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- Response to Fornasaro-Donahue et al, Increasing Breastfeeding in WIC Participants: Cost of Formula as a Motivator. [Letter]
- J Nutr Educ Behav 2014 Sep-Oct; 46(5):e9.
- Assessing Immunization Interventions in the Women, Infants, and Children (WIC) Program. [JOURNAL ARTICLE]
- Am J Prev Med 2014 Sep 10.
Vaccination promotion strategies are recommended in Women, Infants, and Children (WIC) settings for eligible children at risk for under-immunization due to their low-income status.To determine coverage levels of WIC and non-WIC participants and assess effectiveness of immunization intervention strategies.The 2007-2011 National Immunization Surveys were used to analyze vaccination histories and WIC participation among children aged 24-35 months. Grantee data on immunization activities in WIC settings were collected from the 2010 WIC Linkage Annual Report Survey. Coverage by WIC eligibility and participation status and grantee-specific coverage by intervention strategy were determined at 24 months for select antigens. Data were collected 2007-2011 and analyzed in 2013.Of 13,183 age-eligible children, 5,699 (61%, weighted) had participated in WIC, of which 3,404 (62%, weighted) were current participants. In 2011, differences in four or more doses of the diphtheria, tetanus toxoid, and acellular pertussis (DTaP) vaccine by WIC participation status were observed: 86% (ineligible); 84% (current); 77% (previous); and 69% (never-eligible). Children in WIC exposed to an immunization intervention strategy had higher coverage levels than WIC-eligible children who never participated, with differences as great as 15% (DTaP).Children who never participated in WIC, but were eligible, had the lowest vaccination coverage. Current WIC participants had vaccination coverage comparable to more affluent children, and higher coverage than previous WIC participants.
- An abnormal resting-state functional brain network indicates progression towards Alzheimer's disease. [Journal Article]
- Neural Regen Res 2013 Oct 25; 8(30):2789-99.
Brain structure and cognitive function change in the temporal lobe, hippocampus, and prefrontal cortex of patients with mild cognitive impairment and Alzheimer's disease, and brain network-connection strength, network efficiency, and nodal attributes are abnormal. However, existing research has only analyzed the differences between these patients and normal controls. In this study, we constructed brain networks using resting-state functional MRI data that was extracted from four populations (normal controls, patients with early mild cognitive impairment, patients with late mild cognitive impairment, and patients with Alzheimer's disease) using the Alzheimer's Disease Neuroimaging Initiative data set. The aim was to analyze the characteristics of resting-state functional neural networks, and to observe mild cognitive impairment at different stages before the transformation to Alzheimer's disease. Results showed that as cognitive deficits increased across the four groups, the shortest path in the resting-state functional network gradually increased, while clustering coefficients gradually decreased. This evidence indicates that dementia is associated with a decline of brain network efficiency. In addition, the changes in functional networks revealed the progressive deterioration of network function across brain regions from healthy elderly adults to those with mild cognitive impairment and Alzheimer's disease. The alterations of node attributes in brain regions may reflect the cognitive functions in brain regions, and we speculate that early impairments in memory, hearing, and language function can eventually lead to diffuse brain injury and other cognitive impairments.
- WIC Mothers' Social Environment and Postpartum Health on Breastfeeding Initiation and Duration. [JOURNAL ARTICLE]
- Breastfeed Med 2014 Sep 4.
Abstract A low breastfeeding rate has been a consistent maternal and child health problem in the United States, especially for low-income families. Understanding mothers' social environment and overall well-being is important in determining how mothers will take care of themselves and their infants during the postnatal period in relation to the breastfeeding rate among low-income mothers. In this study, we examined the effects of the social environment of mothers enrolled in a Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program in eastern Illinois and their postpartum health on breastfeeding initiation (n=103) and maintaining breastfeeding for at least 3 months (n=73). Using logistic regression models, a significant positive association (adjusted odds ratio [AOR]=3.47; 95% confidence interval [CI], 1.15-10.47; p=0.03) between marital status and breastfeeding initiation and a significant negative association (AOR=0.23; 95% CI, 0.06-0.88) between receiving food stamps and breastfeeding initiation were found. WIC mothers who were married were 4.1 times as likely to maintain any breastfeeding for at least 3 months than single mothers, and the association was significant (AOR=4.08; 95% CI, 1.36-12.27; p=0.01). The breastfeeding initiation rate was 77.7%, however, the mean±standard deviation age of the child when breastfeeding stopped was 2.2±1.4 months. There was a nonsignificant association between postpartum depression and breastfeeding initiation and maintaining any breastfeeding for 3 months. This study has shown that the familial environment of mothers plays a very important role in improving breastfeeding rates among WIC mothers. In addition, there is a negative relationship between using a food assistance program and breastfeeding among low-income women.
- Effects of Parental Nativity and Length of Stay in the US on Fruit and Vegetable Intake Among WIC-Enrolled Preschool-Aged Children. [JOURNAL ARTICLE]
- J Immigr Minor Health 2014 Sep 2.
Exposure to US culture is negatively associated with fruits and vegetables (F&V) intake. Our goal was to investigate how parent's nativity and length of stay in the US influences preschoolers' F&V intake. We analyzed survey data from 2,352 children, aged 36-60 months, who participate in the Supplemental Nutrition Program for Women, Infants and Children (WIC) in Los Angeles County. Using multiple linear regression, we examined children's F&V intake by parent's nativity and years in the US, adjusting for possible confounders. Children of foreign born parents who had lived in the US for <10 years consumed fewer servings of vegetables than children of US born parents and of foreign born parents who had lived in the US for ≥10 years. Children of newer immigrant families may be at greater risk for consuming poor-quality diets. Research to identify determinants of poor diet quality among children of immigrant families may increase the effectiveness of WIC in addressing this population's nutritional needs.
- A novel approach to the treatment of diabetic foot abscesses - a case series. [Journal Article]
- J Wound Care 2014 Aug; 23(8):394-9.
Diabetic foot abscesses are an occasional complication of diabetic foot infections usually involving osteomyelitis and significant soft tissue injury. The standard of care for diabetic foot abscesses is the performance of immediate surgical drainage and debridement. However, this therapeutic mode involves more often than not, some extent of minor amputation and bony loss. With the advent of new therapeutic techniques it may be possible to treat diabetic foot abscesses conservatively.To explore adjunct therapies in the treatment of diabetic foot abscesses in order to avoid extensive surgery, amputation and tissue loss whilst maintaining limb integrity.Between January 2011 and June 2012, six patients with a diabetic foot abscess and osteomyelitis presented at our diabetic foot clinic. They were treated with topical oxygen and the abscesses were drained using PolyMem® Wic® Silver Rope (PWSR). All patients experienced full recovery and remained disease free during a follow up period of 4-21 months.Amputation and the removal of infected bone had once been considered the sole treatment for diabetic foot osteomyelitis. Multiple case series and accumulation of clinical experience has shown otherwise, and nowadays medical management of osteomyelitis is the preferred treatment in select patients. In our study, we present a case series of patients suffering from diabetic foot abscesses treated non-surgically. Hopefully this series will lay the foundation for further data demonstrating the feasibility of a conservative approach for diabetic foot abscesses, which may overcome the infection without requiring amputation.There were no external sources of funding for this study. YK received a travel grant from Ferris Mfg. Corporation for presentation of this work at the EWMA 2012 conference.
- Changes in Breastfeeding Among WIC Participants Following Implementation of the New Food Package. [JOURNAL ARTICLE]
- Matern Child Health J 2014 Aug 6.
In December of 2007, the Federal Register published an Interim Rule establishing revised food packages for participants in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) that was implemented by states in 2009. We analyze changes in breastfeeding among WIC participants from the period before to period after implementation of the new food package We used linear regression to analyze data from the Pregnancy Risk Assessment Monitoring System (PRAMS) in 19 states from 2004 to 2010, the Pediatric Nutrition Surveillance System (PedNSS) in 16 states monthly from January 2007 to October 2010 and the National Immunization Survey (NIS) from all 50 states and the District of Columbia from 2004 to 2010 for evidence of an association between time-series patterns of breastfeeding among women or children who participated in WIC and changes in the new food package. Data from all three sources evidenced steady upward trends in ever breastfed infants on WIC during the study period. In neither PRAMS nor the NIS were trends in breastfeeding after implementation of the new food package statistically different from trends in breastfeeding among low-income women not on WIC. We also uncovered no break in monthly breastfeeding rates by birth cohort associated with new food package in the PedNSS. Rates of ever breastfed children are rising nationally but the increase is not associated with changes in WIC's new food package as evidenced in national and state surveys of postpartum women.
- Telephone Peer Counseling of Breastfeeding Among WIC Participants: A Randomized Controlled Trial. [Journal Article]
- Pediatrics 2014 Sep; 134(3):e700-9.
The US Surgeon General has recommended that peer counseling to support breastfeeding become a core service of the Supplemental Nutrition Program for Women, Infants, and Children (WIC). As of 2008, 50% of WIC clients received services from local WIC agencies that offered peer counseling. Little is known about the effectiveness of these peer counseling programs. Randomized controlled trials of peer counseling interventions among low-income women in the United States showed increases in breastfeeding initiation and duration, but it is doubtful that the level of support provided could be scaled up to service WIC participants nationally. We tested whether a telephone peer counseling program among WIC participants could increase breastfeeding initiation, duration, and exclusivity.We randomly assigned 1948 WIC clients recruited during pregnancy who intended to breastfeed or were considering breastfeeding to 3 study arms: no peer counseling, 4 telephone contacts, or 8 telephone contacts.We combined 2 treatment arms because there was no difference in the distribution of peer contacts. Nonexclusive breastfeeding duration was greater at 3 months postpartum for all women in the treatment group (adjusted relative risk: 1.22; 95% confidence interval [CI]: 1.10-1.34) but greater at 6 months for Spanish-speaking clients only (adjusted relative risk: 1.29; 95% CI: 1.10-1.51). The likelihood of exclusive breastfeeding cessation was less among Spanish-speaking clients (adjusted odds ratio: 0.78; 95% CI: 0.68-0.89).A telephone peer counseling program achieved gains in nonexclusive breastfeeding but modest improvements in exclusive breastfeeding were limited to Spanish- speaking women.
- Associations Between Preterm Birth, Low Birth Weight, and Postpartum Health in a Predominantly Hispanic WIC Population. [JOURNAL ARTICLE]
- J Nutr Educ Behav 2014 Aug 1.
To describe the postpartum health of predominantly Hispanic participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and identify how health characteristics differ between mothers who delivered preterm or low birth weight infants and those who did not.Cross-sectional survey among postpartum WIC mothers.Los Angeles and Orange Counties, CA.WIC participants within 1 year of delivery (n = 1,420).Postpartum health behaviors, health characteristics, and birth spacing intentions and behaviors.Frequencies of health characteristics were estimated using analyses with sample weights. Differences were assessed with chi-square and Fisher exact tests with Bonferroni correction for pairs of tests.Many women exhibited postpartum risk factors for future adverse health events, including overweight or obesity (62.3%), depressive symptoms (27.5%), and no folic acid supplementation (65.5%). Most characteristics did not differ significantly (P > .025) between mothers of preterm infants and full-term infants or between mothers of low birth weight and normal birth weight infants.Despite few differences between postpartum characteristics of mothers who delivered preterm or low birth weight infants and those who did not, a high percentage of mothers had risk factors that need to be addressed. Current postpartum educational activities of WIC programs should be evaluated and shared.