Discordant secular trends in elevated blood pressure and obesity in children and adolescents in a rapidly developing country

BACKGROUND: The effect of the increasing prevalence of obesity on blood pressure (BP) secular trends is unclear. We analyzed BP and body mass index secular trends between 1998 and 2006 in children and adolescents of the Seychelles, a rapidly developing island state in the African region. METHODS AND RESULTS: School-based surveys were conducted annually between 1998 and 2006 among all students in 4 school grades (kindergarten and 4th, 7th, and 10th years of compulsory school). We used the Centers for Disease Control and Prevention criteria to define obesity and elevated BP. The same methods and instruments were used in all surveys. Some 25 586 children and adolescents 4 to 18 years of age contributed 43 867 observations. Although the prevalence of obesity in boys and girls increased from 5.1% and 6.0%, respectively, in 1998 to 2000 to 8.0% and 8.7% in 2004 to 2006, the prevalence of elevated BP decreased from 8.4% and 9.8% to 6.9% and 7.8%. During the interval, mean age-adjusted body mass index increased by 0.57 kg/m(2) in boys and 0.58 kg/m(2) in girls. Mean age- and height-adjusted systolic BP decreased by -3.0 mm Hg in boys and -2.8 mm Hg in girls, whereas mean diastolic BP did not change substantially in boys (-0.2 mm Hg) and increased slightly in girls (0.4 mm Hg). CONCLUSIONS: At a population level, the marked increase in the prevalence of obesity in children and adolescents in the Seychelles was not associated with a commensurate secular rise in mean BP.

Geophagia secondary to anaemia in a rich country?

Case Report: A 19 year old female, originally from Cameroon, residentin Switzerland for 10 years, consults for chronic fatigue, constipationand menorrhagia. Clinical examination reveals pain in the iliac fossa,laboratory tests show an iron deficiency anaemia with a hemoglobinof 74 g/l (N: 117-157) and a ferritin less than 3 μg/l (N: 30-300).Gynecological aetiology is strongly suspected.Findings: The dietary history reveals a high intake of African chalkcalled "Mabel" in Lingala, for which she has a craving with criteria forsubstance dependence according to the Diagnostic and StatisticalManual IV. Eating non-food products is called "PICA" and the eatingof earth "geophagia". It is often assumed by the patient that geophagiaoffers nutritional virtues of the earth, and that the land would act asantitoxic, anti-emetic, immune-stimulant, strengthen the intestinalbarrier and be rich in calcium, iron and many nutrients. But insteadgeophagia causes anemia, iron chelation, heavy metal poisoningand significant constipation or obstruction.Management: The patient, following our advice, stopped ingestingchalk. Parenteral iron substitution of ferric carboxymaltose 1000 mgstopped the craving, and resolved her subjective state of fatigue andher haemoglobin normalized to 140 g/l. The menorrhagia resolved withhormone replacement and the constipation subsequently disappeared.Discussion: Our patient was suffering from iron deficiency resulting ina craving for non-food products in this case the earth. We advisepractitioners to systematically ask the question in patients of Africanand South American origin by using synonyms for the word "Mabel"(African chalk, kaolin, Kalaba, calabash chalk, calabash Stone, Kaolin,hurdle, or clay Nzu). A simple question can sometimes avoid costlyinvestigations. The ferrous replacement intravenously can probably stopthe practice of geophagy faster. Finally, we must remember that thispractice is underestimated and rarely expressed by patients as it isoften felt to be a shameful practice.

Relation between high-sensitivity C-reactive protein and cardiovascular and renal markers in a middle-income country in the African region.

BACKGROUND: High-sensitivity C-reactive protein (hs-CRP) is associated with several cardiovascular risk factors (CVRF) and with renal function markers. However, these associations have not been examined in populations in the African region. We analyzed the distribution of hs-CRP and the relationship with a broad set of CVRF, renal markers and carotid intima-media thickness (IMT), in the Seychelles (African region). METHODS: We conducted a survey in the population aged 25-64years (n=1255, participation rate: 80.2%). Analyses were restricted to persons of predominantly African descent (n=1011). RESULTS: Mean and median hs-CRP serum concentrations (mg/l) were 3.1 (SD 7.6) and 1.4 (IQR 0.7-2.9) in men and 4.5 (SD 6.7) and 2.2 (IQR 1.0-5.4) in women (p<0.001 for difference between men and women). hs-CRP was significantly associated with several conventional CVRF, and particularly strongly with markers of adiposity. With regards to renal markers, hs-CRP was strongly associated with cystatin C and with microalbuminuria but not with creatinine. hs-CRP was not associated with IMT. CONCLUSIONS: Serum concentration of hs-CRP was significantly associated with sex, several CVRF and selected renal function markers, which extends similar findings in Europe and in North America to a population in the African region. These findings can contribute to guide recommendations for the use of hs-CRP in clinical practice in the region.

Parents living with HIV in a high-income country: do patients need specific support?

The number of HIV-infected persons with children and caregiving duties is likely to increase. From this statement, the present study was designed to establish how HIV infected caregivers organise their parenting routines and to determine their support needs. A further aim was to ascertain caregivers' perception of conspicuous behaviours displayed by their children. Finally, it sought to determine the extent to which the caregivers' assessment of their parenting activity is influenced by the required support and their children's perceived conspicuous behaviours. The study design was observational and cross-sectional. Sampling was based on the 7 HIV Outpatient Clinics associated with the national population-based Swiss HIV Cohort Study. It focused on persons living with HIV who are responsible for raising children below the age of 18. A total of 520 caregivers were approached and 261 participated. An anonymous, standardised, self-administered questionnaire was used for data collection. The data were analysed using descriptive statistical procedures and backward elimination multiple regression analysis. The 261 respondents cared for 406 children and adolescents under 18 years of age; the median age was 10 years. The caregivers' material resources were low. 70% had a net family income in a range below the median of Swiss net family income and 30% were dependent on welfare assistance. 73% were undergoing treatment with 86% reporting no physical impairments. The proportion of single caregivers was 34%. 92% of the children were living with their HIV infected caregivers. 80% of the children attended an institution such as a school or kindergarten during the day. 89% of the caregivers had access to social networks providing support. Nevertheless, caregivers required additional support in performing their parenting duties and indicated a need for assistance on the material level, in connection with legal problems and with participation in the labour market. 46% of the caregivers had observed one or more conspicuous behaviours displayed by their children, which indicates a challenging situation. However, most of these caregivers assessed their parenting activity very favourably. Backward elimination multiple regression analysis indicated that a smaller number of support needs, younger age of the eldest child and fewer physical impairments on the part of the caregiver enhance the caregivers' assessment of their parenting activity. Physicians should speak to caregivers living with HIV about their parenting responsibilities and provide the necessary scope for this subject in their consultation sessions. Physicians are in a position to draw their patients' attention to the services available to them.

A recent inventory of the bats of Mozambique with new documentation of 7 new species for the country

The bat fauna of Mozambique is poorly documented. We conducted a series of inventories across the country between 2005 and 2009, resulting in the identification of 50 species from 41 sites. Of these, seven species represent new national records that increase the country total to 67 species. These data include results from the first detailed surveys across northern Mozambique, over an area representing almost 50% of the country. We detail information on new distribution records and measurements of these specimens. Special attention is paid to the Rhinolophidae, because these include several taxa that are currently in a state of taxonomic confusion. Furthermore, we also present some notes on taxonomy, ecology and echolocation calls. Finally, we combine modelled distributions to present predicted species richness across the country. Species richness was lowest across the coastal plain, to the east and far north, and is predicted to increase in association with rising altitude and higher topographic unevenness of the landscape.

Club Deportivo Maratón

Aplicación web para el Club Deportivo Maratón mediante la que se da a conocer el club y sus actividades e instalaciones. Así mismo, se proporciona una aplicación de escritorio para la gestión de los contenidos de la web.

Impact of Duration of Primary Education on School Enrollment, Graduation and Drop-outs: A Cross- Country Analysis

Using a panel data for non-OECD countries covering the period 1970-2012, this chapter analyzes the impact of the duration of primary education on school enrollment, drop-out and completion rates. The empirical results show that for children in elementary school one ad- ditional grade of primary education have a negative impact on the enrollment rate, while the e ect on drop-outs is positive. Analogously, it is obtained that an additional grade in primary education reduces the enrollment rate in secondary education. These results are in line with the fertility model approach, that is, in developing and underdeveloped countries parents do not have incentive to send children to school given the high perceived economic value of children.

The study club program : suggestions relating to courses of study and aids furnished by the Traveling Library, 1909

This leaflet includes information on programs for Women's Clubs. Some possible subjects for the club's discussions are literature, history and fine arts. Several methods of study are covered. Groups are encouraged to use public libraries and the Iowa Traveling Library to obtain reference materials for their topics.

Gestión de un club de pádel

Este proyecto es un estudio que pretende realizar una aplicación dirigida a centros deportivos, implementando a través de BIOMAX el acceso a las instalaciones utilizando tarjetas de proximidad. Además la aplicación permitirá gestionar de forma eficiente a sus socios e instalaciones. De esta manera se consigue automatizar - mejorando en tiempo y calidad -una tarea imprescindible de realizar, control de accesos de forma sencilla y con un mantenimiento fácil por parte de los usuarios que la utilicen. Para ello se utilizará un dispositivo KIMALDI que nos permitirá gestionar el control de accesos

Planificació i gestió esportiva en equips base de clubs de futbol amateur. Factors determinants en l'elecció d'un club de tipus lúdic o competitiu

L’etapa d’iniciació a l’esport té una importància majúscula en el procés d’aprenentatge dels jugadors, i per això també podem trobar dos tipus de clubs: els competitius, els quals estan influïts bàsicament pels resultats obtinguts; i els lúdics, on preval la diversió i el joc sobre l’especialització a l’esport. El que es pretén amb aquesta investigació és descobrir quins factors són més determinants per fer que les famílies escullin un tipus de club o un altre. Per tant, basant-nos amb el que diuen autors com Pacheco (2007), Wein (2004), Frattarola i Sans (2006) i Lasierra i Lavega (1993), s’han concretat una sèrie de factors determinants per l’elecció de cada tipus de club, així com d’altres que seran significatius per les famílies a l’hora de decantar-se per un o per l’altre. Pel que fa a la part metodològica, dir que és una investigació descriptiva transversal. A més, s’ha utilitzat l’estratègia de l’enquesta amb l’instrument del qüestionari, el qual s’ha basat en una mostra formada per 60 pares i mares de nens i nenes d’iniciació en l’esport, i 20 pares i mares de nens d’escoleta, previ a la iniciació esportiva. Pel que fa als resultats obtinguts, aquests mostren que al club lúdic es compleixen els tres factors d’aquest àmbit, mentre que al club competitiu es compleixen els dos mateixos factors lúdics de l’altre club i només un factor competitiu. D’altra banda, cal tenir present la importància que tenen els factors contaminadors en els resultats obtinguts degut a la significativitat d’aquests.

Impacte de la Gimnàstica artística a Vic: la relació gimnasta-entrenadora dins del Club Gimnàstic Osona (CGO)

L’objectiu d’aquest estudi és comprovar si una millor relació entre gimnasta i entrenadora és un factor determinant per a poder obtenir més resultats en les competicions. S’estudien tres grups dividits per tres nivells diferents: Escolar (8 gimnastes), Promogym (11 gimnastes) i Tecnificació (28 gimnastes). A partir d’una adaptació feta dels qüestionaris Cart-Q de Jowett i Ntoumanis (2004) i l’ SF-PANAS de Thompson (2007) es realitzarà l’anàlisi de la relació gimnasta-entrenadora abans de dues competicions, on s’analitzaran els podis. Observant l’estudi, una baixada de mitjanes dels aspectes de les 3 C’s (proximitat, compromís i complementarietat) estava acompanyat d’una baixada de resultats i una pujada de les mitjanes de les 3 C’s estava relacionat amb l’obtenció de més podis. Per tant, a l’hora de valorar els resultats en competició la relació gimnasta-entrenadora és un factor important a tenir en compte.