Intracranial region of the vertebral artery: morphometric study in the context of clinical usefulness

Background: The aim of this study was to analyse the morphometry of the intracranial segment of the vertebral artery in the context of clinical usefulness. The results were compared with published data available in full-text archived medical journals. Materials and methods: More than 100 digital subtraction angiography (DSA) and 3-dimensional (3D) angio-computed tomography (CT) examinations were used to measure the following parameters: the whole and partial length of V4 in characteristic anatomical points, the diameter in three places (on the level of foramen magnum, in point of exit to the posterior inferior cerebellar artery, and in the vertebro-basilar junction), the angle of connection to the vertebral arteries, and all anatomical variations including fenestration, duplication, dolichoectasia or absent artery. Results: The left V4 section was predominant over the right artery, which is manifested by length, width, cases of ectasia and fewer cases of hypoplasia. The incidences of V4 ectasia were identified more often than those documented in the accessible literature, and they were found in the natural location of formation of saccular aneurysms. Conclusions: The presented knowledge of anatomical variation and abnormali­ties of vertebral circulation can improve the accuracy and “safety” of the surgical procedures in this region, help to determine the range of surgical approach and avoid associated complications. The radiological examinations using 3D CT, DSA reveal unlimited observation of anatomical structures in contrast to studies based on cadavers, and can complement the morphometry in anatomical preparations

Aktywność fizyczna dziewcząt w okresie dojrzewania = Physical activity in girls at puberty

Pilewska–Kozak Anna B., Łepecka–Klusek Celina, Stadnicka Grażyna, Dobrowolska Beata, Pawłowska–Muc Agnieszka K., Kozak Łukasz A., Ulan Agnieszka, Wagner Emilia. Aktywność fizyczna dziewcząt w okresie dojrzewania = Physical activity in girls at puberty. Journal of Education, Health and Sport. 2015;5(9):305-316. ISSN 2391-8306. DOI10.5281/zenodo.30805http://dx.doi.org/10.5281/zenodo.30805http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%289%29%3A305-316https://pbn.nauka.gov.pl/works/623257Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja.Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie.Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r.The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014).© The Author (s) 2015;This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, PolandOpen Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium,provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License(http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited.This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercialuse, distribution and reproduction in any medium, provided the work is properly cited.The authors declare that there is no conflict of interests regarding the publication of this paper.Received: 25.08.2015. Revised 05.09.2015. Accepted: 08.09.2015. Aktywność fizyczna dziewcząt w okresie dojrzewaniaPhysical activity in girls at puberty Anna B. Pilewska–Kozak1, Celina Łepecka–Klusek1, Grażyna Stadnicka2, Beata Dobrowolska3, Agnieszka K. Pawłowska–Muc4, Łukasz A. Kozak5, Agnieszka Ulan6, Emilia Wagner6 1Katedra i Klinika Ginekologii i Endokrynologii Ginekologicznej Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie2Samodzielna Pracownia Umiejętności Położniczych Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie3Katedra Rozwoju Pielęgniarstwa Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie4Ośrodek Kształcenia Podyplomowego Pielęgniarek i Położnych Radomski Szpital Specjalistyczny im. dr Tytusa Chałubińskiego w Radomiu5Oddział Chirurgii Urazowo – Ortopedycznej z Chirurgią Kręgosłupa, Samodzielny Publiczny Zakład Opieki Zdrowotnej w Puławach6Studentka III roku kierunku położnictwo, Studenckie Koło Naukowe przy Katedrze i Klinice Ginekologii i Endokrynologii Ginekologicznej, Wydział Nauk o Zdrowiu Uniwersytet Medyczny w Lublinie Streszczenie Wstęp         Sprawność fizyczna ukształtowana w wieku młodzieńczym ma swoje odzwierciedlenie w życiu dorosłym. Wpływa na ogólny dobrostan, na elastyczne przystosowywanie się do ról w życiu zawodowym, na równowagę emocjonalną i większą odporność na stres. Warunkuje odpowiedzialność, wytrwałość w dążeniu do wyznaczonych celów oraz zdyscyplinowanie, a także pozwala na podtrzymanie dobrej kondycji w wieku dojrzałym i w okresie starości.Cel pracy         Sprawdzenie, czy dziewczęta w okresie dojrzewania ćwiczą na lekcjach wychowania fizycznego i są aktywne ruchowo poza szkołą oraz czy ma to związek z miejscem ich zamieszkania.Materiał i metoda         Badaniami ankietowymi objęto 169 uczennic gimnazjów (80 mieszkających w mieście i 89 na wsi) w województwie lubelskim. Wiek dziewcząt wahał się w granicach od 11 lat do 17 lat (Mediana = 15 lat). Kryterium włączenia było wystąpienie menarche. Na prowadzenie badań uzyskano zgody Komisji Bioetycznej Uniwersytetu Medycznego w Lublinie nr KE-0254/224/2013 z dnia 26 września 2013r. oraz nr KE-0254/246/2013 z dnia 24 października 2013r.Wyniki badań         Większość uczennic, zarówno ze wsi, jak i z miasta (odpowiednio 66; 74.1% i 59; 73.8%), oświadczyła, że prowadzi aktywny tryb życia. Innych - analogicznie 10 (11.2%) i 8 (10.0%) było przeciwnego zdania, a co piąta (19; 21.3%) dziewczynka z terenów wiejskich i 13 (16,3%) z miejskich nie potrafiła tego ocenić. Regularne uczęszczanie na lekcje wychowania fizycznego potwierdziły 94 (55,6%) badane. Pozostałe oświadczyły, iż czynią to nieregularnie (68; 40.2%) lub mają zwolnienie lekarskie z tych zajęć (7; 4.1%).  Stwierdzono istotną statystycznie zależność między uczęszczaniem na lekcje wychowania fizycznego a miejscem zamieszkania uczennic (p<0,05), na korzyść mieszkanek miast, które częściej czyniły to regularnie. Ponadto stwierdzono istotne statystycznie zależności pomiędzy preferowanymi formami wypoczynku w okresie szkolnym i wakacyjnym (p<0,001). Różnice zarysowały się także, gdy wzięto pod uwagę miejsce zamieszkania badanych – w okresie zajęć szkolnych formy czynne istotnie częściej, niż bierne preferowały mieszkanki miast niż wsi (p=0.005), a w okresie wakacji odwrotnie (p<0.001).WnioskiWiele dziewcząt w okresie dojrzewania nie ćwiczy regularnie na lekcjach wychowania fizycznego, przy czym częściej mieszkanki wsi niż miast.Aktywne formy wypoczynku w okresie szkolnym preferują częściej mieszkanki miast niż wsi, a w okresie wakacji odwrotnie. Słowa kluczowe: aktywność fizyczna, dojrzewanie, dziewczęta. Summary Introduction         Fitness formed in adolescence is reflected in adulthood. It affects general wellbeing, flexibility to adapt to future roles in professional life, emotional balance and greater resistance to stress. It determines responsibility, persistent pursuit of targets and discipline, and also allows to maintain good health through adulthood and old age.Objective         To verify that girls at puberty do physical exercises at physical education (PE) classes and are physically active outside school, and to establish whether it is related to their place of residence.Material and Methods         The survey was conducted in 169 junior high school students, 80 living in the urban area and89 inthe rural region, aged 11 -17 years (median = 15 years) in The Lublin Province. The inclusion criterion was the occurrence of menarche. The  research was approved by the Bioethics Committee of the Medical University of Lublin No. KE-0254/224/2013 of 26 September 2013 and No. KE-0254/246/2013 of 24 October 2013.Results         Most of the students, both from the country as well as from the city (respectively 66, 74.1% and 59; 73.8%) admitted to leading an active lifestyle. The others, respectively 10 (11.2%) and 8 (10.0%) respondents were of the opposite opinion;  in the group of country girls, one girl in five (19; 21.3%), and 13 girls from the town group (16.3%) were unable to evaluate that. Regular attendance at PE classes was confirmed by 94 (55.6%) respondents. Others stated that they did not do it regularly (68; 40.2%) or were exempted from PE classes due to medical reasons (7; 4.1%). A statistically significant correlation between attending PE and place of residence of students was found (p <0.05) in favor of the inhabitants of the cities who more often did exercise regularly. In addition, statistically significant relationship was determined between preferred forms of rest during the school year and in the summer (p <0.001). Differences also emerged when the place of respondents’ residence was taken into account, i.e. in the period of school, the girls from towns preferred active forms to passive significantly more frequently in comparison to the girls from rural areas (p = 0.005); the situation reversed during the holiday period (p <0.001).ConclusionsMany girls at puberty do not exercise regularly at physical education classes, it is more frequent among the girls from rural regions compared to the girls living in town.During the period of school year, the girls living in urban areas more often prefer active forms of recreation compared to the girls from rural regions and the situation is reversed  during the holiday period. Key words: physical activity, girls, puberty

A bit or a lot on the side? Observational study of the energy content of starters, sides and desserts in major UK restaurant chains

Objectives Our objective was to examine the kilocalorie (kcal) content of starters, sides and desserts served in major UK restaurant chains, comparing the kcal content of these dishes in fast-food and full-service restaurants. Design Observational study. Setting Menu and nutritional information provided online by major UK restaurant chains. Method During October to November 2018, we accessed websites of restaurant chains with 50 or more outlets in the UK. Menu items that constituted starters, sides or desserts were identified and their kcal content was extracted. Accompanying beverages were not included. We used multilevel modelling to examine whether mean kcal content of dishes differed in fast-food versus full-service restaurants. Main outcome measures The mean kcal content of dishes and the proportion of dishes exceeding public health recommendations for energy content in a main meal (>600 kcal). Results A total of 1009 dishes (212 starters, 318 sides and 479 desserts) from 27 restaurant chains (21 full-service, 6 fast-food) were included. The mean kcal content of eligible dishes was 488.0 (SE=15.6) for starters, 397.5 (SE=14.9) for sides and 430.6 (SE=11.5) for desserts. The percentage of dishes exceeding 600 kcal was 26.4% for starters, 21.7% for sides and 20.5% for desserts. Compared with fast-food chains, desserts offered at full-service restaurants were on average more calorific and were significantly more likely to exceed 600 kcal. Conclusions The average energy content of sides, starters and desserts sold in major UK restaurants is high. One in four starters and one in five sides and desserts in UK chain restaurants exceed the recommended energy intake for an entire meal

Projected impact of the Portuguese sugar-sweetened beverages tax on obesity incidence across different age groups: a modelling study

Background Excessive consumption of sugar has a well-established link with obesity. Preliminary results show that a tax levied on sugar-sweetened beverages (SSBs) by the Portuguese government in 2017 led to a drop in sales and reformulation of these products. This study models the impact the market changes triggered by the tax levied on SSBs had on obesity incidence across various age groups in Portugal. Methods and findings We performed a national market analysis and population-wide modelling study using market data for the years 2014–2018 from the Portuguese Association of Non-Alcoholic Drinks (GlobalData and Nielsen Consumer Panel), dietary data from a national survey (IAN-AF 2015–2016), and obesity incidence data from several cohort studies. Dietary energy density from SSBs was calculated by dividing the energy content (kcal/gram) of all SSBs by the total food consumption (in grams). We used the potential impact fraction (PIF) equation to model the projected impact of the tax-triggered change in sugar consumption on obesity incidence, through both volume reduction and reformulation. Results showed a reduction of 6.6 million litres of SSBs sold per year. Product reformulation led to a decrease in the average energy density of SSBs by 3.1 kcal/100 ml. This is estimated to have prevented around 40–78 cases of obesity per year between 2016 and 2018, with the biggest projected impact observed in adolescents 10 to <18 years old. The model shows that the implementation of this tax allowed for a 4 to 8 times larger projected impact against obesity than would be achieved though reformulation alone. The main limitation of this study is that the model we used includes data from various sources, which can result in biases—despite our efforts to mitigate them—related to the methodological differences between these sources. Conclusions The tax triggered both a reduction in demand and product reformulation. These, together, can reduce obesity levels among frequent consumers of SSBs. Such taxation is an effective population-wide intervention. Reformulation alone, without the decrease in sales, would have had a far smaller effect on obesity incidence in the Portuguese population

A scoping review of outdoor food marketing: exposure, power and impacts on eating behaviour and health

Background: There is convincing evidence that unhealthy food marketing is extensive on television and in digital media, uses powerful persuasive techniques, and impacts dietary choices and consumption, particularly in children. It is less clear whether this is also the case for outdoor food marketing. This review (i) identifies common criteria used to define outdoor food marketing, (ii) summarises research methodologies used, (iii) identifies available evidence on the exposure, power (i.e. persuasive creative strategies within marketing) and impact of outdoor food marketing on behaviour and health and (iv) identifies knowledge gaps and directions for future research. Methods: A systematic search was conducted of Medline (Ovid), Scopus, Science Direct, Proquest, PsycINFO, CINAHL, PubMed, the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials and a number of grey literature sources. Titles and abstracts were screened by one researcher. Relevant full texts were independently checked by two researchers against eligibility criteria. Results: Fifty-three studies were conducted across twenty-one countries. The majority of studies (n = 39) were conducted in high-income countries. All measured the extent of exposure to outdoor food marketing, twelve also assessed power and three measured impact on behavioural or health outcomes. Criteria used to define outdoor food marketing and methodologies adopted were highly variable across studies. Almost a quarter of advertisements across all studies were for food (mean of 22.1%) and the majority of advertised foods were unhealthy (mean of 63%). The evidence on differences in exposure by SES is heterogenous, which makes it difficult to draw conclusions, however the research suggests that ethnic minority groups have a higher likelihood of exposure to food marketing outdoors. The most frequent persuasive creative strategies were premium offers and use of characters. There was limited evidence on the relationship between exposure to outdoor food marketing and eating behaviour or health outcomes. Conclusions: This review highlights the extent of unhealthy outdoor food marketing globally and the powerful methods used within this marketing. There is a need for consistency in defining and measuring outdoor food marketing to enable comparison across time and place. Future research should attempt to measure direct impacts on behaviour and health

A systematic review of patient reported factors associated with uptake and completion of cardiovascular lifestyle behaviour change

Background: Healthy lifestyles are an important facet of cardiovascular risk management. Unfortunately many individuals fail to engage with lifestyle change programmes. There are many factors that patients report as influencing their decisions about initiating lifestyle change. This is challenging for health care professionals who may lack the skills and time to address a broad range of barriers to lifestyle behaviour. Guidance on which factors to focus on during lifestyle consultations may assist healthcare professionals to hone their skills and knowledge leading to more productive patient interactions with ultimately better uptake of lifestyle behaviour change support. The aim of our study was to clarify which influences reported by patients predict uptake and completion of formal lifestyle change programmes. Methods: A systematic narrative review of quantitative observational studies reporting factors (influences) associated with uptake and completion of lifestyle behaviour change programmes. Quantitative observational studies involving patients at high risk of cardiovascular events were identified through electronic searching and screened against pre-defined selection criteria. Factors were extracted and organised into an existing qualitative framework. Results: 374 factors were extracted from 32 studies. Factors most consistently associated with uptake of lifestyle change related to support from family and friends, transport and other costs, and beliefs about the causes of illness and lifestyle change. Depression and anxiety also appear to influence uptake as well as completion. Many factors show inconsistent patterns with respect to uptake and completion of lifestyle change programmes. Conclusion: There are a small number of factors that consistently appear to influence uptake and completion of cardiovascular lifestyle behaviour change. These factors could be considered during patient consultations to promote a tailored approach to decision making about the most suitable type and level lifestyle behaviour change support

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income&nbsp;countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was &lt;1.1 kg m–2 in the vast majority of&nbsp;countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults.

BACKGROUND: Underweight, overweight, and obesity in childhood and adolescence are associated with adverse health consequences throughout the life-course. Our aim was to estimate worldwide trends in mean body-mass index (BMI) and a comprehensive set of BMI categories that cover underweight to obesity in children and adolescents, and to compare trends with those of adults. METHODS: We pooled 2416 population-based studies with measurements of height and weight on 128·9 million participants aged 5 years and older, including 31·5 million aged 5-19 years. We used a Bayesian hierarchical model to estimate trends from 1975 to 2016 in 200 countries for mean BMI and for prevalence of BMI in the following categories for children and adolescents aged 5-19 years: more than 2 SD below the median of the WHO growth reference for children and adolescents (referred to as moderate and severe underweight hereafter), 2 SD to more than 1 SD below the median (mild underweight), 1 SD below the median to 1 SD above the median (healthy weight), more than 1 SD to 2 SD above the median (overweight but not obese), and more than 2 SD above the median (obesity). FINDINGS: Regional change in age-standardised mean BMI in girls from 1975 to 2016 ranged from virtually no change (-0·01 kg/m2 per decade; 95% credible interval -0·42 to 0·39, posterior probability [PP] of the observed decrease being a true decrease=0·5098) in eastern Europe to an increase of 1·00 kg/m2 per decade (0·69-1·35, PP>0·9999) in central Latin America and an increase of 0·95 kg/m2 per decade (0·64-1·25, PP>0·9999) in Polynesia and Micronesia. The range for boys was from a non-significant increase of 0·09 kg/m2 per decade (-0·33 to 0·49, PP=0·6926) in eastern Europe to an increase of 0·77 kg/m2 per decade (0·50-1·06, PP>0·9999) in Polynesia and Micronesia. Trends in mean BMI have recently flattened in northwestern Europe and the high-income English-speaking and Asia-Pacific regions for both sexes, southwestern Europe for boys, and central and Andean Latin America for girls. By contrast, the rise in BMI has accelerated in east and south Asia for both sexes, and southeast Asia for boys. Global age-standardised prevalence of obesity increased from 0·7% (0·4-1·2) in 1975 to 5·6% (4·8-6·5) in 2016 in girls, and from 0·9% (0·5-1·3) in 1975 to 7·8% (6·7-9·1) in 2016 in boys; the prevalence of moderate and severe underweight decreased from 9·2% (6·0-12·9) in 1975 to 8·4% (6·8-10·1) in 2016 in girls and from 14·8% (10·4-19·5) in 1975 to 12·4% (10·3-14·5) in 2016 in boys. Prevalence of moderate and severe underweight was highest in India, at 22·7% (16·7-29·6) among girls and 30·7% (23·5-38·0) among boys. Prevalence of obesity was more than 30% in girls in Nauru, the Cook Islands, and Palau; and boys in the Cook Islands, Nauru, Palau, Niue, and American Samoa in 2016. Prevalence of obesity was about 20% or more in several countries in Polynesia and Micronesia, the Middle East and north Africa, the Caribbean, and the USA. In 2016, 75 (44-117) million girls and 117 (70-178) million boys worldwide were moderately or severely underweight. In the same year, 50 (24-89) million girls and 74 (39-125) million boys worldwide were obese. INTERPRETATION: The rising trends in children's and adolescents' BMI have plateaued in many high-income countries, albeit at high levels, but have accelerated in parts of Asia, with trends no longer correlated with those of adults. FUNDING: Wellcome Trust, AstraZeneca Young Health Programme