Body fatness or anthropometry for assessment of unhealthy weight status? Comparison between methods in South African children and adolescents

A variety of methods are available for defining undernutrition (thinness/underweight/under-fat) and overnutrition (overweight/obesity/over-fat). The extent to which these definitions agree is unclear. The present cross-sectional study aimed to assess agreement between widely used methods of assessing nutritional status in children and adolescents, and to examine the benefit of body composition estimates. The main objective of the cross-sectional study was to assess underweight, overweight and obesity using four methods: (i) BMI-for-age using WHO (2007) reference data; (ii) BMI-for-age using Cole et al. and International Obesity Taskforce cut-offs; (iii) weight-for-age using the National Centre for Health Statistics/WHO growth reference 1977; and (iv) body fat percentage estimated by bio-impedance (body fat reference curves for children of McCarthy et al., 2006). Comparisons were made between methods using weighted kappa analyses. Subjects Individuals (n 1519) in three age groups (school grade 1, mean age 7 years; grade 5, mean age 11 years; grade 9, mean age 15 years). Results In boys, prevalence of unhealthy weight status (both under- and overnutrition) was much higher at all ages with body fatness measures than with simple anthropometric proxies for body fatness; agreement between fatness and weight-based measures was fair or slight using Landis and Koch categories. In girls, prevalence of unhealthy weight status was also higher with body fatness than with proxies, although agreement between measures ranged from fair to substantial. Methods for defining under- and overnutrition should not be considered equivalent. Weight-based measures provide highly conservative estimates of unhealthy weight status, possibly more conservative in boys. Simple body composition measures may be more informative than anthropometry for nutritional surveillance of children and adolescents

Different landscape factors explain establishment and persistence of river red gum (Eucalyptus camaldulensis) in agricultural landscapes of southeast Queensland

Riparian and floodplain ecosystems in production landscapes are considerably degraded and under continued pressure from surrounding land use. However, little is known about how remnant ecosystems respond to land use and hydrological factors in small non-riverine wetlands. River red gum (Eucalyptus camaldulensis) is a dominant tree species within these scattered remnants, which provides critical ecological functions for the remaining biodiversity. In this study, we investigated how different life stages of E. camaldulensis responded to land use and hydrological variables in the Condamine catchment of south east Queensland. We used logistic regression to develop models for different life stages of E. camaldulensis in two regions with differing land use intensity histories. Broad regional differences and land use practices at smaller scales best explained differences in E. camaldulensis occurrence for younger life stages, while hydrology (groundwater and connectivity to rivers) and land use practices (dryland agriculture and grazing) best explained differences in older life stages. The results indicate that different factors are important in determining the establishment and persistence of E. camaldulensis and that land use practices at the regional scale are key factors in determining the establishment and potential future persistence of E. camaldulensis in floodplain wetlands

Peer Support through Community Building

This poster describes the progress and lessons learned as a result of newly implemented Faculty Mentoring Program in the IUPUI Herron School of Art and Design

Contrasting abundance and residency patterns of two sympatric populations of transient killer whales (Orcinus orca) in the northern Gulf of Alaska

Two sympatric populations of “transient” (mammal-eating) killer whales were photo-identified over 27 years (1984–2010) in Prince William Sound and Kenai Fjords, coastal waters of the northern Gulf of Alaska (GOA). A total of 88 individuals were identified during 203 encounters with “AT1” transients (22 individuals) and 91 encounters with “GOA” transients (66 individuals). The median number of individuals identified annually was similar for both populations (AT1=7; GOA=8), but mark-recapture estimates showed the AT1 whales to have much higher fidelity to the study area, whereas the GOA whales had a higher exchange of individuals. Apparent survival estimates were generally high for both populations, but there was a significant reduction in the survival of AT1 transients after the Exxon Valdez oil spill in 1989, with an abrupt decline in estimated abundance from a high of 22 in 1989 to a low of seven whales at the end of 2010. There was no detectable decline in GOA population abundance or survival over the same period, but abundance ranged from just 6 to 18 whales annually. Resighting data from adjacent coastal waters and movement tracks from satellite tags further indicated that the GOA whales are part of a larger population with a more extensive range, whereas AT1 whales are resident to the study area

Child and adolescent obesity: prevalence and risk factors in a rural South Africa population

The World Health Organization estimates that 22 million children worldwide aged <5 years are overweight and highlights tackling childhood obesity as an urgent priority. Childhood obesity is rising to epidemic proportions in the developing world, reflecting changing physical activity levels and dietary intakes, adding a significant public health burden to countries where undernutrition remains common. Interventions to prevent childhood obesity have had disappointing results, because the science and aetiology of obesity is poorly understood and prevention programmes have not targeted appropriate behaviours nor adequately engaged communities being studied. The origins of obesity appear simple, excess energy intake and/or low energy levels expended on physical activity, leading to chronic energy imbalance. However, the problem is more complex with underlying societal, behavioural and genetic causes of energy imbalance remaining unclear. Obesity is driven by individual, household and community factors: research to date has concentrated on individual factors with almost no significant focus on higher level influences on obesity. Findings from studies in developed countries are unlikely to be applicable to rural African settings where there is an increasing transition from a state of undernutrition to that of overnutrition. Few data exist on the prevalence of child and adolescent obesity from low and middle income countries like South Africa. This thesis aimed to determine the prevalence of overweight and obesity in children and adolescents (aged 7-15 years) within this population and to identify possible risk factors. Participants and Methods The study was cross-sectional and involved collecting primary data in local schools. A total of 1,519 subjects were recruited from three age groups (approximately 500 from each age group 7, 11 and 15 years). Participants were recruited from school grades 1, 5 and 9 corresponding to the ages 7, 11 and 15 years respectively. The study comprised two parts, a main cross-sectional study and a further study including a sub-sample of the participants. In the main cross-sectional study anthropometric measurements (height, weight, mid-upper arm circumference and body fat) were performed on all the participants and a lifestyle questionnaire administered (questions related to water collection, travel to school, TV watching and sport participation). The study took place in a demographic surveillance area and data collected from participants was linked with their household/community data to allow analysis of variables associated with overweight/overfat status. 150 participants were randomly selected from the main study (50 from each age group 7, 11 and 15 years) and invited to take part in a sub-sample study which included objective measurement of physical activity (7 days accelerometry) and dietary assessment (2 x 24 hour multiple pass recall assessments) on each participant. Main Findings Prevalence of overweight and obesity was higher in girls than boys and was highest in the oldest age groups for females. Using the Cole/IOTF BMI for age reference combined overweight and obesity was 23% in grade 9 females compared to only 6% in boys in the same grade (p<0.01). The lifestyle questionnaire revealed high levels of water collection, active commuting and TV watching (al

Perceptual and Contextual Sources of Athletic Training Confidence: The Transition to Professional Entry Level Master’s Programs

Introduction: The shift of athletic training education from undergraduate degrees to professional master’s degrees and the prominence of computer-based credentialing may impact the hands-on experiences beneficial for developing confidence in athletic training competency domains. Health care provider confidence is critical for clinical skill development, performance and enhancing patient care. Purpose: To examine domain specific efficacy, its sources, learning contexts (i.e., classroom, laboratory, clinical settings) and clinical characteristics by program types. Method: Descriptive, cross-sectional design where 178 Athletic Trainers (AT; age 24.25 + 3.76, n = 72 male, n = 106 female) participated in the study (Master’s Program (MP) = 38; Undergraduate Program (UG) = 140). A questionnaire examining athletic training confidence was administered throughout multiple universities with accredited athletic training programs. Background characteristics, certification exam attempts, and programmatic characteristics were also ascertained. Results: Clinical settings were similar in both program types and there were few differences in domain-specific efficacy. Imaginal experiences, verbal persuasion and emotional states sources of efficacy differentiated master’s from undergraduate students. Conclusions: Sources of efficacy (e.g. vicarious experiences) occur naturally in athletic training educational settings; however, these sources need to be utilized. Educators should be informed about efficacy sources and devise strategies targeting each source for implementation across evolving learning contexts

Multifaceted density dependence: Social structure and seasonality effects on Serengeti lion demography

1. Interactions between density and environmental conditions have important effects on vital rates and consequently on population dynamics and can take complex pathways in species whose demography is strongly influenced by social context, such as the African lion, Panthera leo. In populations of such species, the response of vital rates to density can vary depending on the social structure (e.g. effects of group size or composition). 2. However, studies assessing density dependence in populations of lions and other social species have seldom considered the effects of multiple socially explicit measures of density, and—more particularly for lions—of nomadic males. Additionally, vital-rate responses to interactions between the environment and various measures of density remain largely uninvestigated. 3. To fill these knowledge gaps, we aimed to understand how a socially and spatially explicit consideration of density (i.e. at the local scale) and its interaction with environmental seasonality affect vital rates of lions in the Serengeti National Park, Tanzania. We used a Bayesian multistate capture–recapture model and Bayesian generalized linear mixed models to estimate lion stage-specific survival and between-stage transition rates, as well as reproduction probability and recruitment, while testing for season-specific effects of density measures at the group and home-range levels. 4. We found evidence for several such effects. For example, resident-male survival increased more strongly with coalition size in the dry season compared with the wet season, and adult-female abundance affected subadult survival negatively in the wet season, but positively in the dry season. Additionally, while our models showed no effect of nomadic males on adult-female survival, they revealed strong effects of nomads on key processes such as reproduction and takeover dynamics. 5. Therefore, our results highlight the importance of accounting for seasonality and social context when assessing the effects of density on vital rates of Serengeti lions and of social species more generally. Bayesian models, demographic rates, density dependence, density–environment interactions, multistate capture–recapture models, socialitypublishedVersio

Predictive validity of a brief antiretroviral adherence index: Retrospective cohort analysis under conditions of repetitive administration

<p>Abstract</p> <p>Background</p> <p>Newer antiretroviral (ARV) agents have improved pharmacokinetics, potency, and tolerability and have enabled the design of regimens with improved virologic outcomes. Successful antiretroviral therapy is dependent on patient adherence. In previous research, we validated a subset of items from the ACTG adherence battery as prognostic of virologic suppression at 6 months and correlated with adherence estimates from the Medication Event Monitoring System (MEMS). The objective of the current study was to validate the longitudinal use of the Owen Clinic adherence index in analyses of time to initial virologic suppression and maintenance of suppression.</p> <p>Results</p> <p>278 patients (naïve n = 168, experienced n = 110) met inclusion criteria. Median [range] time on the first regimen during the study period was 286 (30 – 1221) days. 217 patients (78%) achieved an undetectable plasma viral load (pVL) at median 63 days. 8.3% (18/217) of patients experienced viral rebound (pVL > 400) after initial suppression. Adherence scores varied from 0 – 25 (mean 1.06, median 0). The lowest detectable adherence score cut point using this instrument was ≥ 5 for both initial suppression and maintenance of suppression. In the final Cox model of time to first undetectable pVL, controlling for prior treatment experience and baseline viral load, the adjusted hazard ratio for time updated adherence score was 0.36_{score ≥ 5}(95% CI: 0.19–0.69) [reference: <5]. In the final generalized estimating equations (GEE) logistic regression model the adjusted odds ratio for time-updated adherence score was 0.17_{score ≥ 5}(0.05–0.66) [reference: <5].</p> <p>Conclusion</p> <p>A brief, longitudinally administered self report adherence instrument predicted both initial virologic suppression and maintenance of suppression in patients using contemporary ARV regimens. The survey can be used for identification of sub-optimal adherence with subsequent appropriate intervention.</p