Feeding and nutritional characteristics in children with moderate or severe cerebral palsy

This study was undertaken to characterize the current feeding situation and nutritional status of moderately or severely disabled children with cerebral palsy (CP). Thirty-five children with CP (17 with diplegia, 11 with dystonia, 6 with tetraplegia and one child with ataxia) were investigated at a median age of 8 years. Information was obtained from parental interviews, medical records and clinical and anthropometric examinations. Twenty-one of the 35 children (60%), most of whom were severely disabled, were reported by the parents to have current feeding problems. Anthropometric indicators of undernutrition were found in 15 children (43%) and of overnutrition in 3 children (9%), compared with reference values of healthy children. Severely disabled children in the youngest age group were most at risk for poor nutritional status. Early identification of children at nutritional risk requires regular assessments of feeding skills and nutritional status.     

汉族青年人中形态的测量及其意义

目的　对通过测量国人汉族青年人中形态所获得的有关数据进行分析 ,探讨人中形态的意义。方法　随机抽取 19～ 2 1岁的 2 0 0例汉族青年 ,观察其人中角形态 ,用游标卡尺测量人中嵴和人中凹的长度及人中凹的宽度、人中凹的深度。结果　将汉族青年的人中角形态分为凹、平、突三种类型。测得人中的各值为 ,人中嵴长度 :女性为(13.2 8± 2 .0 9)mm ,男性为 (13.80± 2 .12 )mm ;人中凹长度 :女性为 (14 .89± 2 .31)mm ,男性为 (15 .12± 2 .2 7)mm ;人中凹上部宽度 :女性为 (5 .2 8± 1.0 2 )mm ,男性为 (6 .2 3± 1.0 6 )mm ;人中凹中部宽度 :女性为 (6 .86± 1.2 0 )mm ,男性为 (7.5 2± 1.10 )mm ;人中凹下部宽度 :女性为 (11.2 4± 1.5 5 )mm ,男性为 (11.95± 1.6 2 )mm ;人中凹深度 :女性为(1.89± 1.0 1)mm ,男性为 (2 .12± 1.0 3)mm。结论　汉族青年的人中角以凹型占多数 ,平型次之 ,凸型最少。人中嵴长度左右对称。男女之间人中形态有差异 ,男性人中凹宽度大于女性     

Relationship between changes in neck circumference and cardiovascular risk factors

OBJECTIVE: Neck circumference (NC) is a simple screening measure for identifying overweight and obese patients. The main aim of the present study was to determine the relationship between changes in NC and changes in cardiovascular risk factors by evaluating some components of the metabolic syndrome. METHODS: The present longitudinal cohort study included 364 subjects (155 men and 209 women) with no known major medical conditions and who were not receiving any medication. Main indicators included NC, waist circumference, waist-to-hip ratio, body mass index, and fasting lipoprotein, glucose and uric acid levels. RESULTS: Pearson's correlation coefficients indicated a significant association between changes in NC and changes in body mass index (men, r=0.67; women, r=0.69; each, P<0.0001), waist circumference (men, r=0.69; women, r=0.56; each, P<0.0001), waist-to-hip ratio (men, r=0.27; women, r=0.33; each, P<0.0001), and total cholesterol (men, r=0.68; women, r=0.64; each, P<0.0001), low density lipoprotein cholesterol (men, r=0.58; women, r=0.59; each, P<0.0001), triglyceride (men, r=0.48; women, r=0.44; each, P<0.0001), glucose (men, r=0.51; women, r=0.44; each, P<0.0001) and uric acid (men, r=0.42; women, r=0.47; each, P<0.0001) levels. The relative changes in NC contributed to independent significant changes in total cholesterol (8% for men and 1% for women), low density lipoprotein cholesterol (1% for men and 1% for women) and triglycerides (23% for men); it did not significantly contribute to changes in high density lipoprotein cholesterol, glucose or uric acid levels. CONCLUSION: Changes in NC are positively correlated with changes in some factors of the metabolic syndrome and, therefore, are correlated with changes in the risk of cardiovascular disease.     

Development of anthropometry-based equations for the estimation of the total body water in Koreans

For developing race-specific anthropometry-based total body water (TBW) equations, we measured TBW using bioelectrical impedance analysis (TBW(BIA)) in 2,943 healthy Korean adults. Among them, 2,223 were used as a reference group. Two equations (TBW(K1) and TBW(K2)) were developed based on age, sex, height, and body weight. The adjusted R2 was 0.908 for TBW(K1) and 0.910 for TBW(K2). The remaining 720 subjects were used for the validation of our results. Watson (TBW(W)) and Hume-Weyers (TBW(H)) formulas were also used. In men, TBW(BIA) showed the highest correlation with TBW(H), followed by TBW(K1), TBW(K2) and TBW(W). TBW(K1) and TBW(K2) showed the lower root mean square errors (RMSE) and mean prediction errors (ME) than TBW(W) and TBW(H). On the Bland-Altman plot, the correlations between the differences and means were smaller for TBW(K2) than for TBW(K1). On the contrary, TBW(BIA) showed the highest correlation with TBW(W), followed by TBW(K2), TBW(K1), and TBW(H) in females. RMSE was smallest in TBW(W), followed by TBW(K2), TBW(K1) and TBW(H). ME was closest to zero for TBW(K2), followed by TBW(K1), TBW(W) and TBW(H). The correlation coefficients between the means and differences were highest in TBW(W), and lowest in TBW(K2). In conclusion, TBW(K2) provides better accuracy with a smaller bias than the TBW(W) or TBW(H) in males. TBW(K2) shows a similar accuracy, but with a smaller bias than TBW(W) in females.     

Is craniofacial dysmorpholgy correlated with structural brain anomalies in schizophrenia?

This study aimed to examine the relationship between craniofacial dysmorphology and anomalies of brain morphology in schizophrenia. Assessments of craniofacial dysmorphology and magnetic resonance imaging of brain were performed independently of each other and blind to each other in 24 males with schizophrenia and 16 male controls. Ventricular cerebrospinal fluid volume was negatively correlated with total dysmorphology score in males with schizophrenia (i.e., the larger the ventricular cerebrospinal fluid volume, the lower the total dysmorphology score) but not in male controls. These findings suggest that craniofacial dysmorphology and anomalies of brain morphology may be associated with independent processes in the etiology of schizophrenia.     

Influence of anthropometric parameters on the body composition measured by bioelectrical impedance analysis or DXA in children

Aim: To investigate the influence of anthropometric measures (skinfold thicknesses, girths, lengths and breadths/lengths) on (1) the whole body impedance and impedance index and (2) the body fat mass measured by means of DXA in children. Methods: Nine skinfolds, 13 girths, eight lengths and eight breadths/lengths were measured in 26 boys and 27 girls, 11-12 y of age. The somatotype components—endomorphy, mesomorphy and ectomorphy—were assessed according to the method of Carter and Heath. Body impedance at 50 kHz was measured (Multiscan 5000, Bodystat Ltd, UK) and impedance index (height ² /impedance) was calculated. Four body components—total body fat mass and separate hands, legs and trunk fat mass—were determined using DXA. Results: Skinfold thicknesses did not influence body impedance or impedance index according to stepwise multiple regression analysis. Impedance index was influenced more by the girth measures than was body impedance. The leg length measures highly influenced the impedance index (50-81%, R ²  × 100). Different breadth/length parameters influenced body impedance and body impedance index (21-49%). Mesomorphy influenced body impedance only in boys (35%). Body fat mass measured by DXA was highly dependent on the measured skinfold thicknesses (59-92%). The influence of lengths and breadths/lengths on the total fat mass was significant (25-49%). Endomorphy characterized total fat mass as 86% and 52% in boys and girls, respectively.

Conclusion: Variation in anthropometry highly determined the variance observed in impedance in children, and the girths were the best predictors of impedance. Selected skinfold thicknesses highly predicted fat mass measured by DXA for total body, trunk, arms and legs.     

BMI-referenced standards for recommended pedometer-determined steps/day in children

BACKGROUND: Recommended levels of youth physical activity (PA) should emerge from data related to important health outcomes. The purpose of the present study was to establish criterion-referenced standards for PA (using pedometer-assessed steps/day) related to healthy body composition. METHODS: This is a secondary analysis of an existing data set (including pedometer-assessed PA and objectively measured BMI) of 1,954 children (995 girls, 959 boys; ages 6-12 years) from the USA, Australia, and Sweden. The contrasting groups method [M.J. Sarif, Introduction to Measurement in Physical Education and Exercise Science, St. Louis, MO: Mosby College Publishing; 1986] for establishing criterion-referenced cut points was used to identify optimal age- and sex-specific standards for steps/day related to international BMI cut points for normal weight and overweight/obesity. RESULTS: The selected cut points for steps/day for 6-12 year olds were 12,000 steps/day for girls and 15,000 steps/day for boys. CONCLUSIONS: The analytical process undertaken in this study illuminated the difference in previously used norm-referenced standards vs. criterion-referenced standards based on BMI categories. The steps/day cut points established herein, using an international sample, are higher than previously suggested normative standards but are not inconsistent with recent advances in our understanding of PA needs in youth. This analysis provides the foundation for cross-validation and evaluation of these BMI-referenced steps/day cut points in independent samples and with longitudinal study designs.     

Intra-individual difference between recumbent length and stature among growing children

Objective Difference between recumbent length and stature in an individual has been observed by many researchers in the past in European and American populations. The present study explores the intra-individual differences between recumbent length and stature (R.L.-Stature).Methods: A sample of 920 school going children was considered in Chandigarh city.Result: These differences are found to be statistically significant and have definite relationship with age and weight of the children. The mean difference between recumbent length and stature is found to be greater in males than in females between 5 through 10 years and between 15 through 18 years of age. However, between 10 through 15 years, it was greater in females than in males.Conclusion: This was largely due to the fact that adolescent spurt in stature preceded by two to three years in girls than that of boys. This difference was also found to be significantly correlated with age, weight and stature in both the sexes. Two regression equations are derived separately for the two sexes, from which, one can convert recumbent length into stature and vice-versa     

Anthropometry and moderate malnutrition in preschool children

OBJECTIVE: For years it has been shown that more children die from moderate malnutrition (MM) than severe. Till yet few studies deal specifically with identifying these children. This study attempts to statistically determine the appropriate anthropometric measures and cut-off points for diagnosing moderate malnutrition in preschool children. METHODS: Anthropometric measurements were obtained from 609 preschool children from the cities of Adigrat, Ethiopia; Janampet, India; San Paulo, Brazil. The values were used to determine the sensitivity, specificity, positive predictive value (PPV) and likelihood ratio (LR) of each index studied. The optimum cutoff point for each index was considered to be the cutoff point with the maximum Kappa coefficient for efficiency. The McNemar Test for the significance of changes was used to determine if these findings were in agreement when applied to this data. RESULTS: Weight for height (WFH) at each site had the highest PPV and LR of 4 but was not signficant by the McNemar Test. Mid-upper arm circumference (MUAC) in India had the same PPV (77%) as WFH but a LR of 2. MUAC in India, Brazil and Ethiopia tested significantly for the McNemar Test. The cut-off point for MUAC in India and Brazil was determined to be <15.5 cm in India and Brazil but was <15 cm in Ethiopia. Waist circumference in India tested a significantly PPV of 64%, and a LR of 2. CONCLUSION: These results show that WFH and MUAC could be used with WFA to identify the MM child. The cut-off points for MUAC may vary per location. WC positive data suggests further study is warranted. The McNemar findings yielded significant evidence that statistically determined indicators can be established to identify MM. With further study these methods may prove to be an important component in the efforts to improve child survival.     

Marriage and mobility in Britain—Secular trends in a nationwide sample

A nationwide sample survey of 2338 married couples provides information on the birthplaces and residences at meeting of couples first married between 1920 and 1960. Four measures of marital mobility are analysed according to year of marriage and year of first meeting. In their original form all measures show the expected increase in mobility from the 1920s to the 1930s with an exceptionally steep rise in the 1940s and a decline after the Second World War. The role of the war in promoting migration both of civilians and of soldiers is briefly reviewed. Women show rather different migration patterns from those of men.

Age at marriage is positively correlated with movement in this sample, but a stronger association is provided by age at first meeting. Mobility averages for each cohort are adjusted for the changes in age at marriage, both real and peculiar to this sample, which have occurred since 1920, and also for variation in the population sizes of birthplaces in the sample over time, and changes in the relative frequencies of different socio-economic classes. After adjustment, little change is seen in material mobility over the four decades covered by the survey and many of the differences which do remain after adjustment lack statistical significance. Some socio-economic explanations are offered for these conclusions.