Intelligence test score and educational level in relation to BMI changes and obesity

OBJECTIVE: To investigate whether intelligence and education are related to subsequent BMI changes and development and persistence of obesity in men from young adulthood through middle-age. RESEARCH METHODS AND PROCEDURES: Subjects were selected among men (median age, 19 years; examined between 1956 and 1977) appearing at Danish draft boards: a group with juvenile-onset obesity, including all men with a BMI of >/=31.0 kg/m(2); and a nonobese group randomly selected as a 1% sample of the study population. The obese group and 50% of the nonobese group were invited to participate in follow-up studies between 1982 and 1984 and between 1992 and 1994. Among 907 men with juvenile-onset obesity and 883 nonobese men, age, examination region, intelligence test score, education, and BMI from baseline to first follow-up were analyzed by multiple linear and logistic regressions analyses. RESULTS: Education and intelligence, analyzed separately, were inversely related to BMI changes in both groups and to the development of obesity in the nonobese group. When adjusted for education, the association between intelligence score and BMI changes and development of obesity vanished, whereas the inverse relationship for education persisted only for BMI changes. Intelligence score was not associated with the persistence of obesity in the obese group, whereas inverse relationships were found for education. DISCUSSION: Intelligence test score was inversely related to risk of BMI changes and the risk of development of obesity, perhaps with education acting as a mediator or indicator of cognitive ability. Education, but not intelligence, was inversely associated with risk of remaining obese.     

健全器官移植随访管理体系提高患者生存质量

目的健全移植患者规范化随访,提高患者长期存活率和生存质量。方法健全移植随访管理体系,完善随访制度,做好随访的环节管理,加强全程健康教育和提供温馨服务。结果（1）不同时期随访模式人／肾成活率结果显示：1年、3年和5年的人／肾成活率,规范化随访组均高于不规范随访组（P〈0．05）。（2）不同时期随访模式下门诊随访结果显示,1年随访率两组差异无统计学意义（98．4％,97．5％,P=0．128）。3年和5年的规范化随访组随访率均大于不规范随访组,差异有统计学意义（90．1％,85．5％;88．3％,55．3％,P〈0．001）。结论健全器官移植随访管理体系,规范化随访移植患者,提高了患者存活率和生存质量。     

The Influence of Constructed Family Membership on HIV Risk Behaviors among Gay,Bisexual, and Other Men Who Have Sex with Men in New Orleans

Gay, bisexual, and other men who have sex with men (MSM) represent more new HIV infections than all other at-risk populations. Many young black MSM belong to constructed families (i.e., the house ball community, gay families, and pageant families) which are often organized in a family structure with members referred to as parents and children. Many constructed families are associated with a family surname which is informally adopted by members. In some cases, however, constructed families do not identify with a collective family name. In 2014, 553 MSM were recruited through venue-based time-space sampling during the National HIV Behavioral Surveillance (NHBS) in New Orleans to complete a structured survey and HIV test. Black, Latino, and other race MSM were more likely to belong to constructed families in comparison to white MSM. In addition, participants who belonged to constructed families with a family name were more likely to engage in protective behaviors including wearing condoms at last sexual intercourse. Overall, younger, white MSM who did not belong to any social groups were more likely to engage in at least one risk behavior. These findings significantly contribute to understanding variations in HIV risk behavior among members of constructed families.     

Practices in pesticide handling and the use of personal protective equipment in Mexican agricultural workers

Practices related to the safe handling of pesticides and use of personal protective equipment (PPE) are largely unknown among agricultural workers in developing countries. The authors obtained information from 99 Mexican agricultural workers (35 women and 64 men) who answered questions on sociodemographic data, agricultural practices, use of pesticides, use of PPE, and risk perception. As expected, men handled pesticides more frequently than women (67% versus 20%). The workers carried out several agricultural tasks, as is customary in the case of fieldworkers who (1) work in small agricultural enterprises; use a great number of pesticide products (59 commercial brands of pesticides, 33 active ingredients, and 20 chemical families); (2) use mostly manual application equipment; (3) have a low rate of correct usage of PPE (2%), which does not vary according to the education level, the time of year, or the risk perception; and (4) have insufficient hygienic practices. In addition, storage of pesticide products and application equipment at home is frequent among this group of workers (42%), and provides a significant source of para-occupational exposure for the workers' families. These results show the need to develop prevention programs to reduce risks posed by pesticides to agricultural workers and their families.     

'I don't trust you, you are going to tell', adolescents with emotional and behavioural disorders participating in qualitative research

Background   Some groups of young people are considered difficult to reach and study. One such group consists of adolescents with emotional and behavioural disorders (EBD), who have problems with verbal intelligence, thought focussing and paying attention. During a 2-year research study into the preferences of adolescents with EBD regarding drug prevention policy, the author examined these young people's opinions and their experience of participation in research.
Methods   A qualitative, youth-centred method was used, combining group techniques (focus groups, nominal group techniques and feedback sessions) and involving 160 adolescents, aged 12–21 years, with EBD, living in residential settings of the disability sector.
Results   It is possible to carry out qualitative research with young people with EBD. This population is very vulnerable, negatively influenced by their previous experiences and by the social group that they belong to. They have an aversion to 'being studied', and their self-esteem and confidence are low. However, it is possible to build up trust.
Conclusions   It has become clear that there is no reason for excluding adolescents with EBD from participation in research. Research is possible and successful, providing sufficient effort is put into building up trust with these emotionally scarred young people.     

未婚流动青少年生殖健康教育现状、挑战及发展

从未婚流动青少年生殖健康教育需求的视角探讨当前面向未婚流动青少年性与生殖健康教育的现状、挑战及发展方向。中国流动青少年对性与生殖健康教育的需求表现为：内容的广泛性、途径多样性和教育/咨询环境的私密性。当前的挑战主要包括：家庭性与生殖健康观念和知识传输基本功能缺失;农村学校性与生殖健康教育阵地沦陷;社会环境从“谈性色变”到“性开放”的强烈冲击。需从加大政策保障执行力度,在青少年学前和在学期间发挥家庭和父母在性与生殖健康教育中的积极作用,确保青少年在义务教育阶段获得以生活技能为基础的综合化性教育,青年人的性与生殖健康促进要同就业、保健、教育及反暴力等干预相结合4个方面积极应对挑战。     

社区早期婴幼儿教育与服务对婴儿智能发育的影响

目的评价在社区开展的早期婴幼儿教育和服务对婴儿智能发育的影响。方法采用社区干预研究的方法，将359名新生儿及其家庭作为项目对象。在婴儿满月时进行基线调查，干预组随之接受以婴幼儿养育和智力开发为主要内容的干预活动。在婴儿6月龄和12月龄时进行随访调查。婴儿智力测量采用“0～6岁发育筛查测验”量表。结果两组婴儿的性别和出生过程中的情况差异没有统计学意义。干预组和对照组婴儿基线调查时智力指数（MI）得分分别为98.26分和101．79分，发育商（DQ）得分分别为94．50和99．36分。干预组婴儿6月龄和12月龄随访MI得分较基线的增值分别为6．07和8．86分，高于对照组的增值（-2．46分和1．05分）；干预组6月龄和12月龄随访DQ得分较基线的增值分别为12.94和11．24分，高于对照组的增值（-0．18和0．34分）。MI及DQ得分6月龄及12月龄的组别×时间的交互项（干预作用），均高于基线。结论社区早期教育和服务促进了婴儿的智力发育。     

Association of body mass index with educational level in Iranian men and women

OBJECTIVE: Investigation of the relationship between educational level, body mass index (BMI), waist-to-hip ratio (WHR), physical activity and parity in a group of Iranian men and women living in Tehran. DESIGN: A cross-sectional study in a group of Iranian men and women. The subjects were classified into two educational levels: low education (< or =12 y schooling) and high education (>12 y schooling); and BMI, WHR, physical activity and parity (in women) were compared in two groups in men and women, separately. SETTING: Metabolic Unit of Tehran University of Medical Sciences in Tehran. SUBJECTS: Three hundred and fifteen men aged 33.1 (22-46) and 403 women aged 27.9 (22-45). RESULTS: After controlling for age and smoking, women with a higher level of education showed a significantly lower mean BMI than less educated women (24.8+/-4.2 vs 28.3+/-4.9, P <0.01), while more educated men had a higher mean BMI than less educated men (28.4+/-4.3 vs 26.7+/-4.5). In multiple regression analysis, physical activity in leisure time in men and years of education in women were the only determinants of BMI. After controlling for BMI, WHR was not related to the level of education in either men or women. CONCLUSION: The present data indicated an educational difference in BMI for the study population. In Iranian women, like the women in developed countries, the level of education was negatively related to BMI, while in men the association was positive. SPONSORSHIP: This work was financially supported by the Institute of Public Health, Tehran University of Medical Sciences.     

Older, but not wiser: how men get information about AIDS and sexually transmitted diseases after high school

CONTEXT: As they reach adulthood, young men are less likely to use condoms and are at increased risk for exposure to AIDS and other sexually transmitted diseases (STDs). Little is known about which prevention efforts reach men in their 20s. METHODS: Longitudinal data from the 1988, 1990-1991 and 1995 waves of the National Survey of Adolescent Males are used to identify sources of information about AIDS and STDs among 1,290 young men aged 22-26. Information receipt from four main sources, the topics covered by each source and the personal characteristics associated with getting more information are all explored. RESULTS: Twenty-two percent of men surveyed discussed disease prevention topics with a health provider in the last year, 48% attended a lecture or read a brochure, 51% spoke to a partner, friend or family member, and 96% heard about AIDS or STDs from the media (e.g., television advertisements, radio or magazine). Excluding media sources, 30% of young men reported getting no STD or AIDS prevention messages in the last year. Being black or Hispanic, having had a physical exam or an AIDS test in the last year, and having discussions about AIDS or STDs with parents or a health care provider in the past were associated with receiving more information. CONCLUSIONS: Although young men who are at higher risk for STD or HIV infection are more likely than other young men to get information about disease prevention, young adult men are much less likely than adolescents to receive AIDS or STD prevention education. More prevention efforts need to be aimed at young adults.     

Follow-up study on pulmonary function of dust workers: an epidemiological evaluation of discontinued workers of dust operations

An epidemiologic study on 176 dust workers from various facilities was initiated in 1978. Their mean age was 48.3 years and mean duration of employment was 21.6 years. No workers complained of chronic cough and phlegm. Their chest X-rays were found to belong to Category I of the diagnostic criteria for pneumoconiosis in Japan. Pulmonary function test was performed on these workers, however, 54 workers discontinued taking part in the study by the end of 1979, and 49 workers had discontinued by 1981. A total of 73 workers had a five-year follow-up survey of pulmonary function. Forced expiratory volume in one second divided by forced vital capacity (FEV1.0/FVC) and forced expiratory flow rate at 25% of FVC divided by height (V25/H) were mainly compared by smoking habit, work years, type of job, size of company, and the time when they discontinued their jobs. Predicted percentage values of lung function were used for the adjustment of the influence of workers' ages. Decrement of FEV1.0/FVC and V25/H in the five-year follow-up group were larger than the screening level. The mean values of those functional parameters in the early discontinued group were lower than late discontinued and active working groups. The active working group was considered to be a physically healthy workers' population.     

上海市徐汇区2008-2015年自愿咨询检测确认艾滋病病毒阳性人群状况研究

目的 分析徐汇区2008-2015年获得性免疫缺陷综合征（简称艾滋病）（acquired immunodeficiency syndrome,AIDS）自愿咨询检测（voluntary counseling and testing,VCT）确认艾滋病病毒阳性人群的人口学特征和危险因素,比较VCT门诊和医疗机构发现的艾滋病感染者在感染途径、CD4计数和病程变化之间的差异。方法 采用横断面研究,描述性分析VCT确认阳性人群相关信息。建立VCT组和医疗机构组,对两组相关数据进行回顾性分析比较。结果 VCT确认阳性者中男女比例为21.09:1,20~29岁组占48.97%,未婚者占71.60%,大专及以上文化程度占67.49%。男男性行为人群（men who have sex with men,MSM）、<20岁组和 ≥ 50岁组人群、离异或丧偶组人群、低文化程度人群的阳性率较高。VCT组同性传播比例高于医疗机构组。两组首次CD4检测中位值分别为360个/μl和293个/μl。从感染者转变为病人的比例分别为29.63%和49.62%,发病潜伏期中位值分别为2 115 d和942 d。结论 徐汇区VCT确认阳性者以年轻、未婚、高学历的MSM人群为主。青年学生、老年人、低文化程度及离异或丧偶等高危亚人群要重点关注。VCT的早发现优势高于医疗机构。     

Personal and interpersonal risk factors in the consumption of illicit drugs by marginal adolescents and young people from juvenile gangs

Marginal populations are groups which are known to present higher risks of drug consumption. It is possible to identify adolescents and young people from juvenile gangs that constitute this group. The purpose of this study was to analyze the effect of personal and interpersonal risk factors of drug consumption in 175 marginal adolescents and young people who belong to juvenile gangs in Mexico. Results showed a significant effect of personal factors on drug use, with an estimated variation of 26.1%. The factors that presented the highest rates were: gender, age and mental problems. The interpersonal factors (relationships with friends who have maladaptive behaviors and inappropriate relationships with parents) showed an effect with an estimated variation of 15%. These results will allow for reflection and, in the future, the elaboration of adequate preventive programs aimed at this group of young people.     

青少年身心发展状况及趋势分析

目的:描述青少年身心发展状况,探讨青少年不同年龄阶段生理发育和心理发展的差异,为针对不同年龄阶段的青少年的健康教育提供依据。方法:采用"青少年青春期发育与心理社会发展问卷"对510名青少年学生进行调查,了解其青春期发育及心理社会发展状况。结果:生理方面,男孩得分为(12.5±3.57)分,女孩得分为(11.4±2.90)分,随年龄增长生理得分渐增并趋于稳定;青春期分期方面,80.4%的男孩处于青春期中期和晚期,83.4%的女孩处于青春期晚期,女孩性发育早于男孩;心理社会方面,男孩得分为(76.2±37.42)分,女孩得分为(69.0±32.85)分,男女得分差异明显,随年级增长,心理得分呈现先增高后下降的趋势,高一得分最高,男孩心理状况较女孩差;身心发展趋势方面,生理发育与心理发展呈轻度负向相关关系。结论:青春期青少年身心发展遵循一定规律,教育者及健康工作人员应遵循规律做好青春期健康教育工作,重点关注身心剧烈变化时期。     

Prevalence and deteminants of obesity in Spanish children and young people

Prevalence estimates of obesity in a national random sample of Spanish children and young people are presented in this paper, defined by age- and sex-specific BMI national reference standards for the 85th percentile (overweight) and 97th percentile (obesity), as well as by Cole et al. criteria. A random sample of 3534 people, aged 2-24 years, was interviewed between 1998 and 2000. The study protocol included personal data, data on education and socioeconomic status (SES) for the family, dietary assessment, anthropometric measurements and physical activity. The prevalence of obesity was 13.9 % (95 % CI 12.7, 15.1) considering Spanish reference standards as cut-offs. Obesity was significantly higher in boys (15.6 %) than in girls (12 %). The highest values were observed between 6 and 13 years of age. Using Cole's cut-offs, the estimated prevalence of obesity was 6.3 % (95 % CI 5.4, 7.5) with a similar pattern to that previously described by sex. Regarding sociodemographic factors, sex, age group, region, size of locality of residence, mother's level of education and family SES level were significant predictors for obesity in children and adolescents under 14 years. Among young people, the main sociodemographic predictors for obesity were geographical region and family SES level. Odds ratio for obesity was 1.27 for those with a more frequent consumption of buns, cakes and snacks, and 1.71 for those with more frequent consumption of sugared drinks. Adequate consumption of fruit and vegetables, usually having breakfast and regular sports practice had a protective effect. The available data show that obesity in Spain is a public health issue given its magnitude and increasing trends. Among Spanish children and young people, those at prepubertal age, particularly boys, can be identified as a group at higher risk for overweight and obesity, particularly children from lower SES families.     

Improving the body image, eating attitudes, and behaviors of young male and female adolescents: a new educational approach that focuses on self-esteem

OBJECTIVE: This study examines the effect of an interactive, school-based, self-esteem education program on the body image and eating attitudes and behaviors of young male and female adolescents following the program and after 12 months. METHOD: All 470 eligible students (63% female) aged 11-14 years volunteered to participate. The intervention group students participated in the program, whereas the control group students received their scheduled personal development and health class. RESULTS: The program significantly improved the body satisfaction of the intervention students and significantly changed aspects of their self-esteem; social acceptance, physical appearance, and athletic ability became less important for the intervention students and more important for control students. Female intervention students rated their physical appearance as perceived by others significantly higher than control students and allowed their body weight to increase appropriately by preventing the age increase in weight-losing behaviors of the control students. One year after the intervention, body image and attitude changes were still present. These findings also held for the 116 students (63% females) with low self-esteem and higher anxiety, who were considered at risk for the development of eating disorders. These students also had significantly lower drive for thinness and greater body satisfaction following the intervention and the decreased importance of physical appearance to their self-esteem was present at 12 months. Control at-risk students significantly decreased their body weight, whereas the weight of the intervention at-risk students significantly increased. The intervention program was effective, safe, having no effect on measures of students' anxiety or depression, and was rated highly by students. DISCUSSION: This is the first controlled educational intervention to successfully improve body image and to produce long-term changes in the attitudes and self-image of young adolescents. This new approach to prevent the development of eating disorders by improving self-esteem may be effective, particularly if reinforced by teachers and family.     

A randomized multifactorial intervention study for prevention of ischaemic heart disease (Inter99): the long-term effect on physical activity

AIM: To examine the effect of a randomized multiple risk factor intervention study for prevention of ischaemic heart disease (IHD) on the development in physical activity over a 36-month period. METHODS: Two random samples (high intensity intervention, group A, n=11,708; low intensity intervention, group B, n=1,308) were invited for a health examination, an assessment of absolute risk of developing IHD, and an individualized lifestyle intervention. The participation rate was 52.5%. High-risk persons in group A were also offered diet/physical activity and/or smoking cessation group counselling. High-risk persons in group B were referred to their GP. High-risk persons were re-counselled after 12 and 36 months. The control group (group C, n=5,264, response rate=61.3%) answered a mailed questionnaire. Data were analysed using longitudinal linear regression models with random effects. MAIN OUTCOME: Change in physical activity from baseline to 12-and 36-month follow-up. RESULTS: In men, the high-intensity (group A) intervention had a beneficial effect at 12-month follow-up, whereas after 36 months both the high-intensity and the low-intensity (group B) intervention had a beneficial effect on the development in physical activity when compared with group C. This was regardless of baseline physical activity level. At 36-month follow-up there was no significant difference between groups A and B. There was no intervention effect among women. CONCLUSIONS: Only men seemed to benefit from the intervention.     

Position of the American Dietetic Association: individual-, family-, school-, and community-based interventions for pediatric overweight

The American Dietetic Association (ADA), recognizing that overweight is a significant problem for children and adolescents in the United States, takes the position that pediatric overweight intervention requires a combination of family-based and school-based multicomponent programs that include the promotion of physical activity, parent training/modeling, behavioral counseling, and nutrition education. Furthermore, although not yet evidence-based, community-based and environmental interventions are recommended as among the most feasible ways to support healthful lifestyles for the greatest numbers of children and their families. ADA supports the commitment of resources for programs, policy development, and research for the efficacious promotion of healthful eating habits and increased physical activity in all children and adolescents, regardless of weight status. This is the first position paper of ADA to be based on a rigorous systematic evidence-based analysis of the pediatric overweight literature on intervention programs. The research showed positive effects of two specific kinds of overweight interventions: a) multicomponent, family-based programs for children between the ages of 5 and 12 years, and b) multicomponent, school-based programs for adolescents. Multicomponent programs include behavioral counseling, promotion of physical activity, parent training/modeling, dietary counseling, and nutrition education. Analysis of the literature to date points to the need for further investigation of promising strategies not yet adequately evaluated. Furthermore, this review highlights the need for research to develop effective and innovative overweight prevention programs for various sectors of the population, including those of varying ethnicities, young children, and adolescents. To support and enhance the efficacy of family- and school-based weight interventions, community-wide interventions should be undertaken; few such interventions have been conducted and even fewer evaluated.     

Self-reported health, perceived racial discrimination, and skin color in African Americans in the CARDIA study

This study investigates the association between self-reported physical and mental health and both perceived racial discrimination and skin color in African American men and women. We used data from the longitudinal coronary artery risk development in young adults study (CARDIA) in African American men and women (n=1722) in the USA. We assessed self-reported mental and physical health status and depressive symptoms at the Year 15 (2000-2001) follow-up examination using the Medical Outcomes Study Short Form (SF-12) and the Center for Epidemiologic Studies Depression scale. Skin color was measured at the Year 7 examination (1992-1993). To assess racial discrimination, we used a summary score (range 0-21) for 7 questions on experiencing racial discrimination: at school, getting a job, getting housing, at work, at home, getting medical care, on the street or in a public setting. Self-reported racial discrimination was more common in men than in women (78.1% versus 73.0%, p<0.05) and in those with higher educational attainment, independent of gender. Discrimination was statistically significantly associated with worse physical and mental health in both men and women, before and after adjustment for age, education, income, and skin color. For example, mental health (0-100 scale) decreased an average of 0.29 units per unit increase in racial discrimination score in men; this became 0.32 units after adjustment. There was no association between self-reported physical and mental health and skin color. Further studies of the health consequences of discrimination will require investigation of both the upstream determinants of discrimination and the downstream mechanisms by which perceived discrimination affects health outcomes.