RESUMO
In the United States today, 16 million children are growing up poor. Few studies report multiple environmental factors associated with poverty during the first year of life and effects on infant development. OBJECTIVES: To evaluate maternal, home, and neighborhood environment of low and higher socioeconomic status (SES) infants from birth to 1 year and to evaluate the impact of SES and environment on infant developmental outcome at 1 year. METHODS: Low (n = 30) and higher SES (n = 30) African-American mothers and their healthy term gestation female infants were prospectively compared for environmental characteristics and infant developmental outcome. Wechsler Adult Intelligence Scale-IV (WAIS-IV); Beck Depression Inventory; Perceived Stress Scale; Parenting Stress Index-Fourth Edition (PSI-4); Social Support Scale; Home Observation Measurement of the Environment (HOME); Household Food Insecurity (HFI); Concentrated Neighborhood Disadvantage (CND). Bayley Scales of Infant Development Third Edition (BSID-III); Preschool Language Scale (PLS-5). RESULTS: Environmental risk was greater for low compared with higher SES: lower WAIS-IV (p < .001); higher PSI-4 total (p = .003); lower HOME total and 3 subscales (p < .002); higher HFI (p = .012); and higher CND (p = .027). Low SES infant outcomes differed from higher SES: lower BSID-III Cognitive Composite (p = .005), PLS-5 Total Language (p ≤ .017), and Auditory Comprehension (p ≤ .008). In regressions, after controlling for SES, effects of environmental factors were not found. CONCLUSION: By age 1, low SES infants had been exposed to greater environmental disadvantage and already exhibited poorer developmental functioning than higher SES infants. These findings suggest that support for families and children from impoverished circumstances cannot begin too early.
Assuntos
Desenvolvimento Infantil/fisiologia , Inteligência/fisiologia , Mães/psicologia , Características de Residência , Meio Social , Fatores Socioeconômicos , Populações Vulneráveis , Adulto , Negro ou Afro-Americano/etnologia , Feminino , Humanos , Lactente , Estresse Psicológico/psicologiaRESUMO
OBJECTIVE: To assess the effect of gestational cocaine exposure on the prefrontal cortex (PFC) with functional magnetic resonance imaging (fMRI). STUDY DESIGN: Using an n-back task, we obtained fMRI with a 3T Siemens scanner on 49 adolescents, 25 who were exposed to cocaine and 24 who were not exposed. The primary outcome was PFC activation during task performance. Five functionally derived regions of interest (ROI) were defined; in addition, 2 a priori anatomical ROIs were generated for Brodmann regions 10 and 46. RESULTS: Of the 49 adolescents who underwent imaging, data from 17 who were exposed to cocaine and 17 who were not exposed were in the final analysis. Groups had similar performance on the n-back task (P >/= .4), with both showing a fewer number of correct responses on the 2-back than the 1-back (P < .001), indicating increased demands on working memory with greater task difficulty. In functionally derived ROIs, imaging results showed increased activation for both groups in the 2-back versus the 1-back condition. In anatomical ROIs, both groups showed greater activation in the 2-back versus the 1-back condition, with activation in the non-exposed group proportionally greater for the left prefrontal region (P = .05). CONCLUSION: In this sample of adolescents, participants who were exposed to cocaine and participants who were not exposed were similar in performance on an executive function task and in fMRI activation patterns during task performance.
Assuntos
Cocaína/efeitos adversos , Imageamento por Ressonância Magnética/métodos , Transtornos da Memória/diagnóstico , Transtornos da Memória/etiologia , Córtex Pré-Frontal/patologia , Efeitos Tardios da Exposição Pré-Natal/diagnóstico , Adolescente , Análise de Variância , Mapeamento Encefálico/métodos , Estudos de Coortes , Feminino , Seguimentos , Idade Gestacional , Humanos , Masculino , Exposição Materna/efeitos adversos , Transtornos da Memória/epidemiologia , Memória de Curto Prazo/efeitos dos fármacos , Córtex Pré-Frontal/efeitos dos fármacos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Probabilidade , Valores de Referência , Estudos Retrospectivos , Medição de Risco , Estatísticas não Paramétricas , Análise e Desempenho de Tarefas , Fatores de TempoRESUMO
A case of respiratory distress secondary to the cultural practice of "nasal molding" is reported. Nasal molding should be included as an entity causing nasal obstruction without choanal atresia. Furthermore, this report underscores the role of interpreters in provision of health care.