Maternal responsiveness and toddler body mass index z-score: Prospective analysis of maternal and child mealtime interactions

Responsive feeding, where parents are guided by children's hunger and satiation cues and provide appropriate structure and support for eating, is believed to promote healthier weight status. However, few studies have assessed prospective associations between observed parental feeding and toddler growth. We characterized toddler growth from 18 to 36 months and, in a subset of families, examined whether observed maternal responsiveness to toddler satiation cues and encouraging prompts to eat at 18 and 24 months were associated with toddler body mass index z-score (BMIz) from 18 to 36 months. Participants included 163 toddlers and their mothers with overweight/obesity who had participated in a lifestyle intervention during pregnancy. Anthropometrics were measured at 18, 24, and 36 months. In a subsample, mealtime interactions were recorded in families' homes at 18 (n = 77) and 24 (n = 75) months. On average, toddler BMIz remained stable from 18 to 36 months with 31.3% (n = 51) categorized with a healthy weight, 56.4% (n = 92) with at risk for overweight and 12.3% (n = 20) with overweight. Fewer maternal prompts to eat at 18 months was associated with both higher probability of having at risk for overweight/overweight (p < .05), and higher child 36-month BMIz (p = .002). Higher child weight status at 12 months was also associated with both higher probability of having at risk for overweight/overweight (p < .05), and higher child 36-month BMIz (p < .001). Neither 24-month maternal prompts nor 18 or 24 month responsiveness to satiation cues were associated with toddler BMIz. In this diverse sample, weight status was relatively stable from 18 to 36 months. Maternal prompts to eat measured earlier in toddlerhood and prior child weight status were associated with toddler BMIz.

A-48 The Role of Processing Speed in Verbal and Nonverbal Learning within a Clinical Sample of Older Adults

Objective

Prior research revealed that processing speed predicts nonverbal learning in healthy older adults (Tam & Schmitter-Edgecombe, 2013). This study aims to examine the role of processing speed in both verbal and nonverbal learning in a clinical sample. We expect that processing speed will lend the most variance to the initial learning trials.

Method

Records from 718 patients were reviewed (mean age = 74). Hierarchical regression analyses were conducted using Brief Visuospatial Memory Test –Revised (BVMT-R) and Hopkins Verbal Learning Test –Revised (HVLT-R) learning trials as outcome variables. Demographics were entered in a first step followed by BVMT-R copy or Wechsler Adult Intelligence Scale (WAIS-IV) Digit Span –longest digit span forward raw score, to account for visuoconstruction or simple auditory attention for nonverbal and verbal learning outcomes respectively. A processing speed composite of sample-standardized raw scores was entered in a final step.

Results

Processing speed accounted for 5.4% of the variance in BVMT-R trial 1, 7.5% of the variance in trial 2, and 8.5% of the variance in trial 3, all p < .001. Processing speed accounted for 6.6% of the variance in HVLT-R trial 1, 11.1% of the variance in trial 2, and 11.5% of the variance in trial 3, all p < .001.

Conclusions

Processing speed significantly predicted all verbal and nonverbal learning trials. Contrary to our hypotheses, processing speed actually had a greater contribution during subsequent learning trials. These findings have implications for evaluating memory performance in patients with syndromes where processing speed is typically affected (e.g., cerebrovascular disease, Parkinson’s disease).

C-03 The sensitivity and specificity of the Montreal Cognitive Assessment is Age Dependent for Amyloid Positivity in a Mixed Clinical Sample

Objective

The Montreal Cognitive Assessment (MoCA) is a widely-used screening tool for neurodegenerative disorders. Despite widespread use, there have been few investigations into correlations between MoCA and biomarkers of Alzheimer's disease pathology. This study examined the relationship between MoCA performance and the presence of amyloid as detected by positron emission tomography (PET).

Methods

Sensitivity and specificity for the total MoCA score were determined for 76 individuals (26 amyloid-negative, 50 amyloid- positive) who were between the ages of 55 and 90 and diagnosed with MCI or mild dementia with a CDR score of 0-1 and were participating in a longitudinal, observational study at the Cleveland Clinic Lou Ruvo Center for Brain Health. All individuals underwent an amyloid PET scan and cognitive screening.

Results

Sensitivity and specificity for the total score were determined using amyloid positivity as the standard. A cutpoint of 25 yielded the best balance between sensitivity and specificity (74% and 74%, respectively). A total score of 27 was required to achieve 90% sensitivity to identify amyloid positive individuals (i.e. only a 10% risk that individuals with a score of 28-30 have a positive scan). A score of 26 was required in individuals over the age of 75.

Conclusions

With the emergence of new diagnostic biomarkers, there is need to define the utility of affordable, widely-available screening tools. In this mixed clinical sample, the MoCA score showed good sensitivity for detecting amyloid pathology but with low specificity. Thus a total MoCA score of 28 is needed to confidently rule out risk for AD pathology.

C-02 An Unbiased Biomarker Approach to Neuropsychological, Behavioral, and Psychiatric Symptoms in a Mixed Clinical Sample

Objective

Suspected Non-Alzheimer’s Pathology (SNAPs) are individuals who present with a cognitive syndrome meeting clinical criteria for Alzheimer’s disease (AD) but are found to lack underlying AD pathology. Current clinical criteria for AD lack specificity in predicting underlying neurodegenerative pathology. With the advent of amyloid positron emission tomography (PET) the presence of amyloid pathology can now be identified in vivo. Using a biomarker-based approach, we aimed to characterize the neuropsychological, behavioral, and psychiatric profile of SNAPs in contrast to those with AD pathology (APs).

Method

76 individuals (26 amyloid-negative [SNAPs], 50 amyloid- positive [APs]) completed neuropsychological testing and a PET amyloid scan as a part of a longitudinal observational study at the Cleveland Clinic LRCBH. Individuals meeting NIA-A criteria for MCI or mild AD with a Clinical Dementia Rating score of .05 -1 were included. Amyloid status was determined via clinical read of two clinicians trained in reading amyloid scans (neuroradiologist and neuropsychiatrist). Independent samples t tests assessed group differences between SNAPs and APs across cognitive, behavioral, and psychiatric measures.

Results

Mini-Mental State Examination scores were equivalent between SNAPs and APs. SNAPs performed significantly better on measures of verbal and nonverbal memory, set-shifting, and semantic fluency, as well as aspects of processing speed and working memory (all p’s < .05). Additionally, SNAPs endorsed more RBD symptoms (p < .05). No significant group differences were observed across neuropsychiatric or functional measures.

Conclusion(s)

Differences in an individual’s neuropsychological, behavioral, and psychiatric profile in consideration with a biomarker approach may provide key insights and afford greater diagnostic clarity.

Effect of experimental change in children's sleep duration on television viewing and physical activity

BACKGROUND

Paediatric observational studies demonstrate associations between sleep, television viewing and potential changes in daytime activity levels.

OBJECTIVE(S)

To determine whether experimental changes in sleep lead to changes in children's sedentary and physical activities.

METHODS

Using a within-subject counterbalanced design, 37 children 8-11 years old completed a 3-week study. Children slept their typical amount during a baseline week and were then randomized to increase or decrease mean time in bed by 1.5 h/night for 1 week; the alternate schedule was completed the final week. Children wore actigraphs on their non-dominant wrist and completed 3-d physical activity recalls each week.

RESULTS

Children reported watching more television (p < 0.001) and demonstrated lower daytime actigraph-measured activity counts per epoch (p = 0.03) when sleep was decreased (compared with increased). However, total actigraph-measured activity counts accrued throughout the entire waking period were higher when sleep was decreased (and children were awake for longer) than when it was increased (p < 0.001).

CONCLUSION(S)

Short sleep during childhood may lead to increased television viewing and decreased mean activity levels. Although additional time awake may help to counteract negative effects of short sleep, increases in reported sedentary activities could contribute to weight gain over time.

Dental students' preparation and study habits for the National Board Dental Examination Part I

The purpose of this study was to assess dental students' study habits and level of preparation necessary to successfully prepare for the National Board Dental Examination (NBDE) Part I. Four hundred thirty-seven dental students from across the United States participated in a web-based survey about their goals, results, and study habits in preparation for taking the NBDE Part I. A majority of the respondents (76 percent; n=331) reported taking the web-based version of the exam. More than one-third (n=168) of the respondents indicated they wanted to achieve a scaled score of 90 or above, while only about one-quarter (n=120) actually achieved this target score. Students preferred to use the Dental Decks and released Part I exams to study for the exam, regardless of their score. No significant correlations between type of study source used and the score achieved on the exam were found.

Knowledge, attitudes, and perceptions of participants and instructors taking part in a dental school simulation course for potential dental students

Four two-day dental school simulation courses were conducted over a two-year period for the purpose of allowing prospective dental students the opportunity to gain hands-on experience in a dental simulation lab. A total of 292 subjects from thirty-four colleges and universities participated in the courses. The courses were planned and taught by dental students attending the host school, with oversight by faculty members. Participants took pre- and posttests assessing their knowledge of dental practices and completed surveys before and after the course to assess their attitudes toward the dental profession. Student instructors completed a post-course survey of the experience. The simulation course was effective in increasing participants' desire (8 percent increase) to attend the host school. Dental knowledge improved 34 percent following the course. Thirty-four percent of student instructors indicated they were more likely to pursue a career in academics following this experience. Results suggest that a dental school simulation course can be a positive experience for both participants and student instructors.

Recent admissions trends at UNLV-SDM: perspectives on recruitment of female and minority students at a new dental school

As the U.S. population continues to become more diverse, there has been a movement toward the recruitment of more diverse students into the dental profession. The purpose of this study was to assess the current and historical trends in diversity among dental school applicants and enrollees at a new dental institution, the University of Nevada, Las Vegas, School of Dental Medicine (UNLV-SDM). Applicant and enrollment data for the first four cohorts, sorted by gender and ethnicity, were retrieved and summarized by the Office of Admissions and Student Affairs at UNLV-SDM. The principal findings of this analysis revealed enrollment of females at UNLV-SDM was relatively consistent during this time interval, although significantly lower than the U.S. average of all dental schools. The enrollment of minorities at UNLV-SDM, however, was consistent and comparable to the U.S. average, although these percentages were disproportionately smaller than the percentage of minorities in the general population. Based upon these findings, a new model for outreach and recruitment of females and minorities was recently created, based in part upon evidence of successful strategies by dental educators at other institutions, in order to increase the enrollment of female and underrepresented minority students.