Monitoring and Discussing Health-Related Quality of Life in Adolescents With Type 1 Diabetes Improve Psychosocial Well-Being: A randomized controlled trial

OBJECTIVE—To test the effects of monitoring and discussing of health-related quality of life (HRQoL) in adolescents with type 1 diabetes in a multicenter randomized controlled trial

The usefulness of growth hormone treatment for psychological status in young adult survivors of childhood leukaemia: an open-label study

-1 SD) were included in the study. A final group of 13 patients (9 males and 4 females), mean age 23.7 ± 2.9 years (range 20 – 29.7) completed a 2-year treatment with GH. IQ and neuropsychological performance were assessed at pre-treatment (T1) and after one (T2) and two (T3) years. ANOVA was performed with assessment at T1, T2 and T3 as repeated measurements factor. Relations between test score changes and changes of IGF-I levels were determined by calculating the Pearson correlation coefficient. Results Scores on the cognitive tests were in the normal range. Verbal short- and long-term memory performance decreased between T1 and T2, and increased between T2 and T3. Performance at T3 was not significantly different from that at T1. Performance for sustained attention improved from T1 to T2 and from T1 to T3. Visual-spatial memory was improved after one year of GH treatment. A significant positive correlation was found for Δ IGF-I (T2-T1) with difference scores of visual-spatial memory (T2-T1 and T3-T1), indicating that IGF-I increase after one year of GH treatment is associated with increase in cognitive-perceptual performance at month 12 and 24. Conclusion Since the level of intellectual functioning of our patient cohort was in the normal range the present finding that GH treatment has negative effects on verbal memory and positive on attention and visual-spatial memory warrants similar studies in other groups of ALL survivors. Also, a lower dose of GH should be determined inducing as much IGF as needed to improve verbal as well as visual cognitive functions. The present findings indicate that more knowledge is needed before GH treatment may be recommended to enhance cognitive functions in ALL survivors

Go4it; study design of a randomised controlled trial and economic evaluation of a multidisciplinary group intervention for obese adolescents for prevention of diabetes mellitus type 2

<p>Abstract</p> <p>Background</p> <p>In the Netherlands, the first adolescents with diabetes mellitus type 2 as a result of obesity have recently been diagnosed. Therefore, it is very important that programs aiming at the prevention of type 2 diabetes of obese adolescents are developed and evaluated.</p> <p>Methods</p> <p>Go4it is a multidisciplinary group treatment that focuses on: 1) increasing awareness of the current dietary and physical activity behaviour (i.e. energy balance behaviour), 2) improving diet, 3) decreasing sedentary behaviour, 4) increasing levels of physical activity, and 5) coping with difficult situations. Go4it consists of 7 sessions with an interval of 2–3 weeks.</p> <p>The effectiveness of the multidisciplinary group treatment compared with usual care (i.e. referral to a dietician) was evaluated in a randomised controlled trial. We examined effects on BMI(sds), body composition, energy expenditure, glucose tolerance and insulin resistance (primary outcome measure), as well as dietary and physical activity behaviour and quality of life. An economic evaluation from a societal perspective was conducted alongside the randomised trial to evaluate the cost-effectiveness of the multidisciplinary treatment program vs. usual care.</p> <p>Discussion</p> <p>In this paper we described a multidisciplinary treatment program (Go4it) for obese adolescents and the design of a randomised controlled trial and economic evaluation to evaluate its effectiveness and cost-effectiveness.</p> <p>Trial registration</p> <p>Netherlands Trial Register (ISRCTN27626398).</p

No association between glucocorticoid receptor polymorphisms and long-term respiratory outcome after very preterm birth

Developmen

Self-reported screen time and cardiometabolic risk in obese dutch adolescents

BACKGROUND: It is not clear whether the association between sedentary time and cardiometabolic risk exists among obese adolescents. We examined the association between screen time (TV and computer time) and cardiometabolic risk in obese Dutch adolescents. METHODS AND FINDINGS: For the current cross-sectional study, baseline data of 125 Dutch overweight and obese adolescents (12-18 years) participating in the Go4it study were included. Self-reported screen time (Activity Questionnaire for Adolescents and Adults) and clustered and individual cardiometabolic risk (i.e. body composition, systolic and diastolic blood pressure, low-density (LDL-C), high-density (HDL-C) and total cholesterol (TC), triglycerides, glucose and insulin) were assessed in all participants. Multiple linear regression analyses were used to assess the association between screen time and cardiometabolic risk, adjusting for age, gender, pubertal stage, ethnicity and moderate-to-vigorous physical activity. We found no significant relationship between self-reported total screen time and clustered cardiometabolic risk or individual risk factors in overweight and obese adolescents. Unexpectedly, self-reported computer time, but not TV time, was slightly but significantly inversely associated with TC (B = -0.002; CI = [-0.003;-0.000]) and LDL-C (B = -0.002; CI = [-0.001;0.000]). CONCLUSIONS: In obese adolescents we could not confirm the hypothesised positive association between screen time and cardiometabolic risk. Future studies should consider computer use as a separate class of screen behaviour, thereby also discriminating between active video gaming and other computer activities

Gender differences in respiratory symptoms in 19-year-old adults born preterm

Objective: To study the prevalence of respiratory and atopic symptoms in (young) adults born prematurely, differences between those who did and did not develop Bronchopulmonary Disease (BPD) at neonatal age and differences in respiratory health between males and females. Methods: Design: Prospective cohort study. Setting: Nation wide follow-up study, the Netherlands. Participants: 690 adults (19 year old) born with a gestational age below 32 completed weeks and/or with a birth weight less than 1500g. Controls were Dutch participants of the European Community Respiratory Health Survey (ECRHS). Main outcome measures: Presence of wheeze, shortness of breath, asthma, hay fever and eczema using the ECRHS-questionnaire

Metabolic implications of GH treatment in small for gestational age

Fetal growth retardation is associated with decreased postnatal growth, resulting in a lower adult height. In addition, a low birth weight is associated with an increased risk of developing diseases during adulthood, such as insulin resistance, type 2 diabetes mellitus, hypertension, dyslipidemia, and cardiovascular diseases. Children with persistent postnatal growth retardation, i.e., incomplete catch-up growth, can be treated with human GH. The GH/IGF-I axis is involved in the regulation of carbohydrate and lipid metabolism. The question of whether treatment with GH in children born small for gestational age (SGA) has long-term implications with respect to glucose/insulin and lipid metabolism has not been answered yet. In this article, the available data are reviewed

Growth during early childhood in asthmatic children: Relation to inhalation steroid dose and clinical severity score

Background/Aim: While short-term studies reported a growth retardation in children with asthma treated with inhaled steroids, long-term studies described attainment of adult heights within the target height range. In the present work, we describe the growth pattern of children with asthma. Methods: In 58 children with asthma, we compared the height at age 3 years with the height at a mean age of 7.5 years during a 12-month study period. Results: No differences in growth could be detected within the study year. Children in the lowest tertile but not in other tertiles for asthma severity score and inhaled steroid dose showed a significant decrease in height standard deviation scores from age 3 to age 7.5 years. Conclusion: The decrease in height standard deviation scores might be explained by undertreatment or an individual sensitivity to inhaled steroids

Influence of socioeconomic status on the association between low weight at birth and stunted growth or overweight in rural and urban Indonesian prepubertal children

Background Low birth weight (LBW) has been associated with in- creased risk for both stunted growth andand overweight later in life. Objective To assess relative contribution of LBW on the preva- lence of stunted growth or overweight in rural and urban Indo- nesian children in Indonesia. Methods This is a cross-sectional survey of 2 833 (1125 rural and 1708 urban) school-aged prepubertal children. Each child had data on age, sex, stature, BMI (body mass index) and birth weight. Results Compared to the urban population, the prevalence of stunted growth was significantly higher in the rural, i.e. 16.3 vs. 32.7%, P<O.OOl. However, there was no significant difference iin n the prevalence of LBW in the two communities. While overall, stunted children were more likely to be born with LBW, OR 1.80 (95%CI 1.31; 2.47), P<O.OOl. After stratifying data into rural and urban residences, the contribution of LBW on the risk of stunted growth appeared to be only significant in the urban population, OR 2.42 (95%CI 1.59; 3.68), P<O.OOl. In the rural, similar proportions of LBW were found in stunted and not stunted children. Test of in- teraction showed that this difference in OR was significant, the ratio of OR 1.88 (95%CI 1.11; 3.17), P=0.02. We observed no association between LBW and overweight. Conclusions In rural area, LBW is not an important contributor for stunted growth, while in urbanarea LBW is an important risk factor for stunted growth. As there is no significant difference in the prevalence of LBW between the two communities, the dif- ference in the prevalence of stunted growth is more likely to be associated with different pattern of post-natal growt