No abstract

Studies of disinfection byproducts ( DBPs ) in drinking water and risk of adverse reproductive outcome have usually relied on approximate measures of exposure. Individual differences in consumption of bottled or filtered water, variability in tap water consumption at home and at work, dermal and inhalation exposure to volatile contaminants, and changes in residency during pregnancy may lead to exposure misclassification. We characterized exposures to tap water and other risk factors among 71 pregnant and 43 non -pregnant women attending public health clinics. Nearly all residences had a municipal water source, but 25% of women drank filtered or bottled water. Fifty percent of the women in our sample reported working outside the home where, on average, one third of their daily water intake took place. Pregnant women consumed more water than non -pregnant women ( 3.4 vs. 3.0 total l / day ) , especially cold tap water at home ( 1.8 vs. 1.3 l / day, 95% CI for the difference = 0.1, 0.9 ) . Patterns of showering were similar for both groups of women, but pregnant women were more likely to bathe and to bathe more frequently. The prevalence of smoking was lower among pregnant women ( 22.5% vs. 32.6% ) , as was the consumption of alcohol ( 4.2% vs. 53.5%, 95% CI for the difference = À 64.9, À 33.7 ) . Thirty -two percent of women had moved during their current pregnancy. The data reaffirm the importance of collecting individual -level data for water consumption and exposure to potential confounders to avoid misclassification bias. This study is the first to target women of low socio -economic status ( SES ) and therefore of particular interest in studies of adverse reproductive outcomes for which this group is at increased risk.

Addressing cultural factors related to pain management in underserved families may instill greater confidence in managing pain.

Purpose: This study aimed to determine the relationships between parent and child weight status, parental perceptions of weight, child feeding, food insecurity, and acculturation in Hispanic preschoolers and their parents in a southern California school district. Methods: Eighty-five parent-child dyads participated. Height and weight, parental weight perceptions, child feeding, acculturation, and food insecurity data were obtained. Results: Eighty-five percent of parents were born in Mexico, although 94% of their children were born in the US. Eighty percent of parents and 43% of the children were overweight or obese. None of the constructs measured predicted child BMI, although parents significantly underestimated their children's body size. Parents' BMI correlated positively with restrictive child feeding practices, and obese parents pressured their children to eat more than did non-obese parents. Conclusions: Obesity exists disproportionately in Hispanics compared to other ethnic populations. While factors predicting children's weight status are difficult to identify, parents' weight, perceptions of child's weight, adherence to the Hispanic culture, and food insecurity do appear to impact parental concerns and parenting behaviors, particularly restrictive and pressuring-to-eat behaviors. Parental underestimation of their children's weight may hinder behavior change if concerns about unhealthy weight are inaccurate. Interventions should consider parental weight, weight perceptions, and feeding practices.

Background:Latinas are at a higher risk than Caucasians for both type 1 and type 2 diabetes (DM), as well as DM-associated reproductive health (RH) complications. Healthcare providers (HCPs) should deliver culturally-sensitive care to enhance the care relationship between Latinos and HCPs and to improve patient outcomes. This study explored an expert panel’s cultural understanding, experiences, barriers, and facilitators regarding RH and preconception counseling (PC) for adolescent Latinas with DM and their families.Methods:This study used open-ended questions with a focus group of 8 HCPs from the mid-Atlantic, Southwest, and Northwest regions of the United States in a teleconference format. Two researchers transcribed and reviewed the transcript for accuracy. Using content analysis, four members of the team identified themes. All researchers discussed themes and a 100% consensus was reached. For confirmation, a coding protocol was created based on the emerging themes.Results:Five themes related to cultural understanding and experiences were identified: 1) issues of identity; 2) acculturation; 3) stigma; 4) ambivalence toward birth control, RH education, and PC; and 5) cultural sensitivity vs. best practice. Four barriers were identified: 1) language; 2) religion; 3) access to healthcare, and 4) discomfort with discussion. Ten facilitators were identified: 1) the importance of support and support networks; 2) promoting trust among HCPs, daughters, and families; 3) assessing emotional development; 4) empowerment; 5) emphasizing safety; 6) communicating in patients’ preferred language; 7) discussing RH-related topics and PC using cultural sensitivity; 8) importance of being ready/temporality/planning for the future; 9) the importance of family-centered care; and 10) variation in educational tailoring and dissemination/ care delivery.Conclusions:Findings support the need for culturally sensitive and developmentally appropriate PC programs to empower adolescent Latinas with DM.