Parental Determinants of Overweight and Obesity in Iranian Adolescents: A National Study

Objective

Overweight among adolescents is not only an important public health problem but also a problem affecting economic growth in developing countries. The aim of this study was to investigate the parental determinants of overweight and obesity in Iranian adolescents at national level.

Methods

This cross sectional study was conducted within the framework of the Comprehensive Study on Household Food Consumption Patterns and Nutritional Status of IR Iran during 2001-2003. In adolescents, anthropometric indices were defined based on the CDC 2000 cut-off points for age and gender-specific body mass index (BMI). Parental characteristics were collected by questionnaire. Among the 7158 participating households, data on 7908 adolescents aged 11-19 years (3750 girls and 4158 boys) was analyzed.

Findings

The prevalence of overweight (85–94th percentile) in boys and girls was 6.2%, and 8.7%, respectively. The prevalence of obesity (≥95th percentile) among boys and girls was similar (3.3%). Parents’ weight status, father''s job and parents’ education showed significant association with weight status in adolescents. Logistic regression analysis showed that parental overweight and obesity, parental education and father''s job were the main parental determinants of overweight and obesity in Iranian adolescents.

Conclusion

Parental overweight and obesity, parental education and father''s job seem to be the major parental determinants of overweight in Iranian adolescents. Future prevention programs must take these risk factors into account.     

Physical activity,fatigue and sleep quality at least 6 months after mild traumatic brain injury in adolescents and young adults: A comparison with orthopedic injury controls

ObjectivesTo compare physical activity (PA), fatigue and sleep quality in adolescents and young adults (AYAs) after mild TBI (mTBI) to persons of similar age after orthopedic injury (OI) on the longer term.SettingFollow-up at least 6 months after visiting the emergency department of one of 2 general hospitals.ParticipantsForty-nine patients aged 12–25 years (mean 18.4 years), diagnosed with mTBI and 54 patients aged 12–25 years (mean 15.8 years) with OI.DesignCross-sectional electronic survey study.Main outcome measuresThe Activity Questionnaire for Adults and Adolescents with results dichotomized for meeting/not meeting Dutch Health Enhancing PA recommendations (D-HEPA), the Checklist Individual Strength (range 20–140, low-high) measuring fatigue, and the Pittsburgh Sleep Quality Index (range 0–21, high-low) measuring sleep quality were administered.ResultsPatients with mTBI less frequently met D-HEPA recommendations than patients with OI (49% vs. 70%; OR 2.87, 95%CI 1.07, 7.72) and reported more concentration-related fatigue problems (mean 19.1 (SD 8.0), mean 13.9 (SD 7.8), respectively; β 3.98, 95%CI 0.39, 7.56), after adjusting for potential confounders, sex, BMI, age and time since injury. No differences were found in sleep quality.ConclusionsIdentifying symptoms and limitations in activities is important after mTBI so that rehabiliation treatment can be initiated. Whether physical activity or fatigue is the best target for treatment remains to be established.     

A collaborative outreach clinic for pregnant youth and adolescent mothers: Description of a pilot clinic and its patients

OBJECTIVE:

To describe the pregnant youth and adolescent parents seen at an adolescent health outreach clinic in an urban community setting during a two-year pilot project.

METHODS:

A retrospective chart review of all adolescents who presented at the monthly half-day clinics from January 2008 through January 2010 (n=36) was performed. Measures extracted from charts included demographic information, reason for referral, social history, mental health history and outcome of assessment.

RESULTS:

All participants were female (mean age 17 years). Forty-two percent were pregnant at initial assessment, while the remainder had one or two children, or a recent pregnancy loss. Sixty-one percent had no primary care physician. The primary reason for referral was mental health concerns, most commonly depression. Almost one-half of patients relied on social assistance and almost one-third were living in shelters. At the time of first visit, 42% of patients were not attending school; the highest level of school completed for most patients was grade 8. The majority had a history of mental health issues and previous drug and/or alcohol use.

CONCLUSIONS:

Adolescents presenting to the clinic had a history of disadvantage in terms of income, educational attainment, living arrangements and mental health background, and are in need of various health services including primary care practitioners. These findings will help to inform future program development for these vulnerable youth, and have implications for practitioners caring for this population.     

Results from the Active Healthy Kids Canada 2012 Report Card on Physical Activity for Children and Youth

The present article summarizes the results from the Active Healthy Kids Canada 2012 Report Card on Physical Activity for Children and Youth. The Report Card assessed the physical activity levels of Canadian children and youth nationally, and the initiatives of public and nongovernment sectors to promote and facilitate physical activity opportunities for children and youth in Canada. Based on a comprehensive collection of data that were analyzed and/or published in 2011, 24 indicators relating to physical activity were graded. The Physical Activity Levels indicator, the core indicator of the Report Card, was graded an ‘F’ for the sixth consecutive year. Although the majority of grades remained unchanged from the previous year, four grades improved and two worsened. These results suggest that few Canadian children and youth have sufficient physical activity levels, and that greater efforts are required across sectors to promote and facilitate physical activity opportunities for children and youth in Canada.     

Parenting Intervention to Improve Nutrition and Physical Activity for Preschoolers with Type 1 Diabetes: A Feasibility Study

Objective

This study reports the feasibility and acceptability of a healthy eating and physical-activity-focused behavioral intervention for parents of young children with type 1 diabetes (T1D).

Three patients and their drugs: A parallel case paper on paediatric opiate use and withdrawal

Clinicians are increasingly aware of the important role that opioids play in the management of a variety of paediatric conditions. Frequently, clinicians encounter challenges in initiating opioid therapy and, then, in weaning paediatric patients off opioids. In the present article, three different cases (an infant and two adolescents) are used to illustrate why and how opiates may be used in paediatrics and how they can be discontinued. The presentations include neonatal abstinence syndrome, chronic headache and cystic fibrosis. The cases are meant to emphasize the distinctions rather than the similarities among the cases, which is why this is called a case parallel, rather than a case series. The article downplays the use of rigid rules in managing patients on opioids, and emphasizes a flexible and patient-centred approach.     

Having Fun and Staying Active! Children with Disabilities and Participation in Physical Activity: A Follow-Up Study

Aim: This study investigated change in the participation profile of physical activity over 15 months after a three-week intensive rehabilitation that used physical activity as the main intervention. Methods: The Children's Assessment of Participation and Enjoyment (CAPE) was used in a longitudinal prospective study (pre- and post-design) with three measurements over 15 months. Eighty children with physical disabilities (6–17 years old; mean score 11.1; SD 2.4), some with additional cognitive challenges, completed all three measurements. Results: Participation diversity and intensity of all 55 leisure activities declined significantly over the 15-month period. The largest decline was for children aged between 10 and 13 years. Among physical activities, there was a stable level of participation of the total group, and sub-groups. Boys preferred “active physical activities” to a greater extent, while girls preferred “skill-based activities.” Both genders expressed a higher level of enjoyment in their preferred activities according to the Preferences for Activities of Children. Conclusions: This intervention may have the potential to maintain the level of physical activity among children and youths with disabilities, yet further controlled studies are needed. Gender differences should be taken into consideration to facilitate stable participation in physical activities with a high level of enjoyment.     

A Group Motor Skills Program for Children with Coordination Difficulties: Effect on Fundamental Movement Skills and Physical Activity Participation

Aims: Children with coordination difficulties are at risk of low levels of physical activity (PA) participation. This intervention examined the effects of a multidisciplinary program that emphasized parent participation on motor skill performance and PA. Methods: Ten boys (5–7 years) completed a group program consisting of conditioning exercises and activities designed to address child-selected goals. Motor proficiency and PA participation were assessed before and after the program using the Test of Gross Motor Development (TGMD-2) and triaxial accelerometers, respectively. Rating scales captured child and parent perceptions of performance for each child's goals. Results: TGMD-2 subtest raw scores, age equivalent and percentile scores improved, along with parent ratings of their child's performance. Six children reported skill improvements. On average, moderate to vigorous PA improved by 10 min per day although these gains were not significant. Time spent in sedentary activities was unchanged. None of the children met the Canadian PA and sedentary behaviour guidelines. Conclusions: The results support effectiveness of a group program to improve gross motor performance and levels of PA in children with coordination difficulties. Gains in both of these domains also have the potential to impact quality of life and reduce health risks associated with inactivity.     

Adolescent and Young Adult Patient Engagement and Participation in Survey‐Based Research: A Report From the “Resilience in Adolescents and Young Adults With Cancer” Study

Conducting patient‐reported outcomes research with adolescents and young adults (AYAs) is difficult due to low participation rates and high attrition. Forty‐seven AYAs with newly diagnosed cancer at two large hospitals were prospectively surveyed at the time of diagnosis and 3–6 and 12–18 months later. A subset participated in 1:1 semistructured interviews. Attrition prompted early study closure at one site. The majority of patients preferred paper–pencil to online surveys. Interview participants were more likely to complete surveys (e.g., 93% vs. 58% completion of 3–6 month surveys, P = 0.02). Engaging patients through qualitative methodologies and using patient‐preferred instruments may optimize future research success.     

Moving towards Therapists Becoming Better Educators: A Commentary on Changes in the Content of Pediatric Physical Therapy for Infants: A Quantitative,Observational Study

Abstract

Patients and their families have expressed that they want information (Hendricks, 2000) and as a result often turn to Google for health and medical information. Society as a whole is more informed than ever and no longer rely only on medical practitioners as in previous generations. Instead, and rightly so, they question medical experts and want to know the reasoning and rationale behind everything they experience. This combined with the shift towards family-centred principles over the last 20?years underscores the need to provide comprehensive and effective education to families. But what should that look like? Improving parental competence through education promotes their beliefs that they can be positive agents of change in their child’s life (Guimond et al., 2008 Guimond, A., Wilcox, M., &; Lamorey, S. (2008). The Early Intervention Parenting Self-Efficacy Scale (EIPSES). Journal of Early Intervention, 30(4), 295–320. doi: 10.1177/1053815108320814[Crossref], [Web of Science ®] , [Google Scholar]). Similarly, therapists are slowly starting to concede that parents have the greatest amount of time and influence over their children’s development (Mahoney and Perales, 2006 Mahoney, G., &; Perales, F. (2006). The role of parents in early motor intervention. Down's Syndrome, Research and Practice: The Journal of the Sarah Duffen Centre, 10(2), 67–73.[Crossref], [PubMed] , [Google Scholar]), and as a result, are the primary agents of change.     

AN EPIDEMIOLOGICAL STUDY OF A DANISH SCHOOL POPULATION I. Reference Values for Serum Lipids Based on a Clinical and Biochemical Study of 284 Girls and 268 Boys

Abstract. A study was performed on a Danish school population to obtain reference values of the following serum lipids: total lipid, phospholipid, cholesterol, glycerol and triglyceride. 92% of 630 children participated, but 23 were excluded following clinical examination. Thus values are given for 301 girls and 274 boys aged 8 to 17 years.