Prevalence of fatty liver in Japanese children and relationship to obesity

The prevalence of fatty liver in children is unknown and its relationship to obesity is poorly defined. The present study of 810 northern Japanese children (4–12 years old) determined the prevalence of fatty liver in the pediatric population and its relationship to obesity. Diagnosis of fatty liver was based on established real-time ultrasonographic criteria. The overall prevalence of fatty liver was 2.6% and was higher for boys (3.4%) than for girls (1.8%), although not statistically significant (P=0.15). Fatty liver was found in children as young as 6 years of age. There was no significant association between the prevalence of fatty liver and height (physical growth). There was a strong positive correlation between fatty liver prevalence and established obesity indices: Rohrer's index-² linear trend =59.2,P<0.0001; body mass index-² linear trend =91.6,P<0.0001; and age-gender-adjusted Japanese standard index of weight for height-² linear trend =93.2,P<0.0001. However, direct measurement of abdominal subcutaneous fat thickness by ultrasonography was the best predictor of fatty liver: ² linear trend =159,P<0.0001. These results indicate that fatty liver may develop very early in life, and there is a direct relationship between degree of obesity and fatty liver in children.     

Exercise training and nutrient intake in elderly women

This study examined the relationship between moderate exercise training (five 30- to 40-minute sessions per week for 12 weeks at 60% of heart rate reserve) and changes in nutrient intake in a group of 30 sedentary elderly women aged 67 to 85 years. Subjects were placed randomly into two groups (those who walked and those who did calisthenics) and were followed for 12 weeks. Measurements were done at three times (baseline, 5 weeks, and 12 weeks). Dietary intake was based on 7-day food records. The 12-week walking program resulted in a significant (12.6%) improvement in maximum oxygen consumption ( ₂max) but no change in body weight or skinfold thicknesses compared with the calisthenics program. Despite the improvement in cardiorespiratory fitness, no significant group × time interaction effects were observed for most of the nutrient intake variables tested. To test the effects of high levels of physical activity on nutrient intake, cross-sectional comparisons were made at baseline between highly conditioned and sedentary elderly women. The highly conditioned elderly women had higher energy and nutrient intakes, especially when expressed on a weight-adjusted basis. However, no differences in measures of dietary quality were found. Dietitians should not expect spontaneous improvement in either the quantity or quality of nutrient intake by elderly women who adopt a moderate exercise program. Although nutrient intake was greater in highly conditioned elderly women, their level of fitness and physical activity may be beyond the reach of many elderly women.     

Quality-of-Life Concerns of Chinese Patients With Advanced Cancer

This study aimed to examine the quality of life (QOL) of patients with advanced cancer in Hong Kong. Ninety participants were recruited from the oncology ward of the study hospital. They responded to a 28-item, 8-subscale multidimensional questionnaire and a single-item scale that measured QOL in a face-to-face interview. Participation in health care decisions, food-related concerns, and existential distress were some QOL concerns that require health care professionals' attention. Walking ability predicted the level of QOL in certain QOL domains that surfaces patients' need for rehabilitation. That the QOL domain value of life was the most important domain that predicted overall QOL calls for meaning-of-life interventions for palliative care.     

Appropriate Use of Health Risk Appraisals with School-age Children

ABSTRACT: Health Risk Appraisals (HRAs) use personal risk assessment as an educational approach to encourage adoption of positive health-related behavior. An individual's behavior and health history are compared to morbidity and mortality tables to estimate a level of personal risk. Current trends suggest HRAs will continue to be popular with school health educators. Appropriate use of HRAs requires an understanding of the assumptions, interpretations, and limitations of these instruments. This article reviews the development, validity, and reliability of HRA methodology. The educational usefulness of HRAs designed for school-age populations is examined. Recommendations are offered to optimize the instructional benefits of HRAs while minimizing potential deficiencies.     

Practical guidance for the use of a pattern‐matching technique in case‐study research: A case presentation

This paper reports on a study that demonstrates how to apply pattern matching as an analytical method in case‐study research. Case‐study design is appropriate for the investigation of highly‐contextualized phenomena that occur within the social world. Case‐study design is considered a pragmatic approach that permits employment of multiple methods and data sources in order to attain a rich understanding of the phenomenon under investigation. The findings from such multiple methods can be reconciled in case‐study analysis, specifically through a pattern‐matching technique. Although this technique is theoretically explained in the literature, there is scant guidance on how to apply the method practically when analyzing data. This paper demonstrates the steps taken during pattern matching in a completed case‐study project that investigated the influence of cultural diversity in a multicultural nursing workforce on the quality and safety of patient care. The example highlighted in this paper contributes to the practical understanding of the pattern‐matching process, and can also make a substantial contribution to case‐study methods.     

A meta-analysis of the role of smoking in inflammatory bowel disease

A relationship between not smoking and ulcerative colitis has been examined in all English reports. This paper evaluates the ulcerative colitis/nonsmoking and the Crohn's disease/smoking association by meta-analysis and against causality criterion for chronic diseases. A review of the literature, meta-analysis of selected studies, and assessment of causality criterion all suggest that not smoking and ulcerative colitis and smoking and Crohn's disease are consistent with a causal relationship. It is not inconceivable that tobacco may contain some substance beneficial to ulcerative colitis patients. Identification of the specific product in tobacco producing a beneficial effect would be a prudent next step in the study of this association. In spite of the findings of this review and analysis, the author finds no justification for health care providers to change the Surgeon General's recommendations on smoking or tobacco use for ulcerative colitis patients specifically.This work was partially supported by R01 DK38829-01 and R01 DK38693-01.