Tongan adolescents' eating patterns : opportunities for intervention

The purpose of this mixed methods study was to examine the sources of food and dietary patterns of Tongan adolescents (n = 2084) and their perceptions of sociocultural influences. The study incorporated anthropometric measurements, a behavioral survey, and qualitative interviews. More adolescent Tongan females (82.5%) than males (74.3%) reported sourcing morning tea and/or lunch (females 81.9%, males 72.6%) from school canteens or nearby food outlets. More females than males reported consuming obesity-promoting foods such as packaged snack foods (females 38.2%, males 21.3%), chocolates (females 24.7%, males 15.0%), and soft drinks (females 55.3%, males 50.4%). Food purchased for consumption at schools was predominantly energy dense and nutrient poor. Ensuring that students have access to foods of high nutritional quality sourced from school or home, and restricting access to local food outlets that supply unhealthy products would improve the nutrition status of adolescents in Tonga. Furthermore, it is important that obesity prevention interventions are informed by culture-specific influences to optimize uptake of healthy diets.

Domestic and sexual violence and abuse : findings from a Delphi expert consultation on therapeutic and treatment interventions with victims, survivors and abusers, children adolescents, and adults

This report presents the results of one piece of research conducted as a part of the Victims of Violence and Abuse Prevention Programme (VVAPP) in the UK, namely a three round Delphi consultation. This Delphi consultation was undertaken to identify where there is and is not consensus among experts about what is known and what works in the treatment and care of people affected by child sexual abuse, domestic violence and abuse, and rape and sexual assault. It enables the identification of areas of agreement and disagreement about effective mental health service responses, and thereby contributes to the evidence base in this area.

Body image and body change strategies among Tongan adolescents in Tonga and New Zealand

Aim : The aim of this study was to evaluate the body image and body change strategies of adolescents from Tonga, and Tongans who are resident New Zealand.

Method : In total, 598 Tongans from Tonga and 388 Tongans from New Zealand completed measures of body image, body change strategies and messages about their body.

Results : Tongans in Tonga were more likely to receive positive messages about a larger body from adults at school, church and the media, and losing weight from the media. They were also more likely to adopt strategies to lose weight, increase weight and increase muscles.

Conclusion : The large body ideal appears to be still valued in Tonga, whereas Tongans also want to lose weight because of media messages to achieve a healthy body weight.

Psychological responses to acute resistance exercise in men and women who are obese

The purpose of the study was to investigate the psychological response to the very first session of resistance exercise on positive well-being (PWB), psychological distress (PD), and perception of fatigue in untrained men and women who are obese. Forty-five (male = 22, female = 23) untrained, middle-aged volunteers (mean ± SEM, 51.0 ± 1.0; range, 40-69 years) participated in the study. Participants were divided into 4 groups according to sex and obesity level (i.e., men who are obese, men who are nonobese, women who are obese, women who are nonobese). The threshold for obesity was defined as waist circumference ≥94 cm for men and 80 cm for women. Measures included body composition, aerobic power, muscle strength, and quality of life (Short Form 36, SF-36). Before and after resistance exercise, participants completed the Subjective Exercise Experience Scale (SEES). Paired sample t-tests were used to assess changes in SEES scores within group pre- and post-exercise and repeated-measures analysis of variance were used to assess changes in SEES scores between groups. Exercise increased the perception of PWB in both women who are obese and nonobese, without changes in PD or fatigue. In women, the change in PWB after exercise was negatively correlated with most scales of the SF-36, particularly with the mental health dimension (r = -0.55, p < 0.01). No significant changes in PWB, PD, or fatigue were found in men who are obese. Acute resistance exercise improved PWB in women who are obese and nonobese and those with lower self-perceived quality of life scores at the start improved the most. In addition, resistance exercise did not increase feelings of distress in either women or men who are obese.

The effect of acute exercise on undercarboxylated osteocalcin in obese men

Summary : The purpose of this study was to examine if the reduction in glucose post-exercise is mediated by undercarboxylated osteocalcin (unOC). Obese men were randomly assigned to do aerobic or power exercises. The change in unOC levels was correlated with the change in glucose levels post-exercise. The reduction in glucose post-acute exercise may be partly related to increased unOC.

Introduction : Osteocalcin (OC) in its undercarboxylated (unOC) form may contribute to the regulation of glucose homeostasis. As exercise reduces serum glucose and improves insulin sensitivity in obese individuals and individuals with type 2 diabetes (T2DM), we hypothesised that this benefit was partly mediated by unOC.

Methods : Twenty-eight middle-aged (52.4 ± 1.2 years, mean ± SEM), obese (BMI = 32.1 ± 0.9 kg m⁻²) men were randomly assigned to do either 45 min of aerobic (cycling at 75% of VO2peak) or power (leg press at 75% of one repetition maximum plus jumping sequence) exercises. Blood samples were taken at baseline and up to 2 h post-exercise.

Results : At baseline, unOC was negatively correlated with glucose levels (r = −0.53, p = 0.003) and glycosylated haemoglobin (HbA1c) (r = −0.37, p = 0.035). Both aerobic and power exercises reduced serum glucose (from 7.4 ± 1.2 to 5.1 ± 0.5 mmol L⁻¹, p = 0.01 and 8.5 ± 1.2 to 6.0 ± 0.6 mmol L⁻¹, p = 0.01, respectively). Aerobic exercise significantly increased OC, unOC and high-molecular-weight adiponectin, while power exercise had a limited effect on OC and unOC. Overall, those with higher baseline glucose and HbA1c had greater reductions in glucose levels after exercise (r = −0.46, p = 0.013 and r = −0.43, p = 0.019, respectively). In a sub-group of obese people with T2DM, the percentage change in unOC levels was correlated with the percentage change in glucose levels post-exercise (r = −0.51, p = 0.038).

Conclusions : This study reports that the reduction in serum glucose post-acute exercise (especially aerobic exercise) may be partly related to increased unOC.r exercises. The change in unOC levels was correlated with the change in glucose levels post-exercise. The reduction in glucose post-acute exercise may be partly related to increased unOC.

Accumulated oxygen deficit measurements during and after high-intensity exercise in trained male and female adolescents

The purpose of this study was to compare accumulated oxygen deficits and markers of anaerobic metabolism [plasma ammonia (NH3) and lactate (La⁻) concentrations] in anaerobically trained male [n = 8, age 14.8 (0.5) years; maximal oxygen consumption V˙O2 max 61.74 (2.23) ml ·  kg⁻¹ · min⁻¹] and female [n = 8, age 14.5 (0.2) years; V˙O2 max 49.62 (3.52) ml · kg⁻¹ · min⁻¹] adolescents. The exercise protocol consisted of runs to exhaustion at speeds predicted to represent 120% and 130% of V˙O2 max. Arterialised blood samples were obtained from a pre-warmed hand via a catheter inserted into a forearm vein. Samples were taken at rest and after 1, 3, 5, 7, 10, 15 and 20 min of recovery. The high-intensity exercise resulted in mean accumulated oxygen deficits that were less (P < 0.05) in females (52.3 ml · kg⁻¹) than in males (68.6 ml · kg⁻¹). Lower (P < 0.05) plasma concentrations of NH3 and La⁻¹, and a higher pH were evident in females compared with males during various stages of the 20-min recovery period. The increase in anaerobic performance in the male adolescent athletes when compared with their female counterparts was associated with an increased plasma concentration of selected plasma and blood metabolites. The observed results may reflect well-established differences between the sexes in the morphology and metabolic power of muscle.

Current empirical assessment methods for adolescents and children who sexually abuse others

The assessment of adolescents and children who commit sexually abusive behavior is a complex and challenging task. Incorporating empirically based assessment methods into psychosexual evaluations promises appropriate coverage of relevant domains, sound interpretation of the meaning of data, reduced clinician biases and error, and greater certainty in decision-making. In this paper we review empirically-based assessment methods currently available for use in psychosexual assessment of adolescents and children who sexually abuse others. Our review describes the robustness of these measures and provides guidance for their appropriate use in assessment. The review highlighted that several empirically-based measures are suitable for clinical use with adolescents, but very little is available to guide assessment of children's abusive behavior per se.

The effects of playing violent video games on adolescents : should parents be quaking in their boots?

Debate regarding the psychological and behavioural effects of playing violent video games has recently led to claims that violent video games increase aggression effects in adolescents, and that this issue has now been settled. However, other researchers have found either no detrimental effects from game playing or even positive (cathartic) effects. In this research we demonstrate that these different conclusions are not mutually exclusive and can be explained by the method of assessment and analytic techniques utilised. We had adolescents play a violent video game (Quake II) and took measurements of anger both before, during and after game play. The results demonstrated that some people increase, some decrease and the majority show no change in anger ratings. Unlike past research, we also demonstrate that these changes are mediated by the player's feelings immediately prior to game play and a labile temperament - one predisposed to aggression - and that these variables predict people's reactions with an average 73% concordance rate.

Continuity of midwifery care and gestational weight gain in obese women : a randomised controlled trial

Background: The increased prevalence of obesity in pregnant women in Australia and other developed countries is a significant public health concern. Obese women are at increased risk of serious perinatal complications and guidelines recommend weight gain restriction and additional care. There is limited evidence to support the effectiveness of dietary and physical activity lifestyle interventions in preventing adverse perinatal outcomes and new strategies need to be evaluated. The primary aim of this project is to evaluate the effect of continuity of midwifery care on restricting gestational weight gain in obese women to the recommended range. The secondary aims of the study are to assess the impact of continuity of midwifery care on: women’s experience of pregnancy care; women’s satisfaction with care and a range of psychological factors.
Methods/Design: A two arm randomised controlled trial (RCT) will be conducted with primigravid women recruited from maternity services in Victoria, Australia. Participants will be primigravid women, with a BMI≥30 who are less than 17 weeks gestation. Women allocated to the intervention arm will be cared for in a midwifery continuity of care model and receive an informational leaflet on managing weight gain in pregnancy. Women allocated to the control group will receive routine care in addition to the same informational leaflet. Weight gain during pregnancy, standards of care, medical and obstetric information will be extracted from medical records. Data collected at recruitment (self administered survey) and at 36 weeks by postal survey will include sociodemographic information and the use of validated scales to measure secondary outcomes.
Discussion: Continuity of midwifery care models are well aligned with current Victorian, Australian and many international government policies on maternity care. Increasingly, midwifery continuity models of care are being introduced in low risk maternity care, and information on their application in high risk populations is required. There is an identified need to trial alternative antenatal interventions to reduce perinatal risk factors for women who are obese and the findings from this project may have application in other maternity services. In addition this study will inform a larger trial that will focus on birth and postnatal outcomes.

Characteristics of energy under-reporting in children and adolescents

Under-reporting (UR) of food intake is an issue of concern, as it may distort the relationships studied between diet and health. This topic has been scarcely addressed in children. The objective of the study was to assess the extent of UR in French children and investigate associated covariates. A total of 1455 children aged 3–17 years were taken from the nationally representative cross-sectional French étude Individuelle Nationale des Consommations Alimentaires (INCA2) dietary survey (2006–7). Food intake was reported in a 7 d diet record. Socio-economic status, sedentary behaviour, weight perception variables and food habits were collected by questionnaires. Weight and height were measured. Under-reporters were identified according to the Goldberg criterion adapted to children. Multivariate logistic regressions investigated the associations between UR and covariates. Rates of under-reporters were 4·9 and 26·0 % in children aged 3–10 and 11–17 years, respectively (P < 0·0001), without significant differences between boys and girls. Overall, UR was positively associated with a lower socio-economic status, overweight, skipping breakfast and dinner, a higher contribution of proteins to energy intake (EI), and a lower contribution of simple carbohydrates to EI. Under-reporters aged 3–10 years also had a higher sedentary behaviour and a lower snack-eating frequency. In adolescents, UR was also associated with a less-frequent school canteen attendance, a perception of being overweight, a wish to weigh less, and current and past restrictive diets. In conclusion, under-reporters differ from plausible reporters in several characteristics related to diet, lifestyle, weight status and socio-economic status. Therefore, it is important to consider this differential UR bias when investigating diet–disease associations in children.