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.     

Obesity among offspring of women with type 1 diabetes

OBJECTIVE: To determine subsequent growth and body composition of children born to women with type 1 diabetes compared with controls. DESIGN: Prospective cohort study. SETTING: Follow-up of offspring born to women with type 1 diabetes and controls from an earlier study of diabetes and lactation. SUBJECTS: Seventeen nondiabetic offspring of women with type 1 diabetes and 18 offspring of control women (age range 5.9 to 9.0 years). OUTCOME MEASURES: Anthropometric measures at follow-up included height, weight, triceps and subscapular skinfold thickness. Information on usual nutrient intakes and physical activity patterns was elicited through questionnaires. Body composition was determined from skinfold thickness measures and bioelectrical impedance analysis. A child was identified as obese if he or she met at least 2 of the following 4 criteria for obesity: (1) weight-for-height equal to or greater than 120% of the National Center for Health Statistics (NCHS) reference median plus triceps skinfold greater than the 85th percentile; (2) body mass index (BMI) greater than the 95th percentile for age and sex; (3) percent body fat (from impedance measures) equal to or greater than 25 for boys and 30 for girls; or (4) percent body fat (from sum of skinfold measures) equal to or greater than 25 for boys and 30 for girls. RESULTS: There were 7 obese children in the type 1 diabetes group and none in the control group (p = 0.007). Obese children did not differ from nonobese children in birth weight, body fat patterning, nutrient intake, physical activity patterns, maternal pregravid weight or blood glucose control during the last trimester of pregnancy. Mothers of obese children, however, had fewer years of education and gained more weight during pregnancy compared with mothers of nonobese children in the type 1 diabetes group (p < 0.05). CONCLUSION: Obesity during childhood is a significant problem among nondiabetic children of women with type 1 diabetes. The association of childhood obesity with lower maternal education and excessive pregnancy weight gain warrants further investigation.     

A longitudinal analysis of risk factors for child maltreatment: findings of a 17-year prospective study of officially recorded and self-reported child abuse and neglect

OBJECTIVE: To identify demographic, family, parent, and child factors prospectively associated with risk for child abuse and neglect among families in the community, using data on child maltreatment obtained from both official records and youth self-reports. METHOD: Surveys assessing demographic variables, family relationships, parental behavior, and characteristics of parents and children were administered to a representative sample of 644 families in upstate New York on four occasions between 1975 and 1992. Data on child abuse and neglect were obtained from New York State records and retrospective self-report instruments administered when youths were > or = 18 years old. RESULTS: Logistic regression analyses indicated that different patterns of risk factors predicted the occurrence of physical abuse, sexual abuse, and neglect, although maternal youth and maternal sociopathy predicted the occurrence of all three forms of child maltreatment. In addition, the prevalence of child abuse or neglect increased from 3% when no risk factors were present to 24% when > or = 4 risk factors were present. State records and self-reports of child maltreatment did not correspond in most cases when maltreatment was reported through at least one data source, underlining the importance of obtaining data from both official records and self-reports. CONCLUSIONS: Assessment of a number of risk factors may permit health professionals to identify parents and children who are at high risk for child maltreatment, facilitating appropriate implementation of prevention and treatment interventions.     

Effects of a controlled trial of a school-based exercise program on the obesity indexes of preschool children

Exercise has been found to be effective for prevention of weight gain and maintenance of a stable weight in adults. The objective of this study was to evaluate the effect of a school-based aerobic exercise program on the obesity indexes of preschool children. Subjects were 292 second-year elementary school pupils from 2 kindergartens in Hat Yai municipality, Songkhla province, southern Thailand. A specially designed exercise program, including a 15-min walk before beginning the morning class and a 20-min aerobic dance session after the afternoon nap, 3 times a week, was conducted for 29.6 wk. Weight, height, and triceps skinfold thickness were measured 4 times. At the end of the study, the prevalence of obesity, using 95th percentile National Center for Health Statistics triceps-skinfold-thickness cutoffs, of both the exercise and control groups decreased. That of the exercise group decreased from 12.2% at baseline to 8.8% (Wilcoxon signed-rank test, P = 0.058), whereas that of the control group decreased from 11.7% to 9.7% (Wilcoxon signed-rank test, P = 0.179). A sex difference in the response of body mass index (BMI) to exercise was observed. Girls in the exercise group had a lower likelihood of having an increasing BMI slope than the control girls did (odds ratio: 0.32; 95% CI: 0.18, 0.56). In conclusion, our study suggests that a 29.6-wk school-based exercise program can prevent BMI gain in girls and may induce a remission of obesity in preschool-age children.     

Expression of cellular adhesion regulatory molecule in hepatocellular carcinoma

OBJECTIVE: Studying gender differences in fat mass and distribution in a homogeneous group of children. DESIGN: Cross-sectional study. SUBJECTS: 610 children aged 5-7 y in Kiel, Germany. METHODS: Anthropometric measures, bioelectrical impedance analysis (BIA). RESULTS: Although boys had increased body weights (P<0.05), body mass indexes (BMI's) (P<0.001) and waist/hip ratios (WHRs) (P<0.001), the %fat mass as assessed by BIA (P<0.05) was increased in girls. Although the increased BMI in boys was independent of the percentile used, gender differences (that is, lower values for boys than for girls at the same age) in WHR, the sum of four skinfolds and %fat were seen up to the 90th percentile. By contrast, above the 90th percentile there were no differences in skinfold thickness and %fat between boys and girls. Studying 42 BMI-matched pairs (boys and girls) also showed that the %fat estimated by BIA (P<0.001) was increased in girls. Plotting the average of %fat as obtained from skinfold- and BAI-measurements against the difference between data obtained by the use of the two methods shows that BIA %fat overestimates skinfold %fat at low or normal percent fat mass (that is, up to 20%) in both genders. By contrast, at increased fat mass, BIA %fat seems to underestimate skinfold %fat in both genders. CONCLUSIONS: Gender differences in fat mass and fat distribution are obvious in children aged 5-7 y. These differences are independent of gender differences in body weight. However, the nutritional state has an influence and gender differences cannot be detected in overweight and obese children. Our data also suggest that a children-specific formula used to calculate %fat from skinfold measurements is inappropriate.     

Dosimetric comparison of centered and off-centered posterior neck electron fields

The effect of visual skills, such as binocularity, on saccadic eye movement test performance is currently unknown. Therefore, the relationship between performance on commonly used clinical saccadic eye movement tests and visual skill was studied in a masked investigation of 181 kindergartners and first graders (mean age 6.25 years) from a middle class, suburban, elementary school near Cleveland, Ohio. The New York State Optometric Association King-Devick saccade test (NYSOA K-D) and the Developmental Eye Movement test (DEM) were employed because they are two commonly used clinical saccadic eye movement tests. A Modified Clinical Technique (MCT) vision screening and Randot stereoacuity test were performed to evaluate other visual skills. Analysis revealed that for the whole study population, total errors on the NYSOA K-D were significantly related to referral on the MCT screening (p = 0.015) and stereoacuity worse than 100 sec arc (p = 0.011). A trend toward significance was also found between DEM ratio and stereoacuity worse than 50 sec arc for the whole study population. However, in the children who passed the MCT, stereoacuity was not found to be significantly related to performance on NYSOA K-D or DEM. Thus, our findings indicate that visual difficulties may affect performance on the NYSOA K-D in this population.     

Ethnic variation in the prevalence of obesity in North American children and youth

The estimated prevalence of obesity in North American children and youth (6 to 17 years) in the 1960s through the 1980s is reported. Use of the triceps skinfold and BMI independently and in combination as indicators of obesity provides different estimates of prevalence due to ethnicity. With the triceps skinfold as the indicator, there is an increase in the prevalence of obesity and a reduction in variation between Black and White children and youth from the 1960s to 1980; however, with the BMI as the indicator, there is no change in the prevalence of obesity and negligible ethnic difference in these national data sets. On the other hand, the prevalence of obesity has increased over time in Mexican American and American Indian children and youth. Data for American children and youth of Asiatic ancestry are limited.     

Height, weight and personality

In a representative sample of Basle 8th grade students (165 boys and 237 girls) born in 1960, 23 MMPI scales were compared to height and triceps skinfold thikness. No correlation was found among boys; in girls height showed a positive, skinfold thickness a negative correlation with the social rating of a number of scales.     

Ultrastructural studies of spermiogenesis in rabbit exposed to chronic fluoride toxicity

OBJECTIVE: To compare skinfold thickness measurements with bioelectrical impedance analysis (BIA) as a measure of body fat for use in a survey of children (the National Study of Health and Growth). DESIGN: Part cross-sectional, part repeated measurement study. SETTING: A junior school in Bath. SUBJECTS: 42 boys and 33 girls aged from 9 to 11 years. INTERVENTIONS: Measurements of BIA, height, weight, and triceps, biceps, subscapular and suprailiac skinfolds. RESULTS: All measurements were highly repeatable with intraclass correlation coefficients > 0.90. The level of agreement between estimates of percentage of body fat derived from prediction equations based on impedance or skinfold measurements respectively was poor: the mean difference (impedance estimate minus skinfold estimate) was 4.67% (95% range -3.47 to 12.82) for boys and 7.81% (95% range 1.27 to 14.34) for girls. The two estimates were found to correlate highly (r = 0.83 for boys and r = 0.81 for girls) because weight, used to convert estimates of fat-free mass derived from impedance to fat mass, was highly correlated with impedance and moderately highly correlated with skinfold thicknesses. The correlations of resistance (R) and (H)2/R with skinfold thicknesses were very low. There was a moderate correlation of R and H2/R with log(weight-for-height index), but lower than that of log(weight-for-height index) with each of the skinfolds. CONCLUSIONS: As currently available equations for converting impedance-based estimates of total body water to fat mass are not fully developed for use in children of varying ages, estimates of body fat calculated from skinfold thickness measurements remain preferable in epidemiological studies of children's health and growth.     

The effect of portal hypertension on transforming growth factor-alpha and epidermal growth factor receptor in the gastric mucosa of rats

BACKGROUND: The physical activity levels of US children are declining. Opportunities for physical activity within city schools are constrained by time and space limits. This study determined whether a supplemental program of physical activity would significantly alter the fitness levels of low-income, minority, urban elementary schoolchildren. METHODS: Ninety-nine students from two Cleveland Public Schools served as subjects. One school received a 15-week intervention program where teams of two medical students met with urban elementary schoolchildren three times a week for physical activity sessions. The other school served as a control and received no supplemental activity other than a regularly scheduled physical education class held once a week. We obtained field measurements of skinfold thickness, heart rate response to submaximal exercise, and sit and reach flexibility. RESULTS: The supplemental activity group showed significant improvements in flexibility, body composition, and heart rate response to submaximal exercise. CONCLUSIONS: This investigation indicates that a program of fitness activities conducted within the classroom can significantly improve levels of fitness in urban elementary schoolchildren.     

Obesity and body fat distribution in New Zealanders: a pattern of coronary heart disease risk

AIMS: To describe the prevalence of obesity and the body fat distribution of New Zealanders. To discuss this in the context of the coronary heart disease risk. METHODS: Body weight and height, body mass index (BMI), waist:hip ratio (WHR) and six skinfold measurements were determined for 3204 randomly selected New Zealanders who responded to an invitation to a health check (response rate 56%). RESULTS: In the study sample BMI generally increased with age. Fifty five percent of men and 38 per cent of women aged 18-64 had a BMI exceeding 25, and of these 13 per cent and 10 per cent were obese (BMI > 30). WHR was greater in men than in women of all ages, and a third of the men and a quarter of the women had values exceeding 0.9 and 0.8 respectively. Central skinfold measurements (subscapular, suprailiac and abdominal) were lowest in young men, but rose markedly with age and were similar to women above age 35. Limb skinfolds were lower in men. CONCLUSIONS: This survey indicates that a large percentage of New Zealanders are overweight or obese and their excess body fat tends to be centrally distributed, especially in men. Obesity is thus a significant health problem in New Zealand.     

Social and economic consequences of overweight in adolescence and young adulthood

BACKGROUND AND METHODS: Overweight in adolescents may have deleterious effects on their subsequent self-esteem, social and economic characteristics, and physical health. We studied the relation between overweight and subsequent educational attainment, marital status, household income, and self-esteem in a nationally representative sample of 10,039 randomly selected young people who were 16 to 24 years old in 1981. Follow-up data were obtained in 1988 for 65 to 79 percent of the original cohort, depending on the variable studied. The characteristics of the subjects who had been overweight in 1981 were compared with those for young people with asthma, musculoskeletal abnormalities, and other chronic health conditions. Overweight was defined as a body-mass index above the 95th percentile for age and sex. RESULTS: In 1981, 370 of the subjects were overweight. Seven years later, women who had been overweight had completed fewer years of school (0.3 year less; 95 percent confidence interval, 0.1 to 0.6; P = 0.009), were less likely to be married (20 percent less likely; 95 percent confidence interval, 13 to 27 percent; P < 0.001), had lower household incomes ($6,710 less per year; 95 percent confidence interval, $3,942 to $9,478; P < 0.001), and had higher rates of household poverty (10 percent higher; 95 percent confidence interval, 4 to 16 percent; P < 0.001) than the women who had not been overweight, independent of their base-line socioeconomic status and aptitude-test scores. Men who had been overweight were less likely to be married (11 percent less likely; 95 percent confidence interval, 3 to 18 percent; P = 0.005). In contrast, people with the other chronic conditions we studied did not differ in these ways from the nonoverweight subjects. We found no evidence of an effect of overweight on self-esteem. CONCLUSIONS: Overweight during adolescence has important social and economic consequences, which are greater than those of many other chronic physical conditions. Discrimination against overweight persons may account for these results.     

Role of the microbiology laboratory in the diagnosis of lower respiratory tract infections

A randomized, double-blind trial was undertaken to measure the effects of zinc supplementation on catch-up growth in severe protein-energy malnutrition, with particular reference to linear growth. One hundred forty-one children between the ages of 6 mo and 3 y were enrolled after admission to a nutritional rehabilitation unit in Dhaka, Bangladesh, and randomly assigned to receive elemental zinc by mouth, 1.5 mg/kg for 15 d, 6.0 mg/kg for 15 d, or 6.0 mg/kg for 30 d, and thereafter they were followed for a total of 90 d. Anthropometric outcome measures included change in knee-heel length, midupper arm circumference, subscapular and triceps skinfold thicknesses, and change in height-for-age, weight-for-age, and weight-for-height z scores. Higher zinc doses were not associated with significant change in any anthropometric measurement, but mortality was significantly greater in children who received high-dose zinc (6.0 mg/kg) initially as opposed to those who received low-dose zinc supplementation (1.5 mg/kg) (Yates-corrected chi-square P value of 0.033 and a risk ratio of 4.53; 95% CI: 1.09 < risk ratio < 18.8). We conclude that there is no benefit to using high-dose zinc supplementation regimens and that they could contribute to increased mortality in severely malnourished children.     

Characteristics of children selecting low-fat foods in an elementary school lunch program

OBJECTIVE: To describe the demographic characteristics of children that were associated with the selection of low-fat entrees available in a school lunch program. DESIGN: For 5 consecutive months, we recorded student entree selections on the 46 days in which one of the two available lunch entrees was low fat (< or = 30% of calories from fat). Entree selections were tracked using a computerized meal-card system. The lunch menus did not indicate that one of the two entrees was low fat. Demographic and family characteristics were obtained from the school district's registration database and, in one school, from a household telephone survey. SETTING: A school lunch program in two public elementary schools in Bellevue, Wash. PARTICIPANTS: Students who regularly eat school lunches (N = 471). Sixty-five percent were from families with incomes less than 185% of the federal poverty level, and 49% were nonwhite. INTERVENTION: None. MAIN OUTCOME MEASURE: The proportion of days that each student selected the low-fat entree. RESULTS: Girls selected the low-fat entree more often than boys (33% of days vs 27% of days; P < .001), and the proportion of students selecting the low-fat entree increased with grade level (P = .003). Children were more likely to select low-fat entrees if a household member was known to have an elevated blood cholesterol level (P = .004). The proportion of students selecting the low-fat entree increased with maternal education level (P = .007), but children receiving free or reduced-price lunches (< 185% of the federal poverty level) chose the low-fat entree as often as those receiving full-price lunches (30% of days vs 29% of days; P = .14). There were no significant differences in entree selection among races. CONCLUSIONS: Given a choice of low-fat school lunch entrees, girls, older children, and those who had family members with elevated cholesterol levels were most likely to select these entrees. While parental education level was directly related to the selection of low-fat entrees, race and family income had little association with entree selection.     

Elementary Psychology for Eighth Graders: Four Years Later.

In September 1954, the author introduced a course in elementary psychology as an 8th grade elective in a junior high school in Buffalo, New York. This article reports a summary of results from responses to an information questionnaire distributed in May 1959 to seniors who took the original psychology class. Replies were split 50-50 as to whether or not students' interest in the subject had continued. When asked whether or not the course had wrought any changes in themselves, 19 (of 20) claimed that their attitudes and opinions had changed, 17 reported changes in personal relationships, and 10 affirmed their behavior patterns had changed. The unit remembered the most was the one on hypnotism, followed by the psychology of advertising, dreams, ESP, and personality development. It is noted that because of the numbers of students who elect this course, additional classes with larger class sizes have been opened. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer-led program for the treatment and prevention of obesity in the schools.

Studied 89 overweight children in Grades 2–5 from 2 schools to assess the maintenance of weight loss achieved through school-based programs for obese children. 48 Ss in a Catholic elementary school participated in a 12-wk weight-reduction program conducted primarily by older children trained as peer counselors, while 41 additional Ss from another Catholic school served as control Ss. No program was conducted in the control school, and controls' contact was limited to 3 weigh-ins. Results show that experimental Ss lost 0.15 kg and reduced their percentage overweight by 5.3%, whereas controls gained 1.3 kg and increased their percentage overweight by 0.3%. Experimental Ss also showed positive changes in self-concept, as compared with controls, and displayed improvements in food selection. Changes in weight, self-concept, and food selection were only partially maintained at 18-wk follow-up, however, pointing to the need for an ongoing program of weight loss maintenance. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Spatial visualizing in children.

Conducted 4 experiments on visualization of space in 108 2nd and 11th graders and undergraduates, 102 4-5, 6-7, and 9-10 yr olds, and 30 kindergartners and 3rd and 6th graders. Exp I used a localization task, and evidence was found that both children and adults spontaneously visualize their unseen hand when it is touched. In the remaining 3 experiments, S was required to manipulate spatial information mentally. Results show that (a) preelementary school children did not carry out such manipulations and responded instead to the topological properties of the problem; (b) elementary school children were increasingly more skilled at mental manipulation with age; and (c) the ability to manipulate spatial images correlated with performance on a test of spatial visualization, particularly in older elementary school children. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Endovascular treatment of thoracic aortic aneurysm]

OBJECTIVES: The purpose of this study was to explore changes in breast-feeding initiation from 1979 to 1996 among infants born in New York City hospitals. METHODS: All New York City hospitals were surveyed every 2 years. Hospital staff reported feeding method at newborn discharge. RESULTS: New York City breast-feeding initiation rates increased consistently from 1979 to 1996 (from 29% to 58%, P < .0001), including 1984 to 1990, when rates decreased nationally. CONCLUSIONS: A 1984 New York State regulation requiring each hospital to designate a lactation coordinator may have been associated with the continuing increases in breast-feeding initiation.     

Relationships between an index of body fat distribution (based on waist and hip circumferences) and stature, and biochemical complications in obese children

OBJECTIVE: To determine the clinical utility of a new age-adjusted measure of body fat distribution (based on waist and hip circumferences) and stature, in relation to biochemical complications in obese children. DESIGN: Cross-sectional, clinical study. The formula to calculate the common standard deviation score (SDS) of waist-to-hip ratio/height (WHR/Ht) was obtained from the data of control children. The relationship between WHR/Ht SDS, as the age-adjusted measure, in obese children and their clinical laboratory data was evaluated. SUBJECTS: Outpatient obese Japanese children (102 boys and 75 girls) and control children (508 boys and 549 girls), ranging in age from 6-15 y. MEASUREMENTS: Height, body weight, waist girth, hip girth, triceps and subscapular skinfold thicknesses, as anthropometric measures. Percent overweight, percent body fat, waist girth, WHR and WHR/Ht SDS as criteria for obesity. Clinical laboratory analyses for fasting blood samples of obese children. RESULTS: The WHR/Ht SDS closely correlated with age in obese children, thus reflecting the progress of abdominal obesity during growth. The obese boys were more hyperlipidaemic than the girls were, although the percent overweight was similar in both genders. The percent overweight, percent body fat, waist girth and WHR/Ht SDS all correlated well with triglyceride (TG), alanine aminotransferase (ALT) and insulin in boys, whereas only waist girth and WHR/Ht SDS showed a close correlation with TG and insulin in girls. The obese subjects were subdivided according to the number of abnormal values observed in TG, ALT and insulin. For obese boys, all five indices of obesity were higher in the groups with complications than in the group without. In the girls, only the WHR/Ht SDS constantly differed between subgroups. WHR/Ht SDS most obviously distinguished the groups with complications from the other group with a wide margin of difference (2-fold in boys and > 2-fold in girls) in the mean values. CONCLUSION: The WHR/Ht SDS can serve as an index predicting the occurrence of biochemical complications in obese children ranging from the age of 6-15 y.