A systematic review and quantitative analysis of resting energy expenditure prediction equations in healthy overweight and obese children and adolescents

© The British Dietetic Association Ltd. This is the peer reviewed version of 'Chima, L., Mulrooney, H. M., Warren, J., & Madden, A. (2020). A systematic review and quantitative analysis of resting energy expenditure prediction equations in healthy overweight and obese children and adolescents. Journal of Human Nutrition and Dietetics. https://doi.org/10.1111/jhn.12735'. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.Background:  Resting energy expenditure (REE) estimate sare often needed in young people and can be predicted using prediction equations based on body weight.  However,these equations may perform poorly in obesity and overweight. The aim of this systematic review was to identify equations based on simple anthropometric and demographic variables which provide the most accurate and precise estimates of REE in healthy obese and overweight young people. Methodology:Systematic searches for relevant studies in healthy obese and overweight young people aged ≤18 years were undertaken using PubMed, Scopus, Cinahl, OpenGrey and Cochrane Library (completed January 2018). Search terms included metabolism, calorimetry, obesity and prediction equation. Data extraction,study appraisal and synthesis followed PRISMA guidelines. Results:From 390 screened titles, 13 studies met inclusion criteria. The most accurate REE predictions (least biased) were provided by Schofield equations (+0.8%[3-18 years]; 0% [11-18 years]; +1.1% [3-10 years]). The most precise REE estimations (percentage of predictions ±10% of measured) for 11-18 years were provided by Mifflin equations (62%), and for 7-18 years by the equations of Schmelzle (57%), Henry (56%) and Harris Benedict (54%). Precision of Schofield predictions was 43% in both age groups. No accuracy data were available for those <3 years or for precision for those <7 years. Principal conclusions: No single equation provided accurate and precise REE estimations in this population.  Schofield equations provided the most accurate REE predictions so are useful for groups.  Mifflin equations provided the most precise estimates for individuals aged 11-18 but tended to underestimate REE.  Peer reviewedFinal Accepted Versio

Long-term sequelae of SARS in children

Severe acute respiratory syndrome (SARS) runs a more benign course in children during the acute phase. Unlike adult patients, no fatalities were reported among the paediatric SARS patients. Published data on long-term sequelae of SARS are very limited. In our follow-up study, although patients have clinically recovered from their initial illness, exercise impairment and residual radiological abnormalities were demonstrated at 6 months after diagnosis. It is important to assess these patients on a regular basis to detect and provide appropriate management for persistent or emerging long-term sequelae in the physical, psychological and social domains. © 2004 Elsevier Ltd. All rights reserved.link_to_subscribed_fulltex

Childhood Obstructive Sleep Apnoea: What Parents Want to Know What Are the Symptoms and Signs?

Abstract This article is the result of five years of accumulating knowledge, experience gained from our clinical work and research carried out by our team on childhood obstructive sleep apnoea syndrome (OSAS). It is very much a review of our personal practice and we try to provide as much evidence based materials as possible though available data is often limited. There is no doubt that a large gap is still waiting to be filled regarding this important and common condition. We hope this article would help practicing clinicians to provide answers to questions commonly asked by parents of children suspected of having OSAS. Key words Child; Obstructive sleep apnoea; Polysomnography between 0.7-10.3% but it is important to note that these studies had methodological flaws and may not be a true representation for our locality. 3-7 Therefore a well-designed population-based cohort study with an adequate sample size is urgently required to answer the question of how common OSAS is among our local children

Evaluating an integrated parallel group intervention for Chinese asthma children and their parents

Conference Theme: Bridging Disciplinary Boundarie

Cluster Evaluation on Teenage Pregnancy Management in Hong Kong

Poster Presentation (Doctor’s Session)INTRODUCTION: The Comprehensive Child Development Service (CCDS), a community-based early childhood intervention program aiming to improve child health and targeting high-risk families, was implemented step-by-step in different districts of Hong Kong after the 2005 policy address. Pregnant teenage ladies aged below 18 were one of the targeted risk groups under the program which provided antenatal and child care by collaboration of the Departments of Obstetrics, Paediatrics and Maternity and Child Health Centers. The New Territories West cluster was one of the first pilot clusters for the CCDS program provided by Tuen Mun Hospital from 2006. This service was extended to the New Territories East cluster in March 2012. AIM: The aim of this evaluation is to compare child health problems among the intervention cluster (NTW) and control cluster (NTE) over the following 2 periods: (1) the period without a CCDS program in 2001 to 2005 and (2) the period with the CCDS program implemented in 2007 to 2011 in NTW. Method: Data was retrieved by the Clinical Data Analysis Report System (CDARS). Results: There were 146 and 167 of births from teenage in NTW in these 2 periods respectively, whereas, 129 and 104 in NTE. No significant difference was found in all demographic parameters of birth weight, gender ratio, gestational age, mode of delivery or requirement of NICU admission in these two periods in both intra or inter-cluster comparisons. There was a significant increase in the number of Accident and Emergency unit (A & E) attendance of children aged below 2 years with teenage mothers in NTW, changing from 48.5% to 73.3% respectively, before and after the implementation of the CCDS program (p<0.0009). However, this trend increase was not noted in the control cluster (NTE). The median number of A & E admissions rose from zero to three times in the intervention cluster (NTW) after the CCDS program was implemented (p<0.0035). But there was no positive associated increase in hospital admission in the same periods, which indicates that the medical consultations were not for urgent or serious conditions (p=0.14). After the implementation of the CCDS program in NTW, 99% of children aged under 2 years with teenage mothers were followed under the CCDS Paediatrician (p<0.001). The median number of attendance rose from zero to three times in NTW during the 2 periods. (p<0.001) In contrast, the control cluster showed a significant decrease in the number of A & E attendances which fell from 73.9% to 45% (p=0.001). Moreover, in this control cluster the median attendance number of outpatient consultations dropped from two to zero over these periods. Longer follow up for analysing details of admissions, death rate or child abuse rate are required. CONCLUSION: A comprehensive inter-departmental and well planned program providing antenatal and child care was successfully reaching nearly all targeted teenage mothers. The increase in A & E attendance after the commencement of the CCDS program may indicate the satisfactory engagement and rapport among the Paediatrician and the families, and the enhancement in the early recognition of subtle symptoms. Moreover, this group of teenage mothers under the CCDS program was more ready to seek public medical services. We would like to suggest for long term follow up for details of adverse outcomes

Incorporating family therapy into asthma group intervention: A randomized waitlist-controlled trial

Asthma psychoeducational programs have been found to be effective in terms of symptom-related outcome. They are mostly illness-focused, and pay minimal attention to systemic/familial factors. This study evaluated a novel asthma psychoeducation program that adopted a parallel group design and incorporated family therapy. A randomized waitlist-controlled crossover clinical trial design was adopted. Children with stable asthma and their parents were recruited from a pediatric chest clinic. Outcome measures included, for the patients: exhaled nitric oxide (eNO), spirometry, and adjustment to asthma; and for the parents: perceived efficacy in asthma management, Hospital Anxiety and Depression Scale anxiety subscale, Body Mind Spirit Well-being Inventory emotion subscale, and Short Form 12 health-related quality of life scale. Forty-six patients participated in the study. Attrition rates were 13.0% and 26.0% for the active and control groups, respectively. Repeated-measures ANOVA revealed a significant decrease in airway inflammation, as indicated by eNO levels, and an increase in patient's adjustment to asthma and parents' perceived efficacy in asthma management. Serial trend analysis revealed that most psychosocial measures continued to progress steadily after intervention. Significant improvements in both symptom-related measures and mental health and relationship measures were observed. The findings supported the value of incorporating family therapy into asthma psychoeducation programs. 2008 © FPI, Inc.link_to_subscribed_fulltex

Effects of Short-Term Resistance Training on Serum Leptin Levels in Obese Adolescents

The purpose of this study was to examine the effects of a short-term resistance training program on serum leptin concentrations in obese adolescents. Eighteen Chinese obese adolescents participated in the supervised weight management program. Resistance training was conducted three times a week on alternate days for 6 weeks. Body composition [body fat mass (FM) and body lean mass (LM)] determined by dual-energy X-ray absorptiometry, muscle strength and leptin, insulin and glucose were measured before and after training. Subjects demonstrated significantly improved strength of leg, chest and bicep under conditions of stability in weight, FM and LM. There were positive correlations between leptin and body mass index, FM, %FM, waist girth and hip girth, and negative correlations between leptin and %L M at the resting state before and after 6 weeks of resistance training. No significant relationship was found between leptin concentration and the parameters of muscular strength or concentrations of insulin and glucose. Compared to pre-training values, serum leptin levels were not significantly altered, while relative leptin (leptin/FM) decreased significantly after the short-term resistance training. These results indicate that short-term resistance training enhances muscle strength but does not alter leptin levels in obese adolescents with weight and FM stability. The results also suggest that 6 weeks of resistance training decreases the requirement of leptin per unit of FM and improves leptin sensitivity in obese adolescents. © 2010 Elsevier (Singapore) Pte Ltd. All rights reserved.link_to_subscribed_fulltex