Evaluation of cellular immunity to mumps in vaccinated individuals with or without circulating antibodies up to 16 years after their last vaccination

In this observational study, mumps-specific in vitro lympho-proliferation was measured in 24 subjects with low antibody titers and 24 subjects with high antibody titers who received their last vaccine dose up to 16 years previously. Overall, a significant lymphoproliferative response was found in 32 subjects (66.7%)-namely, in 13 (54.2%) of those with low antibody titers and 19 (79.2%) of those with high antibody titers. The mean stimulation index for subjects with low antibody titers was 4.47, whereas that for subjects with high antibody titers was 8.31 (P = .032). Mumps vaccine-induced cell-mediated immunity appears to be more persistent than the antibody response

Lockdown and non-COVID-19 deaths: cause-­specific mortality during the first wave of the 2020 pandemic in Norway: a population-­based register study

Objective To explore the potential impact of the first wave of COVID-19 pandemic on all cause and cause-specific mortality in Norway. Design Population-based register study. Setting The Norwegian cause of Death Registry and the National Population Register of Norway. Participants All recorded deaths in Norway from March to May from 2010 to 2020. Main outcome measures Rate (per 100 000) of all-cause mortality and causes of death in the European Shortlist for Causes of Death from March to May 2020. The rates were age standardised and adjusted to a 100% register coverage and compared with a 95% prediction interval (PI) from linear regression based on corresponding rates for 2010–2019. Results 113 710 deaths were included, of which 10 226 were from 2020. We did not observe any deviation from predicted total mortality. There were fewer than predicted deaths from chronic lower respiratory diseases excluding asthma (11.4, 95% PI 11.8 to 15.2) and from other non-ischaemic, non-rheumatic heart diseases (13.9, 95% PI 14.5 to 20.2). The death rates were higher than predicted for Alzheimer’s disease (7.3, 95% PI 5.5 to 7.3) and diabetes mellitus (4.1, 95% PI 2.1 to 3.4). Conclusions There was no significant difference in the frequency of the major causes of death in the first wave of the 2020 COVID-19 pandemic in Norway compared with corresponding periods 2010–2019. There was an increase in diabetes mellitus and Alzheimer’s deaths. Reduced mortality due to some heart and lung conditions may be linked to infection control measures.publishedVersio

Estudio transversal del crecimiento infantil y de adolescentes en Ecuador

Child growth is internationally recognized as an important indicator for monitoring health in populations. There exists a wide controversy regarding the use of international growth standards versus local references. This study seeks to construct reference growth curves for school-age Ecuadorian children and adolescents, and to compare them with World Health Organization (WHO) standards, in order to identify the differences and their public health implications. The study authors enrolled 2891 children (1644 girls and 1247 boys) aged 5 to 18 years, from a variety of climatic zones and ethnic groups. LMS method was used to construct Ecuadorian curves for height, weight and Body Mass Index. Comparisons of Ecuadorian and WHO curves were graphically illustrated. U.S children were taller than Ecuadorian children across all age ranges, with larger differences between the two populations in children over 13 years. Consequently, estimates of low height and extremely low height, as well as overweight, obese and undernourished, were significantly different between WHO standards and the Ecuadorian references. Population-specific growth curves may be more adequate for growth monitoring of Ecuadorian children than WHO growth curves. We advocate for the construction of an Ecuadorian growth reference for clinical use based on national population, from conception to maturity, as an accurate instrument for monitoring growth.El crecimiento infantil es reconocido internacionalmente como un indicador importante para monitorear la salud en las poblaciones. Existe una gran controversia con respecto al uso de estándares de crecimiento internacional versus referencias locales. Este estudio busca construir referencias de crecimiento para niños y adolescentes ecuatorianos, y compararlas con los estándares de la Organización Mundial de la Salud (OMS), para identificar las diferencias y sus implicaciones para la salud pública. Se incluyó 2891 niños (1644 niñas y 1247 niños) de 5 a 18 años de una variedad de zonas climáticas y grupos étnicos. El método LMS se utilizó para construir las curvas ecuatorianas de altura, peso e índice de masa corporal. Las comparaciones de curvas ecuatorianas y de la OMS se ilustraron gráficamente. Los niños de EE. UU., fueron más altos que los niños ecuatorianos en todos los rangos de edad, con mayores diferencias entre las dos poblaciones en niños mayores de 13 años. En consecuencia, las estimaciones de baja altura y altura extremadamente baja, así como sobrepeso, obesidad y desnutrición, fueron significativamente diferentes entre los estándares de la OMS y las referencias ecuatorianas. Las curvas de crecimiento específicas de la población pueden ser un parámetro de monitoreo del crecimiento para niños ecuatorianos más adecuado que las curvas de crecimiento de la OMS. Abogamos por la construcción de una referencia de crecimiento ecuatoriana para uso clínico basada en la población nacional, desde la concepción hasta la madurez, como un instrumento preciso para monitorear el crecimiento.Asociación de Antropología Biológica de la República Argentin

References for ultrasound staging of breast maturation, tanner breast staging, pubic hair, and menarche in Norwegian girls

Context - Discriminating adipose and glandular tissue is challenging when clinically assessing breast development. Ultrasound facilitates staging of pubertal breast maturation (US B), but has not been systematically compared to Tanner breast (Tanner B) staging, and no normative data have been reported. Objective - To present normative references for US B along with references for Tanner B, pubic hair (PH), and menarche. Design, Setting, and Participants - A cross-sectional sample of 703 healthy girls aged 6 to 16 years were examined. Main Outcome Measures - Breast development was determined with US B and Tanner B staging. Tanner PH and menarcheal status were recorded. The age distributions of entry in US B, Tanner B, and PH stages and menarche were estimated with generalized linear and generalized additive models with a probit link. Method agreement was tested with weighted Cohen’s kappa. Results - The median (±2SD) ages for thelarche, US B2 and Tanner B2, were 10.2 (7.7, 12.8) and 10.4 (8.0, 12.7) years. The median (±2SD) ages at Tanner PH2 and menarche were 10.9 (8.5, 13.3) and 12.7 (11.0, 16.2) years. Cohen’s kappa of agreement (95% confidence interval) between US B and Tanner B was 0.87 (0.85–0.88). When the methods disagreed, US B was usually more advanced. Conclusion - Thelarche occurred at a slightly younger age when assessed with ultrasound compared to clinical Tanner staging, although the 2 methods had a very good agreement when determining pubertal breast maturation. A significant decrease of 2.8 months in age at menarche was observed during the past decade in Norwegian girls

Estudio transversal del crecimiento infantil y de adolescentes en Ecuador

Child growth is internationally recognized as an important indicator for monitoring health in populations. There exists a wide controversy regarding the use of international growth standards versus local references. This study seeks to construct reference growth curves for school-age Ecuadorian children and adolescents, and to compare them with World Health Organization (WHO) standards, in order to identify the differences and their public health implications. The study authors enrolled 2891 children (1644 girls and 1247 boys) aged 5 to 18 years, from a variety of climatic zones and ethnic groups. LMS method was used to construct Ecuadorian curves for height, weight and Body Mass Index. Comparisons of Ecuadorian and WHO curves were graphically illustrated. U.S children were taller than Ecuadorian children across all age ranges, with larger differences between the two populations in children over 13 years. Consequently, estimates of low height and extremely low height, as well as overweight, obese and undernourished, were significantly different between WHO standards and the Ecuadorian references. Population-specific growth curves may be more adequate for growth monitoring of Ecuadorian children than WHO growth curves. We advocate for the construction of an Ecuadorian growth reference for clinical use based on national population, from conception to maturity, as an accurate instrument for monitoring growth.El crecimiento infantil es reconocido internacionalmente como un indicador importante para monitorear la salud en las poblaciones. Existe una gran controversia con respecto al uso de estándares de crecimiento internacional versus referencias locales. Este estudio busca construir referencias de crecimiento para niños y adolescentes ecuatorianos, y compararlas con los estándares de la Organización Mundial de la Salud (OMS), para identificar las diferencias y sus implicaciones para la salud pública. Se incluyó 2891 niños (1644 niñas y 1247 niños) de 5 a 18 años de una variedad de zonas climáticas y grupos étnicos. El método LMS se utilizó para construir las curvas ecuatorianas de altura, peso e índice de masa corporal. Las comparaciones de curvas ecuatorianas y de la OMS se ilustraron gráficamente. Los niños de EE. UU., fueron más altos que los niños ecuatorianos en todos los rangos de edad, con mayores diferencias entre las dos poblaciones en niños mayores de 13 años. En consecuencia, las estimaciones de baja altura y altura extremadamente baja, así como sobrepeso, obesidad y desnutrición, fueron significativamente diferentes entre los estándares de la OMS y las referencias ecuatorianas. Las curvas de crecimiento específicas de la población pueden ser un parámetro de monitoreo del crecimiento para niños ecuatorianos más adecuado que las curvas de crecimiento de la OMS. Abogamos por la construcción de una referencia de crecimiento ecuatoriana para uso clínico basada en la población nacional, desde la concepción hasta la madurez, como un instrumento preciso para monitorear el crecimiento.Asociación de Antropología Biológica de la República Argentin

Estudio transversal del crecimiento infantil y de adolescentes en Ecuador

Child growth is internationally recognized as an important indicator for monitoring health in populations. There exists a wide controversy regarding the use of international growth standards versus local references. This study seeks to construct reference growth curves for school-age Ecuadorian children and adolescents, and to compare them with World Health Organization (WHO) standards, in order to identify the differences and their public health implications. The study authors enrolled 2891 children (1644 girls and 1247 boys) aged 5 to 18 years, from a variety of climatic zones and ethnic groups. LMS method was used to construct Ecuadorian curves for height, weight and Body Mass Index. Comparisons of Ecuadorian and WHO curves were graphically illustrated. U.S children were taller than Ecuadorian children across all age ranges, with larger differences between the two populations in children over 13 years. Consequently, estimates of low height and extremely low height, as well as overweight, obese and undernourished, were significantly different between WHO standards and the Ecuadorian references. Population-specific growth curves may be more adequate for growth monitoring of Ecuadorian children than WHO growth curves. We advocate for the construction of an Ecuadorian growth reference for clinical use based on national population, from conception to maturity, as an accurate instrument for monitoring growth.El crecimiento infantil es reconocido internacionalmente como un indicador importante para monitorear la salud en las poblaciones. Existe una gran controversia con respecto al uso de estándares de crecimiento internacional versus referencias locales. Este estudio busca construir referencias de crecimiento para niños y adolescentes ecuatorianos, y compararlas con los estándares de la Organización Mundial de la Salud (OMS), para identificar las diferencias y sus implicaciones para la salud pública. Se incluyó 2891 niños (1644 niñas y 1247 niños) de 5 a 18 años de una variedad de zonas climáticas y grupos étnicos. El método LMS se utilizó para construir las curvas ecuatorianas de altura, peso e índice de masa corporal. Las comparaciones de curvas ecuatorianas y de la OMS se ilustraron gráficamente. Los niños de EE. UU., fueron más altos que los niños ecuatorianos en todos los rangos de edad, con mayores diferencias entre las dos poblaciones en niños mayores de 13 años. En consecuencia, las estimaciones de baja altura y altura extremadamente baja, así como sobrepeso, obesidad y desnutrición, fueron significativamente diferentes entre los estándares de la OMS y las referencias ecuatorianas. Las curvas de crecimiento específicas de la población pueden ser un parámetro de monitoreo del crecimiento para niños ecuatorianos más adecuado que las curvas de crecimiento de la OMS. Abogamos por la construcción de una referencia de crecimiento ecuatoriana para uso clínico basada en la población nacional, desde la concepción hasta la madurez, como un instrumento preciso para monitorear el crecimiento.Asociación de Antropología Biológica de la República Argentin

Evaluating national guidelines for monitoring early growth using routinely collected data in Bergen, Norway

Aims: The overarching aim of this study was to evaluate the Norwegian guidelines for growth monitoring using routinely collected data from healthy children up to five years of age. We analysed criteria for both status (size for age) and change (centile crossing) in growth. Methods: Longitudinal data were obtained from the electronic health record (EHR) at the well-baby clinic for 2130 children included in the Bergen growth study 1 (BGS1). Measurements of length, weight, weight-for-length, body mass index (BMI) and head circumference were converted to z-scores and compared with the World Health Organization (WHO) growth standards and the national growth reference. Results: Using the WHO growth standard, the proportion of children above +2SD was generally higher than the expected 2.3% for all traits at birth and for length at all ages. Crossing percentile channels was common during the first two years of life, particularly for length/height. By the age of five years, 37.9% of the children had been identified for follow-up regarding length/height, 33% for head circumference and 13.6% for high weight-for-length/BMI. Conclusions: The proportion of children beyond the normal limits of the charts is higher than expected, and a surprisingly large number of children were identified for rules concerning length or growth in head circumference. This suggests the need for a revision of the current guidelines for growth monitoring in Norway.publishedVersio

Perceived barriers in family-based behavioural treatment of paediatric obesity – Results from the FABO study

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.Background: To date, few studies have investigated perceived barriers among those who participate in and drop out of family-based behavioural treatment (FBT) for paediatric obesity. Examining experienced barriers during treatment, and their role in participation and completion of treatment has important implications for clinical practice. Objectives: To compare perceived barriers to participating in a family-based behavioural social facilitation treatment (FBSFT) for obesity among families who completed and did not complete treatment. Methods: Data were analysed from 90 families of children and adolescents (mean (M) age = 12.8 years, standard deviation (SD) = 3.05) with severe obesity enrolled in a 17-session FBSFT program. After completing 12 sessions or at the time of dropout, parents and therapists completed the Barriers to Treatment Participation Scale (BTPS), a 5-point Likert scale (1 = never a problem, 5 = very often a problem) which includes four subscales: 1. Stressors and obstacles that compete with treatment, 2. Treatment demands and issues, 3. Perceived relevance of treatment, 4. Relationship with the therapist. Results: Families who did not complete treatment scored significantly higher on the BTPS subscales stressors and obstacles that compete with treatment (M = 2.03, SD = 0.53 vs. M = 1.70, SD = 0.42), p = 0.010 and perceived relevance of treatment (M = 2.27, SD = 0.48 vs. M = 1.80, SD = 0.50), p < 0.001 than families who completed treatment. No other significant differences between groups were observed. Conclusion: Families are more likely to drop out of FBSFT when experiencing a high burden from life stressors or when treatment is not meeting the expectations and perceived needs of the family.publishedVersio

Trends in the prevalence of breastfeeding up to 6 months of age using structured data from routine child healthcare visits

Aim The Norwegian Action Plan for a Healthier Diet (2017–2021) set the target that 25% of infants should be exclusively breastfed for 6 months by 2022. Our aim was to determine trends in the prevalence and duration of breastfeeding in the municipality of Bergen. Methods Data on breastfeeding status in 2010–2018 were extracted from a standardised electronic medical record kept by public child health centres and recorded as exclusive, partial or none, at 6 weeks and 6 months of age. Results We found that 28,503 and 26,735 infants attended the 6-week and 6-month consultations, respectively. The prevalence of any breastfeeding was 92.0% at 6 weeks and 78.0% at 6 months with no trend over time between 2010 and 2018. The prevalence of exclusive breastfeeding at 6 weeks was 73.9% and stable over time, but it declined at 6 months, from 28.1% in 2010 to 11.1% in 2014 and remained stable thereafter. Conclusion During 2010–2018, the prevalence of any and exclusive breastfeeding at 6 weeks and any breastfeeding at 6 months was stable. Exclusive breastfeeding at 6 months declined halfway through the study period, to a stable, but low, prevalence of 11.1% by 2014.publishedVersio

Levels of per- and polyfluoroalkyl substances (PFAS) in Norwegian children stratified by age and sex - Data from the Bergen Growth Study 2

Background and aim Due to the persistence, bioaccumulation and potential adverse health effects, there have been restrictions and phase out in the production of certain per- and polyfluoroalkyl substances (PFAS) since the early 2000s. Published serum levels of PFAS during childhood are variable and may reflect the impact of age, sex, sampling year and exposure history. Surveying the concentrations of PFAS in children is vital to provide information regarding exposure during this critical time of development. The aim of the current study was therefore to evaluate serum concentrations of PFAS in Norwegian schoolchildren according to age and sex. Material and methods Serum samples from 1094 children (645 girls and 449 boys) aged 6–16 years, attending schools in Bergen, Norway, were analyzed for 19 PFAS. The samples were collected in 2016 as part of the Bergen Growth Study 2. Statistical analyses included Student t-test, one-way ANOVA and Spearman's correlation analysis of log-transformed data. Results Of the 19 PFAS examined, 11 were detected in the serum samples. Perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorohexanesulfonic acid (PFHxS) and perfluorononaoic acid (PFNA) were present in all samples with geometric means of 2.67, 1.35, 0.47 and 0.68 ng/mL, respectively. In total, 203 children (19%) had PFAS levels above the safety limits set by the German Human Biomonitoring Commission. Significantly higher serum concentrations were found in boys compared to girls for PFOS, PFNA, PFHxS and perfluoroheptanesulfonic acid (PFHpS). Furthermore, serum concentrations of PFOS, PFOA, PFHxS and PFHpS were significantly higher in children under the age of 12 years than in older children. Conclusions PFAS exposure was widespread in the sample population of Norwegian children analyzed in this study. Approximately one out of five children had PFAS levels above safety limits, indicating a potential risk of negative health effects. The majority of the analyzed PFAS showed higher levels in boys than in girls and decreased serum concentrations with age, which may be explained by changes related to growth and maturation.publishedVersio