裕固族4～13岁儿童身高、体重状况调查分析

了解裕固族4～13岁儿童身高、体重发育现状,分析该儿童4～7岁组及7～13岁组生长发育随年龄的变化关系, 为儿童保健工作提供参考依据和合理化建议。采用随机整群抽样的方法抽取484名儿童, 测量身高和体重。以全国身高体重值为参比值, 计算年龄别身高(HAZ)和年龄别体重(WAZ)值评价4～7岁儿童体格生长迟缓和低体重状况; 身体质量指数(BMI)评价7～13岁儿童超重和消瘦情况。结果显示, 调查对象身高均高于对比值, 4～7岁儿童超重检出率为3.45%, 偏瘦检出率2.30%; 7～13岁裕固族儿童营养不良人数占裕固族儿童总人数的36.90%, 严重消瘦的人数占13.10%, 其中女生的消瘦程度较男生差。所以, 儿童身高、体重生长发育符合一般生长规律。7～13岁裕固族男女生身体偏瘦人数较多的问题值得关注, 建议改善该人群营养膳食, 加强各项体育锻炼。     

慢传输型便秘患者肠道粪便菌群的变化特征

目的通过16S rDNA高通量测序技术,研究慢传输型便秘(slow transit constipation,STC)患者粪便菌群的变化特征。方法选取12例慢传输型便秘患者(STC组)及12例健康志愿者(对照组),留取粪便标本后,应用16S rDNA高通量测序技术对标本进行测序,并分析测序结果。结果 STC组与对照组人群肠道在菌群物种种类(Chao1指数和Sobs指数)上差异存在统计学意义(Z=-2.771,P=0.006;Z=-2.425,P=0.015),对照组人群肠道菌群物种种类明显高于STC组;两组在物种均一性(Shannon指数、Simpson指数)上差异无统计学意义(Z=-0.520,P=0.603;Z=-0.348,P=0.728)。在门水平,两组人群粪便菌群多样性差异无统计学意义。在属水平,Phascolarctobacterium(Z=-2.194,P=0.028)、Streptococcus(Z=-4.157,P0.001)、Eggerthella(Z=-2.427,P=0.015)和Actinomyces(Z=-2.310,P=0.021)在STC组人群肠道中相对丰度增加,而Faecalibacterium(Z=-2.887,P=0.004)、Roseburia(Z=-3.118,P=0.002)、Sphingomonas(Z=-4.157,P0.001)、Variovorax(Z=-2.732,P=0.006)、Holdemania(Z=-1.970,P=0.049)、Phyllobacterium(Z=-2.732,P=0.006)、Pseudomonas(Z=-2.439,P=0.015)、Acinetobacter(Z=-2.732,P=0.006)、Aquabacterium(Z=-2.134,P=0.033)和Novosphingobium(Z=-2.134,P=0.033)在STC组中相对丰度减少。结论 STC组与对照组人群肠道在菌群物种种类丰富度上差异存在统计学意义,而在菌群分布均一性上差异无统计学意义;在菌属水平,两组人群的粪便菌群构成也存在较大差异。     

手足口病患儿血清降钙素原、C反应蛋白、白介素-6及白介素-10检测的意义

目的 通过检测手足口病(HFMD)患儿血清降钙素原(PCT)、C反应蛋白(CRP)、白介素-6(IL-6)及白介素-10(IL-10)水平,探讨其临床意义.方法 采用电化学发光法检测126例HFMD患儿及30例正常对照儿童血清PCT水平;采用免疫速率散射比浊法检测126例患儿及30例正常儿童血清CRP水平;用酶联免疫吸附试验(ELISA)检测64例HFMD患儿及24例正常对照儿童的血清IL-6、IL-10水平.结果 普通病例组的PCT浓度为0.054(0.035～0.080) ng/mL,重症病例组的PCT浓度为0.067(0.043～0.119) ng/mL,正常对照组为0.037 (0.026～0.044) ng/mL,各组差异有统计学意义(H=26.678,P=0.000);普通病例组的CRP浓度为1.950(1.100～3.575) ng/mL,重症病例组的CRP浓度为2.450(1.100 ～ 12.075) ng/mL,正常对照组为1.600(1.075 ～ 2.550) ng/mL,重症病例组高于正常对照组(Z=-2.081,P=0.037);PCT、CRP、IL-6和IL-10重症病例组与普通病例组间差异无统计学意义(Z=-1.865,P=0.062;Z=-1.707,P=0.088;Z=-1.396,P=0.163;Z=-0.951,P=0.342);126例HFMD患儿中,PCT阳性率为60.32％,CRP阳性率为15.08％,PCT和CRP在HFMD患儿中阳性率均升高(P≤0.05),PCT阳性率明显高于CRP(P ＜0.001).结论 血清PCT可作为HFMD患儿炎症性参考指标,反映HFMD免疫性炎症改变.     

益生菌、益生元、合生元与2型糖尿病的Meta分析

目的系统评价膳食添加益生菌、益生元、合生元对2型糖尿病患者血糖、血脂与应激状态的影响。方法检索MEDLINE、EMBASE、Cochrane对照试验中心注册数据库(cochrance central register of controlled trials,CENTRAL),检索语言为英语,检索起止时间为2000年至2015年。检索词为:type2diabetes,prebiotics。纳入对糖尿病患者添加益生菌、益生元、合生元的随机对照试验,采用Jadad量表进行研究质量评价,使用RevMan 5.2软件进行Meta分析。结果最终纳入的6项来自2个不同国家的高质量研究。试验组患者空腹血浆葡萄糖水平(I2=61%,95%CI=-41.10~-10.27,Z=-25.67,P=0.001)、甘油三酯(I2=40%,95%CI=-54.61~14.86,Z=-34.74,P=0.0006)、超敏C反应蛋白CRP(I2=0%,95%CI=-8.68~-4.52,Z=-6.6,P0.00001)低于对照组,差异具有统计学意义。糖化血红蛋白(I2=71%,95%CI=-0.80~0.23,Z=1.08,P=0.28)、胆固醇(I2=78%,95%CI=-39.87~3.12,Z=-18.37,P=0.09)在两组之间差异无统计学意义。结论膳食补充益生菌、益生元、合生元可以改善2型糖尿病患者血糖、血脂状况,降低应激反应。     

难治性便秘患儿症状与生活质量的相关性分析

摘要 目的：探讨难治性便秘患儿症状与生活质量的相关性。方法：选取2018年12月~2020年8月就诊于南京医科大学附属儿童医院消化科的450例功能性便秘患儿为研究对象,分为难治性便秘组(150例)及非难治性便秘组(300例),采用儿童生存质量测定量表(PedsQL4.0)评估其生活质量,并与150例健康体检儿童(健康对照组)比较。采用便秘症状评估表对难治性便秘患儿症状进行调查统计,分析难治性便秘患儿的症状与生活质量评分的相关性。结果：150例难治性便秘患儿出现较多的症状为：硬便148例(98.67%)、排便困难144例(96.00%)、排便频率减少(＞3 d/次)117例(78.00%)。与非难治性便秘组比较,难治性便秘组的便秘症状6个条目得分与总分均明显增加 (P＜0.05)。与健康对照组比较,难治性便秘组和非难治性便秘组的生理功能、情感功能、社交功能、学校表现评分及总分均明显降低(P＜0.05);与非难治性便秘组比较,难治性便秘组的生理功能、情感功能、社交功能、学校表现评分及总分均明显降低(P＜0.05)。难治性便秘患儿便秘症状总分与情感功能、学校表现和生活质量总分呈负相关(P＜0.05)。结论：难治性便秘患儿的生活质量下降,患儿便秘相关症状与生活质量密切相关。提示难治性便秘患儿治疗过程中,重视生理功能恢复的同时,还应当重视社会心理健康的恢复,从而改善患儿的生活质量。     

高龄Ⅲ型前列腺炎患者血清和前列腺液中神经生长因子、炎性因子的表达水平及临床意义

目的:探讨高龄Ⅲ型慢性前列腺炎(CP)患者血清和前列腺液(EPS)中神经生长因子(NGF)、炎性因子的表达水平及其临床意义。方法:收集2015年5月~2016年12月我院收治的150例高龄Ⅲ型CP患者(CP组),其中ⅢA型81例,ⅢB型69例,另选择150例健康体检者作为对照(对照组)。采用双抗体夹心酶联免疫吸附法(ABC-ELISA)检测其血清、EPS中NGF、IL-8和TNF-α的表达水平,分析NIH-CPSI、NGF、IL-8和TNF-α之间的相关性。结果:CP组血清、EPS中TNF-α、IL-8、NGF水平均明显高于对照组(P0.05);与IIIB型患者比较,IIIA型患者TNF-α、IL-8水平明显升高(P0.05);EPS中TNF-α、IL-8、NGF水平均明显高于血清(P0.05)。IIIB型患者的NIH-CPSI症状评分明显低于IIIA型(P0.05)。CP患者EPS中NGF和TNF-α、IL-8均呈显著正相关(P0.05);血清中NGF和TNF-α、IL-8亦呈显著正相关(P0.05)。III型CP患者血清、EPS中,TNF-α、IL-8、NGF与NIH-CPSI呈显著正相关(P0.05)。结论:高龄III型CP患者血清、EPS中TNF-α、IL-8、NGF表达水平明显升高,且与NIH-CPSI明显相关,联合检测有助于评估III型CP患者的病情严重程度。     

MRSA感染性创面菌群结构分析

目的探究耐甲氧西林金黄色葡萄球菌(MRSA)感染性创面与创面旁菌种组成的差异并寻找可能的有益菌,为从皮肤微生态角度治疗MRSA感染性创面提供理论依据。方法采集湖南省人民医院MRSA感染性创面及创面旁的皮肤样本,其中创面部位样本22份为D组,创面旁样本11份为N组,提取样本DNA,采用高通量测序技术对16S rRNA基因V3-V4区测序并进行生物信息学分析。结果根据Alpha多样性分析,D组的Chao1指数、Ace指数和Shannon指数明显低于N组(Z=62, P=0.023 8；Z=66, P=0.035 9；Z=30, P=0.000 2),而Simpson指数明显高于N组(Z=211, P=0.000 3)。Beta多样性分析显示2组皮肤菌群组成具有差异,表明分组合理(R=0.584 3、0.467 3, P=0.001 0)。D组葡萄球菌属(Staphylococcus)及韦荣球菌属(Veillonella)丰度显著性升高(Z=213, P=0.000 5；Z=48.5, P=0.004 8),其他常驻菌群均下降。N组的乳杆菌属(Lactobacillus)相对丰度均值较D组高(Z=38, P=0.000 8)。结论MRSA感染性创面的菌群结构较创面旁组具有一定变化,Lactobacillus为皮肤有益菌,可能对创面的恢复有益。     

维持性血液透析患者三维积极心理品质与症状负担的相关性研究

目的探讨维持性血液透析患者三维积极心理品质与症状负担的相关性。方法通过便利抽样选取2019年11～12月在广西某地区3所血液透析中心进行维持性血液透析患者184例为研究对象,调查三维积极心理品质和症状负担并进行相关性分析。结果 184例患者的三维积极心理品质总分得分及三个维度得分分别为(50.79±7.940)、(16.56±3.538)、(18.59±2.522)、(15.44±3.206)分,透析症状负担总分及生理、心理症状得分为别为(48.82±37.931)、(39.70±31.517)、(9.11±8.982)分。经t检验、单因素ANOVA分析显示,文化程度(β=0.249,P=0.001)、性别(β=0.239,P=0.002)、年龄(β=0.152,P=0.026)是三维积极心理品质的影响因素;Spearman相关分析显示,患者三维积极心理品质与透析症状负担呈负相关,差异均有统计学意义(P0.05)。结论维持性血液透析患者的三维积极心理品质与透析症状负担呈负相关。     

可溶性膳食纤维联合益生菌治疗老年便秘型肠易激综合征的临床疗效观察

目的观察可溶性膳食纤维联合益生菌治疗老年便秘型肠易激综合征的临床疗效及安全性。方法将2017年1月至2019年1月本院就诊的130例老年便秘型肠易激综合征患者随机分为膳食纤维联合益生菌组、益生菌组和膳食纤维组。膳食纤维联合益生菌组患者服用可溶性膳食纤维联合双歧杆菌三联活菌片,益生菌组口服双歧杆菌三联活菌片,膳食纤维组使用可溶性膳食纤维,三组疗程均为30 d。比较三组患者症状改善情况、PAC-QOL评分、CSI评分。结果三组患者治疗后PAC-QOL评分、CSI评分较治疗前显著减低,且膳食纤维联合益生菌组治疗后PAC-QOL评分均低于益生菌组和膳食纤维组,差异有统计学意义(P0.05)。膳食纤维联合益生菌组患者治疗后临床总有效率较益生菌组和膳食纤维组明显增高,差异有统计学意义(P0.05)。结论可溶性膳食纤维联合益生菌治疗老年便秘型肠易激综合征患者效果显著,无明显不良反应。     

圣乔治呼吸问卷对慢性阻塞性肺疾病患者生活质量的调查

目的:探讨慢性阻塞性肺疾病(COPD)患者应用圣乔治呼吸问卷(SGRQ)对其生活质量的评价作用。方法:回顾性分析我院2013年2月~2015年4月所收治的120例COPD稳定期患者临床病历资料,所有患者均进行肺功能检测,并采用SGRQ进行评价。结果:SGRQ中症状部分、活动部分、影响部分及总分与FEV1呈负相关性(r=-0.561、-0.720、-0.671、-0.711,P0.05);活动部分、影响部分、症状部分及总分间均呈一定相关性(P0.05);I、II级患者活动部分、影响部分、症状部分及总分间存在明显差异(P0.05);治疗后COPD患者活动部分、影响部分、症状部分及总分均较治疗前显著改善,差异均有统计学意义(P0.05)。结论:SGRQ对COPD患者的生活质量具有较好评价作用,同时还可较好地反映患者治疗效果,因此具有一定应用价值。     

功能性消化不良患儿Hp 治疗前后的症状及胃排空变化的超声观察

目的:探讨功能性消化不良患儿(Functional Dyspepsia,FD)幽门螺杆菌(Helicobacterpylori,Hp)治疗前后的症状及胃排空变化的超声观察。方法:选择我院6~10岁FD小儿患者70例为FD组,将其中28例Hp阴性者作为Hp阴性组,其余42例Hp阳性者作为治疗组。选取健康小儿72例作为对照组。超声测量入选者服用试餐即刻、20、40、60、90 min的近端、远端胃区面积,计算胃半排空时间。结果:FD组患儿上腹疼痛、上腹烧灼感、腹胀、恶心、嗳气和早饱症状的发生率均高于对照组,差异具有统计学意义(P0.05);FD组近端、远端、全胃的半排空时间均较对照组慢,差异具有统计学意义(P0.05)。腹胀、嗳气和早饱是远端胃半排空延迟的危险因素(OR1,P0.05);腹胀和上腹疼痛是全胃半排空延迟的危险因素(OR1,P0.05)。Hp阴性组、Hp治疗组近端、远端、全胃半排空时间较常规治疗组短,差异有统计学意义(P0.05);Hp治疗组与Hp阴性组之间差异无统计学意义(P0.05)。结论:FD患儿的胃排空有所延迟,对Hp感染患儿进行Hp根治有助于消化不良症状的改善,在临床工作中可合理选择应用。     

膳食纤维添加联合中医推拿对幼儿功能性便秘的疗效及安全性研究

摘要 目的：探讨膳食纤维添加联合中医推拿对幼儿功能性便秘的的疗效及安全性。方法：选择2017年1月~2020年6月在佛山市妇幼保健院儿科门诊诊治的135例功能性便秘幼儿作为研究对象。采用回顾性分析方法分为A组（基础治疗组,42例）、B组（膳食纤维添加组,52例）及C组（膳食纤维添加联合中医推拿组,41例）。治疗四周后,比较三组患儿排便困难症状评分和治疗效果。监测三组患儿治疗期间发生不良反应情况。随访观察6个月,比较三组患儿复发率。结果：治疗后三组患儿排便困难、腹胀、排便频率及症状评分总分比较差异有统计学意义（P＜0.05）,其中C组排便困难评分和症状评分总分低于A组和B组,B组和C组腹胀评分低于A组,C组排便频率评分低于A组,差异均有统计学意义（P＜0.05）。三组患儿总有效率比较差异有统计学意义（P＜0.05）,C组和B组总有效率高于A组的,差异有统计学意义（P＜0.05）,C组总有效率高于B组,差异有统计学意义（P＜0.05）。治疗期间三组患儿均未出现明显药物不良反应,如恶心、腹胀、呕吐、腹痛、腹泻、皮疹等。三组复发率比较差异有统计学意义（P＜0.05）。C组复发率明显低于对照组A组,差异有统计学（P＜0.05）。结论：在常规治疗基础上,膳食纤维添加联合中医推拿治疗幼儿功能性便秘,能提高临床治疗效果,降低远期复发率,是幼儿便秘安全有效的治疗方法。     

Prevalence and Predictors of Malnutrition among Guatemalan Children at 2 Years of Age

ObjectiveTo identify the prevalence and predictors of malnutrition among 2-year old children in the Western Highlands of Guatemala.MethodsProspective cohort of 852 Guatemalan children in San Lucas Toliman, Guatemala followed from birth to age 2 from May 2008 to December 2013. Socio-demographic, anthropometric, and health data of children was collected at 2 month intervals.ResultsAmong the 402 males and 450 females in the cohort, mean weight-for-age Z-score (WAZ) declined from -0.67 ± 1.01 at 1 year to -1.07 ± 0.87 at 2 years, while mean height-for-age Z-score (HAZ) declined from -1.88 ± 1.19 at 1 year to -2.37 ± 0.99 at 2 years. Using multiple linear regression modeling, number of children <5 years old, vomiting in the past week, fever in the past week, and WAZ at 1 year were significant predictors of WAZ at 2 years. Significant predictors of HAZ at 2 years included household size, number of children <5 years old, diarrhea in the past week, WAZ at 1 year, and HAZ at 1 year. Vomiting in the past week and WAZ at 1 year were significant predictors of weight-for-height z-score (WHZ) at 2 years.ConclusionsNumber of children <5 years old, symptoms such as vomiting or diarrhea in the previous week, and prior nutritional status were the most significant predictors of malnutrition in this cohort. Future research may focus on the application of models to develop predictive algorithms for mobile device technology, as well as the identification of other predictors of malnutrition that are not well characterized such as the interaction of environmental exposures with protein consumption and epigenetics.     

Carotid Intima-Media Thickness at Age 30, Birth Weight,Accelerated Growth during Infancy and Breastfeeding: A Birth Cohort Study in Southern Brazil

Objective

To examine the relationship between carotid intima-media thickness (IMT) at age 30 and birth characteristics, growth during infancy, and breastfeeding duration, among subjects who have been prospectively followed since birth.

Methods and Results

In 1982, all births in the city of Pelotas, southern Brazil, were identified and those children (n = 5,914) whose families lived in the urban area of the city have been followed and evaluated at several time points. The cohort participants were evaluated in 2012–13, and IMT was measured at the posterior wall of the right and left common carotid arteries in longitudinal planes using ultrasound imaging. We obtained valid IMT measurements for 3,188 individuals. Weight-for-age z-score (WAZ) at age 2 years, weight-for-height z-score (WHZ) at age 4, height-for-age z-score (HAZ) at 4 years, WAZ at age 4 and relative conditional weight at 4 years were positively associated with IMT, even after controlling for confounding variables. The beta-coefficient associated with ≥1 s.d. WAZ at age 2 (compared to those with a <–1 s.d.) was 3.62 μm (95% CI 0.86 to 6.38). The beta-coefficient associated with ≥1 s.d. WHZ at 4 (in relation to <–1 s.d) was 3.83 μm (95% CI 0.24 to 7.42). For HAZ at 4, the beta-coefficient for ≥1 s.d. in relation to <–1 s.d. was 4.19 μm (95% CI 1.14 to 7.25). For WAZ at 4, the beta-coefficient associated with ≥1 s.d. in relation to <–1 s.d. was 4.28 μm (95% CI 1.59 to 6.97). The beta-coefficient associated with conditional weight gain at age 2–4 was 1.26 μm (95% CI 0.49 to 2.02).

Conclusion

IMT at age 30 was positively associated with WAZ at age 2 years, WHZ at age 4, HAZ at age 4, WAZ at age 4 and conditional weight gain at age 4 years.     

Determinants of well-being in North Korea: Evidence from the post-famine period

North Korea has survived the breakdown of the communist bloc and has been immune to the democratization process of the 1990s. In spite of national famines and economic collapse, the totalitarian regime in Pyongyang maintains a firm grip on its power. Reliable information on the population's biosocial welfare is scarce. Using height and weight data of 5991 North Korean pre-school children measured in 2002, we investigate determinants of height-for-age z-score (HAZ), weight-for-age z-score (WAZ) and weight-for-height z-score (WHZ) as an indicator for child health. We find a statistically significant impact of the age of the child and of the mother, as well as the sex of the child on HAZ and WAZ. In contrast, social status and wealth proxies at the individual and household level are not statistically significant possibly because of errors in these variables. We do not find a consistent effect for geographic regions or for rural-urban residents either. Yet, urban provinces seem to be better-off. Most importantly, we find that children living in families who benefit from food aid of the United Nations are healthier in terms of HAZ, WAZ and WHZ than those depending on the government. Hence, further delivery of United Nations food aid is likely to mitigate the effects of the ongoing food crisis in North Korea.     

Predictive values for different cancers and inflammatory bowel disease of 6 common abdominal symptoms among more than 1.9 million primary care patients in the UK: A cohort study

BackgroundThe diagnostic assessment of abdominal symptoms in primary care presents a challenge. Evidence is needed about the positive predictive values (PPVs) of abdominal symptoms for different cancers and inflammatory bowel disease (IBD).Methods and findingsUsing data from The Health Improvement Network (THIN) in the United Kingdom (2000–2017), we estimated the PPVs for diagnosis of (i) cancer (overall and for different cancer sites); (ii) IBD; and (iii) either cancer or IBD in the year post-consultation with each of 6 abdominal symptoms: dysphagia (n = 86,193 patients), abdominal bloating/distension (n = 100,856), change in bowel habit (n = 106,715), rectal bleeding (n = 235,094), dyspepsia (n = 517,326), and abdominal pain (n = 890,490). The median age ranged from 54 (abdominal pain) to 63 years (dysphagia and change in bowel habit); the ratio of women/men ranged from 50%:50% (rectal bleeding) to 73%:27% (abdominal bloating/distension). Across all studied symptoms, the risk of diagnosis of cancer and the risk of diagnosis of IBD were of similar magnitude, particularly in women, and younger men. Estimated PPVs were greatest for change in bowel habit in men (4.64% cancer and 2.82% IBD) and for rectal bleeding in women (2.39% cancer and 2.57% IBD) and lowest for dyspepsia (for cancer: 1.41% men and 1.03% women; for IBD: 0.89% men and 1.00% women). Considering PPVs for specific cancers, change in bowel habit and rectal bleeding had the highest PPVs for colon and rectal cancer; dysphagia for esophageal cancer; and abdominal bloating/distension (in women) for ovarian cancer. The highest PPVs of abdominal pain (either sex) and abdominal bloating/distension (men only) were for non-abdominal cancer sites. For the composite outcome of diagnosis of either cancer or IBD, PPVs of rectal bleeding exceeded the National Institute of Health and Care Excellence (NICE)-recommended specialist referral threshold of 3% in all age–sex strata, as did PPVs of abdominal pain, change in bowel habit, and dyspepsia, in those aged 60 years and over. Study limitations include reliance on accuracy and completeness of coding of symptoms and disease outcomes.ConclusionsBased on evidence from more than 1.9 million patients presenting in primary care, the findings provide estimated PPVs that could be used to guide specialist referral decisions, considering the PPVs of common abdominal symptoms for cancer alongside that for IBD and their composite outcome (cancer or IBD), taking into account the variable PPVs of different abdominal symptoms for different cancers sites. Jointly assessing the risk of cancer or IBD can better support decision-making and prompt diagnosis of both conditions, optimising specialist referrals or investigations, particularly in women.

Annie Herbert and co-workers study possible relevance of common abdominal symptoms for specialist referral in UK primary care.     

Use of dietary diversity score as a proxy indicator of nutrient adequacy of rural elderly people in Sri Lanka

ABSTRACT: BACKGROUND: Macro and micro nutrient deficiencies are public health concerns in most developing countries including Sri Lanka, partly due to monotonous, cereal-based diet that lacks diversity. The objective of the study was to assess validity of food variety score (FVS), dietary diversity score (DDS) and dietary serving score (DSS) as indicators of nutrient adequacy of rural elderly people in Sri Lanka. FINDINGS: A sample of 200 apparently healthy elderly people >60y of age were studied. A single 24 h recall was performed to compute dietary diversity indicators. Pearson's correlation was used to assess the utility of FVS, DDS and DSS as indicators of nutrient adequacy. Sensitivity (Se) and specificity (Spe) analysis were done to determine the most appropriate cut-off points for using FVS and DDS to categorize elderly people with adequate nutrient intake. The average (standard deviation) of the food variety score, dietary diversity score and dietary serving score was 8.4 (2), 4.4 (0.9) and 11.4 (2.5), respectively. Mean adequacy ratio (MAR) of 12 nutrients was 0.39 (39 %). Pearson's correlation coefficients between MAR and FVS was 0.45 (P < 0.01), for DDS it was 0.48 (P < 0.01) and for DSS it was 0.58 (P < 0.01). When maximizing sensitivity and specificity, the best cut-off point for achieving 50 % of MAR was about 9 and 4.5 for FVS and DDS, respectively. CONCLUSION: In conclusion, FVS, DDS and DSS were useful proxy indicators of nutrient adequacy of rural elderly people in Sri Lanka. Indeed, the performance of the indicators is improved when considering the quantities of food consumed.     

Are fibre supplements really necessary in diverticular disease of the colon? A controlled clinical trial.

Fifty-eight patients with uncomplicated diverticular disease of the colon took bran crispbread, ispaghula drink, and placebo for four months each in a randomised, cross-over, double-blind controlled trial. Assessments were made subjectively, using a monthly self-administered questionnaire, and objectively, by examining a seven-day stool collection at the end of each treatment period. In terms of a pain score, lower bowel symptom score (the pain score and sensation of incomplete emptying, straining, stool consistency, flatus, and aperients taken), and total symptom score (belching, nausea, vomiting, dyspepsia, and abdominal distension) fibre supplementation conferred no benefit. Symptoms of constipation, however, when assessed alone, were significantly relieved. Both fibre regimens produced the expected changes in stool weight, consistency, and frequency. It is concluded that dietary fibre supplements in the commonly used doses do no more than relieve constipation. Perhaps the impression that fibre helps diverticular disease is simply a manifestation of Western civilisation''s obsession with the need for regular frequent defecation.     

Effect of undernutrition on deciduous tooth emergence among Rajput children of Shimla District of Himachal Pradesh, India

This article examines the influence of nutritional status on the emergence of deciduous dentition in a cross-sectional sample of 510 rural Rajput children from the Jubbal and Kotkhai Tehsils, Shimla District, Himachal Pradesh, India. The nutritional status of each child was evaluated using Z-scores of height/supine length-for-age (HAZ), weight-for-age (WAZ), and weight-for-height (WHZ). The effects of sex and side on deciduous dental emergence were not statistically significant. Partial correlation indicates that the number of emerged teeth (T) was more strongly correlated with height than with other anthropometric variables. In most age groups, the stunted boys and girls (HAZ <-2) had fewer emerged teeth than nonstunted age peers (HAZ >-2). The mean T in underweight children was also less than that of the normal children, with a few exceptions. The stunted children have a significantly greater likelihood of delayed emergence of deciduous dentition. Measures of linear growth status are more closely related to dental development than measures of growth in mass. The findings indicate that even moderate undernutrition can delay deciduous tooth emergence.     

Three‐dimensional analysis of sexual dimorphism in human thoracic vertebrae: Implications for the respiratory system and spine morphology

Research suggests that nonmaternal caregivers (allomothers) offer essential assistance through caregiving and provisioning, helping to support lengthy child development. Here, we examine the role of allomothers and the broader social and sharing network on Aka forager children's anthropometrics. We hypothesize that nonmaternal investors strategically target their assistance when it is most needed and when it will have the greatest effect. We evaluate children's nutritional status using WHO standards [weight‐for‐age (WAZ), height‐for‐age (HAZ), and weight‐for‐height (WHZ)] during four periods of child development [early infancy (birth to <9 months), mobility to weaning (9 to <36 months), early childhood (36 to <72 months), and middle childhood (72 to <120 months); N = 127]. We explore the effects of allomothers and the social network across these different risk periods and examine whether the broader social network buffers the loss of a primary allomother. ANOVA results suggest that girls may be experiencing some growth faltering, while boys start smaller and remain small across these stages. We used OLS multiple regression models to evaluate the effects of sex, camp composition, risk periods, and allomothers' presence on WAZ, HAZ, and WHZ. Grandmothers are the most influential allomother, with their effect most evident during the 9 to <36 month period. Camp size was also associated with greater WAZ, suggesting that children residing in small camps may be disadvantaged. Our findings also indicate that, under specific residence patterns, cooperative child rearing networks buffer the loss of a grandmother. Overall, our results suggest the importance of social networks to children's nutritional status and that individuals target investment to critical phases. Am J Phys Anthropol 153:513–525, 2014. © 2014 Wiley Periodicals, Inc.