Given the risk for less optimal developmental attainment in children born to adolescent and young mothers, this study examined associations among child characteristics, parenting stress, and child risk for developmental delay from birth to age five years in mother-child dyads who attended a free-of-cost teen parenting program. Participants were 133 mothers and their target child classified in five age groups; mothers self-reported on the Parenting Stress Index-Short Form. While 68 % of children showed typical development across age groups, 32 % showed increased risk of developmental delay in five areas and overall using the Ages and Stages Questionnaire (ASQ-3). Maternal age did not increase the odds of child's developmental delay. Multivariate analyses showed that the adjusted odds ratio of delay was higher among boys (vs girls), in Personal-social (aOR = 6.2) and Overall (aOR = 2.7). Compared to baseline age group (1-9 months), the odds of delay were higher in age 10-18 months for Personal-social (aOR = 5.3); in age 19-31 months for Communication (aOR = 13.5) and Overall (aOR = 6.3); and in age 32-44 months for Communication (aOR = 7.0). The odds of a delay were higher in children of mothers with higher parenting stress in three of the five developmental areas (Fine Motor, Problem Solving, Personal-social) and Overall. Children's ages 3-4 and boys were associated with increased odds of delay in language and personal-social areas. Beyond screening for child developmental delay, surveillance for highly stressed mothers may be important to broaden risk reduction efforts among adolescent and young mother-child dyads served in primary care settings.
The maintenance of physical activity is crucial for the prevention and management of type 2 diabetes (T2D), and exercise induced changes including production of metabolites like ammonia can result in fatigue and exercise intolerance. Nutritional supplements may serve as an effective measure in supporting patients undergoing physical training by acting on their metabolism. This study investigates the effects of supplementation with α-keto acids (KAS) on exercise tolerance and glucose control in T2D patients. In a double-blind, placebo-controlled, randomized study 28 T2D patients underwent 6 weeks training on a cycle ergometer while they were supplemented with either a placebo or KAS (0.2 g kg(-1) body weight each day). The weekly training volume, power output at maximum and lactic threshold, leg muscle torque, the plasma concentration and 8 h urinary discharge of glucose, ammonia and urea were determined before and after the training as well as after one week of recovery. With KAS the patients did significantly more voluntary exercise (213 vs. 62 min, P < 0.01), reached a higher VO2max (27.3 vs. 24.8 ml min(-1) kg(-1)), higher power output (224 vs. 193 watts, P < 0.05) and greater endurance capacity (108 vs. 96 watts at lactic threshold, P < 0.05). Although the patients without KAS improved their glucose control after the training (P < 0.05), this effect could not be maintained after recovery as it was in the KAS group, where there was a prolonged benefit in glucose control. KAS also affected the ammonia and urea metabolism. KAS delivered supportive effects on the physical training along with a prolonged benefit in glucose control in T2D patients.
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