Browsing by Subject "Children"

Now showing 1 - 20 of 60
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    Assessing Temporomandibular Joint Hypermobility in a Young Population: A Pilot Study
    (2023-06) Burgstahler, Elizabeth
    Introduction: Hypermobile individuals may be more common than once thought. Since these people tend to experience negative sequelae over the course of their lives, it would be beneficial to devise a simple test or set of tests to screen for these patients. The general dentist or orthodontist is in a unique position to assist as they see their patients for frequent recall. Aim: To evaluate if the maximum mandibular movements can be positively correlated to the Beighton score. Methods: 30 children aged 9 to 12 years old with no signs or symptoms of TMD were recruited and their maximum mandibular opening and lateral excursives were recorded, along with their Beighton score. They were also examined for the presence or absence of oral frena and the Gorlin sign. Participants completed the Grahame and Hakim questionnaire and were also asked about their tendency to bruise. Descriptive statistics, linear and ordinal regressions, and univariate analyses were used to analyze the collected data. P-values less than 0.05 were considered statistically significant. Results: Based on the small sample size of this study, there are no statistically significant relationships between the maximum mandibular border movements and the Beighton score in children of this age. Other signs, such as missing frena and presence of Gorlin sign, could not be evaluated due to the small number of affected individuals. Conclusions: Because a relationship between the Beighton score and the maximum mandibular border movements may exist, a larger cohort should be evaluated in the future. Additionally, while the Grahame and Hakim questionnaire has been found to be valid in adults, its validity in children is still questionable, but shows promise. Future avenues of improvement include measuring the knees when participants are standing, adding visual aids to the Grahame and Hakim questionnaire, and taking angular measurements of the maximum opening, instead of linear ones.
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    Children and Sexuality: The Observations and Opinions of Family Daycare Providers. Results and Technical Report.
    (Minnesota Center for Survey Research (MCSR), 1992) Gladchild, Patricia
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    Children and youth transport in different urban morphological types
    (Journal of Transport and Land Use, 2016) Sarjala, Satu; Broberg, Anna; Hynynen, Ari
    As demonstrated in many earlier studies, the qualities of physical environment have great impacts on physical activity (PA) behavior. However, studying individual built-environment variables often produces contradictory effects between studies. To overcome this, we composed multivariate environment types using principal component analysis that takes notice of the inter-correlations between physical-environment variables. To get a realistic view of the places children and adolescents visit in their daily life, we used mapping methodology in which children themselves defined their important places. Based on 16 built-environment variables, six built-environment types were composed around these places. We found that walking and cycling were most prominent in residential environments and least common in mixed-use business districts. Areas with big commercial buildings as well as green environments had the highest proportions of car use. Most places, in general, were visited with friends, but most typically areas with big commercial buildings and mixed-use business districts were reached in the company of friends. Relatively many places were visited alone in residential areas.
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    Cost-effectiveness analysis of dental sealant using econometric modeling
    (2009-05) Ouyang, Wei
    Dental sealants have been shown to be effective in reducing caries. Most believe sealants are still underused, particularly among children who need sealants the most. Because the caries prevalence continues to decline, and the disparities in children's dental heath and dental care still exist, more efficient sealant placement strategies should be implemented based on the scientific information from cost-effectiveness analysis (CEA) of dental sealant at the community level. Previous CEAs of sealant using observational datasets were unreliable because they did not address the self-selection problem. The objectives of this study are to examine the utilization of dental sealants and its determinants, evaluate the incremental effectiveness and expenditure associated with sealant placement after correcting the potential selection issue, and explore the differences in sealant's cost-effectiveness among subpopulations. This study mainly utilized enrollment data and encounter data from a large Health Maintenance Organization in Minnesota. The study sample included 3,700 children aged 6 to 17 years during 1997 to 2001 and were continuously enrolled for 5 years. They all had a caries risk assessment (CRA), which was conducted at the beginning of the observation period, and no prior caries record for their included first permanent molars (FPMs). The CRAs were classified into three scores: low, moderate and high risk. Information on the 64 dentists who participated in the study was linked to the encounter data to identify those who conducted CRAs. Outcome variables included discounted effectiveness, as measured by the duration of caries-free state (healthy months) of a FPM, and the discounted cost associated with caries treatments, within the study period. The key independent variables included demographic variables (e.g., age, gender, race), caries risk level, socio-economic status, sealant placement, and preventive care utilization. Bivariate analysis and logistic analysis were performed to examine the pattern of sealant utilization and identify the determinants affecting sealant placement decision. Econometric models including classic Tobit model, selectivity-corrected Tobit model, classic two-part model, and selectivity-corrected two-part model were used to examine the selection issue and obtain unbiased marginal effects of sealant on caries-free duration and caries-related treatment cost. The working experience of the dentists who conducted the initial CRAs was used as the instrumental variable. The bootstrap method was used to obtain standard errors and confidence intervals for the incremental cost-effectiveness ratios. Sensitivity analysis and subgroup analysis were performed. In this study, approximately 77% of the sample had one or more FPM sealed during the entry period, more than half of them had all four FPMs sealed. Children aged 6 to 8 were more likely to receive sealant than children aged 9 or older. Children at relatively high caries risk, as well as children who visited dentists for preventive care more than once a year, had greater odds of receiving sealants. Non-white children or those from families with low incomes or low education level were more likely to receive sealant. This study also identified some dentists' characteristics, such as age, gender, and working experience as the good predictors of sealant decision. After 5 years, the sealant group had more individuals (83.9%) and more FPMs (94.3%) that stayed healthy compared with the non-sealant group in which 83.1% of the sample individuals and 91.8% of FPMs stayed healthy. A sealed FPM was associated with $56.84 expenditure (initial sealant charge was $39.00) over 5 years, and an unsealed FPM was associated with $13.13 expenditure. The sample-average incremental cost-effectiveness ratio (ICER) was $38/caries-free month for each FPM. Based on the results from econometric models, sealants were associated with a lower probability of having any caries, longer caries-free duration, an increased probability of using any resource, and less resources consumption. The final ICER indicates that sealant cost $42.16 more than non-sealant treatment to get one more caries-free month for each FPM. The 95% CI was $22.64 to $85.40 per one more caries-free month for each FPM. Significant selection or endogeniety issue was not found in either the effectiveness or cost analysis based on the whole sample, but it existed when analyzing sealant effects among certain subgroup children. The results from subgroup analysis show that sealing children at high risk for caries appears to be highly cost effective. In contrast, sealing children at low risk for caries would be much less cost effective. Sealing the FPMs of infrequent utilizers of preventive care appears to be more cost effective than frequent utilizers of preventive care. There is no significant difference in ICERs between sealing younger children and sealing older children. In conclusion, sealant application is not always cost effective. A uniform and fixed sealant utilization goal may not be appropriate. Sealant application should be increased among the high risk populations, such as those with previous caries or low dental care utilizers, or those directly deemed at high caries risk by dentists. The caries risk assessment procedure can improve clinical decisions on sealant application and increase efficient sealant delivery.
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    Current Definition of Vitamin D Status Misclassifies Maladapted Children of First Generation African Immigrants to the Northern US
    (2017-06) Hamdoun, Elwaseila
    Skin pigmentation, vitamin D inactivation and genetic variation of vitamin D binding protein (DBP) are all essential mechanisms for adaptive vitamin D metabolism in African children living near the equator. The widely used measurement of total serum 25-hydroxyvitamin D (25OHD) test ignores their inherent differences and maladaptive vitamin D metabolism, and potentially misclassifies their vitamin D status in northern parts of the United States. The goal of this multi-center international cross-sectional observational study was to better define vitamin D status in Somali immigrants living in the northern US. Well children aged 6 months to 7 years from Minnesota (US-born of Somali descent, n=55) and in Uganda (n=95) were enrolled. 25OHD and other vitamin D metabolites (24,25(OH)2D) were measured by immune-affinity extraction and liquid chromatography-tandem mass spectrometry. Parathyroid hormone (PTH) and hypocalcemia status were used as indicators of insufficiency. DBP haplotypes were determined. Ninety-one percent of the Minnesota Somali participants had 25OHD levels <30 ng/mL (vs 48% in Ugandans). Compared to the Ugandan group, and despite better nutritional status (milk intake), MN Somali children had lower 25OHD (23.7 ng/mL vs 30.1; p<0.0001) and calcium levels (9.1 mg/dL vs 9.5; p<0.0001), and higher PTH levels (47 pg/mL vs 36; p<0.0001). Somalis had a significantly higher frequency (57% vs 14% in Ugandans; p<0.001) of calcium in the lower level of normal even at 25OHD levels > 20 (American Academy of Pediatrics (AAP) cutoff for sufficiency). This was not significantly different from the Somali group with 25OHD < 20 (p<0.3). The high affinity allele Gc1f was the predominant DBP variant in both Somalis and Ugandans, yet MN Somalis had a higher percentage of low serum calcium status. The Somali group had significantly higher levels of vitamin D inactivation (higher 24,25(OH)2D) despite having lower 25OHD levels, raising a concern of maladaptive vitamin D metabolism and inherent susceptibility to vitamin D deficiency independent of limited cutaneous vitamin D synthesis as a result of darker skin tone. These results suggest that 25OHD levels 20-30 ng/mL (above the AAP cutoff for sufficiency (>20 ng/mL)) are common in children of Somali descent in northern US, and are clinically significant. Also, while African children living near the equator possess adaptive mechanisms for acquisition and utilization of vitamin D, those same mechanisms could render them susceptible to insufficiency when migrating to high latitude regions such as the northern US.
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    Defining Excellence for School-Linked Services.
    (Center for Urban and Regional Affairs, University of Minnesota, 1996) Wattenberg, Esther; Pearson, Yvonne
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    A developmental perspective of Self-regulatory failure in preschool and middle childhood.
    (2012-08) Cowell, Jason Michael
    The present studies were intended to detail developmental differences in self-regulatory failure. Study 1 is a downward extension (4-year-old children) of the standard dual-task approach to investigating self-regulatory failure in adults. In Study 1, 4-year-old participants (N = 61) were administered a consecutive dual-task paradigm (Baumeister et al., 1998). While this approach has been quite fruitful in the study of adult self-regulation, individual differences in self-control in children likely overshadowed any potential evidence for self-regulatory failure in Study 1. Indeed, 4-year-old children are in the early stages of the development of self-control, and demonstrate marked differences in performance and ability to self-regulate. Study 2 utilized a modified approach to the study of self-regulatory failure, informed by the extensive individual differences seen in Study 1. Participants ages 4 (n = 45), 6 (n = 55), and 8 years (n = 46), were given a within-subjects, pre-post self-control task. Each participant completed a tangram task, a 5-minute direction following task, and then another tangram task. While Study 2 does replicate the null findings of Study 1 with respect to condition differences in future persistence (direction following versus neutral), Study 2 also provides potential evidence for an alternative manifestation of performance failure. Wherein persistence on a difficult tangram after a direction following task is significantly less than persistence before the direction task (F (2, 144) = 8.76, p < .01). This effect was consistently found in all three age groups, even though older children (6 and 8 years) were found to persist significantly longer than younger children (4 years) (Tukey HSD = -85.07, p < .05; Tukey HSD = -119.29, p < .01, respectively). These results highlight the potential early onset of self-regulatory failure, as well as the necessity for the study of individual differences leading to differential magnitude of self-regulatory failure.
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    Deviants and dissidents: children's sexuality and the limits of liberation.
    (2010-08) Patters, N’Jai-An Elizabeth
    My dissertation takes the child as its focus to understand both liberation politics and social conservative movements in the postwar United States. I reveal that, even as leftist social movements viewed children as possessing "sexuality" and argued for the liberation of children's sexual expression, they simultaneously invoked the child as a vulnerable figure who must be protected from sexual abuse and violence in a dangerous postwar culture. Ultimately, the protectionist rhetoric about children's sexuality proved more powerful and influential than the libratory rhetoric, in large part because it shared features with the burgeoning rhetoric of the religious right, who found political power in a broad call to "save the children." My analysis of these competing rhetorical frameworks reveals the ways in which the child came to structure late-20th-century political discourse by marking the limits of liberation. Using children's sexuality as a point of entry into postwar political activism, my dissertation sheds light on the evolution of political identities. Ultimately, my work highlights the shrinking of progressive political possibilities and the emergence of a consolidated conservative political discourse. This dissertation argues that 1970s social movement groups' attention to and use of the figure of the child, particularly children's sexuality, was central to their efforts to advance libratory frameworks. I trace the ways that three Boston groups--the Boston Women's Health Collective, the Elizabeth Stone House, and the North American Man/Boy Love Association--organized around issues of children's sexuality. Each adopted seemingly altruistic child-focused agendas that were used to benefit the groups' adult members. In advancing these agendas, group members participated in the creation of a symbolic child-victim whose invocation would become a means of foreclosing political debate and establishing a cultural consensus of protection in the 1980s. In the end, the figure of the child that was so central to libratory movements of the 1970s was the very thing that limited their vocabularies and contained their agendas by the 1980s. Rather than focusing on a single movement, this project demonstrates that the child repeatedly emerged as a political tool in leftist activism and argues that this figure shaped the boundaries of liberation and the content of radicalism.
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    Do children walk where they bike? Exploring built environment correlates of children's walking and bicycling
    (Journal of Transport and Land Use, 2016) Moran, Mike; Plaut, Pnina; Baron-Epel, Orna
    Previous studies examined environmental correlates of children's physical activity. While most of these studies used aggregated physical activity measures (i.e., overall physical activity, active travel), little is known about the contribution of specific environmental attributes to specific types of physical activity. This study examined associations between GIS-based environmental measures and children’s self-reported walking and bicycling. The study area included “traditional neighborhoods” (N=4), characterized by high-density, land-use mix and grid-street network, and "suburban neighborhoods" (N=3), characterized by low-density, land-use segregation, and cul-de-sac streets. Data on children’s physical activity and psychosocial and socio-demographic factors were obtained through a school survey (of fifth and sixth graders) (N=573). Urban-form measures (intersection density, residential density, and built coverage) were significantly positively associated with walking and negatively associated with bicycling. These associations remained significant after controlling for social, intra- and inter-personal factors. These findings suggest that certain environments may encourage children’s walking and hinder their bicycling at the same time (and vice versa) and therefore raise the need for a more clear distinction between child-related walkability and bikeablilty.
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    Documenting perceptions about pesticides and other environmental exposures with photovoice : mothers' concerns for their children
    (2008-11) Stedman-Smith, Margaret M.
    Women of childbearing age and children living in rural agricultural regions are at-risk for pesticide exposure from a variety of pathways including occupational track-in, drift from farming activities, residential usage, and dietary intake. The purpose of this dissertation research is to answer the questions: "What do mothers perceive as pesticide exposure pathways for themselves and their children? How do these perceptions differ between cultural groups?" The study involves a secondary analysis of data collected during the summer of 2007 in the Red River Basin of the North from the University of Minnesota's Regional Sustainable Development Partnerships and the Division of Environmental Health Sciences. Sixteen women from three diverse groups participated: Caucasians enrolled in the Women Infant and Children federally subsidized nutrition program, new American immigrants, and Native Americans. Due to culture, economics, and geography, these groups may experience increased health risks from pesticide exposure. Photovoice was used as a qualitative methodology to document mothers' concerns about pesticide exposure and other health issues for their children, since it enables participants, including those who lack verbal acumen in the language of the dominant culture, to use photographs to address questions like, "Why does this situation exist? Do we want to change it, and, if so, how?" Caucasian and Native American mothers voiced concern about pesticide exposure from drift due to agricultural spraying on the ground and by plane. All participants wanted advanced notice to take precautionary measures before fogging or spraying. Perceptions of pesticide exposure differed according to the cultural lens of each group: Caucasian women saw the necessity of industrial agriculture and pesticide usage as a trade-off; Native American women voiced concerns about pesticide contamination to traditional foods; and new American immigrants expressed a need to learn how to read labels and use pesticides safely. Participants suggested culturally congruent strategies for the delivery of educational information. Consumption of locally grown organic foods was identified as one strategy to reduce pesticide exposure. This research assists public health professionals, extension educators, and primary care providers with the aim of reducing pesticide exposure to children living in rural agricultural regions.
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    Effectiveness of Behavioral Economics-Informed Strategies and Enhanced Food Preparation Skills to Increase Vegetable Intake and Variety of Vegetables Eaten among Low-Income Children
    (2017-11) Overcash, Francine
    Obesity prevalence among children continues to be a serious problem, especially for those in low-income households. Inadequate vegetable intake leading to low dietary quality may be a contributing factor to the obesity problem among children. The field of behavioral economics has gained momentum in nutrition interventions for improving vegetable intake, mainly in school and other cafeteria settings, using low-to-no cost modifications to the food environment. Similar strategies have yet to be tested in the home in a large-scale trial. The overall objective of the following dissertation was to determine if an intervention comprised of 6 behavioral economics-informed strategies within a 6-session vegetable-focused cooking skills program, grounded in Social Cognitive Theory, was more effective for improving vegetable intake, vegetable liking, variety of vegetable eaten, BMI-z score, and home availability of vegetables for a diverse sample of low-income children (ages 9-12) than a control condition of the vegetable-focused cooking skills program alone. The 6 strategies tested were: 1) child helping to prepare the vegetables, 2) using a plate that shows the appropriate proportion of food groups within a meal, 3) making the vegetables the most available and visible part of the meal, 4) serving at least 2 vegetables with the meal, 5) serving the vegetables before the meal, and 6) using a bigger spoon to serve the vegetables. The three separate reports included in this dissertation utilized data collected in a longitudinal controlled intervention trial conducted in the Minneapolis-St. Paul metropolitan area from September 2014-June 2017. Outcome measures were collected at 4 time points: baseline, immediate post-course, 6-months post-course, and 12-months post-course. Mixed model regression analyses and t-tests were used to compare outcomes between intervention and control groups. A total of 103 parent/child pairs were enrolled with 91 who completed the weekly cooking skills program. The child outcomes of vegetable intake, vegetable liking, variety of vegetables eaten, and BMI-z score, as well as home availability of vegetables were not improved for the intervention children more than the control children. The immediate impact of the vegetable-focused cooking skills program on parent and child psychosocial measures (e.g. cooking self-efficacy and interest in cooking) was assessed. Baseline and immediate post-course survey data from the intervention and control groups were combined since both groups participated in the cooking skills program. The combined data were used to assess changes in outcome measures from pre- to post-course. Validated parent self-report questionnaires were used to assess changes in the following psychosocial outcomes: cooking confidence, healthy food preparation, cooking barriers, and food resource management. Parents and children were asked if they had ever tried each of 37 different vegetables and if yes, to rate their liking. Changes between pre- and post-course responses were tested using paired t-tests or Wilcoxon signed-rank tests. Improvements were observed for parental cooking confidence, healthy food preparation skills, number of vegetables present in the home, parental vegetable liking, parental variety of vegetables eaten, and confidence in cooking individual vegetables and using several vegetable cooking methods. Improvements were also observed for child cooking self-efficacy and variety of vegetables eaten. Vegetable liking and acceptability for a wide variety of vegetables was measured among a racially and ethnically diverse sample of 9-12 year old children. Child liking data were combined from the present study and another in-home intervention study with a similar study population. Mean liking ratings for each vegetable were calculated. The number of children that found each vegetable acceptable and unacceptable was also tabulated. The most liked vegetables were corn, potatoes, lettuce, and carrots. Artichoke, onion, and beets were the 3 vegetables with the lowest mean liking. Overall, children found a wide variety of vegetables acceptable.
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    Effects of noise on fast mapping and word learning scores in preschool children with and without hearing loss.
    (2010-01) Blaiser, Kristina M.
    This study examines the fast mapping and word learning abilities of three- to five-year old children with and without hearing loss, in quiet and noise conditions. Nineteen children with hearing loss (HL) and 17 normal hearing peers (NH) participated in this study. Children were introduced to eight novel words in each condition. Children's ability to `fast map' (i.e., comprehend or produce new words after minimal experience) was measured in the first session (Time 1). `Word learning' (the comprehension or production of previously unfamiliar words following additional exposures) was measured following three individual training sessions (i.e., Time 2). Results indicated that children in the HL group performed similarly to NH peers on fast mapping and word learning measures in quiet. In noise, the HL group performed significantly poorer at the fast mapping time point than the NH group. However, at Time 2 there were no significant between-group differences in the noise condition. A series of correlation and regression analyses was used to investigate variables associated with fast mapping and novel word learning in quiet and noise conditions. Age was significantly correlated to fast mapping and word learning performance in quiet and noise in the NH group, but not in the HL group. Age fit with hearing aids was the only traditional hearing loss factor that was correlated with fast mapping performance in noise for the HL group. Results showed that age was a significant predictor of fast mapping performance in noise for the NH group, but not the HL group. Word learning in quiet was a significant predictor for word learning in noise for the NH group, fast mapping in noise was a significant predictor for the HL group. In addition, performance in quiet significantly predicted fast mapping and word learning scores in noise for the NH group; however, there was no significant correlation between performance in quiet and noise for the HL group.
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    An Electrophysiological Investigation of Linguistic Pitch Processing in Tonal-language-speaking Children with Autism
    (2018-09) Yu, Luodi
    Speech perception is a fundamental skill interfacing sound to meaning; however, systematic characterization of autism in relation to this issue is still lacking, presumably due to insufficient consideration of the language-specific nature of speech processing. Although nearly 70% of world languages are tonal, tonal language users have been significantly under-represented in autism research. An overview of the limited literature reveals that there is a trend of distinct patterns across different language users (i.e., tonal language vs. non-tonal language), indicating potentially disrupted neural specialization for linguistic structures in individuals with autism. This dissertation examined the rapid cortical processing of pitch patterns varying in linguistic status in native Chinese school-age children with autism and age-matched typically developing (TD) peers using electroencephalography (EEG). The auditory stimuli were nonsense speech and nonspeech sounds presented in passive listening conditions. In comparison with the TD group, the autism group displayed neural timing issues at various levels of information processing as indicated by neural response latency. Moreover, the autism group displayed not only hyposensitivity for native vs. nonnative (or prototypical vs. non-prototypical) difference in the early information processing stage but also hypersensitivity in the later processing stage accompanied by diffusive scalp distribution with a rightward dominance. The results collectively support the idea of disrupted neural specialization for linguistic structures in autism. The findings underscore the proposition that autism is bound with auditory and phonological atypicalities in addition to the syndromic social and communication deficits, which have important implications for requiring language-specific considerations in autism research and clinical practice.
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    Environmental Risks and Children’s Mental Health Treatment Outcomes: A Person-Centered Analysis
    (2017-10) Witham, Matthew
    Treatment outcomes for children receiving mental health services at community-based clinics have been inconsistent. There is an urgent need to study treatment effectiveness and to identify factors that influence symptom changes. Previous research has demonstrated the impact of environmental risks on children’s functioning, and research is needed to understand the effects of risks on mental health treatment outcomes. In partnership with a community-based mental health clinic, this study aimed to (a) determine whether a racially-diverse sample of children (N = 1176; 59.4% male; ages 4-17 years) demonstrated post-treatment symptom reduction, (b) identify environmental risk subgroups of children through latent class analysis, and (c) assess for subgroup differences on outcome change scores. Paired sample t-tests were used to test for significant change over time between pre- and post- treatment symptoms levels and between high- and post- treatment symptoms levels. Significant symptom reduction was observed over time, as assessed by the Strengths and Difficulties Questionnaire. Latent class analysis was used to identify and define environmental risk subgroups. Fit indices and theoretical constructs conjointly endorsed four parsimonious latent classes: Low-Risk, High-Poverty, High-Risk, and Low-Poverty with Maltreatment. An ANCOVA was used to test whether the four classes differed on their respective change scores; no significant differences were found. Findings indicate meaningful symptom reduction after treatment and the existence of meaningful subgroups of children based upon risks. However, there is inadequate evidence that symptom changes vary based upon environmental risk classes. Implications of findings for clinical practice and future research are discussed.
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    Ethnicity/Race, Sex and Physical Activity: Supporting Physical Activity from Childhood to Adulthood in Diverse Populations
    (2017-07) Miller, Jonathan
    Interventions to increase population physical activity are often conducted in diverse populations, particularly in schools. Understanding differences in intervention effects and determinants of physical activity across population subgroups should help improve the effectiveness of interventions. We examined how an intervention effect and determinants of physical activity differ by or are consistent across ethnicities/races and the sexes. In the first manuscript, we estimated the effect of the Minne-Loppet Ski Program, an elementary school cross-country ski intervention, on motivation to exercise and tested whether effects differ by ethnicities/race or sex. Motivation to ski increased among Minne-Loppet Ski program participants compared to students in control classrooms. Motivation to exercise increased among African American and white participants but not Hispanic participants. In the second manuscript, we used cross-sectional data from Project EAT-2010 to test a social-ecological model of determinants of physical activity. Determinants clustered into eight factors. A factor that included personal and social determinants had the strongest association with physical activity. In the third manuscript, we used cross-sectional data from Project EAT-2010 to estimate differences in personal, social and environmental determinants of physical activity across ethnicities/races and the sexes in middle and high school students. Most determinants of physical activity did not vary by ethnicity/race. Among females, neighborhood road connectivity, distance to trails and perceived mother’s physical activity differed in their associations with physical activity by ethnicity/race. Among males home media equipment and sports participation differed in their associations with physical activity by ethnicity/race. In the fourth manuscript we used longitudinal data from Project EAT-I through EAT-IV to estimate differences in trajectories of physical activity and its determinants across ethnicities/races and the sexes in middle and high school students. Declines in physical activity happened later among males than among females. Only the association of BMI with physical activity differed by ethnicity/race and sex. The results from these analyses show that there is a great deal of consistency in the determinants of physical activity across ethnicities/races, but differences that emerge should be considered when implementing future physical activity interventions.
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    Fatigue, physical performance, and carnitine levels in children and adolescents receiving chemotherapy.
    (2009-04) Hooke, Mary Catherine
    Fatigue in childhood cancer is a pervasive and distressing symptom that has a physical component described as a "lack of energy". Fatigue, physical performance, and a micronutrient, carnitine, all relate to physical energy and may be influenced by chemotherapy. The purpose of this pilot study is to examine the relationship between the physical performance and carnitine plasma levels and fatigue in child and adolescent cohorts receiving chemotherapy. The study included 30 patients, ages 6 to 17, who were newly diagnosed with cancer and receiving chemotherapy. There were 20 males and 10 females; the child cohort had 16 subjects ages 6 to12. The 14 subjects in the adolescent cohort were ages 13 to 17. Standardized instruments were administered in the 1st and 3rd cycle of chemotherapy between day 15 and 29. Instruments included physical performance tests (Timed Up and Down Stairs [TUDS] and 6-Minute Walk test [6MWT]), carnitine plasma levels, and self-reported Childhood Fatigue Scale or Fatigue Scale for Adolescents. In the child cohort, physical performance measures appeared to improve (TUDS, p = 0.09 and 6MWT, p = 0.09) and free carnitine plasma levels decreased (p = 0.01) between cycles 1 and 3. Fatigue scores also tended to improve (p = 0.05). In the adolescent cohort, there was a suggestion that fatigue decreased (p = 0.15) but other variables evidenced little change. Spearman's rank-order correlation was used to examine relationships between the change in variables from cycle 1 to 3. In 6 to 12 year olds, when time on the TUDS decreased, fatigue tended to decrease (p = 0.11), and when 6MWT distance increased, fatigue decreased (p=0.01). In 13 to 17 year olds, correlations between changes in the physical performance variables and fatigue were slight and not significant. Fatigue may decrease early in treatment as disease symptoms resolve. Fatigue in the 6-12 age group was related to physical performance, which is consistent with previous studies that define fatigue in children as primarily a physical sensation. Adolescent fatigue was not related to physical performance which supports the concept that, in adolescents, fatigue is more complex and includes mental and emotional components.
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    Feeding the future: the global emergence of school lunch programs.
    (2009-06) Rutledge, Jennifer Geist
    My dissertation is motivated by a puzzle of international social policy and norm emergence and diffusion. Today, children in one hundred and forty-one countries receive free or subsidized school lunches. Yet less than a century ago, no state had a national child nutrition policy. Feeding children was clearly not considered a state responsibility a century ago, why is it considered one today? In addition to analyzing this policy emergence and diffusion, I argue that this policy emergence represents an emergent international norm - a norm that there is public responsibility beyond the family to feed children. Scholars tend to explain policy and norm emergence and diffusion as due to the work of activists, diffusion effects or with world polity theory. However, these explanations tend to focus on either the national or international level as the causal source. Instead, I look at how the national and international levels interact in the creation of policy. In addition, my argument incorporates ideational factors into the field of social policy, which has long focused on material factors to explain policy emergence. I do this by utilizing insights from constructivist international relations theory. Specifically, my argument focuses on the ability of policy entrepreneurs to manipulate certain, internationalized, frames, or ideational cultural structures, within their domestic context in order to produce school lunch programs. The dissertation is structured around the historical development of school lunch programs and traces their progress from their inception as food surplus disposal and military readiness programs, to their current use as a development tool by the international community. After using my global dataset of school lunch programs to assess conventional social policy theories, I develop my argument through in-depth case studies of the US, UK, Canada, India, the UN's World Food Programme, Catholic Relief Services and the New Partnership for African Development. In each case study I focus on the interaction between the different ways the problem of child malnutrition was framed in each context and the political consequences of the emergence of structural agricultural surpluses at the global level.
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    Fidelity and Feedback: A mixed methods analysis of prototype testing of children's toys
    (2023-05) Codner, Andria
    Prototyping is an essential part of the design process that helps determine desirability, feasibility, and viability of a product. Prototype testing with intended end users is important to determine if the current direction of the product meets the user’s needs, if the concept is feasible, and if the model functions correctly. Typically, prototype testing occurs with the intended end user, however, when designing products for children this has not historically been the case. Prototypes of products designed for children were tested with adults. In doing that, the designers missed the opportunity to truly engage with their intended audience and to learn more about their specific wants and needs. Because this field of testing prototypes with children is relatively new, there are multiple areas in which more research could be completed. One research area that deserves more exploration is how the fidelity of physical prototypes affects children’s understanding of the prototypes, and therefore impacts the feedback that the children give the design team. Another area of research that is needed is understanding how to balance prototype testing feedback received from multiple stakeholders; for toy products, this can include stakeholders like children, parents/guardians, experts in the toy industry and/or design field, and the client.This thesis research begins to fill those gaps in the research by using mixed methods to analyze data collected from a project-based design course, which was developing new toy products for children. The data captured were students’ reports of stakeholders’ feedback in testing sessions and the students’ own reflections on the experiences of testing. The relationships between the children’s understanding and feedback and the fidelities of the prototypes in terms of form and function were explored. The feedback from multiple stakeholders is also compared on the types of feedback, how feedback is given, and how feedback is implemented into the design of the product. The results of this thesis will aid designers in making effective and efficient decisions when deciding how to prototype and test children’s products.
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    Fostering Attitudes of Empathy towards Animals in Youth Ages 4-7 through Play Experiences in a Zoo Setting
    (2011) Faris, Heidi M
    Zoos are place-based education facilities that have the ability to utilize their natural play spaces to enhance the social and cognitive development of children using live animals. Playing outdoors in nature has shown to increase physical, attentive, cognitive and social development during early childhood. By using place-based learning, zoos can guide children to use different play behaviors to foster attitudes of care and empathy increasing their appreciation to nature. During the week of July 18th-21st, 2011, observations of children playing at the San Antonio Zoo in the Kronkosky's Tiny Tot Nature Spot, to determine if children who play in a zoo setting show empathy for animals and an appreciation for nature. 97 children, both boys and girls between the estimated ages of 4-7 were recorded. Five popular play spaces within the children's area were chosen as observation sites. A coding form and accompanying notebook were used to record observations. Data was collected and coded using different aspects, such as play behaviors per area, boys vs. girls, time spent in an area, actions and language spoken. Children who played in the various play areas showed different levels of empathy towards animals based on the expressions and actions recorded. Further research is needed to include predetermined factors, expanding to more than one zoo, and conduct a longitudinal study to understand long term effects of the role of zoo and nature play areas.