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1.
Int J Psychol ; 58(6): 554-562, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37470342

RESUMO

This study examined the mediating role of parental cognitive engagement and parental guidance on the associations between family socioeconomic and home environment resource risk factors and children's literacy and social skills in Guyana. The sample consisted of 1208 families from diverse ethnic and socioeconomic backgrounds drawn from the 2019 to 2020 country-level UNICEF MICS data. Caregivers provided assessments of socioeconomic conditions, educational resources in the home environment, cognitive engagement, parental guidance and children's literacy and social skills. Family socioeconomic risk had an indirect association with social skills through cognitive engagement. Home environment educational resource risk had indirect associations with children's literacy and social skills through parental guidance. Findings are discussed in terms of identifying protective factors within families in low- and middle-income Caribbean countries that can better inform intervention efforts geared at reducing risks to childhood development.


Assuntos
Alfabetização , Habilidades Sociais , Humanos , Criança , Guiana , Pais/psicologia , Fatores de Risco , Cognição
2.
Int J Psychol ; 53(4): 304-312, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27550643

RESUMO

Historical and cultural experiences have shaped the life experiences of cultural communities in Trinidad and Tobago. Using a cultural focus, the goal of this investigation was to examine ethnic variations both in the prevalence of common mental disorder (CMD) symptoms as well as in the associations between sociodemographic, psychosocial, physical health correlates and CMDs among mothers in Trinidad and Tobago. Participants included 1002 mothers (359 African-, 353 Indo- and 290 Mixed-Ethnic Trinidadian). Mean comparisons indicated similarities in the levels of depression, somatisation and anxiety across ethnic groups. The associations between physical ill health, experiences of pain and depression and between physical ill health and somatisation were stronger for Mixed-Ethnic Trinidadian than Indo-Trinidadian mothers. The relationship between early experiences of domestic violence and depression was stronger for Indo-Trinidadian than Mixed-Ethnic Trinidadian mothers. The associations between early experiences of domestic violence and depression and between experiences of pain and somatisation were stronger for African Trinidadian than Mixed-Ethnic Trinidadian mothers. Thus beyond the direct effects, mothers belonging to specific ethnic groups indicated greater or lesser vulnerabilities to CMDs depending on their exposure to specific correlates. Results have applicability for the development of culturally sensitive interventions for mothers experiencing CMDs.


Assuntos
Etnicidade/psicologia , Saúde Mental/etnologia , Adulto , Feminino , Humanos , Masculino , Saúde Mental/tendências , Mães , Prevalência , Trinidad e Tobago
3.
Aggress Behav ; 42(4): 380-93, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-26541646

RESUMO

We examined the role of financial strain, parent-to-parent violence, parent-to-child violence, emotional distress, and alcohol use in intimate partner violence perpetrated by young adult women against men in Ukraine. The moderating role of acceptability of intimate partner violence and violence-related laws and regulations was also examined. Four hundred and six full-time female university students from four universities in Ukraine participated in the study. We found that emotional distress, parent-to-parent, and parent-to-child violence mediated the link between financial strain and intimate partner violence perpetrated by women on men. However, we found limited support for the moderating role of acceptability of intimate partner violence and violence-related laws and regulations in the relationship between individual and familial factors on intimate partner violence. The findings from this investigation suggest that there is a distinct need for supporting families and individuals in dealing with issues of intimate partner violence directed by women against men in Ukraine. Aggr. Behav. 42:380-393, 2016. © 2015 Wiley Periodicals, Inc.


Assuntos
Cultura , Família/psicologia , Violência por Parceiro Íntimo/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Fatores de Risco , Estresse Psicológico/psicologia , Ucrânia , Adulto Jovem
4.
J Adolesc ; 37(6): 915-25, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25025967

RESUMO

This study examined the direct and indirect associations of general and smoking-specific parenting practices with Chinese adolescents' smoking behaviors. Adolescents aged 14-17 years (N = 658) and their parents were recruited from three high schools in mainland China. Adolescents completed an anonymous online survey on their smoking behaviors, perceptions of parenting behaviors, and smoking-related cognitions including attitude, subjective norm, and perceived behavioral control. Parents completed a paper-and-pencil questionnaire on their parenting behaviors. Results indicated that psychological control and frequency of communication about smoking were positively linked to adolescent smoking through the mediation of two smoking-related cognitions-attitude and subjective norm. Parental knowledge of adolescent activities, disapproval of adolescent smoking, and home rules were negatively linked to adolescent smoking through the mediation of attitude and subjective norm. Results suggest that parenting practices and smoking-related cognitions are critical components to be incorporated in prevention and intervention programs for adolescent smoking in China.


Assuntos
Comportamento do Adolescente , Poder Familiar , Prevenção do Hábito de Fumar , Adolescente , Atitude , China/epidemiologia , Comunicação , Feminino , Humanos , Masculino , Relações Pais-Filho , Fumar/epidemiologia
5.
Int J Psychol ; 49(4): 271-9, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24990638

RESUMO

This study assessed the moderating role of Indo-Guyanese mothers' warmth and affection on the associations between harshness and justness of physical punishment and prosocial behaviours and anger in preschoolers. One hundred and thirty-nine rural Indo-Guyanese mothers filled out Rohner's Parental Acceptance-Rejection (PARQ) and Physical Punishment Questionnaires (PPQ). Teachers provided assessments of children's prosocial behaviours and anger in preschool settings. Maternal warmth did not moderate the relationship between harshness of physical punishment and children's prosocial behaviours and anger, but it did moderate the relationship between justness of physical punishment and prosocial behaviours for sons as well as the association between justness of physical punishment and anger for daughters. In Caribbean societies where harsh punishment is normative, maternal warmth may work more effectively with justness, and not with harshness of physical punishment, to lower negative childhood behavioural outcomes.


Assuntos
Ira , Comportamento Infantil , Características Culturais , Comportamento Materno/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Punição/psicologia , Comportamento Social , Comportamento Infantil/etnologia , Comportamento Infantil/fisiologia , Pré-Escolar , Feminino , Guiana , Humanos , Masculino , Comportamento Materno/etnologia , Pais , População Rural , Fatores Sexuais , Inquéritos e Questionários
6.
J Pediatr Psychol ; 38(10): 1144-54, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23942994

RESUMO

OBJECTIVE: The purpose of this study was to examine the associations among community characteristics, family economic adversity, parents' health beliefs, and parents' and children's health using cross-level mediation analyses. METHODS: Survey data were collected from a nationally representative sample of 1,337 families with children between 3 and 6 years nested within 45 Trinidad and Tobago community clusters. RESULTS: At the individual level, parents' health belief of internality was a significant mediator between family economic adversity, adult health, and children's health. In the cross-level mediation analyses, health belief of internality was a significant mediator between community health problems and children's health. There were between-community variations in the relationship between adult health, health belief of powerful others, and children's health. CONCLUSIONS: There is strong evidence of the role of community and family influences on children's health. Findings indicate the need to use a multilevel analytical approach in studies of children's health.


Assuntos
Atitude Frente a Saúde/etnologia , Nível de Saúde , Pais/psicologia , Pobreza/etnologia , Características de Residência , Adulto , Criança , Pré-Escolar , Cultura , Feminino , Humanos , Masculino , Trinidad e Tobago/etnologia
7.
Am J Orthopsychiatry ; 93(3): 236-244, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36931837

RESUMO

Using models of risk and resilience as a guide, this study examined the mediating role of constructive conflict behaviors on the associations between maternal depressive symptoms, intimate partner violence (IPV), and child behavior problems. The nature of the mediation pathways was also examined for two groups of families, one experiencing high and another experiencing low levels of partner social support. Participants included 196 mothers and their preschool-aged children from diverse ethnic and socioeconomic backgrounds in Guyana. Constructive conflict behaviors partially mediated the link between maternal depressive symptoms and children's externalizing behaviors. Maternal depressive symptoms and physical intimate partner violence were directly related to children's internalizing behaviors. Constructive conflict behaviors were not a mediator of the association between risk factors and children's behavioral outcomes for families experiencing high or low levels of partner social support. In the context of families experiencing high partner social support, constructive conflict behaviors appeared to be more effective in reducing children's externalizing problem behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Violência por Parceiro Íntimo , Comportamento Problema , Pré-Escolar , Feminino , Humanos , Criança , Guiana , Depressão , Mães
8.
Matern Child Health J ; 15(8): 1350-5, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21052803

RESUMO

This study examines the predictors of birth outcomes among women of European and African ancestry and considers the birthplace of the babies' fathers (foreign born vs. native born) as a protective factor. This is a secondary data analysis of 146,431 singleton births among women of European and African ancestry, both native-born and foreign-born, in a 21 birth hospital region of Central New York State from 1996 to 2003. Foreign born fathers were found to have 15% fewer low birth weight infants than US-born fathers, after controlling for the race and birthplace of the mother, tobacco use and Medicaid. Although this secondary data analysis does not allow us to determine the social determinants of the better birth outcomes among infants of foreign born fathers, it does demonstrate that fathers matter and that foreign born fathers are associated with reduced low birth weight in their infants.


Assuntos
Negro ou Afro-Americano , Emigrantes e Imigrantes , Pai , Recém-Nascido de Baixo Peso , População Branca , Feminino , Humanos , Recém-Nascido , Masculino , Medicaid , New York , Sistema de Registros , Estados Unidos
9.
Matern Child Health J ; 14(4): 535-47, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19655237

RESUMO

The purpose was to develop, implement and evaluate a peer-led nutrition curriculum Healthy Eating and Harambee that addresses established objectives of maternal and infant health and to shift the stage for African American women of childbearing age in Genesee County toward healthier dietary patterns using a socio-cultural and biomedical orientation. The PEN-3 model, which frames culture in the context of health promotion interventions, was integrated with the Transtheoretical Model to guide this 13-week pre-test/post-test curriculum. Materials developed included soul food plate visuals, a micronutrient availability worksheet, a fruit stand, and gardening kits. Learning activities included affirmations, stories, case-scenarios, point-of-purchase product recognition, church health teams, and community health fairs. We investigated health-promoting dietary behaviors (consumption of more fruits and vegetables (F&V), serving more F&V to their families, and moderating dietary sodium and fat intakes), and biomedical behaviors (self-monitoring blood pressure and exercising) across five stages of change. Session attendance and program satisfaction were assessed. N = 102 women participated (mean age = 27.5 years). A majority (77%) reported adopting at least one healthy eating behavior (moderating sodium, serving more F&V to their families), 23% adopted at least two such behaviors (reading food labels for sodium; using culinary herbs/spices; serving more F&V to their families), and 45% adopted both dietary (moderating sodium; eating more fruits) and biomedical behaviors. Participants and facilitators favorably evaluated the curriculum and suggested improvements. A multi-conceptual approach coupled with cultural and biomedical tailoring has potential to promote young African American women's movement to more advanced stages of change and improve self-efficacy for fruit and vegetable intake, dietary sodium moderation, and self-monitoring blood pressure and physical activity.


Assuntos
Negro ou Afro-Americano/educação , Currículo , Comportamentos Relacionados com a Saúde/etnologia , Educação em Saúde/métodos , Bem-Estar Materno/etnologia , Ciências da Nutrição/educação , Competência Cultural , Feminino , Frutas , Humanos , Bem-Estar Materno/economia , Michigan , Grupo Associado , Cuidado Pré-Concepcional/métodos , Avaliação de Programas e Projetos de Saúde , Verduras
10.
J Fam Psychol ; 34(8): 960-968, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32406732

RESUMO

Using data from the 2014 wave of the China Family Panel Studies (CFPS), a nationally representative survey, we examined the direct and indirect effects of family economic hardship on children's outcomes using the family stress model (FSM). Multitrait-multimethod data were from a sample of 777 two-parent families. Data from both parents and one of their school-age children (M = 11.36) were used to test the proposed conceptual model using structural equation modeling conducted in Mplus 8. The results indicate partial support for the FSM in the Chinese context and show variations in the pathways for rural and urban families. The mediating role of economic pressure and parental distress in the association between family economic hardship and child emotional distress was supported. The findings have implications for the development of intervention programs and for future studies on the association between family economic hardship and child emotional distress and child self-concept in the Chinese context. The study findings suggest that clinical and policy endeavors should be directed at alleviating the effects of economic pressure and targeting efforts toward reducing parental emotional distress. These attempts could be valuable in advancing child outcomes in the face of family economic hardship. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Desenvolvimento Infantil , Família , Pobreza/estatística & dados numéricos , Autoimagem , Estresse Psicológico/epidemiologia , Criança , China/epidemiologia , Feminino , Humanos , Masculino
11.
Cultur Divers Ethnic Minor Psychol ; 15(2): 173-82, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19364204

RESUMO

Using a creolization conceptual framework, this study assessed beliefs about paternal and maternal roles, time spent in child care, and household labor among 60 Indo-Caribbean immigrant couples with young children. Analyses revealed belief systems about maternal and paternal roles that fell along traditional lines. Mothers invested significantly more time in major areas of child care and domestic labor than fathers did. Findings are discussed in terms of the lack of movement away from traditional gendered ideologies and the assumption of child care and household labor in Indo-Caribbean families in their new cultural community.


Assuntos
Educação Infantil/etnologia , Emigrantes e Imigrantes/estatística & dados numéricos , Relações Pai-Filho/etnologia , Relações Mãe-Filho/etnologia , Poder Familiar/etnologia , Adulto , Atitude Frente a Saúde , Região do Caribe/etnologia , Criança , Relações Familiares/etnologia , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Pessoa de Meia-Idade , Percepção Social , Fatores Socioeconômicos , Inquéritos e Questionários , Estados Unidos/epidemiologia
12.
World Health Popul ; 17(2): 32-45, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28677524

RESUMO

The purpose of this paper was to develop a valid and reliable measure of financial strain for use with college-attending young adults in Ukraine. The newly developed measure represents an alternative approach to currently used objective measures of poverty and economic hardship. Objective measures are not adequate or applicable for use with Ukrainian young adults who are mainly dependent on their families for economic support. Financial strain was conceptualized as the financial adjustments that young adults have to make to meet their basic housing, food and clothing needs. Items were generated to capture the construct of financial strain, and content validity of the scale was assessed. Exploratory factor analysis strongly supported the unidimensional nature of the scale. In addition, findings from simultaneous multiple-group confirmatory factor analyses indicated configural, metric and factor invariance of the measure across the southern and central regions of Ukraine. The new measure of financial strain was positively correlated with emotional distress and violence against romantic partners, indicating good predictive validity. The scale also showed good internal consistency. We suggest that the new measure is appropriate to use with young adults in other Eastern European countries in transition.


Assuntos
Pobreza/psicologia , Estudantes/psicologia , Inquéritos e Questionários/normas , Adolescente , Consumo de Bebidas Alcoólicas/epidemiologia , Emoções , Análise Fatorial , Feminino , Humanos , Violência por Parceiro Íntimo/estatística & dados numéricos , Masculino , Satisfação Pessoal , Psicometria , Reprodutibilidade dos Testes , Fatores Sexuais , Estresse Psicológico/epidemiologia , Ucrânia , Universidades , Adulto Jovem
13.
Environ Health Perspect ; 114(11): 1636-42, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17107846

RESUMO

OBJECTIVES: The specific objectives are threefold: to describe the biologically plausible mechanistic pathways by which exposure to particulate matter (PM) may lead to the adverse perinatal outcomes of low birth weight (LBW), intrauterine growth retardation (IUGR), and preterm delivery (PTD); review the evidence showing that nutrition affects the biologic pathways; and explain the mechanisms by which nutrition may modify the impact of PM exposure on perinatal outcomes. METHODS: We propose an interdisciplinary conceptual framework that brings together maternal and infant nutrition, air pollution exposure assessment, and cardiopulmonary and perinatal epidemiology. Five possible albeit not exclusive biologic mechanisms have been put forth in the emerging environmental sciences literature and provide corollaries for the proposed framework. CONCLUSIONS: Protecting the environmental health of mothers and infants remains a top global priority. The existing literature indicates that the effects of PM on LBW, PTD, and IUGR may manifest through the cardiovascular mechanisms of oxidative stress, inflammation, coagulation, endothelial function, and hemodynamic responses. PM exposure studies relating mechanistic pathways to perinatal outcomes should consider the likelihood that biologic responses and adverse birth outcomes may be derived from both PM and non-PM sources (e.g., nutrition). In the concluding section, we present strategies for empirically testing the proposed model and developing future research efforts.


Assuntos
Poluentes Atmosféricos/toxicidade , Material Particulado/toxicidade , Resultado da Gravidez , Fenômenos Fisiológicos da Nutrição Pré-Natal , Dieta , Modificador do Efeito Epidemiológico , Exposição Ambiental/efeitos adversos , Feminino , Humanos , Gravidez
14.
J Fam Psychol ; 19(2): 246-51, 2005 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-15982102

RESUMO

This study examined the interrelationships among economic pressure, maternal depression, social support, and marital conflict in a sample of 239 mothers in Romania. Data were collected through a school-based survey. Findings indicated that higher levels of economic pressure were associated with higher levels of marital conflict. Economic pressure was also associated with higher marital conflict indirectly through increased maternal depression and lowered social support. The present results were similar to those obtained in studies conducted among U.S. samples.


Assuntos
Conflito Psicológico , Relações Familiares , Casamento/psicologia , Pobreza/psicologia , Adulto , Distribuição de Qui-Quadrado , Criança , Análise Fatorial , Feminino , Humanos , Pessoa de Meia-Idade , Romênia , Cônjuges/psicologia , Inquéritos e Questionários
15.
J Aging Health ; 27(2): 257-83, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25223559

RESUMO

OBJECTIVES: To examine gender variations in the linkages among family stressors, home demands and responsibilities, coping resources, social connectedness, and older adult health problems. METHODS: Data were collected from 3,800 elderly participants (1,654 men and 2,146 women) residing in Kanchanaburi province, Thailand. RESULTS: Findings indicated gender variations in the levels of these constructs and in the mediational pathways. Thai women indicated greater health problems than men. Emotional empathy was the central variable that linked financial strain, home demands and responsibilities, and older adult health problems through social connectedness. Financial strain (and negative life events for women) was associated with lowered coping self-efficacy and increased health problems. The model indicated greater strength in predicting female health problems. DISCUSSION: Findings support gender variations in the relationships between ecological factors and older adult health problems.


Assuntos
Adaptação Psicológica , Família/psicologia , Disparidades nos Níveis de Saúde , Relações Interpessoais , Estresse Psicológico/psicologia , Idoso , Feminino , Humanos , Acontecimentos que Mudam a Vida , Masculino , Fatores Sexuais , Fatores Socioeconômicos , Tailândia
16.
J Interpers Violence ; 30(11): 1828-46, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25246435

RESUMO

This study problematizes the literature's conceptualization of sexual compliance, predominantly defined as willing participation in, and consent to, unwanted sexual activity in the absence of immediate partner pressure. Using a feminist theoretical framework, we argue that covert forms of social coercion, including normalized expectations for heterosexual women to participate in sexual activity and maintain relationship satisfaction, ultimately pressure women into participating in unwanted sexual activity. In other words, immediate partner pressure is not necessary for a sexually coercive experience to occur. Results of the current study indicate that relationship control and media influence significantly predict sexual acquiescence, and women acquiesce to unwanted sexual activity in an effort to maintain relationships and partner satisfaction as well as to avoid negative outcomes. Women cite various forms of social coercion, such as fulfilling sexual scripts and relationship obligations, as primary reasons for participating in unwanted sexual activity without resisting their partners.


Assuntos
Coerção , Relações Interpessoais , Delitos Sexuais/psicologia , Comportamento Sexual/psicologia , Adolescente , Adulto , Feminino , Humanos , Adulto Jovem
17.
J Fam Psychol ; 17(4): 488-98, 2003 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-14640799

RESUMO

This investigation used a family systems perspective to examine how family dynamics within 3-generation households were associated with mothers' satisfaction with father involvement. The participants were low-income African American adolescent mothers (n=148) and grandmothers recruited at delivery and followed over 6 months. The overall model explained 68% of the variance in satisfaction with father involvement. Fathers who were involved with caregiving activities had positive relationships with adolescent mothers and grandmothers. Grandmothers served as gatekeepers; when grandmothers reported positive relationships with the 2 young parents, adolescent mothers reported positive relationships with their male partners. Mothers who reported positive partner relationships also reported high parenting efficacy and satisfaction with father involvement. Efforts to increase paternal involvement should focus on role clarification for grandmothers and fathers and on parenting activities for mothers and fathers, regardless of their romantic relationship.


Assuntos
População Negra/psicologia , Pai/psicologia , Relação entre Gerações , Casamento/psicologia , Mães/psicologia , Satisfação Pessoal , Gravidez na Adolescência/psicologia , Apoio Social , Adolescente , Adulto , Depressão/diagnóstico , Depressão/psicologia , Feminino , Humanos , Individualidade , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Mães/educação , Poder Familiar/psicologia , Gravidez , Assistência Pública , Fatores de Risco , Autoeficácia , Meio Social , Fatores Socioeconômicos , Teoria de Sistemas
18.
J Abnorm Child Psychol ; 42(6): 1057-68, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-24522936

RESUMO

The objective of this investigation was to examine the associations among neighborhood conditions, neighborhood collective efficacy, family economic disadvantage, parental control behaviors, and children's behavioral outcomes using multilevel and cross-level analyses. The proposed conceptual model incorporated propositions advanced by social disorganization theory, the structural-process model, as well as the Family Stress Model. Data were collected from a nationally representative sample of 1,337 families with children between 3 and 6 years (668 boys) drawn from 45 communities in Trinidad and Tobago. Neighborhood level indicators were assessed using census as well as parent reports whereas individual level constructs were assessed using parent reports. Findings indicated support for the Family Stress Model in that harsh punishment and parental monitoring functioned as mediators of the relationship between family economic disadvantage and behavioral difficulties (parental monitoring for prosocial behaviors). Findings from the multilevel analyses indicated that the relationship between neighborhood infrastructure deprivation and children's behavioral difficulties and prosocial behaviors was mediated through neighborhood collective efficacy and parental harsh punishment. Cross-level interactions indicated that neighborhood collective efficacy buffered the relationship between parental discipline, monitoring, harsh discipline and behavioral difficulties. Given the importance of communities and families in influencing children's behavioral outcomes, due consideration must be given to utilizing multilevel and cross-level perspectives both in research as well as in the development of intervention programs. Policies and programs designed to improve neighborhoods conditions, promote neighborhood collective efficacy, and advance the socioeconomic opportunities for families can help enhance the well-being of children.


Assuntos
Transtornos do Comportamento Infantil/psicologia , Família/psicologia , Relações Pais-Filho , Poder Familiar/psicologia , Características de Residência , Pré-Escolar , Feminino , Humanos , Masculino , Fatores Socioeconômicos , Trinidad e Tobago
19.
Cien Saude Colet ; 12(6): 1591-602, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-18813495

RESUMO

This article has three objectives: to describe the biologically plausible mechanistic pathways by which exposure to particulate matter (PM) may lead to adverse perinatal outcomes of low birth weight (LBW), intrauterine growth retardation (IUGR), and preterm delivery (PTD); review evidence showing that nutrition affects biologic pathways; and explain mechanisms by which nutrition may modify the impact of PM exposure on perinatal outcomes. We propose an interdisciplinary framework that brings together maternal and infant nutrition, air pollution exposure assessment, and cardiopulmonary and perinatal epidemiology. Five possible biologic mechanisms have been put forth in the emerging environmental sciences literature and provide corollaries for the proposed framework. The literature indicates that the effects of PM on LBW, PTD, and IUGR may manifest through the cardiovascular mechanisms of oxidative stress, inflammation, coagulation, endothelial function, and hemodynamic responses. PM exposure studies relating mechanistic pathways to perinatal outcomes should consider the likelihood that biologic responses and adverse birth outcomes may be derived from both PM and non-PM sources. We present strategies for empirically testing the proposed model and developing future research efforts.

20.
Pediatrics ; 120(1): 59-69, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17606562

RESUMO

OBJECTIVES: We sought to examine the impact of a randomized, controlled trial of home visiting among infants with failure to thrive on growth, academic/cognitive performance, and home/classroom behavior at age 8. METHODS: Infants with failure to thrive (N = 130) or adequate growth (N = 119) were recruited from pediatric primary care clinics serving low-income, urban communities. Eligibility criteria included age <25 months, gestational age >36 weeks, birth weight >2500 g, and no significant medical conditions. Evaluation included anthropometries, Bayley scales, maternal anthropometries, demographics, negative affect, IQ, and the Home Observation for Measurement of the Environment scale. Infants with failure to thrive were treated in an interdisciplinary growth and nutrition clinic and randomized into clinical-intervention-plus-home-intervention or clinical-care-only groups. The home-visiting curriculum promoted maternal sensitivity, parent-infant relationships, and child development. Follow-up visits were conducted by evaluators who were unaware of the children's growth or intervention history. At age 8, the evaluation included anthropometries, the Wechsler Intelligence Scale for Children III, and the Wide Range Achievement Test, Revised. Mothers completed the Child Behavior Checklist and teachers completed the Teacher Report Form. ANALYSIS: Multivariate analyses of variance were used to examine differences in growth, cognitive/academic performance, and home/school behavior, adjusted by maternal education, public assistance, and, when appropriate, infant Bayley score, maternal BMI, height, negative affect, IQ, and Home Observation for Measurement of the Environment scores. RESULTS: Retention was 74% to 78%. Children in the adequate-growth group were significantly taller, heavier, and had better arithmetic scores than the clinical-intervention-only group, with the clinical-intervention-plus-home-intervention group intermediate. There were no group differences in IQ, reading, or mother-reported behavior problems. Children in the clinical-intervention-plus-home-intervention group had fewer teacher-reported internalizing problems and better work habits than the clinical-intervention-only group. CONCLUSIONS: Early failure to thrive increased children's vulnerability to short stature, poor arithmetic performance, and poor work habits. Home visiting attenuated some of the negative effects of early failure to thrive, possibly by promoting maternal sensitivity and helping children build strong work habits that enabled them to benefit from school. Findings provide evidence for early intervention programs for vulnerable infants.


Assuntos
Intervenção Educacional Precoce , Insuficiência de Crescimento/terapia , Serviços de Assistência Domiciliar , Criança , Comportamento Infantil , Desenvolvimento Infantil , Cognição , Escolaridade , Feminino , Seguimentos , Crescimento , Humanos , Lactente , Inteligência , Masculino , Relações Mãe-Filho , Pobreza , Assistência Pública , Fatores Socioeconômicos
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