Sample records for development nichd study

  1. What Are Normal Puberty, Precocious Puberty, and Delayed Puberty?

    MedlinePlus

    ... Snapshot of Pregnancy & Infant Development Advances Snapshot of Child Development Advances Snapshot of Adult & Family Health Advances NICHD ... the New NICHD Director Exploring Factors That Influence Child Development Picture This: NICHD Support for Neuroscience Research All ...

  2. 42 CFR 68c.1 - What is the scope and purpose of the National Institute of Child Health and Human Development...

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Institute of Child Health and Human Development (NICHD) Contraception and Infertility Research Loan... purpose of the National Institute of Child Health and Human Development (NICHD) Contraception and... payments under the National Institute of Child Health and Human Development (NICHD) Contraception and...

  3. 42 CFR 68c.1 - What is the scope and purpose of the National Institute of Child Health and Human Development...

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Institute of Child Health and Human Development (NICHD) Contraception and Infertility Research Loan... purpose of the National Institute of Child Health and Human Development (NICHD) Contraception and... payments under the National Institute of Child Health and Human Development (NICHD) Contraception and...

  4. 42 CFR 68c.1 - What is the scope and purpose of the National Institute of Child Health and Human Development...

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Institute of Child Health and Human Development (NICHD) Contraception and Infertility Research Loan... purpose of the National Institute of Child Health and Human Development (NICHD) Contraception and... payments under the National Institute of Child Health and Human Development (NICHD) Contraception and...

  5. 77 FR 10759 - Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); Notice...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-23

    ... National Institute of Child Health and Human Development (NICHD); Notice of Meeting Pursuant to the NIH... National Institute of Child Health and Human Development (NICHD) will host a meeting to enable public... Shriver National Institute of Child Health and Human Development. Dates and Times: March 7, 2012, at 3 p.m...

  6. Discover the NICHD. NIH Publication No. 13-7976

    ERIC Educational Resources Information Center

    National Institute of Child Health and Human Development (NICHD), 2013

    2013-01-01

    This four-page document provides an overview of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), a health research agency within the federal government. NICHD is a part of the National Institutes of Health in the U.S Department of Health and Human Services. This brief report describes the mission of…

  7. NICHD Research Networks Help Piece Together the Puzzle of Polycystic Ovary Syndrome

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  8. Vasectomy

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  9. Necrotizing Enterocolitis (NEC)

    MedlinePlus

    ... Snapshot of Pregnancy & Infant Development Advances Snapshot of Child Development Advances Snapshot of Adult & Family Health Advances NICHD ... decipher how group of proteins regulate immune cell development in mice Getting to Know the New NICHD Director Addressing Infants’ ... Safe to Sleep® National Child & Maternal Health Education Program RELATED WEBSITES NIH.gov ...

  10. What Is Endometriosis?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  11. Biobehavioral Development. From Cells to Selves.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    Key to the mission of the National Institute of Child Health and Human Development (NICHD) is answering fundamental questions about how a single fertilized cell eventually develops into a fully functional adult human being and how a multitude of genetic and environmental factors influence that process. This document details part of NICHD's…

  12. 77 FR 1705 - Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD); Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-11

    ... National Institute of Child Health & Human Development (NICHD); Notice of Meeting Pursuant to section 10(d... meeting of the National Advisory Child Health and Human Development Council. The meeting will be open to... Committee: National Advisory Child Health and Human Development Council. Date: January 26, 2012. Open...

  13. Preterm Labor and Birth

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  14. Sexually Transmitted Diseases (STDs)

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  15. What Is Fertility Preservation?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  16. Surgical Treatments for Fibroids

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  17. Contraception and Birth Control

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  18. Phenylketonuria (PKU)

    MedlinePlus

    ... less common among people of African, Hispanic, or Asian ancestry. 3 NICHD. (2000, updated 2006). Report of the NIH consensus development conference on phenylketonuria (PKU): Screening and management . Retrieved May 15, 2012, from http://www.nichd. ...

  19. How Is a Vasectomy Done?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  20. How Effective Is Male Contraception?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  1. What Are the Risks of Vasectomy?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  2. DASH, the data and specimen hub of the National Institute of Child Health and Human Development

    PubMed Central

    Hazra, Rohan; Tenney, Susan; Shlionskaya, Alexandra; Samavedam, Rajni; Baxter, Kristin; Ilekis, John; Weck, Jennifer; Willinger, Marian; Grave, Gilman; Tsilou, Katerina; Songco, David

    2018-01-01

    The benefits of data sharing are well-established and an increasing number of policies require that data be shared upon publication of the main study findings. As data sharing becomes the new norm, there is a heightened need for additional resources to drive efficient data reuse. This article describes the development and implementation of the Data and Specimen Hub (DASH) by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) to promote data sharing from NICHD-funded studies and enable researchers to comply with NIH data sharing policies. DASH’s flexible architecture is designed to archive diverse data types and formats from NICHD’s broad scientific portfolio in a manner that promotes FAIR data sharing principles. Performance of DASH over two years since launch is promising: the number of available studies and data requests are growing; three manuscripts have been published from data reanalysis, all within two years of access. Critical success factors included NICHD leadership commitment, stakeholder engagement and close coordination between the governance body and technical team. PMID:29557977

  3. What Are the Common Treatments for Necrotizing Enterocolitis?

    MedlinePlus

    ... Snapshot of Pregnancy & Infant Development Advances Snapshot of Child Development Advances Snapshot of Adult & Family Health Advances NICHD ... decipher how group of proteins regulate immune cell development in mice Getting to Know the New NICHD Director Addressing Infants’ ... Safe to Sleep® National Child & Maternal Health Education Program RELATED WEBSITES NIH.gov ...

  4. 78 FR 27408 - Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD); Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-10

    ... National Institute of Child Health & Human Development (NICHD); Notice of Meeting Pursuant to section 10(d... meeting of the National Advisory Child Health and Human Development Council. The meeting will be open to... Committee: National Advisory Child Health and Human Development Council. Date: June 6, 2013. Open: June 6...

  5. How Do Health Care Providers Diagnose Birth Defects?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  6. What Are the Treatments for Primary Ovarian Insufficiency (POI)?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  7. How Do Health Care Providers Diagnose Pregnancy Loss or Miscarriage?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  8. How Do Health Care Providers Diagnose Intellectual & Developmental Disabilities (IDDs)?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  9. How Do Health Care Providers Diagnose Polycystic Ovary Syndrome (PCOS)?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  10. How Can Men Reduce the Risk of Getting a Sexually Transmitted Disease (STD)?

    MedlinePlus

    ... NICHD Contacts for Funding Information Peer Review Small Business Programs About the Programs NICHD Priorities Funding Opportunities ... Opportunities Grants Process, Policies & Strategies Peer Review Small Business Programs Training & Career Development For Applicants Sample Applications ...

  11. 78 FR 50425 - Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD); Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-19

    ..., NICHD, at 301- 496-0536 to make your reservation, additional seating will be available in the meeting.... 93.864, Population Research; 93.865, Research for Mothers and Children; 93.929, Center for Medical...

  12. Other Pelvic Pain FAQs

    MedlinePlus

    ... Research Information Find a Study Resources and Publications Pelvic Floor Disorders Condition Information NICHD Research Information Find a Study Resources and Publications Pelvic Pain About NICHD Research Information Find a Study ...

  13. Vulvodynia

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... or contact with the area, such as having sex, using a tampon, having a gynecological exam, or ...

  14. Pregnancy

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... as developmental delays, vision and hearing problems, and cerebral palsy. 4 Infants born between 34 and 36 weeks ...

  15. How Are Newborn Screening Tests Done?

    MedlinePlus

    ... Health Advances NICHD Nobel Prize Winners Leadership & Other Staff Profiles Leadership Biosketches Get to Know NICHD Budget & ... Listservs About NICHD Organization History Accomplishments Leadership & Other Staff Profiles Budget & Appropriations Advisory Groups Jobs at NICHD ...

  16. Population Research.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    The scope of population research as carried on by the National Institute of Child Health and Human Development (NICHD) is set forth in this booklet. Population problems of the world, United States, and the individual are considered along with international population policies based on voluntary family planning programs. NICHD goals for biological…

  17. 42 CFR 68c.10 - What does an individual have to do in return for loan repayments received under the CIR-LRP?

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... AND HUMAN DEVELOPMENT CONTRACEPTION AND INFERTILITY RESEARCH LOAN REPAYMENT PROGRAM § 68c.10 What does... with respect to contraception and/or infertility at an NICHD intramural laboratory or an eligible NICHD...

  18. 42 CFR 68c.10 - What does an individual have to do in return for loan repayments received under the CIR-LRP?

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... AND HUMAN DEVELOPMENT CONTRACEPTION AND INFERTILITY RESEARCH LOAN REPAYMENT PROGRAM § 68c.10 What does... with respect to contraception and/or infertility at an NICHD intramural laboratory or an eligible NICHD...

  19. Turner Syndrome

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... The 23rd pair of chromosomes are called the sex chromosomes—X and Y—because they determine whether ...

  20. What Are the Parts of the Nervous System?

    MedlinePlus

    ... Research Information Find a Study Resources and Publications Neuroscience Condition Information NICHD Research Information Find a Study ... functions does the nervous system control? Why study neuroscience? What are the areas of neuroscience? NICHD Research ...

  1. Can Vaginitis Be Prevented?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... kill "good" bacteria or cause irritation. Practicing safe sex can help protect against sexually transmitted forms of ...

  2. How Is Pelvic Pain Diagnosed?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... button to look inside the pelvis 4 Pelvic MRI (magnetic resonance imaging) scan, an imaging test that ...

  3. A new customized fetal growth standard for African American women: the PRB/NICHD Detroit Study

    PubMed Central

    Tarca, Adi L.; Romero, Roberto; Gudicha, Dereje W.; Erez, Offer; Hernandez-Andrade, Edgar; Yeo, Lami; Bhatti, Gaurav; Pacora, Percy; Maymon, Eli; Hassan, Sonia S.

    2018-01-01

    Background The assessment of fetal growth disorders requires a standard. Current nomograms for the assessment of fetal growth in African American women have been derived either from neonatal (rather than fetal) biometry data or have not been customized for maternal ethnicity, weight, height, parity, and fetal sex. Objective We sought to 1) develop a new customized fetal growth standard for African American mothers; and 2) compare such a standard to three existing standards for the classification of fetuses as small (SGA) or large (LGA) for gestational age. Study Design A retrospective cohort study included 4,183 women (4,001 African American and 182 Caucasian) from the Detroit metropolitan area who underwent ultrasound examinations between 14 and 40 weeks of gestation (the median number of scans per pregnancy was 5, interquartile range 3-7) and for whom relevant covariate data were available. Longitudinal quantile regression was used to build models defining the “normal” estimated fetal weight (EFW) centiles for gestational age in African American women, adjusted for maternal height, weight, parity, and fetal sex, and excluding pathologic factors with a significant effect on fetal weight. The resulting Perinatology Research Branch/Eunice Kennedy Shriver National Institute of Child Health and Human Development (hereinafter, PRB/NICHD) growth standard was compared to 3 other existing standards—the customized gestation-related optimal weight (GROW) standard; the Eunice Kennedy Shriver National Institute of Child Health and Human Development (hereinafter, NICHD) African American standard; and the multinational World Health Organization (WHO) standard—utilized to screen fetuses for SGA (<10th centile) or LGA (>90th centile) based on the last available ultrasound examination for each pregnancy. Results 1) First, the mean birthweight at 40 weeks was 133g higher for neonates born to Caucasian than to African American mothers and 150g higher for male than female neonates; maternal weight, height, and parity had a positive effect on birthweight.Second, analysis of longitudinal EFW revealed the following features of fetal growth: (1) all weight centiles were about 2% higher for male than for female fetuses; (2) maternal height had a positive effect on EFW, with larger fetuses being affected more (2% increase in the 95th centile of weight for each 10-cm increase in height); and (3) maternal weight and parity had a positive effect on EFW that increased with gestation and varied among the weight centiles. Third, the screen-positive rate for SGA was 7.2% for the NICHD African American standard, 12.3% for the GROW standard, 13% for the WHO standard customized by fetal sex, and 14.4% for the PRB/NICHD customized standard. For all standards, the screen-positive rate for SGA was at least two-fold higher among fetuses delivered preterm than at term.Fourth, the screen-positive rate for LGA was 8.7% for the GROW standard, 9.2% for the PRB/NICHD customized standard, 10.8% for the WHO standard customized by fetal sex, and 12.3% for the NICHD African American standard. Finally, the highest overall agreement among standards was between the GROW and PRB/NICHD customized standards (Cohen’s inter-rater agreement, kappa=0.85). Conclusions We developed a novel customized PRB/NICHD fetal growth standard from fetal data in an African American population without assuming proportionality of the effects of covariates and also without assuming that these effects are equal on all centiles of weight; we also provide an easy-to-use centile calculator. This standard classified more fetuses as being at risk for SGA compared to existing standards, especially among fetuses delivered preterm, but classified about the same number of LGA fetuses. The comparison among the four growth standards also revealed that the most important factor determining agreement among standards is whether they account for the same factors known to affect fetal growth. PMID:29422207

  4. How Are Uterine Fibroids Diagnosed?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... the uterus to help create the ultrasound image Magnetic resonance imaging (MRI), which uses magnets and radio waves to ...

  5. Seeking New Treatments for Endometriosis

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... no known history of endometriosis, who undergo pelvic magnetic resonance imaging to identify whether they have endometriosis or another ...

  6. Vulvodynia

    MedlinePlus

    ... NICHD Research Information Research Goals Activities and Advances Scientific Articles Find a Study More Information Other FAQs Resources ... of life. NICHD Research Goals ​​​Activities and Advances ​Scientific Articles ​​​ More >> Find a Study Find a Study on ...

  7. How Is Vaginitis Treated?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  8. What Causes Prader-Willi Syndrome?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  9. What Happens During Sleep?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  10. Treatments for STDs and STIs

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  11. Medical Treatments for Fibroids

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  12. Autism Spectrum Disorder (ASD)

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  13. What Is Preterm Labor and Birth?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... death. Infants born prematurely are at risk for cerebral palsy (a group of nervous system disorders that affect ...

  14. How Do Health Care Providers Diagnose Pheochromocytoma?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... several imaging methods, including computed tomography (CT) and magnetic resonance imaging (MRI). CT scans use X-rays to produce ...

  15. How Do Health Care Providers Diagnose Spina Bifida?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... an image scan such as an X-ray, MRI, or CT. « What causes it? Is there a ...

  16. How Do Health Care Providers Diagnose Endometriosis?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... uses sound waves to make the picture, and magnetic resonance imaging (MRI) , which uses magnets and radio waves to ...

  17. Study of Early Child Care and Youth Development (SECCYD)

    MedlinePlus

    ... Snapshot of Pregnancy & Infant Development Advances Snapshot of Child Development Advances Snapshot of Adult & Family Health Advances NICHD ... Meetings and Events BACK TO TOP Content Owner Child Development and Behavior Branch Last Reviewed Date 12/30/ ...

  18. What Are the Symptoms of Primary Ovarian Insufficiency (POI)?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... Hot flashes Night sweats Irritability Poor concentration Decreased sex drive Pain during sex Vaginal dryness 2 , 3 ...

  19. Treatments for Diseases That Cause Infertility

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  20. What Are the Symptoms of Uterine Fibroids?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  1. What Are the Symptoms of Bacterial Vaginosis?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  2. What Are the Symptoms of Pelvic Pain?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  3. What Are the Treatments for Autism?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  4. What Are the Symptoms of Vulvodynia?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  5. What Are the Treatments for Rett Syndrome?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002503 United Cerebral Palsy. (2009). Can Rett syndrome be treated? Retrieved June ...

  6. How Do Health Care Providers Diagnose Precocious Puberty and Delayed Puberty?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... organs and blood flow in real time An MRI (magnetic resonance imaging) scan of the brain and ...

  7. How Do Health Care Providers Diagnose Neural Tube Defects?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... and complications. These tests might include X-ray, magnetic resonance imaging, computed tomography scan to look for spinal defects ...

  8. Rett Syndrome: Overview

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  9. What Are Treatments for Intellectual & Developmental Disabilities (IDDs)?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  10. What Treatments Can Reduce the Chances of Preterm Labor and Birth?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... magnesium sulfate may also reduce the risk of cerebral palsy if the child is born early. 2 American ...

  11. What Are Some Ways to Promote Infant Safety in a Car?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... 6, 2012, from http://www.nhtsa.gov/Safety/CPS / American Academy of Pediatrics. (2012). Car seats: Information ...

  12. What Are the Risks of Preeclampsia and Eclampsia to the Fetus?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Cerebral Palsy Condition Information NICHD Research Information Find a Study ... related to being born early, including learning disorders, cerebral palsy, epilepsy, deafness, and blindness. Infants born preterm may ...

  13. Fragile X Syndrome Overview

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  14. Fragile X Syndrome: Other FAQs

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  15. Who Is at Increased Risk of Health Problems during Pregnancy?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities Menstruation and ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find a Study ...

  16. Expanding treatment options for youth with type 2 diabetes: Current problems and proposed solutions: A white paper from the NICHD Diabetes Working Group

    USDA-ARS?s Scientific Manuscript database

    The Best Pharmaceuticals for Children Act of 2002 mandated that the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) carries out critical reviews of the gaps in knowledge and unmet needs regarding safe and effective pharmacologic treatment of infants, children,...

  17. Prader-Willi Syndrome (PWS): Other FAQs

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  18. What Are the Treatments for Osteogenesis Imperfecta?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  19. What Are the Symptoms of Fragile X Syndrome?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  20. What Are the Treatments for Fragile X Syndrome?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  1. How Do Health Care Providers Diagnose Fragile X Syndrome?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  2. How Do Health Care Providers Diagnose Rett Syndrome?

    MedlinePlus

    ... Browse AZTopics Browse A-Z Adrenal Gland Disorders Autism Spectrum Disorder (ASD) Down Syndrome Endometriosis Learning Disabilities ... NICHD Research Information Find a Study More Information Autism Spectrum Disorder (ASD) About NICHD Research Information Find ...

  3. Primary Ovarian Insufficiency (POI)

    MedlinePlus

    ... Research Information Find a Study Resources and Publications Turner Syndrome Condition Information NICHD Research Information Find a Study ... site for more information. Most women who have Turner syndrome develop POI. Turner syndrome is a condition in ...

  4. 77 FR 52338 - Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD); Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-29

    ... 552b(c)(6), Title 5 U.S.C., as amended for the review and discussion of grant applications. Individuals..., NICHD; 2) and annual review of Division of Intramural Research; and other business of the Council... being allowed on campus. Visitors will be asked to show one form of identification (for example, a...

  5. What Are the Types and Phases of Rett Syndrome?

    MedlinePlus

    ... Snapshot of Pregnancy & Infant Development Advances Snapshot of Child Development Advances Snapshot of Adult & Family Health Advances NICHD ... fact, these infants show problems with very early development. In one study, ... . The child loses skills (regresses) quickly. Purposeful hand movements and ...

  6. Agreement of three interpretation systems of intrapartum foetal heart rate monitoring by different levels of physicians.

    PubMed

    Pruksanusak, Ninlapa; Thongphanang, Putthaporn; Chainarong, Natthicha; Suntharasaj, Thitima; Kor-Anantakul, Ounjai; Suwanrath, Chitkasaem; Petpichetchian, Chusana

    2017-11-01

    A prospective study was conducted in centre in Southern Thailand, to evaluate agreement in EFM interpretation among various physicians in order to find out the most practical system for daily use. We found strong agreement of very normal FHR tracings among the FIGO, NICHD 3-tier and 5-tier systems. The NICHD 3-tier was more compatible with the FIGO system than 5-tier system. Overall inter-observer agreement was moderate for the NICHD 3-tier system while inter-observer agreement of 5-tier system was fair also the intra-observer agreement was higher in the NICHD 3-tier system. So the 3-tier systems are more suitable than the 5-tier system in general obstetric practice. Impact statement What is already known on this subject: The 3-tier and 5-tier systems were widely used in general obstetrics practice. What the results of this study add: The inter- and intra-observer agreement of NICHD 3-tier system was higher than the 5-tier system. What the implications are of these findings for clinical practice and/or further research: The 3-tier systems were more suitable than the 5-tier systems in general obstetrics practice.

  7. What Are Common Traumatic Brain Injury (TBI) Symptoms?

    MedlinePlus

    ... NICHD Research Information Find a Study More Information Traumatic Brain Injury (TBI) Condition Information NICHD Research Information Find a ... Care Providers Home Health A to Z List Traumatic Brain Injury (TBI) Condition Information What are common symptoms? Share ...

  8. Pheochromocytoma and Paraganglioma

    MedlinePlus

    ... Get to Know NICHD Podcasts and Audio Social Media Join NICHD Listservs About NICHD Organization Office of the Director Director's Corner Office of Administrative Management (OAM) Office of Communications (OC) Office of Global Health (OGH) Office of ...

  9. Deja Vu All Over Again: A Researcher Explains the NICHD Study. Viewpoint.

    ERIC Educational Resources Information Center

    Caldwell, Bettye M.

    2001-01-01

    Describes methods and findings of the NICHD Study of Early Child Care. Argues that media focused too heavily on one isolated finding relating quantity of day care to child aggression. Describes the conduct of a steering committee to coordinate study design. Advocates improving child care quality and examines ways to prevent aggressive behavior and…

  10. What Treatment Options Are Available for Male Infertility?

    MedlinePlus

    ... Get to Know NICHD Podcasts and Audio Social Media Join NICHD Listservs About NICHD Organization Office of the Director Director's Corner Office of Administrative Management (OAM) Office of Communications (OC) Office of Global Health (OGH) Office of ...

  11. What Are the Symptoms of Vaginitis?

    MedlinePlus

    ... Videos Get to Know NICHD Podcasts and Audio Social Media Join NICHD Listservs About NICHD Organization Office of the Director Director's Corner Office of Administrative Management (OAM) Office of Communications (OC) Office of Global Health (OGH) Office of ...

  12. Double Jeopardy: Poorer Social-Emotional Outcomes for Children in the NICHD SECCYD Experiencing Home and Child-Care Environments that Confer Risk

    ERIC Educational Resources Information Center

    Watamura, Sarah Enos; Phillips, Deborah A.; Morrissey, Taryn W.; McCartney, Kathleen; Bub, Kristen

    2011-01-01

    Using data from the National Institute of Child Health and Human Development Early Child Care Research Network (NICHD SECCYD), the authors examined whether interactions between home and child-care quality affect children's social-emotional adjustment at 24, 36, and 54 months (N = 771). Triadic splits on quality of home and child care were used to…

  13. Why classroom climate matters for children high in anxious solitude: A study of differential susceptibility.

    PubMed

    Hughes, Kathleen; Coplan, Robert J

    2018-03-01

    The goal of the current study was to examine the complex links among anxious solitude, classroom climate, engagement, achievement, and gender. In particular, drawing upon the differential susceptibility hypothesis (Belsky, 1997), we investigated if children high in anxious solitude were particularly sensitive and responsive to the classroom environment. Participants were N = 712 children in Grade 3, drawn from the National Institute of Child and Human Development (NICHD) Study of Early Child Care and Youth Development data set. Classroom climate and engagement were assessed using the Classroom Observation Scale (NICHD, 1998). Teachers completed the Teacher Report Form (Achenbach, 1991) as a measure of anxious solitude and the Academic Rating Scale (NICHD, 2010) as a measure of achievement. Hypothesized associations among variables were tested by way of a moderated-mediation model. Among the results, engagement was found to mediate the relation between classroom climate and achievement. In addition, anxious solitude and gender were found to moderate the relation between classroom climate and engagement. Support for the differential susceptibility hypothesis was found, suggesting that children high in anxious solitude may be more reactive (both positively and negatively) to elements of the classroom environment. In addition, gender differences were observed, indicating that boys may be more responsive to the classroom environment as compared with girls. Implications for future research and educational policies are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  14. Klinefelter Syndrome (KS): Condition Information

    MedlinePlus

    ... Z Topics Men's Reproductive Health Infertility and Fertility Learning Disabilities NICHD News and Features Getting to Know the New NICHD Director March is Trisomy Awareness Month: Time to Get "DS Connected" Picture This: NICHD Support for Neuroscience Research All related news BACK TO TOP Content ...

  15. Child Development and Behavior Branch (CDBB), NIHCD, Report to the NACHHD Council

    ERIC Educational Resources Information Center

    National Institute of Child Health and Human Development (NICHD), 2009

    2009-01-01

    The Child Development & Behavior (CDB) Branch of the National Institute of Child Health and Human Development (NICHD) seeks to improve the health and well-being of individuals from infancy through early adulthood by supporting research into healthy growth and development, including all aspects of child development. The study of typical child…

  16. Parenting and Preschool Self-Regulation as Predictors of Social Emotional Competence in 1st Grade

    ERIC Educational Resources Information Center

    Russell, Beth S.; Lee, Jungeun Olivia; Spieker, Susan; Oxford, Monica L.

    2016-01-01

    The current longitudinal study used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD) to examine a model of development that emphasizes early caregiving environments as predictors of social emotional competence (including classroom competence). This path analysis…

  17. Mothers' Depressive Symptoms and Children's Cognitive and Social Agency: Predicting First-Grade Cognitive Functioning

    ERIC Educational Resources Information Center

    Yan, Ni; Dix, Theodore

    2016-01-01

    Using data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (N = 1,364), the present study supports an agentic perspective; it demonstrates that mothers' depressive symptoms in infancy predict children's poor first-grade cognitive functioning because depressive symptoms…

  18. Relations between Early Family Risk, Children's Behavioral Regulation, and Academic Achievement

    ERIC Educational Resources Information Center

    Sektnan, Michaella; McClelland, Megan M.; Acock, Alan; Morrison, Frederick J.

    2010-01-01

    This study examined relations among early family risk, children's behavioral regulation at 54 months and kindergarten, and academic achievement in first grade using data on 1298 children from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development. Family risk was indexed by ethnic…

  19. School Readiness among Low-Income Black Children: Family Characteristics, Parenting, and Social Support

    ERIC Educational Resources Information Center

    Bono, Katherine E.; Sy, Susan R.; Kopp, Claire B.

    2016-01-01

    This study focuses on the associations between family variables and academic and social school readiness in low-income Black children. Analyses drew from the National Institute for Child Development (NICHD) Study of Early Child Care and Youth Development dataset. The participants included 122 children and their mothers. Data collection occurred…

  20. Monoclonal Antibody Fragments for Targeting Therapeutics to Growth Plate Cartilage | NCI Technology Transfer Center | TTC

    Cancer.gov

    Researchers at The Eunice Kennedy Shriver National Institute on Child Health and Human Development (NICHD) have discovered monoclonal antibodies that bind to matrilin-3, a protein specifically expressed in cartilage tissue, that could be used for treating or inhibiting growth plate disorders, such as a skeletal dysplasia or short stature. The monoclonal antibodies can also be used to target therapeutic agents, such as anti-arthritis agents, to cartilage tissue. NICHD seeks statements of capability or interest from parties interested in collaborative research to co-develop, evaluate, or commercialize treatment of skeletal disorders using targeting antibodies.

  1. Maternal Employment and Child Cognitive Outcomes in the First Three Years of Life: The NICHD Study of Early Child Care.

    ERIC Educational Resources Information Center

    Brooks-Gunn, Jeanne; Han, Wen-Jui; Waldfogel, Jane

    2002-01-01

    Examined data on 900 European American children from the NICHD Study of Early Child Care to explore links between maternal employment during the child's first year and child cognitive outcomes. Found that maternal employment by the child's ninth month related to lower school readiness scores at 36 months, with more pronounced effects for certain…

  2. Parent Involvement and Children's Academic and Social Development in Elementary School

    ERIC Educational Resources Information Center

    El Nokali, Nermeen E.; Bachman, Heather J.; Votruba-Drzal, Elizabeth

    2010-01-01

    Data from the National Institute of Child Health and Human Development (NICHD) Study of Early Childcare and Youth Development (N = 1,364) were used to investigate children's trajectories of academic and social development across 1st, 3rd, and 5th grades. Hierarchical linear modeling was used to examine within- and between-child associations among…

  3. Changes in Parent-Child Relationship Quality across Early Adolescence: Implications for Engagement in Sexual Behavior

    ERIC Educational Resources Information Center

    McElwain, Alyssa D.; Bub, Kristen L.

    2018-01-01

    The present study investigated how changes in specific dimensions of the parent-adolescent relationship predict adolescent engagement in sexual intercourse and oral sex. Longitudinal data from 1,364 participants in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development were gathered at…

  4. Do Children's Executive Functions Account for Associations between Early Autonomy-Supportive Parenting and Achievement through High School?

    ERIC Educational Resources Information Center

    Bindman, Samantha W.; Pomerantz, Eva M.; Roisman, Glenn I.

    2015-01-01

    This study evaluated whether the positive association between early autonomy-supportive parenting and children's subsequent achievement is mediated by children's executive functions. Using observations of mothers' parenting from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (N…

  5. Heterogeneity in Externalizing Problems at Age 3: Association with Age 15 Biological and Environmental Outcomes

    ERIC Educational Resources Information Center

    Fanti, Kostas A.; Kimonis, Eva

    2017-01-01

    Investigating heterogeneity in antisocial behavior early in life is essential for understanding the etiology, development, prognosis, and treatment of these problems. Data from the longitudinal National Institute of Child Health and Development (NICHD) study of Early Child Care were used to identify homogeneous groups of young antisocial children…

  6. Teacher-Child Relationships and the Development of Academic and Behavioral Skills during Elementary School: A within- and between-Child Analysis

    ERIC Educational Resources Information Center

    Maldonado-Carreno, Carolina; Votruba-Drzal, Elizabeth

    2011-01-01

    Despite recent growth in research highlighting the potential of teacher-child relationships to promote children's development during the early years of school, questions remain about the importance of these relationships across elementary school. Using data from the NICHD Study of Early Child Care (N = 1,364), this study examines between- and…

  7. Teacher-Student Interactions in Fifth Grade Classrooms: Relations with Children's Peer Behavior

    ERIC Educational Resources Information Center

    Luckner, Amy E.; Pianta, Robert C.

    2011-01-01

    This study investigates the extent to which teacher-student interactions in fifth grade classrooms are associated with peer behavior in fifth grade, accounting for prior peer functioning. Participants included 894 fifth grade students from the NICHD Study of Early Child Care and Youth Development. The quality of teacher-student interactions…

  8. Maternal Education, Early Child Care and the Reproduction of Advantage

    ERIC Educational Resources Information Center

    Augustine, Jennifer March; Cavanagh, Shannon E.; Crosnoe, Robert

    2009-01-01

    The social and human capital that educational attainment provides women enables them to better navigate their children's passages through school. In this study, we examine a key mechanism in this intergenerational process: mothers' selection of early child care. Analyses of the NICHD Study of Early Child Care and Youth Development revealed that…

  9. Exposure to Neighborhood Affluence and Poverty in Childhood and Adolescence and Academic Achievement and Behavior

    ERIC Educational Resources Information Center

    Anderson, Sara; Leventhal, Tama; Dupéré, Véronique

    2014-01-01

    Evidence points to associations between the socioeconomic composition of neighborhoods and children's and adolescents' development. A minimal amount of research, however, examines how timing of exposure to neighborhood socioeconomic conditions matters. This study used longitudinal data from the NICHD Study of Early Child Care and Youth Development…

  10. From Parent to Child to Parent...: Paths in and out of Problem Behavior

    ERIC Educational Resources Information Center

    Bradley, Robert H.; Corwyn, Robert

    2013-01-01

    This study used data from the NICHD Study of Early Child Care and Youth Development to examine relations between parenting, self-control and externalizing behavior from early childhood to mid-adolescence (N = 956; 49.9 % male). Results indicated that maternal sensitivity, parental harshness and productive activity are related to externalizing…

  11. Perceived Neighborhood Safety and Adolescent School Functioning

    ERIC Educational Resources Information Center

    Martin-Storey, Alexa; Crosnoe, Robert

    2014-01-01

    This study examined the association between adolescents' perceptions of their neighborhoods' safety and multiple elements of their functioning in school with data on 15 year olds from the NICHD Study of Early Child Care and Youth Development (n = 924). In general, perceived neighborhood safety was more strongly associated with aspects of schooling…

  12. From Early Attachment to Engagement with Learning in School: The Role of Self-Regulation and Persistence

    ERIC Educational Resources Information Center

    Drake, Kim; Belsky, Jay; Fearon, R. M. Pasco

    2014-01-01

    This article presents theoretical arguments and supporting empirical evidence suggesting that attachment experiences in early life may be important in the later development of self-regulation and conscientious behavior. Analyses of data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth…

  13. Preconception Care and Prenatal Care

    MedlinePlus

    ... Audio Social Media Join NICHD Listservs About NICHD Organization Office of the Director Director's Corner Office of Administrative Management (OAM) Office of Communications (OC) Office of Global ...

  14. Hypothermia for neonatal hypoxic-ischemic encephalopathy: NICHD Neonatal Research Network contribution to the field.

    PubMed

    Shankaran, Seetha; Natarajan, Girija; Chalak, Lina; Pappas, Athina; McDonald, Scott A; Laptook, Abbot R

    2016-10-01

    In this article, we summarize the NICHD Neonatal Research Network (NRN) trial of whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy in relation to other randomized controlled trials (RCTs) of hypothermia neuroprotection. We describe the NRN secondary studies that have been published in the past 10 years evaluating clinical, genetic, biochemical, and imaging biomarkers of outcome. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Pipeline for Contraceptive Development

    PubMed Central

    Blithe, Diana L.

    2016-01-01

    The high rates of unplanned pregnancy reflect unmet need for effective contraceptive methods for women, especially for individuals with health risks such as obesity, diabetes, hypertension, and other conditions that may contraindicate use of an estrogen-containing product. Improvements in safety, user convenience, acceptability and availability of products remain important goals of the contraceptive development program. Another important goal is to minimize the impact of the products on the environment. Development of new methods for male contraception has the potential to address many of these issues with regard to safety for women who have contraindications to effective contraceptive methods but want to protect against pregnancy. It also will address a huge unmet need for men who want to control their fertility. Products under development for men would not introduce eco-toxic hormones in the waste water. Investment in contraceptive research to identify new products for women has been limited in the pharmaceutical industry relative to investment in drug development for other indications. Pharmaceutical R&D for male contraception was active in the 1990’s but was abandoned over a decade ago. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) has supported a contraceptive development program since 1969. Through a variety of programs including research grants and contracts, NICHD has developed a pipeline of new targets/products for male and female contraception. A number of lead candidates are under evaluation in the NICHD Contraceptive Clinical Trials Network (CCTN) (1–3). PMID:27523300

  16. What Is Spinal Cord Injury?

    MedlinePlus

    ... A-Z Topics Rehabilitation Medicine Rehabilitative and Assistive Technology Pediatric Injury NICHD News and Features Focus on Caring for Critically Ill Children Getting to Know the New NICHD Director Selected ...

  17. What Are the Symptoms of Rett Syndrome?

    MedlinePlus

    ... Applicants Sample Applications Find a Program Officer Forms Clinical Research Newsroom News Digital Media Join NICHD Listservs About NICHD Organization History Accomplishments Leadership & Other Staff Profiles Budget & Appropriations ...

  18. Child Care Effects in Context: Quality, Stability, and Multiplicity in Nonmaternal Child Care Arrangements during the First 15 Months of Life

    ERIC Educational Resources Information Center

    Tran, Henry; Weinraub, Marsha

    2006-01-01

    Main and interactive effects of child care quality, stability, and multiplicity on infants' attachment security, language comprehension, language production, and cognitive development at 15 months were examined using data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care. Thirty-nine percent of the…

  19. Infant attachment insecurity and dissociative symptomatology: findings from the NICHD Study of Early Child Care and Youth Development.

    PubMed

    Haltigan, John D; Roisman, Glenn I

    2015-01-01

    Based on data from the NICHD Study of Early Child Care and Youth Development (N = 1,149), the current article provides the first large-sample investigation of associations between different forms of infant attachment insecurity and dissociative symptomatology from childhood through midadolescence as measured by scales based on the mother, teacher, and youth self-report versions of the Achenbach System of Empirically Based Assessments. Findings did not replicate the previously reported and highly cited evidence that infant attachment disorganization is associated with dissociative symptomatology. In contrast, correlations of small magnitude were observed between infant avoidance and dissociative symptomatology, as assessed by teachers and mothers (but not self-report). Results were not moderated by contextual risk. Limitations of the study included the absence of measures of maltreatment and interpersonal trauma, leaving open the possibility that infant attachment disorganization is a diathesis for later dissociation in the context of severe and/or chronic trauma. Nevertheless, the present results strongly indicate the need for additional research exploring the possible role of environmental factors in the development of dissociative symptomatology. © 2014 Michigan Association for Infant Mental Health.

  20. Opportunities for Learning Math in Elementary School: Implications for SES Disparities in Procedural and Conceptual Math Skills

    ERIC Educational Resources Information Center

    Bachman, Heather J.; Votruba-Drzal, Elizabeth; El Nokali, Nermeen E.; Castle Heatly, Melissa

    2015-01-01

    The present study examined whether multiple opportunities to learn math were associated with smaller socioeconomic status (SES) disparities in fifth-grade math achievement using data from the NICHD Study of Early Child Care and Youth Development (SECCYD; N = 1,364). High amounts of procedural math instruction were associated with higher…

  1. Parental Strains and Rewards among Mothers: The Role of Education

    ERIC Educational Resources Information Center

    Nomaguchi, Kei M.; Brown, Susan L.

    2011-01-01

    Using data from the NICHD Study of Early Child Care and Youth Development (N = 1,198), this study examines the associations between education and parental strains and rewards among mothers of young children. Findings indicate that a college degree or more is related to less parenting anxiety, but more role captivity, and less new life meaning from…

  2. Group-Based Modeling of Time Spent in Structured Activity Trajectories from Middle Childhood into Early Adolescence

    ERIC Educational Resources Information Center

    Mata, Andrea D.; van Dulmen, Manfred H. M.

    2012-01-01

    This study investigated trajectories of time spent in structured activities from middle childhood to early adolescence by using data from the National Institute of Child Health & Human Development (NICHD) Study of Early Child Care. We used latent class growth analyses and identified five trajectories (stable low, increasing high, decreasing low,…

  3. The Effect of Multipart Prompts on Children's Testimonies in Sexual Abuse Investigations

    ERIC Educational Resources Information Center

    Katz, Carmit; Hershkowitz, Irit

    2012-01-01

    Objective: The current study aimed to explore the frequency and effects of multipart prompts on the testimonies of children who were alleged victims of sexual abuse and were interviewed using the National Institute of Child Health and Human Development (NICHD) Investigative Protocol. The effects of the multipart prompts were studied by considering…

  4. The Effect of Family Processes on School Achievement as Moderated by Socioeconomic Context

    ERIC Educational Resources Information Center

    Oxford, Monica L.; Lee, Jungeun Olivia

    2011-01-01

    This longitudinal study examined a model of early school achievement in reading and math, as it varies by socioeconomic context, using data from the NICHD Study of Early Child Care and Youth Development. A conceptual model was tested that included features of family stress, early parenting, and school readiness, through both a single-group…

  5. How Is Spinal Cord Injury (SCI) Diagnosed?

    MedlinePlus

    ... A-Z Topics Rehabilitation Medicine Rehabilitative and Assistive Technology Pediatric Injury NICHD News and Features Focus on Caring for Critically Ill Children Getting to Know the New NICHD Director Selected ...

  6. Associations of Marital Conflict with Emotional and Physiological Stress: Evidence for Different Patterns of Dysregulation

    ERIC Educational Resources Information Center

    Lucas-Thompson, Rachel G.

    2012-01-01

    The goal of this study was to explore theoretically suggested but untested links between interparental conflict and stress physiology in late adolescence. A multi-method study was conducted involving families (n = 42) who previously participated in the University California, Irvine site of the NICHD Study of Early Child Care and Youth Development;…

  7. Pediatric Terminology

    Cancer.gov

    The National Institute of Child Health and Human Development (NICHD) works with NCI Enterprise Vocabulary Services (EVS) to provide standardized terminology for coding pediatric clinical trials and other research activities.

  8. Fathers' Autonomy Support and Social Competence of Sons and Daughters

    ERIC Educational Resources Information Center

    Corwyn, Robert F.; Bradley, Robert H.

    2016-01-01

    Relations between paternal autonomy support and four aspects of adolescent social competence and responsibility at age 16 were examined using data from the NICHD Study of Early Child Care and Youth Development. With controls on maternal autonomy support, significant relations were observed between paternal autonomy support and three of the four…

  9. High-Risk Pregnancy

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  10. Congenital Adrenal Hyperplasia

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  11. A Profile Approach to Child Care Quality, Quantity, and Type of Setting: Parent Selection of Infant Child Care Arrangements

    ERIC Educational Resources Information Center

    Sosinsky, Laura Stout; Kim, Se-Kang

    2013-01-01

    Building on prior variable-oriented research which demonstrates the independence of the associations of child care quality, quantity, and type of setting with family factors and child outcomes, the current study identifies four profiles of child care dimensions from the NICHD Study of Early Child Care and Youth Development. Profiles accounted for…

  12. How Early Child Care Affects Later Development. Science Briefs

    ERIC Educational Resources Information Center

    National Scientific Council on the Developing Child, 2007

    2007-01-01

    "Science Briefs" summarize the findings and implications of a recent study in basic science or clinical research. This brief reports on the study "Are there Long-Term Effects of Early Child Care?" (J. Belsky, D. L. Vandell, M. Burchinal, K. A. Clarke-Stewart, K. McCartney, M. T. Owen, M. T., and The NICHD Early Child Care Research Network).…

  13. Within-Day Variability in the Quality of Classroom Interactions during Third and Fifth Grade: Implications for Children's Experiences and Conducting Classroom Observations

    ERIC Educational Resources Information Center

    Curby, Timothy W.; Stuhlman, Megan; Grimm, Kevin; Mashburn, Andrew; Chomat-Mooney, Lia; Downer, Jason; Hamre, Bridget; Pianta, Robert C.

    2011-01-01

    The quality of classroom interactions has typically been studied using aggregates of ratings over time. However, within-day ratings may contain important variability. This study investigated within-day variability using the NICHD Study of Early Childcare and Youth Development's observational data during grades 3 and 5. The first question examined…

  14. Pituitary Tumors: Condition Information

    MedlinePlus

    ... Congenital Adrenal Hyperplasia (CAH) Cushing Syndrome Infertility and Fertility NICHD News and Features NIH researchers find potential genetic cause of Cushing syndrome Getting to Know the New NICHD Director Little Glands, Big Effects: Understanding and Treating Adrenal Gland Disorders All related ...

  15. What Causes Down Syndrome?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  16. What Causes Cushing's Syndrome?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  17. What Is REM Sleep

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  18. What Are Circadian Rhythms?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  19. What Are the Symptoms of Cushing's Syndrome?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  20. Pregnancy Loss and Miscarriage

    MedlinePlus

    ... About NICHD Organization History Accomplishments Leadership & Other Staff Profiles Budget & Appropriations Advisory Groups Jobs at NICHD Partnering & Donating Freedom of Information Act Director's Corner Contact Us About What are common symptoms? Causes and Risks How is it diagnosed? Is There a Way ...

  1. Attachment and Attention: Protection in Relation to Gender and Cumulative Social-Contextual Adversity

    ERIC Educational Resources Information Center

    Pasco Fearon, R. M.; Belsky, Jay

    2004-01-01

    Data from 918 children from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care were examined to test the interrelation of attachment and attentional performance and 2 known risks for poor attentional performance: male gender and social-contextual adversity. Attachment was measured using the Strange…

  2. Infant-Mother Attachment and the Growth of Externalizing Problems across the Primary-School Years

    ERIC Educational Resources Information Center

    Pasco Fearon, R. M.; Belsky, Jay

    2011-01-01

    Background: Some contend that attachment insecurity increases risk for the development of externalizing behavior problems in children. Method: Latent-growth curve analyses were applied to data on 1,364 children from the NICHD Study of Early Child Care to evaluate the association between early attachment and teacher-rated externalizing problems…

  3. What Are Common Treatments for Phenylketonuria (PKU)?

    MedlinePlus

    ... Snapshot of Pregnancy & Infant Development Advances Snapshot of Child Development Advances Snapshot of Adult & Family Health Advances NICHD ... a small amount of breast milk or regular infant formula to make sure the child ... for normal development but not enough to cause harm. Older children ...

  4. Assessing the effectiveness of the NICHD investigative interview protocol when interviewing French-speaking alleged victims of child sexual abuse in Quebec.

    PubMed

    Cyr, Mireille; Lamb, Michael E

    2009-05-01

    The study was designed to assess the effectiveness of the flexibly structured NICHD Investigative Interview Protocol for child sexual abuse (CSA) investigative interviews by police officers and mental health workers in Quebec. The NICHD Protocol was designed to operationalize "best practice" guidelines and to help forensic interviewers use open-ended prompts to facilitate free recall by alleged victims. A total of 83 interviews with 3- to 13-year-old alleged victims were matched with 83 interviews conducted by the same interviewers before they were trained to use the Protocol. Interviews were matched with respect to the children's ages, children-perpetrator relationships, and the types and frequency of abuse. Coders categorized each of the prompts used to elicit information about the abuse and tabulated the numbers of new forensically relevant details provided in each response. Interviewers used three times as many open-ended prompts in Protocol interviews than in non-Protocol interviews, whereas use of all other types of questions was halved, and the total number of questions asked decreased by 25%. Protocol-guided interviews yielded more details than comparison interviews. The mean number of details per prompt increased from 3 to 5 details when the Protocol was used. Even with young children, interviewers using the Protocol employed more invitations to elicit forensically relevant details. French-speaking investigators using the NICHD Protocol used open-ended prompts rather than focused questions when interviewing alleged victims. In addition, these interviewers needed fewer questions to get relevant information when using the Protocol. A French version of the NICHD Protocol is now available to police officers and social workers who investigate the alleged sexual abuse of young children in French-speaking countries. This French version allowed trained interviewers to increase the use of invitations and reduce the use of more focused and risky questions. When the number of questions was controlled, more central details and more details in total were obtained in Protocol interviews, because the average prompt elicited more detailed answers in Protocol interviews. However, learning to use the NICHD Protocol required extended training and continued feedback sessions to maintain the high quality of interviewing.

  5. What Are the Treatments for Bacterial Vaginosis (BV)?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  6. How Do Health Care Providers Diagnose Bacterial Vaginosis (BV)?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  7. What Are Common Treatments for Problems of Puberty?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  8. FAQs of Pregnancy Loss and Miscarriage

    MedlinePlus

    ... About NICHD Organization History Accomplishments Leadership & Other Staff Profiles Budget & Appropriations Advisory Groups Jobs at NICHD Partnering & Donating Freedom of Information Act Director's Corner Contact Us About What are common symptoms? Causes and Risks How is it diagnosed? Is There a Way ...

  9. Family Background, School-Age Trajectories of Activity Participation, and Academic Achievement at the Start of High School

    ERIC Educational Resources Information Center

    Crosnoe, Robert; Smith, Chelsea; Leventhal, Tama

    2015-01-01

    Applying latent class and regression techniques to data from the NICHD Study of Early Child Care and Youth Development (n = 997), this study explored the potential academic advantages of time spent in out-of-school activities. Of particular interest was how these potential advantages played out in relation to the timing and duration of activity…

  10. What Can Parents Expect During Their Infant's Well-Child Visits?

    MedlinePlus

    ... Snapshot of Pregnancy & Infant Development Advances Snapshot of Child Development Advances Snapshot of Adult & Family Health Advances NICHD ... What can parents expect during their infant’s well-child visits? ... regularly because growth and development occur so quickly in the first 2 years ...

  11. How Do Health Care Providers Diagnose Preeclampsia, Eclampsia, and HELLP Syndrome?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  12. Relations between Parenting Quality and Cognitive Performance of Children Experiencing Varying Amounts of Childcare

    ERIC Educational Resources Information Center

    Adi-Japha, Esther; Klein, Pnina S.

    2009-01-01

    Associations between parenting quality and 3-year-olds' school readiness, receptive, and expressive language were examined in relation to the amount of time they spent in childcare, based on data from the NICHD Study of Early Child Care and Youth Development (N = 1,364). Associations for school readiness and receptive language were stronger among…

  13. Trajectories of Externalizing Behavior from Age 2 to Age 9: Relations with Gender, Temperament, Ethnicity, Parenting, and Rater

    ERIC Educational Resources Information Center

    Miner, Jennifer L.; Clarke-Stewart, K. Alison

    2008-01-01

    Trajectories of children's externalizing behavior were examined using multilevel growth curve modeling of data from the NICHD Study of Early Child Care and Youth Development. According to ratings by both mothers and caregivers/teachers when children were 2, 3, 4, 7, and 9 years old, externalizing behavior declined with age. However, mothers rated…

  14. Caregiving Antecedents of Secure Base Script Knowledge: A Comparative Analysis of Young Adult Attachment Representations

    ERIC Educational Resources Information Center

    Steele, Ryan D.; Waters, Theodore E. A.; Bost, Kelly K.; Vaughn, Brian E.; Truitt, Warren; Waters, Harriet S.; Booth-LaForce, Cathryn; Roisman, Glenn I.

    2014-01-01

    Based on a subsample (N = 673) of the NICHD Study of Early Child Care and Youth Development (SECCYD) cohort, this article reports data from a follow-up assessment at age 18 years on the antecedents of "secure base script knowledge", as reflected in the ability to generate narratives in which attachment-related difficulties are…

  15. Trajectories of Social Withdrawal from Grades 1 to 6: Prediction from Early Parenting, Attachment, and Temperament

    ERIC Educational Resources Information Center

    Booth-LaForce, Cathryn; Oxford, Monica L.

    2008-01-01

    From 1,092 children in the NICHD Study of Early Child Care and Youth Development, the authors identified 3 trajectory patterns of social withdrawal from teacher reports in Grades 1-6: a normative consistently low group (86%), a decreasing group (5%) with initially high withdrawal that decreased, and an increasing group (9%) with initially low…

  16. What Are Some Common Outcomes of Stroke and Some Common Treatments for These Outcomes?

    MedlinePlus

    ... YouTube follow us on Flickr follow us on Instagram Español NICHD Theme Browse AZTopics Browse A-Z ... Publications Sitemap Español facebook twitter pinterest youtube flickr Instagram NEWSROOM NICHD News Videos OUTREACH Safe to Sleep® ...

  17. Early Child Care and Adolescent Functioning at the End of High School: Results from the NICHD Study of Early Child Care and Youth Development

    ERIC Educational Resources Information Center

    Vandell, Deborah Lowe; Burchinal, Margaret; Pierce, Kim M.

    2016-01-01

    Relations between early child care and adolescent functioning at the end of high school (EOHS; M age = 18.3 years) were examined in a prospective longitudinal study of 1,214 children. Controlling for extensive measures of family background, early child care was associated with academic standing and behavioral adjustment at the EOHS. More…

  18. Usefulness of an Online Risk Estimator for Bronchopulmonary Dysplasia in Predicting Corticosteroid Treatment in Infants Born Preterm.

    PubMed

    Cuna, Alain; Liu, Cynthia; Govindarajan, Shree; Queen, Margaret; Dai, Hongying; Truog, William E

    2018-06-01

    To assess the usefulness of a bronchopulmonary dysplasia (BPD) outcome estimator developed by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) in identifying high-risk preterm infants treated with steroids. This was a single-center retrospective study of infants born ≤30 weeks of gestational age. The NICHD BPD outcome estimator was used to retrospectively calculate BPD risk at various postnatal ages. The best combination of risk estimates for identifying steroid treatment was identified using stepwise model selection. A cut-off value with the best combination of sensitivity and specificity was identified using receiver operating characteristic analysis. A total of 165 infants born preterm (mean gestational age 26 ± 1.6 weeks, mean birth weight 837 ± 171 g) were included. Of these, 61 were treated with steroids for BPD and 104 were not. Risk estimates for BPD or death were significantly greater in infants treated with steroids compared with controls. Both combined risk for severe BPD or death and single risk of no BPD were identified as factors with the best predictive power for identifying treatment with steroids, with accurate prediction possible as early as the second week of life. A greater than 37% risk for severe BPD or death or a less than 3% risk of no BPD on day of life 14 had 84%-92% sensitivity and 77%-80% specificity for predicting steroid treatment. The NICHD BPD outcome estimator can be a useful objective tool for identifying infants at high risk for BPD who may benefit from postnatal steroids. Copyright © 2018 Elsevier Inc. All rights reserved.

  19. 76 FR 38191 - New Proposed Collection; Comment Request; Biospecimen and Physical Measures Formative Research...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-29

    ... Institute of Child Health and Human Development (NICHD), the National Institutes of Health (NIH) will..., chemical, biological, and psychosocial) on children's health and development. (b) In General.--The Director of the National Institute of Child Health and Human Development* shall establish a consortium of...

  20. Sudden Unexpected Infant Death and Sudden Infant Death Syndrome: Reducing the Risk

    MedlinePlus

    ... the National Institute of Child Health and Human Development (NICHD) to learn more about these and other actions. Creating a Safe Sleep Environment Learn more about safe sleep environments and reducing ...

  1. Cell Lines Expressing Nuclear and/or Mitochondrial RNAse H1 | NCI Technology Transfer Center | TTC

    Cancer.gov

    The National Institute of Child Health & Human Development (NICHD), Program in Genomics of Differentiation, seeks interested parties to further co-develop small molecule inhibitors of RNase H1, especially in regards to genome instability, transcription, and translation.

  2. 77 FR 73036 - Eunice Kennedy Shriver National Institute of Child Health & Human Development; Notice of Closed...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-07

    ... National Institute of Child Health & Human Development; Notice of Closed Meeting Pursuant to section 10(d... Institute of Child Health and Human Development Special Emphasis Panel. NICHD T32 Teleconference Review... of Scientific Review, Eunice Kennedy Shriver National Institute of Child Health and Human Development...

  3. Differential Susceptibility to Long-Term Effects of Quality of Child Care on Externalizing Behavior in Adolescence?

    ERIC Educational Resources Information Center

    Belsky, Jay; Pluess, Michael

    2012-01-01

    Much research on the quality of child care reveals it--in the case of low-quality child care--to be related to poorer child functioning, net of confounding factors, perhaps especially in the case of cognitive-linguistic performance. Recent work using data from the National Institute of Child Health and Human Development (NICHD) Study of Early…

  4. A Structured Forensic Interview Protocol Improves the Quality and Informativeness of Investigative Interviews with Children: A Review of Research Using the NICHD Investigative Interview Protocol

    ERIC Educational Resources Information Center

    Lamb, Michael; Orbach, Yael; Hershkowitz, Irit; Esplin, Phillip W.; Horowitz, Dvora

    2007-01-01

    Objective: To show how the results of research on children's memory, communicative skills, social knowledge, and social tendencies can be translated into guidelines that improve the quality of forensic interviews of children. Method: We review studies designed to evaluate children's capacities as witnesses, explain the development of the…

  5. First-Year Maternal Employment and Child Development in the First 7 Years

    ERIC Educational Resources Information Center

    Brooks-Gunn, Jeanne; Han, Wen-Jui; Waldfogel, Jane

    2010-01-01

    Using data from the first 2 phases of the NICHD Study of Early Child Care, the authors examine the links between maternal employment in the first 12 months of life and cognitive, social, and emotional outcomes for children at age 3, at age 4.5, and in first grade. Drawing on theory and prior research from developmental psychology as well as…

  6. Genetic Moderation of Early Child-Care Effects on Social Functioning Across Childhood: A Developmental Analysis

    ERIC Educational Resources Information Center

    Belsky, Jay; Pluess, Michael

    2013-01-01

    Data from 508 Caucasian children in the NICHD Study of Early Child Care and Youth Development shows that the DRD4 (but not 5-HTTLPR) polymorphism moderates the effect of child-care quality (but not quantity or type) on caregiver-reported externalizing problems at 54 months and in kindergarten and teacher-reported social skills at kindergarten and…

  7. Class Climate Moderates Peer Relations and Emotional Adjustment in Children with an Early History of Anxious Solitude: A Child x Environment Model

    ERIC Educational Resources Information Center

    Gazelle, Heidi

    2006-01-01

    Classroom emotional climate was hypothesized to moderate psychosocial adjustment in 1st grade for children with an early childhood history of anxious solitude. Participants were 1,364 children in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and their mothers, child-care providers, and teachers.…

  8. What Conditions or Disorders are Commonly Associated with Down Syndrome?

    MedlinePlus

    ... Society Hib Vaccine PKU and Newborn Screening Congenital Hypothyroidism Annual NICHD Research Advances Snapshot of Early Development ... do infants without Down syndrome, for example. 2 Hypothyroidism . The thyroid is a gland that makes hormones ...

  9. 75 FR 52763 - Eunice Kennedy Shriver National Institute of Child Health & Human Development; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-08-27

    ... commercial property such as patentable material, and personal information concerning individuals associated... on the planning of the NICHD Science Vision; and other business of the Council. Place: National...

  10. Child Health and Human Development: An Overview and Strategy for a Five-Year Research Plan.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    The first five-year research plans developed by the National Institute of Child Health and Human Development (NICHD), covering fiscal years 1983-1987 and 10 program areas, are published in this volume. Present knowledge is reviewed and research opportunities are indicated in the areas of reproduction, fetal development, the birth process, the…

  11. 75 FR 27796 - Eunice Kennedy Shriver National Institute of Child Health and Human Development; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-18

    ... secrets or commercial property such as patentable material, and personal information concerning...; (3) a discussion on the planning of the NICHD Science Vision; and other business of the Council...

  12. 76 FR 18228 - Best Pharmaceuticals for Children Act (BPCA) Priority List of Needs in Pediatric Therapeutics

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-04-01

    ... frequency of use and frequency of condition) as well as expert input, a better approach for mass outreach... process, including transparency, stakeholder input, and leadership; and Expert involvement to inform and... BPCA Web site, http://bpca.nichd.nih.gov . As a final step in the process, the NICHD, with input from...

  13. Is the Prediction of Adolescent Outcomes from Early Child Care Moderated by Later Maternal Sensitivity? Results from the NICHD Study of Early Child Care and Youth Development

    ERIC Educational Resources Information Center

    Burchinal, Margaret R.; Lowe Vandell, Deborah; Belsky, Jay

    2014-01-01

    Longitudinal data are used to examine whether effects of early child care are amplified and/or attenuated by later parenting. Analyses tested these interactions using parenting as both a categorical and continuous variable to balance power and flexibility in testing moderation. The most consistent finding was that maternal sensitivity during…

  14. Do Effects of Early Child Care Extend to Age 15 Years? Results from the NICHD Study of Early Child Care and Youth Development

    ERIC Educational Resources Information Center

    Vandell, Deborah Lowe; Belsky, Jay; Burchinal, Margaret; Steinberg, Laurence; Vandergrift, Nathan

    2010-01-01

    Relations between nonrelative child care (birth to 4 1/2 years) and functioning at age 15 were examined (N = 1,364). Both quality and quantity of child care were linked to adolescent functioning. Effects were similar in size as those observed at younger ages. Higher quality care predicted higher cognitive-academic achievement at age 15, with…

  15. Prenatal Tests for Down Syndrome

    MedlinePlus

    ... Information March of Dimes The March of Dimes Web site has information on Down syndrome, genetic testing, and other birth defects. http://www.modimes.org/pnhec/4439.asp National Institute of Child Health and Human Development Facts About Down Syndrome http://www.nichd.nih. ...

  16. 42 CFR 68c.2 - Definitions.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT CONTRACEPTION AND INFERTILITY RESEARCH LOAN...; and (4) Reproductive Medicine Unit identified as a clinical site for the National Cooperative Reproductive Medicine Network, or other sites as designated by the Director. NICHD intramural laboratory means...

  17. 76 FR 55076 - Eunice Kennedy Shriver National Institute of Child Health & Human Development Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-06

    ... Liaison Office, NICHD, at 301-496-0536 to make your reservation. Additional seating will be available in....865, Research for Mothers and Children; 93.929, Center for Medical Rehabilitation Research; 93.209...

  18. 77 FR 29675 - Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD); Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-18

    ... meeting of the National Advisory Child Health and Human Development Council. The meeting will be open to... Committee: National Advisory Child Health and Human Development Council. Date: June 7, 2012. Open: June 7... the Council. Closed: June 7, 2012, 12:30 p.m. to Adjournment. Agenda: To review and evaluate grant...

  19. From early attachment to engagement with learning in school: the role of self-regulation and persistence.

    PubMed

    Drake, Kim; Belsky, Jay; Fearon, R M Pasco

    2014-05-01

    This article presents theoretical arguments and supporting empirical evidence suggesting that attachment experiences in early life may be important in the later development of self-regulation and conscientious behavior. Analyses of data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (NICHD Early Child Care Research Network, 2005; N = 1,149) were conducted to test the association between attachment, measured at 15 and 36 months, and 3 measures of self-regulation (social self-control rated by teachers, task persistence as measured by observers in a series of lab tasks, and a continuous performance test) between Grades 1 and 5. Mediational analyses were also conducted to test whether self-regulation mediates the effect of attachment on children's engagement with learning in the classroom, as measured by direct observation. The results confirmed the hypothesis that attachment would be related to later self-regulation, but only for social self-control, and attentional impulsivity, not task persistence. Furthermore, social self-control at Grade 1 mediated the effect of attachment (at both 15 and 36 months) on school engagement at Grade 5, even when Grade 1 school engagement was statistically controlled. The discussion focuses on the potential importance of early attachment experiences for the development and maintenance of conscientiousness across the lifespan. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

  20. Research Maps New Routes for Reading Success in PLA Early Childhood Initiative.

    ERIC Educational Resources Information Center

    Meyers, Elaine

    2002-01-01

    The Public Library Association (PLA) partnered with the National Institute of Child Health and Human Development (NICHD) to develop research-based tools for parents to prepare children for reading. Inherent in the materials is the major role of the public library in formation of readers. Outlines goals and activities (2001-2002) of the PLA/ALSC…

  1. 78 FR 64520 - Statement of Organization, Functions, and Delegations of Authority

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Statement of Organization... Organization, Functions, and Delegations of Authority for the Department of Health and Human Services (40 FR... Development (NICHD). Section N-T, Organization and Functions, under the heading Eunice Kennedy Shriver...

  2. What Are the Treatments for Congenital Adrenal Hyperplasia (CAH)?

    MedlinePlus

    ... Find a Study Resources and Publications Infertility and Fertility About NICHD Research Information Find a Study More ... treatment very soon after birth to reduce the effects of CAH. Classic CAH is treated with steroids ...

  3. Rehabilitative and Assistive Technology: Overview

    MedlinePlus

    ... to study how people with disabilities function in society. It includes studying barriers to optimal function and designing solutions so that people with disabilities can interact successfully in their environments. The NICHD houses the National Center for Medical ...

  4. Estimating Gestational Age From Ultrasound Fetal Biometrics.

    PubMed

    Skupski, Daniel W; Owen, John; Kim, Sungduk; Fuchs, Karin M; Albert, Paul S; Grantz, Katherine L

    2017-08-01

    To compare the accuracy of a new formula with one developed in 1984 (and still in common use) and to develop and compare racial and ethnic-specific and racial and ethnic-neutral formulas. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Fetal Growth Studies-Singletons was a prospective cohort study that recruited women in four self-reported racial-ethnic groups-non-Hispanic black, Hispanic, non-Hispanic white, and Asian-with singleton gestations from 12 U.S. centers (2009-2013). Women with a certain last menstrual period confirmed by first-trimester ultrasonogram had longitudinal fetal measurements by credentialed study ultrasonographers blinded to the gestational age at their five follow-up visits. Regression analyses were performed with linear mixed models to develop gestational age estimating formulas. Repeated cross-validation was used for validation. The estimation error was defined as the mean squared difference between the estimated and observed gestational age and was used to compare the formulas' accuracy. The new formula estimated the gestational age (±2 SD) within ±7 days from 14 to 20 weeks of gestation, ±10 days from 21 to 27 weeks of gestation, and ±17 days from 28 to 40 weeks of gestation. The new formula performed significantly better than a formula developed in 1984 with an estimation error of 10.4 compared with 11.2 days from 21 to 27 weeks of gestation and 17.0 compared with 19.8 days at 28-40 weeks of gestation, respectively. Racial and ethnic-specific formulas did not outperform the racial and ethnic-neutral formula. The NICHD gestational age estimation formula is associated with smaller errors than a well-established historical formula. Racial and ethnic-specific formulas are not superior to a racial-ethnic-neutral one.

  5. The Road Less Traveled: How the Developmental Sciences Can Prepare Educators to Improve Student Achievement--Policy Recommendations

    ERIC Educational Resources Information Center

    Leibbrand, Jane A.; Watson, Bernardine H.

    2010-01-01

    The most important problem facing public education in the country today is: how can teachers address the needs of all learners? A 2007 report issued by the National Institute of Child Health and Human Development (NICHD) says, "aspects of development--neural, cognitive, social, psychological, physical and ethical--have far-reaching effects on…

  6. What Health Issues or Conditions Are Specific to Women Only?

    MedlinePlus

    ... Research Information Find a Study Resources and Publications Turner Syndrome Condition Information NICHD Research Information Find a Study ... disorders and conditions that affect only women include Turner syndrome , Rett syndrome , and ovarian and cervical cancers. Issues ...

  7. Maternal and Child Health, FY 1983. Special Report to Congress.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

    Providing several examples of current research efforts, this report describes the research on maternal and child health supported by the National Institute of Child Health and Human Development (NICHD). The Institute conducts a coordinated program of research and research training to advance knowledge related to pregnancy and maternal health,…

  8. Teaching Reading: Why the "Fab Five" Should Be the "Big Six"

    ERIC Educational Resources Information Center

    Konza, Deslea

    2014-01-01

    The Report of the National Reading Panel (NICHD, 2000) identified five key elements that were critical to the development of reading, and these have been widely accepted by educational jurisdictions as providing definitive guidelines for early reading instruction. This paper presents a case for the inclusion of oral language and early literacy…

  9. Fragile X-Associated Primary Ovarian Insufficiency (FXPOI): Condition Information

    MedlinePlus

    ... Research Information Find a Study Resources and Publications Turner Syndrome Condition Information NICHD Research Information Find a Study ... fragilex.org/fragile-x-associated-disorders/fragile-x-syndrome/ ... W., York Moore. D., & Turner, G. M. (1996). Confirmation of early menopause in ...

  10. Intrapartum fetal heart rate monitoring: evaluation of a standardized system of interpretation for prediction of metabolic acidosis at delivery and neonatal neurological morbidity.

    PubMed

    Soncini, Emanuele; Paganelli, Simone; Vezzani, Cristina; Gargano, Giancarlo; Giovanni Battista, La Sala

    2014-09-01

    To assess the ability of the intrapartum fetal heart rate interpretation system developed in 2008 by the National Institute of Child Health and Human Development (NICHD) to predict fetal metabolic acidosis at delivery and neonatal neurological morbidity. We analyzed the intrapartum fetal heart rate tracings of 314 singleton fetuses at ≥ 37 weeks using the NICHD three-tier system of interpretation: Category I (normal), Category II (indeterminate) and Category III (abnormal). Category II was further divided into Category IIA, with moderate fetal heart rate variability or accelerations, and Category IIB, with minimal/absent fetal heart rate variability and no accelerations. The presence and duration of the different patterns were compared with several clinical neonatal outcomes and with umbilical artery acid-base balance at birth. The mean values of pH and base excess decreased proportionally as tracings worsened (p < 0.001). The duration of at least 30 min for Category III tracings was highly predictive of a pH <7.00 and a base excess ≤-12 mmol/L. The same was true for the duration of Category IIB tracings that lasted for at least 50 min. Our study demonstrates that the interpretation of fetal heart rate tracings based on a strictly standardized system is closely associated with umbilical artery acid-base status at delivery.

  11. Phenylketonuria in adulthood: a collaborative study.

    PubMed

    Koch, R; Burton, B; Hoganson, G; Peterson, R; Rhead, W; Rouse, B; Scott, R; Wolff, J; Stern, A M; Guttler, F; Nelson, M; de la Cruz, F; Coldwell, J; Erbe, R; Geraghty, M T; Shear, C; Thomas, J; Azen, C

    2002-09-01

    During 1967-1983, the Maternal and Child Health Division of the Public Health Services funded a collaborative study of 211 newborn infants identified on newborn screening as having phenylketonuria (PKU). Subsequently, financial support was provided by the National Institute of Child Health and Human Development (NICHD). The infants were treated with a phenylalanine (Phe)-restricted diet to age 6 years and then randomized either to continue the diet or to discontinue dietary treatment altogether. One hundred and twenty-five of the 211 children were then followed until 10 years of age. In 1998, NICHD scheduled a Consensus Development Conference on Phenylketonuria and initiated a study to follow up the participants from the original Collaborative Study to evaluate their present medical, nutritional, psychological, and socioeconomic status. Fourteen of the original clinics (1967-1983) participated in the Follow-up Study effort. Each clinic director was provided with a list of PKU subjects who had completed the original study (1967-1983), and was asked to evaluate as many as possible using a uniform protocol and data collection forms. In a subset of cases, magnetic resonance imaging and spectroscopy (MRI/MRS) were performed to study brain Phe concentrations. The medical evaluations revealed that the subjects who maintained a phenylalanine-restricted diet reported fewer problems than the diet discontinuers, who had an increased rate of eczema, asthma, mental disorders, headache, hyperactivity and hypoactivity. Psychological data showed that lower intellectual and achievement test scores were associated with dietary discontinuation and with higher childhood and adult blood Phe concentrations. Abnormal MRI results were associated with higher brain Phe concentrations. Early dietary discontinuation for subjects with PKU is associated with poorer outcomes not only in intellectual ability, but also in achievement test scores and increased rates of medical and behavioural problems.

  12. 77 FR 76057 - Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD); Notice of...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-12-26

    ... the public as indicated below, with attendance limited to space available. A portion of this meeting... attendance at the open session of Council, additional seating will be available in the meeting overflow rooms...: December 18, 2012. Michelle Trout, Program Analyst, Office of Federal Advisory Committee Policy. [FR Doc...

  13. Mental Retardation and Developmental Disabilities (MRDD) Branch. NICHD Report to the NACHHD Council

    ERIC Educational Resources Information Center

    National Institute of Child Health and Human Development (NICHD), 2005

    2005-01-01

    This document is the quadrennial report of the Mental Retardation and Developmental Disabilities (MRDD) Branch to the National Advisory Child Health and Human Development (NACHHD) Council. The MRDD Branch is a vital, evolving entity within the Center for Developmental Biology and Perinatal Medicine (CDBPM) at the National Institute of Child …

  14. Mental Retardation and Developmental Disabilities Branch (NICHD) Report to the NACHHD Council.

    ERIC Educational Resources Information Center

    National Inst. of Child Health and Human Development (NIH), Bethesda, MD. Mental Retardation and Developmental Disabilities Branch.

    This report highlights some of the projects supported by the Mental Retardation and Developmental Disabilities (MRDD) Branch of the Center for Research for Mothers and Children at the National Institute of Child Health and Human Development since its last report in January 1997. The MRDD Branch provides support for research, research training,…

  15. Training residents to be factually accurate and articulate: A case study using foetal heart rate monitoring nomenclature.

    PubMed

    Stohl, Hindi E; Miller, David A

    2016-10-01

    Careful communication between members of the obstetric team about intrapartum foetal heart rate is critical for clinical management and patient safety. This study evaluated the benefits of two testing modalities in assessing resident physician knowledge of the 2008 NICHD nomenclature. Multiple-choice (MC) and short-answer (SA) examinations were administered to Obstetrics and Gynecology resident physicians before an educational intervention and then immediately after the training, at 6 months and at 12 months. Test scores on both the MC and the SA examinations improved after the training session. The improvement was sustained over the course of the study. Residents performed higher on the MC examination than on the SA test. This study suggests that formalised teaching in foetal heart rate monitoring improves resident physician knowledge of the NICHD nomenclature and that SA examinations may better discriminate between residents who are and are not able to accurately articulate foetal heart rate monitoring terminology.

  16. The National Childrens Study: It’s All About Our Children | NIH MedlinePlus the Magazine

    MedlinePlus

    ... Director of NICHD. Participants are asked to answer questions, and not to change what they normally do. In person and via telephone, computer, and mailed questionnaire, they collect information on women’s ...

  17. Pre-Kindergarten and Kindergarten Classroom Quality and Children's Social and Academic Skills in Early Elementary Grades

    ERIC Educational Resources Information Center

    Mokrova, Irina; Broekhuizen, Martine; Burchinal, Margaret

    2015-01-01

    A growing body of research has shown that high quality early care and education (ECE) is positively related to the development of children's social and academic skills (e.g., Barnett, 2011; Lamb & Ahnert, 2006; NICHD ECCRN, 2006). There is evidence that high quality ECE experiences can improve children's levels of social adjustment (Bierman et…

  18. A modified fetal heart rate tracing interpretation system for prediction of cesarean section

    PubMed Central

    Schnettler, William T.; Rogers, Jennifer; Barber, Rachel E.; Hacker, Michele R.

    2013-01-01

    Objective To investigate whether a modified version of the 2008 National Institute of Child Health and Human Development (NICHD) interpretation system upon admission decreases cesarean delivery risk. Methods This retrospective cohort study ascribed a modified category to the first 30 min of fetal heart rate (FHR) tracings in labor. Category I was divided into two subsets (Ia and Ib) by the presence of accelerations. Category II was divided into four subsets (IIa–IId) based on baseline FHR, variability, response to stimulation and decelerations. Log-binomial regression was used to calculate risk ratios (RR) and 95% confidence intervals (CI). Results A category was ascribed to 910 women. Most FHR tracings were Category Ia (65.8%), Ib (7.7%), IIb (11.8%) and IId (14.0%). Category Ib tracings (fewer than two accelerations) were 2.26 (95% CI: 1.13–4.52) times more likely to result in cesarean delivery for abnormal FHR tracing than Category Ia tracings. A similar increase in risk was seen when comparing Category IIb and Category IId with Category Ia. Conclusion Application of a modified version of the 2008 NICHD FHR interpretation system to the initial 30 min of labor can identify women at increased risk of cesarean delivery for abnormal FHR tracing. PMID:21942513

  19. Bronchopulmonary dysplasia: effect of altitude correction and role for the Neonatal Research Network Prediction Algorithm.

    PubMed

    Gulliver, Kristina; Yoder, Bradley A

    2018-05-09

    To determine the effect of altitude correction on bronchopulmonary dysplasia (BPD) rates and to assess validity of the NICHD "Neonatal BPD Outcome Estimator" for predicting BPD with and without altitude correction. Retrospective analysis included neonates born <30 weeks gestational age (GA) between 2010 and 2016. "Effective" FiO 2 requirements were determined at 36 weeks corrected GA. Altitude correction performed via ratio of barometric pressure (BP) in our unit to sea level BP. Probability of death and/or moderate-to-severe BPD was calculated using the NICHD BPD Outcome Estimator. Five hundred and sixty-one infants were included. Rate of moderate-to-severe BPD decreased from 71 to 40% following altitude correction. Receiver-operating characteristic curves indicated high predictability of BPD Outcome Estimator for altitude-corrected moderate-to-severe BPD diagnosis. Correction for altitude reduced moderate-to-severe BPD rate by almost 50%, to a rate consistent with recent published values. NICHD BPD Outcome Estimator is a valid tool for predicting the risk of moderate-to-severe BPD following altitude correction.

  20. Childhood Anxiety Trajectories and Adolescent Disordered Eating: Findings from the NICHD Study of Early Child Care and Youth Development

    PubMed Central

    Zerwas, Stephanie; Von Holle, Ann; Watson, Hunna; Gottfredson, Nisha; Bulik, Cynthia M.

    2015-01-01

    Objective The goal of the present paper was to examine whether childhood anxiety trajectories predict eating psychopathology. We predicted that girls with trajectories of increasing anxiety across childhood would have significantly greater risk of disordered eating in adolescence in comparison to girls with stable or decreasing trajectories of anxiety over childhood. Method Data were collected as part of the prospective longitudinal NICHD Study of Early Child Care and Youth Development (N=450 girls). Childhood anxiety was assessed yearly (54 months through 6th grade) via maternal report on the Child Behavior Checklist. Disordered eating behaviors were assessed at age 15 via adolescent self-report on the Eating Attitudes Test (EAT-26). We conducted latent growth mixture modeling to define girls’ childhood anxiety trajectories. Maternal sensitivity, maternal postpartum depression, maternal anxiety, and child temperament were included as predictors of trajectory membership. Results The best fitting model included three trajectories of childhood anxiety, the low-decreasing class (22.9% of girls), the high-increasing class (35.4%), and the high-decreasing class (41.6%). Mothers with more symptoms of depression and separation anxiety had girls who were significantly more likely to belong to the high-increasing anxiety trajectory. There were no significant differences in adolescent disordered eating for girls across the three childhood anxiety trajectories. Conclusions Childhood anxiety, as captured by maternal report, may not be the most robust predictor of adolescent disordered eating and may be of limited utility for prevention programs that aim to identify children in the community at greatest risk for disordered eating. PMID:24938214

  1. The BADER Consortium

    DTIC Science & Technology

    2014-10-01

    neuromusculoskeletal injury o Determining factors that predict development and successful treatment of osteoarthritis, osteoporosis, low back pain , or other... students . The abstract highlights the collaborative work of the BADER-NICHD and potential to expand this model of collaborative work to other non-federal...regular contact with Drs. Dingwell and Wilken to complete on-going manuscripts.  Dr. McLagan and Ms. Mandy Salinas (U. Texas Ph.D. Student , hired Sept

  2. Why Should There Be an NICHD?

    PubMed Central

    2011-01-01

    In its nearly 5 decades of existence, the Eunice Kennedy Shriver National Institute of Child Health and Human Development has expended $23 billion in conducting and supporting research and translating discoveries to practice. The resulting dramatic impact on peoples' lives and improved health for children and families, chronicled herein, are a testament to the benefits of having this institute at the National Institutes of Health. PMID:21199851

  3. Very Early Language Skills of Fifth-Grade Poor Comprehenders

    ERIC Educational Resources Information Center

    Justice, Laura; Mashburn, Andrew; Petscher, Yaacov

    2013-01-01

    This study tested the theory that future poor comprehenders would show modest but pervasive deficits in both language comprehension and production during early childhood as compared with future poor decoders and typical readers. Using an existing database (NICHD ECCRN), fifth-grade students were identified as having poor comprehension skills…

  4. Children's early child care and their mothers' later involvement with schools.

    PubMed

    Crosnoe, Robert; Augustine, Jennifer March; Huston, Aletha C

    2012-01-01

    Theory and policy highlight the role of child care in preparing children for the transition into school. Approaching this issue in a different way, this study investigated whether children's care experiences before this transition promoted their mothers' school involvement after it, with the hypothesized mechanism for this link being the cultivation of children's social and academic skills. Analyses of 1,352 children (1 month-6 years) and parents in the NICHD Study of Early Child Care and Youth Development revealed that mothers were more involved at their children's schools when children had prior histories of high-quality nonparental care. This pattern, which was fairly stable across levels of maternal education and employment, was mediated by children's academic skills and home environments. © 2012 The Authors. Child Development © 2012 Society for Research in Child Development, Inc.

  5. Interactive Contributions of Attribution Biases and Emotional Intensity to Child-Friend Interaction Quality During Preadolescence.

    PubMed

    Chen, Xi; McElwain, Nancy L; Lansford, Jennifer E

    2017-12-20

    Using data from a subsample of 913 study children and their friends who participated in the NICHD Study of Early Child Care and Youth Development, the interactive contributions of child-reported attribution biases and teacher-reported child emotional intensity (EI) at Grade 4 (M = 9.9 years) to observed child-friend interaction at Grade 6 (M = 11.9 years) were examined. Study children's hostile attribution bias, combined with high EI, predicted more negative child-friend interaction. In contrast, benign attribution bias, combined with high EI, predicted more positive child-friend interaction. The findings are discussed in light of the "fuel" interpretation of EI, in which high-intensity emotions may motivate children to act on their cognitive biases for better or for worse. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

  6. Classroom Quality and Student Engagement: Contributions to Third-Grade Reading Skills

    PubMed Central

    Guo, Ying; Connor, Carol McDonald; Tompkins, Virginia; Morrison, Frederick J.

    2011-01-01

    This study, using NICHD Study of Early Child Care and Youth Development longitudinal data, investigated the effects of classroom quality and students’ third-grade behavioral engagement on students’ third-grade reading achievement (n = 1,364) and also examined the extent to which students’ third-grade behavioral engagement mediated the association between classroom quality and children's reading skills. SEM results revealed that controlling for family socio economic risk and students’ first-grade reading achievement, classroom quality significantly, and positively predicted children's behavioral engagement, which in turn predicted greater reading achievement. Higher levels of children's behavioral engagement were associated with higher reading achievement. Implications for policy and practice are discussed. PMID:21779272

  7. Teacher-Child Relationship Quality: The Roles of Child Temperament and Teacher-Child Interactions

    ERIC Educational Resources Information Center

    Rudasill, Kathleen Moritz; Rimm-Kaufman, Sara E.

    2009-01-01

    Young children's relationships with teachers predict social and academic success. This study examines contributions of child temperament (shyness, effortful control) and gender to teacher-child relationship quality both directly and indirectly through the frequency of teacher-child interactions in the classroom. Using an NICHD SECCYD sample of 819…

  8. Parent Involvement and Children's Academic and Social Development in Elementary School

    PubMed Central

    El Nokali, Nermeen E.; Bachman, Heather J.; Votruba-Drzal, Elizabeth

    2010-01-01

    Data from the NICHD Study of Early Childcare and Youth Development (N= 1364) were used to investigate children's trajectories of academic and social development across first, third and fifth grade. Hierarchical linear modeling was used to examine within- and between-child associations among maternal- and teacher-reports of parent involvement and children's standardized achievement scores, social skills, and problem behaviors. Findings suggest that within-child improvements in parent involvement predict declines in problem behaviors and improvements in social skills but do not predict changes in achievement. Between-child analyses demonstrated that children with highly involved parents had enhanced social functioning and fewer behavior problems. Similar patterns of findings emerged for teacher- and parent-reports of parent involvement. Implications for policy and practice are discussed. PMID:20573118

  9. Family Income and Its Relation to Preschool Children's Adjustment for Families in the NICHD Study of Early Child Care

    ERIC Educational Resources Information Center

    Mistry, Rashmita S.; Biesanz, Jeremy C.; Taylor, Lorraine C.; Burchinal, Margaret; Cox, Martha J.

    2004-01-01

    The current study examines relations of mean-level estimates, linear changes, and instability in income and family processes to child outcomes and addresses whether income, through its impact on family functioning, matters more for children living in poverty. Temporal changes and instability in family processes, but not income, predicted…

  10. Father-Child Interaction: Associations with Self-Control and Aggression among 4.5-Year-Olds

    ERIC Educational Resources Information Center

    Meece, Darrell; Robinson, Cheryl Malone

    2014-01-01

    Examined correlates of positive father caregiving and harsh control among 721 (350 girls) four-year-old children through analysis of NICHD Study of Early Child Care data and 7050 (3450 girls) four-year-old children through analysis of Early Childhood Longitudinal Study-Birth Cohort data. Findings from both samples suggest that, for both boys and…

  11. Very extensive nonmaternal care predicts mother-infant attachment disorganization: Convergent evidence from two samples.

    PubMed

    Hazen, Nancy L; Allen, Sydnye D; Christopher, Caroline Heaton; Umemura, Tomotaka; Jacobvitz, Deborah B

    2015-08-01

    We examined whether a maximum threshold of time spent in nonmaternal care exists, beyond which infants have an increased risk of forming a disorganized infant-mother attachment. The hours per week infants spent in nonmaternal care at 7-8 months were examined as a continuous measure and as a dichotomous threshold (over 40, 50 and 60 hr/week) to predict infant disorganization at 12-15 months. Two different samples (Austin and NICHD) were used to replicate findings and control for critical covariates: mothers' unresolved status and frightening behavior (assessed in the Austin sample, N = 125), quality of nonmaternal caregiving (assessed in the NICHD sample, N = 1,135), and family income and infant temperament (assessed in both samples). Only very extensive hours of nonmaternal care (over 60 hr/week) and mothers' frightening behavior independently predicted attachment disorganization. A polynomial logistic regression performed on the larger NICHD sample indicated that the risk of disorganized attachment exponentially increased after exceeding 60 hr/week. In addition, very extensive hours of nonmaternal care only predicted attachment disorganization after age 6 months (not prior). Findings suggest that during a sensitive period of attachment formation, infants who spend more than 60 hr/week in nonmaternal care may be at an increased risk of forming a disorganized attachment.

  12. The economics of pediatric formulation development for off-patent drugs.

    PubMed

    Milne, Christopher-Paul; Bruss, Jon B

    2008-11-01

    Many drugs currently used in children have never been adequately studied in rigorous scientific trials. Although these medications can still be prescribed in the pediatric setting, they are considered "off-label" because they are not specifically approved for use in children. The role of the Economics Working Group (EWG) within the Pediatric Formulation Initiative (PFI) of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) is to identify economic barriers and to propose possible mechanisms to create cost-effective and appropriately formulated products for off-patent pediatric drugs and to ensure their distribution and availability. The purpose of this article was to briefly outline the EWG's considerations and recommendations on these topics. Information for this article was gathered from the proceedings of a PFI workshop sponsored by the NICHD, held December 6 and 7, 2005, in Bethesda, Maryland. Other information was based on: the authors' unpublished and published research as well as personal communication with members of the EWG; a comprehensive search of Web sites, publications, and publicly accessible databases of the European Medicines Agency, the US Food and Drug Administration, the Agency for Healthcare Research and Quality, and the NICHD; and the databases and publications available from the Louis Lasagna Library of the Tufts Center for the Study of Drug Development (Boston, Massachusetts). The US Congress has attempted to remedy the lack of incentives to develop pediatric drugs by passing 2 key pieces of legislation. After >10 years, this US pediatric initiative has stimulated a great deal of pediatric drug research, and similar initiatives have been emulated in Europe and proposed in Japan. Although the initiative is generally considered successful in the United States, an incentive gap exists that still hinders pediatric drug development. It results from a series of factors, including: (1) a relatively small market size (<10% of the overall pharmaceutical market); (2) a predominance of off-patent drug use in the pediatric setting (perhaps as much as 70%); (3) no pediatric incentives for generic drug manufacturers; (4) fewer chronic illnesses in children than in adults; (5) a higher proportion of uninsured (mostly Medicaid recipients) and underinsured (many young families) patients; and (6) higher per-patient costs as well as greater complexity of drug development. By understanding these barriers, more appropriate incentives can be generated by government, where these incentives are not inherently present in the market. The lack of child-friendly formulations leaves 40% of the world's population at increased risk for avoidable adverse events, suboptimal dosing, noncompliance, and lack of access to new medicines. Incentive programs are the surest and least expensive means to overcome the tendency of "big pharma" to overlook the pediatric market as too small, and of start-up and specialty companies to consider it too problematic. Given the relatively lengthy period required to build product development infrastructure, these several decades-when market growth potential, demographics, and public health considerations are aligned in favor of pediatric formulation needs-are a critical time frame for creating a private and public sector environment to support this effort.

  13. Sensitivity, child regulatory processes, and naturally occurring declines in antisocial behavior across childhood.

    PubMed

    Buck, Katharine Ann

    2014-12-01

    Despite considerable research on why antisocial behavior develops and interventions that reduce it, aspects of everyday family processes that may promote naturally occurring declines in antisocial behavior or that may result from such declines in most children without intervention are poorly understood. The current study explored family processes that may enable children to replace antisocial tendencies and the effects that declines in antisocial behavior may have on parenting and child regulatory processes. Longitudinal data from 1,022 children (54 months-6th grade) from the NICHD Study of Early Child Care and Youth Development were examined. Findings demonstrated that naturally occurring declines in antisocial behavior both predicted and were predicted by maternal sensitivity, emotion regulation, and social skills. These declines predicted but were not predicted by declines in hostile attributions. The data revealed multiple indirect paths, which highlight the complex nature of these variables across development.

  14. Expected Consequences of Disclosure Revealed in Investigative Interviews with Suspected Victims of Child Sexual Abuse

    ERIC Educational Resources Information Center

    Malloy, Lindsay C.; Brubacher, Sonja P.; Lamb, Michael E.

    2011-01-01

    The current study explored the expected consequences of disclosure discussed by 204 5- to 13-year-old suspected victims of child sexual abuse during the course of investigative interviews conducted using the NICHD Investigative Interview Protocol. Expected consequences were mentioned in nearly half of all interviews, with older children and those…

  15. Shyness Trajectories in Slow-to-Warm-Up Infants: Relations with Child Sex and Maternal Parenting

    ERIC Educational Resources Information Center

    Grady, Jessica Stoltzfus; Karraker, Katherine; Metzger, Aaron

    2012-01-01

    Little is known about slow-to-warm-up temperament in infancy. This study examined the trajectory of shyness in children who were slow-to-warm-up in infancy in comparison to children with other temperament profiles in infancy. Participants were 996 mothers and children in the NICHD SECC studied from 6 months to first grade. Latent growth curve…

  16. Perceived Neighborhood Safety and Adolescent School Functioning

    PubMed Central

    Martin-Storey, Alexa; Crosnoe, Robert

    2014-01-01

    This study examined the association between adolescents’ perceptions of their neighborhoods’ safety and multiple elements of their functioning in school with data on 15 year olds from the NICHD Study of Early Child Care and Youth Development (n = 924). In general, perceived neighborhood safety was more strongly associated with aspects of schooling that were more psychosocial in nature (e.g., school attachment) than those that were more cognitive (e.g., test scores). Examination of neighborhood and family moderators of these associations revealed that perceived neighborhood safety was negatively associated with grades for youth from low-income families but was positively associated with school attachment for youth from such families when they lived in neighborhoods rated by observers as high in physical disorder. PMID:25045245

  17. Parental Strains and Rewards among Mothers: The Role of Education

    PubMed Central

    Nomaguchi, Kei M.; Brown, Susan L.

    2012-01-01

    Using data from the NICHD Study of Early Child Care and Youth Development (N = 1,198), this study examines the associations between education and parental strains and rewards among mothers of young children. Findings indicate that a college degree or more is related to less parenting anxiety, but more role captivity, and less new life meaning from parenting than lower levels of education. Differences by education are partly explained by variation in levels of progressive parenting values and work commitment, but remain significant. These patterns indicate that education provides greater resources that ease parental anxiety, but also leads to greater perceived demands of having a successful career, which contribute to more role captivity and less new life meaning from parenting. PMID:23136449

  18. Estimating onset time from longitudinal and cross-sectional data with an application to estimating gestational age from longitudinal maternal anthropometry during pregnancy and neonatal anthropometry at birth.

    PubMed

    Ortega-Villa, Ana Maria; Grantz, Katherine L; Albert, Paul S

    2018-06-01

    Determining the date of conception is important for estimating gestational age and monitoring whether the fetus and mother are on track in their development and pregnancy. Various methods based on ultrasound have been proposed for dating a pregnancy in high resource countries. However, such techniques may not be available in under-resourced countries. We develop a shared random parameter model for estimating the date of conception using longitudinal assessment of multiple maternal anthropometry and cross-sectional neonatal anthropometry. The methodology is evaluated with a training-test set paradigm as well as with simulations to examine the robustness of the method to model misspecification. We illustrate this new methodology with data from the NICHD Fetal Growth Studies.

  19. Democratic Parenting Beliefs and Observed Parental Sensitivity: Reciprocal Influences Between Coparents

    PubMed Central

    Schofield, Thomas; Weaver, Jennifer

    2016-01-01

    Three hundred and sixty-five two-parent families from the NICHD Study of Early Child Care and Youth Development were rated by trained observers on their parenting behavior at six assessments ranging from six months after the child's birth to when the child was in fifth grade (M = 10.4 years old at fifth grade). Across assessments, parents reported on their parenting beliefs and mothers reported on the child's externalizing behavior problems. Parenting beliefs predicted change in parenting behavior, and to a lesser degree parenting behavior predicted change in parenting beliefs. Parenting behavior and parenting beliefs both showed reciprocal effects between coparents, after controlling for child externalizing behavior and parent education. PMID:26551656

  20. Differential Effects of Maternal Sensitivity to Infant Distress and Nondistress on Social-Emotional Functioning

    ERIC Educational Resources Information Center

    Leerkes, Esther M.; Blankson, A. Nayena; O'Brien, Marion

    2009-01-01

    Associations between maternal sensitivity to infant distress and nondistress and infant social-emotional adjustment were examined in a subset of dyads from the NICHD Study of Early Child Care (N = 376). Mothers reported on infant temperament at 1 and 6 months postpartum, and maternal sensitivity to distress and nondistress were observed at 6…

  1. Child Care and Work Absences: Trade-Offs by Type of Care

    ERIC Educational Resources Information Center

    Gordon, Rachel A.; Kaestner, Robert; Korenman, Sanders

    2008-01-01

    Parents face a trade-off in the effect of child-care problems on employment. Whereas large settings may increase problems because of child illness, small group care may relate to provider unavailability. Analyzing the NICHD Study of Early Child Care, we find that child-care centers and large family day care lead to mothers' greater work absences…

  2. Early Detection of Prostate Cancer with New Nanoparticle Based UltrasoundContrast Agents Targeted to PSMA

    DTIC Science & Technology

    2017-08-01

    biodistribution studies with FMT, ultrasound imaging and ex vivo tissue analysis (months 10-14) 2d. Measure bubble dynamic parameters (months 10-14) 1...doctoral training studying post -transcriptional gene regulation National Institutes of Health-NICHD, Bethesda, MD Postdoctoral Fellow 02/1996 IRTA...and manage these studies . My research career has been hybrid consisting of experience in the biotech industry in addition to my academic position

  3. The effect of family processes on school achievement as moderated by socioeconomic context.

    PubMed

    Oxford, Monica L; Lee, Jungeun Olivia

    2011-10-01

    This longitudinal study examined a model of early school achievement in reading and math, as it varies by socioeconomic context, using data from the NICHD Study of Early Child Care and Youth Development. A conceptual model was tested that included features of family stress, early parenting, and school readiness, through both a single-group analysis and also a multiple-group analysis. Latent profile analysis was used to identify subgroups of more advantaged and less advantaged families. Family stress and parenting were shown to operate differently depending on the socioeconomic context, whereas child-based school readiness characteristics were shown to operate similarly across socieodemographic contexts. Implications for intervention are discussed. Copyright © 2011 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  4. Urinary Tract Health

    MedlinePlus

    ... News and Features Podcast: NICHD supports research on pelvic floor disorders Focus on Women’s Health ... Safe to Sleep® National Child & Maternal Health Education Program RELATED WEBSITES NIH.gov HHS.gov USA. ...

  5. Relations between early family risk, children’s behavioral regulation, and academic achievement

    PubMed Central

    Sektnan, Michaella; McClelland, Megan M.; Acock, Alan; Morrison, Frederick J.

    2010-01-01

    This study examined relations among early family risk, children’s behavioral regulation at 54 months and kindergarten, and academic achievement in first grade using data on 1,298 children from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development. Family risk was indexed by ethnic minority status, low maternal education, low average family income from 1 – 54 months, and high maternal depressive symptoms from 1 - 54 months. Results of structural equation modeling indicated that minority status, low maternal education, and low family income had significant negative effects on reading, math, and vocabulary achievement in first grade. Modest indirect effects were also found from ethnicity, maternal education, and maternal depressive symptoms, through 54-month and kindergarten behavioral regulation to first-grade achievement. Discussion focuses on the importance of behavioral regulation for school success especially for children facing early risk. PMID:20953343

  6. Down syndrome: national conference on patient registries, research databases, and biobanks.

    PubMed

    Oster-Granite, Mary Lou; Parisi, Melissa A; Abbeduto, Leonard; Berlin, Dorit S; Bodine, Cathy; Bynum, Dana; Capone, George; Collier, Elaine; Hall, Dan; Kaeser, Lisa; Kaufmann, Petra; Krischer, Jeffrey; Livingston, Michelle; McCabe, Linda L; Pace, Jill; Pfenninger, Karl; Rasmussen, Sonja A; Reeves, Roger H; Rubinstein, Yaffa; Sherman, Stephanie; Terry, Sharon F; Whitten, Michelle Sie; Williams, Stephen; McCabe, Edward R B; Maddox, Yvonne T

    2011-01-01

    A December 2010 meeting, "Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks," was jointly sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) in Bethesda, MD, and the Global Down Syndrome Foundation (GDSF)/Linda Crnic Institute for Down Syndrome based in Denver, CO. Approximately 70 attendees and organizers from various advocacy groups, federal agencies (Centers for Disease Control and Prevention, and various NIH Institutes, Centers, and Offices), members of industry, clinicians, and researchers from various academic institutions were greeted by Drs. Yvonne Maddox, Deputy Director of NICHD, and Edward McCabe, Executive Director of the Linda Crnic Institute for Down Syndrome. They charged the participants to focus on the separate issues of contact registries, research databases, and biobanks through both podium presentations and breakout session discussions. Among the breakout groups for each of the major sessions, participants were asked to generate responses to questions posed by the organizers concerning these three research resources as they related to Down syndrome and then to report back to the group at large with a summary of their discussions. This report represents a synthesis of the discussions and suggested approaches formulated by the group as a whole. Copyright © 2011. Published by Elsevier Inc. All rights reserved.

  7. Conference Proceedings: “Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks”

    PubMed Central

    Oster-Granite, Mary Lou; Parisi, Melissa A.; Abbeduto, Leonard; Berlin, Dorit S.; Bodine, Cathy; Bynum, Dana; Capone, George; Collier, Elaine; Hall, Dan; Kaeser, Lisa; Kaufmann, Petra; Krischer, Jeffrey; Livingston, Michelle; McCabe, Linda L.; Pace, Jill; Pfenninger, Karl; Rasmussen, Sonja A.; Reeves, Roger H.; Rubinstein, Yaffa; Sherman, Stephanie; Terry, Sharon F.; Whitten, Michelle Sie; Williams, Stephen; McCabe, Edward R.B.; Maddox, Yvonne T.

    2011-01-01

    A December 2010 meeting, “Down Syndrome: National Conference on Patient Registries, Research Databases, and Biobanks,” was jointly sponsored by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) at the National Institutes of Health (NIH) in Bethesda, MD, and the Global Down Syndrome Foundation (GDSF)/Linda Crnic Institute for Down Syndrome based in Denver, CO. Approximately 70 attendees and organizers from various advocacy groups, federal agencies (Centers for Disease Control and Prevention, and various NIH Institutes, Centers, and Offices), members of industry, clinicians, and researchers from various academic institutions were greeted by Drs. Yvonne Maddox, Deputy Director of NICHD, and Edward McCabe, Executive Director of the Linda Crnic Institute for Down Syndrome. They charged the participants to focus on the separate issues of contact registries, research databases, and biobanks through both podium presentations and breakout session discussions. Among the breakout groups for each of the major sessions, participants were asked to generate responses to questions posed by the organizers concerning these three research resources as they related to Down syndrome and then to report back to the group at large with a summary of their discussions. This report represents a synthesis of the discussions and suggested approaches formulated by the group as a whole. PMID:21835664

  8. What Happens during Prenatal Visits?

    MedlinePlus

    ... Snapshot of Adult & Family Health Advances NICHD Nobel Prize Winners Leadership & Other Staff Profiles Leadership Biosketches Get ... health care providers won't schedule a visit any earlier unless you have a medical condition, have ...

  9. How Do Health Care Providers Diagnose Down Syndrome?

    MedlinePlus

    ... gov/10004766 National Human Genome Research Institute. (2010). Learning about Down syndrome . Retrieved June 11, 2012, from http://www.genome.gov/19517824#3 ... NICHD News and Features Release: NIH launches INCLUDE ...

  10. Hypoparathyroidism

    MedlinePlus

    ... NICHD News Videos OUTREACH Safe to Sleep® National Child & Maternal Health Education Program RELATED WEBSITES NIH.gov HHS.gov USA.gov ClinicalTrials.gov WEBSITE POLICIES Disclaimer FOIA Privacy Policy Accessibility NIH...Turning Discovery Into Health ®

  11. Children’s Early Child Care and their Mothers’ Later Involvement with Schools

    PubMed Central

    Crosnoe, Robert; Augustine, Jennifer March; Huston, Aletha C.

    2011-01-01

    Theory and policy highlight the role of child care in preparing children for the transition into school. Approaching this issue in a different way, this study investigated whether children’s care experiences before this transition promoted their mothers’ school involvement after it, with the hypothesized mechanism for this link being the cultivation of children’s social and academic skills. Analyses of 1,352 children (1 month-6 years) and parents in the NICHD Study of Early Child Care and Youth Development revealed that mothers were more involved at their children’s schools when children had prior histories of high quality non-parental care. This pattern, which was fairly stable across levels of maternal education and employment, was mediated by children’s academic skills and home environments. PMID:22313134

  12. Deflected Pathways: Becoming Aggressive, Socially Withdrawn, or Prosocial with Peers During the Transition to Adolescence

    PubMed Central

    Monahan, Kathryn C.; Booth-LaForce, Cathryn

    2014-01-01

    Although research has suggested strong continuity in children's adaptive or maladaptive behavior with peers across the transition to adolescence, less is known about deflected developmental pathways of peer social competence across this transition. This study investigates how mother-child and best friend relationship quality predict the deflection of youth from adaptive to maladaptive behavior with peers or the reverse. Using data from the NICHD Study of Early Child Care and Youth Development (N=1055), high-quality friendships were associated with changes in peer social competence from 3rd to 6th grade. More positive and fewer negative interactions with a friend were linked with becoming more prosocial with peers, whereas less positive interactions with a friend were linked to becoming aggressive or withdrawn. PMID:27231420

  13. From Parent to Child to Parent…: Paths In and Out of Problem Behavior

    PubMed Central

    Bradley, Robert H.; Corwyn, Robert

    2014-01-01

    This study used data from the NICHD Study of Early Child Care and Youth Development to examine relations between parenting, self-control and externalizing behavior from early childhood to mid-adolescence (N=956; 49.9% male). Results indicated that maternal sensitivity, parental harshness and productive activity are related to externalizing problems but that patterns of relations change from early childhood to middle childhood to adolescence, with evidence suggesting that externalizing behavior influences parenting more than the reverse from middle childhood onward. Self-control measured during early adolescence partially mediated relations between maternal sensitivity and adolescent-reported externalizing behavior. Parental monitoring during adolescence was also related to externalizing behavior at age 15. Monitoring partially mediated the relation between externalizing behavior in early adolescence and externalizing at age 15. PMID:23135289

  14. Changes in Young Children’s Family Structures and Child Care Arrangements

    PubMed Central

    Crosnoe, Robert; Prickett, Kate Chambers; Smith, Chelsea; Cavanagh, Shannon

    2013-01-01

    Family structure change can disrupt the settings of children’s daily lives. Most scholarship focuses on disruption in the home environment. Moving beyond the home, this study explores the association between changes in family structure and changes in several dimensions of early child care. With longitudinal data from the NICHD Study of Early Child Care and Youth Development (n = 1,298), first-difference models reveal that family structure transitions are associated with changes in the type and quantity of early care as well as the number of care arrangements used, especially during the latter part of infancy. Given prior evidence linking these child care dimensions to behavioral and cognitive outcomes, these results suggest a policy-relevant mechanism by which family change may create inequalities among children. PMID:24243268

  15. How Is Muscular Dystrophy Diagnosed?

    MedlinePlus

    ... dystrophy advanced by new genetic test. Medical News Today. Retrieved June 21, 2012, from http://www.medicalnewstoday. ... Here’s How NICHD Research Is Improving Patients’ Lives Today’s Research on Medicines for Children Offers Hope for ...

  16. Preeclampsia and Eclampsia

    MedlinePlus

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  17. Uterine Fibroids

    MedlinePlus

    ... NICHD News Videos OUTREACH Safe to Sleep® National Child & Maternal Health Education Program RELATED WEBSITES NIH.gov HHS.gov USA.gov ClinicalTrials.gov WEBSITE POLICIES Disclaimer FOIA Privacy Policy Accessibility NIH...Turning Discovery Into Health ®

  18. Infertility and Fertility

    MedlinePlus

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  19. Infant Care and Infant Health

    MedlinePlus

    ... SIDS)? What are some ways to promote infant safety in a car? What can parents expect during their infant’s well-child visits? Why are immunizations important for my infant’s health? Other FAQs NICHD Research ...

  20. Brain injury following trial of hypothermia for neonatal hypoxic–ischaemic encephalopathy

    PubMed Central

    Shankaran, Seetha; Barnes, Patrick D; Hintz, Susan R; Laptook, Abbott R; Zaterka-Baxter, Kristin M; McDonald, Scott A; Ehrenkranz, Richard A; Walsh, Michele C; Tyson, Jon E; Donovan, Edward F; Goldberg, Ronald N; Bara, Rebecca; Das, Abhik; Finer, Neil N; Sanchez, Pablo J; Poindexter, Brenda B; Van Meurs, Krisa P; Carlo, Waldemar A; Stoll, Barbara J; Duara, Shahnaz; Guillet, Ronnie; Higgins, Rosemary D

    2013-01-01

    Objective The objective of our study was to examine the relationship between brain injury and outcome following neonatal hypoxic–ischaemic encephalopathy treated with hypothermia. Design and patients Neonatal MRI scans were evaluated in the National Institute of Child Health and Human Development (NICHD) randomised controlled trial of whole-body hypothermia and each infant was categorised based upon the pattern of brain injury on the MRI findings. Brain injury patterns were assessed as a marker of death or disability at 18–22 months of age. Results Scans were obtained on 136 of 208 trial participants (65%); 73 in the hypothermia and 63 in the control group. Normal scans were noted in 38 of 73 infants (52%) in the hypothermia group and 22 of 63 infants (35%) in the control group. Infants in the hypothermia group had fewer areas of infarction (12%) compared to infants in the control group (22%). Fifty-one of the 136 infants died or had moderate or severe disability at 18 months. The brain injury pattern correlated with outcome of death or disability and with disability among survivors. Each point increase in the severity of the pattern of brain injury was independently associated with a twofold increase in the odds of death or disability. Conclusions Fewer areas of infarction and a trend towards more normal scans were noted in brain MRI following whole-body hypothermia. Presence of the NICHD pattern of brain injury is a marker of death or moderate or severe disability at 18–22 months following hypothermia for neonatal encephalopathy. PMID:23080477

  1. Deviant Peer Behavior and Adolescent Delinquency: Protective Effects of Inhibitory Control, Planning, or Decision Making?

    PubMed

    Hinnant, J Benjamin; Forman-Alberti, Alissa B

    2018-05-09

    We examined relations between adolescent perceptions of deviant peer behavior and delinquency as moderated by inhibitory control, planning, and decision making in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development at age 15 (N = 991). Adolescents reported perceptions of deviant peer behavior. Inhibitory control, planning, and decision making were assessed behaviorally. Delinquency was evaluated with a latent variable comprised of parent-guardian perceptions of adolescent delinquency and adolescent self-reports. Only inhibitory control moderated the relationship between deviant peer behavior and delinquency, showing that better inhibition protected against delinquency in contexts of high levels of adolescent perceptions of deviant peer behavior. Findings are discussed in the context of theories of adolescent delinquency and risk taking. © 2018 Society for Research on Adolescence.

  2. Mothers' depressive symptoms and children's cognitive and social agency: Predicting first-grade cognitive functioning.

    PubMed

    Yan, Ni; Dix, Theodore

    2016-08-01

    Using data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (N = 1,364), the present study supports an agentic perspective; it demonstrates that mothers' depressive symptoms in infancy predict children's poor first-grade cognitive functioning because depressive symptoms predict children's low social and cognitive agency-low motivation to initiate social interaction and actively engage in activities. When mothers' depressive symptoms were high in infancy, children displayed poor first-grade cognitive functioning due to (a) tendencies to become socially withdrawn by 36 months and low in mastery motivation by 54 months and (b) tendencies for children's low agency to predict declines in mothers' sensitivity and cognitive stimulation. Findings suggest that mothers' depressive symptoms undermine cognitive development through bidirectional processes centered on children's low motivation to engage in social interaction and initiate and persist at everyday tasks. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  3. Peer Harassment and Risky Behavior among Sexual Minority Girls and Boys

    PubMed Central

    Martin-Storey, Alexa; Crosnoe, Robert

    2017-01-01

    The role of peer harassment in the association between sexual minority status and adolescent risky behavior was examined for 15 year olds in the NICHD Study of Early Child Care and Youth Development (n = 957). The findings, although exploratory, suggest the importance of gender. For girls, peer harassment was best viewed as a moderator of the link between sexual minority status and increased risky behavior. It intensified an existing association, reflecting the gendered nature of the impact of sexual minority status on the adolescent social context. For boys, peer harassment was primarily a mediator, such that sexual minority status was associated with more risky behavior via elevated harassment, although sexual minority status itself was associated with lower risky behavior overall. PMID:24826828

  4. What Is Labor?

    MedlinePlus

    ... know about postpartum depression? Related A-Z Topics Breastfeeding and Breast Milk Preconception Care and Prenatal Care Preterm Labor and Birth NICHD News and Features Release: Women with pregnancy-related diabetes may be at risk for chronic kidney disease ...

  5. What Are the Treatments for Spinal Cord Injury (SCI)?

    MedlinePlus

    ... potential risk factors for persons with SCI) Functional electrical stimulation for assistance with restoration of neuromuscular function, ... A-Z Topics Rehabilitation Medicine Rehabilitative and Assistive Technology Pediatric Injury NICHD News and Features Focus on ...

  6. How Is Infertility Diagnosed?

    MedlinePlus

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  7. Clinical Research and Clinical Trials

    MedlinePlus

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  8. What is Down Syndrome?

    MedlinePlus

    ... NICHD News Videos OUTREACH Safe to Sleep® National Child & Maternal Health Education Program RELATED WEBSITES NIH.gov HHS.gov USA.gov ClinicalTrials.gov WEBSITE POLICIES Disclaimer FOIA Privacy Policy Accessibility NIH...Turning Discovery Into Health ®

  9. A dynamic developmental link between verbal comprehension-knowledge (Gc) and reading comprehension: verbal comprehension-knowledge drives positive change in reading comprehension.

    PubMed

    Reynolds, Matthew R; Turek, Joshua J

    2012-12-01

    Intelligence and general academic achievement have a well-established relation, but the interrelated development of the two constructs over time is less well-known. In this study, the dynamic developmental relation between verbal comprehension-knowledge (Gc) and reading comprehension was examined by applying bivariate dual change score models (McArdle, 2009) to longitudinal data collected from children aged 9 through 15 who were part of the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD SECCYD). A unidirectional dynamic link was found in which higher levels of prior Gc led to increased positive change in reading comprehension scores. This unidirectional link was not altered by including intelligence measured at 24-months, SES, sex, basic reading, and reading volume as time-invariant covariates. Gc is a leading indicator of reading comprehension and should be considered when developing and monitoring long-term reading comprehension interventions for children. Copyright © 2012 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  10. What Is a Cesarean Delivery?

    MedlinePlus

    ... know about postpartum depression? Related A-Z Topics Breastfeeding and Breast Milk Preconception Care and Prenatal Care Preterm Labor and Birth NICHD News and Features Release: Women with pregnancy-related diabetes may be at risk for chronic kidney disease ...

  11. What Are the Types of Birth Defects?

    MedlinePlus

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  12. What are some causes of infertility?

    MedlinePlus

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  13. Surgery on Fetus Reduces Complications of Spina Bifida

    MedlinePlus Videos and Cool Tools

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  14. Methodological issues in the design and analyses of neonatal research studies: Experience of the NICHD Neonatal Research Network.

    PubMed

    Das, Abhik; Tyson, Jon; Pedroza, Claudia; Schmidt, Barbara; Gantz, Marie; Wallace, Dennis; Truog, William E; Higgins, Rosemary D

    2016-10-01

    Impressive advances in neonatology have occurred over the 30 years of life of The Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network (NRN). However, substantial room for improvement remains in investigating and further developing the evidence base for improving outcomes among the extremely premature. We discuss some of the specific methodological challenges in the statistical design and analysis of randomized trials and observational studies in this population. Challenges faced by the NRN include designing trials for unusual or rare outcomes, accounting for and explaining center variations, identifying other subgroup differences, and balancing safety and efficacy concerns between short-term hospital outcomes and longer-term neurodevelopmental outcomes. In conclusion, the constellation of unique patient characteristics in neonates calls for broad understanding and careful consideration of the issues identified in this article for conducting rigorous studies in this population. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Neonatal Pulmonary MRI of Bronchopulmonary Dysplasia Predicts Short-term Clinical Outcomes.

    PubMed

    Higano, Nara S; Spielberg, David R; Fleck, Robert J; Schapiro, Andrew H; Walkup, Laura L; Hahn, Andrew D; Tkach, Jean A; Kingma, Paul S; Merhar, Stephanie L; Fain, Sean B; Woods, Jason C

    2018-05-23

    Bronchopulmonary dysplasia (BPD) is a serious neonatal pulmonary condition associated with premature birth, but the underlying parenchymal disease and trajectory are poorly characterized. The current NICHD/NHLBI definition of BPD severity is based on degree of prematurity and extent of oxygen requirement. However, no clear link exists between initial diagnosis and clinical outcomes. We hypothesized that magnetic resonance imaging (MRI) of structural parenchymal abnormalities will correlate with NICHD-defined BPD disease severity and predict short-term respiratory outcomes. Forty-two neonates (20 severe BPD, 6 moderate, 7 mild, 9 non-BPD controls; 40±3 weeks post-menstrual age) underwent quiet-breathing structural pulmonary MRI (ultrashort echo-time and gradient echo) in a NICU-sited, neonatal-sized 1.5T scanner, without sedation or respiratory support unless already clinically prescribed. Disease severity was scored independently by two radiologists. Mean scores were compared to clinical severity and short-term respiratory outcomes. Outcomes were predicted using univariate and multivariable models including clinical data and scores. MRI scores significantly correlated with severities and predicted respiratory support at NICU discharge (P<0.0001). In multivariable models, MRI scores were by far the strongest predictor of respiratory support duration over clinical data, including birth weight and gestational age. Notably, NICHD severity level was not predictive of discharge support. Quiet-breathing neonatal pulmonary MRI can independently assess structural abnormalities of BPD, describe disease severity, and predict short-term outcomes more accurately than any individual standard clinical measure. Importantly, this non-ionizing technique can be implemented to phenotype disease and has potential to serially assess efficacy of individualized therapies.

  16. Healthy Pre-Pregnancy Diet and Exercise May Reduce Risk of Gestational Diabetes

    MedlinePlus

    ... 21, 2014 All NICHD Spotlights Zhang, C., Liu, S., Solomon, C. G., & Hu, F. B. (2006). Dietary fiber ... 2241. PMID: 19940226 Zhang, C., Schulze, M. B., Solomon, C. G., & Hu, F. B. (2006). A prospective ...

  17. What Preconception Tests Might I Need?

    MedlinePlus

    ... Topics Pregnancy Sexually Transmitted Diseases (STDs) Diabetes NICHD News Spotlights Science Update: Diets low in certain minerals linked to problem with ovulation Release: Elevated blood pressure before pregnancy may increase chance of pregnancy ... BACK TO TOP Content Owner Office of Communications ...

  18. Does Attention-Deficit/Hyperactivity Disorder Have a Dimensional Latent Structure? A Taxometric Analysis

    PubMed Central

    Marcus, David K.; Barry, Tammy D.

    2010-01-01

    An understanding of the latent structure of attention-deficit/hyperactivity disorder (ADHD) is essential for developing causal models of this disorder. Although some researchers have presumed that ADHD is dimensional and others have assumed that it is taxonic, there has been relatively little research directly examining the latent structure of ADHD. The authors conducted a set of taxometric analyses using data from the NICHD Study of Early Child Care and Youth Development (ns between 667–1078). The results revealed a dimensional latent structure across a variety of different analyses and sets of indicators, for inattention, hyperactivity/impulsivity, and ADHD. Furthermore, analyses of correlations with associated features indicated that dimensional models demonstrated stronger validity coefficients with these criterion measures than dichotomous models. These findings jibe with recent research on the genetic basis of ADHD and with contemporary models of ADHD. PMID:20973595

  19. Does attention-deficit/hyperactivity disorder have a dimensional latent structure? A taxometric analysis.

    PubMed

    Marcus, David K; Barry, Tammy D

    2011-05-01

    An understanding of the latent structure of attention-deficit/hyperactivity disorder (ADHD) is essential for developing causal models of this disorder. Although some researchers have presumed that ADHD is dimensional and others have assumed that it is taxonic, there has been relatively little research directly examining the latent structure of ADHD. The authors conducted a set of taxometric analyses using data from the NICHD Study of Early Child Care and Youth Development (ns between 667 and 1,078). The results revealed a dimensional latent structure across a variety of different analyses and sets of indicators for inattention, hyperactivity/impulsivity, and ADHD. Furthermore, analyses of correlations with associated features indicated that dimensional models demonstrated stronger validity coefficients with these criterion measures than dichotomous models. These findings jibe with recent research on the genetic basis of ADHD and with contemporary models of ADHD.

  20. Apgar scores at 10 min and outcomes at 6-7 years following hypoxic-ischaemic encephalopathy.

    PubMed

    Natarajan, Girija; Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; Bann, Carla M; McDonald, Scott A; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R; Vohr, Betty R

    2013-11-01

    To determine the association between 10 min Apgar scores and 6-7-year outcomes in children with perinatal hypoxic-ischaemic encephalopathy (HIE) enrolled in the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) whole body cooling randomised controlled trial (RCT). Evaluations at 6-7 years included the Wechsler Preschool and Primary Scale of Intelligence III or Wechsler Intelligence Scale for Children IV and Gross Motor Functional Classification Scale. Primary outcome was death/moderate or severe disability. Logistic regression was used to examine the association between 10 min Apgar scores and outcomes after adjusting for birth weight, gestational age, gender, outborn status, hypothermia treatment and centre. In the study cohort (n=174), 64/85 (75%) of those with 10 min Apgar score of 0-3 had death/disability compared with 40/89 (45%) of those with scores >3. Each point increase in 10 min Apgar scores was associated with a significantly lower adjusted risk of death/disability, death, death/IQ <70, death/cerebral palsy (CP) and disability, IQ<70 and CP among survivors (all p<0.05). Among the 24 children with a 10 min Apgar score of 0, five (20.8%) survived without disability. The risk-adjusted probabilities of death/disability were significantly lower in cooled infants with Apgar scores of 0-3; there was no significant interaction between cooling and Apgar scores (p=0.26). Among children with perinatal HIE enrolled in the NICHD cooling RCT, 10 min Apgar scores were significantly associated with school-age outcomes. A fifth of infants with 10 min Apgar score of 0 survived without disability to school age, suggesting the need for caution in limiting resuscitation to a specified duration.

  1. Apgar scores at 10 min and outcomes at 6–7 years following hypoxic-ischaemic encephalopathy

    PubMed Central

    Natarajan, Girija; Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; Bann, Carla M; McDonald, Scott A; Das, Abhik; Higgins, Rosemary D; Hintz, Susan R; Vohr, Betty R

    2014-01-01

    Aim To determine the association between 10 min Apgar scores and 6–7-year outcomes in children with perinatal hypoxic-ischaemic encephalopathy (HIE) enrolled in the National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN) whole body cooling randomised controlled trial (RCT). Methods Evaluations at 6–7 years included the Wechsler Preschool and Primary Scale of Intelligence III or Wechsler Intelligence Scale for Children IV and Gross Motor Functional Classification Scale. Primary outcome was death/moderate or severe disability. Logistic regression was used to examine the association between 10 min Apgar scores and outcomes after adjusting for birth weight, gestational age, gender, outborn status, hypothermia treatment and centre. Results In the study cohort (n=174), 64/85 (75%) of those with 10 min Apgar score of 0–3 had death/disability compared with 40/89 (45%) of those with scores >3. Each point increase in 10 min Apgar scores was associated with a significantly lower adjusted risk of death/disability, death, death/IQ <70, death/cerebral palsy (CP) and disability, IQ<70 and CP among survivors (all p<0.05). Among the 24 children with a 10 min Apgar score of 0, five (20.8%) survived without disability. The risk-adjusted probabilities of death/disability were significantly lower in cooled infants with Apgar scores of 0–3; there was no significant interaction between cooling and Apgar scores (p=0.26). Conclusions Among children with perinatal HIE enrolled in the NICHD cooling RCT, 10 min Apgar scores were significantly associated with school-age outcomes. A fifth of infants with 10 min Apgar score of 0 survived without disability to school age, suggesting the need for caution in limiting resuscitation to a specified duration. PMID:23896791

  2. Peer harassment and risky behavior among sexual minority girls and boys.

    PubMed

    Martin-Storey, Alexa; Crosnoe, Robert

    2014-01-01

    The role of peer harassment in the association between sexual minority status and adolescent risky behavior was examined for 15-year-olds in the NICHD Study of Early Child Care and Youth Development (n = 957). The findings, although exploratory, suggest the importance of gender. For girls, peer harassment was best viewed as a moderator of the link between sexual minority status and increased risky behavior. It intensified an existing association, reflecting the gendered nature of the impact of sexual minority status on the adolescent social context. For boys, peer harassment was primarily a mediator, such that sexual minority status was associated with more risky behavior via elevated harassment, although sexual minority status itself was associated with lower risky behavior overall. (c) 2014 APA, all rights reserved.

  3. Attachment and attention: protection in relation to gender and cumulative social-contextual adversity.

    PubMed

    Fearon, R M Pasco; Belsky, Jay

    2004-01-01

    Data from 918 children from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care were examined to test the interrelation of attachment and attentional performance and 2 known risks for poor attentional performance: male gender and social-contextual adversity. Attachment was measured using the Strange Situation at 15 months, attentional performance by a Continuous Performance Test (CPT) and maternal questionnaires at 54 months, and social-contextual adversity by a variety of measures from birth to 54 months. Findings indicated (a) that children with secure attachment were less susceptible to the effects of cumulative risk and gender on CPT attentional performance than their insecure counterparts and that (b) no such differential risk susceptibility was evident for maternal reports of attention-related behavior problems.

  4. Trajectories of Social Withdrawal from Grades 1 to 6: Prediction from Early Parenting, Attachment, and Temperament

    PubMed Central

    Booth-LaForce, Cathryn; Oxford, Monica L.

    2015-01-01

    From 1092 children in the NICHD Study of Early Child Care and Youth Development, we identified three trajectory patterns of social withdrawal from teacher reports in Grades 1-6: A Normative consistently low group (86%); a Decreasing group (5%) with initially high withdrawal that decreased; and an Increasing group (9%) with initially low withdrawal that increased. Prediction models supported the role of early dysregulated temperament, insensitive parenting, and attachment. Preschool shy temperament was a specific pathway to decreasing withdrawal, and poor inhibitory control, to increasing withdrawal. Children on the increasing pathway were more lonely, solitary, and excluded by peers. Results suggest differentiated pathways to varying trajectories of social withdrawal and highlight the importance of identification of longitudinal patterns in relation to risk. PMID:18793064

  5. Infertility Research at the NICHD

    MedlinePlus

    ... on this finding, visit PubMed ID: 21719000 . Previous experimental evidence has suggested a possible link between persistent ... in which uterine lining tissue grows out of control, including endometrial cancer and ... in all the groups whether or not women were treated with progestin ...

  6. NIH Institutes and Centers Served by TTC | NCI Technology Transfer Center | TTC

    Cancer.gov

    TTC services the NCI Intramural Research laboratories as well as nine other NIH institutes a range of services--NIDA, NIA, NIMHD, NICHD, NLM, CIT, NCCIH, Clinical Center, NEI. | [google6f4cd5334ac394ab.html

  7. What age-related factors may be involved with infertility in females and males?

    MedlinePlus

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  8. Sexual Minority Status, Peer Harassment, and Adolescent Depression

    PubMed Central

    Martin-Storey, Alexa; Crosnoe, Robert

    2012-01-01

    The well-documented higher rates of depression among sexual minority youth are increasingly viewed by developmentalists as a byproduct of the stigmatization of sexual minority status in American society and of the negative impact this stigma has on the processes associated with depression. This study attempted to spur future research by testing Hatzenbuehler’s (2009) psychological mediation framework to investigate the ways in which peer harassment related to sexuality puts young people at risk by influencing the cognitive, social, and regulatory factors associated with depression. Analyses of 15 year olds in the NICHD Study of Early Child Care and Youth Development revealed that sexual minority status was largely associated with depressive outcomes via harassment, which was subsequently associated with depression via cognitive and social factors. Results point to various avenues for exploring the importance of the social world and self-concept for the outcomes of sexual minority adolescents in the future. PMID:22401842

  9. Do Children's Executive Functions Account for Associations Between Early Autonomy-Supportive Parenting and Achievement Through High School?

    PubMed Central

    Bindman, Samantha W.; Pomerantz, Eva M.; Roisman, Glenn I.

    2015-01-01

    This study evaluated whether the positive association between early autonomy-supportive parenting and children's subsequent achievement is mediated by children's executive functions. Using observations of mothers’ parenting from the NICHD Study of Early Child Care and Youth Development (N = 1,306), analyses revealed that mothers’ autonomy support over the first 3 years of life predicted enhanced executive functions (i.e., inhibition, delay of gratification, and sustained attention) during the year prior to kindergarten and academic achievement in elementary and high school even when mothers’ warmth and cognitive stimulation, as well as other factors (e.g., children's early general cognitive skills and mothers’ educational attainment) were covaried. Mediation analyses demonstrated that over and above other attributes (e.g., temperament), children's executive functions partially accounted for the association between early autonomy-supportive parenting and children's subsequent achievement. PMID:26366009

  10. Do Children's Executive Functions Account for Associations Between Early Autonomy-Supportive Parenting and Achievement Through High School?

    PubMed

    Bindman, Samantha W; Pomerantz, Eva M; Roisman, Glenn I

    2015-08-01

    This study evaluated whether the positive association between early autonomy-supportive parenting and children's subsequent achievement is mediated by children's executive functions. Using observations of mothers' parenting from the NICHD Study of Early Child Care and Youth Development ( N = 1,306), analyses revealed that mothers' autonomy support over the first 3 years of life predicted enhanced executive functions (i.e., inhibition, delay of gratification, and sustained attention) during the year prior to kindergarten and academic achievement in elementary and high school even when mothers' warmth and cognitive stimulation, as well as other factors (e.g., children's early general cognitive skills and mothers' educational attainment) were covaried. Mediation analyses demonstrated that over and above other attributes (e.g., temperament), children's executive functions partially accounted for the association between early autonomy-supportive parenting and children's subsequent achievement.

  11. Family Background, School-Age Trajectories of Activity Participation, and Academic Achievement at the Start of High School.

    PubMed

    Crosnoe, Robert; Smith, Chelsea; Leventhal, Tama

    2015-07-01

    Applying latent class and regression techniques to data from the NICHD Study of Early Child Care and Youth Development ( n = 997), this study explored the potential academic advantages of time spent in out-of-school activities. Of particular interest was how these potential advantages played out in relation to the timing and duration of activity participation and the family contexts in which it occurred. Participation closer to the start of high school-including consistent participants and latecomers-was associated with higher grades at the transition into high school, especially for youth from low-income families. Sensitivity analyses indicated that this link between school-age activity participation and adolescent academic progress was unlikely to be solely a function of selection. It also tended to be more pronounced among youth from lower-income families, although without varying by other aspects of family status or process.

  12. Maternal employment, work schedules, and children's body mass index.

    PubMed

    Morrissey, Taryn W; Dunifon, Rachel E; Kalil, Ariel

    2011-01-01

    Previous work has shown that mothers' employment is associated with increases in children's body mass index (BMI), a measure of weight for height. Nonstandard work (working evenings or nights, weekends, or an irregular shift) may also be associated with children's BMI. This article examines the association between maternal work and children's BMI and considers the influence of mothers' nonstandard work schedules. Using data from school-age children (approximately 8 to 12 years) in the NICHD's Study of Early Child Care and Youth Development (N = 990), this study found that an increase in the total time a mother is employed is associated with an increase in her child's BMI; additionally, the association between maternal employment and children's weight is much stronger at 6th grade relative to younger ages. There was no evidence that maternal or home characteristics or children's time use mediated these associations, nor was there any evidence that nonstandard work was associated with children's BMI. Implications for policy and future research are discussed. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.

  13. Nonstandard maternal work schedules during infancy: Implications for children's early behavior problems

    PubMed Central

    Daniel, Stephanie S.; Grzywacz, Joseph G.; Leerkes, Esther; Tucker, Jenna; Han, Wen-Jui

    2009-01-01

    This paper examines the associations between maternal nonstandard work schedules during infancy and children's early behavior problems, and the extent to which infant temperament may moderate these associations. Hypothesized associations were tested using data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care (Phase I). Analyses focused on mothers who returned to work by the time the child was 6 months of age, and who worked an average of at least 35 h per week from 6 through 36 months. At 24 and 36 months, children whose mothers worked a nonstandard schedule had higher internalizing and externalizing behaviors. Modest, albeit inconsistent, evidence suggests that temperamentally reactive children may be more vulnerable to maternal work schedules. Maternal depressive symptoms partially mediated associations between nonstandard maternal work schedules and child behavior outcomes. PMID:19233479

  14. Temperament in early childhood and peer interactions in third grade: the role of teacher-child relationships in early elementary grades.

    PubMed

    Rudasill, Kathleen Moritz; Niehaus, Kate; Buhs, Eric; White, Jamie M

    2013-12-01

    Children's interactions with peers in early childhood have been consistently linked to their academic and social outcomes. Although both child and classroom characteristics have been implicated as contributors to children's success, there has been scant research linking child temperament, teacher-child relationship quality, and peer interactions in the same study. The purpose of this study is to examine children's early temperament, rated at preschool age, as a predictor of interactions with peers (i.e., aggression, relational aggression, victimization, and prosociality) in third grade while considering teacher-child relationship quality in kindergarten through second grades as a moderator and mediator of this association. The sample (N=1364) was drawn from the NICHD Study of Early Child Care and Youth Development. Results from structural equation models indicated that teacher-child conflict in early elementary grades mediated links between children's temperament and later peer interactions. Findings underscore the importance of considering children's temperament traits and teacher-child relationship quality when examining the mechanisms of the development of peer interactions. © 2013.

  15. Beyond Story Grammar: Looking at Stories through Cultural Lenses

    ERIC Educational Resources Information Center

    Urbach, Jennifer

    2012-01-01

    Literacy is a socially constructed ideology (Barton & Hamilton, 1998; Street, 1995). Current representations reduce literacy to standards, skill testing, and the five components of reading (NICHD, 2000). This view of literacy discounts the knowledge and skills of many students. This article examines the oral story of Aisha, an African American…

  16. Parenting and Preschool Self-Regulation as Predictors of Social Emotional Competence in 1st Grade

    PubMed Central

    Russell, Beth S.; Lee, Jungeun Olivia; Spieker, Susan; Oxford, Monica L.

    2016-01-01

    The current longitudinal study used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD) to examine a model of development that emphasizes early caregiving environments as predictors of social emotional competence (including classroom competence). This path analysis model included features of parenting, emotion regulation, preschool language skills, and attention to predict child outcomes in 1st grade. Early caregiving environments were directly predictive of peer relationship satisfaction, oppositional behavior, social skills, and classroom competence over and above significant mediated effects through preschool self regulation (language, inattention, and anger/frustration). These results suggest that the characteristics of supportive and stimulating caregiving shift in valence over time, such that qualities of the infant-child relationship that are significant in predicting early childhood outcomes are not the same as the caregiving qualities that move to the foreground in predicting primary school outcomes. Implications for school-readiness programming are discussed, including interventions in the early caregiving system to encourage sensitive and supportive parent child interactions to bolster school readiness via the development of social-emotional competence. PMID:27616805

  17. An SEM Assessment of the Internal Structure and Predictive Validity of the Abbreviated Early Adolescent HOME Inventory.

    PubMed

    Green, Samuel B; Pennar, Amy L; Bradley, Robert H

    2018-05-01

    The Home Observation for Measurement of the Environment (HOME) Inventory is designed to assess the quality and quantity of support, stimulation, and structure provided to children in the home environment. HOME has been widely used for research and applied purposes. We focused on an abbreviated version of the Early Adolescent HOME (EA-HOME-A) that was administered to 15-year-old adolescents and their parents ( N = 958) as part of the NICHD (National Institute of Child Health and Human Development) Study of Early Child Care and Youth Development. Our study had two objectives. First, we hypothesized and tested a bifactor model that specified a general factor in support of the use of the HOME total score and group factors for subsets of items in support of the content domain scores. Second, we applied structural equation modeling to relate the EA-HOME-A factors to outcome factors assessing maladaptive behaviors, autonomy, self-control, and cognitive-academic performance. The results supported the construct validity of the EA-HOME-A with respect to its internal structure as well as its correlates.

  18. Development and Lability in the Parent-Child Relationship During Adolescence: Associations With Pubertal Timing and Tempo

    PubMed Central

    Marceau, Kristine; Ram, Nilam; Susman, Elizabeth

    2014-01-01

    Adolescents' and parents' reactions to pubertal development are hypothesized to contribute to changes in family dynamics. Using 7-year longitudinal data from the NICHD-SECCYD (488 boys, 475 girls) we examined relations between pubertal development (timing, tempo) and trajectories (developmental change and year-to-year lability) of parent-child conflict and closeness from age 8.5 to 15.5 years. Changes were mostly characterized by year-to-year fluctuations – lability. Parent-child conflict increased and closeness decreased some with age. Pubertal timing and tempo were more consistently associated with lability in parent-child relationships than with long-term trends, although faster tempo was associated with steeper decreases in parent-child closeness. Findings provide a platform for examining how puberty contributes to both long-term and transient changes in adolescents' relationships and adjustment. PMID:26321856

  19. Gene Therapy Vector for the Treatment of Glycogen Storage Disease Type Ia (GSD-Ia) | NCI Technology Transfer Center | TTC

    Cancer.gov

    GSD-Ia is an inherited disorder of metabolism associated with life-threatening hypoglycemia, hepatic malignancy, and renal failure caused by the deficiency of glucose-6-phosphatase-alpha (G6Pase-alpha or G6PC). NICHD seeks parties to license this invention towards commercialization.

  20. Sexual minority status, peer harassment, and adolescent depression.

    PubMed

    Martin-Storey, Alexa; Crosnoe, Robert

    2012-08-01

    The well-documented higher rates of depression among sexual minority youth are increasingly viewed by developmentalists as a byproduct of the stigmatization of sexual minority status in American society and of the negative impact this stigma has on the processes associated with depression. This study attempted to spur future research by testing Hatzenbuehler's (2009) psychological mediation framework to investigate the ways in which peer harassment related to sexuality puts young people at risk by influencing the cognitive, social, and regulatory factors associated with depression. Analyses of 15 year olds in the NICHD Study of Early Child Care and Youth Development revealed that sexual minority status was largely associated with depressive outcomes via harassment, which was subsequently associated with depression via cognitive and social factors. Results point to various avenues for exploring the importance of the social world and self-concept for the outcomes of sexual minority adolescents in the future. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  1. Parenting in Infancy and Self-Regulation in Preschool: An Investigation of the Role of Attachment History

    PubMed Central

    Birmingham, R.S.; Bub, K.L.; Vaughn, B.E.

    2017-01-01

    Parenting and attachment are critical in the emergence of self-regulation (SR) in preschool. However, most studies use general indexes of parenting quality, failing to explore the unique contributions of sensitivity and home quality to SR. Further, the nature of the interplay between parenting and attachment history is not well understood. Using a sample of 938 children from The NICHD Study of Early Child Care and Youth Development, a series of structural equation models were fit to determine whether sensitivity and home quality concurrently predicted SR at 54 months, and whether attachment mediated or moderated these pathways. Results suggest that both sensitivity and home quality uniquely predict SR. Further, these early parenting variables were each indirectly associated with SR through children's attachment history. That is, higher levels of sensitivity and home quality predicted secure attachment history, which, along with parenting, predicted more advanced SR skills at 54 months. No moderated pathways emerged, suggesting attachment history may be best conceptualized as a mediating mechanism. PMID:27894211

  2. Family Processes in Child Anxiety: the Long-Term Impact of Fathers and Mothers.

    PubMed

    Stuart Parrigon, Kaela L; Kerns, Kathryn A

    2016-10-01

    The current study investigated links between parent and child anxiety, and family process factors, over a 9 year period. Specifically, we examined the role of partner conflict, attachment security and parental autonomy granting in explaining changes in child, father, and mother anxiety symptoms. We utilized data from the NICHD Study of Early Child Care and Youth Development (N = 661), from when target children were in first grade (6 years), fifth grade (10 years), and 15 years of age. We tested a longitudinal path model including both fathers and mothers, and found that the model was a good fit for the data. We also found that lower attachment security to fathers and a restriction of maternal autonomy granting predicted which children maintained anxiety into adolescence. Partner conflict explained the association between earlier and later parental anxiety, which is a novel finding in the literature. Together, these findings suggest that fathers play an important long-term role in child anxiety, alongside the role of mothers.

  3. Neonatal outcomes of extremely preterm infants from taiwan: comparison with Canada, Japan, and the USA.

    PubMed

    Su, Bai-Horng; Hsieh, Wu-Shiun; Hsu, Chyong-Hsin; Chang, Jui-Hsing; Lien, Reyin; Lin, Chyi-Her

    2015-02-01

    This study compared the current trend in survival rates and morbidity for very low birth weight (VLBW) infants in five Medical Training Centers of Prematurity for the Premature Baby Foundation of Taiwan (PBFT), with the outcomes from the USA, National Institute of Child Health and Human Development Neonatal Research Network (NICHD NRN), the Canadian Neonatal Network (CNN), and the Neonatal Research Network of Japan (NRNJ). The survival rates of VLBW infants according to gestational age (GA) and major morbidities were compared between networks (Taiwan, USA, Canada, and Japan). Taiwanese data for VLBW infants of GA ≤28 weeks between 2007 and 2012 were obtained from the "PBFT Annual Conferences of Premature Care" reports defining survival rate as neonates that survived to the time of discharge. Major morbidities included severe neurological injury (Grade 3 or 4 intraventricular hemorrhage or periventricular leukomalacia), bronchopulmonary dysplasia, severe retinopathy of prematurity, necrotizing enterocolitis, late-onset sepsis, and patent ductus arteriosus. The survival rates of VLBW infants of GA ≤28 weeks from the PBFT (Taiwan), NICHD NRN (USA), CNN (Canada), and NRNJ (Japan) were 77% (1323/1718), 72% (6859/9575), 82% (2353/2872), and 89% (4489/5069), respectively. The annual survival rates in Taiwan from 2007 to 2012 were 72%, 76%, 76%, 74%, 77%, and 78%, respectively. When GA from ≤23 weeks to 28 weeks was assessed in Taiwan, the survival rates of VLBW infants according to each week were 22%, 50%, 70%, 80%, 88%, and 92%, respectively. The survival rate, especially at lower GAs, was highest in the NRNJ (Japan). The major difference between Taiwan and Japan was attributed to the lower survival rates at lower GA (≤26 weeks) in Taiwan. Japan had the lowest rates of major morbidities among the four countries. The survival rate of VLBW infants has improved over the past 6 years in Taiwan. It is higher than the USA, but lower than Canada and Japan. However, the results from Taiwan are from five Medical Training Centers for the PBFT rather than from a population-based study. It is crucial to have a nationwide neonatal research network to develop new practical approaches for VLBW infants in Taiwan. Copyright © 2014. Published by Elsevier B.V.

  4. Family, employment, and individual resource-based antecedents of maternal work-family enrichment from infancy through middle childhood.

    PubMed

    Zhou, Nan; Buehler, Cheryl

    2016-07-01

    This study used data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (N = 1,019) to examine family, employment, and individual antecedents of maternal work-family enrichment from infancy through middle childhood. Work-family conflict and important confounding factors were controlled. From the family domain, higher income-to-needs ratio and social support were associated with higher work-family enrichment. From the employment domain, greater job rewards, benefits of employment for children, and work commitment were associated with higher work-family enrichment. From the individual domain, higher maternal education and extroversion were associated with higher work-family enrichment. No family, employment, and individual characteristics were associated with work-family conflict across time except for partner intimacy. In general, the results supported antecedents of work-family enrichment that supply needed resources. The present study contributed to the literature by identifying antecedents of maternal work-family enrichment across early child developmental stages, which goes beyond examinations of particular life stages and a work-family conflict perspective. Implications for theory and practice are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  5. Distinguishing differential susceptibility from diathesis-stress: recommendations for evaluating interaction effects.

    PubMed

    Roisman, Glenn I; Newman, Daniel A; Fraley, R Chris; Haltigan, John D; Groh, Ashley M; Haydon, Katherine C

    2012-05-01

    This report describes the state of the art in distinguishing data generated by differential susceptibility from diathesis-stress models. We discuss several limitations of existing practices for probing interaction effects and offer solutions that are designed to better differentiate differential susceptibility from diathesis-stress models and quantify their corresponding implications. In addition, we demonstrate the utility of these methods by revisiting published evidence suggesting that temperamental difficulty serves as a marker of enhanced susceptibility to early maternal caregiving across a range of outcome domains in the NICHD Study of Early Child Care and Youth Development. We find that, with the exception of mother reports of psychopathology, there is consistent evidence in the Study of Early Child Care and Youth Development that the predictive significance of early sensitivity is moderated by difficult temperament over time. However, differential susceptibility effects emerged primarily for teacher reports of academic skills, social competence, and symptomatology. In contrast, effects more consistent with the diathesis-stress model were obtained for mother reports of social skills and objective tests of academic skills. We conclude by discussing the value of the application of this work to the next wave of Gene × Environment studies focused on early caregiving experiences.

  6. Erratum to: Less depressed or less forthcoming? Self-report of depression symptoms in women preparing for in vitro fertilization.

    PubMed

    Lewis, Adam M; Liu, Dawei; Stuart, Scott P; Ryan, Ginny

    2015-04-01

    Erratum to: Arch Womens Ment Health (2013) 16:87–92 DOI 10.1007/s00737-012-0317-8. The original version of this article unfortunately missed the Acknowledgment which is stated below: “This work was partially supported by a grant from the NICHD (K12-HD063117).”

  7. Family, Employment, and Individual Resource-Based Antecedents of Maternal Work-Family Enrichment from Infancy through Middle Childhood

    PubMed Central

    Zhou, Nan; Buehler, Cheryl

    2015-01-01

    This study used data from the NICHD Study of Early Child Care and Youth Development (N = 1,019) to examine family, employment, and individual antecedents of maternal work-family enrichment from infancy through middle childhood. Work-family conflict and important confounding factors were controlled. From the family domain, higher income-to-needs ratio and social support were associated with higher work-family enrichment. From the employment domain, greater job rewards, benefits of employment for children, and work commitment were associated with higher work-family enrichment. From the individual domain, higher maternal education and extroversion were associated with higher work-family enrichment. No family, employment, and individual characteristics were associated with work-family conflict across time except for partner intimacy. In general, the results supported antecedents of work-family enrichment that supply needed resources. The present study contributed to the literature by identifying antecedents of maternal work-family enrichment across early child developmental stages, which goes beyond examinations of particular life stages and a work-family conflict perspective. Implications for theory and practice are discussed. PMID:26641483

  8. Syphilis in HIV-Infected Mothers and Infants: Results from the NICHD/HPTN 040 Study

    PubMed Central

    Yeganeh, Nava; Watts, Heather D.; Camarca, Margaret; Soares, Gabriel; Joao, Esau; Pilotto, Jose Henrique; Gray, Glenda; Theron, Gerhard; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa; Ceriotto, Mariana; Machado, Daisy Maria; Veloso, Valdilea G.; Grinzstejn, Beatriz; Morgado, Mariza G; Bryson, Yvonne; Mofenson, Lynne M.; Nielsen-Saines, Karin

    2014-01-01

    Background Untreated syphilis during pregnancy is associated with spontaneous abortion, stillbirth, prematurity and infant mortality. Syphilis may facilitate HIV transmission, which is especially concerning in low and middle income countries where both diseases are common. Methods We performed an analysis of data available from NICHD/HPTN 040 (P1043), a study focused on the prevention of intrapartum HIV transmission to 1684 infants born to 1664 untreated HIV-infected women. The present analysis evaluates risk factors and outcomes associated with a syphilis diagnosis in this cohort of HIV-infected women and their infants. Results Approximately 10% (n=171) of women enrolled had serological evidence of syphilis without adequate treatment documented and 1.4% (n=24) infants were dually HIV and syphilis infected. Multivariate logistic analysis showed that compared to HIV-infected women, co-infected women were significantly more likely to self-identify as non-white (AOR 2.5, 95% CI 1.5-4.2), to consume alcohol during pregnancy (AOR 1.5, 95% CI 1.1-2.1) and to transmit HIV to their infants (AOR 2.1, 95% CI 1.3-3.4), with 88% of HIV infections being acquired in-utero. As compared to HIV infected or HIV exposed infants, co-infected infants were significantly more likely to be born to mothers with VDRL titers ≥1:16 (AOR 3, 95% CI 1.1-8.2) and higher viral loads (AOR 1.5 95% CI 1.1-1.9). Of 6 newborns with symptomatic syphilis, 2 expired shortly after birth, and 2 were HIV-infected. Conclusion Syphilis continues to be a common co-infection in HIV-infected women and can facilitate in utero transmission of HIV to infants. Most infants are asymptomatic at birth, but those with symptoms have high mortality rates. PMID:25742089

  9. Syphilis in HIV-infected mothers and infants: results from the NICHD/HPTN 040 study.

    PubMed

    Yeganeh, Nava; Watts, Heather D; Camarca, Margaret; Soares, Gabriel; Joao, Esau; Pilotto, Jose Henrique; Gray, Glenda; Theron, Gerhard; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa; Ceriotto, Mariana; Machado, Daisy Maria; Grinzstejn, Beatriz; Grinsztejn, Beatriz; Veloso, Valdilea G; Morgado, Mariza G; Bryson, Yvonne; Mofenson, Lynne M; Nielsen-Saines, Karin

    2015-03-01

    Untreated syphilis during pregnancy is associated with spontaneous abortion, stillbirth, prematurity and infant mortality. Syphilis may facilitate HIV transmission, which is especially concerning in low- and middle-income countries where both diseases are common. We performed an analysis of data available from NICHD/HPTN 040 (P1043), a study focused on the prevention of intrapartum HIV transmission to 1684 infants born to 1664 untreated HIV-infected women. This analysis evaluates risk factors and outcomes associated with a syphilis diagnosis in this cohort of HIV-infected women and their infants. Approximately, 10% of women (n=171) enrolled had serological evidence of syphilis without adequate treatment documented and 1.4% infants (n=24) were dually HIV and syphilis infected. Multivariate logistic analysis showed that compared with HIV-infected women, co-infected women were significantly more likely to self-identify as non-white (adjusted odds ratio [AOR] 2.5, 95% CI: 1.5-4.2), to consume alcohol during pregnancy (AOR 1.5, 95% CI: 1.1-2.1) and to transmit HIV to their infants (AOR 2.1, 95% CI: 1.3-3.4), with 88% of HIV infections being acquired in utero. As compared with HIV-infected or HIV-exposed infants, co-infected infants were significantly more likely to be born to mothers with venereal disease research laboratory titers≥1:16 (AOR 3, 95% CI: 1.1-8.2) and higher viral loads (AOR 1.5, 95% CI: 1.1-1.9). Of 6 newborns with symptomatic syphilis, 2 expired shortly after birth, and 2 were HIV-infected. Syphilis continues to be a common co-infection in HIV-infected women and can facilitate in utero transmission of HIV to infants. Most infants are asymptomatic at birth, but those with symptoms have high mortality rates.

  10. Eunice Kennedy Shriver National Institute of Child Health and Human Development Pediatric Formulation Initiative: selected reports from working groups.

    PubMed

    Giacoia, George P; Taylor-Zapata, Perdita; Mattison, Donald

    2008-11-01

    The Pediatric Formulation Initiative (PFI) is a project of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). The PFI was established to address the issue of the lack of appropriate formulations in children and to use this activity as a means to improve pediatric formulations, as mandated by the Best Pharmaceuticals for Children Act of 2002 and 2007. The PFI began in 2005 with the formation of 3 working groups-Scientific, Economics, and Taste and Flavor. These groups began the process of identifying issues, gathering needed information, and considering possible ways to overcome barriers to the development of pediatric drug formulations. The purpose of this supplement was to provide details of the working groups' activities through presentation of full-length articles. Also presented is an article that discusses the 2007 European Union (EU) regulation on medicinal products for pediatric use. Information for this article was gathered from the proceedings of a PFI workshop, sponsored by the NICHD, that was held in Bethesda, Maryland, on December 6 and 7, 2005, as well as postworkshop discussions of the different working groups. The increased awareness that the majority of medications used today have not been labeled for use in children, and have not been tested to define safety, efficacy, and appropriate dosing, has led to the passage of legislation in the United States and in the EU to create incentives to stimulate the testing of drugs in this special population. It is imperative that the problems associated with the compounding and use of extemporaneous formulations as described in this supplement be addressed. Regulatory barriers to the availability of commercially developed pediatric formulations in different countries will need to be minimized or removed. New drug delivery systems will need to be tested and made available to pediatric patients. Further research in the mediators of bitter taste and study of taste blockers, as well as newer methods for taste testing in pediatrics, should be encouraged. An overarching goal for the future is addressing the economic barriers to develop appropriate pediatric dosage forms for drugs with limited market penetration. The lack of appropriate formulations is part of a larger problem that includes limited development and manufacture of medicines tailored for pediatric patients (particularly those affected by neglected diseases), insufficient investment in drug trials, and limited research on drug disposition in various pediatric populations worldwide. The solution to these issues will require alignment of vision and commitment as a global priority of policy makers, regulators, scientists, pharmaceutical sponsors, academic institutions, governments, and research foundations.

  11. Can teacher-child relationships alter the effects of early socioeconomic status on achievement in middle childhood?

    PubMed

    McCormick, Meghan P; O'Connor, Erin E; Parham Horn, E

    2017-10-01

    Using data from the NICHD SECCYD (N=1053), we used two-level hierarchical linear models with site fixed effects to examine whether teacher-child closeness and conflict moderated associations between two indicators of early socioeconomic status (maternal education and family income) and standardized measures of children's math and reading achievement at 54months, 1st, 3rd, and 5th grades. Children whose mothers had lower levels of education and conflictual relationships with teachers exhibited lower reading achievement, on average, across elementary school. At the same time, children with less educated mothers who experienced increases in teacher-child closeness and decreases in teacher-child conflict exhibited improvements in reading achievement across elementary school. Finally, low teacher-child closeness elevated the risk for poor math achievement posed by low family income. Implications for intervention design and development are discussed. Copyright © 2017 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  12. Do human figure diagrams help alleged victims of sexual abuse provide elaborate and clear accounts of physical contact with alleged perpetrators?

    PubMed

    Teoh, Yee-San; Yang, Pei-Jung; Lamb, Michael E; Larsson, Anneli S

    2010-02-01

    The present study examined whether the use of human figure diagrams within a well-structured interview was associated with more elaborate and clearer accounts about physical contact that had occurred in the course of an alleged abuse. The sample included investigative interviews of 88 children ranging from 4 to 13 years of age. Children were interviewed using the NICHD Investigative Interview Protocol, and were then asked a series of questions in association with unclothed gender-neutral outline diagrams of a human body. A new coding scheme was developed to examine the types and clarity of touch-related information. Use of the HFDs was associated with reports of new touches not mentioned before and elaborations regarding the body parts reportedly touched. The HFDs especially helped clarify reports by the oldest rather than the youngest children. The clarity of children's accounts of touch was also greater when details were sought using recall prompts.

  13. Caregiving Antecedents of Secure Base Script Knowledge: A Comparative Analysis of Young Adult Attachment Representations

    PubMed Central

    Steele, Ryan D.; Waters, Theodore E. A.; Bost, Kelly K.; Vaughn, Brian E.; Truitt, Warren; Waters, Harriet S.; Booth-LaForce, Cathryn; Roisman, Glenn I.

    2015-01-01

    Based on a sub-sample (N = 673) of the NICHD Study of Early Child Care and Youth Development (SECCYD) cohort, this paper reports data from a follow-up assessment at age 18 years on the antecedents of secure base script knowledge, as reflected in the ability to generate narratives in which attachment-related difficulties are recognized, competent help is provided, and the problem is resolved. Secure base script knowledge was (a) modestly to moderately correlated with more well established assessments of adult attachment, (b) associated with mother-child attachment in the first three years of life and with observations of maternal and paternal sensitivity from childhood to adolescence, and (c) partially accounted for associations previously documented in the SECCYD cohort between early caregiving experiences and Adult Attachment Interview states of mind (Booth-LaForce & Roisman, 2014) as well as self-reported attachment styles (Fraley, Roisman, Booth-LaForce, Owen, & Holland, 2013). PMID:25264703

  14. Mother-child relationships, family context, and child characteristics as predictors of anxiety symptoms in middle childhood.

    PubMed

    Kerns, Kathryn A; Siener, Shannon; Brumariu, Laura E

    2011-05-01

    The goal of the study was to examine several factors that may explain the development of anxiety symptoms in middle childhood. Using data from the NICHD Study of Early Child Care (n = 1,364 families), we examined mother-child relationships, other aspects of family context, and child characteristics as predictors of anxiety in preadolescence. Latent growth curve analyses revealed that children who were more anxious at the beginning of middle childhood had been more behaviorally inhibited as preschoolers, and in middle childhood lived in families who experienced more negative life events and had mothers who were more anxious. Children who became more anxious across middle childhood were less behaviorally inhibited as preschoolers and in middle childhood perceived less security in their attachments to their mothers, experienced more negative life events, and had mothers who were more anxious. The findings illustrate the need to include a broad set of risk factors in etiological models of anxiety. In addition, the evidence for cumulative effects suggests several possible points of intervention with anxious children and their parents.

  15. The Impact of Fluency Intervention on the Oral Reading Fluency and Comprehension of Middle School Students with Learning Disabilities

    ERIC Educational Resources Information Center

    Russell, Janice M.

    2012-01-01

    Proficient reading is a necessary skill for a quality life. While educators would like to believe that most students master the art of reading and can understand what they read, national reports indicate that learning to read and becoming a skilled reader is not mastered by all (No Child Left Behind Act, 2001; NICHD, 2000a). One component of…

  16. External-environmental and internal-health early life predictors of adolescent development.

    PubMed

    Hartman, Sarah; Li, Zhi; Nettle, Daniel; Belsky, Jay

    2017-12-01

    A wealth of evidence documents associations between various aspects of the rearing environment and later development. Two evolutionary-inspired models advance explanations for why and how such early experiences shape later functioning: (a) the external-prediction model, which highlights the role of the early environment (e.g., parenting) in regulating children's development, and (b) the internal-prediction model, which emphasizes internal state (i.e., health) as the critical regulator. Thus, by using data from the NICHD Study of Early Child Care and Youth Development, the current project draws from both models by investigating whether the effect of the early environment on later adolescent functioning is subject to an indirect effect by internal-health variables. Results showed a significant indirect effect of internal health on the relation between the early environment and adolescent behavior. Specifically, early environmental adversity during the first 5 years of life predicted lower quality health during childhood, which then led to problematic adolescent functioning and earlier age of menarche for girls. In addition, for girls, early adversity predicted lower quality health that forecasted earlier age of menarche leading to increased adolescent risk taking. The discussion highlights the importance of integrating both internal and external models to further understand the developmental processes that effect adolescent behavior.

  17. Growth regulation by estrogen in breast cancer 1 (GREB1) is a novel progesterone-responsive gene required for human endometrial stromal decidualization.

    PubMed

    Camden, Alison J; Szwarc, Maria M; Chadchan, Sangappa B; DeMayo, Francesco J; O'Malley, Bert W; Lydon, John P; Kommagani, Ramakrishna

    2017-09-01

    Is Growth Regulation by Estrogen in Breast Cancer 1 (GREB1) required for progesterone-driven endometrial stromal cell decidualization? GREB1 is a novel progesterone-responsive gene required for progesterone-driven human endometrial stromal cell (HESC) decidualization. Successful establishment of pregnancy requires HESCs to transform from fibroblastic to epithelioid cells in a process called decidualization. This process depends on the hormone progesterone, but the molecular mechanisms by which it occurs have not been determined. Primary and transformed HESCs in which GREB1 expression was knocked down were decidualized in culture for up to 6 days. Wild-type and progesterone receptor (PR) knockout mice were treated with progesterone, and their uteri were assessed for levels of GREB1 expression. Analysis of previous data included data mining of expression profile data sets and in silico transcription factor-binding analysis. Endometrial biopsies obtained from healthy women of reproductive age during the proliferative phase (Days 8-12) of their menstrual cycle were used for isolating HESCs. Experiments were carried out with early passage (no more than four passages) HESCs isolated from at least three subjects. Transcript levels of decidualization markers prolactin (PRL) and insulin-like growth factor-binding protein-1 (IGFBP-1) were detected by quantitative RT-PCR as readouts for HESC decidualization. Cells were also imaged by phase-contrast microscopy. To assess the requirement for GREB1, PR and SRC-2, cells were transfected with specifically targeted small interfering RNAs. Results are shown as mean and SE from three replicates of one representative patient-derived primary endometrial cell line. Experiments were also conducted with transformed HESCs. Progesterone treatment of mice and transformed HESCs led to an ~5-fold (5.6 ± 0.81, P < 0.05, and 5.2 ± 0.26, P < 0.01, respectively) increase in GREB1 transcript levels. This increase was significantly reduced in the uteri of PR knock-out mice (P < 0.01), in HESCs treated with the PR antagonist RU486 (P < 0.01), or in HESCs in which PR expression was knocked down (P < 0.05). When GREB1 expression was knocked down, progesterone-driven decidualization markers in both immortalized and primary HESCs was significantly reduced (P < 0.05 and P < 0.01). Finally, GREB1 knock down signficantly reduced expression of the PR target genes WNT4 and FOXOA1 (P < 0.05 and P < 0.01, respectively). This study used the Nuclear Receptor Signaling Atlas. Although in vitro cell culture studies indicate that GREB1 is required for endoemtrial decidualization, the in vivo role of GREB1 in endometrial function and dysfunction should be assessed by using knock-out mouse models. Identification and functional analysis of GREB1 as a key molecular mediator of decidualization may lead to improved diagnosis and clinical management of women with peri-implantation loss due to inadequate endometrial decidualization. This research was funded in part by: a National Institutes of Health (NIH)/ National Institute of Child Health and Human Development (NICHD) grant (R00 HD080742) and Washington University School of Medicine start-up funds to R.K., an NIH/NICHD grant (RO1 HD-07857) to B.W.O.M., and a NIH/NICHD grant (R01 HD-042311) to J.P.L. The authors declare no conflicts of interests. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  18. Summary of the NICHD-BPCA Pediatric Formulation Initiatives Workshop-Pediatric Biopharmaceutics Classification System (PBCS) Working Group

    PubMed Central

    Abdel-Rahman, Susan; Amidon, Gordon L.; Kaul, Ajay; Lukacova, Viera; Vinks, Alexander A.; Knipp, Gregory

    2012-01-01

    The Biopharmaceutics Classification System (BCS) allows compounds to be classified based on their in vitro solubility and intestinal permeability. The BCS has found widespread use in the pharmaceutical community as an enabling guide for the rational selection of compounds, formulation for clinical advancement and generic biowaivers. The Pediatric Biopharmaceutics Classification System (PBCS) working group was convened to consider the possibility of developing an analogous pediatric based classification system. Since there are distinct developmental differences that can alter intestinal contents, volumes, permeability and potentially biorelevant solubilities at the different ages, the PBCS working group focused on identifying age specific issues that would need to be considered in establishing a flexible, yet rigorous PBCS. Objective To summarize the findings of the PBCS working group and provide insights into considerations required for the development of a pediatric based biopharmaceutics classification system. Methods Through several meetings conducted both at The Eunice Kennedy Shriver National Institute of Child Health, Human Development (NICHD)-US Pediatric Formulation Initiative (PFI) workshop (November 2011) and via teleconferences, the PBCS working group considered several high level questions that were raised to frame the classification system. In addition, the PBCS working group identified a number of knowledge gaps that would need to be addressed in order to develop a rigorous PBCS. Results It was determined that for a PBCS to be truly meaningful, it would need to be broken down into several different age groups that would account for developmental changes in intestinal permeability, luminal contents, and gastrointestinal transit. Several critical knowledge gaps where identified including: 1) a lack of fully understanding the ontogeny of drug metabolizing enzymes and transporters along the gastrointestinal (GI) tract, in the liver and in the kidney; 2) an incomplete understanding of age-based changes in the GI, liver and kidney physiology; 3) a clear need to better understand age-based intestinal permeability and fraction absorbed required to develop the PBCS; 4) a clear need for the development and organization of pediatric tissue biobanks to serve as a source for ontogenic research; and 5) a lack of literature published in age-based pediatric pharmacokinetics in order to build Physiologically- and Population-Based Pharmacokinetic (PBPK) databases. Conclusions To begin the process of establishing a PBPK model, ten pediatric therapeutic agents were selected (based on their adult BCS classifications). Those agents should be targeted for additional research in the future. The PBCS working group also identified several areas where a greater emphasis on research is needed to enable the development of a PBCS. PMID:23149009

  19. Patient Safety in the Context of Neonatal Intensive Care: Research and Educational Opportunities

    PubMed Central

    Raju, Tonse N. K.; Suresh, Gautham; Higgins, Rosemary D.

    2012-01-01

    Case reports and observational studies continue to report adverse events from medical errors. However, despite considerable attention to patient safety in the popular media, this topic is not a regular component of medical education, and much research needs to be carried out to understand the causes, consequences, and prevention of healthcare-related adverse events during neonatal intensive care. To address the knowledge gaps and to formulate a research and educational agenda in neonatology, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) invited a panel of experts to a workshop in August 2010. Patient safety issues discussed were: the reasons for errors, including systems design, working conditions, and worker fatigue; a need to develop a “culture” of patient safety; the role of electronic medical records, information technology, and simulators in reducing errors; error disclosure practices; medico-legal concerns; and educational needs. Specific neonatology-related topics discussed were: errors during resuscitation, mechanical ventilation, and performance of invasive procedures; medication errors including those associated with milk feedings; diagnostic errors; and misidentification of patients. This article provides an executive summary of the workshop. PMID:21386749

  20. Presence and Quality of Kindergarten Children’s Friendships: Concurrent and Longitudinal Associations with Child Adjustment in the Early School Years

    PubMed Central

    Engle, Jennifer M.; McElwain, Nancy L.

    2010-01-01

    The presence and quality of friendships are posited to have developmental significance, yet little is known about the extent to which children without friends versus low-quality friendships compare on socioemotional adjustment. The current study utilized data from a subsample of 567 children (289 boys) participating in the NICHD Study of Early Child Care and Youth Development. Based on maternal reports at kindergarten, four friendship groups were formed: no friends, low quality, average quality, and high quality, and these groups were used to predict teacher-reported behavior problems and social skills concurrently (in kindergarten) and longitudinally (in first and third grade). Concurrently, low-quality friendships were associated with greater externalizing behavior, whereas high-quality friendships were associated with greater social skills. Longitudinally, having no friends in kindergarten was associated with higher levels of externalizing behavior for boys, but lower levels for girls. Children without friends also showed more internalizing problems at first grade. Lastly, having a high-quality friendship in kindergarten was associated with greater social skills in first and third grades, but only for boys. Results underscore high-quality friendship as a context for the development of social skills and indicate different trajectories of problem behavior for kindergarten children with no friends versus low-quality friendships. PMID:21822401

  1. Quantitative CT scans of lung parenchymal pathology in premature infants ages 0-6 years.

    PubMed

    Spielberg, David R; Walkup, Laura L; Stein, Jill M; Crotty, Eric J; Rattan, Mantosh S; Hossain, Md Monir; Brody, Alan S; Woods, Jason C

    2018-03-01

    Bronchopulmonary dysplasia (BPD) is a common, heterogeneous disease in premature infants. We hypothesized that quantitative CT techniques could assess lung parenchymal heterogeneity in BPD patients across a broad age range and demonstrate how pathologies change over time. A cross-sectional, retrospective study of children age 0-6 years with non-contrast chest CT scans was conducted. BPD subjects met NICHD/NHLBI diagnostic criteria for BPD and were excluded for congenital lung/airway abnormalities or other known/suspected pulmonary diagnoses; control subjects were not premature and had normal CT scan findings. Radiologic opacities, lucencies, and spatial heterogeneity were quantified via: 1) thresholding using CT-attenuation (HU); 2) manual segmentation; and 3) Ochiai reader-scoring system. Clinical outcomes included BPD severity by NICHD/NHLBI criteria, respiratory support at NICU discharge, wheezing, and respiratory exacerbations. Heterogeneity (standard deviation) of lung attenuation in BPD was significantly greater than in controls (difference 36.4 HU [26.1-46.7 HU], P < 0.001); the difference between the groups decreased 0.58 HU per month of age (0.08-1.07 HU per month, P = 0.02). BPD patients had greater amounts of opacities and lucencies than controls except with automated quantification of lucencies. Cross-sectionally, lucencies per Ochiai score and opacities per manual segmentation decreased with time. No approach measured a statistically significant relationship to BPD clinical severity. Opacities, lucencies, and overall heterogeneity of lungs via quantitative CT can distinguish BPD patients from healthy controls, and these abnormalities decrease with age across BPD patients. Defining BPD severity by clinical outcomes such as respiratory support at several time points (vs a single time point, per current guidelines) may be meaningful. © 2017 Wiley Periodicals, Inc.

  2. Dyslipidemia in a Cohort of HIV-infected Latin American Children Receiving Highly Active Antiretroviral Therapy*

    PubMed Central

    Brewinski, Margaret; Megazzini, Karen; Freimanis Hance, Laura; Cruz, Miguel Cashat; Pavia-Ruz, Noris; Della Negra, Marinella; Ferreira, Flavia Gomes Faleiro; Marques, Heloisa

    2011-01-01

    In order to describe the prevalence of hypercholesterolemia and hypertriglyceridemia in a cohort of HIV-infected children and adolescents in Latin America and to determine associations with highly active antiretroviral therapy (HAART), we performed this cross-sectional analysis within the NICHD International Site Development Initiative pediatric cohort study. Eligible children had to be at least 2 years of age and be on HAART. Among the 477 eligible HIV-infected youth, 98 (20.5%) had hypercholesterolemia and 140 (29.4%) had hypertriglyceridemia. In multivariable analyses, children receiving protease inhibitor (PI)-containing HAART were at increased risk for hypercholesterolemia [adjusted odds ratio (AOR) = 2.7, 95% confidence interval (CI) 1.3–5.6] and hypertriglyceridemia (AOR = 3.5, 95% CI 1.9–6.4) compared with children receiving non-nucleoside reverse transcriptase inhibitor (NNRTI)-containing HAART. In conclusion, HIV-infected youth receiving PI-containing HAART in this Latin American cohort were at increased risk for hypercholesterolemia and hypertriglyceridemia compared with those receiving NNRTI-containing HAART. PMID:20889625

  3. Are middle schools harmful? The role of transition timing, classroom quality and school characteristics.

    PubMed

    Holas, Igor; Huston, Aletha C

    2012-03-01

    Are middle schools ill-suited for early adolescents, or can school characteristics account for any differences in student functioning? Achievement, school engagement, and perceived competence of children starting middle schools in 5th and 6th grades were compared to those of their same-grade peers in elementary schools in a national, longitudinal sample (NICHD Study of Early Child Care and Youth Development, n = 855; 52% Female, 82% White). Classroom quality (observed and teacher-reported) and school characteristics (composition and size) were considered as explanations for any relationships between school-level and student functioning. Fifth grade middle school students did not differ from those in elementary school, but students entering middle school in 6th grade, compared to those in elementary school, experienced lower classroom quality, which in turn predicted slightly lower achievement. They also had lower school engagement, explained by larger school size. Classroom quality and school characteristics predicted youth functioning regardless of school type. We suggest reshaping the research and policy debate with renewed focus on classroom quality and school size instead of grade organization.

  4. Infants’ Early Visual Attention and Social Engagement as Developmental Precursors to Joint Attention

    PubMed Central

    Salley, Brenda; Sheinkopf, Stephen J.; Neal-Beevers, A. Rebecca; Tenenbaum, Elena J.; Miller-Loncar, Cynthia L.; Tronick, Ed; Lagasse, Linda L.; Shankaran, Seetha; Bada, Henrietta; Bauer, Charles; Whitaker, Toni; Hammond, Jane; Lester, Barry M.

    2016-01-01

    This study examined infants’ early visual attention (at 1 month of age) and social engagement (4 months) as predictors of their later joint attention (12 and 18 months). The sample (n=325), drawn from the Maternal Lifestyle Study, a longitudinal multicenter project conducted at four centers of the NICHD Neonatal Research Network, included high-risk (cocaine exposed) and matched non-cocaine exposed infants. Hierarchical regressions revealed that infants’ attention orienting at 1 month significantly predicted more frequent initiating joint attention at 12 (but not 18) months of age. Social engagement at 4 months predicted initiating joint attention at 18 months. Results provide the first empirical evidence for the role of visual attention and social engagement behaviors as developmental precursors for later joint attention outcome. PMID:27786527

  5. Interpersonal and Genetic Origins of Adult Attachment Styles: A Longitudinal Study from Infancy to Early Adulthood

    PubMed Central

    Fraley, R. Chris; Roisman, Glenn I.; Booth-LaForce, Cathryn; Owen, Margaret Tresch; Holland, Ashley S.

    2013-01-01

    One of the assumptions of attachment theory is that individual differences in adult attachment styles emerge from individuals’ developmental histories. To examine this assumption empirically the authors report data from an age 18 follow-up (Booth-LaForce & Roisman, 2012) of the NICHD Study of Early Child Care and Youth Development, a longitudinal investigation that tracked a cohort of children and their parents from birth to age 15. Analyses indicate that individual differences in adult attachment can be traced to variations in the quality of individuals’ caregiving environments, their emerging social competence, and the quality of their best friendship. Analyses also indicate that assessments of temperament and most of the specific genetic polymorphisms thus far examined in the literature on genetic correlates of attachment styles were essentially uncorrelated with adult attachment, with the exception of a polymorphism in the serotonin receptor gene (HTR2A rs6313), which modestly predicted higher attachment anxiety and that revealed a G × E interaction such that changes in maternal sensitivity across time predicted attachment-related avoidance. The implications of these data for contemporary perspectives and debates concerning adult attachment theory are discussed. PMID:23397970

  6. Mothers' part-time employment: associations with mother and family well-being.

    PubMed

    Buehler, Cheryl; O'Brien, Marion

    2011-12-01

    The associations between mothers' part-time employment and mother well-being, parenting, and family functioning were examined using seven waves of the NICHD Study of Early Child Care and Youth Development data (N = 1,364), infancy through middle childhood. Concurrent comparisons were made between families in which mothers were employed part time and both those in which mothers were not employed and those in which mothers were employed full time. Using multivariate analysis of covariance with extensive controls, results indicated that mothers employed part time had fewer depressive symptoms during the infancy and preschool years and better self-reported health at most time points than did nonemployed mothers. Across the time span studied, mothers working part time tended to report less conflict between work and family than those working full time. During their children's preschool years, mothers employed part time exhibited more sensitive parenting than did other mothers, and at school age were more involved in school and provided more learning opportunities than mothers employed full time. Mothers employed part time reported doing a higher proportion of child care and housework than mothers employed full time. Part-time employment appears to have some benefits for mothers and families throughout the child rearing years.

  7. Relations between three dopaminergic system genes, school attachment, and adolescent delinquency.

    PubMed

    Fine, Adam; Mahler, Alissa; Simmons, Cortney; Chen, Chuansheng; Moyzis, Robert; Cauffman, Elizabeth

    2016-11-01

    Both environmental factors and genetic variation, particularly in genes responsible for the dopaminergic system such as DRD4, DRD2, and DAT1 (SLC6A3), affect adolescent delinquency. The school context, despite its developmental importance, has been overlooked in gene-environment research. Using data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (NICHD ECCYD), this study examined key interactions between school attachment and (a) each of the DRD4, DRD2, and DAT1 (SLC6A3) genotypes; and (b) a polygenic score. Results indicate that there is a main effect of school attachment, unlike genetic variation, on delinquency. Interestingly, there are important interactive effects of school attachment and dopaminergic genotypes on delinquency. Carriers of the DRD2-A1 allele were differentially affected by both positive and negative school environments, whereas DAT1-10R carriers fared the same as 9R homozygotes in poorer and moderate school environments, but fared disproportionately better in more positive environments. Contrary to expectations, youth without the DRD4-7R allele were particularly affected by the school environment. These findings contribute to the literature considering the roles of both context and genes in delinquency research, and inform our understanding of the individual-level traits that influence sensitivity to particular contexts. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  8. Peer Exclusion During the Pubertal Transition: The Role of Social Competence.

    PubMed

    Carter, Rona; Halawah, Amira; Trinh, Sarah L

    2018-01-01

    For some youth, early puberty is accompanied by peer exclusion. Yet early developers may experience less peer exclusion if they have social competence, which would bolster their ability to develop and maintain positive relationships with their peers. Accordingly, the present study tests whether pubertal timing and tempo predicts decrements in children's social competence and whether decrements in social competence account for associations between puberty (timing and tempo) and peer exclusion over time. Longitudinal data were drawn from 1364 families (48% female; 76% White; M = 9.32 years, SD = .48, at Wave 3) who participated in Waves 3-5 (i.e., grades 4-6) of Phase III of the NICHD-SECCYD. The results from latent growth curve models indicated that earlier pubertal timing and more rapid pubertal tempo among girls were associated with high initial levels of peer exclusion. Moreover, mediation analyses revealed that early developers' susceptibility to peer exclusion was associated with their initial level of social competence. In boys, pubertal timing and tempo were not directly associated with peer exclusion; instead, indirect effects of pubertal timing on peer exclusion (intercept, slope) occurred through initial levels of social competence. On average, early developers' who had low levels of social competence also had high initial levels of peer exclusion but experienced decrements in peer exclusion over time. The association between the intercepts for puberty and peer exclusion and the slopes for social competence and peer exclusion were stronger for boys than girls. Overall, our findings suggest that early developers' susceptibility to and experiences of peer exclusion are associated with their development of social competence.

  9. Infants in cocktail parties

    NASA Astrophysics Data System (ADS)

    Newman, Rochelle S.

    2003-04-01

    Most work on listeners' ability to separate streams of speech has focused on adults. Yet infants also find themselves in noisy environments. In order to learn from their caregivers' speech in these settings, they must first separate it from background noise such as that from television shows and siblings. Previous work has found that 7.5-month-old infants can separate streams of speech when the target voice is more intense than the distractor voice (Newman and Jusczyk, 1996), when the target voice is known to the infant (Barker and Newman, 2000) or when infants are presented with an audiovisual (rather than auditory-only) signal (Hollich, Jusczyk, and Newman, 2001). Unfortunately, the paradigm in these studies can only be used on infants at least 7.5 months of age, limiting the ability to investigate how stream segregation develops over time. The present work uses a new paradigm to explore younger infants' ability to separate streams of speech. Infants aged 4.5 months heard a female talker repeat either their own name or another infants' name, while several other voices spoke fluently in the background. We present data on infants' ability to recognize their own name in this cocktail party situation. [Work supported by NSF and NICHD.

  10. Trajectories of externalizing behavior from age 2 to age 9: relations with gender, temperament, ethnicity, parenting, and rater.

    PubMed

    Miner, Jennifer L; Clarke-Stewart, K Alison

    2008-05-01

    Trajectories of children's externalizing behavior were examined using multilevel growth curve modeling of data from the NICHD Study of Early Child Care and Youth Development. According to ratings by both mothers and caregivers/teachers when children were 2, 3, 4, 7, and 9 years old, externalizing behavior declined with age. However, mothers rated children as higher in externalizing behavior than did caregivers and teachers. Higher levels of age 9 externalizing behavior were predicted by the following factors: child male gender (for caregiver/teacher reports only), infant difficult temperament (for children with harsh mothers only), harsher maternal attitude toward discipline, higher level of maternal depression (for maternal reports only), and lower level of maternal sensitivity (especially for boys). Caregivers and teachers reported higher levels of externalizing behavior in African American children than in European American children, increasingly so over time; mothers' ratings revealed the reverse. The declining slope of externalizing behavior was predicted by infant difficult temperament for mother reports only. Additional analyses suggested that the association between parenting and externalizing behavior was bidirectional. (PsycINFO Database Record (c) 2008 APA, all rights reserved).

  11. Is the Prediction of Adolescent Outcomes From Early Child Care Moderated by Later Maternal Sensitivity? Results From the NICHD Study of Early Child Care and Youth Development

    PubMed Central

    Burchinal, Margaret R.; Vandell, Deborah Lowe; Belsky, Jay

    2016-01-01

    Longitudinal data are used to examine whether effects of early child care are amplified and/or attenuated by later parenting. Analyses tested these interactions using parenting as both a categorical and continuous variable to balance power and flexibility in testing moderation. The most consistent finding was that maternal sensitivity during adolescence accentuated the association between child care quality and adolescent academic-cognitive skills at age 15 years when maternal sensitivity during adolescence was high. This interaction was obtained in analyses with maternal sensitivity as both a categorical and continuous variable. Relations between early child care hours and adolescent behavioral outcomes also were moderated by maternal sensitivity, with longer child care hours predicting more impulsivity and externalizing at age 15 when maternal sensitivity during middle childhood, scored as a categorical variable, was low to moderate and when maternal sensitivity during adolescence, scored as a continuous variable, was lower. These findings suggest that some child care effects are moderated by subsequent parenting and that this moderation may take both linear and nonlinear forms. PMID:23937381

  12. Multiple Domains of Parental Secure Base Support During Childhood and Adolescence Contribute to Adolescents’ Representations of Attachment as a Secure Base Script

    PubMed Central

    Vaughn, Brian E.; Waters, Theodore E. A.; Steele, Ryan D.; Roisman, Glenn I.; Bost, Kelly K.; Truitt, Warren; Waters, Harriet S.; Booth-LaForce, Cathryn

    2016-01-01

    Although attachment theory claims that early attachment representations reflecting the quality of the child’s “lived experiences” are maintained across developmental transitions, evidence that has emerged over the last decade suggests that the association between early relationship quality and adolescents’ attachment representations is fairly modest in magnitude. We used aspects of parenting beyond sensitivity over childhood and adolescence and early security to predict adolescents’ scripted attachment representations. At age 18 years, 673 participants from the NICHD Study of Early Child Care and Youth Development (SECCYD) completed the Attachment Script Assessment (ASA) from which we derived an assessment of secure base script knowledge. Measures of secure base support from childhood through age 15 years (e.g., parental monitoring of child activity, father presence in the home) were selected as predictors and accounted for an additional 8% of the variance in secure base script knowledge scores above and beyond direct observations of sensitivity and early attachment status alone, suggesting that adolescents’ scripted attachment representations reflect multiple domains of parenting. Cognitive and demographic variables also significantly increased predicted variance in secure base script knowledge by 2% each. PMID:27032953

  13. Mothers’ Part-time Employment: Associations with Mother and Family Well-being

    PubMed Central

    Buehler, Cheryl; O’Brien, Marion

    2011-01-01

    The associations between mothers’ part-time employment and mother well-being, parenting, and family functioning were examined using seven waves of the NICHD Study of Early Child Care and Youth Development data (N = 1,364), infancy through middle childhood. Concurrent comparisons were made between families in which mothers were employed part time and both those in which mothers were not employed and those in which mothers were employed full time. Using multivariate analysis of covariance with extensive controls, results indicated that mothers employed part time had fewer depressive symptoms during the infancy and preschool years and better self-reported health at most time points than did nonemployed mothers. Across the time span studied, mothers working part time tended to report less conflict between work and family than those working full time. During their children’s preschool years, mothers employed part time exhibited more sensitive parenting than did other mothers, and at school age were more involved in school and provided more learning opportunities than mothers employed full time. Mothers employed part time reported doing a higher proportion of child care and housework than mothers employed full time. Part-time employment appears to have some benefits for mothers and families throughout the child-rearing years. PMID:22004432

  14. Mothers' depressive symptoms and infant negative emotionality in the prediction of child adjustment at age 3: testing the maternal reactivity and child vulnerability hypotheses.

    PubMed

    Dix, Theodore; Yan, Ni

    2014-02-01

    This study examined individual differences in how mothers' depressive symptoms affect children's early adjustment. It tested whether problematic development among children high in negative emotionality is accentuated by (a) maternal reactivity, the negative reactivity of mothers with depressive symptoms to difficult child characteristics; and (b) child vulnerability, the susceptibility of negatively emotional children to the negative parenting of mothers with depressive symptoms. Based on 1,364 participants from the NICHD Study of Early Child Care, results showed that mothers' depressive symptoms predicted greater risk for adjustment problems at age 3 among children who as infants were high rather than low in negative emotionality. Increased risk was evident for behavior problems, low responsiveness, high separation distress, and low social competence. Mediational tests suggested that increased risk reflected maternal reactivity: the stronger mothers' depressive symptoms, the more they responded with negative parenting to children high in negative emotionality. The proposal that child vulnerability mediates the greater impact of mothers' depressive symptoms on negatively emotional children was verified only for separation distress. The results support the proposal that, when mothers are high in depressive symptoms, aversive characteristics of children and their behavior increasingly influence early adjustment and do so because they elicit negative parent behavior.

  15. Outcomes of Extremely Low Birth Weight Infants with Acidosis at Birth

    PubMed Central

    Randolph, David A.; Nolen, Tracy L.; Ambalavanan, Namasivayam; Carlo, Waldemar A.; Peralta-Carcelen, Myriam; Das, Abhik; Bell, Edward F.; Davis, Alexis S.; Laptook, Abbot R.; Stoll, Barbara J.; Shankaran, Seetha; Higgins, Rosemary D.

    2014-01-01

    OBJECTIVES To test the hypothesis that acidosis at birth is associated with the combined primary outcome of death or neurodevelopmental impairment (NDI) in extremely low birth weight (ELBW) infants, and to develop a predictive model of death/NDI exploring perinatal acidosis as a predictor variable. STUDY DESIGN The study population consisted of ELBW infants born between 2002-2007 at NICHD Neonatal Research Network hospitals. Infants with cord blood gas data and documentation of either mortality prior to discharge or 18-22 month neurodevelopmental outcomes were included. Multiple logistic regression analysis was used to determine the contribution of perinatal acidosis, defined as a cord blood gas with a pH<7 or base excess (BE)<-12, to death/NDI in ELBW infants. In addition, a multivariable model predicting death/NDI was developed. RESULTS 3979 patients were identified of whom 249 had a cord gas pH<7 or BE<-12 mEq/L. 2124 patients (53%) had the primary outcome of death/NDI. After adjustment for confounding variables, pH<7 and BE<-12 mEq/L were each significantly associated with death/NDI (OR=2.5[1.6,4.2]; and OR=1.5[1.1,2.0], respectively). However, inclusion of pH or BE did not improve the ability of the multivariable model to predict death/NDI. CONCLUSIONS Perinatal acidosis is significantly associated with death/NDI in ELBW infants. Perinatal acidosis is infrequent in ELBW infants, however, and other factors are more important in predicting death/NDI. PMID:24554564

  16. Risk Factors for Post-NICU Discharge Mortality Among Extremely Low Birth Weight Infants

    PubMed Central

    De Jesus, Lilia C.; Pappas, Athina; Shankaran, Seetha; Kendrick, Douglas; Das, Abhik; Higgins, Rosemary D.; Bell, Edward F.; Stoll, Barbara J.; Laptook, Abbot R.; Walsh, Michele C.

    2012-01-01

    Objective To evaluate maternal and neonatal risk factors associated with post-neonatal intensive care unit (NICU) discharge mortality among ELBW infants. Study design This is a retrospective analysis of extremely low birth weight (<1,000 g) and <27 weeks' gestational age infants born in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network sites from January 2000 to June 2007. Infants were tracked until death or 18–22 months corrected age. Infants who died between NICU discharge and the 18–22 month follow-up visit were classified as post-NICU discharge mortality. Association of maternal and infant risk factors with post-NICU discharge mortality was determined using logistic regression analysis. A prediction model with six significant predictors was developed and validated. Results 5,364 infants survived to NICU discharge. 557 (10%) infants were lost to follow-up, and 107 infants died following NICU discharge. Post-NICU discharge mortality rate was 22.3 per 1000 ELBW infants. In the prediction model, African-American race, unknown maternal health insurance, and hospital stay ≥120 days significantly increased risk, and maternal exposure to intra-partum antibiotics was associated with decreased risk of post-NICU discharge mortality. Conclusion We identified African-American race, unknown medical insurance and prolonged NICU stay as risk factors associated with post-NICU discharge mortality among ELBW infants. PMID:22325187

  17. The effect of drawing on children's experiences of investigations following alleged child abuse.

    PubMed

    Katz, Carmit; Barnetz, Zion; Hershkowitz, Irit

    2014-05-01

    The primary aim of the study was to evaluate investigative interviews from the perspectives of the children, comparing children who drew with children who did not. One hundred twenty-five children, alleged victims of sexual abuse, were asked about their investigative experience. The uniqueness of the study is that all of the interviews were conducted according to the NICHD Protocol and that children were randomly assigned into one of the two research conditions (drawing vs. non-drawing). The results clearly demonstrate the advantage that drawing has on the children's experience of the investigation, with children in the drawing group more often reporting feelings of hope and success. This study provides practical guidelines for practitioners by emphasizing the beneficial effects that drawing can have. The study stresses the importance of integrating into forensic investigations interventions that enhance children's testimonies and ensure that the investigation is an empowering experience that generates feelings of trust, self-worth, and justice. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. A combined histological and MRI brain atlas of the common marmoset monkey, Callithrix jacchus.

    PubMed

    Newman, John D; Kenkel, William M; Aronoff, Emily C; Bock, Nicholas A; Zametkin, Molly R; Silva, Afonso C

    2009-12-11

    The common marmoset, Callithrix jacchus, is of growing importance for research in neuroscience and related fields. In the present work, we describe a combined histological and magnetic resonance imaging (MRI) atlas constructed from the brains of two adult female marmosets. Histological sections were processed from Nissl staining and digitized to produce an atlas in a large format that facilitates visualization of structures with significant detail. Naming of identifiable brain structures was performed utilizing current terminology. The histological sections and a simplified schematic atlas are available online at http://udn.nichd.nih.gov/brainatlas_home.html.

  19. The development of perceptual attention and articulatory skill in one or two languages

    NASA Astrophysics Data System (ADS)

    Fowler, Carol; Best, Catherine

    2002-05-01

    Infants acquire properties of their native language especially during the second half of the first year of life. Models, such as Jusczyk's WRAPSA, Best's PAM, Kuhl's NLM, and Werker's account describe changes in perceptual or attentional space that may underlie the perceptual changes that infants exhibit. Unknown is the relation of these changes to changes in speechlike vocalizations that occur at the same time. Future research should address whether the perceptual models predict production learning. Other issues concern how the perceptual and articulatory systems develop for infants exposed to more than one language. Do multiple perceptual spaces develop, or does one space accommodate both languages? For infants exposed to just one language, but living in an environment where the ambient and pedagogical language is different (say, infants in a monolingual Spanish home in the U.S.), early language learning fosters learning the native language, but it may impede learning the ambient language. How much or how little does early exposure to the ambient language allow development of perceptual and articulatory systems for the ambient language? A final issue addresses whether the emergence of lexical, morphological and/or syntactic abilities in the second year is related to further changes in speech perception and production. [Work supported by NICHD.

  20. WORK-UP OF STILLBIRTH: A REVIEW OF THE EVIDENCE

    PubMed Central

    SILVER, Robert M.; VARNER, Michael W.; REDDY, Uma; GOLDENBERG, Robert; PINAR, Halit; CONWAY, Deborah; BUKOWSKI, Radek; CARPENTER, Marshall; HOGUE, Carol; WILLINGER, Marian; DUDLEY, Donald; SAADE, George; STOLL, Barbara

    2009-01-01

    Despite improvements in antenatal and intrapartum care, stillbirth, defined as in utero fetal death at 20 weeks of gestation or greater, remains an important, largely unstudied, and poignant problem in obstetrics. Over 26,000 stillbirths were reported in the US in 2001. Although several conditions have been linked to stillbirth, it is difficult to define the precise etiology in many cases. This paper reviews known and suspected causes of stillbirth including genetic abnormalities, infection, fetal-maternal hemorrhage, and a variety of medical conditions in the mother. The proportion of stillbirths that have a diagnostic explanation is higher in centers that conduct a defined and systematic evaluation. Recommended diagnostic tests for stillbirth are discussed. The on-going work of the NICHD Stillbirth Collaborative Research Network, a consortium of 5 academic centers in the United States that are studying the scope and causes of stillbirth, is presented. PMID:17466694

  1. Paternal Autonomy Restriction, Neighborhood Safety, and Child Anxiety Trajectory in Community Youth.

    PubMed

    Cooper-Vince, Christine E; Chan, Priscilla T; Pincus, Donna B; Comer, Jonathan S

    2014-07-01

    Intrusive parenting, primarily examined among middle to upper-middle class mothers, has been positively associated with the presence and severity of anxiety in children. This study employed cross-sectional linear regression and longitudinal latent growth curve analyses to evaluate the main and interactive effects of early childhood paternal autonomy restriction (AR) and neighborhood safety (NS) on the trajectory of child anxiety in a sample of 596 community children and fathers from the NICHD SECYD. Longitudinal analyses revealed that greater paternal AR at age 6 was actually associated with greater decreases in child anxiety in later childhood. Cross-sectional analyses revealed main effects for NS across childhood, and interactive effects of paternal AR and NS that were present only in early childhood, whereby children living in safer neighborhoods demonstrated increased anxiety when experiencing lower levels of paternal AR. Findings further clarify for whom and when paternal AR impacts child anxiety in community youth.

  2. Paternal Autonomy Restriction, Neighborhood Safety, and Child Anxiety Trajectory in Community Youth

    PubMed Central

    Cooper-Vince, Christine E.; Chan, Priscilla T.; Pincus, Donna B.; Comer, Jonathan S.

    2014-01-01

    Intrusive parenting, primarily examined among middle to upper-middle class mothers, has been positively associated with the presence and severity of anxiety in children. This study employed cross-sectional linear regression and longitudinal latent growth curve analyses to evaluate the main and interactive effects of early childhood paternal autonomy restriction (AR) and neighborhood safety (NS) on the trajectory of child anxiety in a sample of 596 community children and fathers from the NICHD SECYD. Longitudinal analyses revealed that greater paternal AR at age 6 was actually associated with greater decreases in child anxiety in later childhood. Cross-sectional analyses revealed main effects for NS across childhood, and interactive effects of paternal AR and NS that were present only in early childhood, whereby children living in safer neighborhoods demonstrated increased anxiety when experiencing lower levels of paternal AR. Findings further clarify for whom and when paternal AR impacts child anxiety in community youth. PMID:25242837

  3. Explaining the black-white gap in cognitive test scores: Toward a theory of adverse impact.

    PubMed

    Cottrell, Jonathan M; Newman, Daniel A; Roisman, Glenn I

    2015-11-01

    In understanding the causes of adverse impact, a key parameter is the Black-White difference in cognitive test scores. To advance theory on why Black-White cognitive ability/knowledge test score gaps exist, and on how these gaps develop over time, the current article proposes an inductive explanatory model derived from past empirical findings. According to this theoretical model, Black-White group mean differences in cognitive test scores arise from the following racially disparate conditions: family income, maternal education, maternal verbal ability/knowledge, learning materials in the home, parenting factors (maternal sensitivity, maternal warmth and acceptance, and safe physical environment), child birth order, and child birth weight. Results from a 5-wave longitudinal growth model estimated on children in the NICHD Study of Early Child Care and Youth Development from ages 4 through 15 years show significant Black-White cognitive test score gaps throughout early development that did not grow significantly over time (i.e., significant intercept differences, but not slope differences). Importantly, the racially disparate conditions listed above can account for the relation between race and cognitive test scores. We propose a parsimonious 3-Step Model that explains how cognitive test score gaps arise, in which race relates to maternal disadvantage, which in turn relates to parenting factors, which in turn relate to cognitive test scores. This model and results offer to fill a need for theory on the etiology of the Black-White ethnic group gap in cognitive test scores, and attempt to address a missing link in the theory of adverse impact. (c) 2015 APA, all rights reserved).

  4. Repeat pregnancy in women with HIV infection in Latin America and the Caribbean

    PubMed Central

    Megazzini, Karen; Melo, Victor Hugo; Coelho, Débora Fernandes; Watts, D. Heather; Krauss, Margot; Gouvea, Maria Isabel; Duarte, Geraldo; Losso, Marcelo H.; Siberry, George K.

    2016-01-01

    Intended and unintended pregnancies occur frequently among HIV-infected women. We evaluated the occurrence of repeat pregnancy and characteristics associated with this outcome among HIV-infected women in Latin America and the Caribbean who were participating in the National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI). Of the 1342 HIV-infected pregnant women enrolled in NISDI, 124 (9.2%) had one or more repeat pregnancies on study. Median time between the index delivery and date of conception of the subsequent pregnancy was 1.4 years (range 0.1–5.7). Younger age [odds ratio (OR)=1.07, 95% confidence interval (CI): 1.04–1.11 per one-year decrease in age], hospitalization during the index pregnancy or up to 6 months postpartum [OR=2.0, 95% CI: 1.2–3.4], and poor index pregnancy outcome (stillbirth or spontaneous/therapeutic abortion) [OR=3.4, 95% CI: 1.4–8.4] were associated with increased occurrence of repeat pregnancy in multivariable analysis. Among women with repeat pregnancies, the proportion receiving antiretroviral treatment (versus prophylaxis) increased from 39.4% at the time of the index pregnancy to 81.8% at the time of the repeat pregnancy (p<0.001). These results can help identify women most likely to benefit from reproductive counseling in order to assist with healthy pregnancy planning and prevention of unintended pregnancies. PMID:26288031

  5. Molecular-genetic correlates of infant attachment: A cautionary tale

    PubMed Central

    Booth-Laforce, Cathryn; Belsky, Jay; Burt, Keith B.; Groh, Ashley M.

    2014-01-01

    This paper advises caution in relation to the increasing interest in molecular-genetic association studies in developmental psychology based on a set of empirical examples from the NICHD Study of Early Child Care and Youth Development (SECCYD) that highlight the fragility of effects reported in the literature on the molecular-genetic correlates of infant attachment. Specifically, this paper updates and provides three extensions to results reported in Luijk et al. (2011), which recently failed to replicate evidence from smaller-sample studies that a set of dopaminergic, serotonergic, and oxytonergic markers are significantly associated with infant attachment security or disorganization. First, we report here that the average effect of “usual suspect” polymorphisms on infant attachment security and disorganization in the SECCYD is approximately zero. Second, because Luijk et al. (2011) reported data based exclusively on the White infants in the SECCYD, this paper reveals that the average effect of polymorphisms featured in this literature is also of trivial magnitude in the non-White sub-sample (cf. Chen, Barth, Johnson, Gotlib, & Johnson, 2011). Third, this paper attempts, but fails, to replicate a recent finding by Raby et al. (2012) suggesting that, although molecular-genetic polymorphisms might not be implicated in security versus insecurity, the serotonin transporter gene contributes to variation in emotional distress during the Strange Situation Procedure. Implications for future research on the genetics of developmental phenotypes in general and attachment in particular are discussed, with a focus on statistical power and model-based theory testing. PMID:23421800

  6. Neurodevelopmental Outcome of Extremely Low Birth Weight Infants with Candida Infection

    PubMed Central

    Adams-Chapman, Ira; Bann, Carla M.; Das, Abhik; Goldberg, Ronald N.; Stoll, Barbara J.; Walsh, Michele C.; Sanchez, Páblo J.; Higgins, Rosemary D.; Shankaran, Seetha; Watterberg, Kristi L.; Duara, Shahnaz; Miller, Nancy A.; Heyne, Roy J.; Peralta-Carcelen, Myriam; Goldstein, Ricki F.; Steichen, Jean J.; Bauer, Charles R.; Hintz, Susan R.; Evans, Patricia W.; Acarregui, Michael J.; Myers, Gary J.; Vohr, Betty R.; Wilson-Costello, Deanne E.; Pappas, Athina; Vaucher, Yvonne E.; Ehrenkranz, Richard A.; McGowan, Elisabeth C.; Dillard, Robert G.; Fuller, Janell; Benjamin, Daniel K.

    2013-01-01

    Objective Candida remains an important cause of late-onset infection in preterm infants. Mortality and neurodevelopmental outcome of extremely low birthweight (ELBW) infants enrolled in the Candida study was evaluated based on infection status. Study design ELBW infants born at NICHD Neonatal Research Network (NRN) centers between March 2004 and July 2007 screened for suspected sepsis were eligible for inclusion in the Candida study. Primary outcome data for neurodevelopmental impairment (NDI) or death were available for 1317/1515 (90%) of the infants enrolled in the Candida study. The Bayley Scales of Infant Development (BSID)-II or the BSID-III was administered at 18 months adjusted age. A secondary comparison with 864 infants registered with NRN enrolled during the same cohort never screened for sepsis and therefore not eligible for the Candida study was performed. Results Among ELBW infants enrolled in the Candida study, 31% with Candida and 31% with late-onset non-Candida sepsis had NDI at 18 months. Infants with Candida sepsis and/or meningitis had an increased risk of death and were more likely to have the composite outcome of death and/or NDI compared with uninfected infants in adjusted analysis. Compared with infants in the NRN registry never screened for sepsis, overall risk for death were similar but those with Candida infection were more likely to have NDI (OR 1.83 (1.01,3.33, p=0.047). Conclusion In this cohort of ELBW infants, those with infection and/or meningitis were at increased risk for death and/or NDI. This risk was highest among those with Candida sepsis and/or meningitis. PMID:23726546

  7. Relationship Between Family Economic Resources, Psychosocial Well-being, and Educational Preferences of AIDS-Orphaned Children in Southern Uganda: Baseline Findings

    PubMed Central

    Ssewamala, Fred M.; Nabunya, Proscovia; Ilic, Vilma; Mukasa, Miriam N.; Ddamulira, Christopher

    2015-01-01

    This study examines the relationship between economic resources, psychosocial well-being, and educational preferences of AIDS-orphaned children in southern Uganda. We use baseline data from a sample of 1410 AIDS-orphaned children (defined as children who have lost one or both biological parents to AIDS) enrolled in the Bridges to the Future study, a National Institute of Child Health and Human Development (NICHD) funded study. Analyses from both bivariate and multiple regression analyses indicate the following: 1) despite the well-documented economic and psychosocial challenges AIDS-orphaned children face, many of these children have high educational plans and aspirations; 2) educational aspirations differ by orphanhood status (double orphan vs. single orphan); 3) regardless of orphanhood status, children report similar levels of psychosocial well-being; 4) high levels of family cohesion, positive perceptions of the future, school satisfaction, and lower levels of hopelessness (hopefulness) are associated with high educational aspirations; and 5) reported family economic resources at baseline, all seem to play a role in predicting children's educational preferences and psychosocial well-being. These findings suggest that the focus for care and support of orphaned children should not be limited to addressing their psychosocial needs. Addressing the economic needs of the households in which orphaned children live is equally important. Indeed, in the context of extreme poverty—in which most of the children represented in this study live—addressing structural factors, including poverty, may be a key driver in addressing their psychosocial functioning. PMID:26146601

  8. Head Circumference and Height in Autism

    PubMed Central

    Lainhart, Janet E.; Bigler, Erin D.; Bocian, Maureen; Coon, Hilary; Dinh, Elena; Dawson, Geraldine; Deutsch, Curtis K.; Dunn, Michelle; Estes, Annette; Tager-Flusberg, Helen; Folstein, Susan; Hepburn, Susan; Hyman, Susan; McMahon, William; Minshew, Nancy; Munson, Jeff; Osann, Kathy; Ozonoff, Sally; Rodier, Patricia; Rogers, Sally; Sigman, Marian; Spence, M. Anne; Stodgell, Christopher J.; Volkmar, Fred

    2016-01-01

    Data from 10 sites of the NICHD/NIDCD Collaborative Programs of Excellence in Autism were combined to study the distribution of head circumference and relationship to demographic and clinical variables. Three hundred thirty-eight probands with autism-spectrum disorder (ASD) including 208 probands with autism were studied along with 147 parents, 149 siblings, and typically developing controls. ASDs were diagnosed, and head circumference and clinical variables measured in a standardized manner across all sites. All subjects with autism met ADI-R, ADOS-G, DSM-IV, and ICD-10 criteria. The results show the distribution of standardized head circumference in autism is normal in shape, and the mean, variance, and rate of macrocephaly but not microcephaly are increased. Head circumference tends to be large relative to height in autism. No site, gender, age, SES, verbal, or non-verbal IQ effects were present in the autism sample. In addition to autism itself, standardized height and average parental head circumference were the most important factors predicting head circumference in individuals with autism. Mean standardized head circumference and rates of macrocephaly were similar in probands with autism and their parents. Increased head circumference was associated with a higher (more severe) ADI-R social algorithm score. Macrocephaly is associated with delayed onset of language. Although mean head circumference and rates of macrocephaly are increased in autism, a high degree of variability is present, underscoring the complex clinical heterogeneity of the disorder. The wide distribution of head circumference in autism has major implications for genetic, neuroimaging, and other neurobiological research. PMID:17022081

  9. "I know it because it happened to me!" Confrontations of children within forensic investigations.

    PubMed

    Katz, Carmit; Barnetz, Zion

    2018-06-06

    Confrontations and cross-examination are considered to be a vital stage in forensic investigations; however, laboratory and field studies have systematically shown their adverse effects on children`s testimonies. The current field study aimed to assess the strategies utilized, and the frequency with which they are used, in confrontations within forensic investigations involving children following suspected abuse, and to assess their effects on the children's testimonies. The forensic investigations were conducted using the National Institute of Child Health and Human Development (NICHD) Protocol. The transcripts of 224 children aged 4-14, who were referred for forensic investigation following suspected physical or sexual abuse, were analyzed. All the cases included external evidence suggesting a high probability of abuse. The results indicated that confrontations of children were utilized in more than 60% of the forensic interviews, regardless of the child`s age. The vast majority of the interviewers' confrontation strategies involved references to the alleged suspects, with the number of confrontations ranging from 1 to 18 per interview. An examination of the children`s responses to the confrontations revealed that most of the children insisted on their initial reported testimonies; however, some of the children displayed confusion or fear, and one child recanted the allegation. The discussion addresses how confrontations and cross-examination, as a necessary stage of forensic investigation, can affect children`s testimonies, and the implications of these effects for the forensic context. Copyright © 2018 Elsevier Ltd. All rights reserved.

  10. Factors Associated with Maternal Serum Levels of Perfluoroalkyl Substances and Organochlorines: A Descriptive Study of Parous Women in Norway and Sweden

    PubMed Central

    Lauritzen, Hilde B.; Larose, Tricia L.; Øien, Torbjørn; Odland, Jon Ø.; van de Bor, Margot; Jacobsen, Geir W.; Sandanger, Torkjel M.

    2016-01-01

    Introduction Perfluoroalkyl substances (PFASs) and organochlorines (OCs) are ubiquitous and persistent in the environment and proposed endocrine disrupting chemicals (EDCs). They can be transferred across the placenta during pregnancy, and studies suggest that the prenatal period may be particularly sensitive for influences on fetal growth and development. Several studies have investigated socio-demographic and pregnancy related factors associated with maternal serum PFAS and OC levels, but few studies have been conducted in time periods with increasing emissions of PFASs and recent emissions of OCs. Methods Serum from 424 pregnant women participating in the NICHD Scandinavian Successive Small-for-gestational Age (SGA) births study was collected in 1986–1988, and analyses of two PFASs and six OCs were conducted. Associations between EDCs and geographic, time dependent, socio-demographic and pregnancy related variables were evaluated by using multivariable linear regression models. Results Previous breastfeeding duration, time since last breastfeeding period, sampling date and country of residence were important factors associated with serum levels of PFOS and PFOA. Smoking status and pre-pregnancy BMI were negatively associated with PFOS, and maternal height was borderline negatively associated with PFOS and PFOA. Glomerular filtration rate (GFR) was negatively associated with PFOS in a sub-sample. Maternal serum levels of OCs were positively associated with maternal age, and negatively associated with previous breastfeeding duration and sampling date. Smoking had a consistently negative association with PCB 118 in a dose-dependent manner. Education level, pre-pregnancy BMI and alcohol consumption varied in importance according to the compound under study. Conclusions Several maternal factors, including potentially modifiable factors, markers of pregnancy physiology and factors also related to perinatal outcomes were associated with EDC levels. Results from this study are relevant to populations with still high PFAS and OC levels, i.e. developing countries. Moreover, we can use this knowledge about associated factors on emerging EDCs with similar properties. PMID:27824939

  11. Severe Vitamin D Deficiency in HIV-infected Pregnant Women is Associated with Preterm Birth

    PubMed Central

    Jao, Jennifer; Freimanis, Laura; Mussi-Pinhata, Marisa M.; Cohen, Rachel A.; Monteiro, Jacqueline Pontes; Cruz, Maria Leticia; Branch, Andrea; Sperling, Rhoda S.; Siberry, George K.

    2017-01-01

    Background Low maternal vitamin D has been associated with preterm birth (PTB). HIV-infected pregnant women are at risk for PTB, but data on maternal vitamin D and PTB in this population is scarce. Methods In a cohort of Latin American HIV-infected pregnant women from the NICHD International Site Development Initiative (NISDI) protocol, we examined the association between maternal vitamin D status and PTB. Vitamin D status was defined as the following 25-hydroxyvitamin D levels: severe deficiency (<10 ng/mL), deficiency (10-20 ng/mL), insufficiency (21–29 ng/mL), and sufficiency (≥30 ng/mL). PTB was defined as delivery at <37 weeks gestational age (GA). Logistic regression was used to assess the association between maternal vitamin D status and PTB. Results Of 715 HIV-infected pregnant women, 13 (1.8%) were severely vitamin D deficient, 224 (31.3%) deficient, and 233 (32.6%) insufficient. Overall, 23.2% (166/715) of pregnancies resulted in PTB [median GA of PTBs =36 wks (interquartile range: 34-36)]. In multivariate analysis, severe vitamin D deficiency was associated with PTB [Odds Ratio=4.7, 95% Confidence Interval: 1.3-16.8)]. Conclusion Severe maternal vitamin D deficiency is associated with PTB in HIV-infected Latin American pregnant women. Further studies are warranted to determine if vitamin D supplementation in HIV-infected women may impact PTB. PMID:27716863

  12. Mediation and Moderation of Divorce Effects on Children’s Behavior Problems

    PubMed Central

    Weaver, Jennifer; Schofield, Thomas

    2016-01-01

    Using data from the NICHD Study of Early Child Care and Youth Development, we examined children’s internalizing and externalizing behavior problems from age 5 to age 15 in relation to whether they had experienced a parental divorce. Children from divorced families had more behavior problems compared with a propensity score-matched sample of children from intact families according to both teachers and mothers. They exhibited more internalizing and externalizing problems at the first assessment after the parents’ separation and at the last available assessment (age 11 for teacher reports, or age 15 for mother reports). Divorce also predicted both short-term and long-term rank-order increases in behavior problems. Associations between divorce and child behavior problems were moderated by family income (assessed before the divorce) such that children from families with higher incomes prior to the separation had fewer internalizing problems than children from families with lower incomes prior to the separation. Higher levels of pre-divorce maternal sensitivity and child IQ also functioned as protective factors for children of divorce. Mediation analyses showed that children were more likely to exhibit behavior problems after the divorce if their post-divorce home environment was less supportive and stimulating, their mother was less sensitive and more depressed, and their household income was lower. We discuss avenues for intervention, particularly efforts to improve the quality of home environments in divorced families. PMID:25419913

  13. A Latent Class Analysis of Maternal Depressive Symptoms over 12 Years and Offspring Adjustment in Adolescence

    PubMed Central

    Campbell, Susan B.; Morgan-Lopez, Antonio A.; Cox, Martha J.; McLoyd, Vonnie C.

    2009-01-01

    We used data from the NICHD Study of Early Child Care and Youth Development and latent class analysis to model patterns of maternal depressive symptoms from infant age 1 month to the transition to adolescence (age 12), and then examined adolescent adjustment at age 15 as a function of the course and severity of maternal symptoms. We identified five latent classes of symptoms in these 1357 women while also taking into account sociodemographic measures: never depressed; stable subclinical; early-decreasing; moderately elevated; chronic. Women with few symptoms were more likely to be married, better educated, and in better physical health than women with more elevated symptoms. Family size and whether the pregnancy was planned also differentiated among classes. At age 15, adolescents whose mothers were in the chronic, elevated, and stable subclinical latent classes reported more internalizing and externalizing problems and acknowledged engaging in more risky behavior than did children of never-depressed mothers. Latent class differences in self-reported loneliness and dysphoria were also found. Finally, several significant interactions between sex and latent class suggested that girls whose mothers reported elevated symptoms of depression over time experienced more internalizing distress and dysphoric mood relative to their male counterparts. Discussion focuses on adolescent adjustment, especially among offspring whose mothers report stable symptoms of depression across their childhoods. PMID:19685946

  14. Trajectories of growth in body mass index across childhood: Associations with maternal and paternal employment.

    PubMed

    Morrissey, Taryn W

    2013-10-01

    Research links mothers' employment to higher body mass index (BMI), a measure of weight-for-height, among their children. However, how maternal employment patterns relate to their children's BMI trajectories, and the role that fathers' employment plays in when and at what rate children grow, remain unclear. With data on children from 2 to 15 years of age living in two-parent families from the U.S. NICHD's Study of Early Child Care and Youth Development (N = 1107), individual growth models are used to describe American children's BMI trajectories as predicted by maternal and paternal employment characteristics. Results indicate that, by age 15, children's BMIs are, on average, nearly one-half of a standard deviation above recommended levels, and the majority of growth occurs during the preschool period. The duration of maternal employment, and combined measures of maternal and paternal employment duration, are both associated with higher child BMI across childhood. Associations are small but cumulative. Notably, the association between the duration of time children lived in dual-earner families and child BMI is larger than that between maternal employment duration alone and children's BMI, which is strongest during the preschool period. Combined measures of maternal and paternal employment intensity, defined as the number of periods both parents worked 35 or more hours per week, are associated with higher child BMI during the preschool period only. Findings highlight the importance of taking into account both parents' employment characteristics in investigating children's physical development. Copyright © 2012 Elsevier Ltd. All rights reserved.

  15. Development of a Pediatric Adverse Events Terminology

    PubMed Central

    Gipson, Debbie S.; Kirkendall, Eric S.; Gumbs-Petty, Brenda; Quinn, Theresa; Steen, A.; Hicks, Amanda; McMahon, Ann; Nicholas, Savian; Zhao-Wong, Anna; Taylor-Zapata, Perdita; Turner, Mark; Herreshoff, Emily; Jones, Charlotte; Davis, Jonathan M.; Haber, Margaret; Hirschfeld, Steven

    2017-01-01

    In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Pediatric Terminology Harmonization Initiative to establish a core library of terms to facilitate the acquisition and sharing of knowledge between pediatric clinical research, practice, and safety reporting. A coalition of partners established a Pediatric Terminology Adverse Event Working Group in 2013 to develop a specific terminology relevant to international pediatric adverse event (AE) reporting. Pediatric specialists with backgrounds in clinical care, research, safety reporting, or informatics, supported by biomedical terminology experts from the National Cancer Institute’s Enterprise Vocabulary Services participated. The multinational group developed a working definition of AEs and reviewed concepts (terms, synonyms, and definitions) from 16 pediatric clinical domains. The resulting AE terminology contains >1000 pediatric diseases, disorders, or clinical findings. The terms were tested for proof of concept use in 2 different settings: hospital readmissions and the NICU. The advantages of the AE terminology include ease of adoption due to integration with well-established and internationally accepted biomedical terminologies, a uniquely temporal focus on pediatric health and disease from conception through adolescence, and terms that could be used in both well- and underresourced environments. The AE terminology is available for use without restriction through the National Cancer Institute’s Enterprise Vocabulary Services and is fully compatible with, and represented in, the Medical Dictionary for Regulatory Activities. The terminology is intended to mature with use, user feedback, and optimization. PMID:28028203

  16. Development of a Pediatric Adverse Events Terminology.

    PubMed

    Gipson, Debbie S; Kirkendall, Eric S; Gumbs-Petty, Brenda; Quinn, Theresa; Steen, A; Hicks, Amanda; McMahon, Ann; Nicholas, Savian; Zhao-Wong, Anna; Taylor-Zapata, Perdita; Turner, Mark; Herreshoff, Emily; Jones, Charlotte; Davis, Jonathan M; Haber, Margaret; Hirschfeld, Steven

    2017-01-01

    In 2009, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) established the Pediatric Terminology Harmonization Initiative to establish a core library of terms to facilitate the acquisition and sharing of knowledge between pediatric clinical research, practice, and safety reporting. A coalition of partners established a Pediatric Terminology Adverse Event Working Group in 2013 to develop a specific terminology relevant to international pediatric adverse event (AE) reporting. Pediatric specialists with backgrounds in clinical care, research, safety reporting, or informatics, supported by biomedical terminology experts from the National Cancer Institute's Enterprise Vocabulary Services participated. The multinational group developed a working definition of AEs and reviewed concepts (terms, synonyms, and definitions) from 16 pediatric clinical domains. The resulting AE terminology contains >1000 pediatric diseases, disorders, or clinical findings. The terms were tested for proof of concept use in 2 different settings: hospital readmissions and the NICU. The advantages of the AE terminology include ease of adoption due to integration with well-established and internationally accepted biomedical terminologies, a uniquely temporal focus on pediatric health and disease from conception through adolescence, and terms that could be used in both well- and underresourced environments. The AE terminology is available for use without restriction through the National Cancer Institute's Enterprise Vocabulary Services and is fully compatible with, and represented in, the Medical Dictionary for Regulatory Activities. The terminology is intended to mature with use, user feedback, and optimization. Copyright © 2017 by the American Academy of Pediatrics.

  17. Income gains predict cognitive functioning longitudinally throughout later childhood in poor children.

    PubMed

    Raffington, Laurel; Prindle, John J; Shing, Yee Lee

    2018-04-26

    Alleviating disadvantage in low-income environments predicts higher cognitive abilities during early childhood. It is less established whether family income continues to predict cognitive growth in later childhood or whether there may even be bidirectional dynamics. Notably, living in poverty may moderate income-cognition dynamics. In this study, we investigated longitudinal dynamics over 7 waves of data collection from 1,168 children between the ages of 4.6 and 12 years, 226 (19%) of whom lived in poverty in at least 1 wave, as part of the NICHD Study of Early Child Care and Youth Development. Two sets of dual change-score models evaluated, first, whether a score predicted change from that wave to the next and, second, whether change from 1 wave to the next predicted the following score. As previous comparisons have documented, poor children had substantially lower average starting points and cognitive growth slopes through later childhood. The first set of models showed that income scores did not predict cognitive change. In reverse, child cognitive scores positively predicted income change. We speculated that parents may reduce their work investment, thus reducing income gains, when their children fall behind. Second, income changes continued to positively predict higher cognitive scores at the following wave for poor children only, which suggests that income gains and losses continue to be a leading indicator in time of poor children's cognitive performance in later childhood. This study underlined the need to look at changes in income, allow for poverty moderation, and explore bidirectional income-cognition dynamics in middle childhood. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  18. Head circumference and height in autism: a study by the Collaborative Program of Excellence in Autism.

    PubMed

    Lainhart, Janet E; Bigler, Erin D; Bocian, Maureen; Coon, Hilary; Dinh, Elena; Dawson, Geraldine; Deutsch, Curtis K; Dunn, Michelle; Estes, Annette; Tager-Flusberg, Helen; Folstein, Susan; Hepburn, Susan; Hyman, Susan; McMahon, William; Minshew, Nancy; Munson, Jeff; Osann, Kathy; Ozonoff, Sally; Rodier, Patricia; Rogers, Sally; Sigman, Marian; Spence, M Anne; Stodgell, Christopher J; Volkmar, Fred

    2006-11-01

    Data from 10 sites of the NICHD/NIDCD Collaborative Programs of Excellence in Autism were combined to study the distribution of head circumference and relationship to demographic and clinical variables. Three hundred thirty-eight probands with autism-spectrum disorder (ASD) including 208 probands with autism were studied along with 147 parents, 149 siblings, and typically developing controls. ASDs were diagnosed, and head circumference and clinical variables measured in a standardized manner across all sites. All subjects with autism met ADI-R, ADOS-G, DSM-IV, and ICD-10 criteria. The results show the distribution of standardized head circumference in autism is normal in shape, and the mean, variance, and rate of macrocephaly but not microcephaly are increased. Head circumference tends to be large relative to height in autism. No site, gender, age, SES, verbal, or non-verbal IQ effects were present in the autism sample. In addition to autism itself, standardized height and average parental head circumference were the most important factors predicting head circumference in individuals with autism. Mean standardized head circumference and rates of macrocephaly were similar in probands with autism and their parents. Increased head circumference was associated with a higher (more severe) ADI-R social algorithm score. Macrocephaly is associated with delayed onset of language. Although mean head circumference and rates of macrocephaly are increased in autism, a high degree of variability is present, underscoring the complex clinical heterogeneity of the disorder. The wide distribution of head circumference in autism has major implications for genetic, neuroimaging, and other neurobiological research.

  19. A re-audit of the use of definitions of sudden infant death syndrome (SIDS) in peer-reviewed literature.

    PubMed

    Byard, Roger W; Lee, Vivian

    2012-11-01

    The use of different definitions of sudden infant death syndrome (SIDS) may make comparison of data among studies difficult. Fifty randomly selected papers dealing with SIDS that were published between 2010 and 2011 in peer-reviewed journals were reviewed to determine whether one of three internationally accepted definitions of SIDS had been either written in the text or referenced. A significant improvement in the use of definitions has occurred since 2005, with the percentage of papers either quoting or referencing a standard definition increasing by 26%, from 42 to 68%. The 1989 NICHD definition remained the most commonly used definition (35.1%) followed by the 2004 San Diego definition (26.3%). Although the percentage of papers where either no definition was provided or where an idiosyncratic or mis-cited definition was used fell 26%, from 58 to 32%, nearly one in three papers published on SIDS in peer-reviewed journals that were included in this study still did not cite a standard definition. Copyright © 2012 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  20. "Big" versus "little" science: comparative analysis of program projects and individual research grants.

    PubMed

    Baumeister, A A; Bacharach, V R; Baumeister, A A

    1997-11-01

    Controversy about the amount and nature of funding for mental retardation research has persisted since the creation of NICHD. An issue that has aroused considerable debate, within the mental retardation research community as well as beyond, is distribution of funds between large group research grants, such as the program project (PO1) and the individual grant (RO1). Currently within the Mental Retardation and Developmental Disabilities Branch, more money is allocated to the PO1 mechanism than the RO1. We compared the two types of grants, focusing on success rates, productivity, costs, impact, publication practices, and outcome and conducted a comparative analysis of biomedical and behavioral research. Other related issues were considered, including review processes and cost-effectiveness.

  1. Trajectories of BMI from early childhood through early adolescence: SES and psychosocial predictors.

    PubMed

    Lane, Sean P; Bluestone, Cheryl; Burke, Christopher T

    2013-02-01

    This study examined the ways in which body mass index (BMI) percentile - an identified risk factor for overweight and cardiovascular disease in adulthood - develops from birth through early adolescence. In addition, we examined whether psychosocial factors, such as parenting style and maternal depression, mediated the link between socio-economic status (SES) and BMI growth. Design. Data were obtained from phases 1-3 of the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD) - a longitudinal study that followed children from 10 communities in the United States from birth to age 11. We applied growth mixture models to identify distinct subtypes of BMI development. Within these models, we performed between- and within-class mediation analyses to examine whether SES predicted class membership or differences in development within each class via maternal depression and parenting styles. Results identified three prototypic trajectories of BMI percentile growth, elevated, steady increase, and stable. We found evidence for both between- and within-class mediation, suggesting multiple pathways by which SES can affect BMI development. These findings add to the research that suggests that being in a family with a low SES is associated with falling into patterns of development characterized by early and lasting increases in BMI relative to one's peers, and that this association is partly accounted for by maternal depression and parenting styles. What is already known? Past research has found evidence that patterns of childhood overweight are impacted by socioeconomic status through psychosocial factors like parenting and depression. This evidence is often limited to individual points in time where neglectful, permissive, and authoritarian parenting and higher levels of maternal depression are associated with higher levels of overweight status among children from infancy to adolescence. However, little research has linked together whether the children who receive non-authoritative parenting and are overweight in infancy are the same children who are overweight in adolescence. WHAT DOES THIS STUDY ADD?: • Evidence for 3 different prototypes of BMI percentile growth over the course of childhood approaching adolescence. • Adds complexity re the influence of parenting styles as an influence on patterns of weight gain. • Buttresses existing research as to early and lasting effects of SES on patterns of BMI. © 2012 The British Psychological Society.

  2. Association of Dyslipidemia and Glucose Abnormalities with Antiretroviral Treatment in a Cohort of HIV-infected Latin American Children

    PubMed Central

    Paganella, MP; Cohen, RA; Harris, DR; Kuchenbecker, RS; Sperhacke, RD; Kato, SK; Silva, CLO; Sturzbecher, FT; Oliveira, RHS; Pavía Ruz, N; Hazra, R

    2016-01-01

    Objective(s) To estimate the incidence of lipid and glucose abnormalities and assess their association with exposure to antiretroviral (ARV) regimens among perinatally HIV-infected Latin American children. Design Longitudinal cohort study. Methods Data were analyzed from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI) Pediatric Latin American Countries Epidemiologic Study (PLACES). The incidence of dyslipidemia (total cholesterol>200mg/dL, HDL<35mg/dL, LDL≥130mg/dL, triglycerides>110mg/dL [age<10 years] or >150mg/dL [≥10 years]) and fasting glucose abnormalities (homeostasis model assessment of insulin resistance >2.5 [Tanner Stage 1] or >4.0 [Tanner Stage>1]; impaired glucose: 110 to <126mg/dL; diabetes: ≥126 mg/dL) was estimated. Proportional hazards regression was used to evaluate the risk of abnormalities associated with ARV regimen, adjusted for covariates. Results There were 385 children eligible for analysis (mean age 6.6 years). Incident cholesterol abnormalities were reported in 18.1% of participants (95% confidence interval [CI] 14.1–22.8%), HDL and LDL cholesterol abnormalities in 19.6% (15.1–24.7%) and 15.0% (11.3–19.5%), respectively, and triglyceride abnormalities in 44.2% (37.7–50.8%). In multivariable analysis, ARV regimen was only associated with triglyceride abnormalities; participants receiving a protease inhibitor-containing (PI) regimen were 3.6 times as likely to experience a triglyceride abnormality as those receiving no ARVs (95% CI: 1.3–10.5; p=0.0167). The cumulative incidence of insulin resistance was 3.8% (1.8–7.1%); there were no incident cases of diabetes and only two of impaired fasting glucose. Conclusions Children receiving PI-containing regimens were at increased risk of developing triglyceride abnormalities. Continued monitoring of lipid levels in children receiving PI-containing regimens appears warranted. PMID:27570910

  3. Improving Safe and Effective Use of Drugs in Pregnancy and Lactation: Workshop Summary.

    PubMed

    Riley, Laura E; Cahill, Alison G; Beigi, Richard; Savich, Renate; Saade, George

    2017-07-01

    In February 2015, given high rates of use of medications by pregnant women and the relative lack of data on safety and efficacy of many drugs utilized in pregnancy, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the Society for Maternal-Fetal Medicine (SMFM), the American College of Obstetricians and Gynecologists (ACOG), and the American Academy of Pediatrics (AAP) convened a group of experts to review the "current" state of the clinical care and science regarding medication use during the perinatal period. The expert panel chose select medications to demonstrate what existing safety and efficacy data may be available for clinicians and patients when making decisions about use in pregnancy or lactation. Furthermore, these example medications also provided opportunities to highlight where data are lacking, thus forming a list of research gaps. Last, after reviewing the existing vaccine safety surveillance system as well as the legislative history surrounding the use of drugs for pediatric diseases, the expert panel made specific recommendations concerning policy efforts to stimulate more research and regulatory attention on drugs for pregnant and lactating women. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. A new algorithm for detection of apnea in infants in neonatal intensive care units

    NASA Astrophysics Data System (ADS)

    Lee, Hoshik; Vergales, Brooke; Paget-Brown, Alix; Rusin, Craig; Moorman, Randall; Kattwinkel, John; Delos, John

    2011-03-01

    Apnea is a very common problem for premature infants: apnea of prematurity (AOP) occurs in >50% of babies whose birth weight is less than 1500 g, and AOP is found in almost all babies who are < 1000 g at birth. Current respiration detectors often fail to detect apnea, and also give many false alarms. We have created a new algorithm for detection of apnea. Respiration is monitored by continuous measurement of chest impedance (CI). However, the pulsing of the heart also causes fluctuations in CI. We developed a new adaptive filtering system to remove heart activity from CI, thereby giving much more reliable measurements of respiration. The new approach is to rescale the impedance measurement to heartbeat-time, sampling 30 times per interbeat interval. We take the Fourier transform of the rescaled signal, bandstop filter at 1 per beat to remove fluctuations due to heartbeats, and then take the inverse transform. The filtered signal retains all properties except the impedance changes due to cardiac filling and emptying. We convert the variance of CI into an estimated likelihood of apnea. This work is supported by NICHD 5RCZHD064488.

  5. Soluble fms-Like Tyrosine Kinase 1 (sFlt1), Endoglin and Placental Growth Factor (PlGF) in Preeclampsia among High Risk Pregnancies

    PubMed Central

    Powers, Robert W.; Jeyabalan, Arun; Clifton, Rebecca G.; Van Dorsten, Peter; Hauth, John C.; Klebanoff, Mark A.; Lindheimer, Marshall D.; Sibai, Baha; Landon, Mark; Miodovnik, Menachem

    2010-01-01

    Background Differences in circulating concentrations of antiangiogenic factors sFlt1 and soluble endoglin (sEng) and the pro-angiogenic growth factor PlGF are reported to precede the onset of preeclampsia weeks to months in low-risk pregnant women. The objective of this study was to investigate whether similar changes can be detected in pregnant women at high-risk to develop the syndrome. Methods This study is a secondary analysis of the NICHD MFMU trial of aspirin to prevent preeclampsia in high-risk pregnancies. Serum samples were available from 194 women with pre-existing diabetes, 313 with chronic hypertension, 234 with multifetal gestation, and 252 with a history of preeclampsia in a previous pregnancy. Samples collected across pregnancy were analyzed in a blinded fashion for sFlt1, sEng and PlGF. Results The odds of developing preeclampsia were significantly increased among women with multiple fetuses for each 2-fold elevation in sFlt1, sEng and the ratio of angiogenic factors (e.g. OR 2.18, 95% CI 1.46-3.32), and significantly decreased for each 2-fold elevation in circulating PlGF (OR 0.50, 95% CI 0.30-0.82) between 7 and 26 weeks' gestation. Cross-sectional analysis of the angiogenic factors across gestation showed significant differences during the third trimester in women who develop preeclampsia compared with appropriate controls in all high-risk groups. However, when data were examined in relation to the gestational week when preeclampsia was diagnosed only sFlt1 was significantly higher 2 to 5 weeks before the clinical onset of preeclampsia and only in women with previous preeclampsia. Conclusions The pattern of elevated concentrations of sFlt1 and sEng, and low PlGF in high-risk pregnant subjects who develop preeclampsia is similar to that reported in low-risk pregnant women. However, differences in these factors among high-risk women who do and do not develop preeclampsia are modest, and do not appear to be clinically useful predictors in these high-risk pregnant women. PMID:20948996

  6. Time spent in sedentary behavior and changes in childhood BMI: a longitudinal study from ages 9 to 15 years.

    PubMed

    Mitchell, J A; Pate, R R; Beets, M W; Nader, P R

    2013-01-01

    To determine if time spent in objectively measured sedentary behavior is associated with a change in body mass index (BMI) between ages 9 and 15 years, adjusting for moderate-to-vigorous physical activity (MVPA). Prospective observational study of children at ages 9 (2000), 11 (2002), 12 (2003) and 15 years (2006). Longitudinal quantile regression was used to model the influence of predictors on changes at the 10th, 25th, 50th, 75th and 90th BMI percentiles over time. Participants were enrolled in the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development and include both boys and girls (n=789). Objectively measured BMI (kg m(-2)) was the outcome variable and objectively measured sedentary behavior was the main predictor. Adjustment was also made for MVPA, gender, race, maternal education, hours of sleep and healthy eating index. Increases in BMI were observed at all percentiles, with the greatest increase observed at the 90th BMI percentile. Spending more time in sedentary behavior (h per day) was associated with additional increases in BMI at the 90th, 75th and 50th BMI percentiles, independent of MVPA and the other covariates (90th percentile=0.59, 95% confidence interval (95% CI): 0.19-0.98 kg m(-2); 75th percentile=0.48, 95% CI: 0.25-0.72 kg m(-2); and 50th percentile=0.19, 95% CI: 0.05-0.33 kg m(-2)). No associations were observed between sedentary behavior and changes at the 25th and 10th BMI percentiles. Sedentary behavior was associated with greater increases in BMI at the 90th, 75th and 50th BMI percentiles between ages 9 and 15 years, independent of MVPA. Preventing an increase in sedentary behavior from childhood to adolescence may contribute to reducing the number of children classified as obese.

  7. An audit of the use of definitions of sudden infant death syndrome (SIDS).

    PubMed

    Byard, Roger W; Marshall, Drew

    2007-11-01

    Given that there are a number of contradictions in the SIDS literature and that the definition of SIDS that was relied upon to authenticate cases in reports is not always specified, an audit of publications was undertaken. Fifty papers dealing with SIDS that were published in 2005 were reviewed. The majority (58%) of reports had either not specified a definition of SIDS, or had used non-standard or idiosyncratic definitions. Of the papers that had documented a definition: 30% used the 1989 NICHD definition, 10% used the 2004 San Diego definition, and 2% used the 1969 Seattle definition. Failure to use standard published definitions of SIDS and/or to clearly specify the definition that has been followed may severely hamper the evaluation of SIDS research.

  8. Socioeconomic status and executive function: developmental trajectories and mediation.

    PubMed

    Hackman, Daniel A; Gallop, Robert; Evans, Gary W; Farah, Martha J

    2015-09-01

    Childhood socioeconomic status (SES) predicts executive function (EF), but fundamental aspects of this relation remain unknown: the developmental course of the SES disparity, its continued sensitivity to SES changes during that course, and the features of childhood experience responsible for the SES-EF relation. Regarding course, early disparities would be expected to grow during development if caused by accumulating stressors at a given constant level of SES. Alternatively, they would narrow if schooling partly compensates for the effects of earlier deprivation, allowing lower-SES children to 'catch up'. The potential for later childhood SES change to affect EF is also unknown. Regarding mediating factors, previous analyses produced mixed answers, possibly due to correlation amongst candidate mediators. We address these issues with measures of SES, working memory and planning, along with multiple candidate mediators, from the NICHD Study of Early Childcare (n = 1009). Early family income-to-needs and maternal education predicted planning by first grade, and income-to-needs predicted working memory performance at 54 months. Effects of early SES remained consistent through middle childhood, indicating that the relation between early indicators of SES and EF emerges in childhood and persists without narrowing or widening across early and middle childhood. Changes in family income-to-needs were associated with significant changes in planning and trend-level changes in working memory. Mediation analyses supported the role of early childhood home characteristics in explaining the association between SES and EF, while early childhood maternal sensitivity was specifically implicated in the association between maternal education and planning. Early emerging and persistent SES-related differences in EF, partially explained by characteristics of the home and family environment, are thus a potential source of socioeconomic disparities in achievement and health across development. © 2015 John Wiley & Sons Ltd.

  9. Biomarkers of Nutrition for Development—Iodine Review1234

    PubMed Central

    Rohner, Fabian; Zimmermann, Michael; Jooste, Pieter; Pandav, Chandrakant; Caldwell, Kathleen; Raghavan, Ramkripa; Raiten, Daniel J.

    2014-01-01

    The objective of the Biomarkers of Nutrition for Development (BOND) project is to provide state-of-the-art information and service with regard to selection, use, and interpretation of biomarkers of nutrient exposure, status, function, and effect. Specifically, the BOND project seeks to develop consensus on accurate assessment methodologies that are applicable to researchers (laboratory/clinical/surveillance), clinicians, programmers, and policy makers (data consumers). The BOND project is also intended to develop targeted research agendas to support the discovery and development of biomarkers through improved understanding of nutrient biology within relevant biologic systems. In phase I of the BOND project, 6 nutrients (iodine, vitamin A, iron, zinc, folate, and vitamin B-12) were selected for their high public health importance because they typify the challenges faced by users in the selection, use, and interpretation of biomarkers. For each nutrient, an expert panel was constituted and charged with the development of a comprehensive review covering the respective nutrient’s biology, existing biomarkers, and specific issues of use with particular reference to the needs of the individual user groups. In addition to the publication of these reviews, materials from each will be extracted to support the BOND interactive Web site (http://www.nichd.nih.gov/global_nutrition/programs/bond/pages/index.aspx). This review represents the first in the series of reviews and covers all relevant aspects of iodine biology and biomarkers. The article is organized to provide the reader with a full appreciation of iodine’s background history as a public health issue, its biology, and an overview of available biomarkers and specific considerations for the use and interpretation of iodine biomarkers across a range of clinical and population-based uses. The review also includes a detailed research agenda to address priority gaps in our understanding of iodine biology and assessment. PMID:24966410

  10. Factors associated with fathers' caregiving activities and sensitivity with young children. NICHD Early Child Care Research Network.

    PubMed

    2000-06-01

    A multifactorial model was used to identify child, sociodemographic, paternal, and maternal characteristics associated with 2 aspects of fathers' parenting. Fathers were interviewed about their caregiving responsibilities at 6, 15, 24, and 36 months, and a subset was videotaped during father-child play at 6 and 36 months. Caregiving activities and sensitivity during play interactions were predicted by different factors. Fathers were more involved in caregiving when fathers worked fewer hours and mothers worked more hours, when fathers and mothers were younger, when fathers had more positive personalities, when mothers reported greater marital intimacy, and when children were boys. Fathers who had less traditional child-rearing beliefs, were older, and reported more marital intimacy were more sensitive during play. These findings are consistent with a multifactorial and multidimensional view of fathering.

  11. Clone and genomic repositories at the American Type Culture Collection

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Maglott, D.R.; Nierman, W.C.

    1990-01-01

    The American Type Culture Collection (ATCC) has a long history of characterizing, preserving, and distributing biological resource materials for the scientific community. Starting in 1925 as a repository for standard bacterial and fungal strains, its collections have diversified with technologic advances and in response to the requirements of its users. To serve the needs of the human genetics community, the National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), established an international Repository of Human DNA Probes and Libraries at the ATCC in 1985. This repository expanded the existing collections of recombinant clones and librariesmore » at the ATCC, with the specific purposes of (1) obtaining, amplifying, and distribution probes detecting restriction fragment length polymorphisms (RFLPs); (2) obtaining, amplifying, and distributing genomic and cDNA clones from known genes independent of RFLP detection; (3) distributing the chromosome-specific libraries generated by the National Laboratory Gene Library Project at the Lawrence Livermore and Los Alamos National Laboratories and (4) maintaining a public, online database describing the repository materials. Because it was recognized that animal models and comparative mapping can be crucial to genomic characterization, the scope of the repository was broadened in February 1989 to include probes from the mouse genome.« less

  12. Efficacy of pharmacologic closure of patent ductus arteriosus in small-for-gestational-age extremely preterm infants.

    PubMed

    Boghossian, Nansi S; Do, Barbara T; Bell, Edward F; Dagle, John M; Brumbaugh, Jane E; Stoll, Barbara J; Vohr, Betty R; Das, Abhik; Shankaran, Seetha; Sanchez, Pablo J; Wyckoff, Myra H; Bethany Ball, M

    2017-10-01

    Optimal management of the patent ductus arteriosus (PDA) in preterm infants remains controversial. Therefore, studies identifying infants who are most likely to benefit from PDA treatment are needed. We sought to examine if significant intrauterine growth restriction, defined by birth weight z-score, reduces the efficacy of PDA closure with indomethacin or ibuprofen and thereby increases the need for surgical closure of PDA after pharmacologic treatment. We studied infants 23-28weeks' gestation born 2006-2013 at NICHD Neonatal Research Network centers. We examined the responses to PDA treatment with indomethacin and/or ibuprofen and whether the PDA was subsequently closed surgically. Logistic regression generated adjusted odds ratios (ORs) for the associations between the z-score groups (<-2, -2 to -0.5, and >-0.5) and PDA surgery following pharmacologic treatment. 5606 infants were diagnosed with PDA; 3587 (64.0%) received indomethacin or ibuprofen or both, and 909 (25.3%) underwent PDA surgery. Mothers of infants with PDA non-closure were less likely to have hypertension (19% vs. 28%). Infants with non-closure were more likely to be female (53% vs. 49%), have lower gestational age and birth weight and to develop sepsis (42% vs. 31%). Compared to infants with z-score>-0.5, PDA surgery was increased among infants with z-score -2 to -0.5 (OR=1.23; 95% CI 1.02-1.47) but not among infants with z-score<-2. Infants with birth weight z-score -2 to -0.5 are more likely than normally grown infants to require PDA surgery following pharmacologic treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Workplace Stress and Working from Home Influence Depressive Symptoms Among Employed Women with Young Children.

    PubMed

    Shepherd-Banigan, Megan; Bell, Janice F; Basu, Anirban; Booth-LaForce, Cathryn; Harris, Jeffrey R

    2016-02-01

    Poor balance between work and family can be a major stressor for women with young children and have a negative impact on emotional well-being. Family-friendly workplace attributes may reduce stress and depressive symptoms among this population. However, few studies have analyzed the role of specific workplace attributes on mental health outcomes among women with young children because available data are limited. This study examines the impact of workplace attributes on changes in depressive symptoms among working women with young children between 6 and 24 months of age. This study uses data from the National Institute of Child Health and Human Development (NICHD) Study of Early Child Care and Youth Development (SECCYD) collected between 1991 and 1993 to examine the effects of work intensity, work schedule (night/day/variable), schedule flexibility, working from home, and work stress on changes in depressive symptoms among a national US sample of 570 women who returned to work within 6 months after childbirth. Depressive symptoms were assessed using the CES-D score. Treatment effects were estimated using fixed effects regression models. Working from home and work stress predicted within-individual changes in depressive symptoms between 6 and 24 months postchildbirth. Women who worked from home reported a statistically significant decrease in depression scores over time (β = -1.36, SE = 0.51, p = 0.002). Women who reported a one-unit increase in job concerns experienced, on average, a 2-point increase in depression scores over time (β = 1.73, SE = 0.37, p < 0.01). Work intensity, work schedule, and schedule flexibility were not associated with changes in depressive symptoms. This study is one of the few to use longitudinal data and causal-inference techniques to examine whether specific workplace attributes influence depressive symptoms among women with young children. Reducing stress in the workplace and allowing women to work from home may improve mental health among women who transition back to work soon after childbirth.

  14. Outcomes following vaginal prolapse repair and mid urethral sling (OPUS) trial--design and methods.

    PubMed

    Wei, John; Nygaard, Ingrid; Richter, Holly; Brown, Morton; Barber, Matthew; Xiao Xu; Kenton, Kimberly; Nager, Charles; Schaffer, Joseph; Visco, Anthony; Weber, Anne

    2009-04-01

    The primary aims of this trial are to determine whether the use of a concomitant prophylactic anti-incontinence procedure may prevent stress urinary incontinence symptom development in women undergoing vaginal prolapse surgery and to evaluate the cost-effectiveness of this prophylactic approach. To present the rationale and design of a randomized controlled surgical trial (RCT), the Outcomes following vaginal Prolapse repair and mid Urethral Sling (OPUS) Trial highlighting the challenges in the design and implementation. The challenges of implementing this surgical trial combined with a cost-effectiveness study and patient preference group are discussed including the study design, ethical issues regarding use of sham incision, maintaining the masking of study staff, and pragmatic difficulties encountered in the collection of cost data. The trial is conducted by the NICHD-funded Pelvic Floor Disorders Network. The ongoing OPUS trial started enrollment in May 2007 with a planned accrual of 350. The use of sham incision was generally well accepted but the collection of cost data using conventional billing forms was found to potentially unmask key study personnel. This necessitated changes in the study forms and planned timing for collection of cost data. To date, the enrollment to the patient preference group has been lower than the limit established by the protocol suggesting a willingness on the part of women to participate in the randomization. Given the invasive nature of surgical intervention trials, potential participants may be reluctant to accept random assignment, potentially impacting generalizability. Findings from the OPUS trial will provide important information that will help surgeons to better counsel women on the benefits and risks of concomitant prophylactic anti-incontinence procedure at the time of vaginal surgery for prolapse. The implementation of the OPUS trial has necessitated that investigators consider ethical issues up front, remain flexible with regards to data collection and be constantly aware of unanticipated opportunities for unmasking. Future surgical trials should be aware of potential challenges in maintaining masking and collection of cost-related information.

  15. Longitudinal relationships between whole body and central adiposity on weight-bearing bone geometry, density, and bone strength: a pQCT study in young girls

    PubMed Central

    Farr, Joshua N.; Laudermilk, Monica J.; Lee, Vinson R.; Blew, Robert M.; Stump, Craig; Houtkooper, Linda; Lohman, Timothy G.; Going, Scott B.

    2015-01-01

    Summary Longitudinal relationships between adiposity (total body and central) and bone development were assessed in young girls. Total body and android fat masses were positively associated with bone strength and density parameters of the femur and tibia. These results suggest adiposity may have site-specific stimulating effects on the developing bone. Introduction Childhood obesity may impair bone development, but the relationships between adiposity and bone remain unclear. Failure to account for fat pattern may explain the conflicting results. Purpose Longitudinal associations of total body fat mass (TBFM) and android fat mass (AFM) with 2-year changes in weight-bearing bone parameters were examined in 260 girls aged 8–13 years at baseline. Peripheral quantitative computed tomography was used to measure bone strength index (BSI, square milligrams per quartic millimeter), strength–strain index (SSI, cubic millimeters), and volumetric bone mineral density (vBMD, milligrams per cubic centimeter) at distal metaphyseal and diaphyseal regions of the femur and tibia. TBFM and AFM were assessed by dual-energy x-ray absorptiometry. Results Baseline TBFM and AFM were positively associated with the change in femur BSI (r =0.20, r =0.17, respectively) and femur trabecular vBMD (r =0.19, r =0.19, respectively). Similarly, positive associations were found between TBFM and change in tibia BSI and SSI (r =0.16, r =0.15, respectively), and femur total and trabecular vBMD (r =0.12, r =0.14, respectively). Analysis of covariance showed that girls in the middle thirds of AFM had significantly lower femur trabecular vBMD and significantly higher tibia cortical vBMD than girls in the highest thirds of AFM. All results were significant at p <0.05. Conclusions Whereas baseline levels of TBFM and AFM are positive predictors of bone strength and density at the femur and tibia, higher levels of AFM above a certain level may impair cortical vBMD growth at weight-bearing sites. Future studies in obese children will be needed to test this possibility. NIH/NICHD #HD-050775. PMID:24113839

  16. Inhaled Nitric Oxide Therapy for Pulmonary Disorders of the Term and Preterm Infant

    PubMed Central

    Sokol, Gregory M.; Konduri, G. Ganesh; Van Meurs, Krisa P.

    2016-01-01

    The 21st century began with the FDA approval of inhaled nitric oxide therapy for the treatment of neonatal hypoxic respiratory failure associated with pulmonary hypertension in recognition of the two randomized clinical trials demostrating a significant reduction in the need for extracorporeal support in the term and near-term infant. Inhaled nitric oxide is one of only a few therapeutic agents approved for use through clinical investigations primarily in the neonate. This article provides an overview of the pertinent biology and chemistry of nitric oxide, discusses potential toxicities, and reviews the results of pertinent clinical investigations and large randomized clinical trials including neurodevelopmental follow-up in term and preterm neonates. The clinical investigations conducted by the Eunice Kennedy Shriver NICHD Neonatal Research Network will be discussed and placed in context with other pertinent clinical investigations exploring the efficacy of inhaled nitric oxide therapy in neonatal hypoxic respiratory failure. PMID:27480246

  17. Natural cycle IVF reduces the risk of low birthweight infants compared with conventional stimulated IVF.

    PubMed

    Mak, Winifred; Kondapalli, Laxmi A; Celia, Gerard; Gordon, John; DiMattina, Michael; Payson, Mark

    2016-04-01

    Are perinatal outcomes improved in singleton pregnancies resulting from fresh embryo transfers performed following unstimulated/natural cycle IVF (NCIVF) compared with stimulated IVF? Infants conceived by unstimulated/NCIVF have a lower risk of being low birthweight than infants conceived by stimulated IVF; however, this risk did not remain significant after adjusting for gestation age. Previous studies have shown that infants born after modified NCIVF have a higher average birthweight and are less likely to be low birthweight than those infants conceived with conventional stimulated IVF. Retrospective cohort study of singleton live births in non-smoking women undergoing fresh IVF-embryo transfer cycles from 2007 to 2013 in a single IVF center. The women were stratified by stimulated (n = 174) or unstimulated (n = 190) IVF exposure status. Unstimulated/NCIVF is defined as IVF without the use of exogenous gonadotrophins, and only includes the use of HCG to time oocyte retrieval. Demographic data including maternal age, BMI, infertility diagnosis and IVF cycle characteristics were collected. The perinatal outcomes used for comparison between the two study groups were length of gestation, birthweight, preterm delivery, very preterm delivery, low birthweight, small for gestational age and large for gestational age. Although women in the NCIVF group were older than those in the stimulated group (35.0 versus 34.2 years, P < 0.05), parity and history of prior ART cycles were comparable between the groups. The mean birthweight was significantly higher in the NCIVF group by 163 g than in the stimulated group (3436 ± 420 g versus 3273 ± 574 g, P < 0.05). Consistent with this finding, there were also less low birthweight (<2500 g) infants in the NCIVF group versus stimulated group (1 versus 8.6%, P < 0.005). The reduction in risk for low birthweight in the NCIVF group remained significant after adjustment for maternal age, infertility diagnosis, ICSI, number of embryos transferred and blastocyst transfer (odds ratio (OR) 0.07; 95% CI 0.014-0.35). As NCIVF group had less preterm infants, additional adjustment for gestational age was performed and this showed a tendency towards lower risk of low birthweight in NCIVF (OR 0.11; 95% CI 0.01-1.0). While gestational age at delivery was comparable between the groups, both preterm births (<37 weeks gestation) (31 versus 42%, P < 0.05) and very preterm births (<32 weeks gestation) (0.52 versus 6.3%, P < 0.005) were significantly reduced in the NCIVF group. However, after adjustment for potential confounders, the reduction in risk of preterm and very preterm delivery associated with the NCIVF group was no longer significant (OR 1.1; 95% CI 0.48-2.5). Limitations of this study are the retrospective nature of the data collection and the lack of information about parental characteristics associated with birthweight. The improved perinatal outcomes following successful unstimulated/NCIVF suggest that this treatment should be considered as a viable option for infertile couples. NCIVF could reduce potential adverse perinatal outcomes such as low birthweight related to fresh embryo transfers performed following ovarian stimulation. The etiology of the improved perinatal outcomes following NCIVF needs to be explored further to determine if the improvement is derived from endometrial factors versus follicular/oocyte factors. The study was supported by the following grants from the Eunice Kennedy Shriver National Institute of Child Health and Human Development, NICHD K12HD047018 (W.M.), NICHD K12HD001271 (L.A.K.). The authors have no competing interests. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  18. Neighborhood food retail environment and health outcomes among urban Ghanaian women

    NASA Astrophysics Data System (ADS)

    Taflin, Helena Janet

    Over the past several decades there has been a global dietary shift, occurring at different rates across time and space. These changes are reflective of the nutrition transition--a series of potentially adverse changes in diet, health and physical activity. These dietary shifts have been associated with significant health consequences, as seen by the global rise in nutrition-related non-communicable diseases (NR-NCDs) such as diabetes, hypertension, cancer, coronary heart disease as well as obesity. Clinical studies have confirmed that overweight and obese individuals are at increased risk for diabetes and hypertension, among other cardiovascular diseases. However, these linkages between the nutrition transition and health are not spatially random. They vary according to personal characteristics ("who you are") and the neighborhood environment in which you live ("where you are"). Leveraging existing demographic and health resources, in this project I aim to investigate the relationship between the food retail environment and health outcomes among a representative sample of urban Ghanaian women ages 18 and older, normally resident in the Accra Metropolitan Area (AMA), using a mixed methods spatial approach. Data for this study are drawn primarily from the 2008-09 Women's Health Study of Accra (WHSA II) which was funded by the U.S. National Institute of Child Health and Human Development (NICHD) (John R. Weeks, Project Director/Principal Investigator). It was conducted as a joint collaboration between the Institute of Statistical, Social and Economic Research (ISSER) at the University of Ghana, the Harvard School of Public Health and San Diego State University. Results from this study highlights the importance of addressing the high prevalence of hypertension among adult women in Accra and should be of concern to both stakeholders and the public. Older populations, overweight and obese individuals, those with partners living at home, limited number of food retailers in one's neighborhood and living in close proximity to a modern food retailer all increase the risk of hypertension among women sampled in WHSA-II.

  19. Maternal sensitivity and effortful control in early childhood as predictors of adolescents' adjustment: The mediating roles of peer group affiliation and social behaviors.

    PubMed

    Laible, Deborah; Carlo, Gustavo; Davis, Alexandra N; Karahuta, Erin

    2016-06-01

    Longitudinal links between early childhood temperament, maternal sensitivity, and adolescents' adjustment have been proposed and found in several longitudinal studies, but the mechanisms of influence have not been explored. The authors examined the paths from maternal sensitivity and temperament in early childhood to adolescents' prosocial, aggressive, and delinquent behaviors via childhood social behaviors and peer group affiliation. Data at 54 months, Grade 3 (M age = 9.03, SD = .31), Grade 6 (M age = 11.95, SD = .34), and Grade 9 (M age = 15.57, SD = .78) from the NICHD SECCYD longitudinal investigation of 1,364 participants (52% boys) was analyzed. Overall, results yielded evidence that maternal sensitivity and child temperament at 54 months of age predicted prosocial, aggressive, and delinquent outcomes at age 15. Affiliation with peer groups (especially with prosocial peers) and social behaviors in childhood mediated the aforementioned paths for effortful control, but not for maternal sensitivity. Discussion focuses on the implications for understanding the long-term effects of early childhood predictors on behavioral outcomes in adolescence. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Intrauterine human chorionic gonadotropin infusion in oocyte donors promotes endometrial synchrony and induction of early decidual markers for stromal survival: a randomized clinical trial.

    PubMed

    Strug, Michael R; Su, Renwei; Young, James E; Dodds, William G; Shavell, Valerie I; Díaz-Gimeno, Patricia; Ruíz-Alonso, Maria; Simón, Carlos; Lessey, Bruce A; Leach, Richard E; Fazleabas, Asgerally T

    2016-07-01

    Does a single intrauterine infusion of human chorionic gonadotropin (hCG) at the time corresponding to a Day 3 embryo transfer in oocyte donors induce favorable molecular changes in the endometrium for embryo implantation? Intrauterine hCG was associated with endometrial synchronization between endometrial glands and stroma following ovarian stimulation and the induction of early decidual markers associated with stromal cell survival. The clinical potential for increasing IVF success rates using an intrauterine hCG infusion prior to embryo transfer remains unclear based on previously reported positive and non-significant findings. However, infusion of CG in the non-human primate increases the expression of pro-survival early decidual markers important for endometrial receptivity, including α-smooth muscle actin (α-SMA) and NOTCH1. Oocyte donors (n=15) were randomly assigned to receive an intrauterine infusion of 500 IU hCG (n=7) or embryo culture media vehicle (n=8) 3 days following oocyte retrieval during their donor stimulation cycle. Endometrial biopsies were performed 2 days later, followed by either RNA isolation or tissue fixation in formalin and paraffin embedding. Reverse transcription of total RNA from endometrial biopsies generated cDNA, which was used for analysis in the endometrial receptivity array (ERA; n = 5/group) or quantitative RT-PCR to determine relative expression of ESR1, PGR, C3 and NOTCH1. Tissue sections were stained with hematoxylin and eosin followed by blinded staging analysis for dating of endometrial glands and stroma. Immunostaining for ESR1, PGR, α-SMA, C3 and NOTCH1 was performed to determine their tissue localization. Intrauterine hCG infusion was associated with endometrial synchrony and reprograming of stromal development following ovarian stimulation. ESR1 and PGR were significantly elevated in the endometrium of hCG-treated patients, consistent with earlier staging. The ERA did not predict an overall positive impact of intrauterine hCG on endometrial receptivity. However, ACTA2, encoding α-SMA was significantly increased in response to intrauterine hCG. Similar to the hCG-treated non-human primate, sub-epithelial and peri-vascular α-SMA expression was induced in women following hCG infusion. Other known targets of hCG in the baboon were also found to be increased, including C3 and NOTCH1, which have known roles in endometrial receptivity. This study differs from our previous work in the hCG-treated non-human primate along with clinical studies in infertile patients. Specifically, we performed a single intrauterine infusion in oocyte donors instead of either continuous hCG via an osmotic mini-pump in the baboon or infusion followed by blastocyst-derived hCG in infertile women undergoing embryo transfer. Therefore, the full impact of intrauterine hCG in promoting endometrial receptivity may not have been evident. Our findings suggest a potential clinical benefit for intrauterine hCG prior to embryo transfer on Day 3 in counteracting endometrial dyssynchrony from ovarian stimulation and promoting expression of markers important for stromal survival. Finally, there were no obvious negative effects of intrauterine hCG treatment. Funding for this work was provided by NICHD R01 HD042280 (A.T.F.) and NICHD F30 HD082951 (M.R.S.). C.S. and P.D.-G are co-inventors of the patented ERA, which is owned by IGENOMIX SL and was used in this study, and C.S. is a shareholder in IGENOMIX SL. M.R.-A. is employed by IGENOMIX SL. No other authors have any conflicts of interest to report. This study was registered with ClinicalTrials.gov (NCT01786252). 5 February 2013. 10 May 2013. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Longitudinal Associations Between Parental Monitoring Discrepancy and Delinquency: An Application of the Latent Congruency Model.

    PubMed

    Ksinan, Albert J; Vazsonyi, Alexander T

    2016-12-01

    Studies have shown that discrepancies (relative concordance or discordance) between parent and adolescent ratings are predictive of problem behaviors; monitoring, in particular, has been consistently linked to them. The current study tested whether discrepancies in perceptions of maternal monitoring, rated by mothers and youth at age 12, foretold delinquency (rule breaking) at age 15, and whether parental closeness and conflict predicted higher discrepancies, and indirectly, higher delinquency. The final study sample used the NICHD longitudinal dataset with N = 966 youth (50.1 % female) and their mothers (80.1 % European American, 12.9 % African American, 7 % other ethnicity). The analytic approach consisted of an extension and application of the Latent Congruency Model (LCM) to estimate monitoring discrepancies as well as age 15 delinquency scores. Findings showed that age 12 monitoring discrepancy was predictive of age 15 delinquency for both boys and girls based on youth reports, but not for maternal reports. Age 11 closeness predicted age 12 monitoring discrepancy, which served as a mediator for its effect on age 15 adolescent-reported delinquency. Thus, based on the rigorous LCM analytic approach which seeks to minimize the effects by competing explanations and to maximize precision in providing robust estimates, rates of perceived discordance in parenting behaviors during early adolescence matter in understanding variability in adolescent delinquency during middle adolescence.

  2. Maternal intrusiveness, family financial means, and anxiety across childhood in a large multiphase sample of community youth

    PubMed Central

    Cooper-Vince, Christine E.; Pincus, Donna B.; Comer, Jonathan S.

    2013-01-01

    Intrusive parenting has been positively associated with child anxiety, although examinations of this relationship to date have been largely confined to middle to upper middle class families and have rarely used longitudinal designs. With several leading interventions for child anxiety emphasizing the reduction of parental intrusiveness, it is critical to determine whether the links between parental intrusiveness and child anxiety broadly apply to families of all financial means, and whether parental intrusiveness prospectively predicts the development of child anxiety. This study employed latent growth curve analysis to evaluate the interactive effects of maternal intrusiveness and financial means on the developmental trajectory of child anxiety from 1st grade to age 15 in 1,121 children (50.7% male) and their parents from the NICHD SECCYD. The overall model was found to provide good fit, revealing that early maternal intrusiveness and financial means did not impact individual trajectories of change in child anxiety, which were stable from 1st to 5th grade, and then decrease from 5th grade to age 15. Cross-sectional analyses also examined whether family financial means moderated contemporaneous relationships between maternal intrusiveness and child anxiety in 3rd and 5th grades. The relationship between maternal intrusiveness and child anxiety was moderated by family financial means for 1st graders, with stronger links found among children of lower family financial means, but not for 3rd and 5th graders. Neither maternal intrusiveness nor financial means in 1st grade predicted subsequent changes in anxiety across childhood. Findings help elucidate for whom and when maternal intrusiveness has the greatest link with child anxiety and can inform targeted treatment efforts. PMID:23929005

  3. Sleep Problem of Children with Autistic Spectrum Disorder Assessed by Children Sleep Habits Questionnaire-Abbreviated in Indonesia and Japan.

    PubMed

    Irwanto; Rehatta, Nancy Margarita; Hartini, Sri; Takada, Satoshi

    2016-07-04

    Sleep problems are associated with problems of cognitive functioning, learning, attention and school performance. It has been found that sleep problems are highly prevalent in children with Autistic spectrum disorders (ASD), with rates ranging from 40% to 80%. We aimed to identify the prevalence of sleep problems on children with ASD in Indonesia and Japan. A cross-sectional study was conducted in Surabaya, Indonesia and Kobe, Japan. Children aged 4 -10 years old were enrolled using stratified cluster sampling. Children's Sleep Habits Questionnaire-Abbreviated (CSHQ-A) was used in this research to assess the sleep problems, consisted of 22 questions (NICHD SECCYD-Wisconsin). Data were analyzed with Mann-Whitney U test to compare the CSHQ-A scores between Indonesian and Japanese children, while the proportion of sleep problems was evaluated by chi-square test with 95% confidence interval. Fifty children with ASD were included in this study, 25 children from Kobe, Japan and 25 children from Surabaya, Indonesia. The prevalence of sleep problems on children with ASD was 60% (15 children) in Indonesia and 16% (4 children) in Japan respectively. There were significant differences in total waking during the night and in morning wake for the CSHQ-A between children from Indonesia and Japan (p<0.005). The prevalence of sleep problems on children with ASD was higher in children from Indonesia than from Japan.

  4. Intrauterine human chorionic gonadotropin infusion in oocyte donors promotes endometrial synchrony and induction of early decidual markers for stromal survival: a randomized clinical trial

    PubMed Central

    Strug, Michael R.; Su, Renwei; Young, James E.; Dodds, William G.; Shavell, Valerie I.; Díaz-Gimeno, Patricia; Ruíz-Alonso, Maria; Simón, Carlos; Lessey, Bruce A.; Leach, Richard E.; Fazleabas, Asgerally T.

    2016-01-01

    STUDY QUESTION Does a single intrauterine infusion of human chorionic gonadotropin (hCG) at the time corresponding to a Day 3 embryo transfer in oocyte donors induce favorable molecular changes in the endometrium for embryo implantation? SUMMARY ANSWER Intrauterine hCG was associated with endometrial synchronization between endometrial glands and stroma following ovarian stimulation and the induction of early decidual markers associated with stromal cell survival. WHAT IS KNOWN ALREADY The clinical potential for increasing IVF success rates using an intrauterine hCG infusion prior to embryo transfer remains unclear based on previously reported positive and non-significant findings. However, infusion of CG in the non-human primate increases the expression of pro-survival early decidual markers important for endometrial receptivity, including α-smooth muscle actin (α-SMA) and NOTCH1. STUDY DESIGN, SIZE, DURATION Oocyte donors (n=15) were randomly assigned to receive an intrauterine infusion of 500 IU hCG (n=7) or embryo culture media vehicle (n=8) 3 days following oocyte retrieval during their donor stimulation cycle. Endometrial biopsies were performed 2 days later, followed by either RNA isolation or tissue fixation in formalin and paraffin embedding. PARTICIPANTS/MATERIALS, SETTING, METHODS Reverse transcription of total RNA from endometrial biopsies generated cDNA, which was used for analysis in the endometrial receptivity array (ERA; n = 5/group) or quantitative RT–PCR to determine relative expression of ESR1, PGR, C3 and NOTCH1. Tissue sections were stained with hematoxylin and eosin followed by blinded staging analysis for dating of endometrial glands and stroma. Immunostaining for ESR1, PGR, α-SMA, C3 and NOTCH1 was performed to determine their tissue localization. MAIN RESULTS AND THE ROLE OF CHANCE Intrauterine hCG infusion was associated with endometrial synchrony and reprograming of stromal development following ovarian stimulation. ESR1 and PGR were significantly elevated in the endometrium of hCG-treated patients, consistent with earlier staging. The ERA did not predict an overall positive impact of intrauterine hCG on endometrial receptivity. However, ACTA2, encoding α-SMA was significantly increased in response to intrauterine hCG. Similar to the hCG-treated non-human primate, sub-epithelial and peri-vascular α-SMA expression was induced in women following hCG infusion. Other known targets of hCG in the baboon were also found to be increased, including C3 and NOTCH1, which have known roles in endometrial receptivity. LIMITATIONS, REASONS FOR CAUTION This study differs from our previous work in the hCG-treated non-human primate along with clinical studies in infertile patients. Specifically, we performed a single intrauterine infusion in oocyte donors instead of either continuous hCG via an osmotic mini-pump in the baboon or infusion followed by blastocyst-derived hCG in infertile women undergoing embryo transfer. Therefore, the full impact of intrauterine hCG in promoting endometrial receptivity may not have been evident. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest a potential clinical benefit for intrauterine hCG prior to embryo transfer on Day 3 in counteracting endometrial dyssynchrony from ovarian stimulation and promoting expression of markers important for stromal survival. Finally, there were no obvious negative effects of intrauterine hCG treatment. STUDY FUNDING/COMPETING INTEREST(S) Funding for this work was provided by NICHD R01 HD042280 (A.T.F.) and NICHD F30 HD082951 (M.R.S.). C.S. and P.D.-G are co-inventors of the patented ERA, which is owned by IGENOMIX SL and was used in this study, and C.S. is a shareholder in IGENOMIX SL. M.R.-A. is employed by IGENOMIX SL. No other authors have any conflicts of interest to report. TRIAL REGISTRATION NUMBER This study was registered with ClinicalTrials.gov (NCT01786252). TRIAL REGISTRATION DATE 5 February 2013. DATE OF FIRST PATIENT'S ENROLLMENT 10 May 2013. PMID:27122490

  5. Early postnatal nutritional requirements of the very preterm infant based on a presentation at the NICHD-AAP workshop on research in neonatology.

    PubMed

    Hay, W W

    2006-07-01

    Normal fetal nutrition is a useful guide for understanding postnatal nutrition of infants born very preterm. Fetal lipid uptake gradually increases towards term and is primarily used to produce fat in adipose tissue, with essential fatty acid uptake providing necessary structural and functional elements in membranes of cells in the central nervous system. Fetal glucose uptake and utilization rates are nearly twice as high at 23-26 weeks gestation as they are at term, contributing primarily to energy production and glycogen formation. Amino-acid uptake by the fetus is two-to threefold greater at 23-26 weeks gestation than at term and is required to meet the very high fractional protein synthesis and growth rates at this gestational period; amino acids also contribute significantly to fetal energy production. In contrast, after birth most of the very preterm infants are fed more lipid and glucose and less amino acids and protein than they need. Not surprisingly, therefore, very preterm infants accumulate fat but remain relatively growth restricted at term gestational age compared to those infants who grew normally in utero, and this postnatal growth restriction has long-term adverse growth, development, and health consequences. More thorough understanding of the unique nutritional, metabolic, and growth requirements of the normally growing fetus and the very preterm infant, once born, are needed to determine optimal nutritional strategies to improve the outcome of preterm infants.

  6. The Trial to Reduce IDDM in the Genetically at Risk (TRIGR) study: recruitment, intervention and follow-up.

    PubMed

    Akerblom, H K; Krischer, J; Virtanen, S M; Berseth, C; Becker, D; Dupré, J; Ilonen, J; Trucco, M; Savilahti, E; Koski, K; Pajakkala, E; Fransiscus, M; Lough, G; Bradley, B; Koski, M; Knip, M

    2011-03-01

    The Trial to Reduce IDDM in the Genetically at Risk (TRIGR) study was designed to establish whether weaning to a highly hydrolysed formula in infancy subsequently reduces the risk of type 1 diabetes. The study population comprises newborn infants who have first-degree relatives with type 1 diabetes and meet the increased risk HLA inclusion, but not exclusion criteria. The study is being performed in 15 countries in three continents. First-degree relatives of patients with type 1 diabetes were identified from diabetes clinics, diabetes registries, and from other endocrinology or obstetrics offices and websites. HLA typing was performed at birth from cord or heel stick blood, and the results sent to the study's Data Management Unit within 2 weeks for communication of eligibility to the clinical study centre. All mothers recruited were encouraged to breastfeed. The intervention lasted for 6 to 8 months, and weaning formulas based on hydrolysed casein and standard cow's milk were compared. TRIGR recruited 5,606 infants, of whom 2,160 were enrolled as eligible participants, 6% more than the target of 2,032. Of those enrolled, 80% were exposed to the study formula. The overall retention rate over the first 5 years is 87%, with protocol compliance at 94%. The randomisation code will be opened when the last recruited child turns 10 years of age, i.e. in 2017. The TRIGR experience demonstrates the feasibility and successful implementation of an international dietary intervention study. TRIGR is the first ever primary prevention trial for type 1 diabetes and, if completed successfully, will provide a definite answer to the research question. ClinicalTrials.gov NCT00179777 The study was funded by the National Institute of Child Health and Development (NICHD) and National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health (NIH) (grant numbers HD040364, HD042444 and HD051997), Canadian Institutes of Health Research, the Juvenile Diabetes Research Foundation International and the Commission of the European Communities (specific RTD programme 'Quality of Life and Management of Living Resources', contract number QLK1-2002-00372 'Diabetes Prevention'. Other funding came from the EFSD/JDRF/Novo Nordisk Focused Research Grant, Academy of Finland, Dutch Diabetes Research Foundation and Finnish Diabetes Research Foundation).

  7. Ketamine anesthesia during the first week of life can cause long-lasting cognitive deficits in rhesus monkeys.

    PubMed

    Paule, M G; Li, M; Allen, R R; Liu, F; Zou, X; Hotchkiss, C; Hanig, J P; Patterson, T A; Slikker, W; Wang, C

    2011-01-01

    Previously our laboratory has shown that ketamine exposure (24h of clinically relevant anesthesia) causes significant increases in neuronal cell death in perinatal rhesus monkeys. Sensitivity to this ketamine-induced neurotoxicity was observed on gestational days 120-123 (in utero exposure via maternal anesthesia) and on postnatal days (PNDs) 5-6, but not on PNDs 35-37. In the present study, six monkeys were exposed on PND 5 or 6 to intravenous ketamine anesthesia to maintain a light surgical plane for 24h and six control animals were unexposed. At 7 months of age all animals were weaned and began training to perform a series of cognitive function tasks as part of the National Center for Toxicological Research (NCTR) Operant Test Battery (OTB). The OTB tasks used here included those for assessing aspects of learning, motivation, color discrimination, and short-term memory. Subjects responded for banana-flavored food pellets by pressing response levers and press-plates during daily (M-F) test sessions (50 min) and were assigned training scores based upon their individual performance. As reported earlier (Paule et al., 2009) beginning around 10 months of age, control animals significantly outperformed (had higher training scores than) ketamine-exposed animals for approximately the next 10 months. For animals now over 3 and one-half years of age, the cognitive impairments continue to manifest in the ketamine-exposed group as poorer performance in the OTB learning and color and position discrimination tasks, as deficits in accuracy of task performance, but also in response speed. There are also apparent differences in the motivation of these animals which may be impacting OTB performance. These observations demonstrate that a single 24-h episode of ketamine anesthesia, occurring during a sensitive period of brain development, results in very long-lasting deficits in brain function in primates and provide proof-of-concept that general anesthesia during critical periods of brain development can result in subsequent functional deficits. Supported by NICHD, CDER/FDA and NCTR/FDA. Published by Elsevier Inc.

  8. Polycystic ovary morphology is associated with insulin resistance in women with polycystic ovary syndrome.

    PubMed

    Hong, So-Hyeon; Sung, Yeon-Ah; Hong, Young Sun; Jeong, Kyungah; Chung, Hyewon; Lee, Hyejin

    2017-10-01

    Polycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by chronic anovulation, hyperandrogenism, polycystic ovary morphology (PCOM) and metabolic disturbances including insulin resistance and type 2 diabetes mellitus. Although insulin resistance could be associated with PCOM, recent studies have shown controversial results. The aim of this study was to determine the relationship between PCOM and insulin resistance. This was a cross-sectional clinical study. A total of 679 women with PCOS who were diagnosed using the National Institute of Child Health and Human Disease (NICHD) criteria and 272 control women were analysed. We measured fasting glucose and insulin levels, 75 g oral glucose tolerance test-derived glucose and insulin levels, testosterone levels, ovarian volume and follicle number. Polycystic ovary morphology was described in 543 women (80.0%) with PCOS. Women with PCOS had significantly higher 2 hours postload glucose, fasting and 2 hours postload insulin levels, ovarian volume, ovarian follicle numbers and lower insulin sensitivity compared with those of the controls (all P<.01). In women with PCOS, ovarian volume and ovarian follicle number were negatively associated with the quantitative insulin sensitivity check index after adjusting for age, body mass index and total testosterone; however, this association was not observed in the controls. In the logistic regression analysis, increased ovarian follicle number was associated with decreased insulin sensitivity in women with PCOS. In PCOS, enlarged ovarian volume and follicle excess were associated with insulin resistance, and the number of ovarian follicles could be a predictor of insulin resistance. © 2017 John Wiley & Sons Ltd.

  9. Developmental Outcomes of Very Preterm Infants with Tracheostomies

    PubMed Central

    DeMauro, Sara B.; D'Agostino, Jo Ann; Bann, Carla; Bernbaum, Judy; Gerdes, Marsha; Bell, Edward F.; Carlo, Waldemar A.; D'Angio, Carl; Das, Abhik; Higgins, Rosemary; Hintz, Susan R.; Laptook, Abbot R.; Natarajan, Girija; Nelin, Leif; Poindexter, Brenda B.; Sanchez, Pablo J.; Shankaran, Seetha; Stoll, Barbara J.; Truog, William; Van Meurs, Krisa P.; Vohr, Betty; Walsh, Michele C.; Kirpalani, Haresh

    2014-01-01

    Objectives To evaluate the neurodevelopmental outcomes of very preterm (<30 weeks) infants who underwent tracheostomy. Study design Retrospective cohort study from 16 centers of the NICHD Neonatal Research Network over 10 years (2001-2011). Infants who survived to at least 36 weeks (N=8,683), including 304 infants with tracheostomies, were studied. Primary outcome was death or neurodevelopmental impairment (NDI, a composite of one or more of: developmental delay, neurologic impairment, profound hearing loss, severe visual impairment) at a corrected age of 18-22 months. Outcomes were compared using multiple logistic regression. We assessed impact of timing, by comparing outcomes of infants who underwent tracheostomy before and after 120 days of life. Results Tracheostomies were associated with all neonatal morbidities examined, and with most adverse neurodevelopmental outcomes. Death or NDI occurred in 83% of infants with tracheostomies and 40% of those without [odds ratio (OR) adjusted for center 7.0 (95%CI, 5.2-9.5)]. After adjustment for potential confounders, odds of death or NDI remained higher [OR 3.3 (95%CI, 2.4-4.6)], but odds of death alone were lower [OR 0.4 (95%CI, 0.3-0.7)], among infants with tracheostomies. Death or NDI was lower in infants who received their tracheostomies before, rather than after, 120 days of life [adjusted OR 0.5 (95%CI, 0.3-0.9)]. Conclusions Tracheostomy in preterm infants is associated with adverse developmental outcomes, and cannot mitigate the significant risk associated with many complications of prematurity. These data may inform counseling about tracheostomy in this vulnerable population. PMID:24472229

  10. Genetic and Environmental Influences on Fetal Growth Vary during Sensitive Periods in Pregnancy.

    PubMed

    Workalemahu, Tsegaselassie; Grantz, Katherine L; Grewal, Jagteshwar; Zhang, Cuilin; Louis, Germaine M Buck; Tekola-Ayele, Fasil

    2018-05-08

    Aberrant fetal growth is associated with morbidities and mortality during childhood and adult life. Although genetic and environmental factors are known to influence in utero growth, their relative contributions over pregnancy is unknown. We estimated, across gestation, the genetic heritability, contribution of shared environment, and genetic correlations of fetal growth measures (abdominal circumference (AC), humerus length (HL), femur length (FL), and estimated fetal weight (EFW)) in a prospective cohort of dichorionic twin gestations recruited through the NICHD Fetal Growth Studies. Structural equation models were fit at the end of first trimester, during mid-gestation, late second trimester, and third trimester of pregnancy. The contribution of fetal genetics on fetal size increased with gestational age, peaking in late second trimester (AC = 53%, HL = 57%, FL = 72%, EFW = 71%; p < 0.05). In contrast, shared environment explained most of phenotypic variations in fetal growth in the first trimester (AC = 50%, HL = 54%, FL = 47%, EFW = 54%; p < 0.05), suggesting that the first trimester presents an intervention opportunity for a more optimal early fetal growth. Genetic correlations between growth traits (range 0.34-1.00; p < 0.05) were strongest at the end of first trimester and declined with gestation, suggesting that different fetal growth measures are more likely to be influenced by the same genes in early pregnancy.

  11. Trajectories of parenting behavior and maternal depression.

    PubMed

    Azak, Schale; Raeder, Sabine

    2013-06-01

    This study investigated trajectories of maternal parenting behavior across the infants' first 18 months of life in relation to maternal depression. Furthermore, predictors of the quality of the mother-infant relationship at 18 months were examined. Participants consisted of three types of mother-infant dyads: mothers with comorbid depression and anxiety (n=19), mothers with depression (n=7) and nondepressed mothers (n=24). Maternal behaviors and the quality of relationship were rated on a global scale (NICHD) from video-taped mother-infant interactions. Maternal behaviors rated at six, 12 and 18 months were collapsed into a composite variable maternal style. The quality of the relationship captured as dyadic mutuality was rated at 18 months. Comorbid and depressed mothers showed lower quality in maternal style compared with the nondepressed mothers at six months. Over the follow-up the comorbid mothers were lower in maternal style compared to the nondepressed mothers, but the comorbid mothers increased significantly in maternal style despite elevated depression symptoms. Mean maternal style and infant cognitive skills predicted the quality in relationship at 18 months suggesting that the mother-toddler relationship depends on contributions from the mother and the child. Higher growth in maternal style despite of depression symptoms among comorbid mothers was interpreted against the background that the majority of the comorbid mother-infant dyads received several treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Neonatal Outcomes of Extremely Preterm Infants From the NICHD Neonatal Research Network

    PubMed Central

    Stoll, Barbara J.; Hansen, Nellie I.; Bell, Edward F.; Shankaran, Seetha; Laptook, Abbot R.; Walsh, Michele C.; Hale, Ellen C.; Newman, Nancy S.; Schibler, Kurt; Carlo, Waldemar A.; Kennedy, Kathleen A.; Poindexter, Brenda B.; Finer, Neil N.; Ehrenkranz, Richard A.; Duara, Shahnaz; Sánchez, Pablo J.; O’Shea, T. Michael; Goldberg, Ronald N.; Van Meurs, Krisa P.; Faix, Roger G.; Phelps, Dale L.; Frantz, Ivan D.; Watterberg, Kristi L.; Saha, Shampa; Das, Abhik; Higgins, Rosemary D.

    2010-01-01

    OBJECTIVE This report presents data from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network on care of and morbidity and mortality rates for very low birth weight infants, according to gestational age (GA). METHODS Perinatal/neonatal data were collected for 9575 infants of extremely low GA (22–28 weeks) and very low birth weight (401–1500 g) who were born at network centers between January 1, 2003, and December 31, 2007. RESULTS Rates of survival to discharge increased with increasing GA (6% at 22 weeks and 92% at 28 weeks); 1060 infants died at ≤ 12 hours, with most early deaths occurring at 22 and 23 weeks (85% and 43%, respectively). Rates of prenatal steroid use (13% and 53%, respectively), cesarean section (7% and 24%, respectively), and delivery room intubation (19% and 68%, respectively) increased markedly between 22 and 23 weeks. Infants at the lowest GAs were at greatest risk for morbidities. Overall, 93% had respiratory distress syndrome, 46% patent ductus arteriosus, 16% severe intraventricular hemorrhage, 11% necrotizing enterocolitis, and 36% late-onset sepsis. The new severity-based definition of bronchopulmonary dysplasia classified more infants as having bronchopulmonary dysplasia than did the traditional definition of supplemental oxygen use at 36 weeks (68%, compared with 42%). More than one-half of infants with extremely low GAs had undetermined retinopathy status at the time of discharge. Center differences in management and outcomes were identified. CONCLUSION Although the majority of infants with GAs of ≥24 weeks survive, high rates of morbidity among survivors continue to be observed. PMID:20732945

  13. Serum surfactant protein D as a marker for bronchopulmonary dysplasia.

    PubMed

    Vinod, Suja; Gow, Andrew; Weinberger, Barry; Potak, Debra; Hiatt, Mark; Chandra, Shaku; Hegyi, Thomas

    2017-10-26

    Lung epithelial cells express surfactant protein D (SP-D), a calcium-dependent lectin that plays an important role in antibody-independent pulmonary host defense. Previous studies have shown that it is found in the peripheral circulation in patients with pulmonary disease, likely because of translocation into the blood when lung epithelial barriers are disrupted by inflammation or acute injury. In adults, serum SP-D levels are biomarkers for the progression and severity of chronic lung disease. In neonates, elevated SP-D levels in cord blood and on day 1 have been associated with prenatal risk factors and with an increased risk of respiratory distress syndrome and infections. It is not known whether serum SP-D during the first week of life is a marker for bronchopulmonary dysplasia (BPD), a form of chronic lung disease of prematurity that is associated with lung parenchymal maldevelopment and injury. The goal of this study is to determine whether serum SP-D on days 3 and 7 of life are associated with the development of BPD in preterm infants. Serum samples were obtained on postnatal days 3 and 7 from 106 preterm infants (500-2000 g birth weight, 23-32-week gestation). SP-D was quantified by Western blot. BPD was determined at 36 weeks PMA using NICHD criteria. The mean birth weight was 1145 ± 347 g and gestational age 29.2 ± 7.4 weeks. BPD was diagnosed in 7 and "BPD or death" in 16 infants. Days 3 and 7 values tracked significantly (r = 0.648), and did not correlate with birth weight or gestational age. Contrary to expectations, serum SP-D was not associated with BPD. Significant gender differences were noted, with SP-D dropping from day 3 to day 7 in males, while increasing in females (p < .05). Elevated serum SP-D does not appear to be a useful marker for BPD. Decreasing serum SP-D levels in males, as compared to females, during the first week of life are likely related to gender differences in lung maturation, consistent with the higher incidence of BPD in males.

  14. Predicting Time to Hospital Discharge for Extremely Preterm Infants

    PubMed Central

    Hintz, Susan R.; Bann, Carla M.; Ambalavanan, Namasivayam; Cotten, C. Michael; Das, Abhik; Higgins, Rosemary D.

    2010-01-01

    As extremely preterm infant mortality rates have decreased, concerns regarding resource utilization have intensified. Accurate models to predict time to hospital discharge could aid in resource planning, family counseling, and perhaps stimulate quality improvement initiatives. Objectives For infants <27 weeks estimated gestational age (EGA), to develop, validate and compare several models to predict time to hospital discharge based on time-dependent covariates, and based on the presence of 5 key risk factors as predictors. Patients and Methods This was a retrospective analysis of infants <27 weeks EGA, born 7/2002-12/2005 and surviving to discharge from a NICHD Neonatal Research Network site. Time to discharge was modeled as continuous (postmenstrual age at discharge, PMAD), and categorical variables (“Early” and “Late” discharge). Three linear and logistic regression models with time-dependent covariate inclusion were developed (perinatal factors only, perinatal+early neonatal factors, perinatal+early+later factors). Models for Early and Late discharge using the cumulative presence of 5 key risk factors as predictors were also evaluated. Predictive capabilities were compared using coefficient of determination (R2) for linear models, and AUC of ROC curve for logistic models. Results Data from 2254 infants were included. Prediction of PMAD was poor, with only 38% of variation explained by linear models. However, models incorporating later clinical characteristics were more accurate in predicting “Early” or “Late” discharge (full models: AUC 0.76-0.83 vs. perinatal factor models: AUC 0.56-0.69). In simplified key risk factors models, predicted probabilities for Early and Late discharge compared favorably with observed rates. Furthermore, the AUC (0.75-0.77) were similar to those of models including the full factor set. Conclusions Prediction of Early or Late discharge is poor if only perinatal factors are considered, but improves substantially with knowledge of later-occurring morbidities. Prediction using a few key risk factors is comparable to full models, and may offer a clinically applicable strategy. PMID:20008430

  15. Respiratory Outcomes of the Surfactant Positive Pressure and Oximetry Randomized Trial

    PubMed Central

    Stevens, Timothy P.; Finer, Neil N.; Carlo, Waldemar A.; Szilagyi, Peter G.; Phelps, Dale L.; Walsh, Michele C.; Gantz, Marie G.; Laptook, Abbot R.; Yoder, Bradley A.; Faix, Roger G.; Newman, Jamie E.; Das, Abhik; Do, Barbara T.; Schibler, Kurt; Rich, Wade; Newman, Nancy S.; Ehrenkranz, Richard A.; Peralta-Carcelen, Myriam; Vohr, Betty R.; Wilson-Costello, Deanne E.; Yolton, Kimberly; Heyne, Roy J.; Evans, Patricia W.; Vaucher, Yvonne E.; Adams-Chapman, Ira; McGowan, Elisabeth C.; Bodnar, Anna; Pappas, Athina; Hintz, Susan R.; Acarregui, Michael J.; Fuller, Janell; Goldstein, Ricki F.; Bauer, Charles R.; O’Shea, T. Michael; Myers, Gary J.; Higgins, Rosemary D.

    2014-01-01

    Objective To explore the early childhood pulmonary outcomes of infants who participated in the NICHD SUPPORT Trial, using a factorial design that randomized extremely preterm infants to lower vs. higher oxygen saturation targets and delivery room CPAP vs. intubation/surfactant, found no significant difference in the primary composite outcome of death or BPD. Study design The Breathing Outcomes Study, a prospective secondary to SUPPORT, assessed respiratory morbidity at 6 month intervals from hospital discharge to 18–22 months corrected age (CA). Two pre-specified primary outcomes, wheezing more than twice per week during the worst 2 week period and cough longer than 3 days without a cold were compared between each randomized intervention. Results One or more interviews were completed for 918 of 922 eligible infants. The incidence of wheezing and cough were 47.9% and 31.0%, respectively, and did not differ between study arms of either randomized intervention. Infants randomized to lower vs. higher oxygen saturation targets had similar risks of death or respiratory morbidities (except for croup, treatment with oxygen or diuretics at home). Infants randomized to CPAP vs. intubation/surfactant had fewer episodes of wheezing without a cold (28.9% vs. 36.5%, p<0.05), respiratory illnesses diagnosed by a doctor (47.7% vs. 55.2%, p<0.05) and physician or emergency room visits for breathing problems (68.0% vs. 72.9%, p<0.05) by 18–22 months CA. Conclusion Treatment with early CPAP rather than intubation/surfactant is associated with less respiratory morbidity by 18–22 months CA. Longitudinal assessment of pulmonary morbidity is necessary to fully evaluate the potential benefits of respiratory interventions for neonates. PMID:24725582

  16. A cocktail-party listening experiment with children

    NASA Astrophysics Data System (ADS)

    Wightman, Frederic; Callahan, Michael; Kistler, Doris

    2003-04-01

    In an experiment modeled after one reported recently by Brungart and Simpson [J. Acoust. Soc. Am. 112, 2985-2995 (2002)], 38 children (ages 4-16) and 10 adults responded to a monaural target speech signal in the presence of one or two distracter speech signals. The target speaker was a male and the distracter speakers were females. When two distracters were present they were in different ears. Performance at several different target ear S/N was measured and psychometric functions were fitted to estimate threshold, or the 50% performance level. The youngest children required approximately 20 dB higher S/N than adults to achieve threshold with a single distracter. This difference disappeared by age 16. The impact of adding the contralateral distracter, which is thought to contribute only informational masking, was roughly constant across age, however. Adult thresholds increased about 11 dB and the thresholds for the youngest children increased about 10 dB. This was surprising given previous experiments that showed much larger informational masking effects in young children. Also inconsistent with previous results is the lack of individual differences. Nearly all listeners showed almost the same contralateral distracter effect. [Work supported by NICHD.

  17. Placenta previa and maternal hemorrhagic morbidity.

    PubMed

    Gibbins, Karen J; Einerson, Brett D; Varner, Michael W; Silver, Robert M

    2018-02-01

    Placenta previa is associated with maternal hemorrhage, but most literature focuses on morbidity in the setting of placenta accreta. We aim to characterize maternal morbidity associated with previa and to define risk factors for hemorrhage. This is a secondary cohort analysis of the NICHD Maternal-Fetal Medicine Units Network Cesarean Section Registry. This analysis included all women undergoing primary Cesarean delivery without placenta accreta. About 496 women with previa were compared with 24,201 women without previa. Primary outcome was composite maternal hemorrhagic morbidity. Non-hemorrhagic morbidities and risk factors for hemorrhage were also evaluated. Maternal hemorrhagic morbidity was more common in women with previa (19 versus 7%, aRR 2.6, 95% CI 1.9-3.5). Atony requiring uterotonics (aRR 3.1, 95% CI 2.0-4.9), red blood cell transfusion (aRR 3.8, 95% CI 2.5-5.7), and hysterectomy (aRR 5.1, 95% CI 1.5-17.3) were also more common with previa. For women with previa, factors associated with maternal hemorrhage were pre-delivery anemia, thrombocytopenia, diabetes, magnesium use, and general anesthesia. Placenta previa is an independent risk factor for maternal hemorrhagic morbidity. Some risk factors are modifiable, but many are intrinsic to the clinical scenario.

  18. Caprine blastocyst formation following intracytoplasmic sperm injection and defined culture.

    PubMed

    Keskintepe, L; Morton, P C; Smith, S E; Tucker, M J; Simplicio, A A; Brackett, B G

    1997-08-01

    Experiments were undertaken to develop intracytoplasmic sperm injection (ICSI) to produce caprine embryos out of the normal breeding season. Oocytes were obtained from 2-6 mm ovarian follicles at slaughter. Selected oocytes with two to four layers of cumulus cells were incubated in 1 ml of H-TCM199 supplemented with 10 micrograms each of oFSH and bLH (NHPP, NIDDK, NICHD, USDA) and 20% fetal bovine serum (FBS) in a thermos (38.5 degrees C) for 4.5 h during transportation. Then, oocytes were transferred into 75 microliters of freshly prepared maturation medium under paraffin oil and a mixture of 5% O2, 5% CO2 and 90% N2. Approximately 26 h after recovery oocytes were denuded by incubation with hyaluronidase (100 IU/ml) and pipetting and held at 38.5 degrees C for 90 min. Spermatozoa frozen in egg yolk extender were thawed in a 37 degrees C water bath for 15 s. Motile fractions were selected by swim-up, then incubated for 90 min in TALP with 10 micrograms heparin/ml. Each oocyte was positioned with its first polar body at 6 or 12 o'clock by a holding pipette. Sperm (1 microliter) were added to 10 microliters medium containing 10% polyvinylpyrrolidone. A sperm cell was aspirated into a pipette, and then injected head-first into the cytoplasm of an oocyte maintained in H-TCM199 + 20% FBS at 37 degrees C. Injected oocytes were transferred to HM and, after 90 min, cultured in 50 microliters of BSA-free synthetic oviduct fluid plus polyvinyl alcohol, citrate and non-essential amino acids. Results demonstrate that caprine blastocysts can be produced outside the breeding season by the use of frozen-thawed semen and injection of sperm cells with broken tails into ova followed by culture in defined medium.

  19. Anticholinergic versus botulinum toxin A comparison trial for the treatment of bothersome urge urinary incontinence: ABC trial.

    PubMed

    Visco, Anthony G; Brubaker, Linda; Richter, Holly E; Nygaard, Ingrid; Paraiso, Marie Fidela; Menefee, Shawn A; Schaffer, Joseph; Wei, John; Chai, Toby; Janz, Nancy; Spino, Cathie; Meikle, Susan

    2012-01-01

    This trial compares the change in urgency urinary incontinence episodes over 6 months, tolerability and cost effectiveness between women receiving daily anticholinergic therapy plus a single intra-detrusor injection of saline versus a single intra-detrusor injection of 100 U of botulinum toxin A plus daily oral placebo tablets. We present the rationale and design of a randomized-controlled trial, Anticholinergic versus Botulinum Toxin, Comparison Trial for the Treatment of Bothersome Urge Urinary Incontinence: ABC trial, conducted by the NICHD-funded Pelvic Floor Disorders Network. We discuss the innovative nature of this trial and the challenges related to choice of patient population, maintaining masking, cost effectiveness, ethical considerations, measuring adherence, and placebo development and testing. Enrollment began in April, 2010. 242 participants will be randomized and primary outcome data analysis is anticipated to begin in mid 2012. Several challenges in the trial design are discussed. Randomization to placebo intra-detrusor injections may limit recruitment, potentially impacting generalizability. Other challenges included the heavy marketing of drugs for overactive bladder which could impact recruitment of drug-naïve women. In addition, anticholinergic medications often cause dry mouth, making masking difficult. Finally, adverse reporting of transient urinary retention is challenging as there is no standardized definition; yet this is the most common adverse event following intra-detrusor botulinum toxin injection. The ABC trial will help women with urgency urinary incontinence balance efficacy, side effects and cost of anticholinergic medication versus botulinum toxin intra-detrusor injection. The results have the potential to fundamentally change the therapeutic approach to this condition. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Early sepsis does not increase the risk of late sepsis in very low birth weight neonates

    PubMed Central

    Wynn, James L.; Hansen, Nellie I.; Das, Abhik; Cotten, C. Michael; Goldberg, Ronald N.; Sánchez, Pablo J.; Bell, Edward F.; Van Meurs, Krisa P.; Carlo, Waldemar A.; Laptook, Abbot R.; Higgins, Rosemary D.; Benjamin, Daniel K.; Stoll, Barbara J.

    2012-01-01

    Objective To examine whether preterm very low birth weight (VLBW) infants have an increased risk of late-onset sepsis (LOS) following early-onset sepsis (EOS). Study design Retrospective analysis of VLBW infants (401-1500 g) born September 1998 through December 2009 who survived >72 hours and were cared for within the NICHD Neonatal Research Network. Sepsis was defined by growth of bacteria or fungi in a blood culture obtained ≤72 hr of birth (EOS) or >72 hr (LOS) and antimicrobial therapy for ≥5 days or death <5 d while receiving therapy. Regression models were used to assess risk of death or LOS by 120d and LOS by 120d among survivors to discharge or 120d, adjusting for gestational age and other covariates. Results Of 34,396 infants studied 504 (1.5%) had EOS. After adjustment, risk of death or LOS by 120d did not differ overall for infants with EOS compared with those without EOS [RR:0.99 (0.89-1.09)] but was reduced in infants born at <25wk gestation [RR:0.87 (0.76-0.99), p=0.048]. Among survivors, no difference in LOS risk was found overall for infants with versus without EOS [RR:0.88 (0.75-1.02)], but LOS risk was shorter in infants with BW 401-750 g who had EOS [RR:0.80 (0.64-0.99), p=0.047]. Conclusions Risk of LOS after EOS was not increased in VLBW infants. Surprisingly, risk of LOS following EOS appeared to be reduced in the smallest, most premature infants, underscoring the need for age-specific analyses of immune function. PMID:23295144

  1. Assessment of Insulin Resistance and Impaired Glucose Tolerance in Lean Women with Polycystic Ovary Syndrome

    PubMed Central

    Bailey, Amelia Purser; Pastore, Lisa M.

    2011-01-01

    Abstract Objective To analyze insulin resistance (IR) and determine the need for a 2-hour oral glucose tolerance test (OGTT) for the identification of IR and impaired glucose tolerance (IGT) in lean nondiabetic women with polycystic ovary syndrome (PCOS). Methods This was a cross-sectional analysis of treatment-naive women with PCOS who enrolled in a university-based clinical trial. Nondiabetic women with PCOS based on the Eunice Kennedy Shriven National Institute of Child Health and Human Development (NICHD) definition, aged 18–43 years and weighing ≤113 kg, were evaluated. Glucose and insulin levels were assessed at times 0, 30, 60, 90, and 120 minutes after a 75-g glucose load. Lean was defined as body mass index (BMI) <25 kg/m2. Multiple linear regression was performed. Results A cohort of 78 women was studied. The prevalence of IR was 0% among lean women vs. 21% among nonlean subjects based on fasting insulin I0 and 40%–68% based on two different homeostatic model assessment (HOMA) cutoff points (p < 0.005). All women with IR had a BMI ≥ 28. Controlling for age and race, BMI explained over 57% of the variation in insulin fasting (Io), glucose fasting/Io (Go/Io), the qualitative insulin sensitivity check index (QUICKI), and HOMA and was a highly significant predictor of these outcomes (p < 0.0001). Only 1 of 31 (3%) of the lean PCOS women had IGT based on a 2-hour OGTT, and no lean subjects had IGT based on their fasting blood glucose. Conclusions Diabetes mellitus, IGT, and IR are far less common in young lean women with PCOS compared with obese women with PCOS. These data imply that it is unnecessary to routinely perform either IR testing or 2-hour OGTT in lean women with PCOS; however, greater subject accumulation is needed to determine if OGTT is necessary in lean women with PCOS. BMI is highly predictive of both insulin and glucose levels in women with PCOS. PMID:21194310

  2. Assessment of insulin resistance and impaired glucose tolerance in lean women with polycystic ovary syndrome.

    PubMed

    Stovall, Dale William; Bailey, Amelia Purser; Pastore, Lisa M

    2011-01-01

    To analyze insulin resistance (IR) and determine the need for a 2-hour oral glucose tolerance test (OGTT) for the identification of IR and impaired glucose tolerance (IGT) in lean nondiabetic women with polycystic ovary syndrome (PCOS). This was a cross-sectional analysis of treatment-naive women with PCOS who enrolled in a university-based clinical trial. Nondiabetic women with PCOS based on the Eunice Kennedy Shriven National Institute of Child Health and Human Development (NICHD) definition, aged 18-43 years and weighing ≤113 kg, were evaluated. Glucose and insulin levels were assessed at times 0, 30, 60, 90, and 120 minutes after a 75-g glucose load. Lean was defined as body mass index (BMI) <25 kg/m(2). Multiple linear regression was performed. A cohort of 78 women was studied. The prevalence of IR was 0% among lean women vs. 21% among nonlean subjects based on fasting insulin I(0) and 40%-68% based on two different homeostatic model assessment (HOMA) cutoff points (p < 0.005). All women with IR had a BMI ≥ 28. Controlling for age and race, BMI explained over 57% of the variation in insulin fasting (I(o)), glucose fasting/Io (G(o)/I(o)), the qualitative insulin sensitivity check index (QUICKI), and HOMA and was a highly significant predictor of these outcomes (p < 0.0001). Only 1 of 31 (3%) of the lean PCOS women had IGT based on a 2-hour OGTT, and no lean subjects had IGT based on their fasting blood glucose. Diabetes mellitus, IGT, and IR are far less common in young lean women with PCOS compared with obese women with PCOS. These data imply that it is unnecessary to routinely perform either IR testing or 2-hour OGTT in lean women with PCOS; however, greater subject accumulation is needed to determine if OGTT is necessary in lean women with PCOS. BMI is highly predictive of both insulin and glucose levels in women with PCOS.

  3. Preterm Induction of Labor: Predictors of Vaginal Delivery and Labor Curves

    PubMed Central

    Feghali, Maisa; Timofeev, Julia; Huang, Chun-Chih; Driggers, Rita; Miodovnik, Menachem; Landy, Helain J.; Umans, Jason G.

    2014-01-01

    Objective To evaluate the labor curves of patients undergoing preterm induction of labor (IOL) and assess possible predictors of vaginal delivery (VD). Study Design Data from the NICHD Consortium on Safe Labor were analyzed. A total of 6,555 women undergoing medically-indicated IOL before 37 weeks gestational age (GA) were included in this analysis. Patients were divided into four groups based on gestational age: A: 24-27+6, B: 28-30+6, C: 31-33+6, and D: 34-36+6 weeks. Pregnant women with a contraindication to VD, IOL at or after 37 weeks and those without data from cervical exam on admission were excluded. ANOVA was used to assess differences between GA groups. Multiple logistic regression was used to assess predictors of VD. A repeated measures analysis was used to determine average labor curves. Results Rates of vaginal live births increased with GA, from 35% (Group A) to 76% (Group D). Parous women [odds ratio (OR)=6.78, 95% confidence interval (CI) 6.38-7.21] and those with a favorable cervix at the start of IOL (OR=2.35, 95% CI 2.23-2.48) were more likely to deliver vaginally. Analysis of labor curves in nulliparous women showed shorter duration of labor with increasing GA; the active phase of labor was, however, similar across all GA. Conclusion The majority of women undergoing medically-indicated preterm IOL between 24 and 36+6 weeks’ GA deliver vaginally. The strongest predictor of VD was parity. Preterm IOL had a limited influence on estimated labor curves across gestational age. PMID:25068566

  4. Negative Emotionality Moderates Associations among Attachment, Toddler Sleep, and Later Problem Behaviors

    PubMed Central

    Troxel, Wendy M.; Trentacosta, Christopher J.; Forbes, Erika E.; Campbell, Susan B.

    2013-01-01

    Secure parent-child relationships are implicated in children’s self-regulation, including the ability to self-soothe at bedtime. Sleep, in turn, may serve as a pathway linking attachment security with subsequent emotional and behavioral problems in children. We used path analysis to examine the direct relationship between attachment security and maternal-reports of sleep problems during toddlerhood, and the degree to which sleep serves as a pathway linking attachment with subsequent teacher-reported emotional and behavioral problems. We also examined infant negative emotionality as a vulnerability factor that may potentiate attachment-sleep-adjustment outcomes. Data were drawn from 776 mother-infant dyads participating in the NICHD Study of Early Child Care (SECC). In the full sample, after statistically adjusting for mother and child characteristics, including child sleep and emotional and behavioral problems at 24 months, we did not find evidence for a statistically significant direct path between attachment security and sleep problems at 36 months; however, there was a direct relationship between sleep problems at 36 months and internalizing problems at 54 months. Path models that examined the moderating influence of infant negative emotionality demonstrated significant direct relationships between attachment security and toddler sleep problems, and sleep problems and subsequent emotional and behavioral problems, but only among children characterized by high negative emotionality at 6 months of age. In addition, among this subset, there was a significant indirect path between attachment and internalizing problems through sleep problems. These longitudinal findings implicate sleep as one critical pathway linking attachment security with adjustment difficulties, particularly among temperamentally vulnerable children. PMID:23421840

  5. The Stillbirth Classification System for the Safe Passage Study: Incorporating Mechanism, Etiology, and Recurrence

    PubMed Central

    Boyd, Theonia K.; Wright, Colleen A.; Odendaal, Hein J.; Elliott, Amy J.; Sens, Mary Ann; Folkerth, Rebecca D.; Roberts, Drucilla J.; Kinney, Hannah C.

    2017-01-01

    OBJECTIVE Describe the classification system for the assignment of the cause of death for stillbirth in the Safe Passage Study, an international, multi-institutional, prospective analysis conducted by the NIAAA/NICHD funded PASS Network (The Prenatal Alcohol in SIDS and Stillbirth (PASS) Research Network). The study mission is to determine the role of prenatal alcohol and/or cigarette smoke exposure in adverse pregnancy outcomes, including stillbirth, in a high-risk cohort of 12,000 maternal/fetal dyads. METHODS The PASS Network classification system is based upon 5 ‘sites of origin’ for cause of stillbirth (Fetal, Placental, Maternal, External/Environmental, or Undetermined), further subdivided into mechanism subcategories (e.g., Placental Perfusion Failure). Both site of origin and mechanism stratification are employed to assign an ultimate cause of death. Each PASS stillbirth (n=19) in the feasibility study was assigned a cause of death, and status of sporadic versus recurrent. Adjudication involved review of the maternal and obstetrical records, and fetal autopsy and placental findings, with complete consensus in each case. Two published classification systems, i.e., INCODE and ReCoDe, were used for comparison. RESULTS Causes of stillbirth classified were: fetal (n=5, 26%), placental (n=10, 53%), external (n=1, 5%), and undetermined (n=3, 16%). Nine cases (47%) had placental causes of death due to maternal disorders that carry recurrence risks. There was complete agreement for the cause of death across the three classification systems in 26% of cases, and a combination of partial or complete agreement in 68% of cases. Complete vs. partial agreements were predicated upon the classification schemes used for comparison. CONCLUSIONS The proposed PASS system is a user-friendly classification system that provides comparable information to previously published systems. Advantages include its simplicity, mechanistic formulations, tight clinicopathologic integration, provision for an undetermined category, and its wide applicability for use by perinatal mortality review boards with access to information routinely collected during clinicopathologic evaluations. PMID:27116324

  6. Racial/ethnic standards for fetal growth: the NICHD Fetal Growth Studies.

    PubMed

    Buck Louis, Germaine M; Grewal, Jagteshwar; Albert, Paul S; Sciscione, Anthony; Wing, Deborah A; Grobman, William A; Newman, Roger B; Wapner, Ronald; D'Alton, Mary E; Skupski, Daniel; Nageotte, Michael P; Ranzini, Angela C; Owen, John; Chien, Edward K; Craigo, Sabrina; Hediger, Mary L; Kim, Sungduk; Zhang, Cuilin; Grantz, Katherine L

    2015-10-01

    Fetal growth is associated with long-term health yet no appropriate standards exist for the early identification of undergrown or overgrown fetuses. We sought to develop contemporary fetal growth standards for 4 self-identified US racial/ethnic groups. We recruited for prospective follow-up 2334 healthy women with low-risk, singleton pregnancies from 12 community and perinatal centers from July 2009 through January 2013. The cohort comprised: 614 (26%) non-Hispanic whites, 611 (26%) non-Hispanic blacks, 649 (28%) Hispanics, and 460 (20%) Asians. Women were screened at 8w0d to 13w6d for maternal health status associated with presumably normal fetal growth (aged 18-40 years; body mass index 19.0-29.9 kg/m(2); healthy lifestyles and living conditions; low-risk medical and obstetrical history); 92% of recruited women completed the protocol. Women were randomized among 4 ultrasonography schedules for longitudinal fetal measurement using the Voluson E8 (GE Healthcare, Milwaukee, WI). In-person interviews and anthropometric assessments were conducted at each visit; medical records were abstracted. The fetuses of 1737 (74%) women continued to be low risk (uncomplicated pregnancy, absent anomalies) at birth, and their measurements were included in the standards. Racial/ethnic-specific fetal growth curves were estimated using linear mixed models with cubic splines. Estimated fetal weight (EFW) and biometric parameter percentiles (5th, 50th, 95th) were determined for each gestational week and comparisons made by race/ethnicity, with and without adjustment for maternal and sociodemographic factors. EFW differed significantly by race/ethnicity >20 weeks. Specifically at 39 weeks, the 5th, 50th, and 95th percentiles were 2790, 3505, and 4402 g for white; 2633, 3336, and 4226 g for Hispanic; 2621, 3270, and 4078 g for Asian; and 2622, 3260, and 4053 g for black women (adjusted global P < .001). For individual parameters, racial/ethnic differences by order of detection were: humerus and femur lengths (10 weeks), abdominal circumference (16 weeks), head circumference (21 weeks), and biparietal diameter (27 weeks). The study-derived standard based solely on the white group erroneously classifies as much as 15% of non-white fetuses as growth restricted (EFW <5th percentile). Significant differences in fetal growth were found among the 4 groups. Racial/ethnic-specific standards improve the precision in evaluating fetal growth. Published by Elsevier Inc.

  7. Post-hoc analysis of vitamin D status and reduced risk of preterm birth in two vitamin D pregnancy cohorts compared with South Carolina March of Dimes 2009-2011 rates.

    PubMed

    Wagner, C L; Baggerly, C; McDonnell, S; Baggerly, K A; French, C B; Baggerly, L; Hamilton, S A; Hollis, B W

    2016-01-01

    Two vitamin D pregnancy supplementation trials were recently undertaken in South Carolina: The NICHD (n=346) and Thrasher Research Fund (TRF, n=163) studies. The findings suggest increased dosages of supplemental vitamin D were associated with improved health outcomes of both mother and newborn, including risk of preterm birth (<37 weeks gestation). How that risk was associated with 25(OH)D serum concentration, a better indicator of vitamin D status than dosage, by race/ethnic group and the potential impact in the community was not previously explored. While a recent IOM report suggested a concentration of 20 ng/mL should be targeted, more recent work suggests optimal conversion of 25(OH)D-1,25(OH)2D takes place at 40 ng/mL in pregnant women. Post-hoc analysis of the relationship between 25(OH)D concentration and preterm birth rates in the NICHD and TRF studies with comparison to Charleston County, South Carolina March of Dimes (CC-MOD) published rates of preterm birth to assess potential risk reduction in the community. Using the combined cohort datasets (n=509), preterm birth rates both for the overall population and for the subpopulations achieving 25(OH)D concentrations of ≤20 ng/mL, >20 to <40 ng/mL, and ≥40 ng/mL were calculated; subpopulations broken down by race/ethnicity were also examined. Log-binomial regression was used to test if an association between 25(OH)D serum concentration and preterm birth was present when adjusted for covariates; locally weighted regression (LOESS) was used to explore the relationship between 25(OH)D concentration and gestational age (weeks) at delivery in more detail. These rates were compared with 2009-2011 CC-MOD data to assess potential risk reductions in preterm birth. Women with serum 25(OH)D concentrations ≥40 ng/mL (n=233) had a 57% lower risk of preterm birth compared to those with concentrations ≤20 ng/mL [n=82; RR=0.43, 95% confidence interval (CI)=0.22,0.83]; this lower risk was essentially unchanged after adjusting for covariates (RR=0.41, 95% CI=0.20,0.86). The fitted LOESS curve shows gestation week at birth initially rising steadily with increasing 25(OH)D and then plateauing at ∼40 ng/mL. Broken down by race/ethnicity, there was a 79% lower risk of preterm birth among Hispanic women with 25(OH)D concentrations ≥40 ng/mL (n=92) compared to those with 25(OH)D concentrations ≤20 ng/mL (n=29; RR=0.21, 95% CI=0.06,0.69) and a 45% lower risk among Black women (n=52 and n=50; RR=0.55, 95% CI=0.17,1.76). There were too few white women with low 25(OH)D concentrations for assessment (n=3). Differences by race/ethnicity were not statistically significant with 25(OH)D included as a covariate. Compared to the CC-MOD reference group, women with serum concentrations ≥40 ng/mL in the combined cohort had a 46% lower rate of preterm birth overall (n=233, p=0.004) with a 66% lower rate among Hispanic women (n=92, p=0.01) and a 58% lower rate among black women (n=52, p=0.04). In this post-hoc analysis, achieving a 25(OH)D serum concentration ≥40 ng/mL significantly decreased the risk of preterm birth compared to ≤20 ng/mL. These findings suggest the importance of raising 25(OH)D levels substantially above 20 ng/mL; reaching 40 ng/mL during pregnancy would reduce the risk of preterm birth and achieve the maximal production of the active hormone. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Survival and Morbidity Outcomes of Very Low Birth Weight Infants with Down Syndrome

    PubMed Central

    Boghossian, Nansi S.; Hansen, Nellie I.; Bell, Edward F.; Stoll, Barbara J.; Murray, Jeffrey C.; Laptook, Abbot R.; Shankaran, Seetha; Walsh, Michele C.; Das, Abhik; Higgins, Rosemary D.

    2010-01-01

    OBJECTIVE Individuals with Down syndrome (DS) are at increased risk of several morbidities with lifelong health consequences. Little is known about mortality or morbidity risks in early infancy among very-low-birth-weight (VLBW) infants with DS. Our objective was to compare survival and neonatal morbidities between VLBW infants with DS and VLBW infants with other non-DS chromosomal anomalies, other non-chromosomal birth defects, and VLBW infants without major birth defects. METHODS Data were collected prospectively for infants weighing 401-1500 grams born and/or cared for at one of the study centers participating in the NICHD Neonatal Research Network from 1994 through 2008. Risk of death and morbidities including patent ductus arteriosus (PDA), necrotizing enterocolitis (NEC), late onset sepsis (LOS), retinopathy of prematurity (ROP), and bronchopulmonary dysplasia (BPD), were compared between VLBW infants with DS and infants in the other groups. RESULTS Infants with DS were at increased risk of death (adjusted relative risk [RR] 2.47, 95% confidence interval [CI] 2.00-3.07), PDA, NEC, LOS, and BPD relative to infants with no birth defects. Decreased risk of death (RR 0.40, 95% CI 0.31-0.52) and increased risks of NEC and LOS were observed when comparing infants with DS to infants with other non-DS chromosomal anomalies. Relative to infants with non-chromosomal birth defects, infants with DS were at increased risk of PDA and NEC. CONCLUSION The increased risk of morbidities among VLBW infants with DS provides useful information for counseling parents and for caretakers in anticipating the need for enhanced surveillance for prevention of these morbidities. PMID:21098157

  9. Neonatal Candidiasis: Epidemiology, Risk Factors, and Clinical Judgment

    PubMed Central

    Benjamin, Daniel K.; Stoll, Barbara J.; Gantz, Marie G.; Walsh, Michele C.; Sanchez, Pablo J.; Das, Abhik; Shankaran, Seetha; Higgins, Rosemary D.; Auten, Kathy J.; Miller, Nancy A.; Walsh, Thomas J.; Laptook, Abbot R.; Carlo, Waldemar A.; Kennedy, Kathleen A.; Finer, Neil N.; Duara, Shahnaz; Schibler, Kurt; Chapman, Rachel L.; Van Meurs, Krisa P.; Frantz, Ivan D.; Phelps, Dale L.; Poindexter, Brenda B.; Bell, Edward F.; O’Shea, T. Michael; Watterberg, Kristi L.; Goldberg, Ronald N.

    2011-01-01

    OBJECTIVE Invasive candidiasis is a leading cause of infection-related morbidity and mortality in extremely low-birth-weight (<1000 g) infants. We quantify risk factors predicting infection in high-risk premature infants and compare clinical judgment with a prediction model of invasive candidiasis. METHODS The study involved a prospective observational cohort of infants <1000 g birth weight at 19 centers of the NICHD Neonatal Research Network. At each sepsis evaluation, clinical information was recorded, cultures obtained, and clinicians prospectively recorded their estimate of the probability of invasive candidiasis. Two models were generated with invasive candidiasis as their outcome: 1) potentially modifiable risk factors and 2) a clinical model at time of blood culture to predict candidiasis. RESULTS Invasive candidiasis occurred in 137/1515 (9.0%) infants and was documented by positive culture from ≥ 1 of these sources: blood (n=96), cerebrospinal fluid (n=9), urine obtained by catheterization (n=52), or other sterile body fluid (n=10). Mortality was not different from infants who had positive blood culture compared to those with isolated positive urine culture. Incidence varied from 2–28% at the 13 centers enrolling ≥ 50 infants. Potentially modifiable risk factors (model 1) included central catheter, broad-spectrum antibiotics (e.g., third-generation cephalosporins), intravenous lipid emulsion, endotracheal tube, and antenatal antibiotics. The clinical prediction model (model 2) had an area under the receiver operating characteristic curve of 0.79, and was superior to clinician judgment (0.70) in predicting subsequent invasive candidiasis. Performance of clinical judgment did not vary significantly with level of training. CONCLUSION Prior antibiotics, presence of a central catheter, endotracheal tube, and center were strongly associated with invasive candidiasis. Modeling was more accurate in predicting invasive candidiasis than clinical judgment. PMID:20876174

  10. Is phototherapy exposure associated with better or worse outcomes in 501–1000 gram birth weight infants?

    PubMed Central

    Hintz, Susan R.; Stevenson, David K.; Yao, Qing; Wong, Ronald J.; Das, Abhik; Van Meurs, Krisa P.; Morris, Brenda H.; Tyson, Jon E.; Oh, William; Poole, W. Kenneth; Phelps, Dale L.; McDavid, Georgia E.; Grisby, Cathy; Higgins, Rosemary D.

    2012-01-01

    Aim To compare risk-adjusted outcomes at 18–22 months corrected age for extremely low birth weight (ELBW) infants who never received phototherapy (NoPTx) to those who received any phototherapy (PTx) in the NICHD Neonatal Research Network randomized trial of Aggressive vs. Conservative Phototherapy. Methods Outcomes at 18–22 months corrected age included death, neurodevelopmental impairment (NDI), and Bayley Scales Mental Developmental Index (MDI). Regression models evaluated the independent association of PTx with adverse outcomes controlling for center and other potentially confounding variables. Results Of 1972 infants, 216 were NoPTx and 1756 were PTx. For the entire 501–1000 g BW cohort, PTx was not independently associated with death or NDI (OR 0.85, 95% CI 0.60 –1.20), death, or adverse neurodevelopmental endpoints. However, among infants 501–750 g BW, the rate of significant developmental impairment with MDI<50 was significantly higher for NoPTx (29%) than PTx (12%) (p=0.004). Conclusions Phototherapy did not appear to be independently associated with death or NDI for the overall ELBW group. Whether PTx increases mortality could not be excluded due to bias from deaths before reaching conservative treatment threshold. The higher rate of MDI<50 in the 501–750g BW NoPTx group is concerning, and consistent with NRN Trial results. PMID:21272067

  11. Spontaneous labor curves in women with pregnancies complicated by diabetes

    PubMed Central

    Timofeev, Julia; Huang, Chun-Chih; Singh, Jasbir; Driggers, Rita W.; Landy, Helain J.

    2013-01-01

    Objective To test the hypothesis that the first stage of labor will be longer in nulliparous and multiparous women with diabetes compared to non-diabetic counterparts. Methods A retrospective analysis was performed from 228,668 deliveries between 2002–2008 from the Consortium of Safe Labor (NICHD, NIH). Patients with spontaneous onset of labor from 37 0/7 – 41 6/7 weeks gestation were included (71,282) and classified as nulliparous or multiparous. Pregnancies were further subdivided regarding presence of preexisting diabetes (preDM) or gestational diabetes (GDM), and normal controls. Labor curves were created matching for body mass index (BMI) and neonatal birth weight. Statistical analysis was performed on descriptive variables using χ2 with significance designated as p<0.05. Results Among nulliparous patients, there were 118 women with preDM and 475 women with GDM; 25,771 patients served as normal controls. Among multiparous women, there were 311 with preDM and 1,079 with GDM and 43,528 in the control group. Although differences in dilatation rates were observed in nulliparous and multiparous women with and without diabetes, labor curves were similar between the subgroups when matched for maternal BMI and birth weight. Conclusions Labor curves of women with preDM and GDM approximate those of non-diabetics, regardless of BMI, birth weight, or parity. PMID:21955108

  12. First birth Caesarean section and subsequent fertility: a population-based study in the USA, 2000-2008.

    PubMed

    Kjerulff, K H; Zhu, J; Weisman, C S; Ananth, C V

    2013-12-01

    Is first birth Caesarean delivery associated with a lower likelihood of subsequent childbearing when compared with first birth vaginal delivery? In this study of US women whose first delivery was in 2000, those who had a Caesarean delivery were less likely to have a subsequent live birth than those who delivered vaginally. Some studies have reported lower birth rates subsequent to Caesarean delivery in comparison with vaginal delivery, while other studies have reported no difference. We conducted a retrospective cohort study of 52 498 women who had a first singleton live birth in the State of Pennsylvania, USA in 2000 and were followed to the end of 2008 via Pennsylvania birth certificate records to identify subsequent live births during the 8- to 9-year follow-up period. Birth certificate records of first singleton births were linked to the hospital discharge data for each mother and newborn, and linked to all birth certificate records for each mother's subsequent deliveries which occurred in 2000 to the end of 2008. Poisson regression models were used to evaluate the association between first birth factors and whether or not there was a subsequent live birth during the follow-up period. Over an average of 8.5 years of follow-up, 40.2% of women with a Caesarean first birth did not have a subsequent live birth, compared with 33.1% of women with a vaginal first birth (risk ratio (RR): 1.21, 95% confidence interval (CI): 1.18-1.25). Adjustment for the demographic confounders of maternal age, race, education, marital status and health insurance coverage attenuated the RR to 1.16 (95% CI: 1.13-1.19). Specific pregnancy and childbirth-related complications associated with not having a subsequent live birth included diabetes-related disorders, abnormalities of organs and soft tissues of the pelvis, fetal abnormalities, premature or prolonged rupture of membranes, hypertensive disorders, amnionitis, fetal distress and other maternal health problems. However, adjustment for the pregnancy and childbirth complications had little effect on the RR of not having a subsequent live birth (RR = 1.15, 95% CI: 1.11-1.19). We were unable to distinguish between women who did not have a subsequent live birth and those who moved out of the state, which may have introduced a selection bias if those who had Caesarean births were more likely to emigrate than those who delivered vaginally. In addition we were unable to measure pre-pregnancy body mass index, weight gain during pregnancy and prior infertility, which would have been helpful in our efforts to reduce selection bias. The results of this study provide further corroboration of previous studies that have reported reduced fertility subsequent to Caesarean section in comparison with vaginal delivery. This study was funded by the US National Institute of Child Health and Human Development (NICHD, R01-HD052990). No competing interests are declared.

  13. Reduced homeobox protein MSX1 in human endometrial tissue is linked to infertility.

    PubMed

    Bolnick, Alan D; Bolnick, Jay M; Kilburn, Brian A; Stewart, Tamika; Oakes, Jonathan; Rodriguez-Kovacs, Javier; Kohan-Ghadr, Hamid-Reza; Dai, Jing; Diamond, Michael P; Hirota, Yasushi; Drewlo, Sascha; Dey, Sudhansu K; Armant, D Randall

    2016-09-01

    Is protein expression of the muscle segment homeobox gene family member MSX1 altered in the human secretory endometrium by cell type, developmental stage or fertility? MSX1 protein levels, normally elevated in the secretory phase endometrium, were significantly reduced in endometrial biopsies obtained from women of infertile couples. Molecular changes in the endometrium are important for fertility in both animals and humans. Msx1 is expressed in the preimplantation mouse uterus and regulates uterine receptivity for implantation. The MSX protein persists a short time, after its message has been down-regulated. Microarray analysis of the human endometrium reveals a similar pattern of MSX1 mRNA expression that peaks before the receptive period, with depressed expression at implantation. Targeted deletion of uterine Msx1 and Msx2 in mice prevents the loss of epithelial cell polarity during implantation and causes infertility. MSX1 mRNA and cell type-specific levels of MSX1 protein were quantified from two retrospective cohorts during the human endometrial cycle. MSX1 protein expression patterns were compared between fertile and infertile couples. Selected samples were dual-labeled by immunofluorescence microscopy to localize E-cadherin and β-catenin in epithelial cells. MSX1 mRNA was quantified by PCR in endometrium from hysterectomies (n = 14) determined by endometrial dating to be in the late-proliferative (cycle days 10-13), early-secretory (cycle days 14-19) or mid-secretory (cycle days 20-24) phase. MSX1 protein was localized using high-throughput, semi-quantitative immunohistochemistry with sectioned endometrial biopsy tissues from fertile (n = 89) and infertile (n = 89) couples. Image analysis measured stain intensity specifically within the luminal epithelium, glands and stroma during the early-, mid- and late- (cycle days 25-28) secretory phases. MSX1 transcript increased 5-fold (P < 0.05) between the late-proliferative and early secretory phase and was then down-regulated (P < 0.05) prior to receptivity for implantation. In fertile patients, MSX1 protein displayed strong nuclear localization in the luminal epithelium and glands, while it was weakly expressed in nuclei of the stroma. MSX1 protein levels accumulated throughout the secretory phase in all endometrial cellular compartments. MSX1 protein decreased (P < 0.05) in the glands between mid- and late-secretory phases. However, infertile patients demonstrated a broad reduction (P < 0.001) of MSX1 accumulation in all cell types throughout the secretory phase that was most pronounced (∼3-fold) in stroma and glands. Infertility was associated with persistent co-localization of E-cadherin and β-catenin in epithelial cell junctions in the mid- and late-secretory phases. Details of the infertility diagnoses and other patient demographic data were not available. Therefore, patients with uterine abnormalities (Mullerian) could not be distinguished from other sources of infertility. Antibody against human MSX2 is not available, limiting the study to MSX1. However, both RNAs in the human endometrium are similarly regulated. In mice, Msx1 and Msx2 are imperative for murine embryo implantation, with Msx2 compensating for genetic ablation of Msx1 through its up-regulation in a knockout model. This investigation establishes that the MSX1 homeobox protein accumulation is associated with the secretory phase in endometrium of fertile couples, and is widely disrupted in infertile patients. It is the first study to examine MSX1 protein localization in the human endometrium, and supported by genetic findings in mice, suggests that genes regulated by MSX1 are linked to the loss of epithelial cell polarity required for uterine receptivity during implantation. This research was supported by the NICHD National Cooperative Reproductive Medicine Network grant HD039005 (M.P.D.), NIH grants HD068524 (S.K.D.), HD071408 (D.R.A., M.P.D.), and HL128628 (S.D.), the Intramural Research Program of the NICHD, March of Dimes (S.K.D., S.D.) and JSPS KAKENHI grant 26112506 (Y.H.). There were no conflicts or competing interests. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  14. The fetal heart rate collaborative practice project: situational awareness in electronic fetal monitoring-a Kaiser Permanente Perinatal Patient Safety Program Initiative.

    PubMed

    MacEachin, S Rachel; Lopez, Connie M; Powell, Kimberly J; Corbett, Nancy L

    2009-01-01

    Electronic fetal monitoring has historically been interpreted with wide variation between and within disciplines on the obstetric healthcare team. This leads to inconsistent decision making in response to tracing interpretation. To implement a multidisciplinary electronic fetal monitoring training program, utilizing the best evidence available, enabling standardization of fetal heart rate interpretation to promote patient safety. Local multidisciplinary expertise along with an outside consultant collaborated over a series of meetings to create a multimedia instructional electronic fetal monitoring training program. After production was complete, a series of conferences attended by nurses, certified nurse midwives, and physician champions, from each hospital, attended to learn how to facilitate training at their own perinatal units. All healthcare personnel across the Kaiser Permanente perinatal program were trained in NICHD nomenclature, emergency response, interpretation guidelines, and how to create local collaborative practice agreements. Metrics for program effectiveness were measured through program evaluations from attendees, the Safety Attitudes Questionnaire. Program evaluations rendered very positive scores from both physicians and clinicians. Comparing baseline to 4 years later, the perception of safety from the staff has increased over 10% in 5 out of the 6 factors analyzed. Active participation from all disciplines in this training series has highlighted the importance of teamwork and communication. The Fetal Heart Rate Collaborative Practice Project continues to evolve utilizing other educational modalities, such as online EFM education and unit-based interdisciplinary tracing reviews.

  15. Modeling of live-birth rates and cost-effectiveness of oocyte cryopreservation for cancer patients prior to high- and low-risk gonadotoxic chemotherapy.

    PubMed

    Lyttle Schumacher, B; Grover, N; Mesen, T; Steiner, A; Mersereau, J

    2017-10-01

    What is the live-birth rate (LBR) and cost-effectiveness of fertility preservation with oocyte cryopreservation (FP-OC) compared to expectant management in cancer patients age 25-40 based on estimated gonadotoxicity of treatments 5 years after cancer diagnosis? Oocyte cryopreservation prior to cancer treatment is more costly, yet more effective (producing more live births), than not undergoing oocyte cryopreservation but it is most beneficial for patients undergoing high-risk chemotherapy (HRC). The decision to undergo FP prior to treatment is multifactorial and can be costly and delay treatment. Not all treatments carry the same gonadotoxicity and patients may choose to undergo FP-OC based on the probability of premature ovarian insufficiency, predicted outcomes and cost. A comprehensive model that incorporates age at diagnosis and toxicity of treatment to help guide patients in the decision to undergo FP-OC does not yet exist. This study used a Decision Analysis Model to estimate effectiveness and cost of FP for cancer patients. Age-based estimates of LBR and cost per live birth were calculated for ages 25-40 years based on gonadotoxicity of treatment. A decision analysis model was constructed using Treeage Pro 2015 with case base probabilities derived from national registries, practice guidelines and medical records from a national network of infertility practices (IntegraMed). Compared to no FP-OC, FP-OC improved LBRs for women of all ages undergoing either low-risk chemotherapy (LRC) or HRC; however, it was most cost effective for women undergoing LRC at older ages or HRC at younger ages. Although FP-OC results in higher LBRs, it was always more costly. Using donor oocyte IVF can be a successful alternative to autologous FP-OC. Decision tree results reflect probabilities of certain events and are compiled from multiple reputable sources but are not directly derived from a recruited cohort of patients. Outcomes are based on United States estimates and should be interpreted in the broader context of individual patient diagnoses, treatment care plans and country of origin. The development of this analytic model will help guide practitioners in their counseling of women from age 25 to 40 years, who are considering FP-OC at the time of cancer diagnosis. It provides a realistic pathway from diagnosis to LB and accounts for the majority of costs and outcome possibilities. This study was partially funded by a grant from National Institute of Health (NIH)/National Institute of Child Health and Human Development (NICHD) (R01 HD67683) to A.Z.S. There are no conflicts of interest to declare. N/A. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  16. Urinary bisphenol A concentrations and association with in vitro fertilization outcomes among women from a fertility clinic.

    PubMed

    Mínguez-Alarcón, Lidia; Gaskins, Audrey J; Chiu, Yu-Han; Williams, Paige L; Ehrlich, Shelley; Chavarro, Jorge E; Petrozza, John C; Ford, Jennifer B; Calafat, Antonia M; Hauser, Russ

    2015-09-01

    Are urinary BPA concentrations associated with in vitro fertilization (IVF) outcomes among women attending an academic fertility center? Urinary BPA concentrations were not associated with adverse reproductive and pregnancy outcomes among women from a fertility clinic. Bisphenol A (BPA), an endocrine disruptor, is detected in the urine of most Americans. Although animal studies have demonstrated that BPA reduces female fertility through effects on the ovarian follicle and uterus, data from human populations are scarce and equivocal. This prospective cohort study between 2004 and 2012 at the Massachusetts General Hospital Fertility Center included 256 women (n = 375 IVF cycles) who provided up to two urine samples prior to oocyte retrieval (total N = 673). Study participants were women enrolled in the Environment and Reproductive Health (EARTH) Study. Intermediate and clinical end-points of IVF treatments were abstracted from electronic medical records. We used generalized linear mixed models with random intercepts to evaluate the association between urinary BPA concentrations and IVF outcomes adjusted by age, race, body mass index, smoking status and infertility diagnosis. The specific gravity-adjusted geometric mean of BPA was 1.87 µg/l, which is comparable to that for female participants in the National Health and Nutrition Examination Survey, 2011-2012. Urinary BPA concentrations were not associated with endometrial wall thickness, peak estradiol levels, proportion of high quality embryos or fertilization rates. Furthermore, there were no associations between urinary BPA concentrations and implantation, clinical pregnancy or live birth rates per initiated cycle or per embryo transfer. Although we did not find any associations between urinary BPA concentrations and IVF outcomes, the relation between BPA and endometrial wall thickness was modified by age. Younger women (<37 years old) had thicker endometrial thickness across increasing quartiles of urinary BPA concentrations, while older women (≥37 years old) had thinner endometrial thickness across increasing quartiles of urinary BPA concentrations. Limitations to this study include a possible misclassification of BPA exposure and difficulties in extrapolating the findings to the general population. Data on the relation between urinary BPA concentrations and reproductive outcomes remain scarce and additional research is needed to clarify its role in human reproduction. This work was supported by NIH grants R01ES022955, R01ES009718 and R01ES000002 from the National Institute of Environmental Health Sciences (NIEHS) and grant T32DK00770316 from the National Institute of Child Health and Human Development (NICHD). None of the authors has any conflicts of interest to declare. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Cytomegalovirus Urinary Shedding in HIV-infected Pregnant Women and Congenital Cytomegalovirus Infection.

    PubMed

    Adachi, Kristina; Xu, Jiahong; Ank, Bonnie; Watts, D Heather; Mofenson, Lynne M; Pilotto, Jose Henrique; Joao, Esau; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa M; Gray, Glenda; Theron, Gerhard; Morgado, Mariza G; Bryson, Yvonne J; Veloso, Valdilea G; Klausner, Jeffrey D; Moye, Jack; Nielsen-Saines, Karin

    2017-08-01

    Cytomegalovirus (CMV) urinary shedding in pregnant women infected with human immunodeficiency virus (HIV) was evaluated to determine whether it poses an increased risk for congenital CMV infection (cCMV). A subset of mother-infant pairs enrolled in the perinatal NICHD HPTN 040 study (distinguished by no antiretroviral use before labor) was evaluated. Maternal and infant urines were tested by qualitative real-time polymerase chain reaction (RT-PCR) for CMV DNA with quantitative RT-PCR performed on positive specimens. Urine specimens were available for 260 women with 85.4% from the Americas and 14.6% from South Africa. Twenty-four women (9.2%) had detectable CMV viruria by qualitative PCR. Maternal CMV viruria was not associated with mean CD4 cell counts or HIV viral load but was associated with younger maternal age (P = .02). Overall, 10 of 260 infants (3.8%) had cCMV. Women with detectable peripartum CMV viruria were more likely to have infants with cCMV than those without: 20.8% (5/24) versus 2.1% (5/236), (P = .0001). Women with CMV viruria had significantly higher rates of HIV perinatal transmission (29.2% vs. 8.1%, P = .002). They were 5 times (adjusted odds ratio [aOR] = 5.6, 95% confidence interval [CI] 1.9-16.8) and nearly 30 times (aOR, 29.7; 95% CI, 5.4-164.2) more likely to transmit HIV and CMV to their infants, respectively. Maternal gonorrhea (aOR, 19.5; 95% CI, 2.5-151.3) and higher maternal HIV log10 viral load (OR, 2.8; 95% CI, 1.3-6.3) were also significant risk factors for cCMV. In this cohort of HIV-infected pregnant women not on antiretrovirals, urinary CMV shedding was a significant risk factor for CMV and HIV transmission to infants. NCT00099359. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com

  18. Prediction of Early Childhood Outcome of Term Infants using Apgar Scores at 10 Minutes following Hypoxic-Ischemic Encephalopathy

    PubMed Central

    Laptook, Abbot R.; Shankaran, Seetha; Ambalavanan, Namasivayam; Carlo, Waldemar A.; McDonald, Scott A.; Higgins, Rosemary D.; Das, Abhik

    2010-01-01

    Context Death or severe disability is so common following an Apgar score of 0 at 10 minutes in observational studies that the Neonatal Resuscitation Program suggests considering discontinuation of resuscitation after 10 minutes of effective CPR. Objective To determine if Apgar scores at 10 minutes are associated with death or disability in early childhood following perinatal hypoxic-ischemic encephalopathy (HIE). Design, Setting, and Patients This is a secondary analysis of infants enrolled in the NICHD Neonatal Research Network hypothermia trial. Infants ≥ 36 weeks gestation had clinical and/or biochemical abnormalities at birth, and encephalopathy at < 6 hours. Logistic regression and classification and regression tree (CART) analysis was used to determine associations between Apgar scores at 10 minutes and neurodevelopmental outcome adjusting for covariates. Associations are expressed as odds ratios (OR) and 95% confidence interval (CI). Main Outcome Measure Death or disability (moderate or severe) at 18–22 months of age. Results Twenty of 208 infants were excluded (missing data). More than 90% of infants had Apgar scores of 0–2 at 1 minute and Apgars at 5 and 10 minutes shifted to progressively higher values; at 10 minutes 27% of infants had Apgar scores of 0–2. After adjustment each point decrease in Apgar score at 10 minutes was associated with a 45% increase in the odds of death or disability (OR 1.45, CI 1.22–1.72). Death or disability occurred in 76, 82 and 80% of infants with Apgar scores at 10 minutes of 0, 1 and 2, respectively. CART analysis indicated that Apgar scores at 10 minutes were discriminators of outcome. Conclusion Apgar scores at 10 minutes provide useful prognostic data before other evaluations are available for infants with HIE. Death or moderate/severe disability is common but not uniform with Apgar scores < 3; caution is needed before adopting a specific time interval to guide duration of resuscitation. PMID:19948631

  19. Elevated Temperature and 6-7 Year Outcome of Neonatal Encephalopathy

    PubMed Central

    Laptook, Abbot R.; McDonald, Scott A.; Shankaran, Seetha; Stephens, Bonnie E.; Vohr, Betty R.; Guillet, Ronnie; Higgins, Rosemary D.; Das, Abhik

    2013-01-01

    OBJECTIVE Determine if higher temperature after hypoxia-ischemia is associated with death or IQ < 70 at 6-7 yr among infants treated with intensive care without hypothermia. DESIGN/METHODS Control infants (non-cooled, n=106) of the NICHD Neonatal Research Network hypothermia trial had serial esophageal and skin temperatures over 72hrs. Each infant's temperature was ranked to derive an average of the upper and lower quartile, and median of each site. Temperatures were used in logistic regressions to determine adjusted associations with death or IQ < 70 at 6-7yrs. Secondary outcomes were death, IQ < 70, and moderate/severe CP. IQ and motor function were assessed with Wechsler Scales for Children and Gross Motor Function Classification System. Results are odds ratio (OR, per °C increment within the quartile or median) and 95% confidence interval (CI). RESULTS Primary outcome was available for 89 infants. At 6-7yrs death or IQ < 70 occurred in 54 infants (37 deaths, 17 survivors with IQ < 70) and moderate/severe CP in 15 infants. Death or IQ < 70 was associated with the upper quartile average of esophageal (OR 7.3, 95% CI 2.0-26.3) and skin temperature (OR 3.5, 95% 1.2-10.4). CP was associated with the upper quartile average of esophageal (OR 12.5, 95% CI 1.02-155) and skin temperature (OR 10.3, 95% 1.3-80.2). CONCLUSIONS Among non-cooled infants of a randomized trial, elevated temperatures during the first post-natal days are associated with increase odds of a worse outcome at 6-7yrs. PMID:23595408

  20. Prenatal coke: what's behind the smoke? Prenatal cocaine/alcohol exposure and school-age outcomes: the SCHOO-BE experience.

    PubMed

    Delaney-Black, V; Covington, C; Templin, T; Ager, J; Martier, S; Compton, S; Sokol, R

    1998-06-21

    Despite media reports and educators' concerns, little substantive data have been published to document or refute the emerging reports that children prenatally exposed to cocaine have serious behavioral problems in school. Recent pilot data from this institution have indeed demonstrated teacher-reported problem behaviors following prenatal cocaine exposure after controlling for the effects of prenatal alcohol use and cigarette exposure. Imperative in the study of prenatal exposure and child outcome is an acknowledgement of the influence of other control factors such as postnatal environment, secondary exposures, and parenting issues. We report preliminary evaluation from a large ongoing historical prospective study of prenatal cocaine exposure on school-age outcomes. The primary aim of this NIDA-funded study is to determine if a relationship exists between prenatal cocaine/alcohol exposures and school behavior and, if so, to determine if the relationship is characterized by a dose-response relationship. A secondary aim evaluates the relationship between prenatal cocaine/alcohol exposures and school achievement. Both relationships will be assessed in a black, urban sample of first grade students using multivariate statistical techniques for confounding as well as mediating and moderating prenatal and postnatal variables. A third aim is to evaluate the relationship between a general standardized classroom behavioral measure and a tool designed to tap the effects thought to be specific to prenatal cocaine exposure. This interdisciplinary research team can address these aims because of the existence of a unique, prospectively collected perinatal Database, funded in part by NIAAA and NICHD. The database includes repeated measures of cocaine, alcohol, and other substances for over 3,500 births since 1986. Information from this database is combined with information from the database of one of the largest public school systems in the nation. The final sample will be composed of over 600 first grade students for whom the independent variables, prenatal cocaine/alcohol exposures, were prospectively assessed and quantified at the university maternity center. After informed consent, the primary dependent variable, school behavior, is assessed, using the PROBS-14 (a teacher consensus developed instrument), the Child Behavior Check List, and the Conners' Teacher Rating Scale. The secondary dependent measure, school achievement, is measured by the Metropolitan Achievement Text and the Test of Early Reading Ability. Control variables, such as the environment and parenting, are measured by several instruments aimed at capturing the child and family ecology since birth. All analyses will be adjusted as appropriate for prospectively gathered control variables such as perinatal risk, neonatal risk, and other prenatal drug and cigarette exposures. Further adjustment will be made for postnatal social risk factors which may influence outcome. Of particular concern are characteristics of the home (adaptation of HOME), parent (depression, stress), and neighborhood (violence exposure). Finally, postnatal exposure to lead and other drugs is being considered.

  1. Temperature control during therapeutic hypothermia for newborn encephalopathy using different Blanketrol devices.

    PubMed

    Laptook, Abbot R; Kilbride, Howard; Shepherd, Edward; McDonald, Scott A; Shankaran, Seetha; Truog, William; Das, Abhik; Higgins, Rosemary D

    2014-12-01

    Therapeutic hypothermia improves the survival and neurodevelopmental outcome of infants with newborn encephalopathy of a hypoxic-ischemic origin. The NICHD Neonatal Research Network (NRN) Whole Body Cooling trial used the Cincinnati Sub-Zero Blanketrol II to achieve therapeutic hypothermia. The Blanketrol III is now available and provides additional cooling modes that may result in better temperature control. This report is a retrospective comparison of infants undergoing hypothermia using two different cooling modes of the Blanketrol device. Infants from the NRN trial were cooled with the Blanketrol II using the Automatic control mode (B2 cohort) and were compared with infants from two new NRN centers that adopted the NRN protocol and used the Blanketrol III in a gradient mode (B3 cohort). The primary outcome was the percent time the esophageal temperature stayed between 33°C and 34°C (target 33.5°C) during maintenance of hypothermia. Cohorts had similar birth weight, gestational age, and level of encephalopathy at the initiation of therapy. Baseline esophageal temperature differed between groups (36.6°C ± 1.0°C for B2 vs. 33.9°C ± 1.2°C for B3, p<0.0001) reflecting the practice of passive cooling during transport prior to initiation of active device cooling in the B3 cohort. This difference prevented comparison of temperatures during induction of hypothermia. During maintenance of hypothermia the mean and standard deviation of the percent time between 33°C and 34°C was similar for B2 compared to B3 cohorts (94.8% ± 0.1% vs. 95.8% ± 0.1%, respectively). Both the automatic and gradient control modes of the Blanketrol devices appear comparable in maintaining esophageal temperature within the target range during maintenance of therapeutic hypothermia.

  2. Temperature Control During Therapeutic Hypothermia for Newborn Encephalopathy Using Different Blanketrol Devices

    PubMed Central

    Kilbride, Howard; Shepherd, Edward; McDonald, Scott A.; Shankaran, Seetha; Truog, William; Das, Abhik; Higgins, Rosemary D.

    2014-01-01

    Therapeutic hypothermia improves the survival and neurodevelopmental outcome of infants with newborn encephalopathy of a hypoxic-ischemic origin. The NICHD Neonatal Research Network (NRN) Whole Body Cooling trial used the Cincinnati Sub-Zero Blanketrol II to achieve therapeutic hypothermia. The Blanketrol III is now available and provides additional cooling modes that may result in better temperature control. This report is a retrospective comparison of infants undergoing hypothermia using two different cooling modes of the Blanketrol device. Infants from the NRN trial were cooled with the Blanketrol II using the Automatic control mode (B2 cohort) and were compared with infants from two new NRN centers that adopted the NRN protocol and used the Blanketrol III in a gradient mode (B3 cohort). The primary outcome was the percent time the esophageal temperature stayed between 33°C and 34°C (target 33.5°C) during maintenance of hypothermia. Cohorts had similar birth weight, gestational age, and level of encephalopathy at the initiation of therapy. Baseline esophageal temperature differed between groups (36.6°C±1.0°C for B2 vs. 33.9°C±1.2°C for B3, p<0.0001) reflecting the practice of passive cooling during transport prior to initiation of active device cooling in the B3 cohort. This difference prevented comparison of temperatures during induction of hypothermia. During maintenance of hypothermia the mean and standard deviation of the percent time between 33°C and 34°C was similar for B2 compared to B3 cohorts (94.8%±0.1% vs. 95.8%±0.1%, respectively). Both the automatic and gradient control modes of the Blanketrol devices appear comparable in maintaining esophageal temperature within the target range during maintenance of therapeutic hypothermia. PMID:25285767

  3. Three postpartum antiretroviral regimens to prevent intrapartum HIV infection.

    PubMed

    Nielsen-Saines, Karin; Watts, D Heather; Veloso, Valdilea G; Bryson, Yvonne J; Joao, Esau C; Pilotto, Jose Henrique; Gray, Glenda; Theron, Gerhard; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa M; Ceriotto, Mariana; Machado, Daisy; Bethel, James; Morgado, Marisa G; Dickover, Ruth; Camarca, Margaret; Mirochnick, Mark; Siberry, George; Grinsztejn, Beatriz; Moreira, Ronaldo I; Bastos, Francisco I; Xu, Jiahong; Moye, Jack; Mofenson, Lynne M

    2012-06-21

    The safety and efficacy of adding antiretroviral drugs to standard zidovudine prophylaxis in infants of mothers with human immunodeficiency virus (HIV) infection who did not receive antenatal antiretroviral therapy (ART) because of late identification are unclear. We evaluated three ART regimens in such infants. Within 48 hours after their birth, we randomly assigned formula-fed infants born to women with a peripartum diagnosis of HIV type 1 (HIV-1) infection to one of three regimens: zidovudine for 6 weeks (zidovudine-alone group), zidovudine for 6 weeks plus three doses of nevirapine during the first 8 days of life (two-drug group), or zidovudine for 6 weeks plus nelfinavir and lamivudine for 2 weeks (three-drug group). The primary outcome was HIV-1 infection at 3 months in infants uninfected at birth. A total of 1684 infants were enrolled in the Americas and South Africa (566 in the zidovudine-alone group, 562 in the two-drug group, and 556 in the three-drug group). The overall rate of in utero transmission of HIV-1 on the basis of Kaplan-Meier estimates was 5.7% (93 infants), with no significant differences among the groups. Intrapartum transmission occurred in 24 infants in the zidovudine-alone group (4.8%; 95% confidence interval [CI], 3.2 to 7.1), as compared with 11 infants in the two-drug group (2.2%; 95% CI, 1.2 to 3.9; P=0.046) and 12 in the three-drug group (2.4%; 95% CI, 1.4 to 4.3; P=0.046). The overall transmission rate was 8.5% (140 infants), with an increased rate in the zidovudine-alone group (P=0.03 for the comparisons with the two- and three-drug groups). On multivariate analysis, zidovudine monotherapy, a higher maternal viral load, and maternal use of illegal substances were significantly associated with transmission. The rate of neutropenia was significantly increased in the three-drug group (P<0.001 for both comparisons with the other groups). In neonates whose mothers did not receive ART during pregnancy, prophylaxis with a two- or three-drug ART regimen is superior to zidovudine alone for the prevention of intrapartum HIV transmission; the two-drug regimen has less toxicity than the three-drug regimen. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development [NICHD] and others; ClinicalTrials.gov number, NCT00099359.).

  4. Screening and treatment of maternal genitourinary tract infections in early pregnancy to prevent preterm birth in rural Sylhet, Bangladesh: a cluster randomized trial.

    PubMed

    Lee, Anne C C; Quaiyum, Mohammad A; Mullany, Luke C; Mitra, Dipak K; Labrique, Alain; Ahmed, Parvez; Uddin, Jamal; Rafiqullah, Iftekhar; DasGupta, Sushil; Mahmud, Arif; Koumans, Emilia H; Christian, Parul; Saha, Samir; Baqui, Abdullah H

    2015-12-07

    Approximately half of preterm births are attributable to maternal infections, which are commonly undetected and untreated in low-income settings. Our primary aim is to determine the impact of early pregnancy screening and treatment of maternal genitourinary tract infections on the incidence of preterm live birth in Sylhet, Bangladesh. We will also assess the effect on other adverse pregnancy outcomes, including preterm birth (stillbirth and live birth), late miscarriage, maternal morbidity, and early onset neonatal sepsis. We are conducting a cluster randomized controlled trial that will enroll 10,000 pregnant women in Sylhet district in rural northeastern Bangladesh. Twenty-four clusters, each with ~4000 population (120 pregnant women/year) and served by a community health worker (CHW), are randomized to: 1) the control arm, which provides routine antenatal and postnatal home-based care, or 2) the intervention arm, which includes routine antenatal and postnatal home-based care plus screening and treatment of pregnant women between 13 and 19 weeks of gestation for abnormal vaginal flora (AVF) and urinary tract infection (UTI). CHWs conduct monthly pregnancy surveillance, make 2 antenatal and 4 postnatal home visits for all enrolled pregnant women and newborns, and refer mothers or newborns with symptoms of serious illness to the government sub-district hospital. In the intervention clusters, CHWs perform home-based screening of AVF and UTI. Self-collected vaginal swabs are plated on slides, which are Gram stained and Nugent scored. Women with AVF (Nugent score ≥4) are treated with oral clindamycin, rescreened and retreated, if needed, after 3 weeks. Urine culture is performed and UTI treated with nitrofurantoin. Repeat urine culture is performed after 1 week for test of cure. Gestational age is determined by maternal report of last menstrual period at study enrollment using prospectively completed study calendars, and in a subset by early (<20 week) ultrasound. CHWs prospectively collect data on all pregnancy outcomes, maternal and neonatal morbidity and mortality. Findings will enhance our understanding of the burden of AVF and UTI in rural Bangladesh, the impact of a maternal screening-treatment program for genitourinary tract infections on perinatal health, and help formulate public health recommendations for infection screening in pregnancy in low-resource settings. The study was registered on ClinicalTrials.gov:NCT01572532 on December 15, 2011. The study was funded by NICHD: R01HD066156 .

  5. Postoperative Outcomes of Extremely Low Birth-Weight Infants With Necrotizing Enterocolitis or Isolated Intestinal Perforation

    PubMed Central

    Blakely, Martin L.; Lally, Kevin P.; McDonald, Scott; Brown, Rebeccah L.; Barnhart, Douglas C.; Ricketts, Richard R.; Thompson, W Raleigh; Scherer, L R.; Klein, Michael D.; Letton, Robert W.; Chwals, Walter J.; Touloukian, Robert J.; Kurkchubasche, Arlett G.; Skinner, Michael A.; Moss, R Lawrence; Hilfiker, Mary L.

    2005-01-01

    Objective: Purposes of this study were: 1) to compare mortality and postoperative morbidities (intra-abdominal abscess, wound dehiscence, and intestinal stricture) in extremely low birth weight (ELBW) infants who underwent initial laparotomy or drainage for necrotizing enterocolitis (NEC) or isolated intestinal perforation (IP); 2) to determine the ability to distinguish NEC from IP preoperatively and the importance of this distinction on outcome measures; and 3) to evaluate the association between extent of intestinal disease determined at operation and outcome measures. Background: ELBW infants who undergo operation for NEC or IP have a postoperative, in-hospital mortality rate of approximately 50%. Whether to perform laparotomy or drainage initially is controversial. Also unknown is the importance of distinguishing NEC from IP and the current ability to make this distinction based on objective data available prior to operation. Methods: A prospective, multicenter cohort study of 156 ELBW infants at 16 neonatal intensive care units (NICU) within the NICHD Neonatal Research Network. Results: Among the 156 enrolled infants, 80 underwent initial peritoneal drainage and 76 initial laparotomy. Mortality rate was 49% (76 of 156). Ninety-six patients had a preoperative diagnosis of NEC and 60 had presumed IP. There was a high level of agreement between the presumed preoperative diagnosis and intraoperative diagnosis in patients undergoing initial laparotomy (kappa = 0.85). The relative risk for death with a preoperative diagnosis of NEC (versus IP) was 1.4 (95% confidence interval, 0.99–2.1, P = 0.052). The overall incidence of postoperative intestinal stricture was 10.3%, wound dehiscence 4.4%, and intra-abdominal abscess 5.8%, and did not significantly differ between groups undergoing initial laparotomy versus initial drainage. Conclusions: Survival to hospital discharge after operation for NEC or IP in ELBW neonates remains poor (51%). Patients with a preoperative diagnosis of NEC have a relative risk for death of 1.4 compared with those with a preoperative diagnosis of IP. A distinction can be made preoperatively between NEC and IP based on abdominal radiographic findings and the patient's age at operation. Future randomized trials that compare laparotomy versus drainage would likely benefit from stratification of treatment assignment based on preoperative diagnosis. PMID:15912048

  6. Infertility treatment and children's longitudinal growth between birth and 3 years of age

    PubMed Central

    Yeung, E.H.; Sundaram, R.; Bell, E.M.; Druschel, C.; Kus, C.; Xie, Y.; Buck Louis, G.M.

    2016-01-01

    STUDY QUESTION Does early childhood growth from birth through to 3 years of age differ by mode of conception? SUMMARY ANSWER Findings suggest early childhood growth was comparable for children irrespective of infertility treatment, but twins conceived with ovulation induction with or without intrauterine insemination (OI/IUI) were slightly smaller than twins conceived without treatment. WHAT IS KNOWN ALREADY Although studies have found that babies conceived with infertility treatment are born lighter and earlier than infants conceived without treatment, little research especially for non-assisted reproductive technology (ART) treatments has focused on their continued growth during early childhood. STUDY DESIGN, SIZE, DURATION Upstate KIDS recruited infants born (2008–2010) to resident upstate New York mothers. Infants were sampled based on birth certificate indication of infertility treatment; specifically, for every singleton conceived by infertility treatment, three singletons without infertility treatment were recruited and matched on region of birth. All multiple births irrespective of treatment were also recruited. Children were prospectively followed, returning questionnaires every 4–6 months until 3 years of age. In total, 3905 singletons, 1129 sets of multiples (96% of whom were twins) enrolled into the study. Analyses included 3440 (88%) singletons (969 conceived with treatment; specifically, 433 with ART and 535 with OI/IUI) and 991 (88%) sets of multiples (439 conceived with treatment; specifically 233 with ART and 206 with OI/IUI) with growth data available. PARTICIPANTS/MATERIALS, SETTING, METHODS Mothers reported infertility treatment use at baseline and children's height and weight from pediatric visits. Self-reported use of ART was previously verified by linkage with the US Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) database. Mixed linear models with cubic splines accounting for age and age–gender interactions were used to estimate mean differences in growth from birth to 3 years by infertility treatment status and adjusting for maternal age, race, education, private insurance, smoking status during pregnancy, maternal pre-pregnancy and paternal body mass indices (BMI). MAIN RESULTS AND THE ROLE OF CHANCE Compared with singletons conceived without treatment (n = 2471), singletons conceived by infertility treatment (433 by assisted reproductive technologies (ART), 535 by OI/IUI and 1 unknown specific type) did not differ in growth. Compared with twins not conceived with treatment (n = 1076), twins conceived with OI/IUI (n = 368) weighed slightly less over follow-up (122 g). They were also proportionally smaller for their length (−0.17 weight-for-length z-score units). No differences in mean size over the 3 years were observed for twins conceived by ART, though some evidence of rapid weight gain from birth to 4 months (adjusted OR 1.08; 95% CI: 1.00–1.16) suggestive of catch up growth was observed. LIMITATIONS, REASONS FOR CAUTION Participants from upstate New York may not be representative of US infants. Although accounted for in statistical analysis, attrition during follow-up may have limited power to detect small differences. WIDER IMPLICATIONS OF THE FINDINGS This study is the first to prospectively track the growth of children conceived with and without infertility treatment in the USA, including a substantial number of twins. Our findings are similar to what was previously observed in the ART literature outside of the states. STUDY FUNDING/COMPETING INTEREST(S) Supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; contracts #HHSN275201200005C, #HHSN267200700019C). Authors have no competing interests to declare. TRIAL REGISTRATION NUMBER Not applicable. PMID:27165624

  7. Sphingosine-1-phosphate prevents chemotherapy-induced human primordial follicle death.

    PubMed

    Li, Fang; Turan, Volkan; Lierman, Sylvie; Cuvelier, Claude; De Sutter, Petra; Oktay, Kutluk

    2014-01-01

    Can Sphingosine-1-phosphate (S1P), a ceramide-induced death pathway inhibitor, prevent cyclophosphamide (Cy) or doxorubicin (Doxo) induced apoptotic follicle death in human ovarian xenografts? S1P can block human apoptotic follicle death induced by both drugs, which have differing mechanisms of cytotoxicity. S1P has been shown to decrease the impact of chemotherapy and radiation on germinal vesicle oocytes in animal studies but no human translational data exist. Experimental human ovarian xenografting to test the in vivo protective effect of S1P on primordial follicle survival in the chemotherapy setting. The data were validated by assessing the same protective effect in the ovaries of xenografted mice in parallel. Xenografted mice were treated with Cy (75 mg/kg), Cy+S1P (200 μM), Doxo (10 mg/kg), Doxo+S1P or vehicle only (Control). S1P was administered via continuous infusion using a mini-osmotic pump beginning 24 h prior to and ending 72 h post-chemotherapy. Grafts were then recovered and stained with anti-caspase 3 antibody for the detection of apoptosis in primordial follicles. The percentage of apoptotic to total primordial follicles was calculated in each group. Both Cy and Doxo resulted in a significant increase in apoptotic follicle death in human ovarian xenografts compared with controls (62.0 ± 3.9% versus 25.7 ± 7.4%, P < 0.01 and 76.7 ± 7.4% versus 25.7 ± 7.4%, P < 0.01, respectively). This chemotherapy-induced apoptotic death was reduced both in the Cy+S1P (32.7 ± 4.4%, P < 0.01) and the Doxo+S1P group (27.1 ± 7.6%, P < 0.01) compared with Cy and Doxo groups, respectively. In the Doxo+S1P and Cy+S1P groups, the percentages of apoptotic follicles were similar to those of vehicle-treated controls (P > 0.05). The findings from the ovaries of the severe combined immunodeficient mice mirrored the findings with human tissue. The functionality of the rescued human ovarian follicles needs to be evaluated in future studies though the studies in rodents showed that rescued oocytes can result in healthy offspring. In addition, the impact of S1P on cancer cells should be further studied. S1P and its future analogs hold promise for preserving fertility by pharmacological means for patients undergoing chemotherapy. This research is supported by NIH's NICHD and NCI (5R01HD053112-06 and 5R21HD061259-02) and the Flemish Foundation for Scientific Research (FWO-Vlaanderen, grant number FWO G0.065.11N10). The authors have no conflicts of interest to disclose.

  8. Combined evaluation of sexually transmitted infections in HIV-infected pregnant women and infant HIV transmission

    PubMed Central

    Xu, Jiahong; Yeganeh, Nava; Camarca, Margaret; Morgado, Mariza G.; Watts, D. Heather; Mofenson, Lynne M.; Veloso, Valdilea G.; Pilotto, Jose Henrique; Joao, Esau; Gray, Glenda; Theron, Gerhard; Santos, Breno; Fonseca, Rosana; Kreitchmann, Regis; Pinto, Jorge; Mussi-Pinhata, Marisa M.; Ceriotto, Mariana; Machado, Daisy Maria; Bryson, Yvonne J.; Grinsztejn, Beatriz; Moye, Jack; Klausner, Jeffrey D.; Bristow, Claire C.; Dickover, Ruth; Mirochnick, Mark; Nielsen-Saines, Karin

    2018-01-01

    Background Sexually transmitted infections (STIs) including Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Treponema pallidum (TP), and cytomegalovirus (CMV) may lead to adverse pregnancy and infant outcomes. The role of combined maternal STIs in HIV mother-to-child transmission (MTCT) was evaluated in mother-infant pairs from NICHD HPTN 040. Methodology Urine samples from HIV-infected pregnant women during labor were tested by polymerase chain reaction (PCR) for CT, NG, and CMV. Infant HIV infection was determined by serial HIV DNA PCR testing. Maternal syphilis was tested by VDRL and confirmatory treponemal antibodies. Results A total of 899 mother-infant pairs were evaluated. Over 30% had at least one of the following infections (TP, CT, NG, and/or CMV) detected at the time of delivery. High rates of TP (8.7%), CT (17.8%), NG (4%), and CMV (6.3%) were observed. HIV MTCT was 9.1% (n = 82 infants). HIV MTCT was 12.5%, 10.3%, 11.1%, and 26.3% among infants born to women with CT, TP, NG or CMV respectively. Forty-two percent of HIV-infected infants were born to women with at least one of these 4 infections. Women with these infections were nearly twice as likely to have an HIV-infected infant (aOR 1.9, 95% CI 1.1–3.0), particularly those with 2 STIs (aOR 3.4, 95% CI 1.5–7.7). Individually, maternal CMV (aOR 4.4 1.5–13.0) and infant congenital CMV (OR 4.1, 95% CI 2.2–7.8) but not other STIs (TP, CT, or NG) were associated with an increased risk of HIV MTCT. Conclusion HIV-infected pregnant women identified during labor are at high risk for STIs. Co-infection with STIs including CMV nearly doubles HIV MTCT risk. CMV infection appears to confer the largest risk of HIV MTCT. Trial registration NCT00099359. PMID:29304083

  9. Impact of Timing of Birth and Resident Duty-Hour Restrictions on Outcome of Small Preterm Infants

    PubMed Central

    Bell, Edward F.; Hansen, Nellie I.; Morriss, Frank H.; Stoll, Barbara J.; Ambalavanan, Namasivayam; Gould, Jeffrey B.; Laptook, Abbot R.; Walsh, Michele C.; Carlo, Waldemar A.; Shankaran, Seetha; Das, Abhik; Higgins, Rosemary D.

    2010-01-01

    OBJECTIVE To examine the impact of birth at night, on the weekend, and during July or August – the first months of the academic year – and the impact of resident duty-hour restrictions on mortality and morbidity of VLBW infants. METHODS Outcomes were analyzed for 11,137 infants with birth weight 501–1250 grams enrolled in the NICHD Neonatal Research Network registry 2001–2005. Approximately half were born before the introduction of resident duty-hour restrictions in 2003. Follow-up assessment at 18–22 months was completed for 4,508 infants. Mortality (7-day and 28-day), short-term morbidities, and neurodevelopmental outcome were examined with respect to the timing of birth: night vs day, weekend vs weekday, and July or August vs other months, and after vs before implementation of resident duty-hour restrictions. RESULTS There was no effect of hour, day, or month of birth on mortality and no impact on the risks of short-term morbidities except the risk of ROP requiring operative treatment was lower for infants born during the late night hours than during the day. There was no impact of timing of birth on neurodevelopmental outcome except the risk of hearing impairment or death was slightly lower among infants born in July or August compared with other months. The introduction of resident and fellow duty-hour restrictions had no impact on mortality or neurodevelopmental outcome. The only change in short-term morbidity after duty-hour restrictions were introduced was an increase in the risk of ROP (stage 2 or higher). CONCLUSION In this network of academic centers, the timing of birth and the introduction of duty-hour restrictions had little effect on the risks of mortality and morbidity of VLBW infants, suggesting that staffing patterns were adequate to provide consistent care. PMID:20643715

  10. Sphingosine-1-phosphate prevents chemotherapy-induced human primordial follicle death

    PubMed Central

    Li, Fang; Turan, Volkan; Lierman, Sylvie; Cuvelier, Claude; De Sutter, Petra; Oktay, Kutluk

    2014-01-01

    STUDY QUESTION Can Sphingosine-1-phosphate (S1P), a ceramide-induced death pathway inhibitor, prevent cyclophosphamide (Cy) or doxorubicin (Doxo) induced apoptotic follicle death in human ovarian xenografts? SUMMARY ANSWER S1P can block human apoptotic follicle death induced by both drugs, which have differing mechanisms of cytotoxicity. WHAT IS KNOWN ALREADY S1P has been shown to decrease the impact of chemotherapy and radiation on germinal vesicle oocytes in animal studies but no human translational data exist. STUDY DESIGN, SIZE, DURATION Experimental human ovarian xenografting to test the in vivo protective effect of S1P on primordial follicle survival in the chemotherapy setting. The data were validated by assessing the same protective effect in the ovaries of xenografted mice in parallel. PARTICIPANTS/MATERIALS, SETTING, METHODS Xenografted mice were treated with Cy (75 mg/kg), Cy+S1P (200 μM), Doxo (10 mg/kg), Doxo+S1P or vehicle only (Control). S1P was administered via continuous infusion using a mini-osmotic pump beginning 24 h prior to and ending 72 h post-chemotherapy. Grafts were then recovered and stained with anti-caspase 3 antibody for the detection of apoptosis in primordial follicles. The percentage of apoptotic to total primordial follicles was calculated in each group. MAIN RESULTS AND THE ROLE OF CHANCE Both Cy and Doxo resulted in a significant increase in apoptotic follicle death in human ovarian xenografts compared with controls (62.0 ± 3.9% versus 25.7 ± 7.4%, P < 0.01 and 76.7 ± 7.4% versus 25.7 ± 7.4%, P < 0.01, respectively). This chemotherapy-induced apoptotic death was reduced both in the Cy+S1P (32.7 ± 4.4%, P < 0.01) and the Doxo+S1P group (27.1 ± 7.6%, P < 0.01) compared with Cy and Doxo groups, respectively. In the Doxo+S1P and Cy+S1P groups, the percentages of apoptotic follicles were similar to those of vehicle-treated controls (P > 0.05). The findings from the ovaries of the severe combined immunodeficient mice mirrored the findings with human tissue. LIMITATIONS, REASONS FOR CAUTION The functionality of the rescued human ovarian follicles needs to be evaluated in future studies though the studies in rodents showed that rescued oocytes can result in healthy offspring. In addition, the impact of S1P on cancer cells should be further studied. WIDER IMPLICATIONS OF THE FINDINGS S1P and its future analogs hold promise for preserving fertility by pharmacological means for patients undergoing chemotherapy. STUDY FUNDING/COMPETING INTEREST(S) This research is supported by NIH's NICHD and NCI (5R01HD053112-06 and 5R21HD061259-02) and the Flemish Foundation for Scientific Research (FWO-Vlaanderen, grant number FWO G0.065.11N10). The authors have no conflicts of interest to disclose. PMID:24221908

  11. Dairy intake in relation to in vitro fertilization outcomes among women from a fertility clinic.

    PubMed

    Afeiche, M C; Chiu, Y-H; Gaskins, A J; Williams, P L; Souter, I; Wright, D L; Hauser, R; Chavarro, J E

    2016-03-01

    Is dairy food consumption associated with live birth among women undergoing infertility treatment? There was a positive association between total dairy food consumption and live birth among women ≥35 years of age. Dairy food intake has been previously related to infertility risk and measures of fertility potential but its relation to infertility treatment outcomes are unknown. Our study population comprised a total of 232 women undergoing 353 in vitro fertilization (IVF) treatment cycles between February 2007 and May 2013, from the Environment and Reproductive Health study, an ongoing prospective cohort. Diet was assessed before assisted reproductive technology (ART) treatment using a validated food frequency questionnaire. Study outcomes included ovarian stimulation outcomes (endometrial thickness, estradiol levels and oocyte yield), fertilization rates, embryo quality measures and clinical outcomes (implantation, clinical pregnancy and live birth rates). We used generalized linear mixed models with random intercepts to account for multiple ART cycles per woman while simultaneously adjusting for age, caloric intake, BMI, race, smoking status, infertility diagnosis, protocol type, alcohol intake and dietary patterns. The age- and calorie-adjusted difference in live birth between women in the highest (>3.0 servings/day) and lowest (<1.34 servings/day) quartile of dairy intake was 21% (P = 0.02). However, after adjusting for additional covariates, this association was observed only among women ≥35 years (P, interaction = 0.04). The multivariable-adjusted live birth (95% CI) in increasing quartiles of total dairy intake was 23% (11, 42%), 39% (24, 56%), 29% (17, 47%) and 55% (39, 69%) (P, trend = 0.02) among women ≥35 years old, and ranged from 46 to 54% among women <35 years old (P, trend = 0.69). There was no association between dairy intake and any of the intermediate outcomes. The lack of a known biological mechanism linking dairy intake to infertility treatment outcomes calls for caution when interpreting these results and for additional work to corroborate or refute them. Dairy intake does not appear to harm IVF outcomes and, if anything, is associated with higher chances of live birth. This work was supported by NIH grants R01-ES009718 and R01ES000002 from NIEHS, P30 DK046200 from NIDDK and T32HD060454 from NICHD. M.C.A. was supported by a Ruth L. Kirschstein National Research Service Award T32 DK 007703-16 from NIDDK. She is currently employed at the Nestlé Research Center, Switzerland and completed this work while at the Harvard School of Public Health. The other authors declare no conflicts of interest. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  12. A prostaglandin E2 receptor antagonist prevents pregnancies during a preclinical contraceptive trial with female macaques

    PubMed Central

    Peluffo, M.C.; Stanley, J.; Braeuer, N.; Rotgeri, A.; Fritzemeier, K.-H.; Fuhrmann, U.; Buchmann, B.; Adevai, T.; Murphy, M.J.; Zelinski, M.B.; Lindenthal, B.; Hennebold, J.D.; Stouffer, R.L.

    2014-01-01

    STUDY QUESTION Can administration of a prostaglandin (PG) E2 receptor 2 (PTGER2) antagonist prevent pregnancy in adult female monkeys by blocking periovulatory events in the follicle without altering menstrual cyclicity or general health? SUMMARY ANSWER This is the first study to demonstrate that a PTGER2 antagonist can serve as an effective non-hormonal contraceptive in primates. WHAT IS KNOWN ALREADY The requirement for PGE2 in ovulation and the release of an oocyte surrounded by expanded cumulus cells (cumulus–oocyte expansion; C-OE) was established through the generation of PTGS2 and PTGER2 null-mutant mice. A critical role for PGE2 in primate ovulation is supported by evidence that intrafollicular injection of indomethacin in rhesus monkeys suppressed follicle rupture, whereas co-injection of PGE2 with indomethacin resulted in ovulation. STUDY DESIGN, SIZE, DURATION First, controlled ovulation protocols were performed in adult, female rhesus monkeys to analyze the mRNA levels for genes encoding PGE2 synthesis and signaling components in the naturally selected pre-ovulatory follicle at different times after the ovulatory hCG stimulus (0, 12, 24, 36 h pre-ovulation; 36 h post-ovulation, n = 3–4/time point). Second, controlled ovarian stimulation cycles were utilized to obtain multiple cumulus–oocyte complexes (COCs) from rhesus monkeys to evaluate the role of PGE2 in C-OE in vitro (n = 3–4 animals/treatment; ≥3 COCs/animal/treatment). Third, adult cycling female cynomolgus macaques were randomly assigned (n = 10/group) to vehicle (control) or PTGER2 antagonist (BAY06) groups to perform a contraceptive trial. After the first treatment cycle, a male of proven fertility was introduced into each group and they remained housed together for the duration of the 5-month contraceptive trial that was followed by a post-treatment reversibility trial. PARTICIPANTS/MATERIALS, SETTING, METHODS Quantitative real-time PCR, COC culture and expansion, immunofluorescence/confocal microscopy, enzyme immunoassay, contraceptive trial, ultrasonography, complete blood counts, serum biochemistry tests and blood lipid profiles. MAIN RESULTS AND THE ROLE OF CHANCE Several mRNAs encoding proteins involved in PGE2 synthesis, metabolism and signaling increase (P < 0.05) in the periovulatory follicle after administration of an ovulatory hCG bolus. PGE2 signaling through PTGER2 induces cumulus cell expansion and production of hyaluronic acid, which are critical events for fertilization. Moreover, chronic administration of a selective PTGER2 antagonist resulted in a significant (P < 0.05 versus vehicle-treated controls) contraceptive effect without altering steroid hormone patterns or menstrual cyclicity during a 5-months contraceptive trial. Fertility recovered as early as 1 month after ending treatment. LIMITATIONS, REASONS FOR CAUTION This is a proof-of-concept study in a non-human primate model. Further investigations are warranted to elucidate the mechanism(s) of PTGER2 antagonist action in the primate ovary. Although PTGER2 antagonist treatment did not produce any obvious undesirable effects, improvements in the mode of administration, as well as the efficacy of these compounds, are necessary to consider such a contraceptive for women. WIDER IMPLICATIONS OF THE FINDINGS Monitoring as well as improving the efficacy and safety of female contraceptives is an important public health activity. Even though hormonal contraceptives are effective for women, concerns remain regarding their side-effects and long-term use because of the widespread actions of such steroidal products in many tissues. Moreover, some women cannot take hormones for medical reasons. Thus, development of non-hormonal contraceptives for women is warranted. STUDY FUNDING/COMPETING INTEREST(S) Supported by Bayer HealthCare Pharmaceuticals, The Eunice Kennedy Shriver NICHD Contraceptive Development and Research Center (U54 HD055744), NIH Office of the Director (Oregon National Primate Research Center P51 OD011092), and a Lalor Foundation Postdoctoral Basic Research Fellowship (MCP). The use of the Leica confocal was supported by grant number S10RR024585. Some of the authors (N.B., A.R., K.-H.F., U.F., B.B. and B.L.) are employees of Bayer Healthcare Pharma. PMID:24781425

  13. A prostaglandin E2 receptor antagonist prevents pregnancies during a preclinical contraceptive trial with female macaques.

    PubMed

    Peluffo, M C; Stanley, J; Braeuer, N; Rotgeri, A; Fritzemeier, K-H; Fuhrmann, U; Buchmann, B; Adevai, T; Murphy, M J; Zelinski, M B; Lindenthal, B; Hennebold, J D; Stouffer, R L

    2014-07-01

    Can administration of a prostaglandin (PG) E2 receptor 2 (PTGER2) antagonist prevent pregnancy in adult female monkeys by blocking periovulatory events in the follicle without altering menstrual cyclicity or general health? This is the first study to demonstrate that a PTGER2 antagonist can serve as an effective non-hormonal contraceptive in primates. The requirement for PGE2 in ovulation and the release of an oocyte surrounded by expanded cumulus cells (cumulus-oocyte expansion; C-OE) was established through the generation of PTGS2 and PTGER2 null-mutant mice. A critical role for PGE2 in primate ovulation is supported by evidence that intrafollicular injection of indomethacin in rhesus monkeys suppressed follicle rupture, whereas co-injection of PGE2 with indomethacin resulted in ovulation. First, controlled ovulation protocols were performed in adult, female rhesus monkeys to analyze the mRNA levels for genes encoding PGE2 synthesis and signaling components in the naturally selected pre-ovulatory follicle at different times after the ovulatory hCG stimulus (0, 12, 24, 36 h pre-ovulation; 36 h post-ovulation, n = 3-4/time point). Second, controlled ovarian stimulation cycles were utilized to obtain multiple cumulus-oocyte complexes (COCs) from rhesus monkeys to evaluate the role of PGE2 in C-OE in vitro (n = 3-4 animals/treatment; ≥3 COCs/animal/treatment). Third, adult cycling female cynomolgus macaques were randomly assigned (n = 10/group) to vehicle (control) or PTGER2 antagonist (BAY06) groups to perform a contraceptive trial. After the first treatment cycle, a male of proven fertility was introduced into each group and they remained housed together for the duration of the 5-month contraceptive trial that was followed by a post-treatment reversibility trial. Quantitative real-time PCR, COC culture and expansion, immunofluorescence/confocal microscopy, enzyme immunoassay, contraceptive trial, ultrasonography, complete blood counts, serum biochemistry tests and blood lipid profiles. Several mRNAs encoding proteins involved in PGE2 synthesis, metabolism and signaling increase (P < 0.05) in the periovulatory follicle after administration of an ovulatory hCG bolus. PGE2 signaling through PTGER2 induces cumulus cell expansion and production of hyaluronic acid, which are critical events for fertilization. Moreover, chronic administration of a selective PTGER2 antagonist resulted in a significant (P < 0.05 versus vehicle-treated controls) contraceptive effect without altering steroid hormone patterns or menstrual cyclicity during a 5-months contraceptive trial. Fertility recovered as early as 1 month after ending treatment. This is a proof-of-concept study in a non-human primate model. Further investigations are warranted to elucidate the mechanism(s) of PTGER2 antagonist action in the primate ovary. Although PTGER2 antagonist treatment did not produce any obvious undesirable effects, improvements in the mode of administration, as well as the efficacy of these compounds, are necessary to consider such a contraceptive for women. Monitoring as well as improving the efficacy and safety of female contraceptives is an important public health activity. Even though hormonal contraceptives are effective for women, concerns remain regarding their side-effects and long-term use because of the widespread actions of such steroidal products in many tissues. Moreover, some women cannot take hormones for medical reasons. Thus, development of non-hormonal contraceptives for women is warranted. Supported by Bayer HealthCare Pharmaceuticals, The Eunice Kennedy Shriver NICHD Contraceptive Development and Research Center (U54 HD055744), NIH Office of the Director (Oregon National Primate Research Center P51 OD011092), and a Lalor Foundation Postdoctoral Basic Research Fellowship (MCP). The use of the Leica confocal was supported by grant number S10RR024585. Some of the authors (N.B., A.R., K.-H.F., U.F., B.B. and B.L.) are employees of Bayer Healthcare Pharma.

  14. In vitro antiprogestational/antiglucocorticoid activity and progestin and glucocorticoid receptor binding of the putative metabolites and synthetic derivatives of CDB-2914, CDB-4124, and mifepristone.

    PubMed

    Attardi, Barbara J; Burgenson, Janet; Hild, Sheri A; Reel, Jerry R

    2004-03-01

    In determining the biological profiles of various antiprogestins, it is important to assess the hormonal and antihormonal activity, selectivity, and potency of their proximal metabolites. The early metabolism of mifepristone is characterized by rapid demethylation and hydroxylation. Similar initial metabolic pathways have been proposed for CDB-2914 (CDB: Contraceptive Development Branch of NICHD) and CDB-4124, and their putative metabolites have been synthesized. We have examined the functional activities and potencies, in various cell-based assays, and relative binding affinities (RBAs) for progesterone receptors (PR) and glucocorticoid receptors (GR) of the putative mono- and didemethylated metabolites of CDB-2914, CDB-4124, and mifepristone and of the 17alpha-hydroxy and aromatic A-ring derivatives of CDB-2914 and CDB-4124. The binding affinities of the monodemethylated metabolites for rabbit uterine PR and human PR-A and PR-B were similar to those of the parent compounds. Monodemethylated mifepristone bound to rabbit thymic GR with higher affinity than monodemethylated CDB-2914 or CDB-4124. T47D-CO cells were used to assess inhibition of R5020-stimulated endogenous alkaline phosphatase activity and transactivation of the PRE(2)-thymidine kinase (tk)-luciferase (LUC) reporter plasmid in transient transfections. The antiprogestational potency was as follows: mifepristone/CDB-2914/CDB-4124/monodemethylated metabolites (IC(50)'s approximately 10(-9)M) > aromatic A-ring derivatives (IC(50)'s approximately 10(-8)M) > didemethylated/17alpha-hydroxy derivatives (IC(50)'s approximately 10(-7)M). Antiglucocorticoid activity was determined by inhibition of dexamethasone-stimulated transcriptional activity in HepG2 cells. The mono- and didemethylated metabolites of CDB-2914 and CDB-4124 had less antiglucocorticoid activity (IC(50)'s approximately 10(-6)M) than monodemethylated mifepristone (IC(50) approximately 10(-8)M) or the other test compounds. At 10(-6)M in transcription assays, none of these compounds showed progestin agonist activity, whereas mifepristone and its monodemethylated metabolite manifested slight glucocorticoid agonist activity. The reduced antiglucocorticoid activity of monodemethylated CDB-2914 and CDB-4124 was confirmed in vivo by the thymus involution assay in adrenalectomized male rats. The aromatic A-ring derivatives-stimulated transcription of an estrogen-responsive reporter plasmid in MCF-7 and T47D-CO human breast cancer cells but were much less potent than estradiol. Taken together, these data suggest that the proximal metabolites of mifepristone, CDB-2914, and CDB-4124 contribute significantly to the antiprogestational activity of the parent compounds in vivo. Furthermore, the reduced antiglucocorticoid activity of CDB-2914 and CDB-4124 compared to mifepristone in vivo may be due in part to decreased activity of their putative proximal metabolites.

  15. Association of Antenatal Corticosteroids with Mortality, Morbidity, and Neurodevelopmental Outcomes in Extremely Preterm Multiple Gestation Infants

    PubMed Central

    Boghossian, Nansi S.; McDonald, Scott A.; Bell, Edward F.; Carlo, Waldemar A.; Brumbaugh, Jane E.; Stoll, Barbara J.; Laptook, Abbot R.; Shankaran, Seetha; Walsh, Michele C.; Das, Abhik; Higgins, Rosemary D.

    2017-01-01

    Importance Little is known about the benefits of antenatal corticosteroids on extremely preterm multiples. Objective To examine in extremely preterm multiples if use of antenatal corticosteroids is associated with improvement in major outcomes. Design, Setting, and Participants Infants with gestational age 22–28 weeks born at an NICHD Neonatal Research Network center (1998–2013) were studied. Generalized estimating equation models were used to generate adjusted relative risks (aRR) controlling for important maternal and neonatal variables. Main Outcome Measures In-hospital mortality, the composite outcome of neurodevelopmental impairment at 18–22 months’ corrected age or death before assessment. Results Of 6925 multiple-birth infants, 6094 (88%) were born to women who received antenatal corticosteroids. In-hospital mortality was lower among infants with exposure to antenatal corticosteroids vs no exposure (aRR=0.87, 95% CI 0.78–0.96). Neurodevelopmental impairment or death was not significantly lower among those exposed to antenatal corticosteroids vs no exposure (aRR=0.93, 95% CI 0.84–1.03). Other adverse outcomes that occurred less frequently among infants of women receiving antenatal corticosteroids included severe intraventricular hemorrhage (aRR=0.68, 95% CI 0.58–0.78) and the combined outcomes of necrotizing enterocolitis or death and severe intraventricular hemorrhage or death. Subgroup analyses indicated that exposure to antenatal corticosteroids was associated with a lower risk of mortality and the composite of neurodevelopmental impairment or mortality among non-small for gestational age multiples (aRR=0.82, 95% CI 0.74–0.92 and aRR=0.89, 95% CI 0.80–0.98, respectively) and a higher risk among small for gestational age multiples (aRR=1.40, 95% CI 1.02–1.93 and aRR=1.62, 95% CI 1.22–2.16, respectively). Antenatal corticosteroids were associated with higher neurodevelopmental impairment or mortality among multiple-birth infants of mothers with diabetes (aRR=1.55, 95% CI 1.00–2.38) but not among infants of mothers without diabetes (aRR=0.91, 95% CI 0.83–1.01). Conclusion In extremely preterm multiples, exposure to antenatal corticosteroids compared with no exposure was associated with a lower risk of mortality with no significant differences for the composite of neurodevelopmental impairment or death. Future research should investigate the increased risks of mortality and the composite of neurodevelopmental impairment or death associated with exposure to corticosteroids among small for gestational age multiples. PMID:27088897

  16. Childhood outcomes after hypothermia for neonatal encephalopathy.

    PubMed

    Shankaran, Seetha; Pappas, Athina; McDonald, Scott A; Vohr, Betty R; Hintz, Susan R; Yolton, Kimberly; Gustafson, Kathryn E; Leach, Theresa M; Green, Charles; Bara, Rebecca; Petrie Huitema, Carolyn M; Ehrenkranz, Richard A; Tyson, Jon E; Das, Abhik; Hammond, Jane; Peralta-Carcelen, Myriam; Evans, Patricia W; Heyne, Roy J; Wilson-Costello, Deanne E; Vaucher, Yvonne E; Bauer, Charles R; Dusick, Anna M; Adams-Chapman, Ira; Goldstein, Ricki F; Guillet, Ronnie; Papile, Lu-Ann; Higgins, Rosemary D

    2012-05-31

    We previously reported early results of a randomized trial of whole-body hypothermia for neonatal hypoxic-ischemic encephalopathy showing a significant reduction in the rate of death or moderate or severe disability at 18 to 22 months of age. Long-term outcomes are now available. In the original trial, we assigned infants with moderate or severe encephalopathy to usual care (the control group) or whole-body cooling to an esophageal temperature of 33.5°C for 72 hours, followed by slow rewarming (the hypothermia group). We evaluated cognitive, attention and executive, and visuospatial function; neurologic outcomes; and physical and psychosocial health among participants at 6 to 7 years of age. The primary outcome of the present analyses was death or an IQ score below 70. Of the 208 trial participants, primary outcome data were available for 190. Of the 97 children in the hypothermia group and the 93 children in the control group, death or an IQ score below 70 occurred in 46 (47%) and 58 (62%), respectively (P=0.06); death occurred in 27 (28%) and 41 (44%) (P=0.04); and death or severe disability occurred in 38 (41%) and 53 (60%) (P=0.03). Other outcome data were available for the 122 surviving children, 70 in the hypothermia group and 52 in the control group. Moderate or severe disability occurred in 24 of 69 children (35%) and 19 of 50 children (38%), respectively (P=0.87). Attention-executive dysfunction occurred in 4% and 13%, respectively, of children receiving hypothermia and those receiving usual care (P=0.19), and visuospatial dysfunction occurred in 4% and 3% (P=0.80). The rate of the combined end point of death or an IQ score of less than 70 at 6 to 7 years of age was lower among children undergoing whole-body hypothermia than among those undergoing usual care, but the differences were not significant. However, hypothermia resulted in lower death rates and did not increase rates of severe disability among survivors. (Funded by the National Institutes of Health and the Eunice Kennedy Shriver NICHD Neonatal Research Network; ClinicalTrials.gov number, NCT00005772.).

  17. Age shock: misperceptions of the impact of age on fertility before and after IVF in women who conceived after age 40

    PubMed Central

    Mac Dougall, K.; Beyene, Y.; Nachtigall, R.D.

    2013-01-01

    STUDY QUESTION What do older women understand of the relationship between age and fertility prior and subsequent to delivering their first child? SUMMARY ANSWER Women who were first-time parents over the age of 40 did not accurately perceive the relationship between age and fertility prior to conceiving with IVF. WHAT IS KNOWN ALREADY While increases in women's age at their first birth have been most pronounced in relatively older women, the rapidity of fertility decline is not appreciated by most non-infertility specialist physicians, the general public or men and women who are delaying childbearing. STUDY DESIGN, SIZE AND DURATION Qualitative retrospective interviews were conducted from 2009 to 2011 with 61 self-selected women who were patients in one of two fertility clinics in the USA. PARTICIPANTS/MATERIALS, SETTING, METHODS All participants had delivered their first child following IVF when the woman was 40 years or older. The data include women's responses to the semi-structured and open-ended interview questions ‘What information did you have about fertility and age before you started trying to get pregnant?’ and ‘What did you learn once you proceeded with fertility treatment?’ MAIN RESULTS AND THE ROLE OF CHANCE Of the women, 30% expected their fertility to decline gradually until menopause at around 50 years and 31% reported that they expected to get pregnant without difficulty at the age of 40. Reasons for a mistaken belief in robust fertility included recollections of persistent and ongoing messaging about pregnancy prevention starting in adolescence (23%), healthy lifestyle and family history of fertility (26%), and incorrect information from friends, physicians or misleading media reports of pregnancies in older celebrity women (28%). Participants had not anticipated the possibility that they would need IVF to conceive with 44% reporting being ‘shocked’ and ‘alarmed’ to discover that their understanding of the rapidity of age-related reproductive decline was inaccurate’. In retrospect, their belated recognition of the effect of age on fertility led 72% of the women to state that they felt ‘lucky’ or had ‘beaten the odds’ in successfully conceiving after IVF. Of the women, 28% advocated better fertility education earlier in life and 23% indicated that with more information about declining fertility, they might have attempted conception at an earlier age. Yet 46% of women acknowledged that even if they had possessed better information, their life circumstances would not have permitted them to begin childbearing earlier. LIMITATIONS AND REASONS FOR CAUTION Both the self-selected nature of recruitment and the retrospective design can result in biases due to memory limitations or participant assimilation and/or contrast of past events with current moods. The cohort did not reflect broad homogeneity in that the participants were much more likely to be highly educated, Caucasian and better able to pay for treatment than national population norms. As attitudes of older women who were unsuccessful after attempting IVF in their late 30s or early 40s are not represented, it is possible (if not likely) that the recollections of women who did not conceive after IVF would have been more strongly influenced by feelings of regret or efforts to deflect blame for their inability to conceive. WIDER IMPLICATIONS OF THE FINDINGS While the failure to appreciate the true biological relationship between aging and fertility may be common and may reflect inaccessibility or misinterpretation of information, it is not sufficient to explain the decades-long socio-demographic phenomenon of delayed childbearing. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the US National Institute of Child and Human Development (NICHD, RO1-HD056202). PMID:23203214

  18. Effect of randomized serum progesterone concentration on secretory endometrial histologic development and gene expression.

    PubMed

    Young, Steven L; Savaris, Ricardo F; Lessey, Bruce A; Sharkey, Andrew M; Balthazar, Ursula; Zaino, Richard J; Sherwin, Robert A; Fritz, Marc A

    2017-09-01

    What doses of secretory phase progesterone (P) in women are associated with altered endometrial structure and/or function? Consistently delayed histological maturation was seen at the lowest tested daily P dose (2.5 mg), whereas consistently altered functional response, as reflected by microarray analysis of gene expression was seen at both the 5 and 2.5 mg doses. Progesterone is absolutely required for normal embryo implantation and pregnancy survival. Progesterone supplementation is beneficial in ART cycles. In this case-control experimental trial, 46 healthy young female volunteers (age 19-34) underwent a single modeled endometrial cycle after GnRH down-regulation or monitored in natural cycles. In a university hospital, modeled cycles were obtained by GnRH agonist down-regulation, transdermal estradiol (E2) (0.2 mg/d), and daily injections of P in oil for 10 days: 2.5 mg (n = 6), 5 mg (n = 6), 10 mg (n = 12) or 40 mg (n = 12), after the 10th day of E2. Ten healthy, ovulatory women were used as controls. Endometrial biopsies were obtained on the 10th day of P exposure, or urinary LH surge (in controls). Analysis included histological dating, serum progesterone levels, microarray analysis of the whole genome, RT-PCR, western blot and comparison with the GEO database. In endometrial biopsies, a morphological delay appears in the 2.5 mg/day of P group. Higher sub-physiological levels of P (≥5 mg/day) resulted in normal histology, but aberrant gene expression. P levels required for consistent histological delay were lower than those in all ovulatory women. Gene expression abnormalities occurred at higher sub-physiological P concentrations, without a change in histology, a functional-morphological disassociation. The expression of some endometrial receptivity-associated genes appeared multiphasic, with peak or nadir of mean or median expression levels between the lowest and highest doses, suggesting sustained supraphysiological doses seen in ART treatment cycles may not be optimal. GEO DataSets ID: 200056980; GSE 56980. These results were obtained in fertile women, who may respond differently from infertile subjects. The dose of P required for normal endometrial structure (5 mg/day) corresponds to a P concentration well below that seen in ovulatory women, suggesting that persistently delayed mid-secretory histology cannot be solely due to inadequate P concentrations in an ovulatory cycle. Endometrial gene expression is differentially regulated by different doses of progesterone. The apparent multiphasic response of some genes to P dose suggests the possibility that P concentration kinetics may play a role in normal endometrial preparation for receptivity. These findings strongly confirm that histologic development is not a reliable measure of endometrial P action. Supported by The Eunice Kennedy Shriver National Institute for Child Health and Disease, National Institute of Health, USA (NICHD/NIH) (R01HD067721 and U54HD30476; SLY and BAL) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) 240239/2012-1 (RFS). All authors have no competing interests. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  19. Maternal and Neonatal Outcomes With Early Compared With Delayed Pushing Among Nulliparous Women

    PubMed Central

    Yee, Lynn M.; Sandoval, Grecio; Bailit, Jennifer; Reddy, Uma M.; Wapner, Ronald J.; Varner, Michael W.; Caritis, Steve N.; Prasad, Mona; Tita, Alan T.N.; Saade, George; Sorokin, Yoram; Rouse, Dwight J.; Blackwell, Sean C.; Tolosa, Jorge E.

    2016-01-01

    Objective To describe factors associated with delayed pushing and evaluate the relationship between delayed pushing and perinatal outcomes in nulliparous women with singleton term gestations. Methods This was a secondary analysis of NICHD Assessment of Perinatal Excellence (APEX) cohort of 115,502 women and their neonates born in 25 U.S. hospitals from 2008-2011. Nulliparous women with singleton, cephalic, nonanomalous term births who achieved 10 cm cervical dilation were included. Women in whom pushing was delayed by ≥60 minutes (delayed group) were compared with those who initiated pushing within 30 minutes (early group). Multivariable regression analyses were used to assess the independent association of delayed pushing with mode of delivery, length of second stage and other maternal and perinatal outcomes (significance defined as p<0.05). Results Of 21,034 women in the primary analysis sample, pushing was delayed in 18.4% (n=3870). Women who were older, privately insured, or non-Hispanic white, as well as those who had induction or augmentation of labor, diabetes, or epidural analgesia were more likely to have delayed pushing. Delayed pushing was more common when the second stage began during daytime hours or in hospitals with dedicated 24-hour obstetric anesthesia, although differences were small. After adjusting for differences in baseline and labor characteristics including center, women in the delayed group had longer mean durations of the second stage (191 vs. 84 min, p<0.001) and of active pushing (86 vs. 76 min, p<0.001). Delayed pushing was associated with greater rates of cesarean delivery (11.2% vs 5.1%; adjusted odds ratio [aOR] 1.86, 95% confidence interval [CI] 1.63-2.12), operative vaginal delivery (aOR 1.26, 95% CI 1.14-1.40), postpartum hemorrhage (aOR 1.43, 95% CI 1.05-1.95) and blood transfusion (aOR 1.51, 95% CI 1.04-2.17). Delayed pushing was not associated with increased odds of adverse neonatal outcomes compared with early pushing. Conclusion In this large birth cohort, delayed pushing was associated with longer second stage duration, increased odds of cesarean delivery, and increased odds of postpartum hemorrhage, but was not associated with neonatal morbidity. PMID:27741203

  20. Fibrin promotes development and function of macaque primary follicles during encapsulated three-dimensional culture.

    PubMed

    Xu, J; Lawson, M S; Yeoman, R R; Molskness, T A; Ting, A Y; Stouffer, R L; Zelinski, M B

    2013-08-01

    Does fibrin introduced into the extracellular matrix affect the growth and maturation of individual primate follicles during encapsulated three-dimensional (3D) culture? While not altering follicle survival, fibrin-alginate (FIBRIN) improves macaque primary, but not secondary, follicle development during encapsulated 3D culture in terms of growth, steroidogenesis, anti-Müllerian hormone (AMH)/vascular endothelial growth factor (VEGF) production and oocyte maturation. Efforts to grow non-human primate ovarian follicles from the secondary to the antral stage during encapsulated 3D culture have been successful. However, the growth and maturation of primary follicles in vitro has not been reported in primates, especially in chemically defined conditions. In vitro follicle maturation was investigated using the rhesus macaque (Macaca mulatta). Ovaries (n = 7 pairs) were obtained during the early follicular phase of the menstrual cycle (cycle day 1-4). Primary (80-120 µm diameter) and secondary (125-225 µm diameter) follicles were isolated mechanically, randomly assigned to experimental groups, encapsulated into alginate (0.25% w/v) or FIBRIN (25 mg/ml fibrinogen-0.25% alginate) and cultured for 13 and 5 weeks, respectively. Individual follicles were cultured in alpha minimum essential medium supplemented with FSH. Follicle survival and growth were assessed by microscopy. Follicles that reached the antral stage were treated with recombinant hCG. Metaphase II (MII) oocytes were inseminated via ICSI. Follicle morphology was evaluated by hematoxylin and eosin (H&E) staining. Immunohistochemistry was performed for cytochrome P450 family 17 subfamily A polypeptide 1 (CYP17A1) and 19 subfamily A polypeptide 1 (CYP19A1). Culture medium was analyzed for estradiol (E2) and progesterone by chemiluminescence, androstenedione (A4) by radioimmunoassay, as well as anti-Müllerian hormone (AMH) and vascular endothelial growth factor (VEGF) by enzyme-linked immunosorbent assay. A total of 105 primary and 133 secondary follicles were collected. The presence of fibrin in the alginate matrix had no effect on either primary or secondary follicle survival. Growing primary and secondary follicles formed an antrum at Weeks 9 and 3, respectively. The percentage of growing follicles was higher (P < 0.05) for primary follicles cultured in FIBRIN than alginate at Week 13. The diameters were larger for the growing secondary follicles cultured in alginate than FIBRIN at Week 5 (P < 0.05). H&E staining revealed the typical morphology for small antral follicles. CPY17A1 immunostaining was detected in theca cells, while CYP19A1 was observed in granulosa cells. E2 increased (P < 0.05) during antrum formation in growing follicles at Week 9 for primary and Week 3 for secondary follicles. AMH levels in medium from growing primary follicles increased (P < 0.05) after Week 4 with peak levels at Weeks 9-11. AMH increased (P < 0.05) in growing secondary follicles at Weeks 3-5. VEGF levels in medium were elevated (P < 0.05) in growing primary follicles at Week 9. VEGF increased (P < 0.05) in medium from growing secondary follicles at Weeks 3-5. E2, AMH and VEGF production was higher (P < 0.05) in primary follicle culture with FIBRIN than alginate alone. One primary follicle cultured in FIBRIN (1 of 5 follicles harvested) and a secondary follicle cultured in alginate alone (1 of 15 follicles harvested) yielded an MII oocyte. The fertilized oocyte from primary follicle culture arrested without cell division after fertilization, while the oocyte from secondary follicle culture cleaved and reached the morula stage. The study reports on in vitro development and function of individual macaque follicles, that is limited to the interval from the primary and secondary stage to the small antral stage. The findings await translation to human ovarian follicles. The 3D model for primate follicle development offers a unique opportunity to investigate the growth and regulation of primate primary, as well as secondary follicles, and their enclosed oocytes, as they grow to the antral stage by monitoring and manipulating factors or signaling pathways in vitro. Since primate primary follicles, in addition to secondary follicles, can be cultured to the antral stage to provide mature oocytes, they represent an additional source of pre-antral follicles for in vitro follicle maturation with the potential to provide gametes for assisted reproductive technology as an option for fertility preservation in women, including patients with cancer. This work was supported by The Oncofertility Consortium (NIH U54 RR024347-HD058294, PL1-EB008542), NIH U54-HD18185 (Eunice Kennedy Shriver Specialized Cooperative Centers Program in Reproduction and Infertility Research), NIH ORWH/NICHD 2K12HD043488 (BIRCWH), Oregon National Primate Research Center 8P51OD011092. There are no conflicts of interest.

  1. Effect of depth and duration of cooling on deaths in the NICU among neonates with hypoxic ischemic encephalopathy: a randomized clinical trial.

    PubMed

    Shankaran, Seetha; Laptook, Abbot R; Pappas, Athina; McDonald, Scott A; Das, Abhik; Tyson, Jon E; Poindexter, Brenda B; Schibler, Kurt; Bell, Edward F; Heyne, Roy J; Pedroza, Claudia; Bara, Rebecca; Van Meurs, Krisa P; Grisby, Cathy; Huitema, Carolyn M Petrie; Garg, Meena; Ehrenkranz, Richard A; Shepherd, Edward G; Chalak, Lina F; Hamrick, Shannon E G; Khan, Amir M; Reynolds, Anne Marie; Laughon, Matthew M; Truog, William E; Dysart, Kevin C; Carlo, Waldemar A; Walsh, Michele C; Watterberg, Kristi L; Higgins, Rosemary D

    Hypothermia at 33.5°C for 72 hours for neonatal hypoxic ischemic encephalopathy reduces death or disability to 44% to 55%; longer cooling and deeper cooling are neuroprotective in animal models. To determine if longer duration cooling (120 hours), deeper cooling (32.0°C), or both are superior to cooling at 33.5°C for 72 hours in neonates who are full-term with moderate or severe hypoxic ischemic encephalopathy. A randomized, 2 × 2 factorial design clinical trial performed in 18 US centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network between October 2010 and November 2013. Neonates were assigned to 4 hypothermia groups; 33.5°C for 72 hours, 32.0°C for 72 hours, 33.5°C for 120 hours, and 32.0°C for 120 hours. The primary outcome of death or disability at 18 to 22 months is ongoing. The independent data and safety monitoring committee paused the trial to evaluate safety (cardiac arrhythmia, persistent acidosis, major vessel thrombosis and bleeding, and death in the neonatal intensive care unit [NICU]) after the first 50 neonates were enrolled, then after every subsequent 25 neonates. The trial was closed for emerging safety profile and futility analysis after the eighth review with 364 neonates enrolled (of 726 planned). This report focuses on safety and NICU deaths by marginal comparisons of 72 hours' vs 120 hours' duration and 33.5°C depth vs 32.0°C depth (predefined secondary outcomes). The NICU death rates were 7 of 95 neonates (7%) for the 33.5°C for 72 hours group, 13 of 90 neonates (14%) for the 32.0°C for 72 hours group, 15 of 96 neonates (16%) for the 33.5°C for 120 hours group, and 14 of 83 neonates (17%) for the 32.0°C for 120 hours group. The adjusted risk ratio (RR) for NICU deaths for the 120 hours group vs 72 hours group was 1.37 (95% CI, 0.92-2.04) and for the 32.0°C group vs 33.5°C group was 1.24 (95% CI, 0.69-2.25). Safety outcomes were similar between the 120 hours group vs 72 hours group and the 32.0°C group vs 33.5°C group, except major bleeding occurred among 1% in the 120 hours group vs 3% in the 72 hours group (RR, 0.25 [95% CI, 0.07-0.91]). Futility analysis determined that the probability of detecting a statistically significant benefit for longer cooling, deeper cooling, or both for NICU death was less than 2%. Among neonates who were full-term with moderate or severe hypoxic ischemic encephalopathy, longer cooling, deeper cooling, or both compared with hypothermia at 33.5°C for 72 hours did not reduce NICU death. These results have implications for patient care and design of future trials. clinicaltrials.gov Identifier: NCT01192776.

  2. Effect of Depth and Duration of Cooling on Deaths in the NICU Among Neonates With Hypoxic Ischemic Encephalopathy

    PubMed Central

    Shankaran, Seetha; Laptook, Abbot R.; Pappas, Athina; McDonald, Scott. A.; Das, Abhik; Tyson, Jon E.; Poindexter, Brenda B.; Schibler, Kurt; Bell, Edward F.; Heyne, Roy J.; Pedroza, Claudia; Bara, Rebecca; Van Meurs, Krisa P.; Grisby, Cathy; Petrie Huitema, Carolyn M.; Garg, Meena; Ehrenkranz, Richard A.; Shepherd, Edward G.; Chalak, Lina F.; Hamrick, Shannon E. G.; Khan, Amir M.; Reynolds, Anne Marie; Laughon, Matthew M.; Truog, William E.; Dysart, Kevin C.; Carlo, Waldemar A.; Walsh, Michele C.; Watterberg, Kristi L.; Higgins, Rosemary D.

    2015-01-01

    IMPORTANCE Hypothermia at 33.5°C for 72 hours for neonatal hypoxic ischemic encephalopathy reduces death or disability to 44% to 55%; longer cooling and deeper cooling are neuroprotective in animal models. OBJECTIVE To determine if longer duration cooling (120 hours), deeper cooling (32.0°C), or both are superior to cooling at 33.5°C for 72 hours in neonates who are full-term with moderate or severe hypoxic ischemic encephalopathy. DESIGN, SETTING, AND PARTICIPANTS Arandomized, 2 × 2 factorial design clinical trial performed in 18 US centers in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network between October 2010 and November 2013. INTERVENTIONS Neonates were assigned to 4 hypothermia groups; 33.5°C for 72 hours, 32.0°C for 72 hours, 33.5°C for 120 hours, and 32.0°C for 120 hours. MAIN OUTCOMES AND MEASURES The primary outcome of death or disability at 18 to 22 months is ongoing. The independent data and safety monitoring committee paused the trial to evaluate safety (cardiac arrhythmia, persistent acidosis, major vessel thrombosis and bleeding, and death in the neonatal intensive care unit [NICU]) after the first 50 neonates were enrolled, then after every subsequent 25 neonates. The trial was closed for emerging safety profile and futility analysis after the eighth review with 364 neonates enrolled (of 726 planned). This report focuses on safety and NICU deaths by marginal comparisons of 72 hours’ vs 120 hours’ duration and 33.5°C depth vs 32.0°C depth (predefined secondary outcomes). RESULTS The NICU death rates were 7 of 95 neonates (7%) for the 33.5°C for 72 hours group, 13 of 90 neonates (14%) for the 32.0°C for 72 hours group, 15 of 96 neonates (16%) for the 33.5°C for 120 hours group, and 14 of 83 neonates (17%) for the 32.0°C for 120 hours group. The adjusted risk ratio (RR) for NICU deaths for the 120 hours group vs 72 hours group was 1.37 (95% CI, 0.92–2.04) and for the 32.0°C group vs 33.5°C group was 1.24 (95% CI, 0.69–2.25). Safety outcomes were similar between the 120 hours group vs 72 hours group and the 32.0°C group vs 33.5°C group, except major bleeding occurred among 1% in the 120 hours group vs 3% in the 72 hours group (RR, 0.25 [95% CI, 0.07–0.91]). Futility analysis determined that the probability of detecting a statistically significant benefit for longer cooling, deeper cooling, or both for NICU death was less than 2%. CONCLUSIONS AND RELEVANCE Among neonates who were full-term with moderate or severe hypoxic ischemic encephalopathy, longer cooling, deeper cooling, or both compared with hypothermia at 33.5°C for 72 hours did not reduce NICU death. These results have implications for patient care and design of future trials. PMID:25536254

  3. Fertility-related quality of life from two RCT cohorts with infertility: unexplained infertility and polycystic ovary syndrome

    PubMed Central

    Santoro, Nanette; Eisenberg, Esther; Trussell, J.C.; Craig, LaTasha B.; Gracia, Clarisa; Huang, Hao; Alvero, Ruben; Casson, Peter; Christman, Gregory; Coutifaris, Christos; Diamond, Michael; Jin, Susan; Legro, Richard S.; Robinson, Randal D.; Schlaff, William D.; Zhang, Heping

    2016-01-01

    STUDY QUESTION Does fertility-related quality of life (FertiQOL) differ by infertility diagnosis between women with polycystic ovary syndrome (PCOS) and their partners, compared with couples with unexplained infertility (UI)? SUMMARY ANSWER Women with PCOS report lower QOL than those with UI, whereas males with UI report lower QOL than males with PCOS partners. WHAT IS KNOWN ALREADY The fertility-specific QOL survey, FertiQOL, has been used to examine fertility-related QOL in a number of worldwide cohorts. Few data have addressed fertility-related QOL as a function of infertility diagnosis. Overall, men report better QOL than women with infertility, and there is variation in FertiQOL scores across different samples from different countries. STUDY DESIGN, SIZE, DURATION This was a prospective, cohort study derived from two concurrent, randomized clinical trials, and designed to examine QOL in infertile females with PCOS and UI at the time of enrollment compared with each other and their male partners; to compare concordance FertiQOL scores in this study across other worldwide cohorts; and to determine if baseline FertiQOL was associated with pregnancy outcome. PARTICIPANTS/MATERIALS, SETTING, METHODS Women with PCOS and their partners (n = 733 and n = 641, respectively), and couples with UI (n = 865 women and 849 men) completed a validated fertility-specific QOL survey (FertiQOL) at the time of the study screening visit. PCOS women were randomized to either clomiphene citrate or letrozole treatment; couples with UI were randomized to clomiphene citrate, letrozole or gonadotrophin plus IUI. FertiQOL results were compiled by diagnosis (PCOS or UI) and compared by diagnosis and sex using Wilcoxon Rank-Sum testing. Relationships between baseline FertiQOL and pregnancy outcomes were examined using logistic regression. Multivariable models were performed to assess the association between FertiQOL scores and key participant characteristics. MAIN RESULTS AND THE ROLE OF CHANCE Women with PCOS had lower total FertiQOL scores (72.3 ± 14.8) than those with UI (77.1 ± 12.8; P < 0.001); this was true for each domain (except Relational). These differences were largely explained by variation in BMI, hirsutism, household income and age. Women had lower overall FertiQOL scores than their male partners. Males with PCOS partners had higher scores than males with UI (84.9 ± 10.2 versus 83.3 ± 10.8; P = 0.003). Scores were not consistently associated with conception or pregnancy outcome. LIMITATIONS, REASONS FOR CAUTION The use of multiple tests of association may have resulted in spurious statistically significant findings. Inherent sociodemographic differences between women with PCOS and those with UI largely account for the lower QOL in women with PCOS. Our study was unable to assess if changes in QOL affected pregnancy outcome as FertiQOL data were collected prior to treatment. Finally, the participants for both studies represent their local communities, but are not a population-based sample and thus firm conclusions about how representative these couples are to the general population must be made with caution. WIDER IMPLICATIONS OF THE FINDINGS Women with PCOS with elevated BMI and hirsutism scores and with lower socioeconomic status may require more, targeted psychosocial support than those with other diagnoses. Possible attribution of infertility to the male partner appears to result in a lower QOL. There appears to be substantial national variation in FertiQOL scores, with US-based cohorts reporting overall higher QOL. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Grants U10 HD39005 (to M.D.), U10 HD38992 (to R.S.L.), (to C.C.), U10 HD38998 (to R.A.), U10 HD055942 (to R.D.R.), HD055944 (to P.C.), U10 HD055936 (to G.C.), U10HD055925 (to H.Z.); and U10 U54-HD29834 (to the University of Virginia Center for Research in Reproduction Ligand Assay and Analysis Core of the Specialized Cooperative Centers Program in Reproduction and Infertility Research). Most importantly, this research was made possible by the funding by American Recovery and Reinvestment Act. N.S., E.E., J.C.T., C.G., H.H., R.A., P.C., G.C., C.C., M.D., S.J., W.D.S. and H.Z. report no conflicts of interests/disclosures. L.B.C. reports research support from Ferring Pharmaceuticals and Roche Diagnostics; R.S.L. reports receipt of consulting fees from AstraZeneca, Euroscreen, Sprout Pharmaceuticals, Taken, Kindex, Clarus and Bayer, Inc., and research support from AstraZeneca and Ferring Pharmaceuticals. R.D.R. reports research support from AbbVie. TRIAL REGISTRATION NUMBER Pregnancy in Polycystic Ovary Syndrome II (PPCOS II), NCT00719186; Assessment of Multiple Intrauterine Gestations in Ovulation Stimulation (AMIGOS) NCT01044862, clinicaltrials.gov. TRIAL REGISTRATION DATE PPCOS II 17 July 2008; AMIGOS 7 January 2010. DATE OF FIRST PATIENT'S ENROLMENT PPCOS II 19 February 2009; AMIGOS 2 August 2010. PMID:27402910

  4. Fertility-related quality of life from two RCT cohorts with infertility: unexplained infertility and polycystic ovary syndrome.

    PubMed

    Santoro, Nanette; Eisenberg, Esther; Trussell, J C; Craig, LaTasha B; Gracia, Clarisa; Huang, Hao; Alvero, Ruben; Casson, Peter; Christman, Gregory; Coutifaris, Christos; Diamond, Michael; Jin, Susan; Legro, Richard S; Robinson, Randal D; Schlaff, William D; Zhang, Heping

    2016-10-01

    Does fertility-related quality of life (FertiQOL) differ by infertility diagnosis between women with polycystic ovary syndrome (PCOS) and their partners, compared with couples with unexplained infertility (UI)? Women with PCOS report lower QOL than those with UI, whereas males with UI report lower QOL than males with PCOS partners. The fertility-specific QOL survey, FertiQOL, has been used to examine fertility-related QOL in a number of worldwide cohorts. Few data have addressed fertility-related QOL as a function of infertility diagnosis. Overall, men report better QOL than women with infertility, and there is variation in FertiQOL scores across different samples from different countries. This was a prospective, cohort study derived from two concurrent, randomized clinical trials, and designed to examine QOL in infertile females with PCOS and UI at the time of enrollment compared with each other and their male partners; to compare concordance FertiQOL scores in this study across other worldwide cohorts; and to determine if baseline FertiQOL was associated with pregnancy outcome. Women with PCOS and their partners (n = 733 and n = 641, respectively), and couples with UI (n = 865 women and 849 men) completed a validated fertility-specific QOL survey (FertiQOL) at the time of the study screening visit. PCOS women were randomized to either clomiphene citrate or letrozole treatment; couples with UI were randomized to clomiphene citrate, letrozole or gonadotrophin plus IUI. FertiQOL results were compiled by diagnosis (PCOS or UI) and compared by diagnosis and sex using Wilcoxon Rank-Sum testing. Relationships between baseline FertiQOL and pregnancy outcomes were examined using logistic regression. Multivariable models were performed to assess the association between FertiQOL scores and key participant characteristics. Women with PCOS had lower total FertiQOL scores (72.3 ± 14.8) than those with UI (77.1 ± 12.8; P < 0.001); this was true for each domain (except Relational). These differences were largely explained by variation in BMI, hirsutism, household income and age. Women had lower overall FertiQOL scores than their male partners. Males with PCOS partners had higher scores than males with UI (84.9 ± 10.2 versus 83.3 ± 10.8; P = 0.003). Scores were not consistently associated with conception or pregnancy outcome. The use of multiple tests of association may have resulted in spurious statistically significant findings. Inherent sociodemographic differences between women with PCOS and those with UI largely account for the lower QOL in women with PCOS. Our study was unable to assess if changes in QOL affected pregnancy outcome as FertiQOL data were collected prior to treatment. Finally, the participants for both studies represent their local communities, but are not a population-based sample and thus firm conclusions about how representative these couples are to the general population must be made with caution. Women with PCOS with elevated BMI and hirsutism scores and with lower socioeconomic status may require more, targeted psychosocial support than those with other diagnoses. Possible attribution of infertility to the male partner appears to result in a lower QOL. There appears to be substantial national variation in FertiQOL scores, with US-based cohorts reporting overall higher QOL. This work was supported by National Institutes of Health (NIH)/Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Grants U10 HD39005 (to M.D.), U10 HD38992 (to R.S.L.), (to C.C.), U10 HD38998 (to R.A.), U10 HD055942 (to R.D.R.), HD055944 (to P.C.), U10 HD055936 (to G.C.), U10HD055925 (to H.Z.); and U10 U54-HD29834 (to the University of Virginia Center for Research in Reproduction Ligand Assay and Analysis Core of the Specialized Cooperative Centers Program in Reproduction and Infertility Research). Most importantly, this research was made possible by the funding by American Recovery and Reinvestment Act. N.S., E.E., J.C.T., C.G., H.H., R.A., P.C., G.C., C.C., M.D., S.J., W.D.S. and H.Z. report no conflicts of interests/disclosures. L.B.C. reports research support from Ferring Pharmaceuticals and Roche Diagnostics; R.S.L. reports receipt of consulting fees from AstraZeneca, Euroscreen, Sprout Pharmaceuticals, Taken, Kindex, Clarus and Bayer, Inc., and research support from AstraZeneca and Ferring Pharmaceuticals. R.D.R. reports research support from AbbVie. Pregnancy in Polycystic Ovary Syndrome II (PPCOS II), NCT00719186; Assessment of Multiple Intrauterine Gestations in Ovulation Stimulation (AMIGOS) NCT01044862, clinicaltrials.gov. PPCOS II 17 July 2008; AMIGOS 7 January 2010. PPCOS II 19 February 2009; AMIGOS 2 August 2010. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  5. Identification and replication of prediction models for ovulation, pregnancy and live birth in infertile women with polycystic ovary syndrome.

    PubMed

    Kuang, Hongying; Jin, Susan; Hansen, Karl R; Diamond, Michael P; Coutifaris, Christos; Casson, Peter; Christman, Gregory; Alvero, Ruben; Huang, Hao; Bates, G Wright; Usadi, Rebecca; Lucidi, Scott; Baker, Valerie; Santoro, Nanette; Eisenberg, Esther; Legro, Richard S; Zhang, Heping

    2015-09-01

    Can we build and validate predictive models for ovulation and pregnancy outcomes in infertile women with polycystic ovary syndrome (PCOS)? We were able to develop and validate a predictive model for pregnancy outcomes in women with PCOS using simple clinical and biochemical criteria particularly duration of attempting conception, which was the most consistent predictor among all considered factors for pregnancy outcomes. Predictive models for ovulation and pregnancy outcomes in infertile women with polycystic ovary syndrome have been reported, but such models require validation. This is a secondary analysis of the data from the Pregnancy in Polycystic Ovary Syndrome I and II (PPCOS-I and -II) trials. Both trials were double-blind, randomized clinical trials that included 626 and 750 infertile women with PCOS, respectively. PPCOS-I participants were randomized to either clomiphene citrate (CC), metformin, or their combination, and PPCOS-II participants to either letrozole or CC for up to five treatment cycles. Linear logistic regression models were fitted using treatment, BMI, and other published variables as predictors of ovulation, conception, clinical pregnancy, and live birth as the outcome one at a time. We first evaluated previously reported significant predictors, and then constructed new prediction models. Receiver operating characteristic (ROC) curves were constructed and the area under the curves (AUCs) was calculated to compare performance using different models and data. Chi-square tests were used to examine the goodness-of-fit and prediction power of logistic regression model. Predictive factors were similar between PPCOS-I and II, but the two participant samples differed statistically significantly but the differences were clinically minor on key baseline characteristics and hormone levels. Women in PPCOS-II had an overall more severe PCOS phenotype than women in PPCOS-I. The clinically minor but statistically significant differences may be due to the large sample sizes. Younger age, lower baseline free androgen index and insulin, shorter duration of attempting conception, and higher baseline sex hormone-binding globulin significantly predicted at least one pregnancy outcome. The ROC curves (with AUCs of 0.66-0.76) and calibration plots and chi-square tests indicated stable predictive power of the identified variables (P-values ≥0.07 for all goodness-of-fit and validation tests). This is a secondary analysis. Although our primary objective was to confirm previously reported results and identify new predictors of ovulation and pregnancy outcomes among PPCOS-II participants, our approach is exploratory and warrants further replication. We have largely confirmed the predictors that were identified in the PPCOS-I trial. However, we have also revealed new predictors, particularly the role of smoking. While a history of ever smoking was not a significant predictor for live birth, a closer look at current, quit, and never smoking revealed that current smoking was a significant risk factor. The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Grants U10 HD27049, U10 HD38992, U10HD055925, U10 HD39005, U10 HD33172, U10 HD38998, U10 HD055936, U10 HD055942, and U10 HD055944; and U54-HD29834. Heilongjiang University of Chinese Medicine Grants 051277 and B201005. R.S.L. reports receiving consulting fees from Euroscreen, AstraZeneca, Clarus Therapeutics, and Takeda, and grant support from Ferring, Astra Zeneca, and Toba. K.R.H. reports receiving grant support from Roche Diagnostics and Ferring Pharmascience. G.C. reports receiving Honorarium and grant support from Abbvie Pharmaceuticals and Bayer Pharmaceuticals. M.P.D. holds equity from Advanced Reproductive Care Inc. and DS Biotech, receives fees from Advanced Reproductive Care Inc., Actamax, Auxogyn, ZSX Medical, Halt Medical, and Neomed, and receives grant support from Boehringer-Ingelheim, Abbott, and BioSante, Ferring Pharmaceuticals, and EMD Serono. H.Z. receives research support from the Chinese 1000-scholar plan. Others report no disclosures other than NIH grant support. PPCOS-I and -II were respectively registered at Clinicaltrials.gov: NCT00719186 and NCT00719186. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Chronic hyperandrogenemia and western-style diet beginning at puberty reduces fertility and increases metabolic dysfunction during pregnancy in young adult, female macaques.

    PubMed

    Bishop, C V; Stouffer, R L; Takahashi, D L; Mishler, E C; Wilcox, M C; Slayden, O D; True, C A

    2018-04-01

    What are the impacts of elevated testosterone (T) and an obesogenic western-style diet (WSD), either independently or together, on fertility and metabolic adaptations of pregnancy in primates? Testosterone increases the time to achieve pregnancy, while a WSD reduces overall fertility, and the combination of testosterone and WSD additionally impairs glucose tolerance and causes pregnancy loss. Both hyperandrogenemia and obesity are hallmarks of polycystic ovary syndrome, which is a leading cause of infertility among women worldwide. Female macaques receiving T and WSD beginning at puberty show increased metabolic, ovarian and uterine dysfunction in the non-pregnant state by 3 years of treatment. The same cohort of female rhesus macaques continued treatments from the time of puberty (2.5 years) to 4 years, including this fertility trial. There were four groups (n = 9-10/group): controls (C), T-treated (T; average total serum level 1.35 ng/ml), WSD-treated, and combined T and WSD-treated (T + WSD) females. Females, which were typically having menstrual cycles, were paired for 4 days with a proven male breeder following the late follicular rise in circulating estradiol (≥100 pg/ml). The presence of sperm in the reproductive tract was used to confirm mating. Animals went through up to three successive rounds of mating until they became pregnant, as confirmed by a rise in circulating mCG during the late luteal phase and ultrasound evidence of a gestational sac at Day 30 post-mating (GD30). Placental vascular parameters were also measured at GD30. Metabolic measurements consisted of fasting levels of blood glucose and insulin at approximately GD30, 60, 90 and 115, as well as an intravenous (iv) glucose tolerance test (GTT) at GD115. While all animals in the C and T groups eventually became pregnant, T-treated females on average had a greater interval to achieve pregnancy (P < 0.05). However, only ~70% of animals in the WSD and T + WSD groups became pregnant (P < 0.004). One pregnancy in T + WSD group resulted in an anembryonic pregnancy which miscarried around GD60, while another T + WSD female conceived with a rare identical twin pregnancy which required cessation due to impending fetal loss at GD106. Thus, the number of viable fetuses was less in the T + WSD group, compared to C, T or WSD. Placental blood volume at GD30 was reduced in all treatments compared to the C group (P < 0.05). Maternal P4 levels were elevated in the WSD (P < 0.03) group and E2 levels were elevated in T + WSD animals (P < 0.05). An increase in serum A4 levels throughout gestation was observed in all groups (P < 0.03) except WSD (P = 0.3). All groups displayed increased insulin resistance with pregnancy, as measured from the ivGTT during pregnancy. However, only the T + WSD group had a significant increase in fasting glucose levels and glucose clearance during the GTT indicating a worsened glucose tolerance. WSD treatment decreased female fetuses third trimester weights, but there was an interaction between WSD and T to increase female fetal weight when normalized to maternal weight. N/A. The small number of pregnancies in the WSD and T + WSD groups hampers the ability to make definitive conclusions on effects during gestation. Also, the high fertility rate in the controls indicates the cohort was at their breeding prime age, which may impair the ability to observe subtle fertility defects. The low number of fetuses used for male and female analysis requires additional studies. The current findings strongly suggest that both hyperandrogenemia and obesity have detrimental effects on fertility and gestation in primates, which may be directly relevant to women with polycystic ovary syndrome. All ONPRC Cores and Units were supported by NIH Grant P51 OD011092 awarded to ONPRC. Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) of the National Institutes of Health (NIH) under Award Number P50HD071836 (to R.L.S.). The authors have no competing conflict of interests to disclose.

  7. Chronic hyperandrogenemia in the presence and absence of a western-style diet impairs ovarian and uterine structure/function in young adult rhesus monkeys.

    PubMed

    Bishop, Cecily V; Mishler, Emily C; Takahashi, Diana L; Reiter, Taylor E; Bond, Kise R; True, Cadence A; Slayden, Ov D; Stouffer, Richard L

    2018-01-01

    Does chronic hyperandrogenemia beginning at menarche, in the absence and presence of a western-style diet (WSD), alter ovarian and uterine structure-function in young adult rhesus monkeys? Phenotypic alterations in ovarian and uterine structure/function were induced by exogenous testosterone (T), and compounded in the presence of a WSD (T+WSD). Hyperandrogenemia is a well-established component of PCOS and is observed in adolescent girls, indicating a potential pubertal onset of disease symptoms. Obesity is often associated with hyperandrogenemia and it is hypothesized that metabolic dysfunction exacerbates PCOS symptoms. Macaque females (n = 40) near the onset of menarche (~2.5 years of age) were assigned to a 2 by 2 factorial cohort design. Effects on reproductive characteristics were evaluated after 3 years of treatment. Rhesus macaques (Macaca mulatta) were fed either a normal balanced diet (n = 20) or a WSD (n = 20). Additionally, implants containing cholesterol (n = 20) or T (n = 20) were implanted subcutaneously to elevate serum T approximately 5-fold. This resulted in treatment groups of controls (C), T, WSD and T+WSD (n = 10/group). Vaginal swabbing was performed daily to detect menses. After 3 years of treatment, daily serum samples from one menstrual cycle were assayed for hormone levels. Ovarian structure was evaluated in the early follicular phase by 3D/4D ultrasound. Uterine endometrial size and ovarian/luteal vascular function was also evaluated in subgroups (n = 6/group) in the late follicular and mid-luteal phases by 3D/4D ultrasound and contrast-enhanced ultrasound, respectively. Expression of steroid hormone receptors and markers of decidualization and endometrial receptivity were assessed in endometrial biopsies at mid-luteal phase. Approximately 90% of menstrual cycles appeared ovulatory with no differences in frequency or duration between groups. Serum estradiol (E2) levels during the early follicular phase were greatest in the T alone group, but reduced in T+WSD (P < 0.02). Serum LH was elevated in the T group (P < 0.04); however, there were no differences among groups in FSH levels (P > 0.13). Ovarian size at menses tended to be greater in the WSD groups (P < 0.07) and antral follicles ≥1 mm were more numerous in the T+WSD group (P < 0.05). Also, females in T and T+WSD groups displayed polycystic ovarian morphology (PCOM) at greater frequency than C or WSD groups (P < 0.01). Progesterone (P4) levels during the luteal phase were reduced in the T+WSD group compared to C and T groups (P < 0.05). Blood volume (BV) and vascular flow (VF) within the corpus luteum was reduced in all treatment groups compared to C (P < 0.01, P = 0.03), with the WSD alone group displaying the slowest BV and VF (P < 0.05). C and WSD groups displayed endometrial glands at mid-luteal phase with low estrogen receptor 1 (ESR1) and progesterone receptor (PGR) mRNA and immunohistochemical staining in the functionalis zone, but appreciable PGR in the stroma. In contrast, T and T+WSD treatment resulted in glands with less secretory morphology, high ESR1 expression in the glandular epithelium and low PGR in the stroma. Endometrial levels of TIMP3 and MMP26 mRNA and immunostaining were also decreased in the T and T+WSD groups, whereas AR expression was unchanged. None. Females are young adults, so effects could change as they reach prime reproductive age. The T level generated for hyperandrogenemia may be somewhat greater than the 3-4-fold increase observed in adolescent girls, but markedly less than those observed in male monkeys or adolescent boys. Alterations to ovarian and uterine structure-function observed in T and, in particular, T+WSD-treated female macaques are consistent with some of the features observed in women diagnosed with polycystic ovary syndrome (PCOS), and suggest impaired fertility. Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD) of the National Institutes of Health (NIH) under Award Number P50HD071836 (to RLS). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. Additional funding was provided by Office of the Director, NIH under Award Number P51OD011092 (Support for National Primate Research Center). Authors declare no competing interests. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

  8. First-Year Maternal Employment and Child Development in the First Seven Years.

    PubMed

    Brooks-Gunn, Jeanne; Han, Wen-Jui; Waldfogel, Jane

    2010-08-01

    Using data from the first 2 phases of the NICHD Study of Early Child Care, we examine the links between maternal employment in the first 12 months of life and cognitive, social, and emotional outcomes for children at age 3, age 4½, and first grade. Drawing on theory and prior research from developmental psychology as well as economics and sociology, we address three main questions. First, what associations exist between first-year maternal employment and cognitive, social, and emotional outcomes for children over the first seven years of life? Second, to what extent do any such associations vary by the child's gender and temperament, or the mother's occupation? Third, to what extent do mother's earnings, the home environment (maternal depressive symptoms, sensitivity, and HOME scores), and the type and quality of child care mediate or offset any associations between first-year employment and child outcomes, and what is the net effect of first-year maternal employment once these factors are taken into account? We compare families in which mothers worked full time (55%), part time (23%), or did not work (22%) in the first year for non-Hispanic white children (N=900) and for African-American children (N=113). Comparisons are also made taking into account the timing of mothers' employment within the first year. A rich set of control variables are included. OLS and SEM analyses are constructed. With regard to cognitive outcomes, first, we find that full-time maternal employment in the first 12 months of life (but not part-time employment) is associated with significantly lower scores on some, but not all, measures of cognitive development at age 3, 4 ½, and first grade for non-Hispanic white children, but with no significant associations for the small sample of African-American children Part-time employment in the first year is associated with higher scores than full-time employment for some measures. Employment in the second and third year of life is not associated with the cognitive outcomes. Second, we examine the role of the child's gender and temperament and the mother's occupation in moderating the associations between first-year maternal employment and cognitive outcomes, but find few significant interactions for either child characteristics or mother's occupation. Third, we examine the role of an extensive set of potential mediators - the mother's earnings, the home environment, and the type and quality of child care. We find that mothers who worked full time have higher income in the first year of life and thereafter, that mothers who worked part time have higher HOME and maternal sensitivity scores than mothers who did not work or worked full time, and that mothers who worked either full time or part time were more likely to place their children in high-quality child care by age 3 and 4 ½ and their children spent more time in center-based care by age 4 ½ than in families where mothers did not work in the first year of life. However, we also find some links between first-year maternal employment and elevated levels of maternal depressive symptoms thereafter. Turning to results from structural equation modeling, we find that the overall effects of first-year maternal employment on the cognitive outcomes are neutral. This occurs because significantly negative direct effects of full-time first-year employment are offset by significantly positive indirect effects working through more use of center-based care and greater maternal sensitivity by age 4 ½. Regarding social and emotional outcomes, several findings, again limited to non-Hispanic white children, stand out. First, we find no significant associations between first-year maternal employment and later social and emotional outcomes (including attachment security) when comparing children whose mothers worked full-time or part-time in the first year with the reference group of children whose mothers did not work in the first year, although in models that take the timing of employment within the first year into account, we find some significant associations between full-time maternal employment in the first year and higher levels of caregiver- or teacher-reported externalizing problems at age 4 ½ and first grade. Second, part-time maternal employment by 12 months tends to be associated with fewer externalizing problems at age 4 ½ and first grade than full time maternal employment by 12 months. These results are unchanged when we allow for the possibility of moderation by child characteristics or maternal occupation. Third, the results from SEM models indicate that, while neither full-time nor part-time first-year employment has significant total effects on children's externalizing behavior problems at age 4 ½ or first grade, part-time first-year employment has indirect positive effects, working primarily through differences in the home environment and maternal sensitivity. Another important finding from the SEM models is that center-based care, which is often associated with maternal employment, is not significantly associated with elevated levels of child behavior problems. Taken together, our findings provide new insight as to the net effects of first-year maternal employment as well as the potential pathways through which associations between first-year maternal employment and later child outcomes, where present, come about. Our SEM results indicate that, on average, the associations between first-year maternal employment and later cognitive, social, and emotional outcomes are neutral, because negative effects, where present, are offset by positive effects. These results confirm that maternal employment in the first year of life may confer both advantages and disadvantages and that for the average non-Hispanic white child, those effects balance each other.

  9. First-Year Maternal Employment and Child Development in the First Seven Years

    PubMed Central

    Brooks-Gunn, Jeanne; Han, Wen-Jui; Waldfogel, Jane

    2010-01-01

    Using data from the first 2 phases of the NICHD Study of Early Child Care, we examine the links between maternal employment in the first 12 months of life and cognitive, social, and emotional outcomes for children at age 3, age 4½, and first grade. Drawing on theory and prior research from developmental psychology as well as economics and sociology, we address three main questions. First, what associations exist between first-year maternal employment and cognitive, social, and emotional outcomes for children over the first seven years of life? Second, to what extent do any such associations vary by the child’s gender and temperament, or the mother’s occupation? Third, to what extent do mother’s earnings, the home environment (maternal depressive symptoms, sensitivity, and HOME scores), and the type and quality of child care mediate or offset any associations between first-year employment and child outcomes, and what is the net effect of first-year maternal employment once these factors are taken into account? We compare families in which mothers worked full time (55%), part time (23%), or did not work (22%) in the first year for non-Hispanic white children (N=900) and for African-American children (N=113). Comparisons are also made taking into account the timing of mothers’ employment within the first year. A rich set of control variables are included. OLS and SEM analyses are constructed. With regard to cognitive outcomes, first, we find that full-time maternal employment in the first 12 months of life (but not part-time employment) is associated with significantly lower scores on some, but not all, measures of cognitive development at age 3, 4 ½, and first grade for non-Hispanic white children, but with no significant associations for the small sample of African-American children Part-time employment in the first year is associated with higher scores than full-time employment for some measures. Employment in the second and third year of life is not associated with the cognitive outcomes. Second, we examine the role of the child’s gender and temperament and the mother’s occupation in moderating the associations between first-year maternal employment and cognitive outcomes, but find few significant interactions for either child characteristics or mother’s occupation. Third, we examine the role of an extensive set of potential mediators – the mother’s earnings, the home environment, and the type and quality of child care. We find that mothers who worked full time have higher income in the first year of life and thereafter, that mothers who worked part time have higher HOME and maternal sensitivity scores than mothers who did not work or worked full time, and that mothers who worked either full time or part time were more likely to place their children in high-quality child care by age 3 and 4 ½ and their children spent more time in center-based care by age 4 ½ than in families where mothers did not work in the first year of life. However, we also find some links between first-year maternal employment and elevated levels of maternal depressive symptoms thereafter. Turning to results from structural equation modeling, we find that the overall effects of first-year maternal employment on the cognitive outcomes are neutral. This occurs because significantly negative direct effects of full-time first-year employment are offset by significantly positive indirect effects working through more use of center-based care and greater maternal sensitivity by age 4 ½. Regarding social and emotional outcomes, several findings, again limited to non-Hispanic white children, stand out. First, we find no significant associations between first-year maternal employment and later social and emotional outcomes (including attachment security) when comparing children whose mothers worked full-time or part-time in the first year with the reference group of children whose mothers did not work in the first year, although in models that take the timing of employment within the first year into account, we find some significant associations between full-time maternal employment in the first year and higher levels of caregiver- or teacher-reported externalizing problems at age 4 ½ and first grade. Second, part-time maternal employment by 12 months tends to be associated with fewer externalizing problems at age 4 ½ and first grade than full time maternal employment by 12 months. These results are unchanged when we allow for the possibility of moderation by child characteristics or maternal occupation. Third, the results from SEM models indicate that, while neither full-time nor part-time first-year employment has significant total effects on children’s externalizing behavior problems at age 4 ½ or first grade, part-time first-year employment has indirect positive effects, working primarily through differences in the home environment and maternal sensitivity. Another important finding from the SEM models is that center-based care, which is often associated with maternal employment, is not significantly associated with elevated levels of child behavior problems. Taken together, our findings provide new insight as to the net effects of first-year maternal employment as well as the potential pathways through which associations between first-year maternal employment and later child outcomes, where present, come about. Our SEM results indicate that, on average, the associations between first-year maternal employment and later cognitive, social, and emotional outcomes are neutral, because negative effects, where present, are offset by positive effects. These results confirm that maternal employment in the first year of life may confer both advantages and disadvantages and that for the average non-Hispanic white child, those effects balance each other. PMID:25152543

  10. Antiphospholipid antibody-induced miR-146a-3p drives trophoblast interleukin-8 secretion through activation of Toll-like receptor 8.

    PubMed

    Gysler, Stefan M; Mulla, Melissa J; Guerra, Marta; Brosens, Jan J; Salmon, Jane E; Chamley, Lawrence W; Abrahams, Vikki M

    2016-07-01

    What is the role of microRNAs (miRs) in antiphospholipid antibody (aPL)-induced trophoblast inflammation? aPL-induced up-regulation of trophoblast miR-146a-3p is mediated by Toll-like receptor 4 (TLR4), and miR-146a-3p in turn drives the cells to secrete interleukin (IL)-8 by activating the RNA sensor, TLR8. Obstetric antiphospholipid syndrome (APS) is an autoimmune disorder characterized by circulating aPL and an increased risk of pregnancy complications. We previously showed that aPL recognizing beta2 glycoprotein I (β2GPI) elicit human first trimester trophoblast secretion of IL-8 by activating TLR4. Since some miRs control TLR responses, their regulation in trophoblast cells by aPL and functional role in the aPL-mediated inflammatory response was investigated. miRs can be released from cells via exosomes, and therefore, miR exosome expression was also examined. A panel of miRs was selected based on their involvement with TLR signaling: miR-9; miR-146a-5p and its isomiR, miR-146a-3p; miR-155, miR-210; and Let-7c. Since certain miRs can activate the RNA sensor, TLR8, this was also investigated. For in vitro studies, the human first trimester extravillous trophoblast cell line, HTR8 was studied. HTR8 cells transfected to express a TLR8 dominant negative (DN) were also used. Plasma was evaluated from pregnant women who have aPL, either with or without systemic lupus erythematous (SLE) (n = 39); SLE patients without aPL (n = 30); and healthy pregnant controls (n = 20). Trophoblast HTR8 wildtype and TLR8-DN cells were incubated with or without aPL (mouse anti-human β2GPI mAb) for 48-72 h. HTR8 cells were also treated with or without aPL in the presence and the absence of a TLR4 antagonist (lipopolysaccharide from Rhodobacter sphaeroides; LPS-RS), specific miR inhibitors or specific miR mimics. miR expression levels in trophoblast cells, trophoblast-derived exosomes and exosomes isolated from patient plasma were measured by qPCR. Trophoblast IL-8 secretion was measured by ELISA. aPL significantly increased trophoblast cellular and exosome expression of miR-146a-5p, miR-146a-3p, miR-155 and miR-210. aPL-induced up-regulation of trophoblast miR-146a-5p, miR-146a-3p and miR-210, but not miR-155, was inhibited by the TLR4 antagonist, LPS-RS. While inhibition or overexpression of miR-146a-5p had no effect on aPL-induced trophoblast IL-8 secretion, miR-146a-3p inhibition significantly reduced this response. aPL-induced trophoblast IL-8 secretion was inhibited by the presence of the TLR8-DN. In the absence of aPL, transfection of trophoblast cells with a miR-146a-3p mimic significantly increased IL-8 secretion and this was inhibited by the presence of the TLR8-DN. Patients with aPL and adverse pregnancy outcomes (APOs) expressed significantly higher levels of circulating miR-146a-3p compared with healthy pregnant controls with no pregnancy complications (P < 0.05). While the enrichment of miR-146a-3p in trophoblast-derived exosomes support the role of this miR acting in a paracrine or endocrine manner through exosome delivery, this has not been demonstrated. However, miR-146a-3p may also exert its pro-inflammatory effect intracellularly within the same trophoblast cell targeted by aPL. These findings provide a novel mechanism of trophoblast inflammation through miRs activating RNA-sensing receptors. Furthermore, circulating exosomal-associated miR-146a-3p in APS patients may serve clinically as a biomarker for related APOs. This study was supported in part by grants from the American Heart Association (#10GRNT3640032 to V.M.A.), the March of Dimes Foundation (Gene Discovery and Translational Research Grant #6-FY12-255 to V.M.A.), NICHD, NIH (R01HD049446 to V.M.A.), the Gina M. Finzi Memorial Student Summer Fellowship from the Lupus Foundation of America (to S.M.G.), and the Yale University School of Medicine Medical Student Fellowship (to S.M.G.). The authors declare no competing financial interests. N/A. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. Universities' Role in Regional Development: A Case Study of University for Development Studies, Ghana

    ERIC Educational Resources Information Center

    Abonyi, Usman Kojo

    2016-01-01

    This study, employing an interpretive research paradigm, sought to investigate into how University for Development Studies (UDS) is responding to its regional development mandate with a specific focus on how it is responding to human capital development, innovation capabilities, and social and environmental development in northern Ghana. A study…

  12. Making Their Own Path: Preservice Teachers' Development of Purpose in Social Studies Teacher Education

    ERIC Educational Resources Information Center

    Hawley, Todd S.; Crowe, Alicia R.

    2016-01-01

    Despite a solid body of research on rationale development in social studies teacher education, little research exists exploring how social studies preservice teachers' purposes develop over time. This article presents four examples of social studies preservice teachers as they grappled with developing a purpose for teaching social studies.…

  13. 24 CFR 570.415 - Community Development Work Study Program.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 3 2011-04-01 2010-04-01 true Community Development Work Study... Grants § 570.415 Community Development Work Study Program. (a) Applicability and objectives. HUD makes... students who participate in a work study program while enrolled in full-time graduate programs in community...

  14. Do We Need a National Standards-Based K-12 Deaf Studies Curriculum? An Analytic History of Trends and Discourse in Development of Deaf Studies Curriculum

    ERIC Educational Resources Information Center

    Zernovoj, Alexander

    2007-01-01

    This study provides a complete review of discussion and development leading up to the current trends in Deaf Studies curriculum development, and also analyzes existing known curriculum (or curriculum-like) materials to help inform development of an ideal standards-based Deaf Studies curriculum. The common shared arguments identified in this…

  15. Developing the role of the healthcare assistant.

    PubMed

    Hancock, H; Campbell, S

    Two studies are described in this article. The first evaluated the preparedness of healthcare assistants (HCAs) to develop a new role and attend an HCA development programme. The second examined the impact of one NHS trust's HCA development programme on the role of the HCA, on other members of the multidisciplinary team and on patients. The research methodology was qualitative and inductive, using a naturalistic approach in both studies, and a 360 degree model of assessment and feedback in study two. For both studies, the data were analysed following the principles of thematic analysis. Findings Eight out of 12 HCAs in study one were prepared to attend the programme and to develop their role. Study two indicated a positive but restricted impact of the HCA development programme on the HCAs' role, that of other healthcare professionals and on patient care. The findings have implications for role development in the NHS and for the development of programmes that aim to address these changes. The HCA development programme has been reviewed and extended, and strategies to promote and support role development in the clinical setting have been introduced in the trust where the research was conducted.

  16. Evaluation of the Professional Development Program on Web Based Content Development

    ERIC Educational Resources Information Center

    Yurdakul, Bünyamin; Uslu, Öner; Çakar, Esra; Yildiz, Derya G.

    2014-01-01

    The aim of this study is to evaluate the professional development program on web based content development (WBCD) designed by the Ministry of National Education (MoNE). Based on the theoretical CIPP model by Stufflebeam and Guskey's levels of evaluation, the study was carried out as a case study. The study group consisted of the courses that…

  17. STEM professional development: What's going on from the presenters' and participants' perspectives?

    NASA Astrophysics Data System (ADS)

    Williams, Randi

    This study was designed to explore elementary STEM professional development viewed from the presenters' and participants' perspectives. Numerous committees and educational organizations recommend investing in STEM professional development at the local, state, and national level. This investment must begin with research that inquires how STEM professional development is structured and what is needed for teacher and student success. Since there is a recent STEM education push in schools, elementary teachers need effective professional development in order to gain the necessary content, skills, confidence, and pedagogy required for those changing demands. This qualitative study embraced. Yin's case study methodology by observing short-duration STEM professional development for elementary teachers within a large metropolitan school system and an educational professional development agency. The study discussed the analysis and findings in the context of Bandura's sources of efficacy and Desimone's critical features of professional development. Data were gathered form professional development observations, presenter interviews, and participant interviews. The research questions for this study included: (a) based on Desimone's (2009) framework for professional development, what does content focused, active learning, coherence, duration, and collective participation look like in initial STEM professional development for elementary teachers? (b) are Bandura's (1997) four sources of self- efficacy: mastery experiences, vicarious experiences, social persuasion, and affective states evidenced within the short duration professional development? and (c) how do these two frameworks align between presenter and participant thoughts and actions? This study uncovered additional sources of efficacy are present in short-duration STEM professional development. These found sources include coherence, content, and active learning delivered in a definitive order. The findings of this study have implications for educators, policy makers, and developers of professional development. Future research is needed to add to the small body of literature about STEM professional development, specifically research to fully understand the structure of STEM professional development and how this differs for other areas of learning.

  18. Management Development Study.

    ERIC Educational Resources Information Center

    Department of Transportation, Washington, DC.

    This document reports on a management development study within the Department of Transportation (DOT). The aim of the study was to develop a systematic approach to management development for military and civilian personnel. A variety of methods was used to gather data including having DOT staff members gather the information to be passed on to the…

  19. Shaping Professional Development to Promote the Diffusion of Instructional Expertise among Teachers

    ERIC Educational Resources Information Center

    Sun, Min; Penuel, William R.; Frank, Kenneth A.; Gallagher, H. Alix; Youngs, Peter

    2013-01-01

    This study examines how high-quality professional development can promote the diffusion of effective teaching strategies among teachers through collaboration. Drawing on longitudinal and sociometric data from a study of writing professional development in 39 schools, this study shows that teachers' participation in professional development is…

  20. Community College Student Perceptions Regarding Personal Development during a Study Abroad Program According to Arthur Chickering's Seven Vectors of Student Development

    ERIC Educational Resources Information Center

    Blahusiak, Katarzyna

    2012-01-01

    This qualitative study explored community college student development during a study abroad program. The main research question was: How do community college students perceive the impact of participation in a study abroad program on their personal development? In addition, there were seven follow-up questions generated to understand students'…

  1. Interpretation in Historical Writing: The Study of Development in Librarianship.

    ERIC Educational Resources Information Center

    Colson, John Calvin

    Study of the development of libraries and librarianship may be done only historically, by analysis of the records of development. Such study necessarily is interpretive because historical study does not establish facts, but proceeds from them. In historical study an hypothesis may not be used as in scientific study, because the hypothesis is not…

  2. Annotation: Development of facial expression recognition from childhood to adolescence: behavioural and neurological perspectives.

    PubMed

    Herba, Catherine; Phillips, Mary

    2004-10-01

    Intact emotion processing is critical for normal emotional development. Recent advances in neuroimaging have facilitated the examination of brain development, and have allowed for the exploration of the relationships between the development of emotion processing abilities, and that of associated neural systems. A literature review was performed of published studies examining the development of emotion expression recognition in normal children and psychiatric populations, and of the development of neural systems important for emotion processing. Few studies have explored the development of emotion expression recognition throughout childhood and adolescence. Behavioural studies suggest continued development throughout childhood and adolescence (reflected by accuracy scores and speed of processing), which varies according to the category of emotion displayed. Factors such as sex, socio-economic status, and verbal ability may also affect this development. Functional neuroimaging studies in adults highlight the role of the amygdala in emotion processing. Results of the few neuroimaging studies in children have focused on the role of the amygdala in the recognition of fearful expressions. Although results are inconsistent, they provide evidence throughout childhood and adolescence for the continued development of and sex differences in amygdalar function in response to fearful expressions. Studies exploring emotion expression recognition in psychiatric populations of children and adolescents suggest deficits that are specific to the type of disorder and to the emotion displayed. Results from behavioural and neuroimaging studies indicate continued development of emotion expression recognition and neural regions important for this process throughout childhood and adolescence. Methodological inconsistencies and disparate findings make any conclusion difficult, however. Further studies are required examining the relationship between the development of emotion expression recognition and that of underlying neural systems, in particular subcortical and prefrontal cortical structures. These will inform understanding of the neural bases of normal and abnormal emotional development, and aid the development of earlier interventions for children and adolescents with psychiatric disorders.

  3. Service impact of a national clinical leadership development programme: findings from a qualitative study.

    PubMed

    Fealy, Gerard M; McNamara, Martin S; Casey, Mary; O'Connor, Tom; Patton, Declan; Doyle, Louise; Quinlan, Christina

    2015-04-01

    The study reported here was part of a larger study, which evaluated a national clinical leadership development programme with reference to resources, participant experiences, participant outcomes and service impact. The aim of the present study was to evaluate the programme's service impact. Clinical leadership development develops competencies that are expressed in context. The outcomes of clinical leadership development occur at individual, departmental and organisational levels. The methods used to evaluate the service impact were focus groups, group interviews and individual interviews. Seventy participants provided data in 18 separate qualitative data collection events. The data contained numerous accounts of service development activities, initiated by programme participants, which improved service and/or improved the culture of the work setting. Clinical leadership development programmes that incorporate a deliberate service impact element can result in identifiable positive service outcomes. The nuanced relationship between leader development and service development warrants further investigation. This study demonstrates that clinical leadership development can impact on service in distinct and identifiable ways. Clinical leadership development programmes should focus on the setting in which the leadership competencies will be demonstrated. © 2013 John Wiley & Sons Ltd.

  4. Model development of production management unit to enhance entrepreneurship attitude of vocational school students from fashion department

    NASA Astrophysics Data System (ADS)

    Sumaryani, Sri

    2018-03-01

    The purpose of this study is to develop a model of production management unit to enhance entrepreneurship attitude of vocational school students from fashion department. This study concerns in developing students' entrepreneurship attitude in management which includes planning, organizing, applying and evaluation. The study uses Research and Development (R & D) approach with three main steps; preliminary study, development step, and product validation. Research subject was vocational school teachers from fashion department in Semarang, Salatiga and Demak. This study yields a development model of production management unit that could enhance vocational school students' entrepreneurship attitude in fashion department. The result shows that research subjects have understood about of production management unit in Vocational School (SMK).

  5. Launcher Systems Development Cost: Behavior, Uncertainty, Influences, Barriers and Strategies for Reduction

    NASA Technical Reports Server (NTRS)

    Shaw, Eric J.

    2001-01-01

    This paper will report on the activities of the IAA Launcher Systems Economics Working Group in preparations for its Launcher Systems Development Cost Behavior Study. The Study goals include: improve launcher system and other space system parametric cost analysis accuracy; improve launcher system and other space system cost analysis credibility; and provide launcher system and technology development program managers and other decisionmakers with useful information on development cost impacts of their decisions. The Working Group plans to explore at least the following five areas in the Study: define and explain development cost behavior terms and concepts for use in the Study; identify and quantify sources of development cost and cost estimating uncertainty; identify and quantify significant influences on development cost behavior; identify common barriers to development cost understanding and reduction; and recommend practical, realistic strategies to accomplish reductions in launcher system development cost.

  6. Instructional Technology Professional Development Evaluation: Developing a High Quality Model

    ERIC Educational Resources Information Center

    Gaytan, Jorge A.; McEwen, Beryl C.

    2010-01-01

    Background: The literature contains very few studies that focused on evaluating the impact of professional development activities on student learning. And, many of these studies failed to determine whether the professional development activities met their primary goal--to improve the learning process. Purpose: The purpose of this study was to use…

  7. Development of e-Career Guidance Programme for Secondary Schools in Akwa Ibom State

    ERIC Educational Resources Information Center

    John, Imitoro E.; Udofia, Nsikak-Abasi; Udoh, Nsisong A.; Anagbogu, Mercy A.

    2016-01-01

    This study developed and field tested an electronic career guidance package for secondary schools, the e-Career Guidance System. The study was an educational research and development study and thus utilised the instrumentation research design. The formative evaluation of the developed programme was carried out using the pretest-posttest…

  8. The Development of Professional Learning Community in Primary Schools

    ERIC Educational Resources Information Center

    Sompong, Samoot; Erawan, Prawit; Dharm-tad-sa-na-non, Sudharm

    2015-01-01

    The objectives of this research are: (1) To study the current situation and need for developing professional learning community in primary schools; (2) To develop the model for developing professional learning community, and (3) To study the findings of development for professional learning community based on developed model related to knowledge,…

  9. Understanding the Development of a Hybrid Practice of Inquiry-Based Science Instruction and Language Development: A Case Study of One Teacher's Journey Through Reflections on Classroom Practice

    NASA Astrophysics Data System (ADS)

    Capitelli, Sarah; Hooper, Paula; Rankin, Lynn; Austin, Marilyn; Caven, Gennifer

    2016-04-01

    This qualitative case study looks closely at an elementary teacher who participated in professional development experiences that helped her develop a hybrid practice of using inquiry-based science to teach both science content and English language development (ELD) to her students, many of whom are English language learners (ELLs). This case study examines the teacher's reflections on her teaching and her students' learning as she engaged her students in science learning and supported their developing language skills. It explicates the professional learning experiences that supported the development of this hybrid practice. Closely examining the pedagogical practice and reflections of a teacher who is developing an inquiry-based approach to both science learning and language development can provide insights into how teachers come to integrate their professional development experiences with their classroom expertise in order to create a hybrid inquiry-based science ELD practice. This qualitative case study contributes to the emerging scholarship on the development of teacher practice of inquiry-based science instruction as a vehicle for both science instruction and ELD for ELLs. This study demonstrates how an effective teaching practice that supports both the science and language learning of students can develop from ongoing professional learning experiences that are grounded in current perspectives about language development and that immerse teachers in an inquiry-based approach to learning and instruction. Additionally, this case study also underscores the important role that professional learning opportunities can play in supporting teachers in developing a deeper understanding of the affordances that inquiry-based science can provide for language development.

  10. Near-infrared spectroscopy as an auxiliary tool in the study of child development

    PubMed Central

    de Oliveira, Suelen Rosa; Machado, Ana Carolina Cabral de Paula; de Miranda, Débora Marques; Campos, Flávio dos Santos; Ribeiro, Cristina Oliveira; Magalhães, Lívia de Castro; Bouzada, Maria Cândida Ferrarez

    2015-01-01

    OBJECTIVE: To investigate the applicability of Near-Infrared Spectroscopy (NIRS) for cortical hemodynamic assessment tool as an aid in the study of child development. DATA SOURCE: Search was conducted in the PubMed and Lilacs databases using the following keywords: ''psychomotor performance/child development/growth and development/neurodevelopment/spectroscopy/near-infrared'' and their equivalents in Portuguese and Spanish. The review was performed according to criteria established by Cochrane and search was limited to 2003 to 2013. English, Portuguese and Spanish were included in the search. DATA SYNTHESIS: Of the 484 articles, 19 were selected: 17 cross-sectional and two longitudinal studies, published in non-Brazilian journals. The analyzed articles were grouped in functional and non-functional studies of child development. Functional studies addressed the object processing, social skills development, language and cognitive development. Non-functional studies discussed the relationship between cerebral oxygen saturation and neurological outcomes, and the comparison between the cortical hemodynamic response of preterm and term newborns. CONCLUSIONS: NIRS has become an increasingly feasible alternative and a potentially useful technique for studying functional activity of the infant brain. PMID:25862295

  11. DEVELOPING A QUALITY SYSTEM FOR THE NATIONAL CHILDREN'S STUDY

    EPA Science Inventory

    A Quality Management Plan (QMP) is under development for a national, interagency, long-term study known as the National Children's Study (NCS). The NCS is a study to examine the effects of environmental influences on the health and development of more than 100,000 children acros...

  12. Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study.

    PubMed

    Gross, Wibke; Linden, Ulrike; Ostermann, Thomas

    2010-07-21

    Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children. Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication. This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic and supportive therapy for children with delayed speech development. Further studies should be conducted to investigate the mechanisms of these interactions in greater depth. The trial is registered in the German clinical trials register; Trial-No.: DRKS00000343.

  13. The pea stem

    PubMed Central

    Karahara, Ichirou

    2012-01-01

    The Casparian strip is commonly observed in the endodermis of roots of vascular plants and, in some cases, also in the stems. Pea stems develop the Casparian strip, and its development has been reported to be regulated by blue light. In addition, for the purpose of photobiological studies, pea stems provide a unique experimental system for other physiological studies of the development of the Casparian strip. In this article, I have briefly summarized (1) the effects of environmental factors on the development of the Casparian strip, (2) the advantage of using pea stems for physiological studies of the development of the Casparian strip, and (3) cellular events indicated to be involved in the development of the Casparian strip, focusing on the studies using pea stems as well as other recent studies. PMID:22899074

  14. A systematic review of studies evaluating Australian indigenous community development projects: the extent of community participation, their methodological quality and their outcomes.

    PubMed

    Snijder, Mieke; Shakeshaft, Anthony; Wagemakers, Annemarie; Stephens, Anne; Calabria, Bianca

    2015-11-21

    Community development is a health promotion approach identified as having great potential to improve Indigenous health, because of its potential for extensive community participation. There has been no systematic examination of the extent of community participation in community development projects and little analysis of their effectiveness. This systematic review aims to identify the extent of community participation in community development projects implemented in Australian Indigenous communities, critically appraise the qualitative and quantitative methods used in their evaluation, and summarise their outcomes. Ten electronic peer-reviewed databases and two electronic grey literature databases were searched for relevant studies published between 1990 and 2015. The level of community participation and the methodological quality of the qualitative and quantitative components of the studies were assessed against standardised criteria. Thirty one evaluation studies of community development projects were identified. Community participation varied between different phases of project development, generally high during project implementation, but low during the evaluation phase. For the majority of studies, methodological quality was low and the methods were poorly described. Although positive qualitative or quantitative outcomes were reported in all studies, only two studies reported statistically significant outcomes. Partnerships between researchers, community members and service providers have great potential to improve methodological quality and community participation when research skills and community knowledge are integrated to design, implement and evaluate community development projects. The methodological quality of studies evaluating Australian Indigenous community development projects is currently too weak to confidently determine the cost-effectiveness of community development projects in improving the health and wellbeing of Indigenous Australians. Higher quality studies evaluating community development projects would strengthen the evidence base.

  15. Developing Public Mind Curriculum for Lower Secondary School Classes Using Contemplative Education Methods

    ERIC Educational Resources Information Center

    Srijumnong, Sirithorn; Sri-ampai, Pissamai; Chano, Jiraporn

    2015-01-01

    The purposes of this study were to develop a public mind curriculum with Contemplative Education and to study the effect of using the curriculum to enhance public minds. The study was carried out using the research and development process, consisting of three phases: investigating fundamental data, developing a curriculum, and evaluating the…

  16. Development of an Instructional Quality Assurance Model in Nursing Science

    ERIC Educational Resources Information Center

    Ajpru, Haruthai; Pasiphol, Shotiga; Wongwanich, Suwimon

    2011-01-01

    The purpose of this study was to develop an instructional quality assurance model in nursing science. The study was divided into 3 phases; (1) to study the information for instructional quality assurance model development (2) to develop an instructional quality assurance model in nursing science and (3) to audit and the assessment of the developed…

  17. Development and Validation of Supervisory Behaviour Description Scale

    ERIC Educational Resources Information Center

    Unal, Ali

    2013-01-01

    The aim of this study is to develop a scale which will describe how education supervisors' behaviours are perceived. Four separate studies have been conducted in order to develop the scale. In the first study the scale that was developed is applied to a working group consisting of 704 teachers. The factor structure of the scale is examined by…

  18. Net Generation of Youth: A Case Study of Students in a Technology-Based Youth Development Program

    ERIC Educational Resources Information Center

    James, Coran

    2013-01-01

    The purpose of this interpretive study was to understand how students made sense of their experiences in a technology-based youth development program. This study was framed by James P. Connell and Michelle A. Gambone's, Community Action Framework for Youth Development, conceptual model for understanding youth development that identifies the…

  19. Mapping the Context and Practice of Training, Development and HRD in European Call Centres

    ERIC Educational Resources Information Center

    Garavan, Thomas N.; Wilson, John P.; Cross, Christine; Carbery, Ronan

    2008-01-01

    Purpose: Utilising data from 18 in-depth case studies, this study seeks to explore training, development and human resource development (HRD) practices in European call centres. It aims to argue that the complexity and diversity of training, development and HRD practices is best understood by studying the multilayered contexts within which call…

  20. A Longitudinal Study of Mass Media Development in Less-Developed Countries.

    ERIC Educational Resources Information Center

    Shah, Hemant

    A study was conducted to examine the causal predictors of mass media development in 105 underdeveloped countries for various lengths of time to determine if there were consistent relationships among the dependent and independent variables regardless of the time lag. The study also sought to determine how mass media developed during the 29-year…

  1. Ethical Becoming: Adult Ethical Development in Christian Congregations

    ERIC Educational Resources Information Center

    Carr-Chellman, Davin J.

    2011-01-01

    This is a study of adult ethical development in Christian congregations. Using an empirical hermeneutic phenomenological methodology, this study examined how five pastors understand and encourage ethical development, developing an in-depth analysis and interpretation of their perceptions of the phenomenon of adult ethical development. Two primary…

  2. Imaging brain development: the adolescent brain.

    PubMed

    Blakemore, Sarah-Jayne

    2012-06-01

    The past 15 years have seen a rapid expansion in the number of studies using neuroimaging techniques to investigate maturational changes in the human brain. In this paper, I review MRI studies on structural changes in the developing brain, and fMRI studies on functional changes in the social brain during adolescence. Both MRI and fMRI studies point to adolescence as a period of continued neural development. In the final section, I discuss a number of areas of research that are just beginning and may be the subject of developmental neuroimaging in the next twenty years. Future studies might focus on complex questions including the development of functional connectivity; how gender and puberty influence adolescent brain development; the effects of genes, environment and culture on the adolescent brain; development of the atypical adolescent brain; and implications for policy of the study of the adolescent brain. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. Sustainable Development in Higher Education: Current Practice and Future Development: A Case Study of University of Calabar-Nigeria

    ERIC Educational Resources Information Center

    Ajake, Uchenna E.; Omori, Anne E.; Essien, Margaret

    2011-01-01

    The study highlighted the Nigerian Universities' new sustainable development strategies: emphasizes the role that entrepreneurship education can play in both raising awareness among young people about sustainable development and giving them the skills to put sustainable development into practice. Universities place priority on the development of…

  4. Classroom Teacher Candidates' Perceptions of Teacher Self-Efficacy in Developing Students' Reading, Writing and Verbal Skills: Scale Development Study

    ERIC Educational Resources Information Center

    Canbulat, Ayse Nur Kutluca

    2017-01-01

    This work uses exploratory and confirmatory factor analyses to study Verbal Skills Development Teacher Self-Efficacy Scale (VSDTS), Reading Skills Development Teacher Self-Efficacy Scale (RSDTS) and Writing Skills Development Teacher Self-Efficacy Scale (WSDTS) developed to identify classroom teacher candidates' perceptions of teacher…

  5. Development Education and Engineering: A Framework for Incorporating Reality of Developing Countries into Engineering Studies

    ERIC Educational Resources Information Center

    Perez-Foguet, A.; Oliete-Josa, S.; Saz-Carranza, A.

    2005-01-01

    Purpose: To show the key points of a development education program for engineering studies fitted within the framework of the human development paradigm. Design/methodology/approach: The bases of the concept of technology for human development are presented, and the relationship with development education analysed. Special attention is dedicated…

  6. On the pursuit of a nuclear development capability: The case of the Cuban nuclear program

    NASA Astrophysics Data System (ADS)

    Benjamin-Alvarado, Jonathan Calvert

    1998-09-01

    While there have been many excellent descriptive accounts of modernization schemes in developing states, energy development studies based on prevalent modernization theory have been rare. Moreover, heretofore there have been very few analyses of efforts to develop a nuclear energy capability by developing states. Rarely have these analyses employed social science research methodologies. The purpose of this study was to develop a general analytical framework, based on such a methodology to analyze nuclear energy development and to utilize this framework for the study of the specific case of Cuba's decision to develop nuclear energy. The analytical framework developed focuses on a qualitative tracing of the process of Cuban policy objectives and implementation to develop a nuclear energy capability, and analyzes the policy in response to three models of modernization offered to explain the trajectory of policy development. These different approaches are the politically motivated modernization model, the economic and technological modernization model and the economic and energy security model. Each model provides distinct and functionally differentiated expectations for the path of development toward this objective. Each model provides expected behaviors to external stimuli that would result in specific policy responses. In the study, Cuba's nuclear policy responses to stimuli from domestic constraints and intensities, institutional development, and external influences are analyzed. The analysis revealed that in pursuing the nuclear energy capability, Cuba primarily responded by filtering most of the stimuli through the twin objectives of economic rationality and technological advancement. Based upon the Cuban policy responses to the domestic and international stimuli, the study concluded that the economic and technological modernization model of nuclear energy development offered a more complete explanation of the trajectory of policy development than either the politically-motivated or economic and energy security models. The findings of this case pose some interesting questions for the general study of energy programs in developing states. By applying the analytical framework employed in this study to a number of other cases, perhaps the understanding of energy development schemes may be expanded through future research.

  7. 23 CFR 450.318 - Transportation planning studies and project development.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 23 Highways 1 2011-04-01 2011-04-01 false Transportation planning studies and project development... § 450.318 Transportation planning studies and project development. (a) Pursuant to section 1308 of the... transportation operator(s) may undertake a multimodal, systems-level corridor or subarea planning study as part...

  8. Feasibility Study: New Knowledge Demands in Turbulent Business World

    NASA Astrophysics Data System (ADS)

    Sprice, Renate; Kirikova, Marite

    Feasibility study is one of the early activities in information systems (IS) development when important decisions regarding choice among several possible systems development alternatives are to be made. In times of relatively stable business environment and waterfall model as a systems development approach, the role and methods of feasibility study where quite clear (Kendall and Kendall 1995). However, new software development methods and the necessity to develop more rapidly new IS or their parts may. challenge the possibility to evaluate project feasibility in the early stages of IS development.

  9. An Update on Structural Seal Development at NASA GRC

    NASA Technical Reports Server (NTRS)

    Dunlap, Pat; Steinetz, Bruce; Finkbeiner, Josh; DeMange, Jeff; Taylor, Shawn; Daniels, Chris; Oswald, Jay

    2006-01-01

    A viewgraph presentation describing advanced structural seal development for NASA exploration is shown. The topics include: 1) GRC Structural Seals Team Research Areas; 2) Research Areas & Objective; 3) Wafer Seal Geometry/Flow Investigations; 4) Wafer Seal Installation DOE Study; 5) Results of Wafer Seal Installation DOE Study; 6) Wafer Geometry Study: Thickness Variations; 7) Wafer Geometry Study: Full-Size vs. Half-Size Wafers; 8) Spring Tube Seal Development; 9) Resiliency Improvement for Rene 41 Spring Tube; 10) Spring Tube Seals: Go-Forward Plan; 11) High Temperature Seal Preloader Development: TZM Canted Coil Spring; 12) TZM Canted Coil Spring Development; 13) Arc Jet Test Rig Development; and 14) Arc Jet Test Rig Status.

  10. Program Development for Primary School Teachers' Critical Thinking

    ERIC Educational Resources Information Center

    Boonjeam, Waraporn; Tesaputa, Kowat; Sri-ampai, Anan

    2017-01-01

    The objectives of this research were: 1) to study the elements and indicators of primary school teachers' critical thinking, 2) to study current situation, desirable situation, development technique, and need for developing the primary school teachers' critical thinking, 3) to develop the program for developing the primary school teachers'…

  11. Classroom-Level Curriculum Development: EFL Teachers as Curriculum-Developers, Curriculum-Makers and Curriculum-Transmitters

    ERIC Educational Resources Information Center

    Shawer, Saad F.

    2010-01-01

    This qualitative study aimed to explore teacher curriculum approaches and the strategies attached to each approach because they influence the taught curriculum, teacher development and student learning. The study was therefore grounded in teacher curriculum development, curriculum implementation, teacher development, student cognitive and…

  12. Teachers' Development Model to Authentic Assessment by Empowerment Evaluation Approach

    ERIC Educational Resources Information Center

    Charoenchai, Charin; Phuseeorn, Songsak; Phengsawat, Waro

    2015-01-01

    The purposes of this study were 1) Study teachers authentic assessment, teachers comprehension of authentic assessment and teachers needs for authentic assessment development. 2) To create teachers development model. 3) Experiment of teachers development model. 4) Evaluate effectiveness of teachers development model. The research is divided into 4…

  13. Staff Development and Student Achievement: Making the Connection.

    ERIC Educational Resources Information Center

    Weathersby, Jeanie; Harkreader, Steve

    This study examined connections between staff development and student achievement in order to develop a base of knowledge for improving Georgia's staff development. The study asked whether differences in how districts and schools provided staff development for teachers accounted for some of the variation in student achievement across Georgia…

  14. VIOLENCE AND NON-VIOLENCE-RELATED INJURIES AND ALCOHOL IN WOMEN FROM DEVELOPED AND DEVELOPING COUNTRIES: A MULTI-SITE EMERGENCY ROOM STUDY

    PubMed Central

    da Silva, Rosiane Lopes; Diehl, Alessandra; Cherpitel, Cheryl J.; Figlie, Neliana B.

    2014-01-01

    This study sought to analyze the association between alcohol consumption and the occurrence of injuries in women attending the emergency room (ER) from developing and developed countries. The sample consisted of ER data from women in 15 countries that were collected as part of two multi-site studies using similar methodologies: the Emergency Room Collaborative Alcohol Analysis Project (ERCAAP), and World Health Organization Collaborative Study on Alcohol and Injuries (WHO Study). Women ranged in age from 18 and 98 years. Those from developed countries had higher levels of education (43% completed high-school) than women from developing countries (37%). Over half of the women from developing countries reported they had not consumed alcohol in the last 12 months (abstentious), while 2% reported drinking every day. In addition, current drinking women from developing countries reported more binge drinking episodes (33% reported 5 to 11 drinks and 15% reported 12 or more drinks on an occasion) compared to those from developed countries (28% and 11%, respectively). Violence-related injury was more prevalent in developing countries (18%) compared to developed countries (9%). An association between injury and the frequency of alcohol consumption in the last 12 months was observed in both developing and developed countries. Although women from developing countries who suffered violence-related injuries were more likely to demonstrate alcohol abstinence or have lower rates of daily alcohol consumption, these women drank in a more dangerous way, and violence-related injuries were more likely to occur in these women than in those living in developed countries. PMID:25452073

  15. The Hedwig van Ameringen Executive Leadership in Academic MedicineRTM Program for Women: An Explanatory Study Regarding Its Development and Persistence

    ERIC Educational Resources Information Center

    Mensel, Ruth

    2010-01-01

    This study was designed to determine which factors contributed to the development and persistence of a women's leadership development program in higher education. The "Hedwig van Ameringen" Executive Leadership in Academic Medicine[R] "Program for Women" was the basis for this single-case study. To speculate about ELAM's development and…

  16. Development, Implementation, and Evaluation of a Professional Skills Development Program: The Case of Concordia University's GradProSkills

    ERIC Educational Resources Information Center

    Venkatesh, Vivek; Rabah, Jihan; Lamoureux-Scholes, Laurie; Pelczer, Ildiko; Urbaniak, Kathryn; Martin, Frédérica

    2014-01-01

    The Graduate and Professional Skills (GradProSkills) program is an initiative developed and run by Concordia University's School of Graduate Studies and the university's Office of the Vice-President, Research and Graduate Studies. This paper presents a case study in which we describe the development, implementation, and evaluative components of…

  17. Swiss Armed Forces Organizational Level Leader Development: A Qualitative Case Study

    DTIC Science & Technology

    2017-06-09

    chapter, divided in five distinct parts, describes the chosen research methodology , explain why the qualitative case study is appropriate to conduct...research study uses a qualitative methodology by performing a qualitative case study on the organizational level leader’s development process within...develop an in-depth understsanding of the phenomen.”82 Summary This research study uses a qualitative methodology by performing a case study on the

  18. Commentary: Memory Development: Halfway There?

    ERIC Educational Resources Information Center

    Newcombe, Nora S.

    2015-01-01

    The study of development vacillates between a focus on change (i.e., studying how and why infants are so different from adults) and excitement about early competence and continuity (i.e., studying how capable infants are, and marveling at how similar they turn out to be to adults). The study of memory development has been no exception. This…

  19. Improving Teaching through Lesson Study

    ERIC Educational Resources Information Center

    Rock, Tracy C.; Wilson, Cathy

    2005-01-01

    This article presents a professional development initiative developed by a university-school partnership based on the Japanese lesson-study model described by Stigler and Hiebert (1999) in "The Teaching Gap." Lesson study ("jugyoukenkyu"), an inquiry model of teacher professional development, is used extensively throughout…

  20. Overview of the Japan Children’s Study 2004–2009; Cohort Study of Early Childhood Development

    PubMed Central

    Yamagata, Zentaro; Maeda, Tadahiko; Anme, Tokie; Sadato, Norihiro

    2010-01-01

    Background There are still a lot of unknown aspects about the childhood development of sociability which are based on neuroscientific basis. Purpose of the Japan Children’s Study (JCS) was to verify the normal process of child development of sociability; the trajectory and factors related development of sociability, and to collect findings and integrate the knowledge to make the plan of long-term and large scale cohort study. Methods A child cohort study underway in Japan since 2005. There are the cohort study including a infant cohort study at age of 4 months to 30 months and a preschool cohort study at age of 5 years old to 8 years old. Questionnaires, direct observation of children and cognitive testing were performed. Results In infant cohort study, 465 infants were recruited at 4 months and 367 children were followed up to 30 months, follow up rate was 78.9% and in the preschool cohort study, total 192 children (112 at 2005 and 80 at 2007) at age of 5 years old and 169 followed up to 6 years (follow up rate was 88.0%), and 79 children were followed up to 8 years old (follow up rate was 70.5%) old. Several new measurements to evaluate child sociability were developed. Some factors related to development of child sociability were found for example the ‘praise’ was related to child sociability in cohort study based on neuroscience findings. Conclusions Though the trajectory of child sociability development were not clarified, some significant factors related to development of sociability, and the basic findings to conduct a long-term and large scale cohort study were provided. PMID:20179361

  1. Through the eyes of professional developers: Understanding the design of learning experiences for science teachers

    NASA Astrophysics Data System (ADS)

    Higgins, Tara Eileen

    Professional development is important for improving teacher practice and student learning, particularly in inquiry-oriented and technology-enhanced science instruction. This study examines professional developers' practices and their impact on teachers' classroom instruction and student achievement. It analyzes professional developers designing and implementing a five-year professional development program designed to support middle school science teachers. The professional developers are four university-based researchers who worked with sixteen science teachers over three years, setting program goals, facilitating workshops, providing in-classroom support for teachers, and continually refining the program. The analysis is guided by the knowledge integration perspective, a sociocognitive framework for understanding how teachers and professional developers integrate their ideas about teaching and learning. The study investigates the professional developers' goals and teachers' interpretations of those goals. It documents how professional developers plan teacher learning experiences and explores the connection between professional development activities and teachers' classroom practice. Results are based on two rounds of interviews with professional developers, audio recordings of professional developers' planning meetings and videotaped professional development activities. Data include classroom observations, teacher interviews, teacher reflections during professional development activities, and results from student assessments. The study shows the benefit of a professional development approach that relies on an integrated cycle of setting goals, understanding teachers' interpretations, and refining implementation. The professional developers based their design on making inquiry and technology accessible, situating professional development in teachers' work, supporting collaboration, and sustaining learning. The findings reflect alignment of the design goals with the perspective guiding the curriculum design, and consider multiple goals for student and teacher learning. The study has implications for professional development design, particularly in supporting inquiry-oriented science and technology-enhanced instruction. Effective professional developers formulate coherent conceptions of program goals, use evidence of teacher outcomes to refine their goals and practices, and connect student and teacher learning. This study illustrates the value of research on the individuals who design and lead professional development programs.

  2. [Near-infrared spectroscopy as an auxiliary tool in the study of child development].

    PubMed

    Oliveira, Suelen Rosa de; Machado, Ana Carolina Cabral de Paula; Miranda, Débora Marques de; Campos, Flávio Dos Santos; Ribeiro, Cristina Oliveira; Magalhães, Lívia de Castro; Bouzada, Maria Cândida Ferrarez

    2015-01-01

    To investigate the applicability of Near-Infrared Spectroscopy (NIRS) for cortical hemodynamic assessment tool as an aid in the study of child development. Search was conducted in the PubMed and Lilacs databases using the following keywords: "psychomotor performance/child development/growth and development/neurodevelopment/spectroscopy/near-infrared" and their equivalents in Portuguese and Spanish. The review was performed according to criteria established by Cochrane and search was limited to 2003 to 2013. English, Portuguese and Spanish were included in the search. Of the 484 articles, 19 were selected: 17 cross-sectional and two longitudinal studies, published in non-Brazilian journals. The analyzed articles were grouped in functional and non-functional studies of child development. Functional studies addressed the object processing, social skills development, language and cognitive development. Non-functional studies discussed the relationship between cerebral oxygen saturation and neurological outcomes, and the comparison between the cortical hemodynamic response of preterm and term newborns. NIRS has become an increasingly feasible alternative and a potentially useful technique for studying functional activity of the infant brain. Copyright © 2015 Associação de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  3. Designing Large-Scale Multisite and Cluster-Randomized Studies of Professional Development

    ERIC Educational Resources Information Center

    Kelcey, Ben; Spybrook, Jessaca; Phelps, Geoffrey; Jones, Nathan; Zhang, Jiaqi

    2017-01-01

    We develop a theoretical and empirical basis for the design of teacher professional development studies. We build on previous work by (a) developing estimates of intraclass correlation coefficients for teacher outcomes using two- and three-level data structures, (b) developing estimates of the variance explained by covariates, and (c) modifying…

  4. Current Faculty Development Practices for Alternative Delivery Systems in Christian Higher Education Institutions: A Qualitative Study

    ERIC Educational Resources Information Center

    Yates, Steven Lowell

    2009-01-01

    This research study was an investigation of current faculty development practices for alternative delivery systems. Attention was given to faculty development in general as well as specific facets of faculty development for alternative delivery systems. Future or intended faculty development practices were pursued, along with factors that…

  5. Professional Development Sites: Revitalizing Preservice Education in Middle Schools.

    ERIC Educational Resources Information Center

    Bell, Nancy M.

    This case study reports on the experiences of teachers and student teachers during the process of developing and implementing professional development sites (PDSs) at one urban and two rural middle schools. The study examines the phases of development that teachers go through in the process of developing PDSs and how teachers' level of development…

  6. The MAL-ED Cohort Study: Methods and Lessons Learned When Assessing Early Child Development and Caregiving Mediators in Infants and Young Children in 8 Low- and Middle-Income Countries

    PubMed Central

    Murray-Kolb, Laura E.; Rasmussen, Zeba A.; Scharf, Rebecca J.; Rasheed, Muneera A.; Svensen, Erling; Seidman, Jessica C.; Tofail, Fahmida; Koshy, Beena; Shrestha, Rita; Maphula, Angelina; Vasquez, Angel Orbe; da Costa, Hilda P.; Yousafzai, Aisha K.; Oria, Reinaldo B.; Roshan, Reeba; Bayyo, Eliwasa B.; Kosek, Margaret; Shrestha, Sanjaya; Schaefer, Barbara A.; Bessong, Pascal; Ahmed, Tahmeed; Lang, Dennis

    2014-01-01

    More epidemiological data are needed on risk and protective factors for child development. In The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development (MAL-ED) cohort study, we assessed child development in a harmonious manner across 8 sites in Bangladesh, Brazil, India, Nepal, Pakistan, Peru, South Africa, and Tanzania. From birth to 24 months, development and language acquisition were assessed via the Bayley Scales of Infant and Toddler Development and a modified MacArthur Communicative Development Inventory. Other measures were infant temperament, the child's environment, maternal psychological adjustment, and maternal reasoning abilities. We developed standard operating procedures and used multiple techniques to ensure appropriate adaptation and quality assurance across the sites. Test adaptation required significant time and human resources but is essential for data quality; funders should support this step in future studies. At the end of this study, we will have a portfolio of culturally adapted instruments for child development studies with examination of psychometric properties of each tool used. PMID:25305296

  7. Evaluation systems for clinical governance development: a comparative study.

    PubMed

    Hooshmand, Elaheh; Tourani, Sogand; Ravaghi, Hamid; Ebrahimipour, Hossein

    2014-01-01

    Lack of scientific and confirmed researches and expert knowledge about evaluation systems for clinical governance development in Iran have made studies on different evaluation systems for clinical governance development a necessity. These studies must provide applied strategies to design criteria of implementing clinical governance for hospital's accreditation. This is a descriptive and comparative study on development of clinical governance models all over the world. Data have been gathered by reviewing related articles. Models have been studied in comprehensive review method. The evaluated models of clinical governance development were Australian, NHS, SPOCK and OPTIGOV. The final aspects extracted from these models were Responsiveness, Policies and Strategies, Organizational Structure, Allocating Resources, Education and Occupational Development, Performance Evaluation, External Evaluation, Patient Oriented Approach, Risk Management, Personnel's Participation, Information Technology, Human Resources, Research and Development, Evidence Based Medicine, Clinical Audit, Health Technology Assessment and Quality. These results are applicable for completing the present criteria which evaluating clinical governance application and provide practical framework to evaluate country's hospital on the basis of clinical governance elements.

  8. Microenterprise Development Interventions for Sexual Risk Reduction: A Systematic Review

    PubMed Central

    Lee, Ramon; Thirumurthy, Harsha; Muessig, Kathryn E.; Tucker, Joseph D.

    2013-01-01

    Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies. PMID:23963497

  9. Microenterprise development interventions for sexual risk reduction: a systematic review.

    PubMed

    Cui, Rosa R; Lee, Ramon; Thirumurthy, Harsha; Muessig, Kathryn E; Tucker, Joseph D

    2013-11-01

    Comprehensive interventions that address both individual and structural determinants associated with HIV/STI risk are gaining increasing attention over the past decade. Microenterprise development offers an appealing model for HIV prevention by addressing poverty and gender equality. This study systematically reviewed the effects of microenterprise development interventions on HIV/STI incidence and sexual risk behaviors. Microenterprise development was defined as developing small business capacity among individuals to alleviate poverty. Seven eligible research studies representing five interventions were identified and included in this review. All of the studies targeted women, and three focused on sex workers. None measured biomarker outcomes. All three sex worker studies showed significant reduction in sexual risk behaviors when compared to the control group. Non-sex worker studies showed limited changes in sexual risk behavior. This review indicates the potential utility of microenterprise development in HIV risk reduction programs. More research is needed to determine how microenterprise development can be effectively incorporated in comprehensive HIV control strategies.

  10. Why Missing Data Matter in the Longitudinal Study of Adolescent Development: Using the 4-H Study to Understand the Uses of Different Missing Data Methods

    ERIC Educational Resources Information Center

    Jelicic, Helena; Phelps, Erin; Lerner, Richard M.

    2010-01-01

    The study of adolescent development rests on methodologically appropriate collection and interpretation of longitudinal data. While all longitudinal studies of adolescent development involve missing data, the methods to treat missingness that have been recommended most often focus on missing data from cross-sectional studies. The problems of…

  11. Making Sense of Education "Responsibly": Findings from a Study of Student Teachers' Understanding(s) of Education, Sustainable Development and Education for Sustainable Development

    ERIC Educational Resources Information Center

    Nikel, Jutta

    2007-01-01

    This article discusses findings from a tri-country study of student teachers' understandings of the purposes of education, their conceptions of sustainable development and the task of Education for Sustainable Development (ESD). At its heart are case studies of 30 student teachers from Initial Teacher Education Programmes in England, Denmark and…

  12. Model of Learning Organizational Development of Primary School Network under the Office of Basic Education Commission

    ERIC Educational Resources Information Center

    Sai-rat, Wipa; Tesaputa, Kowat; Sriampai, Anan

    2015-01-01

    The objectives of this study were 1) to study the current state of and problems with the Learning Organization of the Primary School Network, 2) to develop a Learning Organization Model for the Primary School Network, and 3) to study the findings of analyses conducted using the developed Learning Organization Model to determine how to develop the…

  13. Flight simulator for hypersonic vehicle and a study of NASP handling qualities

    NASA Technical Reports Server (NTRS)

    Ntuen, Celestine A.; Park, Eui H.; Deeb, Joseph M.; Kim, Jung H.

    1992-01-01

    The research goal of the Human-Machine Systems Engineering Group was to study the existing handling quality studies in aircraft with sonic to supersonic speeds and power in order to understand information requirements needed for a hypersonic vehicle flight simulator. This goal falls within the NASA task statements: (1) develop flight simulator for hypersonic vehicle; (2) study NASP handling qualities; and (3) study effects of flexibility on handling qualities and on control system performance. Following the above statement of work, the group has developed three research strategies. These are: (1) to study existing handling quality studies and the associated aircraft and develop flight simulation data characterization; (2) to develop a profile for flight simulation data acquisition based on objective statement no. 1 above; and (3) to develop a simulator and an embedded expert system platform which can be used in handling quality experiments for hypersonic aircraft/flight simulation training.

  14. A Study on the State of Development of Higher Education Confucius Institutes from Mainland China

    ERIC Educational Resources Information Center

    Jeng-Yi, Lin

    2016-01-01

    Confucius Institutes are the target of this study, and the study uses document analysis method to analyze the origins of their establishment, purpose, organizational structure, administration model, and state of development. This study finds that Confucius Institutes are facing the following problems: problems in the development and management of…

  15. Experiences of Followers in the Development of the Leader-Follower Relationship in Long-Term Health Care: A Phenomenological Study

    ERIC Educational Resources Information Center

    Lucia, David

    2010-01-01

    This descriptive phenomenological study explored the perceptions and experiences of followers in the development of the leader-follower relationship, within a long-term health care environment. This study is also framed within the disciplinary context of human resource development (HRD). This study addressed the research question, "During your…

  16. A Study of First-Generation African American and Latino Undergraduates Developing Sociopolitical Consciousness in Introductory Sociology Classes

    ERIC Educational Resources Information Center

    Castillo-Montoya, Milagros

    2013-01-01

    This study examines the development of first-generation African American and Latino college students' sociopolitical consciousness in the context of their learning of sociology as a component of their liberal education studies. Given the paucity of research on how college students develop sociopolitical consciousness, this study addresses: (1) the…

  17. Education for Rural Development - A Portfolio of Studies. Volume 3: Health and Nutrition Education.

    ERIC Educational Resources Information Center

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Asian Centre for Educational Innovation for Development.

    Volume 3 of a five-volume portfolio of studies reflecting different facets of the concept of education for rural development contains three studies on health and nutrition. The first study, "Health Education in Rural Development," by K. D. Ariyadasa (Sri Lanka), discusses the role of education in the transmission of health and integrated…

  18. A Case Study of a Mixed Methods Study Engaged in Integrated Data Analysis

    ERIC Educational Resources Information Center

    Schiazza, Daniela Marie

    2013-01-01

    The nascent field of mixed methods research has yet to develop a cohesive framework of guidelines and procedures for mixed methods data analysis (Greene, 2008). To support the field's development of analytical frameworks, this case study reflects on the development and implementation of a mixed methods study engaged in integrated data analysis.…

  19. Teacher Evaluation Project. The Beginning Teacher Program, Intellectual Skills Development, Validity Studies of the Evaluation System, Special Instrument Development. Report for 1984-1985.

    ERIC Educational Resources Information Center

    Florida Coalition for the Development of a Performance Measurement System, Tallahassee.

    Reports, summaries, and recommendations are presented on the following research studies: (1) Beginning Teacher Studies; (2) Instructional Skills for Teaching Higher Order Thinking; (3) Development of the Conferential Observation Instrument; (4) Predictive Validity Studies Conducted to Test the Relationship Between Teacher Performance as Measured…

  20. Effects of music therapy in the treatment of children with delayed speech development - results of a pilot study

    PubMed Central

    2010-01-01

    Background Language development is one of the most significant processes of early childhood development. Children with delayed speech development are more at risk of acquiring other cognitive, social-emotional, and school-related problems. Music therapy appears to facilitate speech development in children, even within a short period of time. The aim of this pilot study is to explore the effects of music therapy in children with delayed speech development. Methods A total of 18 children aged 3.5 to 6 years with delayed speech development took part in this observational study in which music therapy and no treatment were compared to demonstrate effectiveness. Individual music therapy was provided on an outpatient basis. An ABAB reversal design with alternations between music therapy and no treatment with an interval of approximately eight weeks between the blocks was chosen. Before and after each study period, a speech development test, a non-verbal intelligence test for children, and music therapy assessment scales were used to evaluate the speech development of the children. Results Compared to the baseline, we found a positive development in the study group after receiving music therapy. Both phonological capacity and the children's understanding of speech increased under treatment, as well as their cognitive structures, action patterns, and level of intelligence. Throughout the study period, developmental age converged with their biological age. Ratings according to the Nordoff-Robbins scales showed clinically significant changes in the children, namely in the areas of client-therapist relationship and communication. Conclusions This study suggests that music therapy may have a measurable effect on the speech development of children through the treatment's interactions with fundamental aspects of speech development, including the ability to form and maintain relationships and prosodic abilities. Thus, music therapy may provide a basic and supportive therapy for children with delayed speech development. Further studies should be conducted to investigate the mechanisms of these interactions in greater depth. Trial registration The trial is registered in the German clinical trials register; Trial-No.: DRKS00000343 PMID:20663139

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