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Biomedical subjects

J Brooks-Gunn

Publications and source records attributed to J Brooks-Gunn.

At least 19 recordsLinked to original sources
PubMed1992

Effects of early intervention on cognitive function of low birth weight preterm infants.

The Infant Health and Development Program is a randomized clinical trial to test the efficacy of educational and family support services and pediatric follow-up, offered during the first 3 years of life, in reducing the incidence of developmental delay in low birth weight preterm infants at eight clinical sites (N = 985). It was hypothesized that larger intervention effects would be found for the domains in which low birth weight preterm infants are known to have problems, specifically visual-motor and spatial skills and receptive language skills. These analyses explore the effects of the Infant Health and Development Program on different domains of cognitive functioning. Cognitive domains are identified by means of factor analysis of the intelligence tests used at 12, 24, and 36 months (Bayley Scales of Infant Development (including the Mental and Motor scales) at 12 and 24 months; the Stanford-Binet, Peabody Picture Vocabulary Test, and Beery Test of Visual Motor Intergration at 36 months). Our results reveal that, although intervention benefits accrue across cognitive domains at 24 and 36 months, gains are most pronounced for receptive language and visual-motor and spatial skills.

Child Development↗
PubMed1992

Enhancing the cognitive outcomes of low birth weight, premature infants: for whom is the intervention most effective?

The Infant Health and Development Program is a national collaborative study to test the efficacy of combining early child development and family support services with pediatric follow-up to reduce the incidence of health and developmental problems among low birth weight, preterm infants in eight medical school sites. Its efficacy in enhancing intellectual outcomes at age 3 in more and less environmentally vulnerable, low birth weight, preterm children, as defined by maternal education (high school completion or less vs some college) and race (black vs white/other), is explored. Children whose mothers had a high school education or less benefited from the intervention. This was true for both the black and white samples. Children whose mothers had attended college did not exhibit significant enhancement in IQ scores at 3 years. Birth weight affected the response to treatment for one of the four subgroups: Among white mothers with some college, the lighter (less than 2000 g) low birth weight, preterm children were less influenced by the intervention than were the corresponding heavier children. Implications for targeting certain subgroups of low birth weight, preterm children for services are considered.

Child Health Services↗
PubMed1992

Impaired emotional health in children with mild reading disability.

Children with reading disabilities are at risk for emotional difficulties. There is some evidence that reading-disabled children with high socioeconomic status may be at risk of having low self-esteem. We conducted a preliminary study of the impact of reading disability on children's self-esteem and emotional health in a select group of mildly impaired reading disabled children with well-educated parents who were well informed about reading disabilities. We interviewed 28 healthy, preadolescent boys and girls with mean reading delay of 9.0 months and 39 comparable nonreading disabled children who formed the control group. Children and parents completed the Harter's Self-Perception Profile. Parents completed the Achenbach Child Behavior Checklist and Rand Mental Health Survey. We found that these mildly impaired reading-disabled children were more anxious and less happy than were nondisabled students despite having well-informed, well-educated parents (mean level of education = 17.0 years). Reading-disabled children considered themselves to be less competent scholastically, and their parents rated them as less competent than nondisabled children on all measures of self-esteem. These well-educated mothers tended to underrate their child's perceived scholastic competence. Controlling for behavior problems, Achenbach Child Behavior Checklist scores for social competence were lower for reading-disabled children. These findings suggest that the mildly impaired reading-disabled children with high socioeconomic status are at risk for low self-esteem and poor emotional health.

Adaptation, Psychological↗
PubMed1991

Health care use among young children in day care. Results in a randomized trial of early intervention.

Exposure of young children to group day-care settings increases the risk of illness and may result in higher use of medical care. These observations raise concerns that the use of such settings for early intervention programs for low-birth-weight infants may increase the already high burden of medical care costs incurred by these children and their families. To address the question of medical care use associated with center-based care, we examined the hospital-based and ambulatory care reported for participants of the Infant Health and Development Program. This project is a multisite randomized trial of an early intervention program for preterm low-birth-weight infants with an intervention including 2 years of center-based care. The Intervention group did not differ in hospital-based care and averaged only two more physicians' visits over the 3-year observation period than the comparison group. We conclude that early intervention programs involving high-quality group care are not accompanied by substantial increases in health care use.

Ambulatory Care↗
PubMed1991

Methodological issues in the study of divergent views of the family.

A wealth of methodologies, both qualitative and quantitative, are available for conducting research on divergent views in the family. While the pathways for investigating divergent views of the family are clearer for those who chose more quantitative methods (as current literature reflects this tradition), qualitative methods may serve to clarify the process through which divergent views occur and are maintained within the family, both on an individual and on a dyadic or triadic level. In terms of the analysis of data from quantitative designs, divergent views of the family can quite easily be explored by viewing the family as a system and the individual family members as components of that system. This approach minimizes problems arising from having sampled families and included more than one family member from each. In addition, the organization of the data as family (rather than individual) records enables the researcher to directly examine divergences between family members by comparing ratings by different family members on the same construct. The issues involved in such analyses were discussed, first, in terms of the reliability of difference scores and then, in more detail, in terms of alternative regression-based models that estimate the effects of differences on a dependent variable. Although differences between variables are reputed to be (and often are) unreliable, the conditions under which these scores are likely to be reliable are the conditions found when examining divergent family views. Also, the reliability of difference variables can be treated directly. The discussion of regression models indicated the statistical equivalence (or in some instances nonequivalence) of models containing difference variables to alternative models not containing difference variables. Although algebraically equivalent, these alternative linear models provide different views of the same information. When moving from linear models to nonlinear models, however, researchers are cautioned to choose each specific model carefully since the nonlinear terms containing difference variables are actually more complex than they at first appear. The current volume speaks to the importance of variation in family members' views for the adjustment and well-being of adolescents. This chapter has taken on the question of how best to look at these divergences, and how different methods and statistical techniques may yield similar or different information regarding divergent views. The diversity in research methods and analytical strategies creates a challenging task for the investigator, and the continued exploration of questions regarding the implications of divergent views in the family should enhance our knowledge of how and why views diverge, as well as what divergences mean to family members.

Data Collection↗
PubMed1991

Do parent-child relationships change during puberty?

This article reviews changes in parent-child relationships during puberty, emphasizing the developmental processes that might be implicated in these changes. Evidence suggests increases in conflict and less warm interactions in relationships between parents and children during puberty. Changes are assumed to be short term, although little longitudinal research has directly addressed the issue of long-lasting effects. Other developmental changes occurring for the adolescent, the parent, or both (such as social cognitive or self-definitional change), as well as other relationship changes, personality characteristics, and the sheer number of life events or transitions have all been posited as potential contributors to changes in the parent-child relationship for young adolescents. These possible contributors, however, have seldom been studied in conjunction with pubertal changes. Such integrative research is necessary to test various models through which puberty, social relationships, social cognitive, self-definitional, and other processes influence one another and are influenced by one another during the transition to adolescence.

Adolescent↗
PubMed1991

Cohort reconstruction: which infants can be restudied at school age?

Longer-term follow-up of infants with specific health concerns, such as low birthweight, is critical to assessing the effect of medical interventions. This report examines the approach of reconstructing previously studied cohorts in terms of the factors discriminating between respondents and non-respondents. Follow-up was attempted during 1987-1988 for 1875 children born during a 6-month period in 1978 in three geographically defined regions in the United States, for whom 1-year assessments of health and developmental status were obtained at 1 year of age as part of a previous study. For a 25% sample, participation involved a clinic visit for developmental assessments; for the remainder an interview by telephone or home visit. Follow-up was obtained for 72.5% of the cohort. Refusal rates were low (7%); most non-response was due to an inability to locate the families. Predictors of non-response reflected primarily low socio-economic status; completion rates were not influenced by mode of assessment. The role of a tracing agency is discussed. We conclude that cohort reconstruction is feasible with response rates comparable to some prospective studies with ongoing cohort maintenance.

Child Development↗
PubMed1991

Lack of bone accretion and amenorrhea: evidence for a relative osteopenia in weight-bearing bones.

Bone mineral density (BMD) was studied in young exercising amenorrheic girls to determine if density was compromised and the change related to injury. Ninety-eight volunteers (professional ballet dancers and controls) were studied in a cross-sectional study. Dancers and controls were further subdivided into normally cycling and amenorrheic subjects. Amenorrhea significantly lowered bone density of the spine (P less than 0.0001), wrist (P less than 0.03), and metatarsal (P less than 0.01); effects on the wrist were eliminated by controlling for age while controlling for weight eliminated all effects of amenorrhea at three sites. BMD of the metatarsal, a weight-bearing bone, showed an interaction between amenorrhea and dancing (exercising) P less than 0.035); surprisingly, dancing was associated with a further lowering of bone density. This interaction was eliminated when controlling for age, but not when controlling for weight. With multiple comparisons of the groups, spine, wrist, and metatarsal bone density was significantly lower in amenorrheic dancers when compared to normal dancers (P less than 0.05), even when controlling for age and weight in the metatarsal (P less than 0.05), and age in the spine (P less than 0.05). Estradiol levels correlated with bone density of both the wrist and the spine (r = 0.25, r = 0.23, P less than 0.02). Metatarsal density correlated with estradiol levels only in the dancers (r = 0.34, P less than 0.02). The only variable found to correlate with the occurrence of stress fractures was age of menarche. This was also the only variable of 9 (BMD of the wrist, spine or foot, calories ingested and expended, amount of calcium ingested, involvement in high energy activity, age of menarche or presence of amenorrhea) to predict stress fractures. Thus, BMD is significantly affected by the presence of amenorrhea but the effects are generally weight dependent. The compensatory increase in bone density generally seen in stressed bones, such as the metatarsal in ballet dancers, is deficient in amenorrheic premenopausal women even when controlling for weight but this effect may be age and estrogen dependent. Bone mass may not accumulate in the same manner in adolescents as in the mature women, thus putting them at risk for injury.

Adolescent↗
PubMed1991

Resting metabolic rate and energy balance in amenorrheic and eumenorrheic runners.

This study investigated metabolic and nutritional factors in association with athletic menstrual dysfunction (AMD). Three groups of women were studied: amenorrheic runners (amenorrheic), eumenorrheic runners (eumenorrheic), and eumenorrheic sedentary controls (sedentary). Amenorrheic and eumenorrheic were similar in age, weight, percent body fat by hydrodensitometry, training pace and mileage, best 10 km race time, years running, and maximal oxygen consumption. When adjusted for body weight or for fat-free mass by analysis of covariance, RMR was significantly lower in amenorrheic than in eumenorrheic and sedentary. The daily caloric intakes of the groups did not differ significantly, but the amenorrheic scored significantly higher than the eumenorrheic and sedentary on a scale of aberrant eating patterns. Amenorrheic high mileage runners seem to have a less adequate diet than eumenorrheic runners but appear to maintain energy balance and stable weight through a reduction in RMR.

Adaptation, Physiological↗
PubMed1990

Factors associated with smoking in low-income pregnant women: relationship to birth weight, stressful life events, social support, health behaviors and mental distress.

Since low-income women are at increased risk of having low birth weight infants, factors associated with birth weight among such groups have special relevance. Cigarette-smoking has emerged as an important predictor of low birth weight due to intrauterine growth retardation and pre-term delivery. After confirming the relation of smoking with birth weight, we examined the association of smoking with sociodemographic factors, attitudes towards pregnancy, health behaviors, stressful life events, social support, and symptoms of mental distress in a cohort of 458 Central Harlem women. We found that social support, stress and mental health were associated with smoking behavior but not directly with birth weight. These findings suggest that programs designed to modify health behaviors such as smoking during pregnancy must also take into account such characteristics of the women and their environments which may make behavioral change difficult. Moreover, programs aimed at fostering better health behaviors to improve pregnancy outcome may have to extend beyond the current pregnancy, as indicated by an association between prior adverse pregnancy outcome and smoking in the current pregnancy.

Adult↗
PubMed1990

Transition to motherhood and the self: measurement, stability, and change.

Different ways of conceptualizing and measuring change in attitudes during transition to motherhood are examined. A series of analyses was performed on data from a cross-sectional sample (N = 667) and a smaller longitudinal sample (n = 48) to demonstrate sound psychometric properties for 2 new scales and to show construct comparability across different phases of childbearing. For Childbearing Attitudes Questionnaire, results demonstrated equality of covariance for 16 scales and comparability of structure and meaning of 4 higher order factors--identification with motherhood, social orientation, self-confidence, and negative aspects of giving birth. For Mothering Self-Definition Questionnaire, results demonstrated equality of covariance of 5 scales and comparability of structure and meaning of a single higher order factor, interpreted as reflecting positive feelings about one's mothering characteristics. Analyses of correlations and mean differences identified areas of change and stability.

Adult↗
PubMed1990

Nutrition and the incidence of stress fractures in ballet dancers.

The effects of nutrition on the incidence of stress fractures among classical ballet dancers were studied. Ten dancers with stress fractures were compared with a group of dancers without stress fractures and a group of nondancing control subjects. Subject pairs were matched for age, weight, and height. Specific nutrient intake and eating patterns were thus isolated to determine if dietary patterns could account for the incidence of stress fractures among these dancers. The majority (80%) of the 10 dancers with recent stress fractures had weights less than 75% of ideal (p less than 0.05) and showed a greater incidence of eating disorders (p less than 0.05). This group also showed a lower fat intake and a higher intake of low-calorie food (p less than 0.05). Menstrual patterns and bone density studies of the wrist, foot, and spine did not differ among the three groups, showing that stress fractures were significantly associated with a more-restrictive diet.

Adolescent↗
PubMed1990

Effects of hormonal status on bone density in adolescent girls.

Few data are available on bone density in late adolescence. We studied factors affecting peak bone density in females. Forty-three white girls, aged 13-20 yr, were studied. Integrated estrogen exposure over the pubertal years was obtained by a score based on physiological events known to reflect circulation estrogen levels. The subjects were selected to provide great variation in estrogen exposure. Bone mineral density (BMD) was measured by single photon absorptiometry (midradius) and dual photon absorptiometry (spine and first metatarsal of the foot). Weight, estrogen score, and testosterone levels were highly correlated with BMD of the spine, wrist, and foot (P less than 0.05). Age correlated positively only with the BMD of the wrist. Twenty-four girls reaching ages 18-20 yr in the 2 yr of observation were divided into groups reflecting low (less than 24), medium (25-48), and high (greater than or equal to 49) estrogen exposure. The lowest scoring groups had the lowest spine and wrist BMD (P less than 0.05). This group weighed less and had lower weight to height ratio (P less than 0.05), the lowest weight (P less than 0.05) during adolescence, the highest age of menarche, and the highest amount of fiber in the diet (P less than 0.05). These subjects were separated into low and high BMD groups. Those subjects with the lowest values for spine, wrist, and foot were found to have significantly lower estrogen exposure scores and lower weight/height ratios; in addition, low BMD of the foot was associated with higher activity levels. Thus, wrist and spine BMD are affected by estrogen exposure during adolescence and weight; foot BMD, in addition, was negatively affected by activity, suggesting that bone mass in the active adolescent is affected by the absence of estrogen exposure.

Absorptiometry, Photon↗
PubMed1990

Are Head Start effects sustained? A longitudinal follow-up comparison of disadvantaged children attending Head Start, no preschool, and other preschool programs.

This study investigates the sustained effects into kindergarten and grade 1 of Project Head Start for disadvantaged black children. Participation in generic Head Start programs was compared to both no preschool and other preschool experience for disadvantaged children in two American cities in 1969-1970. Incorporating both pretest/posttest and comparison group information, the study has advantages over other Head Start impact studies. Both preprogram background and cognitive differences were controlled in a covariance analysis design, using dependent measures in the cognitive, verbal, and social domains. Children who attended Head Start maintained educationally substantive gains in general cognitive/analytic ability, especially when compared to children without preschool experience. These effects were not as large as those found immediately following the Head Start intervention. Findings suggest an effect of preschool rather than of Head Start per se. Initial findings of greater effectiveness of Head Start for children of below average initial ability were reduced but not reversed. The diminution of effects over time, especially for low-ability children, may reflect differences in quality of subsequent schooling or home environment.

Achievement↗
PubMed1990

Coming of age in the era of AIDS: puberty, sexuality, and contraception.

The existing discrepancies between adolescent and societal constructions of teenage sexuality in America are further exacerbated by AIDS. Male and female teenagers receive different and often conflicting messages about sexuality from diverse sources; their parents' lack of frankness about sexual intercourse contrasts sharply with the media's emphasis on sex and with highly rationalistic discussions about sexuality in schools, complicating adolescents' decisions about entering and continuing sexual relationships. Survey research indicates that not all teenagers engaging in sexual intercourse reduce risks of HIV infection as much as they might. While AIDS has prompted many teenagers to change their sexual behavior, serious questions remain about adolescents' conceptions of the dangers of unprotected sex.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Outreach as case finding: its effect on enrollment in prenatal care.

One mechanism proposed for encouraging use of prenatal services in low-income communities involves the employment of community residents to encourage and support individuals in the use of available medical care. This study examines the effect of such workers on the start of prenatal care among a cohort of women receiving prenatal services at clinics affiliated with Harlem Hospital. Of the 599 women enrolling for prenatal care during the intake period for the study, only 52 had had an outreach contact before the start of prenatal care despite extensive field activity. No difference in the week of gestation at the start of prenatal care was noted between those with and without outreach contacts. Controlling for factors associated both with trimester of initiation of prenatal care in this population and with outreach contact did not account for this lack of difference. This type of outreach, known as case-finding, proved to be very labor intensive. Other less costly techniques for encouraging use of services in mobile, urban populations should be sought.

Adolescent↗
PubMed1989

Biological and social contributions to negative affect in young adolescent girls.

This study is a preliminary attempt to investigate whether internal or external pubertal changes and whether social or biological factors are more likely to be associated with negative affect. About 100 white girls aged 10-14 years were given a physical examination, had blood drawn, and filled out the Youth Behavior Profile and a life-events checklist. Negative affect increased during the most rapid rises in hormone levels; however, hormones accounted for only 4% of the variance in negative affect. Pubertal status and timing were not associated with negative affect. In contrast, social factors accounted for more variance than hormonal pubertal factors alone (8%-18%), as did the interaction of negative life events and pubertal factors (9%-15%). Results are discussed in terms of what hormonal activation effects are most likely to be found, the meaning of such effects for subsequent behavior, and the interaction of biological and social events.

Adolescent↗