Adherence to the Mediterranean diet and weight status in children: the role of parental feeding practices

Abstract

The study examines Parental Feeding Practices (PFP) in relation to adherence to the Mediterranean Diet (MD) and children’s weight status. It’s a cross-sectional study of 402 parents (68.4% mothers), with children aged 2–12 years. Parents completed the Comprehensive Parental Feeding Questionnaire and the Mediterranean Diet Quality Index for children and adolescents (KIDMED), evaluating children’s adherence to the MD. Logistic regression showed that in children aged 2–<6 years, “emotion regulation/food as reward” and “pressure” decrease MD adherence (OR?=?0.186, p?<?0.0001 and OR?=?0.496, p?=?0.004), and “monitoring” decrease excess body weight (OR?=?0.284, p?=?0.009). In older children (6–12 years), “healthy eating guidance” and “monitoring” increase MD adherence (OR?=?3.262, p?=?0.001 and OR?=?3.147, p?<?0.0001), “child control” decreases MD adherence (OR?=?0.587, p?=?0.049), “pressure” decrease excess body weight (OR?=?0.495, p?<?0.0001) and “restriction” increase excess body weight (OR?=?1.784, p?=?0.015). “Healthy eating guidance” and “monitoring” seem to be the best PFP employed, in terms of children’s MD adherence and weight status.     

Association between intimate partner violence and HIV status among Haitian Women

ABSTRACT

The prevalence of intimate partner violence (IPV) among women living in Haiti increased from 25% in 2006–29% in 2012, with escalating reports of crisis in the last several years. We examined the association between IPV and HIV status among these women in Haiti. Participants were drawn from a larger sample of women (n?=?513) with a history of IPV. Women living with HIV (n?=?55) were matched to uninfected women (n?=?110) to form a control group. Attitudes towards gender roles, mental and physical well-being, and partner violence were assessed and compared. Logistic regressions were utilised to calculate multivariable-adjusted odds ratios. Women living with HIV were more likely to report more severe forms of psychological violence (p?<?0.01), and severe physical violence (p?<?0.0001). Women who experienced severe forms of IPV were 3.5 times more likely to have an HIV positive status compared to those who did not experience severe IPV (p?<?0.0001). There were significant associations between severe forms of IPV, and HIV status among Haitian women. IPV severity should be integrated into eligibility screening for biomedical strategies of prevention such as pre-exposure prophylaxis (PrEP) among Haitian women.     

Determinants of HIV/AIDS Risk Behaviors in Expectant Fathers in Haiti

Haiti has an HIV/AIDS epidemic of the highest magnitude outside of sub-Saharan Africa. Factors such as relationship power imbalances, traditional gender role acceptance, and patriarchal belief systems that devalue women's sexuality have increased Haitian women's vulnerability to HIV infection. Because of these influences and since the HIV epidemic is largely heterosexually transmitted, it is important to understand the role that men's beliefs and behaviors play in the continuing risk of young men and women in Haiti. The purpose of this study was to gather information from male community members through semi-structured interviews in order to describe the prevalence of HIV/AIDS risk behaviors (e.g., condom use, number of sexual partners) among expectant fathers in Haiti and identify predictive psychosocial variables of HIV/AIDS risk behaviors. Results from this study showed that men who were not married (OR = 0.22, p = 0.05) and men who had medium (OR = 22.50, p < 0.001) and high sexual communication (OR = 36.51, p < 0.001) were more likely to use condoms. This study also showed that high stigma associated with HIV (OR = 16.07, p < 0.05), low HIV knowledge (OR = 0.10, p < 0.01), and high decision making power (OR = 62.52, p < 0.001) were predictors of multiple sex partners for the expectant fathers in the sample. HIV prevention programs should be designed to increase knowledge about HIV transmission, treatment, prevention and personal risk of contraction as well as correct misconceptions about individuals with HIV or AIDS and promote sex communication among partners.Magee and Kershaw are with the Department of Epidemiology and Public Health, Yale University, New Haven, CT, USA; Small is with the Department of Maternal Fetal Medicine, Yale University, New Haven, CT, USA; Frederic and Joseph are with the Hoˆ pital Albert Schweitzer, Deschappelles, Haiti; Joseph is with the Department of Health Administration and Public Health, Universite de Montreal, Montreal, Canada.     

Patterns of E-Cigarette Use Among Primary Care Patients at an Urban Community Center

Tobacco use remains the leading cause of preventable disease and death in the US. The number of tobacco products has grown over the past decade. E-cigarette use has increased rapidly in recent years, but patterns and correlates of use have not been thoroughly assessed. We examined relationships among demographic factors, e-cigarette and conventional cigarette use in a large sample (N?=?12,409) of adult patients at a community health center in the Northeastern US. Overall, 13% (N?=?1675) of the sample reported ever using e-cigarettes. In logistic regression models, ever having used e-cigarettes was associated with younger age (ages 18–25; OR?=?3.5, p?<?0.001). Being transgender (OR?=?1.8, p?<?0.001), bisexual (OR?=?1.5, p?<?0.001), un-partnered (OR?=?1.5, p?<?0.001), having a lower income (OR?=?1.6, p?<?0.001) or a high BMI (OR?=?1.4, p?=?0.009) were associated with increased odds of use, whereas being a woman (OR?=?0.7, p?<?0.001) or Black/African American (OR?=?0.7, p?=?0.007) were associated with lower odds of use. Of the participants who reported e-cigarette use, a majority also endorsed current or former use of conventional cigarettes. Individuals who formerly used conventional cigarettes were nearly three times more likely to report daily e-cigarette use than current users. Among primary care patients at a community health center, e-cigarette use was reported by a sizeable portion of the sample. Overall, odds of use were higher in certain patient populations, and individuals who formally used cigarettes were more likely to report e-cigarette use than individuals who currently smoke, suggesting that e-cigarettes may be functioning as a cessation aid or a strategy to reduce conventional cigarette use.

     

A comprehensive programme to strengthen adherence to antiretroviral drug therapy and achieve virological control in HIV infected children in Thailand

Abstract

As antiretroviral treatments begin to reach HIV-infected children in developing countries, there is an urgent need to develop and document effective and feasible strategies to optimize adherence in children. A comprehensive adherence programme, including ongoing HIV education and care training for children and caregivers, was established in Chiang Rai Hospital, Thailand. One hundred and ten treatment-naïve children, median age 9 years, initiated therapy and participated in this programme between February 2002 and January 2004. Ninety per cent of children during the first 6 months of therapy and 87% during the following 6 months adhered to over 95% of the scheduled drug intakes (pill count). Children over 9 years old and children cared for by grandparents were less likely to be adherent (p?=?0.11). In a subset of patients with available viral load measurements, lack of adherence (p?=?0.001 and 0.04 at 6 and 12 months, respectively), and irregular attendance to training for children and caregivers were associated with failure to control viral load below 400 copies/ml. No single intervention was associated with strict adherence sustained over time. These results support the need for a comprehensive and long-term approach using multiple tools and educational/support activities to maintain optimal adherence.     

Neurodevelopment and growth of institutionalized children with vertically transmitted human immunodeficiency virus

Human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) in sub-Saharan Africa has resulted in millions of children being infected with the virus and/or orphaned as a consequence of the virus. This is compounded by the fact that this area also has a high incidence of poverty, limited basic resources and malnutrition. Because HIV is both neurotrophic and lymphotrophic, infected children are at risk of developmental delays and growth impairments. Limited height-for-age (stunting) is a commonly reported finding. The objective of this study was to compare the neurodevelopment and anthropometric measurements of vertically infected HIV children not on antiretroviral treatment and HIV-uninfected children, as well as changes within the groups over 6–8 months. A comparative longitudinal study was conducted of 16 HIV-infected and 24 HIV-uninfected children between the ages of 16 and 42 months. The study sample was derived from two institutions in Gauteng, South Africa. Bayley Scales of Infant Development II were used to evaluate the children's mental and motor development. Growth was assessed using mean Z-scores for weight-for-age, height-for-age, weight-for-height and head circumference-for-age. Evaluations were carried out at two time-points, 6–8 months apart. The results showed that HIV-infected children scored significantly lower than HIV-uninfected children at both time-points in neurodevelopment (mental developmental index p < 0.02 and p < 0.00; psychomotor developmental index p < 0.00 and p < 0.00) and also in anthropometric measurements (weight p < 0.00 and p < 0.01; height p < 0.00 and p < 0.00; head circumference p < 0.00 and p < 0.07). It is concluded that HIV affects the neurodevelopment (both mental and motor) and growth of HIV-infected children, particularly height-for-age.     

Vitamin D insufficiency in obese children and relation with lipid profile

Abstract

Vitamin D (25OHD) deficiency is reported in obese children. Low 25OHD levels are associated with dyslipidemia and increased risk of cardiovascular complication in adulthood. Within an observational study, 120 obese subjects in pediatric age were enrolled: 59 had 25OHD <20?ng/ml (group A) while 61 had 25OHD >20?ng/ml (group B). Group A versus Group B showed elevated total cholesterol (TC), p?=?0.017, low-density lipoprotein cholesterol (LDL-C), p?=?0.045, and parathormone (PTH), p?=?0.008. Apolipoprotein B (ApoB) showed a similar trend, p?=?0.074. Negative correlations were found between 25OHD and the following parameters: TC (ρ?=??0.22, p?=?0.01), LDL (ρ?=??0.22; p?=?0.03), ApoB (ρ?=??0.20; p?=?0.03), and PTH (ρ?=??0.33, p?=?0.003). No differences in High Lipoprotein Cholesterol (HDL-C) were found. In multivariate regression the most powerful predictor for explaining 25OHD variation were TC (p?=?0.048) and PTH (p?=?0.055). Within a pediatric obese population an association between 25OHD low levels and unfavourable lipid patterns has been found.     

Changing social and HIV/AIDS risk behaviours: Effects of life skills education among urban street youths

Abstract

The objective of this study was to examine the effect of a life skills education intervention among male and female youth in Ibadan, Nigeria, on knowledge about prevention and safe sexual practices, sexual roles and responsibilities, HIV/AIDS, money management, assertiveness and communication through follow-up interviews four weeks and eight weeks following the intervention. The participants were 98 males and females, and part of an initial survey of social and health problems of street youths in Ibadan, Nigeria. They were locality-separated, with consecutive assignments to two groups of experimental (n?=?54, exposure to a manual driven life skills education) and control (n?=?44, non-exposure to life skills education, but attention given) participants, and evaluated subsequently at four weeks and then at eight-week follow-ups. At the four-week post-intervention assessment, the experimental group showed significantly increased scores in the knowledge of antisocial behaviour prevention (p < 0.01), about HIV/AIDS (p < 0.001), about safe sexual practices (p < 0.001), about social roles and responsibilities and about assertiveness and communication (p < 0.01). At eight-week follow-up assessment, substantial significant reductions in reported antisocial and unsafe sexual behaviours were observed across the experimental group compared with the control group. The results suggest that street youths can be empowered through life skills education but with limitation to safe sexual practices over a sustained period of time in Nigeria.     

Disclosure of parental HIV/AIDS to children in rural China

Abstract

The purpose of this study is to examine the complex issue of disclosure of parental HIV/AIDS to children in rural China. Semi-structured interviews were conducted with children affected by HIV/AIDS aged 8–17 (n?=?16), their caregivers (n?=?16) and key informants in the community (n?=?5). Findings showed that most children were shielded from knowing the HIV/AIDS status of their parents, although many children may have drawn their own conclusions through observation or sources outside the family. Caregivers felt discouraged and hesitated to discuss parental HIV/AIDS with children due to societal stigma and lack of knowledge and skills. Interventions are needed to improve caregivers' skills to communicate about HIV/AIDS with children. Interventions are also needed to reduce the stigma and discrimination towards people living with HIV/AIDS and their families.     

Factors associated with young people's attendance at an IPV prevention intervention in informal settlements in South Africa: A prospective analysis

ABSTRACT

Understanding factors shaping attendance at behavioural interventions is critical for programmatic planning. Through the Stepping Stones and Creating Futures intervention trial amongst young (18-30) women and men to reduce intimate partner violence and strengthen livelihoods, we prospectively assessed factors associated with intervention attendance. Baseline data were collected between September 2015 and September 2016 among 677 women and 675 men. For women, in multinomial models, compared to high attenders, medium (β?=??0.04, p?=?0.001) and low (β?=??0.05, p?=?0.003) attenders had lived less time in the community, medium attenders were more likely to have children (β?=?0.97, p?=?0.001), and low attenders had less gender-equitable attitudes (β?=??0.57, p?=?0.035). For men, in multinomial models, compared to high attenders, medium attenders were more likely to have completed secondary school (β?=?1.48, p?=?0.011) and to have worked in the past three months (β?=?0.64, p?=?0.021). Low attenders had lived for a shorter period in the community (β?=??0.06, p?=?0.005), and were more likely to have worked in the past three months (β?=?0.66, p?=?0.041) compared to high attenders. Attendance was shaped by structural factors, and gender-specific factors, and these need to be incorporated into future interventions.     

Relationship Between B-Vitamin Biomarkers and Dietary Intake with Apolipoprotein E є4 in Alzheimer’s Disease

Abstract

The potential for B-vitamins to reduce plasma homocysteine (Hcy) and reduce the risk of Alzheimer’s disease (AD) has been described previously. However, the role of Apolipoprotein E ?4 (APOE4) in this relationship has not been adequately addressed. This case-control study explored APOE4 genotype in an Australian sample of 63 healthy individuals (female?=?38; age?=?76.9?±?4.7 y) and 63 individuals with AD (female?=?35, age?=?77.1?±?5.3 y). Findings revealed 55 of 126 participants expressed the APOE4 genotype with 37 of 126 having both AD and the APOE4 genotype. Analysis revealed an increased likelihood of AD when Hcy levels are >11.0 µmol/L (p?=?0.012), cysteine levels were <255?µmol/L (p?=?0.033) and serum folate was <22.0?nmol/L (p?=?0.003; in males only). In females, dietary intake of total folate <336 µg/day (p=0.001), natural folate <270?µg/day (p?=?0.011), and vitamin B2?<?1.12?mg/day (p?=?0.028) was associated with an increased AD risk. These results support Hcy, Cys, and SF as useful biomarkers for AD, irrespective of APOE4 genotype and as such should be considered as part of screening and managing risk of AD.     

HIV-infected pregnant adolescents and youth: results from a European cohort study

Abstract

Globally the HIV epidemic mainly affects young people, particularly young females who are vulnerable to acquisition of HIV as a result of their biological and social susceptibility. Women represent an increasing proportion of newly diagnosed HIV cases in Western and Eastern Europe, reaching 35% and 40%, respectively, in 2004. In the European Collaborative Study (ECS), HIV-infected pregnant women are enrolled and their infants followed-up prospectively. By the end of 2005, 5956 women had enrolled, of whom 1912 (32%) were aged?<?25 years at delivery. Enrolments of youth declined in Western European centres from 59% in 1985 to 18% in 2005. In Ukraine, youth enrolments declined from 52% in 2001 to 43% in 2005. Median ages of the young and older sub-cohorts were 22.3 and 29.9 years, respectively. Injecting drug use (IDU) was more common in the older than younger sub-cohorts [42% (n?=?1684) vs. 35% (n?=?675), p?<?0.001]. However, young IDUs were more likely to be currently using injecting drugs than older IDUs (59% vs. 38%, p?<?0.001), to report current sharing of injecting equipment (22% vs. 13%, p?=?0.001) and to report an IDU sex partner (59% vs. 48%, p?<?0.02). Young HIV-infected pregnant women in Europe are a heterogeneous group, possibly less identifiable as being at risk of HIV infection. They will have diverse needs for services during and after pregnancy, including harm reduction services and psychosocial support, in addition to a universal need for prevention of mother-to-child transmission services.     

Promotion of physical activity in primary care: knowledge and practice of general practitioners and physiotherapists

Aim

Being physically active has many proven health benefits and promoting physical activity to patients in primary care is an important component of public health programmes. This study examined the knowledge and practices of general practitioners and physiotherapists in the promotion of physical activity in primary care.

Subject and methods

A cross-sectional population survey was conducted in Ireland to establish participants’ knowledge of physical activity guidelines and current practice in the promotion of physical activity. A total of 342 general practitioners (response rate 65 %; n?=?543) and 89 physiotherapists (response rate 88 %; n?=?101) responded to the survey.

Results

More physiotherapists (50.5 %; n?=?45) than general practitioners (28 %; n?=?97) correctly reported the minimal physical activity guidelines (X²?=?16.56, p?<?.005, df?=?1). General practitioners reported screening physical activity opportunistically (41 %; n?=?139) and when related to a patient’s presenting complaint (37 %; n?=?126). Physiotherapists reported screening physical activity routinely (34 %; n?=?30) and when related to the presenting complaint (28 %; n?=?25). With the exception of overweight patients, general practitioners were more likely than physiotherapists to promote physical activity to patients with known cardiovascular risk factors such as hypertension (X²?=?49.65, p?<?.001, df?=?2) and hypercholesterolemia (X²?=?32.58, p?<?.001, df?=?2). Physiotherapists, however, were more likely to promote physical activity to healthy populations (X²?=?9.91; p?<?.01, df?=?2). Education and advice was the intervention most frequently used (general practitioners 76 %; n?=?258, physiotherapists 97 %; n?=?86).

Conclusion

Despite high levels of awareness of physical activity promotion amongst general practitioners and physiotherapists, there is scope to improve physical activity promotion particularly to healthy populations and ongoing challenges to incorporate evidence based interventions into routine care.     

The Val34Leu genetic variation in the A Subunit of Coagulation Factor XIII in recurrent spontaneous abortion

The present study was carried out to assess the frequencies of factor XIII (FXIII) Val34Leu genetic variation in the patients with recurrent spontaneous abortion and healthy fertile women of Azeri Turkish origin. A total of 54 patients with recurrent spontaneous abortion and 46 healthy fertile women as controls were studied for the FXIII Val34Leu genetic variation by a RFLP-PCR method. Statistical analysis showed that patients (χ²?=?2.4, p value?=?0.292) and controls (χ²?=?1.035, p value?=?0.596) were in agreement with Hardy-Weinberg equilibrium. The Leu allele frequency was 0.18 and 0.13 in patients and controls, respectively. FXIII Leu34Leu (homozygous for 34Leu) genotype was not found in patients and controls. FXIII Val/Leu and Val/Val genotype frequencies were 19 (35.19%) and 31 (64.81%) in patients and 12 (26.09%) and 34 (73.91%) in controls, respectively. FXIII 34Leu allele and Val34Leu genotypes were more common in the case group containing individuals with unexplained RSA but the differences of FXIII Val34Leu (G/T genotype) (odds ratio?=?0.65 (0.25?<?OR?<?1.67) corresponding to 95% CI, χ²?=?0.96, p value?=?0.32) and FXIII 34Leu (T allele) (odds ratio?=?0.70 (0.30?<?OR?<?1.64) corresponding to 95% CI, χ² ₌ 0.78, p value?=?0.37) was not statistically significant. These results suggest that factor XIII Val34Leu genetic variation is not associated with recurrent spontaneous abortion.     

Persistent misconceptions about HIV transmission among males and females in Malawi

Background

The prevalence of HIV in Malawi is one of the highest in sub-Saharan Africa, and misconceptions about its mode of transmission are considered a major contributor to the continued spread of the virus.

Methods

Using the 2010 Malawi Demographic and Health Survey, the current study explored factors associated with misconceptions about HIV transmission among males and females.

Results

We found that higher levels of ABC prevention knowledge were associated with lower likelihood of endorsing misconceptions among females and males (OR?=?0.85, p?<?0.001; OR?=?0.85, p?<?0.001, respectively). Compared to those in the Northern region, both females and males in the Central (OR?=?0.54, p?<?0.001; OR?=?0.53, p?<?0.001, respectively) and Southern regions (OR?=?0.49, p?<?0.001; OR?=?0.43, p?<?0.001, respectively) were less likely to endorse misconceptions about HIV transmission. Moreover, marital status and ethnicity were significant predictors of HIV transmission misconceptions among females but not among males. Also, household wealth quintiles, education, religion, and urban–rural residence were significantly associated with endorsing misconceptions about HIV transmission.

Conclusion

Based on our findings, we recommend that education on HIV transmission in Malawi should integrate cultural and ethnic considerations of HIV/AIDS.

     

Serum levels of phytoestrogens as biomarkers of intake in Mexican women

Abstract

Phytoestrogens have generated interest in human health in view of their potential effect to reduce the risk of developing chronic diseases. Serum levels of phytoestrogens have been proposed as an alternative to measure the exposure of phytoestrogens. We evaluated the use of serum as a biomarker of phytoestrogen’s intake in healthy women. Phytoestrogens in serum (luteolin, kaempferol, equol, biochanin A, formononetin, quercetin, naringenin, coumestrol, secoisolariciresinol, genistein, matairesinol, enterolactone, enterodiol, daidzein, glycitein and resveratrol) were analyzed by HPLC-ESI-MS. Subjects were asked to recall all foods and beverages consumed the previous 24 h. Association of dietary intake and serum concentrations was performed by Spearman correlation. Correlations were found for naringenin (r?=?0.47, p?<?0.001), luteolin (r?=?0.4 p?<?0.001), genistein (r?=?0.32, p?<?0.01) enterolactone (r?=?0.35, p?=?0.0553), coumestrol (r?=?0.26, p?=?0.0835) and resveratrol (r?=?0.29, p?=?0.0517). Serum levels as biomarkers of intake along with a 24-h recall would be useful in order to investigate the relationship between phytoestrogens and health.     

Construct Validity of the Mealtime Scan: A Secondary Data Analysis of the Making Most of Mealtimes (M3) Study

Long-term care (LTC) physical and psychosocial mealtime environments have been inconsistently assessed due to the lack of a standardized measure. The purpose of this study was to examine the construct validity of a new standardized observational measure, the Mealtime Scan (MTS), using the Making Most of Mealtimes data collected on 639 residents in 82 dining rooms in 32 LTC homes. The MTS includes physical, social, and person-centered care summary scales scored from 1 to 8. Mean ratings on these summary scales were moderate for physical (5.6 SD 0.9), social (5.0 SD 0.9), and person-centered care (PCC; 5.5 SD 0.8). Regression analyses determined which items within the MTS were associated with these summary scales: physical – music (B?=?0.27, p?=?0.04), number of staff passing food (B?=??0.11, p?=?0.03), number of residents (B?=??0.03, p?=?0.01); social – social sound (B?= 0.31 p?p?=?0.02); PCC – lighting (B?=?0.01 p?=?0.04), and total excess noise (B?=?0.05, p?相似文献   

Emotional Development and Nutritional Status of HIV/AIDS Orphaned Children Aged 6–12 Years Old in Thailand

Objective To explore the emotional development and nutritional status of HIV/AIDS orphans by their infection status. Methods A community-based cross-sectional survey was conducted during January and December 2005 in four provinces and Bangkok Metropolis where the prevalence of HIV/AIDS among pregnant women was high. The study population consisted of 388 HIV/AIDS orphans who were maternal or paternal or double orphans aged 6–12 years old. The orphans’ main caregivers gave informed consent to the project and assessed the emotional development of their orphaned children. The children were measured for weight, height, and emotional development by standard instruments. They were divided into three groups regarding their HIV/AIDS infection status reported by their caregivers: infected, non-infected, and unknown. The χ² test was used to determine the association between nutritional status and infection status. Results Regarding HIV/AIDS infected children, 19.1% were infected, 57.5% were not infected, and 23.4% were unknown. The main caregivers of all types of orphans were grandparents. Only 13.7% of infected orphans lived with their mothers. Most caregivers were females and more than 40 years old. Infected orphans had mean scores of overall emotional development and for each domain less than other groups. The mean scores of self-control and quick recovery were significantly different between infected and non-infected groups (P-value < 0.05). Nearly 50% of infected orphans were rather short and approximately 42% were under weight and light. The findings revealed a significant association between height for age, weight for age and infection status of orphans at a P-value of <0.001. Conclusions Orphanhood itself is a vulnerable status and HIV/AIDS infected orphans are most vulnerable. Acceptable and friendly services for orphans and their families are crucial. The services should continue and protect stigmatization.