Developmental coordination disorder,sex, and activity deficit over time: a longitudinal analysis of participation trajectories in children with and without coordination difficulties

Aim Children with developmental coordination disorder (DCD) are known to participate in active play less than typically developing children. However, it is not known whether the activity deficit between children with and without DCD widens or diminishes over time. Method Data were obtained from a large, prospective cohort study of children (baseline n=2278, total n=2470). Motor coordination was assessed for 2083 students using the short form of the Bruininks–Oseretsky Test of Motor Proficiency. Participation in organized and free‐play activities was assessed using a participation questionnaire on five occasions over 3 years. Mixed‐effects modelling was used to examine differences in participation over time between children with probable DCD (pDCD, n=111, 46 males, 65 females) and their typically developing peers (n=1972, 1016 males, 956 females). The mean age for the whole sample was 9 years 11 months (SD 5mo) at assessment 1, 10 years 5 months (SD 5mo) at assessment 2, 10 years 11 months (SD 5mo) at assessment 3, 11 years 4 months (SD 4mo) at assessment 4, and 11 years 11 months (SD 4mo) at assessment 5. Results Children with pDCD reported less participation in organized and free‐play activities than their typically developing peers, and these differences persisted over time. Among males, the gap in participation in free‐play activities between those with DCD and typically developing children diminished substantially over time; among females, it increased slightly. Interpretation DCD is associated with a persistent activity deficit in children. Its effect on participation appears to be particularly serious among females but may diminish with time among males.     

A Randomized Controlled Trial Evaluating Nutrition Counseling with or without Oral Supplementation in Malnourished HIV-Infected Patients

Objective To evaluate the effects of nutrition counseling with or without oral supplementation in malnourished patients infected with the human immunodeficiency virus (HIV).Design Randomized controlled trial.Subjects HIV-infected men (n=118) who were less than 90% of usual weight for height or who had lost more than 10% of body weight.Intervention Nutrition counseling alone (control group) vs nutrition counseling plus enteral supplementation (supplement group) for 6 weeks. All patients were instructed to consume a diet that exceeded estimated total energy expenditure by 960 kcal/day.Main outcome measures Weight, skinfold thickness, fat-free mass, grip strength, quality of life, and cognitive function (Buschke test).Statistical analyses Differences in baseline variables and outcomes were evaluated using analysis of variance or the Wilcoxon rank sum test.Results Ninety-nine men completed at least 4 weeks of treatment, 49 in the supplement group and 50 in the control group. Half the patients in each treatment group achieved at least 80% of their energy target. No differences in weight, skinfold thickness measurements, or quality of life were observed. Compared with the control group, the supplement group had larger increases in fat-free mass and grip strength, although the differences did not reach statistical significance.Applications In the short term, nutrition counseling with or without oral supplementation can achieve a substantial increase in energy intake in about 50% of malnourished HIV-infected patients. Although further study is needed to evaluate long-term effects, these findings suggest that nutrition counseling has an important role in the management of malnourished HIV-infected patients. J Am Diet Assoc. 1998;98:434-438.     

Unstable sleep and higher sympathetic activity during late‐sleep periods of rats: implication for late‐sleep‐related higher cardiovascular events

We proposed that the higher incidence of sleep fragmentation, sympathovagal imbalance and baroreceptor reflex impairment during quiet sleep may play a critical role in late‐sleep‐related cardiovascular events. Polysomnographic recording was performed through wireless transmission using freely moving Wistar–Kyoto rats over 24 h. The low‐frequency power of arterial pressure variability was quantified to provide an index of vascular sympathetic activity. Spontaneous baroreflex sensitivity was assessed by slope of arterial pressure–RR linear regression. As compared with early‐light period (Zeitgeber time 0–6 h), rats during the late‐light period (Zeitgeber time 6–12 h) showed lower accumulated quiet sleep time and higher paradoxical sleep time; furthermore, during quiet sleep, the rats showed a lower δ% of electroencephalogram, more incidents of interruptions, higher σ% and higher β% of electroencephalogram, raised low‐frequency power of arterial pressure variability value and lower baroreflex sensitivity parameters. During the light period, low‐frequency power of arterial pressure variability during quiet sleep had a negative correlation with accumulated quiet sleep time and δ% of electroencephalogram, while it also had a positive correlation with σ% and β% of electroencephalogram and interruption events. However, late‐sleep‐related raised sympathetic activity and sleep fragmentation diminished when an α1‐adrenoceptor antagonist was given to the rats. Our results suggest that the higher incidence of sleep fragmentation and sympathovagal imbalance during quiet sleep may play a critical role in late‐sleep‐related cardiovascular events. Such sleep fragmentation is coincident with an impairment of baroreflex sensitivity, and is mediated via α1‐adernoceptors.     

Alcohol and violence-related injuries: an emergency room study

Drinking patterns, alcohol-related problems and drinking-in-the-injury event were compared between those admitted to the emergency room (ER) with and without injuries resulting from violence. A probability sample of 1770 adult casualty patients in four hospitals in a single California suburb county were breathalyzed and interviewed at the time of the ER visit. Among all males and females over 30, those with violence-related injuries were more likely than those with other injuries to have positive breathalyzer readings and to report drinking prior to the event, frequent heavy drinking, consequences of drinking, experiences associated with alcohol dependence and loss of control and prior treatment for an alcohol problem. The data suggest a need for research to test whether a brief intervention at the time of the ER visit for problem drinking or a referral for more extensive alcohol treatment can effect a reduction in alcohol-related violence and other alcohol-related problems.     

HIV, substance use and related behaviour of gay and bisexual men: an examination of the talking sex project cohort

This paper reports on the substance use of 612 gay and bisexual men who participated in an HIV risk reduction project. Use/non-use, level of substance use, and reported frequency of use prior to sexual activity were examined in relation to number of sexual fanners, sexual activities, HIV antibody test seeking behaviour and known HIV status. The use of substances among the study cohort appear to be higher than in a comparable heterosexual male group. An association was found between substance use, and both number of sexual partners and sexual activities. However, no significant difference was found in substance use between men participating in protected versus unprotected anal sex. Similarly, no significant difference was found in the reported frequency of substance use prior to sex by those participating in protected and unprotected anal intercourse. Greater drug use was reported among those who were known to be HIV antibody pisitive. These findings raise issues for further research. The high use of alcohol and drugs by gay and bisexual men may pose significant health risks for this group of men.     

Low-Fat Diet Practices of Older Women: Prevalence and Implications for Dietary Assessment

Objective To evaluate the importance of information on low-fat diet practices and consumption of reduced-fat foods for accurate assessment of energy and fat intakes using a semiquantitative food frequency questionnaire (FFQ).Subjects Subjects were 7,419 women, aged 50 to 79 years, who filled out an FFQ as part of eligibility screening for a diet modification component and/or a hormone replacement trial in a multicenter study of chronic disease prevention in postmenopausal women (Women's Health Initiative).Statistical analysis For 26 FFQ questions, we receded the low-fat diet choices of participants to a high-fat counterpart and recalculated energy and fat intakes. We then determined the decrease in energy and nutrient estimates attributable to adding low-fat options to the FFQ.Results Low-fat diet practices were widespread in this population. For example, 69% of respondents rarely or never ate skin on chicken, 76% rarely or never ate fat on meat, 36% usually drank nonfat milk, 52% usually ate low-fat or fat-free mayonnaise, 59% ate low-fat chips/snacks, and 42% ate nonfat cheese. These low-fat choices had substantial effects on energy and nutrient estimates. Absolute decreases (and mean percentage decreases) for energy and nutrient measures attributable to adding low-fat diet options to the FFQ were 196 kcal (11.4%) energy, 9 percentage points in percentage energy from fat (22.3%), 23.2 g fat (29.0%), and 9.6 g saturated fat (32.5%). Black and Hispanic women and women of lower socioeconomic status reported significantly fewer low-fat diet practices than white women and women of higher socioeconomic status.Conclusion Failure to collect information on low-fat diet practices with an FFQ will result in an upward bias in estimates of energy and fat intake, and the amount of error will vary by the personal characteristics of respondents. J Am DietAssoc. 1996; 96:670-676, 679.     

Amnhinfusion: An Update

Amnioinfusion is one of the most innovative techniques of the decade. The authors reviewed current literature, research indications, and nursing implications for amnioinfusion. Current technology has simplified the amnioinfusion procedure. This technique provides both therapeutic and prophylactic regimens for the intrapartum mother and her fetus, and it has many clinical implications for nursing.     

ANALYSIS OF MULTIVARIATE RELIABILITY STRUCTURES AND THE INDUCED BIAS IN LINEAR MODEL ESTIMATION

Least squares provides consistent estimates of the regression coefficients β in the model E[Y|x] = β′x when fully accurate measurements of x are available. However, in biomedical studies one must frequently substitute unreliable measurements X in place of x. This induces bias in the least squares coefficient estimates. In the univariate case, the bias manifests itself as a shrinkage toward zero, but this result does not generalize. When x is multivariate, then there are no predictable relationships between the signs or magnitudes of actual and estimated regression coefficients. In this article, we characterize the estimation bias, and review a relatively simple adjustment procedure to correct it. We also show that several natural conjectures about the bias are false. We present three definitions of reliability coefficient matrices that generalize the univariate case, and we illustrate their application to dietary intake data from a cancer prevention study.     

Alcohol and injuries resulting from violence: a review of emergency room studies

This paper reviews emergency room (ER) studies from a number of countries which have reported findings related to the association of alcohol and injuries resulting from violence. Special attention is given to those studies which used probability samples of patients which were representative of the population served by the emergency room facility where the data were collected, and which compared those admitted to the ER with violence-related injuries with those admitted to the same ER during the same period of time with injuries unrelated to violence. Those with violence-related injuries were more likely to be admitted to the ER with a positive blood alcohol concentration, to report drinking prior to the event, to report more frequent heavy drinking and to report more alcohol-related problems than those admitted with injuries from other causes.