Solid organ transplantation: are there predictors for posttransplant noncompliance? A literature overview

BACKGROUND: Many studies confirm that noncompliance or poor compliance is one of the great problems in health care as it results in waste of resources and funds. METHODS: This overview includes literature on heart, liver, and kidney transplants with emphasis on heart transplantation in adult and pediatric transplant patients and addresses the following variables as potential predictors of postoperative compliance problems: demographic variables (age, marital status, gender) psychological variables (anxiety, denial) psychiatric disorders (major depression, anxiety, and personality disorders), poor social support, pretransplant noncompliance, obesity, substance abuse, and health-related variables (distance from transplant center, indication for transplantation, required pretransplant assist device). Relevant studies on these topics that were conducted up to 1999 are included and discussed in this overview. The most important results are presented in tables. RESULTS: Unfortunately, there has not been any systematic and comprehensive review of the literature on predictors of noncompliance in organ transplant patients so far. With organ transplantation noncompliance impairs both life quality and life span as it is a major risk factor for graft rejection episodes and is responsible for up to 25% of deaths after the initial recovery period. Therefore, it might be assumed that well-informed transplant patients are a highly motivated group whose compliance is just as high. This is not the case. However, even when graft loss means loss of life as in heart or liver transplantation, noncompliance occurs. To best select potential organ recipients, it would be ideal if patients who are very likely to show noncompliant behavior could be identified already before being transplanted. CONCLUSION: The literature overview shows the necessity of preoperative psychosocial screening regarding predictors for posttransplant noncompliance.

Fenofibrate metabolism in the cynomolgus monkey using ultraperformance liquid chromatography-quadrupole time-of-flight mass spectrometry-based metabolomics

Fenofibrate, widely used for the treatment of dyslipidemia, activates the nuclear receptor, peroxisome proliferator-activated receptor alpha. However, liver toxicity, including liver cancer, occurs in rodents treated with fibrate drugs. Marked species differences occur in response to fibrate drugs, especially between rodents and humans, the latter of which are resistant to fibrate-induced cancer. Fenofibrate metabolism, which also shows species differences, has not been fully determined in humans and surrogate primates. In the present study, the metabolism of fenofibrate was investigated in cynomolgus monkeys by ultraperformance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-QTOFMS)-based metabolomics. Urine samples were collected before and after oral doses of fenofibrate. The samples were analyzed in both positive-ion and negative-ion modes by UPLC-QTOFMS, and after data deconvolution, the resulting data matrices were subjected to multivariate data analysis. Pattern recognition was performed on the retention time, mass/charge ratio, and other metabolite-related variables. Synthesized or purchased authentic compounds were used for metabolite identification and structure elucidation by liquid chromatographytandem mass spectrometry. Several metabolites were identified, including fenofibric acid, reduced fenofibric acid, fenofibric acid ester glucuronide, reduced fenofibric acid ester glucuronide, and compound X. Another two metabolites (compound B and compound AR), not previously reported in other species, were characterized in cynomolgus monkeys. More importantly, previously unknown metabolites, fenofibric acid taurine conjugate and reduced fenofibric acid taurine conjugate were identified, revealing a previously unrecognized conjugation pathway for fenofibrate.

Hormonal risk factors and testicular cancer

The cause of testicular cancer is not known and recent hypotheses have suggested an altered hormonal milieu may increase the risk of testis cancer. This study examined modulation of testicular cancer risk by hormonal factors, specifically: environmental xenoestrogens (e.g. organochlorines), prenatal maternal estrogens, testosterone indices (age at puberty, severe adolescent acne, self-reported balding), sedentary lifestyle and dietary consumption of fats and phytoestrogens.^ A hospital based friend matched case-control study was conducted at the University of Texas M. D. Anderson Cancer Center in Houston, Texas, between January 1990 and October 1996. Cases had a first primary testis tumor diagnosed between age 18 to 50 years and resided in Texas, Louisiana, Oklahoma or Arkansas.^ Cases and friend controls completed a mail questionnaire and case/control mothers were contacted by phone regarding pregnancy related variables. The study population comprised 187 cases, 148 controls, 147 case mothers and 86 control mothers. Odds ratios were virtually identical whether the match was retained or dissolved, thus the analyses were conducted using unconditional logistic regression.^ Cryptorchidism was a strong risk factor for testis cancer with an age-adjusted odds ratio (OR) of 7.7 (95% confidence interval (CI): 2.3-26.3). In a final model (adjusted for age, education, and cryptorchidism), history of severe adolescent acne and self-reported balding were both significantly protective, as hypothesized. For acne (yes vs. no) the OR was 0.5 (CI: 0.3-1.0) and for balding (yes vs. no) the OR was 0.6 (CI: 0.3-1.0). Marijuana smoking was a risk factor among heavy, regular users (17 times/week, OR = 2.4; CI: 0.9-6.4) and higher saturated fat intake increased testis cancer risk (saturated fat intake $>$ 15.2 grams/day vs. $<$ 11.8 grams/day, OR = 3.3; CI: 1.5-7.1). Early puberty, xenoestrogen exposure, elevated maternal estrogen levels, sedentary lifestyle and dietary phytoestrogen intake were not associated with risk of testicular cancer.^ In conclusion, testicular cancer may be associated with endogenous androgen metabolism although environmental estrogen exposure can not be ruled out. Further research is needed to understand the underlying hormonal mechanisms and possible dietary influences. ^

Dental erosive wear assessment among adolescents and adults utilizing the basic erosive wear examination (BEWE) scoring system.

OBJECTIVES To investigate erosive tooth wear and related variables among adolescents and adults in Israel, utilizing the new basic erosive wear examination (BEWE) scoring system, in an attempt to contribute to the ongoing review, evaluation, and further development of an international standardized index. MATERIAL AND METHODS A cross-sectional, descriptive, and analytic survey was conducted among 500 subjects of five age groups. Dental erosion was measured according to the new BEWE scoring system. Independent variables included gender, age, origin, education, employment status, and diet. A backward stepwise linear regression model was applied to identify significantly associated variables. RESULTS Fifty percent of the survey subjects demonstrated erosive tooth wear; among them, 10 % had distinct erosion of over 50 % of the dental surface. Total BEWE score differences by age groups were statistically significant; as the age increased, the mean total BEWE scores increased (p < 0.001). The association between acidic foods and erosion was evident among the younger population (p = 0.038). In a multiple regression model, age (p < 0.001) and diet (p = 0.044) achieved statistical significance as variables associated with dental erosive wear. CONCLUSIONS Our study is one of the first to use the BEWE scoring system in an epidemiological survey among adolescents and adults. It was found that the BEWE index is straightforward, easy to conduct, and comfortably accepted by the examinees. CLINICAL RELEVANCE The present findings, together with further international research, should contribute toward continued evaluation of the BEWE system as an international standard and thereby, toward more optimal understanding, evidence-based treatment, and prevention of dental erosive wear.

Low back pain risk factors associated with persistence, recurrence and delayed presentation

BACKGROUND: There is little knowledge in the literature on the role of time-related variables for the prognosis of acute and subacute low back pain (LBP). OBJECTIVE: The aim of this study was to estimate the relationship between time-related LBP characteristics and prognostic factors for acute/subacute LBP. METHODS: We performed a prospective inception cohort study of 315 patients attending a health practitioner for acute/subacute LBP or recurrent LBP. One-tailed correlations were conducted between patient characteristics and time-related variables. RESULTS: The pattern of correlation between risk factors for and resources against persistent LBP differed between three time-related variables. 'Subacute LBP' and 'delayed presentation' were positively associated with psychological factors. Both indicators were negatively correlated with resources against development of persistent LBP. Moreover, 'delayed presentation' was related positively with occupational stressors. In contrast, 'recurrent LBP' was only related to more impaired health-related factors. CONCLUSIONS: Patients with current LBP waiting longer until seeking help in primary care have a more disadvantageous profile of occupational and psychological risk factors and lower resource levels. A similar but less pronounced pattern occurred in those with subacute LBP compared to those with acute LBP. Consideration of time characteristics of LBP may help to better understand LBP.

The influence of absorbed solar radiation by Saharan dust on hurricane genesis

To date, the radiative impact of dust and the Sahar an air layer (SAL) on North Atlantic hurricane activity is not yet known. According to previous studies, dust stabilizes the atmosphere due to absorption of solar radiation but thus shifts convection to regions more conducive for hurricane genesis. Here we analyze differences in hurricane genesis and frequency from ensemble sensitivity simulations with radiatively active and inactive dust in the aerosol-climate model ECHAM6-HAM. We investigate dust burden and other hurricane-related variables and determine their influence on disturbances which develop into hurricanes (developing disturbances, DDs) and those which do not (nondeveloping disturbances, NDDs). Dust and the SAL are found to potentially have both inhibiting and supporting influences on background conditions for hurricane genesis. A slight southward shift of DDs is determined when dust is active as well as a significant warming of the SAL, which leads to a strengthening of the vertical circulation associated with the SAL. The dust burden of DDs is smaller in active dust simulations compared to DDs in simulations with inactive dust, while NDDs contain more dust in active dust simulations. However, no significant influence of radiatively active dust on other variables in DDs and NDDs is found. Furthermore, no substantial change in the DD and NDD frequency due to the radiative effects of dust can be detected.

Psychological distress in medical seeking ED care for somatic reasons: results of a systematic review

Objectives: The aim of this systematic literature review is to investigate (A) currently used instruments for assessing psychological distress, (B) the prevalence of psychological distress in medical emergency department (ED) patients with acute somatic conditions and (C) empirical evidence on how predictors are associated with psychological distress. Methods: We conducted an electronic literature search using three databases to identify studies that used validated instruments for detection of psychological distress in adult patients presented to the ED with somatic (non-psychiatric) complaints. From a total of 1688 potential articles, 18 studies were selected for in-depth review. Results: A total of 13 instruments have been applied for assessment of distress including screening questionnaires and briefly structured clinical interviews. Using these instruments, the prevalence of psychological distress detected in medical ED patients was between 4% and 47%. Psychological distress in general and particularly depression and anxiety have been found to be associated with demographic factors (eg, female gender, middle age) and illness-related variables (eg, urgency of triage category). Some studies reported that coexisting psychological distress of medical patients identified in the ED was associated with physical and psychological health status after ED discharge. Importantly, during routine clinical care, only few patients with psychological distress were diagnosed by their treating physicians. Conclusions: There is strong evidence that psychological distress is an important and prevalent cofactor in medically ill patients presenting to the ED with harmful associations with (subjective) health outcomes. To prove causality, future research should investigate whether screening and lowering psychological distress with specific interventions would result in better patient outcomes.

Motivational profiles of sporting event volunteers

This article presents an approach for segmenting sporting event volunteers according to differences in their motives. Empirical data were obtained from a sample of 1169 volunteers who registered for the 2014 European Athletics Championships in Zürich. They completed the ‘Volunteer Motivation Scale for International Sporting Events’ (VMS-ISE) questionaire. The validity of the VMS-ISE was replicated by confirmatory factor analysis and the data were cluster analysed to identify distinct motivation-based volunteer profiles. These segmented volunteers on the basis of mutually exclusive motivational characteristics. The external validity of the four motivation-based types (‘community supporters’, ‘material incentive seekers’, ‘social networkers’ and ‘career and personal growth orienteers’) was confirmed with socio-economic, sport-related and volunteer activity-related variables. It is concluded that motivation-based segmentation represents a useful way of gaining a clearer understanding of the patterns underlying the heterogeneity of sporting events volunteers.

Forecasting and Analyzing Economic Activity with Coincident and Leading Indexes: The Case of Connecticut

We develop coincident and leading employment indexes for the Connecticut economy. Four employment-related variables enter the coincident index while five employment-related variables enter the leading index. The peaks and troughs in the leading index lead the peaks and troughs in the coincident index by an average of 3 and 9 months. Finally, we use the leading index in vector-autoregressive (VAR) and Bayesian vector-autoregressive (BVAR) models to forecast the coincident index, nonfarm employment, and the unemployment rate.

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) nasal colonization among dental professionals

Background. MRSA (methicillin-resistant Staphylococcus aureus) is a multi-drug resistant bacterium that is quite prevalent in social environments where close person-to-person contact and crowding are an issue. In dental settings, the likelihood of transmission of MRSA may be higher than among other healthcare practitioners because of the close proximity between a patient's nose (where MRSA colonizes) and the field of procedure (the mouth) to the dental professional. Objective. To estimate the prevalence of MRSA nasal colonization among dental professionals (dentists and dental hygienists) in the Greater Houston Metropolitan Area, Texas, and analyze its associations with demographic, professional and personal protective equipment-related variables. Methods. 800 dental professionals (400 dentists and 400 dental hygienists) were randomly selected in the Greater Houston Metropolitan Area. Multiple waves of nasal swab kits and a self-administered questionnaire were mailed to increase the response rate of the study population. The swabs were cultured on chromagenic agar growth medium and bacterial growth results were evaluated after 18 hours. Positively selected bacterial colonies were confirmed as MRSA by further culturing these isolated bacteria on blood agar plates. Associations between positive nasal swabs and self-reported professional practice patterns, personal protective equipment use and demographics were analyzed using multiple logistic regression. Main Results. Completed questionnaires and nasal swabs were received from 496 study participants (68%). Fourteen cultures were positive for MRSA (4.2% among dentists and 1.6% among dental hygienists, p=0.07). After adjusting for gender, dental hygienists had a significantly lower prevalence of nasal colonization of MRSA as compared to dentists (OR: 0.20, 95% CI: 0.05–0.75). No other significant associations or interactions were found. Conclusion. The prevalence of nasal colonization with MRSA among dentists is similar to that reported for health care workers in general, whereas prevalence among dental hygienists is only slightly above that of the general population (1%). Differences in practice patterns and use of personal protective equipment did not explain this difference in this study, and was possibly due either to residual confounding or unexplored risk factors. Increased prevalence of MRSA among dentists warrants further investigation as to the reason for the increased rate and to allow implementation of measures to avoid transmission and progression to disease. ^

Industrialization Policies of Korea and Taiwan and Their Effects on Manufacturing Productivity

In this paper the total factor productivity (TFP) of the manufacturing sectors in Taiwan and the Republic of Korean was measured and compared using the growth accounting method. Through descriptive analysis, inefficiency in the Korean manufacturing sectors was revealed, especially for the period prior to 1986. Also for the period posterior to 1986, it was found that TFP tended to contribute more to the value-added growth in both countries. An econometric analysis with industrialization-related variables revealed a contrast in the structure of TFP growth between the two countries. Import penetration, capital intensity, and growth of real output were estimated to exert a positive productivity impact in Taiwan, reflecting Taiwan's flexibility and superiority in factor utilization compared with Korea. It was estimated that the export ratio did not have any major productivity impact in both countries, in contrast with the results reported by the World Bank (The East Asian Miracle: Economic Growth and Public Policy, New York: Oxford University Press, 1993).

Epidemiology of injuries in First Division Spanish football

Abstract The aim was to examine the injuries sustained by Spanish football players in the First Division and to compare injury-related variables in the context of both competition and training. The injury data were prospectively collected from 16 teams (427 players) using a specific web-based survey during the 2008/2009 season. A total of 1293 injuries were identified (145 were recurring injuries). The overall injury incidence was 5.65 injuries per 1000 h of exposure. Injuries were much more common during competition than during training (43.53 vs. 3.55 injuries per 1000 h of exposure, P menor que 0.05). Most of the injuries (89.6%) involved the lower extremities, and overuse (65.7%) was the main cause. Muscle and tendon injuries were the most common types of injury (53.8%) among the players. The incidence of training injuries was greater during the pre-season and tended to decrease throughout the season, while the incidence of competition injuries increased throughout the season (all P menor que 0.05). In conclusion, the results of this study suggest the need for injury prevention protocols in the First Division of the Spanish Football League to reduce the number of overuse injuries in the muscles and tendons in the lower extremities. In addition, special attention should be paid during the pre-season and the competitive phase II (the last four months of the season) in order to prevent training and competition injuries, respectively.

Modelo del sistema de gestión de la calidad y el desempeño organizacional en la producción de petróleo

El proceso de cambio de una sociedad industrial a una sociedad del conocimiento, que experimenta el mundo globalizado en el siglo XXI, induce a las empresas y organizaciones a desarrollar ventajas competitivas y sostenibles basadas en sus activos intangibles, entre los cuales destacan los sistemas de gestión en general y los sistemas de gestión de la calidad (SGC) en particular. Las organizaciones dedicadas a la producción de petróleo están influenciadas por dicha tendencia. El petróleo es un recurso natural con reservas limitadas, cuya producción y consumo ha crecido progresivamente, aportando la mayor cuota (35 %) del total de la energía que se consume en el mundo contemporáneo, aporte que se mantendrá hasta el año 2035, según las previsiones más conservadoras. Por tanto, se hace necesario desarrollar modelos de producción innovadores, que contribuyan a la mejora del factor de recobro de los yacimientos y de la vida útil de los mismos, al tiempo que satisfagan los requerimientos de producción y consumo diarios de los exigentes mercados globales. El objeto de esta investigación es el desarrollo de un modelo de gestión de la calidad y su efecto en el desempeño organizacional, a través del efecto mediador de los constructos satisfacción del cliente interno y gestión del conocimiento en la producción de petróleo. Esta investigación de carácter explicativo, no experimental, transeccional y ex-postfacto, se realizó en la región petrolífera del lago de Maracaibo, al occidente de Venezuela, la cual tiene más de 70 años en producción y cuenta con yacimientos maduros. La población objeto de estudio fue de 369 trabajadores petroleros, quienes participaron en las mesas técnicas de la calidad, durante los meses de mayo y julio del año 2012, los cuales en su mayoría están en proceso de formación como analistas, asesores y auditores de los SGC. La técnica de muestreo aplicada fue de tipo aleatorio simple, con una muestra de 252 individuos. A la misma se le aplicó un cuestionario diseñado ad hoc, el cual fue validado por las técnicas de juicio de expertos y prueba piloto. El procedimiento de investigación se realizó a través de una secuencia, que incluyó la elaboración de un modelo teórico, basado en la revisión del estado del arte; un modelo factorial, sobre la base del análisis factorial de los datos de la encuesta; un modelo de regresión lineal, elaborado a través del método de regresión lineal simple y múltiple; un modelo de análisis de sendero, realizado con el software Amos 20 SPSS y finalmente, un modelo informático, realizado con el simulador Vensim PLE v.6.2. Los resultados obtenidos indican que el modelo teórico se transformó en un modelo empírico, en el cual, la variable independiente fue el SGC, la variable mediadora fue la integración de las dimensiones eliminación de la no conformidad, satisfacción del cliente interno y aprendizaje organizacional (ENCSCIAO) y la variable respuesta la integración de las dimensiones desempeño organizacional y aprendizaje organizacional (DOOA). Se verificó el efecto mediador del ENSCIAO sobre la relación SGC-DOOA con una bondad del ajuste, del 42,65%. En el modelo de regresión múltiple se encontró que las variables determinantes son eliminación de la no conformidad (ENC), conocimiento adquirido (CA) y conocimiento espontáneo (CE), lo cual fue corroborado con el modelo de análisis de sendero. El modelo informático se desarrolló empleando datos aproximados de una unidad de producción tipo, generándose cuatro escenarios; siendo el más favorable, aquel en el cual se aplicaba el SGC y variables relacionadas, reduciendo la desviación de la producción, incrementando el factor de recobro y ampliando la vida útil del yacimiento. Se concluye que la aplicación del SGC y constructos relacionados favorece el desempeño y la producción de las unidades de explotación de yacimientos petrolíferos maduros. Los principales aportes de la tesis son la obtención de un modelo de gestión de la producción de petróleo en yacimientos maduros, basado en los SGC. Asimismo, el desarrollo de un concepto de gestión de la calidad asociado a la reducción de la desviación de la producción petrolífera anual, al incremento del factor de recobro y al aumento de la vida útil del yacimiento. Las futuras líneas de investigación están orientadas a la aplicación del modelo en contextos reales y específicos, para medir su impacto y realizar los ajustes pertinentes. ABSTRACT The process of change from an industrial society to a knowledge-based society, which undergoes the globalized world in the twenty-first century, induces companies and organizations to develop a sustainable and competitive advantages based on its intangible assets, among which are noteworthy the management systems in general and particularly the quality management systems (QMS). Organizations engaged in oil production are influenced by said trend. Oil is a natural resource with limited reserves, where production and consumption has grown progressively, providing the largest share (35%) of the total energy consumed in the contemporary world, a contribution that will remain until the year 2035 according to the more conservative trust estimations. Therefore, it becomes necessary to develop innovative production models which contribute with the improvement of reservoirs´ recovery factor and the lifetime thereof, while meeting the production requirements and daily consumption of demanding global markets. The aim of this research is to develop a model of quality management and its effect on organizational performance through the mediator effect of the constructs, internal customer satisfaction and knowledge management in oil production. This research of explanatory nature, not experimental, transactional and expos-facto was carried out in the oil-region of Maracaibo Lake located to the west of Venezuela, which has more than 70 years in continuous production and has mature reservoirs. The population under study was 369 oil workers who participated in the technical quality workshops, during the months of May and July of 2012, the majority of which were in the process of training as analysts, consultants and auditors of the QMS. The sampling technique applied was simple random type. To a sample of 252 individuals of the population it was applied an ad hoc designed questionnaire, which was validated by the techniques of expert judgment and pilot test. The research procedure was performed through a sequence, which included the elaboration of a theoretical model, based on the review of the state of the art; a factorial model with based on factorial analysis of the survey data; a linear regression model, developed through the method of simple and multiple linear regression; a structural equation model, made with software °Amos 20 SPSS° and finally, a computer model, performed with the simulator Vensim PLE v.6.2. The results indicate that the theoretical model was transformed into an empirical model, in which the independent variable was the QMS, the mediator variable was the integration of the dimensions: elimination of non-conformity, internal customer satisfaction and organizational learning (ENCSCIAO) and the response variable the integration of the dimensions, organizational performance and learning organizational (DOOA). ENSCIAO´s mediator effect on the relation QMS-DOOA was verified with a goodness of fit of 42,65%. In the multiple regression model was found to be the determining variables are elimination of nonconformity (ENC), knowledge acquired (CA) and spontaneous knowledge (EC), which was verified with the structural equation model. The computer model was developed based on approximate data of an oil production unit type, creating four (04) scenarios; being the most favorable, that one which it was applied the QMS and related variables, reducing the production deviation, increasing the recovery factor and extending the lifetime of the reservoir. It is concluded that QMS implementation powered with the related constructs, favors performance and production of mature oilfield of exploitation reservoirs units. The main contributions of this thesis are obtaining a management model for oil production in mature oilfields, based on QMS. In addition, development of a concept of quality associated to reduce the annual oil production deviation, increase the recovery factor and increase oilfield lifetime. Future lines of research are oriented to the implementation of this model in real and specific contexts to measure its impact and make the necessary adjustments that might take place.

Performance profiles of football teams in the UEFA Champions League considering situational efficiency

Performance of football teams varies constantly due to the dynamic nature of this sport, whilst the typical performance and its spread can be represented by profiles combining different performance-related variables based on data from multiple matches. The current study aims to use a profiling technique to evaluate and compare match performance of football teams in the UEFA Champions League incorporating three situational variables (i.e. strength of team and opponent, match outcome and match location). Match statistics of 72 teams, 496 games across four seasons (2008-09 to 2012-13) of this competition were analysed. Sixteen performance-related events were included: shots, shots on target, shots from open play, shots from set piece, shots from counter attack, passes, pass accuracy (%), crosses, through balls, corners, dribbles, possession, aerial success (%), fouls, tackles, and yellow cards. Teams were classified into three levels of strength by a k-cluster analysis. Profiles of overall performance and profiles incorporating three situational variables for teams of all three levels of strength were set up by presenting the mean, standard deviation, median, lower and upper quartiles of the counts of each event to represent their typical performances and spreads. Means were compared by using one-way ANOVA and independent sample t test (for match location, home and away differences), and were plotted into the same radar charts after unifying all the event counts by standardised score. Established profiles can present straightforwardly typical performances of football teams of different levels playing in different situations, which could provide detailed references for coaches and analysts to evaluate performances of upcoming opposition and of their own.

Associations between macronutrient intake and serum lipid profile depend on body fat in European adolescents: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study

The present study aimed to investigate the relationships between macronutrient intake and serum lipid profile in adolescents from eight European cities participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) cross-sectional study (2006–7), and to assess the role of body fat-related variables in these associations. Weight, height, waist circumference, skinfold thicknesses, total choles- terol, HDL-cholesterol (HDL-C), LDL-cholesterol, TAG, apoB and apoA1 were measured in 454 adolescents (44 % boys) aged 12·5–17·5 years. Macronutrient intake (g/4180 kJ per d (1000 kcal per d)) was assessed using two non-consecutive 24 h dietary recalls. Associations were evaluated by multi-level analysis and adjusted for sex, age, maternal education, centre, sum of four skinfolds, moderate-to-vigorous.