scholarly journals Exploring Brazilian Immigrant Mothers’ Beliefs, Attitudes, and Practices Related to Their Preschool-Age Children’s Sleep and Bedtime Routines: A Qualitative Study Conducted in the United States

2018 ◽  
Vol 15 (9) ◽  
pp. 1923 ◽  
Author(s):  
Ana Lindsay ◽  
Carlos Moura Arruda ◽  
Márcia Tavares Machado ◽  
Gabriela De Andrade ◽  
Mary Greaney
Keyword(s):  
United States ◽  
Immigrant Families ◽  
The United States ◽  
Preschool Age ◽  
Immigrant Mothers ◽  
Attitudes And Practices ◽  
Increased Risk ◽  
The Us ◽  
Family Housing ◽  
Children’S Sleep

In the United States (US), racial/ethnic minority children, low-income children, and children of immigrant families are at increased risk of childhood obesity. Mounting evidence documents that sleep duration and sleep quality are important modifiable factors associated with increased risk of obesity among preschool-aged children. The number of Brazilian immigrants in the US is increasing, yet no existing research, to our knowledge, has examined factors affecting sleep and bedtime routines of children of Brazilian immigrant families. Therefore, the purpose of this qualitative study was to explore Brazilian immigrant mothers’ beliefs, attitudes, and practices related to sleep and bedtime routines among preschool-aged children. Seven focus group discussions (FGDs) were conducted with 37 Brazilian immigrant mothers of preschool-age children living in the US. The audio-recordings of the FGDs were transcribed verbatim in Portuguese without identifiers and analyzed using thematic analyses. Mothers also completed a brief questionnaire assessing socio-demographic and acculturation. Analyses revealed that most mothers were aware of the importance of sleep and sleep duration for their children’s healthy growth and development. Mothers also spoke of children needing consistent bedtime routines. Nevertheless, many mothers reported inconsistent and suboptimal bedtime routines (e.g., lack of predictable and orderly bedtime activities such as bath, reading, etc. and use of electronics in bed). These suboptimal routines appeared to be influenced by day-to-day social contextual and environmental factors that are part of Brazilian immigrant families’ lives such as parents’ work schedule, living with extended family, living in multi-family housing, neighborhood noise, etc. Analyses identified several modifiable parenting practices related to young children’s sleep and bedtime routines (e.g., irregular bedtime, late bedtime, inconsistent bedtime routines, use of electronics in bed, etc.) that can be addressed in parenting- and family-based obesity prevention interventions. Interventions should consider the social context of the home/family (e.g., parents’ work schedules) and the environment (e.g., multi-family housing; neighborhood noise, etc.) faced by Brazilian immigrant families when developing health promotion messages and parenting interventions tailored to this ethnic group.

scholarly journals “If You Let Them, They Will Be on It 24 Hours a Day”: Qualitative Study Conducted in the United States Exploring Brazilian Immigrant Mothers’ Beliefs, Attitudes, and Practices Related to Screen Time Behaviors of Their Preschool-Age Children (Preprint)

2018 ◽  
Author(s):  
Ana Cristina Lindsay ◽  
Carlos André Moura Arruda ◽  
Márcia MT Machado ◽  
Mary L Greaney
Keyword(s):  
United States ◽  
Qualitative Study ◽  
Screen Time ◽  
Parenting Practices ◽  
The United States ◽  
Preschool Age ◽  
Health Concern ◽  
Immigrant Mothers ◽  
Attitudes And Practices ◽  
Preschool Age Children

BACKGROUND The increasing prevalence of excessive screen time (ST) among children is a growing public health concern, with evidence linking it to an increased risk of overweight and obesity among children. OBJECTIVE This study aimed to explore the beliefs, attitudes, and practices of Brazilian immigrant mothers living in the United States related to their preschool-age children’s ST behaviors. METHODS A qualitative study comprising 7 focus group discussions (FGDs) was conducted with Brazilian immigrant mothers living in the United States. All FGDs were audio-recorded and professionally transcribed verbatim. The Portuguese transcripts were analyzed using thematic analysis. RESULTS In total, 37 women participated in the FGDs. Analyses revealed that although most mothers expressed concerns for their preschool-age children’s ST, nearly all viewed ST as an acceptable part of their children’s daily lives. Furthermore, mothers perceived that ST has more benefits than disadvantages. The mothers’ positive beliefs about (eg, educational purposes and entertainment) and perceived functional benefits of ST (eg, ability to keep children occupied so tasks can be completed and facilitation of communication with family outside the United States) contributed to their acceptance of ST for their preschool-age children. Nevertheless, most mothers spoke of needing to balance their preschool-age children’s ST with other activities. Mothers reported using several parenting practices including monitoring time and content, setting limits and having rules, and prompting their children to participate in other activities to manage their preschool-age children’s ST. CONCLUSIONS This study provides new information on the beliefs, attitudes, and practices of Brazilian immigrant mothers living in the United States related to their preschool-age children’s ST. Study findings revealed several potentially modifiable maternal beliefs and parenting practices that may provide important targets for parenting- and family-based interventions aimed at limiting preschool-age children’s ST.

scholarly journals Food Insecurity Is Associated With Cardiovascular and All‐Cause Mortality Among Adults in the United States

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Yangbo Sun ◽  
Buyun Liu ◽  
Shuang Rong ◽  
Yang Du ◽  
Guifeng Xu ◽  
...  
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Food Security ◽  
Food Insecurity ◽  
The United States ◽  
Sampling Weights ◽  
Cardiovascular Disease Mortality ◽  
Disease Mortality ◽  
Increased Risk ◽  
The Us

Background Food insecurity is a global leading public health challenge that affects not only developing countries but also developed countries, including the United States. About 50 million Americans are food insecure. In this study we examined the associations of the adult food insecurity with all‐cause and cardiovascular disease mortality in a nationally representative sample of US adults. Methods and Results We included 27 188 US adults (age ≥40 years of age) who participated in the US National Health and Nutrition Examination Survey from 1999 to 2014. Food insecurity status was assessed using the Food Security Survey Module developed by the US Department of Agriculture. Mortality from all causes and cardovascular disease was ascertained through data linkage to the National Death Index through December 31, 2015. We used multivariable Cox proportional hazards regression with sampling weights to estimate hazard ratios ( HR s) and 95% CIs of all‐cause and cardiovascular disease mortality, according to food security status. During 205 389 person‐years of the period, 5039 deaths occurred, including 1084 cardiovascular disease deaths. After adjustment for age, sex, race/ethnicity, education, income, and dietary and lifestyle factors, participants with very low food security had higher risk of all‐cause and cardiovascular disease mortality, with multivariable‐adjusted HR s of 1.32 (95% CI , 1.07–1.62), and 1.53 (95% CI, 1.04–2.26), respectively, compared with those with high food security. Conclusions Food insecurity is significantly associated with increased risk of excess death from cardiovascular disease and all causes in US adults.

scholarly journals The Impact of Winter Months on Patients with Deep Vein Thrombosis (DVT) or Pulmonary Embolism (PE), a Retrospective Analysis of Hospital Outcomes in the United States (US) from 1998-2011

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4451-4451
Author(s):  
Danielle Krol ◽  
Parshva Patel ◽  
Konstantine Halkidis ◽  
Gaurav Varma ◽  
Ravindra Sangitha ◽  
...  
Keyword(s):  
United States ◽  
Length Of Stay ◽  
The United States ◽  
Mortality Rates ◽  
Teaching Hospitals ◽  
Hospital Outcomes ◽  
North Central ◽  
Increased Risk ◽  
The Us ◽  
The Impact

Abstract Background: DVT and PE are common complications in hospitalized patients. Many hospitals have implemented EMR-based protocols to identify patients who could benefit from prophylactic anticoagulation, because of the increased morbidity, mortality, and cost associated with thrombotic disease. Several groups have sought to characterize the potential seasonal and winter variation in the incidence of DVT and PE, with several international studies supporting a so called "Winter effect" (Damnjanović et al., Hippokratia 2013); however, no study has demonstrated a "Winter effect" on patients within the US (Stein et al., Am J Cardiol 2004). Objective: (1) To compare mortality rates and length of stay (LOS) in hospitals by month to identify a "Winter effect" in patients diagnosed with either DVT or PE; and (2) characterize other factors that might influence mortality and LOS, using the Nationwide Inpatient Sample (NIS), Healthcare Cost and Utilization Project (HCUP), Agency for Healthcare Research and Quality. Methods: The NIS was queried from 1998-2011. Inclusion criteria were a diagnosis of DVT (ICD-9 453.4X, 453.8X) and/or PE (ICD-9 415.1X) in patients aged 18 years or more. The sample was weighted to approximate the full inpatient population of the United States over the period of interest. Admission data was then analyzed to compare mortality rates over those years by month. Demographics, Charlson Comorbidity Index (CCI), length of stay, hospital region, and admission type (emergent/urgent versus elective admissions) were assessed. Linear and logistic models were generated for complex survey design to assess predictors of mortality and LOS. Results: A total of 1,449,113 DVT/PE cases were identified in the NIS (weighted n = 7,150,613). 54.7% of admission were for females, 56.4% were white, and 49% of admissions were at a teaching facility. Mortality over the 12 months was 6.4% and was noted to be higher in four months: November (6.52%), December (6.9%), January (6.94%), and February (6.93%), as indicated in the graph below. A similar trend was noted on a regional basis with higher mortality noted in winter months for all hospital regions (Northeast, Midwest or North Central, South, and West). No significant trend was noted in DVT/PE hospitalization rates between regions over 12 months (p=0.7674). Mortality in the total cohort was found to be significantly higher in December, OR 1.10 (95% CI: 1.06-1.14), p<0.0001; January, OR 1.11 (95% CI: 1.08-1.15), p<0.0001; and February, OR 1.11 (95% CI: 1.07-1.15), p<0.0001 compared to June (Table 1). Mortality was significantly lower in the Midwest or North Central, OR 0.78 (95% CI: 0.72-0.83), p<0.0001; and West, OR 0.80 (95% CI: 0.73-0.87), p<0.0001 compared to the Northeast. Mortality was also significantly higher in teaching hospitals than in nonteaching hospitals (OR 1.16 [95% CI: 1.10-1.22], p<0.0001), with mortality higher in teaching hospitals in all months. Length of stay was also significantly increased in the winter months. Similar results were noted in the subgroups of patients greater than age 80 or with a CCI score of 2 or more. Conclusion: This national study identified an increased risk of mortality and increased LOS associated with hospitalizations for DVT/PE during the winter months (December, January, and February), supporting the existence of a "Winter effect" on hospital outcomes. Our data differs from previous reports on seasonal variation in DVT/PE in the US because of the database used (Bekkers et al., Clin Orthop Relat Res 2014). Since no regional variation was shown, decreased activity or cold temperature is unlikely to be the cause of this phenomenon. Alternative explanations should be sought. Figure 1. Figure 1. Disclosures No relevant conflicts of interest to declare.

Chemical Composition and Carcinogenicity of Smokeless Tobacco

1997 ◽  
Vol 11 (3) ◽  
pp. 322-329 ◽  
Author(s):  
D. Hoffmann ◽  
M.V. Djordjevic
Keyword(s):  
United States ◽  
Smokeless Tobacco ◽  
The United States ◽  
Laboratory Animals ◽  
Chewing Tobacco ◽  
The Past ◽  
Carcinogenic Potential ◽  
Increased Risk ◽  
The Us ◽  
Oral Tumors

In the United States, smokeless tobacco (ST) is marketed as chewing tobacco and as oral snuff. During the past 15 years, consumption of chewing tobacco has declined by 30.6%, whereas snuff use has significantly increased, namely, by 51.8%. This increase is primarily due to the growing popularity of oral snuff use among teenage and young adolescent males. Chewing of tobacco is associated with an increased risk for oral cancer. Snuff dipping is causally and specifically associated with cancer of the cheek, gum, and pharynx. In laboratory animals, snuff induces cancer of the mouth. Several carcinogens have been identified in ST, the tobacco-specific N-nitrosamine (TSNA), N'-nitrosonornicotine (NNN), and 4(methylnitrosamino)-l-(3-pyridyl)-l-butanone (NNK) being the most important. NNN and NNK are formed from nicotine during curing, aging, and especially during fermentation of tobacco. Oral swabbing of a low concentration of a mixture of NNN plus NNK in water induces oral tumors in rats. The concentration of the strongly carcinogenic TSNA is higher in snuff than in other ST products. According to our analytical studies, the three leading snuff brands in the US (92% of the market) contain far higher concentrations of nicotine, unprotonated nicotine, and TSNA than the less popular brands. Thus, the leading US snuff brands are the strongest inducers of nicotine dependence and also have the highest carcinogenic potential.

scholarly journals Asthma Risk Associated with Indoor Mold Contamination in Hispanic Communities in Eastern Coachella Valley, California

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Ryan Sinclair ◽  
Charity Russell ◽  
Genevieve Kray ◽  
Stephen Vesper
Keyword(s):  
United States ◽  
Low Income ◽  
House Dust ◽  
Respiratory Illness ◽  
The United States ◽  
Coachella Valley ◽  
Asthma Risk ◽  
Increased Risk ◽  
The Us ◽  
Indoor Mold

Indoor mold contamination has been associated in many studies with an increased risk of asthma and respiratory illness. This study investigated indoor mold contamination and the prevalence of asthma/respiratory illness in two low-income, Hispanic communities, Mecca and Coachella City, in the Eastern Coachella Valley (ECV) of California. The study consisted of a questionnaire to assess asthma/respiratory illness and the quantification of mold contamination in house dust samples using the Environmental Relative Moldiness Index (ERMI) scale. About 11% of the adults and 17% of the children in both Mecca and Coachella City met our definitions of asthma/respiratory illness. The average ERMI values in Mecca and Coachella City housing (10.3 and 6.0, respectively) are in the top 25% of ERMI values for the United States (US) homes. Overall, the homes surveyed in these ECV communities had an average prevalence of occupant asthma of 12.8% and an average ERMI value of 9.0. The prevalence of asthma/respiratory illness in the Hispanic communities of Mecca and Coachella City and the mold contamination in their homes appear to be greater than the averages for the rest of the US. The higher levels of mold contamination in their homes appear to be associated with a greater risk of asthma/respiratory illness for these low-income, Hispanic communities.

scholarly journals Digital Manipulation of Images of Models' Appearance in Advertising: Strategies for Action Through Law and Corporate Social Responsibility Incentives to Protect Public Health

2019 ◽  
Vol 45 (1) ◽  
pp. 7-31 ◽  
Author(s):  
Caitlin McBride ◽  
Nancy Costello ◽  
Suman Ambwani ◽  
Breanne Wilhite ◽  
S. Bryn Austin
Keyword(s):  
Public Health ◽  
United States ◽  
Eating Disorders ◽  
Body Dissatisfaction ◽  
The United States ◽  
Policy Initiatives ◽  
Legal Context ◽  
Increased Risk ◽  
The Us ◽  
Corporate Social

AbstractContext:Widespread digital retouching of advertising imagery in the fashion, beauty, and other consumer industries promotes unrealistic beauty standards that have harmful effects on public health. In particular, exposure to misleading beauty imagery is linked with greater body dissatisfaction, worse mood, poorer self-esteem, and increased risk for disordered eating behaviors. Moreover, given the social, psychological, medical, and economic burden of eating disorders, there is an urgent need to address environmental risk factors and to scale up prevention efforts by increasing the regulation of digitally altered advertising imagery.Methods:This manuscript summarizes the health research literature linking digital retouching of advertising to increased risk of eating disorders, disordered weight and appearance control behaviors, and body dissatisfaction in consumers, followed by a review of global policy initiatives designed to regulate digital retouching to reduce health harms to consumers. Next, we turn to the US legal context, reporting on findings generated through legal research via Westlaw and LexisNexis, congressional records, federal agency websites, law review articles, and Supreme Court opinions, in addition to consulting legal experts on both tax law and the First Amendment, to evaluate the viability of various policy initiatives proposed to strengthen regulation on digital retouching in the United States.Findings:Influencing advertising practices via tax incentives combined with corporate social responsibility initiatives may be the most constitutionally feasible options for the US legal context to reduce the use of digitally alternated images of models' bodies in advertising.Conclusions:Policy and corporate initiatives to curtail use of digitally altered images found to be harmful to mental and behavioral health of consumers could reduce the burden of eating disorders, disordered weight and appearance control behaviors, and body dissatisfaction and thereby improve population health in the United States.

scholarly journals PATRO children, a multi-center, non-interventional study of the safety and effectiveness of Omnitrope® (somatropin) treatment in children: update on the United States cohort

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Philippe Backeljauw ◽  
Bradley S. Miller ◽  
Richard Levy ◽  
Kenneth McCormick ◽  
Hichem Zouater ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
United States ◽  
Human Growth ◽  
The United States ◽  
Hormone Deficiency ◽  
Moderate Intensity ◽  
Interventional Study ◽  
Increased Risk ◽  
The Us ◽  
Report Data

Abstract Objectives Omnitrope® (somatropin, Sandoz Inc.) is one of several recombinant human growth hormones (rhGH) approved in the United States (US) for use in pediatric indications, including growth hormone deficiency (GHD) and idiopathic short stature (ISS). We report data on the effectiveness and safety of Omnitrope® in the US cohort of the PATRO Children (international, longitudinal, non-interventional) study. Methods All visits and assessments are carried out according to routine clinical practice, and doses of Omnitrope® are given according to country-specific prescribing information. Results By September 2018, 294 US patients were recruited; the two largest groups were GHD (n=193) and ISS (n=62). Across all indications, HSDS improvement (ΔHSDS) from baseline at three years was +1.0 (rhGH-naïve, +1.2; pre-treated, +0.7). In pre-pubertal patients, ΔHSDS from baseline at three years was +0.94 (rhGH-naïve, +1.3; pre-treated, +0.7). Following three years of treatment, ΔHSDS from baseline was +1.3 in rhGH-naïve GHD patients and +1.1 in rhGH-naïve ISS patients. In pre-pubertal rhGH-naïve patients, ΔHSDS from baseline was +1.3 and +1.2 in GHD and ISS patients, respectively. Overall, 194 patients (66.0%) experienced adverse events (AEs; n=886 events); most were of mild-moderate intensity. Five patients (1.7%) had AEs that were suspected to be treatment-related (n=5 events). All reported neoplasms were benign, non-serious, and considered unrelated to rhGH therapy. No AEs of diabetes mellitus or hyperglycemia were reported. Conclusions Omnitrope® appears to be well tolerated and effective in the majority of patients, without evidence of an increased risk of developing unexpected AEs, diabetes mellitus, or new malignancies during treatment.

scholarly journals Epidemiology of Reopening in the COVID-19 Pandemic in the United States, Europe and Asia

2020 ◽  
Author(s):  
Weiqi Zhang ◽  
Alina Oltean ◽  
Scott Nichols ◽  
Fuad Odeh ◽  
Fei Zhong
Keyword(s):  
United States ◽  
Age Groups ◽  
Interrupted Time Series ◽  
The United States ◽  
Interrupted Time Series Analysis ◽  
Us States ◽  
Younger Age ◽  
Increased Risk ◽  
The Us ◽  
Novel Coronavirus

Since the discovery of the novel coronavirus (SARS-CoV-2), COVID-19 has become a global healthcare and economic crisis. The United States (US) and Europe exhibited wide impacts from the virus with more than six million cases by the time of our analysis. To inhibit spread, stay-at-home orders and other non-pharmaceutical interventions (NPIs) were instituted. Beginning late April 2020, some US states, European, and Asian countries lifted restrictions and started the reopening phases. In this study, the changes of confirmed cases, hospitalizations, and deaths were analyzed after reopening for 11 countries and 40 US states using an interrupted time series analysis. Additionally, the distribution of these categories was further analyzed by age due to the known increased risk in elderly patients. Reopening had varied effects on COVID-19 cases depending on the region. Recent increases in cases did not fully translate into increased deaths. Eight countries had increased cases after reopening while only two countries showed the same trend in deaths. In the US, 30 states had observed increases in cases while only seven observed increased deaths. In addition, we found that states with later reopening dates were more likely to have significant decreases in cases, hospitalizations, and deaths. Furthermore, age distributions through time were analyzed in relation to COVID-19 in the US. Younger age groups typically had an increased share of cases after reopening.

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