Unhealthy weight among children in Spain and the role of the home environment

Objective: Unhealthy weight is a major global health concern. This study examines unhealthy weight among children in Spain and the role of the home environment therein. Data are from a 2010 national survey of families with children. We examined unhealthy weight among children ages 5-10 years using the WHO Child Growth Standards and used multivariate logistic regression to assess associations with family characteristics. Results: There was a high prevalence of unhealthy weight, with only 46% of children at normal weight. Both underweight and obesity were higher among boys (14%; 22%) than girls (13%; 12%). Underweight and obesity were higher among children of mothers with obesity and those with unemployed parents. Obesity was higher among children of mothers who were less educated (35%) and among children of immigrants (19%). We find high levels of unhealthy weight in children, with both underweight and obesity being predicted by the same family environment characteristics

Unhealthy Weight Among Young Children in the Middle East and North African Region

ABSTRACT Objective: To understand early-life growth in the Middle East and North African Region, and how it has changed over time, we estimated the prevalence of wasting and overweight at ages under five years. Design: Cross-sectional data from twenty-nine Demographic and Health Surveys with direct anthropometric data and parent-reported demographic information were examined. The study utilized the WHO Child Growth Standards to classify overweight (weight-for-height z-score ≥2 SD above the median), wasting (weight-for-height z-score ≤2 SD below the median) and unhealthy weight defined as either wasting or overweight. Setting: Nationally representative for nine of the MENA countries (Armenia, Azerbaijan, Egypt, Jordan, Mauritania, Morocco, Tunisia, Turkey, and Yemen). Participants: Children under age five from nine MENA countries between 1987 and 2016 (n=155,961). Results: Across the region, at the most recent time point, between 7.3%-23.6% of children experienced unhealthy weight (Jordan-7.3%, Egypt- 23.6%); 1.7%-16.6% had wasting (Turkey, Yemen) and 2.0%-15.0% had overweight (Yemen, Egypt). Overweight was more common than wasting in all countries except Yemen and Mauritania. Between 1987 and 2016, the prevalence of unhealthy weight in the region increased (10.0% to 18.4%) due to increases in both wasting and overweight. Boys had a higher prevalence of unhealthy weight than girls. Conclusion: Undernutrition continues to be a problem in some countries in the MENA region and overnutrition is emerging as a health concern in many countries in the region. Countries in the region must advance programs that reduce undernutrition while not overlooking or inadvertently promoting overnutrition

Alcohol Consumption and Incident Stroke Among Older Adults.

Objectives: This study examines the relationship between alcohol consumption and incident stroke among older adults and tests whether alcohol consumption contributes to observed race and sex differences in stroke. Method: Data are from a U.S. national cohort of black and white adults aged 45 and older, the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. Current and past drinking levels were reported at baseline (2003-2007). Participants who had never had a stroke were followed for adjudicated stroke events through September 2015 (n = 27,265). We calculated Cox proportional hazard models for stroke, adjusting for demographic, socioeconomic, behavioral, and health characteristics. Results: Participants, mean age 64.7 years, consumed on average 2.2 drinks/week and experienced 1,140 first-time stroke events over median 9.1 years follow-up. Nondrinkers had a 12% higher risk of stroke than current drinkers; the risk of stroke among nondrinkers largely reflected high risks among past drinkers; these differences were explained by socioeconomic characteristics. Among current drinkers, light drinkers had significantly lower stroke risks than moderate drinkers after accounting for demographic, socioeconomic, behavioral, and health characteristics. Implications of alcohol did not differ between blacks and whites but did differ by sex: Especially among women, nondrinkers, and specifically past drinkers, had higher risks; these differences were largely explained by health characteristics and behaviors. Alcohol did not explain race and sex differences in stroke incidence. Discussion: Among older adults, those who used to, but no longer, drink had higher risks of stroke, especially among women; current light drinkers had the lowest risk of stroke

Pregnancy Surveillance Methods within Health and Demographic Surveillance Systems.

BACKGROUND: Pregnancy identification and follow-up surveillance can enhance the reporting of pregnancy outcomes, including stillbirths and perinatal and early postnatal mortality. This paper reviews pregnancy surveillance methods used in Health and Demographic Surveillance Systems (HDSSs) in low- and middle-income countries. METHODS: We searched articles containing information about pregnancy identification methods used in HDSSs published between January 2002 and October 2019 using PubMed and Google Scholar. A total of 37 articles were included through literature review and 22 additional articles were identified via manual search of references. We reviewed the gray literature, including websites, online reports, data collection instruments, and HDSS protocols from the Child Health and Mortality Prevention Study (CHAMPS) Network and the International Network for the Demographic Evaluation of Populations and Their Health (INDEPTH). In total, we reviewed information from 52 HDSSs described in 67 sources. RESULTS: Substantial variability exists in pregnancy surveillance approaches across the 52 HDSSs, and surveillance methods are not always clearly documented. 42% of HDSSs applied restrictions based on residency duration to identify who should be included in surveillance. Most commonly, eligible individuals resided in the demographic surveillance area (DSA) for at least three months. 44% of the HDSSs restricted eligibility for pregnancy surveillance based on a woman's age, with most only monitoring women 15-49 years. 10% had eligibility criteria based on marital status, while 11% explicitly included unmarried women in pregnancy surveillance. 38% allowed proxy respondents to answer questions about a woman's pregnancy status in her absence. 20% of HDSSs supplemented pregnancy surveillance with investigations by community health workers or key informants and by linking HDSS data with data from antenatal clinics. CONCLUSIONS: Methodological guidelines for conducting pregnancy surveillance should be clearly documented and meticulously implemented, as they can have implications for data quality and accurately informing maternal and child health programs

Data Cleaning: Detecting, Diagnosing, and Editing Data Abnormalities

In this policy forum the authors argue that data cleaning is an essential part of the research process, and should be incorporated into study design

Delineating the genotypic and phenotypic spectrum of HECW2-related neurodevelopmental disorders

Background Variants in HECW2 have recently been reported to cause a neurodevelopmental disorder with hypotonia, seizures and impaired language; however, only six variants have been reported and the clinical characteristics have only broadly been defined. Methods Molecular and clinical data were collected from clinical and research cohorts. Massive parallel sequencing was performed and identified individuals with a HECW2-related neurodevelopmental disorder. Results We identified 13 novel missense variants in HECW2 in 22 unpublished cases, of which 18 were confirmed to have a de novo variant. In addition, we reviewed the genotypes and phenotypes of previously reported and new cases with HECW2 variants (n=35 cases). All variants identified are missense, and the majority of likely pathogenic and pathogenic variants are located in or near the C-terminal HECT domain (88.2%). We identified several clustered variants and four recurrent variants (p.(Arg1191Gln);p.(Asn1199Lys);p.(Phe1327Ser);p.(Arg1330Trp)). Two variants, (p.(Arg1191Gln);p.(Arg1330Trp)), accounted for 22.9% and 20% of cases, respectively. Clinical characterisation suggests complete penetrance for hypotonia with or without spasticity (100%), developmental delay/intellectual disability (100%) and developmental language disorder (100%). Other common features are behavioural problems (88.9%), vision problems (83.9%), motor coordination/movement (75%) and gastrointestinal issues (70%). Seizures were present in 61.3% of individuals. Genotype-phenotype analysis shows that HECT domain variants are more frequently associated with cortical visual impairment and gastrointestinal issues. Seizures were only observed in individuals with variants in or near the HECT domain. Conclusion We provide a comprehensive review and expansion of the genotypic and phenotypic spectrum of HECW2 disorders, aiding future molecular and clinical diagnosis and management.Peer reviewe

On the basis of visa type: Insights into incorporation and health among foreign-born people in the United States

Foreign-born people have different patterns of health, and several psychosocial and contextual factors may contribute to these differences. Type of visa with which one resettles is an important consideration because it is linked both with the reason for initially migrating and with experiences after arriving in the U.S. This study examines the association between visa type and health in terms of self-rated health and diagnosed chronic conditions. Using the New Immigrant Survey (NIS), a nationally representative study of foreign-born people at the time of receiving legal permanent residence in the U.S., we used logistic regression models to estimate the odds of having chronic conditions and the odds of reporting fair or poor health. People who had refugee, asylum, parole and post-arrival legalization visa types had the highest prevalence of any chronic condition; they were also most likely to report being in fair or poor self-rated health, even after controlling for other characteristics. Conversely, people who had diversity visas had the highest self-rated health and the fewest chronic conditions. Overall, the type of visa a person holds is associated with health and chronic disease even years after resettlement

Sandwiches and Subversion: Teachers’ Mealtime Strategies and Preschoolers’ Agency

Mealtimes are understudied processes in the social research on childhood. Our study uses ethnographic methods in two preschools in the southeastern United States to understand the types of strategies teachers use during meals and children’s responses to these strategies. We identified three strategies teachers used to attempt to modify children’s consumption: gatekeeping, directives, and hyperbolic justifications of consumption. We argue that children used agency to subvert to teachers’ strategies using silent and verbal techniques, including attempting to open packages of restricted foods, pretending to eat, and refusing to eat. Their subversion manifested in either “dissent” or “feigned assent.