Digital Commons Network^™

A Study Into The Diagnosis Of Obesity In Infants Less Than Two Years Old In The State Of Virginia, Lindsay Ann Bruno

Senior Honors Projects, 2010-2019

In 2007, the CDC reported approximately 12.5 million children and adolescents in the U.S. were obese. Among 24-month old clinically obese children, only 23% were diagnosed as obese. The most concerning is the prevalence of obesity in 6-month olds; 16% of 6-month old infants in the U.S. are obese, of which only 14% are diagnosed as being obese. Previous research concentrates on the factors that influence infant obesity, but does not address the prevalence of diagnosing obesity in children, particularly those under two years of age. The purpose of this project was to pioneer a survey exploring the prevalence of …

Impact Of Implementing Performance-Based Financing On Childhood Malnutrition In Rwanda, Agnes Binagwaho, Jeanine Condo, Claire Wagner, Fidele Ngabo, Corine Karema, Steve Kanters, Jamie I. Forrest, Jean De Dieu Bizimana

Dartmouth Scholarship

Background: Malnutrition remains a serious concern in Rwanda, particularly among children under-5 years. Performance-based financing (PBF), an innovative health systems financing strategy, has been implemented at the national level since 2008. This study aimed to assess the impact of PBF and other factors associated with the prevalence of three classifications of malnutrition (stunting, wasting and underweight) in children under-5 years in Rwanda. Methods: The study is a cross-sectional study comprising of 713 children under five years old from 557 households, whose anthropometric measurements (height, weight and age) had been obtained as part of the 2008 Rwanda General Health and HIV …

Estimation Of Length Or Height In Infants And Young Children Using Ulnar And Lower Leg Length With Dual-Energy X-Ray Absorptiometry Validation, Lee A. Weidauer, Howard Wey, Hillarie Slater, Laurie Moyer-Mileur, Bonny Specker

Health and Nutritional Sciences Faculty Publications

AIM: We compared the accuracy and reproducibility of using ulnar and lower leg length measurements to predict length and height in infants and children aged 0 to 6 years.

METHOD: Length/height and ulnar and lower leg length were measured in 352 healthy preterm and term-born children (167 males, 185 females) (Mean age= 2.6±1.6 years). Ulna length was measured as the distance between the proximal olecranon process and the distal styloid process of the ulna. Tibia length was measured as the distance from the proximal aspect of the medial condyle and the most distal aspect of the medial malleolus of the …

A Dietary-Wide Association Study (Dwas) Of Environmental Metal Exposure In Us Children And Adults, Matthew A. Davis, Diane Gilbert-Diamond, Margaret R. Karagas, Zhigang Li, Jason H. Moore, Scott M. Williams, H. Robert Frost

Dartmouth Scholarship

Background: A growing body of evidence suggests that exposure to toxic metals occurs through diet but few studies have comprehensively examined dietary sources of exposure in US populations.

Purpose: Our goal was to perform a novel dietary-wide association study (DWAS) to identify specific dietary sources of lead, cadmium, mercury, and arsenic exposure in US children and adults.

Methods: We combined data from the National Health and Nutrition Examination Survey with data from the US Department of Agriculture’s Food Intakes Converted to Retail Commodities Database to examine associations between 49 different foods and environmental metal exposure. Using blood and urinary biomarkers …

Asset Holdings And Undernutrition Of Young Children: Evidence From China Health And Nutrition Survey, Minchao Jin

All Theses and Dissertations (ETDs)

Undernutrition is an underlying determinant of 45% of all childhood deaths annually, resulting in 3.1 million deaths to children less than five years globally (Black et al., 2013). The adverse effects of undernutrition, especially chronic undernutrition, could cause impaired physical growth, mental development retardation, low productivity and poverty during adulthood, and undernutrition of next generation. Worldwide, over 200 million children are undernourished (Black et al., 2013). Thus, there is an imperative to identify effective preventive actions or interventions for child undernutrition. Studies have documented links between undernutrition and low income, but few has tackling the causation from assets to child …

A Multidisciplinary Treatment Of Congenitally Missing Maxillary Lateral Incisors: A 14-Year Follow-Up Case Report, Renato Rodrigues De Almeida, Ana Carolina Morandini, Renata Rodrigues De Almeida-Pedrin, Marcio Rodrigues De Almeida, Renata Cristina Faria Ribeiro Castro, Natalia Martins Insabralde

All Dugoni School of Dentistry Faculty Articles

Absence of the maxillary lateral incisor creates an aesthetic problem which can be managed in various ways. The condition requires careful treatment planning and consideration of the options and outcomes following either space closure or prosthetic replacement. Recent developments in restorative dentistry have warranted a re-evaluation of the approach to this clinical situation. Factors relating both to the patient and the teeth, including the presentation of malocclusion and the effect on the occlusion must be considered. The objective of this study was to describe the etiology, prevalence and alternative treatment modalities for dental agenesis and to present a clinical case …

Global School-Based Childhood Obesity Interventions: A Review, Melinda J. Ickes, Jennifer Mcmullen, Taj Haider, Manoj Sharma

Kinesiology and Health Promotion Faculty Publications

Background: The issue of childhood overweight and obesity has become a global public health crisis. School-based interventions have been developed and implemented to combat this growing concern. The purpose of this review is to compare and contrast U.S. and international school-based obesity prevention interventions and highlight efficacious strategies.

Methods: A systematic literature review was conducted utilizing five relevant databases. Inclusion criteria were: (1) primary research; (2) overweight or obesity prevention interventions; (3) school-based; (4) studies published between 1 January 2002 through 31 December 2013; (5) published in the English language; (6) child-based interventions, which could include parents; and …

Informing Parent Targeted Interventions To Promote Increased Physical Activity Among Youth, Teresia O'Connor

Journal of Applied Research on Children: Informing Policy for Children at Risk

Invited Commentary on "Examining the Disconnect Between Parents' Perceptions and Reality Regarding the Physical Activity Levels of Their Children."

Lean Body Mass May Explain Apparent Racial Differences In Carotid Intima-Media Thickness In Obese Children., Shahryar M. Chowdhury, Melissa H. Henshaw, Brad Friedman, J Philip Saul, Girish S. Shirali, Janet Carter, Bryana M. Levitan, Tom Hulsey

Manuscripts, Articles, Book Chapters and Other Papers

Background: Racial differences in carotid intima-media thickness (cIMT) have been suggested to be associated with the disproportionally high prevalence of cardiovascular disease in black adults. The objective of this study was to evaluate the effects of cardiovascular risk factors on the racial differences seen in cIMT in obese children.

Methods: Obese subjects aged 4 to 21 years were recruited prospectively. Height, weight, blood pressure, fasting insulin, glucose, lipid panel, high-sensitivity C-reactive protein, and body composition by dual-energy x-ray absorptiometry were obtained. B-mode carotid imaging was analyzed by a single blinded physician.

Results: A total of 120 subjects (46 white, 74 …

Mother-Reported Sleep, Accelerometer-Estimated Sleep, And Weight Status In Mexican American Children: Sleep Duration Is Associated With Increased Adiposity And Risk For Overweight/Obese Status, Suzanna M. Martinez, Louise C. Greenspan, Nancy F. Butte, Steven E. Gregorich, Cynthia L. De Groat, Julianna Deardorff, Carlos Penilla, Lauri A. Pasch, Elena Flores, Jeanne M. Tschann

School of Education Faculty Research

We know of no studies comparing parent-reported sleep with accelerometer-estimated sleep in their relation to pediatric adiposity. We examined: 1) the reliability of mother-reported sleep compared with accelerometer-estimated sleep, and 2) the relationship between both sleep measures and child adiposity. The current cross-sectional study included 304 Mexican American mother-child pairs recruited from Kaiser Permanente Northern California. We measured sleep duration, using maternal report and accelerometry, and child anthropometrics. Concordance between sleep measures was evaluated using the Bland-Altman method. We conducted zero-ordered correlations between mother-reported sleep, accelerometer-estimated sleep and child BMI z-scores (BMIz). Using linear regression, we examined three models to …

Depressive Symptoms And Observed Eating In Youth, Mira Mooreville, Lauren B. Shomaker, Samantha A. Reina, Louise M. Hannallah, L. Adelyn Cohen, Amber B. Courville, Merel Kozlosky, Sheila M. Brady, Tania Condarco, Susan Z. Yanovski, Marian Tanofsky-Kraff, Jack A. Yanovski

Uniformed Services University of the Health Sciences

Depressive symptoms in youth may be a risk factor for obesity, with altered eating behaviors as one possible mechanism. We tested whether depressive symptoms were associated with observed eating patterns expected to promote excessive weight gain in two separate samples. In Study 1, 228 nontreatment- seeking youth, ages 12–17 y (15.3 ± 1.4 y; 54.7% female), self-reported depressive symptoms using the Beck Depression Inventory. Energy intake was measured as consumption from a 10,934-kcal buffet meal served at 11:00 am after an overnight fast. In Study 2, 204 non-treatment-seeking youth, ages 8–17 y (13.0 ± 2.8 y; 49.5% female), self-reported depressive …

Examining The Sensory Characteristics Of Preschool Children With Retentive Fecal Incontinence, Isabelle Beaudry-Bellefeuille

Theses and Dissertations

Occupational therapists are concerned with individuals´ abilities to engage in daily occupations. When a daily activity such as bowel management is problematic, participation in key occupations can be limited. Retentive fecal incontinence is a common disorder in children. Behavior seems to be partly responsible for this condition. Occupational therapists have hypothesized that some behaviors could be related to sensory over-responsivity. This study investigated the relationship between retentive fecal incontinence and sensory over-responsivity and examined the Toileting Habit Profile Questionnaire, a tool designed to screen for toileting difficulties. The study showed that a group of children (n=16) with retentive fecal incontinence …

A Study Examining The Effectiveness Of A Sensory-Based Feeding Group For Children With Problematic Eating Behaviors, Laura Notch, Brionna Simenson

Occupational Therapy Capstones

KEY WORDS: children, problematic eating behaviors, sensory, intervention

OBJECTIVE: The purpose of this pilot study was to analyze the process and outcomes of a routine sensory-based feeding group on a child’s problematic eating behaviors.

METHODS: An experimental pretest-posttest research design was used to gather and analyze quantitative and qualitative data on 4 children who demonstrated problematic eating behaviors. The children participated in a routine 8-week sensory-based feeding group, which utilized sensory activities to promote change. The Children’s Eating Behavior Inventory (CEBI) and the Feeding Intake Form (FIF) were completed through parental report prior to and upon completion of the intervention. …

Parental Experiences Of Early Pulmonary Surveillance For Children With Cystic Fibrosis: A Research Proposal For Improved Family Psychosocial Outcomes, Cindy A. Branch-Smith, Tonia Douglas, Linda Shields, Stephen Stick, John Massie, Julie Ann Pooley

Research outputs 2014 to 2021

The Australian Respiratory Early Surveillance Team for Cystic Fibrosis (AREST-CF) conducts an early surveillance program (ESP) for children with cystic fibrosis (CF). The program has the potential to modify long term health outcomes for children through early detection of lung disease, long before signs and symptoms are apparent. The program is aimed specifically at infants and preschool children (~3 months to 6 years) who undergo annual, detailed and relatively invasive surveillance. Although the ESP has been operating for 10 years, how parents experience their child undergoing early surveillance of this nature, and the psychosocial factors that moderate these experiences, is …

American And Brazilian Children With Primary Urolithiasis: Similarities And Disparities., Maria Goretti Moreira Guimarães Penido, Marcelo De Sousa Tavares, Milena Maria Moreira Guimarães, Tarak Srivastava, Uri S. Alon

Manuscripts, Articles, Book Chapters and Other Papers

Objectives. Considering the differences in location, socioeconomic background, and cultural background, the aim of this study was to try to identify possible factors associated with the increased incidence of urolithiasis by comparing American and Brazilian children with stones.
Methods. Data of 222 American and 190 Brazilian children with urolithiasis were reviewed including age, gender, body mass index, imaging technique used (ultrasound and computed tomography), and 24-hour urine volume and chemistries.
Results. There were no differences between age and gender at diagnosis. Brazilian children were leaner but in no population did obesity rate exceed that of the general population. Ultrasound was …

Metals In Commonly Eaten Groceries In Western Australia: A Market Basket Survey And Dietary Assessment, Anna Callan, Andrea Hinwood, Amanda Devine

Research outputs 2014 to 2021

Children’s dietary exposure to metals has received limited attention in Australia. This study undertook a market basket survey and analysed 253 food and beverages for metals. These data were used in conjunction with recent average diet data for children in Western Australia to model dietary metals exposure, with mean metals intakes calculated for boys and girls aged 8, 12, 13 and 16 years. Results show that for some metals, including cadmium, nickel and manganese, dietary intake guidelines have been exceeded in younger children. The mean modelled cadmium intake in children aged 8 years was almost 60% of the World Health …

Effects Of Exercise On Bmi Z-Score In Overweight And Obese Children And Adolescents: A Systematic Review With Meta-Analysis, George A Kelley, Kristi S Kelley, Russell R Pate

Faculty & Staff Scholarship

No abstract provided.

Household Wealth And Neurocognitive Development Disparities Among School-Aged Children In Nepal., Shivani A Patel, Laura E Murray-Kolb, Steven C Leclerq, Subarna K Khatry, James M. Tielsch, Joanne Katz, Parul Christian

Global Health Faculty Publications

BACKGROUND: Wealth disparities in child developmental outcomes are well documented in developed countries. We sought to (1) describe the extent of wealth-based neurocognitive development disparities and (2) examine potential mediating factors of disparities among a population-based cohort of children in rural Nepal.

METHODS: We investigated household wealth-based differences in intellectual, executive and motor function of n = 1692 children aged between 7 and 9 years in Nepal. Using linear mixed models, wealth-based differences were estimated before and after controlling for child and household demographic characteristics. We further examined wealth-based differences adjusted for three sets of mediators: child nutritional status, home …

Recommendations For High-Priority Research On Cancer-Related Fatigue In Children And Adults., Andrea M. Barsevick, Michael R. Irwin, Pamela Hinds, Andrew Miller, Ann Berger, Paul Jacobsen, Sonia Ancoli-Israel, Bryce B Reeve, Karen Mustian, Ann O'Mara, Jin-Shei Lai, Michael Fisch, David Cella

Department of Medical Oncology Faculty Papers

Over the past decades, some scientific progress has been made in understanding and treating cancer-related fatigue (CRF). However, three major problems have limited further progress: lack of agreement about measurement, inadequate understanding of the underlying biology, and problems in the conduct of clinical trials for CRF. This commentary reports the recommendations of a National Cancer Institute Clinical Trials Planning Meeting and an ongoing National Cancer Institute working group to address these problems so that high-priority research and clinical trials can be conducted to advance the science of CRF and its treatment. Recommendations to address measurement issues included revising the current …

Children's Self Perception Of Weight, Carolyn Montoya

Nursing ETDs

The purpose of this study was to determine whether there are differences in children’s self-perceptions of weight based on age, gender, actual body mass index (BMI) category, grade level, and ethnicity compared with their clinically measured BMI and to determine the association of gender, age, grade level, race/ethnicity, and actual BMI category with their perception of ideal BMI category. A total of 424 children from a rural community in New Mexico, aged 8 to 11 years and in Grades 3 through 5, participated in this study. Of this sample 70% (n = 299) is Hispanic; 19% (n = 80) is …

De Novo Frameshift Mutation In Asxl3 In A Patient With Global Developmental Delay, Microcephaly, And Craniofacial Anomalies., Darrell L. Dinwiddie, Sarah E. Soden, Carol J. Saunders, Neil A. Miller, Emily G. Farrow, Laurie D. Smith, Stephen F. Kingsmore

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Currently, diagnosis of affected individuals with rare genetic disorders can be lengthy and costly, resulting in a diagnostic odyssey and in many patients a definitive molecular diagnosis is never achieved despite extensive clinical investigation. The recent advent and use of genomic medicine has resulted in a paradigm shift in the clinical molecular genetics of rare diseases and has provided insight into the causes of numerous rare genetic conditions. In particular, whole exome and genome sequencing of families has been particularly useful in discovering de novo germline mutations as the cause of both rare diseases and complex disorders.

CASE PRESENTATION: …

How Television Fast Food Marketing Aimed At Children Compares With Adult Advertisements, Amy M. Bernhardt, Cara Wilking, Anna M. Adachi-Mejia, Elaina Bergamini, Jill Marijnissen, James D. Sargent

Dartmouth Scholarship

Objectives: Quick service restaurant (QSR) television advertisements for children’s meals were compared with adult advertisements from the same companies to assess whether self-regulatory pledges for food advertisements to children had been implemented. Methods: All nationally televised advertisements for the top 25 US QSR restaurants from July 1, 2009 to June 30, 2010 were obtained and viewed to identify those advertising meals for children and these advertisements were compared with adult advertisements from the same companies. Content coding included visual and audio assessment of branding, toy premiums, movie tie-ins, and depictions of food. For image size comparisons, the diagonal length of …

Effects Of A School-Based Education Intervention On Bmi And Physical Activity, Lauren M. Panner

Evidence-Based Practice Project Reports

In 2011, the CDC reported that there are 12.5 million obese children and adolescents living in the United States (U.S.). The financial burden of childhood obesity in the U.S. is estimated to be 14 billion dollars. The objective of this evidence-based practice (EBP) project was to answer the question: In school-aged children, how does school-based, structured, family-oriented physical activity education affect body mass index (BMI) compared to usual education over an eight week time period? The Stetler Model of EBP and the health belief model were used to guide this project in a rural, Northwest Indiana elementary school. For eight …

Healthy Skin Is In: Effects Of A Multifaceted Sun Safety Program For Adolescents, Lindsay A. Munden

Evidence-Based Practice Project Reports

Skin cancer is a common, potentially life threatening disease notably on the rise among young Americans. A substantial portion of lifetime exposure to ultraviolet (UV) radiation, the greatest modifiable risk factor for skin cancer development, occurs during childhood and adolescence. Schools infrequently integrate sun safety education into the classroom and many lack essential sun safety policies. The purpose of this EBP project was to implement a multifaceted educational intervention providing middle school students with the knowledge behavioral skills needed to minimize the risk of developing skin cancer. The Health Belief Model and ACE Star Model of evidence-based practice guided this …

Variation In Cortical Density Within The Cortical Shell Of Individuals Across A Range In Densities And Ages, Lee A. Weidauer, Teresa L. Binkley, R Berry, Bonny Specker

Health and Nutritional Sciences Faculty Publications

OBJECTIVES: The purpose of this study was to determine variability in cortical volumetric bone density (vBMD) from a single slice tibia image over a range of vBMD readings and ages.

METHODS: Males and females (N=80; aged 6-80) were randomly selected from a previous study. Cortical vBMD at the anterior, posterior, medial, and lateral regions as well as the endocortical, mid-cortical, and pericortical regions of the cortical shell were determined using pQCT.

RESULTS: Mean anterior ROI cortical vBMD (1111±11 mg/cm(3)) was lower than the posterior and lateral ROIs (1169±7 mg/cm(3) and 1151±9 mg/cm(3), respectively), (p

CONCLUSIONS: Variability in cortical vBMD was …

Indicators Of Family Care For Development For Use In Multicountry Surveys, Patricia Kariger, Edward A. Frongillo Jr., Patrice Engle, Pia M. Rebello Britto, Sara M. Sywulka, Purnima Menon

Faculty Publications

Indicators of family care for development are essential for ascertaining whether families are providing their children with an environment that leads to positive developmental outcomes. This project aimed to develop indicators from a set of items, measuring family care practices and resources important for caregiving, for use in epidemiologic surveys in developing countries. A mixed method (quantitative and qualitative) design was used for item selection and evaluation. Qualitative and quantitative analyses were conducted to examine the validity of candidate items in several country samples. Qualitative methods included the use of global expert panels to identify and evaluate the performance of …

Community Outreach And Engagement To Prepare For Household Recruitment Of National Children's Study Participants In A Rural Setting, Nancy L. Fahrenwald, Betty Wey, Ann Martin, Bonny L. Specker

Ethel Austin Martin Program Publications

CONTEXT: The National Children's Study (NCS) is a longitudinal study of environmental influences on children's health. Recruitment of a representative birth cohort that will be followed until 21 years of age requires unique approaches across the nationwide study communities.
PURPOSE: To describe community outreach and engagement in preparation for household recruitment of women of childbearing age at a rural-classified NCS location that includes 4 adjacent Northern Plains counties spanning 2,500 square miles.
METHODS: Outreach and engagement methods focused on rural community characteristics. The team established an advisory council, conducted outreach meetings with agencies and groups, participated in local events, and …

Association Of Iron Depletion With Menstruation And Dietary Intake Indices In Pubertal Girls: The Healthy Growth Study, George Moschonis, Dimitrios Papandreou, Christina Mavrogianni, Angeliki Giannopoulou, Louisa Damianidi, Pavlos Malindretos, Christos Lionis, George P. Chrousos, Yannis Manios

All Works

The aim of the present study was to investigate the associations of iron depletion (ID) with menstrual blood losses, lifestyle, and dietary habits, in pubertal girls. The study sample comprised 1222 girls aged 9-13 years old. Biochemical, anthropometrical, dietary, clinical, and physical activity data were collected. Out of 274 adolescent girls with menses, 33.5% were found to be iron depleted (defined as serum ferritin < 12 g/L) compared to 15.9% out of 948 girls without menses. Iron-depleted girls without menses were found to have lower consumption of poultry (P = 0.017) and higher consumption of fruits (P = 0.044) and fast food (P = 0.041) compared to their peers having normal iron status. Multivariate logistic regression analysis showed that girls with menses were 2.57 (95% CI: 1.37, 4.81) times more likely of being iron depleted compared to girls with no menses. Iron depletion was found to be associated with high calcium intake, high consumption of fast foods, and low consumption of poultry and fruits. Menses was the only factor that was found to significantly increase the likelihood of ID in these girls. More future research is probably needed in order to better understand the role of diet and menses in iron depletion. © 2013 George Moschonis et al.

Brief Oral Health Promotion Intervention Among Parents Of Young Children To Reduce Early Childhood Dental Decay, Peter Arrow, Joseph Raheb, Margaret Miller

Research outputs 2013

Background: Severe untreated dental decay affects a child's growth, body weight, quality of life as well as cognitive development, and the effects extend beyond the child to the family, the community and the health care system. Early health behavioural factors, including dietary practices and eating patterns, can play a major role in the initiation and development of oral diseases, particularly dental caries. The parent/caregiver, usually the mother, has a critical role in the adoption of protective health care behaviours and parental feeding practices strongly influence children's eating behaviours. This study will test if an early oral health promotion intervention through …

Predictors Of The Number Of Under-Five Malnourished Children In Bangladesh: Application Of The Generalized Poisson Regression Model, Mohammad Mafijul Islam, Morshed Alam, Md Tariquzaman, Mohammad Alamgir Kabir, Rokhsona Pervin, Munni Begum, Md Mobarak Hossain Khan

Journal Articles: Biostatistics

BACKGROUND: Malnutrition is one of the principal causes of child mortality in developing countries including Bangladesh. According to our knowledge, most of the available studies, that addressed the issue of malnutrition among under-five children, considered the categorical (dichotomous/polychotomous) outcome variables and applied logistic regression (binary/multinomial) to find their predictors. In this study malnutrition variable (i.e. outcome) is defined as the number of under-five malnourished children in a family, which is a non-negative count variable. The purposes of the study are (i) to demonstrate the applicability of the generalized Poisson regression (GPR) model as an alternative of other statistical methods and …