Influence of gender, BMI and Hispanic ethnicity on physical activity in children.

OBJECTIVE: The purpose of this study was to examine the association between overweight status and physical activity (PA) among gender and ethnic (Hispanic vs. non-Hispanic) sub-groups in elementary school-age children. METHODS: PA was assessed over five days using the Actigraph accelerometer in 169 fourth grade students (mean age 9.4 years; 50% female; 63% Hispanic; and 43% overweight, defined as body mass index, BMI > or = 85th percentile for age and gender) from four elementary schools in Los Angeles County, California. RESULTS: In the total sample, boys and normal weight students had higher levels of total PA (counts per minute, cpm; p<0.05). Boys spent less time in sedentary PA (p=0.02) and more time in combined moderate to vigorous PA (MVPA, p=0.01). There was a significant gender, ethnicity, and overweight interaction for total PA and MVPA (both p<0.01). MVPA and counts per minute were significantly lower in overweight non-Hispanic girls and Hispanic boys (p<0.05) and marginally lower in overweight non-Hispanic boys (p=0.10) when compared with non-overweight students, while overweight Hispanic girls were more physically active than Hispanic non-overweight girls, though the difference was non-significant (p>0.05). CONCLUSIONS: Data from the present study does not consistently support the prevailing hypothesis that overweight subjects engage in less PA. Results show overweight students engage in less PA than non-overweight students, with the exception that non-overweight Hispanic girls do not engage in more PA than their overweight peers. These results suggest the need for further investigation into the role that ethnicity and overweight status plays in PA levels, particularly among ethnic and gender sub-groups.     

A comprehensive view of sex-specific issues related to cardiovascular disease

Cardiovascular disease (CVD) is the leading cause of mortality in women. In fact, CVD is responsible for a third of all deaths of women worldwide and half of all deaths of women over 50 years of age in developing countries. The prevalence of CVD risk factor precursors is increasing in children. Retrospective analyses suggest that there are some clinically relevant differences between women and men in terms of prevalence, presentation, management and outcomes of the disease, but little is known about why CVD affects women and men differently. For instance, women with diabetes have a significantly higher CVD mortality rate than men with diabetes. Similarly, women with atrial fibrillation are at greater risk of stroke than men with atrial fibrillation. Historically, women have been underrepresented in clinical trials. The lack of good trial evidence concerning sex-specific outcomes has led to assumptions about CVD treatment in women, which in turn may have resulted in inadequate diagnoses and suboptimal management, greatly affecting outcomes. This knowledge gap may also explain why cardiovascular health in women is not improving as fast as that of men. Over the last decades, mortality rates in men have steadily declined, while those in women remained stable. It is also becoming increasingly evident that gender differences in cultural, behavioural, psychosocial and socioeconomic status are responsible, to various degrees, for the observed differences between women and men. However, the interaction between sex-and gender-related factors and CVD outcomes in women remains largely unknown.     

Perceptual variation in categorizing individual peripheral joints for the presence or absence of osteoarthritis using a standard homunculus: observations based on an australian twin registry study of osteoarthritis

The clinical diagnosis of osteoarthritis in the peripheral skeleton is dependent on the skilled examination of several features characteristic of the condition. However, we have previously observed that even highly experienced rheumatologists in Australia and Canada may not completely agree on the clinical examination in individuals with osteoarthritis (OA), rheumatoid arthritis, ankylosing spondylitis, fibromyalgia, scleroderma and painful shoulder.     

Optimal use of L-asparaginase (NSC-109229) in acute lymphocytic leukemia

Between 1971 and 1974, 646 evaluable patients under 20 years of age with previously untreated acute lymphocytic leukemia were treated according to Cancer and Leukemia Group B (formerly Acute Leukemia Group B) Protocol 7111. On a random basis, they received a 10-day course of 1,000 units/kg/day of L-asparaginase before, during, or after a 3-week course of vincristine and corticosteroid. A control group received vincristine and corticosteroid for 4 weeks but no asparaginase. The overall complete remission rate was 85%, which was not altered significantly by any of the induction variables. Patients who received asparaginase for 10 days subsequent to vincristine and corticosteroid had a significantly longer complete remission duration with an estimated median of 45 months, compared to 20 months for the group receiving no asparaginase and 27 months for the other 2 asparaginase regimens. The beneficial effect of asparaginase was noted, irrespective of which 1 of the 2 intensification and maintenance programs the patients received. The 5-year projection indicates a complete remission rate of 50% for those patients receiving subsequent asparaginase as compared to 41% of those induced on other regimens in this study and thus is superior to the use of only vincristine and corticosteroid.     

A trial comparing cefaclor with co-trimoxazole in the treatment of acute otitis media.

A prospective random double-blind controlled trial comparing the efficacy of cefaclor with that of co-trimoxazole in the treatment of otitis media was undertaken. Two hundred and twenty-three children aged 12 years or younger were studied. Both drugs were effective, with clinical cure or improvement in more than 90% of the children. The level of compliance was high and side effects few. Both co-trimoxazole and cefaclor can be considered safe and effective drugs for the treatment of acute otitis media.     

Neurozirkulatorische und biomechanische Übereinstimmung bei Counterstrain-Tenderpunkten an der unteren Extremität

In the field of osteopathic manipulative medicine, differentiating which manipulative method to apply requires the proper understanding of what the practitioner hopes to accomplish. The practitioner’s choice of manipulative methods should correspond to the neurocirculatory and biomechanical problem that underlies the somatic dysfunction. Classic counterstrain manipulative medicine approach requires the practitioner to press over anatomically consistent locations in the body to determine if somatic dysfunction is present. These specific areas where tenderness (nociceptive response) can be found are called tender point locations. To determine if tenderness is present, the practitioner presses the tissue with just enough force to blanch under their fingernail. In otherwise normal tissues, this force is not sufficient to elicit a tenderness response. However, a tender point exists if the patient recognizes tenderness to the applied force. This represents somatic dysfunction associated with the tender point site. Classic counterstrain methodology has not depended on specifically testing for motion restriction nor does the nomenclature of tender points specifically identify the neurocirculatory or biomechanical disturbance that underlies the somatic dysfunction. These differences exist in the lower extremities, which can lead to potential misinterpretations of the underlying problem and therapeutic approach required to treat the somatic dysfunction. This article reviews these discrepancies in order to advance the counterstrain model to be more inclusive with the neurocirculatory and biomechanical issues that are present with injuries to the lower extremities in order to improve treatment outcome and communication between healthcare practitioners in the rehabilitative process.     

Using a naturalistic ecological approach to examine the factors influencing youth physical activity across grades 7 to 12.

High levels of inactivity in youth have led researchers and practitioners to focus on identifying the factors that influence physical activity behaviors in young people. The present study employed a qualitative ecological framework to examine the intrapersonal, social, and environmental factors influencing youth physical activity. In grade-specific focus group settings, 160 youth in grades 7 through 12 (aged 12 to 18) were asked how they would increase the physical activity levels of youth their age. Participants identified eight factors that they felt should be addressed in programs and interventions designed to increase the physical activity behaviors of youth. These factors included the importance of fun, having the time to be physically active, the benefits of activity, being active with friends, the role of adults, and the importance of being able to access facilities in their neighborhood.     

Public perception of population health risks in Canada: Risk perception beliefs

A national survey of health risk perception among 1,503 adult Canadians was conducted in 2004 as a follow-up to a previous survey in 1992. Respondents were asked to indicate their personal opinion regarding a range of risk perception belief statements reflecting environmental concern, social concern, genetic concern, dependence on regulators, locus of health risk control (internal, powerful others, chance), risk acceptability and technological enthusiasm. The results indicated considerable concern over the state of the environment in general, however, less concern existed for the environment nearest to the individual. A high degree of concern was expressed over stress in the workplace, and poverty was perceived to represent an important health risk for Canadians. A strong sense of the importance of personal lifestyle factors and personal control over one's health was also observed as were notable increases in trust and dependence on the ability of government and experts to make decisions and regulate health risks in Canada as compared to the previous survey. Belief statements reflecting environmental and social concern correlated with the level of risk perceived for a variety of health hazards and outcomes.     

AIRE deficiency leads to impaired iNKT cell development

Autoimmune Polyendocrine Syndrome type I (APS I) is caused by mutations in the Autoimmune Regulator gene (AIRE), and results in the immunological destruction of endocrine organs. Herein we have characterized the CD1d-restricted invariant NKT cells (iNKT) and NK cells in APS I patients and Aire^?/? mice, two cell populations known to play a role in the regulation of autoimmune disease. We show that the frequency of circulating iNKT cells is reduced in APS I patients compared to healthy controls. In accordance with this, iNKT cells are significantly reduced in the thymus and peripheral organs of Aire^?/? mice. Bone marrow transfer from wild type donors into lethally irradiated Aire^?/? recipients led to a decreased iNKT cell population in the liver, suggesting an impaired development of iNKT cells in the absence of Aire expression in radio-resistant cells. In contrast to the iNKT cells, both conventional NK cells and thymus-derived NK cells were unaffected by Aire deficiency and differentiated normally in Aire^?/? mice. Our results show that expression of Aire in radio-resistant cells is important for the development of iNKT cells, whereas NK cell development and function does not depend on Aire.