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Racial differences in parent report of concerns about their child's development to healthcare providers may contribute to delayed autism spectrum disorder diagnoses in Black children. We tested the hypotheses that compared to White parents, Black parents of children with autism spectrum disorder would report fewer concerns about autism symptoms and would be more likely to report concerns about disruptive behaviors. A sample of 18- to 40-month-old toddlers (N = 174) with autism spectrum disorder and their parent participated. After screening positive for autism spectrum disorder risk, but prior to a diagnostic evaluation, parents completed free-response questions soliciting concerns about their child's development. Parent responses were coded for the presence or the absence of 10 possible concerns, which were grouped into autism concerns (e.g. social and restricted and repetitive behavior concerns) or non-autism concerns (e.g. general developmental and disruptive behavior concerns). Compared to White parents, Black parents reported significantly fewer autism concerns and fewer social and restricted and repetitive behavior concerns. However, Black parents did not report significantly fewer non-autism concerns. Race did not influence parent report of disruptive behavior concerns. Lower reporting of autism concerns by Black parents may impact providers' abilities to identify children who need further screening or evaluation.

Introduction: Respiratory syncytial virus (RSV) is the leading cause of hospitalization among US infants. Characterizing service utilization during infant RSV hospitalizations may provide important information for prioritizing resources and interventions. Objective: The objective of this study was to describe the procedures and services received by infants hospitalized during their first RSV episode in their first RSV season, in addition to what proportion of infants died during this hospitalization. Methods: In this retrospective observational study, we analyzed three different administrative claims datasets to examine healthcare service utilization during RSV hospitalizations among infants. The study population included infants born between July 2016 and February 2020 who experienced an RSV episode during their first RSV season and had an associated inpatient hospitalization. We stratified infants into three comorbidity groups: healthy term, palivizumab-eligible, and other comorbidities. Outcomes included extracorporeal membrane oxygenation, supplemental oxygen use (in-hospital and post-discharge), mechanical ventilation (invasive and non-invasive), chest imaging, infant mortality, length of inpatient stay, intensive care unit (ICU) admission, and number of days in the ICU. Results: Chest imaging was the most frequently administered procedure during RSV-associated hospitalizations, with approximately 34–38% of infants receiving it. Around one-quarter of infants were admitted to the ICU during their first RSV hospitalization. Median lengths of stay in the hospital were 3–4 days, extending to 4–6 days in the presence of ICU admission. Palivizumab-eligible infants had higher utilization of healthcare services and spent more time in the hospital or ICU compared to healthy infants or those with other comorbidities. Conclusions: This study provides insights into the utilization of healthcare services during RSV hospitalizations among infants. Understanding service utilization patterns can aid in improved management and resource allocation for infants in the United States, ultimately contributing to better outcomes and reduced healthcare costs overall. However, likely under-ascertainment of ventilation and oxygen-related services in insurance claims remains an impediment to studying these outcomes. [ABSTRACT FROM AUTHOR]

Background: Growing evidence for the effect of maternal obesity on childhood asthma motivates investigation of mediating pathways. Objective: To investigate if childhood body mass index (BMI), gestational weight gain (GWG) and preterm birth mediate the association of maternal obesity on childhood asthma risk. Methods: We used electronic medical records from mother–child pairs enrolled in Kaiser Permanente Northern California integrated healthcare system. Children were followed from their birth (2005–2014) until at least age 4 (n = 95,723), age 6 (n = 59,230) or age 8 (n = 25,261). Childhood asthma diagnosis at each age was determined using ICD‐9/10 codes and medication dispensings. Prepregnancy BMI (underweight [<18.5], normal [18.5–24.9], overweight [25–29.9], obese [≥30] kg/m2) were defined using height and weight measurements close to the last menstrual period date. Child's BMI (Centers for Disease Control and Prevention BMI‐for‐age percentiles: underweight [<5th], normal [5th–85th], overweight [85th–95th], obese [>95th]) were obtained using anthropometric measurements taken the year preceding each follow‐up age. GWG (delivery weight‐prepregnancy weight) was categorised based on Institutes of Medicine recommendations (inadequate, adequate, excessive). Implementing first causal inference test (CIT) then causal mediator models (to decompose the natural direct and indirect effects), we examined the potential mediating effect of childhood BMI, GWG, and preterm birth on the association between prepregnancy BMI (continuous and categorical) and childhood asthma. Results: Overall, risk of childhood asthma increased as prepregnancy BMI increased (age 4 risk ratio: 1.07, 95% confidence interval: 1.04, 1.09, per 5 kg/m2 increase in BMI; similar for age 6 and 8). CIT identified childhood BMI and preterm birth, but not GWG as potential mediators. Causal mediation models confirmed childhood BMI, but not preterm birth, as having a partial mediating effect. Results were similar for age 6 and 8, and when continuous mediators (instead of binary) were assessed. Conclusions: Childhood overweight/obesity has a modest mediating effect on the association between prepregnancy BMI and childhood asthma. [ABSTRACT FROM AUTHOR]

Background: The accumulation of age‐associated cognitive deficits can lead to Mild Cognitive Impairment (MCI) and dementia. This is a major public health issue for the modern ageing population, as it impairs health, independence and overall quality of life. Keeping the brain active during life has been associated with an increased cognitive reserve, therefore reducing the risk of cognitive impairment in older age. Previous research has identified a potential relationship between musicality and cognition. Objectives: Explore the relationship between musicality and cognitive function in a large cohort of older adults. Methods: This was a nested study within the PROTECT‐UK cohort, which collects longitudinal computerised assessments of cognitive function in adults over 40. Participants were invited to complete the validated Edinburgh Lifetime Musical Experience Questionnaire (ELMEQ) to assess their musical experience and lifetime exposure to music. Linear regression analysis was performed using cognitive data from PROTECT‐UK. Results: Analysis identified an association between musicality and cognition in this cohort. Playing a musical instrument was associated with significantly better performance in working memory and executive function. Significant associations were also found between singing and executive function, and between overall musical ability and working memory. Conclusions: Our findings confirm previous literature, highlighting the potential value of education and engagement in musical activities throughout life as a means of harnessing cognitive reserve as part of a protective lifestyle for brain health. Key points: Playing a musical instrument was associated with significantly better working memory and executive function.Singing and overall musical ability was associated with more favourable cognition.Engagement with musical activities should be considered as part of public health initiatives to promote a protective lifestyle for brain health. [ABSTRACT FROM AUTHOR]

Background: Smell dysfunction has been one of coronavirus disease 2019 (Covid‐19) symptoms. Identification of those with these symptoms are important as olfactory impairment in general has been studied to have increased mortality, poor quality of life, increased incidence of depression and risk for dementia. Smell dysfunction related to Covid‐19 in older adults and its impact is lesser studied. We evaluated impact of covid‐19 infection and smell dysfunction on cognition and quality of life in older adults above 50 years of age. Methods: A longitudinal online survey, Smell and Taste Function in Older Adults in the Covid‐19 Pandemic (STAP) was added as a sub‐study to the ongoing remote wider study‐ Platform for Research Online to investigate Genetics and Cognition in Ageing (www.protect.org.uk). A separate ethics approval was sought for STAP (Reference LRS‐19/20‐18549). Interested participants of PROTECT study within the UK completed online questionnaire following consent, on a quarterly basis for a year. Information on Covid‐19 symptoms, testing, diagnosis, re‐infections, vaccinations and management was collected as part of the questionnaire in addition to socio‐demographic details, medical and lifestyle history and quality of life. Results: Of the 3725 participants who took part in the baseline survey since June 2021, 1017 participants completed the follow up survey with the addendum questionnaire on re‐infections, vaccination history and other symptoms including self‐reported cognitive problems. The mean age was 66.65 years (7.87) and 80.5% were women. Of the 437 of the participants who reported having had Covid‐19 infection, 116 participants (26.5%) had partial or total smell loss. Olfactory impairment caused by Covid‐19 was associated with poorer quality of life especially social activities, diet and mood. People with Covid‐19 related smell impairment had significantly higher mental fatigue, attention and concentration problems, difficulties with memory, planning and organising, word and name finding difficulties and making decisions. Conclusions: Older adults with smell dysfunction related to Covid‐19 infection had poorer quality of life and cognitive abilities affected. Further research is needed not only to understand the longitudinal course of smell impairment related to Covid‐19 and cognition, but also important to devise interventions to support these individuals to improve their well‐being. [ABSTRACT FROM AUTHOR]

Background: Growing evidence suggests that maternal obesity may affect the intrauterine environment and increase a child's risk of developing asthma. We aim to investigate the relationship between prepregnancy obesity and childhood asthma risk. Methods: Cohorts of children enrolled in Kaiser Permanente Northern California integrated healthcare system were followed from birth (2005–2014) to age 4 (n = 104,467), 6 (n = 63,084), or 8 (n = 31,006) using electronic medical records. Child's asthma was defined using ICD codes and asthma‐related prescription medication dispensing. Risk ratios (RR) and 95% confidence intervals (95% CIs) for child's asthma were estimated using Poisson regression with robust error variance for (1) prepregnancy BMI categories (underweight [<18.5], normal [18.5–24.9], overweight [25–29.9], obese 1 [30–34.9], and obese 2/3 [≥35]) and (2) continuous prepregnancy BMI modeled using cubic splines with knots at BMI category boundaries. Models were adjusted for maternal age, education, race, asthma, allergies, smoking, gestational weight gain, child's birth year, parity, infant sex, gestational age, and child's BMI. Results: Relative to normal BMI, RRs (95%CIs) for asthma at ages 4, 6, and 8 were 0.91 (0.75, 1.11), 0.95 (0.78, 1.16), and 0.97 (0.75, 1.27) for underweight, 1.06 (0.99, 1.14), 1.08 (1.01, 1.16), and 1.03 (0.94, 1.14) for overweight, 1.09 (1.00, 1.19), 1.12 (1.03, 1.23), 1.03 (0.91, 1.17) for obese 1, and 1.10 (0.99, 1.21), 1.13 (1.02, 1.25), 1.14 (0.99, 1.31) for obese 2/3. When continuous prepregnancy BMI was modeled with splines, child's asthma risk generally increased linearly with increasing prepregnancy BMI. Conclusions: Higher prepregnancy BMI is associated with modestly increased childhood asthma risk. [ABSTRACT FROM AUTHOR]