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For the first time, the 2020-2025 Dietary Guidelines for Americans provide specific guidance regarding the types of foods and beverages that should be offered in the first 2 years of life. Milk, in various forms (eg, human milk, infant formula, and cow's milk) contributes a large proportion of key nutrients to the diets of infants and toddlers in the United States.The aim of this study was to determine the types of milk (human milk, infant formula, and other milk) fed to US infants and toddlers in the past 12 years and to describe trends over time.This was a cross-sectional analysis of 2-day, 24-hour dietary recalls.Data from the 2007-2018 National Health and Nutrition Examination Survey were used for these analyses. Infants and toddlers aged 0 through 23.9 months with 2 days of dietary recall data (n = 3,079) were included.The main outcome was proportion of infants and toddlers fed different milk types.Survey-adjusted weighted percentages were used to report sociodemographic characteristics and the proportion of subjects fed each milk type category by age group and survey cycles. Binary and multinomial logistic regressions were used to assess differences in subject characteristics by age groups.Sociodemographic characteristics did not differ by age group. The proportion of infants aged 0 to6 months fed infant formula only was 60.2% in 2007-2012 and 44.8% in 2013-2018. The proportion of infants aged 6 to12 months fed partially hydrolyzed infant formula only was 7.3% in 2007-2012 and 13.1% in 2013-2018. In toddlers (12 months old), cow's milk was the predominant milk type in both 2007-2012 and 2013-2018.The percentage of infants fed any human milk increased over the past decade. Unsweetened cow's milk was the most predominate milk type consumed among toddlers.

Aims The first aim examined the relationship between sleep behaviors (duration, napping, and social jetlag) and hemoglobin A1c (HbA1c) among emerging young adults (EYAs) with T1DM between 18 and 25 years old, who are living on a college campus. The second aim characterized the gender differences in glucose management, sleep behaviors, caffeine intake, and nighttime technology. Methods A cross-sectional study of eligible participants used a convenience sample of eligible participants. Using Research Electronic Data Capture (REDCap), participants completed surveys about diabetes management, caffeine intake, nighttime technology use, and sleep-related behaviors. Data were analyzed using correlation and multiple linear regression to predict HbA1c from sleep behaviors, adjusting for covariates. Results Participants (N = 76) average years with T1DM was 10.25 ± 5.70. Compared to females, males had a longer sleep duration lower HbA1c levels. HbA1c levels were negatively correlated with weekday sleep (r = −0.24, p = 0.03) and positively correlated with napping (r = 0.34, p = 0.003). After adjusting for covariates, participants who napped had a higher HbA1c level (β = 0.74, p = 0.03) compared with non-nappers. Conclusions Higher HbA1c levels were found among EYAs with T1DM in college who were nappers and had a longer sleep duration. Modifying sleep behaviors may be an appropriate target to improve glycemic control.

The Breakfast in the Classroom (BIC) initiative, a common approach to implementing the federal School Breakfast Program, is advocated as a method to improve students' academic performance. However, the influences of BIC on academic outcomes are unclear.To examine the effect of a BIC initiative which provided free, universal BIC on attendance and standardized test performance over 2.5 years, vs free universal breakfast served in the cafeteria before school, among students in an urban school district serving a low-income population.Secondary analysis of data from a cluster randomized controlled trial conducted between 2013 and 2016; 16 kindergarten through eighth-grade public schools in Philadelphia, PA, were enrolled and randomized to condition. Baseline data for 1,362 fourth- through sixth-grade students were provided by the school district. Midpoint data were collected after 1.5 years and endpoint data after 2.5 years.Schools were eligible in the case that ≥50% of students qualified for free or reduced-priced meals, did not offer BIC, and received programming as part of the US Department of Agriculture Supplemental Nutrition Assistance Program. Parents consented for their children to participate.Intervention schools provided BIC and breakfast-related nutrition-promotion activities. Control schools provided breakfast in the cafeteria before the school day.Student attendance and standardized exam scores.Weighted generalized estimating equations were used to evaluate differences in outcomes between conditions at midpoint and endpoint.The BIC initiative did not influence attendance (β ± standard error = .004 ± .06; P = 0.94) or standardized reading exam scores (β ± standard error = .02 ± .06; P = 0.79) after 2.5 years. Students in BIC initiative schools had lower standardized math exam scores than those in control schools, although this difference was small (β ± standard error = -.20 ± .07; P = 0.005).BIC did not improve academic outcomes among students attending low-income, urban schools.

Background Radiotherapy completion (RTC) is critical to successful breast conserving treatment. Our aim was to identify patient groups at greatest risk of not achieving timely radiotherapy completion (TRTC) in an urban setting. Methods This observational cohort study used hospital registry data from 2004 to 2010 for female stage I and II breast conserving treatment patients to assess predictors of RTC and TRTC, defined as RTC of 35 to 49 days. Results Two hundred sixty-one patients were analyzed. There was no difference in mean days to RTC by ethnicity (black 46.8, white 46.4, Hispanic 48.1 days, P = .75) or total RTC (black 88.2%, white 97.9%, Hispanic 93.3%, P = .09). However, a substantial difference was seen in TRTC by ethnicity (black 51.8%, white 79.2%, Hispanic 57.8%, P = .03). Multivariate logistic regression analysis of failure to achieve TRTC found associations with black race (odds ratio [OR] 2.67), Medicare (OR 3.46), Medicaid (OR 2.19), and age less than 50 years (OR 4.13). Conclusions This study demonstrates high overall percentage RTC but demonstrates disparities in TRTC. Those at greatest risk of unsuccessful TRTC were younger, Medicare or Medicaid insured, and black race.

Background Factors influencing excessive weight gain in pregnancy have not been well-studied among urban, low-income women. Methods This prospective cohort study of 94 prenatal care patients at a large university hospital in Philadelphia examined associations of modifiable midpregnancy behaviors and nonmodifiable or early pregnancy factors with excessive gestational weight gain. Data were collected through questionnaires and medical record abstraction from 2009 to 2011. Findings The majority of women were African American (83%) and all (100%) received Medicaid. Nearly two thirds (60%) were overweight or obese in early pregnancy and 41% experienced excessive gain. In multivariable logistic regression analyses, significant predictors of excessive gestational weight gain included high early pregnancy body mass index (odds ratio [OR], 4.20; 95% confidence interval [CI], 1.43–12.34 for overweight/obese vs. normal weight), nulliparity (OR, 3.35; 95% CI, 1.17–9.62 for nulliparity vs. multiparity), and clinician advice discordant with Institute of Medicine guidelines (OR, 5.88; 95% CI, 1.04–33.32 for discordant vs. concordant advice). Watching under 2 hours of television daily (OR, 0.18; 95% CI, 0.03–1.03), and engaging in regular physical activity during pregnancy (OR, 0.35; 95% CI, 0.11–1.09) were suggestive of a reduced risk of excessive gain. Conclusions In this sample of urban, low-income women, high early pregnancy body mass index, nulliparity, and discordant clinician advice were directly associated with excessive gestational weight gain, with a trend toward decreased risk for viewing fewer hours of television and engaging in regular physical activity. Intervening on these targets may optimize gestational weight gain and promote long-term maternal health.

Analysis of sediment and macrofaunal samples collected during the Tasmanian marine farming finfish monitoring program – a six-year partnership between industry, management and researchers – revealed several univariate indicators to be useful for detecting effects of aquaculture on the benthic environment. Comparisons with reference sites revealed a significant decline in sediment redox potential to at least 4 cm depth at farm sites, and increased proportional abundance of capitellids and decreased bivalve/total mollusc ratio. At compliance sites located 35 m out from lease boundaries, sediment redox potential and faunal assemblage composition were intermediate between patterns found at farm and reference sites. Redox potential at the sediment surface declined on average by 178 eV at reference sites converted to farm sites, with this indicator proving the most sensitive for detecting regional impacts of farming activity. Fish farm effects that extended to regional scales could not be adequately assessed within the project because reference regions without fish farms were not monitored; however, a significant decrease through time at reference and compliance sites in surface redox potential, and increases in sediment organic matter and total macrofaunal abundance, were suggestive that organic enrichment may have extended at low levels across regional scales. Given the implications to biodiversity conservation of region-wide impacts and a need to distinguish fish farm effects from unrelated long-term environmental change, monitoring of reference sites in regions lacking fish farms is urgently needed.

Personality structure of African-American older adults using the Baltimore Study of Black Aging (BSBA; N = 234; Age range 49–88, M = 67; 72% women; Education M = 11 years) was compared with the census-matched normative NEO-PI-R factor structure. Principal components with Procrustes rotation was used to calculate factor, facet, and total congruence coefficients. Significant factor congruence coefficients at a 99% probability level or beyond were found, and only three facet-level congruence coefficients did not reach significance. With the exception of cross-loadings on a few facets, most primary and secondary loadings generally replicated the normative structure providing evidence that there are little differences among the African-American older adults and the largely European American normative structure.

The importance of variability both between and within families is receiving greater recognition. We set out to identify whether each child's unique experiences (transition, timing, duration) with parent's marital transitions predicted instrumental assistance using a life course perspective. We used longitudinal data from 2,087 parents, aged 50 and older, who reported on their 7,019 adult children in the National Survey of Families and Households (NSFH). Population averaged logistic regression models predicting giving and receipt of instrumental assistance were estimated, accounting for the nested structure of the data. Results suggest that parents’ marital transitions generally predict lower levels of support from parents to children, but greater levels of support from children to parents. Transitions that occur earlier in a child's life are less detrimental, whereas marital transitions that occur when children are adults tend to reduce support from parents to children. More distant transitions predicted a greater likelihood of support from fathers to children, but a lower likelihood of support from children to mothers. Experiences with parents’ marital histories in childhood and adulthood predict current patterns of intergenerational support. The nature, timing, and duration of transitions as anchored in the life of each child affect support. While there are differences for mothers and fathers, effects of marital transitions are accounted for through their effects on needs and resources of each generation.