Free toe transplantation in reconstructive hand surgery]

PURPOSE: Increased understanding of the early determinants of obesity is essential because of the increasing prevalence of obesity in many industrialized countries. METHOD: As part of the evaluation of a school-based heart health promotion intervention, we measured height, weight, and triceps skinfold thickness at baseline in 2108 students aged 9-12 years (80.5% of eligible students) in 24 inner-city elementary schools located in multiethnic, low income neighbourhoods in Montreal, Canada. Data on student's socio-demographic and lifestyle characteristics were collected in classroom-administered questionnaires, and parents completed an at-home self-administered questionnaire. RESULTS: Overall, 35.2% of boys and 33.0% of girls were overweight (> or = 85th age and gender-specific percentiles from NHANES 11, for body mass index and triceps skinfold thickness); 15.1% of boys and 13.3% of girls were obese (> or = 95th age and gender-specific percentiles for body mass index and triceps skinfold thickness). Younger age, having lived all one's life in Canada, and being of European or Central American/Caribbean family origin were independent correlates of obesity in boys. Younger age, ever smoked, mother obese and father obese were independent correlates of obesity in girls. Girls of Asian family origin were protected. CONCLUSIONS: The very high prevalence of overweight students in this low income, multiethnic population suggests an important need for preventive intervention.     

Advances in periodontal diagnosis. 7. Proteolytic and hydrolytic enzymes link with periodontitis

Tobacco use poses one of the greatest health problems at school. Its prevention through health education should be assumed up by all members of the school community and health personnel (especially family and respiratory physicians). We designed an anti-tobacco program lasting three years aimed at all the students of the 6th, 7th and 8th grades at school as well as those in the pre-university years that was implemented in a rural area. This study reports the results of the attitudes of the 610 students (256 boys and 354 girls, between 11 and 20 years old) collected at the end of the program. 59.4% of the boys and 44.1% of the girls reported having smoked on some occasion. The mean age at the time of the first contact with tobacco was 11.8 +/- 2.4 years, this being significantly different between the boys and the girls. The main reasons for starting to smoke tobacco were quoted as peer pressure (57.1%) and curiosity (55.5%). That their parents smoked was only adduced as a reason by 29.5% of the students. Knowledge of the harmful effects of tobacco was limited and only 57% related tobacco smoking to lung cancer and only 41% to coronary pathology. At the end of the program 13.6% of the students involved smoked. 93.9% of those who quit smoking related this event to the program. Of those still smoking, 63.6% said they would like to quit. This justifies the need to reinforce the knowledge that will allow them to switch attitudes and stop smoking. Intervention programs in school populations have proved to be useful in the struggle to decrease smoking among school children. If an adolescent can avoid smoking it is likely that s/he will not smoke in adulthood. It is necessary to further develop this type of anti-tobacco program as reflected in this paper.     

Perceived control in adolescent substance use: Concurrent and longitudinal analyses.

A sample of 9th-grade students (1,293 individuals, 51% girls) attending compulsory schools in Reykjavik, Iceland, was surveyed and followed up 3 years later. The relationship between perceived control and substance use is examined concurrently at age 14 for experimentation with tobacco and alcohol and longitudinally (14–17 years of age) for daily smoking, heavy drinking, and illicit drug use. Taking into account sociodemographic characteristics (family structure, socioeconomic status, and gender) and parental and peer use, the results of concurrent analyses indicate that adolescents who expressed more personal control were less likely to have smoked and to have had a drink at age 14. Longitudinal analyses showed that perceived control at age 14 predicted both daily smoking and illicit drug use among girls at age 17 but not among boys. Conversely, perceived control did not predict heavy drinking among adolescents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Rapid maturation in adolescence results in greater obesity in adulthood: the Amsterdam Growth and Health Study

In this study, the effect of rapid and slow biological maturation on the development of obesity was investigated in boys (n = 79) and girls (n = 98), initially aged a mean of 13 y, and measured six times between 1977 and 1991. Obesity was determined by measuring body mass index (BMI; in kg/m2) and by summing four skinfold thicknesses. Biological maturation was operationalized by skeletal age, the age of peak height velocity (PHVage) for boys, and the age of menarche for girls. Multiple analyses of variance for repeated measurements showed that based on either skeletal age or PHVage, BMI for rapidly maturing boys was significantly higher than for slowly maturing boys between 13 and 27 y of age. Based on skeletal age, rapid maturers also showed higher mean sums of skinfold thicknesses over this period. For girls, BMI and sums of skinfold thicknesses for the rapidly maturing girls, based on either skeletal age or age at menarche, were also higher than for the slowly maturing girls over the entire period of study. In conclusion, individuals who matured rapidly in adolescence were, in general, more obese than slowly maturing adolescents between 13 and 27 y of age. Rapid maturation seems to have long-term consequences for obesity and should therefore be considered a risk indicator for the development of obesity.     

Prevalence and correlates of early smoking among elementary schoolchildren in multiethnic, low-income inner-city neighborhoods

PURPOSE: The prevalence and correlates of early smoking were investigated among schoolchildren in grades 4-6 living in multiethnic, low-income neighborhoods in Montreal. METHODS: As part of the evaluation of a school-based heart health promotion program, baseline data on the prevalence of early smoking were collected from 2285 students aged 9-13 years in 24 inner-city elementary schools during May-June 1993. RESULTS: Overall, 28.7% of boys and 20.3% of girls had smoked. Girls began trying later than boys, but by age 13 the prevalence of experimental or regular smoking by girls overtook that of boys. Univariately, ever smoking varied considerably by family origin, from 2.1% among Vietnamese girls, to 35.8% among Portuguese boys. In multivariate analysis, age, perceived smoking habits of friends, and smoking by family members, were strong correlates of smoking. Being of Asian family origin was negatively associated with smoking. None of the indicators of social class were significantly associated with ever smoking. CONCLUSIONS: Smoking prevention should begin with children even younger than age 9 in multiethnic, low-income, inner-city neighborhoods. With the exception of a lower prevalence of smoking among Asian children, ethnicity and social class were not strong influences on early smoking behavior in this population.     

Sleep problems of junior high school students in Taipei

The objective of this work was to study the relationship between daily sleep time and characteristics of students, e.g. grade level, gender, and academic program. A sleep habit questionnaire was designed to survey students at two junior high schools, one from northern Taipei and the other from southern Taipei. The impact of shortened duration of sleep on daily function was also evaluated. A total of 965 students and their parents were selected randomly in December 1993 for the questionnaire study. The response rate was 96.4% (930) for students and 88.6% (855) for parents. The self-reported daily sleep time of students declined, and daytime sleepiness and moodiness increased in the higher grades. The girls slept fewer hours than the boys and did not show an increase in daytime sleepiness. Those students not taking the senior high school joint entrance examination slept more hours at night and maintained more alertness in the daytime than those who were taking the examination. The more academic pressures that adolescents faced, the fewer hours they slept. Students not participating in the joint entrance examination seemed to show a healthier sleep pattern. Little sleep at night made the students feel sleepy in the daytime and tired, drowsy, moody and difficult at arising in the morning. The reason why girls slept less than boys needs further investigation.     

Smoking among 11-15 year-old adolescents, 1984-1994]

The objectives are to describe smoking habits among 11-15-year olds in Denmark in the period 1984-1994 and to describe the association between smoking and social background factors. The article reports data about children at the age of 11, 13 and 15 years from four cross-sectional studies in 1984-1985, 1988, 1991 and 1994 (n = 678, 1667, 1860 and 4046) based on stratified random samples of schools. Data were collected by standardized questionnaires. Median age for first smoking experience changed from approx 12 years in 1984-1985 to approx. 14 years in 1994. The proportion of smokers among 15 year-olds is almost unchanged from 1984 to 1994. In 1994, the proportion of smokers is respectively 2% and 4% among 11 year-old girls and boys, 16% and 11% among 13 year-old girls and boys, and 33% and 25% among 15 year-old girls and boys. The proportion of girls and boys in the three age groups respectively who smoke every day is 0%, 1%, 3%, 4%, 17%, and 11%. In conclusion, smoking habits among children changed considerably from the 1950's to 1980's. The smoking habits have not changed much since the 1980's apart from a slight delay in first smoking-experience.     

Sexual and reproductive health among primary and secondary school pupils in Mwanza, Tanzania: need for intervention

A cross-sectional questionnaire survey was conducted among 892 randomly selected pupils, aged 12 and above, attending 18 primary schools (PS) and five secondary schools (SS) in four communities of Mwanza Region in Tanzania. The goals were to assess the level of knowledge adolescents have about sexual and reproductive health (SRH), to assess the magnitude of SRH problems and to help design appropriate interventions. Median age of respondents was 15 years (range 12-20 years) and 14 years (range 12-19 years) for PS boys and girls, respectively, and 19 years (range 16-24 years) and 17 years (range 14-19 years) for SS boys and girls. Eighty per cent of PS boys and 68% of PS girls were already sexually active; the corresponding figures were 89% for SS boys and 48% for SS girls. Vaginal sex was the most common first sexual act reported by SS pupils, but 40% of PS pupils reported orogenital sex and 9% of PS pupils reported anal sex as their first sexual act. Almost half of PS girls have had sex with adults, including teachers and relatives. 'Forced sex' was reported by nearly half of PS and SS girls. Fourteen per cent of PS girls had already been pregnant, and over half of these pregnancies ended in illegally induced abortions. Despite a rather high (30%) lifetime rate of condom use, 33% and 25% of PS boys and girls, respectively, reported past experience of sexually transmitted diseases (STDs). STD rates were lower among SS pupils who had a better knowledge of STDs/HIV and fertility issues and reported higher condom use. The survey demonstrated the great vulnerability of school-going adolescents of Mwanza Region to consequences of sexual intercourse. The response should urgently come in the from of comprehensive adolescent SRH programmes.     

A longitudinal study of three-year-old children with delayed development of language

From January 1982 to December 1986, 113 three-year-old children (100 boys and 13 girls) visited the department of pediatrics, Asahikawa Medical College, because of delayed development of language (their expressive language age less than two-year-old). Of these children, 102 children (90%) have visited until they graduated from junior high school for the evaluation of intelligence quotient (IQ), diagnosis, the type of attended school and complications. The mean follow-up period was 10.8 years. The 113 children ware classified as 32 cases of developmental language disorder (DLD), 38 of autistic disorder (Au), 39 of mental retardation (MR), and 4 of deafness based on the results of clinical examination (DSM-III-R), ABR and WPPSI/WISC-R. The purpose of this study is to compare the assessment of language development at the age 3 with the prognosis for intelligence, academic achievement and behavioral adjustment. At the age of three, we divided them into three groups using the Enjoji shiki hattatsu kensa-hyo. Group A including 31 children (29 boys and 2 girls) means delayed development in verbal expression only. Group B including 23 children (17 boys and 6 girls) means delayed development in verbal expression and comprehension. Group C including 59 children (54 boys and 5 girls) means delayed development not only in verbal expression and comprehension but also in communication skills. RESULTS: ABR: Four (2 boys and 2 girls) of 113 children did not show any significant waves on ABR at aged 3, and were also diagnosed as deafness by another audiometry. Comparison between the assessment of verbal expression at aged 3 and full scale IQ (FSIQ): FSIQs in 77% of group A were more than 70, while FSIQs in 79% of groups B and C were 70 or below. The assessment of verbal comprehension at aged 3 was significantly related with FSIQ (x2 = 23.88, p < 0.01). Classification of disorders and type of schools according to the assessment at aged 3: [Group A] Thirty one children were classified as 25 cases of DLD and 6 of MR. Before a graduation from junior high school, 20 children attended regular classes and 8 attended special classes for MR. [Group B] Twenty three children were classified as 4 cases of DLD, 10 of MR, 5 of Au and 4 of deafness. Before a graduation from junior high school, 4 children attended regular classes, 8 attended special classes for MR, 6 attended special schools for MR and 4 attended schools for deafness. [Group C] Fifty nine children were classified as 3 cases of DLD, 23 of MR and 33 of Au. Before graduating from junior high school, 10 children attended regular classes, 18 attended special classes for MR, 19 attended special schools for MR and 2 entered educational facilities. CONCLUSION: 1. Poor mental outcome could be predicted by delayed development of both expressive and comprehensive language, particularly associated with dysfunction of communication skills at the age of three. 2. ABR is a useful method for detecting of hearing loss in non-cooperative young children with delayed development of language.     

Attitudes to food, eating and dieting behaviour in 11 and 14-year-old Swedish children

All students in grades 5 and 8 of three randomly chosen schools in Uppsala (n = 236) were eligible, and 197 participated. The survey included a Swedish version of the Children's Eating Attitudes Test (ChEAT) and a demographic and dieting questionnaire. In total, 47% of the children (girls 70%, boys 25%) wanted to be thinner and 25% had tried to lose weight. In the 5th grade, 49% of the girls reported that they wanted to be thinner and in the 8th grade 83%. Fifty-three percent of the girls in the 8th grade reported that they had tried to lose weight; 36% admitted that they felt too fat but only 5% reported that other people found them too fat. The methods used were caloric restriction and exercise. Compared with US data, the Swedish students dieted less often and showed lower ChEAT scores. Compared with earlier data, our results show that weight concerns begin at an earlier age among Swedish children today.     

First tobacco consumption in children

From 1436 pupils in North-Switzerland 9% of the boys and 3% of the girls smoked their first cigarette within or before the age of six years. 32% of these first cigarettes were smoked in woods or parks. 37% on streets, 31% on other places. 25% of the first cigarettes were stolen, not bought. 50% of all these children remembered to have a headache, vomitying or a stomach-ache after smoking the first cigarette. The boys began to smoke daily at the age of 13, the girls at the age of 14.     

Two decades of annual medical examinations in Japanese obese children: do obese children grow into obese adults?

OBJECTIVE: To investigate trends in frequency of obese children in Japan over two decades, the frequency of obese children who grow into obese adults and predictive factors for adult obesity. DESIGN: Annual cross-sectional studies for 22 y (1974-1995) with a follow-up study. SUBJECTS: Cross-sectional: Cumulatively 13,186 obese (% of standard body weight (SBW): > or = 120%) schoolchildren including 3158 extremely obese (> or = 140% of SBW) children out of 203,088 schoolchildren (age: 6-14 y) in Izumiohtsu City, Osaka, Japan. Follow-up: 151 initially obese children (initial age: 6-14 y and age at follow-up: 20-35 y) who lived in Izumiohtsu City. Control: 3552 Japanese men and 4631 Japanese women (age: 20-35 y). MEASUREMENTS: Cross-sectional: height, weight, trunk circumference, skin-fold thickness, blood pressure and blood biochemicals. Follow-up: height, weight, trunk circumference, skin-fold thickness during childhood, and body height and weight at follow-up. Adulthood obesity: > or = 120% of the average body mass indices (BMI) of the controls. RESULTS: Frequency of obese children increased from 5% to more than 10%, and that of extremely obese children increased from 1% to more than 2% during these 22 y. These increases were most prominent in the schoolboys aged 9-11 y. Prevalence of hyperglycemia and hyperlipidemia in the extremely obese children did not change, and that of hypertension and abnormal liver function gradually decreased during these two decades. After coming of age, 32.2% of the initially obese boys (relative risk: 5.3) and 41.0% of the initially obese girls (relative risk: 6.7) remained obese. BMI, percentage of the SBW and skin-fold thickness at the biceps during childhood were significantly larger in currently-obese girls. Positive correlations were demonstrated between these variables and percentage SBW at follow-up. CONCLUSIONS: Childhood obesity is increasing in Japan, especially in boys aged 9-11 y. Approximately 32% of the obese boys and 41% of the obese girls grow into obese adults, and the degree of obesity is a predictive factor for adult obesity.     

Caring for pregnant teens and their mothers, too

STUDY OBJECTIVE: To describe the sexual behavior and contraception use among a sample of high school and vocational school adolescents in Barcelona, Spain. DESIGN: Cross-sectional study. METHODS: A random sample of 3139 students, aged 14 to 19 years, living in the city of Barcelona, were surveyed by means of an anonymous, self-administered questionnaire. SPSS/PC+ was used for statistical analysis. Significance criterion was set at 0.01. MAIN RESULTS: 13% of the students had previously participated in sexual intercourse; percentages between the sexes was equal. Frequency increased with age. Boys had their first experience at a significantly earlier age, but girls participated in sexual intercourse more often. The majority of adolescents used condoms as their primary contraceptive method; seven (3.3%) of the sexually active girls had been pregnant, and two (1%) boys had caused their partners to become pregnant. CONCLUSIONS: The rate of sexual activity among adolescents in Barcelona is low compared with those in both European and American studies. However, a higher rate of condom use is observed.     

Gender differences in food-related concerns, beliefs and behaviours of north Queensland adolescents

OBJECTIVE: To describe the beliefs, attitudes, behaviours and knowledge of North Queensland adolescents about food and nutrition. METHODOLOGY: A questionnaire surveyed 791 Year 8 students from private schools. RESULTS: More girls than boys felt guilt about food, sometimes ate from boredom, reported trying to select foods that were good for them and were concerned about the fat content of food; 30% of boys and 17% of girls thought they should be concerned about their food intake only when overweight. Low daily dietary intakes were reported for bread, fruit, vegetables and dairy products with only 24% eating at least one fruit, one vegetable, one dairy product and one core cereal food daily. Fat and sugar intake was high: 41% students ate high fat savoury foods and 53% ate high sugar foods at least seven times during the week. Parents, television and school provided information about food and nutrition to 70-80% of these students, followed by friends and magazines with doctors and teachers providing information on weight and weight loss to 10% of students. CONCLUSIONS: Doctors should be aware of the low intake of recommended foods as well as the high intakes of fat and sugar among adolescents and the gender differences in food related beliefs and behaviours when treating nutrition related diseases and providing guidance for their prevention.     

Serum urate levels between ages 10 and 14: changes in sex trends

Urate levels were assayed in sera of 292 subjects between 10 and 14 years of age identified through a probability sample of a natural population. The sex trends in serum urate concentrations characteristic of childhood were seen to continue into early adolescence, with girls maintaining slightly higher means. Between 10 and 14 years there was first an overlap of male and female values followed by a reversal of trends, with much higher means in boys. Serum urate concentrations peaked in girls at age 11 and gradually stabilized at lower levels. Boys, on the other hand, showed little age variation in serum urate at 10 and 11 years but by age 12 showed sharp upward trends which continued throughout adolescence. Since age and body weight are known to be important covariates of serum urate, boys were matched to girls of the same age and body weight. Significant sex differences in urate levels persisted (after matching) only for 14-year-old adolescents and thus at this age could not be ascribed to weight differentials. The study highlights a peripubertal phenomenon whose mechanism might be endocrine related.     

Epidemiology and treatment of otitis media with effusion in children in the first year of primary school

Children with acute lymphoblastic leukaemia (ALL) typically gain weight at excessive rates during and after therapy, and a high proportion of young adult survivors are obese. Previous studies have failed to identify the abnormalities in energy balance that predispose these children to obesity. The aim of this study was to determine the cause of excess weight gain in children treated for ALL by testing the hypothesis that energy expenditure is reduced in these patients. Twenty children [9 boys, 11 girls; mean age 10.9 (3.2) y] treated for ALL who had shown excess weight gain, but were not obese [mean body mass index SD score 0.70 (1.04)], were closely and individually matched with 20 healthy control children [9 boys, 11 girls; mean age 10.7 (3.0) y; mean body mass index SD score 0.27 (0.91)]. In each child we measured total energy expenditure by doubly-labeled water method, resting energy expenditure, energy expended on habitual physical activity, and energy intake. Total energy expenditure was significantly higher in control subjects than in patients: mean paired difference 1185 kJ/d (282 kcal/d), 95% confidence interval (CI) 218-2152. This difference was largely due to reduced energy expended on habitual physical activity in the patients. Resting energy expenditure was lower in the patients: mean paired difference 321 kJ/d (76 kcal/d), 95% CI 100-541. Energy intake was also lower in the patients: mean paired difference 1001 kJ/d (238 kcal/d), 95% CI 93-1909. Children treated for ALL are predisposed to excess weight gain, and subsequently obesity, by reduced total energy expenditure secondary to reduced habitual physical activity. Prevention of obesity in ALL should focus on modest increases in habitual physical activity, modest restriction of dietary intake, and monitoring of excess weight gain.     

Selective extraction of alkaline phosphatase and 5'-nucleotidase from milk fat globule membranes by a single phase n-butanol procedure

A single phase extraction procedure employing 8% (v/v) n-butanol at room temperature extracted over 90% of alkaline phosphatase activity and over 60% of 5'-nucleotidase activity from bovine milk fat globule membranes (MFGM). For 5'-nucleotidase, higher n-butanol concentrations lead to loss of activity, while lower concentrations were ineffective in extracting the enzyme. When extractions were performed at 0 degrees C, similar yields were obtained for alkaline phosphatase extraction with 8% (v/v) n-butanol, but 5'-nucleotidase extraction required 10% (v/v) n-butanol for similar yields. However, 5'-nucleotidase was less susceptible to denaturation during extraction at 0 degrees C. The Km values and substrate specificities for both alkaline phosphatase and 5'-nucleotidase were unchanged by extraction with 8% (v/v) n-butanol. The 8% (v/v) n-butanol extraction procedure provides a 3-fold purification step, and an enzyme preparation suitable for further purification.     

Predictors of changes in weight esteem among mainland Chinese adolescents: A longitudinal analysis.

Weight and body image concerns are prevalent among adolescents across cultures and pose significant threats to well-being, yet there is a paucity of longitudinal research on samples living in non-Western and developing countries. This prospective study assessed the extent to which select sociocultural, psychological, and biological risk factors contributed to changes in weight esteem among adolescent girls and boys living in the People’s Republic of China. Students (181 boys, 320 girls) from middle schools and high schools in Southwest China completed measures of demographics; weight esteem; thin female and lean, muscular male appearance ideals; positive and negative affect; and appearance-based social pressure, teasing, and comparison. Subsequently, weight esteem was reassessed 18 months later. Girls having stronger preferences for thin ideals, a high body mass index, and more negative affect at Time 1 were more likely to experience losses of weight esteem at follow-up. Among boys, high baseline levels of appearance pressure contributed to later reductions in weight esteem—an effect that was also moderated by age. For both sexes, appearance social comparisons also contributed to weight esteem changes in univariate analyses, albeit these effects were attenuated within multivariate prediction models. In sum, this study highlights how specific experiences implicated previously in research on body dissatisfaction in Western samples are also salient in understanding changes in weight esteem for adolescent girls and boys in rapidly developing China. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Appendicular bone mass in children with a high prevalence of low dietary calcium intakes

We have previously documented evidence of dietary calcium deficiency in black children living in a rural community in the eastern part of South Africa. The present study determined the bone mass of the distal one-third of the radius in a random sample of children living in the same community and compared their bone mass measurements with those of black children living in a similar rural community but without evidence of dietary calcium deficiency. Further, factors (weight, height, serum corrected total calcium, phosphorus, and alkaline phosphatase [ALP]) that might influence appendicular bone mass were assessed and correlated with the bone mass measurements. A random sample of 306 boys and 345 girls between the ages of 1 and 20 years were included in the study. Hypocalcemia was found in 6.5% of the boys and 5% of the girls, while elevated ALP values were recorded in 20 and 26% of the boys and girls, respectively. After adjusting for differences in age, weight, and height, bone mineral density (BMD) and bone mineral apparent density (BMAD) were significantly lower and bone width (BW) greater in study than control children. In a stepwise regression analysis, weight and/or height accounted for the majority of the observed variance in BMC, BW, and BMD; however, a significant effect of serum calcium (positively) and ALP (negatively) on BMC and BMD was also found. In boys, but not girls, serum ALP also had a positive effect on BW.BMAD was negatively correlated to ALP and positively correlated to serum calcium in both boys and girls. Those children with hypocalcemia or elevated ALP levels had significantly lower BMC, BMD, and BMAD and a trend toward greater BW than children with normal biochemistry. The findings suggest that low dietary calcium intake may have a detrimental effect on appendicular bone density in rural black children. Whether or not these effects are disadvantageous in the long-term is not known.