BEHAVIORAL SCIENCE AND EPIDEMIOLOGY
ATHEROSCLEROSIS RISK FACTORS: CAN AMERICAN FAMILIES CHANGE
THEIR DIETARY HABITS AND LIFE STYLE?
Univ. of Ariz.,Col of Med., Univ. Hosp., Dept. of Peds.,Tucson
Atherosclerosis r i s k f a c t o r s include hypercholesterolemia,
o b e s i t y , hypertension, l i m i t e d e x e r c i s e and smoking. To inv e s t i g a t e t h e t i t l e question, we studied 199 middle c l a s s
metropolitan f a m i l i e s (715 people of whom 48% were c h i l d r e n ) .
Data were gathered concerning e a t i n g p a t t e r n s , e x e r c i s e , smoki n g , and family h i s t o r y . Seven hours of r i s k f a c t o r education
were o f f e r e d t o p a r t i c i p a n t s . S i x months l a t e r i n 99 f a m i l i e s
(403 people) we obtained complete followup d a t a concerning
whether a t r i s k s u b j e c t s a v a i l e d themselves of medical s e r v i c e s . Our r e s u l t s ( s i g n i f i c a n t a t p<.05) include d e c r e a s e s i n
meat (pork, b e e f , and lamb), eggs, b u t t e r , i c e cream and s a l t
i n t a k e . Poultry and f i s h i n t a k e increased. Changes include
cooking f a t switched from animal t o vegetable source, milk
switched from whole t o skim, and cheese from yellow t o white
v a r i e t i e s . There was no s i g n i f i c a n t change i n smokers but
numbers of c i g a r e t t e s decreased. Fathers became involved i n
r e g u l a r e x e r c i s e programs, but mothers d i d not. The only
change i n family h i s t o r y was t h a t f a t h e r s found hypercholesterolemic r e l a t i v e s . P a t i e n t s a t r i s k did not a v a i l themselves
t o medical s e r v i c e s . Objective d a t a such a s serum c h o l e s t e r o l ,
blood p r e s s u r e s , s k i n f o l d thickness and weight a l l decreased
significantly.
We conclude t h a t minor education endeavors can r e s u l t i n
s i g n i f i c a n t changes i n l i v i n g and d i e t a r y p a t t e r n s i n f a m i l i e s .
DERMATOGLYPHIC ANALYSIS OF CHILDREN WITH LEARNING PROBLEMS.
Donald C. Burns and I r a S. Salafsky ( I n t r . by Henry L. Nadler)
Northwestern Univ. ?.led. Sch., Evanston Hospital, Dept. of
P e d i a t r i c s , Evanston, I l l .
Dermatoglyphic p a t t e r n s can only be a l t e r e d by environmental f a c t o r s during the 1% and e a r l y 2nd t r i m e s t e r s . Since
learning d i s a b i l i t i e s (L.D.) can have a p r e n a t a l e t i o l o g y , i t
i s l i k e l y t h a t c h i l d r e n with L.D. would have a g r e a t e r f r e quency of abnormal dermatoglyphic p a t t e r n s . I n c o n t r a s t t o
the c h i l d r e n with p r e n a t a l f a c t o r s , those with emotional o r
s i t u a t i o n a l problems could be expected t o have normal dermatoglyphics. Dermatoglyphic analyses were performed on 49 males
and 27 females r e f e r r e d t o our Evaluation Center f o r Learning
Problems. Numerous dermatoglyphic parameters were s t u d i e d ,
and, including the following, t h e frequency of s p e c i f i c patt e r n s i n children with learning problems was s i g n i f i c a n t l y
g r e a t e r than the frequency of these p a t t e r n s i n c o n t r o l s .
Palmar a x i a l t r i Bilateral
D-line e x i t
r a d i u s i n t" p o s i t i o n
Controls
Left
1.9%
Males
5.2%
Right
2.3%
Females
8.4%
Scudy group L e f t
7.9% (< .001)
Males
26.5% ( < .001)
Females 40.7% ( < .001)
Risht 17.1% (< .001)
.--(number i n parentheses = p value determined by xL method)
Children
with emotional o r s i t u a t i o n a l problems had normal
- --dermatoglyphics. Dermatoglyphics may be u s e f u l i n recognizing
c h i l d r e n whose L.D. has a p r e n a t a l e t i o l o g y .
.
MOTHER TRAINING AS A E A N S OF ACCELERATING CHILDHOOD DEVELOPMENT IN A HIGH RISK POPULATION:
Earlainti..
d e e n Bad er J a m e s S u t h e r l a n d , U n i v . o f
o f Ped., C i n c i n n a t i , Ohio.
Most p r e s c h o o l p r o g r a m s f o r d i s a d v a n t a g e d h a v e
produced t r a n s i t o r y I Q gains.
However, m o t h e r
t r a i n i n g programs i n I l l i n o i s have demonstrated t h a t
h i g h r i s k f a m i l i e s c a n i n t e r v e n e i n t h e i r own b e h a l f
t o p r o d u c e m o r e s t a b l e d e v e l o p m e n t a l q a i n s . To
confirm t h e s e f i n d i n g s and probe advantages o f even
e a r l i e r t r a i n i n g , a p r o g r a m was begun i n J a n . 1973.
Groups o f 1 2 mother/infant dyads were r e c r u i t e d on
t h e p o s t p a r t u m u n i t a t t h e C i n c i n n a t i G e n e r a l Hospit a l ; i n f a n t s were f i r s t - b o r n , mature, and had h i q h
A p g a r scores.
Groups were matched f o r r a c e and s e x .
A g r o u p o f m o t h e r s less t h a n 1 6 a n d a n o t h e r m o r e
than.18 a t t e n d e d weekly c l a s s e s i n t h e p e d i a t r i c
c l i n i c f r o m o n e month f o l l o w i n q b i r t h .
Two s i m i l a r
g r o u p s w e r e v i s i t e d a t home b y a n i n t e r e s t e d v i s i t o r
who d i d n o t i n s t r u c t .
At 6 months o f age e a r l y
p r o g r e s s was a s s e s s e d b y Uzgiris-Hunt O r d i n a l
Scales.
Analysis o f variance o f weighted scores ind i c a t e d t h a t i n f a n t s o f mothers a t t e n d i n g c l a s s e s
performed s i g n i f i c a n t l y b e t t e r t h a n i n f a n t s i n t h e
o t h e r g r o u p s (pC.01).
T h i s d i f f e r e n c e was g r e a t e r
among c h i l d r e n o f y o u n q m o t h e r s ( p C . 0 0 5 ) .
This is
t h e f i r s t demonstration o f a c t i v e a c c e l e r a t i o n of
development d u r i n q t h e f i r s t y e a r o f l i f e .
THE LONG TERM NEUROLOGICAL SEQUELAE OF ANEMIA I N INFANCY.
Ronald J. Cantwell ( I n t r . by William W. levela and) Univ.
of Miami Sch. of Med. Dept. of Ped. Miami, F l o r i d a .
To determine i f hypoxemia from anemia i n infancy causes
b r a i n damage, 61 f u l l term i n f a n t s from comparable socioeconomic groups were studied developmentally from b i r t h t o 7 y e a r s
Thirty-two of t h e i n f a n t s developed i r o n d e f i c i e n c y anemia
between 6-18 months of age (Hgb range 6.1-9.5 G%) i n t h e absence of p r o t e i n c a l o r i e m a l n u t r i t i o n . Twenty-nine i n f a n t s
received neonatal i r o n dextran i n j e c t i o n s and were not anemic
(Hgb range 11.5-12.962).
Neurological evaluation was done a t 6-7 years of age without knowledge of t h e presence o r absence of p r i o r anemia.
Each t e s t was r a t e d on a 0-3 s c a l e o r by s t a n i n e s . The group
formerly anemic had a higher incidence of " s o f t signs" e.g.
clumsiness with balancing on one f o o t , i n tandem walking, and
r e p e t i t i v e hand o r f o o t movements, e t c . and were more ina t t e n t i v e and hyperactive than t h e non anemic group. Binet
I Q scores averaged 98 i n t h e non anemic and 92 i n t h e anemic
group. Anemia i n infancy appears t o be one cause of
minimal b r a i n dysfunction which may be permanent.
A COMPARISON Or THE WIATRIC EI.'l%CTIVENESS OF THE
BRAZELTON NEDNATAL ASSESSMENT TO A STNARD NEUROLUGICAL
EXAMINATION
CHILDHOOD LEUKEMIA AND MATERNAL INFECTIONS DURING
PREGNANCY
Mary G. McCrea Curnen, Andre Varma, Barbara Christine. *
and Livia Turgeon. (Intr. by Edward C. Curnen. Jr. )
Columbia University College of Physicians & Surgeons
School of Public Health. New York
d
b
t
.
T. Berry Brazelton, Eduard C. Tronick ( I n t r . by Charles A.
Janeway), Harvard University Medical School, The Children's
H o s p i t a l Medical Center, Dept. of Ped., Boston, Mass.
To t e s t t h e c l i n i c a l s i g n i f i c a n c e of t h e Brazelton
Neonatal Examination, we compared i t s p r e d i c t i v e value t o
t h a t of a standard n e u r o l o g i c a l examination. The Brazelton
Assessment t e s t s and documents t h e i n f a n t ' s organized responses t o environmental events ( s o c i a l and non-social) and
his use of " s t a t e " behavior a s an organizing process i n t h e
n e o n a t a l period. The Assessment t e s t s f o r n e u r o l o g i c a l
i n t e g r i t y a s w e l l as f o r i n d i v i d u a l d i f f e r e n c e s i n behaviors
which may r e f l e c t f u t u r e c o g n i t i v e and a f f e c t i v e competence.
The s u b j e c t s were a group of 53 i n f a n t s judged t o be s u s w c t
by p e d i a t r i c examination. A l l t h e i n f a n t s were given t u b
n e u r o l o g i c a l and two Brazelton examinations during t h e neon a t a l period and t h e n followed f o r seven years. Ilowever,
t h e n e u r o l o g i c a l misdiagnosed t h r e e times a s many normal
i n f a n t s a s compared t o t h e Brazelton. This g r e a t e r discriminating c a p a c i t y of t h e Brazelton examination avoids
t h e problems e n t a i l e d in misdiagnoses f o r parents and c h i l d ,
and allows f o r a more e f f e c t i v e focusing of our c l i n i c a l
skills.
The Connecticut Tumor Registry has records of 431 children
who developed leukemia during their f i r s t ten y e a r s of life and
who were born i n Connecticut. These children were grouped into
27 annual birth cohorts f o r the y e a r s 1935 through 1961.
Time/space clustering was studied by various statistical
methods using the date and place of residence a t birth.
The hypothesis that children born of women pregnant during
e ~ i d e m i c sof infectious diseases a r e a t a hieher r i s k of d e v e l o ~ i"
ne
leukemia was tested extensively.
Evidence was sought for a relation between the occurrence of
influenza, chickenpox, measles, German measles, mumps,
poliomyelitis and whooping cou& during pregnancy and leukemia
in the offspring. No significant positive correlations were found.
-
*State of Connecticut Department of Health. Chronic Disease
Control Section, Connecticut Tumor Registry, Hartford
A