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ObjctivesSelf-rated health (SRH) is an important indicator of overall health, predicting morbidity and mortality. This paper investigates what individuals incorporate into their self-assessments of health and how acculturation plays a part in this assessment. The relationship of acculturation to SRH and whether it moderates the association between indicators of health and SRH is also examined. DesignThe paper is based on data from adults in the Boston Puerto Rican Health Study, living in the greater Boston area (n=1357) mean age 57.2 (SD = 7.6). We used multiple regression analysis and testing for moderation effects. ResultsThe strongest predictors of poor SRH were the number of existing medical conditions, functional problems, allostatic load and depressive symptoms. Poor SRH was also associated with being female, fewer years of education, heavy alcohol use, smoking, poverty, and low emotional support. More acculturated Puerto Rican adults rated their health more positively, which corresponded to better indicators of physical and psychological health. Additionally, acculturation moderated the association between some indicators of morbidity (functional status and depressive symptoms) and SRH.Self-assessments of overall health integrate diverse indicators, including psychological symptoms, functional status and objective health indicators such as chronic conditions and allostatic load. However, adults' assessments of overall health differed by acculturation, which moderated the association between health indicators and SRH. The data suggest that when in poor health, those less acculturated may understate the severity of their health problems when rating their overall health, thus SRH might thus conceal disparities. Using SRH can have implications for assessing health disparities in this population. [ABSTRACT FROM AUTHOR]

Context: Per- and polyfluoroalkyl substances (PFAS) are environmental chemicals linked to weight gain and type 2 diabetes.Objective: We examined the extent to which PFAS plasma concentrations during pregnancy were associated with postpartum anthropometry and biomarkers.Design, Patients, and Measures: We studied women recruited between 1999 and 2002 in the Project Viva prospective cohort with pregnancy plasma concentrations of PFAS, including perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and 2-(N-ethyl-perfluorooctane sulfonamide) acetic acid (EtFOSAA). Three-year postpartum anthropometry measurements were available from 786 to 801 women, blood pressure from 761 women, and blood biomarkers from 450 to 454 women. We used multivariable regression to evaluate the association of log2-transformed PFAS with postpartum anthropometry, blood pressure, and blood biomarkers (leptin, adiponectin, sex hormone binding globulin [SHBG], hemoglobin A1c, interleukin-6 [IL-6], C-reactive protein), adjusting for age, prepregnancy body mass index, marital status, race/ethnicity, education, income, smoking, parity, and breastfeeding history.Results: Pregnancy concentrations of certain PFAS were associated with greater adiposity (eg, 0.4 cm [95% confidence interval [95%CI]: -0.1, 0.9] greater waist circumference per doubling in EtFOSAA; 0.2 cm [95%CI: -0.1, 0.5] greater mid-upper arm circumference per doubling in PFOA; 1.2 mm [95%CI: 0.1, 2.2] thicker sum of subscapular and triceps skinfolds per doubling in PFOS) and higher systolic blood pressure (eg, 1.2 mm Hg [95%CI: 0.3, 2.2] per doubling in PFOS) at 3 years postpartum. Higher EtFOSAA concentrations were also associated with 10.8% higher IL-6 (95%CI: 3.3, 18.9) and 6.1% lower SHBG (95%CI: 0.7, 11.2) per doubling.Conclusions: Pregnancy concentrations of EtFOSAA, PFOS, and PFOA were associated with adverse postpartum cardiometabolic markers. [ABSTRACT FROM AUTHOR]

Measuring stride variability and dynamics in children is useful for the quantitative study of gait maturation and neuromotor development in childhood and adolescence. In this paper, we computed the sample entropy (SampEn) and average stride interval (ASI) parameters to quantify the stride series of 50 gender-matched children participants in three age groups. We also normalized the SampEn and ASI values by leg length and body mass for each participant, respectively. Results show that the original and normalized SampEn values consistently decrease over the significance level of the Mann-Whitney U test (p<0.01) in children of 3–14 years old, which indicates the stride irregularity has been significantly ameliorated with the body growth. The original and normalized ASI values are also significantly changing when comparing between any two groups of young (aged 3–5 years), middle (aged 6–8 years), and elder (aged 10–14 years) children. Such results suggest that healthy children may better modulate their gait cadence rhythm with the development of their musculoskeletal and neurological systems. In addition, the AdaBoost.M2 and Bagging algorithms were used to effectively distinguish the children’s gait patterns. These ensemble learning algorithms both provided excellent gait classification results in terms of overall accuracy (≥90%), recall (≥0.8), and precision (≥0.8077). [ABSTRACT FROM AUTHOR]

Background In adults, adherence to the Mediterranean diet has been inversely associated with cardiovascular risk, but the extent to which diet in pregnancy is associated with offspring adiposity is unclear. We aimed to investigate the association between adherence to Mediterranean diet in pregnancy and offspring cardiometabolic traits in two pregnancy cohorts. Methods We studied 997 mother-child pairs from Project Viva in Massachusetts, USA, and 569 pairs from the Rhea study in Crete, Greece. We estimated adherence to the Mediterranean diet with an a priori defined score (MDS) of nine foods and nutrients (0 to 9). We measured child weight, height, waist circumference, skin-fold thicknesses, blood pressure, and blood levels of lipids, c-reactive protein and adipokines in mid-childhood (median 7.7 years) in Viva, and in early childhood (median 4.2 years) in Rhea. We calculated cohort-specific effects and pooled effects estimates with random-effects models for cohort and child age. Results In Project Viva, the mean (SD, standard deviation) MDS was 2.7 (1.6); in Rhea it was 3.8 (1.7). In the pooled analysis, for each 3-point increment in the MDS, offspring BMI z-score was lower by 0.14 units (95% CI, −0.15 to −0.13), waist circumference by 0.39 cm (95% CI, −0.64 to −0.14), and the sum of skin-fold thicknesses by 0.63 mm (95% CI, −0.98 to −0.28). We also observed lower offspring systolic (−1.03 mmHg; 95% CI, −1.65 to −0.42) and diastolic blood pressure (−0.57 mmHg; 95% CI, −0.98 to −0.16). Conclusion Greater adherence to Mediterranean diet during pregnancy may protect against excess offspring cardiometabolic risk. [ABSTRACT FROM AUTHOR]

Background: Previous studies of early life influences on later growth in childhood have varied in their analytical approaches, particularly with respect to 'adjustment' for differences in size at the beginning of the growth period examined.Methods: We compared three commonly used statistical models to assess the effect of maternal body mass index (BMI) on growth between 6.5 and 11.5 years in a large cohort of Belarusian children, as follows: (Model 1) analysis of the difference in anthropometric measurements between the two ages; (Model 2) analysis of the measurement at 11.5 years after adjustment for the same measurement at 6.5 years; and (Model 3) analysis of the difference in measurements after adjustment for the measurement at 6.5 years (mathematically identical to Model 2).Results: Among PROBIT children of obese mothers (BMI ≥ 30 kg/m 2 ) vs those of mothers with normal BMI (18.5 to < 25 kg/m 2 ), Model 1 yielded larger increases in most weight and adiposity outcomes than did Model 2. We show that these larger effects arise because Model 2 parameterizes the effect of maternal BMI twice in same model: once for its effect on size at 6.5 years, and a second time for its effect on growth over the 5-year period between 6.5 and 11.5 years. Similar results were obtained in analogous analyses from cohorts in Boston, MA, and Singapore.Conclusion: Analysing the effect of exposure on change in outcome between two ages (Model 1) is clearly preferable to 'adjustment' for the outcome at the earlier age whenever the exposure under study affects the outcome at the earlier age. [ABSTRACT FROM AUTHOR]

Background Alcoholism has been linked to deficits in cognitive, behavioral, and emotional functions, and the cerebellum is important for optimal functioning of these abilities. However, little is known about how individual differences such as gender and drinking history might influence regional cerebellar abnormalities. Methods Volumetric analyses of the cerebellum and its subregions were performed in relation to the interaction of gender and measures of drinking history. Structural magnetic resonance imaging scans of 44 alcoholic individuals (23 men) and 39 nonalcoholic controls (18 men) were obtained. In addition to measuring total cerebellar gray and white matter volumes, we measured 64 individual cerebellar parcellation units, as well as functionally defined a priori regions of interest that have been shown to correspond to functions impaired in alcoholism. Results Total cerebellar white matter volume was smaller in alcoholic relative to nonalcoholic participants. Moreover, volumes of parcellation units varied with drinking history, showing negative associations between years of heavy drinking and the anterior lobe, the vestibulocerebellar lobe, and the spinocerebellar subdivision. The negative association between anterior volume and years of heavy drinking was driven primarily by alcoholic men. Additionally, we observed larger white and gray matter volumes for alcoholic women than for alcoholic men. Conclusions The identification of drinking-related abnormalities in cerebellar subregions lays a foundation that can be utilized to inform how cerebro-cerebellar networks are perturbed in this pathological condition. These results also provide estimates of how gender and individual differences in drinking history can predict cerebellar volumes. [ABSTRACT FROM AUTHOR]

Background Reliable, valid and theoretically consistent measures that assess a parent's self-efficacy for helping a child with obesity prevention behaviors are lacking. Objectives To develop measures of parental self-efficacy for four behaviors: 1) helping their child get at least 60 minutes of moderate intensity physical activity every day, 2) helping one's child consume five servings of fruits and vegetables each day, 3) limiting sugary drinks to once a week, and 4) limiting consumption of fruit juice to 6 ounces every day. Methods Sequential methods of scale development were used. An item pool was generated based on theory and qualitative interviews, and reviewed by content experts. Scales were administered to parents or legal guardians of children 4-10 years old. The item pool was reduced using principal component analysis. Confirmatory factor analysis tested the resulting models in a separate sample. Subjects 304 parents, majority were women (88%), low-income (61%) and single parents (61%). Ethnic distribution was 40% Black and 37% white. Results All scales had excellent fit indices: Comparative fit index > .98 and chi-squares (Pediatrics 120 Suppl 4:S229-253, 2007) = .85 - 7.82. Alphas and one-week test-retest ICC's were ≥ .80. Significant correlations between self-efficacy scale scores and their corresponding behaviors ranged from .13-.29 (all p < .03). Conclusions We developed four, four-item self-efficacy scales with excellent psychometric properties and construct validity using diverse samples of parents. Clinical trial registration: NCT01768533. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Maine Learning Technology Initiative (MLTI) is a program established in the state of Maine in the United States of America, where all students in 7th and 8th grades are provided with a notebook computer to use at school and at home during the academic year. OBJECTIVE: This study aimed to describe the anthropometric measurements and typing proficiency of a cohort of students in the MLTI. It also investigated the impact of participatory ergonomics education and use of peripheral notebook accessories on their reported musculoskeletal and visual discomfort over the first three years of a six year study. METHODS: This longitudinal study commenced in 2009 with 34 students in 7th grade consenting to participate for six years through the 12th grade. Students received ergonomics education about healthy notebook use, reinforced with web-based resources; and were provided with peripheral notebook accessories including a notebook riser, and external keyboard (split or non-split) and mouse. RESULTS: The use of an external keyboard resulted in a reduction in neck and shoulder pain. Participants self-reported fewer headaches when using an external mouse. Using no external accessories was associated with self-reported back pain. Although other musculoskeletal discomforts decreased over time, the changes were not statistically significant. There was a trend for the reduction of visual symptoms including dry/watery eyes and sore, tired eyes during the study. CONCLUSION: Participatory ergonomics training and use of external devices may have significant health benefits for children involved in notebook programs who have daily exposure to this technology for school and leisure purposes. Internal and external validity of the results were limited by small sample size. [ABSTRACT FROM AUTHOR]

Background: Tunnels created for reconstruction of a torn anterior cruciate ligament (ACL) are critical determinants of joint stability and clinical outcomes. There is limited objective evidence on the ability of transtibial (TT), anteromedial (AM) portal, and outside-in (OI) operative techniques in creating anatomic tunnels.Hypothesis: (1) Tibial tunnel–independent techniques can create tunnels more accurately at the anatomic ACL footprint center than the TT technique, and (2) femoral tunnel exit location of the OI and TT techniques on the lateral cortex will be significantly further away from the lateral epicondyle than the femoral tunnel exit location of the AM portal technique.Study Design: Controlled laboratory study.Methods: Eight cadaveric knee specimens with a mean age of 56 years were used in this study. A digitizing system was used to record points along the outlines of the ACL insertion area and apertures of tunnels created by the TT, AM portal, and OI techniques. The following parameters were measured from the digitized points: (1) amount of ACL, anteromedial bundle, and posterolateral bundle coverage by the tunnels; (2) relationship between the centers of the ACL and the tunnels; and (3) distance between the center of the femoral tunnel exit and the lateral epicondyle. All the recorded parameters were analyzed in 3-dimensional solid modeling software.Results: The percentage of ACL footprint coverage achieved by all 3 surgical techniques was not significantly different from one another. However, larger femoral posterolateral bundle coverage was observed in tunnels created by the AM portal and OI techniques than in the TT tunnel. In terms of anteromedial bundle coverage, no significant differences were observed between the 3 techniques. On average, 27.1% ± 17.4% of the TT tunnel was outside the ACL footprint. This was significantly larger compared with 13.6% ± 15.7% with the AM portal technique (P = .01) and 10.8% ± 10.8% in the OI technique (P = .01). Centers of femoral tunnels created by the TT, AM portal, and OI techniques were located at a distance of 3.0 ± 1.5 mm, 2.1 ± 0.9 mm, and 1.5 ± 1.2 mm, respectively, from the ACL footprint center. The femoral tunnel exit location of the AM portal technique on the lateral femoral cortex was closer to the lateral epicondyle than the femoral tunnel exit location of the OI and TT techniques.Conclusion: Findings of this study indicate that a larger posterolateral bundle coverage is achieved by the AM portal and OI techniques than by the TT technique. Centers of the tunnels created by the AM portal and OI techniques were closer to the native ACL footprint center than the center of the TT technique tunnel. The incidence of a posterior femoral tunnel exit relative to the lateral epicondyle is higher in the AM portal technique than in the OI and TT techniques.Clinical Relevance: For ACL reconstruction using soft tissue grafts, tibial tunnel–independent techniques can produce more anatomic tunnels than the TT technique. [ABSTRACT FROM PUBLISHER]

The Murray Quarry was operated during the 1920s and 1930s in sediments of the Early Jurassic East Berlin Formation. I examined 149 footprints of bipedal dinosaurs on three excavated slabs from the Murray Quarry and the in situ track bed. The three slabs I examined are on display at Forest Park, Springfield, MA; the Wistariahurst Museum in Holyoke, MA; and Mount Holyoke College in South Hadley, MA. The footprints belong to three ichnogenera, Eubrontes , Anchisauripus , and Grallator ; however, evidence such as length parameters suggests that these ichnogenera might be synonymous. Most of the footprints are referable to Eubrontes and Anchisauripus , which are large- and medium-sized ichnotaxa, respectively. Only two footprints are referable to Grallator , a small ichnotaxon. These ichnotaxa are thought to have been made by theropods, suggesting that there is a preservation bias in favor of carnivores, or that theropods dominated the fauna. The variable morphology of the footprints suggests that they were made over a period of time during which the substrate desiccated. Major results included a high percentage of trotting dinosaurs based on trackway evidence, 43% of the total number of trackways. Additionally, two trackways show evidence for running. There are no preferred trackway orientations. [ABSTRACT FROM AUTHOR]