RESUMEN
OBJECTIVE: To examine the association between eating in the absence of hunger (EAH) and adiposity in children. DESIGN: Two cross-sectional studies in community settings. SUBJECTS: For study 1, 348 children (178 girls and 170 boys) aged 7-9 years were recruited as part of the Physical Exercise and Appetite in Children Study. In study 2, participants were a subsample of children aged 9-12 years (N=316; 192 girls and 124 boys) from the Twins Early Development Study. MEASUREMENTS: EAH was operationalized as intake of highly palatable sweet snacks after a mixed meal at school (study 1) or home (study 2). Weight (kg) and height (m) measurements were used to calculate the body mass index (BMI) s.d. scores. Children were grouped using the standard criteria for underweight, healthy weight, overweight and obesity. The healthy weight range was further subdivided into lower healthy weight (
Asunto(s)
Adiposidad/fisiología , Conducta Alimentaria/fisiología , Hambre/fisiología , Índice de Masa Corporal , Peso Corporal , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Análisis de Regresión , Factores SocioeconómicosRESUMEN
OBJECTIVE: To discover whether eating behaviour traits show continuity and stability over childhood. SUBJECTS/METHODS: Mothers of 428 twin children from the Twins Early Development Study participated in a study of eating and weight in 1999 when the children were 4 years old. Families were contacted again in 2006 when the children were aged 10 years, with complete data on 322 children; a response rate of 75%. At both times, mothers completed the Child Eating Behaviour Questionnaire (CEBQ) for each child. Continuity was assessed with correlations between scores at the two time points, and stability by changes in mean scores over time. RESULTS: For all CEBQ subscales, correlations between the two time points were highly significant (P-values <0.001). For satiety responsiveness, slowness in eating, food responsiveness, enjoyment of food, emotional overeating and food fussiness, correlations ranged from r=0.44 to 0.55, with lower continuity for emotional undereating (r=0.29). Over time, satiety responsiveness, slowness in eating, food fussiness, and emotional undereating decreased, while food responsiveness, enjoyment of food and emotional overeating increased. CONCLUSIONS: Eating behaviours, including those associated with a tendency to overeat, emerge early in the developmental pathway and show levels of individual continuity comparable to stable personality traits. Appetitive traits related to higher satiety tended to decrease with maturation, while those associated with food responsiveness tended to increase. This pattern is consistent with strong tracking of body mass index alongside a progressive increase in the risk of obesity.
Asunto(s)
Índice de Masa Corporal , Conducta Infantil/psicología , Conducta Alimentaria/psicología , Gemelos , Niño , Preescolar , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Trastornos de Alimentación y de la Ingestión de Alimentos/psicología , Femenino , Humanos , Masculino , Obesidad/epidemiología , Obesidad/etiología , Obesidad/psicología , Psicometría , Factores de RiesgoRESUMEN
Promoter variations in Toll-like receptor genes (n = 7) and genes encoding pathogen recognition and virus entry receptors (n = 7) were screened to detect any association with human cytomegalovirus (hCMV) reactivation and disease in patients following allogeneic stem-cell transplantation. Two single nucleotide polymorphisms (rs735240, G>A; rs2287886, C>T) in the promoter region of the dendritic cell-specific ICAM3-grabbing non-integrin (DC-SIGN) showed a significant association with an increased risk of development of hCMV reactivation and disease. Furthermore, these genetic markers influenced the expression levels of DC-SIGN on immature dendritic cells, as well as the infection efficiency of immature dendritic cells by hCMV, as determined by hCMV immediate-early antigen staining. Screening of patients following allogeneic stem-cell transplantation for the presence of these defined genetic polymorphisms might help to predict the individual risk of hCMV reactivation and disease.
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Moléculas de Adhesión Celular/genética , Infecciones por Citomegalovirus/genética , Citomegalovirus/aislamiento & purificación , Lectinas Tipo C/genética , Polimorfismo de Nucleótido Simple , Regiones Promotoras Genéticas , Receptores de Superficie Celular/genética , Trasplante de Células Madre/efectos adversos , Activación Viral/genética , Adulto , Infecciones por Citomegalovirus/inmunología , Células Dendríticas/inmunología , Femenino , Expresión Génica , Predisposición Genética a la Enfermedad , Humanos , Masculino , Persona de Mediana Edad , Activación Viral/inmunologíaRESUMEN
Although acute urticaria is common, its eliciting factors, clinical course and therapeutic responsiveness have not been intensively investigated. We have therefore prospectively studied all patients with acute urticaria attending the department of dermatology (n = 72) and a rural dermatology office (n = 37) during the course of 1 year. After a standardized history and physical examination, patients were randomized into treatment with either loratadine (10 mg/day for 3 days) or prednisolene (50 mg/day for 3 days). All patients were followed up until complete remission. Most patients suffered from moderate (42%) to severe (40%) disease. Possible eliciting factors were identified in less than 50% of the cases. Associated upper respiratory tract infections were found most commonly (39.5%), followed by possibly eliciting drugs, mostly analgesics (9.2%) and suspected food intolerance (0.9%). The course of the disease was self-limited in all cases, the longest episode lasting for 3 weeks. Both treatment regimens were effective in controlling whealing, but in corticosteroid-treated patients, symptoms ceased earlier, with complete remission occurring within 3 days of treatment in 93.8%, compared to 65.9% of patients treated with loratadine (p < 0.001). Acute urticaria is thus frequently idiopathic and only rarely associated with IgE-mediated events. It is, however, largely self-limited, with prompt response to symptomatic treatment.
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Urticaria/fisiopatología , Enfermedad Aguda , Adolescente , Adulto , Analgésicos/efectos adversos , Antiinflamatorios/administración & dosificación , Antiinflamatorios/uso terapéutico , Niño , Preescolar , Erupciones por Medicamentos/complicaciones , Femenino , Estudios de Seguimiento , Hipersensibilidad a los Alimentos/complicaciones , Antagonistas de los Receptores Histamínicos H1/administración & dosificación , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Humanos , Inmunoglobulina E/inmunología , Loratadina/administración & dosificación , Loratadina/uso terapéutico , Masculino , Persona de Mediana Edad , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Estudios Prospectivos , Inducción de Remisión , Infecciones del Sistema Respiratorio/complicaciones , Factores de Tiempo , Resultado del Tratamiento , Urticaria/tratamiento farmacológico , Urticaria/etiología , Urticaria/inmunologíaRESUMEN
This article illustrates ethical dilemmas faced by therapists who provide driver reeducation. The dilemmas discussed are (a) accepting a wide range of referral sources and client disabilities versus the inability to know enough to anticipate all driver performance errors, (b) the client's safety versus the client's right to independence, (c) financial constraints versus advantages of technology, and (d) the reporting of poor driving risk versus client confidentiality. A method for determining one's pattern of resolving ethical dilemmas is discussed.
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Conducción de Automóvil , Personas con Discapacidad , Ética Profesional , Terapia Ocupacional/normas , Rehabilitación/normas , Toma de Decisiones , Humanos , Terapia Ocupacional/métodos , Defensa del Paciente , Solución de Problemas , Rehabilitación/métodos , Rol , SeguridadRESUMEN
A study was conducted in very-low-birth-weight (VLBW) neonates to correlate structural damage to the central nervous system due to intracranial hemorrhage (ICH) with electrophysiological function of the lower auditory system as measured by brainstem auditory evoked potentials (BAEP). BAEP testing of 61 VLBW neonates was completed at 36 weeks conceptional age. BAEP Wave III and V latencies significantly increased with increasing severity of ICH. Although significant at conventional levels (P less than 0.05), these correlations were of modest size. Furthermore, after adjusting for the effects of birthweight, hypoxia, lowest pH and associated pCO2 the correlation between ICH and BAEP was reduced in magnitude and no longer significant. Thus, there is little evidence that ICH shortly after birth affected functioning of the auditory brainstem pathways in VLBW neonates at 36 weeks conceptional age.
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Tronco Encefálico/fisiopatología , Hemorragia Cerebral/fisiopatología , Potenciales Evocados Auditivos , Recién Nacido de Bajo Peso , Femenino , Edad Gestacional , Humanos , Recién Nacido , MasculinoRESUMEN
The Neonatal Network, a model program for interagency service coordination for primarily indigent, minority very-low-birth-weight infants and their families is described. The Neonatal Network has been an effective service delivery coordination system and training mechanism that should be applicable and easily replicable in other communities with the same or different target populations.