CLOSE RELATIONSHIPS AMONG YOUNG ADULT SURVIVORS OF CHILDHOOD CANCER:A QUANTITATIVE AND QUALITATIVE ANALYSIS

CLOSE RELATIONSHIPS AMONG YOUNG ADULT SURVIVORS OF CHILDHOOD CANCER: A QUANTITATIVE AND QUALITATIVE ANALYSISAmanda L. Thompson, Ph.D.University of Pittsburgh, 2007The growing body of research focusing on the long-term sequelae of diagnosis and treatment for childhood cancer suggests that while the majority of survivors are not at increased risk for psychopathology, many experience persistent problems in other domains that greatly affect quality of life (QoL). Social well-being, a construct that includes the development and maintenance of interpersonal relationships and issues of affection and sexuality, has been somewhat neglected in the late-effects literature. As such, a multi-method, developmentally sensitive study was conducted 1) to assess whether childhood cancer survivors experience difficulties in their close relationships during young adulthood, 2) to characterize the nature of these difficulties, 3) to identify who may be at risk for long-term social sequelae, and 4) to document survivors' own perceptions of their interpersonal relationships. Sixty young adult (18-25years old) survivors of childhood cancer and 60 controls without a history of chronic illness completed an online assessment of their friendship and romantic relationships. In addition, a subsample of 18 female survivors participated in a follow-up qualitative interview. Quantitative analyses revealed that relative to controls, survivors were involved in fewer romantic relationships over the past five years and reported being significantly more distressed at the dissolution of those relationships. High trait anxiety, male gender, an older age of diagnosis, and higher treatment intensity emerged as significant risk factors for a host of relationship difficulties within the survivor sample, including lower relationship satisfaction, lower levels of reported intimacy, greater fear of intimacy, more conflict, and more distress at break-up. Finally, qualitative findings highlighted relationship issues not captured by the quantitative measures, including cautiousness with personal self-disclosure, self-consciousness as a result of treatment-related physical changes and medical sequelae, and concerns about fertility. In light of the inconsistencies between quantitative and qualitative findings, this study emphasizes the need for more sophisticated measures of survivors' social QoL. Limitations of the study (related to sampling and measurement) are discussed, and a number of future directions are suggested

Intergenerational impact of maternal obesity and postnatal feeding practices on pediatric obesity

The postnatal feeding practices of obese and overweight mothers may place their children at particular risk for the development of obesity through shared biology and family environments. This paper reviews the feeding practices of obese mothers, describes potential mechanisms linking maternal feeding behaviors to child obesity risk, and highlights potential avenues for intervention. This review documents that supporting breastfeeding, improving the food choices of obese women, and encouraging the development of feeding styles that are responsive to hunger and satiety cues are important for improving the quality of the eating environment and preventing the intergenerational transmission of obesity

The Ava bracelet for collection of fertility and pregnancy data in free-living conditions: An exploratory validity and acceptability study

Objective To evaluate the validity and acceptability of the Ava bracelet for collecting heart rate, sleep, mood, and physical activity data among reproductive-aged women (pregnant and nonpregnant) under free-living conditions. Methods Thirty-three participants wore the Ava bracelet on their non-dominant wrist and reported mood and physical activity in the Ava mobile application for seven nights. Criterion validity was determined by comparing the Ava bracelet heart rate and sleep duration measures to criterion measures from the Polar chest strap and ActiGraph GTX3 + accelerometer. Construct validity was determined by comparing self-report measures and the heart rate variability ratio collected in the Ava mobile application to previously validated measures. Acceptability was evaluated using the modified Acceptability of Health Apps among Adolescents Scale. Results Mean absolute percentage error was 11.4% for heart rate and 8.5% for sleep duration. There was no meaningful difference between the Ava bracelet, ActiGraph, and construct a measure of sleep quality. Compared to construct measures, Ava bracelet heart rate variability had a significant low negative correlation (r:−0.28), mood had a significant low positive correlation (r : 0.39), and physical activity level had a significant low (rlevel of physical activity: 0.56) to moderate positive correlation (rMET−minutes/week: 0.71). The acceptability of the Ava bracelet was high for fertility and low for pregnancy tracking. Conclusion Preliminary evidence suggests the Ava bracelet and mobile application estimates of sleep and heart rate are not equivalent to criterion measures in free-living conditions. Further research is needed to establish its utility for collecting prospective, subjective data throughout periods of preconception and pregnancy

The influence of maternal psychosocial characteristics on infant feeding styles

Maternal feeding styles in infancy and early childhood are associated with children’s later risk for overweight and obesity. Maternal psychosocial factors that influence feeding styles during the complementary feeding period, the time during which infants transition from a milk-based diet to one that includes solid foods and other non-milk products, have received less attention. The present study explores how maternal psychosocial factors—specifically self-esteem, parenting self-efficacy, parenting satisfaction, and depression symptoms—influence mothers’ infant feeding styles at nine months of age, a time during which solid foods eating habits are being established. Participants included 160 low-income, African-American mother-infant pairs in central North Carolina who were enrolled in the Infant Care and Risk of Obesity Study. Regression models tested for associations between maternal psychosocial characteristics and pressuring and restrictive feeding styles. Models were first adjusted for maternal age, education, marital status and obesity status. To account for infant characteristics, models were then adjusted for infant weight-for-length, distress to limitations and activity level scores. Maternal self-esteem was negatively associated with pressuring to soothe. Maternal parenting self-efficacy was positively associated with restriction-diet quality. Maternal parenting satisfaction and depression symptoms were not associated with feeding styles in the final models. Focusing on strengthening maternal self-esteem and parenting self-efficacy may help to prevent the development of less desirable infant feeding styles

Beyond the Paleolithic prescription: incorporating diversity and flexibility in the study of human diet evolution

Evolutionary paradigms of human health and nutrition center on the evolutionary discordance or “mismatch” model whereby human bodies, reflecting adaptations established in the Paleolithic era, are ill-suited to modern industrialized diets resulting in rapidly increasing rates of chronic metabolic disease. Whereas this model remains useful, we argue that its utility in explaining the evolution of human dietary tendencies is limited. The assumption that human diets are mismatched to our evolved biology implies that they are instinctual or genetically determined and rooted in the Paleolithic. We review current research indicating that human eating habits are primarily learned through behavioral, social and physiological mechanisms starting in utero and extending throughout the life course. Those adaptations that appear to be strongly genetic likely reflect Neolithic, rather than Paleolithic, adaptations and are significantly influenced by human niche-constructing behavior. Incorporating a broader understanding of the evolved mechanisms by which humans learn and imprint eating habits and the reciprocal effects of those habits on physiology would provide useful tools for structuring more lasting nutrition interventions

Prenatal and postnatal energetic conditions and sex steroids levels across the first year of life

Human biologists have documented variability in reproductive maturation, fertility, and cancer risk related to developmental conditions. Yet no previous studies have directly examined the impact of pre- and post-natal energetic environments on sex steroids in infancy, a critical period for hypothalamic-pituitary-gonadal axis development. Thus, we examined the impact of maternal characteristics, birth size, and feeding practices on fecal sex steroid production in a longitudinal sample of 31 American infants followed from 2 weeks to 12 months of age

Infrared Spectral Observations While Drilling into a Frozen Lunar Simulant

Past and continuing observations indicate an enrichment of volatile materials in lunar polar regions. While these volatiles may be located near the surface, access to them will likely require subsurface sampling, during which it is desirable to monitor the volatile content. In a simulation of such activities, a multilayer lunar simulant was prepared with differing water content, and placed inside a thermal vacuum chamber at Glenn Research Center (GRC). The soil profile was cooled using liquid nitrogen. In addition to the soil, a drill and infrared (IR) spectrometer (~1600-3400 nm) were also located in the GRC chamber. We report the spectral observations obtained during a sequence where the drill was repeatedly inserted and extracted, to different depths, at the same location. We observe an overall increase in the spectral signature of water ice over the duration of the test. Additionally, we observe variations in the water ice spectral signature as the drill encounters different layers

The critical period of infant feeding for the development of early disparities in obesity

Childhood obesity is an increasing public health problem, particularly among minority infants and young children. Disparities in overweight prevalence persist and widen with age, highlighting the need to identify factors contributing to early excess weight gain. We review the behavioral, social and macro-environmental factors contributing to the development of obesogenic early feeding practices among African-American infants and young children. We then examine the sociodemographic, household factors, feeding beliefs and infant characteristics associated with age-inappropriate feeding of liquids and solids (inappropriate feeding) among mothers and infants participating the U.S. Infant Care and Risk of Obesity Study, a cohort study of 217 low-income, first-time mothers and infants followed from 3 to 18 months of age. Maternal and infant anthropometry, infant diet, and maternal and household characteristics were collected at home visits at 3, 6, 9, 12 and 18 months of age. Mixed logistic regression was used to estimate the association between maternal and infant characteristics and inappropriate feeding. Rates of age-inappropriate feeding are high; over 75% of infants received solids or juice by 3 months of age. The odds of age-inappropriate feeding were higher among mothers who were single, depressed or believed that their infant is a “greedy” baby. Inappropriate feeding was associated with higher daily energy intake in infants (β = 109.28 calories, p = 0.01) and with increased odds of high infant weight-for-length (WFL; OR = 1.74, 95%CI: 1.01–3.01). Our findings suggest that age-inappropriate complementary feeding influences current energy intakes and infant WFL, factors that may increase long-term obesity risk by shaping infant appetite, food preferences, and metabolism. Given the intractability of pediatric obesity, understanding the role of early feeding in shaping long-term health disparities is critical for developing prevention strategies to stem obesity in early childhood

“Whatever Average Is”: Understanding African American Mothers’ Perceptions of Infant Weight, Growth, and Health

Biomedical researchers have raised concerns that mothers’ inability to recognize infant and toddler overweight poses a barrier to stemming increasing rates of overweight and obesity, particularly among low-income or minority mothers. Little anthropological research has examined the sociocultural, economic or structural factors shaping maternal perceptions of infant and toddler size or addressed biomedical depictions of maternal misperception as a “socio-cultural problem.” We use qualitative and quantitative data from 237 low-income, African-American mothers to explore how they define ‘normal’ infant growth and infant overweight. Our quantitative results document that mothers’ perceptions of infant size change with infant age, are sensitive to the size of other infants in the community, and are associated with concerns over health and appetite. Qualitative analysis documents that mothers are concerned with their children’s weight status and assess size in relation to their infants’ cues, local and societal norms of appropriate size, interactions with biomedicine, and concerns about infant health and sufficiency. These findings suggest that mothers use multiple models to interpret and respond to child weight. An anthropological focus on the complex social and structural factors shaping what is considered ‘normal’ and ‘abnormal’ infant weight is critical for shaping appropriate and successful interventions

The Local Food Environment and Body Mass Index among the Urban Poor in Accra, Ghana

Obesity in the sub-Saharan Africa region has been portrayed as a problem of affluence, partly because obesity has been found to be more common in urban areas and among the rich. Recent findings, however, reveal rising prevalence among the poor particularly the urban poor. A growing body of literature mostly in Western countries shows that obesity among the poor is partly the result of an obesogenic-built environment. Such studies are lacking in the African context. This study examines the characteristics of the local food environment in an urban poor setting in Accra, Ghana and further investigates the associated risk of obesity for residents. Data on the local food environment was collected using geographic positioning system (GPS) technology. The body mass indices (BMI) of females (15-49 years) and males (15-59 years) were calculated from measured weight and height. Data on the socio-demographic characteristics and lifestyle behaviors of respondents was also collected through a household survey. Spatial analysis tools were used to examine the characteristics of the local food environment while the influence of the food environment on BMI was examined using a two-level multilevel model. The measures of the food environment constituted the level 2 factors while individual socio-demographic characteristics and lifestyle behaviors constituted the level 1 factors. The local food environment in the study communities is suggestive of an obesogenic food environment characterized by an abundance of out-of-home cooked foods, convenience stores, and limited fruits and vegetables options. The results of the multilevel analysis reveal a 0.2 kg/m(2) increase in BMI for every additional convenience store and a 0.1 kg/m(2) reduction in BMI for every out-of-home cooked food place available in the study area after controlling for individual socio-demographic characteristics, lifestyle behaviors, and community characteristics. The findings of this study indicate that the local food environment in urban poor Accra is associated with increased risk of obesity through providing access to convenience stores. In order to reduce the risk of obesity in these urban poor communities, there is the need to regulate the availability of and access to convenience stores while also encouraging healthier offerings in convenience stores