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Lim S.-L.,University of Missouri - Kansas City | Bruce A.S.,University of Kansas Medical Center | Bruce A.S.,Center for Childrens Healthy Lifestyles and Nutrition
Appetite | Year: 2015

Obesity is often related to steeper temporal discounting, that is, higher decision impulsivity for immediate rewards over delayed rewards. However, previous studies have measured temporal discounting parameters through monetary rewards. The aim of this study was to develop a temporal discounting measure based on weight-loss rewards, which may help to understand decision-making mechanisms more closely related to body weight regulation. After having their heights and weights measured, healthy young adults completed the Monetary Choice Questionnaire (MCQ), and an adapted version of the MCQ, with weight-loss as a reward. Participants also completed self-reports that measure obesity-related cognitive variables. For 42 participants who expressed a desire to lose weight, weight-loss rewards were discounted over time and had a positive correlation with temporal discounting for monetary rewards. Higher temporal discounting for weight loss rewards (i.e., preference for immediate weight loss) showed correlations with beliefs that obesity is under obese persons' control and largely due to lack of willpower, while temporal discounting parameters for monetary rewards did not. Taken together, our weight loss temporal discounting measure demonstrated both convergent and divergent validity, which can be utilized for future obesity research and interventions. © 2014 Elsevier Ltd.


Tolbert J.,University of Missouri - Kansas City | Kearns G.L.,University of Missouri - Kansas City | Kearns G.L.,Center for Childrens Healthy Lifestyles and Nutrition
Archives of Disease in Childhood | Year: 2015

In the last two decades, tremendous advances have been made in the treatment of acute lymphocytic leukaemia (ALL) in children with 5 year 'cure' rates in excess of 90%. The maintenance of remission is due, in part, to individualisation of therapy which must consider age, body size, genetic constitution and the impact of disease on drug disposition and action. This review, focused on treatment of ALL and one of the therapeutic mainstays, 6-mercaptopurine, illustrates the importance of obesity as a modulating factor in dose individualisation.


Hampl S.,Center for Childrens Healthy Lifestyles and Nutrition | Demeule M.,Mt Washington Pediatric Hospital | Eneli I.,Nationwide Childrens Hospital | Frank M.,Weill Cornell Komansky Center for Childrens Health | And 7 more authors.
Clinical Pediatrics | Year: 2013

Objective. To describe parent/caregiver reasons for attrition from tertiary care weight management clinics/programs. Study design. A telephone survey was administered to 147 parents from weight management clinics/programs in the National Association of Children's Hospitals and Related Institutions' (now Children's Hospital Association's) FOCUS on a Fitter Future II collaborative. Results. Scheduling, barriers to recommendation implementation, and transportation issues were endorsed by more than half of parents as having a moderate to high influence on their decision not to return. Family motivation and mismatched expectations between families and clinic/program staff were mentioned as influential by more than one-third. Only mismatched expectations correlated with patient demographics and referral patterns. Conclusions. Although limited by small sample size, the study found that parents who left geographically diverse weight management clinics/programs reported similar reasons for attrition. Future efforts should include offering alternative visit times, more treatment options, and financial and transportation assistance and exploring family expectations. © 2013 The Author(s).


Egan A.M.,Childrens Mercy Hospitals and Clinics | Egan A.M.,University of Missouri - Kansas City | Dreyer M.L.,Childrens Mercy Hospitals and Clinics | Dreyer M.L.,Center for Childrens Healthy Lifestyles and Nutrition | And 4 more authors.
Childhood Obesity | Year: 2013

Background: The purpose of this study was to identify rates of overweight and obesity in young children with autism spectrum disorders (ASD) and factors related to overweight. Methods: Retrospective chart reviews were conducted for 273 children with ASD [i.e., autistic disorder, Asperger's disorder, pervasive developmental disorder not otherwise specified (PDD-NOS)] after receiving outpatient services with a developmental pediatrician or the developmental team at a children's hospital. Information on child demographics, height and weight, medications prescribed, and adaptive functioning was collected from charts. Results: Rates of overweight and obesity in children with ASD were found to be above nationally representative prevalence estimates for children. Among children with autistic disorder, 17.16% had a body mass index (BMI) percentile in the overweight range and 21.89% had a BMI percentile in the obese range. For children with Asperger's disorder/PDD-NOS, 12.50% were considered overweight and 10.58% were considered obese. Neither psychotropic medications prescribed nor adaptive functioning was found to be related to whether the child was overweight or obese. Conclusions: Children with ASD are at risk for overweight and obesity, and children with autistic disorder are at greater risk for weight problems than children with Asperger's disorder/PDD-NOS. Further research is needed to identify factors related to overweight in children with ASD. Copyright © 2013, Mary Ann Liebert, Inc. 2013.


Davis A.M.,University of Kansas Medical Center | Davis A.M.,Center for Childrens Healthy Lifestyles and Nutrition | Gallagher K.,Harvard University | Taylor M.,Kansas State University | And 5 more authors.
Journal of Developmental and Behavioral Pediatrics | Year: 2013

Objective: Teenage pregnancy is a major public health concern in the United States. In addition to other life stressors, adolescent mothers and their children are at risk for obesity and other negative health outcomes. The current study examines the impact of a brief in-home educational intervention designed to improve health knowledge and behavior in a sample of low-income adolescent mothers. Method: Forty-six teen mothers received 6 in-home educational sessions focused on nutrition and physical activity, with baseline and follow-up knowledge and behavior assessments. Results: Results indicate significant improvements in mothers' health knowledge and physical activity pertaining to themselves and to their children, and also an unexpected increase in sedentary behaviors. Conclusion: Results from this study indicate that knowledge-focused interventions may be an effective method to facilitate positive health behavioral change for teenage mothers. Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

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