Showing posts with label poverty. Show all posts
Showing posts with label poverty. Show all posts

Tuesday, September 30, 2014

The Role of Parenting & Home Stimulation in Overcoming Cognitive Deficits in Bangladesh

By: Lewis First, MD, MS; Editor-in-Chief 

Bangladeshi children. Photo by Mahmud Rassel via Flickr
Poverty certainly takes its toll on children's health given the association between poverty and cognitive deficit in infancy, but is it possible to improve this deficit with environmental and parental influence?

The answer is a resounding yes according to Hamadani et al. (doi: 10.1542/peds.2014-0694) who performed a longitudinal study of development in more than 2,800 infants in Bangladesh. They followed these infants for IQ changes over their first five years of life as impacted by such factors as parental education and home stimulation by parents. The results are impressive and stress the import of such factors in a way that can be generalizable to our own young patients born into poverty in this country.

To share even more lessons learned from this study, we invited Dr. Andrew Racine (doi: 10.1542/peds.2014-1375) to comment in an accompanying editorial that we are also early releasing this week.

Both the study and commentary are rich in take-aways that will be useful to you and the underserved families you care for.

Related Reading:

Thursday, May 29, 2014

Successfully Screening for Food Insecurity With Just Two Questions

Pediatrics Assistant Editor Lydia Furman, MD, shares her expert perspective on a new article from our June issue. To learn more about Dr. Furman and her work, check out her bio on our Contributors page.

By: Lydia Furman, MD

Photo by Hannah Yoon via Flickr
In an article from the June issue of Pediatrics we’re early releasing this week, Urke and colleagues (doi: 10.1542/peds.2013-3663) draw our attention to the Nunavut Inuit population in the high Canadian Arctic, among whom food insecurity is worrisomely prevalent. Can one or two questions adequately identify families with food insecurity, or are longer (18 question) standard surveys needed? The obvious twin benefits of reduced survey burden for families and speedier assessment for directed assistance drove this research.  Study conduct was marked by utmost respect for the surveyed population, with participatory survey development, an engaged local steering committee, and bilingual (Inuit dialects and English) surveyors.

Two questions, one adult and one child, were the winners, with the highest sensitivity, specificity, predictive values and overall accuracy. For adults, “In the last 12 months, were there times when the food for you and your family just did not last and there was no money to buy more?” showed 93.2 percent accuracy. For children, “In the last 12 months, were there times when it was not possible to feed the children a healthy meal because there was not enough money?” showed 94.7 percent accuracy. The key was combining the two items for a fuller picture of household need.

Prior studies examining one and two question screens for food insecurity were not uniformly successful. The authors point out that the predictive value and accuracy of any screen is dependent on the population prevalence of the condition. Therefore, before we can “grab and go” with this two question screen, additional testing in (economically) diverse populations is needed. This work challenges us to conduct similar studies among families living in urban, rural, hard-to-reach and underserved areas. The beauty of such a brief survey is that any and all of us, including community health nurses, lay health providers, “Help Me Grow” workers, and pediatricians alike will be able to screen and refer families to resources.

This lean, clean paper is an easy read and its potential applicability goes well beyond the unique population and setting.

Recommended Reading: