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.

Constructive micritic envelope developed in the vadose continental environment in the Pleistocene eoliantes of Mallorca (Spain)

In this study we analyze and explain the formation of the constructive micrite envelope in the vadose continental environment. This constructive micrite envelope shows a wide variety of textural components. The principal textural components are: microorganisms, micritic and microspar LMC cement, whisker crystals, microfibres and aggregates of LMC acicular crystals. The main microorganisms are hyphae fungi, although actynomicetes and bacteries also occur. The constructive micrite envelope is due to the action of calcified filaments (hyphae fungi) which collapse and coalesce forming an intertwined mesh as well as due to the precipitation of micritic and microspar cement. The whisker crystals, microfibres and aggregates of LMC acicular crystals are secondary microtextures. Constructive micrite envelopes does not indicate a specific diagenetic environment. The constructive micrite envelopes present irregularities or bumps at the outer surface of the grains, and the destructive micrite envelopes present irregularities towards the grain interior. This morphologic criterion is useful to differenciate the micrite envelope origin, constructive or destructive, in the fossil record.

THE INFLUENCE OF THE REGULATORY ENVIRONMENT ON THE DEFINITION OF PERFORMANCE: THE EXAMPLE OF THE SPORT BETTING AND LOTTERY SECTORS

This thesis examines the interplay between state regulation and the way organisations define performance. Performance is generally understood to be a multidimensional concept, but the extent to which its different facets are shaped by regulation remains an understudied question. This thesis aims to address this question and provide at least a partial answer to it. To do so, it examines whether the level of regulation amplifies or abates the multidimensionality of regulated entities' performance definition, i.e. the way they define the concept of performance. The leading question is whether an organisation's performance definition can be associated with the regulatory intensity its environment confronts it with. Moreover, the study explores whether the type of ownership-public or private-plays a role in regard to how a regulated entity defines performance. In order to undertake this investigation, the thesis focuses on the performance definitions of organisations in six different sport betting and lottery regulations. Qualitative data is gathered from primary and secondary documents as well as through semi-structured interviews with chief executive officers (CEO), members of executive management and gambling experts in each of these countries. The thesis concludes that the performance definitions of the organisations under study are indeed multidimensional, as well as clearly influenced by their respective regulatory environments. However, not all performance dimensions identified in the literature are present, nor can they all be estimated to be part of the performance definition. In addition, the public-private difference in defining performance-as conceptualised in the literature- seems to be abated in a regulated environment. The central role played by regulation in regard to the multidimensionality of the performance definition partially outweighs the effect of the nature of ownership.

Effects of genetics and environment on isoflavone content of soybean from different regions of Brazil

The effects of genetics and environmental factors on isoflavone content of soybean (Glycine max L.) cultivars grown in different locations in Brazil in 1993/94 were evaluated. Seeds of different cultivars were analised by high performance liquid chromatography (HPLC). In Rio Grande do Sul (RS), Paraná (PR), and Mato Grosso do Sul (MS) States, a significant difference in the isoflavone total content average of the cultivars IAS 5 and FT-Abyara (163.9, 116.4 and 79.5 mg/100 g, respectively) was observed. In general, IAS 5 contained higher isoflavone than FT-Abyara. Cultivars IAS 5 and FT-Abyara grown at Vacaria, RS (28°30' S latitude) with temperature average of 19°C, had the highest isoflavone concentrations (218.7 and 163.8 mg/100 g, respectively). In Palotina, PR (24°27' S latitude), where temperature average was 24°C, the isoflavone concentrations were 105.9 and 86.8 mg/100 g, respectively. The lowest isoflavone contents were observed for FT-Estrela and FT-Cristalina, (27.6 and 46.5 mg/100 g, repectively) at Rondonópolis, MT (16°20' S latitude), where the temperature was 27°C.

Maintaining Iowa's Secondary Road Environment, HR-289, 1989

The Iowa counties have been successful in maintaining a good roadway environment on our 90,000 mile secondary road system. However, county highway personnel must remain vigilant in detecting, discovering and correcting potential problems if our roads are to remain so. This presentation was developed for those county personnel who work and travel on secondary roads. The presentation discusses things county personnel can look for during their daily operations which could possibly create a potential problem. If these situations are uncovered and corrected in a timely manner, our secondary road system will be maintained in an appropriate manner.

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.

Activity of beta-glucosidase and levels of isoflavone glucosides in soybean cultivars affected by the environment

The enzyme beta-glucosidase hydrolyses the isoflavone glucosides developing aglycones, which are compounds with anticancer effects, that are also related with the astringency observed in soybean flavor. Due to the importance of this enzyme, a study was carried out to determine beta-glucosidase activity in soybean (Glycine max (L.) Merrill) cultivars with different contents of isoflavone glucosides (enzyme substrate). The enzyme activity was determined in 51 soybean cultivars sowed in Londrina (latitude 23ºS), in Paraná State, Brazil, and in the cultivar IAS 5 from soybean production regions of different Brazilian states. Among the cultivars, a range of variability of 176.1 to 96.3 units of enzyme activity (cultivars IAC-2 and Embrapa 2, respectively) was observed. A significant variability among cultivars could suggest genetic differences. In the states of Rio Grande do Sul, Paraná and Mato Grosso do Sul, the cultivar IAS 5 presented similar average of beta-glucosidase activity: 132.1, 131.9 and 132.5 units, respectively. Among locations in the states, the cultivar IAS 5 presented a variability for enzyme activity from 138.8 to 124.8 units, which were statistically different. In spite of statistics, the numerical values were not too different to assume that environmental conditions affected enzyme activity. A non-significative correlation for isoflavone glucoside concentrations and enzyme activity was observed among cultivars.

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.

Self reported physical activity, public health, and perceived environment: results from a comparative European study

The focus of physical activity promotion is moving from methods for increasing health enhancing physical activity on the individual level to higher level strategies including environmental and policy approaches. Scientific inquiry, traditionally related to individual-based strategies, requires adaptation and refinement when environmental and policy changes become more relevant. The objective of this study is to investigate the significance for behaviour and health of community-based environments that encourage physical activity. DESIGN AND SETTING The article presents data and results from a cross sectional comparative survey of the general population in six European countries (Belgium, Finland, Germany (East and West), Netherlands, Spain, Switzerland). Specifically, the relation between perceived community-based opportunities for physical activity, self reported physical activity, and self rated health status is investigated. PARTICIPANTS Representative samples of general populations (adults 18 years or older). Overall response rate: 53.5%. Sample sizes realised: Belgium: n=389; Finland: n=400; Germany (East): n = 913; Germany (West): n=489; Netherlands: n=366; Spain: n=380; Switzerland: n=406. MAIN RESULTS Analyses show that best opportunities are reported by people who are lightly to moderately physically active. People's self rated health is moderately, but significantly associated with both perceived opportunities, and physical activity itself. These predictors interact in that especially for women, the health impact of physical activity is more pronounced in case of good opportunities. CONCLUSIONS The paper shows the potential of opportunities within residential and community environments with regard to physical activity, both for behaviour and health. Opportunities may enable the population, especially women, to develop an active lifestyle, and thus improve their health. Future studies with objective indicators for physical activity related environments should test the findings that are based on perceptions.

Gene by environment interaction: effects of a single-gene and social-environment on reproductive phenotypes of fire ant queens

1. The gene Pgm-3 (or a closely linked gene) influences the phenotype and reproductive success of queens in multiple-queen (polygynous) colonies but not single-queen (monogynous) colonies of the Fire Ant Solenopsis invicta. 2. We investigated the mechanisms of differential phenotypic expression of Pgm-3 in these alternate social forms. Mature winged queens with the homozygous genotype Pgm-3(a/a) averaged 26% heavier than queens with the genotypes Pgm-3(a/b) and Pgm 3(b/b) in the polygynous form. Heterozygotes were slightly heavier (2%) than Pgm-3(b/b) queens in this form, demonstrating that the allele Pgm-3(a) is not completely recessive in its effects on weight. 3. There was no significant difference in weight among queens of the three Pgm-3 genotypes in the monogynous form, with the mean weight of monogynous queens slightly greater than that of polygynous Pgm-3(a/a) queens. Differences in weight between queens of the two social forms and among queens of the three genotypes in the polygynous form are not evident at the pupal stage and thus appear to develop during sexual maturation of the adults. This suggests that some component of the social environment of polygynous colonies inhibits weight gains during queen maturation and that Pgm-(3a/a) queens are relatively less sensitive to this factor. 4. To test whether the high cumulative queen pheromone level characteristic of polygynous colonies is the factor responsible for the differential queen maturation, we compared phenotypes of winged queens reared in split colonies in which pheromone levels were manipulated by adjusting queen number. Queens produced in colony fragments made monogynous were heavier than those produced in polygynous fragments, a finding consistent with the hypothesis that pheromone level affects the reproductive development of queens. However, genotype-specific differences in weights of queens were similar between the two treatments, suggesting that pheromone level was not the key factor of the social environment responsible for the gene-environment interaction. 5. To test whether limited food availability to winged queens associated with the high brood/worker ratios in polygynous colonies is the factor responsible for this interaction, similar split-colony experiments were performed. Elevated brood/worker ratios decreased the weight of winged queens but there was no evidence that this treatment intensified differential weight gains among queens with different Pgm-3 genotypes. Manipulation of the amount of food provided to colonies had no effect on queen weight. 6. The combined data indicate that cumulative pheromone level and brood/worker ratio are two of the factors responsible for the differences in reproductive phenotypes between monogynous and polygynous winged queens but that these factors are not directly responsible for inducing the phenotypic effects of Pgm-3 in polygynous colonies.

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.

Violent adolescents and their educational environment: a multilevel analysis.

OBJECTIVE: This study examined the respective roles of personal and environmental factors in youth violence in a nationally representative sample of 7548 postmandatory school students and apprentices ages 16-20 years in Switzerland. METHODS: Youth violence was defined as having committed at least one of the following in the previous 12 months: attacking an adult, snatching something, carrying a weapon, or using a weapon in a fight. Different ecological levels were tested, resulting in a three-level model only in males (individual, classroom, and school) as the low prevalence of female violence did not allow for a multilevel analysis. Dependent variables were attributed to each level. For males, the classroom level (10%) and the school level (24%) accounted for more than one third in interindividual variance. RESULTS: Factors associated with violence perpetration in females were being a victim of physical violence and sensation seeking at the individual level. In males, practicing unsafe sex, sensation seeking, being a victim of physical violence, having a poor relationship with parents, being depressed, and living in a single-parent household at the individual level; violence and antisocial acts at the classroom level; and being in a vocational school at the school level showed a correlation with violence perpetration. CONCLUSION: Interventions at the classroom level as well as an explicit school policy on violence and other risk behaviors should be considered a priority when dealing with the problem of youth violence. Furthermore, prevention should take into account gender differences.