DHEA and cortisol concentrations were measured on Day 1 (placebo), Day 8 (DHEA dose 1), Day 15 (DHEA dose 8), Day 22 (DHEA dose 15), and Day 29 (placebo washout dose 7). DHEA administration resulted in a decrease in plasma cortisol concentrations (mean, peak, and/or AUC) in healthy older women and men. The cortisol-lowering effect of DHEA was more pronounced in women than in men in our study; pairwise differences in concentrations between days showed that relative to Day 1, cortisol was lower on Days 15, 22, and 29 in women (p = 0.0001) and on Day 15 in men (p = 0.002). The mechanism by which DHEA lowers plasma cortisol concentrations merits further investigation.

Ethical principles of biomedical research on human subjects: their application and limitations in Latin America and the Caribbean

Biomedical research on human subjects involves certain ethical principles, several of which are described in this article. It is also true, however, that application of these principles in real life poses problems, especially in the case of international research conducted under culturally diverse conditions. This presentation examines certain cultural and institutional circumstances prevailing in much of Latin America and the Caribbean that shows a predilection to pose problems of this kind. This is not done to encourage research without ethical principles, but rather to familiarize investigators with cultural differences, so that these differences can be considered when studies on human subjects are being conducted, thereby improving the prospects for beneficial research that respects ethical principles within different cultural contexts. (AU)