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Jenkins HM, Meeker JD, Zimmerman E, Cathey A, Fernandez J, Montañez GH, Park S, Pabón ZR, Vélez Vega CM, Cordero JF, Alshawabkeh A, Watkins DJ. Gestational glyphosate exposure and early childhood neurodevelopment in a Puerto Rico birth cohort. ENVIRONMENTAL RESEARCH 2024; 246:118114. [PMID: 38211716 DOI: 10.1016/j.envres.2024.118114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Revised: 12/28/2023] [Accepted: 01/03/2024] [Indexed: 01/13/2024]
Abstract
INTRODUCTION N-(phosphonomethyl)glycine, or glyphosate, is a non-selective systemic herbicide widely used in agricultural, industrial, and residential settings since 1974. Glyphosate exposure has been inconsistently linked to neurotoxicity in animals, and studies of effects of gestational exposure among humans are scarce. In this study we investigated relationships between prenatal urinary glyphosate analytes and early childhood neurodevelopment. METHODS Mother-child pairs from the PROTECT-CRECE birth cohort in Puerto Rico with measures for both maternal urinary glyphosate analytes and child neurodevelopment were included for analysis (n = 143). Spot urine samples were collected 1-3 times throughout pregnancy and analyzed for glyphosate and aminomethylphosphonic acid (AMPA), an environmental degradant of glyphosate. Child neurodevelopment was assessed at 6, 12, and 24 months using the Battelle Developmental Inventory, 2nd edition Spanish (BDI-2), which provides scores for adaptive, personal-social, communication, motor, and cognitive domains. We used multivariable linear regression to examine associations between the geometric mean of maternal urinary glyphosate analytes across pregnancy and BDI-2 scores at each follow-up. Results were expressed as percent change in BDI-2 score per interquartile range increase in exposure. RESULTS Prenatal AMPA concentrations were negatively associated with communication domain at 12 months (%change = -5.32; 95%CI: 9.04, -1.61; p = 0.007), and communication subdomain scores at 12 and 24 months. At 24 months, four BDI-2 domains were associated with AMPA: adaptive (%change = -3.15; 95%CI: 6.05, -0.25; p = 0.038), personal-social (%change = -4.37; 95%CI: 7.48, -1.26; p = 0.008), communication (%change = -7.00; 95%CI: 11.75, -2.26; p = 0.005), and cognitive (%change = -4.02; 95%CI: 6.72, -1.32; p = 0.005). Similar trends were observed with GLY concentrations, but most confidence intervals include zero. We found no significant associations at 6 months. CONCLUSIONS Our results suggest that gestational exposure to glyphosate is associated with adverse early neurodevelopment, with more pronounced delays at 24 months. Given glyphosate's wide usage, further investigation into the impact of gestational glyphosate exposure on neurodevelopment is warranted.
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Affiliation(s)
- Haley M Jenkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
| | - John D Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
| | - Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA, 02115, USA.
| | - Amber Cathey
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
| | - Jennifer Fernandez
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
| | - Gredia Huerta Montañez
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA, 02115, USA.
| | - Seonyoung Park
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
| | - Zaira Rosario Pabón
- Department of Electrical and Computer Engineering, Northeastern University, Boston, MA, 02115, USA.
| | - Carmen M Vélez Vega
- Department of Social Sciences, UPR Medical Sciences Campus, University of Puerto Rico Graduate School of Public Health, San Juan, PR, 00936, USA.
| | - José F Cordero
- Department of Epidemiology and Biostatistics, University of Georgia, Athens, GA, 30602, USA.
| | - Akram Alshawabkeh
- Department of Civil and Environmental Engineering, Northeastern University, Boston, MA, 02115, USA.
| | - Deborah J Watkins
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, 48109, USA.
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Nematifard T, Norouzi Tabrizi K, Arsalani N, Fallahi-Khoshknab M, Borimnejad L. The barriers to family-centered care in the pediatric rehabilitation ward: A qualitative study. J Pediatr Nurs 2023; 73:120-129. [PMID: 37666025 DOI: 10.1016/j.pedn.2023.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 08/19/2023] [Accepted: 08/19/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND Family-centered care (FCC) is one of the fundamental principles of care provision to children with disability (CWD). It is based on the collaboration of healthcare providers, patients, and families. However, there is limited information about the barriers to FCC in pediatric rehabilitation settings in Iran. This study aimed at exploring the barriers to FCC in the pediatric rehabilitation ward. METHODS This descriptive qualitative study was conducted in 2022. Participants were nine rehabilitation staff and twelve mothers of hospitalized CWD purposively selected from the pediatric rehabilitation ward of hospital Rofeideh, Tehran, Iran. Rehabilitation staff were three nurses, a head nurse, a nursing manager, a medical specialist, a social worker, a physical therapist, and an occupational therapist. Eleven semi-structured interviews and three focus group discussions were conducted for data collection, and conventional content analysis proposed by Graneheim and Lundman (2004) was used for data analysis. RESULTS The three main categories of the barriers to FCC in the pediatric rehabilitation ward were family-related barriers (subcategories: knowledge about child rehabilitation, sociocultural background, and participation), staff-related barriers (subcategories: knowledge, ethical concerns, and collaboration), and organizational barriers (subcategories: factors related to FCC policies, managerial factors, environmental factors, and factors related to the coronavirus disease 2019 pandemic). CONCLUSION The barriers to FCC in the pediatric rehabilitation ward are very diverse due to the long-term course of child disability and long-term interaction of families with rehabilitation centers. Data collection from both families and rehabilitation staff helped acquire an in-depth understanding about these barriers. More in-depth explorations of family-related barriers such as sociocultural factors are essential to determine the reasons for family resistance to healthcare providers' recommendations to develop more effective care plans.
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Affiliation(s)
- Taban Nematifard
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Kian Norouzi Tabrizi
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
| | - Narges Arsalani
- Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Leili Borimnejad
- Nursing and midwifery Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Disabilities in Early Childhood: A Global Health Perspective. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010155. [PMID: 36670705 PMCID: PMC9857482 DOI: 10.3390/children10010155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
Prior to the launch of the United Nations' Sustainable Development Goals (SDGs) in 2015, childhood disability was rarely considered an important subject in global health. The SDGs till 2030 now require that children under 5 years who are at risk of not benefitting from inclusive quality education are identified, monitored, and promptly supported. A new tool for identifying children who are not developmentally on track has been developed by UNICEF but has limited sensitivity for detecting children with disabilities due to reliance on parental assessment of child behavior in certain everyday situations. In this paper, we identified conditions that are commonly associated with developmental disabilities based on the International Classification of Diseases (ICD) codes and clarified the concept of "developmentally on track" as it relates to children with developmental disabilities and developmental delays. We summarized the latest evidence on the global burden of developmental disabilities in children under 5 years based on the diagnostic and functional approaches for measuring disabilities at the population level. We highlighted the global health context for addressing the needs of children with developmental disabilities and provided an overview of the opportunities and the role of pediatric caregivers in supporting children with developmental disabilities.
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