Combining developmental and sleep health measures for autism spectrum disorder screening: an ECHO study.

Background: Sleep problems are reported for up to 80% of autistic individuals. We examined whether parsimonious sets of items derived from the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) and the Brief Infant Sleep Questionnaire (BISQ) are superior to the standard M-CHAT-R in predicting subsequent autism spectrum disorder (ASD) diagnoses.

Methods: Participants from 11 Environmental influences on Child Health Outcomes (ECHO) cohorts were included.

The evolution of clinical outcomes in metastatic pancreatic adenocarcinoma: a 10-year experience at a tertiary referral center.

Background: Pancreatic ductal adenocarcinoma (PDAC) is the fourth leading cause of cancer mortality in the US. Recent studies have demonstrated survival benefits for FOLFIRINOX (5-FU, leucovorin, irinotecan, and oxaliplatin) and Gem/nab-P (gemcitabine/nab-paclitaxel) over gemcitabine. We aimed to evaluate the clinical outcomes of mPDAC before and after incorporating these newer regimens into the clinical practice.

Effects of Prenatal Exposure to Alcohol and Smoking on Fetal Heart Rate and Movement Regulation.

Negative associations of prenatal tobacco and alcohol exposure (PTE and PAE) on birth outcomes and childhood development have been well documented, but less is known about underlying mechanisms. A possible pathway for the adverse fetal outcomes associated with PTE and PAE is the alteration of fetal autonomic nervous system development. This study assessed PTE and PAE effects on measures of fetal autonomic regulation, as quantified by heart rate (HR), heart rate variability (SD-HR), movement, and HR-movement coupling in a population of fetuses at ≥ 34 weeks gestational age.

Developing a common metric for depression across adulthood: Linking PROMIS depression with the Edinburgh Postnatal Depression Scale.

Depression is a leading mental health concern across the U.S. and worldwide.

SPR Perspectives: scientific opportunities in the Environmental influences on Child Health Outcomes Program.

Drawing upon extant data from existing pediatric cohorts and new follow-up of a diverse set of pediatric cohorts from across the United States, the Environmental influences on Child Health Outcomes (ECHO) Program creates the opportunity for novel and innovative investigations of many previously inaccessible scientific questions in the area of child health. We describe how the large sample size, diversity of participants, emphasis on team science, and infrastructure for improving research methodology make the ECHO Program a major research resource for improving our understanding of early life determinants of childhood health and well-being. Pediatric researchers leverage the unique features of the ECHO Program to address research questions with the potential to yield far-reaching and long-term impacts on child health.

Prophylactic Indomethacin in extremely preterm infants: association with death or BPD and observed early serum creatinine levels.

Objectives: To identify the relationship between prophylactic indomethacin (PI) administration and (1) mortality and bronchopulmonary dysplasia (BPD) at 36-week postmenstrual age (PMA) (primary outcome), and (2) to evaluate for PI-associated acute kidney injury.

Study Design: Retrospective cohort investigation of 22-28 weeks gestation infants (N = 1167) who were admitted to Nationwide Children's Hospital on postnatal days 0-1 between May 2009 and September 2017 and survived ≥24-h postnatal. The associations of PI treatment with mortality or BPD, and other secondary outcomes, were evaluated via multivariable robust-error-variance Poisson regression.

Inclusion of American Indians and Alaskan Natives in Large National Studies: Ethical Considerations and Implications for Biospecimen Collection in the HEALthy Brain and Child Development Study.

This manuscript is the result of an interdisciplinary team approach to examine the ethical and cultural considerations of biospecimen collection among American Indian and Alaskan Native (AIAN) communities for the planned Healthy Brain and Child Development (HBCD) study. We begin by reviewing a brief history of the treatment of AIAN communities by the US government and within research studies. Based in part on this history, we highlight the overlapping and intersecting vulnerabilities of AIAN communities, including historical trauma, poverty, lack of healthcare access, and environmental hazards.

Family Environment, Neurodevelopmental Risk, and the Environmental Influences on Child Health Outcomes (ECHO) Initiative: Looking Back and Moving Forward.

The family environment, with all its complexity and diverse components, plays a critical role in shaping neurodevelopmental outcomes in children. Herein we review several domains of the family environment (family socioeconomic status, family composition and home environment, parenting behaviors and interaction styles, parental mental health and functioning, and parental substance use) and discuss how these domains influence neurodevelopment, with particular emphasis on mental health outcomes. We also highlight a new initiative launched by the National Institutes of Health, the Environmental influences on Child Health Outcomes (ECHO) program.

Prenatal Drinking in the Northern Plains: Differences Between American Indian and Caucasian Mothers.

Introduction: Prenatal alcohol exposure is associated with adverse pregnancy outcomes such as fetal alcohol spectrum disorders. The study characterizes the pattern and risk factors of alcohol use during pregnancy for American Indian and Caucasian mothers in the Northern Plains.

Methods: A general population of pregnant women was recruited from 5 sites, including 2,753 Caucasians and 2,124 American Indians (2006-2017).

Early-Life Predictors of Fetal Alcohol Spectrum Disorders.

Background And Objectives: Fetal alcohol spectrum disorders (FASD) comprise the continuum of disabilities associated with prenatal alcohol exposure. Although infancy remains the most effective time for initiation of intervention services, current diagnostic schemes demonstrate the greatest confidence, accuracy, and reliability in school-aged children. Our aims for the current study were to identify growth, dysmorphology, and neurodevelopmental features in infants that were most predictive of FASD at age 5, thereby improving the timeliness of diagnoses.

Physicians Knowledge and Practice of Safe Sleep Recommendations for Infants in South Dakota.

Introduction: Safe sleep recommendations for infants have been evolving over the past three decades. It has been shown that physicians' recommendations strongly influence parents' choice of infant sleep position. However, the proportion of physicians and/or nurses giving infant sleep advice to parents is reportedly low.

A County-Level Health Index to Capture Geographic Variation in Health Conditions in North Dakota, South Dakota, and Minnesota.

Introduction: Individual health is influenced by multiple, potentially correlated factors including healthcare availability, community context, and socioeconomic factors. To measure the health changes at county-levels across North Dakota, South Dakota, and Minnesota, a measure of relative health, health index, was developed incorporating multiple indicators from domains of health conditions, health behaviors, and social determinants.

Methods: We combined data from all 206 counties in the aforementioned three states for the years 2008-2012 from multiple data sources.

Creating a Culture of Mobility: Using Real-Time Assessment to Drive Outcomes.

Background: Recent studies have demonstrated the safety and feasibility of early mobilization of patients in the hospital setting. Promoting early mobility improves patients' ability to perform daily activities and attend to basic needs. It also preserves patients' dignity and independence.

Pre-loss personal factors and prolonged grief disorder in bereaved mothers.

Background: Identifying characteristics of individuals at greatest risk for prolonged grief disorder (PGD) can improve its detection and elucidate the etiology of the disorder. The Safe Passage Study, a study of women at high risk for sudden infant death syndrome (SIDS), prospectively examined the psychosocial functioning of women while monitoring their healthy pregnancies. Mothers whose infants died of SIDS were followed in bereavement.